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Sample records for le fort distraction

  1. Le Fort I Maxillary Advancement Using Distraction Osteogenesis

    Science.gov (United States)

    Combs, Patrick D.; Harshbarger, Raymond J.

    2014-01-01

    Treatment of maxillary hypoplasia has traditionally involved conventional Le Fort I osteotomies and advancement. Advancements of greater than 10 mm risk significant relapse. This risk is greater in the cleft lip and palate population, whose anatomy and soft tissue scarring from prior procedures contributes to instability of conventional maxillary advancement. Le Fort I advancement with distraction osteogenesis has emerged as viable, stable treatment modality correction of severe maxillary hypoplasia in cleft, syndromic, and noncleft patients. In this article, the authors provide a review of current data and recommendations concerning Le Fort I advancement with distraction osteogenesis. In addition, they outline their technique for treating severe maxillary hypoplasia with distraction osteogenesis using internal devices. PMID:25383054

  2. Le Fort I Maxillary Advancement Using Distraction Osteogenesis

    OpenAIRE

    Combs, Patrick D.; Harshbarger, Raymond J.

    2014-01-01

    Treatment of maxillary hypoplasia has traditionally involved conventional Le Fort I osteotomies and advancement. Advancements of greater than 10 mm risk significant relapse. This risk is greater in the cleft lip and palate population, whose anatomy and soft tissue scarring from prior procedures contributes to instability of conventional maxillary advancement. Le Fort I advancement with distraction osteogenesis has emerged as viable, stable treatment modality correction of severe maxillary hyp...

  3. Le Fort III Distraction With Internal vs External Distractors: A Cephalometric Analysis.

    Science.gov (United States)

    Robertson, Kevin J; Mendez, Bernardino M; Bruce, William J; McDonnell, Brendan D; Chiodo, Michael V; Patel, Parit A

    2018-05-01

    This study compares the change in midface position following Le Fort III advancement using either rigid external distraction (group 1) or internal distraction (group 2). We hypothesized that, with reference to right-facing cephalometry, internal distraction would result in increased clockwise rotation and inferior displacement of the midface. Le Fort III osteotomies and standardized distraction protocols were performed on 10 cadaveric specimens per group. Right-facing lateral cephalograms were traced and compared across time points to determine change in position at points orbitale, anterior nasal spine (ANS), A-point, and angle ANB. Institutional. Twenty cadaveric head specimens. Standard subcranial Le Fort III osteotomies were performed from a coronal approach and adequately mobilized. The specified distraction mechanism was applied and advanced by 15 mm. Changes of position were calculated at various skeletal landmarks: orbitale, ANS, A-point, and ANB. Group 1 demonstrated relatively uniform x-axis advancement with minimal inferior repositioning at the A-point, ANS, and orbitale. Group 2 demonstrated marked variation in x-axis advancement among the 3 points, along with a significant inferior repositioning and clockwise rotation of the midface ( P External distraction resulted in more uniform advancement of the midface, whereas internal distraction resulted in greater clockwise rotation and inferior displacement. External distraction appears to provide increased vector control of the midface, which is important in creating a customized distraction plan based on the patient's individual occlusal and skeletal needs.

  4. Maxillary distraction osteogenesis at Le Fort-I level induces bone apposition at infraorbital rim.

    Science.gov (United States)

    Rattan, Vidya; Jena, Ashok Kumar; Singh, Satinder Pal; Utreja, Ashok Kumar

    2014-09-01

    The aim of this study is to evaluate whether there is any remodeling of bone at infraorbital rim following maxillary distraction osteogenesis (DO) at Le Fort-I level. Twelve adult subjects in the age range of 17-21 years with complete unilateral cleft lip and palate underwent advancement of the maxilla by DO. The effect of maxillary DO on the infraorbital rim remodeling was evaluated from lateral cephalograms recorded prior to the DO (T0), at the end of DO (T1), and at least 2-years after the DO (T2) by Walker's analysis. The ANOVA and two-tailed t test were used and probability value (P value) 0.05 was considered as statistically significant level. There was anterior movement of maxilla by 9.22 ± 3.27 mm and 7.67 ± 3.99 mm at the end of immediate (T1) and long-term (T2) follow-up of maxillary DO, respectively. The Walker's analysis showed 1.49 ± 1.22 mm and 2.31 ± 1.81 mm anterior movement of the infraorbital margin (Orbitale point) at the end of T1 and T2, respectively (P distraction osteogenesis at Le Fort-I level induced significant bone apposition at infraorbital rim. Patients with mild midface hypoplasia who would otherwise may be candidates for osteotomy at Le Fort-II or Le Fort-III level may benefit from maxillary distraction at Le Fort-I level.

  5. Tooth-borne distraction osteogenesis versus conventional Le Fort I in maxillary advancement of cleft lip and palate patients.

    Science.gov (United States)

    Jamilian, Abdolreza; Showkatbakhsh, Rahman; Behnaz, Mohammad; Ghassemi, Alireza; Kamalee, Zinat; Perillo, Letizia

    2018-01-31

    Distraction osteogenesis (DO) is rapidly becoming a mainstream surgical technique for correction of maxillary deficiency. The aim of this study was to compare the effectiveness of a newly designed tooth-borne osteogenic distraction device with conventional LeFort 1 osteotomy in maxillary advancement of cleft lip and palate patients. The DO group consisted of 10 subjects (7 males, 3 females) with a mean age of 21.2 (SD 4.2) years. In these patients, the newly designed distraction device which exerted force anteroposteriorly was cemented after mobilization of the maxilla. After a latency period of 7 days, the distractor was activated twice daily by a total amount of 0.5 mm per day. The activation was continued for 3 weeks. After an 8-week consolidation period, the distraction appliance was removed. Cephalograms of DO patients were obtained at the start of distraction and at the end of consolidation. The LeFort 1 group consisted of 11 subjects (6 males, 5 females) with a mean age of 22.3 (SD 3.7) years. Pre and post-surgery lateral cephalograms were obtained. T-Test and paired T-test were used to evaluate the data. At the end of treatment, the SNA angle of LeFort 1 patients increased by 5.5° (SD 2.3) (Pdistraction device can effectively advance the maxilla forward in patients with cleft lip.

  6. Craniofacial stability in patients with Crouzon or Apert syndrome after Le Fort III distraction osteogenesis

    NARCIS (Netherlands)

    Reitsma, J.H.; Ongkosuwito, E.M.; Buschang, P.H.; van Adrichem, L.N.A.; Prahl-Andersen, B.

    2013-01-01

    Objective: Le Fort III osteotomy with distraction osteogenesis (DO) is used to improve the retruded midface in patients with Crouzon or Apert syndrome. This study aimed to evaluate sagittal and vertical preoperative and postoperative cephalometric changes of DO of the midface in patients with

  7. Craniofacial stability in patients with crouzon or apert syndrome after le fort III distraction osteogenesis

    NARCIS (Netherlands)

    J.H. Reitsma (Jacobus Harmen); E.M. Ongkosuwito (Edwin); P.H. Buschang (Peter); L.N.A. V Adrichem (Léon); B. Prahl-Andersen (Birte)

    2013-01-01

    textabstractObjective: Le Fort III osteotomy with distraction osteogenesis (DO) is used to improve the retruded midface in patients with Crouzon or Apert syndrome. This study aimed to evaluate sagittal and vertical preoperative and postoperative cephalometric changes of DO of the midface in patients

  8. Maxillary distraction osteogenesis using Le Fort I osteotomy without intraoperative down-fracture.

    Science.gov (United States)

    Yamauchi, K; Mitsugi, M; Takahashi, T

    2006-06-01

    The aim of this study is to present a technique for maxillary distraction osteogenesis using Le Fort I osteotomy without down-fracture. Six cleft-related patients suffering from severe midfacial deficiency were treated with maxillary distraction osteogenesis. The RED II system was chosen as the extraoral device and the Leipzig retention plate system to anchor the maxillary segment. Maxillary distraction osteogenesis was successful in all cases. Cephalometric and clinical evaluation after an average follow-up period of 1 year showed stable results with respect to skeletal and dental relationships. The SNA angle increased from 72.3 degrees to 81.4 degrees and the ANB angle increased by 11.0 degrees immediately after removing the distraction device. After 1 year, the sagittal bone gain remained and the SNA angle had decreased by 0.8 degrees . This technique seems to minimize the risk of the surgical procedure and shorten the operation time. It may become an alternative method for the treatment of patients with severe midfacial hypoplasia.

  9. Le Fort I distraction using internal devices for maxillary hypoplasia in patients with cleft lip, palate, and alveolus: complications and their prevention and management.

    Science.gov (United States)

    Mitsukawa, Nobuyuki; Satoh, Kaneshige; Morishita, Tadashi

    2010-09-01

    In recent years, advancement has been made in distraction osteogenesis in the facial area. It has been applied actively to treat maxillary hypoplasia in patients with cleft lip, palate, and alveolus. Le Fort I distraction using internal devices does not lead to disability in daily living, including during the retention period, and has low surgical invasiveness, facile management, and superior aesthetics. Thus, there have been occasional reports on this procedure in recent years. Because an internal device is unidirectional, the greatest disadvantage is the inability to adjust the direction of distraction after its placement. However, past reports have emphasized its advantages, and its complications have rarely been discussed. We performed Le Fort I distraction using internal devices on 15 young patients. Our results showed notable complications in a few cases. When serial cephalometric analysis was performed after maxillary distraction, it demonstrated that the maxilla assumes various three-dimensional distraction morphologies. In particular, cases with insufficient bone grafting of alveolar clefts developed collapse mainly in the alveolar cleft region during postoperative distraction. Mobility and deviation of the maxillary bone fragment occurred. We implemented preventative measures against complications such as using modifications to place the devices parallel on the left and right sides and using a bite splint for distraction. These measures produced improved outcomes, and we describe here the details.

  10. Measurement of Distraction Force in Cleft Lip and Palate Patients During Le Fort I Maxillary Advancement With Rigid External Distraction.

    Science.gov (United States)

    Sawada, Hiromi; Ogawa, Takuya; Kataoka, Keiichi; Baba, Yoshiyuki; Moriyama, Keiji

    2017-03-01

    Maxillary distraction osteogenesis (DO) is a mainstream surgical technique for patients who have severe maxillary hypoplasia associated with craniofacial syndromes and cleft-related deformities. However, limited information about the biomechanical aspects of maxillary DO is available limiting broad utilization and improvements to the procedure. The objective of this study was to analyze force levels during the active distraction process and to investigate the relationship between distraction force and maxillary movement during Le Fort I maxillary DO using a rigid external distraction (RED) system. Microtension gauges were integrated into the distraction wires on each side of the RED system. Six patients with cleft lip and palate aged 12.8 to 23.5 years underwent strain gauge measurements during maxillary advancement with DO using an RED system. Lateral cephalograms were taken to measure maxillary horizontal, vertical, and linear movements after DO. The average linear maxillary movement was 11.2 mm (range 8.5-15.9 mm). The applied forces ranged from 13.4 to 26.8 N. The distance of maxillary movement was proportional to the distraction force. The measurement of distraction forces during DO provides important information with which to establish appropriate protocols. Patients requiring more advancement may require more distraction force. However, other factors such as scarring, patient anatomy, surgical freedom of the osteotomized maxilla, and the like, may affect the required force during DO with the RED system.

  11. Combined orthognathic distraction procedure: Le Fort I maxillary osteotomy and mandibular curvilinear distraction osteogenesis. A new technique for craniofacial management.

    Science.gov (United States)

    Schendel, Stephen A; Hazan-Molina, Hagai; Aizenbud, Dror

    2014-04-01

    Dentofacial deformities are traditionally treated by maxillary and mandibular osteotomies conducted separately or simultaneously. Recently, distraction osteogenesis has become an irreplaceable part of the surgical armamentarium, for its ability to induce new bone formation between the surfaces of bone segments that are gradually separated by incremental traction, along with a simultaneous expansion of the surrounding soft-tissue envelope. The aim of this article is to describe a combined surgical technique consisting of simultaneous maxillary Le Fort I advancement and mandibular surgical repositioning by means of bilateral sagittal split osteotomy with a curvilinear distractor based on a preliminary computerized presurgical prediction.

  12. Soft Tissue Changes in Cleft Lip and Palate Patients: Anterior Maxillary Distraction versus Conventional Le-Fort I Osteotomy.

    Science.gov (United States)

    Markose, Eldho; Paulose, Joby; Paul, Eldho T

    2013-12-01

    The purpose of the study was to compare the soft tissue changes after maxillary advancement in patients with maxillary deficiency associated with cleft lip and palate (CLP) by two approaches-anterior maxillary distraction (AMD) and advancement LeFort I osteotomy (ALO). Twenty patients with maxillary hypoplasia associated with cleft lip and palate who had undergone either LeFort I osteotomy or distraction osteogenesis with maxillary advancement were included in this study. Lateral cephalogram taken at various intervals of time were used to evaluate soft tissue and hard tissue changes over time. In both groups, vertical as well as horizontal changes in pronasale was well observed. A substantial increase in nasal parameters was noted in case of AMD group in comparison to ALO. Though maxillary advancement was evident in both the groups, a significant and consistent change was observed in AMD. Significant vertical and horizontal changes were seen with respect to subnasale and labrale superius in AMD group. Soft tissue as well as hard tissue relapse was greater in ALO group than AMD group. Significant soft tissue and hard tissue changes were clearly observed in both the groups, but the treatment results were more consistent in cases treated with AMD. Hence AMD could be considered as a better treatment of choice in cases of maxillary hypoplasia associated with cleft lip and palate.

  13. Photometric Evaluation of Soft Tissue Changes in CLP Patients: Le Fort I Advancement Osteotomy (ALO) Versus Anterior Maxillary Distraction (AMD).

    Science.gov (United States)

    Paulose, Joby; Markose, Eldho

    2014-12-01

    This paper is a comparative photometric evaluation of soft tissue changes in patients with CLP associated with maxillary deficiency treated with conventional Le Fort I advancement osteotomy (ALO) and anterior maxillary distraction (AMD). Twenty patients with maxillary hypoplasia associated with cleft lip and palate who had undergone either LeFort I osteotomy or distraction osteogenesis with maxillary advancement were included in this study. Frontal and profile photographs were used to ascertain the changes post-surgically. Photographs were obtained before treatment and 1 year after surgical correction in both groups. Vertical as well as horizontal changes in pronasale was well observed in both groups. A substantial increase in nasal parameters was noted in case of AMD group in comparison to ALO group. Though maxillary advancement was quite evident in AMD and ALO groups, a significant and consistent change was observed in AMD group. Significant vertical and horizontal changes were seen with respect to subnasale and labrale superius in AMD group. The hard and soft tissue changes produced by AMD by intra oral distractors were being evaluated so far. The results of the above studies have proved the excellence of AMD over conventional osteotomies. The present study goes hand in hand with the research outcomes till date.

  14. [Stimulation and evaluation on maxillary distraction osteogenesis using CASSOS 2001].

    Science.gov (United States)

    Zhu, Min; Qiu, Wei-liu; Tang, You-sheng; Li, Qing-yun

    2002-09-01

    To simulate maxillary distraction osteogenesis and evaluate the change of soft and hard tissue before and after treatment, using Computer-Assisted Simulation System for Orthognathic Surgery( CASSOS 2001). A fourteen-year-old boy with severe maxillary hypoplasia, due to unilateral cleft lip and palate, was analysed by cephalometric analysis. The simulations of maxillary distraction osteogenesis (Le Fort I osteotomy and Le Fort II osteotomy) were re-analysed. After the treatment, cephalometric analysis was preformed again. The data were compared. The maxillary hypoplasia was well treated using maxillary distraction osteogenesis; Compared with Le fort I osteotomy, more satisfactory results can be obtained by Le fort I distraction osteogenesis. Maxillary distraction osteogenesis is a better way to treat severe maxillary hypoplasia with operated CLP than maxillary osteotomy. CASSOS 2001 can help surgeons and patients on simulation and evaluation of maxillary distraction osteogenesis, and on decision of treatment plan.

  15. Computed tomographic analysis of temporal maxillary stability and pterygomaxillary generate formation following pediatric Le Fort III distraction advancement.

    Science.gov (United States)

    Hopper, Richard A; Sandercoe, Gavin; Woo, Albert; Watts, Robyn; Kelley, Patrick; Ettinger, Russell E; Saltzman, Babette

    2010-11-01

    Le Fort III distraction requires generation of bone in the pterygomaxillary region. The authors performed retrospective digital analysis on temporal fine-cut computed tomographic images to quantify both radiographic evidence of pterygomaxillary region bone formation and relative maxillary stability. Fifteen patients with syndromic midface hypoplasia were included in the study. The average age of the patients was 8.7 years; 11 had either Crouzon or Apert syndrome. The average displacement of the maxilla during distraction was 16.2 mm (range, 7 to 31 mm). Digital analysis was performed on fine-cut computed tomographic scans before surgery, at device removal, and at annual follow-up. Seven patients also had mid-consolidation computed tomographic scans. Relative maxillary stability and density of radiographic bone in the pterygomaxillary region were calculated between each scan. There was no evidence of clinically significant maxillary relapse, rotation, or growth between the end of consolidation and 1-year follow-up, other than a relatively small 2-mm subnasal maxillary vertical growth. There was an average radiographic ossification of 0.5 mm/mm advancement at the time of device removal, with a 25th percentile value of 0.3 mm/mm. The time during consolidation that each patient reached the 25th percentile of pterygomaxillary region bone density observed in this series of clinically stable advancements ranged from 1.3 to 9.8 weeks (average, 3.7 weeks). There was high variability in the amount of bone formed in the pterygomaxillary region associated with clinical stability of the advanced Le Fort III segment. These data suggest that a subsection of patients generate the minimal amount of pterygomaxillary region bone formation associated with advancement stability as early as 4 weeks into consolidation.

  16. Three-Dimensional Eyeball and Orbit Volume Modification After LeFort III Midface Distraction.

    Science.gov (United States)

    Smektala, Tomasz; Nysjö, Johan; Thor, Andreas; Homik, Aleksandra; Sporniak-Tutak, Katarzyna; Safranow, Krzysztof; Dowgierd, Krzysztof; Olszewski, Raphael

    2015-07-01

    The aim of our study was to evaluate orbital volume modification with LeFort III midface distraction in patients with craniosynostosis and its influence on eyeball volume and axial diameter modification. Orbital volume was assessed by the semiautomatic segmentation method based on deformable surface models and on 3-dimensional (3D) interaction with haptics. The eyeball volumes and diameters were automatically calculated after manual segmentation of computed tomographic scans with 3D slicer software. The mean, minimal, and maximal differences as well as the standard deviation and intraclass correlation coefficient (ICC) for intraobserver and interobserver measurements reliability were calculated. The Wilcoxon signed rank test was used to compare measured values before and after surgery. P eyeball volume were 0.87 and 0.86, respectively. The orbital volume increased significantly after surgery: 30.32% (mean, 5.96  mL) for the left orbit and 31.04% (mean, 6.31  mL) for the right orbit. The mean increase in eyeball volume was 12.3%. The mean increases in the eyeball axial dimensions were 7.3%, 9.3%, and 4.4% for the X-, Y-, and Z-axes, respectively. The Wilcoxon signed rank test showed that preoperative and postoperative eyeball volumes, as well as the diameters along the X- and Y-axes, were statistically significant. Midface distraction in patients with syndromic craniostenosis results in a significant increase (P eyeball volumes. The 2 methods (haptic-aided semiautomatic segmentation and manual 3D slicer segmentation) are reproducible techniques for orbit and eyeball volume measurements.

  17. [Biomechanical study of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate].

    Science.gov (United States)

    Hou, Min; Shi, Guang-Yu; Pu, Li-Chen; Song, Da-Li; Zhang, Xi-Zhong; Liu, Chun-Ming

    2009-09-01

    To investigate the biomechanical changes of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate (CLP). 3-D finite element (FEM) analysis was used. 3-D models of Le Fort I, II, III osteotomy and soft tissue were established. Based on the new pattern of internal midface distractor, the distraction of maxillary complex was simulated to advance 10 mm anteriorly. The mechanical change was studied. The maxillary complex in CLP were advanced after distraction. Constriction of alveolar crest and palate occurred in Le Fort I osteotomy, but not in Le Fort II and III osteotomy. The maxillary complex was moved anteriorly en bloc after Le Fort III osteotomy, but some degree of rotation of maxillary complex was observed during the distraction after Le Fort I and II osteotomy. In vertical direction, the maxillary complex had more counterclockwise rotation after Le Fort II osteotomy. 3-D FEM analysis can be used for the study of internal distraction. It can reflect the maxillary movement and provide the theory basis for preoperative design.

  18. Internal maxillary distraction with a new bimalar device.

    Science.gov (United States)

    Kahn, David M; Broujerdi, Joseph; Schendel, Stephen A

    2008-04-01

    Distraction osteogenesis of the Le Fort I segment is advocated for patients who require significant advancement of the maxilla or who have a soft tissue envelope compromised by scar tissue. We present a technique for maxillary distraction using an interconnecting intraoral device anchored to the malar prominences above the osteotomy and either the maxilla and/or the dentition below the level of the osteotomy. Ten patients with nonsyndromic cleft lip and palate, mean age of 18, underwent Le Fort I maxillary distraction osteogenesis for management of maxillary hypoplasia. A Le Fort I osteotomy is performed and a Spectrum Intraoral Midface Multi-Vector Distractor (OsteoMed, Addison, TX) is placed leaving a 1 mm to 2 mm distraction gap. After a 2 to 4 day latency period, distraction begins at a rate of 1 mm a day. Once the desired occlusion is achieved the device is left in place for a minimum of 2 months for consolidation. Preoperative Sella-Nasion-A point measurements from lateral cephalograms averaged 74 degrees (range, 70-76 degrees). Postoperative Sella-Nasion-A point averaged 81 degrees (range, 75-89 degrees). Preoperative overjet averaged -7.4 mm (range, -3 to -13 mm). Postoperative overjet averaged 2.6 mm (range, 1-3 mm). Average distraction was 9 mm (range, 6-16 mm). The average vertical movement was 7.2 mm in an inferior direction (range, 0-15 mm). The results remained stable at a follow-up of 30 months. We report on distraction of the Le Fort I segment using an internal device. The device design allows the forces of distraction to be shared across a larger surface area delivering a uniform and reliable vector of distraction with increased stability.

  19. [An adjustable distractor for transverse maxillary distraction osteogenesis].

    Science.gov (United States)

    Leyder, P; Wycisk, G; Quilichini, J

    2013-06-01

    The posterior skeletal widening in conventional distractions (Surgical Assisted Rapid Maxillary Expansion) is often modest, in contrast with a predominant anterior expansion. Until recently, it was not possible to consider transverse palatal distraction osteogenesis and Le Fort I impaction or advancement in the same procedure, as the osteosynthesis plates impeded maxillary anterior opening. We developed new sliding osteosynthesis plates allowing to perform an advancement or impaction Le Fort I osteotomy associated with a low-resistance bipartite palatal distraction osteogenesis. We had for aim to describe the device and to determine its clinical applications. This new palatal distractor is made up of two independent stainless steel jacks allowing for an adjustable distraction in the anterior or posterior area as needed. Bone-borne and tooth-borne versions are available. This new distractor can be adjusted sagittally. The distraction can be angular or parallel, and the distraction mode can be modified during post-operative distraction. This device should be adapted to all clinical presentations. It can be used in combination with sliding osteosynthesis to perform a Le Fort 1 osteotomy and at the same time a complete correction of vertical, horizontal, and sagittal deficiencies. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  20. Long-term follow-up of syndromic craniosynostosis after Le Fort III halo distraction: a cephalometric and CT evaluation.

    Science.gov (United States)

    Meazzini, Maria Costanza; Allevia, Fabiana; Mazzoleni, Fabio; Ferrari, Luca; Pagnoni, Mario; Iannetti, Giorgio; Bozzetti, Alberto; Brusati, Roberto

    2012-04-01

    Midface distraction osteogenesis (DO) in craniofacial synostosis (CFS) patients has been described by several authors. However, very few cephalometric and computed tomography (CT) long-term follow-up studies are available. A total of 40 consecutive patients affected by CFS subjected to Le Fort III and rigid external distraction (RED) were examined. All patients had pre-DO cephalometric records, immediately post-DO and 6-12 months post-DO. Twenty-seven patients had mid-term records (3 years post-DO) and 20 patients had long-term records (5-10 years post-DO). Fourteen patients had CT data within 1-year of DO, while 10 patients had long-term CT data (range 5-9 years). Excellent post-surgical stability was recorded. Short- and long-term CT data demonstrated excellent ossification at the osteotomy sites post-DO. In the growing patients, surface resorption in the zygomatic-temporal and in the subspinal area (p term follow-up, as well as a mild increment of the corrected exorbitism (p term, in growing patients, in general a class III malocclusion does not re-occur, but physiological remodelling processes at the maxillary-zygomatic level, not coupled with sutural growth, tend to mildly re-express the original midfacial phenotype and the exorbitism. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Vector alignment in maxillary distraction osteogenesis.

    Science.gov (United States)

    Uckan, Sina; Arman, Ayca; Bayram, Burak; Celik, Erkan

    2006-09-01

    Maxillary distraction osteogenesis is an alternative treatment of cleft patients with severe maxillary hypoplasia. The aim of this paper is to present the combined surgical/orthodontic treatment of a cleft lip and palate patient and to evaluate the maxillary distraction procedure and the distraction vector in high Le Fort I osteotomy.

  2. A minipig model of maxillary distraction osteogenesis.

    Science.gov (United States)

    Papadaki, Maria E; Troulis, Maria J; Glowacki, Julie; Kaban, Leonard B

    2010-11-01

    To establish a porcine model for maxillary distraction osteogenesis and to document the sequence of bone formation in the zone of advancement. Female Yucatan minipigs (n = 9) in the mixed dentition stage underwent modified Le Fort I osteotomy through a vestibular incision under general anesthesia. A unidirectional, semiburied Le Fort I distraction device was fixed across the osteotomy. The distraction protocol was 0-day latency, 1-mm/d rate for 12 days, and 24 days of fixation. Maxillary specimens (n = 9) were harvested and divided in half at the end of distraction (n = 6 sides), midfixation (n = 6), and the end of fixation (n = 6). Clinical stability, volume, and radiographic density across the zone of advancement were graded on semiquantitative scales. Specimens were stained with hematoxylin and eosin and examined with light microscopy. Animals tolerated the operation, the distraction and fixation periods. There were no infections and no devices failed. At the end of the distraction period, bone trabeculae were present at the periphery and fibrous tissues, and vessels, preosteoblasts, and osteoblasts were present in the center of the zone of advancement. Islands of chondrocyte-like cells appeared in 1 specimen each at midfixation and the end of fixation. At the end of fixation, clinical stability and radiographic density were graded 3/3 and bone formation was complete across the advancement zone in all specimens. A model for Le Fort I distraction osteogenesis was established. Intramembranous bone formation was the predominant mechanism of healing in the zone of advancement. Latency was not necessary for bone formation in this minipig model. Copyright © 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Corrected Cephalometric Analysis to Determine the Distance and Vector of Distraction Osteogenesis for Syndromic Craniosynostosis

    Science.gov (United States)

    Fukawa, Toshihiko; Hirakawa, Takashi; Satake, Toshihiko; Maegawa, Jiro

    2017-01-01

    Background: The purpose of this study was to confirm the utility of a corrected cephalometric analysis to facilitate the planning of distraction osteogenesis with Le Fort III osteotomy for syndromic craniosynostosis. Methods: This prospective study involved 4 male and 2 female patients (mean patient age, 8 years 9 months; age range, 4 years 6 months to 13 years 2 months) with Crouzon syndrome who were treated with Le Fort III maxillary distraction using our previously described system of analysis of a corrected cephalogram and who underwent clinical follow-up. Lateral cephalograms were obtained immediately after device removal. Results: Distraction of orbitale moved the vector downward to the adult profile, but there was slightly less elongation than the adult profile for the distraction distance. The desired and real mean angles after distraction of point A were 29.2 ± 7.9° and 6.1 ± 8.5°, respectively, and the desired and the real mean distances after distraction of point A were 30.6 ± 12.7 mm and 29.4 ± 4.1 mm, respectively. Conclusions: Using the corrected cephalometric analysis, the distance and vector of distraction osteogenesis with Le Fort III osteotomy could be determined in patients with syndromic craniosynostosis. The distraction system brought the patients' facial bones to the planned position using controlling devices. PMID:29062650

  4. Three-dimensional evaluation of nasal and pharyngeal airway after Le Fort I maxillary distraction osteogenesis.

    Science.gov (United States)

    Gokce, S M; Gorgulu, S; Karacayli, U; Gokce, H S; Battal, B

    2015-04-01

    The aims of this study were to evaluate volumetric changes in the nasal cavity (NC) and pharyngeal airway space (PAS) after Le Fort I maxillary distraction osteogenesis (MDO) using a three-dimensional (3D) simulation program, and to determine the effects of MDO on respiratory function during sleep with polysomnography (PSG). 3D computed tomography images were obtained and analyzed before surgery (T0) and at a mean 8.2 ± 1.2 months postsurgery (T1) (SimPlant-OMS software) for 11 male patients (mean age 25.3 ± 5.9 years) with severe skeletal class III anomalies related to maxillary retrognathia. The simulation of osteotomies and placement of distractors were performed on stereolithographic 3D models. NC and PAS were segmented separately on these models for comparison of changes between T0 and T1. PSG including the apnoea-hypopnoea index (AHI), sleep efficiency, sleep stages (weakness, stages 1-4, and rapid eye movement (REM)), and mean lowest arterial O2 saturation were obtained at T0 and T1 to investigate changes in respiratory function during sleep. MDO was successful in all cases as planned on the models; the average forward movement at A point was 10.2mm. Increases in NC and PAS volume after MDO were statistically significant. These increases resulted in significant improvement in sleep quality. PSG parameters changed after MDO; AHI and sleep stages weakness, 1, and 2 decreased, whereas REM, stages 3 and 4, sleep efficiency, and mean O2 saturation increased. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Anatomy of the Le Fort I segment: Are arterial variations a potential risk factor for avascular bone necrosis in Le Fort I osteotomies?

    Science.gov (United States)

    Bruneder, Simon; Wallner, Jürgen; Weiglein, Andreas; Kmečová, Ĺudmila; Egger, Jan; Pilsl, Ulrike; Zemann, Wolfgang

    2018-05-02

    Osteotomies of the Le Fort I segment are routine operations with low complication rates. Ischemic complications are rare, but can have severe consequences that may lead to avascular bone necrosis of the Le Fort I segment. Therefore the aim of this study was to investigate the blood supply and special arterial variants of the Le Fort I segment responsible for arterial hypoperfusion or ischemic avascular necrosis after surgery. The arterial anatomy of the Le Fort I segment's blood supply using 30 halved human cadaver head specimens was analyzed after complete dissection until the submicroscopic level. In all specimens the arterial variants of the Le Fort I segment and also the arterial diameters measured at two points were evaluated. The typical known vascularization pattern was apparent in 90% of all specimens, in which the ascending palatine (D1: 1,2 mm ± 0,34 mm; D2: 0,8 mm ± 0,34 mm) and ascending pharyngeal artery (D1: 1,3 mm ± 0,58 mm; D2: avascular segment necrosis after surgery. An individualized operation plan may prevent ischemic complications in at-risk patients. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  6. How Do Le Fort-Type Fractures Present in a Pediatric Cohort?

    Science.gov (United States)

    Macmillan, Alexandra; Lopez, Joseph; Luck, J D; Faateh, Muhammad; Manson, Paul; Dorafshar, Amir H

    2018-05-01

    Le Fort-type fractures are very rare in children, and there is a paucity of literature presenting their frequency and characteristics. The purpose of this study was to determine the etiology, frequency, and fracture patterns of children with severe facial trauma associated with pterygoid plate fractures in a pediatric cohort. We performed a retrospective cohort study of all children aged younger than 16 years with pterygoid plate and facial fractures who presented to our institute between 1990 and 2010. Patient charts and radiologic records were reviewed for demographic and fracture characteristics. Patients were categorized into 2 groups as per facial fracture pattern: non-Le Fort-type fractures (group A) and Le Fort-type fractures (group B). Other variables including dentition age, frontal sinus development, mechanism of injury, injury severity, and concomitant injuries were recorded. Univariate methods were used to compare groups. We identified 24 children; 25% were girls, and 20.8% were of nonwhite race. Most presented with Le Fort-type fracture patterns (group B, 66.7%). Age was significantly different between group A and group B (mean, 5.9 years and 9.9 years, respectively; P = .009). No significant differences in Injury Severity Score, rate of operative repair, and length of stay were found between groups. Most children with severe facial fractures and pterygoid plate fractures presented with Le Fort-type fracture patterns in our cohort. The mean age of children with Le Fort-type fractures was greater than in those with non-Le Fort-type patterns. However, Le Fort-type fractures did occur in younger children with deciduous and mixed dentition. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Corrected Cephalometric Analysis to Determine the Distance and Vector of Distraction Osteogenesis for Syndromic Craniosynostosis

    Directory of Open Access Journals (Sweden)

    Shinji Kobayashi, MD

    2017-09-01

    Conclusions:. Using the corrected cephalometric analysis, the distance and vector of distraction osteogenesis with Le Fort III osteotomy could be determined in patients with syndromic craniosynostosis. The distraction system brought the patients' facial bones to the planned position using controlling devices.

  8. Transantral distraction devices in correction of severe maxillary deformity in cleft patients.

    Science.gov (United States)

    Shokirov, Shokhruh; Wangerin, Konrad

    2011-01-01

    Maxillary advancement by Le Fort I osteotomy in cleft patients has an average relapse of about 40-60 percent. With extraoral distraction devices it is possible to obtain an almost unlimited advancement of the upper jaw. Due to the social problems the retention period is normally reduced to some monthes. A relapse of 10-25 % can be seen in these cases. Le Fort I internal distraction osteogenesis offers an alternative to one-step orthognathic advancement, with advantages of gradual lengthening through scar and earlier treatment in growing patients. The objective of this study was to present our experience in the treatment of maxillary deficiency in cleft patients using transantral internal distraction devices. The distraction procedure was successfully accomplished in seventeen patients. For all the seventeen patients maxillary distraction device designed by Konrad Wangerin was used. The distraction distances were 8 to 24 mm. Preoperative, postoperative, and follow-up (12 and 24 months) lateral cephalogram measurements were compared including angular and linear changes. A good new bone was found that was formed in distraction pitch between lines of osteotomy. After distraction of median facial zone, occlusion and profile of soft tissues were considerably improved. All patients after postoperative time required final orthodontic treatment and their final occlusal relationships were satisfactory. The transantral distraction device is a new option for the treatment of severe maxillary hypoplasia in cleft patients.

  9. Maxillary Distraction Osteogenesis in Unilateral Cleft Lip and Palate Patients with Rigid External Distraction System.

    Science.gov (United States)

    Alkhouri, Shadi; Waite, Peter D; Davis, Matthew B; Lamani, Ejvis; Kau, Chung How

    2017-01-01

    Distraction osteogenesis (DO) is a treatment option for patients with maxillary hypoplasia secondary to cleft lip and palate (CLP). The aim of this study is to present a technique for maxillary DO using Le Fort I osteotomy with rigid external distraction (RED) system. The patient presented in this paper was an Asian female with CLP aged 13 years and 6 months. She presented with severe midfacial deficiency with a Class III dental malocclusion with a negative overjet and concave facial profile. Cone-beam computed tomography images were recorded preoperatively and the operation performed involved a high Le Fort I osteotomy. The appliance fabricated was banded to upper first molars used for anchorage of the RED system. Distraction of the maxilla was initiated after 7-day latency period. Postoperative cephalometric analysis showed maxillary advancement anteriorly and superiorly, the total distraction treatment period was 10 days. The maxillary advancement was 10.5 mm and the SNA angle increased from 67.5° to 77.9°. Furthermore, the ANB angle changed from -9.8° to 1.6° and the occlusion changed from Class III to Class I. The profile of the face changed from concave to convex and a much better esthetic result was achieved. The study suggests RED system to be a reliable alternative procedure for the treatment of midfacial hypoplasia with or without cleft. Furthermore, it minimizes the risk of the surgical procedure and shortens the operating time.

  10. Cranial nerve injury after Le Fort I osteotomy.

    Science.gov (United States)

    Kim, J-W; Chin, B-R; Park, H-S; Lee, S-H; Kwon, T-G

    2011-03-01

    A Le Fort I osteotomy is widely used to correct dentofacial deformity because it is a safe and reliable surgical method. Although rare, various complications have been reported in relation to pterygomaxillary separation. Cranial nerve damage is one of the serious complications that can occur after Le Fort I osteotomy. In this report, a 19-year-old man with unilateral cleft lip and palate underwent surgery to correct maxillary hypoplasia, asymmetry and mandibular prognathism. After the Le Fort I maxillary osteotomy, the patient showed multiple cranial nerve damage; an impairment of outward movement of the eye (abducens nerve), decreased vision (optic nerve), and paraesthesia of the frontal and upper cheek area (ophthalmic and maxillary nerve). The damage to the cranial nerve was related to an unexpected sphenoid bone fracture and subsequent trauma in the cavernous sinus during the pterygomaxillary osteotomy. Copyright © 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  11. Treatment of maxillary cleft palate: Distraction osteogenesis vs. orthognathic surgery

    Science.gov (United States)

    Rachmiel, Adi; Even-Almos, Michal; Aizenbud, Dror

    2012-01-01

    Purpose: The purpose of this paper is to compare the treatment of hypoplastic, retruded maxillary cleft palate using distraction osteogenesis vs. orthognathic surgery in terms of stability and relapse, growth after distraction and soft tissue profile changes. Materials and Methods: The cleft patients showed anteroposterior maxillary hypoplasia with class III malocclusion and negative overjet resulting in a concave profile according to preoperative cephalometric measurements, dental relationship, and soft tissue analysis. The patients were divided in two groups of treatment : S0 eventeen were treated by orthognathic Le Fort I osteotomy fixed with four mini plates and 2 mm screws, and 19 were treated by maxillary distraction osteogenesis with rigid extraoral devices (RED) connected after a Le Fort I osteotomy. The rate of distraction was 1 mm per day to achieve Class I occlusion with slight overcorrection and to create facial profile convexity. Following a 10 week latency period the distraction devices were removed. Results: In the RED group the maxilla was advanced an average of 15.80 mm. The occlusion changed from class III to class I. The profile of the face changed from concave to convex. At a 1-year follow up the results were stable. The mean orthognathic movement was 8.4 mm. Conclusion: In mild maxillary deficiency a one stage orthognathic surgery is preferable. However, in patients requiring moderate to large advancements with significant structural deficiencies of the maxilla or in growing patients the distraction technique is preferred. PMID:23483803

  12. Comparison of maxillary stability after Le Fort I osteotomy for occlusal cant correction surgery and maxillary advanced surgery.

    Science.gov (United States)

    Ueki, Koichiro; Hashiba, Yukari; Marukawa, Kohei; Yoshida, Kan; Shimizu, Chika; Nakagawa, Kiyomasa; Yamamoto, Etsuhide

    2007-07-01

    To compare postoperative maxillary stability following Le Fort I osteotomy for the correction of occlusal cant as compared with conventional Le Fort I osteotomy for maxillary advancement. The subjects were 40 Japanese adults with jaw deformities. Of these, 20 underwent a Le Fort I osteotomy and intraoral vertical ramus osteotomy (IVRO) to correct asymmetric skeletal morphology and inclined occlusal cant. The other 20 patients underwent a Le Fort I osteotomy and sagittal split ramus osteotomy (SSRO) to advance the maxilla. Lateral and posteroanterior cephalograms were taken postoperatively and assessed statistically. Thereafter, the 2 groups were followed for time-course changes. There was no significant difference between the 2 groups with regard to time-course changes during the immediate postoperative period. This suggests that maxillary stability after Le Fort I osteotomy for cant correction does not differ from that after Le Fort I osteotomy for maxillary advancement.

  13. One-step transversal palatal distraction and maxillary repositioning: technical considerations, advantages, and long-term stability.

    Science.gov (United States)

    Cortese, Antonio; Savastano, Mauro; Savastano, Germano; Claudio, Pier Paolo

    2011-09-01

    Transversal maxillary hypoplasia in adolescence is a frequently seen pathology, which can be treated with a combination of surgery and orthodontic treatment to widen the maxilla in skeletally matured patients.We evaluated the advantages of a new surgical technique: Le Fort I distraction osteogenesis using a bone-borne device. Because relapse is one of the main problems in surgical maxillary expansion, long-term stability of this new technique was evaluated. Data from 4 adult patients with maxillary restriction, class III malocclusion, or maxillary malposition were collected preoperatively, 4 months after distraction, and 5 years after distraction. Measurements were recorded on dental models to detect palatal expansion at dental level; cephalograms by lateral and posteroanterior plane were analyzed to detect maxillary movements. Maxillary measurements were substantially stable 5 years after distractions. Only minor dental movements occurred at the dental analysis after 5 years related to a lack of orthodontic contention without any compromise of the dental result (no crossbite relapse and class I stability). Le Fort I with down-fracture for expansion and repositioning by bone-borne distractor device can [corrected] be used to simultaneously widen, advance, and vertically reposition the maxilla without causing healing problems, particularly using a rigid distraction device. Long-term stability can be achieved; however, further studies with a larger number of patients will be necessary for better evaluation.

  14. Correction of malocclusion and oral rehabilitation in a case of amelogenesis imperfecta by insertion of dental implants followed by Le Fort I distraction osteogenesis of the edentulous atrophic maxilla.

    Science.gov (United States)

    Apaydin, Aysegul; Sermet, Bulent; Ureturk, Sevin; Kundakcioglu, Abdulsamet

    2014-09-17

    Amelogenesis imperfecta refers a group of hereditary diseases affecting the teeth and can present a variety of clinical forms and appearances, compromising esthetic appearance. Amelogenesis imperfecta variably reduces oral health quality and can result in severe psychological problems. We present the management of an amelogenesis imperfecta Angle class III malocclusion case with speech, esthetics and functional problems. This is an example of the rarely presented delayed eruption with multiple morphologic dental alterations and edentulous maxilla.There are only a few available reports in which this method is used method to correct sagittal discrepancies in edentulous patients.Our treatment plan consisted of a preoperative diagnostic and prosthodontics phase (including preparation of guiding prosthesis), followed by a surgical phase of Le Fort I osteotomy, distraction osteogenesis to correct the malocclusion, implant insertion and a follow up final restorative phase. Our treatment strategy attempts to serve patient needs, achieving function and esthetics while also minimizing the risk of reconstruction failure. Treatment not only restored function and esthetics, but also showed a positive psychological impact and thereby improved perceived quality of life.

  15. Surgical risk factors and maxillary nerve function after le fort I osteotomy

    DEFF Research Database (Denmark)

    Thygesen, Torben Henrik; Jensen, Allan Bardow; Norholt, SE

    2009-01-01

    PURPOSE: Data on intraoperative risk factors for long-term postoperative complications after Le Fort I osteotomy (LFO) are limited. The aim of this study was to describe prospectively the overall postoperative changes in maxillary nerve function after LFO, and to correlate these changes with a nu......PURPOSE: Data on intraoperative risk factors for long-term postoperative complications after Le Fort I osteotomy (LFO) are limited. The aim of this study was to describe prospectively the overall postoperative changes in maxillary nerve function after LFO, and to correlate these changes...

  16. Changes in speech following maxillary distraction osteogenesis.

    Science.gov (United States)

    Guyette, T W; Polley, J W; Figueroa, A; Smith, B E

    2001-05-01

    The purpose of this study was to describe changes in articulation and velopharyngeal function following maxillary distraction osteogenesis. This is a descriptive, post hoc clinical report comparing the performance of patients before and after maxillary distraction. The independent variable was maxillary distraction while the dependent variables were resonance, articulation errors, and velopharyngeal function. The data were collected at a tertiary health care center in Chicago. The data from pre- and postoperative evaluations of 18 maxillary distraction patients were used. The outcome measures were severity of hypernasality and hyponasality, velopharyngeal orifice size as estimated using the pressure-flow technique, and number and type of articulation errors. At the long-term follow-up, 16.7% exhibited a significant increase in hypernasality. Seventy-five percent of patients with preoperative hyponasality experienced improved nasal resonance. Articulation improved in 67% of patients by the 1-year follow-up. In a predominately cleft palate population, the risk for velopharyngeal insufficiency following maxillary distraction is similar to the risk observed in Le Fort I maxillary advancement. Patients being considered for maxillary distraction surgery should receive pre- and postoperative speech evaluations and be counseled about risks for changes in their speech.

  17. [Mandibular-driven simultaneous maxillo-mandibular distraction for hemifacial microsomia with rapid prototyping technology].

    Science.gov (United States)

    Gao, Quan-Wen; Song, Hui-Feng; Xu, Ming-Huo; Liu, Chun-Ming; Chai, Jia-Ke

    2013-11-01

    To explore the clinical application of mandibular-driven simultaneous maxillo-mandihular distraction to correct hemifacial microsomia with rapid prototyping technology. The patient' s skull resin model was manufactured with rapid prototyping technology. The osteotomy was designed on skull resin model. According to the preoperative design, the patients underwent Le Fort I osteotomy and mandibular ramus osteotomy. The internal mandible distractor was embedded onto the osteotomy position. The occlusal titanium pin was implanted. Distraction were carried out by mandibular-driven simultaneous maxillo-mandihular distraction 5 days after operation. The distraction in five patients was complete as designed. No infection and dysosteogenesis happened. The longest distance of distraction was 28 mm, and the shortest distance was 16 mm. The facial asymmetry deformity was significantly improved at the end of distraction. The ocelusal plane of patients obviously improved. Rapid prototyping technology is helpful to design precisely osteotomy before operation. Mandibular-driven simultaneous maxillo-mandibular distraction can correct hemifacial microsomia. It is worth to clinical application.

  18. Blood-flow change and recovery of sensibility in the maxillary dental pulp during and after maxillary distraction: a pilot study.

    Science.gov (United States)

    Harada, Kiyoshi; Sato, Masaru; Omura, Ken

    2004-11-01

    To examine the change in blood flow and recovery of sensibility in the maxillary dental pulp during and after maxillary distraction. The subjects included 5 patients undergoing high Le Fort I osteotomy and maxillary distraction (D-group) and a reference group of 14 patients who underwent a common single-segment Le Fort I osteotomy, 1-stage maxillary advancement, and mandibular setback surgery (C-group). Eleven (D-group) and 54 (C-group) maxillary incisors were assessed preoperatively and at 1-7 days, 14 days, and 3 months postoperatively. Pulpal blood flow (PBF) was measured by laser Doppler flowmetry, and pulpal sensibility (PS) was investigated by electrodiagnostics. From postoperative days 1 to 5 (the latency period), the PBF tended to be higher in the D-group than in the C-group. From day 6 to 3 months postoperatively (during and after maxillary distraction), the PBF values of the 2 groups were similar. The PS remained negative up to 14 days postoperatively in both groups. However, at 3 months after the operation, a higher proportion (90.9%) of teeth in the D-group was positive for PS. These results suggest that maxillary distraction is a favorable technique for maintenance of PBF and recovery of PS in the maxillary teeth after surgery.

  19. Long-term follow-up of early cleft maxillary distraction.

    Science.gov (United States)

    Park, Young-Wook; Kwon, Kwang-Jun; Kim, Min-Keun

    2016-12-01

    Most of cleft lip and palate patients have the esthetic and functional problems of midfacial deficiencies due to innate developmental tendency and scar tissues from repeated operations. In these cases, maxillary protraction is required for the harmonious facial esthetics and functional occlusion. A 7-year old boy had been diagnosed as severe maxillary constriction due to unilateral complete cleft lip and palate. The author tried to correct the secondary deformity by early distraction osteogenesis with the aim of avoiding marked psychological impact from peers of elementary school. From 1999 to 2006, repeated treatments, which consisted of Le Fort I osteotomy and face mask distraction, and complementary maxillary protraction using miniplates were performed including orthodontics. But, final facial profile was not satisfactory, which needs compromising surgery. The result of this study suggests that if early distraction treatment is performed before facial skeletal growth is completed, an orthognathic surgery or additional distraction may be needed later. Maxillofacial plastic and reconstructive surgeons should notify this point when they plan early distraction treatment for cleft maxillary deformity.

  20. Asymmetric Anterior Distraction for Transversely Distorted Maxilla and Midfacial Anteroposterior Deficiency in a Patient With Cleft Lip/Palate: Two-Stage Surgical Approach.

    Science.gov (United States)

    Hirata, Kae; Tanikawa, Chihiro; Aikawa, Tomonao; Ishihama, Kohji; Kogo, Mikihiko; Iida, Seiji; Yamashiro, Takashi

    2016-07-01

    The present report describes a male patient with a unilateral cleft lip and palate who presented with midfacial anteroposterior and transverse deficiency. Correction involved a two-stage surgical-orthodontic approach: asymmetric anterior distraction of the segmented maxilla followed by two-jaw surgery (LeFort I and bilateral sagittal splitting ramus osteotomies). The present case demonstrates that the asymmetric elongation of the maxilla with anterior distraction is an effective way to correct a transversely distorted alveolar form and midfacial anteroposterior deficiency. Furthermore, successful tooth movement was demonstrated in the new bone created by distraction.

  1. Segmental maxillary distraction with a novel device for closure of a wide alveolar cleft.

    Science.gov (United States)

    Bousdras, Vasilios A; Liyanage, Chandra; Mars, Michael; Ayliffe, Peter R

    2014-01-01

    Treatment of a wide alveolar cleft with initial application of segmental distraction osteogenesis is reported, in order to minimise cleft size prior to secondary alveolar bone grafting. The lesser maxillary segment was mobilised with osteotomy at Le Fort I level and, a novel distractor, facilitated horizontal movement of the dental/alveolar segment along the curvature of the maxillary dental arch. Following a latency period of 4 days distraction was applied for 7 days at a rate of 0.5 mm twice daily. Radiographic, ultrasonographic and clinical assessment revealed new bone and soft tissue formation 8 weeks after completion of the distraction phase. Overall the maxillary segment did move minimising the width of the cleft, which allowed successful closure with a secondary alveolar bone graft.

  2. Dimensions of Velopharyngeal Space following Maxillary Advancement with Le Fort I Osteotomy Compared to Zisser Segmental Osteotomy: A Cephalometric Study

    Directory of Open Access Journals (Sweden)

    Furkan Erol Karabekmez

    2015-01-01

    Full Text Available The objectives of this study are to assess the velopharyngeal dimensions using cephalometric variables of the nasopharynx and oropharynx as well as to compare the Le Fort I osteotomy technique to Zisser’s anterior maxillary osteotomy technique based on patients’ outcomes within early and late postoperative follow-ups. 15 patients with severe maxillary deficiency treated with Le Fort I osteotomy and maxillary segmental osteotomy were assessed. Preoperative, early postoperative, and late postoperative follow-up lateral cephalograms, patient histories, and operative reports are reviewed with a focus on defined cephalometric landmarks for assessing velopharyngeal space dimension and maxillary movement (measured for three different tracing points. A significant change was found between preoperative and postoperative lateral cephalometric measurements regarding the distance between the posterior nasal spine and the posterior pharyngeal wall in Le Fort I osteotomy cases. However, no significant difference was found between preoperative and postoperative measurements in maxillary segmental osteotomy cases regarding the same measurements. The velopharyngeal area calculated for the Le Fort I osteotomy group showed a significant difference between the preoperative and postoperative measurements. Le Fort I osteotomy for advancement of upper jaw increases velopharyngeal space. On the other hand, Zisser’s anterior maxillary segmental osteotomy does not alter the dimension of the velopharyngeal space significantly.

  3. Gynecologic Malignancies Post-LeFort Colpocleisis

    Directory of Open Access Journals (Sweden)

    Rayan Elkattah

    2014-01-01

    Full Text Available Introduction. LeFort colpocleisis (LFC is a safe and effective obliterative surgical option for older women with advanced pelvic organ prolapse who no longer desire coital activity. A major disadvantage is the limited ability to evaluate for post-LFC gynecologic malignancies. Methods. We present the first case of endometrioid ovarian cancer diagnosed after LFC and review all reported gynecologic malignancies post-LFC in the English medical literature. Results. This is the second reported ovarian cancer post-LFC and the first of the endometrioid subtype. A total of nine other gynecologic malignancies post-LFC have been reported in the English medical literature. Conclusions. Gynecologic malignancies post-LFC are rare. We propose a simple 3-step strategy in evaluating post-LFC malignancies.

  4. Neurosensory changes of palatal mucousa following Le Fort I osteotomy

    Directory of Open Access Journals (Sweden)

    Bijan Movahedian Attar

    2009-09-01

    Full Text Available

    • BACKGROUND: This study evaluated the sensation of palatal ucosa before and after Le Fort I osteotomy and compared it based on whether greater palatine nerve has been dissected or not.
    • METHODS: Sixteen patients were studied within one week before  urgery and then one week, 6 weeks, 3 months and 6 months after surgery. Four tests including sharp-blunt discrimination, cold perception, pin prick sensation and electrical stimulation were performed.
    • RESULTS: Mean values of electrical stimulation were significantly higher 6 months after surgery (p < 0.05, on the other hand mean values of pin-prick sensation were significantly lower (p < 0.05. All patients regardless of the condition of greater palatine nerve were responsive to cold perception and sharp-blunt discrimination 6 months after surgery.
    • CONCLUSIONS: Following Le Fort I osteotomy, palatal  esponsiveness to electrical stimulation decreases and mechanical hyper sensitization occurs. Dissection of greater palatine nerve was shown to have no effect on the results.
    • KEYWORDS: Lefort I Osteotomy, Palatal Mocousa, Nerve Recovery.

  5. Simultaneous maxillary distraction osteogenesis using a twin-track distraction device combined with alveolar bone grafting in cleft patients: preliminary report of a technique.

    Science.gov (United States)

    Suzuki, Eduardo Yugo; Watanabe, Masayo; Buranastidporn, Boonsiva; Baba, Yoshiyuki; Ohyama, Kimie; Ishii, Masatoshi

    2006-01-01

    The simultaneous use of cleft reduction and maxillary advancement by distraction osteogenesis has not been applied routinely because of the difficulty in three-dimensional control and stabilization of the transported segments. This report describes a new approach of simultaneous bilateral alveolar cleft reduction and maxillary advancement by distraction osteogenesis combined with autogenous bone grafting. A custom-made Twin-Track device was used to allow bilateral alveolar cleft closure combined with simultaneous maxillary advancement, using distraction osteogenesis and a rigid external distraction system in a bilateral cleft lip and palate patient. After a maxillary Le Fort I osteotomy, autogenous iliac bone graft was placed in the cleft spaces before suturing. A latency period of six days was observed before activation. The rate of activation was one mm/d for the maxillary advancement and 0.5 mm/d for the segmental transport. Accordingly, the concave facial appearance was improved with acceptable occlusion, and complete bilateral cleft closure was attained. No adjustments were necessary to the vector of the transported segments during the activation and no complications were observed. The proposed Twin-Track device, based on the concept of track-guided bone transport, permitted three-dimensional control over the distraction processes allowing simultaneous cleft closure, maxillary distraction, and autogenous bone grafting. The combined simultaneous approach is extremely advantageous in correcting severe deformities, reducing the number of surgical interventions and, consequently, the total treatment time.

  6. Trans-sinusal maxillary distraction for correction of midfacial hypoplasia: long-term clinical results.

    Science.gov (United States)

    Nadjmi, N; Schutyser, F; Van Erum, R

    2006-10-01

    Maxillary distraction osteogenesis is indicated in severe angle class III malocclusions, and severe maxillary hypoplasia among some cleft patients and other craniofacial deformities. Twenty patients, aged 8-48 years (mean 17.8+/-10.5 SD) with maxillary and midfacial hypoplasia were treated. The follow-up period was 13-65 months (mean 35+/-16.3 SD). A trans-sinusal maxillary distractor was placed intraorally at each side of the maxilla. The distraction vector was predicted using specialist software, and was transferred to the patients using stereolithographic models and individual templates. A (high) Le Fort I type osteotomy was performed. The amount of activation varied from 8 to 17.5 mm (mean 13.1+/-2.9 SD). Soft and hard tissue formation resulted in complete healing across the distraction gaps. The distractors are almost completely submerged, and can be left in place as long as necessary to avoid relapse. Wit's appraisal was used to measure the stability of the long-term distraction results. Results up to 5 years after distraction showed considerable maxillary advancement with long-term stability. Ongoing growth of the facial skeleton must be considered when distraction osteogenesis is chosen in growing patients.

  7. Assessment of pterygomaxillary separation in Le Fort I Osteotomy in class III patients.

    Science.gov (United States)

    Ueki, Koichiro; Hashiba, Yukari; Marukawa, Kohei; Okabe, Katsuhiko; Alam, Shamiul; Nakagawa, Kiyomasa; Yamamoto, Etsuhide

    2009-04-01

    To examine the separation of the pterygomaxillary region at the posterior nasal spine level after Le Fort I osteotomy in Class III patients. The study group consisted of 37 Japanese patients with mandibular prognathism and asymmetry, with maxillary retrognathism or asymmetry. A total of 74 sides were examined. Le Fort I osteotomy was performed without a pterygoid osteotome, with an ultrasonic curette used to remove interference at the pterygomaxillary region. Postoperative computed tomography (CT) was analyzed for all patients. The separation of the pterygomaxillary region and the location of the descending palatine artery were assessed. Although acceptable separation between the maxilla and pterygoid plates was achieved in all patients, an exact separation of the pterygomaxillary junction at the posterior nasal spine level was found in only 18 of 74 sides (24%). In 29 of 74 sides (39.2%), the separation occurred anterior to the descending palatine artery. In 29 of 74 sides (39.2%), complete separation between the maxilla and lateral and/or medial pterygoid plate was not achieved, but lower level separation of the maxilla and pterygoid plate was always complete. The maxillary segments could be moved to the postoperative ideal position in all cases. Le Fort I osteotomy without an osteotome does not always induce an exact separation at the pterygomaxillary junction at the posterior nasal spine level, but the ultrasonic bone curette can remove the interference between maxillary segment and pterygoid plates more safely.

  8. Anterior maxillary distraction using a tooth-borne device for hypoplastic cleft maxillas-a pilot study.

    Science.gov (United States)

    Richardson, Sunil; Agni, Nisheet A; Selvaraj, Dhivakar

    2011-12-01

    The management of maxillary retrusion in a patient with cleft lip and palate is performed using Le Fort I advancement or distraction osteogenesis using an external or an internal device. Distraction mostly involves movement of the entire maxilla at the Le Fort I level and is characterized by a higher relapse rate and a hampering of speech. Hence, distraction of the anterior maxilla was performed using a tooth-borne palatal distractor similar to the one proposed by Gunaseelan et al (J Oral Maxillofac Surg 65:1044, 2007). However, the technique was modified by placing the distractor preoperatively before performing the osteotomy cut. The main advantage of this modification is that more control over the vector can be achieved and chances of cement failure caused by contamination and an inability to achieve isolation is drastically decreased. This study investigated the efficacy and stability of anterior maxillary distraction in the management of cleft maxillary retrognathia and any resulting complications. Fourteen patients older than 12 years with cleft maxillary retrognathia were included in the study irrespective of gender, type of cleft lip and palate, and the amount of advancement needed. The patients were evaluated using Orthopantomogram and lateral cephalograms preoperatively and at 3 months postoperatively (ie, before appliance removal) and at 6 months postoperatively. The distractor was fabricated extraorally on a cast and cemented into the patient's mouth the day before surgery. The initial deficiency, amount of advancement achieved, and relapses at 6 months, if any, were studied. The data were tabulated and analyzed. Only 1 of the 14 patients showed a relapse, of 2 mm, because this patient was lost to follow-up and thus delayed tooth replacement. Anterior maxillary distraction with a tooth-borne device is a feasible modality for the management of cleft maxillary retrognathia, with stable results. Copyright © 2011 American Association of Oral and

  9. Distraction osteogenesis therapy in patients affected by Goldenhar syndrome: a case series

    Directory of Open Access Journals (Sweden)

    Francesco Grecchi

    2011-06-01

    Full Text Available Background: Hemifacial microsomia (HM is a syndrome characterized by the presence of structural alterations of the skeletal, nervous, vascular, and muscular structures derived from the first and second branchial arch. Goldenhar syndrome (Gs consistisof the triad of craniofacial microsomia, ocular dermoid cysts, and spinal anomalies. When the patient has hypoplasia of the mandible, orthognatic surgery or distraction osteogenesis (DO can be used to correct the asymmetry. Mandibular DO has been applied for many years, but long-term reports showed controversial results. The aim of this paper is to describe three cases of patients affected by Gs in which DO was performed to correct the mandibular asymmetry. Case series: The cases reported show an increasing degree of dismorphism which required a increasing complexity of the surgical approach: a single mandibular DO in the first patient, and a mandibular DO associated with a Le Fort I osteotomy in the second one, a double mandibular DO associated with Le Fort I and surgical disjunction of the middle palatal suture in the third case. Discussion: The effects of DO involve not only the skeletal segment but also all the surrounding soft tissues. DO leads to rapid and remarkable improvement in facial symmetry due to emimandible hypoplasia. When correct spatial repositioning of the maxilla cann ot be expected, mandibular DO can be carried out by associating a Le Fort I osteotomy. In this way DO minimize the need for major osteotomies and allows an earlier treatment in selected cases.

  10. Biomechanical testing of zirconium dioxide osteosynthesis system for Le Fort I advancement osteotomy fixation.

    Science.gov (United States)

    Hingsammer, Lukas; Grillenberger, Markus; Schagerl, Martin; Malek, Michael; Hunger, Stefan

    2018-01-01

    The following work is the first evaluating the applicability of 3D printed zirconium dioxide ceramic miniplates and screws to stabilize maxillary segments following a Le-Fort I advancement surgery. Conventionally used titanium and individual fabricated zirconium dioxide miniplates were biomechanically tested and compared under an occlusal load of 120N and 500N using 3D finite element analysis. The overall model consisted of 295,477 elements. Under an occlusal load of 500N a safety factor before plastic deformation respectively crack of 2.13 for zirconium dioxide and 4.51 for titanium miniplates has been calculated. From a biomechanical point of view 3D printed ZrO 2 mini-plates and screws are suggested to constitute an appropriate patient specific and metal-free solution for maxillary stabilization after Le Fort I osteotomy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. The role of computer-aided 3D surgery and stereolithographic modelling for vector orientation in premaxillary and trans-sinusoidal maxillary distraction osteogenesis.

    Science.gov (United States)

    Varol, Altan; Basa, Selçuk

    2009-06-01

    Maxillary distraction osteogenesis is a challenging procedure when it is performed with internal submerged distractors due to obligation of setting accurate distraction vectors. Five patients with severe maxillary retrognathy were planned with Mimics 10.01 CMF and Simplant 10.01 software. Distraction vectors and rods of distractors were arranged in 3D environment and on STL models. All patients were operated under general anaesthesia and complete Le Fort I downfracture was performed. All distractions were performed according to orientated vectors. All patients achieved stable occlusion and satisfactory aesthetic outcome at the end of the treatment period. Preoperative bending of internal maxillary distractors prevents significant loss of operation time. 3D computer-aided surgical simulation and model surgery provide accurate orientation of distraction vectors for premaxillary and internal trans-sinusoidal maxillary distraction. Combination of virtual surgical simulation and stereolithographic models surgery can be validated as an effective method of preoperative planning for complicated maxillofacial surgery cases.

  12. Use of anterior maxillary distraction osteogenesis in two cleft lip and palate patients

    Science.gov (United States)

    Srivastava, Dhirendra; Ghassemi, Alireza; Ghassemi, Mehrangiz; Showkatbakhsh, Rahman; Jamilian, Abdolreza

    2015-01-01

    Distraction osteogenesis (DO) has become a mainstream surgical technique for patients with jaw deformities. The aim of this study was to report the effect of DO done by a hyrax screw incorporated in an acrylic plate in the treatment of two maxillary deficient cases with cleft lip and palate. Two patients, a 24-year-old female and a 29-year-old male who suffered from maxillary deficiency and cleft lip and palate, were treated by DO. After making vertical cuts between the premolars on both sides and horizontal cuts similar to Le Fort 1, a hyrax screw was mounted on an acrylic plate for the slow anteroposterior expansion of maxillary arch. The expansion was achieved by turning the hyrax screw 0.8 mm per day after the latency period. Treatment was discontinued after achieving satisfactory over jet and occlusion. This study showed that anterior maxillary distraction is a reliable technique for correction of midfacial deformity arising out of cleft lip and palate. Incidences of complications are negligible compared to total maxillary distraction. PMID:26668459

  13. Use of anterior maxillary distraction osteogenesis in two cleft lip and palate patients.

    Science.gov (United States)

    Srivastava, Dhirendra; Ghassemi, Alireza; Ghassemi, Mehrangiz; Showkatbakhsh, Rahman; Jamilian, Abdolreza

    2015-01-01

    Distraction osteogenesis (DO) has become a mainstream surgical technique for patients with jaw deformities. The aim of this study was to report the effect of DO done by a hyrax screw incorporated in an acrylic plate in the treatment of two maxillary deficient cases with cleft lip and palate. Two patients, a 24-year-old female and a 29-year-old male who suffered from maxillary deficiency and cleft lip and palate, were treated by DO. After making vertical cuts between the premolars on both sides and horizontal cuts similar to Le Fort 1, a hyrax screw was mounted on an acrylic plate for the slow anteroposterior expansion of maxillary arch. The expansion was achieved by turning the hyrax screw 0.8 mm per day after the latency period. Treatment was discontinued after achieving satisfactory over jet and occlusion. This study showed that anterior maxillary distraction is a reliable technique for correction of midfacial deformity arising out of cleft lip and palate. Incidences of complications are negligible compared to total maxillary distraction.

  14. New fixation method for maxillary distraction osteogenesis using locking attachments.

    Science.gov (United States)

    Suzuki, Eduardo Yugo; Buranastidporn, Boonsiva; Ishii, Masatoshi

    2006-10-01

    The external traction hooks of the intraoral splint used in the rigid external distraction (RED) system for maxillary distraction osteogenesis interfere with the surgical procedures. The purpose of this study is to introduce an innovative splint fixation method for maxillary distraction osteogenesis with Locking Attachments and evaluate their advantages, such as reduction of operating time compared with the traditional intraoral splint method. Retrospective comparison of operative times of maxillary Le Fort I osteotomy procedures was carried out with the traditional protocol using the intraoral splint cemented to the maxillary dentition (n = 14), and a removable intraoral splint that is inserted postsurgically (n = 14). Operative procedure times were compared and analyzed statistically using the data extracted from the surgical records. There were no complications inserting the removable splint postsurgically, including pain, discomfort, or time-consuming procedure. Stable and secure splint fixation was obtained before the distraction procedure and the desired treatment goals were obtained in all patients. The total operative procedure times were significantly reduced in the Locking Attachments group by 24% to 41% (approximately 65 minutes) compared with earlier operations involving the conventional splints (P Maxillary distraction osteogenesis with the Locking Attachments is a highly effective fixation approach to manage severe hypoplastic maxilla, eliminating lip constraints resulting from scarring and allowing for easier, more deliberate and careful dissection. The use of the Locking Attachments is reliable in craniofacial surgery and has proved to be advantageous in the reduction of the operating time and surgical risks.

  15. Maxillary distraction osteogenesis in cleft lip and palate patients with skeletal anchorage.

    Science.gov (United States)

    Minami, Katsuhiro; Mori, Yoshihide; Tae-Geon, Kwon; Shimizu, Hidetaka; Ohtani, Miyuki; Yura, Yoshiaki

    2007-03-01

    Maxillary distraction osteogenesis with the rigid external distraction (RED) system has been used to treat cleft lip and palate (CLP) patients with severe maxillary hypoplasia. We introduce maxillary distraction osteogenesis for CLP patients with skeletal anchorage adapted on a stereolithographic model. Six maxillary deficiency CLP patients treated according to our CLP treatment protocol had undergone maxillary distraction osteogenesis. In all patients, computed tomography (CT) images were recorded preoperatively, and the data were transferred to a workstation. Three-dimensional skeletal structures were reconstructed with CT data sets, and a stereolithographic model was produced. On the stereolithographic model, miniplates were adapted to the surface of maxilla beside aperture piriforms. The operation performed involved a high Le Fort I osteotomy with pterygomaxillary disjunction. Miniplates were fixed to the maxillary segment with three or four screws and used for anchorage of the RED system. Retraction of the maxillary segment was initiated after 1 week. The accuracy of the stereolithographic models was enough to adapt the miniplates so that there was no need to readjust the plates during surgery. Postoperative cephalometric analysis showed that the direction of the retraction was almost parallel to the palatal plane, and dental compensation did not occur. We performed maxillary distraction osteogenesis with skeletal anchorage adapted on the stereolithographic models. Excellent esthetic outcome and skeletal advancement were achieved without dentoalveolar compensations.

  16. Orthodontic considerations for maxillary distraction osteogenesis in growing patients with cleft lip and palate using internal distractors.

    Science.gov (United States)

    Silveira, Adriana da; Moura, Pollyana Marques de; Harshbarger, Raymond J

    2014-11-01

    The orthodontist plays a key role in the selection of the optimal treatment for patients followed by a craniofacial team. For patients with cleft lip and palate, the need for multidisciplinary treatment planning and sequentially staged treatment is essential for successful patient outcomes. The technique of Le Fort I distraction osteogenesis of the maxilla using an internal device is potentially a predictable, stable, and convenient option for the correction of severe maxillary hypoplasia. It is an alternative option for treatment of maxillary hypoplasia in growing patients. In this article, the authors describe the orthodontist's approach to the management of cleft patients with severe maxillary deficiency with the use of an internal distraction device. The information is presented with a focus on the clinical aspects of treatment, using case illustrations and appropriate literature.

  17. Miniplate fixation of Le Fort I osteotomies.

    Science.gov (United States)

    Rosen, H M

    1986-12-01

    The use of rigid, internal, three-dimensional fixation using vitallium bone plates in 28 consecutive Le Fort I osteotomies is presented. A minimum follow-up period of 6 months was required for inclusion in this patient group. Maxillary movements included advancements (17), intrusions (9), lengthenings (5), and retrusions (2). The majority of maxillae were moved in more than one plane of space. Technical details, complications, and relapse potential are discussed. Advantages of rigid plate fixation include marked reductions in the length of intermaxillary fixation with light training elastics only. Immediate postoperative airway problems are thereby eliminated. Six months of follow-up would appear to indicate a low potential for osseous relapse when compared to wire osteosynthesis, regardless of the direction of maxillary movement. The major disadvantage is the decreased ability of postoperative orthodontics to move dento-osseous segments if skeletal occlusal disharmony persists postoperatively. For this reason, close attention to preoperative planning and operative technique is critical for the success of this fixation method.

  18. Long-term results of maxillary distraction osteogenesis in nongrowing cleft: 5-years experience using internal device.

    Science.gov (United States)

    Hirjak, D; Reyneke, J P; Janec, J; Beno, M; Kupcova, I

    2016-01-01

    Patients with cleft lip and palate (CLP) related deformities frequently have maxillary hypoplasia in all dimensions. These patients usually present with class III malocclusions, retruded midfaces and narrow hard palates. The skeletal problems can be treated by means of Le Fort I maxillary procedures. Surgical and orthodontic correction of severe maxillary hypoplasia, as often seen in CLP patients, has however proved to be challenging. The magnitude of the advancement is often hampered and the post operative stability significantly affected by palatal soft tissue scarring. The slow distraction of bone and the histogenic abilities of distraction osteogenesis (DO) have made it an atractive alternative treatment option for the management of maxillary hypoplasia in these patients. This paper presents the treatment results of 15 nongrowing CLP patients with severe maxillary hypoplasia treated by means of intra oral distraction. The mean anterior distraction of the maxillas was 12.7 mm (9-15.0 mm). The long-term cephalometric and clinical evaluation after a minimum of 60 months (mean follow-up 71 months) proved to be stable. The treatment results revealed, that distraction osteogenesis in nongrowing CLP patients with severe maxillary hypoplasia proved to be a predictable and stable option (Tab. 2, Fig. 3, Ref. 26).

  19. Combined maxillary and mandibular distraction osteogenesis in patients with hemifacial microsomia.

    Science.gov (United States)

    Sant'Anna, Eduardo Franzotti; Lau, Geórgia W T; Marquezan, Mariana; de Souza Araújo, Mônica Tirre; Polley, John W; Figueroa, Alvaro A

    2015-05-01

    Hemifacial microsomia is a deformity of variable expressivity with unilateral hypoplasia of the mandible and the ear. In this study, we evaluated skeletal soft tissue changes after bimaxillary unilateral vertical distraction. Eight patients (4 preadolescents 4 adolescents) each with a grade II mandibular deformity underwent a LeFort I osteotomy and an ipsilateral horizontal mandibular ramus osteotomy. A semiburied distraction device was placed over the ramus, and intermaxillary fixation was applied. Anteroposterior cephalometric and frontal photographic analyses were conducted before and after distraction. Statistics were used to analyze the preoperative and postoperative changes. Cephalometrically, the nasal floor and the occlusal and gonial plane angles decreased. The ratios of affected-unaffected ramus and gonial angle heights improved by 15% and 20%, respectively. The position of menton moved toward the midline. The photographic analysis showed a decrease of the nasal and commissure plane angles, and the chin moved to the unaffected side. The parallelism between the horizontal skeletal and soft tissue planes improved, with an increase in the affected side ramus height and correction of the chin point toward the midline. Simultaneous maxillary and mandibular distraction improved facial balance and symmetry. Patients in the permanent dentition with fixed orthodontic appliances and well-aligned dental arches responded well to this intervention. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  20. Maxillary distraction osteogenesis in cleft lip and palate cases with midface hypoplasia using rigid external distractor: an alternative technique.

    Science.gov (United States)

    Dua, Gaurav; Navin Kumar, Andrews; Roy, Indranil Deb; Roy, Supriyo Kumar

    2014-05-01

    Patients with operated cleft lip and palate present with a problem of midface hypoplasia, and such patients have been traditionally treated with orthognathic surgery. Such a procedure has its own limitations of relapse and hence a newer modality of distraction osteogenesis with histiogenesis can be chosen to overcome such limitations for midfacial advancement. The purpose of this study is to evaluate an alternative technique and its postoperative stability in maxillary distraction osteogenesis in patients of cleft lip and cleft palate using a rigid external device (RED). Nine patients with midface bone stock deficiency were selected for maxillary advancement. At the first surgery under general anesthesia, after Le Fort I osteotomy, RED system was used with the alternative technique. After distraction, evaluation was done for ease of the procedure, stability, and complications. Lateral cephalograms were evaluated at 3 stages: T1, pre-distraction; T2, post-distraction; and T3, 1 year post-distraction. A mean 13.4-mm midface advancement was shown with bone formation at the pterygomaxillary region without losing the vector and having a standby mode in case the wire broke during distraction The results were stable even at 1 year of follow-up. Maxillary position improved in relation to the cranial base. This study showed that the RED was versatile in midface advancement.

  1. Bone-borne palatal distraction to correct the constricted cleft maxilla.

    Science.gov (United States)

    Vyas, Raj M; Jarrahy, Reza; Sisodia, Manisha; Jourabchi, Natanel; Wasson, Kristy L; Bradley, James P

    2009-05-01

    Transverse maxillary hypoplasia, with or without cleft deformity, is typically treated with orthodontic expansion. However, the management of those patients who present later in life with severe uncorrected deformities or who have failed prior orthodontic care remains controversial. Tooth-borne palatal expanders have limitations in this subset of patients with scarred, constricted cleft palate. In this study, we assess the efficacy and safety of using a bone-borne palatal distraction device as an alternative treatment for this difficult subset of patients. Older children with a constricted maxilla who previously had unilateral or bilateral cleft lip and palate repairs and failed orthodontic expansion were included in the study (n = 15). Patients underwent Le Fort I corticotomy with placement of the bone-borne distraction device, expansion at a rate of 0.5 mm/d, and subsequent alveolar bone grafting. Preoperative and follow-up maxillary impressions were compared with assessed improvements in intermolar distance, intercanine distance, alveolar cleft width, and total palatal area. In addition, a small group of noncleft patients with constricted maxillas was treated with bone-borne palatal distraction without a corticotomy (n = 4). The mean amount of distraction in all patients was 14.1 mm, with a follow-up period of 19 months (range, 8-30 months). The average increase in intermolar distance was 8.4 mm, intercanine distance increased by an average of 9.5 mm, and palate surface areas were increased by a mean of 28.9 mm2. Relapse was between 4% and 7%, and all patients underwent subsequent alveolar bone grafting. In addition, the noncleft patients successfully underwent bone-borne palatal distraction without a corticotomy, with a 4% to 5% relapse. Rapid palatal expansion using a bone-borne distraction device in cleft patients with transverse maxillary hypoplasia who have failed nonsurgical orthodontic expansion provides adequate expansion necessary for alveolar bone

  2. Maxillary distraction complications in cleft patients.

    Science.gov (United States)

    Jeblaoui, Y; Morand, B; Brix, M; Lebeau, J; Bettega, G

    2010-06-01

    Cleft lip and palate (CLP) patients often present with a class III malocclusion in connection with a three dimensional maxillary hypoplasia. Twenty-five to 60% of these patients need maxillary advancement. Two solutions are possible: orthognathic surgery and maxillary distraction. The purpose of this study was to evaluate the complications of maxillary distraction in CLP patients. Data was collected from the records of patients treated in our surgery unit between 2000 and 2007. Among the eight patients (four male and four female), five presented with a bilateral CLP, two with a unilateral CLP, and one with a unilateral cleft lip associated to a soft palate cleft. The average age at surgery was 17 years. All underwent a Le Fort I osteotomy with a pterygomaxillary disjunction. An external distractor was used for the first two patients and an internal distractor for the six following patients. After a seven-day latency, activation was implemented at a rate of 1mm twice a day. The average period of consolidation was four months. Maxillary advancement ranged between 7 and 19mm, with an average of 12.6mm. The average follow-up was four years. Complications were noted in seven patients: one intra-operative hemorrhage, one avulsion of a tooth anchored at the pterygoid process during osteotomy, three cases of device dysfunction, two cases of significant pain during activation, one loosening of the orthodontic arch in an external system, two cases of labial ulceration, and one maxillary sinusitis due to migration of a wisdom tooth. Complications of maxillary distraction in CLP patients were very frequent. Most were related to the device and did not interfere with the final result. This must be taken into account when indicating distraction and choosing the device. Two types of complications can occur during distraction: those related to the osteotomy and those related to the device. The complications related to the osteotomy are linked to the cicatricial ground of previous

  3. Long-term follow-up of large maxillary advancements with distraction osteogenesis in growing and non-growing cleft lip and palate patients.

    Science.gov (United States)

    Meazzini, Maria Costanza; Basile, Valentina; Mazzoleni, Fabio; Bozzetti, Alberto; Brusati, Roberto

    2015-01-01

    Maxillary distraction osteogenesis (DO) in cleft lip and palate patients has been described by several authors, but most studies have a relatively short follow-up and do not clearly separate growing patients from non-growing patients. The records of 22 consecutive patients affected by cleft lip and palate, who underwent Le Fort I osteotomy and maxillary distraction with a rigid external distractor (RED), were reviewed. The sample was subdivided into a growing and a non-growing group. All patients had pre-DO cephalometric records, immediately post DO, 12 months post DO and long-term records with a long-term follow-up of >5 years (range 5-13 years). As a control sample for the growing group, cleft children with a negative overjet not subjected to distraction or any protraction treatment during growth were followed up until the completion of growth. The average maxillary advancement in the growing group was 22.2 ± 5.5 mm (range: 15-32 mm); in the non-growing group, it was 17.7 ± 6.6 mm (range: 6-25 mm). Excellent post-surgical stability was recorded in the adult sample. On the other hand, growing children had an average 16% relapse in the first year post DO and an additional 26% relapse in the long-term follow-up. This study seems to point out that early Le Fort I DO allows for the correction of very severe deformities. It is followed by a relatively high amount of true skeletal relapse in children with cleft lip and palate. Prognosis should be discussed in depth with the family and true aesthetic and psychological needs assessed. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. The correction of maxillary defciency with internal distraction devices: a multidisciplinary approach.

    Science.gov (United States)

    Oz, A Alper; Ozer, Mete; Eroglu, Lütfi; Ozdemir, Oguz Suleyman

    2013-09-01

    The purpose of this case report is to present the orthodontic, surgical and restorative treatments in the case of an operated cleft lip and palate and severe maxillary defciency in a 14-year-old female patient. Only orthodontic treatment could be ineffcient for cleft lip and palate patients characterized with maxillary hypoplasia. Orthodontic and surgical treatment shows suffcient results, especially with severe skeletal defciency. A cleft lip and palate patient required complex multidisciplinary treatment to preserve health and restore esthetics. Dental leveling and alignment of the maxillary and mandibular teeth were provided before the surgery. Maxillary advancement and clockwise rotation of the maxillary-mandibular complex was applied by a Le Fort 1 osteotomy with two internal distraction devices. After the active treatment including orthodontic treatment and orthognathic surgery, upper full mouth ceramic restoration was applied. This report shows the efficiency of internal distraction devices in cleft lip palate patients and exemplifes the multidisciplinary care required for such diffcult cases. Clinical signifcance: Stable improved occlusion and skeletal relations were observed after a follow-up examination period of 12 months.

  5. Le fort I osteotomy approach for advanced nasopharyngeal angiofibroma with intracranial extension: Report of a case

    Directory of Open Access Journals (Sweden)

    "Naraghi M

    2002-08-01

    Full Text Available Angiofibromas are the most common benign tumors of the nasopharynx, Intracranial extension has been reported in approximately 20-25% of cases. Intracranial extension may be difficult to treat because of poor exposure that may lead to recurrence. A 16-year-old male patient presented with a 6-month history of nasal obstruction, intermittent epistaxis, right superior orbital fissure syndrome, and proptosis. Imaging studies revealed a large right sinonasal mass with significant intracranial and infratemporal extensions. The tumor was resected by Le fort I technique because of dissatisfaction with other approaches. Postoperative period was uneventful and follow-up visits showed marked improvement in proptosis and ophthalmologic symptoms, without the evidence of tumor recurrence. Commonly used to treat facial deformities. The Le Fort I osteotomy with down fracturing of the entire palate has been adopted as a surgical option in the management of some angiofibromas. Compared with other popular techniques, it provides excellent exposure for angiofibromas. The merits and limitations of this approach as well as its details are discussed.

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

    OpenAIRE

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

    2013-01-01

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

  7. Nasomaxillary hypoplasia with a congenitally missing tooth treated with LeFort II osteotomy, autotransplantation, and nickel-titanium alloy wire.

    Science.gov (United States)

    Ishida, Takayoshi; Ikemoto, Shigehiro; Ono, Takashi

    2015-09-01

    In some skeletal Class III adult patients with nasomaxillary hypoplasia, the LeFort I osteotomy provides insufficient correction. This case report describes a 20-year-old woman with a combination of nasomaxillary hypoplasia and a protrusive mandible with a congenitally missing mandibular second premolar. We performed a LeFort II osteotomy for maxillary advancement. Autotransplantation of a tooth was also performed; the donor tooth was used to replace the missing permanent tooth. To increase the chance of success, we applied light continuous force with an improved superelastic nickel-titanium alloy wire technique before extraction and after transplantation. The patient's profile and malocclusion were corrected, and the autotransplanted tooth functioned well. The postero-occlusal relationships were improved, and ideal overbite and overjet relationships were achieved. The methods used in this case represent a remarkable treatment. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  8. [Maxillary distraction complications in cleft patients].

    Science.gov (United States)

    Jeblaoui, Y; Morand, B; Brix, M; Lebeau, J; Bettega, G

    2008-09-01

    Cleft lip and palate (CLP) patients often present with a class III malocclusion in connection with a three dimensional maxillary hypoplasia. Twenty-five to 60% of these patients require a maxillary advancement. Two solutions are possible: orthognathic surgery and maxillary distraction. The purpose of this study was to evaluate the complications of the maxillary distraction in CLP patients. Data was collected from the records of patients treated at our Surgery Unit between 2000 and 2007. Among the eight patients (four male and four female), five presented a bilateral CLP, two a unilateral CLP and one a unilateral cleft lip associated to a soft palate cleft. The average age at surgery was 17 years old. All had a Le Fort I osteotomy with a pterygomaxillary disjunction. The first two patients had external distractors and the six following internal ones. After a seven-day latency, activation was led to the rate of 1mm per day twice. The period of consolidation was four months on average. The maxillary advancement varied between 7 and 19 mm with an average of 12.6mm. The average follow-up was four years. We encountered difficulties and/or complications in seven patients: one intraoperatively haemorrhage, one avulsion of a tooth fixed at the pterygoid process during the osteotomy, three device failures, two cases of significant pains during activation, one dissociation of the dental anchorage of an external system, two labial ulcerations and one maxillary sinusitis by migration of the 18. Difficulties of maxillary distraction in CLP patients are very frequent. The majority is related to the distractors and did not interfere with the final result. But this frequency must be taken into account in the indication and in the choice of the material. Two types of complications can occur during distraction: those related to the osteotomy and those related to the material. The complications related to the osteotomy are in connection with the cicatricial ground of the CLP. They are

  9. Midfacial Changes Through Anterior Maxillary Distraction Osteogenesis in Patients With Cleft Lip and Palate.

    Science.gov (United States)

    Kanzaki, Hiroyuki; Imai, Yoshimichi; Nakajo, Tetsu; Daimaruya, Takayoshi; Sato, Akimitsu; Tachi, Masahiro; Nunomura, Youhei; Itagaki, Yusuke; Nishimura, Kazuaki; Kochi, Shoko; Igarashi, Kaoru

    2017-06-01

    Maxillary hypoplasia is a major issue in cleft lip and palate patients, and predictable surgical maxillary advancement is required. In the present study, the changes and stability of the maxilla and soft tissue profile achieved after the application of anterior maxillary distraction osteogenesis (AMDO) using intraoral expander in unilateral cleft lip and palate and isolated cleft palate patients were investigated by comparing to the Le Fort I osteotomy (LFI) and maxillary distraction osteogenesis (DO) with rigid external distraction (RED) system.Ten patients who underwent orthognathic treatment with AMDO were examined (AMDO group). Changes in the positions of soft and hard tissue landmarks were calculated from the lateral cephalograms taken before the distraction, at the end of the distraction, and 1 year after the surgery. They were compared with the changes in 7 other unilateral cleft lip and palate patients who underwent LFI (LFI group) and 6 others who underwent DO with RED (RED group).The mean maxillary advancement of the AMDO group was similar to that of the RED group, judged by the change of point A. During DO, the AMDO group showed less clockwise rotation of mandible compared to the RED group. The soft tissue advancement of the upper lip and nose in the AMDO group was similar to that in the RED group, which was significantly larger than that in the LFI group.Our results indicate that AMDO can be surgical option to cleft lip and palate patients with less invasive but excellent improvement in both midfacial skeletal and soft tissue similar to DO-RED.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Elio Hitoshi Shinohara

    2013-01-01

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

  12. Hiérarchie des esprits et esprit fort : le discours médical

    Directory of Open Access Journals (Sweden)

    Isabelle Moreau

    2010-05-01

    Full Text Available L’esprit fort a-t-il un sexe au début de l’époque moderne ? Selon Londa Schiebinger (The Mind has no sex?, 1989 le cartésianisme rompt avec la tradition médicale en rendant impossible la liaison entre sexe et tempérament. En témoigne notamment le cartésien Poullain de la Barre et son livre De l’égalité des deux sexes, publié en 1673. C’est à la lumière de cette thèse que je voudrais évaluer la position des libertins érudits, et ainsi aborder la question du genre masculin, dans sa relation supposée privilégiée à l’incrédulité et au rejet des superstitions. Pour La Mothe Le Vayer, Naudé ou encore Cyrano, en effet, il n’existe pas de raison universelle « asexuée ». Ces libertins rejettent le dualisme cartésien et disqualifient la notion même de sens commun, pour mieux promouvoir une faculté de bien juger ou « Ingenium », directement héritée de Charron. Pour comprendre la masculinité de l’esprit fort, il faut ainsi revenir aux origines médicales de la hiérarchie entre les esprits, construite à partir de l’ancienne théorie humorale et tempéramentale héritée de Hippocrate, Aristote et Galien, retravaillée par Huarte en 1575, reprise ensuite par Charron et par sa postérité libertine. En revenant sur les discours médicaux et philosophiques qui construisent la masculinité de l’esprit fort, je montrerai comment cet idéal se construit sur un modèle de masculinité monologique (certes capable de degrés et de variations, plutôt que par opposition au féminin.Did the mind have a gender during the Early Modern period? According to Londa Schiebinger (The Mind Has No Sex?, 1989, Cartesian philosophy caused an abrupt change within the medical tradition by rendering the link between gender and temperament obsolete. Poullain de la Barre’s On the Equality of the Sexes, published in 1673, is a good example of this shift. It is in the light of this thesis that I intend to assess the Libertine

  13. Maxillary distraction osteogenesis in the adolescent cleft patient: three-dimensional computed tomography analysis of linear and volumetric changes over five years.

    Science.gov (United States)

    Chen, Philip Kuo-Ting; Por, Yong-Chen; Liou, Eric Jein-Wein; Chang, Frank Chun-Shin

    2011-07-01

    To assess the results of maxillary distraction osteogenesis with the Rigid External Distraction System using three-dimensional computed tomography scan volume-rendered images with respect to stability and facial growth at three time frames: preoperative (T0), 1-year postoperative (T1), and 5-years postoperative (T2). Retrospective analysis. Tertiary. A total of 12 patients with severe cleft maxillary hypoplasia were treated between June 30, 1997, and July 15, 1998. The mean age at surgery was 11 years 1 month. Le Fort I maxillary distraction osteogenesis. Distraction was started 2 to 5 days postsurgery at a rate of 1 mm per day. The consolidation period was 3 months. No face mask was used. A paired t test was used for statistical analysis. Overjet, ANB, and SNA and maxillary, pterygoid, and mandibular volumes. From T0 to T1, there were statistically significant increments of overjet, ANB, and SNA and maxillary, pterygoid, and mandibular volumes. The T1 to T2 period demonstrated a reduction of overjet (30.07%) and ANB (54.42%). The maxilla showed a stable SNA and a small but statistically significant advancement of the ANS point. There was a significant increase in the mandibular volume. However, there was no significant change in the maxillary and pterygoid volumes. Maxillary distraction osteogenesis demonstrated linear and volumetric maxillary growth during the distraction phase without clinically significant continued growth thereafter. Overcorrection is required to take into account recurrence of midface retrusion over the long term.

  14. Sinus lifting before Le Fort I maxillary osteotomy: a suitable method for oral rehabilitation of edentulous patients with skelettal class-III conditions: review of the literature and report of a case

    Directory of Open Access Journals (Sweden)

    Meyer Ulrich

    2007-01-01

    Full Text Available Abstract Background Functional rehabilitation of patients afflicted with severe mandibular and maxillary alveolar atrophy might be challenging especially in malformed patients. Methods Treatment planning using sinus lifting and implant placement before Le Fort I maxillary osteotomy in a patient with severe mandibular and posterior maxillary alveolar atrophy and skelettal class-III conditions due to cleft palate are described. Results A full functional and esthetic rehabilitation of the patient was achieved by a stepwise surgical approach performed through sinus lifting as the primary approach followed by implant placement and subsequent Le Fort I maxillary osteotomy to correct the maxillo-mandibular relation. Conclusion Stabilisation of the maxillary complex by a sinus lifting procedure in combination with computer aided implant placement as preorthodontic planning procedure before Le Fort I maxillary osteotomy seems to be suitable in order to allow ideal oral rehabilitation especially in malformed patients.

  15. Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients.

    Science.gov (United States)

    Kloukos, Dimitrios; Fudalej, Piotr; Sequeira-Byron, Patrick; Katsaros, Christos

    2016-09-30

    Cleft lip and palate is one of the most common birth defects and can cause difficulties with feeding, speech and hearing, as well as psychosocial problems. Treatment of orofacial clefts is prolonged; it typically commences after birth and lasts until the child reaches adulthood or even into adulthood. Residual deformities, functional disturbances, or both, are frequently seen in adults with a repaired cleft. Conventional orthognathic surgery, such as Le Fort I osteotomy, is often performed for the correction of maxillary hypoplasia. An alternative intervention is distraction osteogenesis, which achieves bone lengthening by gradual mechanical distraction. To provide evidence regarding the effects and long-term results of maxillary distraction osteogenesis compared to orthognathic surgery for the treatment of hypoplastic maxilla in people with cleft lip and palate. We searched the following electronic databases: Cochrane Oral Health's Trials Register (to 16 February 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2016, Issue 1), MEDLINE Ovid (1946 to 16 February 2016), Embase Ovid (1980 to 16 February 2016), LILACS BIREME (1982 to 16 February 2016), the US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) (to 16 February 2016), and the World Health Organization (WHO) International Clinical Trials Registry Platform (to 16 February 2016). There were no restrictions regarding language or date of publication in the electronic searches. We performed handsearching of six speciality journals and we checked the reference lists of all trials identified for further studies. We included randomised controlled trials (RCTs) comparing maxillary distraction osteogenesis to conventional Le Fort I osteotomy for the correction of cleft lip and palate maxillary hypoplasia in non-syndromic cleft patients aged 15 years or older. Two review authors assessed studies for eligibility. Two review authors independently

  16. LeFort I osteotomy and secondary procedures in full-face transplant patients.

    Science.gov (United States)

    Barret, Juan P; Serracanta, Jordi

    2013-05-01

    Composite tissue allotransplantion has been the latest addition to reconstructive plastic surgery of limbs and faces. These techniques have opened up a new paradigm in reconstruction. However, plastic surgeons will have to face a new patient population that receives the application of vascularised tissue allografts and immunosuppression. Secondary surgery may be necessary in this population, especially in the transplanted tissues, to improve aesthetics and function following the transplant, although little is known regarding the exact clinical protocol to be followed and the feasibility of standard plastic surgery techniques on transplanted tissues. We present our experience of a LeFort I osteotomy, limited ritidectomy and blepharoplasty in a full-face transplant recipient. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. A new palatal distractor device for bodily movement of maxillary bones by rigid self-locking miniplates and screws system.

    Science.gov (United States)

    Cortese, Antonio; Savastano, Mauro; Cantone, Antonio; Claudio, Pier Paolo

    2013-07-01

    A new palatal distractor device for bodily movement of the maxillary bones after complete segmented Le Fort I osteotomy for 1-stage transversal distraction and tridimensional repositioning on 1 patient is presented. The new distractor has an intrinsic tridimensional rigidity also in the fixation system by self-locking miniplates and screws for better control of the 2 maxillary fragments during distraction. Le Fort I distraction and repositioning procedure in association with a bilateral sagittal split osteotomy were performed on 1 patient with complete solution of the cross-bite and class III malocclusion. Results of dental and cephalometric analysis performed before surgery (T1), after surgery and distraction time (T2), and 18 months after surgery and orthodontic appliance removal (T3) are reported. No complications were encountered using the new distractor device. Advantages of this device and technique are presented including improved rigidity of both distraction (jackscrew) and fixation (4 self-locking miniplates and screws) systems resulting in complete control of the position of the 2 maxillary fragments during distraction and surgery. In addition, this new device allows resuming palatal distraction in the event of cross-bite relapse without causing dental-related problems or the risks of screw slackening.

  18. Custom-made prefabricated titanium miniplates in Le Fort I osteotomies: principles, procedure and clinical insights.

    Science.gov (United States)

    Philippe, B

    2013-08-01

    This paper describes a new type of miniplate system that is designed and custom made during virtual surgery planning based on an individual patient's osteotomy. These miniplates are prefabricated with commercially pure porous titanium using direct metal laser sintering. The principles that guide the conception and production of this new miniplate are presented. The surgical procedure from the stage of virtual surgery planning until the final Le Fort I osteotomy and bone fixation are described using a case example. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. [Effects of maxillary distraction osteogenesis on the velopharyngeal configuration of cleft palate patients].

    Science.gov (United States)

    Wang, Xiao-xia; Wang, Xing; Yi, Biao; Li, Zi-li; Liang, Cheng

    2005-12-18

    To study the effects of internal maxillary distraction osteogenesis(DO) on the velopharyngeal configuration of cleft palate patients. Ten patients with severe maxillary hypoplasia secondary to cleft lip and palate patients (7 males and 3 females, average age 20.1 years old) had undertaken high step LeFort I osteotomy, and internal maxillary distraction devices were applied to advance the maxilla. Before surgery, when DO was completed and 6 months after DO was completed, oriented lateral cephalograms at rest position of each patient were taken, and 6 measure indexes of velopharyngeal configuration were collected and analyzed. All patients had successfully accomplished maxillary DO and the maxilla had been averagely advanced 11.3 mm. PNS-PhW, C-PhW, UL and ANS-PNS-T had all significantly increased, and UD had significantly decreased when DO was completed and 6 months after DO was completed as compared with pre-surgery. No significant linear correlation was found between maxilla advancement distance and velopharyngeal configuration changes. Correction of maxillary hypoplasia secondary to cleft palate surgery by using internal maxillary DO can increase the velopharyngeal cavity depth, and may impair velopharyngeal competence, but the compensatory changes of velopharyngeal soft tissue can alleviate this impairment to certain extent.

  20. Stability of the anterior maxillary segment and teeth after segmental le fort I osteotomy and postoperative skeletal elastic fixation with or without occlusal splint

    DEFF Research Database (Denmark)

    Blæhr, Tue Lindberg; Jensen, Thomas; Due, Karen Margrethe

    2014-01-01

    OBJECTIVES: To assess the short term dental and skeletal stability of the anterior maxillary segment after segmental Le Fort I osteotomy with postoperative skeletal elastic fixation with or without occlusal splint. MATERIAL AND METHODS: 29 consecutive patients underwent segmental Le Fort I...... osteotomy and elastic skeletal fixation was applied. Patients were divided into two groups according to whether a fixed occlusal splint was used for six weeks (group A) or dismounted perioperatively (group B). Changes in landmarks and reference planes between the two timepoints were estimated on lateral.......83 to 1.69°). There was no statistically significant difference in stability between the two groups at the P value 0.05. CONCLUSIONS: The skeletal anterior fixation with postoperative elastics for eight weeks may not compromise the early postoperative dental and skeletal stability of the anterior segment...

  1. Special distraction osteogenesis before bone grafting for alveolar cleft defects to correct maxillary deformities in patients with bilateral cleft lips and palates: distraction osteogenesis performed separately for each bone segment.

    Science.gov (United States)

    Mitsukawa, Nobuyuki; Saiga, Atsuomi; Morishita, Tadashi; Satoh, Kaneshige

    2014-07-01

    Patients with bilateral cleft lips and palates have premaxillary protrusion and characteristic jaw deformities involving three-dimensional malposition of the premaxilla and bilateral maxillary bone segments. This study examined patients with bilateral cleft lips and palates who had deviation and hypoplasia of the premaxillas and bilateral maxillary segments. Before bone grafting, the patients were treated with special distraction performed separately for each bone segment using a halo-type external device. This report describes this novel treatment method which produced good results. The subjects were five patients with severe jaw deformities due to bilateral cleft lip and palate. They were treated with maxillary Le Fort I osteotomy and subsequent distraction performed separately for each bone segment using a halo device. In three of five patients, premaxillary osteotomy was not performed, and osteotomy and distraction were performed only for the right and left lateral segments with severe hypoplasia. All patients achieved distraction close to the desired amount. The widths of the alveolar clefts were narrowed, and satisfactory occlusion and maxillary arch form were achieved. After the surgery, three of five patients underwent bone grafting for bilateral alveolar cleft defects and the bone graft survival was satisfactory. This method had many benefits, including narrowing of alveolar clefts, improvement of maxillary hypoplasia, and achievement of a good maxillary arch form. In addition, subsequent bone grafting for alveolar cleft defects was beneficial, dental prostheses were unnecessary, and frequency of surgery and surgical invasiveness were reduced. This method is a good surgical procedure that should be considered for patients with bilateral cleft lips and palates who have premaxillary protrusion and hypoplasia of the right and left lateral segments. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights

  2. Establishing cephalometric landmarks for the translational study of Le Fort-based facial transplantation in Swine: enhanced applications using computer-assisted surgery and custom cutting guides.

    Science.gov (United States)

    Santiago, Gabriel F; Susarla, Srinivas M; Al Rakan, Mohammed; Coon, Devin; Rada, Erin M; Sarhane, Karim A; Shores, Jamie T; Bonawitz, Steven C; Cooney, Damon; Sacks, Justin; Murphy, Ryan J; Fishman, Elliot K; Brandacher, Gerald; Lee, W P Andrew; Liacouras, Peter; Grant, Gerald; Armand, Mehran; Gordon, Chad R

    2014-05-01

    Le Fort-based, maxillofacial allotransplantation is a reconstructive alternative gaining clinical acceptance. However, the vast majority of single-jaw transplant recipients demonstrate less-than-ideal skeletal and dental relationships, with suboptimal aesthetic harmony. The purpose of this study was to investigate reproducible cephalometric landmarks in a large-animal model, where refinement of computer-assisted planning, intraoperative navigational guidance, translational bone osteotomies, and comparative surgical techniques could be performed. Cephalometric landmarks that could be translated into the human craniomaxillofacial skeleton, and that would remain reliable following maxillofacial osteotomies with midfacial alloflap inset, were sought on six miniature swine. Le Fort I- and Le Fort III-based alloflaps were harvested in swine with osteotomies, and all alloflaps were either autoreplanted or transplanted. Cephalometric analyses were performed on lateral cephalograms preoperatively and postoperatively. Critical cephalometric data sets were identified with the assistance of surgical planning and virtual prediction software and evaluated for reliability and translational predictability. Several pertinent landmarks and human analogues were identified, including pronasale, zygion, parietale, gonion, gnathion, lower incisor base, and alveolare. Parietale-pronasale-alveolare and parietale-pronasale-lower incisor base were found to be reliable correlates of sellion-nasion-A point angle and sellion-nasion-B point angle measurements in humans, respectively. There is a set of reliable cephalometric landmarks and measurement angles pertinent for use within a translational large-animal model. These craniomaxillofacial landmarks will enable development of novel navigational software technology, improve cutting guide designs, and facilitate exploration of new avenues for investigation and collaboration.

  3. The effect of cleft maxillary distraction osteogenesis on the levator veli palatini and velopharyngeal function.

    Science.gov (United States)

    Chen, Philip Kuo-Ting; Por, Yong-Chen; Liou, Eric Jein-Wein; Chang, Frank Chun-Shin

    2015-05-01

    Le Fort I maxillary distraction with the rigid external distraction (RED) device is performed to correct severe midface retrusion in cleft patients, but it may adversely affect velopharyngeal function. This study aims to investigate the angular changes in the levator veli palatini (LVP) and its influence on velopharyngeal function after maxillary distraction using 3-dimensional computed tomography (3D CT) scan volume rendered images. This was a retrospective study of 12 patients. Group 1 had no velopharyngeal function deterioration and group 2 had velopharyngeal function deterioration. Preoperative and 1 year postoperative CT scans were analyzed with Mimics v10 software. Segmentation of the LVP and the nasopharyngeal airway was performed and volumetric images were obtained. Six measurements were made: (1) the angle between the levator plane and the Frankfort horizontal, (2) the angle between the levator plane and the soft palate plane, (3) the angle between the 2 LVP muscles, (4) the pharyngeal depth, and (5, 6) the movement of the inferior pharyngeal point with respect to the horizontal and vertical planes. The independent samples t test, Mann-Whitney test, and paired t tests were used for statistical analyses (P < 0.05). Group 2 had statistically significant reduction in the angle between the levator plane and Frankfort horizontal as well as the soft palate plane. Group 1 had a statistically significant increase in the pharyngeal depth and movement of the inferior pharyngeal point with respect to the horizontal plane. A decrease in the angle between the levator plane and the Frankfort horizontal or the soft palate plane was associated with velopharyngeal function deterioration.

  4. Lip-nasal aesthetics following Le Fort I osteotomy.

    Science.gov (United States)

    Rosen, H M

    1988-02-01

    Forty-one patients undergoing Le Fort I osteotomy for superior and/or anterior repositioning of the maxilla were prospectively studied for changes in soft-tissue morphology of the nasomaxillary region. Nasal parameters studied were changes in interalar rim width and nasal tip projection. It was observed that alar rim width increases with anterior and/or superior repositioning of the maxilla, but increases in nasal tip projection occur only when there is an anterior vector of maxillary movement. These nasal changes could not be quantitatively correlated to magnitude of maxillary movement. Lip changes studied were the horizontal displacement at the vermilion border and subnasale versus that of the incisal edge and point A, respectively, when the maxilla is sagittally advanced and the vertical shortening of the lip versus that of the incisal edge when the maxilla is shortened. Using linear regression analysis, horizontal displacement of the upper lip at the vermilion border was 0.82 +/- 0.13 mm for every 1 mm of maxillary advancement at the incisal edge (p less than 0.001) and 0.51 +/- 0.13 at the subnasale for every 1 mm of maxillary advancement at point A (p less than 0.001). Eighty percent of patients undergoing maxillary intrusive procedures had lip shortening ranging from 20 to 50 percent of the vertical maxillary reduction. Surprisingly, no statistically significant correlation could be demonstrated for lip shortening versus extent of vertical maxillary reduction. Previous literature in disagreement with these findings is discussed. Guidelines for treatment planning utilizing these data are suggested.

  5. Stability of the anterior maxillary segment and teeth after segmental le fort I osteotomy and postoperative skeletal elastic fixation with or without occlusal splint.

    Science.gov (United States)

    Blæhr, Tue Lindberg; Jensen, Thomas; Due, Karen Margrethe; Neumann-Jensen, Bjarne

    2014-07-01

    To assess the short term dental and skeletal stability of the anterior maxillary segment after segmental Le Fort I osteotomy with postoperative skeletal elastic fixation with or without occlusal splint. 29 consecutive patients underwent segmental Le Fort I osteotomy and elastic skeletal fixation was applied. Patients were divided into two groups according to whether a fixed occlusal splint was used for six weeks (group A) or dismounted perioperatively (group B). Changes in landmarks and reference planes between the two timepoints were estimated on lateral cephalometric radiographs. The upper incisor had a mean intrusion of -0.56 mm (SD 0.77; range -2.04 to 1.08 mm) and a mean posterior movement of -0.93 mm (SD 1.03; range -2.52 to 0.96 mm). The mean change in the axial inclination of the upper incisor was -0.33° (SD 2.56; range -6° to 4°) (95% CI: -1.75 to 1.08°). Group B: The upper incisor had a mean intrusion of -0.13 mm (SD 1.36; range -1.92 to 3.6 mm) and a mean anterior movement of 0.11 mm (SD 1.78; range -2.88 to 3.84 mm). The mean change in the axial inclination of the upper incisor was -0.07° (SD 3.05; range -5° to 5°) (95% CI: -1.83 to 1.69°). There was no statistically significant difference in stability between the two groups at the P value 0.05. The skeletal anterior fixation with postoperative elastics for eight weeks may not compromise the early postoperative dental and skeletal stability of the anterior segment in segmental Le Fort I osteotomy.

  6. Stability of the Anterior Maxillary Segment and Teeth after Segmental Le Fort I Osteotomy and Postoperative Skeletal Elastic Fixation With or Without Occlusal Splint

    Directory of Open Access Journals (Sweden)

    Tue Lindberg

    2014-10-01

    Full Text Available Objectives: To assess the short term dental and skeletal stability of the anterior maxillary segment after segmental Le Fort I osteotomy with postoperative skeletal elastic fixation with or without occlusal splint. Material and Methods: 29 consecutive patients underwent segmental Le Fort I osteotomy and elastic skeletal fixation was applied. Patients were divided into two groups according to whether a fixed occlusal splint was used for six weeks (group A or dismounted perioperatively (group B. Changes in landmarks and reference planes between the two timepoints were estimated on lateral cephalometric radiographs. Results: Group A: The upper incisor had a mean intrusion of -0.56 mm (SD 0.77; range -2.04 to 1.08 mm and a mean posterior movement of -0.93 mm (SD 1.03; range -2.52 to 0.96 mm. The mean change in the axial inclination of the upper incisor was -0.33° (SD 2.56; range -6° to 4° (95% CI: -1.75 to 1.08°. Group B: The upper incisor had a mean intrusion of -0.13 mm (SD 1.36; range -1.92 to 3.6 mm and a mean anterior movement of 0.11 mm (SD 1.78; range -2.88 to 3.84 mm. The mean change in the axial inclination of the upper incisor was -0.07° (SD 3.05; range -5° to 5° (95% CI: -1.83 to 1.69°. There was no statistically significant difference in stability between the two groups at the P value 0.05. Conclusions: The skeletal anterior fixation with postoperative elastics for eight weeks may not compromise the early postoperative dental and skeletal stability of the anterior segment in segmental Le Fort I osteotomy.

  7. Postdistraction stability of hypoplastic maxilla in unilateral cleft lip and palate treated using rigid external distraction device: An audit

    Directory of Open Access Journals (Sweden)

    Prasanna Kumar

    2015-01-01

    Full Text Available Introduction: Maxillary hypoplasia resulting in skeletal class III malocclusion is common among patients with cleft lip and palate. Large anteroposterior discrepancies and surgical scaring often leads to unpredictable stability of maxillary advancement with Le Fort I osteotomy and is known for a high degree of relapse. The aim of this retrospective study was to evaluate the postdisraction stability after 1-year of maxillary advancement done with rigid external distraction (RED device in patients with unilateral cleft lip and palate. Materials and Methods: Records of 11 cases treated with RED device used for distraction of maxilla in cleft lip and palate cases were assessed. Lateral cephalograms selected were taken at the end of presurgical (T1, immediate postdistraction (T2 and 1-year postdistraction (T3. Five angular measurements and nine linear measurements were used to assess the position of maxilla in all three planes. P values were obtained for repeated measurement by analysis of variance with Bonferroni′s correction for multiple comparisons. Normality was tested using Shapiro-Wilk′s test. Results: The average 1-year postdistraction measurements (T3 did not differ significantly compared to the corresponding average postdistraction measurements (T2 (P > 0.05. Conclusion: Midface distraction with RED device provides a significant structural improvement for patients with cleft lip and palate. There was marked an improvement in dentofacial structures and results were stable during the retention phase.

  8. Perception urbaine, distraction et stratification chez Benjamin, Eisenstein et Vertov

    OpenAIRE

    Rousse, Pascal

    2008-01-01

    La ville à l’écran est le substrat imaginaire et historique du cinéma. Mais le cinéma, burlesque et soviétique, transforme ce contexte tout en constituant sa mémoire. Walter Benjamin inaugura cette problématique avec la notion de « distraction », liant architecture et cinéma sur le fond du paradigme de la stratification de l’appareil psychique chez Freud.

  9. Pharyngeal airway changes associated with maxillary distraction osteogenesis in adult cleft lip and palate patients.

    Science.gov (United States)

    Aksu, Muge; Taner, Tülin; Sahin-Veske, Pınar; Kocadereli, Ilken; Konas, Ersoy; Mavili, Mehmet Emin

    2012-02-01

    To investigate 1) the changes in pharyngeal airway sizes associated with maxillary distraction osteogenesis and 2) the correlations between maxillary skeletal variables and the pharyngeal airway in adult patients with cleft lip and palate. The study was carried out in 14 adult subjects with cleft lip and palate. Predistraction records were taken at a mean age of 22.7 ± 4.6 years. All patients had placement of a rigid external distraction device (RED I; KLS Martin, Tuttlingen, Germany) after Le Fort I osteotomy. Lateral cephalograms were assessed before surgery and at short-term follow-up (8.0 ± 6.4 months). The cephalometric skeletal and pharyngeal airway variables were statistically evaluated by use of the Wilcoxon signed-rank test. Spearman ρ correlation was performed to check the correlations between maxillary skeletal and pharyngeal variables. The maxillary movement was 8.7 mm (P maxillary depth angle (+7.9°) and effective maxillary length (9.4 mm) increased significantly (P distraction, whereas the palatal plane angle remained unchanged. Anterior nasal spine (8.2 mm) and Posterior nasal spine (6.9 mm) moved anteriorly. The overjet increased (9.5 mm) significantly (P maxillary movement. PNS changes showed the highest correlation with posterior airway changes. The significant anterior movement of the maxilla resulted in significant increases in posterior, superoposterior, and middle airway spaces. The posterior airway space showed the highest significant positive correlation with the movement of PNS. The posterior and superoposterior airway spaces also showed significant positive correlations with the maxillary skeletal variables. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Primary invasive carcinoma of the vagina after Le Fort partial colpocleisis for stage IV pelvic organ prolapse: a case report.

    Science.gov (United States)

    Cho, Moon Kyoung; Kim, Chul Hong; Kim, Yoon Ha

    2011-11-01

    We present here the case report of a postmenopausal woman who complained of recurrent pus-like vaginal discharge and perianal pain 1 year after Le Fort colpocleisis, which was subsequently identified as a primary invasive carcinoma of the vagina. Biopsy confirmed a squamous cell carcinoma in the vagina, and the disease was classified as stage III according to FIGO staging. The patient received pelvic radiotherapy. This case emphasizes that differential diagnosis of recurrent vaginal discharge that presents remote from obliterative procedure for pelvic organ prolapse should consider not only pyometra, but also other causes.

  11. Le paludisme, le tsunami silencieux d'Afrique | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    12 janv. 2011 ... Dans un élan de compassion fort justifié, le monde s'est porté au secours des victimes du tsunami qui a touché récemment la région de l'océan Indien. Mais il ignore qu'un « tsunami silencieux », le paludisme, s'abat sans cesse sur l'Afrique et y fait chaque année plus de 1,5 million de victimes, surtout de ...

  12. Minipig model of maxillary distraction osteogenesis: immunohistochemical and histomorphometric analysis of the sequence of osteogenesis.

    Science.gov (United States)

    Papadaki, Maria E; Kaban, Leonard B; Troulis, Maria J

    2012-11-01

    To document the sequence of bone formation in a minipig model of Le Fort I distraction osteogenesis (DO) using immunohistochemistry and histomorphometry. Female Yucatan minipigs (N = 9) in the mixed-dentition stage underwent bilateral maxillary DO. The distraction protocol was 0 days of latency, with a distraction rate of 1 mm/d for 12 days and 24 days of fixation. Specimens were harvested and divided between the central incisors (18 hemi-maxillae) at the end of DO (n = 6), at mid-fixation (n = 6), and at the end of fixation (n = 6). Sections, including the advancement zone, were stained with hematoxylin-eosin, collagen II, CD34, proliferating cell nuclear antigen, and tartrate-resistant acid phosphatase. Light and fluorescence microscope images (original magnification ×200) were obtained, and percentage of surface area (PSA) of the advancement zone occupied by fibrous tissue, vessels, proliferating cells, osteoid, and bone was determined. An intact maxilla served as the control. At the end of DO, in the advancement zone, the PSA (mean values) of proliferating cells was 33.16%; fibrous tissue, 52%; vessels, 4.35%; and new bone, 5.45%. At the end of fixation, the PSA of proliferating cells decreased to 10.53%, fibrous tissue to 2.3%, and vessels to 1.5% whereas the PSA of new bone increased to 44.9%. The results of this study indicate that the progression of osteogenesis in the maxillary DO wound begins with intense cellular proliferation and vascular fibrous tissue formation and progresses to mature, cancellous bone by the end of fixation. The PSA occupied by mature bone is significantly less than in the control maxilla at the end of fixation. This is consistent with the sequence in the mandibular DO wound. Published by Elsevier Inc.

  13. Long-term skeletal stability after maxillary advancement with distraction osteogenesis in nongrowing patients.

    Science.gov (United States)

    Kanno, Takahiro; Mitsugi, Masaharu; Hosoe, Michi; Sukegawa, Shintaro; Yamauchi, Kensuke; Furuki, Yoshihiko

    2008-09-01

    We assessed the long-term skeletal stability of the repositioned maxilla, midface in patients who underwent maxillary advancement using distraction osteogenesis (DO). The study included 19 nongrowing patients with maxillary hypoplasia with a Class III relationship, a normally developed mandible, and follow-up after DO exceeding 2 years. Eleven men and 8 women participated, with a mean age at treatment of 20.7 years (range 15.4-33.4 years). Twelve patients had midfacial hypoplasia associated with a cleft lip and palate (CLP), and 7 patients had developed noncleft-related hypoplasia. The surgical treatment included our modified Le Fort I osteotomy in combination with intraoral (5 cases) or extraoral (14 cases) distraction devices. Distraction was started after a latency period of 5 to 7 days and continued until the proper convexity was obtained. After active distraction, a 3- to 4-week period of retention was allowed, followed by rigid internal fixation (IF) with or without distractor removal. Lateral cephalometric films before midfacial distraction (T0), after IF with or without distractor removal (T1), 6 months after T1 (T2), and 2 or more years (mean 2.8 years) after T1 (T3) were analyzed. The maxillary A-point in the Frankfort horizontal reference plane was used to assess the skeletal changes in the maxillary position (x, y) at each time point (T1-T3). In addition, we analyzed the differences in the devices and techniques. Midfacial DO was successful in all cases, resulting in a mean change obtained at point A of 10.3 mm (8.4 mm horizontally, 4.7 mm inferiorly). Point A underwent a moderate amount of skeletal relapse at T2 [0.4 mm (5%) horizontally and 0.6 mm (13%) superiorly], with a mean of 8% (0.6 mm) horizontally and 19% (1.0 mm) superiorly over the mean 2.8-year (2.0-4.8 years) follow-up. After long-term follow-up, the maxillary advancement with DO was stable in both CLP and non-CLP patients with maxillary hypoplasia. In addition, our original technique

  14. Le paludisme, le tsunami silencieux d'Afrique | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    12 janv. 2011 ... Dans un élan de compassion fort justifié, le monde s'est porté au secours des victimes du tsunami qui a touché récemment la région de l'océan Indien. Mais il ignore qu'un « tsunami silencieux », le paludisme, s'abat sans cesse sur l'Afrique et y fait chaque année plus de 1,5 million de victimes, surtout de ...

  15. The comparison of psychological adjustment of patients with cleft lip and palate after maxillary distraction osteogenesis and conventional orthognathic surgery.

    Science.gov (United States)

    Chua, Hannah Daile P; Ho, Samuel M Y; Cheung, Lim Kwong

    2012-11-01

    The objective of this study was to compare the psychological changes of patients with cleft lip and palate (CLP) undergoing maxillary Le Fort I advancement by distraction osteogenesis (DO) and conventional orthognathic surgery (CO). Prospective randomized controlled study. Participants completed a set of questionnaires to measure their psychological states preoperatively and postoperatively. When compared with CO, CLP patients treated with DO had lower social self-esteem and higher social avoidance and distress levels during the first 3 postoperative months. Their self-esteem, social avoidance, and distress levels improved after the distractors were removed. Both CO and DO patients had similar levels of self-esteem, social avoidance, and distress levels 2 years postoperatively. The CLP patients treated with DO were more satisfied with their lives after 2 years. DO may induce short-term distress to patients up to 3 months but CLP patients who received DO were more satisfied with their lives in the long term. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Nonunion of the external maxillary distraction in cleft lip and palate: analysis of possible reasons.

    Science.gov (United States)

    He, Dongmei; Genecov, David G; Barcelo, Raul

    2010-10-01

    Distraction osteogenesis (DO) is an effective way to treat severe maxillary deficiency in patients with cleft lip and palate. It has been reported to have long-term stability and low relapse rate compared with conventional maxillary osteotomy in large maxillary movement. However, complications such as nonunion are seldom reported. While developing our external distraction techniques, we had 4 nonunion cleft lip and palate (CLP) patients. The aim of this study is to analyze the possible reasons for these conditions by comparing them to patients successfully treated at 1 craniofacial institute. Fifty-six patients with CLP deformities treated with external maxillary distraction from 2000 to 2006 in 1 craniofacial center were reviewed. Among them, 17 had full records and follow-up time of more than 1 year. They had rigid external halo distraction with dental splint after a high Le Fort I osteotomy. Distraction was started at 5 days with a rate of 1 mm per day until the maxilla acquired the planned correction. Consolidation time ranged from 4 weeks to 3 months. Patients' general information, DO protocol, and cephalometric radiograph measurements before DO, immediately after DO, and follow-ups were evaluated. Thirteen of 17 patients successfully completed DO, whereas 4 others developed dental occlusion relapse 2 to 3 months after device removal. Later jaw surgery showed nonunion at the distraction sites. These were our first patients treated with external distraction. Their consolidation time was from 4 to 6 weeks with a mean of 5.2 weeks. After increasing the consolidation time up to 12 weeks, all of the other 13 patients had successful results without nonunion. Their mean consolidation time was 9.8 weeks. The nonunion group had significantly shorter consolidation time, older age, and larger distraction osteogenesis (DO) advancement than the successful group statistically. There was also a greater percentage of bilateral CLP patients in the nonunion group than in the

  17. Le don gratuit. Le cas d'un établissement public

    OpenAIRE

    Barel , Yvan; Frémeaux , Sandrine

    2008-01-01

    Disponible en ligne : http://www.annales.org/gc/2008/gc94/barel.pdf; La logique de la réciprocité est le cadre d'analyse dominant de la relation de travail. La logique du don/contredon s'inscrit dans ce même cadre de référence, en postulant qu'aucune relation d'échange ne peut survivre à une situation d'asymétrie trop forte (MAUSS, 1924). Mais elle ajoute une idée nouvelle en mettant en exergue le " tabou du calcul " (BOURDIEU, 1980) : le désir de contredon n'est pas toujours manifesté, ni mê...

  18. L’Association du personnel, le TREF, le Comité des Finances et le Conseil du CERN

    CERN Multimedia

    Staff Association

    2016-01-01

    L’Association du personnel, forte de son approche participative et consensuelle, recherche toujours le meilleur accord possible pour l’Organisation et son personnel. Pour ce faire, discussions et concertation avec la Direction, travail d’explication et de persuasion au TREF et ailleurs auprès des délégués des États membres sont nos principaux atouts. TREF (Tripartite Employment Conditions Forum), un Forum d’échanges, de discussions « L’objectif du Forum est d’améliorer le processus de prise de décision  en donnant aux personnes concernées la possibilité et le temps de comprendre pleinement la position de tous les participants. » (CERN/RTG/8) Le Forum tripartite sur les conditions d’emploi (TREF), créé par le Conseil du CERN en juin 1994, est composé de r...

  19. Three-dimensional computed tomographic evaluation of bilateral sagittal split osteotomy lingual fracture line and le fort I pterygomaxillary separation in orthognathic surgery using cadaver heads: ultrasonic osteotome versus conventional saw.

    Science.gov (United States)

    Dammous, Sophie; Dupont, Quentin; Gilles, Roland

    2015-06-01

    The purpose of this study was to observe the quality of the fracture line on the lingual side of the mandible after sagittal split osteotomy and the quality of pterygomaxillary separation after Le Fort I osteotomy using the BoneScalpel ultrasonic osteotome. Bimaxillary procedures, according to the standard protocol, were performed using 10 fresh cadaver heads. The ultrasonic osteotome was used in the study group, and a reciprocating saw was used in the control group. Three-dimensional reconstructions of postoperative computed tomographic scans were obtained. The lingual ramus fracture pattern and the pterygomaxillary separation pattern were observed, classified, and compared. Postoperative dissections of the skulls were performed to assess the integrity of the infra-alveolar nerve and the descending palatine artery. No significant differences were found in the cutting time of bone between the BoneScalpel and the sagittal saw. Of the sagittal split osteotomies in the study group, 90% showed a good pattern (vertical pattern of fracture line extending to the inferior border of the mandible running behind the mandibular canal) compared with 50% of the sagittal split osteotomies in the control group. Ideal separation of the pterygoid plates without fractures was observed in 80% of the Le Fort I osteotomies in the study group compared with 50% of the osteotomies in the control group. High-level fractures occurred in 30% of cases in the control group compared with none in the study group. The integrities of the infra-alveolar nerve and the descending palatine artery were preserved in all cases. Use of the ultrasonic BoneScalpel did not require more time than the conventional method. An improved pattern of lingual fracture lines in mandibular sagittal split osteotomy procedures and the pattern of pterygomaxillary separation in Le Fort I osteotomy procedures were observed. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc

  20. High-power diode laser in the circumvestibular incision for Le Fort I osteotomy in orthognathic surgery: a prospective case series study.

    Science.gov (United States)

    Jaeger, Filipe; Chiavaioli, Gustavo Marques; de Toledo, Guilherme Lacerda; Freire-Maia, Belini; Amaral, Marcio Bruno Figueiredo; Mesquita, Ricardo Alves

    2018-01-01

    The incisions during orthognathic surgery are classically performed with conventional scalpel or electrocautery. Considering that the high-power diode laser surgery may provide advantages when compared to conventional incision techniques, the current study aimed to present a prospective case series of patients submitted to circumvestibular incision for Le Fort I osteotomy. Ten patients with dentofacial deformities who underwent to rapid assisted maxillary expansion or bimaxillary orthognathic surgery were enrolled in the study. All incisions were performed by a single surgeon using an 808-nm diode laser, with an optical fiber of 600 μm, at a power of 2.5 W, in a continuous-wave mode. The performance of the incision was evaluated by incision velocity, bleeding, edema, secondary infection, clinical healing, and pain. The velocity of the incision ranged from 0.10 to 0.20 mm/s (mean 0.13 ± 0.03 mm/s). Considering bleeding during the soft tissue incision, all surgeries were classified as absent bleeding. All patients presented a clinical healing of the surgical wound in a period that range from 3 to 5 weeks and experienced swelling during the follow-up period. On average, approximately 50% of the swelling had resolved after the third postoperative week, and 28.8% of swelling remained after 2 months after the surgery. The pain decreased after 2 and 3 days, and 90.0% of the patients reported no pain after 7 postoperative days. High-power diode laser is effective and safety during circumvestibular incisions for Le Fort I osteotomy in orthognathic surgery decreasing bleeding, surgery time, pain, and edema after orthognathic surgery.

  1. Le premier régime de protection sociale du Nigeria | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    14 juin 2017 ... La démarche de financement de la recherche du PEP est singulière et fort efficace, car elle vise plutôt à améliorer l'expertise des chercheurs des pays en développement ... Le modèle du PEP fonctionne bien, a-t-il ajouté, et il a une influence fort positive sur l'élaboration éclairée de politiques nationales. ».

  2. Le Recul de la Forêt au Viet Nam

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le fait d'ignorer la réalité pragmatique dans un souci d'opportunisme politique ne ... Si le texte de l'étude que voici a été rédigé en solo, les choses ont été fort différentes sur ..... Parmi les ressources requises par le système mondial — mis en place par les .... Les guerres dont le Viet Nam a été le théâtre au cours du dernier ...

  3. Le front oriental de Lille

    Directory of Open Access Journals (Sweden)

    Étienne Poncelet

    2011-06-01

    Full Text Available De la porte d’eau de la Basse Deûle jusqu’au fort Saint-Sauveur, le front oriental de Lille, fortifié à l’époque espagnole, glisse ses courtines dans les entrelacs du périphérique et des gares. L’enjeu urbain actuel consiste à s’appuyer sur ces murs historiques pour « passer malgré tout » à travers cet écheveau urbain et retisser les fils de la continuité des promenades au cœur de la ville. Moins connus que le front occidental de la reine des citadelles, ces anciens espaces militaires sont une chance pour l’urbanisme de demain dont les opérations en cours de la Porte de Gand et de la Basse Deûle témoignent déjà.The east wall, at Lille, fortified during the period of Spanish occupation, extends from the Porte d'Eau de la Basse-Deûle to the Saint-Sauveur fort. Its curtain walls emerge today in a landscape of ring roads and railway territories. The issue today is to profit from these historic walls in order to make some sense of the urban chaos and to reinstate some urban continuity in the city-centre walkways. Although they are not as well known as the western wall of this major fortified city, these former military properties are an exciting opportunity for tomorrow's town-planners, as the operations already underway at the Porte de Gand et de la Basse Deûle suggest.

  4. Fortællinger om sorg og tab – når det personlige bliver socialt?

    DEFF Research Database (Denmark)

    Christensen, Dorthe Refslund; Sandvik, Kjetil

    2016-01-01

    Vi fortæller om døden, om det at miste og føle sorg. Kulturhistorisk er litteratur, teater og malerkunst scener for netop dette emne. Som socialt fænomen ser vi dog ikke i samme omfang fortællinger om død, tab og sorg, eftersom emnet typisk har været anskuet som et privat anliggende. Bestemte...

  5. Biomechanical evaluation of sagittal maxillary internal distraction osteogenesis in unilateral cleft lip and palate patient and noncleft patients: a three-dimensional finite element analysis.

    Science.gov (United States)

    Olmez, Sultan; Dogan, Servet; Pekedis, Mahmut; Yildiz, Hasan

    2014-09-01

    To compare the pattern and amount of stress and displacement during maxillary sagittal distraction osteogenesis (DO) between a patient with unilateral cleft lip and palate (UCLP) and a noncleft patient. Three-dimensional finite element models for both skulls were constructed. Displacements of the surface landmarks and stress distributions in the circummaxillary sutures were analyzed after an anterior displacement of 6 mm was loaded to the elements where the inferior plates of the distractor were assumed to be fixed and were below the Le Fort I osteotomy line. In sagittal plane, more forward movement was found on the noncleft side in the UCLP model (-6.401 mm on cleft side and -6.651 mm on noncleft side for the central incisor region). However, similar amounts of forward movement were seen in the control model. In the vertical plane, a clockwise rotation occurred in the UCLP model, whereas a counterclockwise rotation was seen in the control model. The mathematical UCLP model also showed higher stress values on the sutura nasomaxillaris, frontonasalis, and zygomatiomaxillaris on the cleft side than on the normal side. Not only did the sagittal distraction forces produce advancement forces at the intermaxillary sutures, but more stress was also present on the sutura nasomaxillaris, sutura frontonasalis, and sutura zygomaticomaxillaris on the cleft side than on the noncleft side.

  6. La lutte contre le tabagisme en Afrique : Peuples, politique et ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    22 déc. 2011 ... Le tabagisme se répand rapidement en Afrique subsaharienne sous l'impulsion d'une forte croissance économique et des tactiques publicitaires agressives des multinationales du tabac ; bien que les interventions politiques y soient bien comprises, l'économie politique du contrôle du tabagisme ne l'est ...

  7. Three-Dimensional Reconstruction of Post-Traumatic Deficient Anterior Maxilla.

    Science.gov (United States)

    Rachmiel, Adi; Shilo, Dekel; Aizenbud, Dror; Pen, Mark; Rachmiel, Dana; Emodi, Omri

    2017-12-01

    Maxillary retrognathism appears in 14.3% of patients exhibiting malocclusion after trauma treatment. This report describes the application of alveolar distraction osteogenesis (ADO) for treating the severely deficient anterior maxilla after trauma injuries in the vertical and anteroposterior planes. This is a retrospective study of patients exhibiting severe vertical and anteroposterior maxillary bone deficiency after trauma injuries and treated by ADO as a first stage with additional Le Fort I advancement when required. Predictor variables included ADO for alveolar augmentation and Le Fort I advancement for anteroposterior discrepancy after ADO. Outcome variables included dental implant failure and anteroposterior maxillary relations. Twelve patients with severe atrophic anterior maxilla secondary to trauma injuries were included and treated using ADO. In accordance to the size of the horizontal deficiency, 1 or 2 distractors were used. Vertical alveolar distraction was performed and the transported segments were elongated at a rate of 0.5 mm/day to a mean total of 13.9 mm (12 to 15 mm). In 4 of 12 cases, there was a severe anteroposterior discrepancy larger than 8 mm that could not be fully corrected using an anterior inclination during the vertical elongation. Therefore, a second stage of conventional Le Fort I advancement was performed. Thirty-eight dental implants were inserted, with a survival rate of 97.37% (median follow-up, 6.2 yr). This report describes treatment of the deficient anterior maxilla after trauma injuries in the vertical and anteroposterior planes, including implant-based dental rehabilitation. The main advantages include simultaneous bone and mucosa augmentation, no donor site morbidity, considerably higher vertical augmentation compared with other methods, and minimal relapse. Using an additional Le Fort I advancement in severe cases permits a useful method for proper repositioning of the maxilla, thus resulting in superior

  8. : tous les projets | Page 161 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Malgré la très forte croissance économique observée au Pérou, le marché du travail ne permet pas d'offrir de meilleurs emplois à tout le monde. Date de début : 4 septembre 2012. End Date: 4 octobre 2014. Sujet: OCCUPATIONAL STRUCTURE, LABOUR MARKET, ACCESS TO MARKETS, DISADVANTAGED GROUPS, ...

  9. Archaeological Surveys and Evaluations of Four Construction Areas in the Vicinity of Fort Jackson, Plaquemines Parish, Louisiana

    Science.gov (United States)

    1992-04-01

    the officers’ quarters, a hospital, and an inspector’s quarters (Greene 1982:128-129). The fort itself was a regular pentagon with bastions at each...Outside of the moat another brick wall was constructed, facing a second ditch. A bridge over the second ditch led southward to a water battery whose...Archaeological Swrveys and Evaluations at Fort Jackson du Pratz, Le Page 1975 The History of Louisiana. Louisiana American Revolution Bicentennial Commission

  10. La fouille du fort Saint-Georges à Chinon (Indre-et-Loire. Premiers résultats The excavation of fort Saint-Georges at Chinon (Indre-et-Loire. First results

    Directory of Open Access Journals (Sweden)

    Bruno Dufaÿ

    2006-05-01

    Full Text Available Cette note présente les premiers résultats des fouilles menées en 2003 et 2004 sur la quasi-totalité du fort Saint-Georges à Chinon (Indre-et-Loire. Celui-ci est l’un des trois éléments de la forteresse médiévale qui domine la ville. La fouille a permis de préciser la fonction du fort, construit dans la deuxième moitié du XIIe s., à l’époque où Chinon est le centre administratif des possessions continentales des Plantagenêt, rois d’Angleterre. Du point de vue militaire, il formait une fortification avancée, protégeant le château principal, selon une structure que Richard Cœur de Lion appliquera au Château Gaillard. À l’intérieur, de vastes bâtiments constituaient des logis, conçus peut-être au départ pour héberger la chancellerie royale.This article presents the first results of the excavations undertaken in 2003 and 2004 over almost all of the Fort Saint-Georges at Chinon (Indre-et-Loire, one of three elements of the medieval fortress which dominates the town. The excavation enabled us to clarify the function of the fort, built in the 2nd half of the 12th century at a time when Chinon was the administrative centre of the continental possesions of the Plantagenet King of England. From a military point of view, it formed an advanced fortification protecting the main castle, within a structure that Richard the Lionheart would apply to the Chayeau Gaillard. Inside, some vast buildings made up the dwellings, designed perhaps initially to house the royal chanceller.

  11. Field Demonstration of Aviation Turbine Fuel MIL-T-83133C, Grade JP-8 (NATO Code F-34), at Fort Bliss, TX

    Science.gov (United States)

    1992-09-01

    APO NY 09052 CDR US ARMY NATICK RD&E CTR DOD PROJ MGR, MOBILE ELECTRIC POWER ATTN: SATNC-US US ARMY TROOP SUPPORT COMMAND NATICK MA 01760-5020 ATUN ...US ARMY QUARTERMASTER SCHOOL ATUN : LOEA-PL (MR LeVAN) I ATTN: ATSM-CDM 1 NEW CUMBERLAND PA 17070 ATSM-PWD I FORT LEE VA 23801 PETROLEUM FIELD OFFICE...ARTILLERY CENTER US ARMY INFANTRY SCHOOL & FORT BLISS ATTN: ATSH-CD-MIS-M I ATUN : ATZC-ISL-PP 3 ATSH-CD-TSM-T 1 ATZC-ISL-MM 3 FORT BENNING GA 31905-5400

  12. L'analyse des risques l'expert, le décideur et le citoyen

    CERN Document Server

    Chevassus-au-Louis, Bernard

    2007-01-01

    Selon le modèle "standard" d'analyse du risque, utilisé majoritairement aujourd'hui, les experts basent leurs pratiques sur des hypothèses, des concepts, voire des valeurs implicites qui ne peuvent être considérées comme des évidences. La fin du XXe siècle a marqué une crise de l'expertise. Progressivement s'est instauré un débat autour du principe de précaution, principe dont l'application a des conséquences pour la décision et pour l'évaluation du risque lui-même. De son côté, la société civile a un rôle participatif fort à jouer. Se dessinent ainsi les contours d'une analyse de risque "postmoderne", dite "constructiviste", qu'il s'agit de mettre à l'épreuve concrètement.

  13. Electronic Gaming as Pain Distraction

    Directory of Open Access Journals (Sweden)

    Eleanor Jameson

    2011-01-01

    Full Text Available The current study investigated whether active distraction reduces participants’ experience of pain more than passive distraction during a cold pressor task. In the first experiment, 60 participants were asked to submerge their hand in cold (2°C water for as long as they could tolerate. They did this with no distraction, and then with active (electronic gaming system and passive (television distraction, in randomly assigned order. Tolerance time, pain intensity ratings and task absorption ratings were measured for each condition. A second experiment attempted to control for participants’ expectations about the effects of distraction on pain. Forty participants underwent the same experimental procedure, but were given verbal suggestions about the effects of distraction by the experimenter before each distraction condition. Participants in both experiments had a significantly higher pain tolerance and reported less pain with the active distraction compared with passive or no distraction. Participants reported being more absorbed, and were significantly more willing to do the task again when they had the active distraction compared with both passive distraction and no distraction. They also had more enjoyment, less anxiety and greater reduction in pain with active distraction than with passive distraction. There was no effect of suggestion. These experiments offer further support for the use of electronic games as a method of pain control.

  14. Vertical distraction of the severely resorbed mandible - The Groningen Distraction Device

    NARCIS (Netherlands)

    Raghoebar, GM; Heydenrijk, K; Vissink, A

    2000-01-01

    In this paper, both the surgical procedure and the clinical results of a novel distraction device to augment a severely resorbed anterior edentulous mandible are described. The distraction device is non-voluminous, and consists of two distraction screws and one guide screw. Two months after the last

  15. Distraction rate and latency: factors in the outcome of paediatric maxillary distraction.

    Science.gov (United States)

    Higuera, Stephen; Cole, Patrick; Stephenson, J B; Hollier, Larry

    2009-12-01

    Over 50 years ago, current tenets of distraction osteogenesis were developed through work on the lower extremity; however, the application of these tenets in the paediatric craniofacial skeleton remains questionable. Prompted by recent concern that traditional aspects of distraction may be either outdated or wholly inapplicable to the paediatric maxilla, we retrospectively evaluated maxillary distraction protocol using a 24-h latency period in conjunction with a distraction rate of 2mm/day. Following maxillary advancement via a distraction protocol consisting of a 24-h latency period and a distraction rate of 2mm/day, seven consecutive paediatric cases were evaluated. Standard profile photos and cephalometric films taken preoperatively, at device removal and at 1-year follow-up were compared. With the sella as the point of registration, pre- and post-distraction films were superimposed on the sella-nasion plane. Sella-nasion-subspinale, the angle of convexity, the distance from incisal edges to the y-axis, and angulation of the upper incisor to the sella-nasion plane were analysed to evaluate hard-tissue changes. Patient age ranged from 3 to 14 years (mean=7.43 years). Maxillary distraction length averaged 11 mm (range=10-12 mm). Interval from device application to removal averaged 98 days (range=75-180 days). The interval of the active distraction ranged from 11 to 65 days (mean=24 days). From distraction completion to device removal averaged 85 days (range=60-150). Follow-up intervals ranged from 52 to 24 months (mean=34 months). All patients demonstrated substantial clinical advancement of the maxilla with correction of midfacial deficiencies. A single patient developed mild cellulitis at one skin-device interface; no other complications were noted. Cephalometric and clinical evaluations at 1 year post-distraction demonstrated stable results, and parental satisfaction was qualitatively high. The surgical dogma of lower-extremity distraction osteogenesis is not

  16. Distracted Driving

    Science.gov (United States)

    ... and increased awareness of distracted driving using radio advertisements, news stories, and similar media. After the projects ... available at www.trafficsafetymarketing.gov . Distracted Driving Enforcement – TV Ads (Paid). For re-tagging, go to: www. ...

  17. Preoperative and Postoperative CT Scan Assessment of Pterygomaxillary Junction in Patients Undergoing Le Fort I Osteotomy: Comparison of Pterygomaxillary Dysjunction Technique and Trimble Technique-A Pilot Study.

    Science.gov (United States)

    Dadwal, Himani; Shanmugasundaram, S; Krishnakumar Raja, V B

    2015-09-01

    To determine the rate of complications and occurrence of pterygoid plate fractures comparing two techniques of Le Fort I osteotomy i.e., Classic Pterygomaxillary Dysjunction technique and Trimble technique and to know whether the dimensions of pterygomaxillary junction [determined preoperatively by computed tomography (CT) scan] have any influence on pterygomaxillary separation achieved during surgery. The study group consisted of eight South Indian patients with maxillary excess. A total of 16 sides were examined by CT. Preoperative CT was analyzed for all the patients. The thickness and width of the pterygomaxillary junction and the distance of the greater palatine canal from the pterygomaxillary junction was noted. Pterygomaxillary dysjunction was achieved by two techniques, the classic pterygomaxillary dysjunction technique (Group I) and Trimble technique (Group II). Patients were selected randomly and equally for both the techniques. Dysjunction was analyzed by postoperative CT. The average thickness of the pterygomaxillary junction on 16 sides was 4.5 ± 1.2 mm. Untoward pterygoid plate fractures occurred in Group I in 3 sides out of 8. In Trimble technique (Group II), no pterygoid plate fractures were noted. The average width of the pterygomaxillary junction was 7.8 ± 1.5 mm, distance of the greater palatine canal from pterygomaxillary junction was 7.4 ± 1.6 mm and the length of fusion of pterygomaxillary junction was 8.0 ± 1.9 mm. The Le Fort I osteotomy has become a standard procedure for correcting various dentofacial deformities. In an attempt to make Le Fort I osteotomy safer and avoid the problems associated with sectioning with an osteotome between the maxillary tuberosity and the pterygoid plates, Trimble suggested sectioning across the posterior aspect of the maxillary tuberosity itself. In our study, comparison between the classic pterygomaxillary dysjunction technique and the Trimble technique was made by using postoperative CT scan

  18. Fortællingen

    DEFF Research Database (Denmark)

    Hejlsted, Annemette

    Fortællingen - teori og analyse introducerer til teorier om fortællingen og præsenterer et sæt af analytiske tilgange til fortællinger af enhver art. Bogen lægger vægt på læsersynsvinklen og retter opmærksomheden mod de vilkår for menings- og betydningsdannelse, der kendetegner fortællingen. Begr....... Begreber om plot, fortællingens verden, karakterer, fortæller, modus og genre behandles, og deres anvendelse demonstreres på dansk og nordisk litteratur - med inddragelse af eksempler fra film og tv-reklamer....

  19. Lele des institutions dans le processus de l’innovation ; l’apport de Thorstein Veblen

    Directory of Open Access Journals (Sweden)

    Diane-Gabrielle Tremblay

    2007-10-01

    Full Text Available Nous nous intéressons ici au rôle des institutions dans le processus de l’innovation, puisque Veblen le met en valeur. Cet apport de Veblen nous paraît déterminant pour mieux comprendre l’innovation, surtout que l’on parle de plus en plus d’une diversité de formes d’innovation (technologique, mais aussi organisationnelle, sociale et de produit, et que celles-ci sont mieux comprises lorsque l’on tient compte du rôle des institutions dans la diffusion ou le blocage de l’innovation. Veblen met aussi en évidence le caractère parfois retardataire des institutions, ainsi que la réciprocité des effets entre technologie et institutions, autant d’éléments fort pertinents pour l’analyse, encore aujourd’hui.This paper addresses the role of institutions in the process of innovation, since Veblen highlights this role. This contribution of Veblen appears determinant to better understand the process of innovation, especially in a context where we are more and more interested in various forms of innovation (technological, but also organisational, social and product innovations; these various forms of innovation are better understood and analysed when the role of institutions in their diffusion or lack of diffusion is taken into account. Veblen also highlights the fact that institutions sometimes block or slow down the process of diffusion of innovations, as well as the reciprocity of effects between technology and institutions, contributions which are all the more important for the analysis of innovation today.

  20. Distracted Biking: An Observational Study.

    Science.gov (United States)

    Wolfe, Elizabeth Suzanne; Arabian, Sandra Strack; Breeze, Janis L; Salzler, Matthew J

    2016-01-01

    Commuting via bicycle is a very popular mode of transportation in the Northeastern United States. Boston, MA, has seen a rapid increase in bicycle ridership over the past decade, which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at 4 high traffic intersections in Boston during various peak commuting hours for 2 types of distractions: auditory (earbuds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%), 95% CI [29, 33%], were distracted. Of those observed, auditory distractions were the most common (N = 349; 17.7%), 95% CI [16, 19], p = .0003, followed by visual/tactile distractions (N = 266; 13.5%), 95% CI [12, 15]. The highest proportion (40.7%), 95% CI [35, 46], of distracted bicyclists was observed during the midday commute (between 13:30 and 15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost a third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured.

  1. Distraction of the alveolar crest

    NARCIS (Netherlands)

    Raghoebar, GM; Liem, RBS; Schoen, PJ; Vissink, A; Arnaud, E; Diner, PA

    2001-01-01

    The surgical procedure and clinical results of the Groningen Distraction Device (GDD) to augment the severely resorbed edentulous mandible are described. The GGD is non-voluminous, and consists of 2 distraction screws and I guide screw. Two months after the last day of distraction, both distraction

  2. Driven to Distraction.

    Science.gov (United States)

    Strayer, David L; Cooper, Joel M

    2015-12-01

    We address several themes that emerged in the commentaries related to our target article. First, we consider the relationship between cognitive distraction and crash risk. Second, we discuss the development of our cognitive distraction scale. Third, we weigh issues of self-regulation, appropriate baselines, and satisficing. Finally, we identify several areas where additional research is needed to refine our understanding of driver distraction and crash risk. © 2015, Human Factors and Ergonomics Society.

  3. Maxillary distraction in patients with cleft deformity using a rigid external distraction device: a pilot study on the distraction ratio of the maxilla to the device.

    Science.gov (United States)

    Harada, Kiyoshi; Sato, Masaru; Omura, Ken

    2004-01-01

    We examined the ratio between actual maxillary distraction and the distraction of the rigid external distraction device (Rigid external distraction (RED) system) used for maxillary distraction in patients with a cleft deformity. Twelve patients were examined. The amount of maxillary advancement was measured on lateral cephalograms and divided by the activation amount on the RED system. The value obtained was represented as the distraction ratio of the maxilla to the system. The mean ratio in 10 patients with complete cleft lip, palate, and alveolus (complete cleft) was 0.24. However, the ratios in two patients with cleft lip and alveolus or soft cleft palate (incomplete cleft) were considerably higher than the mean ratios in patients with complete cleft. When the maxilla is distracted in patients with complete cleft using the RED system, the amount of activation on the system needs to be about four times the amount of planned maxillary distraction. However, the distraction ratio may be affected by the type of cleft.

  4. Les enjeux du modèle standard

    CERN Document Server

    CERN. Geneva

    2008-01-01

    Toute la matière visible dans l'Univers est décrite par le « Modèle Standard ». Selon cette théorie, la matière est constituée d'atomes, qui contiennent des électrons orbitant autour de noyaux, dont les composants fondamentaux sont les quarks. Quatre forces fondamentales agissent entre ces particules élémentaires : les forces électromagnétique est gravitationnelle, et les interactions nucléaires forte et faible. La description fournie par le Modèle Standard de ces particules et de leurs interactions est en parfait accord avec les expériences. Néanmoins, des questions fondamentales restent sans réponse jusqu'à maintenant : d'où vient la masse des particules ? Pourquoi y a-t-il tant de types de particules ? Existe-t-il une théorie unifiée de toutes les interactions ? Quelle est la nature de la matière cachée prédite par les astrophysiciens ? Le LHC au CERN donnera des éléments de réponse à ces questions au-delà du Modèle Standard.

  5. Le LHC, un tunnel cosmique

    CERN Multimedia

    CERN. Geneva

    2009-01-01

    Et si la lumière au bout du tunnel du LHC était cosmique ? En d’autres termes, qu’est-ce que le LHC peut nous apporter dans la connaissance de l’Univers ? Car la montée en énergie des accélérateurs de particules nous permet de mieux appréhender l’univers primordial, chaud et dense. Mais dans quel sens dit-on que le LHC reproduit des conditions proches du Big bang ? Quelles informations nous apporte-t-il sur le contenu de l’Univers ? La matière noire est-elle détectable au LHC ? L’énergie noire ? Pourquoi l’antimatière accumulée au CERN est-elle si rare dans l’Univers ? Et si le CERN a bâti sa réputation sur l’exploration des forces faibles et fortes qui opèrent au sein des atomes et de leurs noyaux, est-ce que le LHC peut nous apporter des informations sur la force gravitationnelle qui gouverne l’évolution cosmique ? Depuis une trentaine d’années, notre compréhension de l’univers dans ses plus grandes dimensions et l’appréhension de son comportement aux plus peti...

  6. Amélioration de la situation des pauvres sur le marché du travail en ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Les pays africains connaissent enfin une forte croissance économique, ce qui accélère la transition d'économies fondées sur l'agriculture vers le secteur manufacturier. Toutefois, l'agriculture occupe toujours une place plus importante dans l'économie en Afrique que n'importe où ailleurs dans le monde. Au Ghana, à ...

  7. Reflections of distraction in memory: transfer of previous distraction improves recall in younger and older adults.

    Science.gov (United States)

    Thomas, Ruthann C; Hasher, Lynn

    2012-01-01

    Three studies explored whether younger and older adults' free recall performance can benefit from prior exposure to distraction that becomes relevant in a memory task. Participants initially read stories that included distracting text. Later, they studied a list of words for free recall, with half of the list consisting of previously distracting words. When the memory task was indirect in its use of distraction (Study 1), only older adults showed transfer, with better recall of previously distracting compared with new words, which increased their recall to match that of younger adults. However, younger adults showed transfer when cued about the relevance of previous distraction both before studying the words (Study 2) and before recalling the words (Study 3) in the memory test. Results suggest that both younger and older adults encode distraction, but younger adults require explicit cueing to use their knowledge of distraction. In contrast, older adults transfer knowledge of distraction in both explicitly cued and indirect memory tasks. Results are discussed in terms of age differences in inhibition and source-constrained retrieval.

  8. Diaspora et économie internationale: le cas des Sud-Africains d’origine indienne

    Directory of Open Access Journals (Sweden)

    Frédéric Landy

    2003-03-01

    Full Text Available L’Inde rêve que la diaspora indienne joue un rôle économique comparable à celui de la diaspora chinoise pour la Chine. En comparant trois cartes de la répartition mondiale des personnes d’origine indienne et des investissements internationaux, on constate que les pays à forte communauté indienne ne sont pas toujours des partenaires économiques majeurs de l’Inde. Celle-ci demeure une référence forte pour la diaspora, parfois très ancienne. Le cas de l’Afrique du Sud illustre bien la dissolution des liens matériels entre les personnes d’origine indienne et l’Inde, aggravée par la coupure de l’apartheid: la carte de l’Inde a souvent disparu des esprits, au profit d’une Inde bien plus abstraite.

  9. Approximation auto-coherente a deux particules, pseudogap et supraconductivite dans le modele de Hubbard attractif

    Science.gov (United States)

    Allen, Steve

    2000-10-01

    Dans cette these nous presentons une nouvelle methode non perturbative pour le calcul des proprietes d'un systeme de fermions. Notre methode generalise l'approximation auto-coherente a deux particules proposee par Vilk et Tremblay pour le modele de Hubbard repulsif. Notre methode peut s'appliquer a l'etude du comportement pre-critique lorsque la symetrie du parametre d'ordre est suffisamment elevee. Nous appliquons la methode au probleme du pseudogap dans le modele de Hubbard attractif. Nos resultats montrent un excellent accord avec les donnees Monte Carlo pour de petits systemes. Nous observons que le regime ou apparait le pseudogap dans le poids spectral a une particule est un regime classique renormalise caracterise par une frequence caracteristique des fluctuations supraconductrices inferieure a la temperature. Une autre caracteristique est la faible densite de superfluide de cette phase demontrant que nous ne sommes pas en presence de paires preformees. Les resultats obtenus semblent montrer que la haute symetrie du parametre d'ordre et la bidimensionalite du systeme etudie elargissent le domaine de temperature pour lequel le regime pseudogap est observe. Nous argumentons que ce resultat est transposable aux supraconducteurs a haute temperature critique ou le pseudogap apparait a des' temperatures beaucoup plus grandes que la temperature critique. La forte symetrie dans ces systemes pourraient etre reliee a la theorie SO(5) de Zhang. En annexe, nous demontrons un resultat tout recent qui permettrait d'assurer l'auto-coherence entre les proprietes a une et a deux particules par l'ajout d'une dynamique au vertex irreductible. Cet ajout laisse entrevoir la possibilite d'etendre la methode au cas d'une forte interaction.

  10. Distraction in traffic.

    NARCIS (Netherlands)

    2013-01-01

    Many drivers, as well as cyclists and pedestrians, are occupied with all kinds of activities that can distract their attention from traffic, like listening to music, conducting a conversation on their mobile phone, or reading and typing text messages (texting). Distraction has negative effects on

  11. Effet des conditions climatiques sur le niveau du lac Sidi Ali (Moyen Atlas, Maroc)

    OpenAIRE

    Sayad, Ahmed; Chakiri, Saïd; Martin, Claude; Bejjaji, Zohra; Echarfaoui, Hassan

    2012-01-01

    Le lac Sidi Ali est un lac naturel d'altitude (2070-2080 m), sans exutoire superficiel, déterminé par le barrage d'une coulée basaltique. Doté d'un bassin versant apparent de 15,6 km2, il est alimenté par des eaux de ruissellement et par des sources karstiques. Son niveau subit des variations très fortes, annuelles et interannuelles, sous le contrôle des conditions climatiques, et en particulier des pluies et de l'évapotranspiration. Les périodes de sécheresse qui ont marqué les trois dernièr...

  12. Technologies de l'information et de la communication pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le premier titre de cette collection repose sur une série d'études analysant plusieurs expériences concrètes d'adoption et d'utilisation communautaires des technologies de l'information et de la communication (TIC) dans des contextes géographiques, technologiques, socioéconomiques, culturels et institutionnels fort ...

  13. Utilisation du test GeneXpert pour le diagnostic de la tuberculose au ...

    African Journals Online (AJOL)

    Utilisation du test GeneXpert pour le diagnostic de la tuberculose au service des maladies infectieuses du CHNU de Fann. Sylvie Audrey Diop, Aminata Massaly, Daye Ka, Noel Magloire Manga, Louise Fortes-Déguénonvo, Cheikh Tidiane Ndour, Viviane Marie Pierre Cisse, Moussa Seydi ...

  14. Le sous-titrage : une pratique à la marge de la traduction

    Directory of Open Access Journals (Sweden)

    Dumas, Louise

    2014-12-01

    Full Text Available Le sous-titre interlinguistique est un objet difficile à appréhender théoriquement. S'il permet d'aller d'une langue à une autre, il implique aussi un passage de l'écoute à la lecture et du cinéma à l'écriture. Le caractère interlinguistique est souvent mis en avant pour amener à considérer le sous-titrage comme une traduction. Sa complexité médiologique suggère toutefois qu'il est plus qu'une traduction. En même temps, les fortes contraintes (exigence de brièveté, de lisibilité, de cohérence avec l'image cinématographique auxquelles il est soumis font qu'il est moins qu'une traduction – moins exact, moins long, moins « équivalent » au texte original. Le présent travail se propose de réfléchir de manière théorique aux rapports entre sous-titrage et traduction. Pour ce faire, nous confronterons le sous-titrage aux concepts fondamentaux de la traductologie. Premièrement, le passage de l'oral à l'écrit opéré dans les sous-titres est intimement lié à la distinction traductologique entre traduction et interprétariat. Pour pouvoir condenser les dialogues, résumer leur contenu, le sous-titreur est amené à les interpréter, ce qui permet de souligner l'étroite parenté entre traduction, interprétariat et interprétation. Deuxièmement, les fortes contraintes auxquelles sont soumis les sous-titres invitent à s'interroger sur la notion d'équivalence qui se trouve normalement au principe de toute traduction. Toutes les théories traductologiques insistent sur le fait qu'une équivalence n'est jamais parfaite et que le traducteur privilégie certains niveaux d'équivalence : en poussant à l'extrême cette dynamique de sélection constitutive de l'équivalence, on peut considérer que les sous-titres sont équivalents aux dialogues. En tant que cas limite, le sous-titrage permet de tester les concepts fondamentaux de la traductologie et de définir leurs limites.

  15. Le traité de Fort Jackson, 9 août 1814

    Directory of Open Access Journals (Sweden)

    Jean‑Marc Serme

    2006-04-01

    Full Text Available This paper aims to show the motives and goals of the different actors of the War of 1812 as expressed through the Muscogee Creek War (1813‑1814. The fate of the region was sealed when a gigantic land cession was conceded by Native Americans in the Treaty of Fort Jackson. Aug.9, 1814, symbolizes both the end of Native American clout in the Old Southwest and the beginning of a new era in Southern history. Andrew Jackson played a key‑role in this shift in power. Other individuals, but also social groups and entire nations were involved in a complex web of relationships and cultural, political and economic conflicts.

  16. Le Feu et ses Usages Militaires

    Directory of Open Access Journals (Sweden)

    Finó, J. F.

    1970-12-01

    Full Text Available LE feu a toujours été une arme puissante. L'homme préhistorique, les Assyriens, les Grecs, les Byzantins, les Arabes, les bombes incendiaires de notre aviation, autant d'exemples de son usage militaire dans des pays et des temps fort divers. De plus, une de ses variantes, le feu grégeois pulvérulent, a été à l'origine de la poudre à canon. Il a donc paru intéressant de rassembler quelques données à ce sujet et de rappeler briévement la production des feux de guerre, leur lancement et la défense contre ses effets. Accessoirement, de dire quelques mots sur une autre branche de la chimie de guerre: les gaz asphyxiants.

  17. The Reverend Billy Graham: The Preacher in American Politics Le Révérend Billy Graham: Le prêcheur de la politique américaine

    Directory of Open Access Journals (Sweden)

    Stephen Whitfield

    2011-03-01

    Full Text Available Au cours du dernier demi-siècle, aucune personnalité n’a été admirée avec autant de constance par ses concitoyens Américains que le Révérend Billy Graham. Démocrate, on l’associe pourtant plus volontiers à deux présidents républicains : Richard M. Nixon et George W. Bush. La présidence de Nixon fut sanctifiée par les conseils spirituels que Graham prodiguait ouvertement (mais aussi par ses conseils politiques plus confidentiels. Quant à George W. Bush, il incarne le fils prodigue : c’est l’ivrogne, le vaurien que Graham a réussi à rediriger vers le Christ, rendant ainsi possible son étonnante ascension politique. Le fort impact de cet évangéliste sur la politique des Etats-Unis et le fait que Graham soit si intimement associé aux deux présidents les plus controversés des cinquante dernières années seront au centre de notre réflexion.

  18. Development and evolution of distraction devices: Use of indigenous appliances for Distraction Osteogenesis-An overview

    Science.gov (United States)

    Andrade, Neelam; Gandhewar, Trupti; Kalra, Rinku

    2011-01-01

    An attempt has been made to review various devices as well as the outstanding studies done in the past for understanding the methodology of distraction for regeneration of bone. Lengthening of underdeveloped bones inclusive of the maxillofacial complex has been obtained by distraction osteogenesis by many authors. This could be achieved by the use of various extraoral or intraoral devices. Devices used for distraction osteogenesis must have a minimum of 2 important characteristics – they should be able to transfer distraction forces directly to the bone and secondly, should offer adequate rigidity for osseous consolidation to occur. With advanced technology and biomechanical engineering, preformed intraoral distraction devices are now available worldwide. The introduction of these intraoral bone-bourne devices have eliminated the need for bulky, cumbersome extraoral distraction devices which had problems such as external scars, pin tract infections, nerve or tooth bud injuries and poor patient compliance. The design of completely internalized custom made appliance has opened new vistas in the field of Oral and Maxillofacial Surgery. Indigenous internal devices are also economical and locally available. PMID:23482829

  19. ÉTUDE DE CAS — L'Afrique du Nord et le Moyen-Orient : L ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    6 janv. 2011 ... Le problème est le suivant : en règle générale, la sélection faite dans des stations expérimentales bien gérées produit des cultivars supérieurs aux cultivars .... Il est vite apparu que les critères de sélection des agriculteurs, en grande partie fondés sur des facteurs écologiques, sont fort différents de ceux ...

  20. L’addiction au pluriel : le cas des pratiquants de bodybuilding

    Directory of Open Access Journals (Sweden)

    Guillaume Vallet

    2016-04-01

    Full Text Available Cet article s’interroge sur les addictions dans le bodybuilding. A partir de données qualitatives recueillies auprès de 30 bodybuilders masculins et d’une analyse de 27 magazines spécialisés, nous mettons en évidence que les pratiquants les plus engagés ont de fortes probabilités d’expérimenter trois types d’addictions : addictions liées au surentraînement, addictions liées au mode de vie consommatoire, addictions liées au mode de vie identitaire. Ces addictions se construisant dans le temps dans le cadre d’un processus, nous interprétons celles-ci à partir du concept sociologique de « carrière », ce qui nous permet de construire une pyramide de l’engagement et des addictions dans le bodybuilding, reliée notamment à la problématique du genre.

  1. Affective privilege: Asymmetric interference by emotional distracters

    Directory of Open Access Journals (Sweden)

    Crystal eReeck

    2011-09-01

    Full Text Available Numerous theories posit that affectively salient stimuli are privileged in their capacity to capture attention and disrupt ongoing cognition. Two underlying assumptions in this theoretical position are that the potency of affective stimuli transcends task boundaries (i.e., emotional distracters do not have to belong to a current task-set to disrupt processing and that there is an asymmetry between emotional and cognitive processing (i.e., emotional distracters disrupt cognitive processing, but not vice versa. These assumptions have remained largely untested, as common experimental probes of emotion-cognition interaction rarely manipulate task-relevance and only examine one side of the presumed asymmetry of interference. To test these propositions directly, a face-word Stroop protocol was adapted to independently manipulate (a the congruency between target and distracter stimulus features, (b the affective salience of distracter features, and (c the task-relevance of emotional compared to non-emotional target features. A three-way interaction revealed interdependent effects of distracter relevance, congruence, and affective salience. Compared to task-irrelevant distracters, task-relevant congruent distracters facilitated performance and task-relevant incongruent distracters impaired performance, but the latter effect depended on the nature of the target feature and task. Specifically, task-irrelevant emotional distracters resulted in equivalent performance costs as task-relevant non-emotional distracters, whereas task-irrelevant non-emotional distracters did not produce performance costs comparable to those generated by task-relevant emotional distracters. These results document asymmetric cross-task interference effects for affectively salient stimuli, supporting the notion of affective prioritization in human information processing.

  2. Long term results of mandibular distraction

    Directory of Open Access Journals (Sweden)

    Batra Puneet

    2006-03-01

    Full Text Available Mandibular distraction osteogenesis has become a popular surgical modality due to its many advantages over conventional orthognathic surgical procedures. However, in spite of the technique having been used for over 15 years, no concrete long term results are available regarding the stability of results. We discuss the various studies which have reported either in favour or against the stablility of results after distraction. We report a series of 6 cases (3 unilateral and 3 bilateral distraction where distraction was carried out before puberty and followed them up to seven years after removal of distractors. This case series shows that results achieved by distraction osteogenesis are unstable or best unpredictable with respect to producing a permanent size increase in the mandible. The role of the distraction osteogenesis in overcoming the pterygomassetric sling is questionable. We suggest a multicenter study with adequate patient numbers treated with a similar protocol and documented after growth cessation to have meaningful conclusions on the debate of distraction osteogenesis versus orthognathic surgery.

  3. Distraction 'on the buses': a novel framework of ergonomics methods for identifying sources and effects of bus driver distraction.

    Science.gov (United States)

    Salmon, Paul M; Young, Kristie L; Regan, Michael A

    2011-05-01

    Driver distraction represents a significant problem in the public transport sector. Various methods exist for investigating distraction; however, the majority are difficult to apply within the context of naturalistic bus driving. This article investigates the nature of bus driver distraction at a major Australian public transport company, including the sources of distraction present, and their effects on driver performance, through the application of a novel framework of ergonomics methods. The framework represents a novel approach for assessing distraction in a real world context. The findings suggest that there are a number of sources of distraction that could potentially distract bus drivers while driving, including those that derive from the driving task itself, and those that derive from the additional requirements associated with bus operation, such as passenger and ticketing-related distractions. A taxonomy of the sources of bus driver distraction identified is presented, along with a discussion of proposed countermeasures designed to remove the sources identified or mitigate their effects on driver performance. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  4. Thermo-pneumatic canning; Le gainage thermopneumatique

    Energy Technology Data Exchange (ETDEWEB)

    Gauthron, M [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1958-07-01

    In the thermo-pneumatic canning, the fuel is enclosed in its can with a clearance that must be reduced by external heated gas pressure. The principal applications are: a) binding magnesium cans on to uranium in fuel elements of reactors cooled by CO{sub 2} under pressure, b) application of a can to a hollow bar of uranium too thin to resist the pressure of cold hydraulic canning, c) application of an aluminium can to a bar, with an initial diametrical clearance between uranium and can too great to sustain cold hydraulic canning without buckling, d) detection of major leakage in the slugs. (author) [French] Ce procede consiste a appliquer une gaine sur une barre d'uranium par pression hydrostatique d'un gaz chaud. Les principales applications sont: a) le frettage des gaines de magnesium des elements combustibles des piles refroidies au CO{sub 2} sous pression, b) le gainage d'un barreau creux qui serait ecrase a froid, c) le gainage avec un jeu initial trop fort pour etre effectue a froid sans plisser, d) la detection des fuites de cartouches. (auteur)

  5. Assessment of distraction from erotic stimuli by nonerotic interference.

    Science.gov (United States)

    Anderson, Alex B; Hamilton, Lisa Dawn

    2015-01-01

    Distraction from erotic cues during sexual encounters is a major contributor to sexual difficulties in men and women. Being able to assess distraction in studies of sexual arousal will help clarify underlying contributions to sexual problems. The current study aimed to identify the most accurate assessment of distraction from erotic cues in healthy men (n = 29) and women (n = 38). Participants were assigned to a no distraction, low distraction, or high distraction condition. Distraction was induced using an auditory distraction task presented during the viewing of an erotic video. Attention to erotic cues was assessed using three methods: a written quiz, a visual quiz, and a self-reported distraction measure. Genital and psychological sexual responses were also measured. Self-reported distraction and written quiz scores most accurately represented the level of distraction present, while self-reported distraction also corresponded with a decrease in genital arousal. Findings support the usefulness of self-report measures in conjunction with a brief quiz on the erotic material as the most accurate and sensitive ways to simply measure experimentally-induced distraction. Insight into distraction assessment techniques will enable evaluation of naturally occurring distraction in patients suffering from sexual problems.

  6. Recherches d’anatomie comparée sur le genre Stenops d’Illiger

    NARCIS (Netherlands)

    Schroeder van der Kolk, J.L.C.; Vrolik, W.

    1851-01-01

    Le genre Stenops D’Illiger contient des animaux fort curieux, qui, malgré les savantes recherches de plusieurs naturalistes, ne sont qu’imparfaitement connus. Aux observations disséminées dans les ouvrages anatomiques de Cuvier, de Meckel et de Tiedemann, chacun de nous a tâché, il y a quelque

  7. Les bourses du CRDI appuient les futurs chefs de file dans le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    13 mai 2015 ... Un programme de bourses de recherche du CRDI appuie les recherches novatrices et renforce le leadership futur et les connaissances sur les TIC, les ... Internet, la radio communautaire et la vidéo participative, présentent un fort potentiel pour faire face aux répercussions des changements climatiques et ...

  8. Taking Action on Distraction

    DEFF Research Database (Denmark)

    Biskjaer, Michael Mose; Dalsgaard, Peter; Halskov, Kim

    2016-01-01

    Insights → We identify a significant increase in digital distractions and the rise of what we call Do Not Disturb software designed to decrease, delimit, or discard these digital distractions. → Our basic typology and framework can help us understand how Do Not Disturb software is, ironically, de...

  9. Minimum distraction gap: how much ankle joint space is enough in ankle distraction arthroplasty?

    Science.gov (United States)

    Fragomen, Austin T; McCoy, Thomas H; Meyers, Kathleen N; Rozbruch, S Robert

    2014-02-01

    The success of ankle distraction arthroplasty relies on the separation of the tibiotalar articular surfaces. The purpose of this study was to find the minimum distraction gap needed to ensure that the tibiotalar joint surfaces would not contact each other with full weight-bearing while under distraction. Circular external fixators were mounted to nine cadaver ankle specimens. Each specimen was then placed into a custom-designed load chamber. Loads of 0, 350, and 700N were applied to the specimen. Radiographic joint space was measured and joint contact pressure was monitored under each load. The external fixator was then sequentially distracted, and the radiographic joint space was measured under the three different loads. The experiment was stopped when there was no joint contact under 700N of load. The radiographic joint space was measured and the initial (undistracted) radiographic joint space was subtracted from it yielding the distraction gap. The minimum distraction gap (mDG) that would provide total unloading was calculated. The average mDG was 2.4 mm (range, 1.6 to 4.0 mm) at 700N of load, 4.4 mm (range, 3.7 to 5.8 mm) at 350N of load, and 4.9 mm (range, 3.7 to 7.0 mm) at 0N of load. These results suggest that if the radiographic joint space of on a standing X-ray of an ankle undergoing distraction arthroplasty shows a minimum of 5.8 mm of DG, then there will be no contact between joint surfaces during full weight-bearing. Therefore, 5 mm of radiographic joint space, as recommended historically, may not be adequate to prevent contact of the articular surfaces during weight-bearing.

  10. Le modèle standard de la physique des particules de l'électron au boson de Higgs

    CERN Document Server

    Samueli, Jean-Jacques

    2013-01-01

    Le modèle standard de la physique des particules est une théorie qui décrit les constituants élémentaires de la matière et les interactions qui existent entre eux. Le présent ouvrage est un exposé du développement historique de ce modèle qui suppose que toute la matière est composée de quarks et de leptons, particules ponctuelles de spin 1?2. On dénombre trois générations de quarks et autant de leptons. Les interactions faible, forte et électromagnétique sont, pour leur part, décrites par des théories de jauge dont la médiation est effectuée par des quanta de jauge de spin 1. Ces médiateurs sont les ? , W + , W ? , Z ainsi que huit gluons. La gravitation est par ailleurs analysée dans l'ouvrage dans sa formulation classique et relativiste. Enfin le mécanisme dit de Englert-Brout-Higgs prévoit des particules de spin zéro, correspondant à un champ scalaire qui est supposé donner une masse aux quarks, leptons et aux bosons vecteurs intermédiaires W + , W ? , Z . Nous décrivons ce m�...

  11. Speech-Language Dissociations, Distractibility, and Childhood Stuttering

    Science.gov (United States)

    Conture, Edward G.; Walden, Tedra A.; Lambert, Warren E.

    2015-01-01

    Purpose This study investigated the relation among speech-language dissociations, attentional distractibility, and childhood stuttering. Method Participants were 82 preschool-age children who stutter (CWS) and 120 who do not stutter (CWNS). Correlation-based statistics (Bates, Appelbaum, Salcedo, Saygin, & Pizzamiglio, 2003) identified dissociations across 5 norm-based speech-language subtests. The Behavioral Style Questionnaire Distractibility subscale measured attentional distractibility. Analyses addressed (a) between-groups differences in the number of children exhibiting speech-language dissociations; (b) between-groups distractibility differences; (c) the relation between distractibility and speech-language dissociations; and (d) whether interactions between distractibility and dissociations predicted the frequency of total, stuttered, and nonstuttered disfluencies. Results More preschool-age CWS exhibited speech-language dissociations compared with CWNS, and more boys exhibited dissociations compared with girls. In addition, male CWS were less distractible than female CWS and female CWNS. For CWS, but not CWNS, less distractibility (i.e., greater attention) was associated with more speech-language dissociations. Last, interactions between distractibility and dissociations did not predict speech disfluencies in CWS or CWNS. Conclusions The present findings suggest that for preschool-age CWS, attentional processes are associated with speech-language dissociations. Future investigations are warranted to better understand the directionality of effect of this association (e.g., inefficient attentional processes → speech-language dissociations vs. inefficient attentional processes ← speech-language dissociations). PMID:26126203

  12. Anterior ankle arthroscopy, distraction or dorsiflexion?

    Science.gov (United States)

    de Leeuw, Peter A J; Golanó, Pau; Clavero, Joan A; van Dijk, C Niek

    2010-05-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, whereas in ankle distraction the anterior neurovascular bundle is pulled tight towards the joint, thereby decreasing the safe anterior working area. Six fresh frozen ankle specimens, amputated above the knee, were scanned with computed tomography. Prior to scanning the anterior tibial artery was injected with contrast fluid and subsequently each ankle was scanned both in ankle dorsiflexion and in distraction. A special device was developed to reproducibly obtain ankle dorsiflexion and distraction in the computed tomography scanner. The distance between the anterior border of the inferior tibial articular facet and the posterior border of the anterior tibial artery was measured. The median distance from the anterior border of the inferior tibial articular facet to the posterior border of the anterior tibial artery in ankle dorsiflexion and distraction was 0.9 cm (range 0.7-1.5) and 0.7 cm (range 0.5-0.8), respectively. The distance in ankle dorsiflexion significantly exceeded the distance in ankle distraction (P = 0.03). The current study shows a significantly increased distance between the anterior distal tibia and the overlying anterior neurovascular bundle with the ankle in a slightly dorsiflexed position as compared to the distracted ankle position. We thereby conclude that the distracted ankle position puts the neurovascular structures more at risk for iatrogenic damage when performing anterior ankle arthroscopy.

  13. Distraction and mind-wandering under load.

    Science.gov (United States)

    Forster, Sophie

    2013-01-01

    Attention research over the last several decades has provided rich insights into the determinants of distraction, including distractor characteristics, task features, and individual differences. Load Theory represented a particularly important breakthrough, highlighting the critical role of the level and nature of task-load in determining both the efficiency of distractor rejection and the stage of processing at which this occurs. However, until recently studies of distraction were restricted to those measuring rather specific forms of distraction by external stimuli which I argue that, although intended to be irrelevant, were in fact task-relevant. In daily life, attention may be distracted by a wide range of stimuli, which may often be entirely unrelated to any task being performed, and may include not only external stimuli but also internally generated stimuli such as task-unrelated thoughts. This review outlines recent research examining these more general, entirely task-irrelevant, forms of distraction within the framework of Load Theory. I discuss the relation between different forms of distraction, and the universality of load effects across different distractor types and individuals.

  14. Distraction and mind-wandering under load

    Directory of Open Access Journals (Sweden)

    Sophie eForster

    2013-05-01

    Full Text Available Attention research over the last several decades has provided rich insights into the determinants of distraction, including distractor characteristics, task features and individual differences. Load Theory represented a particularly important breakthrough, highlighting the critical role of the level and nature of task load in determining both the efficiency of distractor rejection and the stage of processing at which this occurs. However, until recently studies of distraction were restricted to those measuring rather specific forms of distraction by external stimuli which I argue that, although intended to be irrelevant, were in fact task-relevant. In daily life, attention may be distracted by a wide range of stimuli, which may often be entirely unrelated to any task being performed, and may include not only external stimuli but also internally generated stimuli such as task-unrelated thoughts. This review outlines recent research examining these more general, entirely task-irrelevant, forms of distraction within the framework of Load Theory. I discuss the relation between different forms of distraction, and the universality of load effects across different distractor types and individuals.

  15. A report of 2 patients with transient blindness following Le Fort I osteotomy and a review of past reported cases

    Directory of Open Access Journals (Sweden)

    Philip Mathew

    2015-01-01

    Full Text Available Blindness following a LeFort I osteotomy is a rare but extremely serious complication. Ten cases have been reported to date. None of these patients recovered vision. Optic neuropathy is believed to be the cause but the exact mechanism has not been settled. We report the first, and the only two, documented cases of complete loss of vision that recovered subsequently. The first patient was a 19-year-old male with repaired bilateral cleft lip and palate. He developed loss of vision in the right eye on the second postoperative day. The second patient was a 22-year-old male with repaired unilateral cleft lip and palate. He developed complete loss of vision in the left eye on the day of surgery. Both these patients underwent ongoing studies, which did not show any abnormalities. Both were treated with methylprednisolone. Both the patients gradually showed improvement in their vision. The first patient recovered normal vision several months postoperatively. The second patient′s vision improved to 4/60 by 4 months postoperatively. We discuss the probable mechanisms of optic nerve injury and also the possible reasons why sight was restored in these patients. This is a rare but serious complication following a fairly common procedure. Through this article we wish to create an awareness of this complication and also a possible way of avoiding such a disaster.

  16. Fortæller

    DEFF Research Database (Denmark)

    Larsen, Gorm

    2012-01-01

    Siden Gerard Genettes ”Discours du récit” (1972) er distinktionen mellem hvem, der taler, og hvem, der ser, blevet cementeret som et grundparadigme i narratologien og litteraturteorien. Genettes pointe var, at den etablerede narrative teori – som fx Wayne C. Booths The Rhetoric of Fiction (1961...... narratologi blevet forsøgt udfordret, enten fordi det hævdes, at en tekst ikke nødvendigvis er udstyret med en fortæller, eller fordi begrebet om fortæller antages at bero på en misvisende og reduktiv antropomorficering. Eller omvendt fordi der i Genettes begrebsdannelse ligger en forkastelse af...... forestillingen om en implicit forfatter (implied author) og dermed også en afvisning af en upålidelige fortæller. Kapitlet præsenterer begreberne fortæller og synsvinkel i narratologien med afsæt i Genettes bestemmelser og diskutere de problemer, der opstår i kølvandet herpå. Det være sig både de rent...

  17. Distracted Driving Raises Crash Risk

    Science.gov (United States)

    ... this issue Health Capsule Distracted Driving Raises Crash Risk En español Send us your comments Video technology ... distracted driving, especially among new drivers, raises the risk for car crashes and near crashes. The study ...

  18. Distracted shareholders and corporate actions

    NARCIS (Netherlands)

    Kempf, Elisabeth; Manconi, Alberto; Spalt, Oliver

    Investor attention matters for corporate actions. Our new identification approach constructs firm-level shareholder "distraction" measures, by exploiting exogenous shocks to unrelated parts of institutional shareholders' portfolios. Firms with "distracted" shareholders are more likely to announce

  19. Rigid external maxillary distraction and rhinoplasty for pyknodysostosis.

    Science.gov (United States)

    Varol, Altan; Sabuncuoglu, Fidan Alakus; Sencimen, Metin; Akcam, Timur; Olmez, Hüseyin; Basa, Selçuk

    2011-05-01

    This article reports the treatment of an 33-year-old female patient with pyknodysostosis by rigid external distraction II midface distraction system. The patient with pyknodysostosis described in this report had severe midfacial hypoplasia. Correction of this by use of routine orthognathic surgery would require osteosynthesis and bone grafting. Risk of infection and/or nonunion after such a surgical procedure was considered too great, and therefore the possibility of treatment by distraction osteogenesis of the maxilla was evaluated. The rigid external distraction II midface distraction system was used to relocate the hypoplastic maxilla at anterior-inferior projection. Distraction osteogenesis should be considered as the primary reconstructive method for maxillofacial deformities in patients with sclerosing bone dysplasias, since this is the second reported case treated successfully with rigid external distraction.

  20. Rapid maxillary distraction protocol utilizing the halo distraction system and rigid internal fixation.

    Science.gov (United States)

    Baker, Stephen B; Reid, Russell R; Burkey, Brooke; Bartlett, Scott P

    2007-09-01

    To shorten head frame wear time associated with external halo distraction (HD), we have adapted a protocol for maxillary distraction with the halo system that integrates plate fixation. All patients had a history of cleft lip and/or palate and maxillary retrusion > or = 8 mm. Five patients treated with this protocol and followed for at least 1 year were included in this study. The protocol included a 3-day latency period, variable maxillary distraction, and removal of the halo device with simultaneous rigid internal fixation. Two patients had a variable period of maxillomandibular fixation (MMF), which maintained the maxillary advancement and idealized intercuspal position while permitting further callus maturation. Cephalographs were obtained preoperatively, immediately following distractor removal, and 1 year after rigid internal fixation. The mean age at time of surgery was 18.7 years. The maxillary deficiency ranged from 8 to 15 mm (mean = 10.6 mm). All five patients demonstrated excellent occlusion. Cephalometric analysis 1-year post rigid internal fixation revealed minimal (maxillary distraction followed by MMF to maintain maxillary advancement may reduce halo device wear to 1 to 2 weeks. MMF optimizes occlusion by forcing the maxillary teeth into maximal intercuspal position. Rigid fixation is not only associated with less long-term relapse compared to nonrigid forms of fixation, but also minimizes the incidence of nonunion. This treatment protocol provides the advancement possible with distraction osteogenesis and the accuracy of orthognathic surgery, thereby minimizing external head frame wear.

  1. [Three-dimensional modeling of mandibular distraction].

    Science.gov (United States)

    Morgon, L A; Trunde, F; Coudert, J L; Disant, F

    2003-12-01

    Facial hemi-atrophy affects 1 in 4000 or 5000 children. We propose treating this deformation of the 1st branchial arch with the "bone distraction" lengthening technique first described by Ilizarov in the 1950s, which has already been employed with the mandible. We have modelled mandibular distraction in facial hemi-atrophy patients and discuss the benefits of such pre-surgical planning encompassing the assistance of pre- and post-operative as well as surgically coordinated orthodontic therapy. Using X scanner views of a 5 year-old girl patient, we have developed a distraction-simulation software, which makes the pathological side harmonious with the healthy side along the medial sagittal plane. In order to obtain facial symmetry, put bones in balance, and orient the occlusal plane horizontally, essential requisites of occlusal stability, it is necessary: to employ a 2 or 3-dimensional distractor, to pre-plan the distraction and screw positioning, to set up a fixed orthodontic treatment plan prior to beginning distraction therapy.

  2. Un voyage fort instructif pour des pionniers dans le domaine des ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    26 janv. 2011 ... À l'occasion de l'ouverture du 500e centre en janvier 2008, le président Mahinda Rajapakshe a annoncé l'émission d'un timbre-poste commémoratif et un projet de voyage d'étude spécial en Inde. C'est ainsi qu'une vingtaine d'exploitants de nenasalas, accompagnés de quatre responsables de l'initiative ...

  3. Effects of distraction on memory and cognition: a commentary.

    Science.gov (United States)

    Craik, Fergus I M

    2014-01-01

    This commentary is a review of the findings and ideas reported in the preceding nine articles on the effects of distraction on aspects of cognitive performance. The articles themselves deal with the disruptive effects of distraction on recall of words, objects and events, also on visual processing, category formation and other cognitive tasks. The commentary assesses the part played by "domain-general" suppression of distracting information and the "domain-specific" competition arising when tasks and distraction involve very similar material. Some forms of distraction are meaningfully relevant to the ongoing task, and Treisman's (1964) model of selective attention is invoked to provide an account of findings in this area. Finally, individual differences to vulnerability to distraction are discussed; older adults are particularly affected by distracting stimuli although the failure to repress distraction can sometimes prove beneficial to later cognitive performance.

  4. Distraction: heroic attitude before the metropolis

    Directory of Open Access Journals (Sweden)

    Rafael Zacca Fernandes

    2016-07-01

    Full Text Available Considering distraction as the heroic ethos of  modernity, I intend to analyze the perceptive changes brought about by the advance of the productive forces under capitalism; and the subsequent apprehension  of this change by four contemporary poets, namely Liv Lagerblad, Heyk Pimenta, Alberto Pucheu and Eucanaã Ferraz. Each of these poets brings distraction as what Walter Benjamin classified as inner form. In all cases, distraction appears as a poetic force before the danger of annihilation in big cities. This reflection is the basis for another, another, yet concerning the relations between poetry and politics, thinking with Jacques Rancière its position on the "distribution of the sensible". Finally, a resumption of Baudelaire, a master of distraction, seems to be inevitable.

  5. Effects of distraction on memory and cognition: A commentary

    Directory of Open Access Journals (Sweden)

    Fergus I. M Craik

    2014-07-01

    Full Text Available This commentary is a review of the findings and ideas reported in the preceding nine articles on the effects of distraction on aspects of cognitive performance. The articles themselves deal with the disruptive effects of distraction on recall of words, objects and events, also on visual processing, category formation and other cognitive tasks. The commentary assesses the part played by domain-general suppression of distracting information and the domain-specific competition arising when tasks and distraction involve very similar material. Some forms of distraction are meaningfully relevant to the ongoing task, and Treisman’s (1964 model of selective attention is invoked to provide an account of findings in this area. Finally, individual differences to vulnerability to distraction are discussed; older adults are particularly affected by distracting stimuli although the failure to repress distraction can sometimes prove beneficial to later cognitive performance.

  6. [Factors affecting bone regeneration in Ilizarov callus distraction].

    Science.gov (United States)

    Fink, B; Krieger, M; Schneider, T; Menkhaus, S; Fischer, J; Rüther, W

    1995-12-01

    We evaluated the X-rays of 36 patients who underwent 50 callus distractions. With the aid of a computerized digitalisation system for analogue films, the relative X-ray density of the distraction area was calculated for each X-ray. These relative X-ray densities were figured graphically for the duration of treatment for each patient. In the consolidation phase, the graph of each patient had a logarithmic relationship. The gradients of the logarithmic density curves were considered an indicator of the quantity of new bone formation. These gradients were correlated to the following clinical parameters: age of the patient, beginning of distraction after corticotomy, average speed of distraction, average weight bearing during the distraction and consolidation phase, location of corticotomy (distal femur versus proximal tibia) and diclofenac medication. Except for the location of the corticotomy and diclofenac, all parameters had an influence on osteoneogenesis by callus distraction. The parameters affecting new bone formation the most were the age of the patient and weight bearing. Patients aged under 18 years (p = 0.005), beginning of distraction later than 8 days (p = 0.109), an average distraction speed below 1 mm/day (p = 0.079), and average weight bearing of more than 30 kg (p = 0.068 for the distraction phase and p = 0.089 for the consolidation phase) showed a quantitatively higher rate of new bone formation by callus distraction than the patients in the other groups. Patients with a shorter leg due to poliomyelitis and one patient with an amniotic leg tie showed a slower increase in X-ray density graphs than the other patients.

  7. ALCOHOL AND DISTRACTION INTERACT TO IMPAIR DRIVING PERFORMANCE

    Science.gov (United States)

    Harrison, Emily L. R.; Fillmore, Mark T.

    2011-01-01

    Background Recognition of the risks associated with alcohol intoxication and driver distraction has led to a wealth of simulated driving research aimed at studying the adverse effects of each of these factors. Research on driving has moved beyond the individual, separate examination of these factors to the examination of potential interactions between alcohol intoxication and driver distraction. In many driving situations, distractions are commonplace and might have little or no disruptive influence on primary driving functions. Yet, such distractions might become disruptive to a driver who is intoxicated. Methods The present study examined the interactive impairing effects of alcohol intoxication and driver distraction on simulated driving performance in 40 young adult drivers using a divided attention task as a distracter activity. The interactive influence of alcohol and distraction was tested by having drivers perform the driving task under four different conditions: 0.65 g/kg alcohol; 0.65 g/kg alcohol + divided attention; placebo; and placebo + divided attention. Results As hypothesized, divided attention had no impairing effect on driving performance in sober drivers. However, under alcohol, divided attention exacerbated the impairing effects of alcohol on driving precision. Conclusions Alcohol and distraction continue to be appropriate targets for research into ways to reduce the rates of driving-related fatalities and injuries. Greater consideration of how alcohol and distraction interact to impair aspects of driving performance can further efforts to create prevention and intervention measures to protect drivers, particularly young adults. PMID:21277119

  8. Alcohol and distraction interact to impair driving performance.

    Science.gov (United States)

    Harrison, Emily L R; Fillmore, Mark T

    2011-08-01

    Recognition of the risks associated with alcohol intoxication and driver distraction has led to a wealth of simulated driving research aimed at studying the adverse effects of each of these factors. Research on driving has moved beyond the individual, separate examination of these factors to the examination of potential interactions between alcohol intoxication and driver distraction. In many driving situations, distractions are commonplace and might have little or no disruptive influence on primary driving functions. Yet, such distractions might become disruptive to a driver who is intoxicated. The present study examined the interactive impairing effects of alcohol intoxication and driver distraction on simulated driving performance in 40 young adult drivers using a divided attention task as a distracter activity. The interactive influence of alcohol and distraction was tested by having drivers perform the driving task under four different conditions: 0.65 g/kg alcohol; 0.65 g/kg alcohol+divided attention; placebo; and placebo+divided attention. As hypothesized, divided attention had no impairing effect on driving performance in sober drivers. However, under alcohol, divided attention exacerbated the impairing effects of alcohol on driving precision. Alcohol and distraction continue to be appropriate targets for research into ways to reduce the rates of driving-related fatalities and injuries. Greater consideration of how alcohol and distraction interact to impair aspects of driving performance can further efforts to create prevention and intervention measures to protect drivers, particularly young adults. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  9. Relaxation and Distraction in Experimental Desensitization.

    Science.gov (United States)

    Weir, R. O.; Marshall, W. L.

    1980-01-01

    Compared experimental desensitization with a procedure that replaced relaxation with a distraction task and with an approach that combined both relaxation and distraction. Desensitization generally was more effective than the other two procedures. (Author)

  10. Promouvoir le développement durable dans le commerce mondial et les négociations multilatérales

    Directory of Open Access Journals (Sweden)

    Christophe Bellmann

    2011-05-01

    Full Text Available Les exportations et les importations mondiales reprennent rapidement du volume après le fort déclin accusé par le commerce de marchandises en 2008-2009, comme l’indiquent les performances du commerce mondial des premier et deuxième trimestres de 2010. En dépit de cette reprise impressionnante, les préoccupations des pays de l’OCDE relatives à l’emploi, à la compétitivité et à la politique chinoise des taux de change ont engendré un climat politique défavorable à la poursuite de la libéralisation dans le cadre du Cycle de Doha. Il est intéressant de noter que les pays en développement qui hésitaient à s’engager dans un nouveau cycle de négociations en 2001 se situent maintenant à l’avant-garde de ceux qui souhaitent parvenir rapidement à une conclusion des pourparlers, bien que le consensus sur l’ambitieux « paquet du développement » envisagé initialement à Doha reste hors d’atteinte. Par ailleurs, le commerce a fait l’objet d’une attention et d’un examen sans précédents dans le cadre des débats sur les changements climatiques. Dans le contexte créé par la crise de la coopération multilatérale, la communauté internationale a un urgent besoin de générer de nouveaux types d’arrangements et de trouver des réponses innovantes aux impératifs du développement et de la transition mondiale vers une économie à faible intensité de carbone.

  11. Le modèle périurbain à l’épreuve de la catastrophe

    Directory of Open Access Journals (Sweden)

    Julien Langumier

    2007-05-01

    Full Text Available Le modèle périurbain pavillonnaire est questionné à partir d'une démarche ethnographique conduite sur un village du Narbonnais touché par des inondations catastrophiques. L'histoire de ce mode d'urbanisation montre les liens forts qui existent avec les dynamiques territoriales, en l'occurrence la crise viticole des années soixante-dix. L'inondation de 1999 perturbe ensuite les pratiques domestiques et conduit les sinistrés à redéfinir leur mode d'habiter en délaissant le bonheur pavillonnaire au profit de la quête de sécurité. Les discours des gestionnaires connaissent enfin un renversement depuis le développement urbain des campagnes des années quatre-vingt à l'imposition de la "culture du risque" dans ces quartiers à l'avenir incertain. L'approche ethnologique suit les multiples recompositions du modèle périurbain à travers l'histoire d'un territoire, les pratiques des habitants et les discours des gestionnaires.Suburbanisation is about to represent an unsustainable model of urban development for consummating space, energy and equipments. In this context, the tragic floods which affected Cuxac d’Aude village (Aude, France in 1999 can be explained by hazardous choices of planning suburban neighbourhood in risky places. The ethnographical research proposes an other approach which focuses on the bonds with the territory and the residential practices. For the deep wine crises of the 70’s and 80’s in Languedoc, the urbanization of old vineyards participates to the modernization of rural areas. After the floods, the inhabitants define new domestic practices in damaged houses. The suburban villa is no more the modern symbol of happiness but is the place of fear, stress and risk culture.

  12. Gender differences in the content of cognitive distraction during sex.

    Science.gov (United States)

    Meana, Marta; Nunnink, Sarah E

    2006-02-01

    This study compared 220 college men and 237 college women on two types of self-reported cognitive distraction during sex, performance- and appearance-based. Affect, psychological distress, sexual knowledge, attitudes, fantasies, experiences, body image, satisfaction, and sexual function were assessed with the Derogatis Sexual Functioning Inventory and the Sexual History Form to determine associations with distraction. Between-gender analyses revealed that women reported higher levels of overall and appearance-based distraction than did men, but similar levels of performance-based distraction. Within-gender analyses revealed that women reported as much of one type of distraction as the other, while men reported more performance- than appearance-based distraction. In women, appearance-based distraction was predicted by negative body image, psychological distress, and not being in a relationship, while performance-based distraction was predicted by negative body image, psychological distress, and sexual dissatisfaction. In men, appearance-based distraction was predicted by negative body image, sexual dissatisfaction and not being in a relationship, while performance-based distraction was predicted by negative body image and sexual dissatisfaction. Investigating the content of cognitive distraction may be useful in understanding gender differences in sexual experience and in refining cognitive components of sex therapy.

  13. Quatre propositions pour préciser le projet de socio-économie politique du développement durable

    OpenAIRE

    Figuière , Catherine; Rocca , Michel

    2011-01-01

    14 p.; L'objectif de cette contribution est de formuler quatre propositions pour progresser dans la définition de l'objet "développement durable" dans une démarche de "socio-économie politique". Fortement inspirées du projet d'écodéveloppement, ces propositions visent à recentrer le développement durable sur le principe de double équité inter et intra générationnelle, en combinant durabilité forte et anthropocentrisme.

  14. Distracted walking: Examining the extent to pedestrian safety problems

    Directory of Open Access Journals (Sweden)

    Judith Mwakalonge

    2015-10-01

    Full Text Available Pedestrians, much like drivers, have always been engaged in multi-tasking like using hand-held devices, listening to music, snacking, or reading while walking. The effects are similar to those experienced by distracted drivers. However, distracted walking has not received similar policies and effective interventions as distracted driving to improve pedestrian safety. This study reviewed the state-of-practice on policies, campaigns, available data, identified research needs, and opportunities pertaining to distracted walking. A comprehensive review of literature revealed that some of the agencies/organizations disseminate useful information about certain distracting activities that pedestrians should avoid while walking to improve their safety. Various walking safety rules/tips have been given, such as not wearing headphones or talking on a cell phone while crossing a street, keeping the volume down, hanging up the phone while walking, being aware of traffic, and avoiding distractions like walking with texting. The majority of the past observational-based and experimental-based studies reviewed in this study on distracted walking is in agreement that there is a positive correlation between distraction and unsafe walking behavior. However, limitations of the existing crash data suggest that distracted walking may not be a severe threat to the public health. Current pedestrian crash data provide insufficient information for researchers to examine the extent to which distracted walking causes and/or contributes to actual pedestrian safety problems.

  15. Neural Basis of Visual Distraction

    Science.gov (United States)

    Kim, So-Yeon; Hopfinger, Joseph B.

    2010-01-01

    The ability to maintain focus and avoid distraction by goal-irrelevant stimuli is critical for performing many tasks and may be a key deficit in attention-related problems. Recent studies have demonstrated that irrelevant stimuli that are consciously perceived may be filtered out on a neural level and not cause the distraction triggered by…

  16. Les normes comptables et le monde post-Enron

    OpenAIRE

    Mistral, Jacques; de Boissieu, Christian; Lorenzi, Jean-Hervé

    2003-01-01

    Que révèlent les scandales financiers récents (Enron, Worldcom...) ? Les failles des normes comptables, l'imbrication trop forte de certains métiers (par exemple l'audit et le conseil), l'insuffisance de la "corporate governance" et plus généralement des modes de régulation ? Comment retrouver la confiance dans un mode post-Enron ? Telles sont les questions que les deux rapports, celui de Jacques Mistral et celui de Christian de Boissieu et de Jean-Hervé Lorenzi, abordent. Après avoir mis en ...

  17. Arthroscopic ankle arthrodesis with intra-articular distraction.

    Science.gov (United States)

    Kim, Hyong Nyun; Jeon, June Young; Noh, Kyu Cheol; Kim, Hong Kyun; Dong, Quanyu; Park, Yong Wook

    2014-01-01

    Arthroscopic ankle arthrodesis has shown high rates of union comparable to those with open arthrodesis but with substantially less postoperative morbidity, shorter operative times, less blood loss, and shorter hospital stays. To easily perform arthroscopic resection of the articular cartilage, sufficient distraction of the joint is necessary to insert the arthroscope and instruments. However, sometimes, standard noninvasive ankle distraction will not be sufficient in post-traumatic ankle arthritis, with the development of arthrofibrosis and joint contracture after severe ankle trauma. In the present report, we describe a technique to distract the ankle joint by inserting a 4.6-mm stainless steel cannula with a blunt trocar inside the joint. The cannula allowed sufficient intra-articular distraction, and, at the same time, a 4.0-mm arthroscope can be inserted through the cannula to view the joint. Screws can be inserted to fix the joint under fluoroscopic guidance without changing the patient's position or removing the noninvasive distraction device and leg holder, which are often necessary during standard arthroscopic arthrodesis with noninvasive distraction. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Distraction osteogenesis after irradiation in a rabbit model

    International Nuclear Information System (INIS)

    Tsuchiya, Hiroyuki; Uehara, Kenji; Sakurakichi, Keisuke; Watanabe, Koji; Matsubara, Hidenori; Tomita, Katsuro

    2005-01-01

    The present study was performed to investigate the effects of preoperative irradiation on distraction osteogenesis, as little is known about how preoperative irradiation delays distraction osteogenesis. A single dose of irradiation was applied to the right rear legs of rabbits. This was followed by tibial lengthening at a rate of 0.5 mm/day, which was continued for 4 weeks. Bone regeneration was examined radiographically and histologically. In the irradiation group, the radiographs showed little regeneration during the elongation phase. During the maturation phase, the callus appeared slowly, and its formation was spotty. Furthermore, regeneration was not completed until the fourth week of the maturation period. Histological examination at the end of distraction showed a gap in the distraction consisting of loose connective tissue, with part of the fibrous tissue oriented longitudinally. Four weeks after completion of distraction, the major part of the radiolucent region consisted of cartilage. The spotty osteogenesis was identified as enchondral ossification. Immunohistochemical examination of the regeneration area revealed that the blood vessels were extremely localized, and that the level of expression of vascular endothelial growth factor (VEGF) in the osteoblasts was high. Microangiography showed that vascularization at the distracted sites was poor. Distraction osteogenesis was decreased markedly by preoperative irradiation in terms of both rate and process. The results suggested that most of the osteoprogenitor cells were damaged immediately after irradiation. The high level of VEGF in the osteoblasts and the enchondral ossification also suggested a hypoxic state in the distracted region. Preoperative irradiation interferes with distraction osteogenesis by inducing a state of poor angiogenesis. (author)

  19. Efficacy of Distraction Methods on Procedural Pain and Anxiety by Applying Distraction Cards and Kaleidoscope in Children

    Directory of Open Access Journals (Sweden)

    Nejla Canbulat, PhD

    2014-03-01

    Conclusion: The distraction cards were the most effective method for pain and anxiety relief of children during phlebotomy. Also the distraction method with kaleidoscope was an effective method for pain and anxiety relief during phlebotomy in children.

  20. Two-stage distraction lengthening of the forearm.

    Science.gov (United States)

    Taghinia, Amir H; Al-Sheikh, Ayman A; Panossian, Andre E; Upton, Joseph

    2013-01-01

    Single-stage lengthening of the forearm using callus distraction is well described; however, forearm lengthening using a 2-stage technique of distraction followed by bone grafting has received less attention. A 2-staged technique can be a better alternative in cases where the surgeon desires extensive lengthening. A retrospective review was undertaken of eleven 2-stage forearm lengthening procedures performed by 1 surgeon over a 15-year period. Indications were radial longitudinal deficiency (8 patients), neonatal ischemic contractures (2 patients), and septic growth arrest (1 patient). Average follow-up was 2.8 years. Distraction was performed on patients an average of 82 mm over an average duration of 24 weeks. Average time to union from the time of distractor removal and grafting was 87 days. Average healing index was 32.1 d/cm. Distraction problems were common and related to the length of time that the distractor was in place; they included pain, pin-related infections, and multiple mechanical device difficulties. Three patients had nonunion, and another had delayed union; however, additional procedures resulted in ultimate bony union in all patients. Demineralized bone matrix and autologous corticocancellous bone grafts yielded predictable healing and good functional results in short-distance distractions. For longer distractions, free vascularized fibula transfer produced the best outcomes. Intercalary cortical allografts did not heal well. Patients with neonatal Volkmann contractures had the most difficulty with distraction and healing, ultimately obtaining little to no lengthening and poor functional outcomes.

  1. Impact de la restructuration de la taxe d'accise sur le tabac aux ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Aux Philippines, le taux de tabagisme est élevé et les taxes sur les produits du tabac, peu élevées. La meilleure façon de redresser la situation consiste à adopter des lois qui aug- mentent considérablement les taxes. Une loi restructurant les taxes sur les produits du tabac, qui comporte une forte hausse de la taxe d'accise ...

  2. What drives technology-based distractions? A structural equation model on social-psychological factors of technology-based driver distraction engagement.

    Science.gov (United States)

    Chen, Huei-Yen Winnie; Donmez, Birsen

    2016-06-01

    With the proliferation of new mobile and in-vehicle technologies, understanding the motivations behind a driver's voluntary engagement with such technologies is crucial from a safety perspective, yet is complex. Previous literature either surveyed a large number of distractions that may be diverse, or too focuses on one particular activity, such as cell phone use. Further, earlier studies about social-psychological factors underlying driver distraction tend to focus on one or two factors in-depth, and those that examine a more comprehensive set of factors are often limited in their analyses methods. The present work considers a wide array of social-psychological factors within a structural equation model to predict their influence on a focused set of technology-based distractions. A better understanding of these facilitators can enhance the design of distraction mitigation strategies. We analysed survey responses about three technology-based driver distractions: holding phone conversations, manually interacting with cell phones, and adjusting the settings of in-vehicle technology, as well as responses on five social-psychological factors: attitude, descriptive norm, injunctive norm, technology inclination, and a risk/sensation seeking personality. Using data collected from 525 drivers (ages: 18-80), a structural equation model was built to analyse these social-psychological factors as latent variables influencing self-reported engagement in these three technology-based distractions. Self-reported engagement in technology-based distractions was found to be largely influenced by attitudes about the distractions. Personality and social norms also played a significant role, but technology inclination did not. A closer look at two age groups (18-30 and 30+) showed that the effect of social norms, especially of injunctive norm (i.e., perceived approvals), was less prominent in the 30+ age group, while personality remained a significant predictor for the 30+ age group but

  3. An evidence-based review: distracted driver.

    Science.gov (United States)

    Llerena, Luis E; Aronow, Kathy V; Macleod, Jana; Bard, Michael; Salzman, Steven; Greene, Wendy; Haider, Adil; Schupper, Alex

    2015-01-01

    Cell phone use and texting are prevalent within society and have thus pervaded the driving population. This technology is a growing concern within the confines of distracted driving, as all diversions from attention to the road have been shown to increase the risk of crashes. Adolescent, inexperienced drivers, who have the greatest prevalence of texting while driving, are at a particularly higher risk of crashes because of distraction. Members of the Injury Control Violence Prevention Committee of the Eastern Association for the Surgery of Trauma performed a PubMed search of articles related to distracted driving and cell phone use as a distractor of driving between 2000 and 2013. A total of 19 articles were found to merit inclusion as evidence in the evidence-based review. These articles provided evidence regarding the relationship between distracted driving and crashes, cell phone use contributing to automobile accidents, and/or the relationship between driver experience and automobile accidents. (Adjust methods/results sections to the number of articles that correctly corresponds to the number of references, as well as the methodology for reference inclusion.) Based on the evidence reviewed, we can recommend the following. All drivers should minimize all in-vehicle distractions while on the road. All drivers should not text or use any touch messaging system (including the use of social media sites such as Facebook and Twitter) while driving. Younger, inexperienced drivers should especially not use cell phones, texting, or any touch messaging system while driving because they pose an increased risk for death and injury caused by distractions while driving.

  4. Anterior ankle arthroscopy, distraction or dorsiflexion?

    NARCIS (Netherlands)

    de Leeuw, P.A.J.; Golanó, P.; Clavero, J.A.; van Dijk, C.N.

    2010-01-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly

  5. A shield against distraction

    OpenAIRE

    Halin, N.; Marsh, J.E.; Hellman, A.; Hellstrom, I.; Sörqvist, Patrik

    2014-01-01

    In this paper, we apply the basic idea of a trade-off between the level of concentration and distractibility to test whether a manipulation of task difficulty can shield against distraction. Participants read, either in quiet or with a speech noise background, texts that were displayed either in an easy-to-read or a hard-to-read font. Background speech impaired prose recall, but only when the text was displayed in the easy-to-read font. Most importantly, recall was better in the background sp...

  6. Reward-prospect interacts with trial-by-trial preparation for potential distraction.

    Science.gov (United States)

    Marini, Francesco; van den Berg, Berry; Woldorff, Marty G

    2015-02-01

    When attending for impending visual stimuli, cognitive systems prepare to identify relevant information while ignoring irrelevant, potentially distracting input. Recent work (Marini et al., 2013) showed that a supramodal distracter-filtering mechanism is invoked in blocked designs involving expectation of possible distracter stimuli, although this entails a cost ( distraction-filtering cost ) on speeded performance when distracters are expected but not presented. Here we used an arrow-flanker task to study whether an analogous cost, potentially reflecting the recruitment of a specific distraction-filtering mechanism, occurs dynamically when potential distraction is cued trial-to-trial ( cued distracter-expectation cost ). In order to promote the maximal utilization of cue information by participants, in some experimental conditions the cue also signaled the possibility of earning a monetary reward for fast and accurate performance. This design also allowed us to investigate the interplay between anticipation for distracters and anticipation of reward, which is known to engender attentional preparation. Only in reward contexts did participants show a cued distracter-expectation cost, which was larger with higher reward prospect and when anticipation for both distracters and reward were manipulated trial-to-trial. Thus, these results indicate that reward prospect interacts with the distracter expectation during trial-by-trial preparatory processes for potential distraction. These findings highlight how reward guides cue-driven attentional preparation.

  7. BOUNDZANGA (Noël Bertrand) et NDOMBET (Wilson-André) (dir.), Le malentendu Schweitzer

    OpenAIRE

    Sorg, Jean-Paul

    2014-01-01

    Nul doute que l’ouvrage collectif intitulé Le malentendu Schweitzer rebondit sur l’idée d’un malentendu productif, dégagée et soulignée par Augustin Emane dans Docteur Schweitzer, une icône africaine (voir notre compte rendu ci-dessus). Des universitaires gabonais y ont signé douze études fort diverses et de facture inégale, dont deux avaient été exposées au colloque international organisé à Lambaréné, les 8 et 9 juillet 2013, sur le thème général « Albert Schweitzer : une aventure africaine ...

  8. Driver Distraction Using Visual-Based Sensors and Algorithms.

    Science.gov (United States)

    Fernández, Alberto; Usamentiaga, Rubén; Carús, Juan Luis; Casado, Rubén

    2016-10-28

    Driver distraction, defined as the diversion of attention away from activities critical for safe driving toward a competing activity, is increasingly recognized as a significant source of injuries and fatalities on the roadway. Additionally, the trend towards increasing the use of in-vehicle information systems is critical because they induce visual, biomechanical and cognitive distraction and may affect driving performance in qualitatively different ways. Non-intrusive methods are strongly preferred for monitoring distraction, and vision-based systems have appeared to be attractive for both drivers and researchers. Biomechanical, visual and cognitive distractions are the most commonly detected types in video-based algorithms. Many distraction detection systems only use a single visual cue and therefore, they may be easily disturbed when occlusion or illumination changes appear. Moreover, the combination of these visual cues is a key and challenging aspect in the development of robust distraction detection systems. These visual cues can be extracted mainly by using face monitoring systems but they should be completed with more visual cues (e.g., hands or body information) or even, distraction detection from specific actions (e.g., phone usage). Additionally, these algorithms should be included in an embedded device or system inside a car. This is not a trivial task and several requirements must be taken into account: reliability, real-time performance, low cost, small size, low power consumption, flexibility and short time-to-market. The key points for the development and implementation of sensors to carry out the detection of distraction will also be reviewed. This paper shows a review of the role of computer vision technology applied to the development of monitoring systems to detect distraction. Some key points considered as both future work and challenges ahead yet to be solved will also be addressed.

  9. Driver Distraction Using Visual-Based Sensors and Algorithms

    Directory of Open Access Journals (Sweden)

    Alberto Fernández

    2016-10-01

    Full Text Available Driver distraction, defined as the diversion of attention away from activities critical for safe driving toward a competing activity, is increasingly recognized as a significant source of injuries and fatalities on the roadway. Additionally, the trend towards increasing the use of in-vehicle information systems is critical because they induce visual, biomechanical and cognitive distraction and may affect driving performance in qualitatively different ways. Non-intrusive methods are strongly preferred for monitoring distraction, and vision-based systems have appeared to be attractive for both drivers and researchers. Biomechanical, visual and cognitive distractions are the most commonly detected types in video-based algorithms. Many distraction detection systems only use a single visual cue and therefore, they may be easily disturbed when occlusion or illumination changes appear. Moreover, the combination of these visual cues is a key and challenging aspect in the development of robust distraction detection systems. These visual cues can be extracted mainly by using face monitoring systems but they should be completed with more visual cues (e.g., hands or body information or even, distraction detection from specific actions (e.g., phone usage. Additionally, these algorithms should be included in an embedded device or system inside a car. This is not a trivial task and several requirements must be taken into account: reliability, real-time performance, low cost, small size, low power consumption, flexibility and short time-to-market. The key points for the development and implementation of sensors to carry out the detection of distraction will also be reviewed. This paper shows a review of the role of computer vision technology applied to the development of monitoring systems to detect distraction. Some key points considered as both future work and challenges ahead yet to be solved will also be addressed.

  10. Sound localization in the presence of one or two distracters

    NARCIS (Netherlands)

    Langendijk, E.H.A.; Kistler, D.J.; Wightman, F.L

    2001-01-01

    Localizing a target sound can be a challenge when one or more distracter sounds are present at the same time. This study measured the effect of distracter position on target localization for one distracter (17 positions) and two distracters (21 combinations of 17 positions). Listeners were

  11. Visual Distraction: An Altered Aiming Spatial Response in Dementia

    Directory of Open Access Journals (Sweden)

    Elizabeth E. Galletta

    2012-06-01

    Full Text Available Background/Aims: Healthy individuals demonstrate leftward bias on visuospatial tasks such as line bisection, which has been attributed to right brain dominance. We investigated whether this asymmetry occurred in patients with probable dementia of the Alzheimer type (pAD which is associated with neurodegenerative changes affecting temporoparietal regions. Methods: Subjects with pAD and matched controls performed a line bisection task in near and far space under conditions of no distraction, left-sided visual distraction and right-sided visual distraction. Results: Participants with pAD manifested different motor-preparatory ‘aiming’ spatial bias than matched controls. There were significantly greater rightward ‘aiming’ motor-intentional errors both without distraction and with right-sided distraction. Conclusion: ‘Aiming’ motor-preparatory brain activity may be induced by distraction in pAD subjects as compared to typical visual-motor function in controls.

  12. Driver Distraction in Public Transport

    OpenAIRE

    YOUNG, K; SALMON, P; REGAN MICHAEL, M

    2007-01-01

    There is converging evidence that driver distraction is a contributing factor in car crashes, in Australia and overseas. Surprisingly, no known previous research has attempted to identify and assess the potentially distracting activities undertaken by the drivers of public passenger vehicles. This paper describes research undertaken on this issue. The research was partitioned into three phases: an analysis of the functions and tasks currently undertaken by public passenger vehicle drivers; th...

  13. Nouvelles approches en theorie du champ moyen dynamique: le cas du pouvoir thermoelectrique et celui de l'effet orbital d'un champ magnetique

    Science.gov (United States)

    Arsenault, Louis-Francois

    Les applications reliees a la generation d'energie motivent la recherche de materiaux ayant un fort pouvoir thermoelectrique (S). De plus, S nous renseigne sur certaines proprietes fondamentales des materiaux, comme, par exemple, la transition entre l'etat coherent et incoherent des quasi-particules lorsque la temperature augmente. Empiriquement, la presence de fortes interactions electron-electron peut mener a un pouvoir thermoelectrique geant. Nous avons donc etudie le modele le plus simple qui tient compte de ces fortes interactions, le modele de Hubbard. La theorie du champ moyen dynamique (DMFT) est tout indiquee dans ce cas. Nous nous sommes concentres sur un systeme tridimensionnel (3d) cubique a face centree (fcc), et ce, pour plusieurs raisons. A) Ce type de cristal est tres commun dans la nature. B) La DMFT donne de tres bons resultats en 3d et donc ce choix sert aussi de preuve de principe de la methode. C) Finalement, a cause de la frustration electronique intrinseque au fcc, celui-ci ne presente pas de symetrie particule-trou, ce qui est tres favorable a l'apparition d'une grande valeur de S. Ce travail demontre que lorsque le materiau est un isolant a demi-remplissage a cause des fortes interactions (isolant de Mott), il est possible d'obtenir de grands pouvoirs thermoelectriques en le dopant legerement. C'est un resultat pratique important. Du point de vue methodologique, nous avons montre comment la limite de frequence infinie de S et l'approche dite de Kelvin, qui considere la limite de frequence nulle avant la limite thermodynamique pour S, donnent des estimations fiables de la vraie limite continue (DC) dans les domaines de temperature appropriee. Ces deux approches facilitent grandement les calculs en court-circuit ant la necessite de recourir a de problematiques prolongements analytiques. Nous avons trouve que la methode de calcul a frequence infinie fonctionne bien lorsque les echelles d'energie sont relativement faibles. En d'autres termes

  14. Effect of maxillary distraction osteogenesis on velopharyngeal function: a pilot study.

    Science.gov (United States)

    Harada, Kiyoshi; Ishii, Yoshimasa; Ishii, Masatoshi; Imaizumi, Humiko; Mibu, Michiko; Omura, Ken

    2002-05-01

    The purpose of this study was to examine preoperative and postoperative changes of velopharyngeal function in cleft patients who underwent maxillary distraction osteogenesis using the Rigid External Distraction System. Six cleft patients followed for a minimum of 12 months after maxillary distraction were examined. Plain and contrast lateral-cephalograms were obtained preoperatively and postoperatively, and speech evaluation was performed by the same authorized speech therapist at the same time points. The mean distraction amount at the anterior nasal spine was 11.7 mm (range, 7.4 mm - 15.0 mm). Both the nasopharyngeal depth and velar length increased after maxillary distraction, but the need ratio (nasopharyngeal depth/velar length) also increased after distraction. Although scores for velopharyngeal closure dropped a few points after maxillary distraction, the rating for hypernasality remained unchanged in all patients but the patient whose distraction amount was 15.0 mm. These results suggest that maxillary distraction of less than 15 mm may not markedly affect velopharyngeal function in cleft patients.

  15. 77 FR 61048 - Distracted Driving Grant Program

    Science.gov (United States)

    2012-10-05

    ... DEPARTMENT OF TRANSPORTATION National Highway Traffic Safety Administration Distracted Driving Grant Program AGENCY: National Highway Traffic Safety Administration (NHTSA), Department of... distracted driving grants on August 24, 2012. In this notice, DOT is extending the application submission...

  16. Defense.gov Special Report: Fort Hood Shooting

    Science.gov (United States)

    identify possible insider threats, Army Secretary John M. McHugh told lawmakers. Story Obama: Soldiers ," Army Secretary John M. McHugh told lawmakers. Story President Praises Swift Response to Fort Hood Remarks on Fort Hood Shooting at White House McHugh, Odierno Address Fort Hood Shooting Before Congress

  17. [Barack Obama et le « rêve américain »

    OpenAIRE

    Dumont , Gérard-François

    2009-01-01

    International audience; The “American dream” : an old concept which incorporates a strong demographic component; indeed it is inseparable from the migratory flows involving the United States. Barack Obama’s election also integrated this aspect, with the new president declaring during his campaign that he wanted to keep the American dream alive.; Notion ancienne, le « rêve américain » compte une forte dimension démographique, car il est indissociable des courants migratoires liés aux États-Uni...

  18. Happiness increases distraction by auditory deviant stimuli.

    Science.gov (United States)

    Pacheco-Unguetti, Antonia Pilar; Parmentier, Fabrice B R

    2016-08-01

    Rare and unexpected changes (deviants) in an otherwise repeated stream of task-irrelevant auditory distractors (standards) capture attention and impair behavioural performance in an ongoing visual task. Recent evidence indicates that this effect is increased by sadness in a task involving neutral stimuli. We tested the hypothesis that such effect may not be limited to negative emotions but reflect a general depletion of attentional resources by examining whether a positive emotion (happiness) would increase deviance distraction too. Prior to performing an auditory-visual oddball task, happiness or a neutral mood was induced in participants by means of the exposure to music and the recollection of an autobiographical event. Results from the oddball task showed significantly larger deviance distraction following the induction of happiness. Interestingly, the small amount of distraction typically observed on the standard trial following a deviant trial (post-deviance distraction) was not increased by happiness. We speculate that happiness might interfere with the disengagement of attention from the deviant sound back towards the target stimulus (through the depletion of cognitive resources and/or mind wandering) but help subsequent cognitive control to recover from distraction. © 2015 The British Psychological Society.

  19. Distraction osteogenesis of radiation-induced orbitozygomatic hypoplasia.

    Science.gov (United States)

    Grover, Ramon; Murray, Dylan; Fialkov, Jeffrey A

    2008-05-01

    In the last decade, the application of distraction osteogenesis to the craniofacial skeleton has grown to include not only deformities of the mandible, but of the midface, palate, dentoalveolar region, and calvarium. A major advantage of distraction osteogenesis lies in the simultaneous soft tissue histogenesis that accompanies the bony distraction process, allowing for potentially lower relapse rates and improved cosmesis. Although this may seem appropriately suited to irradiation-induced deformities of both hard and soft tissues, there is little in the literature as to the efficacy of this technique in patients who have received radiotherapy. To introduce an effective application of this technology, and highlight some advantages and disadvantages of its application in the irradiated craniofacial skeleton, we present a case of distraction osteogenesis of the orbitozygomatic complex in a patient with radiation induced orbitozygomatic hypoplasia.

  20. Le Somaliland, un jeune «État» en quête de reconnaissance

    Directory of Open Access Journals (Sweden)

    Jean-Louis Guébourg

    2002-09-01

    Full Text Available Le Somaliland, ex-colonie britannique, composé du clan Issak et fort de 3 millions d’hommes s’est séparé unilatéralement de la Somalie en 1991. Son unique port, Berbera, bénéficie d’une liaison restaurée vers Adis Abeba et de la rupture entre Éthiopie et Érythrée pour augmenter son trafic et concurrencer modestement Djibouti.

  1. Response of ramus following vertical lengthening with distraction osteogenesis.

    Science.gov (United States)

    Tuzuner-Oncul, Aysegul Mine; Kisnisci, Reha S

    2011-09-01

    Vertical lengthening of the mandibular ramus is considered to be one of the least stable surgical procedures in the management of musculoskeletal maxillofacial deformities. The aim of this study was to evaluate the response of the mandibular ramus following vertical lengthening by means of distraction osteogenesis. This study included eight non-syndromic adult patients with temporomandibular joint ankylosis. The vertical height deficiency of the mandibular ramus and the ramus/condyle unit on the affected side were simultaneously reconstructed by transportation of a bone segment using distraction osteogenesis following gap arthroplasty. Lateral and posteroanterior (PA) cephalograms taken postoperatively before active distraction, at the completion of distraction and 6, 12, 24 months after distraction, were compared to evaluate the changes of the ramus height. In all cases the vertical ramus and ramus/condyle unit height loss were successfully reconstructed by distraction osteogenesis. There was no relapse in the amount of height gained by distraction osteogenesis at the 24 months follow-up review (p>0.05). Acute one stage vertical lengthening of the mandibular ramus is considered to be one of the least stable musculoskeletal procedures with relapse being a significant adverse outcome. In this clinical study gradual vertical lengthening of the ramus through ramus/condyle unit distraction osteogenesis has maintained the initial vertical ramus height gained for 24 months. Copyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  2. Assessing Cognitive Distraction in the Automobile.

    Science.gov (United States)

    Strayer, David L; Turrill, Jonna; Cooper, Joel M; Coleman, James R; Medeiros-Ward, Nathan; Biondi, Francesco

    2015-12-01

    The objective was to establish a systematic framework for measuring and understanding cognitive distraction in the automobile. Driver distraction from secondary in-vehicle activities is increasingly recognized as a significant source of injuries and fatalities on the roadway. Across three studies, participants completed eight in-vehicle tasks commonly performed by the driver of an automobile. Primary, secondary, subjective, and physiological measures were collected and integrated into a cognitive distraction scale. In-vehicle activities, such as listening to the radio or an audio book, were associated with a low level of cognitive workload; the conversation activities of talking to a passenger in the vehicle or conversing with a friend on a handheld or hands-free cell phone were associated with a moderate level of cognitive workload; and using a speech-to-text interfaced e-mail system involved a high level of cognitive workload. The research established that there are significant impairments to driving that stem from the diversion of attention from the task of operating a motor vehicle and that the impairments to driving are directly related to the cognitive workload of these in-vehicle activities. Moreover, the adoption of voice-based systems in the vehicle may have unintended consequences that adversely affect traffic safety. These findings can be used to help inform scientifically based policies on driver distraction, particularly as they relate to cognitive distraction stemming from the diversion of attention to other concurrent activities in the vehicle. © 2015, Human Factors and Ergonomics Society.

  3. The WIMS-E module W-FORTE

    International Nuclear Information System (INIS)

    Roth, M.J.

    1983-09-01

    There are three distinct versions of the WIMS lattice cell program. WIMS-E is the most general, WIMSD4 is restricted to clusters or to one dimensional slab or annular geometry, and LWRWIMS is designed principally for light water reactor geometries. W-FORTE is used to transfer data from WIMSD4 or LWRWIMS to WIMS-E. A description of the W-FORTE module is given, and includes the relevant data for WIMSD4, LWRWIMS and W-FORTE. (UK)

  4. Relationship of distraction rate with inferior alveolar nerve degeneration-regeneration shift

    Directory of Open Access Journals (Sweden)

    Ying-hua Zhao

    2018-01-01

    Full Text Available Distraction osteogenesis is an important technique for the treatment of maxillofacial abnormities and defects. However, distraction osteogenesis may cause the injury of the inferior alveolar nerve. The relationship between distraction rate and nerve degeneration-regeneration shift remains poorly understood. In this study, 24 rabbits were randomly divided into four groups. To establish the rabbit mandibular distraction osteogenesis model, the mandibles of rabbits in distraction osteogenesis groups were subjected to continuous osteogenesis distraction at a rate of 1.0, 1.5 and 2.0 mm/d, respectively, by controlling rounds of screwing each day in the distractors. In the sham group, mandible osteotomy was performed without distraction. Pin-prick test with a 10 g blunt pin on the labium, histological and histomorphometric analyses with methylene blue staining, Bodian's silver staining, transmission electron microscopy and myelinated fiber density of inferior alveolar nerve cross-sections were performed to assess inferior alveolar nerve conditions. At 28 days after model establishment, in the pin-prick test, the inferior alveolar nerve showed no response in the labium to a pin pricks in the 2 mm/d group, indicating a severe dysfunction. Histological and histomorphometric analyses indicated that the inferior alveolar nerve suffered more degeneration and injuries at a high distraction rate (2 mm/d. Importantly, the nerve regeneration, indicated by newborn Schwann cells and axons, was more abundant in 1.0 and 1.5 mm/d groups than in 2.0 mm/d group. We concluded that the distraction rate was strongly associated with the inferior alveolar nerve function, and the distraction rates of 1.0 and 1.5 mm/d had regenerative effects on the inferior alveolar nerve. This study provides an experimental basis for the relationship between distraction rate and nerve degeneration-regeneration shift during distraction osteogenesis, and may facilitate reducing nerve

  5. A Source of Distractions in the Classroom: The Teacher.

    Science.gov (United States)

    Wong, Lily Y. S.

    This paper identifies distracting factors which take away pupils' attention from the lesson and focus it on the teacher. Distracting factors include teachers' irritating habits, improper attire, and mannerisms. Examples of distracting features of both males and females are listed in eight categories: (1) attire; (2) hair; (3) make-up; (4) personal…

  6. Percutaneous distraction lengthening in brachymetacarpia.

    Science.gov (United States)

    Volpi, Alexander D; Fragomen, Austin T

    2011-08-08

    Brachymetacarpia is a condition manifesting a shortened metacarpal that is caused by early closure of the epiphyseal plate and believed to arise idiopathically. The correction for brachymetacarpia is usually for cosmetic reasons as brachymetacarpia does not impair function. The literature indicates several different approaches to lengthening digits, including single-stage lengthening and rapid distraction lengthening with a bone graft. However, gradual distraction is the preferred method due to excellent cosmetic outcomes and few postoperative complications. This article reports a case of brachymetacarpia treated with distraction lengthening using a minimally invasive, percutaneous approach. A 16-year-old girl presented with a shortened left ring finger and underwent surgery to correct the deformity. The left ring finger measured 12 mm shorter than her right ring finger; however, there was normal mobility at the joints. In the operating room, an external fixator was attached using 4 self-drilling, self-tapping pins through several 3-mm skin incisions. The total fixation time was 14 weeks; however, the achieved length of 12 mm was achieved 6 weeks postoperatively. The healing index of the fixation period was 81 days/cm. The postoperative course and fixation period were uneventful, with no complications except for 2 pin infections that were treated with oral antibiotics. The method of gradual distraction lengthening in this case successfully achieved the desired length and yielded an excellent cosmetic result. Copyright 2011, SLACK Incorporated.

  7. Jeu et fiction dans un jeu de cartes à collectionner : le cas de Magic : l’Assemblée

    Directory of Open Access Journals (Sweden)

    Pierre Cuvelier

    2011-06-01

    Full Text Available Le genre du jeu de cartes à collectionner apparaît en 1993 avec Magic : l’Assemblée de Richard Garfield. Si la plupart des émules de Magic sont des jeux dérivés d’univers de licence comme Pokémon, Magic se fondait sur un univers de fantasy inédit, enrichi par des extensions successives, et dont les cartes restent le principal vecteur. Je me propose ici de réfléchir sur les rapports qui se nouent entre le jeu et la fiction dans Magic, et d’examiner les contraintes, le fonctionnement et les principaux procédés fictionnels propres à ce support singulier. Magic fait partie des jeux à composante fictionnelle forte, dont les règles comportent un caractère mimétique certain, bien que limité. Les différents éléments d’une même carte et les cartes entre elles fonctionnent comme des fragments qui se combinent pour pointer vers une réalité fictive qui, bien que conçue par l’éditeur sur le modèle des univers de licence à forte cohérence (notamment les récentes fictions transmédiatiques, laisse à rêver aux joueurs par les blancs et les ambiguïtés inhérentes à cette articulation entre jeu et fiction. Les tâtonnements de l’éditeur au fil des extensions sont riches d’enseignements sur les possibilités et les limites d’un tel support, où la fiction narrative linéaire doit laisser place, à petite échelle, à une fiction plus structurelle, prenant la forme d’environnements mis en tension plutôt que de narrations linéaires.

  8. Sadness increases distraction by auditory deviant stimuli.

    Science.gov (United States)

    Pacheco-Unguetti, Antonia P; Parmentier, Fabrice B R

    2014-02-01

    Research shows that attention is ineluctably captured away from a focal visual task by rare and unexpected changes (deviants) in an otherwise repeated stream of task-irrelevant auditory distractors (standards). The fundamental cognitive mechanisms underlying this effect have been the object of an increasing number of studies but their sensitivity to mood and emotions remains relatively unexplored despite suggestion of greater distractibility in negative emotional contexts. In this study, we examined the effect of sadness, a widespread form of emotional distress and a symptom of many disorders, on distraction by deviant sounds. Participants received either a sadness induction or a neutral mood induction by means of a mixed procedure based on music and autobiographical recall prior to taking part in an auditory-visual oddball task in which they categorized visual digits while ignoring task-irrelevant sounds. The results showed that although all participants exhibited significantly longer response times in the visual categorization task following the presentation of rare and unexpected deviant sounds relative to that of the standard sound, this distraction effect was significantly greater in participants who had received the sadness induction (a twofold increase). The residual distraction on the subsequent trial (postdeviance distraction) was equivalent in both groups, suggesting that sadness interfered with the disengagement of attention from the deviant sound and back toward the target stimulus. We propose that this disengagement impairment reflected the monopolization of cognitive resources by sadness and/or associated ruminations. Our findings suggest that sadness can increase distraction even when distractors are emotionally neutral. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  9. The role of alcohol use on recent trends in distracted driving.

    Science.gov (United States)

    Wilson, Fernando A; Stimpson, Jim P; Tibbits, Melissa K

    2013-11-01

    Distracted driving is now an increasingly deadly threat to road safety. We provide evidence that intoxicated driving is increasingly responsible for recent increases in fatalities from distracted driving crashes. This study describes trends in deaths on U.S. public roads caused by alcohol-involved and distracted drivers using the Fatality Analysis Reporting System (FARS)-a census of fatal crashes on U.S. public roads. Fatality rates per vehicle-miles traveled are calculated using data from the Federal Highway Administration. Alcohol-involved drivers who are simultaneously distracted were responsible for 1750 deaths in 2009, an increase of more than 63% from 2005 when there were 1072 deaths. Alcohol use while driving is increasingly responsible for a growing number of fatalities from distracted driving, accounting for 32% of deaths from distracted driving in 2009 versus 24% in 2005. The fatality rate from these crashes increased from 35.9 to 59.2 deaths per 100 billion vehicle-miles traveled after 2005. Alcohol use is quickly increasing as an important factor behind distracted driving fatalities. This has implications for policies combating distracted driving that do not address the role of alcohol use in distracted driving. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Initial Experience With a New Intraoral Midface Distraction Device.

    Science.gov (United States)

    Burstein, Fernando; Soldanska, Magdalena; Granger, Michael; Berhane, ChiChi; Schoemann, Mark

    2015-06-01

    Maxillary hypoplasia that necessitates surgical advancement affects approximately 25% of patients born with cleft lip and palate. Syndromic conditions such as Crouzon may also be accompanied by significant maxillary hypoplasia. Severe maxillary hypoplasia can result in airway obstruction, malocclusion, proptosis, and facial disfigurement. For optimal stability, severe hypoplasia is best addressed with maxillary distraction osteogenesis. Twenty-two patients (15 boys, 7 girls, ages 6-16 years, mean age 10 years) with severe midface hypoplasia underwent midface distraction with new internal maxillary distraction (IMD) device at our institution. Total distraction distances ranged from 15 to 30 mm. There were no major complications, and all of them had improvement in functional and aesthetic parameters. There were 2 minor complications and 2 patients failed to distract the full distance because of converging vectors. Early maxillary distraction in patients with severe midface hypoplasia is a useful technique to provide interval correction of severe maxillary hypoplasia before skeletal maturity and definitive orthognathic surgery is contemplated, and it is a good tool to improve occlusion, aesthetics, and self-perception in younger patients.

  11. Initial Experience With a New Intraoral Midface Distraction Device

    Science.gov (United States)

    Burstein, Fernando; Soldanska, Magdalena; Granger, Michael; Berhane, ChiChi; Schoemann, Mark

    2015-01-01

    Abstract Maxillary hypoplasia that necessitates surgical advancement affects approximately 25% of patients born with cleft lip and palate. Syndromic conditions such as Crouzon may also be accompanied by significant maxillary hypoplasia. Severe maxillary hypoplasia can result in airway obstruction, malocclusion, proptosis, and facial disfigurement. For optimal stability, severe hypoplasia is best addressed with maxillary distraction osteogenesis. Twenty-two patients (15 boys, 7 girls, ages 6–16 years, mean age 10 years) with severe midface hypoplasia underwent midface distraction with new internal maxillary distraction (IMD) device at our institution. Total distraction distances ranged from 15 to 30 mm. There were no major complications, and all of them had improvement in functional and aesthetic parameters. There were 2 minor complications and 2 patients failed to distract the full distance because of converging vectors. Early maxillary distraction in patients with severe midface hypoplasia is a useful technique to provide interval correction of severe maxillary hypoplasia before skeletal maturity and definitive orthognathic surgery is contemplated, and it is a good tool to improve occlusion, aesthetics, and self-perception in younger patients. PMID:26080162

  12. Motivation enhances control of positive and negative emotional distractions.

    Science.gov (United States)

    Walsh, Amy T; Carmel, David; Harper, David; Grimshaw, Gina M

    2018-01-03

    Using cognitive control to ignore distractions is essential for successfully achieving our goals. In emotionally-neutral contexts, motivation can reduce interference from irrelevant stimuli by enhancing cognitive control. However, attention is commonly biased towards emotional stimuli, making them potent distractors. Can motivation aid control of emotional distractions, and does it do so similarly for positive and negative stimuli? Here, we examined how task motivation influences control of distraction from positive, negative, and neutral scenes. Participants completed a simple perceptual task while attempting to ignore task-irrelevant images. One group received monetary reward for fast and accurate task performance; another (control) group did not. Overall, both negative (mutilation) and positive (erotic) images caused greater slowing of responses than neutral images of people, but emotional distraction was reduced with reward. Crucially, despite the different motivational directions associated with negative and positive stimuli, reward reduced negative and positive distraction equally. Our findings suggest that motivation may encourage the use of a sustained proactive control strategy that can effectively reduce the impact of emotional distraction.

  13. Transsutural distraction osteogenesis applied to maxillary complex with new internalized distraction device: analysis of the feasibility and long-term osteogenesis outcome.

    Science.gov (United States)

    Tong, Haizhou; Gao, Feng; Yin, Jiapeng; Zhang, Xiangyu; Zhang, Chen; Yin, Ningbei; Zhao, Zhenmin

    2015-03-01

    The purposes of this study were to evaluate the effects of transsutural distraction osteogenesis applied to the maxillary complex with a new internalized distraction device and to analyze the long-term osteogenesis outcome. Three-month-old beagle dogs were treated with a self-designed internalized distractor. The feasibility was evaluated, and the effects of the maxillary growth were measured using radiography and computed tomography (CT). The regenerated bone was examined with micro-CT, biomechanical testing, and histology 1 year after the distraction. The experimental group showed significantly larger forward displacement of maxillary during the distraction. One year after the distraction, the micro-CT showed more incompact structure and bone volume/total volume was significantly less in the experimental group. Biomechanical testing also showed a significantly lower yield but with no difference in stiffness. Histologic staining found osteoclasts deposited in the region of the suture and osteoblasts on the bone surface. The immunohistochemical staining of osteoprotegrin and receptor activator of nuclear factor-κ B ligand showed evidence of expression in suture area components and osteocytes with no difference between the groups. Transsutural distraction osteogenesis using an internalized distractor with skull anchorage demonstrated feasibility. It is expected that this device may provide new thoughts in developing an appropriate appliance for clinical use in young patients with midfacial hypoplasia. Moreover, the long-term osteogenesis analysis findings suggest that the metabolism of sutural area still remained active, which enhanced our understanding of bone remodeling in the sutural area to manage maxillary relapse after transsutural distraction osteogenesis.

  14. Normalizing memory recall in fibromyalgia with rehearsal: a distraction-counteracting effect.

    Science.gov (United States)

    Leavitt, Frank; Katz, Robert S

    2009-06-15

    To examine the impact of distraction on the retention of rehearsed information in patients with fibromyalgia syndrome (FMS). Data refer to the neurocognitive examination of 134 patients (91 with FMS and 43 control subjects) presenting with memory loss. Four neurocognitive measures free of distraction, along with 2 measures with added distraction, were completed. Differences in the retention of rehearsed and unrehearsed information with a source of distraction present were calculated. Patients with FMS showed normal cognitive functioning on verbal memory tests free of distraction. Adding a source of distraction caused unrefreshed information to be lost at a disproportionate rate in patients with FMS. Over 87% of patients with FMS scored in the impaired range on a task of unrehearsed verbal memory. Adding a source of distraction to well-rehearsed information produced a normal rate of recall in FMS. Rehearsal mechanisms are intact in patients with FMS and play beneficial roles in managing interference from a source of distraction. In the absence of rehearsal, a source of distraction added to unrefreshed information signals a remarkable level of cognitive deficit in FMS that goes undetected by conventionally relied-upon neurocognitive measures. We present a theory to promote understanding of the cognitive deficit of people with FMS based on reduced speed of lexical activation and poor recall after distraction.

  15. Distraction in Verbal Short-Term Memory: Insights from Developmental Differences

    OpenAIRE

    Elliott, Emily; Hughes, Robert W.; Briganti, A; Joseph, Tanya Nicolette; Marsh, John Everett; Macken, William J.

    2016-01-01

    The contribution of two mechanisms of auditory distraction in verbal serial short-term memory-interference with the serial rehearsal processes used to support short-term recall and general attentional diversion-was investigated by exploiting differences in auditory distraction in children and adults. Experiment 1 showed that serial rehearsal plays a role in children's as well as adults' distractibility: Auditory distraction from irrelevant speech was greater for both children and adults as th...

  16. Special Considerations in Distracted Driving with Teens

    Science.gov (United States)

    Durbin, Dennis R; McGehee, Daniel V; Fisher, Donald; McCartt, Anne

    2014-01-01

    Novice teen drivers have long been known to have an increased risk of crashing, as well as increased tendencies toward unsafe and risky driving behaviors. Teens are unique as drivers for several reasons, many of which have implications specifically in the area of distracted driving. This paper reviews several of these features, including the widespread prevalence of mobile device use by teens, their lack of driving experience, the influence of peer passengers as a source of distraction, the role of parents in influencing teens’ attitudes and behaviors relevant to distracted driving and the impact of laws designed to prevent mobile device use by teen drivers. Recommendations for future research include understanding how engagement in a variety of secondary tasks by teen drivers affects their driving performance or crash risk; understanding the respective roles of parents, peers and technology in influencing teen driver behavior; and evaluating the impact of public policy on mitigating teen crash risk related to driver distraction. PMID:24776228

  17. Distracted driving in elderly and middle-aged drivers.

    Science.gov (United States)

    Thompson, Kelsey R; Johnson, Amy M; Emerson, Jamie L; Dawson, Jeffrey D; Boer, Erwin R; Rizzo, Matthew

    2012-03-01

    Automobile driving is a safety-critical real-world example of multitasking. A variety of roadway and in-vehicle distracter tasks create information processing loads that compete for the neural resources needed to drive safely. Drivers with mind and brain aging may be particularly susceptible to distraction due to waning cognitive resources and control over attention. This study examined distracted driving performance in an instrumented vehicle (IV) in 86 elderly (mean=72.5 years, SD=5.0 years) and 51 middle-aged drivers (mean=53.7 years, SD=9.3 year) under a concurrent auditory-verbal processing load created by the Paced Auditory Serial Addition Task (PASAT). Compared to baseline (no-task) driving performance, distraction was associated with reduced steering control in both groups, with middle-aged drivers showing a greater increase in steering variability. The elderly drove slower and showed decreased speed variability during distraction compared to middle-aged drivers. They also tended to "freeze up", spending significantly more time holding the gas pedal steady, another tactic that may mitigate time pressured integration and control of information, thereby freeing mental resources to maintain situation awareness. While 39% of elderly and 43% of middle-aged drivers committed significantly more driving safety errors during distraction, 28% and 18%, respectively, actually improved, compatible with allocation of attention resources to safety critical tasks under a cognitive load. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Velopharyngeal changes after maxillary distraction in cleft patients using a rigid external distraction device: A retrospective study.

    Science.gov (United States)

    Taha, Mahasen; Elsheikh, Yasser M

    2016-11-01

     To evaluate early and late velopharyngeal changes in cleft lip and palate (CLP) patients after use of the Rigid External Distractor (RED) device and to correlate these changes to the amount of maxillary advancement.  Thirty Class III CLP patients were included in the study. Maxillary advancement was performed using the RED device in combination with titanium miniplates and screws for anchorage. Lateral cephalograms, nasometer, and nasopharyngoscope records were taken before distraction, immediately after distraction, and 1 year after distraction. A paired t-test was used to detect differences at P maxillary distraction (P  =  .0001). Statistically significant increases in nasopharyngeal and oropharyngeal depths, velar angle, and need ratio were also found (P  =  .0001). Nasalance scores showed a significant increase (P  =  .008 for nasal text and .044 for oral text). A significant positive correlation was observed between the amount of maxillary advancement and the increase in nasopharyngeal depth and hypernasality (P  =  .012 and .026, respectively).  Nasopharyngeal function was deteriorated after maxillary advancement in CLP patients. There was a significant positive correlation between the amount of maxillary advancement and the increase in nasopharyngeal depth and hypernasality.

  19. Teens' distracted driving behavior: Prevalence and predictors.

    Science.gov (United States)

    Gershon, Pnina; Zhu, Chunming; Klauer, Sheila G; Dingus, Tom; Simons-Morton, Bruce

    2017-12-01

    Teen drivers' over-involvement in crashes has been attributed to a variety of factors, including distracted driving. With the rapid development of in-vehicle systems and portable electronic devices, the burden associated with distracted driving is expected to increase. The current study identifies predictors of secondary task engagement among teenage drivers and provides basis for interventions to reduce distracted driving behavior. We described the prevalence of secondary tasks by type and driving conditions and evaluated the associations between the prevalence of secondary task engagement, driving conditions, and selected psychosocial factors. The private vehicles of 83 newly-licensed teenage drivers were equipped with Data Acquisition Systems (DAS), which documented driving performance measures, including secondary task engagement and driving environment characteristics. Surveys administered at licensure provided psychosocial measures. Overall, teens engaged in a potentially distracting secondary task in 58% of sampled road clips. The most prevalent types of secondary tasks were interaction with a passenger, talking/singing (no passenger), external distraction, and texting/dialing the cell phone. Secondary task engagement was more prevalent among those with primary vehicle access and when driving alone. Social norms, friends' risky driving behaviors, and parental limitations were significantly associated with secondary task prevalence. In contrast, environmental attributes, including lighting and road surface conditions, were not associated with teens' engagement in secondary tasks. Our findings indicated that teens engaged in secondary tasks frequently and poorly regulate their driving behavior relative to environmental conditions. Practical applications: Peer and parent influences on secondary task engagement provide valuable objectives for countermeasures to reduce distracted driving among teenage drivers. Copyright © 2017 National Safety Council and

  20. Effect of cell phone distraction on pediatric pedestrian injury risk.

    Science.gov (United States)

    Stavrinos, Despina; Byington, Katherine W; Schwebel, David C

    2009-02-01

    Early adolescents are using cell phones with increasing frequency. Cell phones are known to distract motor vehicle drivers to the point that their safety is jeopardized, but it is unclear if cell phones might also distract child pedestrians. This study was designed to examine the influence of talking on a cell phone for pediatric pedestrian injury risk. Seventy-seven children aged 10 to 11 years old completed simulated road crossings in an immersive, interactive virtual pedestrian environment. In a within-subjects design, children crossed the virtual street 6 times while undistracted and 6 times while distracted by a cell phone conversation with an unfamiliar research assistant. Participants also completed several other experimental tasks hypothesized to predict the impact of distraction while crossing the street and talking on a cell phone. Children's pedestrian safety was compromised when distracted by a cell phone conversation. While distracted, children were less attentive to traffic; left less safe time between their crossing and the next arriving vehicle; experienced more collisions and close calls with oncoming traffic; and waited longer before beginning to cross the street. Analyses testing experience using a cell phone and experience as a pedestrian yielded few significant results, suggesting that distraction on the cell phone might affect children's pedestrian safety no matter what their experience level. There was some indication that younger children and children who are less attentive and more oppositional may be slightly more susceptible to distraction while talking on the cell phone than older, more attentive, and less oppositional children. Our results suggest that cell phones distract preadolescent children while crossing streets.

  1. A new distraction arthroplasty device using magnetic force; a cadaveric study.

    Science.gov (United States)

    Kamei, Goki; Ochi, Mitsuo; Okuhara, Atsushi; Fujimiya, Mineko; Deie, Masataka; Adachi, Nobuo; Nakamae, Atsuo; Nakasa, Tomoyuki; Ohkawa, Shingo; Takazawa, Kobun; Eguchi, Akio; Katou, Tomohiro; Takada, Tsuyoshi; Usman, Muhammad Andry

    2013-04-01

    It is difficult for an articular cartilage injury to repair spontaneously. There are many procedures for treating cartilage injury, however there is no standard procedure for middle-aged patients who have diffuse knee osteoarthritis, especially of the lateral compartment. Therefore, Ochi developed a new distraction device that uses magnetic power to enlarge a joint space and promote cartilage regeneration with microfracture. The purpose of this study is to evaluate this new distraction arthroplasty system by using the cadaveric knee. This study used ten knees from six cadavers that were embalmed by Thiel's methods. The medial and lateral joint space was measured by AP radiographic view before and after distraction, and after weight-bearing to evaluate the joint distraction. The contact pressure of the medial and lateral compartments at the knee extension position by using a prescale film system was measured before and after weight-bearing with a 15 or 30-kg weight-bearing load to evaluate the effectiveness of this device. The lateral joint space significantly increased from the pre-distraction to the post-distraction; however, it did not change significantly between post-distraction and post-weight-bearing. With a 15 or 30-kg weight-bearing load, the contact pressure of the lateral compartment significantly decreased from the pre-distraction to the post-distraction. The most important advantage of this device is that it maintains a continuous distraction tension and enables almost the full range of motion of the knee. We believe that joint distraction by using magnetic force can be a promising option for cartilage injury in middle-aged patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Safety climate and the distracted driving experiences of truck drivers.

    Science.gov (United States)

    Swedler, David I; Pollack, Keshia M; Agnew, Jacqueline

    2015-07-01

    For truck drivers, distracted driving is a workplace behavior that increases occupational injury risk. We propose safety climate as an appropriate lens through which researchers can examine occupational distracted driving. Using a mixed methods study design, we surveyed truck drivers using the Safety Climate Questionnaire (SCQ) complemented by semi-structured interviews of experts on distracted driving and truck safety. Safety climate was assessed by using the entire SCQ as an overall climate score, followed by factor analysis that identified the following safety climate factors: Communications and Procedures; Management Commitment; and Work Pressure. In multivariate regression, the overall safety climate scale was associated with having ever experienced a crash and/or distraction-involved swerving. Interview participants described how these SCQ constructs could affect occupational distracted driving. To reduce distraction-related crashes in their organizations, management can adhere to safe policies and procedures, invest in engineering controls, and develop safer communication procedures. © 2015 Wiley Periodicals, Inc.

  3. Divided attention reduces resistance to distraction at encoding but not retrieval.

    Science.gov (United States)

    Weeks, Jennifer C; Hasher, Lynn

    2017-08-01

    Older adults show implicit memory for previously seen distraction, an effect attributed to poor attentional control. It is unclear whether this effect results from lack of control over encoding during the distraction task, lack of retrieval constraint during the test task, or both. In the present study, we simulated poor distraction control in young adults using divided attention at encoding, at retrieval, at both times, or not at all. The encoding task was a 1-back task on pictures with distracting superimposed letter strings, some of which were words. The retrieval task was a word fragment completion task testing implicit memory for the distracting words. Attention was divided using an auditory odd digit detection task. Dividing attention at encoding, but not at retrieval, resulted in significant priming for distraction, which suggests that control over encoding processes is a primary determinant of distraction transfer in populations with low inhibitory control (e.g. older adults).

  4. Audiovisual distraction reduces pain perception during shockwave lithotripsy.

    Science.gov (United States)

    Marsdin, Emma; Noble, Jeremy G; Reynard, John M; Turney, Benjamin W

    2012-05-01

    Lithotripsy is an established method to fragment kidney stones that can be performed without general anesthesia in the outpatient setting. Discomfort and/or noise, however, may deter some patients. It has been demonstrated that audiovisual distraction (AV) can reduce sedoanalgesic requirements and improve patient satisfaction in nonurologic settings, but to our knowledge, this has not been investigated with lithotripsy. This randomized controlled trial was designed to test the hypothesis that AV distraction can reduce perceived pain during lithotripsy. All patients in the study received identical analgesia before a complete session of lithotripsy on a fixed-site Storz Modulith SLX F2 lithotripter. Patients were randomized to two groups: One group (n=61) received AV distraction via a wall-mounted 32″ (82 cm) television with wireless headphones; the other group (n=57) received no AV distraction. The mean intensity of treatment was comparable in both groups. Patients used a visual analogue scale (0-10) to record independent pain and distress scores and a nonverbal pain score was documented by the radiographer during the procedure (0-4). In the group that received AV distraction, all measures of pain perception were statistically lower. The patient-reported pain score was reduced from a mean of 6.1 to 2.4 (P<0.0001), and the distress score was reduced from a mean of 4.4 to 1.0 (P=0.0001). The mean nonverbal score recorded by the radiographer was reduced from 1.5 to 0.5 (<0.0001). AV distraction significantly lowered patients' reported pain and distress scores. This correlated with the nonverbal scores reported by the radiographer. We conclude that AV distraction is a simple method of improving acceptance of lithotripsy and optimizing treatment.

  5. Stem cells rejuvenate radiation-impaired vasculogenesis in murine distraction osteogenesis.

    Science.gov (United States)

    Deshpande, Sagar S; Gallagher, Kathleen K; Donneys, Alexis; Nelson, Noah S; Guys, Nicholas P; Felice, Peter A; Page, Erin E; Sun, Hongli; Krebsbach, Paul H; Buchman, Steven R

    2015-03-01

    Radiotherapy is known to be detrimental to bone and soft-tissue repair. Bone marrow stromal cells have been shown to enhance bone regeneration during distraction osteogenesis following radiation therapy. The authors posit that transplanted bone marrow stromal cells will significantly augment the mandibular vascularity devastated by radiation therapy. Nineteen male Lewis rats were split randomly into three groups: distraction osteogenesis only (n = 5), radiation therapy plus distraction osteogenesis (n = 7), and radiation therapy plus distraction osteogenesis with intraoperative placement of 2 million bone marrow stromal cells (n = 7). A mandibular osteotomy was performed, and an external fixator device was installed. From postoperative days 4 through 12, rats underwent a gradual 5.1-mm distraction followed by a 28-day consolidation period. On postoperative day 40, Microfil was perfused into the vasculature and imaging commenced. Vascular radiomorphometric values were calculated for regions of interest. An analysis of variance with post hoc Tukey or Games-Howell tests was used, dependent on data homogeneity. Stereologic analysis indicated significant remediation in vasculature in the bone marrow stromal cell group compared with the radiation therapy/distraction osteogenesis group. Each of five metrics idicated significant improvements from radiation therapy/distraction osteogenesis to the bone marrow stromal cell group, with no difference between the bone marrow stromal cell group and the distraction osteogenesis group. Bone marrow stromal cells used together with distraction osteogenesis can rejuvenate radiation-impaired vasculogenesis in the mandible, reversing radiation therapy-induced isotropy and creating a robust vascular network. Bone marrow stromal cells may offer clinicians an alternative reconstructive modality that could improve the lifestyle of patients with hypovascular bone.

  6. Memory load modulates graded changes in distracter filtering

    Directory of Open Access Journals (Sweden)

    Andria eShimi

    2015-01-01

    Full Text Available Our ability to maintain small amounts of information in mind is critical for successful performance on a wide range of tasks. However, it remains unclear exactly how this maintenance is achieved. One possibility is that it is brought about using mechanisms that overlap with those used for attentional control. That is, the same mechanisms that we use to regulate and optimise our sensory processing may be recruited when we maintain information in visual short-term memory (VSTM. We aimed to test this hypothesis by exploring how distracter filtering is modified by concurrent VSTM load. We presented participants with sequences of target items, the order and location of which had to be maintained in VSTM. We also presented distracter items alongside the targets, and these distracters were graded such that they could be either very similar or dissimilar to the targets. We analysed scalp potentials using a novel multiple regression approach, which enabled us to explore the neural mechanisms by which the participants accommodated these variable distracters on a trial-to-trial basis. Critically, the effect of distracter filtering interacted with VSTM load; the same graded changes in perceptual similarity exerted effects of a different magnitude depending upon how many items participants were already maintaining in VSTM. These data provide compelling evidence that maintaining information in VSTM recruits an overlapping set of attentional control mechanisms that are otherwise used for distracter filtering.

  7. Mandibular Deformity Correction by Distraction Osteogenesis

    Directory of Open Access Journals (Sweden)

    Md Asaduzzaman

    2011-02-01

    Full Text Available Distraction osteogenesis (DO is a biological process of new bone formation. It could be used as an alternative treatment method for the correction of mandibular hypoplastic deformity. Modern distraction osteogenesis evolved primarily from the work of Gavriel llizarov. DO has been first applied to craniofacial region since McCarthy et al. In this case report, the patient was 17 years old male with bird face deformity due to hypoplasia of mandible resulted from bilateral TMJ ankylosis due to the fracture of both condyle at the age of 4 years. Patient’s intraincisal opening was absent 1 year back. He underwent condylectomy in both sides to release the ankylosis and to increase intraincisal opening. His mandibular length was markedly short. To increase his mandibular antero-posterior length, mandibular body distraction was done in Oral and Maxillofacial Surgery department, BSMMU. Through this procedure length of the body of mandibule was increased by 10 mm, occlusion was edge to edge and his lower facial appearance increased markedly. Mandibular body distraction osteogenesis was considerably effective when performed in a hypoplastic mandible to facilitate post-operative functional and esthetic restoration. Long term follow-up is necessary to evaluate relapse and complications. DOI: 10.3329/bsmmuj.v3i2.7061BSMMU J 2010; 3(2: 103-106

  8. Audiovisual distraction for pain relief in paediatric inpatients: A crossover study.

    Science.gov (United States)

    Oliveira, N C A C; Santos, J L F; Linhares, M B M

    2017-01-01

    Pain is a stressful experience that can have a negative impact on child development. The aim of this crossover study was to examine the efficacy of audiovisual distraction for acute pain relief in paediatric inpatients. The sample comprised 40 inpatients (6-11 years) who underwent painful puncture procedures. The participants were randomized into two groups, and all children received the intervention and served as their own controls. Stress and pain-catastrophizing assessments were initially performed using the Child Stress Scale and Pain Catastrophizing Scale for Children, with the aim of controlling these variables. The pain assessment was performed using a Visual Analog Scale and the Faces Pain Scale-Revised after the painful procedures. Group 1 received audiovisual distraction before and during the puncture procedure, which was performed again without intervention on another day. The procedure was reversed in Group 2. Audiovisual distraction used animated short films. A 2 × 2 × 2 analysis of variance for 2 × 2 crossover study was performed, with a 5% level of statistical significance. The two groups had similar baseline measures of stress and pain catastrophizing. A significant difference was found between periods with and without distraction in both groups, in which scores on both pain scales were lower during distraction compared with no intervention. The sequence of exposure to the distraction intervention in both groups and first versus second painful procedure during which the distraction was performed also significantly influenced the efficacy of the distraction intervention. Audiovisual distraction effectively reduced the intensity of pain perception in paediatric inpatients. The crossover study design provides a better understanding of the power effects of distraction for acute pain management. Audiovisual distraction was a powerful and effective non-pharmacological intervention for pain relief in paediatric inpatients. The effects were

  9. Distracted driving: prevalence, problems, and prevention.

    Science.gov (United States)

    Overton, Tiffany L; Rives, Terry E; Hecht, Carrie; Shafi, Shahid; Gandhi, Rajesh R

    2015-01-01

    While the number of motor vehicle crashes has declined over the years, crashes resulting from distracted driving are increasing in the United States resulting in significant morbidity and mortality. The national public seems to be aware of the dangers associated with using technology while driving, but continues to engage in this dangerous behaviour, and may be unaware of or underestimate the impact of cell phone use on their own driving performance. Problems associated with distracted driving are not limited to novice or teenage drivers; multifaceted universal prevention efforts aimed at impacting large segments of the population may have the greatest impact. Legislation limiting drivers' cell phone use has had little impact, possibly due to low regulation and enforcement. Behaviour change programmes, improved vehicle safety, and public awareness campaigns have been developed as potential preventive efforts to reduce accidents caused by distracted drivers.

  10. Evaluating Robotic Surgical Skills Performance Under Distractive Environment Using Objective and Subjective Measures.

    Science.gov (United States)

    Suh, Irene H; LaGrange, Chad A; Oleynikov, Dmitry; Siu, Ka-Chun

    2016-02-01

    Distractions are recognized as a significant factor affecting performance in safety critical domains. Although operating rooms are generally full of distractions, the effect of distractions on robot-assisted surgical (RAS) performance is unclear. Our aim was to investigate the effect of distractions on RAS performance using both objective and subjective measures. Fifteen participants performed a knot-tying task using the da Vinci Surgical System and were exposed to 3 distractions: (1) passive distraction entailed listening to noise with a constant heart rate, (2) active distraction included listening to noise and acknowledging a change of random heart rate from 60 to 120 bpm, and (3) interactive distraction consisted of answering math questions. The objective kinematics of the surgical instrument tips were used to evaluate performance. Electromyography (EMG) of the forearm and hand muscles of the participants were collected. The median EMG frequency (EMG(fmed)) and the EMG envelope (EMG(env)) were analyzed. NASA Task Load Index and Fundamentals of Laparoscopic Surgery score were used to evaluate the subjective performance. One-way repeated analysis of variance was applied to examine the effects of distraction on skills performance. Spearman's correlations were conducted to compare objective and subjective measures. Significant distraction effect was found for all objective kinematics measures (P < .05). There were significant distraction effects for EMG measures (EMG(env), P < .004; EMG(fmed), P = .031). Significant distraction effects were also found for subjective measurements. Distraction impairs surgical skills performance and increases muscle work. Understanding how the surgeons cope with distractions is important in developing surgical education. © The Author(s) 2015.

  11. The Effects of Distraction on Cognitive Task Performance during Toddlerhood

    Science.gov (United States)

    Wyss, Nancy M.; Kannass, Kathleen N.; Haden, Catherine A.

    2013-01-01

    We investigated the effects of distraction on attention and task performance during toddlerhood. Thirty toddlers (24- to 26-month-olds) completed different tasks (2 of each: categorization, problem solving, memory, free play) in one of two conditions: No Distraction or Distraction. The results revealed that the distractor had varying effects on…

  12. Anterior ankle arthroscopy, distraction or dorsiflexion?

    OpenAIRE

    de Leeuw, P.A.J.; Golanó, P.; Clavero, J.A.; van Dijk, C.N.

    2010-01-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, where...

  13. Not All Distraction Is Bad: Working Memory Vulnerability to Implicit Socioemotional Distraction Correlates with Negative Symptoms and Functional Impairment in Psychosis

    Directory of Open Access Journals (Sweden)

    Quintino R. Mano

    2014-01-01

    Full Text Available This study investigated implicit socioemotional modulation of working memory (WM in the context of symptom severity and functional status in individuals with psychosis (N = 21. A delayed match-to-sample task was modified wherein task-irrelevant facial distracters were presented early and briefly during the rehearsal of pseudoword memoranda that varied incrementally in load size (1, 2, or 3 syllables. Facial distracters displayed happy, sad, or emotionally neutral expressions. Implicit socioemotional modulation of WM was indexed by subtracting task accuracy on nonfacial geometrical distraction trials from facial distraction trials. Results indicated that the amount of implicit socioemotional modulation of high WM load accuracy was significantly associated with negative symptoms (r=0.63, P<0.01, role functioning (r=−0.50, P<0.05, social functioning (r=−0.55, P<0.01, and global assessment of functioning (r=−0.53, P<0.05. Specifically, greater attentional distraction of high WM load was associated with less severe symptoms and functional impairment. This study demonstrates the importance of the WM-socioemotional interface in influencing clinical and psychosocial functional status in psychosis.

  14. Auditory distraction and serial memory: The avoidable and the ineluctable

    Directory of Open Access Journals (Sweden)

    Dylan M Jones

    2010-01-01

    Full Text Available One mental activity that is very vulnerable to auditory distraction is serial recall. This review of the contemporary findings relating to serial recall charts the key determinants of distraction. It is evident that there is one form of distraction that is a joint product of the cognitive characteristics of the task and of the obligatory cognitive processing of the sound. For sequences of sound, distraction appears to be an ineluctable product of similarity-of-process, specifically, the serial order processing of the visually presented items and the serial order coding that is the by-product of the streaming of the sound. However, recently emerging work shows that the distraction from a single sound (one deviating from a prevailing sequence results in attentional capture and is qualitatively distinct from that of a sequence in being restricted in its action to encoding, not to rehearsal of list members. Capture is also sensitive to the sensory task load, suggesting that it is subject to top-down control and therefore avoidable. These two forms of distraction-conflict of process and attentional capture-may be two consequences of auditory perceptual organization processes that serve to strike the optimal balance between attentional selectivity and distractability.

  15. Les adakites d'Equateur : modèle préliminaire

    OpenAIRE

    Monzier, Michel; Robin, Claude; Hall, M.L.; Cotten, J.; Mothes, P.; Eissen, Jean-Philippe; Samaniego, P.

    1997-01-01

    L'ensemble des roches de 12 volcans quaternaires des Andes équatoriennes (286 analyses nouvelles) présente une signature adakitique, plus ou moins forte selon les appareils. Cette signature proviendrait de la fusion partielle de matériaux basaltiques métamorphisés de la croûte continentale (MORB et/ou basaltes d'arc) sous l'action des remontées magmatiques d'origine mantellique. Un modèle pétrogénétique préliminaire est proposé, qui explique les grands traits d'ensemble de la géochimie des vo...

  16. Renewable Energy Opportunities at Fort Hood, Texas

    Energy Technology Data Exchange (ETDEWEB)

    Solana, Amy E.; Warwick, William M.; Orrell, Alice C.; Russo, Bryan J.; Parker, Kyle R.; Weimar, Mark R.; Horner, Jacob A.; Manning, Anathea

    2011-11-14

    This report presents the results of Pacific Northwest National Laboratory's (PNNL) follow-on renewable energy (RE) assessment of Fort Hood. Fort Hood receives many solicitations from renewable energy vendors who are interested in doing projects on site. Based on specific requests from Fort Hood staff so they can better understand these proposals, and the results of PNNL's 2008 RE assessment of Fort Hood, the following resources were examined in this assessment: (1) Municipal solid waste (MSW) for waste-to-energy (WTE); (2) Wind; (3) Landfill gas; (4) Solar photovoltaics (PV); and (5) Shale gas. This report also examines the regulatory issues, development options, and environmental impacts for the promising RE resources, and includes a review of the RE market in Texas.

  17. Attention and working memory in elderly: the influence of a distracting environment.

    Science.gov (United States)

    Rodrigues, Pedro F S; Pandeirada, Josefa N S

    2015-02-01

    The present work investigated the effect of a distracting environment in the performance of attentional and working memory (WM) tasks in elderly participants. To this end, forty elderly performed two attentional tasks (simple reaction time and go/no-go tasks), and three WM tasks (arithmetic, memory for digits and sequences of letters and numbers). Each participant performed the tasks in a distracting and a non-distracting environment, with an interval of 14-21 days between sessions. The results revealed better performance in the attentional tasks when these were done in the non-distracting environment, as compared to when they were done in the distracting environment. Specifically, participants provided more accurate responses, fewer false alarms and omissions when responding in the non-distracting environment than when responding in the distracting environment. Participants were also faster at providing correct responses in the go/no-go task when it was performed in the non-distracting environment. As for the memory tasks, the effect of type of environment was significant only in the memory for digits in a forward direction task. Our data suggest the need to consider the potential damaging consequences of distracting environments when the elderly have to perform tasks that demand their attention. Specific examples of such situations are presented in the discussion (e.g., distracting effect of environment on medical and on psychological evaluations).

  18. The pathologic mechanisms underlying lumbar distraction spinal cord injury in rabbits.

    Science.gov (United States)

    Wu, Di; Zheng, Chao; Wu, Ji; Xue, Jing; Huang, Rongrong; Wu, Di; Song, Yueming

    2017-11-01

    A reliable experimental rabbit model of distraction spinal cord injury (SCI) was established to successfully simulate gradable and replicable distraction SCI. However, further research is needed to elucidate the pathologic mechanisms underlying distraction SCI. The aim of this study was to investigate the pathologic mechanisms underlying lumbar distraction SCI in rabbits. This is an animal laboratory study. Using a self-designed spine distractor, the experimental animals were divided into a control group and 10%, 20%, and 30% distraction groups. Pathologic changes to the spinal cord microvessels in the early stage of distraction SCI were identified by perfusion of the spinal cord vasculature with ink, production of transparent specimens, observation by light microscopy, and observation of corrosion casts of the spinal cord microvascular architecture by scanning electron microscopy. Malondialdehyde (MDA) and superoxide dismutase (SOD) concentrations in the injured spinal cord tissue were measured after 8 hours. With an increasing degree and duration of distraction, the spinal cord microvessels were only partially filled and had the appearance of spasm until rupture and hemorrhage were observed. The MDA concentration increased and the SOD concentration decreased in the spinal cord tissue. Changes to the internal and external spinal cord vessels led to spinal cord ischemia, which is a primary pathologic mechanism of distraction SCI. Lipid peroxidation mediated by free radicals took part in secondary pathologic damage of distraction SCI. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. De Bronislaw Malinowski à Virginia Henderson: révélation sur l'origine anthropologique d'un modèle de soins infirmiers

    Directory of Open Access Journals (Sweden)

    NICOLAS VONARX

    2010-10-01

    Full Text Available Le modèle des quatorze besoins fondamentaux de Virginia Henderson est sûrement le plus populaire des modèles de soins chez les infirmières d'ici et d'ailleurs. Par contre, son origine et les grandes inspirations d'Henderson dans l'élaboration de son modèle sont mal connues. Ce texte lève en quelque sorte le voile à ce sujet en montrant que ce modèle trouve sa source en anthropologie et qu'il entretient de très fortes correspondances avec les éléments clefs retrouvés dans les travaux de l'anthropologue Malinowski. En retraçant et en revenant sur ces correspondances, voire sur les emprunts qu'aurait faits Henderson des travaux de Malinowski, nous trouvons dans ce texte une bonne occasion de souligner la part des savoirs empruntés, et notamment des savoirs anthropo-sociologiques, au sein de la discipline infirmière.

  20. Muscle response to leg lengthening during distraction osteogenesis.

    Science.gov (United States)

    Thorey, Fritz; Bruenger, Jens; Windhagen, Henning; Witte, Frank

    2009-04-01

    Continuous lengthening of intact muscles during distraction osteogenesis leads to an increase of sarcomeres and enhances the regeneration of tendons and blood vessels. A high distraction rate leads to an excessive leg and muscle lengthening and might cause damages of muscle fibers with fibrosis, necrosis, and muscle weakness. Complications like muscle contractures or atrophy after postoperative immobilization emphazize the importance of muscles and their function in the clinical outcome. In an animal model of distraction osteogenesis, 18 sheep were operated with an external fixator followed by 4 days latency, 21 days distraction (1.25 mm per day) and 51 days consolidation. The anatomical location (gastrocnemius, peroneus tertius, and first flexor digitorum longus muscle), dimension and occurrence of muscular defects were characterized histologically. The callus formation and leg axis was monitored by weekly X-rays. Additionally, serum creatine kinase was analyzed during a distraction and consolidation period. Significant signs of muscle lesions in all three observed muscles can be found postoperatively, whereas normal callus formation and regular leg axis was observed radiologically. The peroneus tertius and first flexor digitorum longus muscles were found to have significantly more signs of fibrosis, inflammatory, and necrosis. Creatine kinase showed two peaks: 4 and 39 days postoperative as an indication of muscle damage and regeneration. The study implicates that muscle damages should be considered when a long-distance distraction osteogenesis is planned. The surgeon should consider these muscle responses and individually discuss a two-stage treatment or additional muscle tendon releases to minimize the risk of muscle damages.

  1. A simple mechanism for measuring and adjusting distraction forces during maxillary advancement.

    Science.gov (United States)

    Suzuki, Eduardo Yugo; Suzuki, Boonsiva

    2009-10-01

    Direct measurement of distraction forces on the craniofacial skeleton has never been reported. The present report describes the development of a method of assessing and adjusting traction forces applied through maxillary distraction osteogenesis. A simple mechanism to measure and adjust tension force during maxillary distraction osteogenesis was developed and connected bilaterally to the traction screws of a rigid external distraction device. Measurements were carried out before and after activation using a Shimpo (Nidec-Shimpo America Corporation, Itasca, IL) force gauge in 4 patients (2 with unilateral cleft lip and/or palate, 1 with bilateral cleft lip and palate, and 1 with noncleft) during the distraction process. Activation was performed twice a day at a rate of 1 mm/day. The average maximum force applied throughout the distraction period was 42.5 N (range 16.4 to 65.3 N), with increments, after activation, averaging 10.5 N (range 7.9 to 15.7 N). In patients with unilateral cleft lip and/or palate, distraction forces on the larger segment were 65.1% higher than on the lesser segment. A differential pattern of forces was also observed in the patients with asymmetric noncleft. However, the differential forces between lateral segments were not observed in the patient with bilateral cleft lip and palate. During the activation period, distraction forces progressively increased, whereas the amount of maxillary movement decreased. Pain and discomfort were reported with high forces. Through this mechanism, direct measurement and adjustment of distraction forces during maxillary advancement was possible. The unbalanced pattern of forces observed in patients with cleft suggests the necessity of individual adjustments for controlling pain and clinical symptoms. Accordingly, assessment of distraction forces during maxillary distraction osteogenesis is extremely helpful in understanding the biomechanics of the distraction process.

  2. Patient-specific Distraction Regimen to Avoid Growth-rod Failure.

    Science.gov (United States)

    Agarwal, Aakash; Jayaswal, Arvind; Goel, Vijay K; Agarwal, Anand K

    2018-02-15

    A finite element study to establish the relationship between patient's curve flexibility (determined using curve correction under gravity) in juvenile idiopathic scoliosis and the required distraction frequency to avoid growth rod fracture, as a function of time. To perform a parametric analysis using a juvenile scoliotic spine model (single mid-thoracic curve with the apex at the eighth thoracic vertebra) and establish the relationship between curve flexibility (determined using curve correction under gravity) and the distraction interval that allows a higher factor of safety for the growth rods. Previous studies have shown that frequent distraction with smaller magnitude of distractions are less likely to result in rod failure. However there has not been any methodology or a chart provided to apply this knowledge on to the individual patients that undergo the treatment. This study aims to fill in that gap. The parametric study was performed by varying the material properties of the disc, hence altering the axial stiffness of the scoliotic spine model. The stresses on the rod were found to increase with increased axial stiffness of the spine, and this resulted in the increase of required optimal frequency to achieve a factor of safety of two for growth rods. A relationship between the percentage correction in Cobb's angle due to gravity alone, and the required distraction interval for limiting the maximum von Mises stress to 255 MPa on the growth rods was established. The distraction interval required to limit the stresses to the selected nominal value reduces with increase in stiffness of the spine. Furthermore, the appropriate distraction interval reduces for each model as the spine becomes stiffer with time (autofusion). This points to the fact the optimal distraction frequency is a time-dependent variable that must be achieved to keep the maximum von Mises stress under the specified factor of safety. The current study demonstrates the possibility of

  3. Maxillary advancement using distraction osteogenesis with intraoral device.

    Science.gov (United States)

    Takigawa, Yoko; Uematsu, Setsuko; Takada, Kenji

    2010-11-01

    This article describes the surgical orthodontic treatment of maxillary hypoplasia in a patient with cleft lip and palate using maxillary distraction osteogenesis with internal maxillary distractors. Maxillary advancement was performed to correct the retrusive maxillary facial profile and Class III malocclusion. Rotational movement of the distraction segment was made to correct the upper dental midline. Although maxillary advancement was insufficient because of unexpected breakage of the intraoral distractor after completion of the distraction, skeletal traction with a face mask compensated for the shortage. Successful esthetic improvement and posttreatment occlusal stability were achieved with no discernible relapse after 2 years of retention.

  4. A osteogenesis distraction device enabling control of vertical direction for syndromic craniosynostosis.

    Science.gov (United States)

    Kobayashi, Shinji; Fukawa, Toshihiko; Hirakawa, Takashi; Maegawa, Jiro

    2014-02-01

    We have developed a hybrid facial osteogenesis distraction system that combines the advantages of external and internal distraction devices to enable control of both the distraction distance and vector. However, when the advanced maxilla has excessive clockwise rotation and shifts more downward vertically than planned, it might be impossible to pull it up to correct it. We invented devices attached to external distraction systems that can control the vertical vector of distraction to resolve this problem. The purpose of this article is to describe the result of utilizing the distraction system for syndromic craniosynostosis. In addition to a previously reported hybrid facial distraction system, the devices for controlling the vertical direction of the advanced maxilla were attached to the external distraction device. The vertical direction of the advanced maxilla can be controlled by adjustment of the spindle units. This system was used for 2 patients with Crouzon and Apert syndrome. The system enabled control of the vertical distance, with no complications during the procedures. As a result, the maxilla could be advanced into the planned position including overcorrection without excessive clockwise rotation of distraction. Our system can alter the cases and bring them into the planned position, by controlling the vertical vector of distraction. We believe that this system might be effective in infants with syndromic craniosynostosis as it involves 2 osteotomies and horizontal and vertical direction of elongation can be controlled.

  5. Distraction by novel and pitch-deviant sounds in children

    Directory of Open Access Journals (Sweden)

    Nicole Wetzel

    2016-12-01

    Full Text Available The control of attention is an important part of our executive functions and enables us to focus on relevant information and to ignore irrelevant information. The ability to shield against distraction by task-irrelevant sounds is suggested to mature during school age. The present study investigated the developmental time course of distraction in three groups of children aged 7 – 10 years. Two different types of distractor sounds that have been frequently used in auditory attention research – novel environmental and pitch-deviant sounds – were presented within an oddball paradigm while children performed a visual categorization task. Reaction time measurements revealed decreasing distractor-related impairment with age. Novel environmental sounds impaired performance in the categorization task more than pitch-deviant sounds. The youngest children showed a pronounced decline of novel-related distraction effects throughout the experimental session. Such a significant decline as a result of practice was not observed in the pitch-deviant condition and not in older children. We observed no correlation between cross-modal distraction effects and performance in standardized tests of concentration and visual distraction. Results of the cross-modal distraction paradigm indicate that separate mechanisms underlying the processing of novel environmental and pitch-deviant sounds develop with different time courses and that these mechanisms develop considerably within a few years in middle childhood.

  6. Maxillary Tuberosity Reconstruction with Transport Distraction Osteogenesis

    Directory of Open Access Journals (Sweden)

    F. Ugurlu

    2012-01-01

    Full Text Available Severe bone loss due to pathology in the maxillary tuberosity region is a challenging problem both surgically and prosthetically. Large bone grafts have a poor survival rate due to the delicate bony architecture in this area and presence of the maxillary sinus. Our case presentation describes a new technique for reconstructing severe bony defect in the maxillary tuberosity with horizontal distraction osteogenesis in a 45-year-old man. A 4×6×3cm cyst was discovered in the left maxillary molar region and enucleated. Three months postoperatively, the area had a severe bone defect extending to the zygomatic buttress superiorly and hamular notch posteriorly. Three months later, a bone segment including the right upper second premolar was osteotomised and distracted horizontally. The bone segment was distracted 15 mm distally. After consolidation, implants were placed when the distractor was removed. A fixed denture was loaded over the implants after 3 months. Complete alveolar bone loss extending to the cranial base can be reconstructed with transport distraction osteogenesis. Distalisation of the alveolar bone segment adjacent to the bony defect is an easy method for reconstructing such severe defects.

  7. FOUR YEARS OF OPERATIONS AND RESULTS WITH FORTE

    International Nuclear Information System (INIS)

    D. ROUSSEL-DUPRE; P. KLINGNER; L. CARLSON; ET AL

    2001-01-01

    The FORTE (Fast Onboard Recording of Transient Events) satellite was launched on 29 August 1997 and has been in continuous operation since that time. FORTE was placed in a nearly circular, 825-km-altitude, 70 degrees inclination orbit by a Pegasus rocket funded by Air Force Space Test Program. The Department of Energy funded the FORTE satellite, which was designed and built at Los Alamos. FORTE's successful launch and engineered robustness were a result of several years of dedicated work by the joint Los Alamos National Laboratory/Sandia National Laboratory project team, led through mission definition, payload and satellite development, and launch by Dr. Stephen Knox. The project is now led by Dr. Abram Jacobson. FORTE carries a suite of instruments, an optical system and a rf system, for the study of lightning and anthropogenic signals. As a result of this effort, new understandings of lightning events have emerged as well as a more complete understanding of the relationship between optical and rf lightning events. This paper will provide an overview of the FORTE satellite and will discuss the on orbit performance of the subsystems

  8. Neuronal Effects of Auditory Distraction on Visual Attention

    Science.gov (United States)

    Smucny, Jason; Rojas, Donald C.; Eichman, Lindsay C.; Tregellas, Jason R.

    2013-01-01

    Selective attention in the presence of distraction is a key aspect of healthy cognition. The underlying neurobiological processes, have not, however, been functionally well characterized. In the present study, we used functional magnetic resonance imaging to determine how ecologically relevant distracting noise affects cortical activity in 27…

  9. Profile Changes and Stability following Distraction Osteogenesis with Rigid External Distraction in Adult Cleft Lip and Palate Deformities

    Science.gov (United States)

    Painatt, Jaeson M.; Veeraraghavan, Ravi; Puthalath, Ushass; Peter, Sherry; Rao, Latha P.; Kuriakose, Maria

    2017-01-01

    Objectives: The objective of this study is to analyze the hard and soft-tissue profile changes as well as the upper airway changes after distraction osteogenesis (DO) using rigid external distraction device in adult cleft lip and palate (CLP) patients. The study also evaluates the stability of the surgical result. Materials and Methods: Three lateral cephalometric radiographs were taken: Predistraction (T1), postdistraction (T2), and 1 year after distractor removal (T3). The treatment changes (T1 vs. T2) and the stability (T2 vs. T3) were analyzed. The overall treatment changes after 1 year were also evaluated (T1 vs. T3). The lateral cephalograms were digitally analyzed with the help of software named Dolphin. Statistical Analysis Used: Wilcoxon Signed-Ranks test was used, and the probability value (P value) of 0.05 was considered as statistically significant level. Results: Eleven adult patients with CLP were retrospectively analyzed. After distraction, there was a significant mean maxillary advancement of 14 mm (P maxillary relapse of 3.20 mm (P maxillary advancement for CLP patients with DO. There were significant improvements immediately after distraction, but during the 1-year follow-up, some relapse was seen. This stressed on the need for overcorrection of about 35%–40% for adult CLP patients. PMID:28839409

  10. Understanding commercial truck drivers' decision-makin process concerning distracted driving.

    Science.gov (United States)

    Swedler, David I; Pollack, Keshia M; Gielen, Andrea C

    2015-05-01

    A concurrent mixed methods design was used to explore personal and workplace factors, informed by the Theory of Planned Behavior, that affect truck drivers' decision-making about distracted driving on the job. Qualitative data were collected via semi-structured interviews with experts in truck safety and distracted driving, and quantitative data were collected via online survey of truck drivers in the United States. Findings from the interviews illustrated how drivers perceived distractions and the importance of supervisors enforcing organizational distracted driving policies. Survey results found that behavioral intentions were most important in regards to texting and crash and near-crash outcomes, while perceived norms from management best described the correlation between dispatch device use and negative crash-related outcomes. By using a mixed methods design, rather than two separate studies, these findings revealed nuanced differences into the influence of supervisors on distracted driving. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Anterior Segmental Distraction Osteogenesis in the Hypoplastic Cleft Maxilla

    Science.gov (United States)

    Rao (Janardhan), Sruthi; Kotrashetti, S. M.; Lingaraj, J. B.; Pinto, P. X.; Keluskar, K. M.; Jain, Siddharth; Sone, Piyush; Rao, Santhosh

    2013-01-01

    Orthognathic surgery and distraction osteogenesis play a prime role in the correction of maxillary hypoplasia in patients with cleft lip and palate (CLP). Advancement of the anterior maxilla alone without interfering with the velopharyngeal sphincter may be advantageous in cleft patients, who more commonly have speech deficits and dental crowding. We present a case series of anterior maxillary segmental distraction for maxillary hypoplasia in 5 CLP patients with a one-year follow-up. A custom-made tooth-borne distraction device with a hyrax screw positioned anteroposteriorly was used. The evaluation comprised of hard and soft tissue analysis and speech assessment. A stable occlusion with positive overjet and correction of dental-crowding without extraction was achieved at one year post-distraction. Facial profile and lip support improved. There was no deterioration in speech. PMID:23984033

  12. The use of internal maxillary distraction for maxillary hypoplasia: a preliminary report.

    Science.gov (United States)

    Van Sickels, Joseph E; Madsen, Mathew J; Cunningham, Larry L; Bird, Douglas

    2006-12-01

    Distraction osteogenesis is a useful alternative to advance the maxilla in complicated cases of maxillary hypoplasia. The purpose of this article is to review the workup, experience, and preliminary results with the use of internal distraction osteogenesis for maxillary hypoplasia at one teaching institution. Over a 5-year period, more than 300 patients with craniofacial and dentofacial defects have undergone oral and maxillofacial surgery at our center to correct their skeletal discrepancies. Of these, 10 have had maxillary distraction osteogenesis done with internal distractors. Follow-up of 6 months or more was available for 8 patients. Stereolithographic models were used to bend distractors prior to surgery in 6 patients. Latency prior to the start of distraction was 3 to 7 days and varied with the age of the patient. Distraction occurred at approximately 1 mm per day with an average distraction length of 8.5 mm (range, 6-10 mm). Excellent occlusal results were obtained in 5 patients. Major complications including nonunion and failure to achieve acceptable occlusal results were observed in 3 patients. Minor complications including pain and loosening of the distracter devices were observed in 2 patients, but did not appear to affect the esthetic and functional results. Distraction osteogenesis is a useful alternative to traditional orthognathic surgery to treat maxillary hypoplasia. Internal distractions are attractive to patients, but are more difficult to place and can cause discomfort to patients when trying to achieve an ideal primary vector of distraction. Stereolithographic models can help with placement of the device. Changes in design of distractors may help with patient discomfort.

  13. Cognitive Distraction and African American Women's Endorsement of Gender Role Stereotypes

    Science.gov (United States)

    Smith, Kalynda; Craig-Henderson, Kellina

    2010-01-01

    The present study investigated the effect of cognitive distraction on the endorsement of gender role stereotypes in one sample of African American female participants. Participants' awareness and endorsement of gender role stereotypes for male and females was assessed. Following random assignment to distraction or no distraction conditions, they…

  14. Perpendicular serial maxillary distraction osteogenesis in cleft lip and palate patients.

    Science.gov (United States)

    Ylikontiola, Leena P; Sándor, George K; Harila, Virpi

    2015-01-01

    Cleft lip and palate patients often have a retruded maxilla with a severely narrowed deficient maxillary arch. This report aims to describe the management of severe maxillary retrusion and constriction in cleft lip and palate patients using distraction osteogenesis applied in serial sequence in two directions perpendicular to each other. Two adult male cleft lip and palate patients were treated with maxillary distraction osteogenesis in two stages. In the first stage, surgically assisted rapid palatal expansion with a tooth-borne device was performed to significantly expand the maxillary arch in the transverse dimension. After the teeth were orthodontically aligned, the horizontal distraction of the maxilla was made by two internal maxillary distraction devices. In the first patient, the maxilla was initially widened by 11 mm and then distracted forward by 20 mm. Despite the breakage of the shaft of one of the two distractors at the end of distraction, a satisfactory occlusion was found at the time of distractor device removal. The maxillary position has remained stable through 8 years of follow-up. In the second patient, the palate was widened by 14 mm and the maxilla was distracted forward by 22 mm. The maxillary position has remained stable through 3 years of follow-up. Sequential serial distraction of maxilla in two planes perpendicular to each other is a safe and stable approach for the treatment of cleft lip and palate patients with severe transverse and anteroposterior discrepancies.

  15. Impact of distracted driving on safety and traffic flow.

    Science.gov (United States)

    Stavrinos, Despina; Jones, Jennifer L; Garner, Annie A; Griffin, Russell; Franklin, Crystal A; Ball, David; Welburn, Sharon C; Ball, Karlene K; Sisiopiku, Virginia P; Fine, Philip R

    2013-12-01

    Studies have documented a link between distracted driving and diminished safety; however, an association between distracted driving and traffic congestion has not been investigated in depth. The present study examined the behavior of teens and young adults operating a driving simulator while engaged in various distractions (i.e., cell phone, texting, and undistracted) and driving conditions (i.e., free flow, stable flow, and oversaturation). Seventy five participants 16-25 years of age (split into 2 groups: novice drivers and young adults) drove a STISIM simulator three times, each time with one of three randomly presented distractions. Each drive was designed to represent daytime scenery on a 4 lane divided roadway and included three equal roadway portions representing Levels of Service (LOS) A, C, and E as defined in the 2000 Highway Capacity Manual. Participants also completed questionnaires documenting demographics and driving history. Both safety and traffic flow related driving outcomes were considered. A Repeated Measures Multivariate Analysis of Variance was employed to analyze continuous outcome variables and a Generalized Estimate Equation (GEE) Poisson model was used to analyze count variables. Results revealed that, in general more lane deviations and crashes occurred during texting. Distraction (in most cases, text messaging) had a significantly negative impact on traffic flow, such that participants exhibited greater fluctuation in speed, changed lanes significantly fewer times, and took longer to complete the scenario. In turn, more simulated vehicles passed the participant drivers while they were texting or talking on a cell phone than while undistracted. The results indicate that distracted driving, particularly texting, may lead to reduced safety and traffic flow, thus having a negative impact on traffic operations. No significant differences were detected between age groups, suggesting that all drivers, regardless of age, may drive in a manner

  16. Maxillary-driven simultaneous maxillo-mandibular distraction for hemifacial microsomia.

    Science.gov (United States)

    Nakajima, Hideo; Sakamoto, Yoshiaki; Tamada, Ikkei; Ogata, Hisao; Kishi, Kazuo; Sakamoto, Teruo

    2011-12-01

    We treat hemifacial microsomia with a combination of surgery and orthodontic treatment during the growth period, resulting in early improvement in facial asymmetry and the induction of normal growth. We previously used gradual distraction of the mandibular ramus for Pruzansky's type II classification (Pruzansky, 1969). In type II cases, the maxilla should also be treated actively as, using this technique, improvement of the occlusal plane is difficult to achieve, resulting in a cross bite and difficulties in post-operative orthodontic treatment-especially in older patients. Morphologically, the mandibular angle region of the operative side is flat, and the angle of the mouth remains elevated. We performed mandibular-driven simultaneous maxillo-mandibular distraction while the occlusion was maintained using intermaxillary anchorage. However, mandibular-driven distraction tended to elongate the face because the mandible only elongated downwards and the mandibular ramus did not reach the glenoid. Furthermore, external distraction devices produce significant distress for patients until removal of the device and cause scars on the face. We developed a new internal distraction device with a variable angle and performed maxillary-driven simultaneous maxillo-mandibular distraction using this device. The result was morphologically satisfactory and solved the above problems. Because the patient was in the growth period, careful follow-up and induction to normal growth were important while the inferior growth of the affected side was monitored. Copyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  17. Experiences in Performing Posterior Calvarial Distraction.

    Science.gov (United States)

    McMillan, Kevin; Lloyd, Mark; Evans, Martin; White, Nicholas; Nishikawa, Hiroshi; Rodrigues, Desiderio; Sharp, Melanie; Noons, Pete; Solanki, Guirish; Dover, Stephen

    2017-05-01

    The use of posterior calvarial distraction (PCD) for the management of craniosynostosis is well recognized. The advantages of using this technique include increased cranial volume, decreased intracranial pressure, relief of posterior fossa crowding, improved cerebrospinal fluid (CSF) circulation at the cranio-cervical junction with cessation, and possible resolution of syrinx.The authors retrospectively review their first 50 patients who have undergone PCD under the senior author's care in our unit.The demographics, diagnoses, intraoperative approach with techniques in distractor placement and outcomes of each patient were obtained through an electronic craniofacial database and written patient records. Analysis of complication rates (bleeding, distraction problems, CSF leaks, and infection) was included.A total of 31 boys and 19 girls underwent the procedure between October 2006 and September 2015 with a median age was 17.7 months (range 4 months to 19 years). Of those 50 children, 34 of the cohort were proven to be syndromic by genetic testing.The median length of inpatient stay was 9.4 days (range 3-43 days). Average distraction distance was 24 mm.Complications including CSF leaks, bleeding, distractor problems, and severe complications (recorded in 3 patients) are discussed. Our overall complication rate was 50%.Favorable outcomes included resolution of Chiari, syrinx, and raised intracranial pressure in the majority of patients where distraction was successful.The authors recommend that PCD should be considered the primary treatment for increasing calvarial volume. The authors discuss our experiences and technical innovations over the past decade.

  18. Vertical periodontal ligament distraction--a new method for aligning ankylosed and displaced canines.

    Science.gov (United States)

    Wilmes, Benedict; Drescher, Dieter

    2009-05-01

    In the course of a clinical pilot study we tested the vertical periodontal ligament (V-PDL) distraction as a means of aligning ankylosed upper canines. The objective of this study was to analyze the appropriateness und effectiveness of this method. The ankylosed upper canines of five female patients aged between 16 und 19 years were surgically exposed, luxated, and after a latency period of 5 to 7 days, distracted at a rate of 0.5 mm per day. The installed distractors were borne by the periodontal-mucosa, the periodontal-mucosa and the bone, or by the bone exclusively. We evaluated the distraction distance and time and degree of hard and soft tissue generation present in the region surrounding the distracted teeth. All canines were aligned after a mean distraction period of 43.2 days (+/- 3.6 days). The mean distraction distance was 10.8 mm. Three canines had defects at the cemento-enamel junction, and one canine had to be extracted due to a large defect at the root. Vertical PDL distraction is a minimally-invasive therapy to align ankylosed impacted canines. Even if the long-term prognosis of distracted canines with defects is uncertain, the patient benefits from the vertical PDL distraction because both hard and soft tissues are generated in the vicinity of the distracted canine.

  19. National Survey on Distracted Driving Attitudes and Behaviors - 2015

    Science.gov (United States)

    2018-03-01

    The 2015 National Survey on Distracted Driving Attitudes and Behaviors (NSDDAB) is the third in a series of telephone surveys on distracted driving providing data to help further the understanding of driving behavior and to contribute to the developm...

  20. Contrôle, régulation et sécurité en temps réel des ouvrages

    Directory of Open Access Journals (Sweden)

    ROYET, Paul

    2016-09-01

    Full Text Available La gestion patrimoniale des infrastructures, au plan opérationnel, inclut une surveillance des ouvrages en temps réel, en lien fort avec le contrôle et la régulation de leur fonctionnement, afin d'assurer la sécurité des usagers et de l'environnement. Cet article présente les principes et méthodes qui sous-tendent les actions au pas de temps fin pour des patrimoines tels que les digues, les barrages et les réseaux d'eau et d'assainissement et montre comment ces actions contribuent de manière déterminante à la connaissance de l'état du patrimoine.

  1. Interference by Process, Not Content, Determines Semantic Auditory Distraction

    Science.gov (United States)

    Marsh, John E.; Hughes, Robert W.; Jones, Dylan M.

    2009-01-01

    Distraction by irrelevant background sound of visually-based cognitive tasks illustrates the vulnerability of attentional selectivity across modalities. Four experiments centred on auditory distraction during tests of memory for visually-presented semantic information. Meaningful irrelevant speech disrupted the free recall of semantic…

  2. Management of Cleft Maxillary Hypoplasia with Anterior Maxillary Distraction: Our Experience.

    Science.gov (United States)

    Chacko, Tojan; Vinod, Sankar; Mani, Varghese; George, Arun; Sivaprasad, K K

    2014-12-01

    Maxillary hypoplasia is a common developmental problem in cleft lip and palate deformities. Since 1970s these deformities have traditionally been corrected by means of orthognathic surgery. Management of skeletal deformities in the maxillofacial region has been an important challenge for maxillofacial surgeons and orthodontists. Distraction osteogenesis is a surgical technique that uses body's own repairing mechanisms for optimal reconstruction of the tissues. We present four cases of anterior maxillary distraction osteogenesis with tooth borne distraction device-Hyrax, which were analyzed retrospectively for the efficacy of the tooth borne device-Hyrax and skeletal stability of distracted anterior maxillary segment.

  3. 77 FR 15398 - Attentive Driving: Countermeasures for Distraction Forum

    Science.gov (United States)

    2012-03-15

    ... NATIONAL TRANSPORTATION SAFETY BOARD Attentive Driving: Countermeasures for Distraction Forum The National Transportation Safety Board (NTSB) will convene a forum, Attentive Driving: Countermeasures for... a period of 3 months from the date of the event. Distracted driving is a serious safety risk on our...

  4. The potential effect of technology and distractions on undergraduate students' concentration.

    Science.gov (United States)

    Attia, Najya A; Baig, Lubna; Marzouk, Yousef I; Khan, Anwar

    2017-01-01

    In the present era, it is difficult to keep the concentration of college students at its maximum potential during the class time, as there are many distractions that negatively impact students' concentration and prevent optimal learning. Technologies such as laptops and cell phones have invaded the classroom, raising considerable concerns about their effects on college students' attention in the classroom. Despite these concerns, no research has been done in Saudi Arabia on the effects of technology and other types of classroom distractions on students' concentration. In the current study, we have attempted to identify students' perceptions of major distractions in the classroom based on seventeen internally (self-produced) and twenty-four externally produced classroom situations. The students participating in this study rated the degree to which each distraction interferes with their concentration on the class materials and their ability to learn. Data were collected through surveys of 265 students (66 and 199 students from medical and basic classes, respectively), including 97 females and 168 males 17-23 years of age from the academic years 2010 to 2014. A validated self-administered questionnaire was handed to the students in the classroom. The students were asked to report and rate the classroom distraction produced by 24 external internal distracters (Table-II), on a 5-point scale. The results revealed that ringing cell phones in the class were the most commonly reported electronic external distractor for 68% of students, and 21% of them reported being extremely distracted by this noise. Having an instructor who is difficult to understand was the most commonly reported external behavioral distractor for 75% of students, and 48% of them rated this as extremely distracting. Students talking in class were the most self-produced distractor for 72% of students; negatively impacting their concentration and ability to learn, and 42% of them rated it as an extreme

  5. Mandibular distraction in neonates: indications, technique, results

    Directory of Open Access Journals (Sweden)

    Sesenna Enrico

    2012-02-01

    Full Text Available Abstract Background The Pierre Robin Sequence features were first described by Robin in 1923 and include micrognathia, glossoptosis and respiratory distress with an incidence estimated as 1:8,500 to 1:20,000 newborns. Upper airway obstruction and feeding difficulties are the main concerns related to the pathology. Mandibular distraction should be considered a treatment option (when other treatments result inadequate. Patiants and methods Ten patients between the ages of 1 month and 2 years with severe micrognathia and airway obstruction were treated with Mandibular Distraction Osteogenesis (MDO. All patients underwent fibroscopic examination of the upper airway and a radiographic imaging and/or computed tomography scans to detect malformations and to confirm that the obstruction was caused by posterior tongue displacement. All patients were evaluated by a multidisciplinary team. Indications for surgery included frequent apneic episodes with severe desaturation (70%. Gavage therapy was employed in all patients since oral feeding was not possible. The two tracheotomy patients were 5 months and 2 years old respectively, and the distraction procedure was performed to remove the tracheotomy tube. All patients were treated with bilateral mandibular distraction: two cases with an external multivector distraction device, six cases with an internal non-resorbable device and two cases with an internal resorbable device. In one case, the patient with Goldenhar's Syndrome, the procedure was repeated. Results The resolution of symptoms was obtained in all patients, and, when present, tracheotomy was removed without complications. Of the two patients with pre-existing tracheotomies, in the younger patient (5 months old the tracheotomy was removed 7 days postoperatively. In the Goldenhar's syndrome case (2 years old a Montgomery device was necessary for 6 months due to the presence of tracheotomy-inducted tracheomalacia. Patients were discharged when the

  6. Transpalatal distraction for the management of maxillary constriction in pediatric patients

    OpenAIRE

    Adolphs, Nicolai; Ernst, Nicole; Hoffmeister, Bodo; Raguse, Jan-Dirk

    2015-01-01

    Context: The management of severe maxillary constriction can be challenging. For that purpose surgically assisted maxillary expansion by transpalatal distraction (TPD) can typically be recommended after skeletal maturity. However in selected cases bone borne transpalatal distraction devices can contribute to improve maxillary constriction considerably earlier already during mixed dentition. Aims: To assess the possibility of bone borne transpalatal distraction in pediatric patients. Settings ...

  7. Investigating saccade programming in the praying mantis Tenodera aridifolia using distracter interference paradigms.

    Science.gov (United States)

    Yamawaki, Yoshifumi

    2006-10-01

    To investigate the saccadic system in the mantis, I applied distracter interference paradigms. These involved presenting the mantis with a fixation target and one or several distracters supposed to affect saccades towards the target. When a single target was presented, a medium-sized target located in its lower visual field elicited higher rates of saccade response. This preference for target size and position was also observed when a target and a distracter were presented simultaneously. That is, the mantis chose and fixated the target rather than a distracter that was much smaller or larger than the target, or was located above the target. Furthermore, the mantis' preference was not affected by increasing the number of distracters. However, the presence of the distracter decreased the occurrence rate of saccade and increased the response time to saccade. I conclude that distracter interference paradigms are an effective way of investigating the visual processing underlying saccade generation in the mantis. Possible mechanisms of saccade generation in the mantis are discussed.

  8. Effects of individual differences on the efficacy of different distracters during visual sexual stimulation in women.

    Science.gov (United States)

    Roberts, Verena M; Prause, Nicole

    2012-02-01

    Distractions from sexual cues have been shown to decrease the sexual response, but it is unclear how distracters decrease sexual response. Individual differences may modulate the efficacy of distracters. Forty women viewed three sexual films while their labial temperature and continuous self-reported sexual arousal were monitored. One sexual film had simultaneous verbal distracters concerning dissatisfaction with one's physical appearance (higher salience distracter), a second had distracters concerning daily chores (lower salience distracter), and the third sexual film had no distracters. Participant's reporting greater relationship satisfaction and more communication with their partner about their own physical appearance were expected to decrease the efficacy (increased sexual arousal) of the distracters concerning physical appearance. Contrary to expectations, women who received less feedback about their body from their partners reported less sexual arousal during a sexual film with body distracters than a sexual film with general distracters or a sexual film with no distracters. All women exhibited lower labial temperature in Minutes 2 and 3 of the sexual film with body image distracters as compared to the other two sexual films. Possible explanations explored include self-verification theory and individual differences in the indicators that women consider when rating their sexual arousal.

  9. Distract or reappraise? Age-related differences in emotion-regulation choice.

    Science.gov (United States)

    Scheibe, Susanne; Sheppes, Gal; Staudinger, Ursula M

    2015-12-01

    Does aging impact strategy choice with regard to regulating negative emotions? Based on the assumption that older adults are highly motivated to quickly defuse negative states, we predicted that older adults, relative to young adults, would show an increased preference for distraction (a cognitive disengagement strategy) over reappraisal (a cognitive engagement strategy) in the face of negative material. A stronger preference for distraction, in turn, should be associated with higher affective well-being at older ages, as it helps to avoid high physiological arousal. Young (19-28 years, n = 38) and older (65-75 years, n = 39) adults completed a laboratory task of emotion-regulation choice in which they viewed negative pictures of high and low intensity and chose between distraction and reappraisal to regulate their emotional response. Confirming predictions, age was associated with an increased preference to choose distraction over reappraisal. Among older but not young adults, the relative preference for distraction to reappraisal predicted higher state-affective well-being. In addition, across age groups, the preference for distraction over reappraisal was positively predicted by stimulus intensity and negatively by cognitive resources. Findings support the notion of an age-related shift toward disengagement strategies to regulate negative emotions, which maps onto older adults' prohedonic orientation and holds affective benefits. (c) 2015 APA, all rights reserved).

  10. Useful field of view predicts driving in the presence of distracters.

    Science.gov (United States)

    Wood, Joanne M; Chaparro, Alex; Lacherez, Philippe; Hickson, Louise

    2012-04-01

    The Useful Field of View (UFOV) test has been shown to be highly effective in predicting crash risk among older adults. An important question which we examined in this study is whether this association is due to the ability of the UFOV to predict difficulties in attention-demanding driving situations that involve either visual or auditory distracters. Participants included 92 community-living adults (mean age 73.6 ± 5.4 years; range 65-88 years) who completed all three subtests of the UFOV involving assessment of visual processing speed (subtest 1), divided attention (subtest 2), and selective attention (subtest 3); driving safety risk was also classified using the UFOV scoring system. Driving performance was assessed separately on a closed-road circuit while driving under three conditions: no distracters, visual distracters, and auditory distracters. Driving outcome measures included road sign recognition, hazard detection, gap perception, time to complete the course, and performance on the distracter tasks. Those rated as safe on the UFOV (safety rating categories 1 and 2), as well as those responding faster than the recommended cut-off on the selective attention subtest (350 msec), performed significantly better in terms of overall driving performance and also experienced less interference from distracters. Of the three UFOV subtests, the selective attention subtest best predicted overall driving performance in the presence of distracters. Older adults who were rated as higher risk on the UFOV, particularly on the selective attention subtest, demonstrated poorest driving performance in the presence of distracters. This finding suggests that the selective attention subtest of the UFOV may be differentially more effective in predicting driving difficulties in situations of divided attention which are commonly associated with crashes.

  11. Prediction of cartilaginous tissue repair after knee joint distraction

    NARCIS (Netherlands)

    van der Woude, J A D; Welsing, P M; van Roermund, P M; Custers, R J H; Kuchuk, N O; Lafeber, F P J G G

    2016-01-01

    BACKGROUND: For young patients (<65years), knee joint distraction (KJD) may be a joint-saving treatment option for end-stage knee osteoarthritis. Distracting the femur from the tibia by five millimeters for six to eight weeks using an external fixation frame results in cartilaginous tissue repair,

  12. Promoted new bone formation in maxillary distraction osteogenesis using a tissue-engineered osteogenic material.

    Science.gov (United States)

    Kinoshita, Kazuhiko; Hibi, Hideharu; Yamada, Yoichi; Ueda, Minoru

    2008-01-01

    Bilateral maxillary distraction was performed at a higher rate in rabbits to determine whether locally applied tissue-engineered osteogenic material (TEOM) enhances bone regeneration. The material was an injectable gel composed of autologous mesenchymal stem cells, which were cultured then induced to be osteogenic in character, and platelet-rich plasma (PRP). After a 5-day latency period, distraction devices were activated at a rate of 2.0 mm once daily for 4 days. Twelve rabbits were divided into 2 groups. At the end of distraction, the experimental group of rabbits received an injection of TEOM into the distracted tissue on one side, whereas, saline solution was injected into the distracted tissue on the contralateral side as the internal control. An additional control group received an injection of PRP or saline solution into the distracted tissue in the same way as the experimental group. The distraction regenerates were assessed by radiological and histomorphometric analyses. The radiodensity of the distraction gap injected with TEOM was significantly higher than that injected with PRP or saline solution at 2, 3, and 4 weeks postdistraction. The histomorphometric analysis also showed that both new bone zone and bony content in the distraction gap injected with TEOM were significantly increased when compared with PRP or saline solution. Our results demonstrated that the distraction gap injected with TEOM showed significant new bone formation. Therefore, injections of TEOM may be able to compensate for insufficient distraction gaps.

  13. When Distraction Holds Relevance: A Prospective Memory Benefit for Older Adults

    Directory of Open Access Journals (Sweden)

    Joana S. Lourenço

    2015-06-01

    Full Text Available Evidence is accumulating to show that age-related increases in susceptibility to distracting information can benefit older more than young adults in several cognitive tasks. Here we focus on prospective memory (i.e., remembering to carry out future intentions and examine the effect of presenting distracting information that is intention-related as a function of age. Young and older adults performed an ongoing 1-back working memory task to a rapid stream of pictures superimposed with to-be-ignored letter strings. Participants were additionally instructed to respond to target pictures (namely, animals and, for half of the participants, some strings prior to the targets were intention-related words (i.e., animals. Results showed that presenting intention-related distracting information during the ongoing task was particularly advantageous for target detection in older compared to young adults. Moreover, a prospective memory benefit was observed even for older adults who showed no explicit memory for the target distracter words. We speculate that intention-related distracter information enhanced the accessibility of the prospective memory task and suggest that when distracting information holds relevance to intentions it can serve a compensatory role in prospective remembering in older adults.

  14. Bouvard et Pécuchet et le désir amoureux

    Directory of Open Access Journals (Sweden)

    Anne Herschberg Pierrot

    2010-09-01

    Full Text Available L’article propose une étude de genèse du chapitre 7 de Bouvard et Pécuchet, consacré à l’amour, qui forme une étape encyclopédique a priori un peu surprenante. Flaubert s’amuse à écrire ces aventures de Bouvard et Pécuchet, dans un pays qui n’est pas si tendre. L’étude de genèse porte sur le travail de l’écriture de plusieurs temps forts du chapitre (dans l’incipit, et les scènes de duos, notamment la scène entre Mme Castillon et Gorgu. Elle permet de montrer l’effacement de détails érotiques, mais aussi du politique et de l’histoire, qui se trouvent condensés dans le texte final. Elle révèle aussi lele concerté de ce chapitre dans la construction du roman et l’itinéraire des personnages. Anodin en apparence, ce chapitre est emblématique d’une poétique fondée sur l’ellipse, et qui mêle le jeu et le sérieux.This article presents a textual genetics study of Bouvard et Pécuchet’s 7th chapter, about love, which appears to be a surprising encyclopedic stage of the novel. Flaubert has fun writing these adventures in a not so tender country. This genetics study focuses on the writing of several key moments of the chapter (in the beginning and the duo scenes, such as the one between Mme Castillon and Gorgu. It reveals the erasure of erotic details, as well as politics and history, which end up condensed in the final text. It also shows this chapter’s concerted role in the construction of the novel and the characters’ development. Apparently minor, this chapter is emblematic of a poetics founded on the ellipsis, mingling play and seriousness.

  15. Condylar cartilaginous changes after mandibular distraction osteogenesis in rabbits.

    Science.gov (United States)

    Ahn, Sin-Young; Kim, Su-Gwan

    2011-10-01

    The purpose of this study was to evaluate histologic and immunohistochemical changes in the condylar articular surface in response to distraction osteogenesis (DO) of the mandibular body in rabbits. A unilateral osteotomy of the mandible at the premolar area was performed in 16 rabbits. The animals were divided into 4 groups based on different distraction parameters (rate and rhythm). After a 5-day latency, the mandible was lengthened by 0.5 mm daily for 6 days (group 1); 0.5 mm twice daily for 3 days (group 2); 0.5 mm once daily for 10 days (group 3); or 0.5 mm twice daily for 5 days (group 4). All 4 groups underwent a 14-day consolidation period. Four rabbits were included in the control group. The specimens were stained with hematoxylin-eosin for histologic examination. Immunohistochemical analysis was performed to evaluate the expression of growth factors. None of the groups demonstrated any degenerative changes in the temporomandibular joint (TMJ). On the distraction side in all groups, the histopathological examination revealed a hypertrophic thickening of the cartilage zone. Prominent endochondral ossification and high active osteoblasts were observed in groups 3 and 4. On the nondistraction side, no major changes were observed excluding the appearance of osteoclasts in groups 3 and 4. The immunohistochemical analysis revealed tenascin immunoreactivity in bone marrow mesenchymal cells on the distraction side in group 4. Connexin immunoreactivity did not display a marked change in any of the groups. Osteocalcin was observed on the distraction side in group 2, which suggested that bone formation is increased. Nitric oxide synthase 2 immunoreactivity was observed on the distraction side in group 2, which is associated with stress and inflammation. The results indicated that the hypertrophy of the cartilage zone and endochondral ossification became more pronounced as the extent and rate of distraction increased. Copyright © 2011 Mosby, Inc. All rights reserved.

  16. Bent's Old Fort: Amphibians and Reptiles

    Science.gov (United States)

    Muths, E.

    2008-01-01

    Bent's Old Fort National Historic Site sits along the Arkansas River in the semi-desert prairie of southeastern Colorado. The USGS provided assistance in designing surveys to assess the variety of herpetofauna (amphibians and reptiles) resident at this site. This brochure is the results of those efforts and provides visitors with information on what frogs, toads, snakes and salamanders might be seen and heard at Bent's Old Fort.

  17. Distraction decreases prefrontal oxygenation: A NIRS study.

    Science.gov (United States)

    Ozawa, Sachiyo; Hiraki, Kazuo

    2017-04-01

    When near-infrared spectroscopy (NIRS) is used to measure emotion-related cerebral blood flow (CBF) changes in the prefrontal cortex regions, the functional distinction of CBF changes is often difficult because NIRS is unable to measure neural activity in deeper brain regions that play major roles in emotional processing. The CBF changes could represent cognitive control of emotion and emotional responses to emotional materials. Supposing that emotion-related CBF changes in the prefrontal cortex regions during distraction are emotional responses, we examined whether oxygenated hemoglobin (oxyHb) decreases. Attention-demanding tasks cause blood flow decreases, and we thus compared the effects of visually paced tapping with different tempos, on distraction. The results showed that the oxyHb level induced by emotional stimulation decreased with fast-tempo tapping significantly more than slow-tempo tapping in ventral medial prefrontal cortex regions. Moreover, a Global-Local task following tapping showed significantly greater local-minus-global response time (RT) difference scores in the fast- and mid-tempo condition compared with those in the slow-tempo, suggesting an increased attentional focus, and decreased negative emotion. The overall findings indicate that oxyHb changes in a relatively long distraction task, as measured by NIRS, are associated with emotional responses, and oxyHb can be decreased by successfully performing attention-demanding distraction tasks. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Massive epistaxis due to pseudoaneurysm of the sphenopalatine artery: a rare post-operative complication of orthognathic surgery.

    Science.gov (United States)

    Kim, Y-W; Baek, M-J; Kim, H-D; Cho, K-S

    2013-06-01

    To introduce pseudoaneurysm of the sphenopalatine artery as the possible aetiology of acute massive epistaxis in patients with a history of orthognathic surgery accompanied by Le Fort I osteotomy. Case report and literature review. This paper reports a case of acute life-threatening epistaxis following Le Fort I osteotomy. Computed tomography and angiography showed a pseudoaneurysm of the sphenopalatine artery, which was successfully treated by endovascular embolisation. Although a pseudoaneurysm of the sphenopalatine artery following Le Fort I osteotomy is extremely rare, it should be considered as the possible aetiology of acute massive epistaxis in patients with a history of orthognathic surgery accompanied by Le Fort I osteotomy.

  19. Évolution de la normalisation dans le domaine des oléagineux et des corps gras

    Directory of Open Access Journals (Sweden)

    Quinsac Alain

    2003-07-01

    Full Text Available La normalisation joue un grand rôle dans les échanges économiques en participant à l’ouverture et à la transparence des marchés. La filière des Oléagineux et des Corps Gras a intégré depuis longtemps la normalisation dans sa stratégie. Élaborés à partir des besoins de la profession et notamment au niveau de la relation client-fournisseur, les programmes ont concerné principalement l’échantillonnage et l’analyse. Depuis quelques années, une forte évolution du contexte socio-économique et réglementaire (utilisation non-alimentaire, sécurité alimentaire, assurance qualité, a élargi le champ de la normalisation. La démarche normative adoptée dans le cas des bio-diesels et de la détection des OGM dans les oléagineux est expliquée. Les conséquences de l’évolution de la normalisation et les enjeux pour la profession des oléagineux dans le futur sont évoqués.

  20. Stability after Cleft Maxillary Distraction Osteogenesis or Conventional Orthognathic Surgery

    DEFF Research Database (Denmark)

    Andersen, Kristian; Svenstrup, Martin; Pedersen, Thomas Klit

    2015-01-01

    OBJECTIVES: To compare stability of maxillary advancements in patients with cleft lip and palate following distraction osteogenesis or orthognathic surgery. MATERIAL AND METHODS: INCLUSION CRITERIA: 1) cleft lip and palate, 2) advancement > 8 mm. Eleven patients comprised the distraction...... changed in CONVG. At follow-up (T3), VOB increased in CONVG compared with DOG, (P = 0.01). Vertical position of A point differed between the groups (P = 0.04). No significant intergroup differences between soft tissue parameters occurred. CONCLUSIONS: Distraction osteogenesis resulted in a stable position...

  1. Distraction-related road traffic collisions

    African Journals Online (AJOL)

    drivers involved in road traffic collisions (RTC) were using mobile phones. Our study supports ... while driving. Keywords: Distraction, prevention, road traffic collision, mobile phone. ..... keeps us connected with others with great advantages.

  2. Comparaison de différentes associations d'anticoagulants sur les numérations plaquettaires et la formation d'agrégats chez le chat

    OpenAIRE

    Charru, Pauline

    2011-01-01

    Chez le chat, l'hémogramme est un examen complémentaire parfois difficile à interpréter aux vues des nombreuses difficultés d'ordre pré-analytique et analytique potentielle. Parmi elles, on retiendra la forte tendance des plaquettes à s'agréger in vitro, surtout sur EDTA-dépendante, une nouvelle molécule antiagrégante a montré son intérêt : le CTAD (Citrate, Théophylline, Adénosine et Dipyridamole). Dans notre étude, l'utilisation de l'association EDTA et CTAD chez 46 chats sains, en éliminan...

  3. Controlling the vector of distraction osteogenesis in the management of obstructive sleep apnea.

    Science.gov (United States)

    Shilo, Dekel; Emodi, Omri; Aizenbud, Dror; Rachmiel, Adi

    2016-01-01

    Obstructive sleep apnea (OSA) in individuals with craniofacial anomalies can compromise airway and is a serious life-threatening condition. In many cases, tracheostomy is carried out as the treatment of choice. Distraction osteogenesis of the mandible as a treatment modality for OSA is very useful and may spare the need for tracheostomy or allow decannulation, yet controlling the vector of distraction is still a major challenge. We present a method for controlling the vector of distraction. Eight patients with severe respiratory distress secondary to a micrognathic mandible were treated by mandibular distraction osteogenesis using either external or internal devices. Temporary anchorage devices (TADs) and orthodontic elastics were used to control the vector of distraction. Cephalometric X-rays, computed tomography, and polysomnographic sleep studies were used to analyze the results. A mean distraction of 22 mm using the internal devices and a mean of 30 mm using the external devices were achieved. Increase in the pharyngeal airway and hyoid bone advancement was also observed. Anterior-posterior advancement of the mandible was noted with no clockwise rotation. Most importantly, clinical improvement in symptoms of OSA, respiratory distress, and feeding was noted. We describe a method for controlling the vector of distraction used as a treatment for OSA. In these cases, TADs were used as an anchorage unit to control the vector of distraction. Our results show excellent clinical and radiographical results. TADs are a simple and nonexpensive method to control the vector of distraction.

  4. The effects of an oral distraction on cattle during a painful procedure

    Science.gov (United States)

    Aitken, Brooke L.; Stookey, Joseph M.; Noble, Scott; Watts, Jon; Finlay, Don

    2013-01-01

    An oral distraction was investigated as a way to reduce struggle and heart rate of beef cattle undergoing freeze branding. Oral distraction reduced the struggle of steers, regardless of branding treatment. No effect on heart rate was found. Distractions may provide a way to reduce struggle by animals during restraint. PMID:24155450

  5. Psychometrics of Multiple Choice Questions with Non-Functioning Distracters: Implications to Medical Education.

    Science.gov (United States)

    Deepak, Kishore K; Al-Umran, Khalid Umran; AI-Sheikh, Mona H; Dkoli, B V; Al-Rubaish, Abdullah

    2015-01-01

    The functionality of distracters in a multiple choice question plays a very important role. We examined the frequency and impact of functioning and non-functioning distracters on psychometric properties of 5-option items in clinical disciplines. We analyzed item statistics of 1115 multiple choice questions from 15 summative assessments of undergraduate medical students and classified the items into five groups by their number of non-functioning distracters. We analyzed the effect of varying degree of non-functionality ranging from 0 to 4, on test reliability, difficulty index, discrimination index and point biserial correlation. The non-functionality of distracters inversely affected the test reliability and quality of items in a predictable manner. The non-functioning distracters made the items easier and lowered the discrimination index significantly. Three non-functional distracters in a 5-option MCQ significantly affected all psychometric properties (p psychometrically as effective as 5-option items. Our study reveals that a multiple choice question with 3 functional options provides lower most limit of item format that has adequate psychometric property. The test containing items with less number of functioning options have significantly lower reliability. The distracter function analysis and revision of nonfunctioning distracters can serve as important methods to improve the psychometrics and reliability of assessment.

  6. Technology-related distracted walking behaviours in Manhattan's most dangerous intersections.

    Science.gov (United States)

    Basch, Corey H; Ethan, Danna; Rajan, Sonali; Basch, Charles E

    2014-10-01

    Use of mobile devices has been cited as a distraction while driving, and more recently, among pedestrians crossing urban streets. In 2010, over half of New York City traffic fatalities were pedestrians. The aim of this study was to estimate the prevalence of distracted walking due to pedestrians' use of headphones, mobile phones, or both. Data were gathered by direct observations at the 10 intersections in Manhattan with the highest frequency of pedestrian-motor vehicle collisions. More than 1 in 4 of the >3500 pedestrians observed were distracted by mobile electronic devices while crossing during the 'walk' (28.8%) and 'don't walk' (26.3%) signals. Poisson regression analyses established there was a significant difference in individuals talking on a mobile device during the 'walk' signal versus the 'don't walk' signal; however, no other significant differences in other distracted walking behaviours were observed. This study contributes to the emerging literature on distracted walking behaviour by pedestrians in busy urban areas and can help to inform pedestrian-focused safety efforts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. Standardissimo. Les limitations théoriques du Modèle Standard. Quelles réponses y apporter?

    Science.gov (United States)

    Renard, F. M.

    Nous présentons I 'état du Modèle Standard des interactions fortes, faibles et électromagnétiques. Après une description rapide de ses 3 secteurs, secteur de jauge (radiation), secteur fermionique (matière) et secteur scalaire (génération des masses), nous insistons sur le grand nombre de paramètres libres et sur les choix arbitraires qu'il a fallu faire dans l'élaboration du modèle. Nous faisons ressortir les problèmes techniques non résolus et nous dressons la liste des questions fondamentales restées sans réponses. Nous passons ensuite en revue les idées et méthodes proposées pour répondre à ces questions. Elles utilisent essentiellement 3 voies différentes. La première consiste à requérir plus de symétrie (extension du modèle, symétrie Gauche-Droite, Grandes Unifications, Supersymétrie,...). La seconde contient les diverses alternatives au Modèle Standard impliquant des modifications dans certains secteurs (par exemple le secteur scalaire avec le modèle de la Technicouleur) ou de façon plus violente l'hypothèse d'une sous-structure des leptons, des quarks et des bosons W et Z eux-mêmes. Une dernière voie cherche à justifier les particularités du Modèle Standard et relier ses paramètres libres en se basant sur des principes de cohérence interne du modèle. Les conséquences observables de ces diverses approches sont dans chaque cas mentionnées.

  8. Resisting distraction and response inhibition trigger similar enhancements of future performance.

    Science.gov (United States)

    Bissett, Patrick G; Grant, Lauren D; Weissman, Daniel H

    2017-10-01

    Resisting distraction and response inhibition are crucial aspects of cognitive control. Interestingly, each of these abilities transiently improves just after it is utilized. Competing views differ, however, as to whether utilizing either of these abilities (e.g., resisting distraction) enhances future performance involving the other ability (e.g., response inhibition). To distinguish between these views, we combined a Stroop-like task that requires resisting distraction with a restraint variant of the stop-signal task that requires response inhibition. We observed similar sequential-trial effects (i.e., performance enhancements) following trials in which participants (a) resisted distraction (i.e., incongruent go trials) and (b) inhibited a response (i.e., congruent stop trials). First, the congruency effect in go trials, which indexes overall distractibility, was smaller after both incongruent go trials and congruent stop trials than it was after congruent go trials. Second, stop failures were less frequent after both incongruent go trials and congruent stop trials than after congruent go trials. A control experiment ruled out the possibility that perceptual conflict or surprise engendered by occasional stop signals triggers sequential-trial effects independent of stopping. Thus, our findings support a novel, integrated view in which resisting distraction and response inhibition trigger similar sequential enhancements of future performance. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Fort Collins Science Center fiscal year 2010 science accomplishments

    Science.gov (United States)

    Wilson, Juliette T.

    2011-01-01

    The scientists and technical professionals at the U.S. Geological Survey (USGS), Fort Collins Science Center (FORT), apply their diverse ecological, socioeconomic, and technological expertise to investigate complicated ecological problems confronting managers of the Nation's biological resources. FORT works closely with U.S. Department of the Interior (DOI) agency scientists, the academic community, other USGS science centers, and many other partners to provide critical information needed to help answer complex natural-resource management questions. In Fiscal Year 2010 (FY10), FORT's scientific and technical professionals conducted ongoing, expanded, and new research vital to the science needs and management goals of DOI, other Federal and State agencies, and nongovernmental organizations in the areas of aquatic systems and fisheries, climate change, data and information integration and management, invasive species, science support, security and technology, status and trends of biological resources (including the socioeconomic aspects), terrestrial and freshwater ecosystems, and wildlife resources, including threatened and endangered species. This report presents selected FORT science accomplishments for FY10 by the specific USGS mission area or science program with which each task is most closely associated, though there is considerable overlap. The report also includes all FORT publications and other products published in FY10, as well as staff accomplishments, appointments, committee assignments, and invited presentations.

  10. Attention and Distraction

    DEFF Research Database (Denmark)

    Petersen, Anne Ring

    2010-01-01

    This article aims to examine the interrelationship between attention and distraction in the reception of video installation art, a genre which is commonly associated with "immersion" and an intensified feeling of presence in the discourses on new media art and installation art. This tends to veil......, on the other hand, the cultural formations of television, film and computers have fundamentally re-configured "aesthetic experience."...

  11. NSU Art Museum Fort Lauderdale | Art Museum in Fort Lauderdale

    Science.gov (United States)

    NSU Art Museum Fort Lauderdale Visit Admissions Hours & Admission Policies & Accessibility Airports Shop & Dine About the Café & Store Store Café Menu Art Exhibitions Currently on View Thursday 2-for-1 specials on wine and craft beer in the Museum Café, and hands-on art projects for all

  12. Preventing distracted driving among college students: Addressing smartphone use.

    Science.gov (United States)

    Hassani, Sahar; Kelly, Erin H; Smith, Jennifer; Thorpe, Sara; Sozzer, Fatima H; Atchley, Paul; Sullivan, Elroy; Larson, Dean; Vogel, Lawrence C

    2017-02-01

    Based on the National Highway Traffic Safety Association's (NHTSA) Report, fatalities due to distracted driving are on the rise and the highest proportion of fatalities by age group is the 20-29 year old category. To date little has been done to educate college students about the dangers of distracted driving and engage these students in promoting a safe driving culture. Intervening among college students has the potential for making real-time behavior change, can foster a lifetime of safe driving habits among these students, and can help contribute to a culture of safe driving that can be created and sustained through positive messages from peers. The goals of this study were to develop, implement and evaluate a distracted driving presentation for college students to change knowledge, attitude and behavior on distracted driving. A 30-min, multi-media presentation on distracted driving was presented to 19 colleges and universities, totaling 444 college students (mean age 23.7±7.0 years of age, 61% females, 39% males). Students completed three surveys: prior to the workshop (interview 1), immediately after the workshop (interview 2), and 3 months following the workshop (interview 3). We assessed changes between interview 1 and interview 2 and found 15 of the 15 attitude-knowledge based questions significantly improved after the course. In addition, we assessed changes from interviews 1 and 3, and found 11 of the 15 attitude-knowledge based questions maintained their significance. Responses to behavior related questions at three months were also compared to baseline, and significant improvements were found for 12 of the 14 questions. While this study was successful in improving the short-term attitude-knowledge and behaviors on distracted driving, work is needed to sustain (and evaluate) long-term effects. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Maxillary segmental distraction in children with unilateral clefts of lip, palate, and alveolus.

    Science.gov (United States)

    Zemann, Wolfgang; Pichelmayer, Margit

    2011-06-01

    Alveolar clefts are commonly closed by a bone grafting procedure. In cases of wide clefts the deficiency of soft tissue in the cleft area may lead to wound dehiscence and loss of the bony graft. Segmental maxillary bony transfer has been mentioned to be useful in such cases. Standard distraction devices allow unidirectional movement of the transported segment. Ideally the distraction should strictly follow the dental arch. The aim of this study was to analyze distraction devices that were adapted to the individual clinical situation of the patients. The goal was to achieve a distraction strictly parallel to the dental arch. Six children with unilateral clefts of lip, palate, and alveolus between 12 and 13 years of age were included in the study. The width of the cleft was between 7 and 19 mm. Dental cast models were used to manufacture individual distraction devices that should allow a segmental bony transport strictly parallel to the dental arch. Segmental osteotomy was performed under general anesthesia. Distraction was started 5 days after surgery. All distracters were tooth fixed but supported by palatal inserted orthodontic miniscrews. In all patients, a closure of the alveolar cleft was achieved. Two patients required additional bone grafting after the distraction procedure. The distraction was strictly parallel to the dental arch in all cases. In 1 case a slight cranial displacement of the transported maxillary segment could be noticed, leading to minor modifications of the following distractors. Distraction osteogenesis is a proper method to close wide alveolar clefts. Linear segmental transport is required in the posterior part of the dental arch, whereas in the frontal part the bony transport should run strictly parallel to the dental arch. An exact guided segmental transport may reduce the postoperative orthodontic complexity. Copyright © 2011 Mosby, Inc. All rights reserved.

  14. Validating a perceptual distraction model in a personal two-zone sound system

    DEFF Research Database (Denmark)

    Rämö, Jussi; Christensen, Lasse; Bech, Søren

    2017-01-01

    This paper focuses on validating a perceptual distraction model, which aims to predict user’s perceived distraction caused by audio-on-audio interference, e.g., two competing audio sources within the same listening space. Originally, the distraction model was trained with music-on-music stimuli...... that the model performance is equally good in both zones, i.e., with both speech-on-music and music-on-speech stimuli, and comparable to the previous validation round (RMSE approximately 10%). The results further confirm that the distraction model can be used as a valuable tool in evaluating and optimizing...

  15. FORTE spacecraft vibration mitigation. Final report

    International Nuclear Information System (INIS)

    Maly, J.R.

    1996-02-01

    This report documents work that was performed by CSA Engineering, Inc., for Los Alamos National Laboratory (LANL), to reduce vibrations of the FORTE spacecraft by retrofitting damped structural components into the spacecraft structure. The technical objective of the work was reduction of response at the location of payload components when the structure is subjected to the dynamic loading associated with launch and proto-qualification testing. FORTE is a small satellite that will be placed in orbit in 1996. The structure weighs approximately 425 lb, and is roughly 80 inches high and 40 inches in diameter. It was developed and built by LANL in conjunction with Sandia National Laboratories Albuquerque for the United States Department of Energy. The FORTE primary structure was fabricated primarily with graphite epoxy, using aluminum honeycomb core material for equipment decks and solar panel substrates. Equipment decks were bonded and bolted through aluminum mounting blocks to adjoining structure

  16. Fortælling og fortolkning i Jyske Bank

    DEFF Research Database (Denmark)

    Albrechtsen, Charlotte

    Afhandlingen præsenterer en undersøgelse af et konkret eksempel på storytelling brugt som strategisk ledelses- og kommunikationsredskab i en organisations interne kommunikation. Eksemplet er fortællingen "Slaget ved Vejle", som stammer fra Jyske Bank og udgør under afhandlingens case. De overordn......Afhandlingen præsenterer en undersøgelse af et konkret eksempel på storytelling brugt som strategisk ledelses- og kommunikationsredskab i en organisations interne kommunikation. Eksemplet er fortællingen "Slaget ved Vejle", som stammer fra Jyske Bank og udgør under afhandlingens case. De......, at medarbejderne forholder sig reflekteret, nuanceret og kritisk til den strategiske fortælling, og at der er stor diversitet i deres oplevelser, fortolkninger og vurderinger af fortællingen. Desuden ser afhandlingen nærmere på hvad begrebet "storytelling" dækker over, og hvordan der hidtil er forsket i...

  17. Technical feasibility of personalized articulating knee joint distraction for treatment of tibiofemoral osteoarthritis.

    Science.gov (United States)

    Struik, T; Jaspers, J E N; Besselink, N J; van Roermund, P M; Plomp, S; Rudert, M J; Lafeber, F P J G; Mastbergen, S C

    2017-11-01

    Knee osteoarthritis is a highly prevalent degenerative joint disorder characterized by joint tissue damage and pain. Knee joint distraction has been introduced as a joint preserving surgical procedure to postpone knee arthroplasty. An often used standard externally fixation device for distraction poses a burden to patients due to the absence of joint flexion during the 6weeks treatment. Therefore, a personalized articulating distraction device was developed. The aim of this study was to test technical feasibility of this device. Based on an often applied rigid device, using equal bone pin positions and connectors, a hinge mechanism was developed consisting of a cam-following system for reproducing the complex joint-specific knee kinematics. In support, a device was developed for capturing the joint-specific sagittal plane articulation. The obtained kinematic data were translated into joint-specific cam shapes that were installed bilaterally in the hinge mechanism of the distraction device, as such providing personalized knee motion. Distraction of 5mm was performed within a range of motion of 30deg. joint flexion. Pre-clinical evaluation of the working principle was performed on human cadaveric legs and system stiffness characteristics were biomechanically evaluated. The desired range of motion was obtained and distraction was maintained under physiologically representative loading. Moreover, the joint-specific approach demonstrated tolerance of deviations from anatomical and alignment origin during initial placement of the developed distraction device. Articulation during knee distraction is considered technically feasible and has potential to decrease burden and improve acceptance of distraction therapy. Testing of clinical feasibility is warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Grunting's competitive advantage: Considerations of force and distraction.

    Science.gov (United States)

    Sinnett, Scott; Maglinti, Cj; Kingstone, Alan

    2018-01-01

    Grunting is pervasive in many athletic contests, and empirical evidence suggests that it may result in one exerting more physical force. It may also distract one's opponent. That grunts can distract was supported by a study showing that it led to an opponent being slower and more error prone when viewing tennis shots. An alternative explanation was that grunting masks the sound of a ball being hit. The present study provides evidence against this alternative explanation by testing the effect of grunting in a sport-mixed martial arts-where distraction, rather than masking, is the most likely mechanism. We first confirmed that kicking force is increased when a grunt is performed (Experiment 1), and then adapted methodology used in the tennis study to mixed martial arts (Experiment 2). Lifting the foot to kick is a silent act, and therefore there is nothing for a grunt to mask, i.e., its effect on an opponent's response time and/or accuracy can likely be attributed to attentional distraction. Participants viewed videos of a trained mixed martial artist kicking that included, or did not include, a simulated grunt. The task was to determine as quickly as possible whether the kick was traveling upward or downward. Overall, and replicating the tennis finding, the present results indicate that a participant's response to a kick was delayed and more error prone when a simulated grunt was present. The present findings indicate that simulated grunting may distract an opponent, leading to slower and more error prone responses. The implications for martial arts in particular, and the broader question of whether grunting should be perceived as 'cheating' in sports, are examined.

  19. Cancer incidence in Fort Chipewyan, Alberta : 1995-2006

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Y. [Alberta Cancer Board, Edmonton, AB (Canada). Division of Population Health and Information Surveillance

    2009-02-15

    A high number of cases of cholangiocarcinoma, a rare form of bile duct cancer, as well as high rates of other cancers were reported by a physician working in Fort Chipewyan, Alberta in 2006. Concerns were raised by local residents, attributing cancers in their community to environmental contamination from a range of industrial development including the oil sands development, uranium mining and pulp mills. However, an initial review of the Alberta Cancer Registry did not confirm an increased incidence of cancer in Fort Chipewyan. In the summer/fall of 2007, a working group was formed to support the Alberta Cancer Board in doing a cluster investigation based on the guidelines of the United States Centre for Disease Control and Prevention. This report presented an investigation to determine if there was an elevated rate of cholangiocarcinoma in Fort Chipewyan and whether there was an elevated rate of cancers overall in Fort Chipewyan. The report provided background information on the Athabasca oil sands, uranium mining, and Fort Chipewyan as well as previous investigations of cancer incidence in Fort Chipewyan. Study methods were also presented with particular reference to study and comparison populations; cancer classification and inclusion criteria; active case ascertainment and verification; methods of analysis; and ethical approval. Results were also presented. The specific cancers that were discussed were cholangiocarcinoma, leukemia, colon cancer, and cancer in First Nations in Alberta. It was concluded that the observed number of cases of cholangiocarcinoma was within the expected range. 121 refs., 12 tabs., 3 figs., 5 appendices.

  20. Google glass: a driver distraction cause or cure?

    Science.gov (United States)

    Sawyer, Ben D; Finomore, Victor S; Calvo, Andres A; Hancock, P A

    2014-11-01

    We assess the driving distraction potential of texting with Google Glass (Glass), a mobile wearable platform capable of receiving and sending short-message-service and other messaging formats. A known roadway danger, texting while driving has been targeted by legislation and widely banned. Supporters of Glass claim the head-mounted wearable computer is designed to deliver information without concurrent distraction. Existing literature supports the supposition that design decisions incorporated in Glass might facilitate messaging for drivers. We asked drivers in a simulator to drive and use either Glass or a smartphone-based messaging interface, then interrupted them with an emergency brake event. Both the response event and subsequent recovery were analyzed. Glass-delivered messages served to moderate but did not eliminate distracting cognitive demands. A potential passive cost to drivers merely wearing Glass was also observed. Messaging using either device impaired driving as compared to driving without multitasking. Glass in not a panacea as some supporters claim, but it does point the way to design interventions that effect reduced load in multitasking. Discussions of these identified benefits are framed within the potential of new in-vehicle systems that bring both novel forms of distraction and tools for mitigation into the driver's seat.

  1. Understanding Factors of Distraction among Intrastate Bus Driver

    Directory of Open Access Journals (Sweden)

    Yunos Muhammad Nur Annuar Mohd

    2017-01-01

    Full Text Available The increase in number of the world population have affected the demand for public transport especially in larger cities. Intrastate buses are chosen as the main public transport by many people due to its affordable fares. Therefore, a better performance of the intrastate bus drivers would be significant to cater the high demand. Nevertheless, distraction among the intrastate bus drivers have been found as one of the major factors that could affect the performance of the drivers. Therefore, the objective of this paper is to provide a better understanding on the factors of distraction among intrastate bus drivers. This paper refers to findings from previous researches which are related to this field of study. In conclusion, this paper will provide a list of factors of distraction among the intrastate bus drivers which may degrade their performance.

  2. Incomplete mobilization of the maxilla resulting in failed maxillary distraction: a case report.

    Science.gov (United States)

    Alkan, Alper; Inal, Samet; Baş, Burcu; Ozer, Mete

    2007-12-01

    Maxillary distraction osteogenesis has become an accepted alternative method in the treatment of patients with severe maxillary hypoplasia in craniofacial syndromes and cleft-related deformities. Insufficient distraction, undesirable soft tissue changes, and occurrence of defective distraction vectors are among the potential complications of intraoral maxillary distraction osteogenesis. A 2-stage procedure combining maxillary advancement by distraction technique with genioplasty and mandibular setback surgery was planned to correct jaw deformities in a 22-year-old patient with severe maxillary retrusion, mandibular prognathism, and excessive lower facial height. In the first stage, osteotomies were performed and maxilla was lightly mobilized after down-fracture. Distractors were placed to the maxilla intraorally. During activation period, the maxilla rotated in a clockwise direction, producing a discrepancy between the planned and the actual vectors. Complete distraction was unsatisfactory and the complication was due to surgical technique. This case report presents the failure of maxillary distraction due to incomplete mobilization of the maxilla. Treatment of the case was achieved by the conventional osteotomy techniques at final operation. The maxilla was successfully advanced to the desired position producing good occlusion and an improved facial profile.

  3. Distraction-related road traffic collisions | Eid | African Health Sciences

    African Journals Online (AJOL)

    Nineteen (5.8%) drivers were distracted by using mobile phones, 12 (3.6%) were pre-occupied with deep thinking, six (1.8%) were talking with other passengers, four (1.2%) were picking things in the vehicle, and three (0.9%) were using entertainment systems. The maximum distraction occurred during the time of 6 am - 12 ...

  4. Perception of alcohol strength impaired by low and high volume distraction

    OpenAIRE

    Stafford, Lorenzo; Agobiani, E.; Fernandes, M.

    2013-01-01

    Recent research demonstrated impaired discrimination of alcohol strength under distracting conditions. The present study aimed to extend this by examining the effects of distraction volume on alcohol perception. In the study here (between subjects design, 34 females/20 males), participants completed standardized taste and olfactory tests, followed by a taste test of alcoholic beverages (0, 1.9, 3.9, 5.6 and 7.5pct abv) in a randomly allocated distractive or control condition [Control, Shadow ...

  5. Sex differences in the response to emotional distraction: an event-related fMRI investigation.

    Science.gov (United States)

    Iordan, Alexandru D; Dolcos, Sanda; Denkova, Ekaterina; Dolcos, Florin

    2013-03-01

    Evidence has suggested that women have greater emotional reactivity than men. However, it is unclear whether these differences in basic emotional responses are also associated with differences in emotional distractibility, and what the neural mechanisms that implement differences in emotional distractibility between women and men are. Functional MRI recording was used in conjunction with a working memory (WM) task, with emotional distraction (angry faces) presented during the interval between the memoranda and the probes. First, we found an increased impact of emotional distraction among women in trials associated with high-confidence responses, in the context of overall similar WM performance in women and men. Second, women showed increased sensitivity to emotional distraction in brain areas associated with "hot" emotional processing, whereas men showed increased sensitivity in areas associated with "cold" executive processing, in the context of overall similar patterns of response to emotional distraction in women and men. Third, a sex-related dorsal-ventral hemispheric dissociation emerged in the lateral PFC related to coping with emotional distraction, with women showing a positive correlation with WM performance in left ventral PFC, and men showing similar effects in the right dorsal PFC. In addition to extending to men results that have previously been reported in women, by showing that both sexes engage mechanisms that are similar overall in response to emotional distraction, the present study identifies sex differences in both the response to and coping with emotional distraction. These results have implications for understanding sex differences in the susceptibility to affective disorders, in which basic emotional responses, emotional distractibility, and coping abilities are altered.

  6. Bilateral sagittal split osteotomy versus distraction osteogenesis for mandibular advancements

    NARCIS (Netherlands)

    Baas, E.M.

    2015-01-01

    The aim of this thesis was to compare the treatment modality of distraction osteogenesis (DO) with the gold standard for mandibular advancement surgery. In fact we compare distraction osteogenesis with the standard of care, which is a conventional bilateral sagittal split osteotomy as described by

  7. La spermiation chez le brochet.

    Directory of Open Access Journals (Sweden)

    DE MONTALEMBERT G.

    1980-01-01

    Full Text Available L'évolution quantitative et qualitative de la production de sperme au cours de la période de spermiation a été étudiée chez des brochets maintenus en captivité dans un étang de 400 m2. Le sperme est prélevé toutes les semaines à partir du début de février, et pendant près de 2 mois. La quantité de sperme recueillie est très faible et présente de fortes variations individuelles ; elle augmente progressivement jusqu'à la 5me semaine et décroit ensuite. La quantité moyenne de sperme récoltée par mâle est de l'ordre de 0,7 ml/semaine et varie considérablement d'un mâle à l'autre (0.07 à 1,5 ml. La concentration du sperme en spermatozoïdes varie entre 18 et 25 milliards par ml ( X = 21,5 109 + 2,11. La quantité de spermatozoïdes récoltée par semaine est de 28,5 106 + 26,4/kg de poids corporel. La qualité du sperme appréciée par l'intensité et la durée de motilité suit une évolution similaire à celle de la quantité de sperme récoltée avec des valeurs maximales à 4 semaines et minimales en début et fin de période de prélèvement. Les premières ovulations détectées sur des femelles stockées dans les mêmes conditions que les mâles ont été observées à la 6me semaine de prélèvements alors que les performances de spermiation avaient déjà fortement déclinées. Il est vraisemblable que les conditions expérimentales particulièrement traumatisantes pour les mâles ont affecté prématurément la spermiation, amplifiant ainsi le décalage fréquemment observé entre les périodes de spermiation et d'ovulation.

  8. Influences shaping nurses' use of distraction for children's procedural pain.

    Science.gov (United States)

    Olmstead, Deborah L; Scott, Shannon D; Mayan, Maria; Koop, Priscilla M; Reid, Kathy

    2014-04-01

    This study explored pediatric nurses' choices to use distraction for managing painful procedures. Using interpretive description approaches, interviews with pediatric nurses provided descriptions of choices to manage procedural pain. Nurses' distress influenced distraction use to mitigate the suffering of children and themselves. Newer nurses described task mastery as influencing distraction choices. Nurses' accounts of performing painful procedures on children mirrored children's descriptions of pain from the literature. Nurses' distress and competency performing painful procedures on children influenced practice. Future qualitative studies could extend understanding of pain management choices by pediatric nurses and the impact on undermanaged pain. © 2014, Wiley Periodicals, Inc.

  9. Etudes optiques de nouveaux materiaux laser: Des orthosilicates dopes a l'ytterbium: Le yttrium (lutetium,scandium) pentoxide de silicium

    Science.gov (United States)

    Denoyer, Aurelie

    La decouverte et l'elaboration de nouveaux materiaux laser solides suscitent beaucoup d'interet parmi la communaute scientifique. En particulier les lasers dans la gamme de frequence du micron debouchent sur beaucoup d'applications, en telecommunication, en medecine, dans le domaine militaire, pour la, decoupe des metaux (lasers de puissance), en optique non lineaire (doublage de frequence, bistabilite optique). Le plus couramment utilise actuellement est le Nd:YAG dans cette famille de laser, mais des remplacants plus performants sont toujours recherches. Les lasers a base d'Yb3+ possedent beaucoup d'avantages compares aux lasers Nd3+ du fait de leur structure electronique simple et de leur deterioration moins rapide. Parmi les matrices cristallines pouvant accueillir l'ytterbium, les orthosilicates Yb:Y 2SiO5, Yb:Lu2SiO5 et Yb:Sc2SiO 5 se positionnent tres bien, du fait de leur bonne conductivite thermique et du fort eclatement de leur champ cristallin necessaire a l'elaboration de lasers quasi-3 niveaux. De plus l'etude fine et systematique des proprietes microscopiques de nouveaux materiaux s'avere toujours tres interessante du point de vue de la recherche fondamentale, c'est ainsi que de nouveaux modeles sont concus (par exemple pour le champ cristallin) ou que de nouvelles proprietes inhabituelles sont decouvertes, menant a de nouvelles applications. Ainsi d'autres materiaux dopes a l'ytterbium sont connus pour leurs proprietes de couplage electron-phonon, de couplage magnetique, d'emission cooperative ou encore de bistabilite optique, mais ces proprietes n'ont encore jamais ete mises en evidence dans Yb:Y 2SiO5, Yb:Lu2SiO5 et Yb:Sc2SiO 5. Ainsi, cette these a pour but l'etude des proprietes optiques et des interactions microscopiques dans Yb:Y2SiO 5, Yb:Lu2SiO5 et Yb:Sc2SiO5. Nous utilisons principalement les techniques d'absorption IR et de spectroscopie Raman pour determiner les excitations du champ cristallin et les modes de vibration dans le materiau

  10. Do absorption and realistic distraction influence performance of component task surgical procedure?

    Science.gov (United States)

    Pluyter, Jon R; Buzink, Sonja N; Rutkowski, Anne-F; Jakimowicz, Jack J

    2010-04-01

    Surgeons perform complex tasks while exposed to multiple distracting sources that may increase stress in the operating room (e.g., music, conversation, and unadapted use of sophisticated technologies). This study aimed to examine whether such realistic social and technological distracting conditions may influence surgical performance. Twelve medical interns performed a laparoscopic cholecystectomy task with the Xitact LC 3.0 virtual reality simulator under distracting conditions (exposure to music, conversation, and nonoptimal handling of the laparoscope) versus nondistracting conditions (control condition) as part of a 2 x 2 within-subject experimental design. Under distracting conditions, the medical interns showed a significant decline in task performance (overall task score, task errors, and operating time) and significantly increased levels of irritation toward both the assistant handling the laparoscope in a nonoptimal way and the sources of social distraction. Furthermore, individual differences in cognitive style (i.e., cognitive absorption and need for cognition) significantly influenced the levels of irritation experienced by the medical interns. The results suggest careful evaluation of the social and technological sources of distraction in the operation room to reduce irritation for the surgeon and provision of proper preclinical laparoscope navigation training to increase security for the patient.

  11. Déchets nucléaires : où est le problème ?

    CERN Document Server

    Sorin, Francis

    2015-01-01

    Faut-il avoir peur des déchets nucléaires ? Sont-ils vraiment, comme le pense une partie du public, ce fardeau empoisonné ingérable faisant peser une menace fatale sur nous-mêmes et sur nos descendants ? Ou sont-ils au contraire, comme l'estime la grande majorité des scientifiques, des résidus que l'on sait fort bien conditionner et mettre hors d'état de nuire ? Entre le public inquiet et les ingénieurs rassurants, comment comprendre l'immense décalage des attitudes ? Et comment, face à ces déchets laissés en héritage, faire la part des choses entre ceux qui dénoncent "un crime contre les générations futures" et ceux qui jugent "la difficulté résolue" ? Bref, "Où est le problème ?" Sans craindre de bousculer bien des idées reçues mais sans méconnaître les risques encourus, Francis Sorin éclaire ici en quelques chapitres percutants les problèmes et les solutions liés à la gestion de ces déchets en France. II s'attache particulièrement au devenir des déchets de haute activité et...

  12. Designing feedback to mitigate teen distracted driving: A social norms approach.

    Science.gov (United States)

    Merrikhpour, Maryam; Donmez, Birsen

    2017-07-01

    The purpose of this research is to investigate teens' perceived social norms and whether providing normative information can reduce distracted driving behaviors among them. Parents are among the most important social referents for teens; they have significant influences on teens' driving behaviors, including distracted driving which significantly contributes to teens' crash risks. Social norms interventions have been successfully applied in various domains including driving; however, this approach is yet to be explored for mitigating driver distraction among teens. Forty teens completed a driving simulator experiment while performing a self-paced visual-manual secondary task in four between-subject conditions: a) social norms feedback that provided a report at the end of each drive on teens' distracted driving behavior, comparing their distraction engagement to their parent's, b) post-drive feedback that provided just the report on teens' distracted driving behavior without information on their parents, c) real-time feedback in the form of auditory warnings based on eyes of road-time, and d) no feedback as control. Questionnaires were administered to collect data on these teens' and their parents' self-reported engagement in driver distractions and the associated social norms. Social norms and real-time feedback conditions resulted in significantly smaller average off-road glance duration, rate of long (>2s) off-road glances, and standard deviation of lane position compared to no feedback. Further, social norms feedback decreased brake response time and percentage of time not looking at the road compared to no feedback. No major effect was observed for post-drive feedback. Questionnaire results suggest that teens appeared to overestimate parental norms, but no effect of feedback was found on their perceptions. Feedback systems that leverage social norms can help mitigate driver distraction among teens. Overall, both social norms and real-time feedback induced

  13. Do absorption and realistic distraction influence performance of component task surgical procedure?

    OpenAIRE

    Pluyter, J.R.; Buzink, S.N.; Rutkowski, A.F.; Jakimowicz, J.J.

    2009-01-01

    Background. Surgeons perform complex tasks while exposed to multiple distracting sources that may increase stress in the operating room (e.g., music, conversation, and unadapted use of sophisticated technologies). This study aimed to examine whether such realistic social and technological distracting conditions may influence surgical performance. Methods. Twelve medical interns performed a laparoscopic cholecystectomy task with the Xitact LC 3.0 virtual reality simulator under distracting con...

  14. Management of post midface distraction occlusal discrepancy using temporary anchorage devices in a cleft patient

    Science.gov (United States)

    Koteswara Prasad, N. K.; Hussain, Syed Altaf; Chitharanjan, Arun B.; Murthy, Jyotsna

    2015-01-01

    Open bite deformity following a successful midface advancement by distraction osteogenesis is a common complication. Temporary anchorage devices can be deployed during the distraction and post-distraction settling phases for restoring the occlusion even in severe cases. The following report describes the management of severe anterior open bite following maxillary distraction. PMID:25991895

  15. Fort Collins Science Center-Fiscal year 2009 science accomplishments

    Science.gov (United States)

    Wilson, Juliette T.

    2010-01-01

    Public land and natural resource managers in the United States are confronted with increasingly complex decisions that have important ramifications for both ecological and human systems. The scientists and technical professionals at the U.S. Geological Survey Fort Collins Science Center?many of whom are at the forefront of their fields?possess a unique blend of ecological, socioeconomic, and technological expertise. Because of this diverse talent, Fort Collins Science Center staff are able to apply a systems approach to investigating complicated ecological problems in a way that helps answer critical management questions. In addition, the Fort Collins Science Center has a long record of working closely with the academic community through cooperative agreements and other collaborations. The Fort Collins Science Center is deeply engaged with other U.S. Geological Survey science centers and partners throughout the Department of the Interior. As a regular practice, we incorporate the expertise of these partners in providing a full complement of ?the right people? to effectively tackle the multifaceted research problems of today's resource-management world. In Fiscal Year 2009, the Fort Collins Science Center's scientific and technical professionals continued research vital to Department of the Interior's science and management needs. Fort Collins Science Center work also supported the science needs of other Federal and State agencies as well as non-government organizations. Specifically, Fort Collins Science Center research and technical assistance focused on client and partner needs and goals in the areas of biological information management and delivery, enterprise information, fisheries and aquatic systems, invasive species, status and trends of biological resources (including human dimensions), terrestrial ecosystems, and wildlife resources. In the process, Fort Collins Science Center science addressed natural-science information needs identified in the U

  16. Undervisning mellem fortælling og feedback

    DEFF Research Database (Denmark)

    Andersen, Kirsten Margrethe

    2016-01-01

    Feedback gør det muligt for den enkelte at forstå, hvordan jeg kan blive bedre til det, jeg er ved at lære. Fortællinger gør det muligt for den enkelte at udvide horisonten og derved komme til en forståelse af, hvilke mulige perspektiver der er for at forholde sig til den verden, som fortællingen...

  17. Long-term follow-up after maxillary distraction osteogenesis in growing children with cleft lip and palate.

    Science.gov (United States)

    Huang, Chiung-Shing; Harikrishnan, Pandurangan; Liao, Yu-Fang; Ko, Ellen W C; Liou, Eric J W; Chen, Philip K T

    2007-05-01

    To evaluate the changes in maxillary position after maxillary distraction osteogenesis in six growing children with cleft lip and palate. Retrospective, longitudinal study on maxillary changes at A point, anterior nasal spine, posterior nasal spine, central incisor, and first molar. The University Hospital Craniofacial Center. Cephalometric radiographs were used to measure the maxillary position immediately after distraction, at 6 months, and more than 1 year after distraction. After maxillary distraction with a rigid external distraction device, the maxilla (A point) on average moved forward 9.7 mm and downward 3.5 mm immediately after distraction, moved backward 0.9 mm and upward 2.0 mm after 6 months postoperatively, and then moved further backward 2.3 mm and downward 6.8 mm after more than 1 year from the predistraction position. In most cases, maxilla moved forward at distraction and started to move backward until 1 year after distraction, but remained forward, as compared with predistraction position. Maxilla also moved downward during distraction and upward in 6 months, but started descending in 1 year. There also was no further forward growth of the maxilla after distraction in growing children with clefts.

  18. Ultrasound control of magnet growing rod distraction in early onset scoliosis.

    Science.gov (United States)

    Pérez Cervera, T; Lirola Criado, J F; Farrington Rueda, D M

    2016-01-01

    The growing rod technique is currently one of the most common procedures used in the management of early onset scoliosis. However, in order to preserve spine growth and control the deformity it requires frequent surgeries to distract the rods. Magnetically driven growing rods have recently been introduced with same treatment goal, but without the inconvenience of repeated surgical distractions. One of the limitations of this technical advance is an increase in radiation exposure due to the increase in distraction frequency compared to conventional growing rods. An improvement of the original technique is presented, proposing a solution to the inconvenience of multiple radiation exposure using ultrasound technology to control the distraction process of magnetically driven growing rods. Copyright © 2014 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Management of post midface distraction occlusal discrepancy using temporary anchorage devices in a cleft patient

    Directory of Open Access Journals (Sweden)

    N K Koteswara Prasad

    2015-01-01

    Full Text Available Open bite deformity following a successful midface advancement by distraction osteogenesis is a common complication. Temporary anchorage devices can be deployed during the distraction and post-distraction settling phases for restoring the occlusion even in severe cases. The following report describes the management of severe anterior open bite following maxillary distraction.

  20. Non-erotic cognitive distractions during sexual activity in sexual minority and heterosexual young adults.

    Science.gov (United States)

    Lacefield, Katharine; Negy, Charles

    2012-04-01

    The present study examined 100 lesbian and gay college students and 100 heterosexual students to determine whether group differences exist in frequency of a range of non-erotic cognitive distractions during sexual activity. Non-erotic cognitive distraction is a descriptive term for both self-evaluative cognitions related to physical performance and body image concerns, as well as additional cognitive distractions (e.g., contracting an STI or emotional concerns) during sexual activity. Participants were matched on gender (96 males and 104 females), age, and ethnicity, and completed questionnaires assessing frequency of non-erotic cognitive distractions during sexual activity, as well as measures of additional variables (trait and body image anxiety, attitudes toward sexual minorities, self-esteem, and religiosity). Results indicated that sexual minorities experienced significantly more cognitive distractions related to body image, physical performance, and STIs during sexual activity than heterosexuals. Regarding gender, men reported more distractions related to STIs than women. Interaction effects were observed between sexual orientation and gender for body image-, disease-, and external/emotional-based distractions. Implications of these findings are discussed.

  1. Le tourisme alpin

    Directory of Open Access Journals (Sweden)

    Andrea Macchiavelli

    2009-06-01

    Full Text Available La forte croissance qu’ont connue les pays alpins dans les dernières décennies a surtout été fondée sur l’offre des activités du ski, avec comme conséquence, un massif développement immobilier, la multiplication d’infrastructures et l’extension des domaines. Aujourd’hui, le marché du ski semble arriver à saturation, la Convention alpine a mis un frein à la poursuite du développement des domaines skiables et on observe donc avec intérêt la diversification de l’offre soutenue par l’innovation. Après avoir rappelé les facteurs de changement en cours les plus significatifs dans le tourisme montagnard, l’article présente une grille interprétative de l’évolution des destinations touristiques alpines, identifiant les phases qui ont caractérisé son développement. Puis il propose une réflexion sur certaines conditions qui peuvent favoriser l’innovation dans le tourisme alpin, ainsi que sur les contradictions qui les accompagnent souvent. Dans la plupart des cas l’innovation est le résultat d’un processus qui a été lancé et qui s’est développé au sein de la communauté alpine, souvent favorisé et soutenu par des institutions nationales et internationales, et grâce auquel les difficultés structurelles qui ont déjà été abordées précédemment ont pu être surmontées avec succès.The spectacular increase in tourism in the Alps in recent decades has been founded mainly on the boom in skiing, resulting in both strong real estate development and an increasing array of infrastructures and ski runs. Today the ski market seems to have virtually reached saturation point and the winter sports sector needs to diversify its offer through innovation. After a review of the main factors of change in mountain tourism, the paper presents a grid for interpreting the life cycle of alpine destinations, identifying the phases that characterize their evolution. The conditions that may favour innovation in alpine

  2. 77 FR 24764 - Visual-Manual NHTSA Driver Distraction Guidelines for In-Vehicle Electronic Devices

    Science.gov (United States)

    2012-04-25

    ...-0053] Visual-Manual NHTSA Driver Distraction Guidelines for In-Vehicle Electronic Devices AGENCY... proposed voluntary NHTSA Driver Distraction Guidelines for in-vehicle electronic devices. The agency... Driver Distraction Guidelines for in-vehicle electronic devices (77 FR 11200). The proposed NHTSA...

  3. Evaluation des explorations hématologiques dans le service de pédiatrie et aux UMCp de 1'EHS (mère-enfant) de Tlemcen.

    OpenAIRE

    GHAFFOUR, ABDESSALAM.

    2014-01-01

    Le but de cette étude était d'évaluer les explorations hématologiques dans le service de pédiatrie générale de l'EHS (mère et enfant) Tlemcen. La taille de l'échantillon était de 418. Les données ont été collectées à l'aide d'un questionnaire. L'hémogramme était l'examen hématologique le plus réalisé (chez 99% des malades). Cette étude nous a révélé la forte prévalence des anémies surtout chez les enfants de l'âge préscolaire, et parmi ces anémies, l'anémie microcytaire hypochr...

  4. Selective modulation of nociceptive processing due to noise distraction.

    Science.gov (United States)

    Boyle, Yvonne; El-Deredy, Wael; Martínez Montes, Eduardo; Bentley, Deborah E; Jones, Anthony K P

    2008-09-15

    This study investigates the effects of noise distraction on the different components and sources of laser-evoked potentials (LEPs) whilst attending to either the spatial component (localisation performance task) or the affective component (unpleasantness rating task) of pain. LEPs elicited by CO2 laser stimulation of the right forearm were recorded from 64 electrodes in 18 consenting healthy volunteers. Subjects reported either pain location or unpleasantness, in the presence and absence of distraction by continuous 85 dBa white noise. Distributed sources of the LEP peaks were identified using Low Resolution Electromagnetic Tomography (LORETA). Pain unpleasantness ratings and P2 (430 ms) peak amplitude were significantly reduced by distraction during the unpleasantness task, whereas the localisation ability and the corresponding N1/N2 (310 ms) peak amplitude remained unchanged. Noise distraction (at 310 ms) reduced activation in the anterior cingulate cortex (ACC) and precuneus during attention to localisation and unpleasantness, respectively. This suggests a complimentary role for these two areas in the control of attention to pain. In contrast, activation of the occipital pole and SII were enhanced by noise during the localisation and unpleasantness task, respectively, suggesting that the presence of noise was associated with increased spatial attentional load. This study has shown selective modulation of affective pain processing by noise distraction, indicated by a reduction in the unpleasantness ratings and P2 peak amplitude and associated activity within the medial pain system. These results show that processing of the affective component of pain can be differentially modulated by top-down processes, providing a potential mechanism for therapeutic intervention.

  5. Wnt/β-catenin signaling is required for distraction osteogenesis in rats.

    Science.gov (United States)

    Wang, Xuemei; Luo, En; Bi, Ruiye; Ye, Bin; Hu, Jing; Zou, Shujuan

    2018-01-01

    The Wnt signaling pathway plays crucial roles in embryonic skeletal development and postnatal bone regeneration. However, mechanisms of Wnt signaling functioning in distraction osteogenesis (DO) haven't been well characterized. We established a DO model using Sprague-Dawley rat tibia. And a Wnt signaling blocking agent, recombinant rat Dickkopf-related protein 1 (rrDkk1), was locally applied in the distracted gap to study the role of Wnt signaling during DO process. Animals in the experimental group received rrDkk1 injections (dose = 25 μg/kg) once daily during distraction period and every third day during consolidation stage (n = 48). Animals in the control group received saline under the same injection strategy (n = 48). Animals at different time points during DO process (1, 3, 6, 12 days after distraction, 10 days and 6 weeks after consolidation) were killed and tissues in the distraction region were harvested for radiography, dual energy X-ray absorptiometry, micro-computed tomography (micro-CT), and histological analyses. Most Wnt ligands, cofactors, receptors, and antagonists were widely expressed in the distraction callus and were significantly upregulated during DO process. After rrDkk1 administration, the majority of these factors were downregulated at the mRNA level, except sFRP and GSK-3β. At the protein level, both β-catenin and Lef-1 were also suppressed by rrDkk1. In the long term, restricted bone healing was observed in the distracted callus in the rrDkk1 injection group. These findings were confirmed by histological and micro-CT analyses. Our findings suggest that Wnt signaling participates in the process of DO, and clinical therapeutic approaches of DO may do well to avoid Wnt pathway suppression.

  6. Grégory DERVILLE (2017), Le pouvoir des médias

    OpenAIRE

    Ben Youssef, Imen

    2018-01-01

    Dans son ouvrage, Grégory Derville s’intéresse au pouvoir des médias ainsi qu’aux rapports entre le champ politique et les médias. Les sociétés occidentales ont connu au cours des dernières décennies la montée en puissance des médias. Celle-ci se manifeste par l’engouement des ménages pour l’acquisition de nouveaux appareils de communication, par la forte consommation des programmes télévisés ainsi que par la hausse de fréquentation des sites Web et des réseaux numériques. Ces bouleversements...

  7. Transpalatal distraction for the management of maxillary constriction in pediatric patients.

    Science.gov (United States)

    Adolphs, Nicolai; Ernst, Nicole; Hoffmeister, Bodo; Raguse, Jan-Dirk

    2015-01-01

    The management of severe maxillary constriction can be challenging. For that purpose surgically assisted maxillary expansion by transpalatal distraction (TPD) can typically be recommended after skeletal maturity. However in selected cases bone borne transpalatal distraction devices can contribute to improve maxillary constriction considerably earlier already during mixed dentition. To assess the possibility of bone borne transpalatal distraction in pediatric patients. Clinical paper. Since 2010 TPD has been applied to six pediatric patients during mixed dentition when severe maxillary constriction was present and conventional orthodontic widening has already failed. Individually selected devices (Surgitec, Belgium) were inserted in general anaesthesia and distraction was performed according to well known parameters. Maxillary constriction could be improved in all six patients without any drawbacks by bone borne devices during mixed dentition. Skeletal conditions were obviously improved for subsequent orthodontic or orthognathic therapy without functional impairment. Follow-up is up to 36 months after device removal. Transpalatal Distraction is recommendable in selected pediatric patients if massive growth disturbance is present or has to be expected. TPD allows for individually adapted maxillary expansion by selection and positioning of appropriate devices in combination with intraoperative testing of maxillary movements and controlled bone removal.

  8. Pedicle distraction increases intervertebral and spinal canal area in a cadaver and bone model.

    Science.gov (United States)

    Hughes, Matthew; Papadakos, Nikolaos; Bishop, Tim; Bernard, Jason

    2018-01-01

    Lumbar spinal stenosis is degenerative narrowing of the spinal canal and/or intervertebral foramen causing compression of the spinal cord and nerve roots. Traditional decompression techniques can often cause significant trauma and vertebral instability. This paper evaluates a method of increasing pedicle length to decompress the spinal and intervertebral foramen, which could be done minimally invasive. Three Sawbone (Sawbones Europe, Sweden) and 1 cadaveric lumbar spine underwent bilateral pedicle distraction at L4. A pedicle channel was drilled between the superior articular process and transverse process into the vertebral body. The pedicles underwent osteotomy at the midpoint. Screws were inserted bilaterally and fixated distraction of 0 mm, 2 mm, 4 mm and 6 mm. CT images were taken at each level of distraction. Foramen area was measured in the sagittal plane at L3/4. Spinal canal area was measured at L4 in the axial images. The cadaver was used to evaluate safety of osteotomy and soft tissue interactions preventing distraction. Statistical analysis was by student paired t-test and Pearson rank test. Increasing distraction led to greater Spinal canal area. From 4.27 cm 2 to 5.72 cm 2 (p = 0.002) with 6 mm distraction. A Maximal increase of 34.1%. Vertebral foramen area also increased with increasing pedicle distraction. From 2.43 cm 2 to 3.22 cm 2 (p = 0.022) with 6 mm distraction. A maximal increase of 32.3%. The cadaver spinal canal increased in area by 21.7%. The vertebral foramen increased in area by 36.2% (left) and 22.6% (right). For each increase in pedicle distraction the area of the spinal and vertebral foramen increases. Pedicle distraction could potentially be used to alleviate spinal stenosis and root impingement. A potential osteotomy plane could be at the midpoint of the pedicle with minimal risk to nerve roots and soft tissue restrictions to prevent distraction. © The Authors, published by EDP Sciences, 2018.

  9. Informational masking of speech in children: Effects of ipsilateral and contralateral distracters

    Science.gov (United States)

    Wightman, Frederic L.; Kistler, Doris J.

    2005-11-01

    Using a closed-set speech recognition paradigm thought to be heavily influenced by informational masking, auditory selective attention was measured in 38 children (ages 4-16 years) and 8 adults (ages 20-30 years). The task required attention to a monaural target speech message that was presented with a time-synchronized distracter message in the same ear. In some conditions a second distracter message or a speech-shaped noise was presented to the other ear. Compared to adults, children required higher target/distracter ratios to reach comparable performance levels, reflecting more informational masking in these listeners. Informational masking in most conditions was confirmed by the fact that a large proportion of the errors made by the listeners were contained in the distracter message(s). There was a monotonic age effect, such that even the children in the oldest age group (13.6-16 years) demonstrated poorer performance than adults. For both children and adults, presentation of an additional distracter in the contralateral ear significantly reduced performance, even when the distracter messages were produced by a talker of different sex than the target talker. The results are consistent with earlier reports from pure-tone masking studies that informational masking effects are much larger in children than in adults.

  10. Videogame distraction using virtual reality technology for children experiencing cold pressor pain: the role of cognitive processing.

    Science.gov (United States)

    Law, Emily F; Dahlquist, Lynnda M; Sil, Soumitri; Weiss, Karen E; Herbert, Linda Jones; Wohlheiter, Karen; Horn, Susan Berrin

    2011-01-01

    This study examined whether increasing the demand for central cognitive processing involved in a distraction task, by involving the child in ongoing, effortful interaction with the distraction stimulus, would increase children's tolerance for cold pressor pain. Seventy-nine children ages 6-15 years underwent a baseline cold pressor trial followed by two cold pressor trials in which they received interactive distraction (i.e., used voice commands to play a videogame) or passive distraction (in which they merely watched the output from the same videogame segment) in counterbalanced order. Both distraction conditions were presented via a virtual reality-type helmet. As expected, children demonstrated significant improvement in pain tolerance during distraction relative to baseline. Children showed the greatest improvement during the interactive distraction task. The effects of distraction on children's cold pressor pain tolerance are significantly enhanced when the distraction task also includes greater demands for central cognitive processing.

  11. Conductivite dans le modele de Hubbard bi-dimensionnel a faible couplage

    Science.gov (United States)

    Bergeron, Dominic

    Le modele de Hubbard bi-dimensionnel (2D) est souvent considere comme le modele minimal pour les supraconducteurs a haute temperature critique a base d'oxyde de cuivre (SCHT). Sur un reseau carre, ce modele possede les phases qui sont communes a tous les SCHT, la phase antiferromagnetique, la phase supraconductrice et la phase dite du pseudogap. Il n'a pas de solution exacte, toutefois, plusieurs methodes approximatives permettent d'etudier ses proprietes de facon numerique. Les proprietes optiques et de transport sont bien connues dans les SCHT et sont donc de bonne candidates pour valider un modele theorique et aider a comprendre mieux la physique de ces materiaux. La presente these porte sur le calcul de ces proprietes pour le modele de Hubbard 2D a couplage faible ou intermediaire. La methode de calcul utilisee est l'approche auto-coherente a deux particules (ACDP), qui est non-perturbative et inclue l'effet des fluctuations de spin et de charge a toutes les longueurs d'onde. La derivation complete de l'expression de la conductivite dans l'approche ACDP est presentee. Cette expression contient ce qu'on appelle les corrections de vertex, qui tiennent compte des correlations entre quasi-particules. Pour rendre possible le calcul numerique de ces corrections, des algorithmes utilisant, entre autres, des transformees de Fourier rapides et des splines cubiques sont developpes. Les calculs sont faits pour le reseau carre avec sauts aux plus proches voisins autour du point critique antiferromagnetique. Aux dopages plus faibles que le point critique, la conductivite optique presente une bosse dans l'infrarouge moyen a basse temperature, tel qu'observe dans plusieurs SCHT. Dans la resistivite en fonction de la temperature, on trouve un comportement isolant dans le pseudogap lorsque les corrections de vertex sont negligees et metallique lorsqu'elles sont prises en compte. Pres du point critique, la resistivite est lineaire en T a basse temperature et devient

  12. Time course of emotion-related responding during distraction and reappraisal.

    Science.gov (United States)

    Schönfelder, Sandra; Kanske, Philipp; Heissler, Janine; Wessa, Michèle

    2014-09-01

    Theoretical accounts of emotion regulation (ER) discriminate various cognitive strategies to voluntarily modify emotional states. Amongst these, attentional deployment (i.e. distraction) and cognitive change (i.e. reappraisal), have been shown to successfully down-regulate emotions. Neuroimaging studies found that both strategies differentially engage neural structures associated with selective attention, working memory and cognitive control. The aim of this study was to further delineate similarities and differences between the ER strategies reappraisal and distraction by investigating their temporal brain dynamics using event-related potentials (ERPs) and their patterns of facial expressive behavior. Twenty-one participants completed an ER experiment in which they had to either passively view positive, neutral and negative pictures, reinterpret them to down-regulate affective responses (reappraisal), or solve a concurrently presented mathematical equation (distraction). Results demonstrate the efficacy of both strategies in the subjective control of emotion, accompanied by reductions of facial expressive activity (Corrugator supercilii and Zygomaticus major). ERP results indicated that distraction, compared with reappraisal, yielded a stronger and earlier attenuation of the late positive potential (LPP) magnitude for negative pictures. For positive pictures, only distraction but not reappraisal had significant effect on LPP attenuation. The results support the process model of ER, separating subtypes of cognitive strategies based on their specific time course. © The Author (2013). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  13. Long-term skeletal and dental changes in patients with cleft lip and palate after maxillary distraction: a report of three cases treated with a rigid external distraction device.

    Science.gov (United States)

    Harada, Kiyoshi; Sato, Masaru; Omura, Ken

    2005-04-01

    We examined long-term skeletal and dental changes in three patients with cleft lip and palate who underwent maxillary distraction using a rigid external distraction device. Two were children, and one was an adult. Changes in the overjet (OJ), overbite (OB), and positions of the anterior nasal spine (ANS), upper incisors (U1), pogonion (Pog), and lower incisors (L1) were measured on preoperative to 36 months postoperative lateral-cephalograms. In the adult, the positions of all examination points were relatively stable from 6 to 36 months postoperatively, and the OJ and OB were maintained at over 2 mm at 36 months. In the children, the positions of ANS and U1 changed inferiorly, Pog and L1 changed anteroinferiorly, and OJ and OB tended to decrease from 6 to 36 months postoperatively. Long-term skeletal and dental stability following maxillary distraction was relatively well maintained in the adult patient. In the children, the maxillomandibular growth was observed after maxillary distraction, but the mandibular overgrowth might have been inhibited by the correction of class III dentoskeletal deformity resulting from the maxillary distraction.

  14. Structural remains at the early mediaeval fort at Raibania, Orissa

    Directory of Open Access Journals (Sweden)

    Bratati Sen

    2013-11-01

    Full Text Available The fortifications of mediaeval India occupy an eminent position in the history of military architecture. The present paper deals with the preliminary study of the structural remains at the early mediaeval fort at Raibania in the district of Balasore in Orissa. The fort was built of stone very loosely kept together. The three-walled fortification interspersed by two consecutive moats, a feature evidenced at Raibania, which is unparallel in the history of ancient and mediaeval forts and fortifications in India. Several other structures like the Jay-Chandi Temple Complex, a huge well, numerous tanks and remains of an ancient bridge add to the uniqueness of the Fort in the entire eastern region.

  15. Alveolar distraction osteogenesis applications in cleft lip and palate patients: a literature review

    Directory of Open Access Journals (Sweden)

    Öznur Mülayim

    2016-05-01

    Full Text Available Distraction osteogenesis technique has been successfully applied in the craniofacial area for long time, and it is being applied increasingly more in cleft lip and palate patients also. Especially in large cleft palate cases, bone grafting or surgical procedures such as distraction osteogenesis can be applied in order to ensure a smooth alveolar arc. In this literature review, alveolar (segmental distraction osteogenesis applications in patients with cleft lip and palate, indications of the technique, advantages and disadvantages, application methods and types of appliances used for this purpose have been evaluated. As conclusion, especially with the application of alveolar (segmental distraction osteogenesis, successful outcome can be achieved in cleft lip and palate patients with velopharyngeal insufficiency, maxillary hypoplasia and maxillary crowding, and this technique may be an alternative to conventional osteotomies and extraoral distractions.

  16. Case Study: Fort Mill High School--A Culture of Continuous Improvement

    Science.gov (United States)

    Southern Regional Education Board (SREB), 2014

    2014-01-01

    This is the latest in a series of case studies highlighting best practices High Schools That Work (HSTW) network schools and districts are implementing to prepare students better for further studies and careers. Fort Mill High School is in Fort Mill, South Carolina, an outlying suburb of Charlotte, North Carolina. Fort Mill links high quality…

  17. Hydrologic Analysis of Fort Leonard Wood, Missouri

    Science.gov (United States)

    2015-08-01

    drainage areas are different, hydrological analysis will be conducted on the two basins individually. The results of the two analyses will be combined to...ER D C TR -1 5- 4 Environmental Quality and Installations Hydrologic Analysis of Fort Leonard Wood, Missouri En gi ne er R es ea rc h...Environmental Quality and Installations ERDC TR-15-4 August 2015 Hydrologic Analysis of Fort Leonard Wood, Missouri Michael L. Follum, Darla C. McVan

  18. Fortællerfiktionen

    DEFF Research Database (Denmark)

    Reitan, Rolf

    Bogen er en kritisk nærlæsning af Gérard Genettes Discours du récit og viser, hvorden den franske teoretiker løser og forenkler en række centrale problemer i traditionel fortælleteori, idet han uudtalt forudsætter et fiktionsbegreb, som han eksplicit afviser som narratologisk relevant. Det...

  19. Fort Valley's early scientists: A legacy of distinction

    Science.gov (United States)

    Andrew J. Sanchez Meador; Susan D. Olberding

    2008-01-01

    When the Riordan brothers of Flagstaff, Arizona, asked Gifford Pinchot to determine why there was a deficit in ponderosa pine seedlings, neither party understood the historical significance of what they were setting in motion for the field of forest research. The direct result of that professional favor was the establishment of the Fort Valley Experiment Station (Fort...

  20. Imagery-inducing distraction leads to cognitive tunnelling and deteriorated driving performance.

    NARCIS (Netherlands)

    Briggs, G.F. Hole, G.J. & Land, M.F.

    2016-01-01

    The effects of imagery-induced distraction on hazard perception and eye movements were investigated in 2 simulated driving experiments. Experiment 1: sixty participants viewed and responded to 2 driving films containing hazards. Group 1 completed the task without distraction; group 2 completed a

  1. Le parcours d’un juste: mémoires politiques, mémoires militantes

    Directory of Open Access Journals (Sweden)

    Alexandra Borsari

    2012-07-01

    Full Text Available Avocat engagé, Robert Badinter s'est retrouvé en situation de mettre en pratique ses idéaux. Son dernier livre, Les épines et les roses, publié chez Fayard (Paris, 2011 est le récit de son parcours de ministre de la Justice. Cet ouvrage soulève ainsi des questions sur les rapports entre mémoires rédigées et image de soi, mais aussi entre la mémoire du sujet et la mémoire collective à laquelle il participe. En racontant sa version du passé, l'auteur entend influencer la lecture de celui-ci et contrôler, en partie, le souvenir qui en sera gardé dans l'opinion. Car, bien qu'il se présente tout au long de l'ouvrage comme un homme ordinaire, arrivé de manière inattendue au pouvoir, Robert Badinter omet de rappeler que tout son parcours postérieur à cette expérience de ministre s'est déroulée à des niveaux de responsabilité en lien étroit avec le pouvoir politique. Après cet accès momentané au pouvoir exécutif, Robert Badinter a ainsi été président du Conseil constitutionnel, fonction à forte dimension politique, avant d'accéder à des fonctions prestigieuses au niveau international. Enfin, son parcours politique s'est poursuivi par son élection au Sénat et donc par une participation directe à l'exercice du pouvoir législatif. Bien sûr, les responsabilités ne sont pas les mêmes, et pour quelqu'un qui s'est souvent refusé à parler de lui, se mettre en scène en tant que garde des Sceaux revêt une signification particulière. Il s'agit ainsi de rendre pérenne le souvenir d'un combat et d'une action dont les résultats les plus forts – abolition de la peine de mort et réforme du code pénal – continuent de façonner, à leur manière, la société française. Mais au-delà du bilan, ce retour sur le passé est également l'occasion de s'ériger en juge du temps présent. Le combat n'est pas terminé et cet ouvrage se veut aussi une oeuvre militante. En analysant cette volonté de se présenter en

  2. Correction of rabbit model with mandibular ramus shortening by distraction osteogenesis at condylar neck.

    Science.gov (United States)

    Meng, Qinggong; Yang, Xuewen; Long, Xing; Li, Jian; Cai, Hengxing

    2012-04-01

    The rabbit model has been established to mimic the effect of temporomandibular joint (TMJ) arthroplasty of ankylosis, and distraction at the level of the condylar neck is used to elongate the ascending ramus. The histomorphologic changes of TMJ and distraction gap were investigated. The unilateral condyles and articular discs were extirpated, and the experimental mandibular rami were shortened by 5 mm. An embedded distracter was used to restore the height of the mandibular ramus by unilateral condylar neck distraction (0.8 mm daily for 7 days). A total of 12 adult white rabbits were used, 8 in the experimental group and 4 in the control group. Of the 8 rabbits in the experimental group, 4 each were killed at 4 and 8 weeks after completion of distraction. The TMJ and distracted calluses were harvested and processed for radiographic and histologic examination. An open bite was seen in all rabbits postoperatively that had diminished at the end of distraction. The newly formed condyles radiologically showed remodeling, flattening, and sclerosis. The bony transport disc had gradually remodeled to a new condyle that was similar to the original condyle in appearance and structure. The surface of the transport disc was covered with a fibrous tissue. Moreover, the bony regeneration was perfect in the distraction gap. These results suggest that distraction osteogenesis at the condylar neck using the traditional preauricular approach of TMJ surgery, without the additional incision, can be performed concurrently with arthroplasty of TMJ ankylosis at the same region. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. VISUAL DISTRACTION WHILE DRIVING

    Directory of Open Access Journals (Sweden)

    Hajime ITO

    2001-01-01

    The article provides background information and summarizes worldwide trends in research on accident rates, the special characteristics of visual behavior and the effects of visual distraction on drivers and vehicle behavior. It also reports on the state of ISO standardization efforts and related technological trends. Finally, it defines a number of topics for future research in the field of human engineering.

  4. Neutron flux distribution measurement in the Fort St. Vrain initial core (results of Fort St. Vrain start-up test A-7)

    International Nuclear Information System (INIS)

    Marshall, A.C.; Brown, J.R.

    1975-01-01

    A description is given of a test to measure the axial flux distribution at several radial locations in the Fort St. Vrain core representing unrodded, rodded, and partially rodded regions. The measurements were intended to verify the calculational accuracy of the three-dimensional calculational model used to compute axial power distributions for the Fort St. Vrain core. (U.S.)

  5. Do as I say, not as I do: Distracted driving behavior of teens and their parents.

    Science.gov (United States)

    Raymond Bingham, C; Zakrajsek, Jennifer S; Almani, Farideh; Shope, Jean T; Sayer, Tina B

    2015-12-01

    Driver distraction is an important contributor to crash risk. Teenage driver distraction can be influenced by the attitudes and behaviors of parents. This study examined teens' and their parents' engagement in distracting behavior while driving. Survey data were collected from a national sample of 403 parent-teen dyads using random-digit dialing telephone interviews. Results demonstrated few parent or teen sex differences in distracting behavior engagement while driving, or in their perceptions of each others' behavior. Parents and teens' frequencies of distracting behavior engagement were positively correlated. Parents' and teens' perceptions of each others' distracting behavior engagement while driving exceeded their own selfreports. Finally, the likelihood that teens reported engaging in distracting behavior while driving was more strongly associated with their perceptions of their parents' distracting behavior than by parents' self reports of their own behavior. These results suggest that parents' examples of driving behavior are an important influence on teen driving behavior, but potentially more important are teens' perceptions of their parents' behaviors. Published by Elsevier Ltd.

  6. Distracted pedestrian sustains orbital fracture while on cell phone

    Directory of Open Access Journals (Sweden)

    Edell AR

    2013-04-01

    Full Text Available Aimée R Edell, Jesse J Jung, Joel M Solomon, Richard N Palu Department of Ophthalmology, New York University School of Medicine, New York, NY, USA Abstract: Use of cell phones in the general population has become increasingly commonplace. The distracting effects of cell phones among automobile drivers are well established, and legislation prohibits the use of handheld cell phones while driving in several states. Recent research has focused on the similar distracting effects of cell phones in the pedestrian population. In this report, an older gentleman suffered extensive facial trauma requiring surgery as a direct effect of cell phone use at the time the trauma occurred. This case highlights the role that portable electronic devices can play as a cause of ocular trauma. Keywords: orbital fracture, ocular trauma, orbital floor fracture, cell phone distraction, pedestrian safety

  7. Differential impact of personality traits on distracted driving behaviors in teens and older adults.

    Science.gov (United States)

    Parr, Morgan N; Ross, Lesley A; McManus, Benjamin; Bishop, Haley J; Wittig, Shannon M O; Stavrinos, Despina

    2016-07-01

    To determine the impact of personality on distracted driving behaviors. Participants included 120 drivers (48 teens, 72 older adults) who completed the 45-item Big Five Personality questionnaire assessing self-reported personality factors and the Questionnaire Assessing Distracted Driving (QUADD) assessing the frequency of distracted driving behaviors. Associations for all five personality traits with each outcome (e.g., number of times texting on the phone, talking on the phone, and interacting with the phone while driving) were analyzed separately for teens and older adults using negative binomial or Poisson regressions that controlled for age, gender and education. In teens, higher levels of openness and conscientiousness were predictive of greater reported texting frequency and interacting with a phone while driving, while lower levels of agreeableness was predictive of fewer reported instances of texting and interacting with a phone while driving. In older adults, greater extraversion was predictive of greater reported talking on and interacting with a phone while driving. Other personality factors were not significantly associated with distracted driving behaviors. Personality traits may be important predictors of distracted driving behaviors, though specific traits associated with distracted driving may vary across age groups. The relationship between personality and distracted driving behaviors provides a unique opportunity to target drivers who are more likely to engage in distracted driving behavior, thereby increasing the effectiveness of educational campaigns and improving driving safety. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Circumplex Model of Affect: A Measure of Pleasure and Arousal During Virtual Reality Distraction Analgesia.

    Science.gov (United States)

    Sharar, Sam R; Alamdari, Ava; Hoffer, Christine; Hoffman, Hunter G; Jensen, Mark P; Patterson, David R

    2016-06-01

    Immersive virtual reality (VR) distraction provides clinically effective pain relief and increases subjective reports of "fun" in medical settings of procedural pain. The goal of this study was to better describe the variable of "fun" associated with VR distraction analgesia using the circumplex model (pleasure/arousal) of affect. Seventy-four healthy volunteers (mean age, 29 years; 37 females) received a standardized, 18-minute, multimodal pain sequence (alternating thermal heat and electrical stimulation to distal extremities) while receiving immersive, interactive VR distraction. Subjects rated both their subjective pain intensity and fun using 0-10 Graphic Rating Scales, as well as the pleasantness of their emotional valence and their state of arousal on 9-point scales. Compared with pain stimulation in the control (baseline, no VR) condition, immersive VR distraction significantly reduced subjective pain intensity (P anxiety, greater fun, greater presence in the VR environment, and positive emotional valence-were associated with subjective analgesia during VR distraction. Immersive VR distraction reduces subjective pain intensity induced by multimodal experimental nociception. Subjects who report less anxiety, more fun, more VR presence, and more positive emotional valence during VR distraction are more likely to report subjective pain reduction. These findings indicate VR distraction analgesia may be mediated through anxiolytic, attentional, and/or affective mechanisms.

  9. Distracted Driving, A Major Preventable Cause of Motor Vehicle Collisions: "Just Hang Up and Drive".

    Science.gov (United States)

    Kahn, Christopher A; Cisneros, Victor; Lotfipour, Shahram; Imani, Ghasem; Chakravarthy, Bharath

    2015-12-01

    For years, public health experts have been concerned about the effect of cell phone use on motor vehicle collisions, part of a phenomenon known as "distracted driving." The Morbidity and Mortality Weekly Report (MMWR) article "Mobile Device Use While Driving - United States and Seven European Countries 2011" highlights the international nature of these concerns. Recent (2011) estimates from the National Highway Traffic Safety Administration are that 10% of fatal crashes and 17% of injury crashes were reported as distraction-affected. Of 3,331 people killed in 2011 on roadways in the U.S. as a result of driver distraction, 385 died in a crash where at least one driver was using a cell phone. For drivers 15-19 years old involved in a fatal crash, 21% of the distracted drivers were distracted by the use of cell phones. Efforts to reduce cell phone use while driving could reduce the prevalence of automobile crashes related to distracted driving. The MMWR report shows that there is much ground to cover with distracted driving. Emergency physicians frequently see the devastating effects of distracted driving on a daily basis and should take a more active role on sharing the information with patients, administrators, legislators, friends and family.

  10. Distraction lengthening of the proximal phalanx in distal thumb amputations.

    Science.gov (United States)

    Cansü, Eren; Ünal, Mehmet Bekir; Parmaksızoğlu, Fatih; Gürcan, Serkan

    2015-01-01

    Thumb amputation is a major cause of hand dysfunction, and the treatment for distal thumb amputations remains controversial. Although finger reconstruction methods using distraction lengthening are known to restore finger length and function, we found no reports in the literature regarding phalangeal lengthening in thumb amputations. We aimed to evaluate proximal phalangeal lengthening in thumb amputations at or near the interphalangeal (IP) joint. We retrospectively evaluated patients who had undergone distraction lengthening of the proximal phalanx of the thumb. All patients underwent osteotomy, either during the initial procedure or as a second-stage procedure. Distraction began 10 days after osteotomy with the use of an external fixator that remained in place until ossification of the gap occurred without bone grafting. Patients were evaluated using the QuickDASH score. Fourteen patients with a mean age of 27 years and a mean follow-up period of 7 years were enrolled. The mean phalangeal lengthening achieved was 20 mm. Ossification occurred at all distraction sites, and the fixators were maintained for a mean of 85 days. The mean healing index was 42.5 days/cm. All 14 patients achieved the desired amount of phalangeal lengthening without major complications such as nonunion, premature union, or gross infection. For reconstruction in cases of distal thumb amputations, distraction lengthening of the proximal phalanx can be used to improve absolute length, web space, and grip distance. The technique is safe and effective, improves functionality/cosmesis, and offers a low complication risk.

  11. Figurativeness in the Sense of Distraction (Studies by Lithuanian Authors

    Directory of Open Access Journals (Sweden)

    Laimutė Monginaitė

    2017-04-01

    Full Text Available The phenomenon of the sense of distraction and the feature of figurativeness in it are analysed with the help of phenomenological description, the concept of sense of Juozas Mureika and the conception of imagination of Kristupas Sabolius. The position is followed that the acts of sense and the being of those existing found in them cannot be known in a purely rational way. Knowing is reached with intuitive insights. The experiencing of distraction is approached as one of the norms or intentions of consciousness. The sense of distraction is acknowledged to be a basic value becoming more and more important in a modern stressful life. The article indicates that the intentional beings of the sense of distraction are expressed in really various human activities and are distinguished with mono-subjectivity and unrepeatable feeling. Figurativeness is perceived as the result of imaginary, creative activity of the imagination and aesthetical quality. The peculiarities of the formation of figurativeness are revealed through the phenomenological description of imagination by Sabolius. Four features of the act of visualisation, determining the quality of figurativeness, are emphasized: intentionality, power of transformation, relation with emotions and the symbolism of the image. The conclusion is made that figurativeness, being the result of the creative act (visualisation of imagination, appears as aesthetical quality or the ensemble of qualities. Figurativeness sharpens the sense of distraction and calls the wave of new experiences.

  12. Evaluating the benefits of distraction on product evaluations : The mindset effect

    NARCIS (Netherlands)

    Lerouge, D.

    2009-01-01

    Past research in consumer behavior typically assumes that distraction during the decision process needs to be avoided. However, a common piece of advice given to consumers who have to make complex decisions is to distract their attention away from the decision problem for some moments. The current

  13. Interactive versus passive distraction for acute pain management in young children: the role of selective attention and development.

    Science.gov (United States)

    Wohlheiter, Karen A; Dahlquist, Lynnda M

    2013-03-01

    To examine whether age and developmental differences in selective attention influence young children's differential responses to interactive and passive distraction. 65 3- to 6-year-old children underwent three cold-pressor trials while receiving no intervention, playing a video game (interactive distraction), or watching a video game (passive distraction). In addition, children completed a test of selective attention, and parents completed ratings of attention. Consistent with neurocognitive models of pain, children benefited more from interactive distraction than from passive distraction. Although older children demonstrated superior pain tolerance overall, age and selective attention skills did not moderate children's responses to the distraction intervention. These findings suggest that younger preschoolers can benefit from interactive distraction to manage acute pain, provided that the distraction activity is developmentally appropriate. Research is needed to determine whether developmental issues are more important moderators of children's responses to distraction when faced with more challenging task demands.

  14. 78 FR 17087 - Special Local Regulation; New River Raft Race, New River; Fort Lauderdale, FL

    Science.gov (United States)

    2013-03-20

    ...-AA08 Special Local Regulation; New River Raft Race, New River; Fort Lauderdale, FL AGENCY: Coast Guard... on the New River in Fort Lauderdale, Florida during the Rotary Club of Fort Lauderdale New River Raft... States during the Rotary Club of Fort Lauderdale New River Raft Race. On March 23, 2013, Fort Lauderdale...

  15. Pedicle distraction increases intervertebral and spinal canal area in a cadaver and bone model

    Directory of Open Access Journals (Sweden)

    Hughes Matthew

    2018-01-01

    Discussion: For each increase in pedicle distraction the area of the spinal and vertebral foramen increases. Pedicle distraction could potentially be used to alleviate spinal stenosis and root impingement. A potential osteotomy plane could be at the midpoint of the pedicle with minimal risk to nerve roots and soft tissue restrictions to prevent distraction.

  16. 40 CFR 81.63 - Metropolitan Fort Smith Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Metropolitan Fort Smith Interstate Air... Air Quality Control Regions § 81.63 Metropolitan Fort Smith Interstate Air Quality Control Region. The Metropolitan Fort Smith Interstate Air Quality Control Region (Arkansas-Oklahoma) has been revised to consist...

  17. Distracted pedestrian sustains orbital fracture while on cell phone

    OpenAIRE

    Edell, Aim?e R; Jung, Jesse J; Solomon, Joel M; Palu, Richard N

    2013-01-01

    Aimée R Edell, Jesse J Jung, Joel M Solomon, Richard N Palu Department of Ophthalmology, New York University School of Medicine, New York, NY, USA Abstract: Use of cell phones in the general population has become increasingly commonplace. The distracting effects of cell phones among automobile drivers are well established, and legislation prohibits the use of handheld cell phones while driving in several states. Recent research has focused on the similar distracting effects of cel...

  18. Effects of hyperbaric oxygen treatment on healing of maxillary distraction osteogenesis in beagle dogs

    International Nuclear Information System (INIS)

    Kudoh, Atsuo

    2008-01-01

    Distraction osteogenesis has been widely used even in the craniofacial region. A long fixation time during the consolidation period, however, is a major clinical disadvantage. Hyperbaric oxygen (HBO) has been used to improve healing in ischemic wounds. We have recently started applying hyperbaric oxygen to cleft palate patients after maxillary distraction, but there is little basic evidence. We hypothesized that hyperbaric oxygen would enhance the healing of distraction osteogenesis in the cleft palate model in dogs. A bony segment including a canine was transported proximally into an artificial bone defect in the left palate. Three dogs were treated with hyperbaric oxygen for 20 days just after the distraction and three other dogs underwent only the distraction process (control group). Blood flow of the canine pulp in the bone segment was monitored using a laser Doppler flowmeter throughout the experiment. All the dogs were sacrificed on day 100, and radiological analysis using peripheral quantitative CT and histomorphometric evaluations were performed. Blood flow in the HBO-treated group recovered to the original level about 30 days faster than in the control group (p<0.05). Cortical bone mineral density was significantly higher at the distraction site in the HBO-treated group than in the control group (p<0.05). The histomorphometric analysis revealed that the newly formed bone area was also larger in the HBO-treated group than in the control group (p<0.05). These results suggest that hyperbaric oxygen treatment could be useful for early removal of the distraction device in distraction osteogenesis. (author)

  19. [Effects of hyperbaric oxygen treatment on healing of maxillary distraction osteogenesis in beagle dogs].

    Science.gov (United States)

    Kudoh, Atsuo

    2008-03-01

    Distraction osteogenesis has been widely used even in the craniofacial region. A long fixation time during the consolidation period, however, is a major clinical disadvantage. Hyperbaric oxygen (HBO) has been used to improve healing in ischemic wounds. We have recently started applying hyperbaric oxygen to cleft palate patients after maxillary distraction, but there is little basic evidence. We hypothesized that hyperbaric oxygen would enhance the healing of distraction osteogenesis in the cleft palate model in dogs. A bony segment including a canine was transported proximally into an artificial bone defect in the left palate. Three dogs were treated with hyperbaric oxygen for 20 days just after the distraction and three other dogs underwent only the distraction process (control group). Blood flow of the canine pulp in the bone segment was monitored using a laser Doppler flowmeter throughout the experiment. All the dogs were sacrificed on day 100, and radiological analysis using peripheral quantitative CT and histomorphometric evaluations were performed. Blood flow in the HBO-treated group recovered to the original level about 30 days faster than in the control group (p<0.05). Cortical bone mineral density was significantly higher at the distraction site in the HBO-treated group than in the control group (p<0.05). The histomorphometric analysis revealed that the newly formed bone area was also larger in the HBO-treated group than in the control group (p<0.05). These results suggest that hyperbaric oxygen treatment could be useful for early removal of the distraction device in distraction osteogenesis.

  20. Rotational Distraction for the Treatment of Severe Mandibular Retrognathia.

    Science.gov (United States)

    Ito, Osamu; Mitsugi, Masaharu; Alcalde, Rafael E; Yano, Tomoyuki; Uemura, Noriko; Okazaki, Mutsumi

    2015-07-01

    The main problem with intraoral distraction of the mandible is the inability to achieve the three-dimensional mandibular correction as planned preoperatively. We developed a technique that allows spontaneous changes in the direction of mandibular elongation using an intraoral distractor. After mandibular osteotomy, the distractor is fixed to the distal segment of the mandible using a single bicortical screw, allowing anterior-posterior, vertical and limited lateromedial changes in the vector of distraction. Mandibular lengthening is performed while keeping the maxilla and mandible in class I occlusion with intermaxillary fixation. As the distraction device is activated allowing mandibular elongation, the proximal segment, guided by the surrounding soft tissues, moves and rotates posterosuperiorly. Mandibular lengthening is continued until the condylar head reaches an adequate position in the mandibular fossa as confirmed clinically and radiographically. Thirty-three patients with mandibular retrognathia received this treatment and good results were obtained.

  1. [Utility of nickel-titanium shape memory alloys of vertebral body reduction fixator with assisted distraction bar].

    Science.gov (United States)

    Man, Yi; Zheng, Yue-huan; Cao, Peng; Chen, Bo; Zheng, Tao; Sun, Chang-hui; Lu, Jiong

    2011-06-07

    To test the nickel-titanium (Ni-Ti) shape memory alloys of vertebral body reduction fixator with assisted distraction bar for the treatment of traumatic and osteoporotic vertebral body fracture. A Ni-Ti shape memory alloys of vertebral body reduction fixator with assisted distraction bar was implanted into the compressed fracture specimens through vertebral pedicle with the radiographic monitoring to reduce the collapsed endplate as well as distract the compressed vertebral fracture. Radiographic film and computed tomographic reconstruction technique were employed to evaluate the effects of reduction and distraction. A biomechanic test machine was used to measure the fatigue and the stability of deformation of fixation segments. Relying on the effect of temperature shape memory, such an assembly could basically reduce the collapsed endplate as well as distract the compressed vertebral fracture. And when unsatisfied results of reduction and distraction occurred, its super flexibility could provide additional distraction strength. A Ni-Ti shape memory alloys of vertebral body reduction fixator with assisted distraction bar may provide effective endplate reduction, restore the vertebral height and the immediate biomechanic spinal stability. So the above assembly is indicated for the treatment of traumatic and osteoporotic vertebral body fracture.

  2. Effect of age and pop out distracter on attended field of view.

    Science.gov (United States)

    Babu, Raiju J; Leat, Susan J; Irving, Elizabeth L

    2014-01-01

    To investigate the functional field of view (FFOV) of younger and older individuals using the attended field of view (AFOV), a method which allows for eye and head movement. The impact of a pop out distracter and a dual task on the FFOV measure was also investigated. Nine young adult (25±6 years) and 9 older participants (72±4 years) took part in the experiment. The AFOV test involved the binocular detection and localization of a white target (Landolt-C) in a field of 24 white rings (distracters). The further AFOV tests were modified to include the presence of a pop out distracter, a dual task condition, and a combination of the two. Older observers had lower viewing efficiency (log [1/presentation time]) in all conditions (pooled mean across conditions: older: 0.05±0.02; younger: 0.48±0.04) than the younger group. The addition of dual or a pop out distracter did not affect the older group (mean difference ∼104±150ms and ∼124±122ms respectively) but the additional pop out distracter reduced the efficiency of the younger group for targets near fixation (mean difference ∼68±35ms). Better viewing efficiency was observed in younger individuals compared to older individuals. Difficulty in disregarding irrelevant stimuli and thereby resorting to inefficient search strategy is proposed as the reason for the differences. The finding that both older and younger individuals are not affected significantly by the presence of the irrelevant pop out distracter has implications in situations such as driving or hazard avoidance. In such scenarios, search performance is likely not impaired beyond what is found with distracters (visual clutter) in the environment. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  3. The Effects of Distraction on Preoperative Anxiety Level in Children.

    Science.gov (United States)

    Aytekin, Aynur; Doru, Özlem; Kucukoglu, Sibel

    2016-02-01

    The purpose of this study was to investigate the effects of distraction on the preoperative anxiety levels of pediatric patients. A prospective, two-group experimental design was used. This study was conducted in the clinic of pediatric surgery of a university hospital in Turkey between November 20, 2013 and January 25, 2014. The population of the study was composed of a total of 83 children (40 in the study group and 43 in the control group) who met the inclusion. The data were collected using the "Personal Information Form," "Separation Scoring," and "State-Trait Anxiety Inventory for Children-State Form." Distraction was performed on the children in the study group during the preoperative period. No intervention was applied to the children in the control group. The results of this study demonstrated that the separation scores and State-Trait Anxiety Inventory for Children-State scores of the children in the study group, on whom distraction was applied, were lower than those of the control group. Distraction applied to children in the preoperative period significantly reduced anxiety and separation anxiety. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  4. Five years experience with a new intraoral maxillary distraction device (RID).

    Science.gov (United States)

    Picard, Arnaud; Diner, Patrick A; Galliani, Eva; Tomat, Catherine; Vazquez, Ma rie Paule; Carls, Friedrich P

    2011-10-01

    Maxillary distraction osteogenesis is well established for the treatment of severe retromaxilla. We report our experience since 2004 of the treatment of 19 patients using a new intraoral maxillary distraction device. Maxillary advancement was successful in all patients with mean advancement of 9.6mm (range 4-17) measured at a point in lateral cephalograms. The new device limited surgical exposure and the amount of materials implanted, and improved control in every phase of the distraction. It was psychologically accepted by patients and was more comfortable than existing devices. Copyright © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Computer tablet distraction reduces pain and anxiety in pediatric burn patients undergoing hydrotherapy: A randomized trial.

    Science.gov (United States)

    Burns-Nader, Sherwood; Joe, Lindsay; Pinion, Kelly

    2017-09-01

    Distraction is often used in conjunction with analgesics to minimize pain in pediatric burn patients during treatment procedures. Computer tablets provide many options for distraction items in one tool and are often used during medical procedures. Few studies have examined the effectiveness of tablet distraction in improving the care of pediatric burn patients. This study examines the effectiveness of tablet distraction provided by a child life specialist to minimize pain and anxiety in pediatric burn patients undergoing hydrotherapy. Thirty pediatric patients (4-12) undergoing hydrotherapy for the treatment of burns participated in this randomized clinical trial. The tablet distraction group received tablet distraction provided by a child life specialist while those in the control group received standard care. Pain was assessed through self-reports and observation reports. Anxiety was assessed through behavioral observations. Length of procedure was also recorded. Nurses reported significantly less pain for the tablet distraction group compared to the control group. There was no significant difference between groups on self-reported pain. The tablet distraction group displayed significantly less anxiety during the procedure compared to the control group. Also, the tablet distraction group returned to baseline after the procedure while those in the control group displayed higher anxiety post-procedure. There was no difference in the length of the procedure between groups. These findings suggest tablet distraction provided by a child life specialist may be an effective method for improving pain and anxiety in children undergoing hydrotherapy treatment for burns. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  6. Fort St. Vrain circulator operating experience

    International Nuclear Information System (INIS)

    Brey, H.L.

    1988-01-01

    Fort St. Vrain, on the system of Public Service Company of Colorado, is the only high-temperature gas-cooled power reactor in the United States. Four helium circulators are utilized in this plant to transfer heat from the reactor to the steam generators. These unique machines have a single stage axial flow helium compressor driven by a single stage steam turbine. A single stage water driven (pelton wheel) turbine is the back-up drive utilizing either feed water, condensate, or fire water as the driving fluid. Developmental testing of the circulators was accomplished prior to installation into Fort St. Vrain. A combined machine operating history of approximately 250,000 hours has shown these machines to be of conservative design and proven mechanical integrity. However, many problems have been encountered in operating the complex auxiliaries which are necessary for successful circulator and plant operation. It has been 15 years since initial installation of the circulators occurred at Fort St. Vrain. During this time, a number of significant issues had to be resolved dealing specifically with machine performance. These events include cavitation damage of the pelton wheels during the initial plant hot functional testing, cracks in the water turbine buckets and cervic coupling, static shutdown seal bellows failure, and, most recently, degradation of components within the steam drive assembly. Unreliable operation particularly with the circulator auxiliaries has been a focus of attention by Public Service Company of Colorado. Actions to replace or significantly modify the existing circulators and their auxiliaries are currently awaiting decisions concerning the long-term future of the Fort St. Vrain plant. (author). 10 refs, 7 figs, 2 tabs

  7. Fort St. Vrain circulator operating experience

    Energy Technology Data Exchange (ETDEWEB)

    Brey, H. L.

    1988-08-15

    Fort St. Vrain, on the system of Public Service Company of Colorado, is the only high-temperature gas-cooled power reactor in the United States. Four helium circulators are utilized in this plant to transfer heat from the reactor to the steam generators. These unique machines have a single stage axial flow helium compressor driven by a single stage steam turbine. A single stage water driven (pelton wheel) turbine is the back-up drive utilizing either feed water, condensate, or fire water as the driving fluid. Developmental testing of the circulators was accomplished prior to installation into Fort St. Vrain. A combined machine operating history of approximately 250,000 hours has shown these machines to be of conservative design and proven mechanical integrity. However, many problems have been encountered in operating the complex auxiliaries which are necessary for successful circulator and plant operation. It has been 15 years since initial installation of the circulators occurred at Fort St. Vrain. During this time, a number of significant issues had to be resolved dealing specifically with machine performance. These events include cavitation damage of the pelton wheels during the initial plant hot functional testing, cracks in the water turbine buckets and cervic coupling, static shutdown seal bellows failure, and, most recently, degradation of components within the steam drive assembly. Unreliable operation particularly with the circulator auxiliaries has been a focus of attention by Public Service Company of Colorado. Actions to replace or significantly modify the existing circulators and their auxiliaries are currently awaiting decisions concerning the long-term future of the Fort St. Vrain plant. (author). 10 refs, 7 figs, 2 tabs.

  8. Expression Study of LeGAPDH, LeACO1, LeACS1A, and LeACS2 in Tomato Fruit (Solanum lycopersicum

    Directory of Open Access Journals (Sweden)

    Pijar Riza Anugerah

    2015-10-01

    Full Text Available Tomato is a climacteric fruit, which is characterized by ripening-related increase of respiration and elevated ethylene synthesis. Ethylene is the key hormone in ripening process of climacteric fruits. The objective of this research is to study the expression of three ethylene synthesis genes: LeACO1, LeACS1A, LeACS2, and a housekeeping gene LeGAPDH in ripening tomato fruit. Specific primers have been designed to amplify complementary DNA fragment of LeGAPDH (143 bp, LeACO1 (240 bp, LeACS1A (169 bp, and LeACS2 (148 bp using polymerase chain reaction. Nucleotide BLAST results of the complementary DNA fragments show high similarity with LeGAPDH (NM_001247874.1, LeACO1 (NM_001247095.1, LeACS1A (NM_001246993.1, LeACS2 (NM_001247249.1, respectively. Expression study showed that LeACO1, LeACS1A, LeACS2, and LeGAPDH genes were expressed in ripening tomato fruit. Isolation methods, reference sequences, and primers used in this study can be used in future experiments to study expression of genes responsible for ethylene synthesis using quantitative polymerase chain reaction and to design better strategy for controlling fruit ripening in agroindustry.

  9. Prédiction de la compacité des bétons compactés au rouleau à l'aide d'un modèle d'empilement granulaire

    OpenAIRE

    POULIOT, N; SEDRAN, T; DE LARRARD, F; MARCHAND, J

    2001-01-01

    Le béton compacté au rouleau (BCR) est régulièrement utilisé pour la construction de barrages, de chaussées routières et d'aires d'entreposage (en particulier, au Canada). La rapidité de mise en place, les faibles teneurs en ciment et l'utilisation d'ajouts minéraux (cendres volantes, fillers calcaires, résidus miniers, etc.) en font un matériau économiquement très intéressant pour l'industrie de la construction. Le BCR possède cependant une structure interne particulière de par sa forte prop...

  10. Benefits of Ilizarov automated bone distraction for nerves and articular cartilage in experimental leg lengthening

    OpenAIRE

    Shchudlo, Nathalia; Varsegova, Tatyana; Stupina, Tatyana; Shchudlo, Michael; Saifutdinov, Marat; Yemanov, Andrey

    2017-01-01

    AIM To determine peculiarities of tissue responses to manual and automated Ilizarov bone distraction in nerves and articular cartilage. METHODS Twenty-nine dogs were divided in two experimental groups: Group M - leg lengthening with manual distraction (1 mm/d in 4 steps), Group A - automated distraction (1 mm/d in 60 steps) and intact group. Animals were euthanized at the end of distraction, at 30th day of fixation in apparatus and 30 d after the fixator removal. M-responses in gastrocnemius ...

  11. Validating a perceptual distraction model using a personal two-zone sound system

    DEFF Research Database (Denmark)

    Rämö, Jussi; Christensen, Lasse; Bech, Søren

    2017-01-01

    This paper focuses on validating a perceptual distraction model, which aims to predict user's perceived distraction caused by audio-on-audio interference. Originally, the distraction model was trained with music targets and interferers using a simple loudspeaker setup, consisting of only two...... sound zones within the sound-zone system. Thus, validating the model using a different sound-zone system with both speech-on-music and music-on-speech stimuli sets. The results show that the model performance is equally good in both zones, i.e., with both speech- on-music and music-on-speech stimuli...

  12. Modeling safety risk perception due to mobile phone distraction among four wheeler drivers

    Directory of Open Access Journals (Sweden)

    Raghunathan Rajesh

    2017-04-01

    Full Text Available Nowadays, there is an increasing trend in the use of information and communication technology devices in new vehicles. Due to these increasing service facilities, driver distraction has become a major concern for transportation safety. To reduce safety risks, it is crucial to understand how distracting activities affect driver behavior at different levels of vehicle control. The objective of this work is to understand how the vehicle and driver characteristics influence mobile phone usage while driving and associated risk perception of road safety incidents. Based on literature review, a man–machine framework for distracted driving and a mobile phone distraction model is presented. The study highlights the findings from a questionnaire survey conducted in Kerala, India. The questionnaire uses a 5-point Likert scale. Responses from 1203 four-wheeler drivers are collected using random sampling approach. The questionnaire items associated with three driver-drive characteristics are: (i Human Factors (age, experience, emotional state, behavior of driver, (ii Driver space (meter, controls, light, heat, steering, actuators of vehicle, (iii Driving conditions (speed, distance, duration, traffic, signals. This mobile phone distraction model is tested using structural equation modeling procedure. The study indicates that among the three characteristics, ‘Human Factors’ has the highest influence on perceived distraction due to mobile phones. It is also observed that safety risk perception due to mobile phone usage while driving is moderate. The practical relevance of the study is to place emphasis on behavior-based controls and to focus on strategies leveraging perception of distraction due to mobile phones while driving.

  13. Pleasures of distraction

    DEFF Research Database (Denmark)

    Svabo, Connie; Bærenholdt, Jørgen Ole

    Actor-network theory, post-ANT material semiotic approaches, and related philosophical perspectives provide a way of conceptualizing visitor experiences which highlights shifting engagements and where interruption, shift and distraction form the course and content of a visit. Interruption, shift...... each other. This insight about the museum visit, which is generated during ethnographic fieldwork and is inspired by ANT and post-ANT approaches, relates to Serres’ philosophy, which in central ways has been foundational to ANT and post-ANT. Conceptualizing the museum visits in terms of shift...

  14. The impact of distracter-target similarity on contextual cueing effects of children and adults.

    Science.gov (United States)

    Yang, Yingying; Merrill, Edward C

    2014-05-01

    Contextual cueing reflects a memory-based attentional guidance process that develops through repeated exposure to displays in which a target location has been consistently paired with a specific context. In two experiments, we compared 20 younger children's (6-7 years old), 20 older children's (9-10 years old), and 20 young adults' (18-21 years old) abilities to acquire contextual cueing effects from displays in which half of the distracters predicted the location of the target and half did not. Across experiments, we varied the similarity between the predictive and nonpredictive distracters and the target. In Experiment 1, the predictive distracters were visually similar to the target and dissimilar from the nonpredictive distracters. In Experiment 2, the nonpredictive distracters were also similar to the target and predictive distracters. All three age groups exhibited contextual cueing in Experiment 1, although the effect was not as strong for the younger children relative to older children and adults. All participants exhibited weaker contextual cueing effects in Experiment 2, with the younger children not exhibiting significant contextual cueing at all. Apparently, when search processes could not be guided to the predictive distracters on the basis of salient stimulus features, younger children in particular experienced difficulty in implicitly identifying and using aspects of the context to facilitate with the acquisition of contextual cueing effects. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Indications of high levels of inattentive and distracted driving in South Africa

    CSIR Research Space (South Africa)

    Venter, Karien

    2016-07-01

    Full Text Available In 2015, the Road Traffic Management Corporation undertook a pilot study to investigate how prevalent driver inattention and distraction is in South Africa. Driver inattention and distraction is the leading factor in near-crashes in for instance...

  16. The effects of coping style on virtual reality enhanced videogame distraction in children undergoing cold pressor pain.

    Science.gov (United States)

    Sil, Soumitri; Dahlquist, Lynnda M; Thompson, Caitlin; Hahn, Amy; Herbert, Linda; Wohlheiter, Karen; Horn, Susan

    2014-02-01

    This study sought to evaluate the effectiveness of virtual reality (VR) enhanced interactive videogame distraction for children undergoing experimentally induced cold pressor pain and examined the role of avoidant and approach coping style as a moderator of VR distraction effectiveness. Sixty-two children (6-13 years old) underwent a baseline cold pressor trial followed by two cold pressor trials in which interactive videogame distraction was delivered both with and without a VR helmet in counterbalanced order. As predicted, children demonstrated significant improvement in pain tolerance during both interactive videogame distraction conditions. However, a differential response to videogame distraction with or without the enhancement of VR technology was not found. Children's coping style did not moderate their response to distraction. Rather, interactive videogame distraction with and without VR technology was equally effective for children who utilized avoidant or approach coping styles.

  17. Le laboratoire, le temple et le marché

    International Development Research Centre (IDRC) Digital Library (Canada)

    De manière générale, les auteurs insistent sur le fait que c'est leur foi qui leur a .... nettement que dans de nombreux cercles, le besoin était vivement ressenti de ... Le Dr Kapur présente tout d'abord une brève discussion sur sa vision du ...... pour les soins aux enfants orphelins et aux pauvres et pour la renaissance des ...

  18. RECOMMANDATIONS 2016 DU COLLOQUE NATIONAL SUR LE DIABETE ET LA NUTRITION

    Directory of Open Access Journals (Sweden)

    Jamal BELKHADIR

    2017-05-01

    Full Text Available La Ligue Marocaine de Lutte contre le Diabète, membre de la Fédération Internationale du Diabète Région MENA, a adopté durant l’année 2016 (Colloque National sur le Diabète et la Nutrition de Rabat les 13 et 14 mai 2016 et célébration de la Journée Mondiale du Diabète à Dakhla les 11, 12 et 13 novembre 2016 deux importantes résolutions :1-     La Déclaration / Plaidoyer pour la mise en place d’un plan d’action national pour une réglementation juridique multisectorielle de lutte contre le diabète et pour la promotion et la protection des droits des diabétiques.2-     l’Appel de Dakhla 2016 pour la mise en œuvre de  « la Charte Internationale des Droits et des Responsabilités des personnes atteintes du Diabète » en Afrique  annonçant la création d’un Observatoire Africain pour la Promotion et la Protection des Droits des Diabétiques».Les recommandations et résolutions de 2016 soulignent l’importance accordée par la Ligue Marocaine à l’effort continue dans la lutte contre l’épidémie du diabète au Maroc, dans la Région MENA et en Afrique.L’implication forte et la participation des différents partenaires dont le Ministère de la Santé, le Conseil National de l’Ordre National des Médecins, les Organismes de Prévoyance Sociale et le Parlement Marocain constitue un acquis considérable dans cette approche multisectorielle et partenariale.Dans ce cadre, le droit des diabétiques constitue un objectif prioritaire, permettant d’engager autant les politiques que l’ensemble des partenaires concernés pour améliorer non seulement la prise en charge thérapeutique du diabétique mais également le droit à l’information, à l’éducation et le droit à la justice sociale.D’autre part, la mise en place d’un Observatoire Africain pour la Protection et la Promotion des Droits des Diabétiques permettra de suivre l’évolution de l’épidémie du Diabète dans le continent autant

  19. An aerial radiological survey of the Fort Calhoun Nuclear Power Plant and surrounding area, Fort Calhoun, Nebraska

    International Nuclear Information System (INIS)

    1994-05-01

    An aerial radiological survey was conducted over the Fort Calhoun Nuclear Power Plant in Fort Calhoun, Nebraska, during the period June 19 through June 28, 1993. The survey was conducted at an altitude of 150 feet (46 meters) over a 25-square-mile (65-square-kilometer) area centered on the power station. The purpose of the survey was to document the terrestrial gamma radiation environment of the Fort Calhoun Nuclear Power Plant and surrounding area. The results of the aerial survey are reported as inferred gamma radiation exposure rates at 1 meter above ground level in the form of a contour map. Outside the plant boundary, exposure rates were found to vary between 6 and 12 microroentgens per hour and were attributed to naturally-occurring uranium, thorium, and potassium. The aerial data were compared to ground-based benchmark exposure rate measurements and radionuclide assays of soil samples obtained within the survey boundary. The ground-based measurements were found to be in good agreement with those inferred from the aerial measuring system. A previous survey was conducted on August 9 and 10, 1972, before the plant began operation. Exposure rates measured in both surveys were consistent with normal terrestrial background

  20. Nasolabial and Interincisal Angle Evaluation in Anterior Maxillary Distraction Osteogenesis: A Case Study

    Directory of Open Access Journals (Sweden)

    Tojan Chacko Thekkekara

    2014-01-01

    Full Text Available Maxillary hypoplasia is a common developmental problem in cleft lip and palate deformities. These deformities have traditionally been corrected by means of orthognathic surgery. Management of skeletal deformities in the maxillofacial region has been a challenge for maxillofacial surgeons and orthodontists. Distraction osteogenesis (DO is a surgical technique that uses body′s own repairing mechanisms for optimal reconstruction of the hard and soft tissues. We present four cases of anterior maxillary distraction osteogenesis with tooth-borne distraction device— Hyrax, which were analyzed retrospectively using cephalometrics. Changes in nasolabial angle and interincisal angle after distraction of anterior maxillary segment were studied to conclude that there was no much change in the the nasolabial angle while the interincisal angle showed marked improvement.

  1. Implantation d'un Modèle Atmosphérique Régional (MAR pour l'étude des variations climatiques et le suivi des campagnes agricoles en Côte d'Ivoire

    Directory of Open Access Journals (Sweden)

    Schayes, G.

    2008-01-01

    Full Text Available Conference: Congo – State, Peace, Economy and Well-being, 21-22 February 2008. Le plateau Adja est l'une des principales zones de production agricole du sud du Bénin avec plus de 90% de sa population dans l'agriculture. Malheureusement, cette zone de très forte pression fonci��re souffre, contrairement à la théorie de Boserup (3, de la persistance de l'agriculture minière et de la dégradation prononcée de l'environnement cultural. Cette étude a pour objectif d'analyser la dynamique de pauvreté sur tout le plateau Adja, aux fins de caractériser les formes de pauvreté dont la prise en compte s'avère nécessaire pour la promotion de l'agriculture durable dans la zone. A partir d'un échantillon de 122 ménages les données collectées portent essentiellement sur les caractéristiques des ménages, leur exploitation agricole, leur dotation en actifs et leurs états de bien-être en 2000 et en 2007 appréciés par les dépenses de consommation par équivalent-adulte comme indicateur. Les analyses de données ont permis d'identifier les traits qui distinguent les ménages pauvres chroniques des ménages pauvres transitoires sur le plateau Adja. Le niveau d'instruction, le nombre de champs, le capital naturel et le capital physique possédés sont les facteurs discriminants importants des deux catégories de pauvres. Sur la période de 2000 à 2007, la pauvreté transitoire domine la pauvreté chronique avec 36,9% des ménages contre 28,7%. La pauvreté chronique se traduit par un déficit persistant en actifs naturels et physiques. Selon le genre, les ménages dirigés par les femmes souffrent largement plus de la pauvreté chronique (47,1% que les ménages dirigés par les hommes (25,7%. En ce qui concerne les pratiques agricoles, les pauvres chroniques mettent moins en oeuvre les pratiques agricoles de conservation des terres que les pauvres transitoires.

  2. Bioresorbable distraction device for the treatment of airway problems for infants with Robin sequence.

    Science.gov (United States)

    Breugem, Corstiaan; Paes, Emma; Kon, Moshe; Mink van der Molen, Aebele B; van der Molen, Aebele B Mink

    2012-08-01

    Pierre Robin sequence is a well known craniofacial entity. There are numerous ways to treat the respiratory insufficiency, but sometimes surgical intervention is needed. Tracheotomy could be associated with morbidity, and distraction osteogenesis has been established as a stable method to obtain a safe airway. Distraction osteogenesis has traditionally been performed with an external device. In this manuscript we describe the feasibility of an internal bioresorbable device. Retrospective descriptive study was performed in a tertiary academic children's hospital. After multidisciplinary team consultation, 12 consecutive patients with Robin sequence were treated with this internal distraction device. The mean age at surgery was 32 days, and the average amount of mandibular distraction was 18 mm. All patients were extubated after an average of 7.5 days after the surgery. The average length of stay in the hospital was 17 days after surgery. There were no major surgical complications. A tracheotomy was prevented in all our patients, and complications were limited. Long-term studies are needed to evaluate the influence that internal distraction has on the growth of the mandible and teeth. The internal distraction system seems safe for infants with micrognathia and has certain benefits when compared to the external distractor.

  3. Cost, operation and hospitalization times in distraction osteogenesis versus sagittal split osteotomy

    NARCIS (Netherlands)

    van Strijen, P. J.; Breuning, K. H.; Becking, A. G.; Perdijk, F. B. T.; Tuinzing, D. B.

    2003-01-01

    Distraction osteogenesis in 'common' surgical orthodontics is mentioned as an alternative for conventional sagittal split osteotomy. After a 'learning curve' in the surgical skills of distraction, the two techniques can be compared concerning time and cost aspects. Forty-seven patients (male n=28,

  4. Selectively Distracted: Divided Attention and Memory for Important Information.

    Science.gov (United States)

    Middlebrooks, Catherine D; Kerr, Tyson; Castel, Alan D

    2017-08-01

    Distractions and multitasking are generally detrimental to learning and memory. Nevertheless, people often study while listening to music, sitting in noisy coffee shops, or intermittently checking their e-mail. The current experiments examined how distractions and divided attention influence one's ability to selectively remember valuable information. Participants studied lists of words that ranged in value from 1 to 10 points while completing a digit-detection task, while listening to music, or without distractions. Though participants recalled fewer words following digit detection than in the other conditions, there were no significant differences between conditions in terms of selectively remembering the most valuable words. Similar results were obtained across a variety of divided-attention tasks that stressed attention and working memory to different degrees, which suggests that people may compensate for divided-attention costs by selectively attending to the most valuable items and that factors that worsen memory do not necessarily impair the ability to selectively remember important information.

  5. Fort Carson Wind Resource Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Robichaud, R.

    2012-10-01

    This report focuses on the wind resource assessment, the estimated energy production of wind turbines, and economic potential of a wind turbine project on a ridge in the southeastern portion of the Fort Carson Army base.

  6. Distracted Driving, A Major Preventable Cause of Motor Vehicle Collisions: “Just Hang Up and Drive”

    Directory of Open Access Journals (Sweden)

    Christopher A. Kahn

    2015-12-01

    Full Text Available For years, public health experts have been concerned about the effect of cell phone use on motor vehicle collisions, part of a phenomenon known as “distracted driving.” The Morbidity and Mortality Weekly Report (MMWR article “Mobile Device Use While Driving - United States and Seven European Countries 2011” highlights the international nature of these concerns. Recent (2011 estimates from the National Highway Traffic Safety Administration are that 10% of fatal crashes and 17% of injury crashes were reported as distraction-affected. Of 3,331 people killed in 2011 on roadways in the U.S. as a result of driver distraction, 385 died in a crash where at least one driver was using a cell phone. For drivers 15-19 years old involved in a fatal crash, 21% of the distracted drivers were distracted by the use of cell phones. Efforts to reduce cell phone use while driving could reduce the prevalence of automobile crashes related to distracted driving. The MMWR report shows that there is much ground to cover with distracted driving. Emergency physicians frequently see the devastating effects of distracted driving on a daily basis and should take a more active role on sharing the information with patients, administrators, legislators, friends and family.

  7. A new noninvasive controlled intra-articular ankle distraction technique on a cadaver model.

    Science.gov (United States)

    Aydin, Ahmet T; Ozcanli, Haluk; Soyuncu, Yetkin; Dabak, Tayyar K

    2006-08-01

    Effective joint distraction is crucial in arthroscopic ankle surgery. We describe an effective and controlled intra-articular ankle distraction technique that we have studied by means of a fresh-frozen cadaver model. Using a kyphoplasty balloon, which is currently used in spine surgery, we tried to achieve a controlled distraction. After the fixation of the cadaver model, standard anteromedial and anterolateral portals were used for ankle arthroscopy. From the same portals, the kyphoplasty balloon was inserted and placed in an appropriate position intra-articularly. The necessary amount of distraction was achieved by inflating the kyphoplasty balloon with a pressure regulation pump. All anatomic sites of the ankle joint were easily visualized with the arthroscope during surgery by changing the pressure and the intra-articular position of the kyphoplasty balloon. Ankle distraction was clearly seen on the arthroscopic and image intensifier view. The kyphoplasty balloon is simple to place through the standard portals and the advantage is that it allows easy manipulation of the arthroscopic instruments from the same portal.

  8. Melatonin Production, Sleep Patterns and Modeled Performance Effectiveness in Subjects in the High Arctic

    Science.gov (United States)

    2014-05-01

    de la photopériode liées aux saisons dans le Haut Arctique exercent une pression particulièrement forte sur le rythme circadien humain, ce qui peut...travaux décrits était d’étudier le rythme circadien du personnel envoyé dans le Haut Arctique en mesurant régulièrement la mélatonine fabriquée par...extrêmes de la photopériode liées aux saisons dans le Haut Arctique exercent une pression particulièrement forte sur le rythme circadien humain, ce

  9. Comparative study of different osteotomy modalities in maxillary distraction osteogenesis for cleft lip and palate.

    Science.gov (United States)

    Yu, Hongbo; Wang, Xudong; Fang, Bing; Shen, Steve Guofang

    2012-11-01

    Conventional maxillary distraction osteogenesis and anterior maxillary segmental distraction were applied in the treatment of severe maxillary hypoplasia secondary to cleft clip and palate. The aim of the present study was to compare the difference between these 2 osteotomy modalities used for rigid external distraction. Ten patients with severe maxillary hypoplasia secondary to CLP were enrolled in our study. They were randomly divided into 2 groups. Conventional maxillary distraction osteogenesis was performed in 5 patients and anterior maxillary segmental distraction in 5 patients. The preoperative and postoperative lateral cephalograms were compared, and cephalometric analysis was performed. The independent sample t test was used to evaluate the differences between the 2 groups. All patients healed uneventfully, and the maxillae moved forward satisfactorily. The sella-nasion-point A angles, nasion-point A-Frankfort horizontal plane angles, overjets, and 0-meridian to subnasale distances had increased significantly after distraction osteogenesis. Significant differences were found in the changes in palatal length between the 2 groups (P maxillary segmental distraction group. No significant difference in the changes in palatopharyngeal depth or soft palatal length was found. With the ability of increasing the palatal and arch length, avoiding changes in palatopharyngeal depth, and preserving palatopharyngeal closure function, anterior maxillary segmental distraction has great value in the treatment of maxillary hypoplasia secondary to CLP. It is a promising and valuable technique in this potentially complicated procedure. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Impaired laparoscopic performance of novice surgeons due to phone call distraction: a single-centre, prospective study.

    Science.gov (United States)

    Yang, Cui; Heinze, Julia; Helmert, Jens; Weitz, Juergen; Reissfelder, Christoph; Mees, Soeren Torge

    2017-12-01

    Distractions such as phone calls during laparoscopic surgery play an important role in many operating rooms. The aim of this single-centre, prospective study was to assess if laparoscopic performance is impaired by intraoperative phone calls in novice surgeons. From October 2015 to June 2016, 30 novice surgeons (medical students) underwent a laparoscopic surgery training curriculum including two validated tasks (peg transfer, precision cutting) until achieving a defined level of proficiency. For testing, participants were required to perform these tasks under three conditions: no distraction (control) and two standardised distractions in terms of phone calls requiring response (mild and strong distraction). Task performance was evaluated by analysing time and accuracy of the tasks and response of the phone call. In peg transfer (easy task), mild distraction did not worsen the performance significantly, while strong distraction was linked to error and inefficiency with significantly deteriorated performance (P phone call distractions result in impaired laparoscopic performance under certain circumstances. To ensure patient safety, phone calls should be avoided as far as possible in operating rooms.

  11. Lele des chefs traditionnels au Ghana : un modèle inspirant ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    8 févr. 2011 ... Avec ses partenaires du Sud, avec aussi le soutien du Centre de recherches pour le développement international ( CRDI ), organisme canadien, Ray a étudié lele des chefs traditionnels au Ghana dans la lutte contre le VIH et le sida. Les collectivités politiques antérieures au colonialisme sont une ...

  12. Use of Multidirectional Cranial Distraction Osteogenesis for Cranial Expansion in Syndromic Craniosynostosis

    Directory of Open Access Journals (Sweden)

    Ataru Sunaga, MD

    2017-12-01

    Full Text Available Summary:. Patients with syndromic craniosynostosis often require a large amount of cranial expansion to avoid intracranial hypertension, but the surgical procedure remains controversial. A patient of severe syndromic craniosynostosis with multiple bony defects and anomalous venous drainage at the occipital region was treated by multidirectional cranial distraction osteogenesis (MCDO at the age of 8 months. Distraction started 5 days after surgery and ceased on postoperative day 16. The distraction devices were removed 27 days after completing distraction. After device removal, the increase of intracranial volume was 155 ml and the cephalic index was improved from 115.5 to 100.5. The resultant cranial shape was well maintained with minimal relapse at postoperative 9 months. In cases of syndromic craniosynostosis with multiple bony defects and/or anomalous venous drainage at the occipital region, expansion of the anterior cranium by MCDO is a viable alternative to conventional methods.

  13. Orchestrating Proactive and Reactive Mechanisms for Filtering Distracting Information: Brain-Behavior Relationships Revealed by a Mixed-Design fMRI Study

    Science.gov (United States)

    Marini, Francesco; Demeter, Elise; Roberts, Kenneth C.; Chelazzi, Leonardo

    2016-01-01

    Given the information overload often imparted to human cognitive-processing systems, suppression of irrelevant and distracting information is essential for successful behavior. Using a hybrid block/event-related fMRI design, we characterized proactive and reactive brain mechanisms for filtering distracting stimuli. Participants performed a flanker task, discriminating the direction of a target arrow in the presence versus absence of congruent or incongruent flanking distracting arrows during either Pure blocks (distracters always absent) or Mixed blocks (distracters on 80% of trials). Each Mixed block had either 20% or 60% incongruent trials. Activations in the dorsal frontoparietal attention network during Mixed versus Pure blocks evidenced proactive (blockwise) recruitment of a distraction-filtering mechanism. Sustained activations in right middle frontal gyrus during 60% Incongruent blocks correlated positively with behavioral indices of distraction-filtering (slowing when distracters might occur) and negatively with distraction-related behavioral costs (incongruent vs congruent trials), suggesting a role in coordinating proactive filtering of potential distracters. Event-related analyses showed that incongruent trials elicited greater reactive activations in 20% (vs 60%) Incongruent blocks for counteracting distraction and conflict, including in the insula and anterior cingulate. Context-related effects in occipitoparietal cortex consisted of greater target-evoked activations for distracter-absent trials (central-target-only) in Mixed versus Pure blocks, suggesting enhanced attentional engagement. Functional-localizer analyses in V1/V2/V3 revealed less distracter-processing activity in 60% (vs 20%) Incongruent blocks, presumably reflecting tonic suppression by proactive filtering mechanisms. These results delineate brain mechanisms underlying proactive and reactive filtering of distraction and conflict, and how they are orchestrated depending on distraction

  14. Renewable Energy Opportunities at Fort Sill, Oklahoma

    Energy Technology Data Exchange (ETDEWEB)

    Boyd, Brian K.; Hand, James R.; Horner, Jacob A.; Orrell, Alice C.; Russo, Bryan J.; Weimar, Mark R.; Nesse, Ronald J.

    2011-03-31

    This document provides an overview of renewable resource potential at Fort Sill, based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. This effort focuses on grid-connected generation of electricity from renewable energy sources and on ground source heat pumps for heating and cooling buildings. The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 Department of Defense (DoD) Renewables Assessment. The site visit to Fort Sill took place on June 10, 2010.

  15. Renewable Energy Opportunities at Fort Polk, Louisiana

    Energy Technology Data Exchange (ETDEWEB)

    Solana, Amy E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Boyd, Brian K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Horner, Jacob A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Gorrissen, Willy J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Orrell, Alice C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Weimar, Mark R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hand, James R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Russo, Bryan J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Williamson, Jennifer L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2010-11-17

    This document provides an overview of renewable resource potential at Fort Polk, based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. This effort focuses on grid-connected generation of electricity from renewable energy sources and also on ground source heat pumps for heating and cooling buildings. The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 Department of Defense (DoD) Renewables Assessment. The site visit to Fort Polk took place on February 16, 2010.

  16. Treatment outcome and long-term stability of skeletal changes following maxillary distraction in adult subjects of cleft lip and palate.

    Science.gov (United States)

    Singh, Satinder Pal; Jena, Ashok Kumar; Rattan, Vidya; Utreja, Ashok Kumar

    2012-04-01

    To evaluate the treatment outcome and long-term stability of skeletal changes following maxillary advancement with distraction osteogenesis in adult subjects of cleft lip and palate. Total 12 North Indian adult patients in the age range of 17-34 years with cleft lip and palate underwent advancement of maxilla by distraction osteogenesis. Lateral cephalograms recorded prior to distraction, at the end of distraction, 6 months after distraction, and at least 24 months (mean 25.5 ± 1.94 months) after distraction osteogenesis were used for the evaluation of treatment outcome and long-term stability of the skeletal changes. Descriptive analysis, ANOVA, and post-hoc test were used, and P-value 0.05 was considered as a statistically significant level. Maxillary distraction resulted in significant advancement of maxilla (Pmaxillary distraction. The position of the mandible and facial heights were stable during distraction. During the first 6 months of the post-distraction period, the maxilla showed relapse of approximately 30%. However, after 6 months post distraction, the relapse was very negligible. Successful advancement of maxilla was achieved by distraction osteogenesis in adult subjects with cleft lip and palate. Most of the relapse occurred during the first 6 months of post-distraction period, and after that the outcomes were stable.

  17. Effect of distraction arthroplasty on osteoarthritic goat models of the articular cartilage

    Directory of Open Access Journals (Sweden)

    Rizky N.H. Putro

    2013-05-01

    Full Text Available Background: Osteoarthritis (OA is the most common knee degenerative disease, the number of OA patients increases along with the increase of life expectancy. Distraction arthroplasty is a less invasive alternatif for OA management by releaving mechanical stress while maintaining intermitten joint fluid pressure changes, thus halting the OA destructive cycle and inducing repair. This study aims to evaluate the anatomical and histopathological changes after distraction arthroplasty on osteoarthritic animal models.Methods: The study was performed on 32 goat stiffle joint (16 goats with mechanically induced OA by lateral meniscectomy. During the study 6 goats were decreased. Distraction arthroplasty was performed using external fixation on 10 knees for 4 weeks, and the contralateral knees left untreated. The knees were anatomically and histopathologically examined using International Cartilage Repair Society (ICRS staging and Osteoarthritis Research Society International (OARSI scoring. The differences of the anatomical and histopathological changes are tested for significance using the Wilcoxon test.Results: There was anatomical and histopathological worsening of the OA on treated knees. The anatomical difference assessed using ICRS stage gave median values of 1.5 and 2.5 respectively (p < 0.002. The histopathological difference assessed using OARSI scoring was significant (6 vs 10; p < 0.002.Conclusion: Distraction arthroplasty in OA goat models in this study, worsens the OA instead of inducing repair. Further studies are required to find out a convincing biological basis of distraction arthroplasty as an alternative treatment for OA. (Med J Indones. 2013;22:64-9Keywords: Animal model, distraction arthroplasty, osteoarthritis

  18. Fort Independence: An Eighteenth-Century Frontier Homesite and Militia Post in South Carolina.

    Science.gov (United States)

    1982-12-01

    included in this instance as a condiment , but it could also indicate that the Fort Independence garrison was familiar with the strategy employed by the Fort...archeological investigation of Fort Charlotte, McCormick County, South Carolina. Notebook, Institute of Archeology and Anthropology, University of South

  19. Maxillary movement in distraction osteogenesis using internal devices in cleft palate patients.

    Science.gov (United States)

    Tomita, Daisuke; Omura, Susumu; Ozaki, Shusaku; Shimazaki, Kazuo; Fukuyama, Eiji; Tohnai, Iwai; Torikai, Katsuyuki

    2011-03-01

    The purpose of this cephalometric study was to compare the actual movement with the planned movement of the maxilla by using internal maxillary distraction in cleft lip and palate patients. Twelve patients, including eight with unilateral and four with bilateral cleft lip and palate, underwent maxillary advancement with internal maxillary distractors. Lateral cephalometric radiographs obtained preoperatively, predistraction, and postdistraction were used for analysis. The movement of the maxilla, angular change of the internal devices and rotation of the mandible were measured at each stage, and the planned vector of advancement predicted from the placement vector of the distractors was compared with the actual vector. Internal maxillary distractors were rotated in a clockwise direction during the distraction period. The angular change of the distractors was 7.7°. The amount of actual advancement at anterior nasal spine with distraction was 6.3 mm, which represented about 70% of the distance of activation of distraction. The actual advanced vector at anterior nasal spine was 9.7° smaller than the planned vector. The mandible underwent a clockwise rotation of 3.5°. In the internal distraction technique, the maxilla was advanced inferiorly to the planned vector and with a slight clockwise rotation. These results are useful for surgical planning when using internal distractors.

  20. Distraction induced enterogenesis: a unique mouse model using polyethylene glycol.

    Science.gov (United States)

    Okawada, Manabu; Maria, Haytham Mustafa; Teitelbaum, Daniel H

    2011-09-01

    Recent studies have demonstrated that the small intestine can be lengthened by applying mechanical forces to the bowel lumen-distraction-induced enterogenesis. However, the mechanisms which account for this growth are unknown, and might be best examined using a mouse model. The purpose of this study is to establish the feasibility of developing distractive-induced small bowel growth in mouse. Twelve-week old C57BL/6J mice had a jejunal segment taken out of continuity, and distended with polyethylene glycol (PEG: 3350 KDa); this group was compared with a control group without stretching. Segment length and diameter were measured intra-operatively and after 5 d. Villus height, crypt depth, and muscle thickness in the isolated segment were assessed. Rate of epithelial cell proliferation (5-bromo-2-deoxyuridine: BrdU incorporation) in crypts were also examined. The mucosal mRNA expression of targeted factors was performed to investigate potential mechanisms which might lead to distraction-induced enterogenesis. At harvest, the PEG-stretched group showed a significant increase in length and diameter versus controls. Villus height, crypt depth, and muscular layer thickness increased in the PEG group. The PEG group also showed significantly increased rates of epithelial cell proliferation versus controls. Real-time PCR showed a trend toward higher β-catenin and c-myc mRNA expression in the PEG-stretched group; however, this difference was not statistically significant. Radial distraction-induced enterogenesis with PEG is a viable method for increasing small intestinal length and diameter. This model may provide a new method for studying the mechanisms leading to distraction-induced enterogenesis. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Plugging the attention deficit: perceptual load counters increased distraction in ADHD.

    Science.gov (United States)

    Forster, Sophie; Robertson, David J; Jennings, Alistair; Asherson, Philip; Lavie, Nilli

    2014-01-01

    Increased vulnerability to extraneous distraction is a key symptom of Attention-Deficit Hyperactivity Disorder (ADHD), which may have particularly disruptive consequences. Here we apply Load Theory of attention to increase understanding of this symptom, and to explore a potential method for ameliorating it. Previous research in nonclinical populations has highlighted increased perceptual load as a means of improving the ability to focus attention and avoid distraction. The present study examines whether adults with ADHD can also benefit from conditions of high perceptual load to improve their focused attention abilities. We tested adults with ADHD and age- and IQ-matched controls on a novel measure of irrelevant distraction under load, designed to parallel the form of distraction that is symptomatic of ADHD. During a letter search task, in which perceptual load was varied through search set size, participants were required to ignore salient yet entirely irrelevant distractors (colorful images of cartoon characters) presented infrequently (10% of trials). The presence of these distractors produced a significantly greater interference effect on the search RTs for the adults with ADHD compared with controls, p = .005, ηp² = .231. Perceptual load, however, significantly reduced distractor interference for the ADHD group and was as effective in reducing the elevated distractor interference in ADHD as it was for controls. These findings clarify the nature of the attention deficit underlying increased distraction in ADHD, and demonstrate a tangible method for overcoming it.

  2. Improving Dental Experiences by Using Virtual Reality Distraction: A Simulation Study

    Science.gov (United States)

    Tanja-Dijkstra, Karin; Pahl, Sabine; P. White, Mathew; Andrade, Jackie; Qian, Cheng; Bruce, Malcolm; May, Jon; Moles, David R.

    2014-01-01

    Dental anxiety creates significant problems for both patients and the dental profession. Some distraction interventions are already used by healthcare professionals to help patients cope with unpleasant procedures. The present study is novel because it a) builds on evidence that natural scenery is beneficial for patients, and b) uses a Virtual Reality (VR) representation of nature to distract participants. Extending previous work that has investigated pain and anxiety during treatment, c) we also consider the longer term effects in terms of more positive memories of the treatment, building on a cognitive theory of memory (Elaborated Intrusions). Participants (n = 69) took part in a simulated dental experience and were randomly assigned to one of three VR conditions (active vs. passive vs. control). In addition, participants were distinguished into high and low dentally anxious according to a median split resulting in a 3×2 between-subjects design. VR distraction in a simulated dental context affected memories a week later. The VR distraction had effects not only on concurrent experiences, such as perceived control, but longitudinally upon the vividness of memories after the dental experience had ended. Participants with higher dental anxiety (for whom the dental procedures were presumably more aversive) showed a greater reduction in memory vividness than lower dental-anxiety participants. This study thus suggests that VR distractions can be considered as a relevant intervention for cycles of care in which people’s previous experiences affect their behaviour for future events. PMID:24621518

  3. Treatment of Severe Maxillary Hypoplasia With Combined Orthodontics and Distraction Osteogenesis.

    Science.gov (United States)

    Lucchese, Alessandra; Albertini, Paolo; Asperio, Paolo; Manuelli, Maurizio; Gastaldi, Giorgio

    2018-01-05

    Distraction osteogenesis (DO) is a technique that allows the generation of new bone in a gap between 2 vascularized bone surfaces in response to the application of graduated tensile stress across the bone gap.Distraction osteogenesis has become a routine treatment of choice to correct skeletal deformities and severe bone defects in the craniofacial complex over the past decade. Distraction osteogenesis has been successfully chosen in lengthening the maxilla and the mandible; in the maxilla and recently in the mandible, the jawbones have been distracted and widened transversely to relieve severe anterior dental crowding and transverse discrepancies between the dental arches.Distraction osteogenesis for maxillary advancement started in 1993 and is now widely used, especially in patients with skeletal Class III malocclusion caused by maxillary hypoplasia.The aim of this study was to present the efficiency of combined orthodontic and DO in the severe maxillary hypoplasia.A 35-year-old Italian man presented to our clinical practice with the chief complaint of esthetic and functionally problems because of skeletal Class III malocclusion with anterior crossbite.Considering that the severity of the skeletal discrepancy is remarkable but compensated by the DO potential, the combined orthodontic and DO treatment was considered adequate, like less invasive and equally effective.It was obtained a good alignment with the upper and lower arch dental alveolar maxillary advancement that allowed to correct the sagittal relationships.The patient was satisfied for the treatment results and had considerable improvement in his self-esteem.

  4. Improving dental experiences by using virtual reality distraction: a simulation study.

    Science.gov (United States)

    Tanja-Dijkstra, Karin; Pahl, Sabine; White, Mathew P; Andrade, Jackie; Qian, Cheng; Bruce, Malcolm; May, Jon; Moles, David R

    2014-01-01

    Dental anxiety creates significant problems for both patients and the dental profession. Some distraction interventions are already used by healthcare professionals to help patients cope with unpleasant procedures. The present study is novel because it a) builds on evidence that natural scenery is beneficial for patients, and b) uses a Virtual Reality (VR) representation of nature to distract participants. Extending previous work that has investigated pain and anxiety during treatment, c) we also consider the longer term effects in terms of more positive memories of the treatment, building on a cognitive theory of memory (Elaborated Intrusions). Participants (n = 69) took part in a simulated dental experience and were randomly assigned to one of three VR conditions (active vs. passive vs. control). In addition, participants were distinguished into high and low dentally anxious according to a median split resulting in a 3×2 between-subjects design. VR distraction in a simulated dental context affected memories a week later. The VR distraction had effects not only on concurrent experiences, such as perceived control, but longitudinally upon the vividness of memories after the dental experience had ended. Participants with higher dental anxiety (for whom the dental procedures were presumably more aversive) showed a greater reduction in memory vividness than lower dental-anxiety participants. This study thus suggests that VR distractions can be considered as a relevant intervention for cycles of care in which people's previous experiences affect their behaviour for future events.

  5. Improving dental experiences by using virtual reality distraction: a simulation study.

    Directory of Open Access Journals (Sweden)

    Karin Tanja-Dijkstra

    Full Text Available Dental anxiety creates significant problems for both patients and the dental profession. Some distraction interventions are already used by healthcare professionals to help patients cope with unpleasant procedures. The present study is novel because it a builds on evidence that natural scenery is beneficial for patients, and b uses a Virtual Reality (VR representation of nature to distract participants. Extending previous work that has investigated pain and anxiety during treatment, c we also consider the longer term effects in terms of more positive memories of the treatment, building on a cognitive theory of memory (Elaborated Intrusions. Participants (n = 69 took part in a simulated dental experience and were randomly assigned to one of three VR conditions (active vs. passive vs. control. In addition, participants were distinguished into high and low dentally anxious according to a median split resulting in a 3×2 between-subjects design. VR distraction in a simulated dental context affected memories a week later. The VR distraction had effects not only on concurrent experiences, such as perceived control, but longitudinally upon the vividness of memories after the dental experience had ended. Participants with higher dental anxiety (for whom the dental procedures were presumably more aversive showed a greater reduction in memory vividness than lower dental-anxiety participants. This study thus suggests that VR distractions can be considered as a relevant intervention for cycles of care in which people's previous experiences affect their behaviour for future events.

  6. Predictors of Cell Phone Use in Distracted Driving: Extending the Theory of Planned Behavior.

    Science.gov (United States)

    Tian, Yan; Robinson, James D

    2017-09-01

    This study examines the predictors of six distracted driving behaviors, and the survey data partially support Ajzen's (1991) Theory of Planned Behavior (TPB). The data suggest that the attitude variable predicted intention to engage in all six distracted driving behaviors (reading and sending text messages, making and answering cell phone calls, reading/viewing social media, and posting on social media while driving). Extending the model to include past experience and the variable perceived safety of technology yielded an improvement in the prediction of the distraction variables. Specifically, past experience predicted all six distracted driving behaviors, and the variable perceived safety of technology predicted intentions to read/view social media and intention to post on social media while driving. The study provides evidence for the importance of incorporating expanded variables into the original TPB model to predict cell phone use behaviors while driving, and it suggests that it is essential to tailor campaign materials for each specific cell phone use behavior to reduce distracted driving.

  7. A comparison between audio and audiovisual distraction techniques in managing anxious pediatric dental patients

    Directory of Open Access Journals (Sweden)

    Prabhakar A

    2007-01-01

    Full Text Available Pain is not the sole reason for fear of dentistry. Anxiety or the fear of unknown during dental treatment is a major factor and it has been the major concern for dentists for a long time. Therefore, the main aim of this study was to evaluate and compare the two distraction techniques, viz, audio distraction and audiovisual distraction, in management of anxious pediatric dental patients. Sixty children aged between 4-8 years were divided into three groups. Each child had four dental visits - screening visit, prophylaxis visit, cavity preparation and restoration visit, and extraction visit. Child′s anxiety level in each visit was assessed using a combination of four measures: Venham′s picture test, Venham′s rating of clinical anxiety, pulse rate, and oxygen saturation. The values obtained were tabulated and subjected to statistical analysis. It was concluded that audiovisual distraction technique was more effective in managing anxious pediatric dental patient as compared to audio distraction technique.

  8. Multi-modal distraction: insights from children's limited attention.

    Science.gov (United States)

    Matusz, Pawel J; Broadbent, Hannah; Ferrari, Jessica; Forrest, Benjamin; Merkley, Rebecca; Scerif, Gaia

    2015-03-01

    How does the multi-sensory nature of stimuli influence information processing? Cognitive systems with limited selective attention can elucidate these processes. Six-year-olds, 11-year-olds and 20-year-olds engaged in a visual search task that required them to detect a pre-defined coloured shape under conditions of low or high visual perceptual load. On each trial, a peripheral distractor that could be either compatible or incompatible with the current target colour was presented either visually, auditorily or audiovisually. Unlike unimodal distractors, audiovisual distractors elicited reliable compatibility effects across the two levels of load in adults and in the older children, but high visual load significantly reduced distraction for all children, especially the youngest participants. This study provides the first demonstration that multi-sensory distraction has powerful effects on selective attention: Adults and older children alike allocate attention to potentially relevant information across multiple senses. However, poorer attentional resources can, paradoxically, shield the youngest children from the deleterious effects of multi-sensory distraction. Furthermore, we highlight how developmental research can enrich the understanding of distinct mechanisms controlling adult selective attention in multi-sensory environments. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Visual attention in violent offenders: Susceptibility to distraction.

    Science.gov (United States)

    Slotboom, Jantine; Hoppenbrouwers, Sylco S; Bouman, Yvonne H A; In 't Hout, Willem; Sergiou, Carmen; van der Stigchel, Stefan; Theeuwes, Jan

    2017-05-01

    Impairments in executive functioning give rise to reduced control of behavior and impulses, and are therefore a risk factor for violence and criminal behavior. However, the contribution of specific underlying processes remains unclear. A crucial element of executive functioning, and essential for cognitive control and goal-directed behavior, is visual attention. To further elucidate the importance of attentional functioning in the general offender population, we employed an attentional capture task to measure visual attention. We expected offenders to have impaired visual attention, as revealed by increased attentional capture, compared to healthy controls. When comparing the performance of 62 offenders to 69 healthy community controls, we found our hypothesis to be partly confirmed. Offenders were more accurate overall, more accurate in the absence of distracting information, suggesting superior attention. In the presence of distracting information offenders were significantly less accurate compared to when no distracting information was present. Together, these findings indicate that violent offenders may have superior attention, yet worse control over attention. As such, violent offenders may have trouble adjusting to unexpected, irrelevant stimuli, which may relate to failures in self-regulation and inhibitory control. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  10. Examining drivers' eye glance patterns during distracted driving: Insights from scanning randomness and glance transition matrix.

    Science.gov (United States)

    Wang, Yuan; Bao, Shan; Du, Wenjun; Ye, Zhirui; Sayer, James R

    2017-12-01

    Visual attention to the driving environment is of great importance for road safety. Eye glance behavior has been used as an indicator of distracted driving. This study examined and quantified drivers' glance patterns and features during distracted driving. Data from an existing naturalistic driving study were used. Entropy rate was calculated and used to assess the randomness associated with drivers' scanning patterns. A glance-transition proportion matrix was defined to quantity visual search patterns transitioning among four main eye glance locations while driving (i.e., forward on-road, phone, mirrors and others). All measurements were calculated within a 5s time window under both cell phone and non-cell phone use conditions. Results of the glance data analyses showed different patterns between distracted and non-distracted driving, featured by a higher entropy rate value and highly biased attention transferring between forward and phone locations during distracted driving. Drivers in general had higher number of glance transitions, and their on-road glance duration was significantly shorter during distracted driving when compared to non-distracted driving. Results suggest that drivers have a higher scanning randomness/disorder level and shift their main attention from surrounding areas towards phone area when engaging in visual-manual tasks. Drivers' visual search patterns during visual-manual distraction with a high scanning randomness and a high proportion of eye glance transitions towards the location of the phone provide insight into driver distraction detection. This will help to inform the design of in-vehicle human-machine interface/systems. Copyright © 2017. Published by Elsevier Ltd.

  11. Treatment outcome and long-term stability of skeletal changes following maxillary distraction in adult subjects of cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Satinder Pal Singh

    2012-01-01

    Full Text Available Aim : To evaluate the treatment outcome and long-term stability of skeletal changes following maxillary advancement with distraction osteogenesis in adult subjects of cleft lip and palate. Materials and Methods: Total 12 North Indian adult patients in the age range of 17-34 years with cleft lip and palate underwent advancement of maxilla by distraction osteogenesis. Lateral cephalograms recorded prior to distraction, at the end of distraction, 6 months after distraction, and at least 24 months (mean 25.5 ± 1.94 months after distraction osteogenesis were used for the evaluation of treatment outcome and long-term stability of the skeletal changes. Descriptive analysis, ANOVA, and post-hoc test were used, and P-value 0.05 was considered as a statistically significant level. Results: Maxillary distraction resulted in significant advancement of maxilla (P<0.001. Counterclockwise rotation of the palatal plane took place after maxillary distraction. The position of the mandible and facial heights were stable during distraction. During the first 6 months of the post-distraction period, the maxilla showed relapse of approximately 30%. However, after 6 months post distraction, the relapse was very negligible. Conclusions: Successful advancement of maxilla was achieved by distraction osteogenesis in adult subjects with cleft lip and palate. Most of the relapse occurred during the first 6 months of post-distraction period, and after that the outcomes were stable.

  12. Happily distracted: mood and a benefit of attention dysregulation in older adults

    Directory of Open Access Journals (Sweden)

    Renée K. Biss

    2012-10-01

    Full Text Available Positive mood states are believed to broaden the focus of attention in younger adults, but it is unclear whether the same is true for older adults. Here we examined one consequence of broader attention that has been shown in young adults: that memory for distraction is greater for those in a positive mood. In the current study, positive and neutral moods were induced in older adults (mean age = 67.9 prior to a 1-back task in which participants were instructed to attend to relevant pictures and ignore distracting words. Following a 10-min filled interval, participants performed a word fragment completion task that tested implicit memory for the distracting words from the 1-back task. Older adults in the positive mood group showed greater implicit memory for previous distraction compared to those in the neutral mood group. These findings suggest that affect influences the ability to regulate attention in a similar manner for younger and older adults.

  13. The effectiveness of virtual reality distraction for pain reduction: a systematic review.

    Science.gov (United States)

    Malloy, Kevin M; Milling, Leonard S

    2010-12-01

    Virtual reality technology enables people to become immersed in a computer-simulated, three-dimensional environment. This article provides a comprehensive review of controlled research on the effectiveness of virtual reality (VR) distraction for reducing pain. To be included in the review, studies were required to use a between-subjects or mixed model design in which VR distraction was compared with a control condition or an alternative intervention in relieving pain. An exhaustive search identified 11 studies satisfying these criteria. VR distraction was shown to be effective for reducing experimental pain, as well as the discomfort associated with burn injury care. Studies of needle-related pain provided less consistent findings. Use of more sophisticated virtual reality technology capable of fully immersing the individual in a virtual environment was associated with greater relief. Overall, controlled research suggests that VR distraction may be a useful tool for clinicians who work with a variety of pain problems. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. Le carcinome neuro-endocrine cutané primitif: à propos d'un nouveau cas et revue de la littérature

    Science.gov (United States)

    Boukind, Samira; Elatiqi, Oumkeltoum; Dlimi, Meriem; Elamrani, Driss; Benchamkha, Yassine; Ettalbi, Saloua

    2015-01-01

    Le carcinome neuro- endocrine cutané primitif (CNEC) est une tumeur cutanée rare et agressive du sujet âgé, favorisée par le soleil et l'immunodépression. Elle est caractérisée par une évolution agressive avec un fort taux de récidive, une évolution ganglionnaire régionale et un risque de métastases à distance. Nous rapportons un cas de cette tumeur chez un patient âgé de 67 ans sous forme d'un placard nodulaire hémorragique mesurant 16 /14 cm. Le patient a bénéficié d'une exérèse chirurgicale large avec couverture de la perte de substance par un lambeau musculo-cutané du muscle grand dorsal, un curage ganglionnaire axillaire et une radiothérapie adjuvante. Après un recul de 2 ans et 2 mois, le patient est toujours vivant sans métastase ni récidive. La littérature étant pauvre, la prise en charge diagnostique et thérapeutique est controversée et donc hétérogène. Globalement le pronostic est mauvais, et certains paramètres corrélés au pronostic sont précisés. PMID:26185585

  15. Experiential exposure to texting and walking in virtual reality: A randomized trial to reduce distracted pedestrian behavior.

    Science.gov (United States)

    Schwebel, David C; McClure, Leslie A; Porter, Bryan E

    2017-05-01

    Distracted pedestrian behavior is a significant public health concern, as research suggests distracted pedestrians have significantly higher risk of injury compared to fully attentive pedestrians. Despite this, efforts to reduce distracted pedestrian behavior are scant. Using a repeated measures experimental research design, we implemented a behavioral intervention to reduce distracted pedestrian behavior in the high-risk environment of an urban college campus and simultaneously monitored behavior on a control urban college campus not exposed to the intervention. We had two primary aims: reduce perceived vulnerability to injury among individual pedestrians and reduce distracted pedestrian behavior in the environment through a change in community-based norms. The hallmark of the behavioral intervention was a week-long opportunity for community members to experience personally the risks of distracted pedestrian behavior by attempting to cross a virtual pedestrian environment street while text-messaging. This was supplemented by traditional and social marketing and publicity through various campus partners. A sample of 219 individuals completed self-report surveys about perceived vulnerability to distracted pedestrian injury before experiencing the distracted virtual street-crossing and again after 2 weeks and 5 months. Observational assessment of distracted pedestrian behavior was conducted at a busy intersection on the campus as well as at a control campus not exposed to the intervention at baseline, post-intervention, 10 weeks, and 6 months. The intervention achieved mixed results. Individuals exposed to texting within a simulated pedestrian environment reported changes in their intentions to cross streets while distracted and in perceived vulnerability to risk while crossing streets, but we did not witness evidence of changed community norms based on observed rates of distracted pedestrian behavior before and after the intervention compared to a control campus not

  16. En fascinerende fortælling om det 20. århundredes musik

    DEFF Research Database (Denmark)

    Bonde, Lars Ole

    2011-01-01

    Anmeldelse af Karl Aage Rasmussen: Musik i det tyvende århundrede: En fortælling. Gyldendal 2011.......Anmeldelse af Karl Aage Rasmussen: Musik i det tyvende århundrede: En fortælling. Gyldendal 2011....

  17. Analysis of Delayed Sea Breeze Onset for Fort Ord Prescribed Burning Operations

    Science.gov (United States)

    2015-12-01

    DELAYED SEA BREEZE ONSET FOR FORT ORD PRESCRIBED BURNING OPERATIONS by Dustin D. Hocking December 2015 Thesis Advisor: Wendell Nuss Second...AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE ANALYSIS OF DELAYED SEA BREEZE ONSET FOR FORT ORD PRESCRIBED BURNING OPERATIONS 5...release; distribution is unlimited 12b. DISTRIBUTION CODE 13. ABSTRACT (maximum 200 words) The U.S. Army conducts prescribed burns at Fort Ord

  18. Technical Modifications of Tooth-borne Distraction Device for Anterior Maxillary Distraction in Cleft Patients

    Directory of Open Access Journals (Sweden)

    Dhivakar Selvaraj

    2014-01-01

    Full Text Available The tooth-borne distractor gained popularity for anterior maxillary distraction because of the effective treatment outcome, no need for external fixation, noninvasive, less chewing difficulty, social tolerance and economical. Tooth-borne distractor device needs modification in terms of maxillary deficiency, tooth position, retained deciduous tooth, and fistula. Hence, we recommend the following modifications in certain circumstances for the successful treatment outcome.

  19. The efficacy of attentional distraction and sensory monitoring in chronic pain patients: A meta-analysis.

    Science.gov (United States)

    Van Ryckeghem, Dimitri Ml; Van Damme, Stefaan; Eccleston, Christopher; Crombez, Geert

    2018-02-01

    Attentional strategies, such as distraction and sensory monitoring, are often offered to reduce pain and pain-related distress. However, evidence for their efficacy in chronic pain patients is equivocal. We report a meta-analysis on the efficacy of distraction and sensory monitoring in chronic pain patients, and explore possible methodological and theoretical moderators. The scientific literature was searched for relevant articles, which were coded for methodological quality and several theoretical and methodological moderator variables. Only 10 articles fulfilled the search criteria. Eight studies allowed us to compare distraction with a control condition, two studies to compare sensory monitoring with a control condition, and four studies to compare the effect of distraction with the effect of sensory monitoring. Overall, results indicate that distraction did not differ from control in altering pain experience (k=8; Hedges' g=0.10, ns) and distress (k=2; Hedges' g=0.549). Sensory monitoring did also not alter pain experience (k=2; Hedges' g=-0.21, ns) and distress (k=1; Hedges' g=-0.191, ns). We found no evidence to support the superiority of distraction or sensory monitoring in altering pain compared to control conditions. We offer guidance for future theory-driven research to investigate distraction and sensory monitoring in this largely unexplored field, albeit one replete with methodological difficulties. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Brain activation for response inhibition under gaming cue distraction in internet gaming disorder

    Directory of Open Access Journals (Sweden)

    Gin-Chung Liu

    2014-01-01

    Full Text Available We evaluated neural substrates related to the loss of control in college students with internet gaming disorder (IGD. We hypothesized that deficit in response inhibition under gaming cue distraction was the possible mechanism for the loss of control internet use. Eleven cases of IGD and 11 controls performed Go/NoGo tasks with/without gaming distraction in the functional magnetic resonance imaging scanner. When the gaming picture was shown as background while individuals were performing Go/NoGo tasks, the IGD group committed more commission errors. The control group increased their brain activations more over the right dorsolateral prefrontal cortex (DLPFC and superior parietal lobe under gaming cue distraction in comparison with the IGD group. Furthermore, brain activation of the right DLPFC and superior parietal lobe were negatively associated with performance of response inhibition among the IGD group. The results suggest that the function of response inhibition was impaired under gaming distraction among the IGD group, and individuals with IGD could not activate right DLPFC and superior parietal lobe to keep cognitive control and attention allocation for response inhibition under gaming cue distraction. This mechanism should be addressed in any intervention for IGD.

  1. Fort Peck-Wolf Point transmission line project, Montana

    International Nuclear Information System (INIS)

    1992-01-01

    The primary objective of the project is to replace the existing 36-mile Fort Peck-Wolf Point transmission line which has reached the end of its useful service life. Presently, the overall condition of this existing section of the 47-year-old line is poor. Frequent repairs have been required because of the absence of overhead ground wires. The continued maintenance of the line will become more expensive and customer interruptions will persist because of the damage due to lightning. The expense of replacing shell rotted poles, and the concern for the safety of the maintenance personnel because of hazards caused by severe shell rot are also of primary importance. The operational and maintenance problems coupled with power system simulation studies, demonstrate the need for improvements to the Wolf Point area to serve area loads. Western's Wolf Point Substation is an important point of interconnection for the power output from the Fort Peck Dam to area loads as far away as Williston, North Dakota. The proposed transmission line replacement would assure that there will continue to be reliable transmission capacity available to serve area electrical loads, as well as provide a reliable second high-voltage transmission path from the Fort Peck generation to back-up a loss of the Fort Peck-Wolf Point 115-kV Line No. 1

  2. SPIDER: A Framework for Understanding Driver Distraction.

    Science.gov (United States)

    Strayer, David L; Fisher, Donald L

    2016-02-01

    The objective was to identify key cognitive processes that are impaired when drivers divert attention from driving. Driver distraction is increasingly recognized as a significant source of injuries and fatalities on the roadway. A "SPIDER" model is developed that identifies key cognitive processes that are impaired when drivers divert attention from driving. SPIDER is an acronym standing for scanning, predicting, identifying, decision making, and executing a response. When drivers engage in secondary activities unrelated to the task of driving, SPIDER-related processes are impaired, situation awareness is degraded, and the ability to safely operate a motor vehicle may be compromised. The pattern of interference helps to illuminate the sources of driver distraction and may help guide the integration of new technology into the automobile. © 2015, Human Factors and Ergonomics Society.

  3. Changes in Maxillary Canine Pulpal Blood Flow During Dentoalveolar Distraction Osteogenesis.

    Science.gov (United States)

    Ersahan, Seyda; Sabuncuoglu, Fidan Alakus

    2016-05-01

    The aim of this study was to assess the effects of dentoalveolar distraction osteogenesis (DD) on the pulpal blood flow (PBF) of maxillary canines. A laser Doppler flowmeter (LDF) was used to measure PBF in maxillary canines of 10 patients undergoing DD (study group) and 10 nonsurgical subjects who received no orthodontic treatment (control group). PBF was measured at baseline, at 4 and 7 days postoperatively, at the end of distraction and at the end of consolidation in the study group and at similar time-points in nonsurgical control subjects. Data were analyzed using paired and Student t tests, with the significance level set at 0.05. Study findings showed that baseline PBF values did not differ significantly between groups. PBF in the control group did not vary over time; however, in the study group, an initial decrease in PBF was observed at 4 days postoperatively and was followed by a gradual increase to preoperative levels at the end of distraction. During the DD latency period, there appears to be a short-lived ischemic phase when perfusion of pulp tissue declines; however, blood-flow returns to normal by the end of distraction.

  4. Breakage of internal maxillary distractor: considerable complication of maxillary distraction osteogenesis.

    Science.gov (United States)

    Aikawa, Tomonao; Iida, Seiji; Isomura, Emiko T; Namikawa, Mari; Matsuoka, Yudai; Yamada, Chiaki; Yamamoto, Taku; Takigawa, Yoko

    2008-07-01

    Maxillary distraction osteogenesis using intraoral distractors is now one of the standard treatments of maxillary retrusion. This report shows 2 cases of breakage of this internal maxillary distractor in patients with cleft lip and palate; one was observed during the distraction period and the other was during the retention period. The first case required a rotational movement of the distraction segment, and this movement caused the laterally dislocation of the posterior part of the distractor, where the distractor suffered some mechanical forces by mouth opening. In the latter case, breakage of distractor was observed on the radiographs taken 3 months after distraction and this complication may have been caused by mechanical force by occlusion and mastication. Both breakages were found at the joint of the anchorage plate and the extension rod, which has some flexibility for adjusting the plate to the bone surface. Therefore, surgeons should pay special attention for this mechanical weak area in this distractor not only during the advancement period, but also during the retention period and should avoid unnecessary frequent bending for adopting the bone surface, which directly weakens the joint.

  5. The influence of various distracting stimuli on spatial working memory

    Directory of Open Access Journals (Sweden)

    Martina Starc

    2016-01-01

    Full Text Available Protecting information from distraction is essential for optimal performance of working memory. We examined how the presence of distracting stimuli influences spatial working memory and compared the effect of both task-similar and negatively emotionally salient distractors. We checked the effect of distractors on the accuracy of high-resolution representations, as well as the maintenance of spatial categories, and more precisely defined not only the existence but also the direction of the distracting influences (towards or away from the position of the distractor. Participants (n = 25, 8 men, 19–31 years old were asked to remember the exact position of a target scrambled image and recall it with a joystick after a delay. In some trials an additional distracting image (scrambled, neutral or negative was shown during the delay. We measured the spread of responses (standard deviation of angular error and shifts of the average response towards the prototype angles (45° or towards the position of distractors. Distracting stimuli did not affect the spread of responses and decreased the tendency of participants to move the responses towards the prototype angle. Different types of distractors did not differ in this effect. Contrary to expectations, the participants moved their responses away from the position of distractors; this effect was more pronounced for negative distractors. In addition to memorizing the exact position and maintaining attention on the position of the stimulus, participants are likely to strategically use information about spatial category membership (quadrants and information about the position of the distractor. The repulsive effect of the distractor likely results from inhibition of its position and indicates the need to supplement computational models of spatial working memory and to take into account different strategies of working memory use.

  6. [3D mandibular distraction planification in a case of severe temporomandibular ankylosis].

    Science.gov (United States)

    Weber, E; Meyer, C; Ernoult, C; Chatelain, B; Benassarou, M

    2015-06-01

    When occurring in childhood, temporomandibular ankylosis joint is responsible for complex maxillofacial deformities, including mandibular growth deficiency. We present a case of temporomandibular joint ankylosis associated with severe mandibular asymmetry treated by mandibular bone distraction performed under computer assistance. A 27-year-old patient presented with a severe facial asymmetry consisting in hypoplasia of the left hemi-mandible and maxilla. Mouth opening was non-existent. The CT-scan showed a left temporomandibular ankylosis. A left mandibular distraction was decided. The distraction characteristics (choice and positioning of the distractor, axis and amount of distraction) were determined preoperatively on the 3D CT-scan. The planning has been transferred to a navigation console (Kolibri®, Brainlab®). A combined intraoral and cutaneous was performed. Navigation allowed for an appropriate placement of the osteotomy line and fixation of the distractor. Distraction was started at the 5th postoperative day at the rate of 1mm per day and lasted 25 days without complication. 3D planning allows for better indication setting, better preparation of the procedure, reducing complications and operative time. It may help as an educational tool for young surgeons and for a better understanding from the patient. Navigation is an accurate method for the transfer of the planning in the operation room. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. Targeting Net Zero Energy at Fort Carson: Assessment and Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, K.; Markel, T.; Simpson, M.; Leahey, J.; Rockenbaugh, C.; Lisell, L.; Burman, K.; Singer, M.

    2011-10-01

    The U.S. Army's Fort Carson installation was selected to serve as a prototype for net zero energy assessment and planning. NREL performed the comprehensive assessment to appraise the potential of Fort Carson to achieve net zero energy status through energy efficiency, renewable energy, and electric vehicle integration. This report summarizes the results of the assessment and provides energy recommendations. This study is part of a larger cross-laboratory effort that also includes an assessment of renewable opportunities at seven other DoD Front Range installations, a microgrid design for Fort Carson critical loads and an assessment of regulatory and market-based barriers to a regional secure smart grid.

  8. Morphological anomalies in two Lutzomyia (Psathyromyia) shannoni (Diptera: Psychodidae: Phlebotominae) specimens collected from Fort Rucker, Alabama, and Fort Campbell, Kentucky.

    Science.gov (United States)

    Florin, David A; Lawyer, Phillip; Rowton, Edgar; Schultz, George; Wilkerson, Richard; Davies, Stephen J; Lipnick, Robert; Keep, Lisa

    2010-09-01

    This report describes two male specimens of the sand fly species Lutzomyia shannoni (Dyar) (Diptera: Psychodidae: Phlebotominae) collected at Fort Rucker, AL, and Fort Campbell, KY, in dry ice-baited light traps during September 2005. The specimens were observed to have anomalies to the number of spines on the gonostyli. The taxonomic keys of Young and Perkins (Mosq. News 44: 263-285; 1984) use the number of spines on the gonostylus in the first couplet to differentiate two major groupings of North American sand flies. The two anomalous specimens were identified as L. shannoni based on the following criteria: (1) both specimens possess antennal ascoids with long, distinct proximal spurs (a near diagnostic character of L. shannoni in North America), (2) the sequences of the partial cytochrome c oxidase subunit 1 gene from both specimens indicated L. shannoni, and (3) the sequences of the internal transcribed spacer 2 molecular marker from both specimens indicated L. shannoni. The anomalous features are fundamentally different from each other as the Fort Rucker specimen possesses a fifth spine (basally located) on just one gonostylus, whereas the Fort Campbell specimen possesses five spines (extra spines subterminally located) on both gonostyli. Because the gonostyli are part of the external male genitalia, anomalies in the number of spines on the gonostyli may have serious biological consequences, such as reduced reproductive success, for the possessors. These anomalies are of taxonomic interest as the specimens could easily have been misidentified using available morphological keys.

  9. Bone Regeneration Is Promoted by Orally Administered Bovine Lactoferrin in a Rabbit Tibial Distraction Osteogenesis Model.

    Science.gov (United States)

    Li, Wenyang; Zhu, Songsong; Hu, Jing

    2015-07-01

    Lactoferrin, an iron-binding glycoprotein which belongs to the transferrin family, has been shown to promote bone growth. However, reports regarding effects of lactoferrin on bone regeneration during distraction osteogenesis are limited. Our study was designed to investigate the effect of bovine lactoferrin treatment on bone formation of the distracted callus. We asked whether bovine lactoferrin enhances bone formation of the distraction callus as determined by (1) radiographic and histologic appearances; (2) dual-energy x-ray absorptiometry (DXA) analysis of bone mineral composition and bone mineral density; (3) micro-CT measures of trabecular architecture; and (4) biomechanical strength of the healing bone. Additionally, serology, reverse transcription (RT)-PCR, and immunohistochemistry were used to explore the possible mechanisms of bovine lactoferrin use on bone formation during distraction osteogenesis. Unilateral tibial osteodistraction was performed on 80 New Zealand White rabbits with a distraction rate of 1 mm per day for 10 days. Animals then were divided randomly into two groups: (1) vehicle and (2) bovine lactoferrin. At 4 and 8 weeks after completion of distraction, the animals were sacrificed. Lengthened tibias and serum samples were obtained and subjected to radiologic, DXA, micro-CT, histologic, and biomechanical examinations, and serum, RT-PCR and immunohistochemical analyses. Radiologic, DXA, micro-CT, histologic, and biomechanical examinations indicated that bovine lactoferrin treatment not only accelerated bone formation at early stages of distraction osteogenesis but also promoted bone consolidation at late stages. The ultimate force of the distracted calluses was increased by 37% (118.8 ± 6.65 N in the lactoferrin group and 86.5 ± 5.47 N in the vehicle group; p bovine lactoferrin treatment significantly increased serum levels of bone alkaline phosphatase and decreased serum levels of tartrate resistant acid phosphatase 5b. In addition, RT

  10. 76 FR 68625 - Establishment of the Fort Monroe National Monument

    Science.gov (United States)

    2011-11-07

    ... period of slavery in the colonies and, later, this Nation. Two hundred and forty-two years later, Fort... 1863. Thus, Old Point Comfort marks both the beginning and end of slavery in our Nation. The Fort... North Beach area lies the only undeveloped shoreline remaining on Old Point Comfort, providing modern...

  11. Texting while driving: A study of 1211 U.S. adults with the Distracted Driving Survey

    Directory of Open Access Journals (Sweden)

    Emily Gliklich

    2016-12-01

    Full Text Available Texting and other cell-phone related distracted driving is estimated to account for thousands of motor vehicle collisions each year but studies examining the specific cell phone reading and writing activities of drivers are limited. The objective of this study was to describe the frequency of cell-phone related distracted driving behaviors. A national, representative, anonymous panel of 1211 United States drivers was recruited in 2015 to complete the Distracted Driving Survey (DDS, an 11-item validated questionnaire examining cell phone reading and writing activities and at what speeds they occur. Higher DDS scores reflect more distraction. DDS scores were analyzed by demographic data and self-reported crash rate. Nearly 60% of respondents reported a cell phone reading or writing activity within the prior 30 days, with reading texts (48%, writing texts (33% and viewing maps (43% most frequently reported. Only 4.9% of respondents had enrolled in a program aimed at reducing cell phone related distracted driving. DDS scores were significantly correlated to crash rate (p < 0.0001, with every one point increase associated with an additional 7% risk of a crash (p < 0.0001. DDS scores were inversely correlated to age (p < 0.0001. The DDS demonstrated high internal consistency (Cronbach's alpha = 0.94. High rates of cell phone-related distraction are reported here in a national sample. Distraction is associated with crash rates and occurs across all age groups, but is highest in younger drivers. The DDS can be used to evaluate the impact of public health programs aimed at reducing cell-phone related distracted driving.

  12. SITUATIONS ET TENDANCES Les agricultures familiales africaines face à la mondialisation : le défi d‘une autre transition

    Directory of Open Access Journals (Sweden)

    Bosc Pierre-Marie

    2002-11-01

    Full Text Available L’agriculture africaine fait face à une situation inédite liée au processus de mondialisation, mais aussi à la forte croissance relative de sa population agricole durant le dernier quart du xxe siècle, contrairement à d’autres continents (ou pays continents. Paradoxalement, alors que l’Afrique se trouve marginalisée dans les échanges commerciaux, sur lesquels se focalise le débat international en matière agricole, l’agriculture africaine et le développement rural restent des domaines stratégiques pour les politiques publiques qui doivent prendre en compte la configuration démographique et économique spécifique du continent. La question du type d’agriculture qui accompagnera la nécessaire transition économique et agricole africaine est en débat. Alors que certains opérateurs et décideurs soutiennent le développement d’une agriculture d’entreprise, les organisations paysannes font massivement le choix de défendre l’agriculture familiale comme axe privilégié de développement, car elle fournit emplois et revenus pour le plus grand nombre. Cependant, les organisations doivent faire face à un rapport de force inégal avec les autres acteurs privés issus du processus de libération. Renforcer leurs capacités de proposition et de négociation apparaît dès lors comme une condition permettant d’envisager une refondation des politiques publiques sur la base d’une réelle contribution des ruraux.

  13. Identification of real-time diagnostic measures of visual distraction with an automatic eye-tracking system.

    Science.gov (United States)

    Zhang, Harry; Smith, Matthew R H; Witt, Gerald J

    2006-01-01

    This study was conducted to identify eye glance measures that are diagnostic of visual distraction. Visual distraction degrades performance, but real-time diagnostic measures have not been identified. In a driving simulator, 14 participants responded to a lead vehicle braking at -2 or -2.7 m/s2 periodically while reading a varying number of words (6-15 words every 13 s) on peripheral displays (with diagonal eccentricities of 24 degrees, 43 degrees, and 75 degrees). As the number of words and display eccentricity increased, total glance duration and reaction time increased and driving performance suffered. Correlation coefficients between several glance measures and reaction time or performance variables were reliably high, indicating that these glance measures are diagnostic of visual distraction. It is predicted that for every 25% increase in total glance duration, reaction time is increased by 0.39 s and standard deviation of lane position is increased by 0.06 m. Potential applications of this research include assessing visual distraction in real time, delivering advisories to distracted drivers to reorient their attention to driving, and using distraction information to adapt forward collision and lane departure warning systems to enhance system effectiveness.

  14. Rapport sur le développement dans le monde sur le thème du rôle ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... rural et sont tributaires principalement de l'agriculture pour assurer leur subsistance. Ce projet permettra de veiller à ce qu'une place soit accordée aux travaux de recherche financés par le CRDI, aux points de vue différents et aux auteurs de l'hémisphère Sud dans le Rapport sur le développement dans le monde 2008.

  15. Inventory of Forts in Indonesia

    Science.gov (United States)

    Rinandi, N.; Suryaningsih, F.

    2015-08-01

    The great archipelago in Indonesia with its wealthy and various nature, the products and commodities of tropic agriculture and the rich soil, was through the centuries a region of interest for other countries all over the world. For several reasons some of these countries came to Indonesia to establish their existence and tried to monopolize the trading. These countries such as the Portuguese, the Spanish, the Dutch and the British built strengthened trade stations which later became forts all over Indonesia to defend their interest. The archipelago of Indonesia possesses a great number of fortification-works as legacies of native rulers and those which were built by European trading companies and later became colonial powers in the 16th to the 19th centuries. These legacies include those specific structures built as a defence system during pre and within the period of World War II. These fortresses are nowadaysvaluable subjects, because they might be considered as shared heritage among these countries and Indonesia. It's important to develop a vision to preserve these particular subjects of heritage, because they are an interesting part of the Indonesian history and its cultural treasures. The Government of the Republic of Indonesia has national program to compile a comprehensive documentation of the existing condition of these various types of forts as cultural heritage. The result of the 3 years project was a comprehensive 442 forts database in Indonesia, which will be very valuable to the implementation of legal protection, preservation matters and adaptive re-use in the future.

  16. [Multimodal distraction to relieve pain in children undergoing acute medical procedures].

    Science.gov (United States)

    Miller, Kate; Rodger, Sylvia; Bucolo, Sam; Wang, Xue-Qing; Kimble, Roy M

    2009-10-01

    Non-pharmacological approaches to pain management have been used by therapists for decades to reduce the anxiety and pain experienced by children during burn care procedures. With a greater understanding of pain and the principles behind what causes a child to be distracted, combined with access to state of the art technology, we have developed an easy to use, hand held multimodal distraction device (MMD). MMD is an interactive device that prepares the child for a procedure and uses developmentally appropriate distraction stories and games during the procedures to alleviate anxiety and pain. This paper summarizes the results of three randomized control trials. The trials aimed to understand the effectiveness of MMD as a distraction and preparation tool in reducing anxiety and pain in children undergoing burns and non-burns medical procedures compared to pure pharmacological approaches Standard Distraction (SD) and off the shelf video games (VG). Three separate prospective randomized control trials involving 182 children having 354 dressing changes were conducted in the burns and orthopedic departments at Royal Children's Hospital, Brisbane, Australia, to address the above aims. Pain and anxiety scores were completed for the child, caregiver and nursing staff according to the Modified Faces, Legs, Activity, Cry and Consolability Scale, Faces Pain Scale-Revised, Visual Analogue Scale and Wong-Baker Faces Pain Rating Scale. Procedural length was recorded. MMD as a preparation and distraction tool were shown to have a significant impact on child, parent and nursing staff reported anxiety and pain during procedures compared to standard care and video games (P positive effect on clinical time and was shown to sustain its impact on pain and time with further dressing changes. MMD is more effective in reducing the pain and anxiety experienced by children in acute medical procedures as compared with SD and VG. MMD is continuing to be trialed and is continuing to show

  17. Systematic Review and Meta-Analysis of Distraction and Hypnosis for Needle-Related Pain and Distress in Children and Adolescents

    Science.gov (United States)

    Noel, Melanie; Parker, Jennifer A.; Chambers, Christine T.; Uman, Lindsay S.; Kisely, Steve R.; McGrath, Patrick J.

    2014-01-01

    Objective To systematically review the evidence (and quality) for distraction and hypnosis for needle-related pain and distress in children and adolescents. To explore the effects of distraction characteristics (e.g., adult involvement, type of distracter), child age, and study risk of bias on treatment efficacy. Methods 26 distraction and 7 hypnosis trials were included and self-report, observer-report, and behavioral pain intensity and distress examined. Distraction studies were coded for 4 intervention characteristics, and all studies coded for child age and study risk of bias. Results Findings showed strong support for distraction and hypnosis for reducing pain and distress from needle procedures. The quality of available evidence was low, however. Characteristics of distraction interventions, child age, and study risk of bias showed some influence on treatment efficacy. Conclusions Distraction and hypnosis are efficacious in reducing needle-related pain and distress in children. The quality of trials in this area needs to be improved. PMID:24891439

  18. Reward, Distraction, and the Overjustification Effect

    Science.gov (United States)

    Smith, Timothy W.; Pittman, Thane S.

    1978-01-01

    This study tests two differing hypotheses: the competing response hypothesis, which states that both reward and non-reward distractions produce decreases in interest which weaken over repeated trials, and the attribution/overjustification hypothesis, which maintains that rewards produce a decrease in interest that does not weaken over trials.…

  19. Validation of a Perceptual Distraction Model in a Complex Personal Sound Zone System

    DEFF Research Database (Denmark)

    Rämö, Jussi; Marsh, Steven; Bech, Søren

    2016-01-01

    This paper evaluates a previously proposed perceptual model predicting user’s perceived distraction caused by interfering audio programmes. The distraction model was originally trained using a simple sound reproduction system for music-on-music interference situations and it has not been formally...

  20. Le prime sensazioni al pianoforte restano per sempre? Indagine sui metodi pianistici per principianti

    Directory of Open Access Journals (Sweden)

    Giuseppe Sellari

    2015-12-01

    Full Text Available I metodi d’insegnamento del pianoforte utilizzati in Italia sono caratterizzati da percorsi basati su differenti ipotesi teoriche e indicazioni pratiche. Il primo libro di pianoforte, qualunque sia il suo valore, stabilisce il primo contatto con lo strumento, lasciando una forte impressione e tracciando il profilo delle competenze inizialmente sviluppate. Una più profonda comprensione di questi testi può mostrare quali sono le capacità e le strategie di apprendimento proposte dai metodi adottati e conseguentemente dagli insegnanti. L'obiettivo di questo studio è quello di identificare quali sono le scelte metodologiche più rappresentative nella didattica pianistica italiana degli ultimi 50 anni. I risultati sono basati sui dati raccolti dai questionari somministrati a 200 pianisti, di età compresa tra 20 e 60, ai quali è stato chiesto, insieme a informazioni generiche, quale fosse stato il loro primo libro pianoforte, quali aspetti positivi o negativi ricordavano maggiormente e quali ritenevano essere più utili. I dati suggeriscono una preferenza rilevante di cinque metodi, che sono stati analizzati secondo una serie di criteri metodologici e analitici. I risultati indicano un panorama metodologico concentrato principalmente sul rapporto iniziale con lo strumento e sulla lettura musicale. Questo studio contribuisce alla riflessione su due aspetti metodologici: lo sviluppo di nuovi repertori e la proposta di metodologie in grado di rispettare il mondo emotivo e cognitivo dei principianti.

  1. Creating the environment for driver distraction: A thematic framework of sociotechnical factors.

    Science.gov (United States)

    Parnell, Katie J; Stanton, Neville A; Plant, Katherine L

    2018-04-01

    As modern society becomes more reliant on technology, its use within the vehicle is becoming a concern for road safety due to both portable and built-in devices offering sources of distraction. While the effects of distracting technologies are well documented, little is known about the causal factors that lead to the drivers' engagement with technological devices. The relevance of the sociotechnical system within which the behaviour occurs requires further research. This paper presents two experiments, the first aims to assess the drivers self-reported decision to engage with technological tasks while driving and their reasoning for doing so with respect to the wider sociotechnical system. This utilised a semi-structured interview method, conducted with 30 drivers to initiate a discussion on their likelihood of engaging with 22 different tasks across 7 different road types. Inductive thematic analysis provided a hierarchical thematic framework that detailed the self-reported causal factors that influence the drivers' use of technology whilst driving. The second experiment assessed the relevance of the hierarchical framework to a model of distraction that was established from within the literature on the drivers use of distracting technologies while driving. The findings provide validation for some relationships studied in the literature, as well as providing insights into relationships that require further study. The role of the sociotechnical system in the engagement of distractions while driving is highlighted, with the causal factors reported by drivers suggesting the importance of considering the wider system within which the behaviour is occurring and how it may be creating the conditions for distraction to occur. This supports previous claims made within the literature based model. Recommendations are proposed that encourage a movement away from individual focused countermeasures towards systemic actors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Multi-modal distraction. Using technology to combat pain in young children with burn injuries.

    Science.gov (United States)

    Miller, Kate; Rodger, Sylvia; Bucolo, Sam; Greer, Ristan; Kimble, Roy M

    2010-08-01

    The use of non-pharmacological pain management remains adhoc within acute paediatric burns pain management protocols despite ongoing acknowledgement of its role. Advancements in adult based pain services including the integration of virtual reality has been adapted to meet the needs of children in pain, as exemplified by the development of multi-modal distraction (MMD). This easy to use, hand held interactive device uses customized programs designed to inform the child about the procedure he/she is about to experience and to distract the child during dressing changes. (1) To investigate if either MMD procedural preparation (MMD-PP) or distraction (MMD-D) has a greater impact on child pain reduction compared to standard distraction (SD) or hand held video game distraction (VG), (2) to understand the impact of MMD-PP and MMD-D on clinic efficiency by measuring length of treatment across groups, and lastly, (3) to assess the efficacy of distraction techniques over three dressing change procedures. A prospective randomised control trial was completed in a paediatric tertiary hospital Burns Outpatient Clinic. Eighty participants were recruited and studied over their first three dressing changes. Pain was assessed using validated child report, caregiver report, nursing observation and physiological measures. MMD-D and MMD-PP were both shown to significantly relieve reported pain (ppositive effects of both MMD-D and MMD-PP were sustained with subsequent dressing changes. The use of MMD as a preparatory or a distraction tool in an outpatient burns clinic offered superior pain reduction across three dressing changes to children when compared to standard practices or hand held video games. This device has the potential to improve clinic efficiency with reductions in treatment lengths.

  3. Distracted pedestrian sustains orbital fracture while on cell phone.

    Science.gov (United States)

    Edell, Aimée R; Jung, Jesse J; Solomon, Joel M; Palu, Richard N

    2013-01-01

    Use of cell phones in the general population has become increasingly commonplace. The distracting effects of cell phones among automobile drivers are well established, and legislation prohibits the use of handheld cell phones while driving in several states. Recent research has focused on the similar distracting effects of cell phones in the pedestrian population. In this report, an older gentleman suffered extensive facial trauma requiring surgery as a direct effect of cell phone use at the time the trauma occurred. This case highlights the role that portable electronic devices can play as a cause of ocular trauma.

  4. The impact of anxiety-inducing distraction on cognitive performance: a combined brain imaging and personality investigation.

    Directory of Open Access Journals (Sweden)

    Ekaterina Denkova

    Full Text Available BACKGROUND: Previous investigations revealed that the impact of task-irrelevant emotional distraction on ongoing goal-oriented cognitive processing is linked to opposite patterns of activation in emotional and perceptual vs. cognitive control/executive brain regions. However, little is known about the role of individual variations in these responses. The present study investigated the effect of trait anxiety on the neural responses mediating the impact of transient anxiety-inducing task-irrelevant distraction on cognitive performance, and on the neural correlates of coping with such distraction. We investigated whether activity in the brain regions sensitive to emotional distraction would show dissociable patterns of co-variation with measures indexing individual variations in trait anxiety and cognitive performance. METHODOLOGY/PRINCIPAL FINDINGS: Event-related fMRI data, recorded while healthy female participants performed a delayed-response working memory (WM task with distraction, were investigated in conjunction with behavioural measures that assessed individual variations in both trait anxiety and WM performance. Consistent with increased sensitivity to emotional cues in high anxiety, specific perceptual areas (fusiform gyrus--FG exhibited increased activity that was positively correlated with trait anxiety and negatively correlated with WM performance, whereas specific executive regions (right lateral prefrontal cortex--PFC exhibited decreased activity that was negatively correlated with trait anxiety. The study also identified a role of the medial and left lateral PFC in coping with distraction, as opposed to reflecting a detrimental impact of emotional distraction. CONCLUSIONS: These findings provide initial evidence concerning the neural mechanisms sensitive to individual variations in trait anxiety and WM performance, which dissociate the detrimental impact of emotion distraction and the engagement of mechanisms to cope with

  5. Reconstruction of a Post Traumatic Anterior Maxillary Defect by Transport Distraction Osteogenesis.

    Science.gov (United States)

    Rajkumar, K; Neelakandan, R S; Devadoss, Pradeep; Bandyopadhyay, T K

    2017-03-01

    Rehabilitation of segmental defects of maxilla presents a reconstructive challenge to obtain an ideal osseous form and height with adequate soft tissue investment. Though variety of prosthetic and surgical reconstructive options like the use of vascularized and non vascularized bone grafts are available they produce less than optimal results. Bone transport distraction is a reliable procedure in various maxillofacial bony defect reconstruction techniques. We describe herein a technique of maxillary bone transport distraction using an indigenously designed, custom made trifocal transport distractor performed in a post traumatic avulsive defect of the anterior maxilla. Transport distraction was successful for anterior maxillary alveolar bony regeneration, with excellent soft tissue cover and vestibular depth, which also helped close an oroantral/oronasal fistula.

  6. Investigating Deviance Distraction and the Impact of the Modality of the To-Be-Ignored Stimuli.

    Science.gov (United States)

    Marsja, Erik; Neely, Gregory; Ljungberg, Jessica K

    2018-03-01

    It has been suggested that deviance distraction is caused by unexpected sensory events in the to-be-ignored stimuli violating the cognitive system's predictions of incoming stimuli. The majority of research has used methods where the to-be-ignored expected (standards) and the unexpected (deviants) stimuli are presented within the same modality. Less is known about the behavioral impact of deviance distraction when the to-be-ignored stimuli are presented in different modalities (e.g., standard and deviants presented in different modalities). In three experiments using cross-modal oddball tasks with mixed-modality to-be-ignored stimuli, we examined the distractive role of unexpected auditory deviants presented in a continuous stream of expected standard vibrations. The results showed that deviance distraction seems to be dependent upon the to-be-ignored stimuli being presented within the same modality, and that the simplest omission of something expected; in this case, a standard vibration may be enough to capture attention and distract performance.

  7. Students distracted by electronic devices perform at the same level as those who are focused on the lecture

    Directory of Open Access Journals (Sweden)

    Romesh P. Nalliah

    2014-09-01

    Full Text Available Background. Little is known about the characteristics of internet distractions that students may engage in during lecture. The objective of this pilot study is to identify some of the internet-based distractions students engage in during in-person lectures. The findings will help identify what activities most commonly cause students to be distracted from the lecture and if these activities impact student learning.Methods. This study is a quasi-experimental pilot study of 26 students from a single institution. In the current study, one class of third-year students were surveyed after a lecture on special needs dentistry. The survey identified self-reported utilization patterns of “smart” devices during the lecture. Additionally, twelve quiz-type questions were given to assess the students’ recall of important points in the lecture material that had just been covered.Results. The sample was comprised of 26 students. Of these, 17 were distracted in some form (either checking email, sending email, checking Facebook, or sending texts. The overall mean score on the test was 9.85 (9.53 for distracted students and 10.44 for non-distracted students. There were no significant differences in test scores between distracted and non-distracted students (p = 0.652. Gender and types of distractions were not significantly associated with test scores (p > 0.05. All students believed that they understood all the important points from the lecture.Conclusions. Every class member felt that they acquired the important learning points during the lecture. Those who were distracted by electronic devices during the lecture performed similarly to those who were not. However, results should be interpreted with caution as this study was a small quasi-experimental design and further research should examine the influence of different types of distraction on different types of learning.

  8. Students distracted by electronic devices perform at the same level as those who are focused on the lecture.

    Science.gov (United States)

    Nalliah, Romesh P; Allareddy, Veerasathpurush

    2014-01-01

    Background. Little is known about the characteristics of internet distractions that students may engage in during lecture. The objective of this pilot study is to identify some of the internet-based distractions students engage in during in-person lectures. The findings will help identify what activities most commonly cause students to be distracted from the lecture and if these activities impact student learning. Methods. This study is a quasi-experimental pilot study of 26 students from a single institution. In the current study, one class of third-year students were surveyed after a lecture on special needs dentistry. The survey identified self-reported utilization patterns of "smart" devices during the lecture. Additionally, twelve quiz-type questions were given to assess the students' recall of important points in the lecture material that had just been covered. Results. The sample was comprised of 26 students. Of these, 17 were distracted in some form (either checking email, sending email, checking Facebook, or sending texts). The overall mean score on the test was 9.85 (9.53 for distracted students and 10.44 for non-distracted students). There were no significant differences in test scores between distracted and non-distracted students (p = 0.652). Gender and types of distractions were not significantly associated with test scores (p > 0.05). All students believed that they understood all the important points from the lecture. Conclusions. Every class member felt that they acquired the important learning points during the lecture. Those who were distracted by electronic devices during the lecture performed similarly to those who were not. However, results should be interpreted with caution as this study was a small quasi-experimental design and further research should examine the influence of different types of distraction on different types of learning.

  9. Removable splint with locking attachments for maxillary distraction osteogenesis with the RED system.

    Science.gov (United States)

    Suzuki, E Y; Suzuki, B

    2007-12-01

    The external traction hooks of the intraoral splint used to control traction forces applied to the maxilla with the rigid external distraction system represent a major barrier to surgical procedures. The purpose of this article is to introduce a removable intraoral splint with locking attachments that can be placed post-surgically immediately before distraction, facilitating surgery and consequently reducing the operative time. Fifteen cleft lip and palate patients underwent maxillary distraction osteogenesis using a rigid external distraction device in combination with the proposed removable splint that was fixed onto the maxillary teeth to provide anchorage. Initial records showed severe maxillary hypoplasia and negative overjet. The removable splint was fabricated using 1.5-mm diameter stainless-steel rigid orthodontic wires soldered to the locking attachments (Y&B Products LP, Chiang Mai, Thailand), making possible its placement post-surgically. Stable splint fixation was achieved prior to the distraction procedure and the desired treatment goals were reached. No complications inserting or removing the splint post-surgically, including pain or discomfort, were observed. The use of the removable splint with locking attachments has proved to be a highly effective fixation approach to manage the severely hypoplastic maxilla, eliminating lip constraints resulting from scarring, and allowing for easier, more deliberate and careful dissection.

  10. Changes in nasorespiratory function in association with maxillary distraction osteogenesis in subjects with cleft lip and palate.

    Science.gov (United States)

    Saito, Kiyo; Ono, Takashi; Mochida, Masumi; Ohyama, Kimie

    2006-01-01

    The current study aimed to determine how nasorespiratory function changes in association with maxillary distraction osteogenesis (DO). Furthermore, with regard to impaired nasorespiratory function, the possibility of a relationship between the cleft side and laterality and any effect of maxillary distraction osteogenesis was investigated. In this descriptive, prospective clinical report, subjective and objective data regarding nasorespiratory function before and after maxillary distraction osteogenesis were compared. Data from 13 subjects with cleft lip and palate were used. Subjects had a severe maxillary deficiency and underwent distraction osteogenesis using a rigid external device system. The subjective measure was the score on a questionnaire regarding nasorespiratory function using a visual analog scale. The objective measure was nasal resistance. The visual analog scale score for two items significantly decreased just after distraction osteogenesis. Nasal resistance also significantly decreased 1 year after distraction osteogenesis. Moreover, nasal resistance on the cleft side was significantly greater than that on the noncleft side just before and 1 year after distraction osteogenesis. There was a significant positive correlation between changes in the visual analog scale score and nasal resistance. These results suggest that nasorespiratory function changes in association with maxillary distraction osteogenesis in subjects with cleft lip and palate. Moreover, it appears that nasal obstruction on the cleft side does not change in subjects with unilateral cleft lip and palate.

  11. Comparison of soft-tissue changes in simultaneous maxillomandibular distraction with mandibular distraction with second-stage maxillary osteotomy.

    Science.gov (United States)

    Balaji, S M; Balaji, Preetha

    2016-01-01

    The purpose of this study was to compare the frontal lip cant changes in common facial asymmetry (FA) cases after simultaneous maxillomandibular distraction osteogenesis (DO) and mandibular DO with maxillary orthognathic surgery. Retrospective analysis of FA cases at tertiary craniofacial referral was performed. Patients of either gender with all medical imaging records and pre- and post-operative (1 year) facial photographs in natural head position were included in the study. The lip cant change was assessed by the ratio of the linear dimension between affected and unaffected side labial commissures and the bi-pupillary reference line. Difference between the pre- and post-operative ratio was analyzed. Statistical analysis was performed for the outcome. P ≤0.05 was taken as significant. The mean preoperative measured value of the affected side was 0.845 ± 0.036 while the postoperative value was 0.95 ± 0.032. The effective change was 0.11 ± 0.044. The postoperative ratio compared with simultaneous DO case was 0.98 ± 0.06 while that of mandibular distraction with orthognathic surgery was 0.92 ± 0.08 (P = 0.048). The mean change of the simultaneous DO case was measured as 0.114 ± 0.041 while the same for the mandibular distraction with orthognathic surgery was 0.069 ± 0.035 (P = 0.013). The results indicate that the simultaneous DO yields more better frontal lip cant change between both halves than the mono-DO with orthognathic surgery. The mean change is much higher in the simultaneous DO cases indicating a more effective correction and desired result. The biological reason and lip musculature mechanism behind the response in both conditions are discussed.

  12. The effects of high dose and highly fractionated radiation on distraction osteogenesis in the murine mandible

    International Nuclear Information System (INIS)

    Monson, Laura A; Cavaliere, Christi M; Deshpande, Sagar S; Ayzengart, Alexander L; Buchman, Steven R

    2012-01-01

    The ability of irradiated tissue to support bony growth remains poorly defined, although there are anecdotal cases reported showing mixed results for the use of mandibular distraction osteogenesis after radiation for head and neck cancer. Many of these reports lack objective measures that would allow adequate analysis of outcomes or efficacy. The purpose of this experiment was to utilize a rat model of mandibular distraction osteogenesis after high dose and highly fractionated radiation therapy and to evaluate and quantify distracted bone formation under these conditions. Male Sprague–Dawley rats underwent 12 fractions of external beam radiation (48 Gray) of the left mandible. Following a two week recovery period, an external frame distractor was applied and gradual distraction of the mandible was performed. Tissue was harvested after a twenty-eight day consolidation period. Gross, radiologic and histological evaluations were undertaken. Those animals subjected to pre-operative radiation showed severe attenuation of bone formation including bone atrophy, incomplete bridging of the distraction gap, and gross bony defects or non-union. Although physical lengthening was achieved, the irradiated bone consistently demonstrated marked damaging effects on the normal process of distraction osteogenesis. This murine model has provided reliable evidence of the injurious effects of high dose radiation on bone repair and regeneration in distraction osteogenesis utilizing accurate and reproducible metrics. These results can now be used to assist in the development of therapies directed at mitigating the adverse consequences of radiation on the regeneration of bone and to optimize distraction osteogenesis so it can be successfully applied to post-oncologic reconstruction

  13. Fort Valley's early scientists: A legacy of distinction (P-53)

    Science.gov (United States)

    Andrew J. Sanchez Meador; Susan D. Olberding

    2008-01-01

    When the Riordan brothers of Flagstaff, Arizona asked Gifford Pinchot to determine why there was a deficit in ponderosa pine seedlings, neither party understood the historical significance of what they were setting in motion for the field of forest research. The direct result of that professional favor was the establishment of the Fort Valley Experiment Station (Fort...

  14. Aging increases distraction by auditory oddballs in visual, but not auditory tasks.

    Science.gov (United States)

    Leiva, Alicia; Parmentier, Fabrice B R; Andrés, Pilar

    2015-05-01

    Aging is typically considered to bring a reduction of the ability to resist distraction by task-irrelevant stimuli. Yet recent work suggests that this conclusion must be qualified and that the effect of aging is mitigated by whether irrelevant and target stimuli emanate from the same modalities or from distinct ones. Some studies suggest that aging is especially sensitive to distraction within-modality while others suggest it is greater across modalities. Here we report the first study to measure the effect of aging on deviance distraction in cross-modal (auditory-visual) and uni-modal (auditory-auditory) oddball tasks. Young and older adults were asked to judge the parity of target digits (auditory or visual in distinct blocks of trials), each preceded by a task-irrelevant sound (the same tone on most trials-the standard sound-or, on rare and unpredictable trials, a burst of white noise-the deviant sound). Deviant sounds yielded distraction (longer response times relative to standard sounds) in both tasks and age groups. However, an age-related increase in distraction was observed in the cross-modal task and not in the uni-modal task. We argue that aging might affect processes involved in the switching of attention across modalities and speculate that this may due to the slowing of this type of attentional shift or a reduction in cognitive control required to re-orient attention toward the target's modality.

  15. Association Between Cognitive Complaints and Vulnerability to Environmental Distraction in Multiple Sclerosis.

    Science.gov (United States)

    Randolph, John J; Randolph, Jennifer S; Wishart, Heather A

    2017-02-01

    Individuals with multiple sclerosis (MS) often report cognitive dysfunction, although neuropsychological evaluation findings may not correlate with subjective concerns. One factor that may explain this lack of correspondence is the controlled testing environment, which differs from busier settings where cognitive lapses are noted to occur. This study used a novel environmental manipulation to determine whether individuals with MS who report cognitive dysfunction are more vulnerable to the effects of auditory distraction during neuropsychological testing. Twenty-four individuals with clinically definite MS or clinically isolated syndrome were administered a cognitive battery during two counterbalanced auditory conditions: quiet/standard condition, and distraction condition with random office background noise. Participants were divided into high versus low cognitive complaint groups using a median split analysis of Perceived Deficits Questionnaire responses. Participants with more cognitive complaints showed a decrement in performance on the oral Symbol Digit Modalities Test during the distraction condition while those with fewer cognitive complaints demonstrated stable performance across conditions. These findings remained significant after controlling for education, premorbid intellect, fatigue, and depressed mood. These results suggest that individuals with MS with more cognitive complaints are vulnerable to environmental distraction, particularly regarding processing speed. Incorporating random environmental noise or other distraction conditions during selected measures may enhance the ecological validity of neuropsychological evaluation results in MS. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Systematic review and meta-analysis of distraction and hypnosis for needle-related pain and distress in children and adolescents.

    Science.gov (United States)

    Birnie, Kathryn A; Noel, Melanie; Parker, Jennifer A; Chambers, Christine T; Uman, Lindsay S; Kisely, Steve R; McGrath, Patrick J

    2014-09-01

    To systematically review the evidence (and quality) for distraction and hypnosis for needle-related pain and distress in children and adolescents. To explore the effects of distraction characteristics (e.g., adult involvement, type of distracter), child age, and study risk of bias on treatment efficacy.  26 distraction and 7 hypnosis trials were included and self-report, observer-report, and behavioral pain intensity and distress examined. Distraction studies were coded for 4 intervention characteristics, and all studies coded for child age and study risk of bias.  Findings showed strong support for distraction and hypnosis for reducing pain and distress from needle procedures. The quality of available evidence was low, however. Characteristics of distraction interventions, child age, and study risk of bias showed some influence on treatment efficacy. Distraction and hypnosis are efficacious in reducing needle-related pain and distress in children. The quality of trials in this area needs to be improved. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Neural correlates of distraction and conflict resolution for nonverbal auditory events.

    Science.gov (United States)

    Stewart, Hannah J; Amitay, Sygal; Alain, Claude

    2017-05-09

    In everyday situations auditory selective attention requires listeners to suppress task-irrelevant stimuli and to resolve conflicting information in order to make appropriate goal-directed decisions. Traditionally, these two processes (i.e. distractor suppression and conflict resolution) have been studied separately. In the present study we measured neuroelectric activity while participants performed a new paradigm in which both processes are quantified. In separate block of trials, participants indicate whether two sequential tones share the same pitch or location depending on the block's instruction. For the distraction measure, a positive component peaking at ~250 ms was found - a distraction positivity. Brain electrical source analysis of this component suggests different generators when listeners attended to frequency and location, with the distraction by location more posterior than the distraction by frequency, providing support for the dual-pathway theory. For the conflict resolution measure, a negative frontocentral component (270-450 ms) was found, which showed similarities with that of prior studies on auditory and visual conflict resolution tasks. The timing and distribution are consistent with two distinct neural processes with suppression of task-irrelevant information occurring before conflict resolution. This new paradigm may prove useful in clinical populations to assess impairments in filtering out task-irrelevant information and/or resolving conflicting information.

  18. Concentration: The Neural Underpinnings of How Cognitive Load Shields Against Distraction.

    Science.gov (United States)

    Sörqvist, Patrik; Dahlström, Örjan; Karlsson, Thomas; Rönnberg, Jerker

    2016-01-01

    Whether cognitive load-and other aspects of task difficulty-increases or decreases distractibility is subject of much debate in contemporary psychology. One camp argues that cognitive load usurps executive resources, which otherwise could be used for attentional control, and therefore cognitive load increases distraction. The other camp argues that cognitive load demands high levels of concentration (focal-task engagement), which suppresses peripheral processing and therefore decreases distraction. In this article, we employed an functional magnetic resonance imaging (fMRI) protocol to explore whether higher cognitive load in a visually-presented task suppresses task-irrelevant auditory processing in cortical and subcortical areas. The results show that selectively attending to an auditory stimulus facilitates its neural processing in the auditory cortex, and switching the locus-of-attention to the visual modality decreases the neural response in the auditory cortex. When the cognitive load of the task presented in the visual modality increases, the neural response to the auditory stimulus is further suppressed, along with increased activity in networks related to effortful attention. Taken together, the results suggest that higher cognitive load decreases peripheral processing of task-irrelevant information-which decreases distractibility-as a side effect of the increased activity in a focused-attention network.

  19. Renewable Energy Opportunities at Fort Campbell, Tennessee/Kentucky

    Energy Technology Data Exchange (ETDEWEB)

    Hand, James R.; Horner, Jacob A.; Kora, Angela R.; Orrell, Alice C.; Russo, Bryan J.; Weimar, Mark R.; Nesse, Ronald J.

    2011-03-31

    This document provides an overview of renewable resource potential at Fort Campbell, based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. This effort focuses on grid-connected generation of electricity from renewable energy sources and also on ground source heat pumps for heating and cooling buildings. The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 Department of Defense (DoD) Renewables Assessment. The site visit to Fort Campbell took place on June 10, 2010.

  20. Renewable Energy Opportunities at Fort Drum, New York

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Scott A.; Orrell, Alice C.; Solana, Amy E.; Williamson, Jennifer L.; Hand, James R.; Russo, Bryan J.; Weimar, Mark R.; Rowley, Steven; Nesse, Ronald J.

    2010-10-20

    This document provides an overview of renewable resource potential at Fort Drum, based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. This effort focuses on grid-connected generation of electricity from renewable energy sources and also on ground source heat pumps for heating and cooling buildings. The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 Department of Defense (DoD) Renewables Assessment. The site visit to Fort Drum took place on May 4 and 5, 2010.

  1. Effects of mobile phone distraction on pedestrians' crossing behavior and visual attention allocation at a signalized intersection: An outdoor experimental study.

    Science.gov (United States)

    Jiang, Kang; Ling, Feiyang; Feng, Zhongxiang; Ma, Changxi; Kumfer, Wesley; Shao, Chen; Wang, Kun

    2018-06-01

    With the rapid growth in mobile phone use worldwide, traffic safety experts have begun to consider the impact of mobile phone distractions on pedestrian crossing safety. This study sought to investigate how mobile phone distractions (music distraction, phone conversation distraction and text distraction) affect the behavior of pedestrians while they are crossing the street. An outdoor-environment experiment was conducted among 28 college student pedestrians. Two HD videos and an eye tracker were employed to record and analyze crossing behavior and visual attention allocation. The results of the research showed that the three mobile phone distractions cause different levels of impairment to pedestrians' crossing performance, with the greatest effect from text distraction, followed by phone conversation distraction and music distraction. Pedestrians distracted by music initiate crossing later, have increased pupil diameter, and reduce their scanning frequency, fixation points and fixation times toward traffic signal area priorities. In addition to the above effects, pedestrians distracted by phone conversation cross the street more slowly, direct fewer fixation points to the right traffic area, and spend less fixation time and lower average fixation duration on the left traffic area. Moreover, pedestrians distracted by texting look left and right less often and switch, distribute and maintain less visual attention on the traffic environment. These findings may inform researchers, policy makers, and pedestrians. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Attention and Distraction:On the Aesthetic Experience of Video Installation Art

    OpenAIRE

    Petersen, Anne Ring

    2010-01-01

    This article aims to examine the interrelationship between attention and distraction in the reception of video installation art, a genre which is commonly associated with "immersion" and an intensified feeling of presence in the discourses on new media art and installation art. This tends to veil the fact that the behaviour of many visitors is characterised by a certain restlessness and distraction. The article suggests that, in contradistinction to traditional disciplines of art like paintin...

  3. Executive and Perceptual Distraction in Visual Working Memory

    Science.gov (United States)

    2017-01-01

    The contents of visual working memory are likely to reflect the influence of both executive control resources and information present in the environment. We investigated whether executive attention is critical in the ability to exclude unwanted stimuli by introducing concurrent potentially distracting irrelevant items to a visual working memory paradigm, and manipulating executive load using simple or more demanding secondary verbal tasks. Across 7 experiments varying in presentation format, timing, stimulus set, and distractor number, we observed clear disruptive effects of executive load and visual distraction, but relatively minimal evidence supporting an interactive relationship between these factors. These findings are in line with recent evidence using delay-based interference, and suggest that different forms of attentional selection operate relatively independently in visual working memory. PMID:28414499

  4. Distraction osteogenesis and orthognathic surgery for a patient with unilateral cleft lip and palate.

    Science.gov (United States)

    Kim, Ji Hyun; Lee, Il Hong; Lee, Sang Min; Yang, Byoung Eun; Park, In Young

    2015-03-01

    Maxillary deficiency is a common feature in patients with repaired cleft lip and palate. Orthognathic surgery has been the conventional approach for the management of cleft-related maxillary hypoplasia. However, for patients with a severe maxillary deficiency, orthognathic surgery alone has many disadvantages, such as high relapse rates of 25% to 40%, instability, limited amount of advancement, and a highly invasive surgical technique. As an alternative treatment method, distraction osteogenesis has been used successfully in the distraction of the mandible, the maxilla, the entire midface, and the orbits as well as the cranial bones, with stable outcomes. The type of distraction device, either external or internal, can be chosen based on the surgical goals set for the patient. In this study, we report on the use of a rigid external distraction device for maxillary advancement in a 22-year-old woman with a repaired unilateral cleft lip and palate and severe maxillary hypoplasia. After the distraction osteogenesis, 2-jaw surgery was performed to correct the maxillary yaw deviation and the mandibular prognathism. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  5. Impact of social and technological distraction on pedestrian crossing behaviour: an observational study.

    Science.gov (United States)

    Thompson, Leah L; Rivara, Frederick P; Ayyagari, Rajiv C; Ebel, Beth E

    2013-08-01

    The objective of the present work was to study the impact of technological and social distraction on cautionary behaviours and crossing times in pedestrians. Pedestrians were observed at 20 high-risk intersections during 1 of 3 randomly assigned time windows in 2012. Observers recorded demographic and behavioural information, including use of a mobile device (talking on the phone, text messaging, or listening to music). We examined the association between distraction and crossing behaviours, adjusting for age and gender. All multivariate analyses were conducted with random effect logistic regression (binary outcomes) and random effect linear regression (continuous outcomes), accounting for clustering by site. Observers recorded crossing behaviours for 1102 pedestrians. Nearly one-third (29.8%) of all pedestrians performed a distracting activity while crossing. Distractions included listening to music (11.2%), text messaging (7.3%) and using a handheld phone (6.2%). Text messaging, mobile phone use and talking with a companion increased crossing time. Texting pedestrians took 1.87 additional seconds (18.0%) to cross the average intersection (3.4 lanes), compared to undistracted pedestrians. Texting pedestrians were 3.9 times more likely than undistracted pedestrians to display at least 1 unsafe crossing behaviour (disobeying the lights, crossing mid-intersection, or failing to look both ways). Pedestrians listening to music walked more than half a second (0.54) faster across the average intersection than undistracted pedestrians. Distracting activity is common among pedestrians, even while crossing intersections. Technological and social distractions increase crossing times, with text messaging associated with the highest risk. Our findings suggest the need for intervention studies to reduce risk of pedestrian injury.

  6. Le sociologue dans l’action collective face au risque

    Directory of Open Access Journals (Sweden)

    Marc Mormont

    2009-11-01

    Full Text Available Le risque est une composante centrale des sociétés industrielles modernes qui en ont organisé la prise en charge à travers une série de dispositifs complexes. Les questions environnementales font émerger de nouveaux risques dits modernes parce qu’ils échappent à ces dispositifs d’évaluation et de gestion. A côté d’attitudes de déni de ces risques on voit apparaître des dynamiques qui sont vues comme des dispositifs de capture des peurs qui ont pour effet de donner une emprise forte à ceux qui peuvent mettre en place des dispositifs de contrôle, qui peuvent détruire les collectifs organisés autour de pratiques vivantes. Le sociologue ne peut plus se contenter de répondre à une demande d’analyse des perceptions des risques ; il doit s’engager dans l’action collective qui confronte les collectifs aux risques pour aider à leur reconfiguration tout en préservant leur autonomie.Risk is a central component of modern industrial societies that have organised complex systems to tackle with them. Environmental problems progressively reveal new risks that are said modern risks because they can be dealt with through usual systems of risk assessment and management. If some authorities still deny these risks, it is important to observe new dynamics that are here described as capture of fear and that are giving strong power to those who are able to propose control systems. These systems can be destructive of many original and creative practices. Sociologist can not be confined in analysis of risk perception, he has to be involved in collective action that try to deal with risks by confronting different collectives and by reorganising them while preserving autonomy.

  7. Le contrôle de gestion des entreprises familiales : un contrôle non-financiarisé ?

    OpenAIRE

    Barbelivien , Dominique

    2016-01-01

    Nous examinons la tendance décrite dans la littérature quant à la financiarisation de la fonction de contrôle de gestion en nous appuyant sur le cas d’une entreprise de taille intermédiaire familiale. Nous constatons que le contrôle de gestion dans le cas étudié correspond à une rationalisation des décisions opérationnelles et développons les raisons qui peuvent expliquer la persistance d’un contrôle de gestion très opérationnel. Le contexte d’entreprise familiale dans laquelle il y a confusi...

  8. Complications of mandibular distraction osteogenesis for developmental deformities: a systematic review of the literature

    NARCIS (Netherlands)

    Verlinden, C. R. A.; van de Vijfeijken, S. E. C. M.; Tuinzing, D. B.; Jansma, E. P.; Becking, A. G.; Swennen, G. R. J.

    2015-01-01

    A systematic review of English and non-English articles on the complications of mandibular distraction osteogenesis (MDO) for patients with developmental deformities was performed, in accordance with the PRISMA statement. Search terms expressing distraction osteogenesis were used in 'AND'

  9. Microgrid Enabled Distributed Energy Solutions (MEDES) Fort Bliss Military Reservation

    Science.gov (United States)

    2014-02-01

    FINAL REPORT Microgrid Enabled Distributed Energy Solutions (MEDES) Fort Bliss Military Reservation ESTCP Project EW-201140 FEBRUARY...TITLE AND SUBTITLE Microgrid Enabled Distributed Energy Solutions (MEDES) 5a. CONTRACT NUMBER W912HQ-11-C-0082 Fort Bliss, Texas...Lockheed Martin’s Intelligent Microgrid Solution can provide more energy security while also lowering electric utility costs and greenhouse gas emissions

  10. L'UTILISATION DE LA PENSÉE LEAN DANS LE CONTEXTE DE LA RESPONSABILITÉ SOCIALE DE L'ENTREPRISE

    Directory of Open Access Journals (Sweden)

    Sorin BRICIU

    2016-06-01

    Full Text Available La responsabilité sociale est un concept toujours plus présent dans l'économie actuelle. Les préoccupations des entreprises dans ce domaine sont dues aux avantages apportés par la mise en pratique de ce concept à moyen et à long terme. Étant donné l'intérêt progressif manifesté envers la responsabilité sociale d'une part, vue comme facteur compétitif pour le succès d'une affaire, et de la pensée lean d'autre part, comme étant la plus importante philosophie de management de notre époque, le but de cet article est de présenter les deux concepts et d'analyser la relation d'entre eux. Les résultats de la recherche ont mis en évidence le fait que la littérature spécialisée offre des arguments forts concernant la relation d'entre la pensée lean et la responsabilité sociale, mais les entreprises qui ont mis en pratique la pensée lean dans leurs activités peuvent être considérées comme des entreprises socialement responsables.

  11. Exploring Factors That Influence Technology-Based Distractions in Bring Your Own Device Classrooms

    Science.gov (United States)

    Kay, Robin; Benzimra, Daniel; Li, Jia

    2017-01-01

    Previous research on distractions and the use of mobile devices (personal digital assistants, tablet personal computers, or laptops) have been conducted almost exclusively in higher education. The purpose of the current study was to examine the frequency and influence of distracting behaviors in Bring Your Own Device secondary school classrooms.…

  12. Treatment outcome and long-term stability of skeletal changes following maxillary distraction in adult subjects of cleft lip and palate

    OpenAIRE

    Satinder Pal Singh; Ashok Kumar Jena; Vidya Rattan; Ashok Kumar Utreja

    2012-01-01

    Aim : To evaluate the treatment outcome and long-term stability of skeletal changes following maxillary advancement with distraction osteogenesis in adult subjects of cleft lip and palate. Materials and Methods: Total 12 North Indian adult patients in the age range of 17-34 years with cleft lip and palate underwent advancement of maxilla by distraction osteogenesis. Lateral cephalograms recorded prior to distraction, at the end of distraction, 6 months after distraction, and at least 24 month...

  13. Texting while driving: A study of 1211 U.S. adults with the Distracted Driving Survey

    OpenAIRE

    Gliklich, Emily; Guo, Rong; Bergmark, Regan W.

    2016-01-01

    Texting and other cell-phone related distracted driving is estimated to account for thousands of motor vehicle collisions each year but studies examining the specific cell phone reading and writing activities of drivers are limited. The objective of this study was to describe the frequency of cell-phone related distracted driving behaviors. A national, representative, anonymous panel of 1211 United States drivers was recruited in 2015 to complete the Distracted Driving Survey (DDS), an 11-ite...

  14. Short-term retention of pictures and words as a function of type of distraction and length of delay interval.

    Science.gov (United States)

    Pellegrino, J W; Siegel, A W; Dhawan, M

    1976-01-01

    Picture and word triads were tested in a Brown-Peterson short-term retention task at varying delay intervals (3, 10, or 30 sec) and under acoustic and simultaneous acoustic and visual distraction. Pictures were superior to words at all delay intervals under single acoustic distraction. Dual distraction consistently reduced picture retention while simultaneously facilitating word retention. The results were interpreted in terms of the dual coding hypothesis with modality-specific interference effects in the visual and acoustic processing systems. The differential effects of dual distraction were related to the introduction of visual interference and differential levels of functional acoustic interference across dual and single distraction tasks. The latter was supported by a constant 2/1 ratio in the backward counting rates of the acoustic vs. dual distraction tasks. The results further suggest that retention may not depend on total processing load of the distraction task, per se, but rather that processing load operates within modalities.

  15. The effects of three different distraction methods on pain and anxiety in children.

    Science.gov (United States)

    Sahiner, Nejla Canbulat; Bal, Meltem Demirgoz

    2016-09-01

    This study aims to investigate of three different distraction methods (distraction cards, listening to the music of cartoon and balloon inflation) on pain and anxiety relief of children during phlebotomy. This study is a prospective, randomized, and controlled trial. The sample consisted of 6 to 12 years old children who require blood tests. Children were randomized into four groups as the distraction cards, the music, the balloon inflation, and the control. Data were obtained by conducting interviews with the children, their parents, and the observer before and after the procedure. The pain levels of the children were assessed by the parent and observer reports as well as self-report using the Wong-Baker FACES. The anxiety levels of children were assessed by parent and observer reports using Children Fear Scale. One hundred and twenty children (mean age: 9.1 ± 1.6 years) were included. The self-reported procedural pain levels showed significant differences among the study groups (p = .040). The distraction card group (2.33 ± 3.24) had significantly lower pain levels (p = .057) than the control group (4.53 ± 3.23). The procedural child anxiety levels reported by the observer showed a significant difference among the study groups (p = .032). All the forms of distraction significantly reduced pain and anxiety perception. © The Author(s) 2015.

  16. Smartphone use during inpatient attending rounds: prevalence, patterns and potential for distraction.

    Science.gov (United States)

    Katz-Sidlow, Rachel J; Ludwig, Allison; Miller, Scott; Sidlow, Robert

    2012-10-01

    While there are numerous benefits of smartphone use for physicians, little is known about the negative effects of using these devices in the context of patient care. To assess resident and faculty smartphone use during inpatient attending rounds and its potential as a source of distraction during transfer of clinical information. Cross-sectional survey. University-affiliated public teaching hospital. All housestaff and inpatient faculty in the departments of Medicine and Pediatrics. Participants were asked about smartphone ownership, usage patterns during attending rounds, and whether team members had ever missed important data during rounds due to distraction from smartphones. Attendings were asked whether policies should be established for smartphone use during rounds. The overall response rate was 73%. Device ownership was prevalent (89% residents, 98% faculty), as was use of smartphones during inpatient rounds (57% residents, 28% attendings). According to self-reports, smartphones were used during rounds for patient care (85% residents, 48% faculty), reading/responding to personal texts/e-mails (37% residents, 12% faculty), and other non-patient care uses (15% residents, 0% faculty). Nineteen percent of residents and 12% of attendings believed they had missed important information because of distraction from smartphones. Residents and faculty agreed that smartphones "can be a serious distraction during attending rounds," and nearly 80% of faculty believed that smartphone policies should be established. Smartphone use during attending rounds is prevalent and can distract users during important information transfer. Attendings strongly favored the institution of formal policies governing appropriate smartphone use during inpatient rounds. Copyright © 2012 Society of Hospital Medicine.

  17. The Distraction in Action Tool©: Feasibility and Usability in Clinical Settings.

    Science.gov (United States)

    Hanrahan, Kirsten; Kleiber, Charmaine; Miller, Ben J; Davis, Heather; McCarthy, Ann Marie

    2017-11-10

    Distraction is a relatively simple, evidence-based intervention to minimize child distress during medical procedures. Timely on-site interventions that instruct parents on distraction coaching are needed. The purpose of this study was to test the feasibility and usability of the Distraction in Action Tool© (DAT©), which 1) predicts child risk for distress with a needle stick and 2) provides individualized instructions for parents on how to be a distraction coach for their child in clinical settings. A mixed-methods descriptive design was used to test feasibility and usability of DAT in the Emergency Department and a Phlebotomy Lab at a large Midwest Academic Medical Center. Twenty parents of children ages 4-10years requiring venipuncture and clinicians performing 13 of those procedures participated. Participants completed an evaluation and participated in a brief interview. The average age of the children was 6.8years, and 80% of parent participants were mothers. Most parents reported the DAT was not difficult to use (84.2%), understandable (100%), and they had a positive experience (89.5%). Clinicians thought DAT was helpful (100%) and did not cause a meaningful delay in workflow (92%). DAT can be used by parents and clinicians to assess their children's risk for procedure related distress and learn distraction techniques to help their children during needle stick procedures. DAT for parents is being disseminated via social media and an open-access website. Further research is needed to disseminate and implement DAT in community healthcare settings. Copyright © 2017. Published by Elsevier Inc.

  18. Effects of the office environment on health and productivity 1: Auditory and visual distraction

    NARCIS (Netherlands)

    Korte, E. de; Kuijt-Evers, L.; Vink, P.

    2007-01-01

    A pilot experiment was conducted to evaluate the effects of visual or auditory distraction in an office environment on productivity, concentration and emotion. Ten subjects performed a simple, standardized computer task in five conditions (undisturbed, 3 variations of auditory distraction and visual

  19. Long-term stability of intra-oral maxillary distraction in unilateral cleft lip and palate: a case report.

    Science.gov (United States)

    Nevzatoğlu, Sirin; Küçükkeleş, Nazan; Güzel, Zeki

    2013-11-01

    This case report presents short and long-term treatment results of a unilateral cleft lip and palate patient treated with a modified intra-oral tooth-bone borne distraction appliance. The chief complaints of a 16 year-old, unilateral cleft lip and palate patient were poor facial aesthetics, crowding and a fistula. Severe maxillary retrognathism was treated via distraction osteogenesis of the maxilla and performed using an intra-oral tooth-bone borne appliance. Treatment continued to completion with a multibracket system. At an eight-year review following the distraction procedure, the short and long-term results were determined cephalometrically. Following the distraction, A-point advanced 7 mm, 2 mm of which relapsed during fixed appliance treatment. At the end of the active treatment, the patient's skeletal and dental Class III relationship improved to Class I, which was preserved at the long-term review. The profile was markedly improved by the distraction osteogenesis. In cases of severe maxillary retrognathism as a result of a cleft lip and palate, maxillary distraction osteogenesis provides a viable alternative to orthognathic surgery.

  20. 77 FR 51610 - Distracted Driving Grant Program

    Science.gov (United States)

    2012-08-24

    .... (2) Prohibition on youth cell phone use while driving. The State statute must-- (a) Prohibit a driver... of texting or using a cell phone while driving; (2) for traffic signs that notify drivers about the... DEPARTMENT OF TRANSPORTATION National Highway Traffic Safety Administration Distracted Driving...

  1. Comparison of acceptance and distraction strategies in coping with experimentally induced pain

    Directory of Open Access Journals (Sweden)

    Moore H

    2015-03-01

    Full Text Available Hazel Moore,1 Ian Stewart,1 Dermot Barnes-Holmes,2 Yvonne Barnes-Holmes,2 Brian E McGuire1,31School of Psychology, National University of Ireland, Galway, 2Department of Psychology, National University of Ireland, Maynooth, 3Centre for Pain Research, National University of Ireland, Galway, IrelandBackground: This study compared an acceptance-based strategy with a control-based strategy (distraction in terms of the ability of participants to tolerate a painful stimulus, across two experiments. In addition, participants were either actively encouraged, or not, to link pain tolerance with pursuit of valued goals to examine the impact of pursuing a personally meaningful goal or value on the extent to which pain will be tolerated.Methods: Participants in experiment 1 (n=41 and experiment 2 (n=52 were equally assigned to acceptance or distraction protocols. Further, half the participants in each group generated examples from their own lives in which they had pursued a valued objective, while the other half did not. In experiment 2, the values focus was enhanced to examine the impact on pain tolerance.Results: There were no significant differences overall between the acceptance and distraction groups on pain tolerance in either experiment. However, in experiment 2, individuals classified as accepting in terms of general coping style and who were assigned to the acceptance strategy showed significantly better pain tolerance than accepting individuals who were in the distraction condition. Across both experiments, those with strong goal-driven values in both protocols were more tolerant of pain. Participants appeared to have more difficulty adhering to acceptance than to distraction as a strategy.Conclusion: Acceptance may be associated with better tolerance of pain, but may also be more difficult to operationalize than distraction in experimental studies. Matching coping style and coping strategy may be most effective, and enhancement of goal

  2. Structural remains at the early mediaeval fort at Raibania, Orissa

    OpenAIRE

    Sen, Bratati

    2013-01-01

    The fortifications of mediaeval India occupy an eminent position in the history of military architecture. The present paper deals with the preliminary study of the structural remains at the early mediaeval fort at Raibania in the district of Balasore in Orissa. The fort was built of stone very loosely kept together. The three-walled fortification interspersed by two consecutive moats, a feature evidenced at Raibania, w...

  3. Black Swan Event Assessment for Fort Leonard Wood, Missouri

    Science.gov (United States)

    2016-03-01

    ER D C/ CE RL S R- 16 -1 Net Zero Planning for Fort Leonard Wood Black Swan Event Assessment for Fort Leonard Wood, Missouri Co ns...search for other technical reports published by ERDC, visit the ERDC online library at http://acwc.sdp.sirsi.net/client/default. Net Zero Planning for...1.8 degrees Celsius knots 0.5144444 meters per second miles (US statute) 1,609.347 meters miles per hour 0.44704 meters per second ERDC/CERL SR

  4. Executive and perceptual distraction in visual working memory.

    Science.gov (United States)

    Allen, Richard J; Baddeley, Alan D; Hitch, Graham J

    2017-09-01

    The contents of visual working memory are likely to reflect the influence of both executive control resources and information present in the environment. We investigated whether executive attention is critical in the ability to exclude unwanted stimuli by introducing concurrent potentially distracting irrelevant items to a visual working memory paradigm, and manipulating executive load using simple or more demanding secondary verbal tasks. Across 7 experiments varying in presentation format, timing, stimulus set, and distractor number, we observed clear disruptive effects of executive load and visual distraction, but relatively minimal evidence supporting an interactive relationship between these factors. These findings are in line with recent evidence using delay-based interference, and suggest that different forms of attentional selection operate relatively independently in visual working memory. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. The neurobiology of focus and distraction: The case for incorporating mindfulness into leadership.

    Science.gov (United States)

    Mohapel, Paul

    2018-05-01

    Increasingly health leaders are experiencing greater demands and pressures, which require the need for better focus while limiting unwarranted distractions. This article offers a neurobiological explanation of how the brain focuses and becomes distracted, in order to help health leaders gain insight into their own effectiveness. Two main neural circuits are contrasted: the mind-wandering default mode circuit and the attentional central executive system. These two systems act in an antagonistic pairing, where the degree of toggling between systems is associated with the degree a person can sustain focus and filter out unwarranted distractions. Excessive multitasking appears to compromise the neural switch of these two systems, thereby diminishing our focus and concentration. In contrast, mindfulness practice is shown to have the opposite effect by enhancing the neural switch, thereby enhancing leadership focus that can lead to greater flexibility, foresight, regulation, and creativity. To conclude, leaders who are excessively distracted, such as with multitasking, may be compromising cognitive brain functioning, while engaging in mindfulness may replenish the brain and thereby enhance leaders' ability to sustain focus and tap into higher cognitive functioning.

  6. Rumination but not distraction increases eating-related symptoms in anorexia and bulimia nervosa.

    Science.gov (United States)

    Naumann, Eva; Tuschen-Caffier, Brunna; Voderholzer, Ulrich; Caffier, Detlef; Svaldi, Jennifer

    2015-05-01

    Recent models of eating disorders emphasize the importance of ruminative thinking in the occurrence of unhealthy eating behavior. Hence, the aim of the current study was to examine the influence of induced rumination and distraction on the desire to engage in eating-related symptoms in anorexia (AN) and bulimia nervosa (BN). After a sadness induction, either a ruminative or distractive emotion regulation style was encouraged in women with AN (n = 38), BN (n = 37), and non-eating disordered controls (CG; n = 36). At baseline and after the emotion regulation induction feelings of sadness, desire to abstain from eating (DTA) and desire to binge (DTB) were assessed. Main results reveal that rumination led to a significant increase of DTA in the AN group and of DTB in patients with BN. In the CG, DTA significantly decreased after distraction. Although there were significant increases in subjective sadness in the rumination condition, no changes were found in the distraction condition. The results suggest that rumination in response to sadness has a detrimental effect on eating-related symptoms in eating disorders. (c) 2015 APA, all rights reserved).

  7. Effects of non-surgical joint distraction in the treatment of severe knee osteoarthritis.

    Science.gov (United States)

    Khademi-Kalantari, Khosro; Mahmoodi Aghdam, Somayeh; Akbarzadeh Baghban, Alireza; Rezayi, Mehdi; Rahimi, Abbas; Naimee, Sedighesadat

    2014-10-01

    The aim of this study was to evaluate the clinical results of non surgical knee distraction in patients with severe knee osteoarthritis. forty female patients with severe knee osteoarthritis were randomly divided in two groups. A standard physiotherapy treatment was applied to both groups and in one group it was accompanied with 20 min knee joint distraction. The patients were treated for 10 sessions. Clinical examination consisted of functional examination, completion of a quality of life questionnaire, pain scale, and assessment of joint mobility and joint edema. The standard physiotherapy treatment accompanied by knee distraction resulted in significantly higher improvement in pain (P = 0.004), functional ability (P = 0.02), quality of life (P = 0.002) and knee flexion range of motion (p = 0.02) compared to the standard physiotherapy treatment alone post treatment and after 1 month follow up. Adding knee distraction to standard physiotherapy treatment can result in further improvement in pain relief, increased functional ability and better quality of life in patients with severe knee osteoarthritis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. The Influence of Various Distraction Stimuli on Affective Responses during Recumbent Cycle Ergometry

    Directory of Open Access Journals (Sweden)

    Paul C. Miller

    2016-03-01

    Full Text Available (1 Background: Acute bouts of exercise have been associated with affective changes. Exercise supplemented with distraction may divert attention from unpleasant feelings commonly associated with exercise to more pleasant feelings. The purpose of this study was to compare affective responses to exercise with and without distraction. (2 Methods: 25 individuals volunteered for this investigation and completed all three conditions. This study included three 30 min cycle ergometry exercise conditions, a control condition with no stimuli and two test conditions; one supplemented with a self-selected video and the other self-selected music. The Feeling Scale (FS was administered prior to, every 10 min during, immediately following, and 10 min post exercise. (3 Results: These data demonstrate a significant condition effect for FS during exercise. The condition effect was due to FS being greater in the video and distraction conditions. There was no time by condition interaction seen during exercise. (4 Conclusion: These data indicate that distraction may be effective in supporting a more pleasant exercise experience and could potentially increase exercise adherence.

  9. Profile changes and stability following distraction osteogenesis with rigid external distraction in adult cleft lip and palate deformities

    Directory of Open Access Journals (Sweden)

    Jaeson M Painatt

    2017-01-01

    Full Text Available Objectives: The objective of this study is to analyze the hard and soft-tissue profile changes as well as the upper airway changes after distraction osteogenesis (DO using rigid external distraction device in adult cleft lip and palate (CLP patients. The study also evaluates the stability of the surgical result. Materials and Methods: Three lateral cephalometric radiographs were taken: Predistraction (T1, postdistraction (T2, and 1 year after distractor removal (T3. The treatment changes (T1 vs. T2 and the stability (T2 vs. T3 were analyzed. The overall treatment changes after 1 year were also evaluated (T1 vs. T3. The lateral cephalograms were digitally analyzed with the help of software named Dolphin. Statistical Analysis Used: Wilcoxon Signed-Ranks test was used, and the probability value (P value of 0.05 was considered as statistically significant level. Results: Eleven adult patients with CLP were retrospectively analyzed. After distraction, there was a significant mean maxillary advancement of 14 mm (P < 0.01 from a T1 value of 73.54 ± 10.38 to a T2 value of 88.2 ± 10.49. The lower facial height and the incisor exposure were significantly increased. The nasolabial angle had a significant improvement of 24.5° (P < 0.01 from a T1 value of 56.6 ± 21.03 to a T2 value of 81.18 ± 14.4.The upper airway was significantly improved by 3.7 mm (P < 0.01 with a T1 value of 13.5 ± 3.8 to a T2 value of 17.2 ± 3.66. After 1-year follow-up, there was a significant maxillary relapse of 3.20 mm (P < 0.05 from a T2 value of 8.29 ± 6.84 to a T3 value of 5.09 ± 5.59. However, the soft-tissue profile and upper airway remained stable. Conclusion: The clinician should have an understanding of the related hard and soft tissues as well as airway changes which may assist him when planning for maxillary advancement for CLP patients with DO. There were significant improvements immediately after distraction, but during the 1-year follow-up, some relapse was

  10. 75 FR 41922 - Notice of Intent To Rule on Request To Release Airport Property at Fort Smith Regional Airport...

    Science.gov (United States)

    2010-07-19

    ... To Release Airport Property at Fort Smith Regional Airport, Fort Smith, AR AGENCY: Federal Aviation... rule and invites public comment on the release of land at Fort Smith Regional Airport under the.... John Parker, Airport Director, Fort Smith Regional Airport, at the following address: Fort Smith...

  11. Experimentally induced distraction impacts cognitive but not emotional processes in think-aloud cognitive assessment

    Directory of Open Access Journals (Sweden)

    Kean J. Hsu

    2014-05-01

    Full Text Available Studies have examined the impact of distraction on basic task performance (e.g., working memory, motor responses, yet research is lacking regarding its impact in the domain of think-aloud cognitive assessment, where the threat to assessment validity is high. The Articulated Thoughts in Simulated Situations think-aloud cognitive assessment paradigm was employed to address this issue. Participants listened to scenarios under three conditions (i.e., while answering trivia questions, playing a visual puzzle game, or with no experimental distractor. Their articulated thoughts were then content-analyzed both by the Linguistic Inquiry and Word Count (LIWC program and by content analysis of emotion and cognitive processes conducted by trained coders. Distraction did not impact indices of emotion but did affect cognitive processes. Specifically, with the LIWC system, the trivia questions distraction condition resulted in significantly higher proportions of insight and causal words, and higher frequencies of non-fluencies (e.g., uh or umm and filler words (e.g., like or you know. Coder-rated content analysis found more disengagement and more misunderstanding particularly in the trivia questions distraction condition. A better understanding of how distraction disrupts the amount and type of cognitive engagement holds important implications for future studies employing cognitive assessment methods.

  12. The relationship between dehydroepiandrosterone (DHEA, working memory and distraction--a behavioral and electrophysiological approach.

    Directory of Open Access Journals (Sweden)

    Sónia do Vale

    Full Text Available Dehydroepiandrosterone (DHEA and dehydroepiandrosterone-sulphate (DHEAS have been reported to have memory enhancement effects in humans. A neuro-stimulatory action and an anti-cortisol mechanism of action may contribute to that relation. In order to study DHEA, DHEAS and cortisol relations to working memory and distraction, we recorded the electroencephalogram of 23 young women performing a discrimination (no working memory load or 1-back (working memory load task in an audio-visual oddball paradigm. We measured salivary DHEA, DHEAS and cortisol both before each task and at 30 and 60 min. Under working memory load, a higher baseline cortisol/DHEA ratio was related to higher distraction as indexed by an enhanced novelty P3. This suggests that cortisol may lead to increased distraction whereas DHEA may hinder distraction by leading to less processing of the distractor. An increased DHEA production with consecutive cognitive tasks was found and higher DHEA responses attributed to working memory load were related to enhanced working memory processing as indexed by an enhanced visual P300. Overall, the results suggest that in women DHEA may oppose cortisol effects reducing distraction and that a higher DHEA response may enhance working memory at the electrophysiological level.

  13. Effects of music therapy and distraction cards on pain relief during phlebotomy in children.

    Science.gov (United States)

    Aydin, Diler; Sahiner, Nejla Canbulat

    2017-02-01

    To investigate three different distraction methods (distraction cards, listening to music, and distraction cards + music) on pain and anxiety relief in children during phlebotomy. This study was a prospective, randomized, controlled trial. The sample consisted of children aged 7 to 12years who required blood tests. The children were randomized into four groups, distraction cards, music, distraction cards + music, and controls. Data were obtained through face-to-face interviews with the children, their parents, and the observer before and after the procedure. The children's pain levels were assessed and reported by the parents and observers, and the children themselves who self-reported using Wong-Baker FACES. The children's anxiety levels were also assessed using the Children's Fear Scale. Two hundred children (mean age: 9.01±2.35years) were included. No difference was found between the groups in the self, parent, and observer reported procedural pain levels (p=0.72, p=0.23, p=0.15, respectively). Furthermore, no significant differences were observed between groups in procedural child anxiety levels according to the parents and observer (p=0.092, p=0.096, respectively). Pain and anxiety relief was seen in all three methods during phlebotomy; however, no statistically significant difference was observed. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. The Character as Text in Philip Massinger’s A New Way to Pay Old Debts Le Personnage comme texte dans A New Way to Pay Old Debts de Philip Massinger

    Directory of Open Access Journals (Sweden)

    Wendy Ribeyrol

    2009-06-01

    Full Text Available Dans A New Way to Pay Old Debts de Philip Massinger la réputation est perçue comme une feuille blanche sur laquelle le personnage doit écrire le récit de sa vie. L’idée de la vie d’un homme comme livre ou comme feuille de papier est fort ancienne, elle figure aussi bien dans la Bible que dans les livres d’emblèmes des XVIe et XVIIe siècles. Au moment de la mort, l’homme laisse ainsi à la postérité un texte édifiant dont il aura été l’auteur (auctor. Cet article démontre  qu’il faut néanmoins faire une distinction entre l’homme, qui prend plume et rédige son propre texte, et la femme qui doit attendre passivement qu’un autre compose le sien.

  15. Redo-urethroplasty in pelvic fracture urethral distraction defect: an audit.

    Science.gov (United States)

    Bhagat, Suresh K; Gopalakrishnan, Ganesh; Kumar, Santosh; Devasia, Antony; Kekre, Nitin S

    2011-02-01

    To predict the outcome of redo-urethroplasty after failed single or multiple open urethral procedures for pelvic fracture urethral distraction defects. From January 1997 to December 2006, 43 patients underwent redo-urethroplasty for pelvic fracture urethral distraction defect. Forty-one were referred from other centers. All had undergone open surgery along with an endoscopic procedure (one or more procedures in each patient) which included endoscopic internal urethrotomy, urethral stenting or urethral dilations. There were 43 men with mean age of 29 (range 11-52). Eleven had associated injuries: intraperitoneal bladder rupture (3), bladder neck (2), rectum (3), anal sphincter (2), combined bladder, rectum and anal sphincter (1). Trocar suprapubic cystostomy was performed in 22, rail-road procedures in 10 and open suprapubic cystostomy in 11 along with the management of associated injuries as immediate treatment. Of 43 patients, 28 had progressive perineal, and 12 had transpubic repair. Three patients had total bulbar necrosis, and they underwent prepuceal tube reconstruction (1) and staged substitution with BMG and standard scrotal inlay (2). Analysis of various factors like number of attempts at previous surgery and stricture length did not affect the outcome. A successful result was achieved in 36 (83.72%), improved and stable in five and failure in two. The overall result of redo-urethroplasty for pelvic fracture urethral distraction defect continues to be gratifying. Failures happen usually within the first 3 months. Substitution urethroplasty can be reserved for those who have long distraction defect. Long-term follow-up is essential using stringent criteria to measure success.

  16. L’Asie insulaire, forte exportatrice de main-d’oeuvre féminine possède-t-elle un système migratoire propre ? Les cas indonésien, philippin et sri-lankais

    Directory of Open Access Journals (Sweden)

    Laurence Husson

    2008-09-01

    Full Text Available L'Asie insulaire, forte exportatrice de main-d'oeuvre féminine possède-t-elle un système migratoire propre ? Les cas indonésien, philippin et sri-lankais.Les migrations de travail ont une longue tradition en Asie. Instaurées par les puissances coloniales européennes par le biais des contrats de travail, après l'abolition de l'esclavage, elles ont ainsi favorisé l'expansion de deux solides diasporas, l'une chinoise, l'autre indienne.Ce vaste continent qui abrite désormais 60 % de la population mondiale et les deux tiers de la force de travail mondiale demeure, pour longtemps encore, une zone de très forte mobilité.Trois pays, dont deux archipels et une île, les Philippines, l'Indonésie et le Sri Lanka, sont devenus, en l'espace d'une à trois décennies, les principaux exportateurs de main-d'œuvre à l'échelle mondiale. Ces politiques migratoires visent d'une part à réduire la pauvreté et le chômage et d'autre part à accroître les indispensables rentrées de devises par le biais des transferts financiers des migrants.La féminisation des flux migratoires est particulièrement marquée en Asie insulaire où la proportion de femmes avoisine les 70 % du total des migrantsThe labour migration have a long tradition in Asia. Migration, which were introduced by European colonial powers (through employment contracts, after the abolition of slavery, have encouraged the expansion of two solid diasporas, 'One China, one Indian. This vast continent, home now 60% of the world's population and two thirds of the global labor force, remains for a long time, a zone of very high mobility. Three countries, including two archipelagos and one island, the Philippines, Indonesia and Sri Lanka are now in the space of one to three decades, the main exporters of labour globally . The objective of these policies migration is a part of reducing poverty and unemployment, and secondly to increase the necessary cash currency,with financial transfers of

  17. Liquid radwaste processing history at Fort Calhoun Nuclear Station

    International Nuclear Information System (INIS)

    Bilau, A.; Rutar, F.

    1989-01-01

    This report presents a historical perspective of liquid radwaste processing at the Fort Calhoun Unit 1 Nuclear Power Station, located in east central Nebraska. Of particular interest is the textual and graphical comparison of the operational implications of the various waste processing methods employed in the last ten years at the Fort Calhoun Station. Fort Calhoun's waste collection and processing systems are described in detail. These process systems include evaporation and solidification employing an in-plant drum solidification system. This solidification system was later replaced with vendor solidification services which solidified wastes in large liners. Ultimately, the plant converted its processing operation to ion exchange cleanup using ion selective media. The operational and economic impact of each of these process systems is discussed including overall costs, personnel exposure, capital expenditure requirements, burial volumes generated, maintenance and reliability assessments. Operational goals and performance criteria employed in the decision-making process for selection of the optimal technology are discussed, including the impact of various influent and effluent requirements

  18. 77 FR 12907 - Visual-Manual NHTSA Driver Distraction Guidelines for In-Vehicle Electronic Devices

    Science.gov (United States)

    2012-03-02

    ... require accommodations such as a sign language interpreter or translator. For technical issues concerning... Transportation's Web site on distracted driving, Distraction.gov , NHTSA's Web site, www.nhtsa.gov , or by... available on the Web pages listed above under FOR FURTHER INFORMATION CONTACT and also in the rulemaking...

  19. Perioperative incidents associated with internal maxillary distraction osteogenesis: a retrospective study of 20 patients.

    Science.gov (United States)

    Kristian, Andersen; Erik, Nørholt Sven; Annelise, Küseler; John, Jensen; Klit, Pedersen Thomas

    2012-12-01

    This retrospective study aimed to assess the frequency and distribution of incidents encountered during the perioperative period of maxillary distraction with internal devices. The perioperative period was defined as the period between device placement and removal. Records of 20 patients treated during 2004-2011 with internal maxillary distraction osteogenesis were examined. Incidents were registered in terms of severity and need of intervention. Eighty percent of the patients experienced minor incidents, of which the most frequent were pain during activation and infections; 80% of these experienced ≥1 hard and soft tissue-related incidents, and 20% ≥1 device-related incidents. All incidents were solved with minimal or no intervention. Maxillary distraction using internal devices is a safe treatment with only minor incidents in the perioperative period. Preoperative planning and good cooperation are essential for preventing postoperative incidents. Prophylactic antibiotic treatment during the distraction period may be indicated. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Distractibility in Attention/Deficit/ Hyperactivity Disorder (ADHD): the virtual reality classroom.

    Science.gov (United States)

    Adams, Rebecca; Finn, Paul; Moes, Elisabeth; Flannery, Kathleen; Rizzo, Albert Skip

    2009-03-01

    Nineteen boys aged 8 to 14 with a diagnosis of ADHD and 16 age-matched controls were compared in a virtual reality (VR) classroom version of a continuous performance task (CPT), with a second standard CPT presentation using the same projection display dome system. The Virtual Classroom included simulated "real-world" auditory and visual distracters. Parent ratings of attention, hyperactivity, internalizing problems, and adaptive skills on the Behavior Assessment System for Children (BASC) Monitor for ADHD confirmed that the ADHD children had more problems in these areas than controls. The difference between the ADHD group (who performed worse) and the control group approached significance (p = .05; adjusted p = .02) in the Virtual Classroom presentation, and the classification rate of the Virtual Classroom was better than when the standard CPT was used (87.5% versus 68.8%). Children with ADHD were more affected by distractions in the VR classroom than those without ADHD. Results are discussed in relation to distractibility in ADHD.