Deep Metaphysical Indeterminacy

OpenAIRE

Skow, Bradford

2010-01-01

A recent theory of metaphysical indeterminacy says that metaphysical indeterminacy is multiple actuality: there is metaphysical indeterminacy when there are many ‘complete precisifications of reality’. But it is possible for there to be metaphysical indeterminacy even when it is impossible to precisify reality completely. The orthodox interpretation of quantum mechanics illustrates this possibility. So this theory of metaphysical indeterminacy is not adequate.

Filling Open Screw Holes in the Area of Metaphyseal Comminution Does Not Affect Fatigue Life of the Synthes Variable Angle Distal Femoral Locking Plate in the AO/OTA 33-A3 Fracture Model.

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Grau, Luis; Collon, Kevin; Alhandi, Ali; Kaimrajh, David; Varon, Maria; Latta, Loren; Vilella, Fernando

2018-06-01

The aim of this study is to evaluate the biomechanical effect of filling locking variable angle (VA) screw holes at the area of metaphyseal fracture comminution in a Sawbones® (Sawbones USA, Vashon, Washington) model (AO/OTA 33A-3 fracture) using a Synthes VA locking compression plate (LCP) (Depuy Synthes, Warsaw, Indiana). Seven Sawbones® femur models had a Synthes VA-LCP placed as indicated by the manufacturers technique. A 4cm osteotomy was then created to simulate an AO/OTA 33-A3 femoral fracture pattern with metaphyseal comminution. The control group consisted of four constructs in which the open screw holes at the area of comminution were left unfilled; the experimental group consisted of three constructs in which the VA screw holes were filled with locking screws. One of the control constructs was statically loaded to failure at a rate of 5mm/min. A value equal to 75% of the ultimate load to failure was used as the loading force for fatigue testing of 250,000 cycles at 3Hz. Cycles to failure was recorded for each construct and averages were compared between groups. The average number of cycles to failure in the control and experimental groups were 37524±8187 and 43304±23835, respectively (p=0.72). No significant difference was observed with respect to cycles to failure or mechanism of failure between groups. In all constructs in both the control and experimental groups, plate failure reproducibly occurred with cracks through the variable angle holes in the area of bridged comminution. The Synthes VA-LCP in a simulated AO/OTA 33-A3 comminuted metaphyseal femoral fracture fails in a reproducible manner at the area of comminution through the "honeycomb" VA screw holes. Filling open VA screw holes at the site of comminution with locking screws does not increase fatigue life of the Synthes VA-LCP in a simulated AO/OTA 33-A3 distal femoral fracture. Further studies are necessary to determine whether use of this particular plate is contraindicated when bridging

Low dose PTH improves metaphyseal bone healing more when muscles are paralyzed.

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Sandberg, Olof; Macias, Brandon R; Aspenberg, Per

2014-06-01

Stimulation of bone formation by PTH is related to mechanosensitivity. The response to PTH treatment in intact bone could therefore be blunted by unloading. We studied the effects of mechanical loading on the response to PTH treatment in bone healing. Most fractures occur in the metaphyses, therefor we used a model for metaphyseal bone injury. One hind leg of 20 male SD rats was unloaded via intramuscular botulinum toxin injections. Two weeks later, the proximal unloaded tibia had lost 78% of its trabecular contents. At this time-point, the rats received bilateral proximal tibiae screw implants. Ten of the 20 rats were given daily injections of 5 μg/kg PTH (1-34). After two weeks of healing, screw fixation was measured by pull-out, and microCT of the distal femur cancellous compartment was performed. Pull-out force provided an estimate for cancellous bone formation after trauma. PTH more than doubled the pull-out force in the unloaded limbs (from 14 to 30 N), but increased it by less than half in the loaded ones (from 30 to 44 N). In relative terms, PTH had a stronger effect on pull-out force in unloaded bone than in loaded bone (p=0.03). The results suggest that PTH treatment for stimulation of bone healing does not require simultaneous mechanical stimulation. Copyright © 2014 Elsevier Inc. All rights reserved.

Cancer and metaphysics.

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Zajicek, G

2001-08-01

Metaphysics, is generally a pleasant, and harmless intellectual endeavor. Even if leading to wrong conclusions, nobody is hurt. Suppose that contrary to general belief, the Big Bang (1) never happened and the world is eternal. No harm is done. Some philosophers, like Kant, enjoyed life despite the fact that, nature, or the thing in itself, eluded their understanding (2). But suppose that the thing in itself is your patient, and you apply metaphysical reasoning for his treatment, metaphysics may occasionally be damaging. This is particularly pertinent to cancer, a disease that is haunted by false metaphysical statements. Since cancer is part of medicine, the present discourse deals with medical metaphysics. Medicine provides a simple way, or rule of thumb, for distinguishing between correct and wrong medical metaphysical statements. If they harm the patient, they are wrong, and if they aid him, they are correct. Statements that do not affect a patient's well being, e.g., 'Big Bang may be hazardous to your health', are of no apparent value and doubtful. Since treatment outcome is generally uncertain, the physician continually searches for new ideas that may aid his patient, even if they are metaphysical. In diseases, like cancer, that elude his understanding, his adherence to metaphysics intensifies, and he is ready to consider even doubtful suggestions for treatment. Yet by relaxing the rules of thumb for evaluating metaphysical concepts, he gradually slips into the irrational domain. Copyright 2001 Harcourt Publishers Ltd.

Fibrous metaphyseal defects

International Nuclear Information System (INIS)

Ritschl, P.; Hajek, P.C.; Pechmann, U.

1989-01-01

Sixteen patients with fibrous metaphyseal defects were examined with both plain radiography and magnetic resonance (MR) imaging. Depending on the age of the fibrous metaphyseal defects, characteristic radiomorphologic changes were found which correlated well with MR images. Following intravenous Gadolinium-DTPA injection, fibrous metaphyseal defects invariably exhibited a hyperintense border and signal enhancement. (orig./GDG)

Metaphysical Experience and Constitutive Error in Adorno's "Meditations on Metaphysics"

NARCIS (Netherlands)

Skirke, C.

2012-01-01

That current ideals of cognition impoverish experience is a classical observation, and complaint, of the early Frankfurt School. Adorno reacts to this phenomenon in several ways, among them his conception of metaphysical experiences. Metaphysical experiences are conventionally understood as

Pyle metaphyseal dysplasia in an African child: Case report and review of the literature.

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Wonkam, A; Makubalo, N; Roberts, T; Chetty, M

2016-05-25

Pyle disease (OMIM 265900), also known as metaphyseal dysplasia, is a rare autosomal recessive disorder with no known gene mutation. We report a case of Pyle disease in a 7-year-old African boy of mixed ancestry who presented with finger and wrist fractures following minor trauma. The radiological findings revealed abnormally broad metaphyses of the tubular bones, known as Erlenmeyer-flask bone deformity, and mild cranial sclerosis, both hallmarks of the condition. We report the first case in a patient with African ancestry, which could help in the gene discovery of this rare autosomal recessive skeletal dysplasia with unknown mutations.

Metaphyseal chondrodysplasia with ectodermal dysplasia

Energy Technology Data Exchange (ETDEWEB)

Jequier, S.; Bellini, F.; Mackenzie, D.A.

1981-11-01

The first case of metaphyseal chondrodysplasia with marked cupping of the metaphyses and cone epiphyses combined with complete alopecia was described in 1966 by Bellini. A second identical case was found in another Italian patient. Both show extremely early epiphyseal fusion. This is probably a new form of metaphyseal chondrodysplasia.

Metaphyseal chondrodysplasia with ectodermal dysplasia

International Nuclear Information System (INIS)

Jequier, S.; Bellini, F.

1981-01-01

The first case of metaphyseal chondrodysplasia with marked cupping of the metaphyses and cone epiphyses combined with complete alopecia was described in 1966 by Bellini. A second identical case was found in another Italian patient. Both show extremely early epiphyseal fusion. This is probably a new form of metaphyseal chondrodysplasia. (orig.)

Metaphysics and Learning

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Verran, Helen

2007-01-01

Is it possible to learn and simultaneously articulate the metaphysical basis of that learning? In my contribution to the forum I tell of how I came to recognise that bilingual Yoruba children could articulate the contrasting metaphysical framings of Yoruba and English numbering. The story introduces an arena I call "ontics" that recognises the…

Rickets or abuse? A histologic comparison of rickets and child abuse-related fractures.

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Kepron, Charis; Pollanen, Michael S

2015-03-01

The bone changes of vitamin D deficiency rickets have been invoked as an alternate explanation for child-abuse related fractures identified through medical imaging. The lack of modern histopathologic comparisons between these two entities limits the abilities of the forensic pathologist to address this differential diagnosis, both in their autopsy reports and on the witness stand. We report a comparison of the histologic appearance of the bones in a two year old child with vitamin D deficiency rickets with fractures occurring in three young children with child abuse. In the case of rickets, there was marked architectural disorganization of endochondral ossification at the costochondral junctions and growth plates of long bones. The child abuse-related fractures showed osteochondral callus at different stages of healing, either centered on a discrete fracture line or at metaphyses (e.g. classical metaphyseal lesions). In many instances, the healing fractures disrupted the line of endochondral ossification. In none of the child abuse-related fractures was there any similarity to the histologic appearance of rickets. The maturation disturbance in the growth plate that occurs in rickets is a distinctive entity that cannot be confused histologically with healing fractures, including the classical metaphyseal lesion.

The Everyday Condition of Metaphysics

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Ştefan Afloroaei

2010-12-01

Full Text Available The question I intend to answer is whether one can speak of a tacit metaphysics, not expressed conceptually, but nevertheless common. If the answer is positive and providing that it is specific to day-to-day life, such metaphysics may be called everyday metaphysics. To this end, I review the meaning of everyday life and its ambivalent character. Next, I present several milestones in the debate on the subject, from authors who have focused on a kind of usual, common or ‘natural’ metaphysics. Lastly, I formulate the idea under consideration, namely that everyday life implies or underlies a certain metaphysics. I note that it is an implicit metaphysics – not expressed formally – and rather free. Embraced in experience with a certain degree of freedom, it is recognisable by means of certain representations active in our mind, by the manner of speaking or of understanding and by the common forms of expression. Its vibrancy, concrete and relaxed character makes it highly evocative of the mental life of an era. It ensures a truly essential difference in our everyday mode of being.

Mechanisms, determination and the metaphysics of neuroscience.

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Soom, Patrice

2012-09-01

In this paper, I evaluate recently defended mechanistic accounts of the unity of neuroscience from a metaphysical point of view. Considering the mechanistic framework in general (Sections 2 and 3), I argue that explanations of this kind are essentially reductive (Section 4). The reductive character of mechanistic explanations provides a sufficiency criterion, according to which the mechanism underlying a certain phenomenon is sufficient for the latter. Thus, the concept of supervenience can be used in order to describe the relation between mechanisms and phenomena (Section 5). Against this background, I show that the mechanistic framework is subject to the causal exclusion problem and faces the classical metaphysical options when it comes to the relations obtaining between different levels of mechanisms (Section 6). Finally, an attempt to improve the metaphysics of mechanisms is made (Section 7) and further difficulties are pointed out (Section 8). Copyright © 2012 Elsevier Ltd. All rights reserved.

Ankle fusion for definitive management of non-reconstructable pilon fractures.

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Bozic, Vladimir; Thordarson, David B; Hertz, Jennifer

2008-09-01

Highly comminuted pilon fractures, especially with a compromised soft tissue envelope, present a challenging treatment scenario. This study presents our results for patients managed with ankle fusion rather than ORIF. Fourteen patients with ankle joint incongruence after non-reconstructable tibia pilon fractures were treated with primary tibiotalar arthrodesis using a fixed-angle cannulated blade plate. Delayed metaphyseal unions due to bone defects were treated concurrently. The subtalar joint was preserved in all cases. Metaphyseal healing and stable arthrodesis was obtained in each case. There was one case of blade plate breakage in a patient who still achieved successful arthrodesis without reoperation. Union was achieved at an average of 15 weeks. No secondary procedures were required to obtain union. All 14 patients were ambulatory at last followup. Average followup was 39 weeks. Primary ankle arthrodesis can be achieved using a cannulated blade plate to address a non-reconstructable articular surface and metaphyseal bone defects in complex tibia pilon fractures.

Osteosynthesis with long volar locking plates for meta- physeal-diaphyseal fractures of the distal radius

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Gogna Paritosh

2013-12-01

Full Text Available 【Abstract】Objective: Metaphyseal-diaphyseal fractures of the distal radius are a major treatment dilemma and orthopaedic surgeons have to pay due consideration to restoration of anatomy of distal radius together with ro- tation of the radial shaft and maintenance of radial bow and interosseous space. We performed this study to evaluate the clinic-radiological outcome of metaphyseal-diaphyseal fractures of the distal radius treated with long volar locking plates. Methods: This prospective study involved 27 pa- tients (22 males and 5 females with metaphyseal-diaphy- seal fracture of the distal radius. Their mean age was (30.12± 11.48 years (range 19-52 years and the follow-up was 26.8 months (range 22-34 months. All patients underwent open reduction and internal fixation with a long volar locking plate. According to AO/OTA classification, there were 7 type A3, 13 type C2 and 7 type C3 fractures. Subjective assessment was done based on the disabilities of the arm, shoulder and hand (DASH questionnaire. Functional evaluation was done by measuring grip strength and range of motion around the wrist and the radiological determinants included radial angle, radial length, volar angle and ulnar variance. The final as- sessment was done according to Gartland and Werley scor- ing system. Results: Postoperative radiological parameters were well maintained throughout the trial, and there was signifi- cant improvement in the functional parameters from 6 weeks to final follow-up. The average DASH scores improved from 37.5 at 6 weeks to 4.2 at final follow-up. Final assessment using Gartland and Werley scoring system revealed 66.67% (n=18 excellent and 33.33% (n=9 good results. There was one case of superficial infection which responded to antibi- otics and another carpel tunnel syndrome which was ma- naged conservatively. Conclusion: Volar locking plate fixation for metaphy- seal-diaphyseal fractures of distal radius is associated with excellent to good

Is science metaphysically neutral?

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Fry, Iris

2012-09-01

This paper challenges the claim that science is metaphysically neutral upheld by contenders of the separation of peacefully co-existent science and religion and by evolutionary theists. True, naturalistic metaphysical claims can neither be refuted nor proved and are thus distinct from empirical hypotheses. However, metaphysical assumptions not only regulate the theoretical and empirical study of nature, but are increasingly supported by the growing empirical body of science. This historically evolving interaction has contributed to the development of a naturalistic worldview that renounces the necessity of a transcendent god and of purposeful design. The thesis presented here differs not only from the claims of the "separatists" and of evolutionary theists. In pointing to the metaphysical aspects of science, I also criticize the failure of some evolutionary naturalists to distinguish between empirical and metaphysical contentions. Most important, based on the examination of science suggested here, creationists' false accusation that science is only a naturalistic dogma is refuted. Finally, the difficulties involved in the position endorsed here for the public support of evolution are acknowledged, taking into account the high religious profile of the American society and the social and political context in the US and in other countries. Copyright © 2012 Elsevier Ltd. All rights reserved.

The Scientific Metaphysics of Charles S. Peirce

DEFF Research Database (Denmark)

Sørensen, Bent; Thellefsen, Torkild Leo

Charles S. Peirce (1839-1914) was, perhaps, first and foremost a practising or experimental scientist. However, Peirce was also a philosopher, and to him the relation between science and metaphysics was intimate. Peirce not only wanted to develop a metaphysical system consistent with the important...... scientific results and conceptions of his time, but also, like Immanuel Kant, to set metaphysics on the path of a science. This collection of articles investigates central themes and difficulties in the metaphysics of Peirce - some of the articles clarify aspects of his metaphysics, others also show...

Fractures of the distal tibia treated with polyaxial locking plating.

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Gao, Hong; Zhang, Chang-Qing; Luo, Cong-Feng; Zhou, Zu-Bin; Zeng, Bing-Fang

2009-03-01

We evaluated the healing rate, complications, and functional outcomes in 32 adult patients with very short metaphyseal fragments in fractures of the distal tibia treated with a polyaxial locking system. The average distance from the distal extent of the fracture to the tibial plafond was 11 mm. All fractures healed and the average time to union was 14 weeks. Six patients (19%) reported occasional local disturbance over the medial malleolus. There were two cases of postoperative superficial infections and evidence of delayed wound healing. Using the American Orthopaedic Foot and Ankle Society ankle score, the average functional score was 87.3 points (of 100 total possible points). Our results show the polyaxial locking plates, which offer more fixation versatility, may be a reasonable treatment option for distal tibia fractures with very short metaphyseal segments.

The metaphysics of evolution.

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Dupré, John

2017-10-06

This paper briefly describes process metaphysics, and argues that it is better suited for describing life than the more standard thing, or substance, metaphysics. It then explores the implications of process metaphysics for conceptualizing evolution. After explaining what it is for an organism to be a process, the paper takes up the Hull/Ghiselin thesis of species as individuals and explores the conditions under which a species or lineage could constitute an individual process. It is argued that only sexual species satisfy these conditions, and that within sexual species the degree of organization varies. This, in turn, has important implications for species' evolvability. One important moral is that evolution will work differently in different biological domains.

Conceptual Realism. The Structure of Metaphysical Thought

NARCIS (Netherlands)

Mulder, J.M.

2014-01-01

Metaphysics is now a respectable discipline within analytic philosophy: metaphysical realists are proposing their various theories as to the ultimate structure of reality. However, their project is also being fundamentally questioned, by metaphysical anti-realists. This ambivalent situation is due

Transhumanism, metaphysics, and the posthuman god.

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Bishop, Jeffrey P

2010-12-01

After describing Heidegger's critique of metaphysics as ontotheology, I unpack the metaphysical assumptions of several transhumanist philosophers. I claim that they deploy an ontology of power and that they also deploy a kind of theology, as Heidegger meant it. I also describe the way in which this metaphysics begets its own politics and ethics. In order to transcend the human condition, they must transgress the human.

The many Metaphysics within Physics. Essay review of 'The Metaphysics within Physics' by Tim Maudlin

Science.gov (United States)

Suárez, Mauricio

Tim Maudlin's new book The Metaphysics within Physics (Oxford University Press, 2007) collects six essays by one of the most thoughtful and original minds working in the philosophy of physics nowadays. Some had previously circulated informally for years. For example, Chapter 1 ('A Modest Proposal Concerning Laws, Counterfactuals and Explanations') is as old as my own philosophical career-I recall reading a draft in the early 1990s. The mere publication of such a long-awaited collection is therefore already good news. In addition, the degree of coherence and the lack of redundancy are greater than one would expect from a collection of disparate essays written at diverse times and with a range of different targets. The whole book can be understood coherently as an extended argument in favor of a particular 'physics-based' methodology for inquiry in metaphysics. This methodology recommends a detailed and thorough analysis of current physics as a benchmark for any thesis, dispute or argument in metaphysics. It follows that proper metaphysical inquiry must be suitably informed not just about the current state of play in analytical metaphysics but also about the current state of development of the relevant part of present day physics.

Quantum entanglement and a metaphysics of relations

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Esfeld, Michael

This paper argues for a metaphysics of relations based on a characterization of quantum entanglement in terms of non-separability, thereby regarding entanglement as a sort of holism. By contrast to a radical metaphysics of relations, the position set out in this paper recognizes things that stand in the relations, but claims that, as far as the relations are concerned, there is no need for these things to have qualitative intrinsic properties underlying the relations. This position thus opposes a metaphysics of individual things that are characterized by intrinsic properties. A principal problem of the latter position is that it seems that we cannot gain any knowledge of these properties insofar as they are intrinsic. Against this background, the rationale behind a metaphysics of relations is to avoid a gap between epistemology and metaphysics.

OUT-OF-BODY EXPERIENCE, PURE BEING AND METAPHYSICS

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I. V. Karivets

2016-12-01

Full Text Available Purpose. The author will show that metaphysical concepts and the concepts of empirical sciences derive from experience. The only difference is that metaphysical concepts derive from unusual experience, i.e. out-of-body experience, while empirical sciences – from usual one. The example set metaphysical concept of pure being. Methodology. In order to obtain this goal the author uses two methods. The first one is comparative method. With the help of this method the stories of men who experienced clinical death and returned to life are compared with the famous philosophers’ metaphysical statements (Plato, Descartes, and Bonaventura. The second one is transpersonal method. It helps to study the peculiarities of the extraordinary experience in the state of clinical death or mystical ecstasy. Such experience lies in experience of transcendence, pure being as light, ultimate awareness of truth, which are identical to the metaphysical statements of philosophers and mystics. These ultimate experiences belong to different people, who lived and grown in different cultures, but nevertheless metaphysical statements of philosophers or mystics and statements of the ordinary people who experienced clinical death are the same. Therefore we can say that out-of-body experience is transpersonal. Originality. Metaphysics is neither speculative nor withdrawn from experience of a human being sphere. It arises from out-of-body experience while empirical sciences – from usual experience. Therefore, metaphysical concepts, in particular, pure being, are empirical, because they are based also on (extraordinary experience. In general, metaphysics becomes possible on the basis of out-of-body experience. Conclusions. In this article the author argues that the concepts of metaphysics are not a priori because they originate from out-of-body experience that is from the experience of the distinction between body and soul or body and mind. As a result of such experience

Ingenious method of external fixator use to maintain alignment for nailing a proximal tibial shaft fracture.

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Behera, Prateek; Aggarwal, Sameer; Kumar, Vishal; Kumar Meena, Umesh; Saibaba, Balaji

2015-09-01

Fractures of the tibia are one of the most commonly seen orthopedic injuries. Most of them result from a high velocity trauma. While intramedullary nailing of tibial diaphyseal fractures is considered as the golden standard form of treatment for such cases, many metaphyseal and metaphyseal-diaphyseal junction fractures can also be managed by nailing. Maintenance of alignment of such fractures during surgical procedure is often challenging as the pull of patellar tendon tends to extend the proximal fragment as soon as one flexes the knee for the surgical procedure. Numerous technical modifications have been described in the literature for successfully nailing such fractures including semi extended nailing, use of medial plates and external fixators among others. In this study, it was aimed to report two cases in which we used our ingenious method of applying external fixator for maintaining alignment of the fracture and aiding in the entire process of closed intramedullary nailing of metaphyseal tibial fractures by the conventional method. We were able to get good alignment during and after the closed surgery as observed on post-operative radiographs and believe that further evaluation of this technique may be of help to surgeons who want to avoid other techniques.

Concurrence of metaphyseal fibrous defect and osteosarcoma

International Nuclear Information System (INIS)

Kyriakos, M.; Murphy, W.A.

1981-01-01

The case of a 15-year-old girl with juxtaposition of a femoral metaphyseal fibrous defect (fibrous cortical defect) and an osteosarcoma is reported. Despite the relatively common occurrence of metaphyseal fibrous defects, their reported association with other bone tumors is exceedingly rare. Only two previous acceptable examples of this association were found. Reports of malignant transformation of metaphyseal fibrous defect were reviewed and rejected because they lacked convincing radiologic or histopathologic evidence of a pre-existent benign fibrous lesion. The finding of a malignant bone tumor in association with a metaphyseal fibrous defect appears to be a chance occurrence. (orig.)

Meditations on Metaphysical Modality

OpenAIRE

Willis, Edmund Lindsay James

2011-01-01

Although metaphysical modality has been much discussed and exploited by philosophers, its precise nature is often left unanalysed and obscure. This dissertation marks an attempt to understand it better. After examining modality in general, the specific topic is introduced through consideration of the views of Kripke and Lewis. Comparisons are then made with logical, scientific and conceptual modalities. Finally, it is argued that metaphysical modality is that variety of modality which is alet...

Observability, Visualizability and the Question of Metaphysical Neutrality

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Wolff, Johanna

2015-09-01

Theories in fundamental physics are unlikely to be ontologically neutral, yet they may nonetheless fail to offer decisive empirical support for or against particular metaphysical positions. I illustrate this point by close examination of a particular objection raised by Wolfgang Pauli against Hermann Weyl. The exchange reveals that both parties to the dispute appeal to broader epistemological principles to defend their preferred metaphysical starting points. I suggest that this should make us hesitant to assume that in deriving metaphysical conclusions from physical theories we place our metaphysical theories on a purely empirical foundation. The metaphysics within a particular physical theory may well be the result of a priori assumptions in the background, not particular empirical findings.

On Metaphysical Cases against Political Theories

NARCIS (Netherlands)

M. Buitenhuis (Manuel)

2014-01-01

textabstractThis paper considers some arguments that argue against particular political theories on metaphysical grounds. These arguments contain the implicit premise that political theories are only viable if they are grounded in a plausible metaphysical theory. This thesis was called the

Fracture during intravenous bisphosphonate treatment in a child with osteogenesis imperfecta: an argument for a more frequent, low-dose treatment regimen.

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Biggin, Andrew; Briody, Julie N; Ormshaw, Elizabeth; Wong, Karen K Y; Bennetts, Bruce H; Munns, Craig F

2014-01-01

Intravenous bisphosphonate therapy is the mainstay of medical treatment in osteogenesis imperfecta (OI) and has been shown to increase bone mass, decrease bone pain, improve mobility, and reduce the incidence of fractures. Sclerotic metaphyseal lines parallel to the growth plate are seen on long bone radiographs following cyclical intravenous therapy. These areas create stress risers within the bone that may act as foci for subsequent fractures as exemplified in this clinical case. An 8-year-old girl with OI sustained a distal radial fracture following 3 years of treatment with 6-monthly intravenous zoledronate. Her diagnosis, response to treatment, and subsequent fracture at a sclerotic metaphyseal line is described. Peripheral quantitative computer tomography was used to characterise the presence of multiple stress risers at the distal forearm. Trabecular bone mineral density fluctuated from 34 to 126% compared to neighbouring 2-mm regions. There remain many unanswered questions about optimal bisphosphonate treatment regimens in children with OI. The formation of stress risers following intravenous bisphosphonate treatment raises the hypothesis that a more frequent and low-dose bisphosphonate regimen would provide more uniform dosing of bone in the growing child and reduce the likelihood of fractures compared to current treatment practices.

Salvage of tibial pilon fractures using fusion of the ankle with a 90 degrees cannulated blade-plate: a preliminary report.

Science.gov (United States)

Morgan, S J; Thordarson, D B; Shepherd, L E

1999-06-01

Six patients with ankle joint destruction and delayed metaphyseal union after tibial plafond fracture were surgically treated with tibiotalar arthrodesis and metaphyseal reconstruction, using a fixed-angle cannulated blade-plate. The procedure was performed through a posterior approach in five cases and a lateral approach in one case. The subtalar joint was preserved in all cases. Metaphyseal union and a stable arthrodesis were obtained in all cases without loss of fixation and with no mechanical failure of the blade-plate. Union was obtained in an average of 26 weeks. No secondary procedures were required to obtain union. All six patients were ambulatory at last follow-up. Stable internal fixation for simultaneous tibiotalar fusion and metaphyseal reconstruction can be achieved with a cannulated blade-plate while preserving the subtalar joint in complex plafond fractures.

Factors Associated with Infection Following Open Distal Radius Fractures

OpenAIRE

Glueck, Dane A.; Charoglu, Constantine P.; Lawton, Jeffrey N.

2009-01-01

Open fractures are often classified according to a system described by Gustilo and Anderson. However, this system was applied to open long bone factures, which may not predict the incidence of infection in open metaphyseal fractures of the upper extremity. Other studies have found that wound contamination and systemic illness were the best predictors of infections in open hand fractures. Our study assessed infection in open distal radius fractures and identifies factors that are associated wi...

Karl Popper's Conception of Metaphysics and its Problems

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Cláudia Ribeiro

2014-08-01

Full Text Available http://dx.doi.org/10.5007/1808-1711.2014v18n2p209 In this paper I intend to thoroughly analyse Karl Popper’s relation to metaphysics. I start with his first writings, where he states the differences between science, pseudoscience and metaphysics. I then describe how his thoughts on the subject evolved to culminate in his reflection on metaphysical research programmes and the need for a revival of natural philosophy. A major concern is Popper’s famous testability criterion to set apart science from non-science. I point at the problems of the conception of metaphysics as non-testable theories (which are similar to the problems of the conception of metaphysics as theories involving unobservables and, in order to avoid these problems, I propose to retain nothing but the traditional conception of metaphysics as the general theories about the nature of the world. This leads me to the conclusion that science is not only an empirical task but also, and in a very important sense, a speculative one.

Spondylo-megaepiphyseal-metaphyseal dysplasia: an unusual bone dysplasia

International Nuclear Information System (INIS)

Agarwal, Prachi Pragya; Srinivasan, Ashok; Sharma, Raju; Gupta, Arun Kumar; Kabra, Madhulika

2003-01-01

A rare case of spondylo-megaepiphyseal-metaphyseal dysplasia is reported in a 10-year-old boy. The features were metaphyseal dysplasia, markedly defective ossification of vertebral body centres and enlarged epiphyses. Although it shares some features with spondylo-metaphyseal dysplasia, oto-spondylo-megaepiphyseal dysplasia and cleidocranial dysplasia, the presence of several unusual radiological findings sets it apart. (orig.)

Dewey's Naturalistic Metaphysics: Expostulations and Replies

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Friedman, Randy L.

2011-01-01

Critics of Dewey's metaphysics point to his dismissal of any philosophy which locates ideals in a realm beyond experience. However, Dewey's sustained critique of dualistic philosophies is but a first step in his reconstruction and recovery of the function of the metaphysical. Detaching the discussion of values from inquiry, whether scientific,…

Kantowska metafizyka percepcji (Kant’s Metaphysics of Perception

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Paweł Sikora

2009-06-01

Full Text Available This article treats of an issue of Kant’s the metaphysics of perception as a specific sphere where concept of sense perception within transcendental philosophy seem to be rooted into a wider context of metaphysical presuppositions. The text is an epitome of a few Kant’s aporias which appear when he does not notice a metaphysical background which constitutes basic relation between subject and object in sense perception.

Internal Realism: Putnam's Alternative to Metaphysical Realism

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J Akbari Takhtameshlou

2014-02-01

Full Text Available Hilary Putnam, who was once one of the representatives and proponents of scientific and metaphysical realism, became an unrelenting opponent of metaphysical realism during the mid-70s. Having argued against alethic and ontological dimensions of metaphysical realism, he proposed “internal realism” as an alternative to it. Putnam's major objection to the alethic dimension of metaphysical realism was that this philosophy brings about an unbridgeable gap between the truth of a proposition and our epistemic justifications for it. As to the ontological dimension of metaphysical realism, he proposed the criticism to the effect that according to this philosophical position the world consists of “ready-made” objects. Putnam poses these criticisms because, as he argues, firstly, truth cannot be considered anything but the ideal justification and secondly, the world is not made of ready-made objects, but rather it is we that cut up the world into different objects when we take a conceptual scheme. Indeed, according to Putnam assuming any "external perspective", whether about truth or about ontology, is meaningless. Having introduced and reviewed Putnam's arguments in rejecting metaphysical realism, this article explains and examines the basic elements of internal realism. The results of this article show that Putnam's objections against metaphysical realism lack the necessary credibility and strength and at the same time his proposed alternative (internal realism has serious problems that made to be addressed. By his chosen conception of truth, internal realism, cannot touch its stated purpose i.e. the removal of a huge gap between the truth of a statement and our knowledge of it. The ontological claims of internal realism are not, indeed, the reliable and true consequences of the thesis of conceptual relativity, which is considered as Putnam’s main base in this regard, but rather it is more a consequence of mistaking the

A proper metaphysics for cognitive performance.

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Van Orden, Guy C; Moreno, Miguel A; Holden, John G

2003-01-01

The general failure to individuate component causes in cognitive performance suggests the need for an alternative metaphysics. The metaphysics of control hierarchy theory accommodates the fact of self-organization in nature and the possibility that intentional actions are self-organized. One key assumption is that interactions among processes dominate their intrinsic dynamics. Scaling relations in response time variability motivate this assumption in cognitive performance.

Metaphysical green

DEFF Research Database (Denmark)

Earon, Ofri

2011-01-01

to adapt to urban environment. It explores the potential of Sensation of Green in the city. The paper questions whether the Sensation of Green could introduce a new spectrum of greens, beside the real green. It develops the term of metaphysical green – does green have to be green or can it be only...

On Darwin's 'metaphysical notebooks'. II: "Metaphysics" and final cause.

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Calabi, L

2001-01-01

The first part of this paper was published in Rivista di Biologia/Biology Forum 94 (2001). In the second part below an examination is made of the meaning of the term Metaphysics in some passages of the Darwinian Notebooks for the years 1836-1844. Metaphysics no longer defines a field of philosophical enquiries mainly concerning the being and the essence after the manner of Aristotle; it now refers to a kind of philosophy of mind after the manner of J. Locke's criticism of the Hypokeimenon. However Aristotle's Metaphysics also encompasses a treatment of the idea of causes, and of final cause particularly, in the explanation of events, and in the explanation of natural phenomena especially. The criticism of the idea of final cause in the interpretation of the world of life is one of Darwin's foundational acts in his early years. When conceiving his Système du monde, in the last years of the XVIII Century, Laplace could think that God is a hypothesis not really needed by science, as we are told. For the knowledge of organic nature to attain the status of science, it remained to be shown that since--certain of the exemplariness of Newton's Principles as much as cautious before the mystery of life--did not need the hypothesis of final ends in order to understand and explain the productions of the living nature: not only in the form of that final cause (the First Cause, the Vera Causa) in which Natural Theology still rested, but also in the form of nature's inner finality which still moulded Whewell's Kantian philosophy. Such demonstration is a very important subject in Darwin's early enquiries, where he criticises finalism as a projection of self-conceiving Man, likely inherited from a knowing of causality in nuce to be found also in animals.

Fractures of the Distal Tibia Treated with Polyaxial Locking Plating

OpenAIRE

Gao, Hong; Zhang, Chang-Qing; Luo, Cong-Feng; Zhou, Zu-Bin; Zeng, Bing-Fang

2008-01-01

We evaluated the healing rate, complications, and functional outcomes in 32 adult patients with very short metaphyseal fragments in fractures of the distal tibia treated with a polyaxial locking system. The average distance from the distal extent of the fracture to the tibial plafond was 11 mm. All fractures healed and the average time to union was 14 weeks. Six patients (19%) reported occasional local disturbance over the medial malleolus. There were two cases of postoperative superficial in...

Beyond the realism debate: The metaphysics of 'racial' distinctions.

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Lemeire, Olivier

2016-10-01

The current metaphysical race debate is very much focused on the realism question whether races exist. In this paper I argue against the importance of this question. Philosophers, biologists and anthropologists expect that answering this question will tell them something substantive about the metaphysics of racial classifications, and will help them to decide whether it is justified to use racial categories in scientific research and public policy. I argue that there are two reasons why these expectations are not fulfilled. First of all, the realism question about race leads to a very broad philosophical debate about the semantics of general terms and the criteria for real kinds, rather than to a debate about the metaphysics of racial categories specifically. Secondly, there is a type of race realism that is so toothless that it is almost completely uninformative about the metaphysics of race. In response to these worries, I argue that the metaphysical race debate should rather be focused on the question in what way and to what extent 'racial' distinctions can ground the epistemic practices of various scientific disciplines. I spell out what I mean by this, and go on to demonstrate that trying to answer this question leads to a more fruitful metaphysical debate. Copyright © 2016 Elsevier Ltd. All rights reserved.

Temporary brittle bone disease: fractures in medical care.

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Paterson, Colin R

2009-12-01

Temporary brittle bone disease is the name given to a syndrome first reported in 1990, in which fractures occur in infants in the first year of life. The fractures include rib fractures and metaphyseal fractures which are mostly asymptomatic. The radiological features of this disorder mimic those often ascribed to typical non-accidental injury. The subject has been controversial, some authors suggesting that the disorder does not exist. This study reports five infants with typical features of temporary brittle bone disease in whom all or most of the fractures took place while in hospital. A non-accidental cause can be eliminated with some confidence, and these cases provide evidence in support of the existence of temporary brittle bone disease.

Which radiological investigations should be performed to identify fractures in suspected child abuse?

International Nuclear Information System (INIS)

Kemp, A.M.; Butler, A.; Morris, S.; Mann, M.; Kemp, K.W.; Rolfe, K.; Sibert, J.R.; Maguire, S.

2006-01-01

Aims: To determine which radiological investigations should be performed and which children should be investigated. Materials and methods: An all language literature search of original articles; from 1950-October 2005. Two reviewers independently reviewed each article. A third was carried out on disagreement. Each study was assessed using standardised data extraction, critical appraisal and evidence forms. Results: Thirty-four studies were included. Fifteen addressed the question: which investigation has a higher yield, skeletal surveys (SS) or bone scintigraphy (BS)? Studies gave conflicting results. Overall neither investigation is as good as the two combined. BS predominately missed skull, metaphyseal and epiphyseal fractures, whereas SS commonly missed rib fractures. Two studies showed that a repeat SS 2 weeks after the initial study provided significant additional information about tentative findings, the number and age of fractures. A comparative study evaluated additional oblique views of ribs in 73 children and showed improved diagnostic sensitivity, specificity and accuracy. Four studies addressed the diagnostic yield for occult fractures with respect to age. This was significant for children under 2-years old. Conclusions: In children under 2-years old, where physical abuse is suspected, diagnostic imaging of the skeleton should be mandatory. SS or BS alone is inadequate to identify all fractures. It is recommended that all SS should include oblique views of the ribs. This review suggests that the following options would optimize the diagnostic yield. However, each needs to be evaluated prospectively: SS that includes oblique views, SS and BS, a SS with repeat SS or selected images 2 weeks later or a BS plus skull radiography and coned views of metaphyses and epiphyses

Which radiological investigations should be performed to identify fractures in suspected child abuse?

Energy Technology Data Exchange (ETDEWEB)

Kemp, A.M.; Butler, A.; Morris, S.; Mann, M.; Kemp, K.W.; Rolfe, K.; Sibert, J.R.; Maguire, S

2006-09-15

Aims: To determine which radiological investigations should be performed and which children should be investigated. Materials and methods: An all language literature search of original articles; from 1950-October 2005. Two reviewers independently reviewed each article. A third was carried out on disagreement. Each study was assessed using standardised data extraction, critical appraisal and evidence forms. Results: Thirty-four studies were included. Fifteen addressed the question: which investigation has a higher yield, skeletal surveys (SS) or bone scintigraphy (BS)? Studies gave conflicting results. Overall neither investigation is as good as the two combined. BS predominately missed skull, metaphyseal and epiphyseal fractures, whereas SS commonly missed rib fractures. Two studies showed that a repeat SS 2 weeks after the initial study provided significant additional information about tentative findings, the number and age of fractures. A comparative study evaluated additional oblique views of ribs in 73 children and showed improved diagnostic sensitivity, specificity and accuracy. Four studies addressed the diagnostic yield for occult fractures with respect to age. This was significant for children under 2-years old. Conclusions: In children under 2-years old, where physical abuse is suspected, diagnostic imaging of the skeleton should be mandatory. SS or BS alone is inadequate to identify all fractures. It is recommended that all SS should include oblique views of the ribs. This review suggests that the following options would optimize the diagnostic yield. However, each needs to be evaluated prospectively: SS that includes oblique views, SS and BS, a SS with repeat SS or selected images 2 weeks later or a BS plus skull radiography and coned views of metaphyses and epiphyses.

Locking plate fixation in distal metaphyseal tibial fractures: series of 79 patients

OpenAIRE

Gupta, Rakesh K.; Rohilla, Rajesh Kumar; Sangwan, Kapil; Singh, Vijendra; Walia, Saurav

2009-01-01

Open reduction and internal fixation in distal tibial fractures jeopardises fracture fragment vascularity and often results in soft tissue complications. Minimally invasive osteosynthesis, if possible, offers the best possible option as it permits adequate fixation in a biological manner. Seventy-nine consecutive adult patients with distal tibial fractures, including one patient with a bilateral fracture of the distal tibia, treated with locking plates, were retrospectively reviewed. The 4.5-...

On neuropsychoanalytic metaphysics.

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Talvitie, Vesa; Ihanus, Juhani

2011-12-01

Neuropsychoanalysis focuses on the neural counterparts of psychoanalytically interesting phenomena and has left the difference in the metaphysical presuppositions between neuroscience and psychoanalysis unexamined. The authors analyse the logical possibilities concerning the relation between the brain and the mental unconscious in terms of the serial, parallel, epiphenomenalist and Kantian conceptions, and conclude that none of them provides a satisfactory ground for neuropsychoanalysis. As far as psychoanalytic explanations refer to the mental unconscious, they cannot be verified with the help of neuroscience. Neither is it possible to form a picture of how a neuro-viewpoint might be of help for psychoanalytic theorizing. Neuropsychoanalysis has occasionally been seen as a reductionist affair, but the authors suggest that neuropsychoanalysts themselves lean on the hybrid conception, which combines neuroscientific and psychoanalytic viewpoints. The authors state arguments in favour of the interfield conception of neuropsychoanalysis that takes seriously the metaphysical tensions between neuroscience and psychoanalysis. Copyright © 2011 Institute of Psychoanalysis.

The abundant world: Paul Feyerabend's metaphysics of science.

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Brown, Matthew J

2016-06-01

The goal of this paper is to provide an interpretation of Feyerabend's metaphysics of science as found in late works like Conquest of Abundance and Tyranny of Science. Feyerabend's late metaphysics consists of an attempt to criticize and provide a systematic alternative to traditional scientific realism, a package of views he sometimes referred to as "scientific materialism." Scientific materialism is objectionable not only on metaphysical grounds, nor because it provides a poor ground for understanding science, but because it implies problematic claims about the epistemic and cultural authority of science, claims incompatible with situating science properly in democratic societies. I show how Feyerabend's metaphysical view, which I call "the abundant world" or "abundant realism," constitute a sophisticated and challenging form of ontological pluralism that makes interesting connections with contemporary philosophy of science and issues of the political and policy role of science in a democratic society. Copyright © 2015 Elsevier Ltd. All rights reserved.

Metaphysics and medical ethics: a reply.

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Gillett, G

1994-01-01

The total longitudinal form view of human beings is a metaphysical view which aims to locate our moral judgements about human embryos in a broader set of attitudes and characterisations. On this basis it has explanatory power and a real function in that it grounds our ethical discussion of embryos in other discourses. Contra Leavitt, this grounding suggests a broader criterion of relevance for metaphysical discussion than asking 'what comes out of' such a discussion for a particular ethical dilemma. PMID:8035442

On the metaphysics of experimental physics

CERN Document Server

Rogers, K

2005-01-01

This provocative and critical work addresses the question of why scientific realists and positivists consider experimental physics to be a natural and empirical science. Taking insights from contemporary science studies, continental philosophy, and the history of physics, this book describes and analyses the metaphysical presuppositions that underwrite the technological use of experimental apparatus and instruments to explore, model, and understand nature. By revealing this metaphysical foundation, the author questions whether experimental physics is a natural and empirical science at all.

Hylozoism as an Interpretive Principle in African Metaphysics ...

African Journals Online (AJOL)

Hylozoism as an Interpretive Principle in African Metaphysics. ... is only used as an interpretive principle in African Metaphysics; unlike the widely held assumption by some popular proponents that inanimate beings have elein vitale, that is, life-force. ... LWATI: A Journal of Contemporary Research, 8(1), 319-327, 2011 ...

The tragic and the metaphysical in philosophy and psychoanalysis.

Science.gov (United States)

Stolorow, Robert D; Atwood, George E

2013-06-01

This article elaborates a claim, first introduced by Wilhelm Dilthey, that metaphysics represents an illusory flight from the tragedy of human finitude. Metaphysics, of which psychoanalytic metapsychologies are a form, transforms the unbearable fragility and transience of all things human into an enduring, permanent, changeless reality, an illusory world of eternal truths. Three "clinical cases" illustrate this thesis in the work and lives of a philosopher and two psychoanalytic theorists: Friedrich Nietzsche and his metaphysical doctrine of the eternal return of the same, Sigmund Freud and his dual instinct theory, and Heinz Kohut and his theoretical language of the self. It is contended that the best safeguard against the pitfalls of metaphysical illusion lies in a shared commitment to reflection on the constitutive contexts of all our theoretical ideas.

MR evaluation of 'Metaphyseal' change in Legg-Calve-Perthes disease

International Nuclear Information System (INIS)

Moon, Haeng Jin; Na, Jae Boem; Shin, Chang Min; You, Jin Jong; Chung, Sung Hoon

2001-01-01

To determine the metaphyseal changes occurring in Legg-Calve-Perthes(LCP) disease using MRI. Between 1992 to 1999, 80 LCP patients (87 hips) underwent MR imaging and plain radiography. All MR images were reviewed, bone marrow signal intensity, the size and locatiion of the metaphyseal cyst and its epiphyseal necrosis grade determined. Metaphyses were abnormal in 43hips (49%), while bone marrow edema was present in 28 (32%) and a metaphyseal cyst in 30 (34%). Metaphyseal cysts were classified as either 'true' (n=9) or 'false' (n=21) according to the enhancement pattern. The maximum diameters of true and false cysts were 1.1±0.3 cm and 1.1±0.4 cm, respectively. Their most commom location was the anterior column; a true cyst occurred there in 7cases (78%), and false cyst in 16 (76%). Using the Waldenstrom classification, seven of the nine hips wih a true cyst (78%), were found to be at the avascular stage and 15 of the 21 with a false cyst (71%) were at the fragmentation stage. Seven of these nine (78%) and 19 of these 21 (90%) were Catterall grade IV. According to the findings of MR imaging, the metaphyseal changes occurring in LCP disease were bone marrow edema and metaphyseal cyst. This latter was visualized mainly in the anterior column and severely affected hip, and was classified as 'true' or 'false'

Fall and Rise of Aristotelian Metaphysics in the Philosophy of Science

Science.gov (United States)

Lamont, John

2009-01-01

The paper examines the fortunes of Aristotelian metaphysics in science and the philosophy of science. It considers the Enlightenment claim that such a metaphysics is fundamentally unscientific, and that its abandonment was essential to the scientific revolution. The history of the scientific revolution and the metaphysical debates involved in it…

Traumatic Foot Fractures in Hard Working Donkeys

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M.A. Semieka

2012-10-01

Full Text Available The present study was carried out on 45 hard working donkeys suffering from different types of traumatic foot fractures. These animals were selected from the clinical cases admitted to the Veterinary Teaching Hospital, Assiut University during the period of 2007-2010. Based on history, clinical signs and radiographic examination, various types of traumatic foot fractures were diagnosed and recorded. These fractures were affect metacarpal bones (N. =16, metatarsal bones (N. =9, proximal phalanx (N. = 13, middle phalanx (N. = 3, distal phalanx (N. = 2 and proximal sesamoid bones (N. = 2. It could be concluded that fractures of the large metacarpal bones are the most common types followed by fractures of the proximal phalanx of the thoracic limb then fractures of the metatarsal bones. Fractures of the middle phalanx, distal phalanx and proximal sesamoid bone are less common in donkeys. Single fractures of the metacarpal and metatarsal bones are more common than comminuted one, in addition diaphyseal fractures of these bones are more common than metaphyseal or epiphyseal fractures. In the proximal phalanx, comminuted fractures are more common than single fractures.

Determination of death: Metaphysical and biomedical discourse

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Irayda Jakušovaitė

2016-01-01

Full Text Available The prominence of biomedical criteria relying on brain death reduces the impact of metaphysical, anthropological, psychosocial, cultural, religious, and legal aspects disclosing the real value and essence of human life. The aim of this literature review is to discuss metaphysical and biomedical approaches toward death and their complimentary relationship in the determination of death. A critical appraisal of theoretical and scientific evidence and legal documents supported analytical discourse. In the metaphysical discourse of death, two main questions about what human death is and how to determine the fact of death clearly separate the ontological and epistemological aspects of death. During the 20th century, various understandings of human death distinguished two different approaches toward the human: the human is a subject of activities or a subject of the human being. Extinction of the difference between the entities and the being, emphasized as rational–logical instrumentation, is not sufficient to understand death thoroughly. Biological criteria of death are associated with biological features and irreversible loss of certain cognitive capabilities. Debating on the question “Does a brain death mean death of a human being?” two approaches are considering: the body-centrist and the mind-centrist. By bridging those two alternatives human death appears not only as biomedical, but also as metaphysical phenomenon. It was summarized that a predominance of clinical criteria for determination of death in practice leads to medicalization of death and limits the holistic perspective toward individual's death. Therefore, the balance of metaphysical and biomedical approaches toward death and its determination would decrease the medicalization of the concept of death.

Feng Youlan’s Interpretation of Western Philosophy:A Critical Examination from the Perspective of Metaphysical Methodology

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Derong Chen

2015-04-01

Full Text Available The paper aims to display a limited observation of Feng’s interpretation of Western philosophy through the window of metaphysical methodology. This paper concentrates on Feng’s interpretation of Western philosophy from the perspective of metaphysical methodology and aims to display a limited observation of Feng’s interpretation of Western philosophy through the window of metaphysical methodology. Based on a brief review the recent studies of Feng Youlan and Western philosophy, this paper analyzes the progress and insufficient aspects in current studies on this issue and particularly clarifies what are the metaphysics and metaphysical methods in the context of Feng Youlan’s philosophy. In clarifying Feng’s interpretation of Western philosophy from the perspective of methodology, this paper further critically analyzes the Feng’s positive metaphysical methods and negative metaphysical methods, and assumes that Feng’s negative metaphysical methods essentially is a kind of attitudes towards metaphysics but neither a kind of metaphysics nor a kind of metaphysical methods. Instead of characterizing metaphysical methods as positive and negative as Feng did, this paper suggests an alternative division of metaphysical methods: direct and indirect methods of dealing with metaphysical issues.

Metaphysical outlooks in physics and the anthropic principle.

Science.gov (United States)

Dallaporta, N.

In order to justify the various assumptions current in present day cosmology, it is necessary for each of them to build a frame of metaphysical postulates much more involved and artificial than the opposite straightforwardly metaphysical view of a universe built according to an a priori plan, requiring a planning intelligence adequate to have conceived it.

The Interdependence of Pedagogy, Learning Theory, Morality and Metaphysics.

Science.gov (United States)

Blunden, Ralph

1997-01-01

Explores the incompatibility between constructivist theories of learning and realist metaphysics (belief that knowledge and skills exist in mind-independent workplace practices). Shows how this results in conflict between constructivist teaching approaches and the transmission or banking mode favored by realist metaphysics. (SK)

Metaphyseal giant cell tumor

International Nuclear Information System (INIS)

Pereira, L.F.; Hemais, P.M.P.G.; Aymore, I.L.; Carmo, M.C.R. do; Cunha, M.E.P.R. da; Resende, C.M.C.

1986-01-01

Three cases of metaphyseal giant cell tumor are presented. A review of the literature is done, demostrating the lesion is rare and that there are few articles about it. Age incidence and characteristics of the tumor are discussed. (Author) [pt

Trampoline fracture of the proximal tibial metaphysis in children may not progress into valgus: a report of seven cases and a brief review.

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Kakel, R

2012-06-01

Fracture of the proximal tibial metaphysis in children is a rare injury but notorious for carrying the risk of subsequent valgus deformity of the tibia. Trampoline-caused fracture of the proximal tibial metaphysis in children may not progress into valgus. We followed up six children who collectively sustained seven fractures of the proximal tibial metaphysis while trampolining with other heavier and/or older children. Initial and follow-up x-rays were reviewed by an orthopaedic surgeons and two radiologists. None of the patients developed valgus deformity with follow-up. Trampoline is associated with a specific type of injury to the proximal tibia when children are trampolining with other heavier children even without falling off the trampoline. This fracture is linear and complete, often non-displaced. Unlike "other" proximal tibial metaphyseal fractures, trampoline-associated proximal tibial metaphysical fracture in children is not associated with a risk of subsequent valgus deformity. Level 4. case series. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Metaphyseal osteopathy in a British Shorthair cat.

Science.gov (United States)

Adagra, Carl; Spielman, Derek; Adagra, Angela; Foster, Darren J

2015-04-01

Metaphyseal osteopathy, otherwise known as hypertrophic osteodystrophy, is a disease that causes pyrexia and lethargy accompanied by pain in the thoracic and pelvic limbs of rapidly growing large-breed dogs. While metaphyseal osteopathy has been descibed in association with slipped capital femoral epiphysis in cats, it has not previously been reported as a cause of limb pain and pyrexia in this species. A 7-month-old British Shorthair cat presented with a 1 month history of pyrexia, lethargy and pain in all limbs. Investigation included radiographs of the limbs and chest, abdominal ultrasound, serum biochemical analysis, haematology, bone biopsy, joint fluid aspiration and cytology. Findings were consistent with a diagnosis of metaphyseal osteopathy. The cat's clinical signs resolved following the administration of prednisolone. Symptoms recurred 1 month after the cessation of prednisolone therapy, but resolved when administration was resumed. © ISFM and AAFP 2014.

Determination of death: Metaphysical and biomedical discourse.

Science.gov (United States)

Jakušovaitė, Irayda; Luneckaitė, Žydrunė; Peičius, Eimantas; Bagdonaitė, Živilė; Riklikienė, Olga; Stankevičius, Edgaras

2016-01-01

The prominence of biomedical criteria relying on brain death reduces the impact of metaphysical, anthropological, psychosocial, cultural, religious, and legal aspects disclosing the real value and essence of human life. The aim of this literature review is to discuss metaphysical and biomedical approaches toward death and their complimentary relationship in the determination of death. A critical appraisal of theoretical and scientific evidence and legal documents supported analytical discourse. In the metaphysical discourse of death, two main questions about what human death is and how to determine the fact of death clearly separate the ontological and epistemological aspects of death. During the 20th century, various understandings of human death distinguished two different approaches toward the human: the human is a subject of activities or a subject of the human being. Extinction of the difference between the entities and the being, emphasized as rational-logical instrumentation, is not sufficient to understand death thoroughly. Biological criteria of death are associated with biological features and irreversible loss of certain cognitive capabilities. Debating on the question "Does a brain death mean death of a human being?" two approaches are considering: the body-centrist and the mind-centrist. By bridging those two alternatives human death appears not only as biomedical, but also as metaphysical phenomenon. It was summarized that a predominance of clinical criteria for determination of death in practice leads to medicalization of death and limits the holistic perspective toward individual's death. Therefore, the balance of metaphysical and biomedical approaches toward death and its determination would decrease the medicalization of the concept of death. Copyright © 2016 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Metaphysical Concept of Secularization versus Islamic Concept of Secularization

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Volkan ERTİT

2017-12-01

Full Text Available In early 21st century, the question “Is Turkey becoming secularized contrary to popular belief?” was one of the discussions occupying Turkish public opinion. These discussions led to the encounter of two different concepts of secularization, “theological (Islamic” and "metaphysical", and to put forward different claims using the same concept. Hence, it became evidentwas understood that a discussion was necessary to understand what secularization is and what it is not before starting any debate on Turkey's secularization. That is because the metaphysical discussion that defines secularization as the decline in the social influence of metaphysical realm (religion, religion-like mechanisms, folk religions, superstitious beliefs, etc. is overshadowed by the Islamic definition describing secularization as "irreligiousness" or "non-Islamism". Therefore, discussingTo understand the social transformation in Turkey, this article attempts to explain that metaphysical rather than theological definition of secularization is necessary for understanding the social implications of the process of modernization.

METAPHYSICAL REVOLUTION OF DESCARTES AND TRANSFORMATION OF THE ANTHROPOLOGICAL PROJECT

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Anatolii M. Malivskyi

2015-05-01

Full Text Available The purpose is to reveal and comprehend forms of influence metaphysical' revolution for a way of interpretation of the anthropological project by Descartes on the basis of investigations of modern dekartes's researchers, that is the recognition of a fundamental role of metaphysics. Methodology. As methodological base modern investigations of dekartes's researchers accenting a fundamental role of metaphysics and expediency of unbiassed judgment of heritage of the great thinker are used. The scientific novelty. The transformation of the anthropological project is outlined as manifestation of metaphysical revolution. It is about a transcendencecy of naive anthropology (as an embodiment of reductive mindset, that is interpretations of human nature as its corporality and transition to metaphysical anthropology which consists in upholding of unconditional priority of human thinking as associated with God. As result of transition concentration of attention on intense human nature, that is at tension between sensuality and intelligence, aspiration to truth and tendency to delusion, between Life and Nothing, etc. Conclusions. The appeal to the incomplete anthropological project of Descartes on the basis of innovative researches allows proving the thesis about influence of metaphysical revolution on a way of its interpretation. The main forms of oriented to science ideals of naive anthropology, trust in evidence of the senses, atheism, interpretation of science as the main form of detection rationality of human nature, which Descartes tends constructively to overcome in the text of "meditation", are highlighted. During creation of metaphysical anthropology the attention of the thinker is drawn by the fact of impossibility of comprehension of human nature by means of natural-science rationality and expediency of the appeal to metaphysics. The subject of attention of the thinker is the tension between sensuality and intelligence, need

Metaphyseal and diaphyseal chondroblastomas

Energy Technology Data Exchange (ETDEWEB)

Maheshwari, Aditya V. [State University of New York Downstate Medical Center, Department of Orthopaedics and Rehabilitation, Brooklyn, NY (United States); Washington Hospital Center, Department of Orthopedic Oncology, Washington, DC (United States); Jelinek, James S.; Song, Albert J. [Washington Hospital Center, Department of Radiology, Washington, DC (United States); Nelson, Kenneth J.; Henshaw, Robert M. [Washington Hospital Center, Department of Orthopedic Oncology, Washington, DC (United States); Murphey, Mark D. [The American Institute for Radiologic Pathology, Silver Spring, MD (United States)

2011-12-15

Epiphyseal/apophyseal locations are important diagnostic radiological features of chondroblastomas (CB). Although the tumor may secondarily involve the metaphysis, reports of primary metaphyseal or diaphyseal CB without any epiphyseal or apophyseal involvement are exceptionally rare and frequently present as a diagnostic dilemma. The purpose of this study was to present seven cases of pure metaphyseal and/or diaphyseal CB along with a review of pertinent literature. A retrospective review of databases at two major referral centers revealed 390 cases of CB between 1960 and 2009. Out of these, seven histologically proven CB cases (1.8%) were found to be radiologically located in metaphysis and/or diaphysis, without involving the epiphysis and/or apophysis, and formed the study cohort. There were four males and three females (age range 2-25 years). Locations included proximal femur (n = 1), distal femur (2), proximal humerus (2), clavicle (1), and proximal radius (1). All lesions showed marginal sclerosis. A periosteal reaction was seen in five cases (71%), cortical expansion in four cases (57%), and chondroid matrix in four cases (57%). A CT (two cases) demonstrated a matrix in both cases. An MR (one case) showed extensive perilesional edema. Bone scan (one case) showed intense uptake. Pure metaphyseal and/or diaphyseal CB are exceedingly rare. A presumptive diagnosis may be considered in the appropriate age group in the presence of chondroid matrix, perilesional edema, periosteal reaction, and marginal sclerosis. Regardless of all the diagnostic possibilities, biopsy may still be required. However, knowledge of this entity will help make the final diagnosis and guide the correct treatment. (orig.)

The percutaneous use of a pointed reduction clamp during intramedullary nailing of distal third tibial shaft fractures.

Science.gov (United States)

Forman, Jordanna M; Urruela, Adriana M; Egol, Kenneth A

2011-12-01

The purpose of this retrospective chart and radiographic review is to describe an effective reduction technique during intramedullary nailing of distal metaphyseal tibia fractures with the use of a pointed percutaneous clamp. Between 2007 and 2010, 100 patients who sustained 102 tibia fractures were definitively treated with an intramedullary nail at one of two medical centers. Diaphyseal fractures and injuries with an associated disruption of the distal tibiofibular joint were excluded from our study. A total of 27 patients with 27 distal metaphyseal tibia fractures (OTA types 42-A, 43-A, and 43-B) were included. All 27 patients underwent IM nailing of their fractures with anatomic reduction achieved using a percutaneously placed pointed reduction clamp prior to insertion of the IM implant. Fracture alignment and angular deformity was assessed using goniometric measurement functions on the PACS system (GE, Waukeshau, WI) obtained from preoperative and postoperative anteroposterior and lateral images for all subjects. Malalignment was defined as more than 5 degrees of angulation in any plane. Fourteen of the fractures were classified as OTA 42-A, 9 were OTA 43-A, and 4 were OTA 43-B. Analysis of post-closed reduction, preoperative anteroposterior radiographs revealed a mean of 7.9 degrees of coronal plane (range: 0.9 degrees-26 degrees) angulation. Post closed reduction preoperative lateral radiographs revealed a mean of 6.8 degrees sagittal plane (range: 0 degrees-24.6 degrees) angulation. Postoperative anteroposterior and lateral radiographs showed the distal segment returned to its anatomical alignment with a mean angulation of 0.5 degrees (range, 0 degrees-3.5 degrees) and 0.7 degrees (range, 0 degrees-4.2 degrees) of varus/ valgus and apex anterior/posterior angulation, respectively. These results showed an acceptable postopertative alignment in all 27 distal third fractures. No intra-operative or postoperative complications were noted in the study group. This

The Functionality of Being in Pantaleon's Operative Metaphysics vis ...

African Journals Online (AJOL)

The area of operative metaphysics speaks of a metaphysical system that does not just exist as an ivory tower apart from people's experience, but one that could be applied to a concrete historical circumstance. This piece studies the concept of being as understood by Pantaleon Iroegbu, as being qua belongingness.

Fixation of tibial plateau fractures with synthetic bone graft versus natural bone graft: a comparison study.

LENUS (Irish Health Repository)

Ong, J C Y

2012-06-01

The goal of this study was to determine differences in fracture stability and functional outcome between synthetic bone graft and natural bone graft with internal fixation of tibia plateau metaphyseal defects.

The Problem of Being in Metaphysics | Kanu | African Research ...

African Journals Online (AJOL)

What is being? This was and still is one of the fundamental questions within the area of metaphysics. The researcher in this piece studies the dynamics of the problem of being in metaphysics. A historical approach is adopted to this study. The researcher goes through the Ancient, Medieval, Modern and Contemporary ...

Fractures in infants and toddlers with rickets

Energy Technology Data Exchange (ETDEWEB)

Chapman, Teresa; Done, Stephen [Seattle Children' s Hospital, Department of Radiology, Seattle, WA (United States); Sugar, Naomi; Feldman, Kenneth [Seattle Children' s Hospital, Children' s Protection Program, Seattle, WA (United States); Marasigan, Joanne; Wambold, Nicolle [University of Washington, College of Arts and Sciences, Seattle, WA (United States)

2010-07-15

Rickets affects young infants and toddlers. However, there is a paucity of literature regarding the types of fractures that occur in rachitic patients. To evaluate the age of patients at which radiographically evident rickets occurs, and to characterize the age incidence and fractures that are observed in infants and toddlers with radiographically evident rickets. A retrospective study of children younger than 24 months was performed. Clinical data and radiographs were reviewed. Radiographs obtained within 1 month of the diagnosis were evaluated for the presence or absence of osteopenia, presence or absence of fraying-cupping, and presence and characterization of fractures. After exclusion criteria were applied, 45 children were included in the study. Children with rickets evident by radiograph were in the age range of 2-24 months. Fractures were present in 17.5% of the study group, exclusively in mobile infants and toddlers. Fracture types included transverse long bone fractures, anterior and anterior-lateral rib fractures, and metaphyseal fractures. All fractures occurred exclusively in patients with severe, overtly evident rickets. Fractures occur in older infants and toddlers with overt rickets and can be seen by radiograph. Fractures do not resemble high-risk non-accidental trauma fractures. (orig.)

Newton's Metaphysics of Space as God's Emanative Effect

Science.gov (United States)

Jacquette, Dale

2014-09-01

In several of his writings, Isaac Newton proposed that physical space is God's "emanative effect" or "sensorium," revealing something interesting about the metaphysics underlying his mathematical physics. Newton's conjectures depart from Plato and Aristotle's metaphysics of space and from classical and Cambridge Neoplatonism. Present-day philosophical concepts of supervenience clarify Newton's ideas about space and offer a portrait of Newton not only as a mathematical physicist but an independent-minded rationalist philosopher.

MR evaluation of 'Metaphyseal' change in Legg-Calve-Perthes disease

Energy Technology Data Exchange (ETDEWEB)

Moon, Haeng Jin; Na, Jae Boem; Shin, Chang Min; You, Jin Jong; Chung, Sung Hoon [Gyeongsang National Univ. College of Medicine, Chinju (Korea, Republic of)

2001-06-01

To determine the metaphyseal changes occurring in Legg-Calve-Perthes(LCP) disease using MRI. Between 1992 to 1999, 80 LCP patients (87 hips) underwent MR imaging and plain radiography. All MR images were reviewed, bone marrow signal intensity, the size and locatiion of the metaphyseal cyst and its epiphyseal necrosis grade determined. Metaphyses were abnormal in 43hips (49%), while bone marrow edema was present in 28 (32%) and a metaphyseal cyst in 30 (34%). Metaphyseal cysts were classified as either 'true' (n=9) or 'false' (n=21) according to the enhancement pattern. The maximum diameters of true and false cysts were 1.1{+-}0.3 cm and 1.1{+-}0.4 cm, respectively. Their most commom location was the anterior column; a true cyst occurred there in 7cases (78%), and false cyst in 16 (76%). Using the Waldenstrom classification, seven of the nine hips wih a true cyst (78%), were found to be at the avascular stage and 15 of the 21 with a false cyst (71%) were at the fragmentation stage. Seven of these nine (78%) and 19 of these 21 (90%) were Catterall grade IV. According to the findings of MR imaging, the metaphyseal changes occurring in LCP disease were bone marrow edema and metaphyseal cyst. This latter was visualized mainly in the anterior column and severely affected hip, and was classified as 'true' or 'false'.

Interzones of Law and Metaphysics

DEFF Research Database (Denmark)

Mossin, Christiane

and sources of authority. On the basis of a historical-conceptual understanding of law according to which law, social structure and metaphysical presumptions are inescapably intertwined, the dissertation derives from the binding provisions of law certain essential features of social order. More precisely...

A critical introduction to the metaphysics of time

CERN Document Server

Curtis, Benjamin

2016-01-01

What is the nature of time? Does it flow? Do the past and future exist? Drawing connections between historical and present-day questions, A Critical Introduction to the Metaphysics of Time provides an up-to-date guide to one of the most central and debated topics in contemporary metaphysics. Introducing the views and arguments of Parmenides, Plato, Aristotle, Descartes, Newton and Leibniz, this accessible introduction covers the history of the philosophy of time from the Pre-Socratics to the beginning of the 20th Century. The historical survey presents the necessary background to understanding more recent developments, including McTaggart's 1908 argument for the unreality of time, the open future, the perdurance/endurance debate, the possibility of time travel, and the relevance of current physics to the philosophy of time. Informed by cutting-edge philosophical research, A Critical Introduction to the Metaphysics of Time evaluates influential historical arguments in the context of contemporary developments. ...

The Metaphysical Instincts & Spiritual Bypassing in Integral Psychology

Directory of Open Access Journals (Sweden)

Bahman A.K. Shirazi

2013-09-01

Full Text Available Instincts are innate, unconscious means by which Nature operates in all forms of life including animals and human beings. In humans however, with progressive evolution of consciousness, instincts become increasingly conscious and regulated by egoic functions. Biological instincts associated with the lower-unconscious such as survival, aggressive, and reproductive instincts are well known in general psychology. The higher-unconscious, which is unique to human beings, may be said to have its own instinctual processes referred to here as the ‘metaphysical instincts’. In traditional spiritual practices awakening the metaphysical instincts has often been done at the expense of suppressing the biological instincts—a process referred to as spiritual bypassing. This essay discusses how the metaphysical instincts initially expressed as the religious impulse with associated beliefs and behaviors may be transformed and made fully conscious, and integrated with the biological instincts in integral yoga and psychology in order to achieve wholeness of personality.

Metaphysics and medical education: taking holism seriously.

Science.gov (United States)

Wilson, Bruce

2013-06-01

Medical education is now suffused with concepts that have their source outside the traditional scientific and medical disciplines: concepts such as holism, connectedness and reflective practice. Teaching of these, and other problematic concepts such as medical uncertainty and error, has been defined more by the challenge they pose to the standard model rather than being informed by a strong positive understanding. This challenge typically involves a critical engagement with the idea of objectivity, which is rarely acknowledged as an inherently metaphysical critique. Consequently, these ideas prove to be difficult to teach well. I suggest that the lack of an integrating, positive narrative is the reason for teaching difficulty, and propose that what is needed is an explicit commitment to teach the metaphysics of medicine, with the concept of holism being the fulcrum on which the remaining concepts turn. An acknowledged metaphysical narrative will encompass the scientific realism that medical students typically bring to their tertiary education, and at the same time enable a bigger picture to be drawn that puts the newer and more problematic concepts into context. © 2013 John Wiley & Sons Ltd.

Plate Fixation With Autogenous Calcaneal Dowel Grafting Proximal Fourth and Fifth Metatarsal Fractures: Technique and Case Series.

Science.gov (United States)

Seidenstricker, Chad L; Blahous, Edward G; Bouché, Richard T; Saxena, Amol

Metaphyseal and proximal diaphyseal fractures of the lateral column metatarsals can have problems with healing. In particular, those involving the fifth metatarsal have been associated with a high nonunion rate with nonoperative treatment. Although intramedullary screw fixation results in a high union rate, delayed healing and complications can occur. We describe an innovative technique to treat both acute and chronic injuries involving the metatarsal base from the metaphysis to the proximal diaphyseal bone of the fourth and fifth metatarsals. The surgical technique involves evacuation of sclerotic bone at the fracture site, packing the fracture site with compact cancellous bone, and plate fixation. In our preliminary results, 4 patients displayed 100% radiographic union at a mean of 4.75 (range 4 to 6) weeks with no incidence of refracture, at a mean follow-up point of 3.5 (range 1 to 5) years. The early results with our small series suggest that this technique is a useful treatment choice for metaphyseal and proximal diaphyseal fractures of the fourth and fifth metatarsals. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Developmental coxa vara associated with spondylometaphyseal dysplasia (DCV/SMD): ''SMD-Corner Fracture Type'' (DCV/SMD-CF) demonstrated in most reported cases

International Nuclear Information System (INIS)

Currarino, G.; Birch, J.G.; Herring, J.A.

2000-01-01

Background. This paper reports three children with short stature: developmental coxa vara unilateral in the first case and bilateral in the other two; somewhat squared and ''ovoid'' vertebral bodies in the first patient, and normal to slightly tall vertebral bodies in the third; metaphyseal changes in some long tubular bones including bone fragments similar to the corner fractures seen in child abuse in all three patients. Materials and methods. The first and second patients were sisters; their mother, also quite short, had surgical procedures in early life for bilateral ''coxa vara''; their brother, also of short stature, had bilateral coxa valga with otherwise normal femoral heads and necks, and mild metaphyseal changes associated with two minute ''corner fractures'' in the proximal metaphysis of the left tibia. Results. A review of reported cases of developmental coxa vara associated with spondylometaphyseal dysplasia revealed that simulated corner fractures were present in most instances. (orig.)

Murk Jansen's metaphyseal chondrodysplasia with long-term follow-up

International Nuclear Information System (INIS)

Silverthorn, K.G.; Houston, C.S.; Duncan, B.P.

1987-01-01

The fourteenth reported patient with Murk Jansen's metaphyseal chondrodysplasia is presented, with a remarkable followup from birth to the age of 15 years. Numerous invasive procedures were performed in pursuit of erroneous provisional diagnoses. Five of these patients presented in infancy with radiographic metaphyseal changes similar to rickets, but with preservation of the provisional zone of calcification. Following infancy, these patients reveal the more typical short-limbed dwarfism, with fusiform joints and bowed extremities. (orig.)

Critics to Metaphysics by Modern Philosophers: A Discourse on Human Beings in Reality

Directory of Open Access Journals (Sweden)

Frederikus Fios

2016-01-01

Full Text Available We have entered the 21st century that is popularly known as the era of the development of modern science and technology. Philosophy provides naming for contemporary era as postmodern era. But do we suddenly come to this day and age? No! Because humans are homo viator, persona that does pilgrimage in history, space and time. Philosophy has expanded periodically in the long course of history. Since the days of classical antiquity, philosophy comes with a patterned metaphysical paradigm. This paradigm survives very long in the stage history of philosophy as maintained by many philosophers who hold fast to the philosophical-epistemic claim that philosophy should be (das sollen metaphysical. Classical Greek philosopher, Aristotle was a philosopher who claims metaphysics as the initial philosophy. Then, Immanuel Kant, Hegel, Heidegger, Marx even Habermas offer appropriate shades of metaphysical philosophy versus spirit of the age. Modern philosophers offer a new paradigm in the way of doing philosophy. The new spirit of modern philosophers declared as if giving criticism on traditional western metaphysics (since Aristotle that are considered irrelevant. This paper intends to show the argument between traditional metaphysical and modern philosophers who criticize metaphysics. The author will make a philosophical synthesis to obtain enlightenment to the position of human beings in the space of time. Using the method of Hegelian dialectic (thesis-antiteses-synthesis, this topic will be developed and assessed in accordance with the interests of this paper. 

"Bewitching" or confusing methaphysics? The demarcation between science and metaphysics according to Karl Popper

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M. Elaine Botha

1986-03-01

Full Text Available The problems of both classical and modern theory of knowledge, according to Popper, reside in the problem of demarcation: a problem closely re­ lated to the problem of induction. The paper argues the view that Popper's view of metaphysics is ambiguous, requiring another criterion to distinguish between "good " and "bad " metaphysics. The sources of the problem are pinpointed, and Popper's distinction between three types of theory outlined. The article then explores the distinction between types of theories and the issues of falsification, testability and refutation, before going on to a consideration of the relationship between science and metaphysics, and w eighing up the issue of good ancid metaphysics. From this emerges clearly that the second "criterionot demarcation" is needed to make precisely this distinction; also in view of Popper's u n ­ clear, even ambiguous, view of metaphysics.

Gould on species, metaphysics and macroevolution: A critical appraisal.

Science.gov (United States)

Boucher, Sandy C

2017-04-01

Stephen Jay Gould's views on the ontology of species were an important plank of his revisionist program in evolutionary theory. In this paper I cast a critical eye over those views. I focus on three central aspects of Gould's views on species: the relation between the Darwinian and the metaphysical notions of individuality, the relation between the ontology of species and macroevolution, and the issue of contextualism and conventionalism about the metaphysics of species. Copyright © 2017 Elsevier Ltd. All rights reserved.

Metaphysical Communication of I. Kant’s Theory of Experience: M. Heidegger

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Edvardas Rimkus

2015-07-01

Full Text Available The article examines the reception of Kantian conception of experience in Martin Heidegger’s book Kant and the Problem of Metaphysics. The context of Immanuel Kant’s theory of experience forms the basis for collation of Kant’s and Heidegger’s philosophies. Epistemological and metaphysical components of Kantian conception of experience are extracted. Two main Kant’s theoretical distinctions are discussed: the difference between the sensual matter of experience and conceptual form of experience; and the difference between the thing-in-itself and appearance. The research is focused on Kantian understanding of experience or empirical cognition, which is a process of synthesis of sensuous data and concepts. Collation of Kant’s and Heidegger’s philosophies and evaluation of Heidegger’s interpretational position appeals to theoretical contexts of metaphysical nominalism and metaphysical realism. The basic conclusion states that Heidegger’s interpretation of Kant’s theory of experience is transfused by the premises of Heidegger’s fundamental Dasein ontology. These premises determine significant transformations of Kant’s philosophy and the omission of some aspects of Kant’s theory of experience.

The metaphysical basis of a liberal organ procurement policy.

Science.gov (United States)

Hershenov, David B; Delaney, James J

2010-08-01

There remains a need to properly analyze the metaphysical assumptions underlying two organ procurement policies: presumed consent and organ sales. Our contention is that if one correctly understands the metaphysics of both the human body and material property, then it will turn out that while organ sales are illiberal, presumed consent is not. What we mean by illiberal includes violating rights of bodily integrity, property, or autonomy, as well as arguing for or against a policy in a manner that runs afoul of Rawlsian public reason.

Incorporating Scale-Dependent Fracture Stiffness for Improved Reservoir Performance Prediction

Science.gov (United States)

Crawford, B. R.; Tsenn, M. C.; Homburg, J. M.; Stehle, R. C.; Freysteinson, J. A.; Reese, W. C.

2017-12-01

We present a novel technique for predicting dynamic fracture network response to production-driven changes in effective stress, with the potential for optimizing depletion planning and improving recovery prediction in stress-sensitive naturally fractured reservoirs. A key component of the method involves laboratory geomechanics testing of single fractures in order to develop a unique scaling relationship between fracture normal stiffness and initial mechanical aperture. Details of the workflow are as follows: tensile, opening mode fractures are created in a variety of low matrix permeability rocks with initial, unstressed apertures in the micrometer to millimeter range, as determined from image analyses of X-ray CT scans; subsequent hydrostatic compression of these fractured samples with synchronous radial strain and flow measurement indicates that both mechanical and hydraulic aperture reduction varies linearly with the natural logarithm of effective normal stress; these stress-sensitive single-fracture laboratory observations are then upscaled to networks with fracture populations displaying frequency-length and length-aperture scaling laws commonly exhibited by natural fracture arrays; functional relationships between reservoir pressure reduction and fracture network porosity, compressibility and directional permeabilities as generated by such discrete fracture network modeling are then exported to the reservoir simulator for improved naturally fractured reservoir performance prediction.

DECONSTRUCTION OF THE METAPHYSICS OF PRESENCE IN PHENOMENOLOGY AND STRUCTURALISM

Directory of Open Access Journals (Sweden)

A. A. Polivoda

2017-06-01

Full Text Available Purpose of the work is a description of critical position of J. Derrida on metaphysics of presence in phenomenological and structuralist discourses. As a philosophical strategy, deconstruction tries to destroy a violent hierarchy of terms, in which one term dominates the other according to its ontological or rational sense. Methodology of research is based on J. Derrida’s strategy of deconstruction, which tries to undermine the basic principles of knowledge and Western philosophy existence, for example, the opposition between nature and culture. In terms of J. Derrida, to deconstruct Western philosophy means to explore the tensions and contradictions in text, which should clarify false reliability of accepted hierarchies. The originality of the work lies in the identification of metaphysic of presence problem in structuralist and phenomenological discourses through the deconstruction project. Deconstruction should show instability of logocentrism, which focuses on repression of writing in terms of thought, truth, reason or logic. Conclusions: J. Derrida’s deconstruction appeared as an attempt to overthrow metaphysics and get focused on the concept of writing, which scope is limited by discourse. Deconstruction of metaphysics of presence is a continuous request of legitimacy of the existing logocentrism, and search of its weaknesses, aporias and contradictions, which make impossible the tradition, centered around mind.

Czy sądy metafizyczne mówią coś o świecie? Wittgensteinowskie źródła deflacjonizmu metafizycznego i jego modele [Do metaphysical judgments say something about the world or not? Wittgensteinian roots of deflationary metaphysics and its models

Directory of Open Access Journals (Sweden)

Sebastian Kolodziejczyk

2014-09-01

Full Text Available Many of contemporary philosophers argue against metaphysics putting forward a thesis that metaphysical claims are deflationary. This way of thinking seems to be not only persuasive but above all it rightly expresses a main difficulty of metaphysical inquires. In this paper I am trying to shed a little light on the problem of deflation of metaphysical judgments. In the first section I refer to some Wittgenstein's ideas from Tractatus logico-philosophicus and I focus on the phenomenon of manifestation as a possible source of deflation of metaphysics. The second section is devoted to the Wittgenstein's concepts of language games on the one hand and rules on the other; both of them are a key to understanding of the deepest dimensions of deflationary metaphysics. The third section is an elaboration of three models of deflation of metaphysical expressions: 1. deflation in regard to the informative status of metaphysical judgments; 2. deflation in regard to the metasemantic properties of judgments about the world, and 3. deflation in regard to the semantic ground of ontological judgments. The fourth and last part of the paper is an exposition of two crucial problems which metaphysics has to face with. I call the first of them 'a problem with conceptualization of the metaphysical experience', whereas the second one is labeled 'a problem with semantic inclusion of metaphysical expressions into judgments about facts'.

String theory : physics or metaphysics?

CERN Document Server

Veneziano, Gabriele

2010-01-01

I will give arguments for why the enormous progress made during the last century on understanding elementary particles and their fundamental interactions suggests strings as the truly elementary constituents of Nature. I will then address the issue of whether the string paradigm can in principle be falsified or whether it should be considered as mere metaphysics.

Towards a Metaphysics of Complexity

Science.gov (United States)

Robinson, Keith

2005-01-01

In this paper, I combine aspects of process philosophy and elements from philosophies of difference in order to give some indication of how we might begin to construct a metaphysics of contemporary science. I will focus on the work of Whitehead and Deleuze as representatives of each respective tradition and try to show how their work can be…

Classic metaphyseal lesion following external cephalic version and cesarean section

Energy Technology Data Exchange (ETDEWEB)

Lysack, John T.; Soboleski, Don [Department of Diagnostic Radiology, Queen' s University, Kingston General Hospital, 76 Stuart Street, K7L 2V7, Kingston, Ont. (Canada)

2003-06-01

We report a case of an otherwise healthy neonate diagnosed at birth with a classic metaphyseal lesion of the proximal tibia following external cephalic version for frank breech presentation and a subsequent urgent cesarean section. Although the classic metaphyseal lesion is considered highly specific for infant abuse, this case demonstrates the importance of obtaining a history of obstetric trauma for neonates presenting to the imaging department for suspected non-accidental injury. (orig.)

Classic metaphyseal lesion following external cephalic version and cesarean section

International Nuclear Information System (INIS)

Lysack, John T.; Soboleski, Don

2003-01-01

We report a case of an otherwise healthy neonate diagnosed at birth with a classic metaphyseal lesion of the proximal tibia following external cephalic version for frank breech presentation and a subsequent urgent cesarean section. Although the classic metaphyseal lesion is considered highly specific for infant abuse, this case demonstrates the importance of obtaining a history of obstetric trauma for neonates presenting to the imaging department for suspected non-accidental injury. (orig.)

Parfit's and Scanlon's Non-Metaphysical Moral Realism as Alethic Pluralism

OpenAIRE

Veluwenkamp, Herman

2017-01-01

Thomas Scanlon and Derek Parfit have recently defended a meta-ethical view that is supposed to satisfy our realistic intuitions about morality, without the metaphysical implications that many find hard to accept in other realist views. Both philosophers argue that truths in the normative domain do not have ontological implications, while truths in the scientific domain presuppose a metaphysical reality. What distinguishes Scanlon and Parfit’s approach from other realistic meta-ethical theorie...

A new type of spondylo-metaphyseal dysplasia - Algerian type

International Nuclear Information System (INIS)

Kozlowski, K.; Bacha, L.; Massen, R.; Ayati, M.; Sator, S.; Brahimi, L.

1988-01-01

A new, dominantly inherited, severe form of spondylometaphyseal dysplasia in five members of an Algerian family is reported. Another child, not investigated, was also probably affected. The disease is characterised by a unique clinical and radiological set of features: dwarfism, genu valgum deformity, progressive kypho-scoliosis, wrist deformity, myopia and severe metaphyseal dysplasia, with moderate spinal changes and minimal changes in the hands and feet. In view of the geographical localisation of the disorder and the anatomical distribution we propose the name Algerian type of spondylo-metaphyseal dysplasia. (orig.)

Unusual metaphyseal disturbance in two kittens

International Nuclear Information System (INIS)

Gunn-Moore, D.A.; Hagard, G.; Turner, C.; Duncan, A.W.; Barr, F.J.

1996-01-01

This report describes the presenting features, radiographic changes, biochemical alterations and clinical progress of two kittens, from separate litters, which were found to have a growth plate disturbance initially diagnosed and treated as vitamin D3-dependent rickets, but subsequently suspected to be a metaphyseal chondrodysplasia

Stylistics and the Metaphysics of Poetry

Science.gov (United States)

Anderson, Neil

2007-01-01

In order to better understand the worth of aesthetic experience in encountering poetry, fresh perspectives are helpful. This paper introduces the reader to modern stylistics: that is linguistic examinations of "the speaker's meaning" in literature and notes such "scientific" approaches to poetry do find common metaphysical ground with leading…

The Metaphysics of Chinese Information Philosophy

DEFF Research Database (Denmark)

Liqian, Zhou; Brier, Søren

2015-01-01

Compared with other transdisciplinary frames of information Wu Kun’s philosophy of information differs in its metaphysical framework in that it has a background in a conception of Dialectics of Nature coming from the old Stalin textbook system but also a part of the renewal of thinking in China...

Natural kinds in evolution and systematics: metaphysical and epistemological considerations.

Science.gov (United States)

Brigandt, Ingo

2009-06-01

Despite the traditional focus on metaphysical issues in discussions of natural kinds in biology, epistemological considerations are at least as important. By revisiting the debate as to whether taxa are kinds or individuals, I argue that both accounts are metaphysically compatible, but that one or the other approach can be pragmatically preferable depending on the epistemic context. Recent objections against construing species as homeostatic property cluster kinds are also addressed. The second part of the paper broadens the perspective by considering homologues as another example of natural kinds, comparing them with analogues as functionally defined kinds. Given that there are various types of natural kinds, I discuss the different theoretical purposes served by diverse kind concepts, suggesting that there is no clear-cut distinction between natural kinds and other kinds, such as functional kinds. Rather than attempting to offer a unique metaphysical account of 'natural' kind, a more fruitful approach consists in the epistemological study of how different natural kind concepts are employed in scientific reasoning.

Improving consent in patients undergoing surgery for fractured neck of femur.

Science.gov (United States)

Thiruchandran, Gajendiran; McKean, Andrew R; Rudran, Branavan; Imam, Mohamed A; Yeong, Keefai; Hassan, Abdel

2018-05-02

Background Neck of femur fractures and their subsequent operative fixation are associated with high rates of perioperative morbidity and mortality. Consenting in this setting is suboptimal with the Montgomery court ruling changing the perspective of consent. This quality improvement project assessed the adequacy of consenting against British Orthopaedic Association-endorsed guidance and implemented a series of changes to improve the documentation of risks associated with surgery for fractured neck of femur. Methods Seventy consecutive patients who underwent any operative fixation of a neck of femur fracture were included over a 6-month period at a single centre. Patients unable to consent or without electronic notes were excluded. Consent forms were analysed and the documented potential risks or complications associated with surgery were compared to British Orthopaedic Association-endorsed guidance. A series of changes (using the plan, do study, act (PDSA) approach) was implemented to improve the adequacy of consent. Results Documentation of four out of 12 potential risks or complications was recorded in <50% of cases for patients with intracapsular fractures (n=35), and documentation of seven out of 12 potential risks or complications was recorded in <50% of cases for patients with extracapsular fractures (n=35). Re-audit following raising awareness and attaching consent guidance showed 100% documentation of potential risks or complications in patients with intracapsular and extracapsular fractures (n=70). A neck of femur fracture-specific consent form has been implemented which will hopefully lead to sustained improvement. Conclusions Consenting patients with fractured neck of femur for surgery in the authors' unit was suboptimal when compared to British Orthopaedic Association-endorsed consent guidance. This project has shown that ensuring such guidance is readily available has improved the adequacy of consent. The authors hope that introduction of a neck of

Developmental coxa vara associated with spondylometaphyseal dysplasia (DCV/SMD): ''SMD-Corner Fracture Type'' (DCV/SMD-CF) demonstrated in most reported cases

Energy Technology Data Exchange (ETDEWEB)

Currarino, G. [Texas Univ., Dallas, TX (United States). Dept. of Radiology; Department of Radiology, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219 (United States); Birch, J.G.; Herring, J.A. [Department of Orthopedic Surgery, Texas Scottish Rite Hospital for Children, Dallas, TX (United States)

2000-01-01

Background. This paper reports three children with short stature: developmental coxa vara unilateral in the first case and bilateral in the other two; somewhat squared and ''ovoid'' vertebral bodies in the first patient, and normal to slightly tall vertebral bodies in the third; metaphyseal changes in some long tubular bones including bone fragments similar to the corner fractures seen in child abuse in all three patients. Materials and methods. The first and second patients were sisters; their mother, also quite short, had surgical procedures in early life for bilateral ''coxa vara''; their brother, also of short stature, had bilateral coxa valga with otherwise normal femoral heads and necks, and mild metaphyseal changes associated with two minute ''corner fractures'' in the proximal metaphysis of the left tibia. Results. A review of reported cases of developmental coxa vara associated with spondylometaphyseal dysplasia revealed that simulated corner fractures were present in most instances. (orig.)

Comminuted distal femur closed fractures: a new application of the Ilizarov concept of compression-distraction.

Science.gov (United States)

El-Tantawy, Ahmad; Atef, Ashraf

2015-04-01

The treatment of intra-articular distal femur fractures with severe metaphyseal comminution is challenging. It is important to choose a technique that provides secure fixation, minimum tissue handling, and early ambulation. The aim of this work was to evaluate the outcomes of application of Ilizarov concept as an early definitive treatment of comminuted distal femur closed fractures. A total of 17 male patients (mean age 28.53±6.33 years) presented with comminuted distal femur fractures (with 10 type C2 and 7 type C3-2 fractures according to AO/ASIF system) were included in this prospective study. Initial fixation of the articular fragments was done by inter-fragmentary screws, percutaneously through a limited open approach, and stabilization was completed by Ilizarov fixator. The procedure included acute shortening, through the comminution, followed by gradual re-distraction to compensate the created shortening. Radiological and functional results were assessed according to ASAMI evaluation system. The mean amount of intra-operative shortening was 3.68±0.53 cm. The mean external fixation index was 37.24±2.53 days/cm. The mean follow-up period was 18.18±1.91 months. All fractures united primarily in an average 137.65±4.12 days, with no evident angular deformity or limb-length discrepancy. None of the cases required a second major procedure or bone graft. The functional results were excellent in three cases, good in 12, and fair in two patients. The Ilizarov concept of acute compression-distraction is a valuable alternative for the treatment of distal femur fractures with severe metaphyseal comminution.

The Discovery of the Existence of the Absolute in Existential Metaphysics

Directory of Open Access Journals (Sweden)

Andrzej Maryniarczyk

2016-12-01

Full Text Available The article shows the way in which the discovery of the existence of the Absolute is made in existential metaphysics. This existential metaphysics provides us with knowledge about reality. It shows the content of the experience of being, the content given to us in the transcendentals. It also unveils the foundation of the rational order, which is given to us in the discovery of the first principles of the existence of being and of cognition. Metaphysics provides us also with knowledge concerning the structure of being. It shows us being as composite and plural; being which is “insufficient” in its structure and calls for an explanation. That being—that is problematized in existence, given to us in experience, and incompletely intelligible in itself—lifts us toward its ultimate “complement” and understanding, to the Absolute.

Mind, medicine, and metaphysics: reflections on the reclamation of the human spirit.

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Penn, Michael L; Wilson, Lindsay

2003-01-01

Following the publication of such works as Auguste Comte's Cour de Philosophie Positive (1830-1842), in which he argued the inherent immaturity of metaphysical discourse, metaphysics, for Western intellectuals--and especially for Western intellectuals committed to science--has largely been abandoned. In recent years, however, we have seen renewed interest in metaphysics among some researchers and clinicians, due, in part, to increasing attempts to integrate diverse fields of study into some unified and coherent understanding of human life. For many psychologists and psychiatrists, this renewed interest is accompanied by an implicit, and sometimes explicit, re-embrace of the notion of the "human spirit." In this paper we explore some of the processes animating this movement and some of the clinical implications that flow from it.

Of poetics and possibility: Richard Kearney’s post-metaphysical God

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Yolande Steenkamp

2017-11-01

Full Text Available This article provides an overview of Richard Kearney’s attempt at re-imagining God post-metaphysically. In the context of a continental dialogue on the topic, Kearney has responded to onto-theology with a hermeneutic and phenomenologically informed attempt to rethink God post-metaphysically. This eschatological understanding of God is expounded in the article and is placed in relation to Kearney’s more recent concept of Anatheism. The article closes with a few remarks on what may be gained by Kearney’s work, as well as outlining a few critical questions.

Murk Jansen's metaphyseal chondrodysplasia with long-term follow-up

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Silverthorn, K.G.; Houston, C.S.; Duncan, B.P.

1987-02-01

The fourteenth reported patient with Murk Jansen's metaphyseal chondrodysplasia is presented, with a remarkable followup from birth to the age of 15 years. Numerous invasive procedures were performed in pursuit of erroneous provisional diagnoses. Five of these patients presented in infancy with radiographic metaphyseal changes similar to rickets, but with preservation of the provisional zone of calcification. Following infancy, these patients reveal the more typical short-limbed dwarfism, with fusiform joints and bowed extremities.

Metaphysical Underdetermination and Logical Determination: the Case of Quantum Mechanics

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Arenhart, Jonas R. B.

2014-03-01

The `underdetermination of metaphysics by the physics' is the thesis that our best scientific theories do not uniquely determine their ontologies. Non-relativistic quantum mechanics is famously thought to exemplify this kind of underdetermination: it may be seen as compatible with both an ontology of individual objects and with an ontology of non-individual objects. A possible way out of the dilema thus created consists in adopting some version of Ontic Structural Realism (OSR), a view according to which the metaphysically relevant aspect of the theory is its structure, not the nature of the objects dealt with. According to OSR, particular objects may be dispensed with (eliminated or re-conceptualized) in favor of the structure of the theory. In this paper we shall argue that the underdetermination of metaphysics by the physics is a consequence of a too strict naturalism in ontology. As a result, when a mitigated ontological naturalism is taken into account, underdetermination does not appear to have such dark consequences for object-oriented ontologies in quantum mechanics.

Johann Christoph Sturm's universal mathematics and metaphysics (German Title: Universalmathematik und Metaphysik bei Johann Christoph Sturm)

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Leinsle, Ulrich G.

In order to understand Sturm's concept of a universal mathematics as a replacement or complement of metaphysics, one first has to examine the evolution of the idea of a mathesis universalis up to Sturm, and his concept of metaphysics. According to the understanding of those times, natural theology belongs to metaphysics. The last section is concerned with Sturm's statements on the existence of God and his assessments for a physico-theology.

Reception, criticism and appropriation of the metaphysics in Hegel’s Science of Logic

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Danilo Vaz-Curado R. M. Costa

2017-08-01

Full Text Available The present analysis defends the thesis that Hegel elaborates an original transformation of the concept of metaphysics, assuming its presuppositions as they were developed in the philosophic tradition, that metaphysics is a doctrine of the first principles, a theory of Being, a theodicy and even, as for Kant, a theory of knowledge.

Psychotherapy: What's Metaphysical Got to Do With It?

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Sansone, Randy A; Sansone, Lori A

2009-12-01

Clinicians have a number of treatment options for dealing with the emotional ills of patients, including psychoeducation, psychotherapy, and pharmacotherapy. However, after years of experience in the clinical field, we have recognized that these treatment options may not be sufficient to adequately address the problems of some patients. We have found that adding a metaphysical/spiritual component may be helpful, particularly for those patients with histories of childhood trauma. In this edition of The Interface, we discuss four metaphysical techniques for facilitating patient healing-1) refocusing on the present, 2) reframing adversity, 3) practicing surrender, and 4) meditation. These approaches can be mutually integrated and compliment a psychological treatment in either the psychiatric or primary care setting, regardless of whether or not the patient has formal religious beliefs.

The metaphysical lessons of synthetic biology and neuroscience.

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Baertschi, Bernard

2015-01-01

In this paper, I examine some important metaphysical lessons that are often presented as derived from two new scientific disciplines: synthetic biology and neuroscience. I analyse four of them: the nature of life, the existence of a soul (the mind-body problem), personhood, and free will. Many caveats are in order, and each 'advance' or each case should be assessed for itself. I conclude that a main lesson can nevertheless be learned: in conjunction with modern science, neuroscience and synthetic biology allow us to enrich old metaphysical debates, to deepen and even renew them. In particular, it becomes less and less plausible to consider life, mind, person, and agency as non-natural or non-physical entities. Copyright © 2015 Académie des sciences. Published by Elsevier SAS. All rights reserved.

Quine, Putnam, and the Naturalization of Metaphysics

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Verhaegh, Sander; Baumgartner, S.; Heisenberg, T.; Krebs, S.

2014-01-01

Naturalists argue that metaphysics ought to be in some sense continuous with science. Putnam has claimed that if we push naturalism to its limits, we have to conclude with Quine that reference is indeterminate. Since Putnam believes Quine’s thesis to be extremely counterintuitive, he regards

Metaphysical conspiracism: UFOs as discursive object between popular millennial and conspiracist fields

OpenAIRE

Robertson, David George

2014-01-01

This thesis argues that narratives about Unidentified Flying Objects (UFOs) act as the central point of contact between conspiracist and popular millennial fields. Their confluence has come to form a field here termed ‘metaphysical conspiracism’, combining teleological narratives, the promise of soteriological knowledge and the threat of occluded malevolent agencies. I argue that metaphysical conspiracism offers a unique perspective on the interplay of knowledge, power and the ...

Metaphyseal osteopathy in three Australian Kelpie siblings.

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Greenwell, C M; Brain, P H; Dunn, A L

2014-04-01

Metaphyseal osteopathy (MO) was diagnosed in three Australian Kelpie puppies that were presented for veterinary assessment of lameness. The three puppies were siblings. Each was from a different litter by the same breeding pair. The puppy in case one was seen by the authors, and the puppies in cases two and three were patients at other veterinary hospitals. However, the medical records and radiographs were examined and reviewed for this report. Radiographic investigation of the lameness revealed pathognomonic appearance of MO affecting the metaphyseal region of the long bones in all three puppies. The diagnosis was confirmed on histopathology in one patient. MO is considered a disease of large and giant-breed dogs, being rarely reported in non-large-breed dogs, and has not been reported in the Australian Kelpie, which is considered a medium-breed dog. This case series suggests a previously unreported breed predisposition to MO in the Australian Kelpie. © 2014 Australian Veterinary Association.

Foucauldian diagnostics: space, time, and the metaphysics of medicine.

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Bishop, Jeffrey P

2009-08-01

This essay places Foucault's work into a philosophical context, recognizing that Foucault is difficult to place and demonstrates that Foucault remains in the Kantian tradition of philosophy, even if he sits at the margins of that tradition. For Kant, the forms of intuition-space and time-are the a priori conditions of the possibility of human experience and knowledge. For Foucault, the a priori conditions are political space and historical time. Foucault sees political space as central to understanding both the subject and objects of medicine, psychiatry, and the social sciences. Through this analysis one can see that medicine's metaphysics is a metaphysics of efficient causation, where medicine's objects are subjected to mechanisms of efficient control.

Fibrous metaphyseal defects

International Nuclear Information System (INIS)

Hajek, P.C.; Ritschi, P.; Kramer, J.; Imhof, H.; Karnel, F.

1988-01-01

Eighty-two patients (107 fibrous metaphyseal defects [FMDs]) were investigated with standard radiography and MR imaging (N = 15). Twenty-two of these were followed up sequentially up to 10 years (mean, 7.3 years). Histologic studies proved that FMDs originate at the site of insertion of a tendon in the perichondrium of the epiphyseal cartilage. After normal bone growth is regained, all FMDs were found to move diaphysically, following a straight line parallel to the long axis of the FMDs. This line pointed to the insertion of the tendon originally involved, a fact that was proved with MR imaging. Four characteristic stages were found to define a typical radiomorphologic course of an FMD

[The mark of envy: metaphysics and embryology according to Descartes].

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Gaudemard, Lynda

2012-01-01

This paper explores the interaction between medicine and metaphysics in modern natural philosophy and especially in Descartes' philosophy. I argue that Descartes hypothetical account of birthmarks in connection with his embryology provides an argumentative proof of the metaphysical necessity of a substantial union between mind and body, which however does not threaten his doctrine of the real distinction between these two substances. It would appear that his argument relies on a temporal conception of alethic modalities and provides a new answer to Henricus Regius who in 1641 claimed that, for Descartes, the human being is an ensper accidens.

Defining human death: an intersection of bioethics and metaphysics.

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Manninen, Bertha Alvarez

2009-01-01

For many years now, bioethicists, physicians, and others in the medical field have disagreed concerning how to best define human death. Different theories range from the Harvard Criteria of Brain Death, which defines death as the cessation of all brain activity, to the Cognitive Criteria, which is based on the loss of almost all core mental properties, e.g., memory, self-consciousness, moral agency, and the capacity for reason. A middle ground is the Irreversibility Standard, which defines death as occurring when the capacity for consciousness is forever lost. Given all these different theories, how can we begin to approach solving the issue of how to define death? I propose that a necessary starting point is discussing an even more fundamental question that properly belongs in the philosophical field of metaphysics: we must first address the issue of diachronic identity over time, and the persistence conditions of personal identity. In this paper, I illustrate the interdependent relationship between this metaphysical question and questions concerning the definition of death. I also illustrate how it is necessary to antecedently attend to the metaphysical issue of defining death before addressing certain issues in medical ethics, e.g., whether it is morally permissible to euthanize patients in persistent vegetative states or procure organs from anencephalic infants.

The Role of Metaphysical Naturalism in Science

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Mahner, Martin

2012-01-01

This paper defends the view that metaphysical naturalism is a constitutive ontological principle of science in that the general empirical methods of science, such as observation, measurement and experiment, and thus the very production of empirical evidence, presuppose a no-supernature principle. It examines the consequences of metaphysical…

Feasibility of a reduction protocol in the emergency department for diaphyseal forearm fractures in children.

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Pesenti, S; Litzelmann, E; Kahil, M; Mallet, C; Jehanno, P; Mercier, J-C; Ilharreborde, B; Mazda, K

2015-09-01

Diaphyseal forearm fractures are very common pediatric traumas. At present, distal radius metaphyseal fractures are often successfully treated with closed reduction by emergency physicians. However, the management of diaphyseal fractures remains controversial. The purpose of this study was to analyze the results of diaphyseal forearm fractures in the emergency department (ED) in children. In a prospective 2-year-study, all closed diaphyseal forearm fractures in patients under 15, with an angle of >15° and treated by closed reduction in the ED were included. Fractures with overlapping fragments were excluded. Reduction was performed by an emergency physician, with a standardized analgesic protocol (painkillers and nitrous oxide). Clinical tolerance was checked within the first 24hours, and the radiographic stability of reduction was assessed at days 8 and 15. Initial and final follow-up radiographs were analyzed. Elbow and wrist range of motion was assessed at the final follow-up. Sixty patients (41 boys and 19 girls) were included. Mean age was 5.2 years old (±3). At initial evaluation, the maximum angle was 30° (±11.3). After reduction, the maximum angle was significantly reduced (30° vs. 5°, P<0.001). Mean immobilization in a cast was 11.7 weeks (±2). There were no cast related complications in any of these children. There was no surgery for secondary displacement. Full range of motion was obtained in all patients at the final follow-up. The outcome of conservative treatment of closed diaphyseal forearm fractures, without overlapping fragments was excellent. However, reduction is usually performed in the operating room by orthopedic surgeons under general anesthesia and requires hospitalization, which is very expensive. The results of this study show that high quality care may be obtained in the ED by a trained and experienced team. These results are similar to those for distal metaphyseal fractures, which could extend the indications for reduction in the

Conscience claims, metaphysics, and avoiding an LGBT eugenic.

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Brummett, Abram

2018-06-01

Novel assisted reproductive technologies (ART) are poised to present our society with strange new ethical questions, such as whether lesbian, gay, bisexual, and transgender (LGBT) couples should be allowed to produce children biologically related to both parents, or whether trans-women who want to experience childbirth should be allowed to receive uterine transplants. Clinicians opposed to offering such technologies to LGBT couples on moral grounds are likely to seek legal shelter through the conscience clauses enshrined in U.S. law. This paper begins by briefly discussing some novel ART on the horizon and noting that it is unclear whether current conscience clauses will permit fertility clinics to deny such services to LGBT individuals. A compromise approach to conscience is any view that sees the value of respecting conscience claims within limits. I describe and critique the constraints proposed in the recent work of Wicclair, NeJaime and Siegel as ultimately begging the question. My purpose is to strengthen their arguments by suggesting that in the controversial situations that elicit claims of conscience, bioethicists should engage with the metaphysical claims in play. I argue that conscience claims against LGBT individuals ought to be constrained because the underlying metaphysic-that God has decreed the LGBT lifestyle to be sinful-is highly implausible from the perspective of a naturalized metaphysic, which ought to be the lens through which we evaluate conscience claims. © 2018 John Wiley & Sons Ltd.

Metaphyseal cortical irregularities in children: A new perspective on a multi-focal growth variant

International Nuclear Information System (INIS)

Keats, T.E.; Joyce, J.M.

1984-01-01

The occurrence of metaphyseal cortical irregularities in adolescents in many different bones indicates a commonality of these lesions as a variation of normal growth, rater than a stress or avulsive by-product. The histologically recognized incomplete nature of the metaphysical cortex in children offers an attractive explanation for this phenomenon. (orig.)

Metaphyseal cortical irregularities in children: A new perspective on a multi-focal growth variant

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Keats, T.E.; Joyce, J.M.

1984-07-01

The occurrence of metaphyseal cortical irregularities in adolescents in many different bones indicates a commonality of these lesions as a variation of normal growth, rather than a stress or avulsive by-product. The histologically recognized incomplete nature of the metaphysical cortex in children offers an attractive explanation for this phenomenon.

Characteristics of bone turnover in the long bone metaphysis fractured patients with normal or low Bone Mineral Density (BMD.

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Christoph Wölfl

Full Text Available The incidence of osteoporotic fractures increases as our population ages. Until now, the exact biochemical processes that occur during the healing of metaphyseal fractures remain unclear. Diagnostic instruments that allow a dynamic insight into the fracture healing process are as yet unavailable. In the present matched pair analysis, we study the time course of the osteoanabolic markers bone specific alkaline phosphatase (BAP and transforming growth factor β1 (TGFβ1, as well as the osteocatabolic markers crosslinked C-telopeptide of type-I-collagen (β-CTX and serum band 5 tartrate-resistant acid phosphatase (TRAP5b, during the healing of fractures that have a low level of bone mineral density (BMD compared with fractures that have a normal BMD. Between March 2007 and February 2009, 30 patients aged older than 50 years who suffered a metaphyseal fracture were included in our study. BMDs were verified by dual energy Xray absorptiometry (DXEA scans. The levels of BTMs were examined over an 8-week period. Osteoanabolic BAP levels in those with low levels of BMD were significantly different from the BAP levels in those with normal BMD. BAP levels in the former group increased constantly, whereas the latter group showed an initial strong decrease in BAP followed by slowly rising values. Osteocatabolic β-CTX increased in the bone of the normal BMD group constantly, whereas these levels decreased significantly in the bone of the group with low BMD from the first week. TRAP5b was significantly reduced in the low level BMD group. With this work, we conduct first insights into the molecular biology of the fracture healing process in patients with low levels of BMD that explains the mechanism of its fracture healing. The results may be one reason for the reduced healing qualities in bones with low BMD.

Serial MR findings of metaphyseal cyst in Legg-Calve-Perthes disease: a case report

International Nuclear Information System (INIS)

Shim, Chang Min; Na, Jae Boem; Moon, Haeng Jin

2001-01-01

Metaphyseal cysts are common findings in Lee-Calve-Perthes(LCP) disease, though usually disappear within 6-12 months several studies have described the MR imaging findings of these cysts, though serial MRI findings have not been documented. In this report, therefore, we report the serial MRI results of metaphyseal cyst in LCP patients

Paul Karl Feyerabend: The Projections of Theoretical Proliferation in the Relation Science-Metaphysics

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María Teresa Gargiulo de Vázquez

2015-05-01

Full Text Available The Paul Karl Feyerabend’s doctrine of theoretical proliferation has been interpreted by his experts as an attempt to preserve the ideal of scientific progress. This hermeneutics describes, in part, the intention of our philosopher. However, this reading does not explain the fundamental criticism that theoretical pluralism supposes for Feyerabend. The theoretical proliferation is itself a reductio ad absurdum of the attempts of logical positivism and critical rationalism to define science at the expense of the metaphysical. This article presents the theoretical proliferation as a vindication of the positive role that the metaphysical plays in scientific practice. We expose the Feyerabend’s defense of metaphysics inasmuch as it is constitute the possibility to overcome the conceptual conservatism, to increase empirical content of science and to recover the descriptive value of scientific theories.

Osteosclerotic metaphyseal dysplasia: a skeletal dysplasia that may mimic lead poisoning in a child with hypotonia and seizures

International Nuclear Information System (INIS)

Mennel, Emilie A.; John, Susan D.

2003-01-01

We report the case of a 23-month-old male with hypotonia, developmental delay, and complex seizures. Radiographs revealed profound sclerosis of the metaphyses and epiphyses of the long and short bones in the extremities, with a unique pattern of distribution. Sclerosis also involved the anterior ribs, iliac crests, talus, and calcaneus. The skull and vertebral bodies appeared unaffected. Blood lead levels were normal. We believe that this constellation of clinical and radiographic abnormalities closely resembles osteosclerotic metaphyseal dysplasia (OMD) due to an autosomal recessive defect. Characteristic skeletal findings were instrumental in determining the diagnosis. OMD is a very rare sclerosing bone disorder, first described in 1993. The syndrome is characterized clinically by developmental delay of a progressive nature, hypotonia, elevated alkaline phosphatase, and late-onset spastic paraplegia. We encountered a young child with these neurologic symptoms who displayed sclerotic metaphyseal changes on hand radiographs obtained to determine the bone age. Lead poisoning, a known cause of metaphyseal sclerosis, was initially suspected. Careful analysis of the metaphyseal bone changes helped to distinguish this bone dysplasia from lead poisoning and other causes of metaphyseal sclerosis. (orig.)

The metaphysics of quantum mechanics: Modal interpretations

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Gluck, Stuart Murray

2004-11-01

This dissertation begins with the argument that a preferred way of doing metaphysics is through philosophy of physics. An understanding of quantum physics is vital to answering questions such as: What counts as an individual object in physical ontology? Is the universe fundamentally indeterministic? Are indiscernibles identical? This study explores how the various modal interpretations of quantum mechanics answer these sorts of questions; modal accounts are one of the two classes of interpretations along with so-called collapse accounts. This study suggests a new alternative within the class of modal views that yields a more plausible ontology, one in which the Principle of the Identity of Indisceribles is necessarily true. Next, it shows that modal interpretations can consistently deny that the universe must be fundamentally indeterministic so long as they accept certain other metaphysical commitments: either a perfect initial distribution of states in the universe or some form of primitive dispositional properties. Finally, the study sketches out a future research project for modal interpretations based on developing quantified quantum logic.

Beware of mereologists bearing gifts: prolegomena to a medical metaphysics.

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Khushf, George

2013-10-01

This essay considers implications of formal mereologies and ontologies for medical metaphysics. Edward Fried's extensional mereological account of the human body is taken as representative of a prominent strand in analytic metaphysics that has close affinities with medical positivism. I show why such accounts fail. First, I consider how Fried attempts to make sense of the medical case of Barney Clark, the first recipient of an artificial heart, and show that his analytic metaphysical categories do not have the right kind of fit with the case. A proper medical metaphysic should involve a richer two way dialogue with medicine, and it should not just "apply" formal accounts worked out in other settings. Second, I argue that any effort to account for real wholes with extensional mereological sums requires all sorts of ad hoc, supplementary mechanisms that do the real work, and the full repertoire of these mechanisms involves inconsistencies and semantic shifts. Finally, I consider an alternative strand of work on non-extensional whole/part relations that is closer to medicine and that can deepen reflection on some core problems in bioethics, for example, associated with the determination of death when an organism ceases to function as a whole. In addition to the utility such formal ontologies have for addressing traditional problems such as the determination of death, philosophers of medicine should appreciate the increasingly influential role such formal tools are playing in the development of data system ontologies. Assumptions integral to these ontologies have far reaching implications for the way future research and practice in medicine will be conducted, and much greater critical reflection is needed on the full range of issues associated with the development and use of such medical ontologies.

Fibrous metaphyseal defect (fibrous cortical defect, non-ossifying fibroma)

International Nuclear Information System (INIS)

Freyschmidt, J.; Saure, D.; Dammenhain, S.

1981-01-01

Fibrous cortical defect and nonossifying fibromas can be classified together as fibrous metaphyseal defects (FMD) since they have the same pahtological substrate, with a tendency to the same localisation around the knee, and occuring at the same age. They have a tendency to spontaneous healing, are clinically silent and are usually discovered accidentally during radiological examination. A radiological survey fo 5.674 metaphyseal regions in the upper and lower extremities of 2.065 unselected patients aged one to 20 years revealed an incidence of 1.8%; exlcusive examination of the distal femur showed an incidence of 2.7%. 96% of all lesions were in the lower extremities and only 4% in the upper. The marked discrepancy in the incidence rate between American and German publications is discussed. (orig.) [de

Fracture reduction and primary ankle arthrodesis: a reliable approach for severely comminuted tibial pilon fracture.

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Beaman, Douglas N; Gellman, Richard

2014-12-01

Posttraumatic arthritis and prolonged recovery are typical after a severely comminuted tibial pilon fracture, and ankle arthrodesis is a common salvage procedure. However, few reports discuss the option of immediate arthrodesis, which may be a potentially viable approach to accelerate overall recovery in patients with severe fracture patterns. (1) How long does it take the fracture to heal and the arthrodesis to fuse when primary ankle arthrodesis is a component of initial fracture management? (2) How do these patients fare clinically in terms of modified American Orthopaedic Foot and Ankle Society (AOFAS) scores and activity levels after this treatment? (3) Does primary ankle arthrodesis heal in an acceptable position when anterior ankle arthrodesis plates are used? During a 2-year period, we performed open fracture reduction and internal fixation in 63 patients. Eleven patients (12 ankles) with severely comminuted high-energy tibial pilon fractures were retrospectively reviewed after surgical treatment with primary ankle arthrodesis and fracture reduction. Average patient age was 58 years, and minimum followup was 6 months (average, 14 months; range, 6-22 months). Anatomically designed anterior ankle arthrodesis plates were used in 10 ankles. Ring external fixation was used in nine ankles with concomitant tibia fracture or in instances requiring additional fixation. Clinical evaluation included chart review, interview, the AOFAS ankle-hindfoot score, and radiographic evaluation. All of the ankle arthrodeses healed at an average of 4.4 months (range, 3-5 months). One patient had a nonunion at the metaphyseal fracture, which healed with revision surgery. The average AOFAS ankle-hindfoot score was 83 with 88% having an excellent or good result. Radiographic and clinical analysis confirmed a plantigrade foot without malalignment. No patients required revision surgery for malunion. Primary ankle arthrodesis combined with fracture reduction for the severely comminuted

What is Metaphysical Equivalence? | Miller | Philosophical Papers

African Journals Online (AJOL)

Theories are metaphysically equivalent just if there is no fact of the matter that could render one theory true and the other false. In this paper I argue that if we are judiciously to resolve disputes about whether theories are equivalent or not, we need to develop testable criteria that will give us epistemic access to the obtaining ...

The metaphysical club at the Johns Hopkins University (1879-1885).

Science.gov (United States)

Behrens, Peter J

2005-11-01

Of the earliest American universities, The Johns Hopkins in Baltimore holds a unique position for psychology. At Hopkins, many of America's first psychologists received their graduate training. Of special interest is the Hopkins Metaphysical Club, organized in 1879 by Charles Sanders Peirce. It provided a forum for research and scholarship by faculty and students. Papers related to topics of the "new" psychology began to appear in 1883, about the time G. Stanley Hall was given a 3-year appointment at Hopkins. When Peirce departed Hopkins in 1885, Hall was free to develop psychology in his image and disbanded the club. Nevertheless, the Metaphysical Club played an important role in the emergence of American scientific psychology.

Machine Learning Principles Can Improve Hip Fracture Prediction

DEFF Research Database (Denmark)

Kruse, Christian; Eiken, Pia; Vestergaard, Peter

2017-01-01

Apply machine learning principles to predict hip fractures and estimate predictor importance in Dual-energy X-ray absorptiometry (DXA)-scanned men and women. Dual-energy X-ray absorptiometry data from two Danish regions between 1996 and 2006 were combined with national Danish patient data.......89 [0.82; 0.95], but with poor calibration in higher probabilities. A ten predictor subset (BMD, biochemical cholesterol and liver function tests, penicillin use and osteoarthritis diagnoses) achieved a test AUC of 0.86 [0.78; 0.94] using an “xgbTree” model. Machine learning can improve hip fracture...... prediction beyond logistic regression using ensemble models. Compiling data from international cohorts of longer follow-up and performing similar machine learning procedures has the potential to further improve discrimination and calibration....

Preliminary experience with biodegradable implants for fracture fixation

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Dhillon Mandeep

2008-01-01

Full Text Available Background: Biodegradable implants were designed to overcome the disadvantages of metal-based internal fixation devices. Although they have been in use for four decades internationally, many surgeons in India continue to be skeptical about the mechanical strength of biodegradable implants, hence this study. Materials and Methods: A prospective study was done to assess the feasibility and surgeon confidence level with biodegradable implants over a 12-month period in an Indian hospital. Fifteen fractures (intra-articular, metaphyseal or small bone fractures were fixed with biodegradable implants. The surgeries were randomly scheduled so that different surgeons with different levels of experience could use the implants for fixation. Results: Three fractures (one humeral condyle, two capitulum, were supplemented by additional K-wires fixation. Trans-articular fixator was applied in two distal radius and two pilon fractures where bio-pins alone were used. All fractures united, but in two cases the fracture displaced partially during the healing phase; one fibula due to early walking, and one radius was deemed unstable even after bio-pin and external fixator. Conclusions: Biodegradable -implants are excellent for carefully selected cases of intra-articular fractures and some small bone fractures. However, limitations for use in long bone fractures persist and no great advantage is gained if a "hybrid" composite is employed. The mechanical properties of biopins and screws in isolation are perceived to be inferior to those of conventional metal implants, leading to low confidence levels regarding the stability of reduced fractures; these implants should be used predominantly in fracture patterns in which internal fixation is subjected to minimal stress.

Metaphyseal sclerosis in patients with chronic renal failure

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Young, W.; Sevcik, M.; Tallroth, K. (Michigan Univ., Ann Arbor (USA). Dept. of Radiology)

1991-04-01

We reviewed radiographs of the hand and wrists of 33 patients with immature skeletons and chronic renal disease. Various radiographic manifestations of renal osteodystrophy were seen, including osteopenia in 23 patients (70%), subperiosteal resorption in 20 (61%), distal tuft resorption in 14 (42%), sclerosis of vertebral bodies in 2 (6%), and soft-tissue calcification in 1 (3%). We also noted that 13 patients (39%) exhibited metaphyseal sclerosis adjacent to the growth plates. Five of these 13 showed persistent sclerosis years after the growth plates had fused. None of the patients showed other radiographic changes of rickets, and there was no correlation between the serum calcium, phosphorus, or aluminum levels and the presence of metaphyseal sclerosis. Neiter was there any association with the underlying cause of renal failure, method of treatment, presence of a transplant, or type of dialysis. We view this finding as another manifestation of renal osteodystrophy. The importance of distinguishing it from other sclerotic lesions is discussed. (orig.).

Metaphyseal sclerosis in patients with chronic renal failure

International Nuclear Information System (INIS)

Young, W.; Sevcik, M.; Tallroth, K.

1991-01-01

We reviewed radiographs of the hand and wrists of 33 patients with immature skeletons and chronic renal disease. Various radiographic manifestations of renal osteodystrophy were seen, including osteopenia in 23 patients (70%), subperiosteal resorption in 20 (61%), distal tuft resorption in 14 (42%), sclerosis of vertebral bodies in 2 (6%), and soft-tissue calcification in 1 (3%). We also noted that 13 patients (39%) exhibited metaphyseal sclerosis adjacent to the growth plates. Five of these 13 showed persistent sclerosis years after the growth plates had fused. None of the patients showed other radiographic changes of rickets, and there was no correlation between the serum calcium, phosphorus, or aluminum levels and the presence of metaphyseal sclerosis. Neiter was there any association with the underlying cause of renal failure, method of treatment, presence of a transplant, or type of dialysis. We view this finding as another manifestation of renal osteodystrophy. The importance of distinguishing it from other sclerotic lesions is discussed. (orig.)

An Improved Rate-Transient Analysis Model of Multi-Fractured Horizontal Wells with Non-Uniform Hydraulic Fracture Properties

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Youwei He

2018-02-01

Full Text Available Although technical advances in hydraulically fracturing and drilling enable commercial production from tight reservoirs, oil/gas recovery remains at a low level. Due to the technical and economic limitations of well-testing operations in tight reservoirs, rate-transient analysis (RTA has become a more attractive option. However, current RTA models hardly consider the effect of the non-uniform production on rate decline behaviors. In fact, PLT results demonstrate that production profile is non-uniform. To fill this gap, this paper presents an improved RTA model of multi-fractured horizontal wells (MFHWs to investigate the effects of non-uniform properties of hydraulic fractures (production of fractures, fracture half-length, number of fractures, fracture conductivity, and vertical permeability on rate transient behaviors through the diagnostic type curves. Results indicate obvious differences on the rate decline curves among the type curves of uniform properties of fractures (UPF and non-uniform properties of fractures (NPF. The use of dimensionless production integral derivative curve magnifies the differences so that we can diagnose the phenomenon of non-uniform production. Therefore, it’s significant to incorporate the effects of NPF into the RDA models of MFHWs, and the model proposed in this paper enables us to better evaluate well performance based on long-term production data.

The classic metaphyseal lesion and traumatic injury

International Nuclear Information System (INIS)

Thackeray, Jonathan D.; Wannemacher, Jacob; Adler, Brent H.; Lindberg, Daniel M.

2016-01-01

It is widely accepted that the classic metaphyseal lesion (CML) is a traumatic lesion, strongly associated with abuse in infants. Nevertheless, various non-traumatic origins for CMLs continue to be suggested in medical and legal settings. No studies to date systematically describe the association of CMLs with other traumatic injuries. The primary objective of this study is to examine the association of CMLs with other traumatic injuries in a large data set of children evaluated for physical abuse. This was a retrospectively planned secondary analysis of data from a prospective, observational study of children <120 months of age who underwent evaluation by a child abuse physician. For this secondary analysis, we identified all children ≤12 months of age with an identified CML and determined the number and type of additional injuries identified. Descriptive analysis was used to report frequency of additional traumatic injuries. Among 2,890 subjects, 119 (4.1%) were identified as having a CML. Of these, 100 (84.0%) had at least one additional (non-CML) fracture. Thirty-three (27.7%) had traumatic brain injury. Nearly half (43.7%) of children had cutaneous injuries. Oropharyngeal injuries were found in 12 (10.1%) children. Abdominal/thoracic injuries were also found in 12 (10.1%) children. In all, 95.8% of children with a CML had at least one additional injury; one in four children had three or more categories of injury. CMLs identified in young children are strongly associated with traumatic injuries. Identification of a CML in a young child should prompt a thorough evaluation for physical abuse. (orig.)

The old with the die. A contribution to metaphysics of quantum mechanics

International Nuclear Information System (INIS)

Ijjas, Anna

2011-01-01

Since the rise of quantum mechanics also their ideological implications and consequences were discussed. Meanwhile still scarcely a metaphysical problem exists, which was not supposedly solved under calling on quantum theory. Anna Ijjas inquires the usual practice and developes a new model of the assignment of quantum mechanics and metaphysics. She discusses both the physical foundations and the classical philosophical controversies, before she draws consequencies for the relation determination of brain and consciousness, the problem of freedom of will, as well as for the question of the influence of God in the world.

Local physeal widening on MR imaging: an incidental finding suggesting prior metaphyseal insult

International Nuclear Information System (INIS)

Laor, T.; Hartman, A.L.; Jaramillo, D.

1997-01-01

To offer a descriptive review which characterizes and evaluates the significance of local physeal widening, (cartilaginous signal extending from the physis into the adjacent metaphysis), identified on magnetic resonance (MR) imaging. MR images (recollected from exams performed between 1988 and 1995) of 31 metaphyses in 22 children where we recognized local physeal widening were examined retrospectively. These areas of physeal widening were evaluated for morphology, depth, location, signal intensity, and the coexistence of epiphyseal alterations. The characteristics of the signal abnormalities were correlated with the duration and type of any identifiable insult to the adjacent metaphysis, and with the development of growth disturbance. Twenty-six metaphyses had identifiable insults (19 single event and 7 sustained or repetitive). The widened physes were of focal tongue (n = 15), broad band (n 10), or mixed (n = 6) morphology. Most (n = 27) areas of widening were isointense with the physeal cartilage on all sequences. Subsequent growth disturbance was more likely when the metaphyseal insult was a single event rather than sustained or repetitive (P = 0.023), with focal tongues (P = 0.029), and with centrally located lesions (P = 0.030). In five cases, the adjacent epiphysis showed signal abnormalities; all developed growth disturbance. Histologic examinations available in two limbs confirmed that the MR findings represented extensions of hypertrophic physeal chondrocytes into the metaphysis. Incidentally observed local physeal widening in a growing bone may represent the imprint of a previous or ongoing interference with endochondral ossification from a prior metaphyseal insult, rather than a primary metaphyseal disorder. Single event insults, physeal widening of focal tongue morphology, central distribution in the metaphysis, and concomitant epiphyseal signal abnormalities on MR imaging are significant predictors of subsequent growth disturbance. (orig.). With 9

Training Improves Interobserver Reliability for the Diagnosis of Scaphoid Fracture Displacement

NARCIS (Netherlands)

Buijze, Geert A.; Guitton, Thierry G.; van Dijk, C. Niek; Ring, David; Osterman, A. Lee; Wahegaonkar, Abhijeet L.; Ladd, Amy; Barquet, Antonio; van Vugt, Arie B.; Shyam, Ashok K.; Swigart, Carrie; Coles, Chad P.; Zalavras, Charalampos; Goldfarb, Charles A.; Cassidy, Charles; Allan, Christopher; Beingessner, Daphne; Kalainov, David M.; Eygendaal, Denise; Sancheti, Parag; Feibel, Robert J.; Rocha, Steve; Grosso, Elena; Frihagen, Frede; Dyer, George S. M.; Athwal, George S.; Goslings, J. Carel; Della Rocca, Gregory J.; Harris, Ian; Fanuele, Jason C.; Lawton, Jeff; Jiuliano, John; McAuliffe, John; Capo, John T.; Conflitti, Joseph M.; Segalman, Keith; Egol, Kenneth; Ponsen, Kornelis J.; Jeray, Kyle; Lattanza, Lisa; Catalano, Louis; Swiontkowski, Marc; Boyer, Martin; Richardson, Martin; Soong, Maximillian; Baskies, Michael; Prayson, Michael; McKee, Michael; Chen, Neal C.; Kloen, Peter

2012-01-01

The diagnosis of displacement in scaphoid fractures is notorious for poor interobserver reliability. We tested whether training can improve interobserver reliability and sensitivity, specificity, and accuracy for the diagnosis of scaphoid fracture displacement on radiographs and CT scans. Sixty-four

"Floating arm" injury in a child with fractures of the proximal and distal parts of the humerus: a case report

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Güven Melih

2009-09-01

Full Text Available Abstract Introduction Simultaneous supracondylar humerus fracture and ipsilateral fracture of the proximal humerus in children is rare. Case presentation A 10-year-old Turkish boy with an extension type supracondylar humerus fracture and ipsilateral fracture at the proximal metaphyseal-diaphyseal junction of the humerus was treated by closed reduction and percutaneous Kirschner wire fixation. Closed reduction was performed using a Kirschner wire as a "joystick" to manipulate the humeral shaft after some swelling occurred around the elbow and shoulder. Conclusion The combination of fractures at the proximal and distal parts of the humerus can be termed as "floating arm" injury. Initial treatment of this unusual injury should be focused on the supracondylar humerus fracture. However, closed reduction can be difficult to perform with the swelling around the elbow and shoulder. A temporary Kirschner wire can be used as a "joystick" to fix and reduce the fracture.

Aesthetics as metaphysical meaning-making in the face of death

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Maija Khandro Butters

2016-12-01

Full Text Available In my ethnographic research on death and dying in contemporary Finland, I explore how Finns facing end of life due to a long-term illness or other terminal condition seek to orient themselves and make meaning with cultural tools such as imagery, language, and metaphysical thinking. My primary research material is based on extensive fieldwork at Terhokoti Hospice and in the cancer clinic of Helsinki University Hospital, where I have had numerous conversations with terminally ill patients. This paper seeks to explore the way in which metaphysical aesthetics is assuming the role that religious thinking has traditionally played. When the role of institutional religion is diminishing, it becomes important to understand how emotional and spiritual resolution can be arrived at by means of aesthetics.

Metaphysical Modality, Modality of Predicate and the Theory of

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l nabavi

2010-05-01

This paper discusses the historical overview of the metaphysical modality firstly and then shows that the theory of "Decisive Necessity” is true and justified in a model of modal logic with equivalent accessibility relation and homogeneous possible world view (fixed domain.

Fracture Toughness Improvement of Composites Reinforced with Optimally Shaped Short Ductile Fibers

National Research Council Canada - National Science Library

Wetherhold, Robert C; Patra, Abani K

2001-01-01

The fracture toughness of brittle matrix composites reinforced with ductile fibers has been greatly improved by shaping the fibers so that they fully contribute their plastic work to the fracture process...

Metaphyseal osteopathy-like disease in two sibling kittens.

Science.gov (United States)

Pantaleo, Valeria; D'Ettorre, Paolo; Caldin, Marco; Vezzoni, Aldo

2016-01-01

This report describes the diagnosis and treatment of a growth plate disturbance resembling canine metaphyseal osteopathy in two, two-month-old, sibling, intact, female Domestic Shorthair cats. Clinical signs and radiographic lesions resolved spontaneously after three months. Follow-up examination at six months of age showed complete recovery and no radiographic abnormalities.

On How physics Could impact on the Metaphysics of Space and Time

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Alireza Mansouri

2015-03-01

Full Text Available This paper aims to illustrate the mutual inter-relation of physics and metaphysics in the context of the philosophy of space and time. We especially emphasize, in this paper, that scientific development could impact on our position regarding the reality of space and time. To illustrate this point, we investigate the mutual inter-relation of physics and metaphysics in the modern developments of physics, i.e. neo-Newtonian structure, special and general relativity (GR. This paper ends up anticipating that it is likely, by considering modern physics, especially GR, that substantivalism to be a more defensible position.

Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs.

Science.gov (United States)

Cummings, Steven R; Karpf, David B; Harris, Fran; Genant, Harry K; Ensrud, Kristine; LaCroix, Andrea Z; Black, Dennis M

2002-03-01

To estimate how much the improvement in bone mass accounts for the reduction in risk of vertebral fracture that has been observed in randomized trials of antiresorptive treatments for osteoporosis. After a systematic search, we conducted a meta-analysis of 12 trials to describe the relation between improvement in spine bone mineral density and reduction in risk of vertebral fracture in postmenopausal women. We also used logistic models to estimate the proportion of the reduction in risk of vertebral fracture observed with alendronate in the Fracture Intervention Trial that was due to improvement in bone mineral density. Across the 12 trials, a 1% improvement in spine bone mineral density was associated with a 0.03 decrease (95% confidence interval [CI]: 0.02 to 0.05) in the relative risk (RR) of vertebral fracture. The reductions in risk were greater than predicted from improvement in bone mineral density; for example, the model estimated that treatments predicted to reduce fracture risk by 20% (RR = 0.80), based on improvement in bone mineral density, actually reduce the risk of fracture by about 45% (RR = 0.55). In the Fracture Intervention Trial, improvement in spine bone mineral density explained 16% (95% CI: 11% to 27%) of the reduction in the risk of vertebral fracture with alendronate. Improvement in spine bone mineral density during treatment with antiresorptive drugs accounts for a predictable but small part of the observed reduction in the risk of vertebral fracture.

Metaphysical accounts of the zygote as a person and the veto power of facts.

Science.gov (United States)

Bole, T J

1989-12-01

That the soul of a human person is infused at conception is a metaphysical claim. But given its traditional articulation, it has the empirical consequence that the zygote must have a substantial continuity with the adult person, a continuity which is already determined at conception. This empirical consequence is contradicted by the fact that the zygote may become a hydatidiform mole, or several persons. The metaphysical claim is falsified by the facts.

The will: from metaphysical freedom to normative functionalism.

Science.gov (United States)

Felthous, Alan R

2008-01-01

Free will is regarded by some as the most and by others as the least relevant concept for criminal responsibility. Contributions from religious and philosophical thinkers over the classical and medieval Christian eras demonstrate that, despite the passionate and historically consequential debates over the meaning of "freedom," the unifying theme that joined the will with the intellect remained persistent and pervasive. Leading historical jurists in England eventually dropped the descriptor "free," but retained the central importance of the will to criminal responsibility and emphasized its dependence on the intellect to function properly. Modern rationalist philosophers denied the will's metaphysical freedom, but not its existence. Today the neurosciences reveal more and more about how the will functions, even as lawyers and psychiatrists hesitate to utter the word. In properly avoiding metaphysical freedom within forensic inquiry and discourse, it is a grave conceptual mistake to overlook the will itself. Once greater conceptual clarity on the empirical nature of the will is achieved and accepted, the law itself could rediscover the core mental faculty behind human agency, the will.

Avascular Necrosis of Trochlea After Supracondylar Humerus Fractures in Children.

Science.gov (United States)

Etier, Brian E; Doyle, J Scott; Gilbert, Shawn R

2015-10-01

Avascular necrosis (AVN) is a rare but important complication after supracondylar humerus fractures. Posttraumatic humerus deformity was first reported in 1948 and sporadically thereafter. AVN deformity has been classified as type A (AVN of the lateral ossification center) and type B (AVN of the entire medial crista and a metaphyseal portion). In this article, we present 5 cases of AVN after supracondylar humerus fracture, discuss the importance of late clinical findings, and postulate a mechanism of AVN in nondisplaced fractures. Five cases of AVN after supracondylar humerus fracture were reviewed from the Children's of Alabama database. Four of the 5 patients were female. Four patients sustained a Gartland type III fracture, and 1 patient sustained a nondisplaced Gartland type I fracture. Age at time of injury ranged from 5 years to 10 years. All patients had an asymptomatic clinical period after treatment and re-presented 6 months to 7 years later with elbow pain or loss of motion. All patients were treated symptomatically. AVN of the trochlea has a late clinical presentation. The cause of this complication is interruption of the trochlea blood supply. In displaced fractures, the medial and/or lateral vessels are injured, leading to type A or type B deformity. In nondisplaced fractures, the lateral vessels are interrupted by tamponade because of encased fracture hematoma; this presents as a type A deformity. Both type A and type B deformities can be clinically significant. AVN of the trochlea should be considered in patients with late presentation of pain or loss of motion after treatment of supracondylar humerus fractures.

Bilateral atypical insufficiency fractures of the proximal tibia and a unilateral distal femoral fracture associated with long-term intravenous bisphosphonate therapy: a case report

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Imbuldeniya Arjuna

2012-02-01

Full Text Available Abstract Introduction Atypical insufficiency fractures of the femur in patients on long-term bisphosphonate therapy have been well described in recent literature. The majority of cases are associated with minimal or no trauma and occur in the subtrochanteric or diaphyseal region. Case presentation We describe the case of a 76-year-old British Caucasian woman who presented initially to an emergency department and then to her primary care physician with a long-standing history of bilateral knee pain after minor trauma. Plain radiographs showed subtle linear areas of sclerosis bilaterally in her proximal tibiae. Magnetic resonance imaging confirmed the presence of insufficiency fractures in these areas along with her left distal femur. There are very few reports of atypical insufficiency fractures involving the tibia in patients on long-term bisphosphonate therapy and this appears to be the only documented bilateral case involving the metaphyseal regions of the proximal tibia and distal femur. Conclusion In addition to existing literature describing atypical fractures in the proximal femur and femoral shaft, there is a need for increased awareness that these fractures can also occur in other weight-bearing areas of the skeleton. All clinicians involved in the care of patients taking long-term bisphosphonates need to be aware of the growing association between new onset lower limb pain and atypical insufficiency fractures.

Training improves interobserver reliability for the diagnosis of scaphoid fracture displacement.

Science.gov (United States)

Buijze, Geert A; Guitton, Thierry G; van Dijk, C Niek; Ring, David

2012-07-01

The diagnosis of displacement in scaphoid fractures is notorious for poor interobserver reliability. We tested whether training can improve interobserver reliability and sensitivity, specificity, and accuracy for the diagnosis of scaphoid fracture displacement on radiographs and CT scans. Sixty-four orthopaedic surgeons rated a set of radiographs and CT scans of 10 displaced and 10 nondisplaced scaphoid fractures for the presence of displacement, using a web-based rating application. Before rating, observers were randomized to a training group (34 observers) and a nontraining group (30 observers). The training group received an online training module before the rating session, and the nontraining group did not. Interobserver reliability for training and nontraining was assessed by Siegel's multirater kappa and the Z-test was used to test for significance. There was a small, but significant difference in the interobserver reliability for displacement ratings in favor of the training group compared with the nontraining group. Ratings of radiographs and CT scans combined resulted in moderate agreement for both groups. The average sensitivity, specificity, and accuracy of diagnosing displacement of scaphoid fractures were, respectively, 83%, 85%, and 84% for the nontraining group and 87%, 86%, and 87% for the training group. Assuming a 5% prevalence of fracture displacement, the positive predictive value was 0.23 in the nontraining group and 0.25 in the training group. The negative predictive value was 0.99 in both groups. Our results suggest training can improve interobserver reliability and sensitivity, specificity and accuracy for the diagnosis of scaphoid fracture displacement, but the improvements are slight. These findings are encouraging for future research regarding interobserver variation and how to reduce it further.

Ontological engineering versus metaphysics

Science.gov (United States)

Tataj, Emanuel; Tomanek, Roman; Mulawka, Jan

2011-10-01

It has been recognized that ontologies are a semantic version of world wide web and can be found in knowledge-based systems. A recent time survey of this field also suggest that practical artificial intelligence systems may be motivated by this research. Especially strong artificial intelligence as well as concept of homo computer can also benefit from their use. The main objective of this contribution is to present and review already created ontologies and identify the main advantages which derive such approach for knowledge management systems. We would like to present what ontological engineering borrows from metaphysics and what a feedback it can provide to natural language processing, simulations and modelling. The potential topics of further development from philosophical point of view is also underlined.

Material Fracture Characterization and Toughness Improving Technology Developments

International Nuclear Information System (INIS)

Lee, Bong Sang; Kim, M. C.; Lee, H. J. and others

2005-04-01

Reactor pressure boundary components including pressure vessel and piping are facing a severe aging condition that can degrade the physical-mechanical properties under neutron irradiation, high temperature, high pressure, and corrosive environments. In order to increase the safety of nuclear power plants, it is inevitable to improve the credibility and capability of evaluation technology based on the quantitative fracture mechanics for aging assessment of reactor components. Irradiation embrittlement is the primary aging mechanism of reactor pressure vessel and various techniques have been developed to predict the aging characteristics by using only small volume of irradiated materials. Material database of the domestic structural steels for KSNP's under reactor environments must be very important to play a role in developing an advanced material, in improving the safety of nuclear components, and also in expanding the nuclear industry abroad. This research project has been focused on developing an advanced technology of testing and analysis in the fracture mechanical point of view as well as acquiring test data and improving the performance of nuclear structural steels

Traumatic Fracture in a patient of Osteopoikilosis with review of literature

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Rohan Bansal

2013-04-01

Full Text Available Introduction: Osteopoikilosis or osteopathia condensans disseminata is a rare hereditary autosomal dominant sclerosing bone dysplasia. Patients are usually asymptomatic and the diagnosis is usually made incidentally on radiographs which show presence of symmetric, multiple, well defined, small ovoid areas of increased radiodensity clustered in peri-articular osseous regions with propensity for epiphyseal and metaphyseal involvement. There are no increased risks of pathological fracture in a case of osteopoikilosis and traumatic fracture healing in a case of osteopoikilosis is similar to fracture occurring in other normal patients. Case Report: A 34 years male, electrician came with history of accidental fall from height while working in office leading to development of pain and swelling over left lower leg and ankle diagnosed with Ruedi-Allgower classification type I pilon fracture(without fibula fracture no distal neuro-vascular deficit. Patient was offered surgical treatment in form of open reduction and internal fixation of tibial fracture by plate osteosynthesis using antero-medial approach , showed complete union and was followed up for eight months. Conclusion: Osteopoikilosis has a benign course and it should always be kept as a possible differential diagnosis for osteoblastic metastasis to avoid diagnositic dilemma. Diagnosis can be settled by routine x-rays ( for type ,extent and site of lesions, bones affected, clinical features of patient , histopathology and other systemic or pre-existing conditions. Keywords: Fracture , Osteopoikilosis , union, Pilon, Osteoblastic metastasis

Realitas vs wirklichkeit: the genesis of the two concepts of western metaphysics

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V. Y. Popov

2014-01-01

Full Text Available The terms «reality» and «reality» are used interchangeably, or quite similar to each other іn the modern Ukrainian philosophical literature. However, they have significant substantive differences, which not only with their etymology, but also fundamentally different metaphysical foundations of their origin and use. Category «reality» in the European metaphysics is closely linked substantiality, and not as a process. Category «reality» reflects a dynamic dimension of being, and originates from the «» «Metaphysics» of Aristotle, which later developed into the category of German philosophy Wirklichkeit». In the article it is proved that the notions of «realitas» and «Wirklichkeit» born in the end of the age of high scholasticism, and their founders were Duns Scotus and Eckhart Meister. In particular, the concept of «realitas» is entered Duns Scotus to denote «ultima realitas» («ultimate reality» things that is haecceitas «thisness» individual things. The concept of «realitas» (reality speaking only a subsidiary subsequently in Western ontology acquires metaphysical significance. Eckhart Meister borrows from albert the Great, the term «actualitas» (actuality and translates this word into the language of their sermons as «wercelicheit», which later became «Wirklichkeit». This word in the mouth of a preacher mystic ceases to be a simple translation of «actualitas» turning from the Divine actus purus in «non­action activities». However, these mystical layering subsequently disappear; Сh. Wolf word «Wirklichkeit» means the certainty of the existence or possible implementation. However, in the German classics (I. Kant, G. Hegel a continued separation «Wirklichkeit­Realitt». In Marxism reality more and more identified with the objective reality. Similar processes occur in the English­analytic philosophy (for example L. Wittgenstein. However, the article notes that the problem of the delimitation of the

Arguments for the Existence of God in the Francisco Suarez’ "Metaphysical Disputations"

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Galina Vdovina

2017-12-01

Full Text Available The article considers arguments for the existence of God that are presented in Francisco Suarez’ treatise Metaphysical Disputations. The work of Suarez contains the most developed and detailed exposition of natural theology that exists in the scholastic tradition. Suarez explicitates the problem, formulating three questions: what is a being that we call God? Is it possible to prove or justify his existence? How is it possible? Suarez answers the first question by showing that we come to a concept of the prime and excellent being through a series of divisions in the concept of being. That prime being is infinite, absolute, necessary and uncreated. The second question is answered by the procedure of that division and its result. In his answer to the third question, Suarez distinguishes physical and metaphysical arguments. According to Suarez, the most significant physical proofs are the argument from motion and the argument from the rational soul. Nevertheless, he demonstrates that purely physical arguments cannot lead us to a being, which we call God. Only metaphysical argument from the principle, everything which is produced, is produces by something else, is really effective. The logic of the metaphysical proof is as follows: first, we have to demonstrate the necessary existence of the first non-produced thing: secondly, we are to show that such a thing can only be one. The first point is proved through the demonstration of an absolutely first cause in each series of causes, the second one is made evident through a demonstration of the impossibility to coexist simultaneously for two equally perfect first causes of equal causing power.

Typology reconfigured: from the metaphysics of essentialism to the epistemology of representation.

Science.gov (United States)

Love, Alan C

2009-06-01

The goal of this paper is to encourage a reconfiguration of the discussion about typology in biology away from the metaphysics of essentialism and toward the epistemology of classifying natural phenomena for the purposes of empirical inquiry. First, I briefly review arguments concerning 'typological thinking', essentialism, species, and natural kinds, highlighting their predominantly metaphysical nature. Second, I use a distinction between the aims, strategies, and tactics of science to suggest how a shift from metaphysics to epistemology might be accomplished. Typological thinking can be understood as a scientific tactic that involves representing natural phenomena using idealizations and approximations, which facilitates explanation, investigation, and theorizing via abstraction and generalization. Third, a variety of typologies from different areas of biology are introduced to emphasize the diversity of this representational reasoning. One particular example is used to examine how there can be epistemological conflict between typology and evolutionary analysis. This demonstrates that alternative strategies of typological thinking arise due to the divergent explanatory goals of researchers working in different disciplines with disparate methodologies. I conclude with several research questions that emerge from an epistemological reconfiguration of typology.

Metaphysical perspectives on YHWH as a fictional entity in the Hebrew Bible

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Jacobus W. Gericke

2017-05-01

Full Text Available Within a literary ontology, YHWH in the Hebrew Bible is technically also a fictional entity or object. In Hebrew Bible scholarship, a variety of philosophical issues surrounding fiction have received sustained and in-depth attention. However, the mainstream research on these matters tends to focus on the philosophical foundations of or backgrounds to a particular literary theory, rather than on metaphysical puzzles as encountered in the philosophy of fiction proper. To fill this gap, the present article seeks to provide a meta-theoretical overview of the main contemporary philosophical perspectives on the metaphysics of fictional objects. Three views (and their sub-currents are discussed, namely possibilism, (neo-Meinongianism and (literary creationism. Each view’s theory is introduced and critically appropriated with reference to what is implied to be an answer to the question of what exactly the biblical character YHWH can meaningfully be said to be in the context of the metaphysics of fictional objects. In this way, the present study also goes beyond the traditional concern with the nature of God in Old Testament theology.

Relatively High Complication and Revision Rates of the Mayo® Metaphysical Conservative Femoral Stem in Young Patients.

Science.gov (United States)

Rutenberg, Tal Frenkel; Warshevski, Yaniv; Gold, Aviram; Shasha, Nadav; Snir, Nimrod; Chechik, Ofir; Dolkart, Oleg; Eilig, Dynai; Herman, Amir; Rath, Ehud; Kramer, Moti; Drexler, Michael

2018-05-08

The Mayo metaphysical conservative femoral stem (Zimmer, Warsaw, Indiana) is a wedge-shaped implant designed to transfer loads proximally, reduce femoral destruction, and enable the preservation of bone stock in the proximal femur. Thus, it is a potentially preferred prosthesis for active, non-elderly patients who may require additional future surgeries. This retrospective case study analyzed the outcomes of consecutive patients who underwent total hip replacements with this stem between May 2001 and February 2013. All patients underwent clinical assessment, radiological evaluation for the presence and development of radiolucent lines, and functional assessment (numerical analog scale, Harris hip score, and Short Form-12 questionnaire). Ninety-five hips (79 patients) were available for analysis. The patients' mean age was 43 years (range, 18-64 years), and the mean follow-up was 97 months (range, 26.9-166 months). The postoperative clinical assessments and functional assessments revealed significant improvements. Sixteen patients (20.3%) had 18 orthopedic complications, the most common of which were an intraoperative femoral fracture and implant dislocation requiring revision surgeries in 10 hips (10.5%). Radiological analysis revealed evidence of femoral remodeling in 64 (67.4%) implants, spot welds (neocortex) in 35 (36.8%), and osteolysis in 3 (3.2%). These results suggest that the conservative hip femoral implant has an unacceptable complication rate for non-elderly patients. [Orthopedics. 201x; xx(x):xx-xx.]. Copyright 2018, SLACK Incorporated.

A PROSPECTIVE STUDY OF DISTAL TIBIAL FRACTURES BY MIPO (LCP

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Chandra Sekharam Naidu

2015-05-01

Full Text Available INTRODUCTION: D istal tibial fractures represent a significant challenge to most of the surgeons even today. They constitute 1 - 10% of all lower extremity fractures . 1 The difficulty in treating the fractures of distal tibial end is exemplif ied by orthopedists, who in the first half of twentieth century, believed these injuries were so severe and fraught with so many complications, that these fractures were deemed not amenable for surgical reconstruction . 2 Conservative treatment by POP cast l ead to prolonged immobilization, leading to ankle and knee stiffness affecting quality of life of the patient . 3 Operative treatment is indicated for most tibial fractures caused by high energy trauma. Operative treatment allows early motion, and avoids sho rtening and other complications associated with prolonged immobilization . 4 The fundamental goal of treatment of distal tibial fractures is restoration of normal or near normal alignment and articular congruity and finally to obtain a well healed fracture; pain free weight bearing ; and functional ROM of ankle joint. For the past decade, plating has been successful in treating complex fractures of the lower extremity especially distal tibia . 5 Conventional ORIF have been associated with complications like infe ction and delayed or non - union due to devitalisation of bony fragments and additional damage to the soft tissues . 6 To improve fracture healing, more “biological” methods have been developed in the last decade to lessen the surgical dissection, preserving b lood supply to bony fragments and containing at least partially the fracture haematoma . 7 Recently, the trend is towards use of a Locking compression plate for treatment of fractures of the distal part of the tibia 8 . Compared with a conventional plate, a Lo cking compression plate imparts a higher degree of stability and provides better protection against primary and secondary losses of reduction and minimization of bone

Multiscale Polymer Composites: A Review of the Interlaminar Fracture Toughness Improvement

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Vishwesh Dikshit

2017-10-01

Full Text Available Composite materials are prone to delamination as they are weaker in the thickness direction. Carbon nanotubes (CNTs are introduced as a multiscale reinforcement into the fiber reinforced polymer composites to suppress the delamination phenomenon. This review paper presents the detailed progress made by the scientific and research community to-date in improving the Mode I and Mode II interlaminar fracture toughness (ILFT by various methodologies including the effect of multiscale reinforcement. Methods of measuring the Mode I and Mode II fracture toughness of the composites along with the solutions to improve them are presented. The use of different methodologies and approaches along with their performance in enhancing the fracture toughness of the composites is summarized. The current state of polymer-fiber-nanotube composites and their future perspective are also deliberated.

Fibrous metaphyseal defects - determination of their origin and natural history using a radiomorphological study

International Nuclear Information System (INIS)

Ritschl, P.; Karnel, F.; Hajek, P.

1988-01-01

The radiomorphological appearance of fibrous metaphyseal defects (FMDs) is demonstrated by long-term follow-up studies. A characteristic radiomorphological course rather than a typical single appearance can be established. These findings correlate well with the duration of these tumor-like lesions; therefore, the radiological findings allow conclusions to be made about the age of a fibrous metaphyseal defect. In addition, the characteristic locations of FMDs will be explained in respect of theier origins at insertions of tendons and ligaments. (orig.)

The metaphysics of morality : a dispositionalist account

OpenAIRE

Robinson, William Luke

2005-01-01

Each of the following theses is independently plausible: Principle. Morality is principled: right-making factors or moral reasons entail corresponding moral principles. Conflict. Conflicts of moral obligation are possible and metaphysically unproblematic (even if they can be quite difficult--or even impossible--to resolve). Holism. Whether a given factor contributes to the rightness or wrongness of an action may depend on factors other than itself; hence, what is a right-making factor or mora...

Kant, God and Metaphysics: The Secret Thorn

OpenAIRE

Kanterian, Edward

2017-01-01

Kant is widely acknowledged as the greatest philosopher of modern times. He undertook his famous critical turn to save human freedom and morality from the challenge of determinism and materialism. Intertwined with his metaphysical interests, however, he also had theological commitments, which have received insufficient attention. He believed that man is a fallen creature and in need of ‘redemption’. He intended to provide a fortress protecting religious faith from the failure of rationalist m...

The mind electric: Challenges to clinical categories from a person-centred perspective and the possibilities of metaphysics and art for clinician, patient, and treatment.

Science.gov (United States)

Pârvan, Alexandra

2018-06-21

The paper proposes that frameworks typical to metaphysics and art could be used in clinical treatment in somatic and psychiatric contexts to ensure improved care. The concept of the "body electric" of somatic patients which I introduced in previous work is developed further and paired with the "mind electric" of psychiatric patients. Both are defined as a patient's personally generated metaphysical possibility of being healthy-within-illness which is experientially actualized. Both concepts are used here to explore the alternative and the serious challenges to treatment approaches focused on clinical categories, disease, provision, and promotion of standardized or "black-box" therapies. An argument against the idea implied by the hope for such mass treatments and corresponding overreliance on science, namely, that health comes from fixing and regularizing, is developed based on cultural history and the evidenced fact that personally assumed health, just like art and metaphysics, is transgressive of scientific data, and accommodates the untrue, the impossible or the irregular as actual and normal. Because normality is created only with the help of disorder and from within it for chronic patients, clinicians should offer them the metaphysical care they need to produce and actualize their possibility of irregular normality or their body/mind electric. Better treatments can only be provided when scientific advances will be matched with advances in the humanistic competence of clinicians. © 2018 John Wiley & Sons, Ltd.

Cementless Hip Stem Anteversion in the Dysplastic Hip: A Comparison of Tapered Wedge vs Metaphyseal Filling.

Science.gov (United States)

Taniguchi, Naofumi; Jinno, Tetsuya; Koga, Daisuke; Hagino, Tetsuo; Okawa, Atsushi; Haro, Hirotaka

2017-05-01

Appropriate stem anteversion is important for achieving stability of the prosthetic joint in total hip arthroplasty. Anteversion of a cementless femoral stem is affected by the femoral canal morphology and varies according to stem geometry. We investigated the difference and variation of the increase in anteversion between 2 types of cementless stems, and the correlation between each stem and the preoperative femoral anteversion. We retrospectively compared 2 groups of hips that underwent total hip arthroplasty using a metaphyseal filling stem (78 hips) or a tapered wedge stem (83 hips). All the patients had osteoarthritis due to hip dysplasia. Computed tomography was used to measure preoperative femoral anteversion at 5 levels and postoperative stem anteversion. The increase in anteversion of the tapered wedge stem group (22.7° ± 11.6°) was more than that of the metaphyseal filling stem group (17.2° ± 8.3°; P = .0007). The variation of the increase in the tapered wedge stem group was significantly larger than that in the metaphyseal filling stem group (P = .0016). The metaphyseal filling stem group was more highly and positively correlated with femoral anteversion than the tapered wedge stem group. Femoral anteversion affects stem anteversion differently according to stem geometry. The tapered wedge stems had greater variation of the increase in anteversion than did the metaphyseal filling stems. Based on the results of this study, it is difficult to preoperatively estimate the increase in stem anteversion for tapered wedge stems. Copyright © 2016 Elsevier Inc. All rights reserved.

Prolegomena to any future metaphysics that will be able to come forward as science the Paul Carus translation

CERN Document Server

Kant, Immanuel

1977-01-01

Kant’s Prolegomena -- its full title, in the eighteenth-century manner, is Prolegomena to Any Future Metaphysics Which Will Be Able to Come Forth as Science -- is a classic in metaphysics and the theory of knowledge. It deals with the perennially baffling questions: How do we know? How much can we know? Its answers to these questions are interesting especially now. We live in one of the recurring periods of intellectual and cultural history that are skeptical and impatient of systems of speculative metaphysics, and a distrust of speculation is the leading motif of the Prolegomena. Though Kant's arguments against speculative metaphysics differ from those of our contemporaries, in some of his results he anticipates their negative conclusions. The Prolegomena, however, is not interesting merely as an historical anticipation of recent views; indeed, as such it has been as it were condemned in advance by Kant (Prolegomena, Introduction). Rather, its chief interest to the student of philosophy is probably the way...

Migraine and Metaphysics: Sentinels of science in nineteenth-century physics

DEFF Research Database (Denmark)

Kjærgaard, Peter C.

2010-01-01

In an old boy network of nineteenth-century natural philosophers, all with a background in mathematics from the University of Cambridge, a conspicuous aversion ruled against metaphysics. Within these circles it produced a strong compulsion to define the limits of genuine scientific endeavour...

Conceptual and Metaphysical Origins and Relevance of Temporal Logic

DEFF Research Database (Denmark)

Jakobsen, David; Øhrstrøm, Peter

2016-01-01

Logic has sometimes been seen as an alternative to metaphysics and to speculation. In this paper it is argued that a different story should be told when it comes to temporal logic and tense-logic in particular. A.N. Prior’s first formulation of tense logic was mainly established in order to quali...

Being qua becoming: Aristotle's "Metaphysics", quantum physics, and Process Philosophy

Science.gov (United States)

Johnson, David Kelley

In Aristotle's First Philosophy, science and philosophy were partners, but with the rise of empiricism, went their separate ways. Metaphysics combined the rational and irrational (i.e. final cause/unmoved mover) elements of existence to equate being with substance, postulating prime matter as pure potential that was actuated by form to create everything. Modern science reveres pure reason and postulates its theory of being by a rigorous scientific methodology. The Standard Model defines matter as energy formed into fundamental particles via forces contained in fields. Science has proved Aristotle's universe wrong in many ways, but as physics delves deeper into the quantum world, empiricism is reaching its limits concerning fundamental questions of existence. To achieve its avowed mission of explaining existence completely, physics must reunite with philosophy in a metascience modeled on the First Philosophy of Aristotle. One theory of being that integrates quantum physics and metaphysics is Process Philosophy.

Successful treatment of two cases of metaphyseal osteomyelitis in the dog

International Nuclear Information System (INIS)

Dunn, J.K.; Dennis, R.; Houlton, J.E.F.

1992-01-01

This paper describes two cases of metaphyseal osteomyelitis in young dogs. The condition was characterised by generalised stiffness, muscle atrophy and reluctance to stand. Pain was evident on deep palpation of the distal extremities of long bones. Radiographic lesions, consisting of diffuse areas of bone lysis and pronounced periosteal reaction, were demonstrated in the metaphyseal regions of multiple long bones, particularly the distal radii and ulnae. Growth plates appeared unaffected and remained open. Biochemical abnormalities included significant increases in the plasma concentrations of fibrinogen and alkaline phosphatase. A pronounced neutrophilia and absolute monocytosis were noted in one dog. A six week course of amoxycil-lin/clavulanic acid in combination with metronidazole resulted in complete resolution of clinical and radiographic signs in each case. Growth disturbances were not observed

Patients' substantialization of disease, the hybrid symptom and metaphysical care.

Science.gov (United States)

Pârvan, Alexandra

2015-06-01

In the context of current scholarship concerned with facilitating integration between the biomedical and the patient-centred models of care, the article suggests that disease brings about an ontological disruption in patients, which is not directly addressed in either model, and may interfere with treatment and therapy outcomes if not met with a type of care termed here as 'metaphysical'. The receipt of diagnosis and medical care can give patients the sense that they are ontologically diminished, or less of a human, and along with physicians' approaches to and discourses about disease, may prompt them to seek ontological restoration or security in the same way as psychologically traumatized patients sometimes do: by treating the disease and/or the experience of harm associated with it as a thing that exists per se. I call this 'substantialization' of disease (or harm) and draw on Augustine's theory of non-substantial deficiencies (physiological and moral) and on Plato's and Plotinus's different takes on such defects in order to discuss what substantialization can do for patients. Based on literature that examines patients' ways of talking about and living with their disease, I speculate that substantialization can generate a 'hybrid symptom', consisting in patterns of exercising agency which may predispose to non-adherence. Ways in which physicians could provide metaphysical care are proposed, along with an understanding of chronic patients as hybrid ontological and agentic units, which draws on theories of enactive cognition. I opine that metaphysical care may facilitate integration between the depersonalized and personalized models of care. © 2014 John Wiley & Sons, Ltd.

Stress Fractures of the Distal Femur Involving Small Nonossifying Fibromas in Young Athletes.

Science.gov (United States)

Robertson, Michael; Gilley, Jasen; Nicholas, Richard

2016-11-01

Small nonossifying fibromas (ie, fibrocortical defects) are incidental findings commonly seen on radiographs of young patients evaluated for extremity pain or sport-related trauma. Although pathological fractures have been reported in larger lesions, the subcentimeter, intracortical defects are not generally thought to predispose to pathological fractures. The authors report on 2 young athletes who presented with knee pain after initiating conditioning exercise programs (cross-training). Both were diagnosed with transverse metaphyseal stress fractures involving fibrous cortical defects of the distal femur. Initial radiographs were interpreted without evidence of fractures. However, subsequent magnetic resonance imaging was informative, suggesting that magnetic resonance imaging may have value in identifying potential stress reactions in young athletes. In addition, subsequent plain radiographs of both patients showed subperiosteal new bone formation in these nondisplaced fractures, suggesting that serial radiographs and close clinical follow-up are warranted for patients with persistent symptoms. The authors propose that, in the appropriate clinical setting, the presence of a small nonossifying fibroma may be a clinical indication that further evaluation is needed when plain radiographs show normal findings, as the defect could be an unrecognized area of fracture initiation. [Orthopedics. 2016; 39(6):e1197-e1200.]. Copyright 2016, SLACK Incorporated.

Metaphysics of the principle of least action

Science.gov (United States)

Terekhovich, Vladislav

2018-05-01

Despite the importance of the variational principles of physics, there have been relatively few attempts to consider them for a realistic framework. In addition to the old teleological question, this paper continues the recent discussion regarding the modal involvement of the principle of least action and its relations with the Humean view of the laws of nature. The reality of possible paths in the principle of least action is examined from the perspectives of the contemporary metaphysics of modality and Leibniz's concept of essences or possibles striving for existence. I elaborate a modal interpretation of the principle of least action that replaces a classical representation of a system's motion along a single history in the actual modality by simultaneous motions along an infinite set of all possible histories in the possible modality. This model is based on an intuition that deep ontological connections exist between the possible paths in the principle of least action and possible quantum histories in the Feynman path integral. I interpret the action as a physical measure of the essence of every possible history. Therefore only one actual history has the highest degree of the essence and minimal action. To address the issue of necessity, I assume that the principle of least action has a general physical necessity and lies between the laws of motion with a limited physical necessity and certain laws with a metaphysical necessity.

Mendelssohn and Kant on Mathematics and Metaphysics

OpenAIRE

Callanan, John Joseph

2014-01-01

The difference between the method of metaphysics and the method of mathematics was an issue of central concern for Kant in both the Pre-Critical and Critical periods. I will argue that when Kant speaks of the ‘philosophical method’ in the Doctrine of Method in the Critique of Pure Reason (CPR), he frequently has in mind not his own methodology but rather the method of conceptual analysis associated with rationalism. The particular target is Moses Mendelssohn’s picture of analysis contained in...

Parfit's and Scanlon's Non-Metaphysical Moral Realism as Alethic Pluralism

NARCIS (Netherlands)

Veluwenkamp, Herman

Thomas Scanlon and Derek Parfit have recently defended a meta-ethical view that is supposed to satisfy our realistic intuitions about morality, without the metaphysical implications that many find hard to accept in other realist views. Both philosophers argue that truths in the normative domain do

The fine-grained metaphysics of artifactual and biological functional kinds

NARCIS (Netherlands)

Carrara, M.; Vermaas, P.E.

2008-01-01

In this paper we consider the emerging position in metaphysics that artifact functions characterize real kinds of artifacts. We analyze how it can circumvent an objection by David Wiggins (Sameness and substance renewed, 2001, 87) and then argue that this position, in comparison to expert judgments,

Morals, Metaphysics and The Method of Cases | Beck | South ...

African Journals Online (AJOL)

In this paper I discuss a set of problems concerning the method of cases as it is used in applied ethics and in the metaphysical debate about personal identity. These problems stem from research in social psychology concerning our access to the data with which the method operates. I argue that the issues facing ethics are ...

Reality, locality and all that: "experimental metaphysics" and the quantum foundations

Science.gov (United States)

Cavalcanti, Eric G.

2008-10-01

In recent decades there has been a resurge of interest in the foundations of quantum theory, partly motivated by new experimental techniques, partly by the emerging field of quantum information science. Old questions, asked since the seminal article by Einstein, Podolsky and Rosen (EPR), are being revisited. The work of John Bell has changed the direction of investigation by recognising that those fundamental philosophical questions can have, after all, input from experiment. Abner Shimony has aptly termed this new field of enquiry "experimental metaphysics". The objective of this Thesis is to contribute to that body of research, by formalising old concepts, proposing new ones, and finding new results in well-studied areas. Without losing from sight that the appeal of experimental metaphysics comes from the adjective, every major result is followed by clear experimental proposals for quantum-atom optical setups.

Salter-Harris type II metacarpal and metatarsal fracture in three foals. Treatment by minimally-invasive lag screw osteosynthesis combined with external coaptation.

Science.gov (United States)

Klopfenstein Bregger, Micaël D; Fürst, Anton E; Kircher, Patrick R; Kluge, Katharina; Kummer, Martin

2016-05-18

To describe minimally-invasive lag screw osteosynthesis combined with external coaptation for the treatment of Salter-Harris type II third metacarpal and third metatarsal bone fractures. Three foals aged two weeks to four months with a Salter-Harris type II third metacarpal or third metatarsal fracture. Surgery was carried out under general anaesthesia in lateral recumbency. After fracture reduction, the metaphyseal fragment was stabilized with two cortical screws placed in lag fashion under fluoroscopic control. A cast was applied for at least two weeks. All foals had a good outcome with complete fracture healing and return to complete soundness without any angular limb deformity. All foals had moderate transient digital hyperextension after cast removal. Internal fixation of Salter-Harris type II third metacarpal or third metatarsal fractures with two cortical screws in lag fashion, combined with external coaptation provided good stabilization and preserved the longitudinal growth potential of the injured physis.

Outcome of 28 open pilon fractures with injury severity-based fixation.

Science.gov (United States)

Danoff, Jonathan R; Saifi, Comron; Goodspeed, David C; Reid, J Spence

2015-04-01

Open pilon fracture management and treatment poses a significant challenge to orthopedic surgeons. The purpose of this study was to determine patient outcomes for open pilon fractures based on wound complication and infection rates, as well as subjective outcome instruments. This was a retrospective consecutive case series of 28 fractures with Orthopaedic Trauma Association (OTA)-type 43-B and 43-C open pilon fractures. Mean length of follow-up was 36 months and minimum of 1 year. Ten fractures were Gustilo and Anderson grade IIIB, and the remaining fractures were grades I-IIIA. Patients were initially treated with spanning external fixation and staged wound debridement followed by osteosynthesis of the articular surface. Metaphyseal fixation was by either plate fixation or Ilizarov frame. The primary outcome was the incidence of deep tissue infection requiring surgery. Secondary outcomes included the incidence of other complications (nonunion, malunion, amputation) and functional outcomes (Short Musculoskeletal Functional Assessment Questionnaire and AAOS Foot and Ankle Questionnaire). Four patients developed deep tissue infections, three in the internal fixation group and one in the Ilizarov group, and all were treated successfully with staged debridement. There were two delayed unions required bone grafting, and infection-free union was ultimately achieved in all fractures. Two patients underwent arthrodesis secondary to post-traumatic arthritis, while no patients experienced malunions or amputations. The use of staged wound debridement in conjunction with either plate fixation or Ilizarov frame achieves low rates of wound infection and stable fixation after anatomic joint reconstruction for OTA-type 43-B and 43-C open pilon fractures.

Modes of Learning: Whitehead's Metaphysics and the Stages of Education

Science.gov (United States)

Allan, George

2012-01-01

Educators are familiar with Alfred North Whitehead's three stages of education: romance, precision, and generalization. Philosophers are familiar with his metaphysical theories about the primacy of temporal processes. In "Modes of Learning," George Allan brings these two sides of Whitehead's thought together for the first time in a book…

Peirce’s Scientific and Spiritual Process Metaphysics

DEFF Research Database (Denmark)

Brier, Søren

Peirce saw as his primary task to develop a comprehensive metaphysical and epistemological system in which a new theory of categories, developed after Kant and Hegel, was defined in a completely new way. His triadic category theory was connected to a dynamic triadic web of semiotics viewed...... as the dynamics of objective mind. Peirce’s pragmaticist semiotics attempts to bridge the gap between natural sciences and humanities by combining a phenomenological approach with an evolutionary and realistic understanding of nature and society meaning and logic....

Combining science and metaphysics contemporary physics, conceptual revision and common sense

CERN Document Server

Morganti, Matteo

2013-01-01

Offering a new perspective on the debate concerning naturalism in philosophy, this book defends the autonomy of metaphysics while also making science centre stage. Three independent case studies provide a clear introduction to, and discussion of, key philosophical issues.

Familial congenital bowing with short thick bones and metaphyseal changes, a distinct entity

International Nuclear Information System (INIS)

Rezza, E.; Lendvai, D.; Iannaccone, G.

1984-01-01

The authors describe two siblings, a male and a female, with disproportionate short stature, rhizomelic-mesomelic shortening of the limb bones, marked bowing of the femora, moderate bowing of the humeri, radii and ulnae, straight tibiae and fibulae, normal hands, flared cupped metaphyses of the tibiae, ulnae, raddi and ribs, and narrow chest. There was some improvement of the bone changes with advancing age. These two patients are similar to five other cases from the literature and strongly support Hall and Spranger's view that this pseudocampomelic condition most likely represents a distinct familial bowing syndrome. The differential diagnosis and the hereditary aspects in the two patients, are also briefly discussed. (orig.)

Improving Fracture Toughness of Epoxy Nanocomposites by Silica Nanoparticles

Directory of Open Access Journals (Sweden)

Seyed Reza Akherati Sany

2017-04-01

Full Text Available An epoxy resin was modified by silica nanoparticles and cured with an anhydride. The particles with different batches of 12, 20, and 40 nm sizes were each distributed into the epoxy resin ultrasonically. Electron microscopy images showed that the silica particles were well dispersed throughout the resin. Tensile test results showed that Young’s modulus and tensile strength increased with the volume fraction and surface area of the silica particles. The simultaneous use of two average sizes of 20 and 40 nm diameter silica particles still increased these mechanical properties but other combinations of silica particles were unsuccessful. A three-point bending test on each pre-cracked specimen was performed to measure the mode I fracture toughness energy. The fracture energy increased from 283 J/m2 for the unmodified epoxy to about 740 J/m2 for the epoxy with 4.5 wt% of 12 nm diameter silica nanoparticles. The fracture energy of smaller particles was greater because of their higher surface to volume ratio. The fracture energy results showed also that the combined nanoparticles has a synergic effect on the fracture toughness of nanocomposites. Simultaneous use of 10 and 20 nm particles increased the fracture energy to about 770 J/m2. Finally, crack-opening displacement was calculated and found to be in the range of several micrometers which was much larger than the sizes of particles studied. Thus, the toughening mechanisms of crack pinning and crack deflection have a negligible effect on improvement of toughness, nevertheless, the plastic deformation and plastic void growth are dominant mechanisms in epoxy toughening by nanoparticles.

Abortion, metaphysics and morality: a review of Francis Beckwith's defending life: a moral and legal case against abortion choice.

Science.gov (United States)

Nobis, Nathan

2011-06-01

In Defending Life: A Moral and Legal Case Against Abortion Choice (2007) and an earlier article in this journal, "Defending Abortion Philosophically"(2006), Francis Beckwith argues that fetuses are, from conception, prima facie wrong to kill. His arguments are based on what he calls a "metaphysics of the human person" known as "The Substance View." I argue that Beckwith's metaphysics does not support his abortion ethic: Moral, not metaphysical, claims that are part of this Substance View are the foundation of the argument, and Beckwith inadequately defends these moral claims. Thus, Beckwith's arguments do not provide strong support for what he calls the "pro-life" view of abortion.

Individualized fracture risk assessment: State-of-the-art and room for improvement

Directory of Open Access Journals (Sweden)

Tuan V. Nguyen

2018-03-01

Full Text Available Fragility fracture is a serious clinical event, because it is associated with increased risk of mortality and reduced quality of life. The risk of fracture is determined by multiple risk factors, and their effects may be interactional. Over the past 10 years, a number of predictive models (e.g., FRAX, Garvan Fracture Risk Calculator, and Qfracture have been developed for individualized assessment of fracture risk. These models use different risk profiles to estimate the probability of fracture over 5- and 10-year period. The ability of these models to discriminate between those individuals who will and will not have a fracture (i.e., area under the receiver operating characteristic curve [AUC] is generally acceptable-to-good (AUC, 0.6 to 0.8, and is highly variable between populations. The calibration of existing models is poor, particularly in Asian populations. There is a strong need for the development and validation of new prediction models based on Asian data for Asian populations. We propose approaches to improve the accuracy of existing predictive models by incorporating new markers such as genetic factors, bone turnover markers, trabecular bone score, and time-variant factors. New and more refined models for individualized fracture risk assessment will help identify those most likely to sustain a fracture, those most likely to benefit from treatment, and encouraging them to modify their risk profile to decrease risk. Keywords: Osteoporosis, Fracture, Fracture risk assessment, Genetic profiling, FRAX, Garvan

[Change on the rate of children's finger metaphysics in the non-Kaschin-Beck disease areas of China].

Science.gov (United States)

Gao, Mei; Liu, Yunqi; Zhou, Lingwang; Liu, Hui; Deng, Qing; Song, Jiucheng; Yu, Jun

2014-11-01

36 non-Kaschin-Beck disease villages in five provinces including Jilin, Liaoning, Shaanxi, Shanxi and Inner Mongolia in the severe endemic areas of Kaschin-Beck disease (KBD) were selected. The aim of this project was to provide the basis showing these KBD villages had already eliminated the KBD. Fully digital versatile X-ray radiography systems(DR) was used to shoot children's right hand X-ray, in accordance with the "Kashin-Beck Disease Diagnosis Standard" (WS/T 207-2010) for diagnosis. Results indicated that children showing metaphyseal changes only appeared in 13 of the 36 villages, where the rate of change on metaphyseal was less than or equal to three percent. When KBD had been eliminated in a village, the rate of change on aged 7 to 12 children's metaphyseal would have been less than three percent.

Interzones of Law and Metaphysics

DEFF Research Database (Denmark)

Mossin, Christiane

The dissertation analyzes a contemporary battlefield of law, the field of EU social rights, from a political-philosophical point of view. It is the conviction of the dissertation that law is deeply and inescapably conceptually connected with fundamental features of social order. The interrelations...... between the two do not merely concern the rights and obligations explicitly laid down in the law, but fundamental presumptions regarding the nature of human beings, overall purposes of social order, hierarchical and dynamic features of society and the possibility at all of regulation, its logics...... and sources of authority. On the basis of a historical-conceptual understanding of law according to which law, social structure and metaphysical presumptions are inescapably intertwined, the dissertation derives from the binding provisions of law certain essential features of social order. More precisely...

Interzones of Law and Metaphysics

DEFF Research Database (Denmark)

Mossin, Christiane

between the two do not merely concern the rights and obligations explicitly laid down in the law, but fundamental presumptions regarding the nature of human beings, overall purposes of social order, hierarchical and dynamic features of society and the possibility at all of regulation, its logics......The dissertation analyzes a contemporary battlefield of law, the field of EU social rights, from a political-philosophical point of view. It is the conviction of the dissertation that law is deeply and inescapably conceptually connected with fundamental features of social order. The interrelations...... and sources of authority. On the basis of a historical-conceptual understanding of law according to which law, social structure and metaphysical presumptions are inescapably intertwined, the dissertation derives from the binding provisions of law certain essential features of social order. More precisely...

New Grand Narratives: The Metaphysical Worldview of 'Avatar' and 'Cloud Atlas'

NARCIS (Netherlands)

Früchtl, J.

2016-01-01

Referring to the films Avatar (2009) and Cloud Atlas (2012), the author will demonstrate that a new era of metaphysical holism follows Postmodernism. These films celebrate a resurrection of the flesh with 3-D technology and a reincarnation of souls with the aesthetic technique of morphing. However

Radiographic changes in rhesus macaques affected by scurvy

International Nuclear Information System (INIS)

Morgan, J.P.; Eisele, P.H.

1992-01-01

Spontaneous vitamin C deficiency, or scurvy, was recognized in juvenile rhesus monkeys maintained in a research center as a result of being fed a commercial diet for 2 to 3 months with low levels of vitamin C. Most severely affected animals (13) were radiographed repeatedly up to day 300 following detection of the disease. Early radiographic changes consisted of widened, lucent metaphyses with lateral flaring and radiopaque metaphyseal lines at the junction of the metaphyses and physes. Physeal slippage was noted commonly. Following institution of vitamin C therapy, calcification of subperiosteal hemorrhage occurred in the metaphyseal regions. Metaphyses and physes returned to normal radiographic appearance within 15 to 30 days. Initially, the subperiosteal hemorrhage progressed and a longer time was required for solution of the calcified hematomas. The macaques improved clinically and were released from the hospital when fractures were stable at 4-5 weeks after admission. Of the 13 macaques studied, all but one returned as normal members of the colony

Interpretations of Probability in Quantum Mechanics: A Case of "Experimental Metaphysics"

Science.gov (United States)

Hellman, Geoffrey

After reviewing paradigmatic cases of "experimental metaphysics" basing inferences against local realism and determinism on experimental tests of Bells theorem (and successors), we concentrate on clarifying the meaning and status of "objective probability" in quantum mechanics. The terms "objective" and "subjective" are found ambiguous and inadequate, masking crucial differences turning on the question of what the numerical values of probability functions measure vs. the question of the nature of the "events" on which such functions are defined. This leads naturally to a 2×2 matrix of types of interpretations, which are then illustrated with salient examples. (Of independent interest are the splitting of "Copenhagen interpretation" into "objective" and "subjective" varieties in one of the dimensions and the splitting of Bohmian hidden variables from (other) modal interpretations along that same dimension.) It is then explained why Everett interpretations are difficult to categorize in these terms. Finally, we argue that Bohmian mechanics does not seriously threaten the experimental-metaphysical case for ultimate randomness and purely physical probabilities.

FEASIBILITY OF HYDRAULIC FRACTURING OF SOILS TO IMPROVE REMEDIAL ACTIONS

Science.gov (United States)

Hydraulic fracturing, a method of increasing fluid flow within the subsurface, should improve the effectiveness of several remedial techniques, including pump and treat, vapor extraction, bio-remediation, and soil-flushing. he technique is widely used to increase the yields of oi...

[The metaphysical dimension of animal ethics].

Science.gov (United States)

Walz, Norbert

2008-01-01

Utilitarian ethics recognises animals as moral objects, but it does not attribute an absolute value to human or non-human individuals. Animal ethics according to Regan defines the non-human individual as an inherent value, but concedes that humans should be given precedence over animals if a situation involves a decision between life and death. Such life and death decisions relate to the fundamental structures of biological nature. To individuals these fundamental structures (the paradox of life and death) will necessarily appear absurd. The metaphysical dimension of animal ethics tries to shed light on the connections between life and death, body and mind that underly ethical discussions and searches for alternatives to the natural organisation of life.

INVESTIGATION OF EFFICIENCY IMPROVEMENTS DURING CO2 INJECTION IN HYDRAULICALLY AND NATURALLY FRACTURED RESERVOIRS

Energy Technology Data Exchange (ETDEWEB)

David S. Schechter

2005-04-27

This report describes the work performed during the fourth year of the project, ''Investigating of Efficiency Improvements during CO{sub 2} Injection in Hydraulically and Naturally Fractured Reservoirs.'' The objective of this project is to perform unique laboratory experiments with artificially fractured cores (AFCs) and X-ray CT scanner to examine the physical mechanisms of bypassing in hydraulically fractured reservoirs (HFR) and naturally fractured reservoirs (NFR) that eventually result in more efficient CO{sub 2} flooding in heterogeneous or fracture-dominated reservoirs. In Chapter 1, we worked with DOE-RMOTC to investigate fracture properties in the Tensleep Formation at Teapot Dome Naval Reserve as part of their CO{sub 2} sequestration project. In Chapter 2, we continue our investigation to determine the primary oil recovery mechanism in a short vertically fractured core. Finally in Chapter 3, we report our numerical modeling efforts to develop compositional simulator with irregular grid blocks.

Purpose in the Universe the moral and metaphysical case for ananthropocentric purposivism

CERN Document Server

Mulgan, Tim

2015-01-01

Two familiar worldviews dominate Western philosophy: materialist atheism and the benevolent God of the Abrahamic faiths. Tim Mulgan explores a third way. Ananthropocentric Purposivism claims that there is a cosmic purpose, but human beings are irrelevant to it. Purpose in the Universe develops a philosophical case for Ananthropocentric Purposivism that it is at least as strong as the case for either theism or atheism. The book borrows traditional theist arguments to defend a cosmic purpose. These include cosmological, teleological, ontological, meta-ethical, and mystical arguments. It then borrows traditional atheist arguments to reject a human-centred purpose. These include arguments based on evil, diversity, and the scale of the universe. Mulgan also highlights connections between morality and metaphysics, arguing that evaluative premises play a crucial and underappreciated role in metaphysical debates about the existence of God, and Ananthropocentric Purposivism mutually supports an austere consequentialis...

Fracture toughness improvements of dental ceramic through use of yttria-stabilized zirconia (YSZ) thin-film coatings.

Science.gov (United States)

Chan, Ryan N; Stoner, Brian R; Thompson, Jeffrey Y; Scattergood, Ronald O; Piascik, Jeffrey R

2013-08-01

The aim of this study was to evaluate strengthening mechanisms of yttria-stabilized zirconia (YSZ) thin film coatings as a viable method for improving fracture toughness of all-ceramic dental restorations. Bars (2mm×2mm×15mm, n=12) were cut from porcelain (ProCAD, Ivoclar-Vivadent) blocks and wet-polished through 1200-grit using SiC abrasive. A Vickers indenter was used to induce flaws with controlled size and geometry. Depositions were performed via radio frequency magnetron sputtering (5mT, 25°C, 30:1 Ar/O2 gas ratio) with varying powers of substrate bias. Film and flaw properties were characterized by optical microscopy, scanning electron microscopy (SEM), and X-ray diffraction (XRD). Flexural strength was determined by three-point bending. Fracture toughness values were calculated from flaw size and fracture strength. Data show improvements in fracture strength of up to 57% over unmodified specimens. XRD analysis shows that films deposited with higher substrate bias displayed a high %monoclinic volume fraction (19%) compared to non-biased deposited films (87%), and resulted in increased film stresses and modified YSZ microstructures. SEM analysis shows critical flaw sizes of 67±1μm leading to fracture toughness improvements of 55% over unmodified specimens. Data support surface modification of dental ceramics with YSZ thin film coatings to improve fracture toughness. Increase in construct strength was attributed to increase in compressive film stresses and modified YSZ thin film microstructures. It is believed that this surface modification may lead to significant improvements and overall reliability of all-ceramic dental restorations. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Being Itself and the Being of Beings : Reading Aristotle’s Critique of Parmenides (Physics 1.3) after Metaphysics

OpenAIRE

Backman, Jussi

2018-01-01

The essay studies Aristotle’s critique of Parmenides (Physics 1.3) in the light of the Heideggerian account of Platonic-Aristotelian metaphysics as an approach to being (Sein) in terms of beings (das Seiende). Aristotle’s critique focuses on the presuppositions of the Parmenidean thesis of the unity of being. It is argued that a close study of the presuppositions of Aristotle’s own critique reveals an important difference between the Aristotelian metaphysical framework and the ...

Immediate Care of Open Extremity Fractures: Where Can We Improve?

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R. Walton

2014-01-01

Full Text Available Clear guidelines are set by the British Orthopaedic Association (BOA and British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS on the preoperative management of open fractures. This as well as the clinical consequences of poor management of open fractures means the patient workup for surgery is important as well as the timing of surgery. Experience suggests few patients are managed 100% as per the guidelines and we look to test this hypothesis. A retrospective analysis was undertaken of all open long bone fractures (total 133, excluding hand injuries, which presented to a district general hospital over a 5-year period. The implementation of 7 defined key tasks for initial management was recorded. 101 cases were eligible, with the majority of cases (71.4% having initial orthopaedic assessment outside normal working hours. The mean number of tasks completed was 3.23/7. Assessment out of hours was associated with less tasks being implemented but doctor seniority and the presence of polytrauma made no difference to the quality of acute care. Staff involved in the acute care of open fractures require targeted education to improve the delivery of initial preoperative care. We recommend that other centres assess their performance against this data.

Immediate Care of Open Extremity Fractures: Where Can We Improve?

Science.gov (United States)

Walton, R.; Manara, J.; Elamin, S. E.; Braithwaite, I.; Wood, E.

2014-01-01

Clear guidelines are set by the British Orthopaedic Association (BOA) and British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) on the preoperative management of open fractures. This as well as the clinical consequences of poor management of open fractures means the patient workup for surgery is important as well as the timing of surgery. Experience suggests few patients are managed 100% as per the guidelines and we look to test this hypothesis. A retrospective analysis was undertaken of all open long bone fractures (total 133), excluding hand injuries, which presented to a district general hospital over a 5-year period. The implementation of 7 defined key tasks for initial management was recorded. 101 cases were eligible, with the majority of cases (71.4%) having initial orthopaedic assessment outside normal working hours. The mean number of tasks completed was 3.23/7. Assessment out of hours was associated with less tasks being implemented but doctor seniority and the presence of polytrauma made no difference to the quality of acute care. Staff involved in the acute care of open fractures require targeted education to improve the delivery of initial preoperative care. We recommend that other centres assess their performance against this data. PMID:24672795

Leibniz on the metaphysical foundation of physics

Science.gov (United States)

Temple, Daniel R.

This thesis examines how and why Leibniz felt that physics must be grounded in metaphysics. I argue that one of the strongest motivation Leibniz had for attempting to ground physics in metaphysics was his concern over the problem of induction. Even in his early writings, Leibniz was well aware of the problem of induction and how this problem threatened the very possibility of physics. Both his early and later theories of truth are geared towards solving this deep problem in the philosophy of science. In his early theory of truth, all truths are ultimately grounded in (but not necessarily reducible to) an identity. Hence, all truths are ultimately based in logic. Consequently, the problem of induction is seemingly solved since everything that happens, happens with the force of logical necessity. Unfortunately, this theory is incompatible with Leibniz's theory of possible worlds and hence, jeopardizes the liberty of God. In Leibniz's later theory of truth, Leibniz tries to overcome this weakness by acknowledging truths that are grounded in the free but moral necessity of God's actions. Since God's benevolence is responsible for the actualization of this world, then this world must possess rational laws. Furthermore, since God's rationality ensures that everything obeys the principle of sufficient reason, then we can use this principle to determine the fundamental laws of the universe. Leibniz himself attempts to derive these laws using this principle. Kant attempted to continue this work of securing the possibility of science, and the problems he encountered helped to shape his critical philosophy. So I conclude by a comparative analysis of Leibniz and Kant on the foundations of physics.

Diderot’s ontology and Hollywood metaphysics

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Božovič Miran

2013-01-01

Full Text Available Diderot’s universe is somewhat weird, often dreamlike and hallucinatory, and his ontology fluid and elusive. It comprises the existing, the non-existent and even contradictory entities, the boundaries between which cannot always be clearly delimited. This universe in which nothing is of the essence of a particular being and everything is more or less something or other, resembles the amorphous and oneiric world of Zhuangzi in which nothing is clearly defined, while essenceless things, floating in uncertainty and indeterminacy, literally blend into one another. The author examines what the early Hollywood comedies of Preston Sturges and the Marx brothers can teach us about the metaphysics and the principles at work in this complex and intricate world.

Audism: exploring the metaphysics of oppression.

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Bauman, H-Dirksen L

2004-01-01

This article traces the development of the concept of "audism" from its inception in the mid-1970s by exploring three distinct dimensions of oppression: individual, institutional, and metaphysical. Although the first two aspects of audism have been identified, there is a deeply rooted belief system regarding language and human identity that is yet to be explored within the context of audism. This article attempts to expose how our particular historical and philosophical constructions of language and being have created what French philosopher Jacques Derrida calls phonocentrism. Although Derrida does not discuss audism, his deconstruction of the Western notion of language provides a lens through which we can better see the orientation that has provided fertile ground out of which individual and institutional audism has flourished.

Aeg maast ikus. Ristikivi metafüüsiline kronotoop / Time in the landscape. Ristikivi’s metaphysical chronotope

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Õnne Kepp

2016-09-01

Full Text Available The article examines two novels published during the early years of Karl Ristikivi’s exile, All That Ever Was (1946 and Nothing Happened (1947, and his poetry from 1950s. The main aim is to explain the poetic and semantic mechanism that transformed Ristikivi’s realism of the 1930s into a metaphysical outlook in the 1940s and 1950s. The Estonian landscape has long been a significant source of inspiration for Estonian poetry (and, frequently, prose for the expression of an individual’s spatio-temporal relations. For Ristikivi, landscape plays an essential role in the conception of his literary chronotope. To gain a deeper understanding of the emergence of Ristikivi’s metaphysical chronotope in these two novels one must search for corresponding time and space imagery. Natural elements manifest the spatio-temporal relations that find expression in time-containing landscapes. Often the cyclical landscape reflects a character’s life, although the narrator’s perspective is always from the present to the past. In Ristikivi’s works, the present lacks a sense of place – a permanent relationship with a physical place. Regarding the time aspect, one could however refer to the so-called biographical inversion, biographical reversals, retreating to a long-gone golden era, where space too had different qualities. The spatio-temporal universality of nature imagery is vividly expressed in Ristikivi’s poetry. Metaphysical space is portrayed using concrete metaphors (sea, island, shore, but time-specific independent imagery is missing – time is portrayed as an organic part of landscape and of space as a whole. Here, what is important is not the realistic passage of time and its peripherally associated phenomena, but the experience of an earthly journey, the so-called destined time. The atmosphere is one of metaphysical flight from life, unreal landscapes in a bizarre world and a temporal vacuum. In the lyrics, Risikivi’s metaphysical

Delayed-Choice Experiments and the Metaphysics of Entanglement

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Egg, Matthias

2013-09-01

Delayed-choice experiments in quantum mechanics are often taken to undermine a realistic interpretation of the quantum state. More specifically, Healey has recently argued that the phenomenon of delayed-choice entanglement swapping is incompatible with the view that entanglement is a physical relation between quantum systems. This paper argues against these claims. It first reviews two paradigmatic delayed-choice experiments and analyzes their metaphysical implications. It then applies the results of this analysis to the case of entanglement swapping, showing that such experiments pose no threat to realism about entanglement.

Basic structures of reality essays in meta-physics

CERN Document Server

McGinn, Colin

2011-01-01

In Basic Structures of Reality, Colin McGinn deals with questions of metaphysics, epistemology, and philosophy of mind from the vantage point of physics. Combining general philosophy with physics, he covers such topics as the definition of matter, the nature of space, motion, gravity, electromagnetic fields, the character of physical knowledge, and consciousness and meaning. Throughout, McGinn maintains an historical perspective and seeks to determine how much we really know of the world described by physics. He defends a version of "structuralism": the thesis that our knowledge is p

Room for improvement in the treatment of hip fractures in Denmark

DEFF Research Database (Denmark)

Egerod, Ingrid; Rud, Kirsten; Specht, Kirsten

2010-01-01

INTRODUCTION: Treatment of hip fractures has evolved since the introduction of fast-track surgical programs in the late 1990s. The aim of our study was to describe the quality of treatment and care related to fast-track hip fracture surgery in Denmark by external audit of patient records. MATERIAL......, nutritional screening, ambulation characteristics, training in activities of daily living, and rehabilitation planning were consistently inadequate. Length of stay was 7-11 days. CONCLUSION: Although the principles for fast-track surgery have been adapted to some extent at all departments in Denmark...... with an annual treatment of at least 50 patients with hip fractures, no single department has implemented the whole package. Hospital stay has been reduced since the introduction of fast-track regimes, and improvements were seen in many of the quality indicators. Implications for future practice include better...

Biomechanical in vitro assessment of screw augmentation in locked plating of proximal humerus fractures.

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Röderer, Götz; Scola, Alexander; Schmölz, Werner; Gebhard, Florian; Windolf, Markus; Hofmann-Fliri, Ladina

2013-10-01

Proximal humerus fracture fixation can be difficult because of osteoporosis making it difficult to achieve stable implant anchorage in the weak bone stock even when using locking plates. This may cause implant failure requiring revision surgery. Cement augmentation has, in principle, been shown to improve stability. The aim of this study was to investigate whether augmentation of particular screws of a locking plate aimed at a region of low bone quality is effective in improving stability in a proximal humerus fracture model. Twelve paired human humerus specimens were included. Quantitative computed tomography was performed to determine bone mineral density (BMD). Local bone quality in the direction of the six proximal screws of a standard locking plate (PHILOS, Synthes) was assessed using mechanical means (DensiProbe™). A three-part fracture model with a metaphyseal defect was simulated and fixed with the plate. Within each pair of humeri the two screws aimed at the region of the lowest bone quality according to the DensiProbe™ were augmented in a randomised manner. For augmentation, 0.5 ml of bone cement was injected in a screw with multiple outlets at its tip under fluoroscopic control. A cyclic varus-bending test with increasing upper load magnitude was performed until failure of the screw-bone fixation. The augmented group withstood significantly more load cycles. The correlation of BMD with load cycles until failure and BMD with paired difference in load cycles to failure showed that augmentation could compensate for a low BMD. The results demonstrate that augmentation of screws in locked plating in a proximal humerus fracture model is effective in improving primary stability in a cyclic varus-bending test. The augmentation of two particular screws aimed at a region of low bone quality within the humeral head was almost as effective as four screws with twice the amount of bone cement. Screw augmentation combined with a knowledge of the local bone quality

Deus: metafísica e pensar pós-metafísico (God: metaphysics and post-metaphysical thinking - DOI: 10.5752/P.2175-5841.2010v8n16p8

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Ibraim Vitor de Oliveira

2010-04-01

Full Text Available Normal 0 21 false false false MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabela normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Editorial - Dossiê: Pensamento pós-metafísico e discurso sobre Deus – (Dossier: Post-metaphysical thought and speech about God Normal 0 21 false false false MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabela normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Deus: metafísica e pensar pós-metafísico (God: metaphysics and post-metaphysical thinking - DOI: 10.5752/P.2175-5841.2010v8n16p8 

The Value Question in Metaphysics

Science.gov (United States)

Kahane, Guy

2012-01-01

Much seems to be at stake in metaphysical questions about, for example, God, free will or morality. One thing that could be at stake is the value of the universe we inhabit—how good or bad it is. We can think of competing philosophical positions as describing possibilities, ways the world might turn out to be, and to which value can be assigned. When, for example, people hope that God exists, or fear that we do not possess free will, they express attitudes towards these possibilities, attitudes that presuppose answers to questions about their comparative value. My aim in this paper is to distinguish these evaluative questions from related questions with which they can be confused, to identify structural constraints on their proper pursuit, and to address objections to their very coherence. Answers to such evaluative questions offer one measure of the importance of philosophical disputes. PMID:23024399

The Value Question in Metaphysics.

Science.gov (United States)

Kahane, Guy

2012-07-01

Much seems to be at stake in metaphysical questions about, for example, God, free will or morality. One thing that could be at stake is the value of the universe we inhabit-how good or bad it is. We can think of competing philosophical positions as describing possibilities, ways the world might turn out to be, and to which value can be assigned. When, for example, people hope that God exists, or fear that we do not possess free will, they express attitudes towards these possibilities, attitudes that presuppose answers to questions about their comparative value. My aim in this paper is to distinguish these evaluative questions from related questions with which they can be confused, to identify structural constraints on their proper pursuit, and to address objections to their very coherence. Answers to such evaluative questions offer one measure of the importance of philosophical disputes.

Guideline-Driven Care Improves Outcomes in Patients with Traumatic Rib Fractures.

Science.gov (United States)

Flarity, Kathleen; Rhodes, Whitney C; Berson, Andrew J; Leininger, Brian E; Reckard, Paul E; Riley, Keyan D; Shahan, Charles P; Schroeppel, Thomas J

2017-09-01

There is no established national standard for rib fracture management. A clinical practice guideline (CPG) for rib fractures, including monitoring of pulmonary function, early initiation of aggressive loco-regional analgesia, and early identification of deteriorating respiratory function, was implemented in 2013. The objective of the study was to evaluate the effect of the CPG on hospital length of stay. Hospital length of stay (LOS) was compared for adult patients admitted to the hospital with rib fracture(s) two years before and two years after CPG implementation. A separate analysis was done for the patients admitted to the intensive care unit (ICU). Over the 48-month study period, 571 patients met inclusion criteria for the study. Pre-CPG and CPG study groups were well matched with few differences. Multivariable regression did not demonstrate a difference in LOS (B = -0.838; P = 0.095) in the total study cohort. In the ICU cohort (n = 274), patients in the CPG group were older (57 vs 52 years; P = 0.023) and had more rib fractures (4 vs 3; P = 0.003). Multivariable regression identified a significant decrease in LOS for those patients admitted in the CPG period (B = -2.29; P = 0.019). Despite being significantly older with more rib fractures in the ICU cohort, patients admitted after implementation of the CPG had a significantly reduced LOS on multivariable analysis, reducing LOS by over two days. This structured intervention can limit narcotic usage, improve pulmonary function, and decrease LOS in the most injured patients with chest trauma.

Metaphyseal osteomyelitis in children: how often does MRI-documented joint effusion or epiphyseal extension of edema indicate coexisting septic arthritis?

Energy Technology Data Exchange (ETDEWEB)

Schallert, Erica K.; Kan, J.H.; Monsalve, Johanna; Zhang, Wei; Bisset, George S. [Texas Children' s Hospital, Department of Pediatric Radiology, Houston, TX (United States); Rosenfeld, Scott [Texas Children' s Hospital, Department of Pediatric Orthopedic Surgery, Houston, TX (United States)

2015-08-15

Joint effusions identified by MRI may accompany osteomyelitis and determining whether the joint effusion is septic or reactive has important implications on patient care. Determine the incidence of epiphyseal marrow edema, joint effusions, perisynovial edema and epiphyseal non-enhancement in the setting of pediatric metaphyseal osteomyelitis and whether this may be used to predict coexisting septic arthritis. Following IRB approval, we retrospectively evaluated children who underwent MRI and orthopedic surgical consultation for suspected musculoskeletal infection between January 2011 and September 2013. Criteria for inclusion in the study were microbiologically/pathologically proven infection, MRI prior to surgical intervention, long bone involvement and age 0-18 years. MRI exams were independently reviewed by two faculty pediatric radiologists to confirm the presence of appendicular metaphyseal osteomyelitis, to evaluate extent of edema, to determine subjective presence of a joint effusion and to assess perisynovial edema and epiphyseal non-enhancement. Any discrepant readings were reviewed in consensus. Charts and operative notes were reviewed to confirm the diagnosis of osteomyelitis and septic arthritis. One hundred and three joints with metaphyseal osteomyelitis were identified (mean age: 7.1 years; M:F 1.3:1), of whom 53% (55/103) had joint effusions, and of those, 75% (41/55) had surgically confirmed septic arthritis. The incidence of coexisting septic arthritis was 40% in the setting of epiphyseal edema, 74% in epiphyseal edema and effusion, 75% with perisynovial edema, 76% with epiphyseal non-enhancement and 77% when all four variables were present. Of these, the only statistically significant variable, however, was the presence of a joint effusion with a P-value of <0.0001 via Fisher exact test. Statistical significance for coexisting septic arthritis was also encountered when cases were subdivided into intra-articular vs. extra-articular metaphyses (P

Metaphyseal osteomyelitis in children: how often does MRI-documented joint effusion or epiphyseal extension of edema indicate coexisting septic arthritis?

International Nuclear Information System (INIS)

Schallert, Erica K.; Kan, J.H.; Monsalve, Johanna; Zhang, Wei; Bisset, George S.; Rosenfeld, Scott

2015-01-01

Joint effusions identified by MRI may accompany osteomyelitis and determining whether the joint effusion is septic or reactive has important implications on patient care. Determine the incidence of epiphyseal marrow edema, joint effusions, perisynovial edema and epiphyseal non-enhancement in the setting of pediatric metaphyseal osteomyelitis and whether this may be used to predict coexisting septic arthritis. Following IRB approval, we retrospectively evaluated children who underwent MRI and orthopedic surgical consultation for suspected musculoskeletal infection between January 2011 and September 2013. Criteria for inclusion in the study were microbiologically/pathologically proven infection, MRI prior to surgical intervention, long bone involvement and age 0-18 years. MRI exams were independently reviewed by two faculty pediatric radiologists to confirm the presence of appendicular metaphyseal osteomyelitis, to evaluate extent of edema, to determine subjective presence of a joint effusion and to assess perisynovial edema and epiphyseal non-enhancement. Any discrepant readings were reviewed in consensus. Charts and operative notes were reviewed to confirm the diagnosis of osteomyelitis and septic arthritis. One hundred and three joints with metaphyseal osteomyelitis were identified (mean age: 7.1 years; M:F 1.3:1), of whom 53% (55/103) had joint effusions, and of those, 75% (41/55) had surgically confirmed septic arthritis. The incidence of coexisting septic arthritis was 40% in the setting of epiphyseal edema, 74% in epiphyseal edema and effusion, 75% with perisynovial edema, 76% with epiphyseal non-enhancement and 77% when all four variables were present. Of these, the only statistically significant variable, however, was the presence of a joint effusion with a P-value of <0.0001 via Fisher exact test. Statistical significance for coexisting septic arthritis was also encountered when cases were subdivided into intra-articular vs. extra-articular metaphyses (P

Improvement of the fracture toughness matrix cured by electron beam radiation, by incorporation of thermoplastic

International Nuclear Information System (INIS)

Chauray, E.

2003-07-01

The aim of the present study is to improve the fracture toughness of a vinyl-ester matrix cured by electron beam radiation, by incorporation of a thermoplastic polymer. The ultimate plan is to improve the fracture toughness of the composite material made of this reinforced matrix and carbon fibres. The first step deals with the study of an epoxy matrix reinforced by a polyether-sulfone. This well-known material, as it is used in industrial formulation, allowed us to characterize all the parameters needed to obtain a good reinforcement as for instance the morphology, and also to compare two kinds of processes: thermal and electron beam curing. In fact, we are really interested in increasing fracture toughness of a vinyl-ester matrix that is not miscible with polyether-sulfone. So a copolymer which has a similar structure as polyether-sulfone is synthesized in order to obtain a miscible blend. The corresponding material has good fracture toughness, with an increase of 80 % for 15 % addition of thermoplastic. (author)

Metaphyseal pattern: Uniqueness of this structure in growing bones originating from cartilaginous anlage

International Nuclear Information System (INIS)

Balmain, N.; Moscofian, A.; Cuisinier-Gleizes, P.

1983-01-01

Microradiographic examination of metaphyses in long and short tubular growing bones allowed detection of a repetitive, clearly defined pattern of three adjacent zones; the latter are successively formed by the mineralization of cartilaginous longitudinal intercolumnar septa and by the subsequent apposition of other mineralized tissues concurrently with resorption. Consequently, each zone of the metaphysis includes mineralized tissues of various compositions and ages, identifiable by their different mineralization densities. Microradiography of pieces of the growing skeleton in several animal species shows that the same organization is not only present in long and short tubular bones but also in many other such as the pelvis and scapula, cuboid bones like the calcaneum and talus, and cartilaginous bones at the base of the skull. This suggests that there is no difference between the osteogenesis pattern of these bones and tubular ones. The problem of identifying the factors generating such metaphyseal organization is raised. (orig.)

Like an Image: Sensibility and Reflexivity in Descartes’ Metaphysics

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Augustin Dumont

2014-06-01

Full Text Available This paper aims at questioning the role of image and imagination in Descartes’ Metaphysics, especially in the Meditations on First Philosophy, by holding both a certain doctrinal or theoretical discourse on image/imagination and the Cartesian use of images/imagination. Besides the fact that this rarely considered perspective prevents from freezing the original text, this strategy allows to highlight the ambiguity of theses notions, revealed through what is doing by the act of imagining compared to the act of conceiving with the understanding.

Truth, Art, and the “New Sensuousness”: Understanding Heidegger’s Metaphysical Reading of Nietzsche

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James Magrini

2009-06-01

Full Text Available In the first of four lectures on Nietzsche’s philosophy, “The Will to Poweras Art” (1936-37, Heidegger argues that the unique and importantrelationship between truth and art, which Nietzsche suggests, must beunderstood “with a view to the conquest of nihilism,” i.e., within the historical context of a radically novel interpretation of sensuous reality. Beginning with the project of overturning Platonism as the active countermovement to nihilism, this essay interprets Heidegger’s difficult notion of the discordant relationship between truth (the fixation of semblance and art (the transfiguration of semblance in Nietzsche’s philosophy, emphasizing the supreme importance of art as life’s greatest enhancing force. The analysis is conducted within the context of Nietzsche’s metaphysics as presented by Heidegger, who claims thatas a metaphysical thinker, Nietzsche could not explain such topics as “truth,” “Being,” and “Becoming” in terms beyond the conceptualization of Western philosophy. In spite of that, his thought intimates a movement beyond the constraints of the tradition within which he was entrenched. In addition to providing a detailed exegesis of Heidegger’s lecture course, the problems associated with Heidegger’s metaphysical interpretation of Nietzsche’s philosophy will be discussed, problems that commentators such as Alan Schrift (Nietzsche and the Question of Interpretation believe stem from Heidegger’s stringent and restrictive methodological choices for approaching the reading of Nietzsche.

Different methods and metaphysics in early molecular genetics--a case of disparity of research?

Science.gov (United States)

Deichmann, Ute

2008-01-01

The encounter between two fundamentally different approaches in seminal research in molecular biology--the problems, aims, methods and metaphysics--is delineated and analyzed. They are exemplified by the microbiologist Oswald T. Avery who, in line with the reductionist mechanistic metaphysics of Jacques Loeb, attempted to explain basic life phenomena through chemistry; and the theoretical physicist Max Delbrück who, influenced by Bohr's antimechanistic views, preferred to explain these phenomena without chemistry. Avery's and Delbrück's most important studies took place concurrently. Thus analysis of their contrasting approaches lends itself to examination of the Weltanschauungen view concerning the role of fundamental (metaphysical) assumptions in scientific change, that is, the view that empirical research cannot be neutral in regard to the worldviews of the researchers. This study shows that the initial ostensible disparity (non-integratibility) of the two approaches lasted for just a short time. Ironically it was a student of Delbrück's school, James Watson, who (with Crick) proposed a chemical model, the DNA double helix, as a solution to Delbrück's problem. The structure of DNA has not been seriously challenged over the past half century Moreover, Watson's and Crick's work did not call into question the validity of Delbrück's research, but opened it up to entirely new approaches. The case of Avery and Delbrück demonstrates that after initial obstacles were overcome the different fundamental attitudes and the resulting research practices were capable of integration.

Factors associated with infection following open distal radius fractures.

Science.gov (United States)

Glueck, Dane A; Charoglu, Constantine P; Lawton, Jeffrey N

2009-09-01

Open fractures are often classified according to a system described by Gustilo and Anderson. However, this system was applied to open long bone fractures, which may not predict the incidence of infection in open metaphyseal fractures of the upper extremity. Other studies have found that wound contamination and systemic illness were the best predictors of infections in open hand fractures. Our study assessed infection in open distal radius fractures and identifies factors that are associated with these infections. We hypothesize that contamination, rather than absolute wound size, is the best predictor of infection associated with open distal radius fractures. A review by CPT code yielded 42 patients with open distal radius fractures between 1997 and 2002 treated at a level one trauma center. Medical records and radiographic follow-up were reviewed to assess the time to irrigation and debridement, the number of debridements in initial treatment period, the method of operative stabilization, the Gustilo and Anderson type of fracture, the Swanson type of fracture, and description of wound contamination. Forty-two patients were followed up for an average of 15 months (range 4 to 68 months). Twenty-four fractures were classified as Gustilo and Anderson type I, ten were type II, and eight were type III, 30 were Swanson type I, and 12 were Swanson type II. Five of the 42 fractures were considered contaminated. Two were exposed to fecal contamination. The others were contaminated with tar, dirt/grass, and gravel, respectively. Three of 42 (7%) fractures developed infections. All three infected cases received a single irrigation and debridement. Two of five contaminated fractures (40%) developed a polymicrobial infection. Both were exposed to fecal contamination and, therefore, considered Swanson type II fractures. They were classified as Gustilo and Anderson type II and IIIB based solely upon the size of the wound. Both required multiple debridements and eventually wrist

Percutaneous locking plates for fractures of the distal tibia: our experience and a review of the literature.

Science.gov (United States)

Ahmad, Mudussar Abrar; Sivaraman, Alagappan; Zia, Ahmed; Rai, Amarjit; Patel, Amratlal D

2012-02-01

Distal tibial metaphyseal fractures pose many complexities. This study assessed the outcomes of distal tibial fractures treated with medial locking plates. Eighteen patients were selected based on the fracture pattern and classified using the AO classification and stabilized with an AO medial tibial locking plate. Time to fracture union, complications, and outcomes were assessed with the American Orthopedic Foot and Ankle Society Ankle score at 12 months. Sixteen of the 18 patients achieved fracture union, with 1 patient lost to follow-up. Twelve fractures united within 24 weeks, with an average union time of 23.1 weeks. Three delayed unions, two at 28 weeks and one at 56 weeks. The average time to union was 32 weeks in the smokers and 15.3 weeks in the nonsmokers. Five of the 18 patients (27%) developed complications. One superficial wound infection, and one chronic wound infection, resulting in nonunion at 56 weeks, requiring revision. Two patients required plate removal, one after sustaining an open fracture at the proximal end of the plate 6 months after surgery (postfracture union)and the other for painful hardware. One patient had implant failure of three proximal diaphyseal locking screws at the screwhead/neck junction, but successful fracture union. The average American Orthopedic Foot and Ankle Society ankle score was 88.8 overall, and 92.1 in fractures that united within 24 weeks. Distal tibial locking plates have high fracture union rates, minimum soft tissue complications, and good functional outcomes. The literature shows similar fracture union and complication rates in locking and nonlocking plates. Copyright © 2012 by Lippincott Williams & Wilkins

Absence of rickets in infants with fatal abusive head trauma and classic metaphyseal lesions.

Science.gov (United States)

Perez-Rossello, Jeannette M; McDonald, Anna G; Rosenberg, Andrew E; Tsai, Andy; Kleinman, Paul K

2015-06-01

To determine if rickets is present in cases of infant homicide with classic metaphyseal lesions (CMLs) and other skeletal injuries. This study was exempt from the institutional human subjects board review because all infants were deceased. An archival review (1984-2012) was performed of the radiologic and histopathologic findings of 46 consecutive infant fatalities referred from the state medical examiner's office for the evaluation of possible child abuse. Thirty infants with distal femoral histologic material were identified. Additional inclusion criteria were as follows: (a) The medical examiner determined that the infant had sustained a head injury and that the manner of death was a homicide, (b) at least one CML was evident at skeletal survey, (c) CMLs were confirmed at autopsy, and (d) non-CML fractures were also present. Nine infants (mean age, 3.9 months; age range, 1-9 months) were identified. Two pediatric radiologists independently reviewed the skeletal surveys for rachitic changes at the wrists and knees. A bone and soft tissue pathologist reviewed the distal femoral histologic slices for rickets. There were no radiographic or pathologic features of rickets in the cohort. The findings provide no support for the view that the CML is due to rickets. Rather, they strengthen a robust literature that states that the CML is a traumatic injury commonly encountered in physically abused infants. RSNA, 2015

An introduction to a metaphysics of nature: Representation, realism and scientific laws

Directory of Open Access Journals (Sweden)

Daniel Laskowski Tozzini

2016-12-01

Full Text Available Ghins, Michel. Introdução a uma metafísica da natureza: Representação, realismo e leis científicas (An introduction to a metaphysics of nature: Representation, realism and scientific laws. Transl. Eduardo Barra e Ronei Clécio Mocellin. Editora UFPR, 2013. 96 pp. R$ 35,00 – ISBN- 9788565888356.

Semantics and metaphysics in informatics: toward an ontology of tasks.

Science.gov (United States)

Figdor, Carrie

2011-04-01

This article clarifies three principles that should guide the development of any cognitive ontology. First, that an adequate cognitive ontology depends essentially on an adequate task ontology; second, that the goal of developing a cognitive ontology is independent of the goal of finding neural implementations of the processes referred to in the ontology; and third, that cognitive ontologies are neutral regarding the metaphysical relationship between cognitive and neural processes. Copyright © 2011 Cognitive Science Society, Inc.

Probing the limits of reality: the metaphysics in science fiction

Science.gov (United States)

Taylor, John L.

2003-01-01

Science fiction provides a genre in which metaphysical questions concerning the ultimate structure of reality regularly arise. In addressing these questions, contemporary scientists tend to assume that the questions are of a scientific nature and should be handled solely by reference to our best theories. In this paper, it is argued that we cannot afford to neglect the role of conceptual analysis - a distinctively philosophical task - in thinking critically about the possibilities that science fiction claims to describe.

Let's keep metaphysics out of medical ethics: a critique of Poplawski and Gillett.

Science.gov (United States)

Leavitt, F J

1992-01-01

I argue that the concept of 'longitudinal form', which Poplawski and Gillett have introduced into ethical discussions about embryos and gametes, involves too many metaphysical subtleties to be a useful aid to making moral decisions. I conclude by suggesting a criterion for relevance in medical ethics. PMID:1460650

Compartment syndrome like picture in metaphyseal comminuted fracture of tibia treated by locking plate due to tight closure

Directory of Open Access Journals (Sweden)

Prafulla Herode

2013-01-01

Full Text Available A 22-year-old male came to casualty on 5 th May 2012 after a fall from motorcycle. He complained of excruciating pain and swelling over right knee. There was an open wound of 7 × 2 cm over supra-patellar region and diffuse swelling over knee joint with severe tenderness over proximal aspect of right tibia. X-ray showed intra-articular fracture of proximal tibia extending to diaphysis classified as type 6 by Schatzker classification for proximal tibia, with fibula shaft transverse fracture. The skin over the fracture was contused. Debridement with primary wound closure was done in emergency. Skeletal traction was applied through a lower tibial Steinman pin. Patient was operated after 15 days when wound healed and swelling subsided. Locking plate was applied on medial aspect using Minimally invasive percutaneous plate osteosysthesis (MIPPO technique. Post-operatively over 4 hours patient developed severe pain and swelling in operated leg which mimicked compartment syndrome. Suture removal was done immediately in the ward from the distal aspect, which relieved the symptoms but lead to exposure of the plate. A rotational flap was done to cover the plate in coordination with a plastic surgeon on the next day.

Groundwork for Kant’s Practical Philosophy: Construction and Meaning of the Work "Groundwork for the Metaphysics of Morals"

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Goran Gretić

2006-01-01

Full Text Available In the article, the author provides a systematic analysis and interpretation of Kant’s major work ‘Groundwork for the Metaphysics of Morals’. The author demonstrates that Kant viewed his programme of founding a new kind of metaphysics as a distinctive unity of the practical and theoretical part of philosophy, i.e. a unity of pure practical reason with speculative reason. It is already manifested in the original common assumption of the ‘Groundwork’, because ‘at the end there can only be one and the same reason that can be diff erent only in its application’.

Hughlings Jackson and the "doctrine of concomitance": mind-brain theorising between metaphysics and the clinic.

Science.gov (United States)

Chirimuuta, M

2017-09-11

John Hughlings Jackson (1835-1911) is a major figure at the origins of neurology and neuroscience in Britain. Alongside his contributions to clinical medicine, he left a large corpus of writing on localisation of function in the nervous system and other theoretical topics. In this paper I focus on Jackson's "doctrine of concomitance"-his parallelist theory of the mind-brain relationship. I argue that the doctrine can be given both an ontological and a causal interpretation, and that the causal aspect of the doctrine is especially significant for Jackson and his contemporaries. I interpret Jackson's engagement with the metaphysics of mind as an instance of what I call meta-science-the deployment by scientists of metaphysical positions and arguments which help streamline empirical investigations by bracketing off unanswerable questions and focussing attention on matters amenable to the current tools of experimental research.

The Photodynamic Bone Stabilization System: a minimally invasive, percutaneous intramedullary polymeric osteosynthesis for simple and complex long bone fractures

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Vegt P

2014-12-01

Full Text Available Paul Vegt,1 Jeffrey M Muir,2 Jon E Block2 1Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands; 2The Jon Block Group, San Francisco, CA, USA Abstract: The treatment of osteoporotic long bone fractures is difficult due to diminished bone density and compromised biomechanical integrity. The majority of osteoporotic long bone fractures occur in the metaphyseal region, which poses additional problems for surgical repair due to increased intramedullary volume. Treatment with internal fixation using intramedullary nails or plating is associated with poor clinical outcomes in this patient population. Subsequent fractures and complications such as screw pull-out necessitate additional interventions, prolonging recovery and increasing health care costs. The Photodynamic Bone Stabilization System (PBSS is a minimally invasive surgical technique that allows clinicians to repair bone fractures using a light-curable polymer contained within an inflatable balloon catheter, offering a new treatment option for osteoporotic long bone fractures. The unique polymer compound and catheter application provides a customizable solution for long bone fractures that produces internal stability while maintaining bone length, rotational alignment, and postsurgical mobility. The PBSS has been utilized in a case series of 41 fractures in 33 patients suffering osteoporotic long bone fractures. The initial results indicate that the use of the light-cured polymeric rod for this patient population provides excellent fixation and stability in compromised bone, with a superior complication profile. This paper describes the clinical uses, procedural details, indications for use, and the initial clinical findings of the PBSS. Keywords: osteoporosis, long bone fracture, bone density, polymeric rod, orthopaedics, surgery

Polymer-cement interactions towards improved wellbore cement fracture sealants

Science.gov (United States)

Beckingham, B. S.; Iloejesi, C.; Minkler, M. J.; Schindler, A. K.; Beckingham, L. E.

2017-12-01

Carbon capture, utilization, and storage (CCUS) in deep geologic formations is a promising means of reducing point source emissions of CO2. In these systems, CO2 is captured at the source and then injected to be utilized (eg. in enhanced oil recovery or as a working fluid in enhanced geothermal energy plants) or stored in geologic formations such as depleted oil and gas reservoirs or saline aquifers. While CCUS in subsurface systems could aid in reducing atmospheric CO2 emissions, the potential for CO2 leakage from these systems to overlying formations remains a major limitation and poses a significant risk to the security of injected CO2. Thus, improved materials for both initial wellbore isolation and repairing leakage pathways that develop over time are sought. One approach for the repair of cement fractures in wellbore (and other) systems is the injection of polymer materials into the fracture with a subsequent environmentally dependent (temperature, pressure, pH, etc.) densification or solidification. Here, we aim to investigate novel polymer materials for use to repair leaking wellbores in the context of CCUS. We synthesize and fully characterize a series of novel polymer materials and utilize a suite of analysis techniques to examine polymer-cement interactions at a range of conditions (namely temperature, pressure and pH). Initial findings will be leveraged to design novel polymer materials for further evaluation in polymer-cement composite cores, cement fracture healing, and the aging behavior of healed cements.

[An improved reduction technique for depression fractures of lateral tibial plateau].

Science.gov (United States)

Wang, Hongchuan; Lou, Hua; Liu, Kai; Jiang, Junwei

2013-01-01

To investigate the improved reduction technique for depression fractures of the lateral tibial plateau and its effectiveness. Between January 2008 and December 2010; 48 patients (48 knees) with depression fractures of the lateral tibial plateau (Schatzker II or III fractures) were treated. There were 32 males and 16 females with an average age of 45.8 years (range, 16-79 years). All fractures were fresh closed fractures, which were caused by traffic accident in 27 cases, by falling from height in 5 cases, by crushing in 8 cases, and by sustained falls in 8 cases. According to Schatzker classification, 29 cases were classified as type II and 19 cases as type III. The lateral cortex was cut off to expose the depression and compacted cancellous bone was elevated to reset the articular surface. After reduction, autologous iliac bone graft and locking plate internal fixation were used. Healing of incision by first intention was achieved in all patients, and no complication occurred. All patients were followed up 1.7 years on average (range, 1-3 years). At last follow-up, the knee extension was (-0.5 +/- 0.3) degrees, and the knee flexion was (136.9 +/- 8.8) degrees. X-ray films showed that the fracture healing time was 52 weeks and no breakage of internal fixation occurred. According to Rasmussen clinical score, the results were excellent in 35 cases, good in 10 cases, and fair in 3 cases. According to Rasmussen radiographical score, the results were excellent in 41 cases, good in 7 cases; there were 41 excellent scores and 7 good scores of articular reduction; all gained good recovery of coronal and sagittal alignment and condylar width. The articular surface collapse was (1.0 +/- 0.7) mm at immediate postoperatively and (1.2 +/- 0.7) mm at last follow-up, showing no significant difference (t = -1.42, P = 0.20), but significant differences were found when compared with that at preoperation [(12.2 +/- 8.0) mm, P fracture reduction and can avoid loss of reduction. The

Wearing an active spinal orthosis improves back extensor strength in women with osteoporotic vertebral fractures

DEFF Research Database (Denmark)

Valentin, Gitte Hoff; Pedersen, Louise Nymann; Maribo, Thomas

2014-01-01

.Study design:Experimental follow-up.Methods:The women used the active spinal orthosis for 3 months. Outcomes were changes in isometric back extensor strength, changes in back pain and changes in physical functioning.Results:A total of 13 women were included in the trial. Wearing the orthosis during a 3-month......Background:Vertebral fractures are the most common clinical manifestations of osteoporosis. Vertebral fractures and reduced back extensor strength can result in hyperkyphosis. Hyperkyphosis is associated with diminished daily functioning and an increased risk of falling. Improvements in back...... extensor strength can result in decreased kyphosis and thus a decreased risk of falls and fractures.Objectives:The aim was to examine the effects of an active spinal orthosis - Spinomed III - on back extensor strength, back pain and physical functioning in women with osteoporotic vertebral fractures...

B. Radiologic-pathologic correlation of disturbed growth in children

International Nuclear Information System (INIS)

Borns, P.F.; Borden, S. IV.

1987-01-01

The second part of the course concentrates on the growing metaphysis in children as an indicator of bone growth and physiology. The authors concentrate on growth disturbances that cause abnormalities of metaphyseal contour, growth velocity, and width of the metaphysis. Densities within the metaphysis, including growth arrest lines, healing metaphyseal fractures, catch-up bone growth, and metabolic poisons, are addressed in detail. Radiographs with accompanying histopathologic sections are presented to illustrate the dynamic changes in the metaphyseal region in children. Lucencies in the metaphysis, including leukemic lines, metastatic disease, and acute disuse osteoporosis, receive special attention. Prognostic factors affecting the metasphysis such as intrinsic chondrodysplasia, previous fracture, or closure of the epiphyseal plate are described in detail

EVALUATION OF FUNCTIONAL OUTCOME AFTER OPEN REDUCTION AND INTERNAL FIXATION OF DISTAL FEMUR FRACTURES BY LOCKING COMPRESSION PLATE

Directory of Open Access Journals (Sweden)

L. Lokanadha Rao

2016-09-01

Full Text Available BACKGROUND In the supra and intercondylar fractures of femur particularly with intra articular extension, patient may develop stiffness of knee, shortening, rotational deformities, internal derangement of knee with instability, varus and valgus deformities which affect patient’s routine lifestyle. If these cases were treated with locking compression plate, the results obtained were successful, superior, timesaving providing early ambulation and least disability improving the functional outcome. MATERIALS AND METHODS This is a prospective interventional study. This study includes 25 supracondylar and intercondylar fractures of femur (both Muller’s Type ‘A’, Type B and Type ‘C’ fractures treated with open reduction and internal fixation by Locking Compression Plate in the Department of Orthopaedics, King George Hospital, Visakhapatnam from September 2013 to September 2015. There are 16 males and 9 females with age ranging from 20 to 80 years with an average of 44.6 years. Average age for males is 28.9 years and average age for females is 25 years. 18 fractures were due to road traffic accidents and 6 cases are due to fall from significant heights, 1 case due to simple fall from standing (osteoporosis. 15 cases were in right femur (60% and 10 cases were in left femur (40%. RESULTS 25 cases were included in the study. There is an increase in the rate of union, decreased time taken for union, increased knee range of motion, decreased time for weight-bearing, postoperative complications and duration for hospital stay. CONCLUSION LCP proved to be a good implant which could take the challenges like poor bone stock, severe comminution both metaphyseal and articular and prove successful. The locking head screws distally have prevented varus collapse, even in cases of osteoporosis. The Condylar LCP can be used in either an open or a minimally invasive manner.

The Problem of Absolute Knowledge. Metaphysics as Intellectual Intuition in Classic Modern European Philosophy

Science.gov (United States)

Torubarova, Tatyana V.

2016-01-01

Classic modern European philosophy explicate, reflect; leaving own history in fundamental metaphysical position, where the existence is understood as conscience. This position is representative in the process of historic development, transition of philosophical thought from R. Dekart to G. Hegel. It appears exactly the field of key metaphysical…

Microstructural design in quenched and partitioned (Q&P) steels to improve their fracture properties

International Nuclear Information System (INIS)

Diego-Calderón, I. de; Sabirov, I.; Molina-Aldareguia, J.M.; Föjer, C.; Thiessen, R.; Petrov, R.H.

2016-01-01

Quenching and partitioning (Q&P) is receiving increased attention as a novel heat treatment to produce advanced high strength steels (AHSSs) containing martensite/retained austenite mixtures, with desirable combination of strength, ductility and toughness. Despite the significant body of research on microstructure and mechanical properties of Q&P steels, there is still a significant lack of knowledge on the effect of complex microstructure on their mechanical performance. This work addresses the effect of microstructural architecture in multiphase Q&P steels on their fracture behavior at macro- and micro-scales. It is demonstrated that the RA volume fraction does not affect significantly the local fracture initiation toughness, whereas it can greatly improve the total crack growth resistance in Q&P steels. In addition, matrix conditions can play an important role in the fracture behavior of Q&P steels. Based on the analysis of the experimental results, a general recipe to tailor fracture properties of Q&P steels is proposed.

Biomechanics of the classic metaphyseal lesion: finite element analysis

Energy Technology Data Exchange (ETDEWEB)

Tsai, Andy; Kleinman, Paul K. [Boston Children' s Hospital, Department of Radiology, Harvard Medical School, Boston, MA (United States); Coats, Brittany [University of Utah, Department of Mechanical Engineering, Salt Lake City, UT (United States)

2017-11-15

The classic metaphyseal lesion (CML) is strongly associated with infant abuse, but the biomechanics responsible for this injury have not been rigorously studied. Radiologic and CT-pathological correlates show that the distal tibial CML always involves the cortex near the subperiosteal bone collar, with variable extension of the fracture into the medullary cavity. Therefore, it is reasonable to assume that the primary site of bone failure is cortical, rather than intramedullary. This study focuses on the strain patterns generated from finite element modeling to identify loading scenarios and regions of the cortex that are susceptible to bone failure. A geometric model was constructed from a normal 3-month-old infant's distal tibia and fibula. The model's boundary conditions were set to mimic forceful manipulation of the ankle with eight load modalities (tension, compression, internal rotation, external rotation, dorsiflexion, plantar flexion, valgus bending and varus bending). For all modalities except internal and external rotation, simulations showed increased cortical strains near the subperiosteal bone collar. Tension generated the largest magnitude of cortical strain (24%) that was uniformly distributed near the subperiosteal bone collar. Compression generated the same distribution of strain but to a lesser magnitude overall (15%). Dorsiflexion and plantar flexion generated high (22%) and moderate (14%) localized cortical strains, respectively, near the subperiosteal bone collar. Lower cortical strains resulted from valgus bending, varus bending, internal rotation and external rotation (8-10%). The highest valgus and varus bending cortical strains occurred medially. These simulations suggest that the likelihood of the initial cortical bone failure of the CML is higher along the margin of the subperiosteal bone collar when the ankle is under tension, compression, valgus bending, varus bending, dorsiflexion and plantar flexion, but not under internal

Biomechanics of the classic metaphyseal lesion: finite element analysis

International Nuclear Information System (INIS)

Tsai, Andy; Kleinman, Paul K.; Coats, Brittany

2017-01-01

The classic metaphyseal lesion (CML) is strongly associated with infant abuse, but the biomechanics responsible for this injury have not been rigorously studied. Radiologic and CT-pathological correlates show that the distal tibial CML always involves the cortex near the subperiosteal bone collar, with variable extension of the fracture into the medullary cavity. Therefore, it is reasonable to assume that the primary site of bone failure is cortical, rather than intramedullary. This study focuses on the strain patterns generated from finite element modeling to identify loading scenarios and regions of the cortex that are susceptible to bone failure. A geometric model was constructed from a normal 3-month-old infant's distal tibia and fibula. The model's boundary conditions were set to mimic forceful manipulation of the ankle with eight load modalities (tension, compression, internal rotation, external rotation, dorsiflexion, plantar flexion, valgus bending and varus bending). For all modalities except internal and external rotation, simulations showed increased cortical strains near the subperiosteal bone collar. Tension generated the largest magnitude of cortical strain (24%) that was uniformly distributed near the subperiosteal bone collar. Compression generated the same distribution of strain but to a lesser magnitude overall (15%). Dorsiflexion and plantar flexion generated high (22%) and moderate (14%) localized cortical strains, respectively, near the subperiosteal bone collar. Lower cortical strains resulted from valgus bending, varus bending, internal rotation and external rotation (8-10%). The highest valgus and varus bending cortical strains occurred medially. These simulations suggest that the likelihood of the initial cortical bone failure of the CML is higher along the margin of the subperiosteal bone collar when the ankle is under tension, compression, valgus bending, varus bending, dorsiflexion and plantar flexion, but not under internal

External fixation using locking plate in distal tibial fracture: a finite element analysis.

Science.gov (United States)

Zhang, Jingwei; Ebraheim, Nabil; Li, Ming; He, Xianfeng; Schwind, Joshua; Liu, Jiayong; Zhu, Limei

2015-08-01

External fixation of tibial fractures using a locking plate has been reported with favorable results in some selected patients. However, the stability of external plate fixation in this fracture pattern has not been previously demonstrated. We investigated the stability of external plate fixation with different plate-bone distances. In this study, the computational processing model of external fixation of a distal tibial metaphyseal fracture utilizing the contralateral femoral less invasive stabilization system plate was analyzed. The plate was placed on the anteromedial aspect of tibia with different plate-bone distances: 1, 10, 20, and 30 mm. Under axial load, the stiffness of construct in all groups was higher than intact tibia. Under axial load with an internal rotational force, the stiffness of construct with 1 and 10 mm plate-bone distances was similar to that of an intact tibia and the stiffness of the construct with 20 and 30 mm distances was lower than that of an intact tibia. Under axial load with an external rotational force, the stiffness of the construct in all groups was lower than that of an intact tibia. The maximum plate stresses were concentrated at the two most distal screws and were highest in the construct with the 10 mm plate-bone distance, and least in the construct with a 1 mm plate-bone distance. To guarantee a stable external plate fixation in distal tibial fracture, the plate-bone distance should be less than 30 mm.

About Being a Friend: Friendship and Metaphysics by Plato, Aristotle, Augustine and Albert the Great

Directory of Open Access Journals (Sweden)

Andrés Quero Sánchez

2014-11-01

of friendship in his commentaries on the Nicomachian Ethics (both Super Ethica and Ethica and we show how his metaphysics should be considered as Christian Aristotelism, according to the traditional interpretation, which has, as is known, been questioned for decades

The Radiographic Union Score for Hip (RUSH): the use of a checklist to evaluate hip fracture healing improves agreement between radiologists and orthopedic surgeons

Energy Technology Data Exchange (ETDEWEB)

Chiavaras, Mary M. [McMaster University, Department of Radiology, Hamilton, Ontario (Canada); Hamilton General Hospital, Department of Diagnostic Imaging, Hamilton, Ontario (Canada); Bains, Simrit [University of Western Ontario Medical School, London, Ontario (Canada); Choudur, Hema; Parasu, Naveen [McMaster University, Department of Radiology, Hamilton, Ontario (Canada); Jacobson, Jon [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Ayeni, Olufemi; Petrisor, Brad; Sprague, Sheila; Bhandari, Mohit [McMaster University, Department of Orthopedic Surgery, Hamilton, Ontario (Canada); Chakravertty, Rajesh [University of Toronto, Department of Orthopedic Surgery, Toronto, Ontario (Canada)

2013-08-15

The assessment of fracture healing following intertrochanteric fracture fixation is highly variable with no validated standards. Agreement with respect to fracture healing following surgery is important for optimal patient management. The purpose of this study was to (1) assess reliability of intertrochanteric fracture healing assessment and (2) determine if a novel radiographic scoring system for hip fractures improves agreement between radiologists and orthopedic surgeons. A panel of three radiologists and three orthopedic surgeons assessed fracture healing in 150 cases of intertrochanteric fractures at two separate time points to determine inter-rater and intra-rater agreement. Reviewers, blinded to the time after injury, first subjectively assessed overall healing using frontal and lateral radiographs for each patient at a single time point. Reviewers then scored each fracture using a Radiographic Union Score for Hip (RUSH) form to determine whether this improves agreement regarding hip fracture healing. Inter-rater agreement for the overall subjective impression of fracture healing between reviewer groups was only fair (intraclass coefficient [ICC] = 0.34, 95 % CI: 0.11-0.52). Use of the RUSH score improved overall agreement between groups to substantial (ICC = 0.66, 95 % CI: 0.53-0.75). Across reviewers, healing of the medial cortex and overall RUSH score itself demonstrated high correlations with overall perceptions of healing (r = 0.53 and r = 0.72, respectively).??The RUSH score improves agreement of fracture healing assessment between orthopedic surgeons and radiologists, offers a systematic approach to evaluating intertrochanteric hip fracture radiographs, and may ultimately provide prognostic information that could predict healing outcomes in patients with femoral neck fractures. (orig.)

The Radiographic Union Score for Hip (RUSH): the use of a checklist to evaluate hip fracture healing improves agreement between radiologists and orthopedic surgeons

International Nuclear Information System (INIS)

Chiavaras, Mary M.; Bains, Simrit; Choudur, Hema; Parasu, Naveen; Jacobson, Jon; Ayeni, Olufemi; Petrisor, Brad; Sprague, Sheila; Bhandari, Mohit; Chakravertty, Rajesh

2013-01-01

The assessment of fracture healing following intertrochanteric fracture fixation is highly variable with no validated standards. Agreement with respect to fracture healing following surgery is important for optimal patient management. The purpose of this study was to (1) assess reliability of intertrochanteric fracture healing assessment and (2) determine if a novel radiographic scoring system for hip fractures improves agreement between radiologists and orthopedic surgeons. A panel of three radiologists and three orthopedic surgeons assessed fracture healing in 150 cases of intertrochanteric fractures at two separate time points to determine inter-rater and intra-rater agreement. Reviewers, blinded to the time after injury, first subjectively assessed overall healing using frontal and lateral radiographs for each patient at a single time point. Reviewers then scored each fracture using a Radiographic Union Score for Hip (RUSH) form to determine whether this improves agreement regarding hip fracture healing. Inter-rater agreement for the overall subjective impression of fracture healing between reviewer groups was only fair (intraclass coefficient [ICC] = 0.34, 95 % CI: 0.11-0.52). Use of the RUSH score improved overall agreement between groups to substantial (ICC = 0.66, 95 % CI: 0.53-0.75). Across reviewers, healing of the medial cortex and overall RUSH score itself demonstrated high correlations with overall perceptions of healing (r = 0.53 and r = 0.72, respectively).??The RUSH score improves agreement of fracture healing assessment between orthopedic surgeons and radiologists, offers a systematic approach to evaluating intertrochanteric hip fracture radiographs, and may ultimately provide prognostic information that could predict healing outcomes in patients with femoral neck fractures. (orig.)

Common and rare variants in the exons and regulatory regions of osteoporosis-related genes improve osteoporotic fracture risk prediction.

Science.gov (United States)

Lee, Seung Hun; Kang, Moo Il; Ahn, Seong Hee; Lim, Kyeong-Hye; Lee, Gun Eui; Shin, Eun-Soon; Lee, Jong-Eun; Kim, Beom-Jun; Cho, Eun-Hee; Kim, Sang-Wook; Kim, Tae-Ho; Kim, Hyun-Ju; Yoon, Kun-Ho; Lee, Won Chul; Kim, Ghi Su; Koh, Jung-Min; Kim, Shin-Yoon

2014-11-01

Osteoporotic fracture risk is highly heritable, but genome-wide association studies have explained only a small proportion of the heritability to date. Genetic data may improve prediction of fracture risk in osteopenic subjects and assist early intervention and management. To detect common and rare variants in coding and regulatory regions related to osteoporosis-related traits, and to investigate whether genetic profiling improves the prediction of fracture risk. This cross-sectional study was conducted in three clinical units in Korea. Postmenopausal women with extreme phenotypes (n = 982) were used for the discovery set, and 3895 participants were used for the replication set. We performed targeted resequencing of 198 genes. Genetic risk scores from common variants (GRS-C) and from common and rare variants (GRS-T) were calculated. Nineteen common variants in 17 genes (of the discovered 34 functional variants in 26 genes) and 31 rare variants in five genes (of the discovered 87 functional variants in 15 genes) were associated with one or more osteoporosis-related traits. Accuracy of fracture risk classification was improved in the osteopenic patients by adding GRS-C to fracture risk assessment models (6.8%; P risk in an osteopenic individual.

Mandible Fractures.

Science.gov (United States)

Pickrell, Brent B; Serebrakian, Arman T; Maricevich, Renata S

2017-05-01

Mandible fractures account for a significant portion of maxillofacial injuries and the evaluation, diagnosis, and management of these fractures remain challenging despite improved imaging technology and fixation techniques. Understanding appropriate surgical management can prevent complications such as malocclusion, pain, and revision procedures. Depending on the type and location of the fractures, various open and closed surgical reduction techniques can be utilized. In this article, the authors review the diagnostic evaluation, treatment options, and common complications of mandible fractures. Special considerations are described for pediatric and atrophic mandibles.

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

NARCIS (Netherlands)

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

2013-01-01

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

Fracture resistance improvement of polypropylene by joint action of core-shell particles and nucleating agent

International Nuclear Information System (INIS)

Yang Gang; Han Liang; Ding Haifeng; Wu Haiyan; Huang Ting; Li Xiaoxi; Wang Yong

2011-01-01

Research highlights: →The core-shell particles, which were prepared from melt blending of POE and nano-CaCO 3 , and different nucleating agents (α-form NA or β-form NA) were first introduced into PP to prepare the super toughened PP materials. →NAs control the crystalline structures of PP matrix including the spherulites diameter and the crystal form. →NAs and core-shell particles exhibit apparent joint effect in improving the fracture resistance of PP. - Abstract: As a serial work about the fracture resistance improvement of polypropylene (PP), this work reports the joint effect of core-shell particles and nucleating agent (NA) on the microstructure and fracture resistance of PP. Core-shell particles were prepared through melt blending of ethylene-octene copolymer (POE) and calcium carbonate (CaCO 3 ). Different NA, i.e. α-form NA (P-tert-butylbenzoic acid-Al, MD-NA-28) and β-form NA (aryl amides compound, TMB-5) were introduced into PP matrix to control the crystalline structure. The phase morphology of POE and the distribution of CaCO 3 were characterized by using scanning electron microscope (SEM), and the crystallization behavior of PP matrix were investigated by using differential scanning calorimetry (DSC), wide angle X-ray diffraction (WAXD) and polarization optical microscope (POM). The mechanical properties were obtained through universal tensile measurement and notched Izod impact measurement. Surprisingly, the results show that through addition of so-called core-shell particles and NA simultaneously, the fracture resistance of PP can be dramatically improved.

Fibrous metaphyseal defect (fibrous cortical defect, non-ossifying fibroma). Pt. 2

International Nuclear Information System (INIS)

Freyschmidt, J.; Ostertag, H.; Saure, D.

1981-01-01

FMD, whether in the stage of a fibrous cortical defect or a non-ossifying fibroma, possesses very characteristic radiological appearances which rarely make it necessary to resort to biopsy. In order to avoid mistakes, it is necessary to observe strictly the known radiological features: metaphyseal position, clearcut relationship to the cortex, well defined margins, maximal size 6 to 7 cm., presence during growth, rarely observed in the upper extremity. The differential diagnosis, which needs to be considered only rarely, is discussed. (orig.) [de

Improving time to surgery for hip fracture patients. Impact of the introduction of an emergency theatre

LENUS (Irish Health Repository)

French-O’Carroll, F

2017-01-01

Hip fractures are a major cause of morbidity and mortality1. Surgery performed on the day of or after admission is associated with improved outcome2,3. An audit cycle was performed examining time to surgery for hip fracture patients. Our initial audit identified lack of theatre space as one factor delaying surgery. A dedicated daytime emergency theatre was subsequently opened and a re-audit was performed to assess its impact on time to surgery. Following the opening of the theatre, the proportion of patients with a delay to hip fracture surgery greater than 36 hours was reduced from 49% to 26% with lack of theatre space accounting for 23% (3 of 13) of delayed cases versus 28.6% (9 of 32) previously. 44% of hip fracture surgeries were performed in the emergency theatre during daytime hours, whilst in-hospital mortality rose from 4.6% to 6%. We conclude that access to an emergency theatre during daytime hours reduced inappropriate delays to hip fracture surgery.

'Say goodbye to opinions!' : Plutarch’s philosophy of natural phenomena and the journey to metaphysical knowledge

NARCIS (Netherlands)

Sierksma-Agteres, Suzan; Meeusen, Michiel; van der Stockt, Luc

2015-01-01

As a Platonist, Plutarch acknowledges a clear ontological separation between the sensible and the metaphysical world, and, consequently, a neat epistemological distinction between opinion and knowledge. At the same time, his personal contributions to the study of natural phenomena show his

Coralline hydroxyapatite bone graft substitutes in a canine metaphyseal defect model: Radiographic-biomechanical correlation

International Nuclear Information System (INIS)

Sartoris, D.J.; Resnick, D.; Holmes, R.E.; Tencer, A.F.; Texas Univ., Dallas; Mooney, V.

1986-01-01

Radiographic and biomechanical assessment of a new type of bone graft substitute derived from reef-building sea coral was performed in a canine metaphyseal defect model. Blocks of this material and autogenous iliac crest graft were implanted, respectively, into the right and left proximal tibial metaphyses of eight dogs. Qualitative and quantitative radiographic evaluation was performed in the immediate postoperative period and at 6 months after surgery. Biomechanical testing was carried out on all grafts following harvest at 6 months, as well as on nonimplanted coralline hydroxyapatite and autogenous iliac cancellous bone. In contrast to autografts, incorporation of coralline implants was characterized by predictable osseous growth and apposition with preservation of intrinsic architecture. Greater percent increase in radiography density, higher ultimate compressive strength, and lower stiffness with incorporation were documented advantages of coralline hydroxyapatite over autogenous graft. Densitometric measurements correlated moderately with strength for both types of graft material (r=0.65). These promising results have important implications to the clinical application of coralline hydroxyapatite bone graft substitutes as an alternative to autogenous grafting. (orig.)

Pathological fracture prediction in patients with metastatic lesions can be improved with quantitative computed tomography based computer models

NARCIS (Netherlands)

Tanck, Esther; van Aken, Jantien B.; van der Linden, Yvette M.; Schreuder, H.W. Bart; Binkowski, Marcin; Huizenga, Henk; Verdonschot, Nico

2009-01-01

Purpose: In clinical practice, there is an urgent need to improve the prediction of fracture risk for cancer patients with bone metastases. The methods that are currently used to estimate fracture risk are dissatisfying, hence affecting the quality of life of patients with a limited life expectancy.

Improved magnetic properties and fracture strength of NdFeB by dehydrogenation

Energy Technology Data Exchange (ETDEWEB)

Yan, M. [State Key Laboratory of Silicon Materials, Zhejiang University, Hangzhou 310027 (China)]. E-mail: mse_yanmi@dial.zju.edu.cn; Yu, L.Q. [State Key Laboratory of Silicon Materials, Zhejiang University, Hangzhou 310027 (China); Wu, J.M. [State Key Laboratory of Silicon Materials, Zhejiang University, Hangzhou 310027 (China); Cui, X.G. [State Key Laboratory of Silicon Materials, Zhejiang University, Hangzhou 310027 (China)

2006-11-15

Effects of the dehydrogenation of the hydrogen decrepitated (HD) powders on the magnetic properties and the fracture strength of sintered NdFeB magnets were studied. It was found that the lattice parameters and the crystal phase of NdFeB changed significantly with the various hydrogen contents of the resultant HD powders due to the different degrees of dehydrogenation. The magnetic properties and fracture strength increased with decreasing hydrogen content, reaching the maximum increases of 200% for both intrinsic coercivity and bending strength, which can be ascribed to the improved microstructure of the sintered NdFeB magnets. The hydrogen remaining in the HD powders diffused out and affected drastically the grain and grain boundaries by the hydrogen out-take channel during the subsequent sintering process.

Improved magnetic properties and fracture strength of NdFeB by dehydrogenation

International Nuclear Information System (INIS)

Yan, M.; Yu, L.Q.; Wu, J.M.; Cui, X.G.

2006-01-01

Effects of the dehydrogenation of the hydrogen decrepitated (HD) powders on the magnetic properties and the fracture strength of sintered NdFeB magnets were studied. It was found that the lattice parameters and the crystal phase of NdFeB changed significantly with the various hydrogen contents of the resultant HD powders due to the different degrees of dehydrogenation. The magnetic properties and fracture strength increased with decreasing hydrogen content, reaching the maximum increases of 200% for both intrinsic coercivity and bending strength, which can be ascribed to the improved microstructure of the sintered NdFeB magnets. The hydrogen remaining in the HD powders diffused out and affected drastically the grain and grain boundaries by the hydrogen out-take channel during the subsequent sintering process

Hydraulic fracture diagnostic: recent advances and their impact; Analyses de la fracturation hydraulique: progres recents et leur impact

Energy Technology Data Exchange (ETDEWEB)

Wolhart, St.L. [GRI, United States (United States)

2000-07-01

The use of hydraulic fracturing has grown tremendously since its introduction over 50 years ago. Most wells in low permeability reservoirs are not economic without hydraulic fracture stimulation. Hydraulic fracturing is also seeing increasing use in high permeability applications. The success of this technology can be attributed to the great strides made in three areas: hydraulic fracture theory and modeling, improved surface and subsurface equipment and advanced fluid systems and proppers. However, industry still has limited capabilities when it comes to determining the geometry of the created hydraulic fracture. This limitation, in turn places limits on the continued improvement of hydraulic fracturing as a means to optimize productivity and recovery. GRI's Advanced Hydraulic Fracture Diagnostics Program has developed two new technologies, microseismic hydraulic fracture mapping and downhole tilt-meter hydraulic fracture mapping, to address this limitation. These two technologies have been utilized to improve field development and reduce hydraulic fracturing costs. This paper reviews these technologies and presents case histories of their use. (author)

Failed Surgical Management of Acute Proximal Fifth Metatarsal (Jones) Fractures: A Retrospective Case Series and Literature Review.

Science.gov (United States)

Granata, Jaymes D; Berlet, Gregory C; Philbin, Terrence M; Jones, Grant; Kaeding, Christopher C; Peterson, Kyle S

2015-12-01

Nonunion, delayed union, and refracture after operative treatment of acute proximal fifth metatarsal fractures in athletes is uncommon. This study was a failure analysis of operatively managed acute proximal fifth metatarsal fractures in healthy athletes. We identified 149 patients who underwent operative treatment for fifth metatarsal fractures. Inclusion criteria isolated skeletally mature, athletic patients under the age of 40 with a minimum of 1-year follow-up. Patients were excluded with tuberosity fractures, fractures distal to the proximal metaphyseal-diaphyseal region of the fifth metatarsal, multiple fractures or operative procedures, fractures initially treated conservatively, and medical comorbidities/risk factors for nonunion. Fifty-five patients met the inclusion/exclusion criteria. Four (7.3%) patients required a secondary operative procedure due to refracture. The average time to refracture was 8 months. All refractures were associated with bent screws and occurred in male patients who participated in professional basketball, professional volleyball, and college football. The average time for release to progressive weight-bearing was 6 weeks. Three patients were revised to a bigger size screw and went on to union. One patient was revised to the same-sized screw and required a second revision surgery for nonunion. All failures were refractures in competitive athletes who were initially treated with small diameter solid or cannulated stainless steel screws. The failures were not associated with early postoperative weight-bearing protocol. Maximizing initial fixation stiffness may decrease the late failure rate in competitive athletes. More clinical studies are needed to better understand risk factors for failure after screw fixation in the competitive, athletic population. Prognostic, Level IV: Case series. © 2015 The Author(s).

Is it possible to delete a philosophical consciousness? Metaphysical aspects of Ssearle’s neurobiological approach of free will

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Grujić Snežana

2016-01-01

Full Text Available In an effort to adjust his theoretical comprehension to the existing natural-scientific paradigm, Searle develops neurobiological naturalism, an approach which should rely on basic facts obtained from the neuroscience researches of living organisms when solving basic philosophical problems. This paper briefly presents this view’s theory leading to the argumentation that Searle’s point of view is of metaphysical characteristics which is exactly what he was trying to avoid. The metaphysical character of Searle’s neurobiological naturalism has been seen through the problem of free will resulting from his understanding of consciousness. The argumentation is based on an analysis of the concepts, the gap and the self, as well as on possible solutions of the problem of free will (hypothesis 1 and 2.

The metaphysical art of Giorgio de Chirico. Migraine or epilepsy?

Science.gov (United States)

Blanke, Olaf; Landis, Theodor

2003-01-01

It has been suggested that the great Italian painter Giorgio de Chirico (1888-1978), who developed the unique style of 'metaphysical art', suffered from migraine and used some of his morbid manifestations as a source of inspiration for his paintings. Yet, whereas many of the symptoms that de Chirico described are rare in migraine, they are frequently encountered in patients with temporal lobe epilepsy. Here we rediscuss de Chirico's symptoms critically and suggest that, if his symptoms were of neurological origin, they rather relate to temporal lobe epilepsy than migraine. Copyright 2003 S. Karger AG, Basel

Rejecting medical humanism: medical humanities and the metaphysics of medicine.

Science.gov (United States)

Bishop, Jeffrey P

2008-03-01

The call for a narrative medicine has been touted as the cure-all for an increasingly mechanical medicine. It has been claimed that the humanities might create more empathic, reflective, professional and trustworthy doctors. In other words, we can once again humanise medicine through the addition of humanities. In this essay, I explore how the humanities, particularly narrative medicine, appeals to the metaphysical commitments of the medical institution in order to find its justification, and in so doing, perpetuates a dualism of humanity that would have humanism as the counterpoint to the biopsychosociologisms of our day.

Selectively placing many fractures in openhole horizontal wells improves production

Energy Technology Data Exchange (ETDEWEB)

Love, T. G.; McCarty, R. A. [Chevron USA Inc (United States); Suraatmadja, J. B.; Chambers, R. W.; Grundmann, S. R.

1998-12-31

Result of a simulation of an openhole horizontal well that was treated with hydrajet fracturing, a new fracturing process wherein fractures are placed at different locations in a horizontal well without using sectional isolation techniques, are discussed. The process uses high-pressure jetting to concentrate fracturing energy at a precise fracture location, and data is obtained by means of surface and downhole pressure recorders, flow recorders, and tracers. This technique was used in a substantially depleted horizontal well in New Mexico with good results. The new process is reported to be expensive to implement which prevents widespread application at the present time. 7 refs., 9 figs.

Radiation absorbed-dose estimates for the liver, spleen, and metaphyseal growth complexes in children undergoing gallium-67 citrate scanning

International Nuclear Information System (INIS)

Thomas, S.R.; Gelfand, M.J.; Burns, G.S.; Purdom, R.C.; Kereiakes, J.G.; Maxon, H.R.

1983-01-01

Quantitative conjugate-view external counting techniques were applied to estimate the radiation dose to the liver, spleen, and metaphyseal growth complexes (distal femur and proximal tibia) for ten pediatric patients undergoing gallium-67 scanning procedures. The effective half-life of Ga 67 in these organs was approximately 78 hours. The dose per unit of administered activity for the liver and spleen was between 0.3 and 4.0 rad/mCi (0.08 to 1.08 Gy/GBq) and 0.5 and 7.0 rad/mCi (0.13 to 1.89 Gy/GBq), respectively. For the metaphyseal growth plates, the range was 2.3 to 14.3 rad/mCi (0.62 to 3.86 Gy/GBq)

Infanticide for handicapped infants: sometimes it's a metaphysical dispute.

Science.gov (United States)

Long, T A

1988-01-01

Since 1973 the practice of infanticide for some severely handicapped newborns has been receiving more open discussion and defence in the literature on medical ethics. A recent and important argument for the permissibility of infanticide relies crucially on a particular concept of personhood that excludes the theological. This paper attempts to show that the dispute between the proponents of infanticide and their religious opponents cannot be resolved because one side's perspective on the infant is shaped by a metaphysics that is emphatically rejected by the other. In such a situation philosophical argument is powerless to bring about a resolution because there can be no refutation of one side by the other. PMID:2969052

Metaphysical Modality, Modality of Predicate and the Theory of "Decisive Necessity”

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L. Nabavi

2010-01-01

Full Text Available Aristotle in the Organon (1949: 9,30 a ,15-19 explicitly states that in a categorical syllogism when the minor premise is absolute (without modality operator and the major is necessary, the conclusion will be necessary too. This Aristotle's view has been the source of many conflicts and disputes in the history of logic. The famous logicians and historians of logic in the twentieth century as "Nicholas Rescher" and "Becker" believe that Aristotle's view is justifiable and defensible (at least compared to the first figure only if, the modality of major premise is considered as the property of predicate (modality de re. Today, we know very well that the modality of predicate is closely linked to Metaphysical and philosophical Modality. “Shihab al-Din al- Suhrawardi” in the theory of "Decisive (Battateh Necessity” by accepting this base, explicitly states that, in the beginning, the modality must be mentioned as a part of the predicate and then the modality of relation or copula is summarized and reduced to necessity. The modern formalization of the most important part of this theory is as follows: ("x (àAx É à Bx º ("x □ (àAx É à BxThis paper discusses the historical overview of the metaphysical modality firstly and then shows that the theory of "Decisive Necessity” is true and justified in a model of modal logic with equivalent accessibility relation and homogeneous possible world view (fixed domain.

Spondylo-epi-metaphyseal dysplasia with joint laxity and severe, progressive kyphoscoliosis

Energy Technology Data Exchange (ETDEWEB)

Beighton, P.; Kozlowski, K.

1980-01-01

Spondylo-epi-metaphyseal dysplasia with progressive, severe kyphoscoliosis and gross joint laxity is a distinctive entity. The clinical and radiographic manifestations of seven affected children are presented and it is concluded that this disorder is probably more common than previously suspected. Skeletal survey is indicated in all patients with infantile idiopathic scoliosis, kyphosis, or kyphoscoliosis. In this context, radiographic studies of the pelvis may be of great diagnostic value. Referal for expert orthopaedic management is essential for all patients with this disorder, as profound disability with pulmonary and spinal complications may be expected.

Does fluoroscopy improve outcomes in paediatric forearm fracture reduction?

International Nuclear Information System (INIS)

Menachem, S.; Sharfman, Z.T.; Perets, I.; Arami, A.; Eyal, G.; Drexler, M.; Chechik, O.

2016-01-01

Aim: To compare the radiographic results of paediatric forearm fracture reduced with and without fluoroscopic enhancement to investigate whether fractures reduced under fluoroscopic guidance would have smaller residual deformities and lower rates of re-reduction and surgery. Materials and methods: A retrospective cohort analysis was conducted comparing paediatric patients with acute forearm fracture in two trauma centres. Demographics and radiographic data from paediatric forearm fractures treated in Trauma Centre A with the aid of a C-arm fluoroscopy were compared to those treated without fluoroscopy in Trauma Centre B. Re-reduction, late displacement, post-reduction deformity, and need for surgical intervention were compared between the two groups. Results: The cohort included 229 children (175 boys and 54 girls, mean age 9.41±3.2 years, range 1–16 years) with unilateral forearm fractures (83 manipulated with fluoroscopy and 146 without). Thirty-four (15%) children underwent re-reduction procedures in the emergency department. Fifty-three (23%) children had secondary displacement in the cast, of which 18 were operated on, 20 were re-manipulated, and the remaining 15 were kept in the cast with an acceptable deformity. Twenty-nine additional children underwent operation for reasons other than secondary displacement. There were no significant differences in re-reduction and surgery rates or in post-reduction deformities between the two groups. Conclusion: The use of fluoroscopy during reduction of forearm fractures in the paediatric population apparently does not have a significant effect on patient outcomes. Reductions performed without fluoroscopy were comparably accurate in correcting deformities in both coronal and sagittal planes. - Highlights: • Compared outcomes of pediatric forearm fracture reduction with and without fluoroscopy. • The use of fluoroscopy during reduction of forearm fractures in the pediatric population apparently does not have a

How to improve retromandibular transmasseteric anteroparotid approach for mandibular condylar fractures: our clinical experience.

Science.gov (United States)

Salgarelli, A C; Anesi, A; Bellini, P; Pollastri, G; Tanza, D; Barberini, S; Chiarini, L

2013-04-01

Fractures of the mandibular condyle are common and account for 25-35% of all mandibular fractures reported in the literature. Even with the development of a consensus on the preference for open reduction and internal fixation of these fractures, the clinician is still faced with a dilemma concerning the optimal approach to the ramus-condyle unit. Limited access and injury to the facial nerve are the most common problems. The most commonly used extraoral approaches are the submandibular, retromandibular and preauricular methods. In this study, we propose a modified cosmetic preauricular incision with a short end in the neck, to improve the transmasseteric anteroparotid (TMAP) approach previously described by Wilson et al. in 2005. We retrospectively analysed 13 patients treated in our department for mandibular condylar fractures. Post-operative complications, occlusal status, interincisal opening and joint tenderness were evaluated at 3 months after surgery. The wider skin incision described here provides a convenient approach for open reduction and rigid internal fixation, and good results were obtained. The follow-up ranged from 6 to 40 months. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

The Contingency Of Our Own Beatitude. Some Reflections On Gilson’s The Future Of Augustinian Metaphysics

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James V. Schall

2015-03-01

Full Text Available Inspired by selected passages from Wendell Berry’s story “A Place in Time,” the article discusses Étienne Gilson’s essay “The Future of Augustinian Metaphysics” with a special regard to the relation of habits to metaphysics. The basis of this relation is human being whose life, from the perspective of Augustinian metaphysics, is permanently unsettled. Man is the one mortal being whose perfection does not come with his being, but only with his own input into what it already is. Habits, then, prefect an already constituted human being in what he or she is. Man is not born, however, with habits, but acquires them through acts of the virtues or vices. The article develops the Augustinian idea according to which the moral effort of man to pursue virtues and escape vices results not so much from his natural desire of ‘beatitude’, but rather from the fact of being led to God by God.

Darkened Counsel: The Problem of Evil in Bergson’s Metaphysics of Integral Experience

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Anthony Paul Smith

2016-12-01

Full Text Available Henri Bergson's work is often presented as an optimistic philosophy. This essay presents a counter-narrative to that reading by looking to the place of the problem of evil within his integral metaphysics. For, if Bergson’s philosophy is simply optimistic, or simply derives meaning from the wholeness of experience, then it risks a theodical structure which undercuts its ability to speak to contemporary social and political problems of suffering. A theodical structure is one that, at bottom, justifies the experience of suffering by way of a concept of the whole or some concept that functions to subsume everything within it. Suffering is subsumed and given meaning by placing it within a relation, often with a telos that redeems or sublimates the experience of suffering. This takes such a singular experience such as suffering and renders it merely relative to the part it plays within the system of everything. On my reading, Bergson’s philosophy contains a supplement of what we might call pessimism or negativity inherent in his metaphysics as integral experience. This supplement undermines the theodical structure that may be assumed to undercut Bergson’s philosophy when confronted with evil or suffering and is seen most clearly in his critique of the notion of “everything.”

Crititics to Metaphysics by Modern Philosophers (Discourse on Human Beings in Reality)

OpenAIRE

Frederikus Fios

2016-01-01

We have entered the 21st century that is popularly known as the era of the development of modern science and technology. Philosophy provides naming for contemporary era as postmodern era. But do we suddenly come to this day and age? No! Because humans are homo viator, persona that does pilgrimage in history, space and time. Philosophy has expanded periodically in the long course of history. Since the days of classical antiquity, philosophy comes with a patterned metaphysical paradigm. T...

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

Science.gov (United States)

Majak, Peter; Næss, Pål A

2016-12-01

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

Science and Metaphysics in the Three Religions of the Book

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Toby E. Huff

2000-12-01

Full Text Available The three religions of the Book trace their origins back to the same Abrahamic experience, but only one, Christianity, developed a metaphysical framework consistent with that of modern science. Both Judaism and Islam during their formative years, and continuously up to modern times, considered Greek philosophy and science alien wisdom, jeopardizing their sacred scriptures. The different path followed by Christianity is due to the influence of Hellenistic thought during Christianity's early formative period. Both Judaism and Islam were spared the direct mediation of Greek culture and ideas because both Judaism and Islam developed geographically and linguistically isolated from the Greek influences during the reception of their scriptures.

The old with the die. A contribution to metaphysics of quantum mechanics; Der Alte mit dem Wuerfel. Ein Beitrag zur Metaphysik der Quantenmechanik

Energy Technology Data Exchange (ETDEWEB)

Ijjas, Anna

2011-07-01

Since the rise of quantum mechanics also their ideological implications and consequences were discussed. Meanwhile still scarcely a metaphysical problem exists, which was not supposedly solved under calling on quantum theory. Anna Ijjas inquires the usual practice and developes a new model of the assignment of quantum mechanics and metaphysics. She discusses both the physical foundations and the classical philosophical controversies, before she draws consequencies for the relation determination of brain and consciousness, the problem of freedom of will, as well as for the question of the influence of God in the world.

. I. VVEDENSKIYS’ INTERPRETATION OF THE MORAL TEACHING AND METAPHYSICS OF IMMANUEL KANT

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DMITRY SAMOILOV

2009-05-01

Full Text Available The article is devoted to the works and ideas of Russian philosopher-kantianist, professor of philosophy at Sankt-Petersburg University A. I. Vvedenskiy. The author discusses a contribution of Vvedenskiy to the substantiation of «critical metaphysics» of the German philosopher, based on so called «moral faith». Special attention is given to problem of faith and knowledge, to understanding of postulates of practical reason as dogmata of moral faith, to «logicisation» of Kant’s conception by Vvedenskiy

Spondylo-epi-metaphyseal dysplasia with joint laxity and severe, progressive kyphoscoliosis

International Nuclear Information System (INIS)

Beighton, P.

1980-01-01

Spondylo-epi-metaphyseal dysplasia with progressive, severe kyphoscoliosis and gross joint laxity is a distinctive entity. The clinical and radiographic manifestations of seven affected children are presented and it is concluded that this order is probably more common than previously suspected. Skeletal survey is indicated in all patients with infantile idiopathic scoliosis, kyphosis, or kyphoscoliosis. In this context, radiographic studies of the pelvis may be of great diagnostic value. Referal for expert orhtopaedic management is essential for all patients with this disorder, as profound disability with pulmonary and spinal complications may be expected. (orig./MG) [de

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

Science.gov (United States)

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

2013-09-01

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

Retrospective analysis of extra-articular distal humerus shaft fractures treated with the use of pre-contoured lateral column metaphyseal LCP by triceps-sparing posterolateral approach

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Yatinder Kharbanda

2016-11-01

Full Text Available Abstract Management of extra-articular distal humerus fractures presents a challenge to the treating surgeon due to the complex anatomy of the distal part of the humerus and complicated fracture morphology. Although surgical treatment has shown to provide a more stable reduction and alignment and predictable return to function, it has been associated with complications like iatrogenic radial nerve palsy, infection, non-union and Implant failure. We in the present series retrospectively analysed 20 patients with extra-articular distal humerus shaft fractures surgically treated using the extra-articular distal humeral locking plate approached by the triceps-sparing posterolateral approach. The outcome was assessed using the DASH score, range of motion at the elbow and the time to union. The mean time to radiographic fracture union was 12 weeks.

Retrospective analysis of extra-articular distal humerus shaft fractures treated with the use of pre-contoured lateral column metaphyseal LCP by triceps-sparing posterolateral approach.

Science.gov (United States)

Kharbanda, Yatinder; Tanwar, Yashwant Singh; Srivastava, Vishal; Birla, Vikas; Rajput, Ashok; Pandit, Ramsagar

2017-04-01

Management of extra-articular distal humerus fractures presents a challenge to the treating surgeon due to the complex anatomy of the distal part of the humerus and complicated fracture morphology. Although surgical treatment has shown to provide a more stable reduction and alignment and predictable return to function, it has been associated with complications like iatrogenic radial nerve palsy, infection, non-union and Implant failure. We in the present series retrospectively analysed 20 patients with extra-articular distal humerus shaft fractures surgically treated using the extra-articular distal humeral locking plate approached by the triceps-sparing posterolateral approach. The outcome was assessed using the DASH score, range of motion at the elbow and the time to union. The mean time to radiographic fracture union was 12 weeks.

Substantial Union or Substantial Distinction of Mind and Body in Descartes' Metaphysics

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Fahime Jamei

2009-01-01

Full Text Available According to Descartes’ metaphysics there are two different kinds of substances in the world of creatures: “thinking substance” and “extended substance” or soul and matter. In Descartes’ philosophy the soul is equal to the mind and considered as a “thinking substance”. This immaterial substance is the essence of the human being. Body, being considered as a “matter“, is an “extended substance” and entirely distinct from the soul. The soul, therefore, exists and may be known prior to body and, not being corporeal, can exist after human death. Hence, Descartes can prove the immortality of human soul in the framework of the principle of substantial distinction. On the other hand, as a physiologist and psychologist, Descartes indeed believes in mind-body union, so that some causal interactions between mind and body show their substantial union. In this essay, the authors show that Descartes faces a serious problem in combining substantial union of mind and body with their substantial distinction; despite of his efforts in introducing the idea of pineal gland, the problem remains unsolved. Therefore it seems that as he cannot dispense with his only reason for proving the immortality of human soul, he has to hold the mind-body distinction theory in his metaphysics. Indeed, Descartes prefers to support the distinction theory rather than union theory in confronting a thesis and an antithesis stating one of two theories

Substantial :union: or Substantial Distinction of Mind and Body in Descartes\\' Metaphysics

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f Jamei

2009-06-01

Full Text Available According to Descartes’ metaphysics there are two different kinds of substances in the world of creatures: “thinking substance” and “extended substance” or soul and matter. In Descartes’ philosophy the soul is equal to the mind and considered as a “thinking substance”. This immaterial substance is the essence of the human being. Body, being considered as a “matter“, is an “extended substance” and entirely distinct from the soul. The soul, therefore, exists and may be known prior to body and, not being corporeal, can exist after human death. Hence, Descartes can prove the immortality of human soul in the framework of the principle of substantial distinction. On the other hand, as a physiologist and psychologist, Descartes indeed believes in mind-body :union:, so that some causal interactions between mind and body show their substantial :union:. In this essay, the authors show that Descartes faces a serious problem in combining substantial :union: of mind and body with their substantial distinction despite of his efforts in introducing the idea of pineal gland, the problem remains unsolved. Therefore it seems that as he cannot dispense with his only reason for proving the immortality of human soul, he has to hold the mind-body distinction theory in his metaphysics. Indeed, Descartes prefers to support the distinction theory rather than :union: theory in confronting a thesis and an antithesis stating one of two theories.

Management of osteoporotic vertebral fractures

OpenAIRE

Dionyssiotis, Yannis

2010-01-01

Yannis DionyssiotisRhodes General Hospital, Rhodes, GreeceAbstract: Osteoporotic vertebral fractures are associated with considerable reduction of quality of life, morbidity, and mortality. The management of patients with vertebral fractures should include treatment for osteoporosis and measures to reduce pain and improve mobility. This article provides information for management and rehabilitation of vertebral fractures based on clinical experience and literature.Keywords: vertebral fracture...

Metaphyseal bone loss demonstrated with routine planar radiography

International Nuclear Information System (INIS)

Mintzer, C.M.; Robertson, D.D.; Weissman, B.; Ewald, F.; Spector, M.

1989-01-01

This paper reports on an vitro study performed to examine the ability of current-day radiography for detecting metaphyseal bone loss. A block was cut from the anterior aspect of a cadaveric distal femur, sequential sections (approximately 4% of the BMC of the block) were cut from the block, and a fat-equivalent material was substituted in to the void. Following removal of each bone section, the femur was placed in a water bath, a lateral radiography was taken, and the ash content of the section was determined. Five readers each evaluated over 100 combinations of two radiographs side by side, noting whether there was no difference or whether one femur's region of interest was denser. The readings were compared with bone mineral differences as determined by ashing. All readers identified losses of 25% or more, and 5%-10% losses were seen by four of five readers half of the time

The Metaphysics of Morals: between the a priori and a practical anthropology

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Maria Borges

2017-12-01

Full Text Available In this paper, I analyze the place of the Metaphysics of morals in the Kantian system. I claim that this work is the passage between a pure part of ethics and a practical anthropology. Although this book was first conceived to be a pure moral theory - moralia pura-, it ended up dealing with principle of applications of the moral law to sensible moral beings- philosophia moralis applicata. I also hold that the Doctrine of Virtue presents some sensible elements that are important to understand how morality affects us.

A prospective randomized study of operative treatment for noncomminuted humeral shaft fractures: conventional open plating versus minimal invasive plate osteosynthesis.

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Kim, Ji Wan; Oh, Chang-Wug; Byun, Young-Soo; Kim, Jung Jae; Park, Ki Chul

2015-04-01

To compare the clinical and radiologic results of conventional open plating (COP) and minimally invasive plate osteosynthesis (MIPO) in the treatment of noncomminuted humeral shaft fractures. Randomized prospective study. Five level 1 trauma centers. Sixty-eight consecutive patients were randomized into 2 study groups: those treated by COP (COP group; n = 32) and those treated by MIPO (MIPO group; n = 36). Simple humeral shaft fractures (AO/OTA classification types A and B) were reduced by open reduction or closed reduction and fixed with a narrow 4.5/5.0 locking compression plate, metaphyseal locking compression plate, or proximal humeral internal locking system plate to the anterior lateral aspect of the humerus. Fracture healing time, operative time, radiation exposure time, and intraoperative nerve injury. To assess shoulder and elbow function, we used the University of California, Los Angeles (UCLA) scoring system and the Mayo elbow performance index, including the range of motion and pain. Radiographic measurements included fracture alignment, delayed union, and nonunion. Thirty-one fractures (97%) healed in the COP group within 16 weeks, whereas 36 fractures (100%) were healed in the MIPO group by 15 weeks. No significant difference was observed in the operative time or complication rates. In both groups, all fractures achieved union without malunion and with excellent functional outcomes by definition of the Mayo elbow performance index and UCLA scoring system. This study confirmed a high overall rate of union and excellent functional outcomes in both MIPO and COP groups. MIPO is equivalent to COP as a safe and effective method for simple types of humeral shaft fractures when surgery is indicated, and the surgeon is experienced in the technique. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Into the White: Larry Eigner’s Meta-Physical Poetics

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Sarah Juliet Lauro

2014-01-01

Full Text Available Disabled poet Larry Eigner makes striking use of the space of the page to create poetry that operates in a visual as well as linguistic register. Many critics have read Eigner’s oeuvre in light of his physical condition, but no scholar has previously looked to the parallels between the Black Mountain artists’ experiments in abstraction and Black Mountain poet Larry Eigner’s work, though the same influences are clearly evident. Working collaboratively and interdisciplinarily, the authors combine their expertise in the disciplines of literature and art history, reading both the words on the page and the page as picture, in a manner that engages specifically with phenomenological philosophy, to explicate how these poems work on the body of the reader.   Key words: embodiment, abstraction, poetics, typography, metaphysics, phenomenology

Real-time visual biofeedback during weight bearing improves therapy compliance in patients following lower extremity fractures.

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Raaben, Marco; Holtslag, Herman R; Leenen, Luke P H; Augustine, Robin; Blokhuis, Taco J

2018-01-01

Individuals with lower extremity fractures are often instructed on how much weight to bear on the affected extremity. Previous studies have shown limited therapy compliance in weight bearing during rehabilitation. In this study we investigated the effect of real-time visual biofeedback on weight bearing in individuals with lower extremity fractures in two conditions: full weight bearing and touch-down weight bearing. 11 participants with full weight bearing and 12 participants with touch-down weight bearing after lower extremity fractures have been measured with an ambulatory biofeedback system. The participants first walked 15m and the biofeedback system was only used to register the weight bearing. The same protocol was then repeated with real-time visual feedback during weight bearing. The participants could thereby adapt their loading to the desired level and improve therapy compliance. In participants with full weight bearing, real-time visual biofeedback resulted in a significant increase in loading from 50.9±7.51% bodyweight (BW) without feedback to 63.2±6.74%BW with feedback (P=0.0016). In participants with touch-down weight bearing, the exerted lower extremity load decreased from 16.7±9.77kg without feedback to 10.27±4.56kg with feedback (P=0.0718). More important, the variance between individual steps significantly decreased after feedback (P=0.018). Ambulatory monitoring weight bearing after lower extremity fractures showed that therapy compliance is low, both in full and touch-down weight bearing. Real-time visual biofeedback resulted in significantly higher peak loads in full weight bearing and increased accuracy of individual steps in touch-down weight bearing. Real-time visual biofeedback therefore results in improved therapy compliance after lower extremity fractures. Copyright © 2017 Elsevier B.V. All rights reserved.

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

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

2013-07-01

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

DWORKIN ALÉM DA METAFÍSICA E DO CETICISMO / DWORKIN BEYOND THE METAPHYSICS AND SCEPTICISM

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João Paulo Mansur

2015-08-01

Full Text Available This article starts in the existence or not of justice in personal preferences and in the content of the rules of law. It examines the response of legal idealistic philosophies, specifically, the philosophy of Plato, according to which, there is a metaphysically correct answer for each legal issue. It analyzes the response of skeptical philosophies, specifically the skeptical point of Erasmus of Rotterdam in “Praise of Folly”, according to which, naturalistic responses are results of arbitrary actions that not even the philosopher escapes. It also identifies the influences of skepticism in the political and legal philosophies, as the political realism by Machiavelli and the Legal Positivism. Our research notes the paradox that both platonism and skepticism start from the same conception of truth that is used to criticize human conduct and the contents in the rules of law. It exposes the legal theory of Ronald Dworkin, for which there is rationality and criteria to criticize besides metaphysical entities. This article begins in the comparison of philosophical ideas to achieve the objective of demonstrating the relevance of political tradition in Dworkin.

The Problem of the Object of Mathematics as Intelligible Substance in Aristotle's Metaphysics

OpenAIRE

Cattanei, Elisabetta

2013-01-01

The A. examines the problem of intermediat emathematical entities by analyzing Metaphysics l017a9-l4, since, according to Aristotle. this passage is both a source and a critique of Plato's theory. The goal is to identify four cardinal points that may ground a dialogue between two contesting positions regarding this problem. Through them, it becomes evident that Aristotle severs the question of the intelligible nature of mathematical entities by using the conceptual scalpel of his own ousiolog...

Descartes and the “metaphysical dualism”: Excesses in interpreting a classic

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Ştefan Afloroaei

2010-06-01

Full Text Available The article focuses on one of the most serious accusations brought against Descartes and modern philosophy, namely “the dualism of substance”. The accusers claim that the human body and soul were viewed as completely separate; consequently, their relationship as such and the united being of man become incomprehensible. As has been shown above, the idea of the separation of the soul from the body did not originate with Descartes; it was formulated much earlier, and repeated by a disciple of Descartes’, Henry Leroy, known as Regius. When Descartes became aware of this bizarre interpretation he was dismayed and sought to clarify the matter. He sought to distinguish between two terms, “distinction” and “separation” and to illuminate the relationship between body and soul at three different levels, i.e. ordinary experience, analytical mind and metaphysical meditation.Eventually, he embraced the paradox of the two natures – the double substantial make-up of the human being, a paradox of patristic inspiration. However, the later history of ideas was not sympathetic to Descartes: nowadays, when one looks up the term “metaphysical dualism” in dictionaries or glossaries, even in the studies of prestigious researchers, one will find views similar to those of the unfaithful disciple Regius. The resilience of this locus obscurus is explained both by the power of a new mode of interpreting discourse (as technical or logical analysis and by the ever more privilegedposition of the reader (intentio lectoris. Both attitudes are related to modern ideologies and to changes which have occurred in the intersubjective lifeworld, especially in the communication of the scholarly and academic world.

Effects of a geriatrician-led hip fracture program: improvements in clinical and economic outcomes.

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Miura, Lisa N; DiPiero, Albert R; Homer, Louis D

2009-01-01

The hip fracture service (HFS) is an interdisciplinary, geriatrician-led program instituted to improve the care of frail elderly people who present to the hospital with acute hip fracture. The HFS pilot project used existing hospital personnel and facilities and initiated new practices, including set protocols, preprinted orders, and standardized assessments, to achieve and evaluate patient triage and care and hospital cost savings. Outcome measures for 91 patients with acute hip fracture consecutively admitted to the HFS were compared with those of 72 historical controls managed under standard care in the prior year. Analysis demonstrated better outcomes in terms of length of stay (6.1+/-2.4 days for standard care, 4.6+/-1.1 days for the HFS; Pvs 50.5% of HFS patients; Pmodel showed a reduction in total costs, resulting in a gain in net income, from a deficit of $908+/-4,977 (95% confidence interval (CI)=-$2,078-261) per patient in the standard group to a gain of $1,047+/-2,718 (95% CI=$481-1,613) per patient in the HFS group (Pcost effectiveness of managing elderly patients with hip fracture. Although the results must be interpreted with caution because of the pre-post design, this pilot study provides a model of care for further hypothesis generation and more rigorous testing into the quality and financial benefits of a geriatrics-led care process.

Does surgical stabilization improve outcomes in patients with isolated multiple distracted and painful non-flail rib fractures?

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Girsowicz, Elie; Falcoz, Pierre-Emmanuel; Santelmo, Nicola; Massard, Gilbert

2012-03-01

A best evidence topic was constructed according to a structured protocol. The question addressed was whether surgical stabilization is effective in improving the outcomes of patients with isolated multiple distracted and painful non-flail rib fractures. Of the 356 papers found using a report search, nine presented the best evidence to answer the clinical question. The authors, journal, date and country of publication, study type, group studied, relevant outcomes and results of these papers are given. We conclude that, on the whole, the nine retrieved studies clearly support the use of surgical stabilization in the management of isolated multiple non-flail and painful rib fractures for improving patient outcomes. The interest and benefit was shown not only in terms of pain (McGill pain questionnaire) and respiratory function (forced vital capacity, forced expiratory volume in 1 s and carbon monoxide diffusing capacity), but also in improved quality of life (RAND 36-Item Health Survey) and reduced socio-professional disability. Indeed, most of the authors justified surgical management based on the fact that the results of surgical stabilization showed improvement in short- and long-term patient outcomes, with fast reduction in pain and disability, as well as lower average wait before recommencing normal activities. Hence, the current evidence shows surgical stabilization to be safe and effective in alleviating post-operative pain and in improving patient recovery, thus enhancing the outcome after isolated multiple rib fractures. However, given the little published evidence, prospective trials are necessary to confirm these encouraging results.

Training improves agreement among doctors using the Neer system for proximal humeral fractures in a systematic review

DEFF Research Database (Denmark)

Brorson, Stig; Hróbjartsson, Asbjørn

2008-01-01

OBJECTIVE: To systematically review studies of observer agreement among doctors classifying proximal humeral fractures according to the Neer system. STUDY DESIGN AND SETTING: A systematic review. We searched for observational studies in which doctors classified proximal humeral fractures according......, and the methodological quality was assessed. RESULTS: We included 11 observational studies (88 observers and 468 cases). Mean kappa-values for interobserver agreement ranged from 0.17 to 0.52. Agreement did not improve through selection of experienced observers, advanced imaging modalities, or simplification...

Podoplanin immunopositive lymphatic vessels at the implant interface in a rat model of osteoporotic fractures.

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Katrin Susanne Lips

Full Text Available Insertion of bone substitution materials accelerates healing of osteoporotic fractures. Biodegradable materials are preferred for application in osteoporotic patients to avoid a second surgery for implant replacement. Degraded implant fragments are often absorbed by macrophages that are removed from the fracture side via passage through veins or lymphatic vessels. We investigated if lymphatic vessels occur in osteoporotic bone defects and whether they are regulated by the use of different materials. To address this issue osteoporosis was induced in rats using the classical method of bilateral ovariectomy and additional calcium and vitamin deficient diet. In addition, wedge-shaped defects of 3, 4, or 5 mm were generated in the distal metaphyseal area of femur via osteotomy. The 4 mm defects were subsequently used for implantation studies where bone substitution materials of calcium phosphate cement, composites of collagen and silica, and iron foams with interconnecting pores were inserted. Different materials were partly additionally functionalized by strontium or bisphosphonate whose positive effects in osteoporosis treatment are well known. The lymphatic vessels were identified by immunohistochemistry using an antibody against podoplanin. Podoplanin immunopositive lymphatic vessels were detected in the granulation tissue filling the fracture gap, surrounding the implant and growing into the iron foam through its interconnected pores. Significant more lymphatic capillaries were counted at the implant interface of composite, strontium and bisphosphonate functionalized iron foam. A significant increase was also observed in the number of lymphatics situated in the pores of strontium coated iron foam. In conclusion, our results indicate the occurrence of lymphatic vessels in osteoporotic bone. Our results show that lymphatic vessels are localized at the implant interface and in the fracture gap where they might be involved in the removal of

Podoplanin Immunopositive Lymphatic Vessels at the Implant Interface in a Rat Model of Osteoporotic Fractures

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Lips, Katrin Susanne; Kauschke, Vivien; Hartmann, Sonja; Thormann, Ulrich; Ray, Seemun; Kampschulte, Marian; Langheinrich, Alexander; Schumacher, Matthias; Gelinsky, Michael; Heinemann, Sascha; Hanke, Thomas; Kautz, Armin R.; Schnabelrauch, Matthias; Schnettler, Reinhard; Heiss, Christian; Alt, Volker; Kilian, Olaf

2013-01-01

Insertion of bone substitution materials accelerates healing of osteoporotic fractures. Biodegradable materials are preferred for application in osteoporotic patients to avoid a second surgery for implant replacement. Degraded implant fragments are often absorbed by macrophages that are removed from the fracture side via passage through veins or lymphatic vessels. We investigated if lymphatic vessels occur in osteoporotic bone defects and whether they are regulated by the use of different materials. To address this issue osteoporosis was induced in rats using the classical method of bilateral ovariectomy and additional calcium and vitamin deficient diet. In addition, wedge-shaped defects of 3, 4, or 5 mm were generated in the distal metaphyseal area of femur via osteotomy. The 4 mm defects were subsequently used for implantation studies where bone substitution materials of calcium phosphate cement, composites of collagen and silica, and iron foams with interconnecting pores were inserted. Different materials were partly additionally functionalized by strontium or bisphosphonate whose positive effects in osteoporosis treatment are well known. The lymphatic vessels were identified by immunohistochemistry using an antibody against podoplanin. Podoplanin immunopositive lymphatic vessels were detected in the granulation tissue filling the fracture gap, surrounding the implant and growing into the iron foam through its interconnected pores. Significant more lymphatic capillaries were counted at the implant interface of composite, strontium and bisphosphonate functionalized iron foam. A significant increase was also observed in the number of lymphatics situated in the pores of strontium coated iron foam. In conclusion, our results indicate the occurrence of lymphatic vessels in osteoporotic bone. Our results show that lymphatic vessels are localized at the implant interface and in the fracture gap where they might be involved in the removal of lymphocytes, macrophages

Heterologous embryo transfer: Magisterial answers and metaphysical questions.

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Accad, Michel

2014-02-01

The debate regarding the morality of heterologous embryo transfer (HET) as a solution for the fate of cryopreserved embryos remains active. This paper endeavors to show that the magisterial instructions on bioethical issues can only lead to the conclusion that HET is always morally illicit. I begin by showing that the text of Dignitas personae recognizes HET as a procedure accomplishing a procreative function, and I indicate that it is through gestation that this procreative function occurs. I further show that the previous Instruction, Donum vitae, implicitly points to an ontological or spiritual consideration at play during gestation. This consideration is likely related to the procreative function identified in Dignitas personae. Finally, I place these two textual arguments in the context of the debate concerning HET and conclude that metaphysical questions must be clarified in order for the immorality of HET to be understood from a suitable anthropological perspective and gain more widespread acceptance.

Improved 1-year mortality in elderly patients with a hip fracture following integrated orthogeriatric treatment

NARCIS (Netherlands)

Folbert, E. C.; Hegeman, J H; Vermeer, M; Regtuijt, E M; van der Velde, D; ten Duis, H. J.; Slaets, J. P.

To improve the quality of care and reduce the healthcare costs of elderly patients with a hip fracture, surgeons and geriatricians collaborated intensively due to the special needs of these patients. After treatment at the Centre for Geriatric Traumatology (CvGT), we found a significant decrease in

Socialcultural background of formation of classical metaphysics

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I. Z. Derzhko

2014-09-01

Full Text Available The classical model of philosophy has shaped ideas about its nature and aims that were laid in ancient metaphysics, but have been substantially amended by civilizational change. Socialcultural background of philosophy became trends that began to emerge in late medieval culture has particularly flourished there during modern times. Sphere of existence is important for the development of any spiritual phenomenon. For metaphysics it is the idea of humanity, acting as a kind of cultural protest against the domination of religion. This caused criticism of the medieval way of life and thinking. The idea of human revival based on spirit of antiquity has grounded. Disclaimer theological philosophy medieval variant type is as opposed to free philosophizing, coupled with poetry and literature, University dogmatic philosophy. There were a «rediscovery» of Plato, Aristotle reinterpretation. Philosophers explored a problem of human emotions and relationships, considering the person as a whole being, which is inherent in the mind, which cannot be considered without bodily desires and emotions. Change of the values awakened activity of the human person, led its transformation settings concerning himself and the surrounding world. Thus objectively obtained expression and ideological embodiment of civilization in a need of a new type of man - to a much greater extent compared to medieval activity, initiative, freedom, rationality, responsibility. Under the influence of such attitudes changes within religion gradually took place. Through the efforts of thinkers like Luther, Calvin, Munzer there were laid ideas of the Reformation that go far beyond its borders, gaining general cultural nature. The Church was increasingly losing control over everyday human existence. Gradually standards of a free, relaxed life became conventional; requirements of the body, «earthly» spirit demands fulfilling played a huge role. Thought and Culture of the Renaissance reflects

Life after Newton: an ecological metaphysic.

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Ulanowicz, R E

1999-05-01

Ecology may indeed be 'deep', as some have maintained, but perhaps much of the mystery surrounding it owes more simply to the dissonance between ecological notions and the fundamentals of the modern synthesis. Comparison of the axioms supporting the Newtonian world view with those underlying the organicist and stochastic metaphors that motivate much of ecosystems science reveals strong disagreements--especially regarding the nature of the causes of events and the scalar domains over which these causes can operate. The late Karl Popper held that the causal closure forced by our mechanical perspective on nature frustrates our attempts to achieve an 'evolutionary theory of knowledge.' He suggested that the Newtonian concept of 'force' must be generalized to encompass the contingencies that arise in evolutionary processes. His reformulation of force as 'propensity' leads quite naturally to a generalization of Newton's laws for ecology. The revised tenets appear, however, to exhibit more scope and allow for change to arise from within a system. Although Newton's laws survive (albeit in altered form) within a coalescing ecological metaphysic, the axioms that Enlightenment thinkers appended to Newton's work seem ill-suited for ecology and perhaps should yield to a new and coherent set of assumptions on how to view the processes of nature.

Functional outcome of intra-articular tibial plateau fractures: the impact of posterior column fractures.

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van den Berg, Juriaan; Reul, Maike; Nunes Cardozo, Menno; Starovoyt, Anastasiya; Geusens, Eric; Nijs, Stefaan; Hoekstra, Harm

2017-09-01

INTRODUCTION: Although regularly ignored, there is growing evidence that posterior tibial plateau fractures affect the functional outcome. The goal of this study was to assess the incidence of posterior column fractures and its impact on functional outcome and general health status. We aimed to identify all clinical variables that influence the outcome and improve insights in the treatment strategies. A retrospective cohort study including 218 intra-articular tibial plateau fractures was conducted. All fractures were reclassified and applied treatment was assessed according to the updated three-column concept. Relevant demographic and clinical variables were studied. The patient reported outcome was assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS). Median follow-up was 45.5 (IQR 24.9-66.2) months. Significant outcome differences between operatively and non-operatively treated patients were found for all KOOS subscales. The incidence of posterior column fractures was 61.9%. Posterior column fractures, sagittal malalignment and an increased complication rate were associated with poor outcome. Patients treated according to the updated three-column concept, showed significantly better outcome scores than those patients who were not. We could not demonstrate the advantage of posterior column fracture fixation, due to a limited patient size. Our data indicates that implementation of the updated three-column classification concept may improve the surgical outcome of tibial plateau fractures. Failure to recognize posterior column fractures may lead to inappropriate utilization of treatment techniques. The current concept allows us to further substantiate the importance of reduction and fixation of posterior column fractures with restoration of the sagittal alignment. 3.

The Intuitive Recommencement of Metaphysics

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Camille Riquier

2016-12-01

Full Text Available If we are to understand the complex relationship between Bergson and Kant, we must not approach the former’s philosophy as if it could only be either pre-critical or post-Kantian. Instead, the present essay seeks to shed light on this relationship by treating Kant (after Descartes and before Spencer as another “missing precursor of Bergson.” In Bergson’s eyes, Kant, like Descartes, contains two possible paths for philosophy, which reflect the two fundamental tendencies that are mixed together in the élan vital and continued in humankind: intuition and intelligence. Bergson breaks with Kant from the interior of his philosophy, which he divides into two Kantianisms: the one, which he rejects as ancient, and the other, which he appropriates. What the analysis of this Bergsonian appropriation of Kant reveals, however, is not the existence of a latent Bergsonism in Kant, but rather the recovery of a Kantianism that is completed in Bergson—a Kantianism that embarked down a path that Kant himself, who held himself back from following it in order to dispense with all “intellectual” intuition, had only sketched. Thus, if Bergson is to be believed, an intuitive metaphysics, which installs itself in pure duration, is neither below nor beyond Kantian critique, but can pass through it, can traverse it in its entirety, since it proposes to surpass it, to prolong it following the path that Kant himself had cleared in order to fulfill its suppressed virtualities.

A new syndrome of 'spondylo-epi-metaphyseal dysplasia: mixed type''

International Nuclear Information System (INIS)

Sharma, B.G.

2003-01-01

A new type of rare bone dysplasia is described, which shares some common features with spondylo-meta-epiphyseal dysplasia: short limb-abnormal calcification type and lethal metatropic dysplasia. Besides these features, the present case has some additional unusual features. Facial malformation was very obvious and of a different type. The nose and nares were completely flattened. Hypertrophied acetabular bones, round densities on the ilia, premature ossification of many epiphyses and carpal bones, curvilinear calcifications in some joints, fusion of the ischiopubic rami, calcification of many costal cartilages and thick sclerotic base of the skull were a few of the significant findings. On the basis of the clinical and radiological features, the condition has been named ''spondylo-epi-metaphyseal dysplasia: mixed type''. (orig.)

On Some Troubles with the Metaphysics of Fermionic Compositions

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Bigaj, Tomasz

2016-09-01

In this paper I discuss some metaphysical consequences of an unorthodox approach to the problem of the identity and individuality of "indistinguishable" quantum particles. This approach is based on the assumption that the only admissible way of individuating separate components of a given system is with the help of the permutation-invariant qualitative properties of the total system. Such a method of individuation, when applied to fermionic compositions occupying so-called GMW-nonentangled states, yields highly implausible consequences regarding the number of distinct components of a given composite system. I specify the problem (which I call the problem of fermionic inflation) in detail, and I consider several strategies of solving it. The preferred solution of the problem is based on the premise that spatial location should play a privileged role in identifying and making reference to quantum-mechanical systems.

A new method for improving the reliability of fracture toughness surveillance of nuclear pressure vessel by neutron irradiated embrittlement

International Nuclear Information System (INIS)

Zhang Xinping; Shi Yaowu

1992-01-01

In order to obtain more information from neutron irradiated sample specimens and raise the reliability of fracture toughness surveillance test, it has more important significance to repeatedly exploit the broken Charpy-size specimen which had been tested in surveillance test. In this work, on the renewing design and utilization for Charpy-size specimens, 9 data of fracture toughness can be gained from one pre-cracked side-grooved Charpy-size specimen while at the preset usually only 1 to 3 data of fracture toughness can be obtained from one Chharpy-size specimen. Thus, it is found that the new method would obviously improve the reliability of fracture toughness surveillance test and evaluation. Some factors which affect the reasonable design of pre-cracked deep side-groove Charpy-size compound specimen have been discussed

Predicting Hip Fracture Type With Cortical Bone Mapping (CBM) in the Osteoporotic Fractures in Men (MrOS) Study.

Science.gov (United States)

Treece, Graham M; Gee, Andrew H; Tonkin, Carol; Ewing, Susan K; Cawthon, Peggy M; Black, Dennis M; Poole, Kenneth E S

2015-11-01

Hip fracture risk is known to be related to material properties of the proximal femur, but fracture prediction studies adding richer quantitative computed tomography (QCT) measures to dual-energy X-ray (DXA)-based methods have shown limited improvement. Fracture types have distinct relationships to predictors, but few studies have subdivided fracture into types, because this necessitates regional measurements and more fracture cases. This work makes use of cortical bone mapping (CBM) to accurately assess, with no prior anatomical presumptions, the distribution of properties related to fracture type. CBM uses QCT data to measure the cortical and trabecular properties, accurate even for thin cortices below the imaging resolution. The Osteoporotic Fractures in Men (MrOS) study is a predictive case-cohort study of men over 65 years old: we analyze 99 fracture cases (44 trochanteric and 55 femoral neck) compared to a cohort of 308, randomly selected from 5994. To our knowledge, this is the largest QCT-based predictive hip fracture study to date, and the first to incorporate CBM analysis into fracture prediction. We show that both cortical mass surface density and endocortical trabecular BMD are significantly different in fracture cases versus cohort, in regions appropriate to fracture type. We incorporate these regions into predictive models using Cox proportional hazards regression to estimate hazard ratios, and logistic regression to estimate area under the receiver operating characteristic curve (AUC). Adding CBM to DXA-based BMD leads to a small but significant (p fracture, with AUC increasing from 0.78 to 0.79, assessed using leave-one-out cross-validation. For specific fracture types, the improvement is more significant (p trochanteric fractures and 0.76 to 0.82 for femoral neck fractures. In contrast, adding DXA-based BMD to a CBM-based predictive model does not result in any significant improvement. © 2015 The Authors. Journal of Bone and Mineral Research

Comparing return to sport activities after short metaphyseal femoral arthroplasty with resurfacing and big femoral head arthroplasties.

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Karampinas, Panagiotis K; Papadelis, Eustratios G; Vlamis, John A; Basiliadis, Hlias; Pneumaticos, Spiros G

2017-07-01

Young patients feel that maintaining sport activities after total hip arthroplasty constitutes an important part of their quality of life. The majority of hip surgeons allow patients to return to low-impact activities, but significant caution is advised to taking part in high-impact activities. The purpose of this study is to compare and evaluate the post-operative return to daily living habits and sport activities following short-metaphyseal hip and high functional total hip arthroplasties (resurfacing and big femoral head arthroplasties). In a study design, 48 patients (55 hips) were enrolled in three different comparative groups, one with the short-metaphyseal arthroplasties, a second with high functional resurfacing arthroplasties and a third of big femoral head arthroplasties. Each patient experienced a clinical examination and evaluated with Harris Hip Score, WOMAC, Sf-36, UCLA activity score, satisfaction VAS, anteroposterior and lateral X-rays of the hip and were followed in an outpatient setting for 2 years. Statistical analysis revealed no notable differences between the three groups regarding their demographic data however significant differences have been found between preoperative and postoperative clinical scores of each group. Also, we fail to reveal any significant differences when comparing data of all three groups at the final 2 years postoperative control regarding their clinical scores. The overall outcome of all three groups was similar, all the patients were satisfied and returned to previous level of sport activities. Short metaphyseal hip arthroplasties in young patients intending to return to previous and even high impact sport activities, similar to high functional resurfacing, big femoral head arthroplasties. Short stems with hard on hard bearing surfaces might become an alternative to standard stems and hip resurfacing.

Improvement of Fracture Toughness in Epoxy Nanocomposites through Chemical Hybridization of Carbon Nanotubes and Alumina.

Science.gov (United States)

Zakaria, Muhammad Razlan; Abdul Kudus, Muhammad Helmi; Md Akil, Hazizan; Zamri, Mohd Hafiz

2017-03-16

The current study investigated the effect of adding a carbon nanotube-alumina (CNT-Al₂O₃) hybrid on the fracture toughness of epoxy nanocomposites. The CNT-Al₂O₃ hybrid was synthesised by growing CNTs on Al₂O₃ particles via the chemical vapour deposition method. The CNTs were strongly attached onto the Al₂O₃ particles, which served to transport and disperse the CNTs homogenously, and to prevent agglomeration in the CNTs. The experimental results demonstrated that the CNT-Al₂O₃ hybrid-filled epoxy nanocomposites showed improvement in terms of the fracture toughness, as indicated by an increase of up to 26% in the critical stress intensity factor, K 1 C , compared to neat epoxy.

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

Science.gov (United States)

Galos, David; Taylor, Benjamin; McLaurin, Toni

2017-01-01

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

A Japanese-American Sam Spade: The Metaphysical Detective in Death in Little Tokyo, by Dale Furutani

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Portilho Carla

2017-06-01

Full Text Available The aim of this essay is to discuss the legacy of the roman noir in contemporary detective fiction produced outside the hegemonic center of power, here represented by the novel Death in Little Tokyo (1996, written by Japanese-American author Dale Furutani. Starting from the concept of the metaphysical detective (Haycraft 76; Holquist 153-156, characterized by deep questioning about narrative, interpretation, subjectivity, the nature of reality and the limits of knowledge, this article proposes a discussion about how these literary works, which at first sight represent a traditionally Anglo-American genre, constitute narratives that aim to rescue the memory, history and culture of marginalized communities. Typical of late modernity detective fiction, the metaphysical detective has none of the positivistic detective’s certainties, as he does not share in his Cartesian notion of totality, being presented instead as a successor of the hardboiled detective of the roman noir. In this article I intend to analyze the paths chosen by the author and discuss how his re-reading of the roman noir dialogues with the texts of hegemonic noire detective fiction, inscribing them in literary tradition and subverting them at the same time.

High-resolution CT with histopathological correlates of the classic metaphyseal lesion of infant abuse

Energy Technology Data Exchange (ETDEWEB)

Tsai, Andy; Kleinman, Paul K. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); McDonald, Anna G. [Office of the Chief Medical Examiner, Boston, MA (United States); Rosenberg, Andrew E. [University of Miami Hospital, Department of Pathology, Miami, FL (United States); Gupta, Rajiv [Massachusetts General Hospital, Department of Radiology, Boston, MA (United States)

2014-02-15

The classic metaphyseal lesion (CML) is a common high specificity indicator of infant abuse and its imaging features have been correlated histopathologically in infant fatalities. High-resolution CT imaging and histologic correlates were employed to (1) characterize the normal infant anatomy surrounding the chondro-osseous junction, and (2) confirm the 3-D model of the CML previously inferred from planar radiography and histopathology. Long bone specimens from 5 fatally abused infants, whose skeletal survey showed definite or suspected CMLs, were studied postmortem. After skeletal survey, selected specimens were resected and imaged with high-resolution digital radiography. They were then scanned with micro-CT (isotropic resolution of 45 μm{sup 3}) or with high-resolution flat-panel CT (isotropic resolutions of 200 μm{sup 3}). Visualization of the bony structures was carried out using image enhancement, segmentation and isosurface extraction, together with volume rendering and multiplanar reformatting. These findings were then correlated with histopathology. Study of normal infant bone clarifies the 3-D morphology of the subperiosteal bone collar (SPBC) and the radiographic zone of provisional calcification (ZPC). Studies on specimens with CML confirm that this lesion is a fracture extending in a planar fashion through the metaphysis, separating a mineralized fragment. This disk-like mineralized fragment has two components: (1) a thick peripheral component encompassing the SPBC; and (2) a thin central component comprised predominantly of the radiologic ZPC. By manipulating the 3-D model, the varying appearances of the CML are displayed. High-resolution CT coupled with histopathology provides elucidation of the morphology of the CML, a strong indicator of infant abuse. This new information may prove useful in assessing the biomechanical factors that produce this strong indicator of abusive assaults in infants. (orig.)

High-resolution CT with histopathological correlates of the classic metaphyseal lesion of infant abuse

International Nuclear Information System (INIS)

Tsai, Andy; Kleinman, Paul K.; McDonald, Anna G.; Rosenberg, Andrew E.; Gupta, Rajiv

2014-01-01

The classic metaphyseal lesion (CML) is a common high specificity indicator of infant abuse and its imaging features have been correlated histopathologically in infant fatalities. High-resolution CT imaging and histologic correlates were employed to (1) characterize the normal infant anatomy surrounding the chondro-osseous junction, and (2) confirm the 3-D model of the CML previously inferred from planar radiography and histopathology. Long bone specimens from 5 fatally abused infants, whose skeletal survey showed definite or suspected CMLs, were studied postmortem. After skeletal survey, selected specimens were resected and imaged with high-resolution digital radiography. They were then scanned with micro-CT (isotropic resolution of 45 μm 3 ) or with high-resolution flat-panel CT (isotropic resolutions of 200 μm 3 ). Visualization of the bony structures was carried out using image enhancement, segmentation and isosurface extraction, together with volume rendering and multiplanar reformatting. These findings were then correlated with histopathology. Study of normal infant bone clarifies the 3-D morphology of the subperiosteal bone collar (SPBC) and the radiographic zone of provisional calcification (ZPC). Studies on specimens with CML confirm that this lesion is a fracture extending in a planar fashion through the metaphysis, separating a mineralized fragment. This disk-like mineralized fragment has two components: (1) a thick peripheral component encompassing the SPBC; and (2) a thin central component comprised predominantly of the radiologic ZPC. By manipulating the 3-D model, the varying appearances of the CML are displayed. High-resolution CT coupled with histopathology provides elucidation of the morphology of the CML, a strong indicator of infant abuse. This new information may prove useful in assessing the biomechanical factors that produce this strong indicator of abusive assaults in infants. (orig.)

Spatial arrangement of faults and opening-mode fractures

Science.gov (United States)

Laubach, S. E.; Lamarche, J.; Gauthier, B. D. M.; Dunne, W. M.; Sanderson, David J.

2018-03-01

Spatial arrangement is a fundamental characteristic of fracture arrays. The pattern of fault and opening-mode fracture positions in space defines structural heterogeneity and anisotropy in a rock volume, governs how faults and fractures affect fluid flow, and impacts our understanding of the initiation, propagation and interactions during the formation of fracture patterns. This special issue highlights recent progress with respect to characterizing and understanding the spatial arrangements of fault and fracture patterns, providing examples over a wide range of scales and structural settings. Five papers describe new methods and improvements of existing techniques to quantify spatial arrangement. One study unravels the time evolution of opening-mode fracture spatial arrangement, which are data needed to compare natural patterns with progressive fracture growth in kinematic and mechanical models. Three papers investigate the role of evolving diagenesis in localizing fractures by mechanical stratigraphy and nine discuss opening-mode fracture spatial arrangement. Two papers show the relevance of complex cluster patterns to unconventional reservoirs through examples of fractures in tight gas sandstone horizontal wells, and a study of fracture arrangement in shale. Four papers demonstrate the roles of folds in fracture localization and the development spatial patterns. One paper models along-fault friction and fluid pressure and their effects on fault-related fracture arrangement. Contributions address deformation band patterns in carbonate rocks and fault size and arrangement above a detachment fault. Three papers describe fault and fracture arrangements in basement terrains, and three document fracture patterns in shale. This collection of papers points toward improvement in field methods, continuing improvements in computer-based data analysis and creation of synthetic fracture patterns, and opportunities for further understanding fault and fracture attributes in

THE THIRD MAN ARGUMENT(PARM.132A1-B2-A ‘PURELY’ METAPHYSICAL EXERCISE?

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Marcus Nabielek

2013-11-01

Full Text Available All commentators of the ‘Parmenides’ agree that the Third Man argument, 132a-b2, raises a difficulty for Plato’s theory of forms. Many commentators, following Vlastos, hold that the argument’s infinite regress is vicious for epistemic reasons. Rickless contends that the infinite regress is vicious for exclusively metaphysical reasons. This essay intends to show that Rickless’ interpretation is inadequate, as well as to vindicate Vlastos’ interpretation.

Physical Aspects in Upscaling of Fractured Reservoirs and Improved Oil Recovery Prediction

NARCIS (Netherlands)

Salimi, H.

2010-01-01

This thesis is concerned with upscaled models for waterflooded naturally fractured reservoirs (NFRs). Naturally fractured petroleum reservoirs provide over 20% of the world’s oil reserves and production. From the fluid-flow point of view, a fractured reservoir is defined as a reservoir in which a

Metaphysical and ethical perspectives on creating animal-human chimeras.

Science.gov (United States)

Eberl, Jason T; Ballard, Rebecca A

2009-10-01

This paper addresses several questions related to the nature, production, and use of animal-human (a-h) chimeras. At the heart of the issue is whether certain types of a-h chimeras should be brought into existence, and, if they are, how we should treat such creatures. In our current research environment, we recognize a dichotomy between research involving nonhuman animal subjects and research involving human subjects, and the classification of a research protocol into one of these categories will trigger different ethical standards as to the moral permissibility of the research in question. Are a-h chimeras entitled to the more restrictive and protective ethical standards applied to human research subjects? We elucidate an Aristotelian-Thomistic metaphysical framework in which to argue how such chimeras ought to be defined ontologically. We then examine when the creation of, and experimentation upon, certain types of a-h chimeras may be morally permissible.

Critica metafizicii şi noua retorică a liberalismului (The critics of metaphysics and the new rethoric of liberalism

Directory of Open Access Journals (Sweden)

Mark BUCUCI

2015-03-01

Full Text Available During the Enlightment, the emergence and the prestige of sciences influenced the rhetoric of liberalism. This metaphysical rhetoric, according to Richard Rorty, became an ostacle to liberalism’ efficient marketing . Rorty deconstructs this rhetorical fusion and conceives a new kind of rhetoric for liberalism.

Imaging of vertebral fracture in osteoporosis

International Nuclear Information System (INIS)

Skowronska-Jozwiak, E.; Lewinski, A.; Bieganski, T.

2008-01-01

Vertebral collapses are the most frequent fractures in osteoporosis. They are often overlooked, although their presence is a strong risk factor for development of new fractures. Lateral radiographs of the spine are the accepted standard for assessment of fractures. Qualitative (visual), semiquantitative and quantitative (morphometric) techniques are useful in determining the compressive deformities of vertebral bodies. In the present paper, the advantages and the disadvantages of these methods are discussed. The improvement of scan quality allows to use DXA technique to diagnose the fractures, in both - the visual and the morphometric way. The vertebral morphologic assessment also seems to be an important diagnostic tool in pediatric osteoporosis. Application of multidetector CT and especially MR in vertebral imaging of osteoporosis, improves the sensitivity of fracture detection and enables the differentiation of benign from malignant vertebral body collapses. (author)

Fracture mechanisms and fracture control in composite structures

Science.gov (United States)

Kim, Wone-Chul

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

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

Science.gov (United States)

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

2011-01-01

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

Improving Osteoporosis Management in Primary Care: An Audit of the Impact of a Community Based Fracture Liaison Nurse.

Science.gov (United States)

Chan, Tom; de Lusignan, Simon; Cooper, Alun; Elliott, Mary

2015-01-01

Osteoporosis and associated fragility fractures are a major health problem; they are more common in women over 50 years old. Fracture liaison nurses have been widely used in secondary care to promote the recognition of fragility fractures and to promote the use of bone-sparing medication to reduce the risk of recurrent facture. Audit the impact of a primary care based fracture liaison nurse on the detection of fragility fractures in people with osteoporosis and their treatment with a bone-sparing medication. This audit took place in 12 GP practices using 'before and after' cross-sectional extractions of anonymised routine data. We report, for females 50-74 years and ≥ 75 years old, socio-economic deprivation index, the prevalence of osteoporosis, recording of fragility fractures, dual-energy X-ray absorptiometry (DXA), smoking, and body-mass index (BMI) and use of appropriate bone-sparing medication. We used Altman's test of independent proportions to compare before and after data. Recording of the diagnosis of osteoporosis increased from 1.5% to 1.7% (p = 0.059); the rate of DXA scans fell (1.8% to 1.4%; p = 0.002); recording of fractures and fragility fractures more than doubled (0.8% to 2.0%; p<0.001 and 0.5% to 1.5%; p<0.001, respectively) with approximate doubling of the recording of smoking, and BMI (p<0.001 level). Fragility fracture recording rose from 8.8% to 15% in females aged 50 to 74, and from 0.8% to 2.3% in people aged ≥ 75 years old (p<0.001). There appeared to be inequity in the service, people who were least deprived were more likely to receive DXA scans and the more deprived to be prescribed bone sparing agents. A fracture liaison nurse in primary care has been associated with a period of improved management. Liaison nurses based in different parts of the health system should be tested in a prospective trial.

Improving Osteoporosis Management in Primary Care: An Audit of the Impact of a Community Based Fracture Liaison Nurse.

Directory of Open Access Journals (Sweden)

Tom Chan

Full Text Available Osteoporosis and associated fragility fractures are a major health problem; they are more common in women over 50 years old. Fracture liaison nurses have been widely used in secondary care to promote the recognition of fragility fractures and to promote the use of bone-sparing medication to reduce the risk of recurrent facture.Audit the impact of a primary care based fracture liaison nurse on the detection of fragility fractures in people with osteoporosis and their treatment with a bone-sparing medication.This audit took place in 12 GP practices using 'before and after' cross-sectional extractions of anonymised routine data. We report, for females 50-74 years and ≥ 75 years old, socio-economic deprivation index, the prevalence of osteoporosis, recording of fragility fractures, dual-energy X-ray absorptiometry (DXA, smoking, and body-mass index (BMI and use of appropriate bone-sparing medication. We used Altman's test of independent proportions to compare before and after data.Recording of the diagnosis of osteoporosis increased from 1.5% to 1.7% (p = 0.059; the rate of DXA scans fell (1.8% to 1.4%; p = 0.002; recording of fractures and fragility fractures more than doubled (0.8% to 2.0%; p<0.001 and 0.5% to 1.5%; p<0.001, respectively with approximate doubling of the recording of smoking, and BMI (p<0.001 level. Fragility fracture recording rose from 8.8% to 15% in females aged 50 to 74, and from 0.8% to 2.3% in people aged ≥ 75 years old (p<0.001. There appeared to be inequity in the service, people who were least deprived were more likely to receive DXA scans and the more deprived to be prescribed bone sparing agents.A fracture liaison nurse in primary care has been associated with a period of improved management. Liaison nurses based in different parts of the health system should be tested in a prospective trial.

Treatment of open tibial fracture with bone defect caused by high velocity missiles: A case report

Directory of Open Access Journals (Sweden)

Golubović Zoran

2013-01-01

Full Text Available Introduction .Tibia fracture caused by high velocity missiles is mostly comminuted and followed by bone defect which makes their healing process extremely difficult and prone to numerous complications. Case Outline. A 34-year-old male was wounded at close range by a semi-automatic gun missile. He was wounded in the distal area of the left tibia and suffered a massive defect of the bone and soft tissue. After the primary treatment of the wound, the fracture was stabilized with an external fixator type Mitkovic, with convergent orientation of the pins. The wound in the medial region of the tibia was closed with the secondary stitch, whereas the wound in the lateral area was closed with the skin transplant after Thiersch. Due to massive bone defect in the area of the rifle-missile wound six months after injury, a medical team placed a reconstructive external skeletal fixator type Mitkovic and performed corticotomy in the proximal metaphyseal area of the tibia. By the method of bone transport (distractive osteogenesis, the bone defect of the tibia was replaced. After the fracture healing seven months from the secondary surgery, the fixator was removed and the patient was referred to physical therapy. Conclusion. Surgical treatment of wounds, external fixation, performing necessary debridement, adequate antibiotic treatment and soft and bone tissue reconstruction are essential in achieving good results in patients with the open tibial fracture with bone defect caused by high velocity missiles. Reconstruction of bone defect can be successfully treated by reconstructive external fixator Mitkovic. [Projekat Ministarstva nauke Republike Srbije, br. III 41017 i br. III 41004

Heat Recovery from Multiple-Fracture Enhanced Geothermal Systems: The Effect of Thermoelastic Fracture Interactions

DEFF Research Database (Denmark)

Vik, Hedda Slatlem; Salimzadeh, Saeed; Nick, Hamid

2018-01-01

This study investigates the effect of thermoelastic interactions between multiple parallel fractures on energy production from a multiple-fracture enhanced geothermal system. A coupled thermo-hydro-mechanical finite element model has been developed that accounts for non-isothermal fluid flow within...... increased to maximise the net energy production from the system. Otherwise, the multiple-fracture system fails to improve the energy recovery from the geothermal reservoir, as initially intended....... aperture in the adjacent fracture, and facilitates the creation of favourable flow pathways between the injection and production wells. These flow paths reduce the energy production from the system. The effects of fracture spacing, reservoir temperature gradient and mechanical properties of the rock matrix...

Duhem’s Analysis of Newtonian Method and the Logical Priority of Physics over Metaphysics

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Eduardo Salles de Oliveira Barra

2017-06-01

Full Text Available This article offers a discussion of Duhemian analysis of Newton's method in the Principia considering both the traditional response to this analysis (Popper et alii and the more recent ones (Harper et alii. It is argued that in General Scholium to the Principia, Newton is not advocating what Duhem suggests in his best-known criticism, but he is proposing something very close to the establishment of a logical priority of physics over metaphysics, a familiar thesis defended by the French physicist himself.

Operative treatment of lateral humeral condyle fractures in children.

Science.gov (United States)

Wirmer, Johannes; Kruppa, Christian; Fitze, Guido

2012-08-01

other criteria. Compared with the use of lag screws, both treatments (K-wire and Screw-wire osteosyntheses) bear less risk of nonvascular necrosis or small metaphyseal fragment rupture, by comparable results in the overall outcome. Regarding the long-term development of healed fractures, changes in the carrying angle and the range of motion are of a small degree. Considering the results of this study, we recommend the use of Screw-wire osteosynthesis in the operative treatment of lateral humeral condyle fractures in children. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Rehabilitation in osteoporotic vertebral fractures

OpenAIRE

Pratelli, Elisa; Cinotti, Irene; Pasquetti, Pietro

2010-01-01

Vertebral fractures occur particularly in osteoporotic patients due to an increased bone fragility. Vertebral fractures influence the quality of life, mobility and mortality. Preventive training exercises and proprioception reeducation can be utilised for improving posture, balance and level of daily function and for decreasing pain. Quality of life is improved even beyond the active training period. This mini review provides information based on the literature for the rehabilitation of osteo...

Spreading disease: a controversy concerning the metaphysics of disease.

Science.gov (United States)

D'Amico, R

1998-01-01

This article concerns the metaphysics of disease. Is disease a fixed feature of the world or a social value or preference? I argue that disease is not a value-laden concept and thus debates concerning it differ fundamentally from debates concerning health, harm, or suffering where evaluative judgements are central. I show how the so-called social constructionist view of disease has been motivated both by ethical concerns with medical practices and general theoretical doubts about scientific naturalism. If I can show that ethical concerns about medical treatment can be answered without adopting social constructionism, that leaves only the broader theoretical question of naturalism. I cannot completely answer those theoretical doubts, but I show that the theoretical motivation is less convincing when it is separated from the moral challenge often accompanying it. I conclude that a convincing defense of the non-naturalistic conception of disease is rarely attempted and proves more difficult and counter-intuitive than its proponents assume.

Improvement of the mode II interface fracture toughness of glass fiber reinforced plastics/aluminum laminates through vapor grown carbon fiber interleaves.

Science.gov (United States)

Ning, Huiming; Li, Yuan; Hu, Ning; Cao, Yanping; Yan, Cheng; Azuma, Takesi; Peng, Xianghe; Wu, Liangke; Li, Jinhua; Li, Leilei

2014-06-01

The effects of acid treatment, vapor grown carbon fiber (VGCF) interlayer and the angle, i.e., 0° and 90°, between the rolling stripes of an aluminum (Al) plate and the fiber direction of glass fiber reinforced plastics (GFRP) on the mode II interlaminar mechanical properties of GFRP/Al laminates were investigated. The experimental results of an end notched flexure test demonstrate that the acid treatment and the proper addition of VGCF can effectively improve the critical load and mode II fracture toughness of GFRP/Al laminates. The specimens with acid treatment and 10 g m -2 VGCF addition possess the highest mode II fracture toughness, i.e., 269% and 385% increases in the 0° and 90° specimens, respectively compared to those corresponding pristine ones. Due to the induced anisotropy by the rolling stripes on the aluminum plate, the 90° specimens possess 15.3%-73.6% higher mode II fracture toughness compared to the 0° specimens. The improvement mechanisms were explored by the observation of crack propagation path and fracture surface with optical, laser scanning and scanning electron microscopies. Moreover, finite element analyses were carried out based on the cohesive zone model to verify the experimental fracture toughness and to predict the interface shear strength between the aluminum plates and GFRP laminates.

Challenging and improving conceptual models for isothermal flow in unsaturated, fractured rock through exploration of small-scale processes

International Nuclear Information System (INIS)

Glass, R.J.; Nicholl, M.J.; Tidwell, V.C.

1996-01-01

Over the past several years, the authors have performed experimental studies focused on understanding small-scale flow processes within discrete fractures and individual matrix blocks; much of the understanding gained in that time differs from that underlying the basic assumptions used in effective media representations. Here they synthesize the process level understanding gained from their laboratory studies to explore how such small-scale processes may influence the behavior of fluid flow in fracture networks and ensembles of matrix blocks at levels sufficient to impact the formulation of intermediate-scale effective media properties. They also explore, by means of a thought experiment, how these same small-scale processes could couple to produce a large-scale system response inconsistent with current conceptual models based on continuum representations of flow through unsaturated, fractured rock. Based on their findings, a number of modifications to existing dual permeability models are suggested that should allow them improved applicability; however, even with these modifications, it is likely that continuum representations of flow through unsaturated fractured rock will have limited validity and must therefore be applied with caution

[Early diagnosis, variety of outcomes and prognosis of juvenile schizophrenia with over-value disorders of the "metaphysical intoxication" type onset (results of a late follow-up study)].

Science.gov (United States)

Tsutsul'kovskaia, M Ia; Izvol'skiĭ, S A; Bol'zho, A G; Kopeĭko, G I

1986-01-01

On the basis of follow-up findings about juvenile schizophrenia first expressed in superworship manifestations according to the type of metaphysical intoxication (98 observations), the authors established that most frequently these cases were characterized by a torpid course of the disease in the framework of slowly progressing juvenile schizophrenia. There was a high rate of favourable outcomes at the level of "clinical recovery" (in 42.5%). Favourable prognostic signs were as follows: the complete nature of the clinical picture of the syndrome, its similarity to pubertal crisis manifestations, the absence in its structure of other positive disturbances and a number of specific features of the premorbid picture. The authors determined the pattern of correlation between the typological characteristics of the state of juvenile metaphysical intoxication and the outcome of the disease, peculiarities of manifestations of this phenomenon at the initial stage of psychotic forms of juvenile schizophrenia, as well as distinctive features of superworship formations according to the type of juvenile metaphysical intoxication observed in the framework of pubertal decompensation in schizoid psychopathies.

Particles, particle labels, and quanta: The toll of unacknowledged metaphysics

International Nuclear Information System (INIS)

Redhead, M.; Teller, P.

1991-01-01

The practice of describing multiparticle quantum systems in terms of labeled particles indicates that the authors think of quantum entities as individuatable. The labels, together with particle indistinguishability, create the need for symmetrization or antisymmetrization (or, in principle, higher-order symmetries), which in turn results in 'surplus formal structure' in the formalism, formal structure which corresponds to nothing in the real world. The authors argue that these facts show quanta to be unindividuatable entities, things in principle incapable of supporting labels, and so things which support no factual difference if two of them are thought of as being switched. When thinking of the metaphysics of quanta, one should eschew the misleading labels of the tensor product Hilbert space formalism and prefer the ontologically more faithful description of the Fock space formalism. This conception eliminates puzzles about the quantum statistics of bosons

High temperature fracture of ceramic materials

International Nuclear Information System (INIS)

Wiederhorn, S.M.

1979-01-01

A review is presented of fracture mechanisms and methods of lifetime prediction in ceramic materials. Techniques of lifetime prediction are based on the science of fracture mechanics. Application of these techniques to structural ceramics is limited by our incomplete understanding of fracture mechanisms in these materials, and by the occurrence of flaw generation in these materials at elevated temperatures. Research on flaw generation and fracture mechanisms is recommended as a way of improving the reliability of structural ceramics

Metaphyseal chondrodysplasia, Schmid type - clinical and radiographic deliniation with a review of the literature

International Nuclear Information System (INIS)

Lachmann, R.S.; Rimoin, D.L.; Spranger, J.; Mainz Univ.

1988-01-01

Analysis of 20 cases of metaphyseal chondrodysplasia, Schmid type as well as a review of the world literature reveals a specific autosomal dominant disorder that was often over diagnosed in the past, sometimes resulting in incorrect genetic counselling. Significant radiologic features include an enlarged capital femoral epiphysis in early childhood, coxa vara, greater involvement of the distal femoral metaphysis than the proximal, anterior rib changes and a normal spine. Chondroosseous morphology is not specific. Presentation in nonfamilial cases is no earlier than the second year of life. (orig.)

Identification of Long Bone Fractures in Radiology Reports Using Natural Language Processing to support Healthcare Quality Improvement.

Science.gov (United States)

Grundmeier, Robert W; Masino, Aaron J; Casper, T Charles; Dean, Jonathan M; Bell, Jamie; Enriquez, Rene; Deakyne, Sara; Chamberlain, James M; Alpern, Elizabeth R

2016-11-09

Important information to support healthcare quality improvement is often recorded in free text documents such as radiology reports. Natural language processing (NLP) methods may help extract this information, but these methods have rarely been applied outside the research laboratories where they were developed. To implement and validate NLP tools to identify long bone fractures for pediatric emergency medicine quality improvement. Using freely available statistical software packages, we implemented NLP methods to identify long bone fractures from radiology reports. A sample of 1,000 radiology reports was used to construct three candidate classification models. A test set of 500 reports was used to validate the model performance. Blinded manual review of radiology reports by two independent physicians provided the reference standard. Each radiology report was segmented and word stem and bigram features were constructed. Common English "stop words" and rare features were excluded. We used 10-fold cross-validation to select optimal configuration parameters for each model. Accuracy, recall, precision and the F1 score were calculated. The final model was compared to the use of diagnosis codes for the identification of patients with long bone fractures. There were 329 unique word stems and 344 bigrams in the training documents. A support vector machine classifier with Gaussian kernel performed best on the test set with accuracy=0.958, recall=0.969, precision=0.940, and F1 score=0.954. Optimal parameters for this model were cost=4 and gamma=0.005. The three classification models that we tested all performed better than diagnosis codes in terms of accuracy, precision, and F1 score (diagnosis code accuracy=0.932, recall=0.960, precision=0.896, and F1 score=0.927). NLP methods using a corpus of 1,000 training documents accurately identified acute long bone fractures from radiology reports. Strategic use of straightforward NLP methods, implemented with freely available

Development of Nanoparticle-Stabilized Foams to Improve Performance of Water-less Hydraulic Fracturing

Energy Technology Data Exchange (ETDEWEB)

Prodanovic, Masa [The University of Texas at Austin; Johnston, Keith P. [The University of Texas at Austin

2017-12-29

We have successfully created ultra dry carbon-dioxide-in-water and nitrogen-in-water foams (with water content down to 2-5% range), that are remarkably stable at high temperatures (up to 120 deg, C) and pressures (up to 3000psi) and viscous enough (100-200 cP tunable range) to carry proppant. Two generations of these ultra-dry foams have been developed; they are stabilized either with a synergy of surfactants and nanoparticle, or just with viscoelastic surfactants that viscosify the aqueous phase. Not only does this reduce water utilization and disposal, but it minimizes fluid blocking of hydrocarbon production. Further, the most recent development shows successful use of environmentally friendly surfactants at high temperature and pressure. We pay special attention to the role of nanoparticles in stabilization of the foams, specifically for high salinity brines. The preliminary numerical simulation for which shows they open wider fractures with shorter half-length and require less clean-up due to minimal water use. We also tested the stability and sand carrying properties of these foams at high pressure, room temperature conditions in sapphire cell. We performed on a preliminary numerical investigation of applicability for improved oil recovery applications. The applicability was evaluated by running multiphase flow injection simulations in a case-study oil reservoir. The results of this research thus expand the options available to operators for hydraulic fracturing and can simplify the design and field implementation of foamed fracturing fluids.

On Darwin's 'metaphysical notebooks'. I: teleology and the project of a theory.

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Calabi, L

2001-01-01

Huxley's essay On the Reception of the 'Origin of Species' brings us close to the issue of cause and of why- and how-questions in the understanding of the living world. The present contribution, which is divided into two parts, reviews the problem of Teleology as conceived by Huxley and re-examines Darwin as the author who revealed the existence of a 'foundations problem' in the explanation of an entire realm of nature, i.e., the problem of explaining such realm in terms of its own, specific legality, or iuxta sua propria principia. In the first part the enquiry is mainly focused on the secularization of natural history after Paley; in the second part it is mainly focused on the desubjectivization of the inquiry into natural history after Erasmus Darwin and Lamarck. The second part will be published in the next issue of Rivista di Biologia/Biology Forum. In the first part below an analysis is made of Notebooks M and N. The author disputes the correctness of conceiving them only as the works where Darwin envisages the 'metaphysical' themes later to become the subject of The Expression of the Emotions. He suggests to conceive of them also as the works where Darwin defines the terms of the general project of his own, peculiar evolutionary theory. The author then outlines the intellectual progress of Darwin from the inosculation to the transmutation hypotheses. Darwin's reading of Malthus appears to be analytically decisive, because it offers him the vintage point to attack the metaphysical and theological citadels on the morphological side. Darwin is thus able to re-consider Erasmus' comprehensive zoonomic project, by displacing it, however, from the old idea of the scala naturae to the new one of the "coral of life", and by emphasising the distinction between "the fittest" and "the best" vs. the tradition of Natural Theology.

Additional Tension Screws Improve Stability in Elastic Stable Intramedullary Nailing: Biomechanical Analysis of a Femur Spiral Fracture Model.

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Zachert, Gregor; Rapp, Marion; Eggert, Rebecca; Schulze-Hessing, Maaike; Gros, Nina; Stratmann, Christina; Wendlandt, Robert; Kaiser, Martin M

2015-08-01

For pediatric femoral shaft fractures, elastic stable intramedullary nailing (ESIN) is an accepted method of treatment. But problems regarding stability with shortening or axial deviation are well known in complex fracture types and heavier children. Biomechanical in vitro testing was performed to determine whether two modified osteosyntheses with an additional tension screw fixation or screw fixation alone without nails could significantly improve the stability in comparison to classical ESIN. A total of 24 synthetic adolescent-sized femoral bone models (Sawbones, 4th generation; Vashon, Washington, United States) with an identical spiral fracture (length 100 mm) were used. All grafts underwent retrograde fixation with two C-shaped steel nails (2C). Of the 24, 8 osteosyntheses were supported by one additional tension screw (2C1S) and another 8 by two screws (2S) in which the intramedullary nails were removed before testing. Each configuration underwent biomechanical testing in 4-point bending, external rotation (ER) and internal rotation (IR). Furthermore, the modifications were tested in axial physiological 9 degrees position for shifting and dynamic compression as well as dynamic load. Both screw configurations (2C1S and 2S) demonstrated a significantly higher stability in comparison to the 2C configuration in 4-point bending (anterior-posterior, 0.95 Nm/mm [2C] spiral fracture model, the stability of ESIN could be significantly improved by two modifications with additional tension screws. If transferred in clinical practice, these modifications might offer earlier weight bearing and less problems of shortening or axial deviation. Georg Thieme Verlag KG Stuttgart · New York.

Fracture toughness of Dy123 low porosity bulks at liquid nitrogen temperature

International Nuclear Information System (INIS)

Murakami, A.; Otaka, K.; Miura, T.; Iwamoto, A.

2011-01-01

Fracture toughness values were measured for Dy123 bulks. Fracture toughness was improved by reducing porosity. Fracture toughness values at 77 K were higher than those at room temperature. Fracture toughness was also improved by Ag addition. In order to evaluate the fracture toughness of DyBa 2 Cu 3 O x (Dy123) low porosity bulks, bending tests of V-notched specimens cut from the bulks were carried out. Fracture toughness evaluations of a conventional Dy123 bulk which had pores were also carried out and effects of elimination of pores on the fracture toughness were investigated. Fracture toughness values at 77 K of the low porosity bulks were higher than those of the porous bulk. These fracture toughness values at 77 K were higher than the values at room temperature. Fracture toughness of the low porosity bulk was improved by Ag addition.

Material Fracture Characterization and Toughness Improving Technology Development

International Nuclear Information System (INIS)

Lee, Bong Sang; Yoon, J. H.; Lee, H. J.

2007-06-01

The objectives of this study are the assurance of integrity assessment technique for RPV and primary piping, the accumulation of radiation embrittlement data for RPV steels and development of high toughness/strength radiation-resistant reactor structural materials. The present work is categorized into 4 parts. The contents are as follows. 1. Development of technical guideline for application of fracture master curve to domestic nuclear power plant, 2. Development of radiation embrittlement DB and assessment model for domestic RPV steels, 3. characterzation of crack growth properties for piping and their welds, 4. Improvement of material specification for RPV and piping Since the demand of the citizens for safety insurance of operating NPP is increasing, the results of quantitative evaluation of safety margin related to radiation embrittlement by using advanced techniques can be effectively used for public acceptance. It can provide a technical basis of safety inspection for the regulatory body. Furthermore, it is expected that the techniques and the results would be used for effectiveness of the aging management and periodic safety review programs for domestic NPPs. The results of the study for enhancement of material properties of type 347 for surge line is planed to be involved in special specification for the next KSNP construction. The results for improving strength of RPV material will be an important technical basis of an R and D program for the design and construction of a next generation NPP, such as SCWR

Pragmatism, metaphysics, and bioethics: beyond a theory of moral deliberation.

Science.gov (United States)

Pamental, Matthew

2013-12-01

Pragmatism has been understood by bioethicists as yet another rival in the "methods wars," as yet another theory of moral deliberation. This has led to criticism of pragmatic bioethics as both theoretically and practically inadequate. Pragmatists' responses to these objections have focused mainly on misunderstandings of pragmatism's epistemology. These responses are insufficient. Pragmatism's commitment to radical empiricism gives it theoretical resources unappreciated by critics and defenders alike. Radical empiricism, unlike its more traditional ancestors, undercuts the gaps between theory and practice, and subjective and objective accounts of experience, and in so doing provides the metaphysical and epistemological basis for a thoroughgoing empirical naturalism in ethics. Pragmatism's strength as an approach to moral problems thus emerges as a result of a much wider array of resources than contemporary interpreters have acknowledged, which makes it a richer, deeper framework for understanding moral deliberation in general and bioethical decision making in particular.

[Intramedullary stabilisation of clavicula fractures].

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Prokop, A; Schiffer, G; Jubel, A; Chmielnicki, M

2013-10-01

With an incidence of 64/100,000, clavicular shaft fractures are one of the most common fractures. Intramedullary fixation with Prevot nails was initially reported in the late 1990s. This procedure offers minimally invasive stabilization of the fracture, thus enabling immediate mobilization and rapid loading capacity. Using a case study, the positioning and procedure are demonstrated on video. The intramedullary implant accommodates the varying tension loading of the clavicle. This treatment is ideal for clavicular fractures with 2-3 fragments. Compared to patients treated conservatively, operated patients achieve more rapid and improved mobility. Employment disability is shorter, and malunion occurs less frequently. Georg Thieme Verlag KG Stuttgart · New York.

Beyond positivism: a metaphysical basis for clinical practice?

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Herman, J

1992-09-01

Medicine does not have its own unified body of scientific knowledge. Instead, physicians who are oriented to research make sporadic incursions into the basic sciences such as genetics, biochemistry, immunology, epidemiology, physiology, pharmacology and so on. These latter, taken together, comprise biomedicine which is said to have adopted the positivist epistemology or the Cartesian/Newtonian one that regards the scientist as an uninvolved observer of nature. In effect, medical science has come to rest on a theory of knowledge which links meaning to probability and considers prediction as the scientist's chief task. Like its predecessor, the probability theory of meaning rejects metaphysical speculation and remains connected to observations made, directly or indirectly, by means of the five senses. Despite some brilliant successes touching on relatively uncommon disorders, biomedicine cannot explain most day-to-day clinical activity. An understanding of what transpires between patient and doctor, of its diagnostic potential and therapeutic weight requires hermeneutic, or phenomenological, inquiry which brings about changes in both parties to it. Such a science, as ontological speculation has been called, cannot be deciphered by an epistemology couched in the imagery of physics and chemistry.

Review of treatment modalities of malleolar fractures

Directory of Open Access Journals (Sweden)

Xinhao Li

2015-01-01

Full Text Available The frequency of malleolar fractures according to available literature data is about 40% of bone fractures, the majority of them are severe articular or compound fractures. The article covers the experience, accumulated by the generations of orthopedists concerning diagnostics, choice of efficient treatment, decrease of disability and improvement of patients' living standards.

Metallic Reinforcement of Direct Squeeze Die Casting Aluminum Alloys for Improved Strength and Fracture Resistance

Energy Technology Data Exchange (ETDEWEB)

D. Schwam: J.F. Wallace: Y. Zhu: J.W. Ki

2004-10-01

The utilization of aluminum die casting as enclosures where internal equipment is rotating inside of the casting and could fracture requires a strong housing to restrain the fractured parts. A typical example would be a supercharger. In case of a failure, unless adequately contained, fractured parts could injure people operating the equipment. A number of potential reinforcement materials were investigated. The initial work was conducted in sand molds to create experimental conditions that promote prolonged contact of the reinforcing material with molten aluminum. Bonding of Aluminum bronze, Cast iron, and Ni-resist inserts with various electroplated coatings and surface treatments were analyzed. Also toughening of A354 aluminum cast alloy by steel and stainless steel wire mesh with various conditions was analyzed. A practical approach to reinforcement of die cast aluminum components is to use a reinforcing steel preform. Such performs can be fabricated from steel wire mesh or perforated metal sheet by stamping or deep drawing. A hemispherical, dome shaped casting was selected in this investigation. A deep drawing die was used to fabricate the reinforcing performs. The tendency of aluminum cast enclosures to fracture could be significantly reduced by installing a wire mesh of austenitic stainless steel or a punched austenitic stainless steel sheet within the casting. The use of reinforcements made of austenitic stainless steel wire mesh or punched austenitic stainless steel sheet provided marked improvement in reducing the fragmentation of the casting. The best strengthening was obtained with austenitic stainless steel wire and with a punched stainless steel sheet without annealing this material. Somewhat lower results were obtained with the annealed punched stainless steel sheet. When the annealed 1020 steel wire mesh was used, the results were only slightly improved because of the lower mechanical properties of this unalloyed steel. The lowest results were

Mechanical properties of fracture zones

International Nuclear Information System (INIS)

Leijon, B.

1993-05-01

Available data on mechanical characteristics of fracture zones are compiled and discussed. The aim is to improve the basis for adequate representation of fracture zones in geomechanical models. The sources of data researched are primarily borehole investigations and case studies in rock engineering, involving observations of fracture zones subjected to artificial load change. Boreholes only yield local information about the components of fracture zones, i.e. intact rock, fractures and various low-strength materials. Difficulties are therefore encountered in evaluating morphological and mechanical properties of fracture zones from borehole data. Although often thought of as macroscopically planar features, available field data consistently show that fracture zones are characterized by geometrical irregularities such as thickness variations, surface undulation and jogs. These irregularities prevail on all scales. As a result, fracture zones are on all scales characterized by large, in-plane variation of strength- and deformational properties. This has important mechanical consequences in terms of non-uniform stress transfer and complex mechanisms of shear deformation. Field evidence for these findings, in particular results from the underground research laboratory in Canada and from studies of induced fault slip in deep mines, is summarized and discussed. 79 refs

Comprehensive care improves health outcomes among elderly Taiwanese patients with hip fracture.

Science.gov (United States)

Shyu, Yea-Ing L; Liang, Jersey; Tseng, Ming-Yueh; Li, Hsiao-Juan; Wu, Chi-Chuan; Cheng, Huey-Shinn; Yang, Ching-Tzu; Chou, Shih-Wei; Chen, Ching-Yen

2013-02-01

Few studies have investigated the effects of care models that combine interdisciplinary care with nutrition consultation, depression management, and fall prevention in older persons with hip fracture. The purpose of this study was to compare the effects of a comprehensive care program with those of interdisciplinary care and usual care for elderly patients with hip fracture. A randomized experimental trial was used to explore outcomes for 299 elderly patients with hip fracture receiving three treatment care models: interdisciplinary care (n = 101), comprehensive care (n = 99), and usual care (n = 99). Interdisciplinary care included geriatric consultation, continuous rehabilitation, and discharge planning with post-hospital services. Comprehensive care consisted of interdisciplinary care plus nutrition consultation, depression management, and fall prevention. Usual care included only in-hospital rehabilitation without geriatric consultation, in-home rehabilitation, and home environmental assessment. Participants in the comprehensive care group had better self-care ability (odds ratio, OR = 3.19, p malnutrition (OR = 0.48, p hip fracture benefitted more from the comprehensive care program than from interdisciplinary care and usual care. Older persons with hip fracture benefitted more from comprehensive care including interdisciplinary care and nutrition consultation, depression management, and fall prevention than simply interdisciplinary care.

Four queries concerning the metaphysics of early human embryogenesis.

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Howsepian, A A

2008-04-01

In this essay, I attempt to provide answers to the following four queries concerning the metaphysics of early human embryogenesis. (1) Following its first cellular fission, is it coherent to claim that one and only one of two "blastomeric" twins of a human zygote is identical with that zygote? (2) Following the fusion of two human pre-embryos, is it coherent to claim that one and only one pre-fusion pre-embryo is identical with that postfusion pre-embryo? (3) Does a live human being come into existence only when its brain comes into existence? (4) At implantation, does a pre-embryo become a mere part of its mother? I argue that either if things have quidditative properties or if criterialism is false, then queries (1) and (2) can be answered in the affirmative; that in light of recent developments in theories of human death and in light of a more "functional" theory of brains, query (3) can be answered in the negative; and that plausible mereological principles require a negative answer to query (4).

Philosophical Creationism: Thomas Aquinas’ Metaphysics of Creatio ex Nihilo

Directory of Open Access Journals (Sweden)

Andrzej Maryniarczyk

2016-03-01

Full Text Available All philosophers, beginning with the pre-Socratics, through Plato and Aristotle, and up to Thomas Aquinas, accepted as a certain that the world as a whole existed eternally. The foundation for the eternity of the world was the indestructible and eternal primal building material of the world, a material that existed in the form of primordial material elements (the Ionians, in the form of ideas (Plato, or in the form of matter, eternal motion, and the first heavens (Aristotle. The article outlines the main structure of the philosophical theory of creation ex nihilo developed by St. Thomas Aquinas and indebted to his metaphysical thought. It shows the wisdom-based and ratiocinative foundation of the rational cognition of reality—reality that comes from the personal creative act of God. It concludes that the perception that the beings called to existence by the personal act of God the Creator are intelligible is the ultimate rational justification for the fact that our human cognition, love, and spiritual creativity are rational.

Anchorage strategies in geriatric hip fracture management

Directory of Open Access Journals (Sweden)

Knobe Matthias

2016-12-01

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

Arthroplasty for Unreconstructable Acute Fractures and Failed Fracture Fixation About the Hip and Knee in the Active Elderly: A New Paradigm.

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Kyle, Richard F; Duwelius, Paul J; Haidukewych, George J; Schmidt, Andrew H

2017-02-15

The techniques, materials, and designs for total joint arthroplasty underwent major improvements in the past 30 years. During this time, trauma surgeons classified the severity of fractures as well as identified certain articular fractures that do not have good outcomes and have a high rate of failure after internal fixation. Advanced improvements in arthroplasty have increased its reliability and longevity. Total joint arthroplasty is becoming a standard of care for some acute articular fractures, particularly displaced femoral neck fractures in the active elderly. Total joint arthroplasty also has become the standard of care after failed internal fixation in patients who have very complicated fractures about the knee, hip, and shoulder. As the population ages, fractures worldwide continue to rapidly increase. Elderly patients have a high risk for fractures that result from falls because of their poor bone quality. The current active elderly population participates in higher risk activities than previous elderly populations, which places them at risk for more injuries. This has become both a worldwide healthcare problem and an economic problem. Surgeons need to manage fractures in the active elderly with the latest advancements in technology and patient selection to ensure rapid recovery and the reduction of complications.

[Clinical pathway for hip fracture patients].

Science.gov (United States)

Sáez López, Pilar; Sánchez Hernández, Natalia; Paniagua Tejo, Sonsoles; Valverde García, José Antonio; Montero Díaz, Margarita; Alonso García, Noelia; Freites Esteve, Alfonso

2015-01-01

Hip fracture in the elderly often occurs in patients with high co-morbidity. Effective management requires a comprehensive and multidisciplinary approach. To evaluate the effect of a quality improvement intervention in the detection and treatment of complications in elderly patients admitted for hip fracture. A comparative study was conducted between two groups of patients admitted for hip fracture prior to 2010, and after a quality improvement intervention in 2013. The intervention consisted of implementing improved multidisciplinary measures in accordance with recent scientific evidence. The degree of compliance of the implemented measures was quantified. Patients admitted due to hip fracture in 2010 (216 patients) and 2013 (196 patients) were similar in age, sex, Barthel Index, and a reduced Charlson Index, although there were more comorbidities in 2013. After implementation of the protocols, the detection of delirium, malnutrition, anemia, and electrolyte disturbances increased. A larger number of patients in 2013 were precribed intravenous iron (24% more) and osteoporosis treatment (61.3% more). The average stay was reduced by 45.3% and surgical delay by 29.4%, achieving better functional efficiency. The implementation of a clinical pathway in geriatric patients with hip fracture is useful to detect and treat complications at an early stage, and to reduce pre-operative and overall stay, all without a negative clinical or functional impact. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

Fundamental awareness: A framework for integrating science, philosophy and metaphysics.

Science.gov (United States)

Theise, Neil D; Kafatos, Menas C

2016-01-01

The ontologic framework of Fundamental Awareness proposed here assumes that non-dual Awareness is foundational to the universe, not arising from the interactions or structures of higher level phenomena. The framework allows comparison and integration of views from the three investigative domains concerned with understanding the nature of consciousness: science, philosophy, and metaphysics. In this framework, Awareness is the underlying reality, not reducible to anything else. Awareness and existence are the same. As such, the universe is non-material, self-organizing throughout, a holarchy of complementary, process driven, recursive interactions. The universe is both its own first observer and subject. Considering the world to be non-material and comprised, a priori, of Awareness is to privilege information over materiality, action over agency and to understand that qualia are not a "hard problem," but the foundational elements of all existence. These views fully reflect main stream Western philosophical traditions, insights from culturally diverse contemplative and mystical traditions, and are in keeping with current scientific thinking, expressible mathematically.

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

Science.gov (United States)

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

2018-02-01

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

RESEARCH PROGRAM ON FRACTURED PETROLEUM RESERVOIRS

Energy Technology Data Exchange (ETDEWEB)

Abbas Firoozabadi

2002-04-12

Numerical simulation of water injection in discrete fractured media with capillary pressure is a challenge. Dual-porosity models in view of their strength and simplicity can be mainly used for sugar-cube representation of fractured media. In such a representation, the transfer function between the fracture and the matrix block can be readily calculated for water-wet media. For a mixed-wet system, the evaluation of the transfer function becomes complicated due to the effect of gravity. In this work, they use a discrete-fracture model in which the fractures are discretized as one dimensional entities to account for fracture thickness by an integral form of the flow equations. This simple step greatly improves the numerical solution. Then the discrete-fracture model is implemented using a Galerkin finite element method. The robustness and the accuracy of the approach are shown through several examples. First they consider a single fracture in a rock matrix and compare the results of the discrete-fracture model with a single-porosity model. Then, they use the discrete-fracture model in more complex configurations. Numerical simulations are carried out in water-wet media as well as in mixed-wet media to study the effect of matrix and fracture capillary pressures.

Best BETs from the Manchester Royal Infirmary. BET 3: does hydrotherapy help improve post ankle fracture symptoms?

Science.gov (United States)

Hay, Laura

2013-09-01

A short-cut review was carried out to determine whether hydrotherapy is an effective treatment to reduce pain and improve function in patients recovering from an ankle fracture. Although 12 papers were found using the reported search, no studies were relevant to this three-part question. No evidence was found to support this treatment.

Improving estimates of subsurface gas transport in unsaturated fractured media using experimental Xe diffusion data and numerical methods

Science.gov (United States)

Ortiz, J. P.; Ortega, A. D.; Harp, D. R.; Boukhalfa, H.; Stauffer, P. H.

2017-12-01

Gas transport in unsaturated fractured media plays an important role in a variety of applications, including detection of underground nuclear explosions, transport from volatile contaminant plumes, shallow CO2 leakage from carbon sequestration sites, and methane leaks from hydraulic fracturing operations. Gas breakthrough times are highly sensitive to uncertainties associated with a variety of hydrogeologic parameters, including: rock type, fracture aperture, matrix permeability, porosity, and saturation. Furthermore, a couple simplifying assumptions are typically employed when representing fracture flow and transport. Aqueous phase transport is typically considered insignificant compared to gas phase transport in unsaturated fracture flow regimes, and an assumption of instantaneous dissolution/volatilization of radionuclide gas is commonly used to reduce computational expense. We conduct this research using a twofold approach that combines laboratory gas experimentation and numerical modeling to verify and refine these simplifying assumptions in our current models of gas transport. Using a gas diffusion cell, we are able to measure air pressure transmission through fractured tuff core samples while also measuring Xe gas breakthrough measured using a mass spectrometer. We can thus create synthetic barometric fluctuations akin to those observed in field tests and measure the associated gas flow through the fracture and matrix pore space for varying degrees of fluid saturation. We then attempt to reproduce the experimental results using numerical models in PLFOTRAN and FEHM codes to better understand the importance of different parameters and assumptions on gas transport. Our numerical approaches represent both single-phase gas flow with immobile water, as well as full multi-phase transport in order to test the validity of assuming immobile pore water. Our approaches also include the ability to simulate the reaction equilibrium kinetics of dissolution

Improving Geologic and Engineering Models of Midcontinent Fracture and Karst-Modified Reservoirs Using New 3-D Seismic Attributes

Energy Technology Data Exchange (ETDEWEB)

Susan Nissen; Saibal Bhattacharya; W. Lynn Watney; John Doveton

2009-03-31

Our project goal was to develop innovative seismic-based workflows for the incremental recovery of oil from karst-modified reservoirs within the onshore continental United States. Specific project objectives were: (1) to calibrate new multi-trace seismic attributes (volumetric curvature, in particular) for improved imaging of karst-modified reservoirs, (2) to develop attribute-based, cost-effective workflows to better characterize karst-modified carbonate reservoirs and fracture systems, and (3) to improve accuracy and predictiveness of resulting geomodels and reservoir simulations. In order to develop our workflows and validate our techniques, we conducted integrated studies of five karst-modified reservoirs in west Texas, Colorado, and Kansas. Our studies show that 3-D seismic volumetric curvature attributes have the ability to re-veal previously unknown features or provide enhanced visibility of karst and fracture features compared with other seismic analysis methods. Using these attributes, we recognize collapse features, solution-enlarged fractures, and geomorphologies that appear to be related to mature, cockpit landscapes. In four of our reservoir studies, volumetric curvature attributes appear to delineate reservoir compartment boundaries that impact production. The presence of these compartment boundaries was corroborated by reservoir simulations in two of the study areas. Based on our study results, we conclude that volumetric curvature attributes are valuable tools for mapping compartment boundaries in fracture- and karst-modified reservoirs, and we propose a best practices workflow for incorporating these attributes into reservoir characterization. When properly calibrated with geological and production data, these attributes can be used to predict the locations and sizes of undrained reservoir compartments. Technology transfer of our project work has been accomplished through presentations at professional society meetings, peer-reviewed publications

Simulation-Based Educational Module Improves Intern and Medical Student Performance of Closed Reduction and Percutaneous Pinning of Pediatric Supracondylar Humeral Fractures.

Science.gov (United States)

Butler, Bennet A; Lawton, Cort D; Burgess, Jamie; Balderama, Earvin S; Barsness, Katherine A; Sarwark, John F

2017-12-06

Simulation-based education has been integrated into many orthopaedic residency programs to augment traditional teaching models. Here we describe the development and implementation of a combined didactic and simulation-based course for teaching medical students and interns how to properly perform a closed reduction and percutaneous pinning of a pediatric supracondylar humeral fracture. Subjects included in the study were either orthopaedic surgery interns or subinterns at our institution. Subjects all completed a combined didactic and simulation-based course on pediatric supracondylar humeral fractures. The first part of this course was an electronic (e)-learning module that the subjects could complete at home in approximately 40 minutes. The second part of the course was a 20-minute simulation-based skills learning session completed in the simulation center. Subject knowledge of closed reduction and percutaneous pinning of supracondylar humeral fractures was tested using a 30-question, multiple-choice, written test. Surgical skills were tested in the operating room or in a simulated operating room. Subject pre-intervention and post-intervention scores were compared to determine if and how much they had improved. A total of 21 subjects were tested. These subjects significantly improved their scores on both the written, multiple-choice test and skills test after completing the combined didactic and simulation module. Prior to the module, intern and subintern multiple-choice test scores were significantly worse than postgraduate year (PGY)-2 to PGY-5 resident scores (p < 0.01); after completion of the module, there was no significant difference in the multiple-choice test scores. After completing the module, there was no significant difference in skills test scores between interns and PGY-2 to PGY-5 residents. Both tests were validated using the scores obtained from PGY-2 to PGY-5 residents. Our combined didactic and simulation course significantly improved intern and

[Mechanics analysis of fracture of orthodontic wires].

Science.gov (United States)

Wang, Yeping; Sun, Xiaoye; Zhang, Longqi

2003-03-01

Fracture problem of orthodontic wires was discussed in this paper. The calculation formulae of bending stress and tensile stress were obtained. All main factors that affect bending stress and tensile stress of orthodontic wires were analyzed and discussed. It was concluded that the main causes of fracture of orthodontic wires were fatigue and static disruption. Some improving proposals for preventing fracture of orthodontic wires were put forward.

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

International Nuclear Information System (INIS)

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

2012-01-01

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

Paratrooper's ankle fracture: posterior malleolar fracture.

Science.gov (United States)

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

2015-03-01

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

Advances in Imaging Approaches to Fracture Risk Evaluation

Science.gov (United States)

Manhard, Mary Kate; Nyman, Jeffry S.; Does, Mark D.

2016-01-01

Fragility fractures are a growing problem worldwide, and current methods for diagnosing osteoporosis do not always identify individuals who require treatment to prevent a fracture and may misidentify those not a risk. Traditionally, fracture risk is assessed using dual-energy X-ray absorptiometry, which provides measurements of areal bone mineral density (BMD) at sites prone to fracture. Recent advances in imaging show promise in adding new information that could improve the prediction of fracture risk in the clinic. As reviewed herein, advances in quantitative computed tomography (QCT) predict hip and vertebral body strength; high resolution HR-peripheral QCT (HR-pQCT) and micro-magnetic resonance imaging (μMRI) assess the micro-architecture of trabecular bone; quantitative ultrasound (QUS) measures the modulus or tissue stiffness of cortical bone; and quantitative ultra-short echo time MRI methods quantify the concentrations of bound water and pore water in cortical bone, which reflect a variety of mechanical properties of bone. Each of these technologies provides unique characteristics of bone and may improve fracture risk diagnoses and reduce prevalence of fractures by helping to guide treatment decisions. PMID:27816505

Comprehensive and subacute care interventions improve health-related quality of life for older patients after surgery for hip fracture: a randomised controlled trial.

Science.gov (United States)

Shyu, Yea-Ing L; Liang, Jersey; Tseng, Ming-Yueh; Li, Hsiao-Juan; Wu, Chi-Chuan; Cheng, Huey-Shinn; Chou, Shih-Wei; Chen, Ching-Yen; Yang, Ching-Tzu

2013-08-01

Elderly patients with hip fracture have been found to benefit from subacute care interventions that usually comprise usual care with added geriatric intervention, early rehabilitation, and supported discharge. However, no studies were found on the effects of combining subacute care and health-maintenance interventions on health outcomes for elders with hip fracture. To compare the effects of an interdisciplinary comprehensive care programme with those of subacute care and usual care programmes on health-related quality of life (HRQoL) for elderly patients with hip fracture. Randomised controlled trial. A 3000-bed medical centre in northern Taiwan. Patients with hip fracture (N=299) were randomised into three groups: subacute care (n=101), comprehensive care (n=99), and usual care (n=99). Subacute care included geriatric consultation, continuous rehabilitation, and discharge planning. Comprehensive care consisted of subacute care plus health-maintenance interventions to manage depressive symptoms, manage malnutrition, and prevent falls. Usual care included only 1-2 in-hospital rehabilitation sessions, discharge planning without environmental assessment, no geriatric consultation, and no in-home rehabilitation. HRQoL was measured using the Medical Outcomes Study Short-Form 36 Taiwan version at 1, 3, 6, and 12 months after discharge. Participants in the comprehensive care group improved more in physical function, role physical, general health and mental health than those in the usual care group. The subacute care group had greater improvement in physical function, role physical, vitality, and social function than the usual care group. The intervention effects for both comprehensive and subacute care increased over time, specifically from 6 months after hip fracture onward, and reached a maximum at 12 months following discharge. Both comprehensive care and subacute care programmes may improve health outcomes of elders with hip fracture. Our results may provide a

Positive effects of bisphosphonates on bone and muscle in a mouse model of Duchenne muscular dystrophy.

Science.gov (United States)

Yoon, Sung-Hee; Sugamori, Kim S; Grynpas, Marc D; Mitchell, Jane

2016-01-01

Patients with Duchenne muscular dystrophy are at increased risk of decreased bone mineral density and bone fracture as a result of inactivity. To determine if antiresorptive bisphosphonates could improve bone quality and their effects on muscle we studied the Mdx mouse, treated with pamidronate during peak bone growth at 5 and 6 weeks of age, and examined the outcome at 13 weeks of age. Pamidronate increased cortical bone architecture and strength in femurs with increased resistance to fracture. While overall long bone growth was not affected by pamidronate, there was significant inhibition of remodeling in metaphyseal trabecular bone with evidence of residual calcified cartilage. Pamidronate treatment had positive effects on skeletal muscle in the Mdx mice with decreased serum and muscle creatine kinase and evidence of improved muscle histology and grip strength. Copyright © 2015 Elsevier B.V. All rights reserved.

Comprehensive care improves physical recovery of hip-fractured elderly Taiwanese patients with poor nutritional status.

Science.gov (United States)

Liu, Hsin-Yun; Tseng, Ming-Yueh; Li, Hsiao-Juan; Wu, Chi-Chuan; Cheng, Huey-Shinn; Yang, Ching-Tzu; Chou, Shih-Wei; Chen, Ching-Yen; Shyu, Yea-Ing L

2014-06-01

The effects of nutritional management among other intervention components have not been examined for hip-fractured elderly persons with poor nutritional status. Accordingly, this study explored the intervention effects of an in-home program using a comprehensive care model that included a nutrition-management component on recovery of hip-fractured older persons with poor nutritional status at hospital discharge. A secondary analysis of data from a randomized controlled trial with 24-month follow-up. A 3000-bed medical center in northern Taiwan. Subjects were included only if they had "poor nutritional status" at hospital discharge, including those at risk for malnutrition or malnourished. The subsample included 80 subjects with poor nutritional status in the comprehensive care group, 87 in the interdisciplinary care group, and 85 in the usual care group. The 3 care models were usual care, interdisciplinary care, and comprehensive care. Usual care provided no in-home care, interdisciplinary care provided 4 months of in-home rehabilitation, and comprehensive care included management of depressive symptoms, falls, and nutrition as well as 1 year of in-home rehabilitation. Data were collected on nutritional status and physical functions, including range of motion, muscle power, proprioception, balance and functional independence, and analyzed using a generalized estimating equation approach. We also compared patients' baseline characteristics: demographic characteristics, type of surgery, comorbidities, length of hospital stay, cognitive function, and depression. Patients with poor nutritional status who received comprehensive care were 1.67 times (95% confidence interval 1.06-2.61) more likely to recover their nutritional status than those who received interdisciplinary and usual care. Furthermore, the comprehensive care model improved the functional independence and balance of patients who recovered their nutritional status over the first year following discharge

Comparison Thoracic Epidural and Intercostal Block to Improve Ventilation Parameters and Reduce Pain in Patients with Multiple Rib Fractures

Directory of Open Access Journals (Sweden)

Raheleh Aligholipour Maleki

2011-08-01

Full Text Available Introduction: Chest wall blunt trauma causes multiple rib fractures and will often be associated with significant pain and may compromise ventilator mechanics. Analgesia has great roll in rib fracture therapies, opioid are useful, but when used as sole agent may re-quire such high dose that they produce respiratory depression, especially in el-derly .the best analgesia for a severe chest wall injury is a continuous epidural infusion of local anesthetic. This provides complete analgesia allowing inspiration and coughing without of the risk of respiratory depression. Methods: sixty adult patients who with multiple rib fractures were enrolled in this study. They were divided into Group A or thoracic epidural with bupivacaine 0.125 % +1mg/5ml morphine and group B or inter-costal block with %0.25 bupivacaine. The patients were assessed through ICU and hos-pital stay length, ventilation function tests. Pain score among the patients was meas-ured with verbal rating scale, before and after administration of the analgesia. Results: We found a significant improvement in ventilatory function tests during the 1st, 2nd, and 3rd days after epidural analgesia compared with the intercostal block (P < 0.004. Changes in the visual Analogue Scale were associated with marked improvement re-garding pain at rest and pain caused by coughing and deep breathing in group A com-pared group B... ICU and hospital stay markedly reduced in Group A. Conclusion: tho-racic epidural analgesia is superior to intercostals block regarding pain relief of rib frac-tures. Patients who received epidural analgesia had significantly lower pain scores at all studied times.

Tracer dispersion in two-dimensional rough fractures.

Science.gov (United States)

Drazer, G; Koplik, J

2001-05-01

Tracer diffusion and hydrodynamic dispersion in two-dimensional fractures with self-affine roughness are studied by analytic and numerical methods. Numerical simulations were performed via the lattice-Boltzmann approach, using a boundary condition for tracer particles that improves the accuracy of the method. The reduction in the diffusive transport, due to the fractal geometry of the fracture surfaces, is analyzed for different fracture apertures. In the limit of small aperture fluctuations we derive the correction to the diffusive coefficient in terms of the tortuosity, which accounts for the irregular geometry of the fractures. Dispersion is studied when the two fracture surfaces are simply displaced normally to the mean fracture plane and when there is a lateral shift as well. Numerical results are analyzed using the Lambda parameter, related to convective transport within the fracture, and simple arguments based on lubrication approximation. At very low Péclet number, in the case where fracture surfaces are laterally shifted, we show using several different methods that convective transport reduces dispersion.

Fracture Mechanics

International Nuclear Information System (INIS)

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

1992-08-01

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

Rib fractures and their association With solid organ injury: higher rib fractures have greater significance for solid organ injury screening.

Science.gov (United States)

Rostas, Jack W; Lively, Timothy B; Brevard, Sidney B; Simmons, Jon D; Frotan, Mohammad A; Gonzalez, Richard P

2017-04-01

The purpose of this study was to identify patients with rib injuries who were at risk for solid organ injury. A retrospective chart review was performed of all blunt trauma patients with rib fractures during the period from July 2007 to July 2012. Data were analyzed for association of rib fractures and solid organ injury. In all, 1,103 rib fracture patients were identified; 142 patients had liver injuries with 109 (77%) associated right rib fractures. Right-sided rib fractures with highest sensitivity for liver injury were middle rib segment (5 to 8) and lower segment (9 to 12) with liver injury sensitivities of 68% and 43%, respectively (P rib fractures. Left middle segment rib fractures and lower segment rib fractures had sensitivities of 80% and 63% for splenic injury, respectively (P Rib fractures higher in the thoracic cage have significant association with solid organ injury. Using rib fractures from middle plus lower segments as indication for abdominal screening will significantly improve rib fracture sensitivity for identification of solid organ injury. Copyright © 2016 Elsevier Inc. All rights reserved.

Veins improve fracture toughness of insect wings.

Directory of Open Access Journals (Sweden)

Jan-Henning Dirks

Full Text Available During the lifetime of a flying insect, its wings are subjected to mechanical forces and deformations for millions of cycles. Defects in the micrometre thin membranes or veins may reduce the insect's flight performance. How do insects prevent crack related material failure in their wings and what role does the characteristic vein pattern play? Fracture toughness is a parameter, which characterises a material's resistance to crack propagation. Our results show that, compared to other body parts, the hind wing membrane of the migratory locust S. gregaria itself is not exceptionally tough (1.04±0.25 MPa√m. However, the cross veins increase the wing's toughness by 50% by acting as barriers to crack propagation. Using fracture mechanics, we show that the morphological spacing of most wing veins matches the critical crack length of the material (1132 µm. This finding directly demonstrates how the biomechanical properties and the morphology of locust wings are functionally correlated in locusts, providing a mechanically 'optimal' solution with high toughness and low weight. The vein pattern found in insect wings thus might inspire the design of more durable and lightweight artificial 'venous' wings for micro-air-vehicles. Using the vein spacing as indicator, our approach might also provide a basis to estimate the wing properties of endangered or extinct insect species.

Onset of density-driven instabilities in fractured aquifers

Science.gov (United States)

Jafari Raad, Seyed Mostafa; Hassanzadeh, Hassan

2018-04-01

Linear stability analysis is conducted to study the onset of density-driven convection involved in solubility trapping of C O2 in fractured aquifers. The effect of physical properties of a fracture network on the stability of a diffusive boundary layer in a saturated fractured porous media is investigated using the dual porosity concept. Linear stability analysis results show that both fracture interporosity flow and fracture storativity play an important role in the stability behavior of the system. It is shown that a diffusive boundary layer under the gravity field in fractured porous media with lower fracture storativity and/or higher fracture interporosity flow coefficient is more stable. We present scaling relations for the onset of convective instability in fractured aquifers with single and variable matrix block size distribution. These findings improve our understanding of density-driven flow in fractured aquifers and are important in the estimation of potential storage capacity, risk assessment, and storage site characterization and screening.

Evidence-based medicine: Mandible fractures.

Science.gov (United States)

Morrow, Brad T; Samson, Thomas D; Schubert, Warren; Mackay, Donald R

2014-12-01

After studying this article, the participant should be able to: 1. Describe the anatomy and subunits of the mandible. 2. Review the cause and epidemiology of mandible fractures. 3. Discuss the preoperative evaluation and diagnostic imaging. 4. Understand the principles and techniques of mandible fracture reduction and fixation. The management of mandibular fractures has undergone significant improvement because of advancements in plating technology, imaging, and instrumentation. As the techniques in management continue to evolve, it is imperative for the practicing physician to remain up-to-date with the growing body of scientific literature. The objective of this Maintenance of Certification article is to present a review of the literature so that the physician may make treatment recommendation based on the best evidence available. Pediatric fractures have been excluded from this article.

Improved 1-year mortality in elderly patients with a hip fracture following integrated orthogeriatric treatment.

Science.gov (United States)

Folbert, E C; Hegeman, J H; Vermeer, M; Regtuijt, E M; van der Velde, D; Ten Duis, H J; Slaets, J P

2017-01-01

To improve the quality of care and reduce the healthcare costs of elderly patients with a hip fracture, surgeons and geriatricians collaborated intensively due to the special needs of these patients. After treatment at the Centre for Geriatric Traumatology (CvGT), we found a significant decrease in the 1-year mortality rate in frail elderly patients compared to the historical control patients who were treated with standard care. The study aimed to evaluate the effect of an orthogeriatric treatment model on elderly patients with a hip fracture on the 1-year mortality rate and identify associated risk factors. This study included patients, aged 70 years and older, who were admitted with a hip fracture and treated in accordance with the integrated orthogeriatric treatment model of the CvGT at the Hospital Group Twente (ZGT) between April 2008 and October 2013. Data registration was carried out by several disciplines using the clinical pathways of the CvGT database. A multivariate logistic regression analysis was used to identify independent risk factors for 1-year mortality. The outcome measures for the 850 patients were compared with those of 535 historical control patients who were managed under standard care between October 2002 and March 2008. The analysis demonstrated that the 1-year mortality rate was 23.2 % (n = 197) in the CvGT group compared to 35.1 % (n = 188) in the historical control group (p malnutrition (OR 2.01), physical limitations in activities of daily living (OR 2.35), and decreasing Barthel Index (BI) (OR 0.96). After integrated orthogeriatric treatment, a significant decrease was seen in the 1-year mortality rate in the frail elderly patients with a hip fracture compared to the historical control patients who were treated with standard care. The most important risk factors for 1-year mortality were male gender, increasing age, malnutrition, physical limitations, increasing BI, and medical conditions. Awareness of risk factors that

Subsurface fracture mapping from geothermal wellbores. Final report

Energy Technology Data Exchange (ETDEWEB)

Hartenbaum, B.A.; Rawson, G.

1983-08-01

To advance the state-of-the-art in Hot Dry Rock technology, and evaluation is made of (1) the use of both electromagnetic and acoustic radar to map far-field fractures, (2) the use of more than twenty different conventional well logging tools to map borehole-fracture intercepts, (3) the use of magnetic dipole ranging to determine the relative positions of the injection well and the production well within the fractured zone, (4) the use of passive microseismic methods to determine the orientation and extent of hydraulic fractures, and (5) the application of signal processing techniques to fracture mapping including tomography, holography, synthetic aperture, image reconstruction, and the relative importance of phase and amplitude information. It is found that according to calculations, VHF backscatter radar has the potential for mapping fractures within a distance of 50 +- 20 meters from the wellbore. A new technique for improving fracture identification is presented. The range of acoustic radar is five to seven times greater than that of VHF radar when compared on the basis of equal resolution, i.e., equal wavelengths. Analyses of extant data indicate that when used synergistically the (1) caliper, (2) resistivity dipmeter, (3) televiewer, (4) television, (5) impression packer, and (6) acoustic transmission are useful for mapping borehole-fracture intercepts. A new model of hydraulic fracturing is presented which indicates that a hydraulic fracture is dynamically unstable; consequently, improvements in locating the crack tip may be possible. The importance of phase in signal processing is stressed and those techniques which employ phase data are emphasized for field use.

Analysis of fracture patterns and local stress field variations in fractured reservoirs

Science.gov (United States)

Deckert, Hagen; Drews, Michael; Fremgen, Dominik; Wellmann, J. Florian

2010-05-01

independently estimated regional stress tensor is put as a boundary condition into the BE Model. The computed BE model allows to recognize local 3D stress tensor perturbations caused by the larger faults that act as mechanical inhomogeneities. The geometry of the fracture network from field work together with the local stress tensors derived from the 3D BE models allows examining normal and shear stresses on single fractures in different domains of the investigated area. This in turn is used to evaluate, which of the fractures might preferably act as fluid conduits by describing the dilation potential of single fractures. The combination of an improved understanding of the fracture network along with local stress tensors variations from mechanical models will provide a sound evaluation of fluid pathways in fractured reservoirs. In future applications the accurate investigation of large discontinuity pattern in outcrops might be used for a better mathematical definition of fracture networks which could be implemented into numerical simulations of fluid flow.

Method and metaphysics in Clements's and Gleason's ecological explanations.

Science.gov (United States)

Eliot, Christopher

2007-03-01

To generate explanatory theory, ecologists must wrestle with how to represent the extremely many, diverse causes behind phenomena in their domain. Early twentieth-century plant ecologists Frederic E. Clements and Henry A. Gleason provide a textbook example of different approaches to explaining vegetation, with Clements allegedly committed, despite abundant exceptions, to a law of vegetation, and Gleason denying the law in favor of less organized phenomena. However, examining Clements's approach to explanation reveals him not to be expressing a law, and instead to be developing an explanatory structure without laws, capable of progressively integrating causal complexity. Moreover, Clements and Gleason largely agree on the causes of vegetation; but, since causal understanding here underdetermines representation, they differ on how to integrate recognized causes into general theory--that is, in their methodologies. Observers of the case may have mistakenly assumed that scientific representation across the disciplines typically aims at laws like Newton's, and that representations always reveal scientists' metaphysical commitments. Ironically, in the present case, this assumption seems to have been made even by observers who regard Clements as nai ve for his alleged commitment to an ecological law.

Fatigue and insufficiency fractures

International Nuclear Information System (INIS)

Lodwick, G.S.; Rosenthal, D.I.; Kattapuram, S.V.; Hudson, T.M.

1987-01-01

The incidence of stress fracture is increasing. In our younger society this is due largely to a preocupation with physical conditioning, but in our elderly population it is due to improved recognition and better methods of detection and diagnosis. Stress fracture of the elderly is an insufficiency fracture which occurs in the spine, the pelvis, the sacrum and other bones afflicted with disorders which cause osteopenia. Stress fracture is frequently misdiagnosed as a malignant lesion of bone resulting in biopsy. Scintiscanning provides the greatest frequency of detection, while computed tomography often provides the definitive diagnosis. With increased interest and experience a better insight into the disease has been achieved, and what was once thought of as a simple manifestation of mechanical stress is now known to be an orderly, complex pattern of physiological changes in bone which conform to a model by Frost. The diffuse nature of these changes can be recognized by scintigraphy, radiography and magnetic resonance imaging. 27 refs.; 8 figs

A review on hydraulic fracturing of unconventional reservoir

Directory of Open Access Journals (Sweden)

Quanshu Li

2015-03-01

Full Text Available Hydraulic fracturing is widely accepted and applied to improve the gas recovery in unconventional reservoirs. Unconventional reservoirs to be addressed here are with very low permeability, complicated geological settings and in-situ stress field etc. All of these make the hydraulic fracturing process a challenging task. In order to effectively and economically recover gas from such reservoirs, the initiation and propagation of hydraulic fracturing in the heterogeneous fractured/porous media under such complicated conditions should be mastered. In this paper, some issues related to hydraulic fracturing have been reviewed, including the experimental study, field study and numerical simulation. Finally the existing problems that need to be solved on the subject of hydraulic fracturing have been proposed.

Long-term skeletal findings in Menkes disease

International Nuclear Information System (INIS)

Amador, Eva; Domene, Ruth; Fuentes, Cristian; Carreno, Juan-Carlos; Enriquez, Goya

2010-01-01

Skeletal findings in infants with Menkes disease, the most characteristic of which are metaphyseal spurs, long-bone fractures and wormian bones, have been widely reported. However, the changes in skeletal features over time are not well known. The long-term findings differ completely from those initially observed and consist of undertubulation and metaphyseal flaring, similar to the findings seen in some types of bone dysplasia. The initial and long-term radiological features in an 8-year-old boy with Menkes disease are illustrated. (orig.)

Fracture toughness of Al-Cr alloys with minor additions

International Nuclear Information System (INIS)

Datta, S.; Banerjee, M.K.

2000-01-01

Fracture toughness behavior of aluminium chromium alloys with minor additions is studied to determine its relation with microstructure and ageing conditions. The effect of the minor additions on the fracture toughness property of the alloys is also studied. Fracture toughness of Al-Cr alloys has been improved by selected minor additions. Also, the fracture toughness of the investigated alloys is found to be sensitive to ageing conditions. (author)

Participation: A Descending Road of the Metaphysical Cognition of Being

Directory of Open Access Journals (Sweden)

Andrzej Maryniarczyk

2016-12-01

Full Text Available When we see in the world the fact that there are many beings, and we indicate that the particular beings exist in a compositional way, we face the task of learning about a new problem: how can we define and determine the relations between beings and between the elements within a being? Although the theory of participation has roots that go back to Plato, and so to a philosophy in which the pluralism of being was rejected and which accepted an identity-based conception of being, participation finds its ontological rational justification only (and ultimately in the pluralistic and compositional conception of being. With the description of participation as a “descending road” in the cognition of being, we are restricting ourselves to the presentation of how participation is understood in realistic metaphysics (while we shall leave aside the history of the question. We will show the aspects of participation that provide a foundation for wisdom-oriented cognition, and we will show the specific character of participation-oriented cognition as a “descending road.”

Simulated evolution of fractures and fracture networks subject to thermal cooling: A coupled discrete element and heat conduction model

Energy Technology Data Exchange (ETDEWEB)

Huang, Hai; Plummer, Mitchell; Podgorney, Robert

2013-02-01

Advancement of EGS requires improved prediction of fracture development and growth during reservoir stimulation and long-term operation. This, in turn, requires better understanding of the dynamics of the strongly coupled thermo-hydro-mechanical (THM) processes within fractured rocks. We have developed a physically based rock deformation and fracture propagation simulator by using a quasi-static discrete element model (DEM) to model mechanical rock deformation and fracture propagation induced by thermal stress and fluid pressure changes. We also developed a network model to simulate fluid flow and heat transport in both fractures and porous rock. In this paper, we describe results of simulations in which the DEM model and network flow & heat transport model are coupled together to provide realistic simulation of the changes of apertures and permeability of fractures and fracture networks induced by thermal cooling and fluid pressure changes within fractures. Various processes, such as Stokes flow in low velocity pores, convection-dominated heat transport in fractures, heat exchange between fluid-filled fractures and solid rock, heat conduction through low-permeability matrices and associated mechanical deformations are all incorporated into the coupled model. The effects of confining stresses, developing thermal stress and injection pressure on the permeability evolution of fracture and fracture networks are systematically investigated. Results are summarized in terms of implications for the development and evolution of fracture distribution during hydrofracturing and thermal stimulation for EGS.

Contemporary management of subtrochanteric fractures.

Science.gov (United States)

Joglekar, Siddharth B; Lindvall, Eric M; Martirosian, Armen

2015-01-01

Cephalomedullary interlocking nails that allow for trochanteric entry and minimally invasive fixation have revolutionized the contemporary management of subtrochanteric fractures with improved union rates and decreased incidence of fixation failure. The most successful alternative to intramedullary fixation remains the angled blade plate. Despite biomechanical superiority of contemporary intramedullary implants to previous intramedullary devices, the importance of achieving and maintaining satisfactory fracture reduction prior to and during hardware insertion cannot be overemphasized. In comminuted and more challenging fractures, additional techniques, such as limited open reduction with clamps and/or cables, can allow for canal restoration and more anatomic reductions prior to and/or during nail insertion. Published by Elsevier Inc.

Self-perception of fracture risk: what can it tell us?

Science.gov (United States)

Litwic, A E; Compston, J E; Wyman, A; Siris, E S; Gehlbach, S H; Adachi, J D; Chapurlat, R; Díez-Pérez, A; LaCroix, A Z; Nieves, J W; Netelenbos, J C; Pfeilschifter, J; Rossini, M; Roux, C; Saag, K G; Silverman, S; Watts, N B; Greenspan, S L; March, L; Gregson, C L; Cooper, C; Dennison, E M

2017-12-01

In this study, we report that self-perception of fracture risk captures some aspect of fracture risk not currently measured using conventional fracture prediction tools and is associated with improved medication uptake. It suggests that adequate appreciation of fracture risk may be beneficial and lead to greater healthcare engagement and treatment. This study aimed to assess how well self-perception of fracture risk, and fracture risk as estimated by the fracture prediction tool FRAX, related to fracture incidence and uptake and persistence of anti-osteoporosis medication among women participating in the Global Longitudinal study of Osteoporosis in Women (GLOW). GLOW is an international cohort study involving 723 physician practices across 10 countries in Europe, North America and Australia. Aged ≥ 55 years, 60,393 women completed baseline questionnaires detailing medical history, including co-morbidities, fractures and self-perceived fracture risk (SPR). Annual follow-up included self-reported incident fractures and anti-osteoporosis medication (AOM) use. We calculated FRAX risk without bone mineral density measurement. Of the 39,241 women with at least 1 year of follow-up data, 2132 (5.4%) sustained an incident major osteoporotic fracture over 5 years of follow-up. Within each SPR category, risk of fracture increased as the FRAX categorisation of risk increased. In GLOW, only 11% of women with a lower baseline SPR were taking AOM at baseline, compared with 46% of women with a higher SPR. AOM use tended to increase in the years after a reported fracture. However, women with a lower SPR who were fractured still reported lower AOM rates than women with or without a fracture but had a higher SPR. These results suggest that SPR captures some aspect of fracture risk not currently measured using conventional fracture prediction tools and is also associated with improved medication uptake.

Sacroiliac screw fixation for tile B fractures.

NARCIS (Netherlands)

Bosch, E.W. van den; Zwienen, C.M. van; Hoek van Dijke, G.A.; Snijders, C.J.; Vugt, A.B. van

2003-01-01

BACKGROUND: The purpose of this comparative cadaveric study was to investigate whether the stability of partially unstable pelvic fractures can be improved by combining plate fixation of the symphysis with a posterior sacroiliac screw. METHODS: In six specimens, a Tile B1 (open-book) pelvic fracture

FRACTURING FLUID CHARACTERIZATION FACILITY

Energy Technology Data Exchange (ETDEWEB)

Subhash Shah

2000-08-01

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

Transcendence in the current theology, philosophy and metaphysics in Russian cosmism

Directory of Open Access Journals (Sweden)

Emanuel George Oprea

2016-03-01

Full Text Available Human interests to Religion and Metaphysics are well explained by the desire of the people to answer to fundamental and eternal questions as “what is the sense of life” and “what is the purpose of life”. These questions have accompanied them from the beginning of conscious life. Many intellectuals, scientists and writers of former USSR and democratic Russia have brought essential contributions, opened new directions and finally have enriched with new concepts, ideas, ideologies and systems the worldwide Philosophy and Religion. A possible answer is the Creation allowing to Divinity to transcend in common life. Soul as Spiritual reflection of Divinity tends to perfection, reiterating in every generation the transcendence to God. At first sight there are no meeting points between Transcendence and Cosmism because the last notion has its beginning in the progress of Science. The evolution of modern Sciences, philosophical concepts and Religion gradually demonstrates correlated aspects which must be discovered in the future.

The problem of contextuality and the impossibility of experimental metaphysics thereof

Science.gov (United States)

Hermens, Ronnie

Recently a new impulse has been given to the experimental investigation of contextuality. In this paper we show that for a widely used definition of contextuality there can be no decisive experiment on the existence of contextuality. To this end, we give a clear presentation of the hidden variable models due to Meyer, Kent and Clifton (MKC), which would supposedly nullify the Kochen-Specker theorem. Although we disagree with this last statement, the models do play a significant role in the discussion on the meaning of contextuality. In fact, we introduce a specific MKC-model of which we show that it is non-contextual and completely in agreement with quantum mechanical predictions. We also investigate the possibility of other definitions of non-contextuality-with an emphasis on operational definitions-and argue that any useful definition relies on the specification of a theoretical framework. It is therefore concluded that no experimental test can yield any conclusions about contextuality on a metaphysical level.

Clavicle fractures - incidence of supraclavicular nerve injury

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Pedro Jose Labronici

2013-08-01

Full Text Available OBJECTIVE: To analyze retrospectively 309 fractures in the clavicle and the relation with injury of the supraclavicular nerve after trauma. METHODS: It was analyzed 309 patients with 312 clavicle fractures. The Edinburgh classification was used. Four patients had fractures in the medial aspect of the clavicle, 33 in the lateral aspect and 272 in the diaphyseal aspect and three bilateral fractures. RESULTS: 255 patients were analyzed and five had paresthesia in the anterior aspect of the thorax. Four patients had type 2 B2 fracture and one type 2 B1 fracture. All patients showed spontaneous improvement, in the mean average of 3 months after the trauma. CONCLUSION: Clavicle fractures and/ or shoulder surgeries can injure the lateral, intermediary or medial branches of the supraclavicular nerve and cause alteration of sensibility in the anterior aspect of the thorax. Knowledge of the anatomy of the nerve branches helps avoid problems in this region.

Mandibular ramus fractures: a rarity.

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

2013-01-01

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

Effect of tailored educational intervention to improve self-care maintenance and quality of life in postmenopausal osteoporotic women after a fragility fracture: the Guardian Angel® study.

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Basilici Zannetti, Emanuela; D'Agostino, Fabio; Cittadini, Noemi; Feola, Maurizio; Pennini, Annalisa; Rao, Cecilia; Vellone, Ercole; Tarantino, Umberto; Alvaro, Rosaria

2017-01-01

Osteoporosis has a significant impact on affected patients. Healthcare providers should encourage postmenopausal women to improve self-care maintenance behaviors and quality of life following a fragility fracture. The aims of this study were to a) develop two new instruments for measuring, respectively, self-care maintenance and quality of life, in postmenopausal women with osteoporosis; b) evaluate the effectiveness of a tailored educational intervention to improve self-care maintenance and quality of life after a fragility fracture in postmenopausal women. For the first aim, a cross-sectional study will be performed; for the second aim, a multicenter, quasi-experimental, interventional design will be used. A convenience sample of postmenopausal women admitted to 44 hospitals in Italy with a diagnosis of bone fragility fracture will be enrolled and surveyed at 7, 30, 60 and 180 days after discharge. Trained nurses will conduct the educational intervention. The new instruments will allow the measurement of self-care and quality of life in postmenopausal women following a fragility fracture. Through tailored educational interventions, women can be helped to take their medications correctly, adopt a healthy lifestyle, reduce the occurrence of bone fractures, and have a better quality of life.

Fluid transfers in fractured media: scale effects

International Nuclear Information System (INIS)

Bour, Olivier

1996-01-01

As there has been a growing interest in the study of fluid circulations in fractured media for the last fifteen years, for example for projects of underground storage of different waste types, or to improve water resources, or for exploitation of underground oil products or geothermal resources, this research thesis first gives a large overview of the modelling and transport properties of fractured media. He presents the main notions related to fluid transfers in fractured media (structures of fracture networks, hydraulic properties of fractured media), and the various adopted approaches (the effective medium theory, the percolation theory, double porosity models, deterministic discrete fracture models, equivalent discontinuous model, fractal models), and outlines the originality of the approach developed in this research: scale change, conceptual hypotheses, methodology, tools). The second part addresses scale rules in fracture networks: presentation of fracture networks (mechanical aspects, statistical analysis), distribution of fracture lengths and of fracture networks, length-position relationship, modelling attempt, lessons learned and consequences in terms of hydraulic and mechanical properties, and of relationship between length distribution and fractal dimension. The third part proposes two articles published by the author and addressing the connectivity properties of fracture networks. The fifth chapter reports the application to natural media. It contains an article on the application of percolation theory to 2D natural fracture networks, and reports information collected on a site [fr

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

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Yuwei Li

2018-05-01

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

Enhancing in situ bioremediation with pneumatic fracturing

International Nuclear Information System (INIS)

Anderson, D.B.; Peyton, B.M.; Liskowitz, J.L.; Fitzgerald, C.; Schuring, J.R.

1994-04-01

A major technical obstacle affecting the application of in situ bioremediation is the effective distribution of nutrients to the subsurface media. Pneumatic fracturing can increase the permeability of subsurface formations through the injection of high pressure air to create horizontal fracture planes, thus enhancing macro-scale mass-transfer processes. Pneumatic fracturing technology was demonstrated at two field sites at Tinker Air Force Base, Oklahoma City, Oklahoma. Tests were performed to increase the permeability for more effective bioventing, and evaluated the potential to increase permeability and recovery of free product in low permeability soils consisting of fine grain silts, clays, and sedimentary rock. Pneumatic fracturing significantly improved formation permeability by enhancing secondary permeability and by promoting removal of excess soil moisture from the unsaturated zone. Postfracture airflows were 500% to 1,700% higher than prefracture airflows for specific fractured intervals in the formation. This corresponds to an average prefracturing permeability of 0.017 Darcy, increasing to an average of 0.32 Darcy after fracturing. Pneumatic fracturing also increased free-product recovery rates of number 2 fuel from an average of 587 L (155 gal) per month before fracturing to 1,647 L (435 gal) per month after fracturing

Fracture studies of poly(propylene)/elastomer blend with β-form nucleating agent

International Nuclear Information System (INIS)

Bai Hongwei; Wang Yong; Zhang Danli; Xiao Chengquan; Song Bo; Li Yanli; Han Liang

2009-01-01

Poly(propylene)/elastomer blends with β-form nucleating agent (β-NA) aryl amides compound (TMB-5) were prepared. The effects of β-NA on crystallization, melting behaviors and elastomer morphologies of PP/elastomer blends were studied through polarization optical microscope (POM), differential scanning calorimetry (DSC) and scanning electronic microscope (SEM). The fracture behaviors, including notched Izod impact fracture and single-edge notched tensile (SENT) fracture, were comparatively studied to establish the role of NA in improving the fracture toughness of PP/elastomer blends. Our results showed that the presence of β-NA leads to determinable β-PP formation in the blends, and as a consequence the fracture toughness of the blend is improved dramatically. Compared with notched Izod impact testing, which can efficiently characterize the fracture toughness of the blends only at lower elastomer content, SENT testing provides more detail of fracture behavior in all the compositions. Furthermore, SENT test shows that the significant improvement in fracture toughness of PP/elastomer/β-NA is contributed to the simultaneous enhancement of crack initiation energy and crack propagation energy, but largely dominated by crack propagation stage.

The detection of patients with 'fragility fractures' in fracture clinic - an audit of practice with reference to recent British Orthopaedic Association guidelines.

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Gidwani, S; Davidson, N; Trigkilidas, D; Blick, C; Harborne, R; Maurice, H D

2007-03-01

The British Orthopaedic Association published guidelines on the care of fragility fracture patients in 2003. A section of these guidelines relates to the secondary prevention of osteoporotic fractures. The objective of this audit was to compare practice in our fracture clinic to these guidelines, and take steps to improve our practice if required. We retrospectively audited the treatment of all 462 new patients seen in January and February 2004. Using case note analysis, 38 patients who had sustained probable fragility fractures were selected. Six months' post-injury, a telephone questionnaire was administered to confirm the nature of the injury and to find out whether the patient had been assessed, investigated or treated for osteoporosis. A second similar audit was conducted a year later after steps had been taken to improve awareness amongst the orthopaedic staff and prompt referral. During the first audit period, only 5 of 38 patients who should have been assessed and investigated for osteoporosis were either referred or offered referral. This improved to 23 out of 43 patients during the second audit period. Improvements in referral and assessment rates of patients at risk of further fragility fractures can be achieved relatively easily by taking steps to increase awareness amongst orthopaedic surgeons, although additional strategies and perhaps the use of automated referral systems may be required to achieve referral rates nearer 100%.

Complications of hip fractures: A review

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Carpintero, Pedro; Caeiro, Jose Ramón; Carpintero, Rocío; Morales, Angela; Silva, Samuel; Mesa, Manuel

2014-01-01

Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these are medical, and other related to the surgical treatment itself. Medical complications may affect around 20% of patients with hip fracture. Cognitive and neurological alterations, cardiopulmonary affections (alone or combined), venous thromboembolism, gastrointestinal tract bleeding, urinary tract complications, perioperative anemia, electrolytic and metabolic disorders, and pressure scars are the most important medical complications after hip surgery in terms of frequency, increase of length of stay and perioperative mortality. Complications arising from hip fracture surgery are fairly common, and vary depending on whether the fracture is intracapsular or extracapsular. The main problems in intracapsular fractures are biological: vascularization of the femoral head, and lack of periosteum -a major contributor to fracture healing- in the femoral neck. In extracapsular fractures, by contrast, the problem is mechanical, and relates to load-bearing. Early surgical fixation, the role of anti-thromboembolic and anti-infective prophylaxis, good pain control at the perioperative, detection and management of delirium, correct urinary tract management, avoidance of malnutrition, vitamin D supplementation, osteoporosis treatment and advancement of early mobilization to improve functional recovery and falls prevention are basic recommendations for an optimal maintenance of hip fractured patients. PMID:25232517

Lean business model and implementation of a geriatric fracture center.

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Kates, Stephen L

2014-05-01

Geriatric hip fracture is a common event associated with high costs of care and often with suboptimal outcomes for the patients. Ideally, a new care model to manage geriatric hip fractures would address both quality and safety of patient care as well as the need for reduced costs of care. The geriatric fracture center model of care is one such model reported to improve both outcomes and quality of care. It is a lean business model applied to medicine. This article describes basic lean business concepts applied to geriatric fracture care and information needed to successfully implement a geriatric fracture center. It is written to assist physicians and surgeons in their efforts to implement an improved care model for their patients. Copyright © 2014 Elsevier Inc. All rights reserved.

Improving the preoperative care of patients with femoral neck fractures through the development and implementation of a checklist.

Science.gov (United States)

Agha, Riaz; Edison, Eric; Fowler, Alexander

2014-01-01

The incidence of femoral neck fractures (FNFs) is expected to rise with life expectancy. It is important to improve the safety of these patients whilst under the care of orthopaedic teams. This study aimed to increase the performance of vital preoperative tasks in patients admitted for femoral neck fracture operations by producing and implementing a checklist as an aide memoir. The checklist was designed primarily for use by senior house officers (SHOs) admitting patients from the emergency department. A list of 12 preoperative tasks was identified. A baseline audit of 10 random patients showed that the mean proportion of the 12 tasks completed was 53% (range 25% - 83%). A survey of 14 nurses and surgeons found that the majority of respondents agreed that there was a problem with the performance of most of the tasks. The tasks were incorporated into a checklist which was refined in three plan-do-study-act cycles and introduced into the femoral neck fracture pathway. In the week following the introduction of the checklist, 77% of the checklist tasks were completed, 24% more than at the baseline audit (53%). In week 3, the completion of checklist tasks rose to 88% and to 95% in week 4. In conclusion, a simple checklist can markedly improve the performance and recording of preoperative tasks by SHOs. We recommend the wider adoption of the new checklist to be produced as a sticker for patients' medical records. Further study is required to ascertain the effect of the checklist on clinical outcomes.

A Guide to Improving the Care of Patients with Fragility Fractures, Edition 2

Science.gov (United States)

Mears, Simon C.

2015-01-01

Over the past 4 decades, much has been learned about the pathophysiology and treatment of osteoporosis, the prevention of fragility fractures, and the perioperative management of patients who have these debilitating injuries. However, the volume of published literature on this topic is staggering and far too voluminous for any clinician to review and synthesize by him or herself. This manuscript thoroughly summarizes the latest research on fragility fractures and provides the reader with valuable strategies to optimize the prevention and management of these devastating injuries. The information contained in this article will prove invaluable to any health care provider or health system administrator who is involved in the prevention and management of fragility hip fractures. As providers begin to gain a better understanding of the principles espoused in this article, it is our hope that they will be able to use this information to optimize the care they provide for elderly patients who are at risk of or who have osteoporotic fractures. PMID:26246957

Fracture mechanics and microstructures

International Nuclear Information System (INIS)

Gee, M.G.; Morrell, R.

1986-01-01

The influence of microstructure on defects in ceramics, and the consequences of their presence for the application of fracture mechanics theories are reviewed. The complexities of microstructures, especially the multiphase nature, the crystallographic anisotropy and the resultant anisotropic physical properties, and the variation of microstructure and surface finish from point to point in real components, all lead to considerable uncertainties in the actual performance of any particular component. It is concluded that although the concepts of fracture mechanics have been and will continue to be most useful for the qualitative explanation of fracture phenomena, the usefulness as a predictive tool with respect to most existing types of material is limited by the interrelation between material microstructure and mechanical properties. At present, the only method of eliminating components with unsatisfactory mechanical properties is to proof-test them, despite the fact that proof-testing itself is limited in ability to cope with changes to the component in service. The aim of the manufacturer must be to improve quality and consistency within individual components, from component to component, and from batch to batch. The aim of the fracture specialist must be to study longer-term properties to improve the accuracy of behaviour predictions with a stronger data base. Materials development needs to concentrate on obtaining defect-free materials that can be translated into more-reliable products, using our present understanding of the influence of microstructure on strength and toughness

Dose to the metaphyseal growth complexes in children undergoing /sup 99m/Tc-EHDP bone scans

International Nuclear Information System (INIS)

Thomas, S.R.; Gelfand, M.J.; Kerelakes, J.G.; Ascoli, F.A.; Maxon, H.R.; Saenger, E.L.; Feller, P.A.; Sodd, V.J.; Paras, P.

1978-01-01

The spatial and temporal distribution of radionuclides in children may differ greatly from that accepted for adults. Following injection of a bone-seeking agent (/sup 99m/Tc-EHDP), radioactivity in the metaphyseal growth complexes of the distal femur and proximal tibia was quantitated in a series of children 4 to 16 years of age, using a gamma camera/computer system. The dose to the growth plate was found to range from 0.8 to 4.7 rads when adjusted to an administered activity of 200 μci/kg, compared to approximately 0.6 rad to the adult skeleton for a corresponding study

The production of grain oriented lanthanum titanate (La2Ti2O7) ceramics by uniaxial hot-forging process for improved fracture toughness

International Nuclear Information System (INIS)

Ceylan, Ali

2008-01-01

The layered-structural ceramics, such as lanthanum titanate (La 2 Ti 2 O 7 ), have been known for their good electrical and optical properties at high frequencies and temperatures. However, few studies have been conducted on the mechanical properties of these ceramics. The interest in ceramic hot-forging (HF) has been greatly increased recently due to the enhancement in fracture toughness via bridging effect of oriented grains. In this study, grain oriented lanthanum titanate was produced by the hot-forging process. The characterizations of the samples were achieved by density measurement, scanning electron microscopy (SEM), optical microscopy, X-ray diffraction (XRD), Vickers indentation and three-point bending test. According to X-ray diffraction patterns, the orientation factor (f) was found to be 0.73 for certain hot-forging conditions resulting an improved fracture toughness. The improved fracture toughness of La 2 Ti 2 O 7 (3.2 MPa m 1/2 ) reached to the value of monolithic alumina (Al 2 O 3 ) between 3 and 4 MPa m 1/2

Clinical Utility of Chest Computed Tomography in Patients with Rib Fractures CT Chest and Rib Fractures.

Science.gov (United States)

Chapman, Brandon C; Overbey, Douglas M; Tesfalidet, Feven; Schramm, Kristofer; Stovall, Robert T; French, Andrew; Johnson, Jeffrey L; Burlew, Clay C; Barnett, Carlton; Moore, Ernest E; Pieracci, Fredric M

2016-12-01

Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. Retrospective cohort study of blunt trauma patients with rib fractures at a level I trauma center that had both a CXR and a CT chest. The CT finding of ≥ 3 additional fractures in patients with ≤ 3 rib fractures on CXR was considered clinically meaningful. Student's t-test and chi-square analysis were used for comparison. We identified 499 patients with rib fractures: 93 (18.6%) had CXR only, 7 (1.4%) had chest CT only, and 399 (79.9%) had both CXR and chest CT. Among these 399 patients, a total of 1,969 rib fractures were identified: 1,467 (74.5%) were missed by CXR. The median number of additional fractures identified by CT was 3 (range, 4 - 15). Of 212 (53.1%) patients with a clinically meaningful increase in the number of fractures, 68 patients underwent one or more clinical interventions: 36 SICU admissions, 20 pain catheter placements, 23 epidural placements, and 3 SSRF. Additionally, 70 patients had a chest tube placed for retained hemothorax or occult pneumothorax. Overall, 138 patients (34.5%) had a change in clinical management based upon CT chest. The chest X-ray missed ~75% of rib fractures seen on chest CT. Although patients with a clinical meaningful increase in the number of rib fractures were more likely to be admitted to the intensive care unit, there was no associated improvement in pulmonary outcomes.

A Year of Fractures: a snapshot analysis of the logistics, problems and outcomes of a hospital-based fracture liaison service.

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Vaile, J H; Sullivan, L; Connor, D; Bleasel, J F

2013-10-01

Our fracture liaison service identifies patients with low trauma fractures, determines the need for osteoporosis therapy and instigates therapy if necessary. We describe the tracking and outcome of 768 patients attending our emergency department over 1 year and discuss the problems we encountered and potential solutions. Osteoporotic fractures result in substantial morbidity, mortality and economic cost, and patients sustaining a first fracture are known to be at higher risk of sustaining future fracture. Treatment of at-risk patients has been shown to assist in prevention of future fracture including hip fracture. We established a "First Fracture Project" to identify and treat these patients in 2003. We assessed "A Year of Fractures": the logistics, outcome and problems in tracking patients presenting to our emergency department with a low trauma fracture by our fracture liaison service, over 1 year from July 2008 to June 2009. Patients were tracked by our osteoporosis nurse and offered assessment, and treatment where necessary. In 1 year, 768 patients aged 50 or over were identified from emergency department records as attending with a low trauma fracture. About 84 % of patients eventually received assessment. Of the162 patients progressing through the entire process, 74 % had osteoporosis treatment planned and/or commenced. Our fracture liaison service was effective at identifying most low trauma fracture patients at risk of further fracture and providing access to osteoporosis assessment. There were many difficulties: we outline logistic and practical issues in delivering our service and suggest potential improvements.

Incremental predictive value of sarcopenia for incident fracture in an elderly Chinese cohort: results from the Osteoporotic Fractures in Men (MrOs) Study.

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Yu, Ruby; Leung, Jason; Woo, Jean

2014-08-01

We examined whether sarcopenia is predictive of incident fractures among older men, whether the inclusion of sarcopenia in models adds any incremental value to bone mineral density (BMD), and whether sarcopenia is associated with a higher risk of fractures in elderly with osteoporosis. A cohort of 2000 community-dwelling men aged ≥65 years were examined for which detailed information regarding demographics, socioeconomic, medical history, clinical, and lifestyle factors were documented. Body composition and BMD were measured using dual energy X-ray absorptiometry. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) algorithm. Incident fractures were documented during the follow-up period from 2001 to 2013, and related to sarcopenia and its component measures using Cox proportional hazard regressions. The contribution of sarcopenia for predicting fracture risk was evaluated by receiver operating characteristic analysis, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). During an average of 11.3 years of follow-up, 226 (11.3%) men sustained at least 1 incident fracture, making the incidence of fractures 1200.6/100,000 person-years. After multivariate adjustments, sarcopenia was associated with increased fracture risk (hazard ratio [HR], 1.87, 95% confidence interval [CI], 1.26-2.79) independent of BMD and other clinical risk factors. The addition of sarcopenia did not significantly increase area under curve or IDI but significantly improved the predictive ability on fracture risk over BMD and other clinical risk factors by 5.12% (P sarcopenia (sarco-osteoporosis) resulted in a significantly increased risk of fractures (HR, 3.49, 95% CI, 1.76-6.90) compared with those with normal BMD and without sarcopenia. This study confirms that sarcopenia is a predictor of fracture risk in this elderly men cohort, establishes that sarcopenia provides incremental predictive value for fractures over the

Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation: a systematic review

Directory of Open Access Journals (Sweden)

Andrea M Bruder

2017-10-01

Registration: CRD42016041818. [Bruder AM, Shields N, Dodd KJ, Taylor NF (2017 Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation: a systematic review. Journal of Physiotherapy 63: 205–220

Bimalleolar ankle fracture with proximal fibular fracture

NARCIS (Netherlands)

Colenbrander, R. J.; Struijs, P. A. A.; Ultee, J. M.

2005-01-01

A 56-year-old female patient suffered a bimalleolar ankle fracture with an additional proximal fibular fracture. This is an unusual fracture type, seldom reported in literature. It was operatively treated by open reduction and internal fixation of the lateral malleolar fracture. The proximal fibular

Fracture Toughness of Carbon Nanotube-Reinforced Metal- and Ceramic-Matrix Composites

International Nuclear Information System (INIS)

Chen, Y.L.; Liu, B.; Hwang, K.C.; Chen, Y.L.; Huang, Y.

2011-01-01

Hierarchical analysis of the fracture toughness enhancement of carbon nanotube- (CNT-) reinforced hard matrix composites is carried out on the basis of shear-lag theory and fracture mechanics. It is found that stronger CNT/matrix interfaces cannot definitely lead to the better fracture toughness of these composites, and the optimal interfacial chemical bond density is that making the failure mode just in the transition from CNT pull-out to CNT break. For hard matrix composites, the fracture toughness of composites with weak interfaces can be improved effectively by increasing the CNT length. However, for soft matrix composite, the fracture toughness improvement due to the reinforcing CNTs quickly becomes saturated with an increase in CNT length. The proposed theoretical model is also applicable to short fiber-reinforced composites.

Correlation of Hip Fracture with Other Fracture Types: Toward a Rational Composite Hip Fracture Endpoint

Science.gov (United States)

Colón-Emeric, Cathleen; Pieper, Carl F.; Grubber, Janet; Van Scoyoc, Lynn; Schnell, Merritt L; Van Houtven, Courtney Harold; Pearson, Megan; Lafleur, Joanne; Lyles, Kenneth W.; Adler, Robert A.

2016-01-01

Purpose With ethical requirements to the enrollment of lower risk subjects, osteoporosis trials are underpowered to detect reduction in hip fractures. Different skeletal sites have different levels of fracture risk and response to treatment. We sought to identify fracture sites which cluster with hip fracture at higher than expected frequency; if these sites respond to treatment similarly, then a composite fracture endpoint could provide a better estimate of hip fracture reduction. Methods Cohort study using Veterans Affairs and Medicare administrative data. Male Veterans (n=5,036,536) aged 50-99 years receiving VA primary care between1999-2009 were included. Fractures were ascertained using ICD9 and CPT codes and classified by skeletal site. Pearson correlation coefficients, logistic regression and kappa statistics, were used to describe the correlation between each fracture type and hip fracture within individuals, without regards to the timing of the events. Results 595,579 (11.8%) men suffered 1 or more fractures and 179,597 (3.6%) suffered 2 or more fractures during the time under study. Of those with one or more fractures, rib was the most common site (29%), followed by spine (22%), hip (21%) and femur (20%). The fracture types most highly correlated with hip fracture were pelvic/acetabular (Pearson correlation coefficient 0.25, p<0.0001), femur (0.15, p<0.0001), and shoulder (0.11, p<0.0001). Conclusions Pelvic, acetabular, femur, and shoulder fractures cluster with hip fractures within individuals at greater than expected frequency. If we observe similar treatment risk reductions within that cluster, subsequent trials could consider use of a composite endpoint to better estimate hip fracture risk. PMID:26151123

Economic viability of geriatric hip fracture centers.

Science.gov (United States)

Clement, R Carter; Ahn, Jaimo; Mehta, Samir; Bernstein, Joseph

2013-12-01

Management of geriatric hip fractures in a protocol-driven center can improve outcomes and reduce costs. Nonetheless, this approach has not spread as broadly as the effectiveness data would imply. One possible explanation is that operating such a center is not perceived as financially worthwhile. To assess the economic viability of dedicated hip fracture centers, the authors built a financial model to estimate profit as a function of costs, reimbursement, and patient volume in 3 settings: an average US hip fracture program, a highly efficient center, and an academic hospital without a specific hip fracture program. Results were tested with sensitivity analysis. A local market analysis was conducted to assess the feasibility of supporting profitable hip fracture centers. The results demonstrate that hip fracture treatment only becomes profitable when the annual caseload exceeds approximately 72, assuming costs characteristic of a typical US hip fracture program. The threshold of profitability is 49 cases per year for high-efficiency hip fracture centers and 151 for the urban academic hospital under review. The largest determinant of profit is reimbursement, followed by costs and volume. In the authors’ home market, 168 hospitals offer hip fracture care, yet 85% fall below the 72-case threshold. Hip fracture centers can be highly profitable through low costs and, especially, high revenues. However, most hospitals likely lose money by offering hip fracture care due to inadequate volume. Thus, both large and small facilities would benefit financially from the consolidation of hip fracture care at dedicated hip fracture centers. Typical US cities have adequate volume to support several such centers.

Overcoming O: Dewey and the Problem of Bion's Metaphysics.

Science.gov (United States)

Soffer-Dudek, Nir

2015-10-01

Bion guides us to eschew memory, desire, and understanding in order to become one with O-the ultimate reality of the analytic moment. However, his directions are valid only to the extent that such a meta-reality actually exists. Otherwise there is nothing to unite with and no reason to shun memory or desire. The present work inquires whether we may provide Bion's technique with a less speculative philosophy, specifically Dewey's pragmatist theory of aesthetics. It begins with reviewing the similarities between the two writers' methods, highlighting their shared emphasis on openness to the unknown. Yet listening to their intonations reveals that they actually convey opposite ideas as to what this "unknown" may be. Whereas Dewey sanguinely portrays the possibilities of the "yet-unknown," Bion emphasizes the dread of our inescapable encounter with the unknowable. This dread is embodied in his concept of O. Thus, rather than being merely a metaphysical speculation, O communicates Bion's conviction that fear forms the core of our existence. Banishing O from the counseling room may indeed aid his method in becoming accessible to a wider audience; at the same time, however, doing so might also deprive it of the very context that gives it meaning. © 2015 by the American Psychoanalytic Association.

Optimization of fracture length in gas/condensate reservoirs

Energy Technology Data Exchange (ETDEWEB)

Mohan, J.; Sharma, M.M.; Pope, G.A. [Society of Petroleum Engineers, Richardson, TX (United States)]|[Texas Univ., Austin, TX (United States)

2006-07-01

A common practice that improves the productivity of gas-condensate reservoirs is hydraulic fracturing. Two important variables that determine the effectiveness of hydraulic fractures are fracture length and fracture conductivity. Although there are no simple guidelines for the optimization of fracture length and the factors that affect it, it is preferable to have an optimum fracture length for a given proppant volume in order to maximize productivity. An optimization study was presented in which fracture length was estimated at wells where productivity was maximized. An analytical expression that takes into account non-Darcy flow and condensate banking was derived. This paper also reviewed the hydraulic fracturing process and discussed previous simulation studies that investigated the effects of well spacing and fracture length on well productivity in low permeability gas reservoirs. The compositional simulation study and results and discussion were also presented. The analytical expression for optimum fracture length, analytical expression with condensate dropout, and equations for the optimum fracture length with non-Darcy flow in the fracture were included in an appendix. The Computer Modeling Group's GEM simulator, an equation-of-state compositional simulator, was used in this study. It was concluded that for cases with non-Darcy flow, the optimum fracture lengths are lower than those obtained with Darcy flow. 18 refs., 5 tabs., 22 figs., 1 appendix.

Three-dimensional printing model improves morphological understanding in acetabular fracture learning: A multicenter, randomized, controlled study.

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Zhenfei Huang

Full Text Available Conventional education results in unsatisfactory morphological understanding of acetabular fractures due to lack of three-dimensional (3D details and tactile feedback of real fractures. Virtual reality (VR and 3D printing (3DP techniques are widely applied in teaching. The purpose of this study was to identify the effect of physical model (PM, VR and 3DP models in education of morphological understanding of acetabular fractures. 141 students were invited to participate in this study. Participants were equally and randomly assigned to the PM, VR and 3DP learning groups. Three-level objective tests were conducted to evaluate learning, including identifying anatomical landmarks, describing fracture lines, identifying classification, and inferring fracture mechanism. Four subjective questions were asked to evaluate the usability and value of instructional materials. Generally, the 3DP group showed a clear advantage over the PM and VR groups in objective tests, while there was no significant difference between the PM and VR groups. 3DP was considered to be the most valuable learning tool for understanding acetabular fractures. The findings demonstrate that 3DP modelling of real fractures is an effective learning instrument that can be used to understand the morphology of acetabular fractures and promote subjective interest.

Crusius et la certitude métaphysique en 1762 Crusius and metaphysical certainty in 1762

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Tinca Prunea-Bretonnet

2011-12-01

Full Text Available L’article se propose d’analyser le rôle joué par la pensée de Christian August Crusius dans la genèse et l’articulation de la Preisschrift kantienne de 1762. Décidément anti-wolffien, Kant opte pour la méthode analytique comme seule capable d’assurer la scientificité de la philosophie. Dans un double mouvement de rapprochement et de prise de distance par rapport à certaines thèses crusiennes centrales, il entend démontrer que la certitude atteignable en métaphysique est suffisante pour la conviction, qu’elle est toute aussi « sûre » et « complète » que la certitude mathématique. Ne pouvant fonder cette certitude sur une simple conviction subjective, selon le principe de Crusius, Kant s’éloignera définitivement de ce dernier, non sans avoir intégré dans sa propre doctrine des éléments crusiens fondamentaux.This article aims to discuss the role played by Crusius’ thought in the genesis and the structure of Kant’s Preisschrift of 1762. Definitely opposed to Wolffian philosophy, Kant argues for the analythical method as the only method capable of ensuring a scientific status for philosophy. Simultaneously embracing and criticizing some central Crusian principles, he intends to demonstrate the possibility of a “sure” and “complete” metaphysical certainty, which would be as sufficient for conviction as the mathematical certainty. Kant refuses, however, to base metaphysical certainty on a simply subjective conviction, as Crusius suggests. That is why he ultimately rejects his predecessor’s philosophy, although not without making some fundamental Crusian elements part of his own doctrine.

Functional Improvement in Geriatric Hip Fractures: Does Vitamin D Deficiency Affect the Functional Outcome of Patients With Surgically Treated Intertrochanteric Hip Fractures.

Science.gov (United States)

Seng, W R D; Belani, M H; Ramason, R; Naidu, G; Doshi, H K

2015-09-01

The "Integrated Care Pathway" for geriatric intertrochanteric (IT) fractures in Singapore's Tan Tock Seng Hospital has shown significant functional recovery in patients' activities of daily living. However, the influence of preoperative vitamin D on functional recovery remains equivocal. This retrospective study therefore aims to determine whether patients with preoperative vitamin D deficiency have poorer functional outcomes. A total of 171 patients who had surgical treatment for IT fractures were recruited in the study. They were categorized into group A (vitamin D deficient) and group B (normal vitamin D). Charlson Comorbidity Index (CCI) score and nutritional parameters including hemoglobin, albumin, and adjusted calcium levels on admission were recorded. The Modified Barthel Index (MBI) score was used to measure functional recovery at the following time intervals: at pre-fall, at discharge after surgery, at 6 months, and at 1-year follow-up. The mean age of both the groups (A: 79.7 years, n = 45; B: 83.0 years, n = 126) was statistically different (P < .05). However, the mean CCI (A: 9.42 and B: 10.13), hemoglobin (A: 12.4 and B 11.1), adjusted calcium (A: 2.39 and B: 2.38), and mean albumin (A: 33.6 and B: 33.0) of the groups were not significantly different. Furthermore, the MBI scores were not significantly different for both groups at preinjury (A: 91.5 and B: 89.4), at discharge (A: 55.2 and B: 58.9), at 6 months (A: 70.9 and B: 75.1), and at 1 year (A: 75.8 and B: 79.4). In our cohort, patients with vitamin D deficiency were younger. However, vitamin D deficiency at time of injury had no significant influence on functional recovery in patients with surgically treated hip fracture in our Integrated Care Pathway. In addition, patients who had a normal vitamin D levels had similar functional scores and improvement postoperatively and at 1 year (A: 82.8% and B: 88.9%).

Foal Fractures: Osteochondral Fragmentation, Proximal Sesamoid Bone Fractures/Sesamoiditis, and Distal Phalanx Fractures.

Science.gov (United States)

Reesink, Heidi L

2017-08-01

Foals are susceptible to many of the same types of fractures as adult horses, often secondary to external sources of trauma. In addition, some types of fractures are specific to foals and occur routinely in horses under 1 year of age. These foal-specific fractures may be due to the unique musculoskeletal properties of the developing animal and may present with distinct clinical signs. Treatment plans and prognoses are tailored specifically to young animals. Common fractures not affecting the long bones in foals are discussed in this article, including osteochondral fragmentation, proximal sesamoid bone fractures/sesamoiditis, and distal phalanx fractures. Copyright © 2017 Elsevier Inc. All rights reserved.

KIEVAN PERIOD OF V. V. ZENKOVSKY’S CREATIVE WORK: REFORM OF METAPHYSICAL BACKGROUND OF PSYCHOLOGY

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V. M. LETTSEV

2006-06-01

Full Text Available The article is devoted to the Kiev’s period of creative work of V.V. Zenkovsky, re-markable Christian philosopher, psychologist and pedagogue. The main point of interest of the thinker of that time was a philosophical psychology, i.e. a branch of science direct-ed to the source of psychics and seeking to make clear the nature and basis of mental re-ality. Zenkovsky’s defense of the idea of substantiality of soul and original interpretation of the problem of psychophysical interaction brought him to the deep reform of meta-physical background of psychology. This also became the conceptual basis for his latest investigations in the spheres of pedagogy, theology and pure philosophy

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

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

2017-06-01

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

Mezzo-scopic Analysis of Fracture Toughness in Steels

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Miyata Takashi

2002-01-01

Full Text Available The cleavage fracture toughness of steels was mezzo-scopically analyzed on the basis of the statistical local fracture criterion approach. The statistical stress criterion at the crack tip region suggests that the cleavage fracture toughness in steels can be described as a function of the yield stress, the cleavage fracture stress, and other mechanical properties of the materials. Formulation of the cleavage fracture toughness was first examined through an investigation on correlation between the cleavage toughness and the cleavage fracture stress obtained in notched round bar specimens in accordance with the theoretical prediction. Then, the scatter of the toughness, specimen thickness effect on the toughness, deterioration of the toughness due to cold working and irradiation, and improvement of the toughness caused by the Ni addition, were analyzed through the formulation of the toughness.

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

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Huang Bo

2017-01-01

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

Post-traumatic cyst-like lesion in children: case report and the literature review.

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Angelliaume, Audrey; Simon, Anne-Laure; Tanase, Anca; Mazda, Keyvan; Ilharreborde, Brice

2016-03-01

Reports of post-traumatic cyst-like lesions in children are rare. These lesions occur between 1.5 and 3 months after a fracture. They are more frequent after a distal radius greenstick fracture. Conventional radiographs show a metaphyseal radiolucent lesion inside the most recent subperiosteal bone, adjacent to the initial fracture line. Post-traumatic cyst-like lesions are benign, asymptomatic, nonexpansive, and regress spontaneously. Two typical cases are described in the following report with a literature review of the etiology and main features of these lesions.

Unusual bone dysplasia featuring severe platyspondyly and vertebral 'coronal cleft' in infancy, and changes of metaphyseal chondrodysplasia in childhood

International Nuclear Information System (INIS)

Currarino, G.; Texas Univ., Dallas

1986-01-01

This is the report of a boy who presented at birth with severe generalized platyspondyly, a vertebral ''coronal cleft'', and an abnormal configuration of the pelvis with short and broad iliac and ischial bones and horizontal acetabular roofs. The rest of the skeleton was normal. In the ensuing years the vertebral bodies and pelvis assumed a near normal configuration, but the patient developed changes of metaphyseal chondrodysplasia in the long bones of the lower limbs with progressive shortness of stature. (orig.)

Acetabular Fracture

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Chad Correa

2017-09-01

Full Text Available History of present illness: A 77-year-old female presented to her primary care physician (PCP with right hip pain after a mechanical fall. She did not lose consciousness or have any other traumatic injuries. She was unable to ambulate post-fall, so X-rays were ordered by her PCP. Her X-rays were concerning for a right acetabular fracture (see purple arrows, so the patient was referred to the emergency department where a computed tomography (CT scan was ordered. Significant findings: The non-contrast CT images show a minimally displaced comminuted fracture of the right acetabulum involving the acetabular roof, medial and anterior walls (red arrows, with associated obturator muscle hematoma (blue oval. Discussion: Acetabular fractures are quite rare. There are 37 pelvic fractures per 100,000 people in the United States annually, and only 10% of these involve the acetabulum. They occur more frequently in the elderly totaling an estimated 4,000 per year. High-energy trauma is the primary cause of acetabular fractures in younger individuals and these fractures are commonly associated with other fractures and pelvic ring disruptions. Fractures secondary to moderate or minimal trauma are increasingly of concern in patients of advanced age.1 Classification of acetabular fractures can be challenging. However, the approach can be simplified by remembering the three basic types of acetabular fractures (column, transverse, and wall and their corresponding radiologic views. First, column fractures should be evaluated with coronally oriented CT images. This type of fracture demonstrates a coronal fracture line running caudad to craniad, essentially breaking the acetabulum into two halves: a front half and a back half. Secondly, transverse fractures should be evaluated by sagittally oriented CT images. By definition, a transverse fracture separates the acetabulum into superior and inferior halves with the fracture line extending from anterior to posterior

[Surgical approaches to tibial plateau fractures].

Science.gov (United States)

Krause, Matthias; Müller, Gunnar; Frosch, Karl-Heinz

2018-06-06

Intra-articular tibial plateau fractures can present a surgical challenge due to complex injury patterns and compromised soft tissue. The treatment goal is to spare the soft tissue and an anatomical reconstruction of the tibial articular surface. Depending on the course of the fracture, a fracture-specific access strategy is recommended to provide correct positioning of the plate osteosynthesis. While the anterolateral approach is used in the majority of lateral tibial plateau fractures, only one third of the joint surface is visible; however, posterolateral fragments require an individual approach, e. g. posterolateral or posteromedial. If necessary, osteotomy of the femoral epicondyles can improve joint access for reduction control. Injuries to the posterior columns should be anatomically reconstructed and biomechanically correctly addressed via posterior approaches. Bony posterior cruciate ligament tears can be refixed via a minimally invasive posteromedial approach.

Does a trochanteric lag screw improve fixation of vertically oriented femoral neck fractures? A biomechanical analysis in cadaveric bone.

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Hawks, Michael A; Kim, Hyunchul; Strauss, Joseph E; Oliphant, Bryant W; Golden, Robert D; Hsieh, Adam H; Nascone, Jason W; O'Toole, Robert V

2013-10-01

We assessed the biomechanical performances of a trochanteric lag screw construct and a traditional inverted triangle construct in the treatment of simulated Pauwels type 3 femoral neck fractures. An inverted triangle construct (three 7.3-mm cannulated screws placed in inverted triangle orientation) and a trochanteric lag screw construct (two 7.3-mm cannulated screws placed across the superior portion of the femoral neck and one 4.5-mm lag screw placed perpendicular to the fracture in superolateral to inferomedial orientation) were tested in nine matched pairs of non-osteoporotic human cadaveric femora. We used a previously described vertically oriented femoral neck fracture model and testing protocol that incrementally loaded the constructs along the mechanical axis of the femur to 1400 N. Specimens that survived incremental loading underwent cyclic loading. Apparent construct stiffness, force at 3mm of displacement, and survival of incremental loading were recorded. The trochanteric lag screw group had a 70% increase in stiffness (261 N/mm [29 standard deviation] versus 153 N/mm [16 standard deviation]; P=0.026) and a 43% increase in force required for displacement (620 N versus 435 N; P=0.018) compared with the inverted triangle group. One trochanteric lag screw and no inverted triangle specimen survived incremental loading. A trochanteric lag screw construct applied to vertically oriented femoral neck fractures provides marked improvement in mechanical performance compared with the inverted triangle construct. © 2013.

Comparison thoracic epidural and intercostal block to improve ventilation parameters and reduce pain in patients with multiple rib fractures.

Science.gov (United States)

Hashemzadeh, Shahryar; Hashemzadeh, Khosrov; Hosseinzadeh, Hamzeh; Aligholipour Maleki, Raheleh; Golzari, Samad E J; Golzari, Samad

2011-01-01

Chest wall blunt trauma causes multiple rib fractures and will often be associated with significant pain and may compromise ventilator mechanics. Analgesia has great roll in rib fracture therapies, opioid are useful, but when used as sole agent may require such high dose that they produce respiratory depression, especially in elderly .the best analgesia for a severe chest wall injury is a continuous epidural infusion of local anesthetic. This provides complete analgesia allowing inspiration and coughing without of the risk of respiratory depression. sixty adult patients who with multiple rib fractures were enrolled in this study. They were divided into Group A or thoracic epidural with bupivacaine 0.125 % +1mg/5ml morphine and group B or intercostal block with 0.25% bupivacaine. The patients were assessed through ICU and hospital stay length, ventilation function tests. Pain score among the patients was measured with verbal rating scale, before and after administration of the analgesia. We found a significant improvement in ventilatory function tests during the 1st, 2nd, and 3rd days after epidural analgesia compared with the intercostal block (P pain at rest and pain caused by coughing and deep breathing in group A compared group B... ICU and hospital stay markedly reduced in Group A. thoracic epidural analgesia is superior to intercostals block regarding pain relief of rib fractures. Patients who received epidural analgesia had significantly lower pain scores at all studied times.

Interpretations of Probability in Quantum Mechanics: A Case of ``Experimental Metaphysics''

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Hellman, Geoffrey

After reviewing paradigmatic cases of “experimental metaphysics” basing inferences against local realism and determinism on experimental tests of Bells theorem (and successors), we concentrate on clarifying the meaning and status of “objective probability” in quantum mechanics. The terms “objective” and “subjective” are found ambiguous and inadequate, masking crucial differences turning on the question of what the numerical values of probability functions measure vs. the question of the nature of the “events” on which such functions are defined. This leads naturally to a 2×2 matrix of types of interpretations, which are then illustrated with salient examples. (Of independent interest are the splitting of “Copenhagen interpretation” into “objective” and “subjective” varieties in one of the dimensions and the splitting of Bohmian hidden variables from (other) modal interpretations along that same dimension.) It is then explained why Everett interpretations are difficult to categorize in these terms. Finally, we argue that Bohmian mechanics does not seriously threaten the experimental-metaphysical case for ultimate randomness and purely physical probabilities.

Estimation of fracture parameters using elastic full-waveform inversion

KAUST Repository

Zhang, Zhendong; Alkhalifah, Tariq Ali; Oh, Juwon; Tsvankin, Ilya

2017-01-01

regularization term is added to the objective function to improve the estimation of the fracture azimuth, which is otherwise poorly constrained. The cracks are assumed to be penny-shaped to reduce the nonuniqueness in the inverted fracture weaknesses and achieve

Using microstructure observations to quantify fracture properties and improve reservoir simulations. Final report, September 1998

Energy Technology Data Exchange (ETDEWEB)

Laubach, S.E.; Marrett, R.; Rossen, W.; Olson, J.; Lake, L.; Ortega, O.; Gu, Y.; Reed, R.

1999-01-01

The research for this project provides new technology to understand and successfully characterize, predict, and simulate reservoir-scale fractures. Such fractures have worldwide importance because of their influence on successful extraction of resources. The scope of this project includes creation and testing of new methods to measure, interpret, and simulate reservoir fractures that overcome the challenge of inadequate sampling. The key to these methods is the use of microstructures as guides to the attributes of the large fractures that control reservoir behavior. One accomplishment of the project research is a demonstration that these microstructures can be reliably and inexpensively sampled. Specific goals of this project were to: create and test new methods of measuring attributes of reservoir-scale fractures, particularly as fluid conduits, and test the methods on samples from reservoirs; extrapolate structural attributes to the reservoir scale through rigorous mathematical techniques and help build accurate and useful 3-D models of the interwell region; and design new ways to incorporate geological and geophysical information into reservoir simulation and verify the accuracy by comparison with production data. New analytical methods developed in the project are leading to a more realistic characterization of fractured reservoir rocks. Testing diagnostic and predictive approaches was an integral part of the research, and several tests were successfully completed.

Associations of early premenopausal fractures with subsequent fractures vary by sites and mechanisms of fractures.

Science.gov (United States)

Honkanen, R; Tuppurainen, M; Kroger, H; Alhava, E; Puntila, E

1997-04-01

In a retrospective population-based study we assessed whether and how self-reported former fractures sustained at the ages of 20-34 are associated with subsequent fractures sustained at the ages of 35-57. The 12,162 women who responded to fracture questions of the baseline postal enquiry (in 1989) of the Kuopio Osteoporosis Study, Finland formed the study population. They reported 589 former and 2092 subsequent fractures. The hazard ratio (HR), with 95% confidence interval (CI), of a subsequent fracture was 1.9 (1.6-2.3) in women with the history of a former fracture compared with women without such a history. A former low-energy wrist fracture was related to subsequent low-energy wrist [HR = 3.7 (2.0-6.8)] and high-energy nonwrist [HR = 2.4 (1.3-4.4)] fractures, whereas former high-energy nonwrist fractures were related only to subsequent high-energy nonwrist [HR = 2.8 (1.9-4.1)] but not to low-energy wrist [HR = 0.7 (0.3-1.8)] fractures. The analysis of bone mineral density (BMD) data of a subsample of premenopausal women who underwent dual x-ray absorptiometry (DXA) during 1989-91 revealed that those with a wrist fracture due to a fall on the same level at the age of 20-34 recorded 6.5% lower spinal (P = 0.140) and 10.5% lower femoral (P = 0.026) BMD than nonfractured women, whereas the corresponding differences for women with a former nonwrist fracture due to high-energy trauma were -1.8% (P = 0.721) and -2.4% (P = 0. 616), respectively. Our results suggest that an early premenopausal, low-energy wrist fracture is an indicator of low peak BMD which predisposes to subsequent fractures in general, whereas early high-energy fractures are mainly indicators of other and more specific extraskeletal factors which mainly predispose to same types of subsequent fractures only.

FUNCTIONAL OUTCOME OF SUPRACONDYLAR FRACTURES OF FEMUR MANAGED BY OPEN REDUCTION AND INTERNAL FIXATION WITH LOCKING COMPRESSION PLATE

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Madhusudhana

2015-10-01

Full Text Available INTRODUCTION : Incidence of distal femur fractures is approximately 37 per 1 , 00,000 person - years.¹Distal femoral fractures has two different injury mechanisms, high energy trauma and low energy trauma. In high - energy trauma, the problem of restoring the function in a destroyed knee joint persists. Complex knee ligament injuries frequently occur additionally to extensive cartilage injuries. In elderly patients, extreme osteoporosis represents a particular problem for anchoring the implant. 2 Supracondylar and inter condylar fractures often are unstable and comminuted and tend to occur in the elderly or those with multiple injuries. Treatment options are many with varied results. The final outcome would depend upon the type of fracture, stabilization of fixation and and perhaps patient general condition. 3 The options for operative treatment are traditional plating techniques that require compression of the implant to the femoral shaft (blade plate, Dynamic Condylar Screw, non - locking condylar buttress plate, antegrade nailing fixation, retrograde nailing, sub muscular locked internal fixation and external fixation. 4 However, as the complexity of fractures needing treatment has changed from simple extra - articular supra - condylar types to inter - condylar and metaphyseal comminuted types, these implants may not be ideal. Double plating, and more recently, locked plating techniques have been advocated 5 . However with double plating there is often extensive soft tissue stripping on both sides of the femur, resulting in reduced blood supply and potential non - union and failure of the implants 6 . The LCP is a single beam construct where the strength of its fixation is equal to the sum of all screw - bone interfaces rather than a single screw’s axial stiffness or pullout resistance as seen in unlocked plates 7,8 . Its unique biomechanical function is based on splinting rather than compression resulting in flexible stabilization

Geriatric hip fracture management: keys to providing a successful program.

Science.gov (United States)

Basu, N; Natour, M; Mounasamy, V; Kates, S L

2016-10-01

Hip fractures are a common event in older adults and are associated with significant morbidity, mortality and costs. This review examines the necessary elements required to implement a successful geriatric fracture program and identifies some of the barriers faced when implementing a successful program. The Geriatric Fracture Center (GFC) is a treatment model that standardizes the approach to the geriatric fracture patient. It is based on five principles: surgical fracture management; early operative intervention; medical co-management with geriatricians; patient-centered, standard order sets to employ best practices; and early discharge planning with a focus on early functional rehabilitation. Implementing a geriatric fracture program begins with an assessment of the hospital's data on hip fractures and standard care metrics such as length of stay, complications, time to surgery, readmission rates and costs. Business planning is essential along with the medical planning process. To successfully develop and implement such a program, strong physician leadership is necessary to articulate both a short- and long-term plan for implementation. Good communication is essential-those organizing a geriatric fracture program must be able to implement standardized plans of care working with all members of the healthcare team and must also be able to foster relationships both within the hospital and with other institutions in the community. Finally, a program of continual quality improvement must be undertaken to ensure that performance outcomes are improving patient care.

Potential Benefits of Rib Fracture Fixation in Patients with Flail Chest and Multiple Non-flail Rib Fractures.

Science.gov (United States)

Qiu, Meiguang; Shi, Zhanjun; Xiao, Jun; Zhang, Xuming; Ling, Shishui; Ling, Hao

2016-12-01

The purpose of this study is to evaluate the potential benefits of rib fracture fixation in patients with flail chest and multiple non-flail rib fractures versus conventional treatment modalities. A retrospective reviewed study compared 86 cases which received surgical treatment between June 2009 and May 2013 to 76 cases which received conservative treatment between January 2006 and May 2009. The patients were divided into the flail chest ( n  = 38) and multiple non-flail rib fracture groups ( n  = 124). In the flail chest group, the mechanical ventilation time, ICU monitoring time, tracheostomies, thoracic deformity, and impaired pulmonary function and return to full-time employment were compared. In the multiple non-flail rib fracture group, fracture healing, visual analog scale (VAS) pain score, inpatient length of stay, atelectatic, pulmonary complications, and normal activity-returning time were compared. Patients in the flail chest operative fixation group had significantly shorter ICU stay, decreased ventilator requirements, fewer tracheostomies, less thoracic deformity and impaired pulmonary function, and more returned to full-time employment. Patients in the multiple non-flail rib fracture operative fixation had shorter hospital stay, less pain, earlier return to normal activity, more fracture healing, less atelectasis, and fewer pulmonary infections. This study demonstrates the potential benefits of surgical stabilization of flail chest and multiple non-flail rib fractures with plate fixation. When compared with conventional conservative management, operatively managed patients demonstrated improved clinical outcomes.

Estimation of fracture parameters using elastic full-waveform inversion

KAUST Repository

Zhang, Zhendong

2017-08-17

Current methodologies to characterize fractures at the reservoir scale have serious limitations in spatial resolution and suffer from uncertainties in the inverted parameters. Here, we propose to estimate the spatial distribution and physical properties of fractures using full-waveform inversion (FWI) of multicomponent surface seismic data. An effective orthorhombic medium with five clusters of vertical fractures distributed in a checkboard fashion is used to test the algorithm. A shape regularization term is added to the objective function to improve the estimation of the fracture azimuth, which is otherwise poorly constrained. The cracks are assumed to be penny-shaped to reduce the nonuniqueness in the inverted fracture weaknesses and achieve a faster convergence. To better understand the inversion results, we analyze the radiation patterns induced by the perturbations in the fracture weaknesses and orientation. Due to the high-resolution potential of elastic FWI, the developed algorithm can recover the spatial fracture distribution and identify localized “sweet spots” of intense fracturing. However, the fracture azimuth can be resolved only using long-offset data.

Anaemia impedes functional mobility after hip fracture surgery

DEFF Research Database (Denmark)

Foss, N.B.; Kristensen, M.T.; Kehlet, H.

2008-01-01

mobility in the early post-operative phase after a hip fracture surgery and is an independent risk factor for patients not being able to walk post-operatively. The potential for a liberal transfusion policy to improve the rehabilitation potential in hip fracture patients with anaemia should be investigated......BACKGROUND: the impact of anaemia on the outcome after a hip fracture surgery is controversial, but anaemia can potentially decrease the physical performance and thereby impede post-operative rehabilitation. We therefore conducted a prospective study to establish whether anaemia affected functional...... mobility in the early post-operative phase after a hip fracture surgery. PATIENTS AND METHODS: four hundred and eighty seven consecutive hip fracture patients, treated according to a well-defined multimodal rehabilitation programme with a uniform, liberal transfusion threshold, were studied. Hb...

Divergent effects of obesity on fragility fractures

Directory of Open Access Journals (Sweden)

Caffarelli C

2014-09-01

Full Text Available Carla Caffarelli, Chiara Alessi, Ranuccio Nuti, Stefano Gonnelli Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy Abstract: Obesity was commonly thought to be advantageous for maintaining healthy bones due to the higher bone mineral density observed in overweight individuals. However, several recent studies have challenged the widespread belief that obesity is protective against fracture and have suggested that obesity is a risk factor for certain fractures. The effect of obesity on fracture risk is site-dependent, the risk being increased for some fractures (humerus, ankle, upper arm and decreased for others (hip, pelvis, wrist. Moreover, the relationship between obesity and fracture may also vary by sex, age, and ethnicity. Risk factors for fracture in obese individuals appear to be similar to those in nonobese populations, although patterns of falling are particularly important in the obese. Research is needed to determine if and how visceral fat and metabolic complications of obesity (type 2 diabetes mellitus, insulin resistance, chronic inflammation, etc are causally associated with bone status and fragility fracture risk. Vitamin D deficiency and hypogonadism may also influence fracture risk in obese individuals. Fracture algorithms such as FRAX® might be expected to underestimate fracture probability. Studies specifically designed to evaluate the antifracture efficacy of different drugs in obese patients are not available; however, literature data may suggest that in obese patients higher doses of the bisphosphonates might be required in order to maintain efficacy against nonvertebral fractures. Therefore, the search for better methods for the identification of fragility fracture risk in the growing population of adult and elderly subjects with obesity might be considered a clinical priority which could improve the prevention of fracture in obese individuals. Keywords: bone mineral density, BMI

Quality of Postoperative Pain Management After Maxillofacial Fracture Repair.

Science.gov (United States)

Peisker, Andre; Meissner, Winfried; Raschke, Gregor F; Fahmy, Mina D; Guentsch, Arndt; Schiller, Juliane; Schultze-Mosgau, Stefan

2018-05-01

Effective pain management is an essential component in the perioperative care of surgical patients. However, postoperative pain after maxillofacial fracture repair and its optimal therapy has not been described in detail. In a prospective cohort study, 95 adults rated their pain on the first postoperative day after maxillofacial fracture repair using the questionnaire of the Quality Improvement in Postoperative Pain Management (QUIPS) project. Quality Improvement in Postoperative Pain Management allowed for a standardized assessment of patients' characteristics and pain-related parameters. Overall, the mean maximal pain and pain on activity (numeric rating scales) were significantly higher in patients with mandibular fractures than in patients with midface fractures (P = 0.002 and P = 0.045, respectively). In patients with mandibular fractures, a longer duration of surgery was significantly associated with higher satisfaction with pain intensity (P = 0.015), but was more frequently associated with postoperative vomiting (P = 0.023). A shorter duration of surgery and an absence of preoperative pain counseling in these patients were significantly correlated to desire for more pain medication (P = 0.049 and P = 0.004, respectively). Patients with mandibular fractures that received opioids in the recovery room had significantly higher strain-related pain (P = 0.017). In patients with midface fractures, a longer duration of surgery showed significantly higher levels of decreased mobility (P = 0.003). Patients receiving midazolam for premedication had significantly less minimal pain (P = 0.021). Patients with mandibular fractures seem to have more postoperative pain than patients with midface fractures. Monitoring of postsurgical pain and a procedure-specific pain-treatment protocol should be performed in clinical routine.

Kyphoplasty for severe osteoporotic vertebral compression fractures

International Nuclear Information System (INIS)

Bao Zhaohua; Wang Genlin; Yang Huilin; Meng Bin; Chen Kangwu; Jiang Weimin

2010-01-01

Objective: To evaluate the clininal efficacy of kyphoplasty for severe osteoporotic vertebral compression fractures. Methods: Forty-five patients with severe osteoporotic compressive fractures were treated by kyphoplasty from Jan 2005 to Jan 2009. The compressive rate of the fractured vertebral bodies was more than 75%. According to the morphology of the vertebral compression fracture bodies the unilateral or bilateral balloon kyphoplasty were selected. The anterior vertebral height was measured on a standing lateral radiograph at pre-operative, post-operative (one day after operation) and final follow-up time. A visual analog scale(VAS) and the Oswestry disability index (ODI) were chosen to evaluate pain status and functional activity. Results: The mean follow-up was for 21.7 months (in range from 18 to 48 months). The anterior vertebral body height of fracture vertebra was restored from preoperative (18.7 ± 3.1)% to postoperative (51.4 ± 2.3)%, the follow-up period (50.2 ± 2.7)%. There was a significant improvement between preoperative and postoperative values (P 0.05). The VAS was 8.1 ± 1.4 at preoperative, 2.6 ± 0.9 at postoperative, 2.1 ± 0.5 at final follow-up time; and the ODI was preoperative 91.1 ± 2.3, postoperative 30.7 ± 7.1, follow-up period 26.1 ± 5.1. There was statistically significant improvement in the VAS and ODI in the post-operative assessment compared with the pre-operative assessment (P 0.05). Asymptomatic cement leakage occurred in three cases. New vertebral fracture occurred in one case. Conclusion: The study suggests that balloon kyphoplasty is a safe and effective procedure in the treatment of severe osteoporotic vertebral compression fractures. (authors)

Ballistic fractures: indirect fracture to bone.

Science.gov (United States)

Dougherty, Paul J; Sherman, Don; Dau, Nathan; Bir, Cynthia

2011-11-01

Two mechanisms of injury, the temporary cavity and the sonic wave, have been proposed to produce indirect fractures as a projectile passes nearby in tissue. The purpose of this study is to evaluate the temporal relationship of pressure waves using strain gauge technology and high-speed video to elucidate whether the sonic wave, the temporary cavity, or both are responsible for the formation of indirect fractures. Twenty-eight fresh frozen cadaveric diaphyseal tibia (2) and femurs (26) were implanted into ordnance gelatin blocks. Shots were fired using 9- and 5.56-mm bullets traversing through the gelatin only, passing close to the edge of the bone, but not touching, to produce an indirect fracture. High-speed video of the impact event was collected at 20,000 frames/s. Acquisition of the strain data were synchronized with the video at 20,000 Hz. The exact time of fracture was determined by analyzing and comparing the strain gauge output and video. Twenty-eight shots were fired, 2 with 9-mm bullets and 26 with 5.56-mm bullets. Eight indirect fractures that occurred were of a simple (oblique or wedge) pattern. Comparison of the average distance of the projectile from the bone was 9.68 mm (range, 3-20 mm) for fractured specimens and 15.15 mm (range, 7-28 mm) for nonfractured specimens (Student's t test, p = 0.036). In this study, indirect fractures were produced after passage of the projectile. Thus, the temporary cavity, not the sonic wave, was responsible for the indirect fractures.

Hydraulic fracture propagation modeling and data-based fracture identification