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Sample records for proximal achievement outcomes

  1. Proximal outcomes matter: a multilevel examination of the processes by which coordinating councils produce change.

    Science.gov (United States)

    Javdani, Shabnam; Allen, Nicole E

    2011-03-01

    Communities are engaged in efforts to create a coordinated response to intimate partner violence. Though coordinating councils are commonly employed vehicles for such efforts, research provides only equivocal support regarding their effectiveness. These mixed findings may reflect methodological and conceptual challenges. Specifically, there is an over-reliance on conceptualizing council effectiveness in terms of distal outcomes (e.g., behavior change), rather than the intermediary processes by which councils affect change. A direct assessment of councils' proximal outcomes may highlight change mechanisms. To that end, this study investigates the extent to which councils impact proximal outcomes and examines the processes through which proximal outcomes are interrelated and linked to distal community change. Study findings suggest that perceived proximal outcomes do significantly predict variability in perceived distal community change across councils. Specifically, promotion of social capital and institutionalized change predict achievement of distal community change, and promotion of social capital also predicts achievement of institutionalized change.

  2. The sooner, the better: exercise outcome proximity and intrinsic motivation.

    Science.gov (United States)

    Evans, M Blair; Cooke, Lisa M; Murray, Robyn A; Wilson, Anne E

    2014-11-01

    Despite evidence that outcomes are highly valued when they are expected sooner rather than further into the future (Ainslie, 1975), limited research effort has been devoted to understanding the role of exercise outcome proximity. The purpose of this study was to examine how temporal proximity to positive outcomes influences exercisers' intrinsic motivation. We expected that focusing people on temporally proximal exercise outcomes would increase intrinsic motivation, especially among low-frequency exercisers. This online experimental study was completed by 135 community exercisers (Mage  = 31.11, SD = 10.29; 62% female) who reported an average of 4.86 exercise bouts per week (SD = 2.12). Participants were randomly assigned to a condition that primed temporally proximal positive exercise outcomes (i.e. experienced during or directly following an exercise bout) or temporally distal outcomes (i.e. experienced after days, months, or years of regular exercise). Participants then reported perceptions of behavioral regulation in exercise. As expected, the proximal exercise outcome condition elicited increased intrinsic regulation among those participants who exercised less frequently (i.e. 1 SD below the mean). This study reveals the importance of considering proximity as an important dimension of exercise outcomes-particularly when promoting intrinsic motivation among relatively infrequent exercisers. © 2014 The International Association of Applied Psychology.

  3. Cast index in predicting outcome of proximal pediatric forearm fractures

    Directory of Open Access Journals (Sweden)

    Hassaan Qaiser Sheikh

    2015-01-01

    Conclusion: Cast index is useful in predicting redisplacement of manipulated distal forearm fractures. We found that in proximal half forearm fractures it is difficult to achieve a CI of <0.8, but increased CI does not predict loss of position in these fractures. We therefore discourage the use of CI in proximal half forearm fractures.

  4. How to improve outcome in surgery for Proximal Hypospadias?

    Science.gov (United States)

    Qureshi, Abdul Hafeez; Zaidi, Syed Zafar

    2016-02-01

    To evaluate the role of subdartos fascial tissue as watertight layer in improving outcome for 2-stage proximal hypospadias surgery. The experimental study was conducted at the Department of Urology, Indus Hospital, Karachi, and comprised an audit of patients with proximal hypospadias who underwent surgery from July 1, 2007, to December 31, 2011. The initial two-stage repair of proximal hypospadias led to a high rate of urethrocutanous fistula formation (Group A), and, thus, a modification was introduced and subdartos facial double layer was applied over the urethral suture line (Group B). The results were compared regarding age, type of hypospadias, graft failure and urethrocutanous fistula in these patients. There were 27 patients in Group A and 16(59.3%) of them ended up having urethrocutanous fistula. Group B had 25 patients and only 2(8%) had fistula formation. The application of dartos facial flap waterproofing layer reduced fistula rate.

  5. Initial outcome and efficacy of S3 proximal humerus locking plate in the treatment of proximal humerus fractures

    International Nuclear Information System (INIS)

    Zhang Zhiming; Zhu Xuesong; Bao Zhaohua; Yang Huilin

    2012-01-01

    Objective: to explore the initial outcome and efficacy of S 3 proximal humerus locking plate in the treatment of proximal humerus fractures. Methods: Twenty-two patients with proximal humerus fracture were treated with the S 3 proximal humerus locking plate. Most of the fractures were complex, two-part (n=4), three-part (n=11) and four-part (n=7) fractures according to the Neer classification of the proximal humerus fractures. Results: All patients were followed up for 3∼15 months. There were no complications related to the implant including loosening or breakage of the plate. Good and excellent results were documented in 17 patients fair results in 4 patients according the Neer scores of shoulder. Conclusion: New design concepts of S 3 proximal humerus plate provide the subchondral support and the internal fixation support. With the addition of the proper exercise of the shoulder joint, the outcomes would be satisfied. (authors)

  6. Residential Proximity to Environmental Hazards and Adverse Health Outcomes

    Science.gov (United States)

    Maantay, Juliana A.; Chakraborty, Jayajit

    2011-01-01

    How living near environmental hazards contributes to poorer health and disproportionate health outcomes is an ongoing concern. We conducted a substantive review and critique of the literature regarding residential proximity to environmental hazards and adverse pregnancy outcomes, childhood cancer, cardiovascular and respiratory illnesses, end-stage renal disease, and diabetes. Several studies have found that living near hazardous wastes sites, industrial sites, cropland with pesticide applications, highly trafficked roads, nuclear power plants, and gas stations or repair shops is related to an increased risk of adverse health outcomes. Government agencies should consider these findings in establishing rules and permitting and enforcement procedures to reduce pollution from environmentally burdensome facilities and land uses. PMID:22028451

  7. Functional Outcome of Proximal Humeral Fractures Treated with Philos Plate in Adults

    International Nuclear Information System (INIS)

    Aliuddin, A. M.; Idrees, Z.; Zamir, M.; Kazim, M.; Najjad, R.; Shah, S. A. A.

    2016-01-01

    Background: Proximal humeral fractures account for 4-5 percent of all fractures. Most fractures are minimally displaced and can be managed non-operatively in adults. Displaced and unstable fractures are difficult to manage and should be treated to achieve painless shoulder and full function. Our aim was to evaluate the functional outcome of proximal humerus fractures (Neers classification 2 part, 3 part and 4 part) treated with PHILOS (Proximal humeral internal locking system). Methods: We retrospectively reviewed 22 patients who had proximal humerus fractures treated with PHILOS plate from Jan 2012 to June 2013 conducted at Orthopaedic Department Liaquat National Hospital. Clinical outcome was measured using DASH (disability of arm, shoulder and hand) Score System. Radiological union was assessed by serial X rays. Result. Two patients were lost to follow up. Mean age was 40 years (20-70). Mean follow up was 6 months. 4 patients had two-part fracture, 10 patients had three-part and 6 patients had four-part fracture. Radiological union was achieved in average 8.31 weeks (±1.37SD). Average DASH score in young patients was 15.14 (±1.91SD) and in elderly was 31.66 (±4.08SD). One case of implant failure was noted. Better results in younger patients were achieved as compared to elderly proved by DASH score. Conclusion: Increase in number of fracture parts and delay in treatment did not affect the outcome. Our study concluded that this implant provides stable fixation in younger patients with good quality bone sufficient to allow mobilization. (author)

  8. Proximity to the treating centre and outcomes following subarachnoid hemorrhage.

    Science.gov (United States)

    O'Kelly, Cian J; Spears, Julian; Urbach, David; Wallace, M Christopher

    2011-01-01

    In the management of subarachnoid hemorrhage (SAH), the potential for early complications and the centralization of limited resources often challenge the delivery of timely neurosurgical care. We sought to determine the impact of proximity to the accepting neurosurgical centre on outcomes following aneurysmal SAH. Using administrative data, we analyzed patients undergoing treatment for aneurysmal subarachnoid hemorrhage at neurosurgical centres in Ontario between 1995 and 2004. We compared mortality for patients receiving treatment at a centre in their county (in-county) versus those treated from outside counties (out-of-county). We also examined the impact of distance from the patient's residence to the treating centre. The mortality rates were significantly lower for in-county versus out-of-county patients (23.5% vs. 27.6%, p=0.009). This advantage remained significant after adjusting for potential confounders (HR=0.84, p=0.01). The relationship between distance from the treating centre and mortality was biphasic. Under 300 km, mortality increased with increasing distance. Over 300 km, a survival benefit was observed. Proximity to the treating neurosurgical centre impacts survival after aneurysmal SAH. These results have significant implications for the triage of these critically ill patients.

  9. FUNCTIONAL OUTCOME OF PROXIMAL HUMERUS FRACTURES TREATED WITH LOCKING PLATES

    Directory of Open Access Journals (Sweden)

    Lokesh

    2016-05-01

    Full Text Available INTRODUCTION For more displaced fractures and osteopenic bone, techniques of internal fixation, which emphasise less disruptive soft tissue dissection, and minimal fixation with wire and non-absorbable sutures have been successful with a low complication rate. Even AO type buttress plates are being used, but they require more soft tissue dissection and may lead to infection. Management of these fractures is associated with some morbidity and undesirable sequelae. They include complications like avascular necrosis, malunion, non-union, infection, neurovascular injury, loss of motion of shoulder from adhesive capsulitis, chronic oedema, elbow stiffness and atrophy of the soft tissues of the immobilised limb causing significant disability during healing and afterwards. The purpose of this study is to evaluate the functional outcome of the surgical management of fresh displaced three- and four-part proximal humerus fractures with locking plate system. MATERIAL AND METHODS The present study was carried out from August 2012 to December 2014 at Orthopaedic Department in Bangalore Medical College and Hospital. During this period, 25 patients of proximal humerus fractures were treated with locking plates. All patients were followed up for every 4 weeks. Local examination of the affected shoulder for tenderness, instability, deformity and shoulder movements were assessed. X-rays were taken at each visit to know about progressive fracture union and implant position. Rehabilitation of the affected extremity was done according to the stage of fracture union and time duration from surgery. Patients were followed up till radiological union. RESULTS The present study consists of 25 patients of fresh three- and four-part fractures of proximal humerus which were treated surgically with locking plates from August 2012 to December 2014. All the patients were available for follow-up and they were followed every month for first 3 months then once in 3 months. In this

  10. Fibulectomy for primary proximal fibular bone tumors: A functional and clinical outcome in 46 patients

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    Zile Singh Kundu

    2018-01-01

    Full Text Available Background: Primary benign and malignant tumors of the proximal fibula are not very common. Upper fibula being an expendable bone; the majority of the primary bone tumors at this site are usually treated with en bloc proximal fibulectomy. There is scarce literature on functional results, difficulties faced during dissection when to preserve or sacrifice common peroneal nerve and importance of lateral collateral ligament repair after proximal fibulectomy. The present study attempts at assessing these variables. Materials and Methods: This retrospective study included 46 patients; 30 males and 16 females with age ranging from 12 to 44 years (average: 26 years operated between 2003 and 2014. There were 34 benign and 12 malignant tumors. All were treated with proximal en bloc fibulectomy as indicated and decided by the operating surgeon keeping in view its extent on magnetic resonance imaging. Peroneal nerve sacrifice or preservation was decided as per the type (benign/malignant, its involvement by the tumor and the extent of the tumor. In 14 (for 12 malignant and two benign giant cell tumors [GCTs] patients, the peroneal nerve required resection for the margins. Partial upper tibial resection was performed in cases of malignant tumors and three GCTs. The followup ranged between 24 and 120 months (median: 48 months. Results: Patients with peroneal nerve resection had inferior functional outcome than those without peroneal nerve resection. There was no higher risk of tibia fracture in patients with partial tibial resection. Lateral collateral reconstruction yielded better results and should be performed in all cases. Functional outcome was significantly better in patients with benign tumors than in patients with malignant tumors as these required neither resection of the peroneal nerve nor large amount of muscle excision. The functional results were evaluated using Musculoskeletal Tumor Society (MSTS score, and clinical outcomes were evaluated using

  11. Outcome of plate osteosynthesis in the management of proximal ...

    African Journals Online (AJOL)

    Background: This paper reports the aetiology, presentation and management of proximal humeral fractures (PHF) in our setup. Objective: To ... Five of thirty two operated cases (15%) developed significant shoulder joint stiffness. ... There is need for arthroplasty in those with severe injury, particularly those with osteoporosis.

  12. Long‑Term Outcome of Endoprosthetic Replacement for Proximal ...

    African Journals Online (AJOL)

    Giant cell tumor (GCT) represents 5% of neoplasms of bone. It is a benign locally aggressive tumor usually involving the distal end of the femur, proximal tibia and distal radius in young adults.[1-3] The main variables to be considered for planning treatment include the site of involvement and Campanacci stage of the tumor.

  13. Surgical outcome of delayed presentation of congenital proximal radioulnar synostosis

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    Garg Gaurav

    2015-01-01

    Full Text Available Background: Presentation of proximal radioulnar synostosis varies from cosmetic concerns with no functional limitations to significant pronation deformity which hampers activities of daily living. Surgical management must be considered based on the position of the forearm and functional limitations. We describe the surgical technique, results, and complications of excision of the radial head along with the proximal radius up to the distal extent of the synostosis site and securing the osteotomized radial shaft with a tensor fascia lata graft. Materials and methods: Four patients having six affected elbows with delayed presentation of congenital proximal radioulnar synostosis with dislocated radial head managed surgically were included in the study. There were three males and one female with an average age of 20.25 years (ranging from 16 to 25 years. Preoperatively wrists were locked in the mean pronation position of 51.6° (ranging from 30° to 70°. The indications for surgery were limitation in activities of daily living and an obvious cosmetic deformity. Results: All patients were satisfied with the surgery and showed significant improvement in functional status. Mean active supination was 15° (ranging from 5 to 32° with passive supination was a mean of 24.8° (ranging from 11° to 44°. Similarly, mean active pronation was 58.5° (ranging from 50° to 71° with further passive correction up to a mean of 64.16° (ranging from 57° to 87° at last follow up. Conclusions: This procedure is simple, cost effective, and a reasonable option for treatment of proximal radioulnar synostosis with a dislocated radial head in adult patients. The operation does not require any specialized team or implants, and can be performed in a moderately equipped hospital.

  14. Functional outcome after repair of proximal hamstring avulsions.

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    Birmingham, Patrick; Muller, Mark; Wickiewicz, Thomas; Cavanaugh, John; Rodeo, Scott; Warren, Russell

    2011-10-05

    Rupture of the proximal origin of the hamstrings leads to pain, weakness, and a debilitating decrease in physical activity. Repair of these injuries should be based on the expectation that these deficits can be addressed. The goal of this study was to objectively evaluate the efficacy of repair of proximal hamstring avulsions. Thirty-four patients were identified retrospectively to have a complete rupture of the proximal origin of the hamstrings based on the presence of a bowstring sign and the results of magnetic resonance imaging (MRI).Patients were contacted for follow-up evaluation to fill out a subjective questionnaire, to undergo functional testing, and to undergo isokinetic testing on a Cybex dynamometer. Twenty-three patients were evaluated. There were nine acute and fourteen chronic repairs, and the average period of follow-up was 43.3 months. Twenty-one of twenty-three patients reported returning to activity at an average of 95% of their pre-injury activity level at an average of 9.8 months. Eighteen patients reported excellent results; four, good results; and one, fair results. Hamstring strength was an average of 93% and 90% of that in the uninvolved limb at 240° per second and 180° per second, respectively. The hamstrings-to-quadriceps ratio was 56% for 240° per second and 48% at 180° per second. Hamstring endurance was an average of 81% and 91% of the nonoperative limb at 240° per second and 180° per second, respectively. Postoperative quadriceps strength and endurance were positively correlated with return to pre-injury level of activity (r = 0.6, p hamstring tendon yields good subjective and objective functional results with minimal complications. Overall, patients are satisfied with surgical repair and experience return of functional activity with minimal postoperative weakness.

  15. Complex proximal ulna fractures: outcomes of surgical treatment.

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    Melamed, Eitan; Danna, Natalie; Debkowska, Monika; Karia, Raj; Liporace, Frank; Capo, John T

    2015-07-01

    To review the results of plating of various fracture patterns of proximal ulna fractures including isolated olecranon fractures, olecranon fractures combined with a coronoid fracture, and olecranon fractures combined with a coronoid and radial head fracture. The study included 38 patients with either an isolated olecranon fracture or combined injuries, all treated with open reduction and internal fixation of the olecranon. Other procedures were performed as needed, including radial head fixation or arthroplasty, fixation of the coronoid, and repair of the lateral collateral ligament complex. There were 27 men and 11 women with an average age of 49 years. Clinical and radiographic assessment was obtained at an average follow-up time of 15 and 8.4 months, respectively. All fractures healed within 5 months. The average arc of ulnohumeral motion was 91° (range 0°-140°); average pronation-supination arc was 128° (range 0°-180°). Subgroup analysis showed a statistically significant lower rotational motion arc in patients with associated radial head (73°) or coronoid fractures (68°) compared to isolated olecranon fractures. All other parameters including ulnohumeral motion, complication rate, and revision rate were similar among the groups. A stable, functional elbow can be restored in most patients with proximal ulna fractures treated with open reduction and internal fixation. Loss of full flexion is likely with high-energy trauma, complex fracture patterns, and concomitant injuries. Fracture patterns involving the coronoid and/or the radial head are associated with restricted forearm rotation. III.

  16. Can We Achieve Outcome-Based Education?

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    King, Jean A.; Evans, Karen M.

    1991-01-01

    Outcome-based education is rooted in earlier ideas, such as Tyler's objectives, Spady's outcomes, Glaser's criterion-referenced measurement, Bloom's mastery learning, 1970s accountability concerns, and the 1960s competency-based education movement. Minnesota's experience suggests various practical implementation challenges concerned with…

  17. Proximal Interphalangeal Joint Silicone Arthroplasty for Osteoarthritis: Midterm Outcomes.

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    Naghshineh, Nima; Goyal, Kanu; Giugale, Juan M; Neral, Mithun K; Ferreira, Joel V; Buterbaugh, Glenn A; Imbriglia, Joseph E

    2018-04-01

    Osteoarthritis of the proximal interphalangeal (PIP) joint affects a large percentage of the population and can lead to significant functional disability. The purpose of this study is to evaluate the midterm clinical effectiveness of PIP joint arthroplasty for nonrheumatic arthritis. A single-center retrospective cohort study evaluating preoperative and postoperative objective and subjective measures was conducted. Range of motion (ROM), Disabilities of the Arm, Shoulder and Hand scores, key pinch strength, grip strength, and satisfaction with respect to pain, deformity, function, and strength were measured. Forty-five fingers in 25 patients were followed up for a mean period of 42 months. Preoperative and postoperative mean ROM was equivalent at 59.1° and 59.2°, respectively. Postoperative grip and key pinch strength showed significant improvement and near normalization compared with contralateral extremity. Complication rate was 37% with 20% requiring revision surgery. Patients with diabetes mellitus had higher odds of requiring revision surgery. Pain scores improved from 7.4 to 1.9 on a visual analog scale. Overall satisfaction was high at 84%, and 91% of patients would have the surgery performed again. Silicone arthroplasty for osteoarthritis of the PIP remains a good option for pain relief. Our study presents midterm follow-up data that support significant pain relief, increased grip and key pinch strength, and high satisfaction associated with this implant.

  18. The Outcome in Early Cases of Treatment of Subtrochanteric Fractures with Proximal Femur Locking Compression Plate

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    U Gunadham

    2014-07-01

    Full Text Available The objective of this study was to evaluate the outcome in early treatment of subtrochanteric fractures with proximal femur locking compression plate (PF-LCP.The patients included in this study were those with subtrochanteric fractures (AO type 32A-C treated with PF-LCP (Synthes between Jan 2009 and Jun 2011. The patient characteristics and details of clinical conditions were obtained from records. Clinical and radiographic follow-ups were done at one, two, four and 6 months intervals, and at one year. The primary outcome studied included fracture union and functional ambulatory status. Twenty-six patients were included in the study, 19 of whom were male with a mean age of 42.4 years. Fourteen patients (53.9% had sustained AO type 32B fractures, the majority in motor vehicle accidents. Twenty-two fractures (84.6% achieved union, while sixpatients (23.1% had complications such as broken plate, varus collapse, and broken screw. Four patients (15.4% underwent a second operation. At the end of the follow-ups, 25 patients (96.2% were community ambulators. We conclude that PF-LCP is an effective alternative treatment for subtrochanteric fractures when properly performed.

  19. Improving Outcome Measures Other Than Achievement

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    Kristin Anderson Moore

    2015-05-01

    Full Text Available Research indicates that educational, economic, and life success reflect children’s nonacademic as well as academic competencies. Therefore, longitudinal surveys that assess educational progress and success need to incorporate nonacademic measures to avoid omitted variable bias, inform development of new intervention strategies, and support mediating and moderating analyses. Based on a life course model and a whole child perspective, this article suggests constructs in the domains of child health, emotional/psychological development, educational achievement/attainment, social behavior, and social relationships. Four critical constructs are highlighted: self-regulation, agency/motivation, persistence/diligence, and executive functioning. Other constructs that are currently measured need to be retained, including social skills, positive relationships, activities, positive behaviors, academic self-efficacy, educational engagement, and internalizing/emotional well-being. Examples of measures that are substantively and psychometrically robust are provided.

  20. Residential proximity to major roadways and traffic in relation to outcomes of in vitro fertilization.

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    Gaskins, Audrey J; Hart, Jaime E; Mínguez-Alarcón, Lidia; Chavarro, Jorge E; Laden, Francine; Coull, Brent A; Ford, Jennifer B; Souter, Irene; Hauser, Russ

    2018-03-29

    Emerging data from animal and human studies suggest that traffic-related air pollution adversely affects early pregnancy outcomes; however evidence is limited. We examined whether residential proximity to major roadways and traffic, as proxies for traffic-related air pollution, are associated with in vitro fertilization (IVF) outcomes. This analysis included 423 women enrolled in the Environment and Reproductive Health (EARTH) Study, a prospective cohort study, who underwent 726 IVF cycles (2004-2017). Using geocoded residential addresses collected at study entry, we calculated the distance to nearest major roadway and the traffic density within a 100 m radius. IVF outcomes were abstracted from electronic medical records. We used multivariable generalized linear mixed models to evaluate the associations between residential proximity to major roadways and traffic density and IVF outcomes adjusting for maternal age, body mass index, race, education level, smoking status, and census tract median income. Closer residential proximity to major roadways was statistically significantly associated with lower probability of implantation and live birth following IVF. The adjusted percentage of IVF cycles resulting in live birth for women living ≥400 m from a major roadway was 46% (95% CI 36, 56%) compared to 33% (95% CI 26, 40%) for women living proximity to major roadways was related to reduced likelihood of live birth following IVF. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Divorced fathers' proximity and children's long-run outcomes: evidence from Norwegian registry data.

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    Kalil, Ariel; Mogstad, Magne; Rege, Mari; Votruba, Mark

    2011-08-01

    This study examines the link between divorced nonresident fathers' proximity and children's long-run outcomes, using high-quality data from Norwegian population registers. We follow (from birth to young adulthood) each of 15,992 children born into married households in Norway in the years 1975-1979 whose parents divorced during his or her childhood. We observe the proximity of the child to his or her father in each year following the divorce and link proximity to educational and economic outcomes for the child in young adulthood, controlling for a wide range of observable characteristics of the parents and the child. Our results show that closer proximity to the father following a divorce has, on average, a modest negative association with offspring's outcomes in young adulthood. The negative associations are stronger among children of highly educated fathers. Complementary Norwegian survey data show that highly educated fathers report more post-divorce conflict with their ex-wives as well as more contact with their children (measured in terms of the number of nights that the child spends at the father's house). Consequently, the father's relocation to a more distant location following the divorce may shelter the child from disruptions in the structure of the child's life as they split time between households and/or from post-divorce interparental conflict.

  2. Long-Term Outcomes of ADHD: Academic Achievement and Performance.

    Science.gov (United States)

    Arnold, L Eugene; Hodgkins, Paul; Kahle, Jennifer; Madhoo, Manisha; Kewley, Geoff

    2015-01-12

    The aim of this study was to synthesize published data regarding long-term effects of ADHD on information learned (measured via achievement tests) and success within the school environment (academic performance). A systematic search identified 176 studies (1980-2012) of long-term (≥2 years) academic outcomes with ADHD. Achievement test outcomes (79%) and academic performance outcomes (75%) were worse in individuals with untreated ADHD compared with non-ADHD controls, also when IQ difference was controlled (72% and 81%, respectively). Improvement in both outcome groups was associated with treatment, more often for achievement test scores (79%) than academic performance (42%), also when IQ was controlled (100% and 57%, respectively). More achievement test and academic performance outcomes improved with multimodal (100% and 67%, respectively) than pharmacological (75% and 33%) or non-pharmacological (75% and 50%) treatment alone. ADHD adversely affects long-term academic outcomes. A greater proportion of achievement test outcomes improved with treatment compared with academic performance. Both improved most consistently with multimodal treatment. © 2015 SAGE Publications.

  3. Outcome analysis following removal of locking plate fixation of the proximal humerus

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    Fischer Florian

    2008-10-01

    Full Text Available Abstract Background Concerning surgical management experience with locking plates for proximal humeral fractures has been described with promising results. Though, distinct hardware related complaints after fracture union are reported. Information concerning the outcome after removal of hardware from the proximal humerus is lacking and most studies on hardware removal are focused on the lower extremity. Therefore the aim of this study was to analyze the functional short-term outcome following removal of locking plate fixation of the proximal humerus. Methods Patients undergoing removal of a locking plate of the proximal humerus were prospectively followed. Patients were subdivided into the following groups: Group HI: symptoms of hardware related subacromial impingement, Group RD: persisting rotation deficit, Group RQ: patients with request for a hardware removal. The clinical (Constant-Murley score and radiologic (AP and axial view follow-up took place three and six months after the operation. To evaluate subjective results, the Medical Outcomes Study Short Form-36 (SF-36, was completed. Results 59 patients were included. The mean length of time with the hardware in place was 15.2 ± 3.81 months. The mean of the adjusted overall Constant score before hardware removal was 66.2 ± 25.2% and increased significantly to 73.1 ± 22.5% after 3 months; and to 84.3 ± 20.6% after 6 months (p Conclusion A significant improvement of clinical outcome following removal was found. However, a general recommendation for hardware removal is not justified, as the risk of an anew surgical and anesthetic procedure with all possible complications has to be carefully taken into account. However, for patients with distinct symptoms it might be justified.

  4. Proximal hypospadias: A persistent challenge. Single institution outcome analysis of three surgical techniques over a 10-year period.

    Science.gov (United States)

    Pippi Salle, J L; Sayed, S; Salle, A; Bagli, D; Farhat, W; Koyle, M; Lorenzo, A J

    2016-02-01

    The optimal treatment of proximal hypospadias remains controversial. Several techniques have been described, but the best approach remains unsettled. To evaluate and compare the complication rates of proximal hypospadias with and without ventral curvature (VC), according to three different surgical techniques: tubularized incised plate (TIP) uretroplasty, dorsal inlay graft TIP (DIG), and staged preputial repair (SR). It was hypothesized that SR performs better than TIP and DIG for proximal hypospadias. Single-center, retrospective chart review of all patients with primary proximal hypospadias reconstructed between 2003 and 2013. The DIG was selectively employed in cases with narrow urethral plate (UP) and deficient spongiosum. Extensive urethral plate (UP) mobilization (UPM), dorsal plication (DP) and/or deep transverse incisions of tunica albuginea (DTITA) were selectively performed when attempting to spare transecting the UP. Division of UP and SR was favored in cases with severe VC (>50°), which was often concurrently managed with DTITA if intrinsic curvature was present. For SR, tubularization of the graft was performed 6 months later. A total of 140 patients were included. Tubularized incised plate (TIP), DIG, and SR techniques were performed in 57, 23, and 60 patients, respectively. The TIP and DIG techniques achieved similar success rates, although DIG was performed in cases of narrow and spongiosum-deficient plates. Reoperation rates with TIP and DIG techniques was 52.6% and 52.1% (NS). Urethro-cutaneous fistulas were seen in 31.5% and 13% of TIP and DIG techniques, respectively. Staged repair accomplished better results than both TIP and DIG techniques, despite being performed in the most unfavorable cases (reoperation rate 28%). After technical modifications, the DIG technique achieved similar outcomes of SR. Proximal hypospadias remains challenging, regardless of the technique utilized for its repair. Urethro-cutaneous fistulas were more commonly seen

  5. Closing the achievement gap: the association of racial climate with achievement and behavioral outcomes.

    Science.gov (United States)

    Mattison, Erica; Aber, Mark S

    2007-09-01

    This study investigated the relationship between school racial climate and students' self-reports of academic and discipline outcomes, including whether racial climate mediated and/or moderated the relationship between race and outcomes. Using the Racial Climate Survey-High School Version (M. Aber et al., unpublished), data were gathered from African American (n = 382) and European American students (n = 1456) regarding their perceptions of racial climate. About 18% of the respondents were low-income and approximately 50% were male. Positive perceptions of the racial climate were associated with higher student achievement and fewer discipline problems. Further, race moderated the relationship between racial climate and both achievement and discipline outcomes. Finally, racial differences in students' grades and discipline outcomes were associated with differences in perceptions of racial climate. Results suggest careful attention should be given to the racial climate of secondary schools, particularly for adolescents who perceive schools as unfair.

  6. An Examination of English Language Proficiency and Achievement Test Outcomes

    Science.gov (United States)

    Mojica, Tammy C.

    2013-01-01

    The purpose of the study was to compare the relationship between grade eight English language proficiency as measured by the ACCESS for ELL's assessment (Assessing Comprehension and Communication in English State to State for English Language Learners) and achievement test outcomes on the Pennsylvania System of School Assessment, a state mandated…

  7. Clinical and Functional Outcomes of Treatment for Type A1 Intertrochanteric Femoral Fracture in Elderly Patients: Comparison of Dynamic Hip Screw and Proximal Femoral Nail Antirotation.

    Science.gov (United States)

    Cho, Hong Man; Lee, Kyujung

    2016-12-01

    We aimed to evaluate and compare the clinical and functional outcomes of dynamic hip screw (DHS) and proximal femoral nail antirotation (PFNA) treatment of AO type 1 intertrochanteric fractures in elderly patients. We retrospectively reviewed 194 consecutive patients with type A1 intertrochanteric femoral fractures who were treated with DHS (n=113) or PFNA (n=81). We evaluated operation time, intraoperative blood loss, and functional outcomes, walking ability, and the Barthel activities index. Fracture union, sliding of hip screw, proximal femur shortening, and presence of complications were assessed radiologically at relevant follow-up intervals. The mean operation time and blood loss were significantly lower for the PFNA group, but walking ability and Barthel index decreased to a similar extent for both groups. However, patients in the DHS group complained of significantly more pain ( P =0.049). Although there were no significant differences between the two groups with respect to the time until fracture union was achieved, patients in the DHS group exhibited a higher extent of proximal femoral shortening and sliding of the hip screw. Differences about hip screw sliding and proximal femur shortening within each subgroup were not significant. Compared to DHS treatment, PFNA treatment of type A1 intertrochanteric fractures is associated with reduced blood loss, shorter operation time, and less severe pain after surgery. Additionally, sliding of the hip screw and proximal femur shortening are expected to occur more frequently after DHS.

  8. Birth Outcomes and Maternal Residential Proximity to Natural Gas Development in Rural Colorado

    Science.gov (United States)

    Guo, Ruixin; Witter, Roxana Z.; Savitz, David A.; Newman, Lee S.; Adgate, John L.

    2014-01-01

    Background: Birth defects are a leading cause of neonatal mortality. Natural gas development (NGD) emits several potential teratogens, and U.S. production of natural gas is expanding. Objectives: We examined associations between maternal residential proximity to NGD and birth outcomes in a retrospective cohort study of 124,842 births between 1996 and 2009 in rural Colorado. Methods: We calculated inverse distance weighted natural gas well counts within a 10-mile radius of maternal residence to estimate maternal exposure to NGD. Logistic regression, adjusted for maternal and infant covariates, was used to estimate associations with exposure tertiles for congenital heart defects (CHDs), neural tube defects (NTDs), oral clefts, preterm birth, and term low birth weight. The association with term birth weight was investigated using multiple linear regression. Results: Prevalence of CHDs increased with exposure tertile, with an odds ratio (OR) of 1.3 for the highest tertile (95% CI: 1.2, 1.5); NTD prevalence was associated with the highest tertile of exposure (OR = 2.0; 95% CI: 1.0, 3.9, based on 59 cases), compared with the absence of any gas wells within a 10-mile radius. Exposure was negatively associated with preterm birth and positively associated with fetal growth, although the magnitude of association was small. No association was found between exposure and oral clefts. Conclusions: In this large cohort, we observed an association between density and proximity of natural gas wells within a 10-mile radius of maternal residence and prevalence of CHDs and possibly NTDs. Greater specificity in exposure estimates is needed to further explore these associations. Citation: McKenzie LM, Guo R, Witter RZ, Savitz DA, Newman LS, Adgate JL. 2014. Birth outcomes and maternal residential proximity to natural gas development in rural Colorado. Environ Health Perspect 122:412–417; http://dx.doi.org/10.1289/ehp.1306722 PMID:24474681

  9. Medial Calcar Support and Radiographic Outcomes of Plate Fixation for Proximal Humeral Fractures

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    Shih-Jie Lin

    2015-01-01

    Full Text Available Plate fixation remains one of the most popular surgical procedures for treating proximal humeral fractures (PHFx; however, substantial rates of complications have been reported in the literature. The objectives of the study were to examine how medial calcar support (MCS affects the radiographic outcomes and to determine the prognostic factors predicting treatment failure. We performed a retrospective cohort study of 89 adult patients who had PHFx and were treated with plate fixation at our institution in 2007–2011. The enrolled patients were separated into two groups according to disruption of medial calcar. Our results revealed an increased rate of poor radiographic outcomes in patients with disrupted medial calcar. Osteonecrosis of the humeral head and redisplacement were the two radiographic outcomes which had a positive causality with disruption of medial calcar (P=0.008 and 0.050, resp.. Deficient medial calcar, inadequate reduction, diabetes mellitus, chronic kidney disease, and chronic liver disease were all significant predictors for the development of osteonecrosis in patients after PHFx surgery. Inadequate reduction was also a predictor for redisplacement. We confirmed that the restoration of medial calcar as well as comorbid conditions plays key roles in treatment of patients having PHFx with disrupted medial calcar.

  10. SOARing Into Strategic Planning: Engaging Nurses to Achieve Significant Outcomes.

    Science.gov (United States)

    Wadsworth, Barbara; Felton, Fiona; Linus, Rita

    2016-01-01

    In 2013, a new system chief nursing officer engaged the nursing leaders and staff in an Appreciative Inquiry process utilizing strengths, opportunities, aspirations, and results (SOAR), and a Journey of Excellence to assess and understand the current environment. The ultimate goal was to engage all nurses in strategic planning and goal setting to connect their patient care to the system strategic initiatives. This work led to the creation of a nursing vision, a revised professional practice model and greater council alignment, resulting in significant positive change and ongoing advancement throughout the system. The shared decision-making structure was key to the process with a direct connection of each council's goals, leading to the successful achievement of 34 of the 36 goals in 2 years. This article outlines the process, tools, and staff engagement strategies used to achieve system-wide success. This methodology has improved the outcomes across the organization in both small and system-wide work groups. This work can easily be replicated and adapted to help disparate staffs brought together through mergers or acquisitions to become aligned as a new team. This process, model, and framework, provides structure and results in significant outcomes that recognizes and celebrates the work of individual entities while aligning future strategies and goals.

  11. Patient-Reported Outcome of Surgical Treatment of Nerve Entrapments in the Proximal Forearm

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    Birgitta Svernlöv

    2011-01-01

    Full Text Available The outcome of decompression for long-standing symptoms of nerve entrapments in the proximal forearm was investigated in a retrospective study of 205 patients using a self-assessment questionnaire, 45 months after the operation. The questionnaire consisted of visual analogue scale recordings of pre- and postoperative pain during rest and activity, questions about remaining symptoms and appreciation of the result and the Disabilities of Arm, Shoulder and Hand form (DASH. Altogether, 59% of the patients were satisfied, 58% considered themselves improved, and 3% as being entirely relieved of all symptoms. Pain decreased significantly (=0.001. There was a significant correlation between preoperative duration and patient perceived post-operative pain. Preoperative pain was a chief complaint, and pain reduction appears to be the principal gain of the operation. Although the majority of the patients benefited from the operation, a substantial proportion was not satisfied. There is apparently room for improvement of the diagnostic and surgical methods applied in this study.

  12. Outcome after Reconstruction of the Proximal Tibia--Complications and Competing Risk Analysis.

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    Stephan E Puchner

    Full Text Available The proximal tibia (pT is a common site for bone tumors. Improvements in imaging, chemotherapy and surgical technique made limb salvage surgery the treatment of choice. Yet, reconstructions of the pT have been associated with less favorable outcome compared to other parts of the extremities. The aim of this study was to evaluate the outcome of patients with a modular endoprosthetic reconstruction of the pT.Eighty-one consecutive patients with an average age of 29 years underwent endoprosthetic reconstruction of the pT. Postoperative complications were categorized according to the ISOLS classification, and revision-free survival until first complication (any Type 1-5, soft tissue failure (Type 1, aseptic loosening (Type 2, structural failure (Type 3, infection (Type 4, and local tumor progression (Type 5 was estimated by using a Fine-Gray model for competing risk analyses for univariate and multivariable regression with Firth's bias correction.A total of 45 patients (56% had at least one complication. Cumulative incidence for complication Types 1 to 5 at 5 years with death and amputation as competing events revealed a risk of 41% for the first complication, 14% for Type 1, 16% for Type 2, 11% for Type 3, 17% for Type 4, and 1% for Type 5.Despite inclusion of amputation and death as strong competing events, pT replacements are still associated with a high risk of postoperative failures. The results suggest that infection and soft tissue failures (Type 1 and 5 seem to depend from each other. Sufficient soft tissue reconstruction and closure allow better function and reduce the risk of infection as the most prominent complication. The use of a rotating hinge design has significantly reduced structural failures over time.

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

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    Mohammad Ali Tahririan

    2015-03-01

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

  14. Postoperative outcomes of initial varus versus initial valgus proximal humerus fracture: A systematic review and meta-analysis.

    Science.gov (United States)

    Chandrappa, Mallikarjun Honnenahalli; Hajibandeh, Shahin; Hajibandeh, Shahab

    2017-01-01

    Our objective was to perform a systematic review of the literature and conduct a meta-analysis to investigate the effect of initial varus or valgus displacement of proximal humerus on the outcomes of patients with proximal humerus fractures treated with open reduction and internal fixation. In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards, we performed a systematic review. Electronic databases MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify randomised and non-randomised studies comparing postoperative outcomes associated with initial varus versus initial valgus displacement of proximal humerus fracture. The Newcastle-Ottawa scale was used to assess the methodological quality and risk of bias of the selected studies. Fixed-effect or random-effects models were applied to calculate pooled outcome data. We identified two retrospective cohort studies and one retrospective analysis of a prospective database, enrolling a total of 243 patients with proximal humerus fractures. Our analysis showed that initial varus displacement was associated with a higher risk of overall complication (RR 2.28, 95% CI 1.12-4.64, P  = 0.02), screw penetration (RR 2.30, 95% CI 1.06-5.02, P  = 0.04), varus displacement (RR 4.38, 95% CI 2.22-8.65, P  varus displacement of proximal humerus fractures is associated with higher risk of overall complication, screw penetration, varus displacement, and reoperation compared to initial valgus displacement. The best available evidence is not adequately robust to make definitive conclusions. Further high quality studies, that are adequately powered, are required to investigate the outcomes of initial varus and valgus displacement in specific fracture types. Level II.

  15. Cystoscopic injections of dextranomer hyaluronic acid into proximal urethra for urethral incompetence: efficacy and adverse outcomes.

    Science.gov (United States)

    Lightner, Deborah J; Fox, Janelle; Klingele, Christopher

    2010-06-01

    To determine whether dextranomer/hyaluronic acid would be more efficacious or would produce fewer complications when using the material in a standard proximal-urethra cystoscopically-directed injection technique. Injectable periurethral bulking agents are an alternative to stress incontinence surgery. Dextranomer, a highly hydrophilic dextran polymer, solubilized in a base of nonanimal stabilized hyaluronic acid, has been approved as an injectable agent for the treatment of childhood vesicoureteric reflux (Deflux, Q-Med AB, Uppsala, Sweden), and in Europe for women with stress urinary incontinence (SUI) (Zuidex, Q-Med AB, Uppsala, Sweden). A previous multicenter trial demonstrated nonequivalence compared with bovine glutaraldehyde cross-linked collagen with a high complication rate. We sought to determine whether the failure of the treatment lay in the material itself or the use of a blind, midurethral injection technique. A retrospective case series of 56 patients undergoing cystoscopically guided bladder neck injections of dextranomer/hyaluronic acid with follow-up in 42, included 35 women with intrinsic sphincter deficiency (ISD), 4 men with postprostatectomy incontinence, 2 men with sphincteric denervation secondary to spinal cord injury, and 1 woman with sphincteric failure after a neobladder. Outcome assessment used gender-appropriate International Consultation on Incontinence Questionnaire, clinical records, and/or urodynamic assessment. Of 35 women with ISD, 4 developed pseudoabscess formation with outlet obstruction requiring multiple operative interventions. Patient-defined treatment failure occurred in all 4 carefully selected postprostatectomy incontinent men, and in 23 of 35 females with ISD. Complications with cystoscopically injected dextranomer hyaluronic acid at the bladder neck occurred at a high rate, and using a validated questionnaire, the efficacy of dextranomer hyaluronic acid applied in this manner for ISD was poor. Copyright (c) 2010

  16. Predictive factors for functional outcome and failure in angular stable osteosynthesis of the proximal humerus.

    LENUS (Irish Health Repository)

    Hardeman, Francois

    2012-02-01

    Angular stable osteosynthesis has become the gold standard in the operative treatment of proximal humeral fractures. The aim of this article is to determine the indications for osteosynthesis versus primary arthroplasty based on clinical and radiological parameters.

  17. Achievement goals in the workplace : Conceptualization, prevalence, profiles, and outcomes

    NARCIS (Netherlands)

    Van Yperen, Nico W.; Orehek, Edward

    2013-01-01

    The purpose of the present paper is to discuss an important component of workers' willingness to perform at their jobs, that is, their achievement motivation. More specifically, we will discuss the conceptualization of the four achievement goals from the 2 x 2 achievement goal framework and present

  18. Proximal Hypospadias

    Science.gov (United States)

    Kraft, Kate H.; Shukla, Aseem R.; Canning, Douglas A.

    2011-01-01

    Hypospadias results from abnormal development of the penis that leaves the urethral meatus proximal to its normal glanular position. Meatal position may be located anywhere along the penile shaft, but more severe forms of hypospadias may have a urethral meatus located at the scrotum or perineum. The spectrum of abnormalities may also include ventral curvature of the penis, a dorsally redundant prepuce, and atrophic corpus spongiosum. Due to the severity of these abnormalities, proximal hypospadias often requires more extensive reconstruction in order to achieve an anatomically and functionally successful result. We review the spectrum of proximal hypospadias etiology, presentation, correction, and possible associated complications. PMID:21516286

  19. Maternal residential proximity to sources of extremely low frequency electromagnetic fields and adverse birth outcomes in a UK cohort.

    Science.gov (United States)

    de Vocht, Frank; Hannam, Kimberly; Baker, Philip; Agius, Raymond

    2014-04-01

    Studies have suggested that exposure to extremely low frequency electromagnetic fields (ELF-EMF) may be associated with increased risk of adverse birth outcomes. This study tested the hypothesis that close proximity to residential ELF-EMF sources is associated with a reduction in birth weight and increased the risk of low birthweight (LBW), small for gestational age (SGA) and spontaneous preterm birth (SPTB). Closest residential proximity to high voltage cables, overhead power lines, substations or towers during pregnancy was calculated for 140356 singleton live births between 2004 and 2008 in Northwest England. Associations between proximity and risk for LBW, SGA and SPTB were calculated, as well as associations with birth weight directly. Associations were adjusted for maternal age, ethnicity, parity and for part of the population additionally for maternal smoking during pregnancy. Reduced average birth weight of 212 g (95% confidence interval (CI): -395 to -29 g) was found for close proximity to a source, and was largest for female births (-251 g (95% CI: -487 to -15 g)). No statistically significant increased risks for any clinical birth outcomes with residential proximity of 50 m or less were observed. Living close (50 m or less) to a residential ELF-EMF source during pregnancy is associated with suboptimal growth in utero, with stronger effects in female than in males. However, only a few pregnant women live this close to high voltage cables, overhead power lines, substations or towers, likely limiting its public health impact. © 2014 Wiley Periodicals, Inc.

  20. Communication and proximity effects on outcomes attributable to sense of presence in distance bioinformatics education.

    Science.gov (United States)

    Locatis, Craig; Berner, Eta S; Hammack, Glenn; Smith, Steve; Maisiak, Richard; Ackerman, Michael

    2011-03-14

    Online learning is increasingly popular in medical education and sense of presence has been posited as a factor contributing to its success. Communication media influences on sense of presence and learning outcomes were explored in this study. Test performance and ratings of instruction and technology, factors influenced by sense of presence, are compared under four conditions involving different media and degrees of student physical presence: 1) videoconference co-located, 2) webcast co-located, 3) videoconference dispersed, and 4) webcast dispersed. Eighty one first to forth year medical students heard a lecture on telemedicine and were asked to collaboratively search a telemedicine website under conditions where the lecture was delivered by videoconference or one way streaming (webcast) and where students were either co-located or dispersed. In the videoconference conditions, co-located students could use the technology to interact with the instructor and could interact with each other face to face, while the dispersed students could use the technology to interact with both the instructor and each other. In the webcast conditions, all students could use chat to communicate with the instructor or each other, although the co-located students also could interact orally. After hearing the lecture, students collaboratively searched a telemedicine website, took a test on lecture-website content and rated the instruction and the technology they used. Test scores on lecture and website content and ratings of instruction and technology for the four conditions were compared with analysis of variance and chi-square tests. There were no significant differences in overall measures, although there were on selected ratings of instruction. Students in both webcast conditions indicated they were encouraged more to follow up on their own and felt instruction was more interactive than co-located videoconferencing students. Dispersed videoconferencing students indicated the highest

  1. Communication and proximity effects on outcomes attributable to sense of presence in distance bioinformatics education

    Directory of Open Access Journals (Sweden)

    Maisiak Richard

    2011-03-01

    Full Text Available Abstract Background Online learning is increasingly popular in medical education and sense of presence has been posited as a factor contributing to its success. Communication media influences on sense of presence and learning outcomes were explored in this study. Test performance and ratings of instruction and technology, factors influenced by sense of presence, are compared under four conditions involving different media and degrees of student physical presence: 1 videoconference co-located, 2 webcast co-located, 3 videoconference dispersed, and 4 webcast dispersed. Methods Eighty one first to forth year medical students heard a lecture on telemedicine and were asked to collaboratively search a telemedicine website under conditions where the lecture was delivered by videoconference or one way streaming (webcast and where students were either co-located or dispersed. In the videoconference conditions, co-located students could use the technology to interact with the instructor and could interact with each other face to face, while the dispersed students could use the technology to interact with both the instructor and each other. In the webcast conditions, all students could use chat to communicate with the instructor or each other, although the co-located students also could interact orally. After hearing the lecture, students collaboratively searched a telemedicine website, took a test on lecture-website content and rated the instruction and the technology they used. Test scores on lecture and website content and ratings of instruction and technology for the four conditions were compared with analysis of variance and chi-square tests. Results There were no significant differences in overall measures, although there were on selected ratings of instruction. Students in both webcast conditions indicated they were encouraged more to follow up on their own and felt instruction was more interactive than co-located videoconferencing students

  2. The effect of time-to-surgery on outcome in elderly patients with proximal femoral fractures

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    Trampisch Hans J

    2008-12-01

    Full Text Available Abstract Background Whether reducing time-to-surgery for elderly patients suffering from hip fracture results in better outcomes remains subject to controversial debates. Methods As part of a prospective observational study conducted between January 2002 and September 2003 on hip-fracture patients from 268 acute-care hospitals all over Germany, we investigated the relationship of time-to-surgery with frequency of post-operative complications and one-year mortality in elderly patients (age ≥65 with isolated proximal femoral fracture (femoral neck fracture or pertrochanteric femoral fracture. Patients with short (≤12 h, medium (> 12 h to ≤36 h and long (> 36 h times-to-surgery, counting from the time of the fracture event, were compared for patient characteristics, operative procedures, post-operative complications and one-year mortality. Results Hospital data were available for 2916 hip-fracture patients (mean age (SD in years: 82.1 (7.4, median age: 82; 79.7% women. Comparison of groups with short (n = 802, medium (n = 1191 and long (n = 923 time-to-surgery revealed statistically significant differences in a few patient characteristics (age, American Society of Anesthesiologists ratings classification and type of admission and in operative procedures (total hip endoprosthesis, hemi-endoprosthetic implants, other osteosynthetic procedures. However, comparison of these same groups for frequency of postoperative complications revealed only some non-significant associations with certain complications such as post-operative bleeding requiring treatment (early surgery patients and urinary tract infections (delayed surgery patients. Both unadjusted rates of one-year all-cause mortality (between 18.1% and 20.5%, and the multivariate-adjusted hazard ratios (HR for time-to-surgery: 1.04; p = 0.55 showed no association between mortality and time-to-surgery. Conclusion Although this study found a trend toward more frequent post-operative complications

  3. How do dimensions of proximity relate to the outcomes of collaboration? A survey of knowledge intensive networks in the Dutch water sector

    NARCIS (Netherlands)

    Heringa, P.; Horlings, E.; van der Zouwen, M.; van den Besselaar, P.A.A.; van Vierssen, W.

    2014-01-01

    There is a growing body of literature on the importance of proximity for innovation and other knowledge-related outcomes. We examine the impact of geographical, social, organisational, and cognitive proximity for a heterogeneous population, including people from academia, knowledge institutes,

  4. How do dimensions of proximity relate to the outcomes of collaboration? : A survey of knowledge-intensive networks in the Dutch water sector

    NARCIS (Netherlands)

    Heringa, P.; Horlings, E.; van der Zouwen, Marielle; van den Besselaar, P.; van Vierssen, Wim

    2014-01-01

    There is a growing body of literature on the importance of proximity for innovation and other knowledge-related outcomes. We examine the impact of geographical, social, organisational, and cognitive proximity for a heterogeneous population, including people from academia, knowledge institutes,

  5. Functional Outcomes and Return to Sports After Acute Repair, Chronic Repair, and Allograft Reconstruction for Proximal Hamstring Ruptures.

    Science.gov (United States)

    Rust, David A; Giveans, M Russell; Stone, Rebecca M; Samuelson, Kathryn M; Larson, Christopher M

    2014-06-01

    There are limited data regarding outcomes and return to sports after surgery for acute versus chronic proximal hamstring ruptures. Surgery for chronic proximal hamstring ruptures leads to improved outcomes and return to sports but at a lower level than with acute repair. Proximal hamstring reconstruction with an Achilles allograft for chronic ruptures is successful when direct repair is not possible. Cohort study; Level of evidence, 3. Between 2002 and 2012, a total of 72 patients with a traumatic proximal hamstring rupture (51 acute, 21 chronic) underwent either direct tendon repair with suture anchors (n = 58) or Achilles allograft tendon reconstruction (n = 14). Results from the Single Assessment Numeric Evaluation (SANE) for activities of daily living (ADL) and sports-related activities, Short Form-12 (SF-12), visual analog scale (VAS), and a patient satisfaction questionnaire were obtained. The mean time to surgery in the chronic group was 441.4 days versus 17.8 days in the acute group. At a mean follow-up of 45 months, patients with chronic tears had inferior sports activity scores (70.2% vs 80.3%, respectively; P = .026) and a trend for decreased ADL scores (86.5% vs 93.3%, respectively; P = .085) compared with those with acute tears. Patients with chronic tears, however, reported significant improvements postoperatively for both sports activity scores (30.3% to 70.2%; P sports activity scores equal to those of chronic repair (P = .507 and P = .904, respectively). There were no significant differences between groups in SF-12, VAS, or patient satisfaction outcomes (mean, 85.2% satisfaction overall). Acute repair was superior to chronic surgery with regard to return to sports. Acute and chronic proximal hamstring repair and allograft reconstruction had favorable results for ADL. For low-demand patients or those with medical comorbidities, delayed repair or reconstruction might be considered with an expected 87% return to normal ADL. For patients who desire to

  6. Axillary Artery Injury Associated with Proximal Humeral Fractures: Review of Long-Term Vascular, Orthopedic, and Neurologic Outcomes.

    Science.gov (United States)

    Ng, Andrew Jin-Hean; Arora, Varun; Tang, Howard Ho-Fung; Treseder, Thomas; Jain, Arvind; Wagner, Timothy

    2016-05-01

    Fracture and dislocation of the proximal humerus is common. It is associated with a number of vascular, neurologic, and orthopedic complications; these include brachial plexopathy and avascular necrosis (AVN) of the humeral head. These complications are rare but can potentially cause severe disability to patients; however, they remain poorly described in the literature. To describe vascular, orthopedic, and neurologic outcomes after axillary artery repair, in patients with proximal humeral fractures or dislocations. We conducted a retrospective review of patients admitted to 2 tertiary trauma centers in Victoria, Australia, with fracture or dislocation of the proximal humerus and associated axillary artery injury. Patients were selected according to guidelines for trauma call or alert and the presence of high-risk mechanism of injury. Data on vascular, orthopedic, and neurologic complications were collected. Twenty-one patients were identified. Injury to the first part of the axillary artery was noted in 11 patients (52%). Brachial plexus exploration was performed in 17 patients (81%). Four patients (19%) underwent nerve repair. Long-term neurologic recovery was universally poor. Major orthopedic complications included AVN of the humeral head, delayed union, and the need for prosthesis or arthrodesis. Eleven patients (52%) received upper limb fasciotomy. Five patients (24%) underwent delayed secondary upper limb amputation. There was an unusually high rate of injuries to the first part of the axillary artery. Close clinical observation is recommended for such patients. AVN of the humeral head and brachial plexopathy remain significant and debilitating complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Long-term functional outcomes after penoscrotal hypospadias repair: A retrospective comparative study of proximal TIP, Onlay, and Duckett.

    Science.gov (United States)

    Hueber, Pierre-Alain; Salgado Diaz, Monica; Chaussy, Yann; Franc-Guimond, Julie; Barrieras, Diego; Houle, Anne-Marie

    2016-08-01

    A variety of techniques are available for proximal hypospadias repair. Onlay, proximal tubularized incised plate (TIP), and Duckett are among the popular choices because they can be performed as a one-step procedure. However, the decision to select a procedure often comes down to the surgeon's preference rather than that supported by evidence-based data. In particular, there is a paucity of literature on the long-term urinary outcomes after proximal hypospadias repair. The aim of this study was to evaluate the evolution of long-term uroflowmetry parameters after proximal hypospadias surgery over a long-term follow-up including the adolescent period. Files from patients who underwent primary proximal hypospadias repair at our institution between 1997 and 2001 were reviewed. Only patients with documented serial postoperative uroflowmetry profiles at follow-up visits were included. Comparison between surgeries (pTIP vs. Onlay vs. Duckett) was performed according to the following postoperative time interval endpoints: 0-1 years, 1-2, >2-4, >4-6, >6-10, >10-12, and >12 years. Maximal urinary flow rate (Qmax) in relation to voiding volume (VV) adjusted for age or body surface area (BSA) were also evaluated in comparison to normal children using established Miskolc nomograms and compared between surgery techniques. Fifty-two patients met the inclusion criteria with a median follow-up of 10 years: 25 (59.6%) TIP, 18 (34/6%) Onlay, and nine (17.3%) Duckett. Overall, Qmax increased progressively according to time and age in particular during the period covering adolescence. At follow-up 12 years postoperatively, median Qmax values were 18.5 mL/second, 13.8 mL/second and 16.6 mL/second for TIP, Onlay, and Duckett, respectively, with no significant differenced detected between groups (p = 0.5) see figure). Compared with normal children when adjusted for voiding volume and BSA, the proportion of obstructive uroflowmetry patterns defined as Qmax13 years for all procedures

  8. Outcomes of trochanteric femoral fractures treated with proximal femoral nail: an analysis of 100 consecutive cases.

    Science.gov (United States)

    Korkmaz, Mehmet Fatih; Erdem, Mehmet Nuri; Disli, Zeliha; Selcuk, Engin Burak; Karakaplan, Mustafa; Gogus, Abdullah

    2014-01-01

    In this study, we aimed to report the results of a retrospective study carried out at our institute regarding cases of patients who had suffered proximal femoral fractures between January 2002 and February 2007, and who were treated with a proximal femoral nail. One hundred consecutive cases were included in the study. A case documentation form was used to obtain intraoperative data including age, sex, mechanism of injury, type of fracture according to Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF) classification and the American Society of Anesthesiologists' (ASA) physical status classification (ASA grade). Clinical and radiographic examinations were performed at the time of admission and at the 6th week; subsequent visits were organized on the 3rd month, 6th month, and 12th month, and in patients with longer follow-up and annually postoperatively. The Harris score of hip function was used, and any change in the position of the implants and the progress of the fracture union, which was determined radiologically, was noted. The mean age of the patients was 77.66 years (range: 37-98 years), and the sex distribution was 32 males and 68 females. Seventy-three fractures were reduced by closed means, whereas 27 needed limited open reduction. The mean follow-up time for the study group was 31.3 months (range: 12-75 months). Postoperative radiographs showed a near-anatomical fracture reduction in 78% of patients. The Harris hip score was negatively correlated with the ASA score and patient age. No cases of implant failure were observed. Three patients died before discharge (one due to pulmonary embolism, two due to cardiac arrest), and five patients died due to unrelated medical conditions within the first 3 months of the follow-up. Our study showed that proximal femoral nail is a reliable fixation with good fracture union, and it is not associated with major complications in any type of trochanteric femoral fracture.

  9. Outcomes of trochanteric femoral fractures treated with proximal femoral nail: an analysis of 100 consecutive cases

    Directory of Open Access Journals (Sweden)

    Korkmaz MF

    2014-04-01

    Full Text Available Mehmet Fatih Korkmaz,1 Mehmet Nuri Erdem,2 Zeliha Disli,3 Engin Burak Selcuk,4 Mustafa Karakaplan,1 Abdullah Gogus5 1Department of Orthopedics and Traumatology, Inonu University School of Medicine, Malatya, Turkey; 2Department of Orthopedics and Traumatology, Nisantasi University School of Medicine, Istanbul, Turkey; 3Department of Anesthesiology, Malatya Government Hospital, Malatya, Turkey; 4Department of Family Medicine, Inonu University School of Medicine, Malatya, Turkey; 5Department of Orthopedics and Traumatology, Florence Nightingale Hospital, Istanbul, Turkey Purpose: In this study, we aimed to report the results of a retrospective study carried out at our institute regarding cases of patients who had suffered proximal femoral fractures between January 2002 and February 2007, and who were treated with a proximal femoral nail. Materials and methods: One hundred consecutive cases were included in the study. A case documentation form was used to obtain intraoperative data including age, sex, mechanism of injury, type of fracture according to Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF classification and the American Society of Anesthesiologists' (ASA physical status classification (ASA grade. Clinical and radiographic examinations were performed at the time of admission and at the 6th week; subsequent visits were organized on the 3rd month, 6th month, and 12th month, and in patients with longer follow-up and annually postoperatively. The Harris score of hip function was used, and any change in the position of the implants and the progress of the fracture union, which was determined radiologically, was noted. Results: The mean age of the patients was 77.66 years (range: 37–98 years, and the sex distribution was 32 males and 68 females. Seventy-three fractures were reduced by closed means, whereas 27 needed limited open reduction. The mean follow-up time for the study group was 31.3 months (range

  10. Improving Outcomes Achieved by a New Stroke Program in Hungary

    Directory of Open Access Journals (Sweden)

    Csilla Égi

    2015-10-01

    Full Text Available Background: Stroke is a devastating disease with increasing incidence and prevalence due to population aging. Even with the best care, a proportion of patients dies or is left with significant neurological and cognitive disability. Organization of stroke centers markedly improved outcomes worldwide. We initiated a ‘lysis alarm' program in September 2013 at our medical center. Methods: This is a retrospective review of electronic data from patients with acute ischemic stroke before (October 2012-June 2013 and after (October 2013-June 2014 the ‘lysis alarm' program was introduced at our medical center. Results: Prior to the introduction of the stroke program, there were only 19 thrombolysis procedures in 777 acute stroke patients in 9 months, while this figure rose to 32 thrombolysis procedures in 737 acute stroke patients after the initiation of the program. The ‘door-to-needle' time decreased from 88 to 71 min when the two study periods were compared. These changes were associated with decreased stroke mortality in patients receiving thrombolytic treatment (16% prior to the program and 9% during the program. In 2013, there were 1,439 thrombolysis procedures, representing 3.2% of all stroke cases throughout Hungary. After the introduction of the ‘lysis alarm' program, we have reached a 4% thrombolysis rate at our medical center. Conclusions: Our thrombolysis rate is higher than the national average, but still low compared to the rates of Western European countries. We are continuously working to enhance our stroke program. Here, we discuss those components that need to be further refined in order to improve stroke intervention and outcome.

  11. Achieving clinical nurse specialist competencies and outcomes through interdisciplinary education.

    Science.gov (United States)

    Sievers, Beth; Wolf, Sherry

    2006-01-01

    Without formal education, many healthcare professionals fail to develop interdisciplinary team skills; however, when students are socialized to interdisciplinary practice through academic clinical learning experiences, effective collaboration skills can be developed. Increasingly, educational environments are challenged to include clinical experiences for students that teach and model interdisciplinary collaboration. The purpose of this quality improvement initiative was to create an interdisciplinary educational experience for clinical nurse specialist (CNS) students and postgraduate physicians. The interdisciplinary learning experience, supported by an educational grant, provided an interdisciplinary cohort of learners an opportunity to engage in a clinically focused learning experience. The interdisciplinary cohort consisted of CNS students and physicians in various stages of postgraduate training. The clinical experience selected was a quality improvement initiative in which the students were introduced to the concepts and tools of quality improvement. During this 1-month clinical experience, students applied the new skills by implementing a quality improvement project focusing on medication reconciliation in the outpatient setting. The CNS core competencies and outcomes were used to shape the experience for the CNS students. The CNS students exhibited 5 of the 7 essential characteristics of the CNS (leadership, collaboration, consultation skills, ethical conduct, and professional attributes) while demonstrating competencies and fulfilling performance expectations. During this learning experience, the CNS students focused on competencies and outcomes in the organizational sphere of influence. Multiple facilitating factors and barriers were identified. This interdisciplinary clinical experience in a quality improvement initiative provided valuable opportunities for CNS students to develop essential CNS characteristics and to explore practice competencies in the

  12. Identifying Pedagogy and Teaching Strategies for Achieving Nationally Prescribed Learning Outcomes

    Science.gov (United States)

    Delany, Clare; Kosta, Lauren; Ewen, Shaun; Nicholson, Patricia; Remedios, Louisa; Harms, Louise

    2016-01-01

    With the globalisation of university education, national frameworks are commonly used to prescribe standardised learning outcomes and achieve accountability. However, these frameworks are generally not accompanied by guiding pedagogy to support academics in adjusting their teaching practices to achieve the set outcomes. This paper reports the…

  13. Oncoplastic breast surgery: Achieving oncological and aesthetic outcomes.

    Science.gov (United States)

    van Paridon, Maaike W; Kamali, Parisa; Paul, Marek A; Wu, Winona; Ibrahim, Ahmed M S; Kansal, Kari J; Houlihan, Mary Jane; Morris, Donald J; Lee, Bernard T; Lin, Samuel J; Sharma, Ranjna

    2017-08-01

    Oncoplastic reconstruction allows more patients to become candidates for breast-conserving surgery (BCS). Oncologic resection of a breast lesion is combined with plastic surgical techniques to improve aesthetic results. Choosing the best oncoplastic method is essential to optimize outcomes, improve cosmesis, and minimize postoperative complications. The aim of this study is to present a treatment algorithm incorporating oncoplastic techniques based on diagnosis, tumor size, tumor location, and breast size and shape. A retrospective pilot study of a prospectively collected database was conducted in patients undergoing immediate oncoplastic surgery from 2010 to 2015 at our institution. Oncoplastic surgical techniques were defined as complex layered closure, local tissue rearrangement, pedicled flap, mastopexy, bilateral reduction, or implant placement. Clinical, demographic, and histopathologic data were extracted from electronic patient records. Patient satisfaction was measured by the BREAST-Q questionnaire. A total of 42 women and 46 breasts were included. An algorithm was formulated to assist in selecting an optimal oncoplastic reconstruction plan after BCS. Additionally, patient satisfaction with good aesthetic results was reported. In this study, the authors present a reconstructive algorithm describing various oncoplastic approaches aimed to provide a guideline in clinical practice when employing oncoplastic surgery. © 2017 Wiley Periodicals, Inc.

  14. Outcome of patients with proximal vessel occlusion of the anterior circulation and DWI-PWI mismatch is time-dependent.

    Science.gov (United States)

    Mundiyanapurath, Sibu; Diatschuk, Sascha; Loebel, Sarah; Pfaff, Johannes; Pham, Mirko; Möhlenbruch, Markus Alfred; Wick, Wolfgang; Bendszus, Martin; Ringleb, Peter A; Radbruch, Alexander

    2017-06-01

    Patients with ischemic stroke and large vessel occlusion are assumed to benefit from endovascular therapy (ET) independent of the symptom onset-to-treatment time (OTT) if they present with a mismatch of diffusion- and perfusion-weighted imaging (DWI-PWI mismatch). We aimed at studying the influence of OTT on clinical outcome in these patients. Retrospective database review in a tertiary care university hospital. All patients presented with proximal vessel occlusion of the anterior circulation and DWI-PWI mismatch. Primary outcome was the influence of OTT on modified Rankin scale (mRS) score three months after treatment, dichotomized in favourable (0-2) and unfavourable outcome (3-6). Secondary outcome was the effect of OTT on the shift of the mRS score. Patients treated within an early time window (mismatch according to the definitions from large trials (DEFUSE 2, DEFUSE 3, SWIFT-PRIME, EXTEND-IA). Outcome of patients with comparable DWI-PWI mismatch is time-dependent. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Retrospective analysis of factors associated with outcome of proximal interphalangeal joint arthrodesis in 82 horses including Warmblood and Thoroughbred sport horses and Quarter Horses (1992-2014).

    Science.gov (United States)

    Herthel, T D; Rick, M C; Judy, C E; Cohen, N D; Herthel, D J

    2016-09-01

    Outcomes associated with arthrodesis of the proximal interphalangeal (PIP) joint in Quarter Horses used for Western performance activities are well documented but little is known regarding outcomes for other types of horses. To identify factors associated with outcomes, including breed and activity, after arthrodesis of the PIP joint in Warmbloods, Thoroughbreds and Quarter Horses. Retrospective case series. Surgical case records of 82 Quarter Horses principally engaged in Western performance and Thoroughbred or Warmblood breeds principally engaged in showing, showjumping and dressage, with arthrodesis of the PIP joint were reviewed. Arthrodesis was performed with either 3 transarticular cortex bone screws placed in lag fashion, a dynamic compression plate (DCP) with 2 transarticular cortex bone screws placed in lag fashion, or a locking compression plate (LCP) with 2 transarticular cortex bone screws placed in lag fashion. Demographic data, clinical presentation, radiographic findings, surgical technique, post operative treatment and complications were recorded. Long-term follow-up was obtained for all 82 horses. Osteoarthritis of the PIP joint was the most common presenting condition requiring arthrodesis, which was performed with either the 3 screw technique (n = 41), DCP fixation (n = 22), or LCP fixation (n = 19). Post operatively, 23/31 (74%) Warmbloods/Thoroughbreds and 44/51 (87%) Quarter Horses achieved successful outcomes. Thirteen of 23 (57%) Warmbloods/Thoroughbreds and 24 of 38 (63%) Quarter Horses, used for athletic performance, returned to successful competition. Within this subgroup of horses engaged in high-level activity, regardless of breed type, horses undergoing hindlimb arthrodesis were significantly more likely to return to successful competition (73%; 33/45) than those with forelimb arthrodesis (25%; 4/16, P = 0.002). Arthrodesis of the PIP joint in Warmbloods/Thoroughbreds and Quarter Horses results in a favourable outcome for return to

  16. Conservation covenants on private land: issues with measuring and achieving biodiversity outcomes in Australia.

    Science.gov (United States)

    Fitzsimons, James A; Carr, C Ben

    2014-09-01

    Conservation covenants and easements have become essential tools to secure biodiversity outcomes on private land, and to assist in meeting international protection targets. In Australia, the number and spatial area of conservation covenants has grown significantly in the past decade. Yet there has been little research or detailed policy analysis of conservation covenanting in Australia. We sought to determine how conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties, and factors inhibiting or contributing to measuring these outcomes. In addition, we also investigated the drivers and constraints associated with actually delivering the biodiversity outcomes, drawing on detailed input from covenanting programs. Although all conservation covenanting programs had the broad aim of maintaining or improving biodiversity in their covenants in the long term, the specific stated objectives of conservation covenanting programs varied. Programs undertook monitoring and evaluation in different ways and at different spatial and temporal scales. Thus, it was difficult to determine the extent Australian conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties on a national scale. Lack of time available to covenantors to undertake management was one of the biggest impediments to achieving biodiversity conservation outcomes. A lack of financial resources and human capital to monitor, knowing what to monitor, inconsistent monitoring methodologies, a lack of benchmark data, and length of time to achieve outcomes were all considered potential barriers to monitoring the biodiversity conservation outcomes of conservation covenants.

  17. Impacts of comprehensive reading instruction on diverse outcomes of low- and high-achieving readers.

    Science.gov (United States)

    Guthrie, John T; McRae, Angela; Coddington, Cassandra S; Lutz Klauda, Susan; Wigfield, Allan; Barbosa, Pedro

    2009-01-01

    Low-achieving readers in Grade 5 often lack comprehension strategies, domain knowledge, word recognition skills, fluency, and motivation to read. Students with such multiple reading needs seem likely to benefit from instruction that supports each of these reading processes. The authors tested this expectation experimentally by comparing the effects of Concept-Oriented Reading Instruction (CORI) with traditional instruction (TI) on several outcomes in a 12-week intervention for low achievers and high achievers. Low achievers in the CORI group were afforded explicit instruction, leveled texts, and motivation support. Compared with TI students, CORI students scored higher on posttest measures of word recognition speed, reading comprehension on the Gates-MacGinitie Reading Test, and ecological knowledge. CORI was equally effective for lower achievers and higher achievers. Explicitly supporting multiple aspects of reading simultaneously appeared to benefit diverse learners on a range of reading outcomes.

  18. Proximal femoral replacement in contemporary revision total hip arthroplasty for severe femoral bone loss: a review of outcomes.

    Science.gov (United States)

    Viste, A; Perry, K I; Taunton, M J; Hanssen, A D; Abdel, M P

    2017-03-01

    Loss or absence of proximal femoral bone in revision total hip arthroplasty (THA) remains a significant challenge. While the main indication for the use of proximal femoral replacements (PFRs) is in the treatment of malignant disease, they have a valuable role in revision THA for loosening, fracture and infection in patients with bone loss. Our aim was to determine the clinical outcomes, implant survivorship, and complications of PFRs used in revision THA for indications other than malignancy. A retrospective review of 44 patients who underwent revision THA using a PFR between 2000 and 2013 was undertaken. Their mean age was 79 years (53 to 97); 31 (70%) were women. The bone loss was classified as Paprosky IIIB or IV in all patients. The mean follow-up was six years (2 to 12), at which time 22 patients had died and five were lost to follow-up. The mean Harris Hip Score improved from 42.8 (25.9 to 82.9) pre-operatively to 68.5 (21.0 to 87.7) post-operatively (p = 0.0009). A total of two PFRs had been revised, one for periprosthetic infection eight years post-operatively and one for aseptic loosening six years post-operatively. The Kaplan-Meier survivorship free of any revision or removal of an implant was 86% at five years and 66% years at ten years. A total of 12 patients (27%) had a complication including six with a dislocation. PFRs provide a useful salvage option for patients, particularly the elderly with massive proximal femoral bone loss who require revision THA, with significant clinical improvement. While the survivorship of the implant is good at five years, dislocation continues to be the most common complication. The judicious use of larger femoral heads, dual-mobility constructs, or constrained liners may help to minimise the risk of dislocation. Cite this article: Bone Joint J 2017;99-B:325-9. ©2017 The British Editorial Society of Bone & Joint Surgery.

  19. Medium-Term Outcomes Following Endovascular Repair of Infrarenal Abdominal Aortic Aneurysms with an Unfavourable Proximal Neck

    International Nuclear Information System (INIS)

    Saha, Prakash; Hughes, John; Patel, Ashish S.; Donati, Tommaso; Sallam, Morad; Patel, Sanjay D.; Bell, Rachel E.; Katsanos, Konstantinos; Modarai, Bijan; Zayed, Hany A.

    2015-01-01

    PurposeThe purpose of this study was to evaluate medium-term outcomes following endovascular repair of abdominal aortic aneurysms (EVAR) with unfavourable neck anatomy using stent grafts with a 36 mm or larger proximal diameter.Materials and MethodsA retrospective review of 27 patients who underwent elective EVAR between 2006 and 2008 using a stent graft with a 36 mm or larger proximal diameter was carried out. All patients had computed tomography angiography (CTA) for procedure planning, and detailed assessment of the aneurysm neck was performed using a three-dimensional CTA workstation. Patients were followed up with CTA at 3 and 12 months and annual duplex thereafter.ResultsThe median aneurysm diameter was 7 cm, and the median aneurysm neck diameter was 31 mm. Cook Zenith stent grafts were used in all patients, with a proximal diameter of 36 mm (n = 25) and 40 mm (n = 2). Primary and assisted primary technical success rates were 74 and 93 %, respectively. The follow-up period ranged from 62 to 84 months, with a median of 72 months. 15 patients died during follow-up. Two patients died from aortic rupture, and the remaining patients died from cardiac disease (n = 4), chest sepsis (n = 6), cancer (n = 2) and renal failure (n = 1). Complications included type I endoleak (n = 5), limb occlusion (n = 2), limb stenosis (n = 2), limb kinking (n = 1), dissection of an artery (n = 1), occlusion of a femorofemoral cross-over graft (n = 1) and poor attachment of a distal limb (n = 1).ConclusionsEVAR using stent grafts in the presence of an unfavourable neck has a high risk of complications. Medium-term survival in this group is low but mainly due to patient co-morbidities

  20. Medium-Term Outcomes Following Endovascular Repair of Infrarenal Abdominal Aortic Aneurysms with an Unfavourable Proximal Neck

    Energy Technology Data Exchange (ETDEWEB)

    Saha, Prakash, E-mail: prakash.2.saha@kcl.ac.uk; Hughes, John, E-mail: johnhughes387@rocketmail.com; Patel, Ashish S., E-mail: ashish.s.patel@kcl.ac.uk; Donati, Tommaso, E-mail: tommaso.donati@gstt.nhs.uk; Sallam, Morad, E-mail: morad.sallam@gstt.nhs.uk; Patel, Sanjay D., E-mail: sanjay.patel@gstt.nhs.uk; Bell, Rachel E. [King’s Health Partners, Department of Vascular Surgery, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr [King’s Health Partners, Department of Interventional Radiology, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Modarai, Bijan, E-mail: bijan.modarai@kcl.ac.uk; Zayed, Hany A., E-mail: hany.zayed@gstt.nhs.uk [King’s Health Partners, Department of Vascular Surgery, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom)

    2015-08-15

    PurposeThe purpose of this study was to evaluate medium-term outcomes following endovascular repair of abdominal aortic aneurysms (EVAR) with unfavourable neck anatomy using stent grafts with a 36 mm or larger proximal diameter.Materials and MethodsA retrospective review of 27 patients who underwent elective EVAR between 2006 and 2008 using a stent graft with a 36 mm or larger proximal diameter was carried out. All patients had computed tomography angiography (CTA) for procedure planning, and detailed assessment of the aneurysm neck was performed using a three-dimensional CTA workstation. Patients were followed up with CTA at 3 and 12 months and annual duplex thereafter.ResultsThe median aneurysm diameter was 7 cm, and the median aneurysm neck diameter was 31 mm. Cook Zenith stent grafts were used in all patients, with a proximal diameter of 36 mm (n = 25) and 40 mm (n = 2). Primary and assisted primary technical success rates were 74 and 93 %, respectively. The follow-up period ranged from 62 to 84 months, with a median of 72 months. 15 patients died during follow-up. Two patients died from aortic rupture, and the remaining patients died from cardiac disease (n = 4), chest sepsis (n = 6), cancer (n = 2) and renal failure (n = 1). Complications included type I endoleak (n = 5), limb occlusion (n = 2), limb stenosis (n = 2), limb kinking (n = 1), dissection of an artery (n = 1), occlusion of a femorofemoral cross-over graft (n = 1) and poor attachment of a distal limb (n = 1).ConclusionsEVAR using stent grafts in the presence of an unfavourable neck has a high risk of complications. Medium-term survival in this group is low but mainly due to patient co-morbidities.

  1. Percutaneous internal fixation of proximal fifth metatarsal jones fractures (Zones II and III) with Charlotte Carolina screw and bone marrow aspirate concentrate: an outcome study in athletes.

    Science.gov (United States)

    Murawski, Christopher D; Kennedy, John G

    2011-06-01

    Internal fixation is a popular first-line treatment method for proximal fifth metatarsal Jones fractures in athletes; however, nonunions and screw breakage can occur, in part because of nonspecific fixation hardware and poor blood supply. To report the results from 26 patients who underwent percutaneous internal fixation with a specialized screw system of a proximal fifth metatarsal Jones fracture (zones II and III) and bone marrow aspirate concentrate. Case series; Level of evidence, 4. Percutaneous internal fixation for a proximal fifth metatarsal Jones fracture (zones II and III) was performed on 26 athletic patients (mean age, 27.47 years; range, 18-47). All patients were competing at some level of sport and were assessed preoperatively and postoperatively using the Foot and Ankle Outcome Score and SF-12 outcome scores. The mean follow-up time was 20.62 months (range, 12-28). Of the 26 fractures, 17 were traditional zone II Jones fractures, and the remaining 9 were zone III proximal diaphyseal fractures. The mean Foot and Ankle Outcome Score significantly increased, from 51.15 points preoperatively (range, 14-69) to 90.91 at final follow-up (range, 71-100; P fixation of proximal fifth metatarsal Jones fractures, with a Charlotte Carolina screw and bone marrow aspirate concentrate, provides more predictable results while permitting athletes a return to sport at their previous levels of competition, with few complications.

  2. Advantages and psychometric validation of proximal intensive assessments of patient-reported outcomes collected in daily life.

    Science.gov (United States)

    Carlson, Eve B; Field, Nigel P; Ruzek, Josef I; Bryant, Richard A; Dalenberg, Constance J; Keane, Terrence M; Spain, David A

    2016-03-01

    Ambulatory assessment data collection methods are increasingly used to study behavior, experiences, and patient-reported outcomes (PROs), such as emotions, cognitions, and symptoms in clinical samples. Data collected close in time at frequent and fixed intervals can assess PROs that are discrete or changing rapidly and provide information about temporal dynamics or mechanisms of change in clinical samples and individuals, but clinical researchers have not yet routinely and systematically investigated the reliability and validity of such measures or their potential added value over conventional measures. The present study provides a comprehensive, systematic evaluation of the psychometrics of several proximal intensive assessment (PIA) measures in a clinical sample and investigates whether PIA appears to assess meaningful differences in phenomena over time. Data were collected on a variety of psychopathology constructs on handheld devices every 4 h for 7 days from 62 adults recently exposed to traumatic injury of themselves or a family member. Data were also collected on standard self-report measures of the same constructs at the time of enrollment, 1 week after enrollment, and 2 months after injury. For all measure scores, results showed good internal consistency across items and within persons over time, provided evidence of convergent, divergent, and construct validity, and showed significant between- and within-subject variability. Results indicate that PIA measures can provide valid measurement of psychopathology in a clinical sample. PIA may be useful to study mechanisms of change in clinical contexts, identify targets for change, and gauge treatment progress.

  3. Clinical outcome of the PAS-Port® proximal anastomosis system in off-pump coronary artery bypass grafting in 201 patients.

    Science.gov (United States)

    Verberkmoes, N J; Mokhles, M M; Bramer, S; Van Straten, A H M; Ter Woorst, J F; Maessen, J G; Berreklouw, E

    2013-06-01

    The PAS-Port® Proximal Anastomosis System (Cardica, Inc, Redwood City, CA, USA) has been used worldwide since March 2003. The objective of the present study was to evaluate the clinical outcome of the PAS-Port® Proximal Anastomosis System. All the patients who underwent off-pump coronary artery bypass grafting in the Catharina Hospital Eindhoven between August 2006 and April 2010 were included in a non-randomized retrospective case-control study, if they had at least one proximal vein graft anastomosis. Study end-points consisted of overall survival, coronary reintervention and postoperative stroke. The study included 312 patients (201 cases, 111 controls). After 36 months of follow-up there was no difference in survival between cases and controls (92.2% vs. 93.7%, P=0.52). No significant difference could be detected between cases and controls with respect to overall coronary reintervention-free survival (93% vs. 96.4%, P=0.20) and freedom from coronary reintervention due to proximal vein graft failure (98% vs. 100% P=0.14). The use of the PAS-Port system could not be identified as an independent risk factor of coronary reintervention (p=0.21). Postoperative stroke rates of cases and controls (2% vs. 0.9%, P=0.42) were comparable. The clinical outcomes in patients treated with the PAS-Port® Proximal Anastomosis System were satisfactory compared with those treated with the conventional hand-sewing technique. The use of the PAS-Port system was not associated with higher adverse outcome in terms of overall survival, stroke, coronary reintervention-free survival and freedom from reintervention due to proximal vein graft failure.

  4. Optimization of Extracorporeal Shock Wave Lithotripsy Delivery Rates Achieves Excellent Outcomes for Ureteral Stones: Results of a Prospective Randomized Trial.

    Science.gov (United States)

    Nguyen, Daniel P; Hnilicka, Stefanie; Kiss, Bernhard; Seiler, Roland; Thalmann, George N; Roth, Beat

    2015-08-01

    Management of ureteral stones remains controversial. To determine whether optimizing the extracorporeal shock wave lithotripsy delivery rate would improve the treatment of solitary ureteral stones we compared the outcomes of 2 delivery rates in a prospective randomized trial. From July 2010 to October 2012, 254 consecutive patients were randomized to extracorporeal shock wave lithotripsy at a shock wave delivery rate of 60 and 90 pulses per minute in 130 and 124, respectively. The primary study end point was the stone-free rate at 3-month followup. Secondary end points were stone disintegration, treatment time, complications and the rate of secondary treatments. Descriptive statistics were used to compare end points between the 2 groups. The adjusted OR and 95% CI were calculated to assess predictors of success. The stone-free rate at 3 months was significantly higher in patients who underwent extracorporeal shock wave lithotripsy at a shock wave delivery rate of 90 pulses per minute than in those who received 60 pulses per minute (91% vs 80%, p = 0.01). Patients with proximal (100% vs 83%, p = 0.005) and mid ureteral stones (96% vs 73%, p = 0.03) accounted for the observed difference but not those with distal ureteral stones (81% vs 80%, p = 0.9, respectively). Treatment time, complications and the rate of secondary treatments were comparable between the 2 groups. On multivariable analysis the shock wave delivery rate of 90 pulses per minute, proximal stone location, stone density, stone size and an absent indwelling Double-J® stent were independent predictors of success. Optimizing the extracorporeal shock wave lithotripsy delivery rate can achieve excellent results for ureteral stones. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. Discrepancies between Student Perception and Achievement of Learning Outcomes in a Flipped Classroom

    Science.gov (United States)

    Van Sickle, Jenna

    2016-01-01

    In a college algebra course that used flipped/inverted pedagogy, students achieved learning outcomes at a significantly higher rate, as evidenced by results on the final exam. At the same time, student perception on a number of measures decreased significantly, including how interested students were in the course and whether the instructor…

  6. Influence of Web Based Cooperative Learning Strategy and Achiever Motivation on Student Study Outcome

    Science.gov (United States)

    Hariadi, Bambang; Wurijanto, Tutut

    2016-01-01

    The research aimed at examining the effect of instructional strategy (web-based STAD and text-based STAD) and achiever motivation toward student learning outcomes. The research implied quasi-experimental design with nonequivalent control group factorial version. The subjects were undergraduate students of Information Systems of academic year…

  7. Outcomes Achieved by Private Alternative Schools September 1987 to December 1988 in the Portland Public Schools.

    Science.gov (United States)

    Yagi, Kan

    The outcomes for the 1987-88 school year achieved by eight private alternative schools that have contracted with the Portland (Oregon) Public Schools (PPS) to provide educational services to students are reported. The schools are: (1) Albina Youth Opportunity School (AYOS); (2) AYOS-Genesis; (3) DePaul Center Youth Treatment Services; (4) Lents…

  8. A Comparison of Mathematics Achievement Outcomes among Three Instruction Programs for Pacific Island Elementary Students

    Science.gov (United States)

    Bernardo, Jonathan Christian Amor

    2013-01-01

    The purpose of this study was to compare the mathematics achievement outcomes of 3rd grade students from some Pacific Island elementary schools that use 1 of 3 different modes of instruction: Direct Instruction (DI), Success for All (SFA), and noncomprehensive school reform (non-CSR). The need for this research stems from the large proportion of…

  9. Evolution of curriculum systems to improve learning outcomes and reduce disparities in school achievement

    NARCIS (Netherlands)

    Altinyelken, H.K.

    2015-01-01

    Based on an extensive review of scholarly literature, this paper seeks to overview curriculum reforms aimed at improving learning outcomes and reduce disparities in school achievement in low and middle income countries in the past 15 years. The paper focuses on four major curriculum areas, including

  10. The Impact of Group Design Projects in Engineering on Achievement Goal Orientations and Academic Outcomes

    Science.gov (United States)

    Rambo-Hernandez, Karen E.; Atadero, Rebecca A.; Balgopal, Meena

    2017-01-01

    This study examined the impact of incorporating group design projects into a second-year engineering class on achievement goal orientations and two academic outcomes: concept inventory and final exam scores. In this study, two sections were taught using lecture format, but one section also completed three group design projects as part of their…

  11. Assuring Student Learning Outcomes Achievement through Faculty Development: An Online University Example

    Science.gov (United States)

    Lewis, Shelia; Ewing, Christopher

    2016-01-01

    Asynchronous discussions in the online teaching and learning environment significantly contributes to the achievement of student learning outcomes, which is dependent upon qualified and engaged faculty members. The discourse within this article addresses how an online university conducted faculty development through its unique Robust Learning…

  12. Pedagogies to Achieve Sustainability Learning Outcomes in Civil and Environmental Engineering Students

    Directory of Open Access Journals (Sweden)

    Angela R. Bielefeldt

    2013-10-01

    Full Text Available The civil and environmental engineering disciplines have identified the levels of knowledge about sustainability that are desirable for students to achieve as they graduate with a bachelor’s degree, as well as sustainability-related competencies to be obtained during a master’s degree, and on-the-job, prior to professional licensure. Different pedagogies are better suited to help students attain these levels of cognitive ability, while also developing affective outcomes. This paper provides examples of different methods that have been used at one institution to educate engineering students about sustainability, supported with data that indicates whether the method successfully achieved the targeted learning outcomes. Lectures, in-class active learning, readings, and appropriately targeted homework assignments can achieve basic sustainability knowledge and comprehension by requiring students to define, identify, and explain aspects of sustainability. Case studies and the application of software tools are good methods to achieve application and analysis competencies. Project-based learning (PBL and project-based service-learning (PBSL design projects can reach the synthesis level and may also develop affective outcomes related to sustainability. The results provide examples that may apply to a wider range of disciplines and suggest sustainability outcomes that are particularly difficult to teach and/or assess.

  13. Accuracy of enhanced and unenhanced MRI in diagnosing scaphoid proximal pole avascular necrosis and predicting surgical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Fox, M.G. [University of Virginia, Department of Radiology and Medical Imaging, Charlottesville, VA (United States); Wang, D.T. [University of Virginia, Department of Radiology and Medical Imaging, Charlottesville, VA (United States); Medical College of Wisconsin, Milwaukee, WI (United States); Chhabra, A.B. [University of Virginia Health System, Department of Orthopedics, Charlottesville, VA (United States)

    2015-11-15

    Determine the sensitivity, specificity and accuracy of unenhanced and enhanced MRI in diagnosing scaphoid proximal pole (PP) avascular necrosis (AVN) and correlate whether MRI can help guide the selection of a vascularized or nonvascularized bone graft. The study was approved by the IRB. Two MSK radiologists independently performed a retrospective review of unenhanced and enhanced MRIs from 18 patients (16 males, 2 females; median age, 17.5 years) with scaphoid nonunions and surgery performed within 65 days of the MRI. AVN was diagnosed on the unenhanced MRI when a diffusely decreased T1-W signal was present in the PP and on the enhanced MRI when PP enhancement was less than distal pole enhancement. Surgical absence of PP bleeding was diagnostic of PP AVN. Postoperative osseous union (OU) was assessed with computed tomography and/or radiographs. Sensitivity, specificity and accuracy for PP AVN were 71, 82 and 78 % for unenhanced and 43, 82 and 67 % for enhanced MRI. Patients with PP AVN on unenhanced MRI had 86 % (6/7) OU; 100 % (5/5) OU with vascularized bone grafts and 50 % (1/2) OU with nonvascularized grafts. Patients with PP AVN on enhanced MRI had 80 % (4/5) OU; 100 % (3/3) OU with vascularized bone grafts and 50 % (1/2) OU with nonvascularized grafts. Patients with viable PP on unenhanced and enhanced MRI had 91 % (10/11) and 92 % (12/13) OU, respectively, all but one with nonvascularized graft. When PP AVN is evident on MRI, OU is best achieved with vascularized grafts. If PP AVN is absent, OU is successful with nonvascularized grafts. (orig.)

  14. Accuracy of enhanced and unenhanced MRI in diagnosing scaphoid proximal pole avascular necrosis and predicting surgical outcome.

    Science.gov (United States)

    Fox, M G; Wang, D T; Chhabra, A B

    2015-11-01

    Determine the sensitivity, specificity and accuracy of unenhanced and enhanced MRI in diagnosing scaphoid proximal pole (PP) avascular necrosis (AVN) and correlate whether MRI can help guide the selection of a vascularized or nonvascularized bone graft. The study was approved by the IRB. Two MSK radiologists independently performed a retrospective review of unenhanced and enhanced MRIs from 18 patients (16 males, 2 females; median age, 17.5 years) with scaphoid nonunions and surgery performed within 65 days of the MRI. AVN was diagnosed on the unenhanced MRI when a diffusely decreased T1-W signal was present in the PP and on the enhanced MRI when PP enhancement was less than distal pole enhancement. Surgical absence of PP bleeding was diagnostic of PP AVN. Postoperative osseous union (OU) was assessed with computed tomography and/or radiographs. Sensitivity, specificity and accuracy for PP AVN were 71, 82 and 78% for unenhanced and 43, 82 and 67% for enhanced MRI. Patients with PP AVN on unenhanced MRI had 86% (6/7) OU; 100% (5/5) OU with vascularized bone grafts and 50% (1/2) OU with nonvascularized grafts. Patients with PP AVN on enhanced MRI had 80% (4/5) OU; 100% (3/3) OU with vascularized bone grafts and 50% (1/2) OU with nonvascularized grafts. Patients with viable PP on unenhanced and enhanced MRI had 91% (10/11) and 92% (12/13) OU, respectively, all but one with nonvascularized graft. When PP AVN is evident on MRI, OU is best achieved with vascularized grafts. If PP AVN is absent, OU is successful with nonvascularized grafts.

  15. Measuring implementation of a school-based violence prevention program : Fidelity and teachers' responsiveness as predictors of proximal outcomes

    NARCIS (Netherlands)

    Schultes, Marie Therese; Stefanek, Elisabeth; van de Schoot, Rens|info:eu-repo/dai/nl/304833207; Strohmeier, Dagmar; Spiel, Christiane

    2014-01-01

    When school-based prevention programs are put into practice, evaluation studies commonly only consider one indicator of program implementation. The present study investigates how two different aspects of program implementation - fidelity and participant responsiveness - jointly influence proximal

  16. Studying psychosocial adaptation to end-stage renal disease: the proximal-distal model of health-related outcomes as a base model.

    Science.gov (United States)

    Chan, Ramony; Brooks, Robert; Erlich, Jonathan; Gallagher, Martin; Snelling, Paul; Chow, Josephine; Suranyi, Michael

    2011-05-01

    Studying psychosocial adaptation in end-stage renal disease (ESRD) is increasingly important, as it may explain the variability in health outcomes unaccounted for by clinical factors. The Brenner et al. proximal-distal model of health-related outcomes provides a theoretical foundation for understanding psychosocial adaptation and integrating health outcomes, clinical, and psychosocial factors (Brenner MH, Curbow B, Legro MW. The proximal-distal continuum of multiple health outcome measures: the case of cataract surgery. Med Care. 1995;33(4 Suppl):AS236-44). This study aims to empirically validate the proximal-distal model in the dialysis population and examine the impact of psychosocial factors on the model. A cross-sectional observational study was conducted with a sample of long-term dialysis patients (n=201). Eleven factors: quality of life (QoL), depression, positive affect, comorbidity, symptoms, physical functioning, disease accommodation, loss, self-efficacy, illness acceptance, and social support were measured by standardized psychometric scales. A three-month average of hemoglobin was used. Latent composite structural equation modeling was used to examine the models. The proximal-distal model with slight modification was supported by fit statistics [χ(2)=16.04, df=13, P=.25, root mean square error of approximation (RMSEA)=0.024], indicating that the impact of clinical factors on QoL is mediated through a range of functional and psychological factors, except for hemoglobin which impacts directly on QoL. The model with additional psychosocial factors was also supported by fit statistics (χ(2)=43.59, df=41, P=.36, RMSEA=0.018). These additional factors mainly impact on symptom status, psychological states, and QoL components of the model. The present study supported the proximal-distal model in the dialysis population and demonstrated the considerable impact of psychosocial factors on the model. The proximal-distal model plus psychosocial factors as a

  17. Does aggregate school-wide achievement mediate fifth grade outcomes for former early childhood education participants?

    Science.gov (United States)

    Curenton, Stephanie M; Dong, Nianbo; Shen, Xiangjin

    2015-07-01

    This study used a multilevel mediation model to test the theory that former early childhood education (ECE) attendees' 5th grade achievement is mediated by the aggregate school-wide achievement of their elementary school. Aggregate school-wide achievement was defined as the percentage of 5th graders in a school who were at/above academic proficiency in reading or math. Research questions were: (a) Do ECE program participants have better achievement at 5th grade compared with their matched peers who did not participate in an ECE program?; and (b) Is the association between ECE attendance and 5th grade academic performance mediated by school-wide achievement? Results indicated that children who attended prekindergarten (pre-K) and child care outperformed their matched peers who had not attended ECE programs; conversely, those children who did not attend ECE actually outperformed their Head Start counterparts. Mediation analyses indicated that aggregate school-wide achievement at 5th grade partially mediated the association between former ECE attendance and 5th grade performance; however, these mediated effects were small. Overall, the size of the total effects of ECE and the 5th grade academic outcomes were consistent with prior studies. This research confirms the long-term effects of pre-K and child care until 5th grade. (c) 2015 APA, all rights reserved).

  18. Achievement for All: improving psychosocial outcomes for students with special educational needs and disabilities.

    Science.gov (United States)

    Humphrey, Neil; Lendrum, Ann; Barlow, Alexandra; Wigelsworth, Michael; Squires, Garry

    2013-04-01

    Students with special educational needs and disabilities (SEND) are at a greatly increased risk of experiencing poor psychosocial outcomes. Developing effective interventions that address the cause of these outcomes has therefore become a major policy priority in recent years. We report on a national evaluation of the Achievement for All (AfA) programme that was designed to improve outcomes for students with SEND through: (1) academic assessment, tracking and intervention, (2) structured conversations with parents, and (3) developing provision to improve wider outcomes (e.g. positive relationships). Using a quasi-experimental, pre-test-post-test control group design, we assessed the impact of AfA on teacher ratings of the behaviour problems, positive relationships and bullying of students with SEND over an 18-month period. Participants were 4758 students with SEND drawn from 323 schools across England. Our main impact analysis demonstrated that AfA had a significant impact on all three response variables when compared to usual practice. Hierarchical linear modelling of data from the intervention group highlighted a range of school-level contextual factors and implementation activities and student-level individual differences that moderated the impact of AfA on our study outcomes. The implications of our findings are discussed, and study strengths and limitations are noted. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  19. Varus inclination of the proximal tibia or the distal femur does not influence high tibial osteotomy outcome

    NARCIS (Netherlands)

    T.M. van Raaij (Tom); I. Takacs (Imre); M. Reijman (Max); J.A.N. Verhaar (Jan)

    2009-01-01

    textabstractWe have analysed retrospectively the influence of different sources of knee deformity on failure of closing wedge high tibial valgus osteotomy (HTO). Preoperative frontal plane varus deformities of the lower extremity, distal femur and proximal tibia, and medial convergence of the knee

  20. Outcome Assessment of Hybrid External Fixation in the Treatment of Comminuted Distal Femur and Proximal Tibial Fractures

    Directory of Open Access Journals (Sweden)

    Sarrafan

    2016-02-01

    Full Text Available Background Treatment of comminuted fractures of the distal femur and proximal tibia is difficult, and a challenge in the field of orthopedic trauma. Objectives The aim of this study was to assess the short-term results of hybrid external fixation in the treatment of these fractures. Patients and Methods In a prospective study, 44 patients with comminuted fractures of the distal femur or proximal tibia, with an overlying soft tissue injury treated by closed reduction and hybrid external fixation, were included. Parameters such as pin-track infection, union, limb shortening, knee motion, and alignment were evaluated during a mean follow-up period of 14 months. Results Forty-four patients with distal femoral (n = 23 and proximal tibial (n = 21 fractures were treated using hybrid external fixation. Bone union was seen in 35 (80% of the patients. Pin tract infection was seen in three patients (6.8%, one case (4.6% with a PTF and two cases (8% with DFFs. Malunion was observed in 4 patients (9.1%; of these, three cases (13% had DFF and one case (4.8% of pain was detected in the DFF group. One case had malunion and three cases had union. Findings showed satisfactory results in more than 80% of patients. In general, lower postoperative complications were detected in the proximal tibial fractures than the distal femoral fractures. According to a chi-square test, the difference between the patients with PTFs and those with DFFs was not clinically significant. Conclusions Closed reduction and hybrid external fixation can be used as a definitive treatment for severe comminuted fractures of the distal femur and proximal tibia, when the concomitant contusion of the skin and soft tissue damage prohibits safe open reduction and internal fixation.

  1. Management of unstable pertrochanteric fractures with proximal femoral locking compression plates and affect of neck-shaft angle on functional outcomes.

    Science.gov (United States)

    Kovalak, Emrah; Ermutlu, Cenk; Atay, Tolga; Başal, Özgür

    2017-01-01

    Management of unstable pertrochanteric fractures remains a challenge with various implant choices. Intramedullary devices are usually preferred for the management of the unstable fractures. When nailing is unsuitable for the configuration of the fracture extra medullary procedures are preferred. PFLCP is a contact limited implant that allows multiple angularly stable fixations with preserving more bone stock after implantation as an extramedullary implant. There are only a few reports in the literature about the osteosynthesis of unstable trochanteric fractures with proximal femoral locking compression plates and their results are conflicting. In the present study we aimed to evaluate the functional and radiological outcomes of proksimal femoral locking compression plates in open reduction and internal fixation of AO/OTA 31A2-2 and 3 fractures. Patients older than 18 years of age with a minimum follow-up time of 1 year matching the inclusion criteria retrospectively evaluated. Patients' demographics, Singh index, intra and post-operative data, mobilization and union time gathered from the patients' files. Baumgaertner modified criteria of fracture reduction was used to assess the post-operative reduction quality. Early and last follow-up radiographs were used to evaluate malunion and change in neck- shaft angle. Final clinical outcome was assessed using the Harris Hip scoring system. 18 male and 13 female patients with the mean age of 74 (46-88) met the inclusion criteria. Reduction quality according to Baumgaertner modified criteria was good in 25 patients and acceptable in 6. Mean union time was 21.53 ± 4.18 weeks. There was neither non-union nor malunion. The mean neck-shaft angle change was -3.1° ± 2.16°. The mean HHS was 77.90 ± 4.84 and there was no significance in HHS according to reduction quality and change in neck-shaft angle (p = 0.385, p = 0.0059). HHS was negatively correlated with age, mobilization time and, longer union time (p

  2. Achievement of learning outcome after implemented physical modules based on problem based learning

    Science.gov (United States)

    Isna, R.; Masykuri, M.; Sukarmin

    2018-03-01

    Implementation of Problem BasedLearning (PBL) modules can grow the students' thinking skills to solve the problems in daily life and equip the students into higher education levels. The purpose of this research is to know the achievement of learning outcome after implementation physics module based on PBL in Newton,s Law of Gravity. This research method use the experimental method with posttest only group design. To know the achievement of student learning outcomes was analyzed using t test through application of SPSS 18. Based on research result, it is found that the average of student learning outcomes after appliying physics module based on PBL has reached the minimal exhaustiveness criteria. In addition, students' scientific attitudes also improved at each meeting. Presentation activities which contained at learning sync are also able to practice speaking skills and broaden their knowledge. Looking at some shortcomings during the study, it is suggested the issues raised into learning should be a problem close to the life of students so that, the students are more active and enthusiastic in following the learning of physics.

  3. Student perceptions of their biology teacher's interpersonal teaching behaviors and student achievement and affective learning outcomes

    Science.gov (United States)

    Smith, Wade Clay, Jr.

    The primary goals of this dissertation were to determine the relationships between interpersonal teaching behaviors and student achievement and affective learning outcomes. The instrument used to collect student perceptions of teacher interpersonal teaching behaviors was the Questionnaire on Teacher Interactions (QTI). The instrument used to assess student affective learning outcomes was the Biology Student Affective Instrument (BSAI). The interpersonal teaching behavior data were collected using students as the observers. 111 students in an urban influenced, rural high school answered the QTI and BSAI in September 1997 and again in April 1998. At the same time students were pre and post tested using the Biology End of Course Examination (BECE). The QTI has been used primarily in European and Oceanic areas. The instrument was also primarily used in educational stratified environment. This was the first time the BSAI was used to assess student affective learning outcomes. The BECE is a Texas normed cognitive assessment test and it is used by Texas schools districts as the end of course examination in biology. The interpersonal teaching behaviors model was tested to ascertain if predictive power in the USA and in a non-stratified educational environment. Findings indicate that the QTI is an adequate predictor of student achievement in biology. The results were not congruent with the non-USA data and results, this indicates that the QTI is a society/culturally sensitive instrument and the instrument needs to be normed to a particular society/culture before it is used to affect teachers' and students' educational environments.

  4. Difference between radiological and functional outcome with deltoid-splitting approach versus deltopectoral approach for the management of proximal humeral fractures with philos plate

    Directory of Open Access Journals (Sweden)

    Shah Waliullah

    2013-01-01

    Full Text Available Background: Proximal humeral fractures are one of the common fractures of upper extremity. Good results by various studies have been reported for proximal humeral locking plate (PHILOS fixation in proximal humeral fractures. We want to evaluate whether it is only the implant which has given good results or different surgical approach utilized for fixation of plate also affects result. Materials and Methods: A total of 57 patients with proximal humeral fractures were divided in two groups, in Group A, patient′s classical deltopectoral approach utilized, while in Group B deltoid-splitting approach was used. All patients were managed by PHILOS plate fixation. Cases were followed up clinically as well as radiologically at 4-6 weeks after operation and thereafter at 10-12 weeks and then at 6 monthly for long-term complications. Functional outcomes of patient were accessed in terms Constant Scoring System, while radiological evaluation was done by taking x-rays to access quality of reduction and union of fracture. Results: All patients were followed for a minimum of 18 months. In Group B, reduction of tuberosities was better in 3 part and 4 part fractures. Mean Constant score in Group A at the end of 3 months was 56, while in Group B it was 62 and statistically significant (P = 0.02. At the end of 18 months, mean Constant score in Group A was 79, while in Group B it was 81 and statistically insignificant (P = 0.72. One patient in Group B showed axillary nerve paresis in postoperative period and recovered at the end of 3 months. Conclusion: We recommend that deltoid-splitting approach can be used in 3 part and 4 part complex proximal humeral fractures and in posterior fracture dislocation shoulder, which are difficult to approach with deltopectoral approach; however, care should be taken while inserting calcar screw in PHILOS plate fixation to avoid iatrogenic axillary nerve injury.

  5. Short-term outcomes and nutritional status after laparoscopic subtotal gastrectomy with a very small remnant stomach for cStage I proximal gastric carcinoma.

    Science.gov (United States)

    Furukawa, Haruna; Kurokawa, Yukinori; Takiguchi, Shuji; Tanaka, Koji; Miyazaki, Yasuhiro; Makino, Tomoki; Takahashi, Tsuyoshi; Yamasaki, Makoto; Nakajima, Kiyokazu; Mori, Masaki; Doki, Yuichiro

    2017-08-20

    Total or proximal gastrectomy is usually performed for early proximal gastric carcinoma, but the optimal type of gastrectomy is still unknown. We evaluated short-term outcomes and nutritional status after laparoscopic subtotal gastrectomy (LsTG) in comparison with laparoscopic total gastrectomy (LTG) and laparoscopic proximal gastrectomy (LPG). We analyzed 113 patients who underwent LsTG (n = 38), LTG (n = 48), or LPG (n = 27) for cStage I gastric cancer located in the upper third of the stomach. Postoperative morbidities, nutritional status including body weight, serum albumin, hemoglobin, the prognostic nutritional index (PNI), and endoscopic findings at 1 year after surgery were compared between LsTG and both LTG and LPG. Operation time and intraoperative blood loss were similar among the three groups. The incidence of postoperative morbidities was lower in LsTG than in LTG. The degree of body weight loss was significantly smaller in LsTG than in LTG at 6 and 12 months. At 12 months, LsTG resulted in better serum albumin and PNI than LPG, and better hemoglobin than LTG. Endoscopic examination demonstrated that one LsTG patient and two LPG patients had reflux esophagitis. Remnant gastritis was observed more frequently in LPG than in LsTG. No LsTG patient had bile reflux, although it was observed in four LPG patients. LsTG with a very small remnant stomach had favorable short-term outcomes and nutritional status compared with LTG and LPG, so it may be a better treatment option for cStage I proximal gastric carcinoma.

  6. From Headline to Hard Grind: The Importance of Understanding Public Administration in Achieving Health Outcomes

    Science.gov (United States)

    O’Flynn, Janine

    2016-01-01

    Many public policy programs fail to translate ambitious headlines to on-the-ground action. The reasons for this are many and varied, but for public administration and management scholars a large part of the gap between ambition and achievement is the challenge associated with the operation of the machinery of government itself, and how it relates to the other parties that it relies on to fulfill these outcomes. In their article, Carey and Friel set out key reasons why public health scholars should seek to better understand important ideas in public administration. In commenting on their contribution, I draw out two critical questions that are raised by this discussion: (i) what are boundaries and what forms do they take? and (ii) why work across boundaries? Expanding on these key questions extends the points made by Carey and Friel on the importance of understanding public administration and will better place public health scholars and practitioners to realise health outcomes. PMID:27694672

  7. Treating Proximal Interphalangeal Joint Dislocations.

    Science.gov (United States)

    Saitta, Bradley Hart; Wolf, Jennifer Moriatis

    2018-05-01

    Proximal interphalangeal (PIP) joint dislocation a common injury. Usually, concentric stable reduction can be achieved with closed reduction. Occasionally, PIP joint dislocations are irreducible and open reduction is necessary. Complications include prolonged splinting and delay in presentation with subluxation or persistent dislocation. Surgery is often recommended for contracture or joint reduction. Surgical techniques focus on contracture release, joint reduction, and range of motion. Techniques have evolved from primary repair to tenodesis and suture anchor reconstruction. Most studies on PIP joint dislocations are retrospective case reports with good outcomes but chronic mild contracture and deformity are consistent in the literature. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Which outcomes do women expect to achieve after undergoing induced abortion

    Science.gov (United States)

    Nouhjah, Sedigheh; Zamani-Alavijeh, Fereshteh; Heydarabadi, Akbar Babaei; Hozaili, Maedeh

    2017-01-01

    Introduction Unsafe abortion is one of the most important health problems in many countries. Because of legal and moral issues, abortion is one of the most sensitive decisions. The aim of this study was to understand women’s expected gains from undergoing induced abortion. Methods To explain the factors leading to induced abortion, we collected the stories and experiences of a total of 21 people, including 18 women who underwent induced abortion in their most recent pregnancies, two women’s health providers, and a companion of a mother who died after an induced abortion. This qualitative study was conducted in Imam Khomeini and Razi hospital of Ahvaz and also a number of health centers, from February to September 2014. To collect the required data, we used open and semi-structured deep interviews. Content analysis method was used to analyze the data. Results Three major themes emerged from the analysis of the collected data, which included the following: 1) Expected favorable health-related outcomes, 2) Expected favorable economic outcomes, and 3. Expected favorable outcomes in social level and family relationships. Conclusion The results of this study showed that the studied women, to achieve to desirable outcomes in areas of health, economic and social, have undergone induced abortion. Hence, to develop programs for the prevention of induced abortion it is necessary to consider the motivations of women to intentionally terminate a pregnancy. PMID:28465801

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

    Science.gov (United States)

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

    2017-05-01

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

  10. Clinical Comparison of Outcomes of Early versus Delayed Carotid Artery Stenting for Symptomatic Cerebral Watershed Infarction due to Stenosis of the Proximal Internal Carotid Artery

    Directory of Open Access Journals (Sweden)

    Huakun Liu

    2016-01-01

    Full Text Available The aim of this study was to compare the clinical outcomes of early versus delayed carotid artery stenting (CAS for symptomatic cerebral watershed infarction (sCWI patients due to stenosis of the proximal internal carotid artery. We retrospectively collected clinical data of those who underwent early or delayed CAS from March 2011 to April 2014. The time of early CAS and delayed CAS was within a week of symptom onset and after four weeks from symptom onset. Clinical data such as second stroke, the National Institutes of Health Stroke Scale (NHISS score, and modified Rankin Scale (mRS score and periprocedural complications were collected. The rate of second stroke in early CAS group is lower when compared to that of delayed CAS group. There was no significant difference regarding periprocedural complications in both groups. There was a significant difference regarding mean NHISS score 90 days after CAS in two groups. Early CAS group had a significant better good outcome (mRS score ≤ 2 than delayed CAS group. We suggest early CAS for sCWI due to severe proximal internal carotid artery stenosis as it provides lower rate of second stroke, comparable periprocedural complications, and better functional outcomes compared to that of delayed CAS.

  11. SU-E-T-170: Characterization of the Location, Extent, and Proximity to Critical Structures of Target Volumes Provides Detail for Improved Outcome Predictions Among Pancreatic Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Z; Moore, J; Rosati, L; Mian, O; Narang, A; Herman, J; McNutt, T [Johns Hopkins University, Baltimore, MD (United States)

    2015-06-15

    Purpose: In radiotherapy, size, location and proximity of the target to critical structures influence treatment decisions. It has been shown that proximity of the target predicts dosimetric sparing of critical structures. In addition to dosimetry, precise location of disease has further implications such as tumor invasion, or proximity to major arteries that inhibit surgery. Knowledge of which patients can be converted to surgical candidates by radiation may have high impact on future treat/no-treat decisions. We propose a method to improve our characterization of the location of pancreatic cancer and treatment volume extent with respect to nearby arteries with the goal of developing features to improve clinical predictions and decisions. Methods: Oncospace is a local learning health system that systematically captures clinical outcomes and all aspects of radiotherapy treatment plans, including overlap volume histograms (OVH) – a measure of spatial relationships between two structures. Minimum and maximum distances of PTV and OARs based on OVH, PTV volume, anatomic location by ICD-9 code, and surgical outcome were queried. Normalized distance to center from the left and right kidney was calculated to indicate tumor location and laterality. Distance to critical arteries (celiac, superior mesenteric, common hepatic) is validated by surgical status (borderline resectable, locally advanced converted to resectable). Results: There were 205 pancreas stereotactic body radiotherapy patients treated from 2009–2015 queried. Location/laterality of tumor based on kidney OVH show strong trends between location by OVH and by ICD-9. Compared to the locally advanced group, the borderline resectable group showed larger geometrical distance from critical arteries (p=0.03). Conclusion: Our platform enabled analysis of shape/size-location relationships. These data suggest that PTV volume and attention to distance between PTVs and surrounding OARs and major arteries may be

  12. SU-E-T-170: Characterization of the Location, Extent, and Proximity to Critical Structures of Target Volumes Provides Detail for Improved Outcome Predictions Among Pancreatic Cancer Patients

    International Nuclear Information System (INIS)

    Cheng, Z; Moore, J; Rosati, L; Mian, O; Narang, A; Herman, J; McNutt, T

    2015-01-01

    Purpose: In radiotherapy, size, location and proximity of the target to critical structures influence treatment decisions. It has been shown that proximity of the target predicts dosimetric sparing of critical structures. In addition to dosimetry, precise location of disease has further implications such as tumor invasion, or proximity to major arteries that inhibit surgery. Knowledge of which patients can be converted to surgical candidates by radiation may have high impact on future treat/no-treat decisions. We propose a method to improve our characterization of the location of pancreatic cancer and treatment volume extent with respect to nearby arteries with the goal of developing features to improve clinical predictions and decisions. Methods: Oncospace is a local learning health system that systematically captures clinical outcomes and all aspects of radiotherapy treatment plans, including overlap volume histograms (OVH) – a measure of spatial relationships between two structures. Minimum and maximum distances of PTV and OARs based on OVH, PTV volume, anatomic location by ICD-9 code, and surgical outcome were queried. Normalized distance to center from the left and right kidney was calculated to indicate tumor location and laterality. Distance to critical arteries (celiac, superior mesenteric, common hepatic) is validated by surgical status (borderline resectable, locally advanced converted to resectable). Results: There were 205 pancreas stereotactic body radiotherapy patients treated from 2009–2015 queried. Location/laterality of tumor based on kidney OVH show strong trends between location by OVH and by ICD-9. Compared to the locally advanced group, the borderline resectable group showed larger geometrical distance from critical arteries (p=0.03). Conclusion: Our platform enabled analysis of shape/size-location relationships. These data suggest that PTV volume and attention to distance between PTVs and surrounding OARs and major arteries may be

  13. Parasagittal fractures of the proximal phalanx in Thoroughbred racehorses in the UK: Outcome of repaired fractures in 113 cases (2007-2011).

    Science.gov (United States)

    Smith, M R W; Corletto, F C; Wright, I M

    2017-11-01

    Thirty years have elapsed since the last published review of outcome following fracture of the proximal phalanx in Thoroughbred racehorses in the UK and contemporary results are needed to be able to advise of expected outcome. Collect and analyse outcome data following repair of fractures of the proximal phalanx in Thoroughbred racehorses in the UK. Retrospective case series. Case records of all Thoroughbred racehorses admitted to Newmarket Equine Hospital for evaluation of a parasagittal fracture of the proximal phalanx during a 5 years period were reviewed. Follow-up data regarding racing careers was collected for horses that underwent repair. Following exclusion of outliers, cases with incomplete data sets and comminuted fractures, mixed effect logistic regression was used to identify variables affecting returning to racing and odds ratios and confidence intervals calculated. Of 113 repaired cases, fracture configurations included short incomplete parasagittal (n = 12), long incomplete parasagittal (n = 86), complete parasagittal (n = 12) and comminuted (n = 3). A total of 54 (48%) cases raced after surgery. Horses that fractured at 2 years of age had increased odds of racing following surgery than those older than 2 years of age (OR 1.34; 95% CI 1.13-1.59, P = 0.002). Horses sustaining short incomplete parasagittal fractures had increased odds of racing following surgery compared with those with complete parasagittal fractures (OR 2.62; 95% CI 1.36-5.07, P = 0.006). No horses with comminuted fractures returned to racing. Data are relevant only to Thoroughbred racehorses in the UK. Approximately half of the cases in this series raced following surgical repair. More 2-year-old horses raced following surgery, but this likely reflects horses, specifically older horses, passing out of training from unrelated factors. Fracture configuration affects odds of racing, which is relevant to owners when deciding on treatment. © 2017 EVJ Ltd.

  14. Socially oriented achievement goals of Chinese university students in Singapore: structure and relationships with achievement motives, goals and affective outcomes.

    Science.gov (United States)

    Chang, Weining C; Wong, Kaishi

    2008-10-01

    Contemporary literature on culture, self, and motivations (Markus & Kitayama, 1991) suggests that in collectivistic cultures, individual achievement is interdependent of one's social others. We proposed that this cultural characteristic could be exemplified in the achievement goal orientation and tested the notion with university students in a collectivistic community-Singapore. A socially oriented achievement goal construct was developed by taking into consideration the significant social others in the students' lives. A measuring instrument was established with a sample of Singaporean Chinese university students (N = 196; 144 females and 52 males); its relationships to achievement motives, goals, and consequences were examined. Although the socially oriented achievement goal items were originally constructed from four categories of social others, confirmatory factor analysis suggested a unifactor structure. Results showed that the socially oriented goal was related positively with students' performance goal, mastery goal, and competitive motive; it bore no relationship to mastery motive, work ethic, and interest in learning; and it predicted negatively future engagement. After the effects of mastery and performance goals were controlled for, the socially oriented goal did not predict test anxiety.

  15. Learning science in a cooperative setting: Academic achievement and affective outcomes

    Science.gov (United States)

    Lazarowitz, Reuven; Hertz-Lazarowitz, Rachel; Baird, J. Hugh

    A learning unit in earth science was taught to high school students, using a jigsaw-group mastery learning approach. The sample consisted of 73 students in the experimental group and 47 students who learned the topic in an individualized mastery learning approach. The study lasted 5 weeks. Pretests and posttests on academic achievement and affective outcomes were administered. Data were treated with an analysis of covariance. The results show that students of the experimental group achieved significantly higher on academic outcomes, both normative and objective scores. On the creative essay test, the differences in number of ideas and total essay score were not significant between the groups, although the mean scores for number of words were higher for the individualized mastery learning group. On the affective domain, jigsaw-group mastery learning students scored significantly higher on self-esteem, number of friends, and involvement in the classroom. No differences were found in cohesiveness, cooperation, competition, and attitudes toward the subject learned. The results are discussed through the evaluation and comparison of the two methods of instruction used in this study.The cooperative learning movement began in junior high schools as part of the desegregation process, aiming at facilitating positive ethnic relations and increasing academic achievement and social skills among diverse students (Aronson, Stephan, Sikes, Blaney, & Snapp, 1978; Sharan & Hertz-Lazarowitz, 1980; Slavin, 1980). However, elementary teachers quickly recognized the potential of cooperative methods, and such methods were adopted freely in elementary schools before becoming widespread on the junior and senior high level. It has only been during the past few years that application of cooperative learning has been studied extensively with these older students.Cooperative learning methods generally involve heterogeneous groups working together on tasks that are deliberately structured to

  16. Using peers in a three folded support : student needs and achieving the learning outcomes!

    Directory of Open Access Journals (Sweden)

    Anna Wiberg

    2013-12-01

    Full Text Available This poster describes how librarians, teachers and students collaborate at the Faculty of Law at Lund University in order to support the law students to achieve the learning outcomes. The purpose is to highlight the use of peers as a part of the learning support. When The Bologna process took place in 2007, the library introduced a plan on how to achieve the learning outcomes concerning information literacy. Information literacy is an important competence for law students and professionals and is therefore stressed in the learning outcomes. A central feature is that the outcomes should be closely related to the contents of each course so that the students practice information literacy as part of the subject law. To make best use of different competencies the library suggested a three folded support structure. Student teachers give database instructions for solving course assignments; subject teachers and librarians work together in lectures concerning document cultures and law practices; librarians are responsible for lectures concerning problem solving and information seeking. The faculty has a long tradition of hiring students to assist in teaching on a basic level. One reason to use peers in teaching is that students are close to the learning process and are familiar with difficulties. The students also have other perspectives on the topics being taught, which can be useful in their teaching (Biggs & Tang, 2011, p. 147. The information lectures have very often a high amount of participants, which sort of confirm the teaching organization. The library is responsible for coordinating the information literacy and work in close relation with the student teachers and the subject teachers. The librarians repeatedly discuss with the subject teachers and the student teachers about the learning outcomes and the assignments on the course. Exercises and questions for the students are jointly developed. The librarians also write manuals for the lectures

  17. Achieving the Desired Transformation: Thoughts on Next Steps for Outcomes-Based Medical Education.

    Science.gov (United States)

    Holmboe, Eric S; Batalden, Paul

    2015-09-01

    Since the introduction of the outcomes-based medical education (OBME) movement, progress toward implementation has been active but challenging. Much of the angst and criticism has been directed at the approaches to assessment that are associated with outcomes-based or competency frameworks, particularly defining the outcomes. In addition, these changes to graduate medical education (GME) are concomitant with major change in health care systems--specifically, changes to increase quality and safety while reducing cost. Every sector, from medical education to health care delivery and financing, is in the midst of substantial change and disruption.The recent release of the Institute of Medicine's report on the financing and governance of GME highlights the urgent need to accelerate the transformation of medical education. One source of continued tension within the medical education community arises from the assumption that the much-needed increases in value and improvement in health care can be achieved by holding the current educational structures and architecture of learning in place while concomitantly withdrawing resources. The authors of this Perspective seek to reframe the important and necessary debate surrounding the current challenges to implementing OBME. Building on recent change and service theories (e.g., Theory U and coproduction), they propose several areas of redirection, including reexamination of curricular models and greater involvement of learners, teachers, and regulators in cocreating new training models, to help facilitate the desired transformation in medical education.

  18. Proximal Nephron

    Science.gov (United States)

    Zhuo, Jia L.; Li, Xiao C.

    2013-01-01

    The kidney plays a fundamental role in maintaining body salt and fluid balance and blood pressure homeostasis through the actions of its proximal and distal tubular segments of nephrons. However, proximal tubules are well recognized to exert a more prominent role than distal counterparts. Proximal tubules are responsible for reabsorbing approximately 65% of filtered load and most, if not all, of filtered amino acids, glucose, solutes, and low molecular weight proteins. Proximal tubules also play a key role in regulating acid-base balance by reabsorbing approximately 80% of filtered bicarbonate. The purpose of this review article is to provide a comprehensive overview of new insights and perspectives into current understanding of proximal tubules of nephrons, with an emphasis on the ultrastructure, molecular biology, cellular and integrative physiology, and the underlying signaling transduction mechanisms. The review is divided into three closely related sections. The first section focuses on the classification of nephrons and recent perspectives on the potential role of nephron numbers in human health and diseases. The second section reviews recent research on the structural and biochemical basis of proximal tubular function. The final section provides a comprehensive overview of new insights and perspectives in the physiological regulation of proximal tubular transport by vasoactive hormones. In the latter section, attention is particularly paid to new insights and perspectives learnt from recent cloning of transporters, development of transgenic animals with knockout or knockin of a particular gene of interest, and mapping of signaling pathways using microarrays and/or physiological proteomic approaches. PMID:23897681

  19. On Achieving Transdisciplinary Outcomes from Synergistic Research Efforts in the Northern Gulf of Mexico

    Science.gov (United States)

    Hagen, S. C.

    2017-12-01

    Multiple federal initiatives aim to evaluate and enhance sustainability and resilience at the coastal-land margin. Progressive efforts undertaken in the northern Gulf of Mexico for more than ten years have resulted in synergistic research with multiple means of federal support. Major grants include the FEMA Flood Insurance Studies, the NOAA / NOS Ecological Effects of Sea Level Rise Program, as well as the NSF Coastal SEES Program. Through a careful development of a collective enterprise the results from these and other individual programs (e.g., NOAA Sea Grant College, DHS Center of Excellence, NSF Rapid Response) have been elevated to achieve transdisciplinary outcomes. A direct product of the synergy is a system of systems approach to bio-geophysical science with the inclusion of socioeconomic processes.

  20. Nutrition Prescription to Achieve Positive Outcomes in Chronic Kidney Disease: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Susan Ash

    2014-01-01

    Full Text Available In Chronic Kidney Disease (CKD, management of diet is important in prevention of disease progression and symptom management, however evidence on nutrition prescription is limited. Recent international CKD guidelines and literature was reviewed to address the following question “What is the appropriate nutrition prescription to achieve positive outcomes in adult patients with chronic kidney disease?” Databases included in the search were Medline and CINAHL using EBSCOhost search engine, Embase and the Cochrane Database of Systematic Reviews published from 2000 to 2009. International guidelines pertaining to nutrition prescription in CKD were also reviewed from 2000 to 2013. Three hundred and eleven papers and eight guidelines were reviewed by three reviewers. Evidence was graded as per the National Health and Medical Research Council of Australia criteria. The evidence from thirty six papers was tabulated under the following headings: protein, weight loss, enteral support, vitamin D, sodium, fat, fibre, oral nutrition supplements, nutrition counselling, including protein and phosphate, nutrients in peritoneal dialysis solution and intradialytic parenteral nutrition, and was compared to international guidelines. While more evidence based studies are warranted, the customary nutrition prescription remains satisfactory with the exception of Vitamin D and phosphate. In these two areas, additional research is urgently needed given the potential of adverse outcomes for the CKD patient.

  1. Morgellons disease: experiences of an integrated multidisciplinary dermatology team to achieve positive outcomes.

    Science.gov (United States)

    Mohandas, Padma; Bewley, Anthony; Taylor, Ruth

    2018-03-01

    In recent years, there has been a reported increase in affliction of the skin with small fibres or other particles. The condition has been referred to as Morgellons disease. Patients present with stinging, burning or crawling sensations of the skin, with perceived extrusion of inanimate material alongside fatigue and other systemic symptoms. Sufferers often experience significant morbidity and reduction in quality of life. We aimed to explore the various clinical presentations, management strategies and outcomes employed to treat this condition in our patients. We conducted a retrospective case notes review of 35 patients referred to our multidisciplinary psycho-dermatology clinic at the Royal London Hospital between January 2004 and January 2017. The majority of patients were women (25) 71.4%, with a mean age of 54.6 years (26-80 years). Most (26) 74.2% were living alone. The average duration of illness prior to presentation was 3.8 years (4 months-20 years). Many patients had perceived precipitating factors (54.2%) and often self-diagnosed (28.5%). Psychiatric co-morbidities included 42.8% with depressive symptoms and 25.7% with anxiety. Substance misuse was elicited in five patients (14%). Management of patients included both the treatment of skin disease and psychosocial co-morbidities. Out of the 35 patients who attended (14) 40% cleared or showed significant improvement. Sixteen (45.7%) patients were stable and under review. One patient declined treatment and three did not attend review. One patient died from disease unrelated to her skin condition. Morgellons disease is a condition, which is widely discussed on the internet and patients often self-diagnose. The course of the disease can be chronic and debilitating. For a positive outcome, it is important that a strong physican-patient relationship is cultivated. As demonstrated in this case series, managing patients holistically in an integrated multidisciplinary dermatology setting helps achieve

  2. When nursing takes ownership of financial outcomes: achieving exceptional financial performance through leadership, strategy, and execution.

    Science.gov (United States)

    Goetz, Kristopher; Janney, Michelle; Ramsey, Kristin

    2011-01-01

    With nurses and unlicensed supportive personnel composing the greatest percentage of the workforce at any hospital, it is not surprising nursing leadership plays an increasing role in the attainment of financial goals. The nursing leadership team at one academic medical center reduced costs by more than $10 million over 4 years while outperforming national benchmarks on nurse-sensitive quality indicators. The most critical success factor in attaining exceptional financial performance is a personal and collective accountability to achieving outcomes. Whether it is financial improvement, advancing patient safety, or ensuring a highly engaged workforce, success will not be attained without thoughtful, focused leadership. The accountability model ensures there is a culture built around financial performance where nurses and leaders think and act, on a daily basis, in a manner necessary to understand opportunities, find answers, and overcome obstacles. While structures, processes, and tools may serve as the means to achieve a target, it is leadership's responsibility to set the right goal and motivate others.

  3. Asymptotic proximities

    Directory of Open Access Journals (Sweden)

    Ivan V. Protasov

    2008-10-01

    Full Text Available A ballean is a set endowed with some family of subsets which are called the balls. The properties of the family of balls are postulated in such a way that the balleans can be considered as a natural asymptotic counterparts of the uniform topological spaces. We introduce and study an asymptotic proximity as a counterpart of proximity relation for uniform topological space.

  4. Can Research Design Explain Variation in Head Start Research Results? A Meta-Analysis of Cognitive and Achievement Outcomes

    Science.gov (United States)

    Shager, Hilary M.; Schindler, Holly S.; Magnuson, Katherine A.; Duncan, Greg J.; Yoshikawa, Hirokazu; Hart, Cassandra M. D.

    2013-01-01

    This study explores the extent to which differences in research design explain variation in Head Start program impacts. We employ meta-analytic techniques to predict effect sizes for cognitive and achievement outcomes as a function of the type and rigor of research design, quality and type of outcome measure, activity level of control group, and…

  5. Unexpected outcome of a modification of Bracka repair for proximal hypospadias: High incidence of diverticula with flaps.

    Science.gov (United States)

    Tiryaki, Sibel; Ələkbərova, Vüsalə; Dokumcu, Zafer; Ergun, Raziye; Tekin, Ali; Yagmur, Ismail; Ulman, Ibrahim; Avanoglu, Ali

    2016-12-01

    Various graft and flap techniques have been proposed for urethral reconstruction in proximal hypospadias repair. The Bracka repair involving the transfer of inner prepuce like a Wolfe graft mostly results in satisfactory results besides a high fistula rate. The aim was to decrease the high fistula rate with Bracka repair; we wanted to use the advantages of vascularized skin in the Bracka method. The aim of this study was to evaluate our results with this modification. Our modification involves using a flap instead of a graft. In the first stage, chordee was corrected by transection of the urethral plate and dorsal midline plication when necessary. Instead of a graft as suggested by Bracka, inner preputial skin with ample blood supply was transferred and stitched to the denuded ventral penile surface. In the second stage after 6 months, this flap was tubularized in the Thiersch-Duplay fashion. Hospital records of patients who had undergone two stage modified Bracka repair between June 2007 and July 2012 were reviewed, including complaints, complications, and need for interventions. Thirty-eight patients had undergone this operation. Four patients were lost to follow-up. The main complaint was obstructed urinary flow. Voiding symptoms were first attributed to urethral stenosis, but were, however, found to be due to diverticulum and vortex of the urine in the dilated urethra. Twenty-one patients (61%) had voiding problems and 10 patients (29%) had urinary tract infections. Fistula was observed in 23 and diverticula were observed in 24 patients. Of these, 16 patients had both fistula and diverticula. Only two patients (5%) were free of complications and totally satisfied with the operation, and 23 of the 34 patients had complications requiring intervention (Figure). Inner preputial flaps used in proximal hypospadias repairs are prone to diverticula formation. They become redundant in time requiring reoperation, thus decreasing the success rate. Careful fixation of the

  6. Features of Three- and Four-Part Proximal Humeral Fractures and Outcome of Internal Fixation Using the Philos® Locking Plate

    Directory of Open Access Journals (Sweden)

    Ali Sadighi

    2017-03-01

    Full Text Available Background: Proximal humeral fractures are among common types of fractures and remain a challenging issue for surgical management. This study aimed to assess the clinical outcomes and complication rates of three- vs. four-part proximal humeral fractures, treated with internal fixation using the Philos® plate. Material and Methods: In this cohort study, a total of 30 consecutive patients with three-part or four-part proximal humeral fractures based on the Neer classification were included. Surgical treatment was performed with open reduction and internal fixation using the Philos® plate. The constant score was evaluated 6 months later in follow-up. The P<0.05 was considered significant. Results: Four-part fractures were mainly caused by trauma from above, while insults of opposite direction were responsible for more than half of 3 part fractures (P=0.01. Open fractures were only observed in patients with a four-part fracture (P=0.018. No significant differences were noticed regarding gender, cause, and side of the fracture. The presence of other fractures, fracture of the implant, reduction loss, avascular necrosis (AVN of humerus head, rotator cuff injury, and revision surgery were significantly higher in patients with four-part fractures. The mean constant score was 81.40±11.61 and 65.09±16.09 for three-part and four-part fractures, respectively (P=0.006. Conclusion: Open reduction and internal fixation with Philos® plate yield acceptable results in both types of fractures, however, the prognosis of this intervention is poorer four-part fractures.

  7. Posterior Interosseous Nerve Syndrome Resulting from Parosteal Lipoma of the Proximal Radius: An Elusive Diagnosis Yet Excellent Outcome.

    Science.gov (United States)

    Saaiq, Muhammad; Siddiui, Saad

    2017-01-01

    A 53-year old man presented with seven months history of progressive weakness of extension of the digits and the thumb of the left hand. The wrist extension was normal and sensations were also intact. The patient had also been noticing a progressively enlarging lump on the lower anterolateral aspect of the left antecubital fossa for the last three months. Physical examination andelectro diagnostic studies revealed motor deficit along the posterior interosseous nerve (PIN) distribution with preservation of sensations. Also a soft tissue solitary lump (measuring 6×5 cm in its greatest dimensions) was palpable in the left antecubital fossa. The magnetic resonance imaging (MRI) of the forearm revealed a well-defined, non-enhancing, homogenous, fat intensity lesion in the left antecubital fossa, attached to the proximal radius. The patient underwent surgical excision of the lump with decompression of the PIN in the radial tunnel. Histopathology confirmed the diagnosis of parosteal lipoma. Although the diagnosis was elusive at the very outset, yet prudent clinical judgment, appropriate ancillary investigations and timely surgical intervention resulted in optimal functional recovery of the hand drop. There was complete motor recovery at 4-months follow up with no recurrence of the lipomaafter one year.

  8. The impact of superficial femoral artery (SFA) occlusion on the outcome of proximal sartorius muscle transposition flaps in vascular surgery patients.

    Science.gov (United States)

    Töpel, Ingolf; Betz, Thomas; Uhl, Christian; Steinbauer, Markus G

    2011-04-01

    To demonstrate the feasibility and safety of proximal sartorius muscle rotational flaps in patients with peripheral occlusive artery disease. Retrospective analysis of 53 patients with 56 proximal sartorius muscle flaps. Indication for a flap procedure was postoperative calcitrant lymphorrhea in nine, graft at risk in 13, and graft infection in 34 procedures. Pre- and postoperative patencies of the superficial femoral artery (SFA) and profundal femoral artery (PFA) were documented. Flap viability, wound healing, and limb salvage were examined at follow-up. In 59% of the procedures in this series, the SFA was occluded. The PFA was patent in all patients. Flap viability (100% vs 94%), rate of new (4% vs 6%), and recurrent infections (9% vs 6%), loss of vascular reconstruction rate (9% vs 9%), and limb salvage rate (100% vs 88%) did not differ significantly between the SFA patent and the SFA occluded group. There were four new infections (7%) and three recurrent infections (5.5%) during follow-up, five of which led to a loss of reconstruction. In four of those five patients, the sartorius flap was viable. Two patients died during the immediate postoperative period from septic multi-organ failure (3%). At a median follow-up of 6.4 months, 54 flaps were viable and wound closure was achieved in all surviving 51 patients. Limb salvage rate was 93%. Biologic protection procedures as local muscle flaps are vital adjuncts to vascular surgery techniques in the treatment of complicated wounds in the groin. Occlusion of the SFA in the presence of a patent PFA is not associated with an increased risk of flap loss in proximal sartorius muscle rotational flaps. Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  9. Application of active learning modalities to achieve medical genetics competencies and their learning outcome assessments

    Directory of Open Access Journals (Sweden)

    Hagiwara N

    2017-12-01

    Full Text Available Nobuko Hagiwara Division of Cardiovascular Medicine, Department of Internal Medicine, School of Medicine, University of California, Davis, CA, USA Abstract: The steadily falling costs of genome sequencing, coupled with the growing number of genetic tests with proven clinical validity, have made the use of genetic testing more common in clinical practice. This development has necessitated nongeneticist physicians, especially primary care physicians, to become more responsible for assessing genetic risks for their patients. Providing undergraduate medical students a solid foundation in genomic medicine, therefore, has become all the more important to ensure the readiness of future physicians in applying genomic medicine to their patient care. In order to further enhance the effectiveness of instructing practical skills in medical genetics, the emphasis of active learning modules in genetics curriculum at medical schools has increased in recent years. This is because of the general acceptance of a better efficacy of active learner-centered pedagogy over passive lecturer-centered pedagogy. However, an objective standard to evaluate students’ skill levels in genomic medicine achieved by active learning is currently missing. Recently, entrustable professional activities (EPAs in genomic medicine have been proposed as a framework for developing physician competencies in genomic medicine. EPAs in genomic medicine provide a convenient guideline for not only developing genomic medicine curriculum but also assessing students’ competency levels in practicing genomic medicine. In this review, the efficacy of different types of active learning modules reported for medical genetics curricula is discussed using EPAs in genomic medicine as a common evaluation standard for modules’ learning outcomes. The utility of the EPAs in genomic medicine for designing active learning modules in undergraduate medical genetics curricula is also discussed. Keywords

  10. Outcome of revision total knee arthroplasty with the use of trabecular metal cone for reconstruction of severe bone loss at the proximal tibia

    DEFF Research Database (Denmark)

    Jensen, Claus L; Olsen, Nikolaj Winther; Schrøder, Henrik M

    2014-01-01

    BACKGROUND: The relative effectiveness of different methods for reconstructing large bone loss at the proximal tibia in revision total knee arthroplasty (rTKA) has not been established. The aim of this study was to evaluate the clinical and radiological outcome after the use of trabecular metal......). RESULTS: Clinical and radiological follow-up data were available in 30 patients and missing in six patients: two died and four patients had re-revision (reinfection (n=2), aseptic loosening (n=1), and knee hyperextension (n=1)). Knee- and function scores (follow-up 43 months (range 12-84 months)) improved...... treatment in terms of surgical efficacy, clinical results and radiological results and was evidently at least as effective as the other options reviewed in the literature. LEVEL OF EVIDENCE: IV....

  11. Comparison of the outcomes between reduced and nonreduced triplet pregnancies achieved by Assisted Reproductive Technology.

    Science.gov (United States)

    Shiva, Marzieh; Mohammadi Yeganeh, Ladan; Mirzaagha, Elaheh; Chehrazi, Mohammad; Bagheri Lankarani, Narges

    2014-10-01

    In recent years, the significant increase in multiple pregnancies as a result of assisted reproductive technology (ART) has introduced the concept of multifetal reduction techniques. However, it is still unclear whether there are significant advantages of using this technique. To compare the outcomes of triplet pregnancies achieved by ART managed expectantly with those receiving fetal reduction interventions. In this retrospective study of 115 triplet pregnancies, 57 pregnancies were reduced to twins while 58 were managed expectantly. The fetal loss rate before 24 weeks did not differ between reduced and nonreduced pregnancies (12.3% vs 12.1%). However, the results of those using fetal reduction techniques showed a lower incidence of preterm labour (26.3% vs 50%, P = 0.009), higher mean gestational age at delivery (35.1 ± 2.6 vs 32.4 ± 3.6 weeks, P = 0.002) and higher mean birthweights compared with the control group (2188 ± 547 vs 1674 ± 546 g, P fetal loss. Additionally, there was a lower perinatal mortality, higher live birth rate and lower NICU admission. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  12. A Pedagogical Alliance for Academic Achievement: Socio-Emotional Effects on Assessment Outcomes

    Science.gov (United States)

    Leighton, Jacqueline P.; Guo, Qi; Chu, Man-Wai; Tang, Wei

    2018-01-01

    Assessment of student learning outcomes is often discussed in relation to curriculum, standards and even administration practices. However, assessment of learning outcomes is rarely discussed in light of students' socio-emotional contexts, which might help or hinder learning outcomes. For example, do students' perceptions of the teacher as…

  13. Outcomes Achieved With Use of a Prefabricated Roll-On Total Contact Cast.

    Science.gov (United States)

    Arnold, Jonathan F; Marmolejo, Valerie

    2017-10-01

    The total contact cast (TCC) is considered the gold standard for offloading of plantar diabetic foot ulcerations, yet its use remains suboptimal for a variety of reasons. Prefabricated TCC systems have been developed to help enhance TCC use. The primary objective of this study was to determine if healing rates obtained with use of a prefabricated roll-on TCC were similar to those reported with conventional TCC use. Secondary outcomes measured were the incidence of iatrogenic ulceration, amputation, and recurrent ulceration, and patient tolerance of the device. A retrospective chart review was performed on all patients in whom TCC was used for treatment of an ulceration at our institution from April 2013 to December 2016. Seventy patients (132 ulcerations) were identified. An 85.6% healing rate was achieved. Five subjects (7.1%) sustained 11 iatrogenic ulcerations. All resolved with local treatment and continued casting. Thirteen subjects (18.6%) underwent amputation. No amputation occurred because of TCC application technique or use. Fifteen ulcerations (12 subjects, 17.1%) recurred. Greater than 70% resolved with re-initiation of TCC use. Forty-three subjects (61.4%) tolerated use of the prefabricated roll-on TCC. Similar healing rates and reduced rates of iatrogenic ulceration, amputation, and recurrent ulceration were attained with use of a prefabricated roll-on TCC. These results, good patient tolerance, and the reduced administrative and clinical time related to supply acquisition, training, and proper application supports use of this device as a viable alternative to a conventional TCC for treatment of plantar neuropathic foot ulcerations. Level IV, case series.

  14. Application of active learning modalities to achieve medical genetics competencies and their learning outcome assessments.

    Science.gov (United States)

    Hagiwara, Nobuko

    2017-01-01

    The steadily falling costs of genome sequencing, coupled with the growing number of genetic tests with proven clinical validity, have made the use of genetic testing more common in clinical practice. This development has necessitated nongeneticist physicians, especially primary care physicians, to become more responsible for assessing genetic risks for their patients. Providing undergraduate medical students a solid foundation in genomic medicine, therefore, has become all the more important to ensure the readiness of future physicians in applying genomic medicine to their patient care. In order to further enhance the effectiveness of instructing practical skills in medical genetics, the emphasis of active learning modules in genetics curriculum at medical schools has increased in recent years. This is because of the general acceptance of a better efficacy of active learner-centered pedagogy over passive lecturer-centered pedagogy. However, an objective standard to evaluate students' skill levels in genomic medicine achieved by active learning is currently missing. Recently, entrustable professional activities (EPAs) in genomic medicine have been proposed as a framework for developing physician competencies in genomic medicine. EPAs in genomic medicine provide a convenient guideline for not only developing genomic medicine curriculum but also assessing students' competency levels in practicing genomic medicine. In this review, the efficacy of different types of active learning modules reported for medical genetics curricula is discussed using EPAs in genomic medicine as a common evaluation standard for modules' learning outcomes. The utility of the EPAs in genomic medicine for designing active learning modules in undergraduate medical genetics curricula is also discussed.

  15. Longitudinal Outcomes of Start Time Delay on Sleep, Behavior, and Achievement in High School

    Science.gov (United States)

    Thacher, Pamela V.; Onyper, Serge V.

    2016-01-01

    Study Objectives: To establish whether sleep, health, mood, behavior, and academics improved after a 45-minute delay in high school start time, and whether changes persisted longitudinally. Methods: We collected data from school records and student self-report across a number of domains at baseline (May 2012) and at two follow-up time points (November 2012 and May 2013), at a public high school in upstate New York. Students enrolled during academic years (AY) 2011–2012 and 2012–2013 completed the Pittsburgh Sleep Quality Index; the DASS-21; the “Owl-Lark” Scale; the Daytime Sleepiness Index; and a brief self-report of health. Reports from school records regarding attendance, tardiness, disciplinary violations, and academic performance were collected for AY 2010–2011 through 2013–2014. Results: Students delayed but did not extend their sleep period; we found lasting improvements in tardiness and disciplinary violations after the start-time delay, but no changes to other variables. At the first follow-up, students reported 20 minutes longer sleep, driven by later rise times and stable bed times. At the second follow-up, students maintained later rise times but delayed bedtimes, returning total sleep to baseline levels. A delay in rise time, paralleling the delay in the start time that occurred, resulted in less tardiness and decreased disciplinary incidents, but larger improvements to sleep patterns may be necessary to affect health, attendance, sleepiness, and academic performance. Conclusions: Later start times improved tardiness and disciplinary issues at this school district. A delay in start time may be a necessary but not sufficient means to increase sleep time and may depend on preexisting individual differences. Commentary: A commentary on this article appears in this issue on page 267. Citation: Thacher PV, Onyper SV. Longitudinal outcomes of start time delay on sleep, behavior, and achievement in high school. SLEEP 2016;39(2):271–281. PMID

  16. Isolated Striatocapsular Infarcts after Endovascular Treatment of Acute Proximal Middle Cerebral Artery Occlusions: Prevalence, Enabling Factors, and Clinical Outcome

    Directory of Open Access Journals (Sweden)

    Johannes Kaesmacher

    2017-06-01

    Full Text Available BackgroundStriatocapsular infarcts (SCIs are defined as large subcortical infarcts involving the territory of more than one lenticulostriate artery. SCI without concomitant ischemia in the more distal middle cerebral artery (MCA territory [isolated SCI (iSCI] has been described as a rare infarct pattern. The purpose of this study was to assess the prevalence of iSCI in patients treated with endovascular thrombectomy (ET, to evaluate baseline and procedural parameters associated with this condition, and to describe the clinical course of iSCI patients.MethodsA retrospective analysis of 206 consecutive patients with an isolated MCA occlusion involving the lenticulostriate arteries and treated with ET was performed. Baseline patient and procedural characteristics and ischemic involvement of the striatocapsular and distal MCA territory [iSCI, as opposed to non-isolated SCI (niSCI] were analyzed using multivariate logistic regression models. Prevalence of iSCI was assessed, and clinical course was determined with the rates of substantial neurological improvement and good functional short- and mid-term outcome (discharge/day 90 Modified Rankin Scale ≤2.ResultsiSCI was detected in 53 patients (25.7%, and niSCI was detected in 153 patients (74.3%. Successful reperfusion [thrombolysis in cerebral infarction (TICI 2b/3] [adjusted odds ration (aOR 8.730, 95% confidence interval (95% CI 1.069–71.308] and good collaterals (aOR 2.100, 95% CI 1.119–3.944 were associated with iSCI. In successfully reperfused patients, TICI 3 was found to be an additional factor associated with iSCI (aOR 5.282, 1.759–15.859. Patients with iSCI had higher rates of substantial neurological improvement (71.7 vs. 37.9%, p < 0.001 and higher rates of good functional short- and mid-term outcome (58.3 vs. 23.7%, p < 0.001 and 71.4 vs. 41.7%, p < 0.001. However, while iSCI patients, in general, had a more favorable outcome, considerable heterogeneity in outcome was

  17. Dominant Achievement Goals of Older Workers and Their Relationship with Motivation-Related Outcomes

    Science.gov (United States)

    de Lange, Annet H.; Van Yperen, Nico W.; Van der Heijden, Beatrice I. J. M.; Bal, P. Matthijs

    2010-01-01

    The aim of this study was to increase our insight into older employees' achievement motivation by examining the prevalence of dominant achievement goals among a "unique" group of 172 Dutch workers who remained active after their post-statutory retirement age. Moreover, we investigated how their dominant achievement goals were linked to…

  18. Long-term clinical outcomes for bifurcation treatment using a provisional T-stenting and double proximal optimization technique with Absorb bioresorbable scaffolds

    Directory of Open Access Journals (Sweden)

    Р. Д. Иванченко

    2017-04-01

    Full Text Available Aim. The article presents long-term outcomes of treatment of coronary artery bifurcation lesions by using bioresorbable vascular scaffolds and provisional T-stenting combined with double proximal optimization. Methods. 14 patients aged 44-80 years (mean age 61±6 years including 8 (57.14 % males underwent endovascular treatment of coronary artery bifurcation lesions by using Absorb bioresorbable vascular scaffolds (BVS. Clinical/instrumental analysis was carried out after 23.7±4.12 months. Angiographic examination was performed in 12 cases (85.71 %. 7 patients (50 % underwent optical coherent tomography. Results. 11 patients (78.57 were free of angina during long-term follow-up. 1 patient (7.14 % developed BVS thrombosis and received a drug-eluting stent. A neointimal layer of the main branch increased during long-term follow-up to 29.23±7.82%, that of the lateral branch – up to 19.2±7.48%. Optical coherence tomography (OCT shows that all strata are fully covered with neointima, the number of strata with malappositions is minimal and the loss of the main branch diameter (16.9±4.9% is insignificant. Conclusion. The use of Absorb bioresorbable vascular scaffolds implanted by means of provisional T-stenting combined with double proximal optimization when treating coronary artery bifurcation lesions is a safe and efficient procedure.Received 2 February 2017. Accepted 10 March 2017.Financing: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest.

  19. Proximity detection

    Energy Technology Data Exchange (ETDEWEB)

    Roettig, A.; Ramirez, C. [Modular Mining Systems (United States)

    2006-08-15

    The paper introduces a proximity waring system designed to prevent accidents between shovels and dozers. The system was designed by Modular Mining systems Inc. mine in South America. The basic idea was to use existing technology to automate the announcement of the presence of operators and give constant feedback of the operational situation around each piece of equipment. Since the system has been installed no incidents have been recorded at the South American mine. 3 figs.

  20. Confidence in Science and Achievement Outcomes of Fourth-Grade Students in Korea: Results from the TIMSS 2011 Assessment

    Science.gov (United States)

    House, J. Daniel; Telese, James A.

    2017-01-01

    Findings from assessments of fourth-grade science have indicated that students in Korea scored higher than international averages. Research results have also shown that attitudes toward science were related to achievement outcomes for Korean students. The purpose of this study was to examine the relationship between confidence in science and…

  1. Effects of National Board Certified Teachers on Student Achievement and Behavioral Outcomes: Studies Conducted in Two States. Working Paper

    Science.gov (United States)

    Manzeske, David; Park, So Jung; Liu, Feng; Borman, Trisha; Gnedko-Berry, Natalya; West, Benjamin; Deng, Evelyn

    2017-01-01

    The purpose of this work was to examine the effect of classroom teachers who earn certification as a National Board Certified Teacher (NBCT) by the National Board for Professional Teaching Standards on mathematics and reading achievement and behavioral outcomes (attendance and discipline referrals) for students in Grades 4 and 5. Two studies were…

  2. Can Cooperative Learning Achieve the Four Learning Outcomes of Physical Education? A Review of Literature

    Science.gov (United States)

    Casey, Ashley; Goodyear, Victoria A.

    2015-01-01

    Physical learning, cognitive learning, social learning, and affective learning are positioned as the legitimate learning outcomes of physical education. It has been argued that these four learning outcomes go toward facilitating students' engagement with the physically active life (Bailey et al., 2009; Kirk, 2013). With Cooperative Learning…

  3. [Partial replantation following proximal limb injury].

    Science.gov (United States)

    Dubert, T; Malikov, S A; Dinh, A; Kupatadze, D D; Oberlin, C; Alnot, J Y; Nabokov, B B

    2000-11-01

    Proximal replantation is a technically feasible but life-threatening procedure. Indications must be restricted to patients in good condition with a good functional prognosis. The goal of replantation must be focused not only on reimplanting the amputated limb but also on achieving a good functional outcome. For the lower limb, simple terminalization remains the best choice in many cases. When a proximal amputation is not suitable for replantation, the main aim of the surgical procedure must be to reconstruct a stump long enough to permit fitting a prosthesis preserving the function of the adjacent joint. If the proximal stump beyond the last joint is very short, it may be possible to restore some length by partial replantation of spared tissues from the amputated part. We present here the results we obtained following this policy. This series included 16 cases of partial replantations, 14 involving the lower limb and 2 the upper limb. All were osteocutaneous microsurgical transfers. For the lower limb, all transfers recovered protective sensitivity following tibial nerve repair. The functional calcaeoplantar unit was used in 13 cases. The transfer of this specialized weight bearing tissue provided a stable distal surface making higher support unnecessary. In one case, we raised a 13-cm vascularized tibial segment covered with foot skin for additional length. For the upper limb, the osteocutaneous transfer, based on the radial artery, was not reinnervated, but this lack of sensitivity did not impair prosthesis fitting. One vascular failure was finally amputated. This was the only unsuccessful result. For all other patients, the surgical procedure facilitated prosthesis fitting and preserved the proximal joint function despite an initially very proximal amputation. The advantages of partial replantation are obvious compared with simple terminalization or secondary reconstruction. There is no secondary donor site and, because there is no major muscle mass in the

  4. Incorporating Age-Specific Plans of Care to Achieve Optimal Perioperative Outcomes.

    Science.gov (United States)

    Mower, Juliana

    2015-10-01

    When developing a nursing plan of care, a perioperative nurse identifies nursing diagnoses during the preoperative patient assessment. The ability to identify age-specific outcomes (ie, infant/child, adolescent, adult, elderly adult) in addition to those that are universally applicable is a major responsibility of the perioperative RN. Having an individualized plan of care is one of the best ways to determine whether desired patient outcomes have been successfully attained. Nursing care plans address intraoperative and postoperative risks and allow for a smooth transfer of care throughout the perioperative experience. A good nursing care plan also includes education for the patient and his or her caregiver. Within an overall plan of care, the use of methods such as a concept or mind map can visually demonstrate the relationships between systems, nursing diagnoses, nursing interventions, and desirable outcomes. Copyright © 2015 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  5. Achieving patient satisfaction: the relationship between human motivation and outcome optimization.

    Science.gov (United States)

    Johnson, B C

    1996-01-01

    With the advent of quality improvement and outcome measurement imperatives, providers of healthcare services must fully understand the importance of the human and clinical processes that lead to positive patient encounters. To that end, this article proposes that parallel qualities exist between behavioral need theory and the clinical hierarchy of patient outcomes. A conceptual framework, or construct, is developed and presented that illustrates the importance of this parallel relationship in improving and optimizing patient satisfaction. The article concludes with a discussion of these similarities and implications for the future.

  6. Intuitionistic fuzzy proximity spaces

    OpenAIRE

    Eun Pyo Lee; Seok Jong Lee

    2004-01-01

    We introduce the concept of the intuitionistic fuzzy proximity as a generalization of fuzzy proximity, and investigate its properties. Also we investigate the relationship among intuitionistic fuzzy proximity and fuzzy proximity, and intuitionistic fuzzy topology.

  7. Achievement of course outcome in vector calculus pre-test questions ...

    African Journals Online (AJOL)

    No Abstract. Keywords: pre-test; course outcome; bloom taxanomy; Rasch measurement model; vector calculus. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

  8. A Further Characterization of Empirical Research Related to Learning Outcome Achievement in Remote and Virtual Science Labs

    Science.gov (United States)

    Brinson, James R.

    2017-10-01

    This paper further characterizes recently reviewed literature related to student learning outcome achievement in non-traditional (virtual and remote) versus traditional (hands-on) science labs, as well as factors to consider when evaluating the state and progress of research in this field as a whole. Current research is characterized according to (1) participant nationality and culture, (2) participant education level, (3) participant demography, (4) scientific discipline, and (5) research methodology, which could provide avenues for further research and useful dialog regarding the measurement and interpretation of data related to student learning outcome achievement in, and thus the efficacy of, non-traditional versus traditional science labs. Current research is also characterized by (6) research publication media and (7) availability of non-traditional labs used, which demonstrate some of the obstacles to progress and consensus in this research field.

  9. Monitoring the Achievement of Deaf Pupils in Sweden and Scotland: Approaches and Outcomes

    Science.gov (United States)

    Hendar, Ola; O'Neill, Rachel

    2016-01-01

    Over the past two decades there have been major developments in deaf education in many countries. Medical and technical advances have made it possible for more deaf children to hear and speak successfully. Most deaf pupils learn in ordinary classes in mainstream schools. In this article we explore patterns of achievements of deaf pupils to see if…

  10. What Works Clearinghouse Quick Review: "KIPP Middle Schools: Impacts on Achievement and Other Outcomes, Final Report"

    Science.gov (United States)

    What Works Clearinghouse, 2013

    2013-01-01

    This study examined whether attending a Knowledge is Power Program (KIPP) middle school improved students' reading, math, social studies, and science achievement for up to 4 years following enrollment. The study reported that students attending KIPP middle schools scored statistically significantly higher than matched students on all of the state…

  11. SMS-Based Learning in Tertiary Education: Achievement and Attitudinal Outcomes

    Science.gov (United States)

    Katz, Yaacov J.

    2013-01-01

    SMS delivery platforms are being increasingly used at the university level to enhance student achievement as well as traits and attitudes related to the learning process. SMS delivery provides access to learning materials without being limited by space or time and sophisticated technological advances in SMS delivery have led to enhanced learner…

  12. Dominant Achievement Goals and Academic Outcomes across Tracks in High School

    NARCIS (Netherlands)

    Scheltinga, Peter A.M.; Timmermans, Anneke C.; van der Werf, Greetje P.C.

    2017-01-01

    The self-reported grades Dutch, English and math of 13,970 students in the third grade of Dutch secondary education (US grade 9) were investigated with regard to educational track-level and dominant achievement goal (DAG). The performance approach goal group scored significantly higher on all three

  13. Achieving optimal delivery of follow-up care for prostate cancer survivors: improving patient outcomes

    Directory of Open Access Journals (Sweden)

    Hudson SV

    2015-03-01

    Full Text Available Shawna V Hudson,1 Denalee M O’Malley,2 Suzanne M Miller3 1Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, Somerset, 2Rutgers School of Social Work, New Brunswick, NJ, 3Cancer Prevention and Control Program, Fox Chase Cancer Center/Temple University Health System, Philadelphia, PA, USA Background: Prostate cancer is the most commonly diagnosed cancer in men in the US, and the second most prevalent cancer in men worldwide. High incidence and survival rates for prostate cancer have resulted in a large and growing population of long-term prostate cancer survivors. Long-term follow-up guidelines have only recently been developed to inform approaches to this phase of care for the prostate cancer population. Methods: A PubMed search of English literature through August 2014 was performed. Articles were retrieved and reviewed to confirm their relevance. Patient-reported measures that were used in studies of long-term prostate cancer survivors (ie, at least 2 years posttreatment were reviewed and included in the review. Results: A total of 343 abstracts were initially identified from the database search. After abstract review, 105 full-text articles were reviewed of which seven met inclusion criteria. An additional 22 articles were identified from the references of the included articles, and 29 were retained. From the 29 articles, 68 patient-reported outcome measures were identified. The majority (75% were multi-item scales that had been previously validated in existing literature. We identified four main areas of assessment: 1 physical health; 2 quality of life – general, physical, and psychosocial; 3 health promotion – physical activity, diet, and tobacco cessation; and 4 care quality outcomes. Conclusion: There are a number of well-validated measures that assess patient-reported outcomes that document key aspects of long-term follow-up with respect to patient symptoms and quality of life. However

  14. Physical therapy clinical management recommendations for children with cerebral palsy - spastic diplegia: achieving functional mobility outcomes.

    Science.gov (United States)

    O'Neil, Margaret E; Fragala-Pinkham, Maria A; Westcott, Sarah L; Martin, Karen; Chiarello, Lisa A; Valvano, Joanne; Rose, Rachel Unanue

    2006-01-01

    The purpose of this special report is to present recommendations for the clinical management of children with cerebral palsy, spastic diplegia when increased functional mobility is the identified outcome. These recommendations provide a framework that allows physical therapists to increase their accountability and promote effective interventions for improved patient outcomes. The key components of this special report on clinical management are: a) the Major Recommendations that provide the background and evidence for clinical management; b) a flow chart to assist in clinical decision-making; and c) a Table of Tests and Measures for information on useful tools in the management of children with spastic diplegia. These recommendations are suggestions for clinical management, not an all-inclusive document on physical therapy for children with cerebral palsy. These recommendations may help therapists develop systematic approaches to service delivery and documentation.

  15. Including Emotional Intelligence in Pharmacy Curricula to Help Achieve CAPE Outcomes

    OpenAIRE

    Nelson, Michael H.; Fierke, Kerry K.; Sucher, Brandon J.; Janke, Kristin K.

    2015-01-01

    The importance of emotional intelligence (EI) for effective teamwork and leadership within the workplace is increasingly apparent. As suggested by the 2013 CAPE Outcomes, we recommend that colleges and schools of pharmacy consider EI-related competencies to build self-awareness and professionalism among students. In this Statement, we provide two examples of the introduction of EI into pharmacy curricula. In addition, we provide a 4-phase process based on recommendations developed by EI exper...

  16. Achievable convergence angle and the effect of preparation design on the clinical outcome of full veneer crowns in dogs.

    Science.gov (United States)

    Soukup, Jason W; Snyder, Christopher J; Karls, Tina L; Riehl, Jessica

    2011-01-01

    It is widely accepted that the convergence angle of a full veneer crown preparation should be as close to parallel as possible to attain adequate retention/resistance. The shape of the dog's canine tooth limits the veterinary dentists' ability to achieve the recommended convergence angle. However, the clinically achievable convergence angle of the canine tooth in dogs has not been evaluated. In addition, the convergence angle and other physical properties of a preparation, such as height and base diameter, have been shown to affect the retention/resistance of full veneer crowns, in vitro. This effect has not been evaluated clinically in the dog. Physical properties of 32 stone dies from full veneer crowns of canine teeth were studied to evaluate the clinically achievable convergence angle and the potential effect physical properties of the preparation had on the clinical outcome of the restoration. The clinically achievable convergence angle was much higher than the current recommendation. There was an association, albeit not statistically significant, between physical properties of a preparation (convergence angle, height, base diameter) and the clinical outcome of the restoration.

  17. Achievable Convergence Angle and the Effect of Preparation Design on the Clinical Outcome of Full Veneer Crowns in Dogs

    Science.gov (United States)

    Soukup, Jason W.; Snyder, Christopher J.; Karls, Tina L.; Riehl, Jessica

    2012-01-01

    Summary It is widely accepted that the convergence angle of a full veneer crown preparation should be as close to parallel as possible to attain adequate retention/resistance. The shape of the dog’s canine tooth limits the veterinary dentists’ ability to achieve the recommended convergence angle. However, the clinically achievable convergence angle of the canine tooth in dogs has not been evaluated. In addition, the convergence angle and other physical properties of a preparation, such as height and base diameter, have been shown to affect the retention/resistance of full veneer crowns, in vitro. This effect has not been evaluated clinically in the dog. Physical properties of 32 stone dies from full veneer crowns of canine teeth were studied to evaluate the clinically achievable convergence angle and the potential effect physical properties of the preparation had on the clinical outcome of the restoration. The clinically achievable convergence angle was much higher than the current recommendation. There was an association, albeit not statistically significant, between physical properties of a preparation (convergence angle, height, base diameter) and the clinical outcome of the restoration. PMID:21916370

  18. Description of the incidence, clinical presentation and outcome of proximal limb and pelvic fractures in Hong Kong racehorses during 2003-2014.

    Science.gov (United States)

    McGlinchey, L; Hurley, M J; Riggs, C M; Rosanowski, S M

    2017-11-01

    Few studies have described incidences of proximal limb and pelvic fracture (PLPF) in Thoroughbred racehorses occurring on race day and during training. Information regarding clinical presentations and future racing careers in cases of PLPF is limited. To describe the incidence, clinical presentation and outcome of PLPF sustained by horses in racing and training at the Hong Kong Jockey Club (HKJC) between 2003 and 2014. Retrospective cohort study. Horses with PLPF confirmed by nuclear scintigraphy, ultrasonography, radiography or post-mortem examination were identified using veterinary clinical records. Training and racing data for case horses were described. Incidences of fractures were estimated per 1000 horses in training and per 1000 race starts for fractures sustained during racing. Descriptive statistics were used to describe the study population. A total of 129 instances of PLPF were sustained by 108 racehorses. The most commonly fractured bone was the humerus (49.6%), followed by the tibia (29.4%). Nine horses sustained fatal fractures, eight of which occurred during racing. The incidence of fracture during racing was 0.30 per 1000 starts. Two-thirds of fractures occurred during training. The majority of horses presented with grade 3 lameness (n = 42 of 119 injury events, 35.3%). All horses presenting with grade 5 lameness sustained fatal injuries. Following noncatastrophic injury, all horses underwent box rest and 81 horses subsequently resumed racing; 45 of these won a race. Horses were retired at a median of 25 months (interquartile range: 15-36 months) after injury. Protocols for resting non-training racehorses at the HKJC and for recording rehabilitation regimens post-injury prevented the calculation of horse days at risk. The incidence of PLPF at the HKJC is low. Non-fatal PLPF is not necessarily a career-ending injury and many horses resume racing successfully following conservative treatment. © 2017 EVJ Ltd.

  19. Including Emotional Intelligence in Pharmacy Curricula to Help Achieve CAPE Outcomes.

    Science.gov (United States)

    Nelson, Michael H; Fierke, Kerry K; Sucher, Brandon J; Janke, Kristin K

    2015-05-25

    The importance of emotional intelligence (EI) for effective teamwork and leadership within the workplace is increasingly apparent. As suggested by the 2013 CAPE Outcomes, we recommend that colleges and schools of pharmacy consider EI-related competencies to build self-awareness and professionalism among students. In this Statement, we provide two examples of the introduction of EI into pharmacy curricula. In addition, we provide a 4-phase process based on recommendations developed by EI experts for structuring and planning EI development. Finally, we make 9 recommendations' to inform the process of including EI in pharmacy curricula.

  20. Proximity fuze

    Science.gov (United States)

    Harrison, Thomas R.

    1989-08-22

    A proximity fuze system includes an optical ranging apparatus, a detonation circuit controlled by the optical ranging apparatus, and an explosive charge detonated by the detonation cirtcuit. The optical ranging apparatus includes a pulsed laser light source for generating target ranging light pulses and optical reference light pulses. A single lens directs ranging pulses to a target and collects reflected light from the target. An optical fiber bundle is used for delaying the optical reference pulses to correspond to a predetermined distance from the target. The optical ranging apparatus includes circuitry for providing a first signal depending upon the light pulses reflected from the target, a second signal depending upon the light pulses from the optical delay fiber bundle, and an output signal when the first and second signals coincide with each other. The output signal occurs when the distance from the target is equal to the predetermined distance form the target. Additional circuitry distinguishes pulses reflected from the target from background solar radiation.

  1. Researching achievement and inclusion to improve the educational experiences and outcomes of all learners

    Directory of Open Access Journals (Sweden)

    Lani FLORIAN

    2011-11-01

    Full Text Available This paper considers some of the key issues that must be taken into account when conducting research on inclusive education in an era of standards based reform. It challenges the widely held assumption that high levels of educational inclusion are incompatible with high levels of academic achievement in schools and presents the Framework for Participation, a research tool developed by the authors, which supports practitioners (and other researchers who wish to examine the development of inclusive practice in their own schools.

  2. Do specialty courts achieve better outcomes for children in foster care than general courts?

    Science.gov (United States)

    Sloan, Frank A; Gifford, Elizabeth J; Eldred, Lindsey M; Acquah, Kofi F; Blevins, Claire E

    2013-02-01

    This study assessed the effects of unified family and drug treatment courts (DTCs) on the resolution of cases involving foster care children and the resulting effects on school performance. The first analytic step was to assess the impacts of presence of unified and DTCs in North Carolina counties on time children spent in foster care and the type of placement at exit from foster care. In the second step, the same data on foster care placements were merged with school records for youth in Grades 3-8 in public schools. The effect of children's time in foster care and placement outcomes on school performance as measured by math and reading tests, grade retention, and attendance was assessed using child fixed-effects regression. Children in counties with unified family courts experienced shorter foster care spells and higher rates of reunification with parents or primary caregivers. Shorter foster care spells translated into improved school performance measured by end-of-grade reading and math test scores. Adult DTCs were associated with lower probability of reunification with parents/primary caregivers. The shortened time in foster care implies an efficiency gain attributable to unified family courts, which translate into savings for the court system through the use of fewer resources. Children also benefit through shortened stays in temporary placements, which are related to some improved educational outcomes.

  3. The effect of workshop groups on achievement goals and performance in biology: An outcome evaluation

    Science.gov (United States)

    Born, Wendi Kay

    This two-year quasi-experiment evaluated the effect of peer-led workshop groups on performance of minority and majority undergraduate biology students in a three-course series and investigated motivational explanations for performance differences. The workshop intervention used was modeled after a program pioneered by Treisman (1992) at the University of California. Majority volunteers randomly assigned to workshops (n = 61) performed between 1/2 and 1 standard deviation better than those assigned to the control group (n = 60; p historic control minority students (n = 21), who showed a decreasing pattern (p model of approach and avoidance achievement motivation (Elliot & Church, 1997) were partially supported. Self-report survey measures of achievement goals, modeled after those used by Elliot and colleagues, were requested from all enrolled students. Volunteers (n = 121) reported higher average levels of approach and avoidance goals than nonvolunteers (n = 439; p vs. performance orientation, but were similar to results found by Elliot and colleagues. Contrary to hypotheses, motivational goals did not mediate performance for any group of students. Results suggest that challenge interventions can be highly beneficial for both majority and minority participants and that institutions can promote excellence by incorporating workshop programs like the one described here. These interventions have been shown to be more effective and cost less than remedial interventions.

  4. Long term outcomes following achievement of clinically inactive disease in juvenile idiopathic arthritis: the importance of definition.

    Science.gov (United States)

    Shoop-Worrall, Stephanie Jw; Verstappen, Suzanne Mm; McDonagh, Janet E; Baildam, Eileen; Chieng, Alice; Davidson, Joyce; Foster, Helen; Ioannou, Yiannis; McErlane, Flora; Wedderburn, Lucy R; Thomson, W; Hyrich, Kimme L

    2018-04-12

    Potential targets for treat-to-target strategies in JIA are minimal disease activity (MDA) and clinically inactive disease (CID). Short and long-term outcomes following achievement of MDA and CID on the cJADAS10 and CID on Wallace's preliminary criteria were compared. Children recruited to the Childhood Arthritis Prospective Study, a UK multicentre inception cohort, were selected if recruited prior to January 2011 and diagnosed with oligoarthritis or rheumatoid factor negative or positive polyarthritis. At one year following diagnosis, children were assessed for MDA on the cJADAS10 and CID on both Wallace's preliminary criteria and the cJADAS10. Associations were tested between these disease states and i) functional ability, ii) absence of limited joints, iii) psychosocial health and v) pain at one year and annually to five years. Of 832 children, 70% were female and the majority had oligoarthritis (68%). At one year, 21% had achieved CID according to both definitions, 7% on Wallace's preliminary criteria only, 16% on cJADAS10 only and 56% on neither. Only 10% of children in the entire cohort achieved MDA without also having CID. Achieving either early CID state was associated with greater absence of limited joints. However, only CID on cJADAS10 was associated with improved functional ability and psychosocial health. Achieving CID was superior to MDA in terms of short and long-term pain and the absence of limited joints. CID on the cJADAS10 may be a preferable treatment target to CID on Wallace's preliminary criteria in terms of both feasibility of application and long-term outcomes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  5. Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes.

    Science.gov (United States)

    Wandersman, Abraham; Alia, Kassandra Ann; Cook, Brittany; Ramaswamy, Rohit

    2015-10-01

    While the body of evidence-based healthcare interventions grows, the ability of health systems to deliver these interventions effectively and efficiently lags behind. Quality improvement approaches, such as the model for improvement, have demonstrated some success in healthcare but their impact has been lessened by implementation challenges. To help address these challenges, we describe the empowerment evaluation approach that has been developed by programme evaluators and a method for its application (Getting To Outcomes (GTO)). We then describe how GTO can be used to implement healthcare interventions. An illustrative healthcare quality improvement example that compares the model for improvement and the GTO method for reducing hospital admissions through improved diabetes care is described. We conclude with suggestions for integrating GTO and the model for improvement. 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.

  6. Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes

    Science.gov (United States)

    Wandersman, Abraham; Alia, Kassandra Ann; Cook, Brittany; Ramaswamy, Rohit

    2015-01-01

    While the body of evidence-based healthcare interventions grows, the ability of health systems to deliver these interventions effectively and efficiently lags behind. Quality improvement approaches, such as the model for improvement, have demonstrated some success in healthcare but their impact has been lessened by implementation challenges. To help address these challenges, we describe the empowerment evaluation approach that has been developed by programme evaluators and a method for its application (Getting To Outcomes (GTO)). We then describe how GTO can be used to implement healthcare interventions. An illustrative healthcare quality improvement example that compares the model for improvement and the GTO method for reducing hospital admissions through improved diabetes care is described. We conclude with suggestions for integrating GTO and the model for improvement. PMID:26178332

  7. Quality of care achievements of the Prostate Cancer Outcomes Registry-Victoria.

    Science.gov (United States)

    Sampurno, Fanny; Earnest, Arul; Kumari, Patabendi B; Millar, Jeremy L; Davis, Ian D; Murphy, Declan G; Frydenberg, Mark; Kearns, Paul A; Evans, Sue M

    2016-05-02

    To analyse the performance of the quality of prostate cancer (CaP) care over a 5-year period with reference to three quality indicators (QIs) reported by the Prostate Cancer Outcomes Registry-Victoria (PCOR-Vic):QI-1: Alignment with the modified Prostate Cancer Research International Active Surveillance (PRIAS) protocol guideline;QI-2: Timeliness of CaP care for men with high risk and locally advanced disease;QI-3: Positive surgical margins (PSMs) for organ-confined pathological T2 disease. Between 1 January 2009 and 31 December 2013, 4708 men diagnosed with CaP who met the QI-1, QI-2 or QI-3 inclusion criteria were recruited from Victorian hospitals.Outcome measures and statistical analysis: Trend analysis was conducted to monitor performance according to QI-1, QI-2 and QI-3. We used the autoregressive integrated moving average (ARIMA) model to account for any inherent autocorrelation in the data when analysing the monthly incidence of each indicator. Differences in the annual figures for the indicators across years were also analysed by aggregating data by year and applying the ARIMA model. There was a downward trend over the 5 years in the percentage of men with low risk disease who underwent active treatment (45% to 34%; P = 0.024), an upward trend in the percentage of those with high risk and locally advanced disease who received active treatment within 12 months of diagnosis (88% to 93%; P = 0.181), and a decline in PSM rate in men with pathological T2 disease after radical prostatectomy (21% to 12%; P = 0.036). Limitations of the study include the fact that the improvement in the QIs was detected using PCOR-Vic as a single population, but there may be institutional variations in quality improvement. Over 2009-2013, the performance of the Victorian health system improved according to the three processes of care indicators reported by the PCOR-Vic.

  8. Challenges to the Development and Implementation of Public Policies to Achieve Animal Welfare Outcomes.

    Science.gov (United States)

    Rose, Margaret

    2010-12-31

    Although there is a long-established tradition of concern for the welfare of animals, it was not until the mid 1800's that governments sought to enact legislation to protect animals from cruelty. In the 1950's, questions concerning animal welfare re-emerged and in the ensuing years have been an on-going focus of government activities. These developments occurred against a backdrop of significant social change but there are important differences in what now underpins and informs these considerations. In the formulation and implementation of public policies, governments look for a course of action that represents and protects the interests of the community; the process may be challenging with competing interests but the final determination seeks a middle ground that best meets the needs and interests of the community as a whole. When policy development concerns our relationship with other animals, the complexity of this relationship presents particular challenges not only to the formulation of policies but also to the evaluation of outcomes. Notably, the depth of feelings and diversity of views in our community reflect the complex social, cultural and personal dimensions of this relationship. The use of animals for scientific purposes remains one of the most contentious animal welfare issues primarily because when animals are used for these purposes, accepted animal welfare benchmarks cannot always be met. Based on the Australian experience, this paper will discuss the influences in and on-going challenges to the development and implementation of public policy when animals are used for these purposes.

  9. THE IMPLEMENTATION OF JOBSHEET-BASED STUDENT TEAMS ACHIEVEMENT DIVISION LEARNING MODEL TO IMPROVE STUDENTS LEARNING OUTCOMES

    Directory of Open Access Journals (Sweden)

    Kadek Dodi Permana

    2016-09-01

    Full Text Available This study aims to improve the Information and Communications Technology (ICT learning outcomes of the students in SMA N 2 Singaraja through the learning model of Job sheet-based Student Team Achievement Division (STAD. This is a classroom action research. The data analysis reveals that learning outcomes in cycle I gain a mean score of 80. 51 and a classical provisions of 15%. There are three students who pass with a minimum score of 85 in cycle I. From these categories, the students’ learning outcomes in the first cycle have not met the criterion of 85%. The mean score of cycle II is 88. 57 and the classical provisions is 90%. In the second cycle, there are 18 students who gain a minimum score of 85. Based on the success criterion, a research study is successful if the minimum completeness criterion reaches 85 and the minimum classical completeness criterion reaches 85%. From the categories, the students’ learning outcomes have been successfully improved since the percentage of classical completeness in the second cycle has reached its expected results.

  10. Understanding the DNA damage response in order to achieve desired gene editing outcomes in mosquitoes.

    Science.gov (United States)

    Overcash, Justin M; Aryan, Azadeh; Myles, Kevin M; Adelman, Zach N

    2015-02-01

    Mosquitoes are high-impact disease vectors with the capacity to transmit pathogenic agents that cause diseases such as malaria, yellow fever, chikungunya, and dengue. Continued growth in knowledge of genetic, molecular, and physiological pathways in mosquitoes allows for the development of novel control methods and for the continued optimization of existing ones. The emergence of site-specific nucleases as genomic engineering tools promises to expedite research of crucial biological pathways in these disease vectors. The utilization of these nucleases in a more precise and efficient manner is dependent upon knowledge and manipulation of the DNA repair pathways utilized by the mosquito. While progress has been made in deciphering DNA repair pathways in some model systems, research into the nature of the hierarchy of mosquito DNA repair pathways, as well as in mechanistic differences that may exist, is needed. In this review, we will describe progress in the use of site-specific nucleases in mosquitoes, along with the hierarchy of DNA repair in the context of mosquito chromosomal organization and structure, and how this knowledge may be manipulated to achieve precise chromosomal engineering in mosquitoes.

  11. Challenges to the Development and Implementation of Public Policies to Achieve Animal Welfare Outcomes

    Directory of Open Access Journals (Sweden)

    Margaret Rose

    2010-12-01

    Full Text Available Although there is a long-established tradition of concern for the welfare of animals, it was not until the mid 1800’s that governments sought to enact legislation to protect animals from cruelty. In the 1950’s, questions concerning animal welfare re-emerged and in the ensuing years have been an on-going focus of government activities. These developments occurred against a backdrop of significant social change but there are important differences in what now underpins and informs these considerations. In the formulation and implementation of public policies, governments look for a course of action that represents and protects the interests of the community; the process may be challenging with competing interests but the final determination seeks a middle ground that best meets the needs and interests of the community as a whole. When policy development concerns our relationship with other animals, the complexity of this relationship presents particular challenges not only to the formulation of policies but also to the evaluation of outcomes. Notably, the depth of feelings and diversity of views in our community reflect the complex social, cultural and personal dimensions of this relationship. The use of animals for scientific purposes remains one of the most contentious animal welfare issues primarily because when animals are used for these purposes, accepted animal welfare benchmarks cannot always be met. Based on the Australian experience, this paper will discuss the influences in and on-going challenges to the development and implementation of public policy when animals are used for these purposes.

  12. Qualitative study of motivators and outcomes of Sri Lankan doctors achieving MRCGPInternational.

    Science.gov (United States)

    Pettigrew, Luisa M; Perera, Dinusha; Wass, Val

    2013-07-01

    The UK's Royal College of General Practitioners accredits overseas examinations in family medicine through MRCGP[INT] rather than exporting MRCGP UK. There is limited research on the motivating factors and outcomes of this practice on candidates. To explore factors motivating Sri Lankan doctors to pursue the South Asian MRCGP[INT] and their perceived benefits and barriers to sitting the examination. Qualitative semi-structured 1:1 interviews with 14 successful past MRCGP[INT]SA candidates were undertaken in Sri Lanka. Findings were analysed with N-Vivo software. A phenomenological approach was used. Interpretive dimensions were applied drawing on information from interviews, informal conversations and observations. Motivators to sit the examination included a desire to improve patient care and seeking recognition as a family doctor. Younger doctors had hopes of increased future income and there was some expectation that the examination may improve overseas employment prospects. The examination conferred greater confidence, new patient-centred communication skills, introduced the use of evidence-based guidelines and increased awareness of the UK health system to most participants. There were examples of diffusion of knowledge through different teaching channels. Relative to Sri Lankan examinations, formal training opportunities were limited and value for money of annual membership fees were questioned. Financial and geographical barriers to the examination were noted. Currently MRCGP[INT]SA offers additional value for successful candidates in Sri Lanka who perceive accreditation by a UK college favourably. Improvement of pre- and post-exam support linked to MRCGP[INT]SA in Sri Lanka is needed. Further research into the long-term impact is necessary, in particular regarding equity of access, migration and local training development.

  13. 20 CFR 411.555 - Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Can the EN keep the milestone and outcome... Payment Systems § 411.555 Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all outcome months? (a) Yes. The EN (or State VR agency acting as an EN) can keep each...

  14. Prevalences and pregnancy outcome of vanishing twin pregnancies achieved by in vitro fertilization versus natural conception.

    Science.gov (United States)

    Márton, Virág; Zádori, János; Kozinszky, Zoltan; Keresztúri, Attila

    2016-11-01

    To evaluate whether vanishing twin (VT) pregnancies achieved by in vitro fertilization and intracytoplasmic sperm injection (IVF-ICSI) had a more adverse perinatal outcome than those after natural conception. Longitudinal, retrospective cohort study. Tertiary university hospital. Three hundred and six (78 after IVF-ICSI and 228 after natural conception) VT pregnancies over a 22-year period, with VT cases matched to primarily singleton controls. None. Obstetric and neonatal outcome data. The incidence of VT was statistically significantly higher after natural conception (18.2% of twins) than after IVF-ICSI (12.6% of twins). The odds of VT in pregnancies complicated with pregestational or gestational diabetes were disproportionally higher in IVF-ICSI cases than in spontaneously conceived VT pregnancies (adjusted odds ratio [AOR]: 0.80 vs. 3.10 and 1.00 vs. 1.07, respectively). Previous induced abortion (AOR 1.34) or second-trimester fetal loss (AOR 3.3) increased the risk of VT pregnancies after spontaneous conception. Gestational diabetes mellitus in both the previous (AOR 5.41) and the present (AOR 2.3) pregnancy as well as chronic maternal diseases (AOR 3.5) and placentation anomalies all represented independent risk factors for VT after IVF-ICSI. Vanishing twin pregnancies had a lower prevalence and a worse perinatal outcome after IVF-ICSI as compared with those of their spontaneously conceived counterparts. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Sport-related achievement motivation and alcohol outcomes: an athlete-specific risk factor among intercollegiate athletes.

    Science.gov (United States)

    Weaver, Cameron C; Martens, Matthew P; Cadigan, Jennifer M; Takamatsu, Stephanie K; Treloar, Hayley R; Pedersen, Eric R

    2013-12-01

    Intercollegiate athletes report greater alcohol consumption and more alcohol-related problems than their non-athlete peers. Although college athletes share many of the same problems faced by non-athletes, there are some consequences that are unique to athletes. Studies have demonstrated that alcohol negatively affects athletic performance including increased dehydration, impeded muscle recovery, and increased risk for injury. Beyond risk factors for alcohol misuse that may affect college students in general, research has begun to examine risk factors that are unique to collegiate athletes. For example, research has found that off-season status, the leadership role, and athlete-specific drinking motives are associated with increased alcohol use. Given these findings, it is possible that other athlete-specific variables influence alcohol misuse. One such variable may be sport achievement orientation. The purpose of the current study was to examine the relationship between sport achievement orientation and alcohol outcomes. Given previous research regarding seasonal status and gender, these variables were examined as moderators. Varsity athletes (n=263) completed the Sport Orientation Questionnaire, which assesses sport-related achievement orientation on three scales (Competitiveness, Win Orientation, and Goal Orientation). In addition, participants completed measures of alcohol use and alcohol-related problems. Results indicated that Competitiveness, Win Orientation, and Goal Orientation were all significantly associated with alcohol use, but not alcohol-related problems. Moreover, these relationships were moderated by seasonal status and gender. These interactions, clinical implications, and limitations are discussed. © 2013.

  16. Clinical Outcome of Inter-Proximal Papilla between a Tooth and a Single Implant Treated with CAD/CAM Abutments: a Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Tiago Borges

    2012-09-01

    Full Text Available Objectives: The aim of this study was to assess the clinical outcomes achieved with Computer-Assisted Design/Computer-Assisted Manufacturing implant abutments in the anterior maxilla.Material and Methods: Nineteen patients with a mean age of 41 (range form 26 to 63 years, treated with 21 single tooth implants and 21 Computer-Assisted Design/Computer-Assisted Manufacturing (CAD/CAM abutments in the anterior maxillary region were included in this study. The patients followed 4 criteria of inclusion: (1 had a single-tooth implant in the anterior maxilla, (2 had a CAD/CAM abutment, (3 had a contralateral natural tooth, (4 the implant was restored and in function for at least 6 months up to 2 years. Cases without contact point were excluded. Presence/absence of the interproximal papilla, inter tooth-implant distance (ITD and distance from the base of the contact point to dental crest bone of adjacent tooth (CPB were accessed. Results: Forty interproximal spaces were evaluated, with an average mesial CPB of 5.65 (SD 1.65 mm and distal CPB of 4.65 (SD 1.98 mm. An average mesial ITD of 2.49 (SD 0.69 mm and an average distal ITD of 1.89 (SD 0.63 mm were achieved. Papilla was present in all the interproximal spaces accessed. Conclusions: The restoration of dental implants using CAD/CAM abutments is a predictable treatment with improved aesthetic results. These type of abutments seem to help maintaining a regular papillary filling although the variations of the implant positioning or the restoration teeth relation.

  17. Proximal fibula resection in the treatment of bone tumours.

    Science.gov (United States)

    Dieckmann, Ralf; Gebert, Carsten; Streitbürger, Arne; Henrichs, Marcel-Philipp; Dirksen, Uta; Rödl, Robert; Gosheger, Georg; Hardes, Jendrik

    2011-11-01

    We present a large study of patients with proximal fibula resection. Moreover we describe a new classification system for tumour resection of the proximal fibula independent of the tumour differentiation. In 57 patients the functional and clinical outcomes were evaluated. The follow-up ranged between six months and 22.2 years (median 7.2 years). The indication for surgery was benign tumours in ten cases and malignant tumours in 47 cases. In 13 of 45 patients, where a resection of the lateral ligament complex was done, knee instability occurred. In 32 patients a resection of the peroneal nerve with resulting peroneal palsy was necessary. Patients with peroneal resection had significantly worse functional outcome than patients without peroneal resection. An ankle foot orthosis was tolerated well by these patients. Three of four patients with pathological tibia fracture had local radiation therapy. There was no higher risk of tibia fracture in patients with partial tibial resection. Resection of tumours in the proximal fibula can cause knee instability, peroneal palsy and in cases of local radiation therapy, a higher risk of delayed wound healing and fracture. Despite the risks of proximal fibula resection, good functional results can be achieved.

  18. How to achieve the desired outcomes of advance care planning in nursing homes: a theory of change.

    Science.gov (United States)

    Gilissen, J; Pivodic, L; Gastmans, C; Vander Stichele, R; Deliens, L; Breuer, E; Van den Block, L

    2018-02-14

    Advance care planning (ACP) has been identified as particularly relevant for nursing home residents, but it remains unclear how or under what circumstances ACP works and can best be implemented in such settings. We aimed to develop a theory that outlines the hypothetical causal pathway of ACP in nursing homes, i.e. what changes are expected, by means of which processes and under what circumstances. The Theory of Change approach is a participatory method of programme design and evaluation whose underlying intention is to improve understanding of how and why a programme works. It results in a Theory of Change map that visually represents how, why and under what circumstances ACP is expected to work in nursing home settings in Belgium. Using this approach, we integrated the results of two workshops with stakeholders (n = 27) with the results of a contextual analysis and a systematic literature review. We identified two long-term outcomes that ACP can achieve: to improve the correspondence between residents’ wishes and the care/treatment they receive and to make sure residents and their family feel involved in planning their future care and are confident their care will be according to their wishes. Besides willingness on the part of nursing home management to implement ACP and act accordingly, other necessary preconditions are identified and put in chronological order. These preconditions serve as precursors to, or requirements for, accomplishing successful ACP. Nine original key intervention components with specific rationales are identified at several levels (resident/family, staff or nursing home) to target the preconditions: selection of a trainer, ensuring engagement by management, training ACP reference persons, in-service education for healthcare staff, information for staff, general practitioners, residents and their family, ACP conversations and documentation, regular reflection sessions, multidisciplinary meetings, and formal monitoring. The Theory of

  19. Assessment of axillary nerve function and functional outcome after fixation of complex proximal humeral fractures using the extended deltoid-splitting approach.

    Science.gov (United States)

    Khan, Lukman A K; Robinson, C Michael; Will, Elizabeth; Whittaker, Roger

    2009-02-01

    The extended deltoid-splitting approach was developed as an alternative to the deltopectoral approach in the treatment of three- and four-part proximal humeral fractures. The aim of our prospective study was to determine whether this approach was associated with evidence of nerve injury, functional deficits or other complications in these cases, during the first year following reconstruction. Over a 1-year-period, we treated 14 people (median age 59 years) with open reduction and plate fixation using the extended deltoid-splitting approach. All were prospectively reviewed clinically and radiologically during the first year after surgery. Functional testing involved three scoring systems, spring balance testing of deltoid power, dynamic muscle function testing and, at 1 year, electrophysiological assessment of axillary nerve function. Of the 14 fractures, 13 united without complications and with comparatively minor residual functional deficits. Of these 13 cases, 1 showed slight neurogenic change in the anterior deltoid but no evidence of anterior deltoid paralysis. In the remaining case, osteonecrosis of the humeral head developed 9 months after surgery and functional scores were poor, but without evidence of nerve injury on electrophysiological testing. This technique is a useful alternative in the treatment of complex proximal humeral fractures, providing good access for reduction and implant placement without adverse effects.

  20. Development of a Blended Learning Environment to Support Achievement of Graduate Outcomes through Optimal Learning in an Undergraduate Pharmacy Course

    Directory of Open Access Journals (Sweden)

    Alyson Brown

    2013-10-01

    Full Text Available The development of graduate attributes through health professional courses requires the opportunity to engage with learning and teaching activities that reflect the work-based role to which the student aspires. Such activities allow the contextualisation of discipline-specific knowledge, forging a critical understanding of the underpinning theory, and providing a firm foundation for the development of lifelong learning skills. A blended learning approach can be particularly valuable in supporting achievement of the learning outcomes in modules where performance is measured in terms of competency in work-based scenarios. An action research approach was taken to develop and evaluate a cardiovascular risk assessment as the basis for clinically and professionally relevant problem-based learning. Support for this was provided by means of blended learning including a number of online activities. Talking wall focus groups were used to evaluate the student experience, and this was combined with quantitative data regarding student examination performance. Student performance in the cardiovascular section of the examination paper was significantly higher than in other sections. Students reported very favorably on the use of this approach to support not only examination preparation, but also in terms of developing professional identity and enhancing employability skills.

  1. Reconstruction of scaphoid nonunion fractures of the proximal one third with a vascularized bone graft from the distal radius.

    Science.gov (United States)

    Werdin, Frank; Jaminet, Patrick; Naegele, Beate; Pfau, Matthias; Schaller, Hans-Eberhard

    2014-01-01

    The treatment of proximal located scaphoid nonunion is a well-known and common problem. For these patients, we used a vascular pedicled bone graft of the distal radius. In the last 7 years, 75 patients were treated with the vascular pedicled bone graft. Retrospectively, patients' data, healing rates, and factors influencing scaphoid healing were analyzed. The overall healing rate in cases with proximal located nonunions (n = 54) was approximately 70%. Out of these 54 patients, 47 patients showed avascular proximal fragments. Multivariate analysis showed no significant impact for the factors age, smoking, duration of disease, or previous operation. In our negative selected patient group, we were able to achieve good results with the usage of a pedicled vascularized bone graft of the distal radius. Our results indicate a favorable outcome for the use of a pedicled vascularized distal radius bone graft in both scaphoid nonunion fractures of the proximal third, with or without an avascular proximal pole.

  2. Applying Strengths Model principles to build a rural community-based mental health support service and achieve recovery outcomes.

    Science.gov (United States)

    Dunstan, Debra; Anderson, Donnah

    2018-02-01

    The Personal Helpers and Mentors (PHaMs) service is a non-clinical, community-based Australian Government initiative aimed at increasing opportunities for recovery for people whose lives are severely affected by mental illness. Using a strengths-based recovery model, PHaMs caseworkers support and mentor people 'at risk of falling through the gaps' between state funded clinical treatment services and federally funded social services (such as supported housing, education and employment). While there is evidence that PHaMs realises its aim in metropolitan areas, little is known about how services are developed and function in low resource rural settings and what outcomes are achieved. These questions were addressed in a case study of a PHaMs service in a rural town in the state of New South Wales, Australia. Data were collected from two sources: local service documents prepared for staff orientation and operational purposes, and records and reports of service participants\\' performance and achievements. Participants\\' gains in wellbeing, recovery goals, and the target outcome areas of increased access to services, increased personal capacity and self-reliance, and increased community participation, were gathered from self-reports. The Role Functioning Scale was used as a measure of caseworker ratings of participants\\' adaptive functioning. The qualitative data were examined for semantic content and underlying themes. The quantitative analyses involved repeated measures and between-groups comparisons of uncontrolled pre-test–post-test and retrospective pre-test data. From commencement of the service in October 2009 to June 2014, an estimated 31% of the people living with severe mental illness in the local government area had accessed the PHaMs service (N=126; mean age 31.9 years; 42% male, 27% Aboriginal). The document analysis revealed that despite a lack of detail on how a PHaMs service should be developed or delivered, by focusing on the goal of client recovery

  3. Midterm outcome of EndoAnchors for the prevention of endoleak and stent-graft migration in patients with challenging proximal aortic neck anatomy.

    Science.gov (United States)

    Jordan, William D; de Vries, Jean-Paul P M; Ouriel, Kenneth; Mehta, Manish; Varnagy, David; Moore, William M; Arko, Frank R; Joye, James; Henretta, John

    2015-04-01

    To explore the use of EndoAnchors as an adjunct to endovascular abdominal aortic aneurysm repair for prevention of proximal neck complications in patients with challenging neck anatomy. Over a 28-month period, 208 patients (159 men; mean age 72±8 years) were enrolled in the ANCHOR prospective, multicenter registry (ClinicalTrials.gov; identifier NCT01534819) for prophylaxis against proximal neck complications. Patients were eligible when, in the opinion of the investigators, they were at increased risk for type Ia endoleak or migration owing to a hostile neck (length 28 mm, angulation >60°, mural thrombus or calcium >2 mm in thickness or >180° in circumference, or conical shape). Overall, 123/157 (78.3%) patients met the criteria for a hostile neck according to core laboratory assessment of 157 adequate preoperative computed tomographic (CT) images. Implantation of EndoAnchors was technically successful in 204/208 (98.1%) patients. The frequency of fracture was 0.3% (3/1118); there were no clinical sequelae associated with the fractures. Over the mean 14-month follow-up, 95.2% of patients were alive, and no deaths were attributable to EndoAnchors. There were no ruptures, migrations, or open surgical conversions. Aneurysm-related reinterventions were performed in 8 (3.8%) patients. Among 130 patients with postprocedure contrast CT studies, core laboratory analysis identified 2 (1.5%) patients with type Ia endoleaks. Aneurysm sac diameter decreased >5 mm in 42.9% of patients with CT scans at or beyond 1 year; 1.6% of patients developed sac enlargement >5 mm. Prophylactic EndoAnchor use for challenging aortic neck anatomy was associated with satisfactory midterm results. © The Author(s) 2015.

  4. Multiset proximity spaces

    Directory of Open Access Journals (Sweden)

    A. Kandil

    2016-10-01

    Full Text Available A multiset is a collection of objects in which repetition of elements is essential. This paper is an attempt to explore the theoretical aspects of multiset by extending the notions of compact, proximity relation and proximal neighborhood to the multiset context. Examples of new multiset topologies, open multiset cover, compact multiset and many identities involving the concept of multiset have been introduced. Further, an integral examples of multiset proximity relations are obtained. A multiset topology induced by a multiset proximity relation on a multiset M has been presented. Also the concept of multiset δ- neighborhood in the multiset proximity space which furnishes an alternative approach to the study of multiset proximity spaces has been mentioned. Finally, some results on this new approach have been obtained and one of the most important results is: every T4- multiset space is semi-compatible with multiset proximity relation δ on M (Theorem 5.10.

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

    Science.gov (United States)

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

    2015-06-01

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

  6. The Impact of Achieve3000 on Elementary Literacy Outcomes: Evidence from a Two-Year Randomized Control Trial

    Science.gov (United States)

    Hill, Darryl V.; Lenard, Matthew A.; Page, Lindsay Coleman

    2016-01-01

    School districts are increasingly adopting technology-based resources in an attempt to improve student achievement. This paper reports the two-year results from randomized control trial of Achieve3000 in the Wake County Public School System (WCPSS) in Raleigh, North Carolina. Achieve3000 is an early literacy program that differentiates non-fiction…

  7. Multiset proximity spaces

    OpenAIRE

    Kandil, A.; Tantawy, O.A.; El-Sheikh, S.A.; Zakaria, Amr

    2016-01-01

    A multiset is a collection of objects in which repetition of elements is essential. This paper is an attempt to explore the theoretical aspects of multiset by extending the notions of compact, proximity relation and proximal neighborhood to the multiset context. Examples of new multiset topologies, open multiset cover, compact multiset and many identities involving the concept of multiset have been introduced. Further, an integral examples of multiset proximity relations are obtained. A multi...

  8. ProxImaL: efficient image optimization using proximal algorithms

    KAUST Repository

    Heide, Felix

    2016-07-11

    Computational photography systems are becoming increasingly diverse, while computational resources-for example on mobile platforms-are rapidly increasing. As diverse as these camera systems may be, slightly different variants of the underlying image processing tasks, such as demosaicking, deconvolution, denoising, inpainting, image fusion, and alignment, are shared between all of these systems. Formal optimization methods have recently been demonstrated to achieve state-of-the-art quality for many of these applications. Unfortunately, different combinations of natural image priors and optimization algorithms may be optimal for different problems, and implementing and testing each combination is currently a time-consuming and error-prone process. ProxImaL is a domain-specific language and compiler for image optimization problems that makes it easy to experiment with different problem formulations and algorithm choices. The language uses proximal operators as the fundamental building blocks of a variety of linear and nonlinear image formation models and cost functions, advanced image priors, and noise models. The compiler intelligently chooses the best way to translate a problem formulation and choice of optimization algorithm into an efficient solver implementation. In applications to the image processing pipeline, deconvolution in the presence of Poisson-distributed shot noise, and burst denoising, we show that a few lines of ProxImaL code can generate highly efficient solvers that achieve state-of-the-art results. We also show applications to the nonlinear and nonconvex problem of phase retrieval.

  9. The Economic Benefits of Closing Educational Achievement Gaps: Promoting Growth and Strengthening the Nation by Improving the Educational Outcomes of Children of Color

    Science.gov (United States)

    Lynch, Robert G.; Oakford, Patrick

    2014-01-01

    Our nation is currently experiencing growing levels of income and wealth inequality, which are contributing to longstanding racial and ethnic gaps in education outcomes and other areas. This report quantifies the economic benefits of closing one of the most harmful racial and ethnic gaps: the educational achievement gap that exists between black…

  10. Does the Reason Matter? How Student-Reported Reasons for School Absence Contribute to Differences in Achievement Outcomes among 14-15 Year Olds

    Science.gov (United States)

    Hancock, Kirsten J.; Gottfried, Michael A.; Zubrick, Stephen R.

    2018-01-01

    While an emerging body of research has examined the effects of school absences on student outcomes, there is comparatively little research examining the different reasons contributing to school absence, how common these reasons are, and the extent to which different types of absences are differentially associated with achievement. To address these…

  11. Feelings and Performance in the First Year at University: Learning-Related Emotions as Predictors of Achievement Outcomes in Mathematics and Statistics

    Science.gov (United States)

    Niculescu, Alexandra C.; Templelaar, Dirk; Leppink, Jimmie; Dailey-Hebert, Amber; Segers, Mien; Gijselaers, Wim

    2015-01-01

    Introduction: This study examined the predictive value of four learning-related emotions--Enjoyment, Anxiety, Boredom and Hopelessness for achievement outcomes in the first year of study at university. Method: We used a large sample (N = 2337) of first year university students enrolled over three consecutive academic years in a mathematics and…

  12. The Impact of a Proficiency-Based Assessment and Reassessment of Learning Outcomes System on Student Achievement and Attitudes

    Science.gov (United States)

    Posner, Michael A.

    2011-01-01

    This research compares a student-centered, proficiency-based assessment and reassessment of learning outcomes (PARLO) system to traditional assessment in a college-level introductory statistics class. The PARLO class was assessed on learning outcomes using a three-tiered proficiency scale and given the opportunity to resubmit assignments to…

  13. Proximal Probes Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Proximal Probes Facility consists of laboratories for microscopy, spectroscopy, and probing of nanostructured materials and their functional properties. At the...

  14. A Qualitative Study of Self-Esteem, Peer Affiliation, and Academic Outcome among Low Achieving Students in Hong Kong

    Science.gov (United States)

    Leung, Chi-hung; Choi, Eudora

    2010-01-01

    Background: A limited amount of research has been conducted on children and adolescents who are low achievers. In Hong Kong, educators describe low achieving students in terms of academic performance, they seldom focus on socio-emotional aspects, such as self-esteem, peer affiliation, and inter-personal relationships. However, low achieving…

  15. Proximity and IPO Underpricing

    DEFF Research Database (Denmark)

    Nielsson, Ulf; Wójcik, Dariusz

    2016-01-01

    by superior local information, which associates with more accurate pricing and less money left on the table. The paper further finds that refined measures of local bias, such as proximity to finance professionals and density of financial expertise, correlate more with IPO underpricing than proximity to large...

  16. Proximal focal femoral deficiency: A case report

    Directory of Open Access Journals (Sweden)

    Shashank Sharma

    2015-01-01

    Full Text Available Proximal focal femoral deficiency (PFFD is a rare congenital anomaly resulting in limb shortening and disability in young. The exact cause of the disease is not known and it may present as varying grades of affection involving the proximal femur and the acetabulum. Recognition of this rare abnormality on radiographs can help manage these cases better since early institution of therapy may help in achieving adequate growth of the femur.

  17. Achieving excellence in private intensive care units: The effect of transformational leadership and organisational culture on organisational change outcomes

    Directory of Open Access Journals (Sweden)

    Portia J. Jordan

    2015-12-01

    Full Text Available Orientation: Organisational change outcomes in private intensive care units are linked to higher patient satisfaction, improved quality of patient care, family support, cost-effective care practices and an increased level of excellence. Transformational leadership and fostering a positive organisational culture can contribute to these change outcomes. Research purpose: The study determined whether transformational leadership and a supportive organisational culture were evident in six private intensive care units in the Eastern Cape, South Africa. A conceptual framework to investigate the relationship between transformational leadership, organisational culture, and organisational change outcomes, was proposed and tested. Motivation for the study: The prevalence of transformational leadership, a positive organisational culture and their effect on organisational change outcomes in private healthcare industries require further research in order to generate appropriate recommendations. Research design, approach and method: A positivistic, quantitative design was used. A survey was conducted using a questionnaire which, in previous studies, produced scores with Cronbach’s alpha coefficients greater than 0.80, to collect data from a sample of 130 professional nurses in private intensive care units. Main findings: Transformational leadership and a positive organisational culture were evident in the private intensive care units sampled. A strong, positive correlation exists between transformational leadership, organisational culture, and organisational change outcomes. This correlation provides sufficient evidence to accept the postulated research hypotheses. Innovation and intellectual stimulation were identified as the factors in need of improvement. Practical or managerial implications: The findings of the study may be used by managers in intensive care units to promote organisational change outcomes, linked to transformational leadership and a

  18. Achieving excellence in private intensive care units: The effect of transformational leadership and organisational culture on organisational change outcomes

    Directory of Open Access Journals (Sweden)

    Portia J. Jordan

    2015-03-01

    Full Text Available Orientation: Organisational change outcomes in private intensive care units are linked to higher patient satisfaction, improved quality of patient care, family support, cost-effective care practices and an increased level of excellence. Transformational leadership and fostering a positive organisational culture can contribute to these change outcomes.Research purpose: The study determined whether transformational leadership and a supportive organisational culture were evident in six private intensive care units in the Eastern Cape, South Africa. A conceptual framework to investigate the relationship between transformational leadership, organisational culture, and organisational change outcomes, was proposed and tested.Motivation for the study: The prevalence of transformational leadership, a positive organisational culture and their effect on organisational change outcomes in private healthcare industries require further research in order to generate appropriate recommendations.Research design, approach and method: A positivistic, quantitative design was used. A survey was conducted using a questionnaire which, in previous studies, produced scores with Cronbach’s alpha coefficients greater than 0.80, to collect data from a sample of 130 professional nurses in private intensive care units.Main findings: Transformational leadership and a positive organisational culture were evident in the private intensive care units sampled. A strong, positive correlation exists between transformational leadership, organisational culture, and organisational change outcomes. This correlation provides sufficient evidence to accept the postulated research hypotheses. Innovation and intellectual stimulation were identified as the factors in need of improvement.Practical or managerial implications: The findings of the study may be used by managers in intensive care units to promote organisational change outcomes, linked to transformational leadership and a positive

  19. Translating school health research to policy. School outcomes related to the health environment and changes in mathematics achievement.

    Science.gov (United States)

    Snelling, Anastasia M; Belson, Sarah Irvine; Watts, Erin; George, Stephanie; Van Dyke, Hugo; Malloy, Elizabeth; Kalicki, Michelle

    2015-10-01

    This paper describes an exploration of the relationship between mathematic achievement and the school health environment relative to policy-driven changes in the school setting, specifically with regard to physical education/physical activity. Using school-level data, the authors seek to understand the relationship between mathematics achievement and the school health environment and physical education minutes. This work provides a description of the aspects of the school health environment, an exploration of the interrelationships between school health and student achievement, and an assessment of the effects of the school health policy and practice on student performance and health status. Based on these findings, we identify additional research necessary to describe the relationship between obesity and learning in children. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Views from the Field: Conservation Educators' and Practitioners' Perceptions of Education as a Strategy for Achieving Conservation Outcomes

    Science.gov (United States)

    Ardoin, Nicole M.; Heimlich, Joe E.

    2013-01-01

    This article presents data from a mixed-methods study that collected data through surveys (n = 656), interviews (n = 15), and discussion groups (n = 75) to explore the use of social strategies such as education and outreach by non-governmental organizations and government agencies to reach outcomes related to biodiversity conservation and resource…

  1. Language and Verbal Memory in Individuals with a History of Autism Spectrum Disorders Who Have Achieved Optimal Outcomes

    Science.gov (United States)

    Tyson, Katherine; Kelley, Elizabeth; Fein, Deborah; Orinstein, Alyssa; Troyb, Eva; Barton, Marianne; Eigsti, Inge-Marie; Naigles, Letitia; Schultz, Robert T.; Stevens, Michael; Helt, Molly; Rosenthal, Michael

    2014-01-01

    Some individuals who lose their autism spectrum disorder diagnosis may continue to display subtle weaknesses in language. We examined language and verbal memory in 44 individuals with high-functioning autism (HFA), 34 individuals with "optimal outcomes" (OO) and 34 individuals with typical development (TD). The OO group scored in the…

  2. Strategies for Achieving the New SHAPE America Standards and Grade-Level Outcomes: Bringing Obstacle Course Training into Physical Education

    Science.gov (United States)

    Kulik, Keri S.; Brewer, Hannah; Windish, Lance; Carlson, Hollie

    2017-01-01

    The new SHAPE America standards and grade level outcomes for high-school physical education focus exclusively on physical activities that are suitable for lifelong participation. Some of the fastest-growing physical activities for adults in the United States are non-traditional multi-sport events and obstacle course races. As "Healthy People…

  3. ‘Between two lives': parenting and impacts on academic, professional achievements and socio-emotional outcomes for British-Ghanaians

    OpenAIRE

    Owusu-Kwarteng, Louise

    2010-01-01

    Research undertaken within the Sociology of Education frequently highlights concerns about the underachievement of Black students in education and, later, within the labour market. Yet, there are a number of shortcomings associated with research in this area. Firstly, there is a tendency to homogenise the achievement levels of all Black students. Thus observations made about the outcomes of African-Caribbean students are often applied to all other Black groups. When distinctions between Afric...

  4. Proximal renal tubular acidosis

    Science.gov (United States)

    ... glands that produce tears and saliva are destroyed Wilson disease , an inherited disorder in which there is too much copper in the body's tissues Vitamin D deficiency Symptoms Symptoms of proximal renal tubular acidosis include any ...

  5. Developing a capacity to make "English for Everyone" worthwhile: Reconsidering outcomes and how to start achieving them\\ud

    OpenAIRE

    Wedell, M.

    2008-01-01

    Past decades have seen a growing assumption worldwide that national governments should provide ‘English for Everyone’ (EFE) as a core component of their school curricula. Personal and national benefits expected from such English provision are generally expressed in terms of developing learners’ abilities to communicate in English. Despite enormous financial and human investment, actual outcomes are often disappointing.\\ud One reason for this, in many contexts, is policy makers’ wholesale appr...

  6. Treatment of avascular proximal pole scaphoid nonunions with vascularized distal radius bone grafting.

    Science.gov (United States)

    Lim, Tae Kang; Kim, Hyo Kon; Koh, Kyoung Hwan; Lee, Hyun Il; Woo, Sung Jong; Park, Min Jong

    2013-10-01

    To investigate the outcomes of vascularized distal radius pedicled bone grafting secured with K-wires for scaphoid nonunions with small avascular proximal fragments. We included patients with scaphoid nonunions and small, avascular proximal fragments that were too small for screw fixation. The mean size of the proximal pole fragments was 21% (range, 9% to 28%) of the entire scaphoid, based on quantitative radiographic measurement. All patients had distal radius bone grafting based on the 1,2-intercompartmental supraretinacular artery pedicle and fixation with K-wires. There were 21 wrists in 18 men and 2 women with the mean age of 34 years (range, 22 to 57 y). The mean duration of postoperative follow-up was 40 months (range, 12 to 103 mo). Radiographic union and clinical outcomes, including the ranges of wrist motion, grip strength, and the modified Mayo wrist score, were evaluated. Union was achieved in 18 of 21 wrists (86%) at a mean time of 14 weeks after surgery (range, 8 to 28 wk). Nonunions with proximal fragments less than 20% of the total scaphoid healed in 6 of 8 wrists. In a subset of these 8 wrists in which the proximal fragment was less than 15%, healing occurred in 2 of 4. The modified Mayo wrist score significantly improved from 46 to 78 points, and final wrist functions were rated as excellent in 5, good in 5, fair in 10, and poor in 1. Ranges of motion and grip strengths did not show significant changes after surgery. Vascularized distal radius bone grafting and K-wire fixation can heal scaphoid nonunions with small avascular proximal fragments, although motion and grip strength remain unchanged. Healing may be related to the size of the proximal pole fragment. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  7. Proximity of Practice

    DEFF Research Database (Denmark)

    Ren, Carina Bregnholm; Gyimóthy, Szilvia; Jensen, Martin Trandberg

    2014-01-01

    There is a widespread acknowledgement among European policy-makers that higher education may potentially contribute to enhancing competitiveness of tourism. This has led to a sheer explosion of specific measures encouraging knowledge transfer with the private sector. Despite the importance of kno...... in innovation literature, conditioned by either geographical or social/relational proximity, but also by what we have termed proximity of practice....

  8. "I am a scientist": How setting conditions that enhance focused concentration positively relate to student motivation and achievement outcomes in inquiry-based science

    Science.gov (United States)

    Ellwood, Robin B.

    This research investigated how student social interactions within two approaches to an inquiry-based science curriculum could be related to student motivation and achievement outcomes. This qualitative case study consisted of two cases, Off-Campus and On-Campus, and used ethnographic techniques of participant observation. Research participants included eight eighth grade girls, aged thirteen to fourteen years old. Data sources included formal and informal participant interviews, participant journal reflections, curriculum artifacts including quizzes, worksheets, and student-generated research posters, digital video and audio recordings, photographs, and researcher field notes. Data were transcribed verbatim and coded, then collapsed into emergent themes using NVIVO 9. The results of this research illustrate how setting conditions that promote focused concentration and communicative interactions can be positively related to student motivation and achievement outcomes in inquiry-based science. Participants in the Off-Campus case experienced more frequent states of focused concentration and out performed their peers in the On-Campus case on forty-six percent of classroom assignments. Off-Campus participants also designed and implemented a more cognitively complex research project, provided more in-depth analyses of their research results, and expanded their perceptions of what it means to act like a scientist to a greater extent than participants in the On-Campus case. These results can be understood in relation to Flow Theory. Student interactions that promoted the criteria necessary for initiating flow, which included having clearly defined goals, receiving immediate feedback, and maintaining a balance between challenges and skills, fostered enhanced student motivation and achievement outcomes. This research also illustrates the positive gains in motivation and achievement outcomes that emerge from student experiences with extended time in isolated areas referred to

  9. Younger Patients and Men Achieve Higher Outcome Scores Than Older Patients and Women After Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Webster, Kate E; Feller, Julian A

    2017-10-01

    There is some evidence that functional performance and validated outcome scores differ according to the gender, age, and sport participation status of a patient after anterior cruciate ligament (ACL) reconstruction. However, the impact of these three factors, and interaction among them, has not been studied across a large relatively homogeneous group of patients to better elucidate their impact. We reviewed a large cohort of patients who had undergone ACL reconstruction to determine if ROM, knee laxity, objective performance measures, and validated outcome scores differed according to (1) gender; (2) age; and (3) sport participation status. This was a retrospective analysis of prospectively collected data. Between 2007 and 2016, we performed 3452 single-bundle ACL reconstructions in patients who participated in sport before ACL injury. Of those, complete followup (including preoperative scores and scores at 1 year after surgery; mean, 14 months; range, 12-20 months) was available on 2672 (77%) of patients. Those lost to followup and those accounted for were not different in terms of age, gender, and sports participation at baseline. The study group consisted of 1726 (65%) men and 946 (35%) women with a mean ± SD age of 28 ± 10 years. For these patients, the following measures were obtained: knee ROM (flexion and extension deficit), instrumented knee laxity, single and triple hop for distance limb symmetry index (LSI), International Knee Documentation Committee (IKDC) subjective evaluation, and Single Assessment Numeric Evaluation score. Mean scores and measures of variability were calculated for each outcome measure. Comparisons were made among gender, age, and sport status. Men had less knee laxity after reconstruction (men 1.1 ± 2.2 mm, women 1.3 ± 2.4 mm; mean difference 0.2 mm [0.1-0.4], p 45 years 90% ± 16%, mean difference: 9 [5-11], p < 0.001). Patients who had returned to their preinjury sport also scored higher and had smaller deficits for all

  10. Language and verbal memory in individuals with a history of autism spectrum disorders who have achieved optimal outcomes.

    Science.gov (United States)

    Tyson, Katherine; Kelley, Elizabeth; Fein, Deborah; Orinstein, Alyssa; Troyb, Eva; Barton, Marianne; Eigsti, Inge-Marie; Naigles, Letitia; Schultz, Robert T; Stevens, Michael; Helt, Molly; Rosenthal, Michael

    2014-03-01

    Some individuals who lose their autism spectrum disorder diagnosis may continue to display subtle weaknesses in language. We examined language and verbal memory in 44 individuals with high-functioning autism (HFA), 34 individuals with "optimal outcomes" (OO) and 34 individuals with typical development (TD). The OO group scored in the average range or above on all measures and showed few differences from the TD group. The HFA group performed within the average range but showed significantly lower mean performance than the other groups on multiple language measures, even when controlling for verbal IQ. Results also indicate that OO individuals show strong language abilities in all areas tested, but that their language may show greater reliance on verbal memory.

  11. Neighborhoods and manageable proximity

    Directory of Open Access Journals (Sweden)

    Stavros Stavrides

    2011-08-01

    Full Text Available The theatricality of urban encounters is above all a theatricality of distances which allow for the encounter. The absolute “strangeness” of the crowd (Simmel 1997: 74 expressed, in its purest form, in the absolute proximity of a crowded subway train, does not generally allow for any movements of approach, but only for nervous hostile reactions and submissive hypnotic gestures. Neither forced intersections in the course of pedestrians or vehicles, nor the instantaneous crossing of distances by the technology of live broadcasting and remote control give birth to places of encounter. In the forced proximity of the metropolitan crowd which haunted the city of the 19th and 20th century, as well as in the forced proximity of the tele-presence which haunts the dystopic prospect of the future “omnipolis” (Virilio 1997: 74, the necessary distance, which is the stage of an encounter between different instances of otherness, is dissipated.

  12. Atrofia muscular proximal familiar

    Directory of Open Access Journals (Sweden)

    José Antonio Levy

    1962-09-01

    Full Text Available Os autores relatam dois casos de atrofia muscular proximal familiar, moléstia caracterizada por déficit motor e atrofias musculares de distribuição proximal, secundárias a lesão de neurônios periféricos. Assim, como em outros casos descritos na literatura, foi feito inicialmente o diagnóstico de distrofia muscular progressiva. O diagnóstico correto foi conseguido com auxílio da eletromiografia e da biopsia muscular.

  13. Redesigning a course to help students achieve higher-order cognitive thinking skills: from goals and mechanics to student outcomes.

    Science.gov (United States)

    Casagrand, Janet; Semsar, Katharine

    2017-06-01

    Here we describe a 4-yr course reform and its outcomes. The upper-division neurophysiology course gradually transformed from a traditional lecture in 2004 to a more student-centered course in 2008, through the addition of evidence-based active learning practices, such as deliberate problem-solving practice on homework and peer learning structures, both inside and outside of class. Due to the incremental nature of the reforms and absence of pre-reform learning assessments, we needed a way to retrospectively assess the effectiveness of our efforts. To do this, we first looked at performance on 12 conserved exam questions. Students performed significantly higher post-reform on questions requiring lower-level cognitive skills and those requiring higher-level cognitive skills. Furthermore, student performance on conserved questions was higher post-reform in both the top and bottom quartiles of students, although lower-quartile student performance did not improve until after the first exam. To examine student learning more broadly, we also used Bloom's taxonomy to quantify a significant increase in the Bloom's level of exams, with students performing equally well post-reform on exams that had over twice as many questions at higher cognitive skill levels. Finally, we believe that four factors provided critical contributions to the success of the course reform, including: transformation efforts across multiple course components, alignment between formative and evaluative course materials, student buy-in to course instruction, and instructional support. This reform demonstrates both the effectiveness of incorporating student-centered, active learning into our course, and the utility of using Bloom's level as a metric to assess course reform. Copyright © 2017 the American Physiological Society.

  14. Proximate Analysis of Coal

    Science.gov (United States)

    Donahue, Craig J.; Rais, Elizabeth A.

    2009-01-01

    This lab experiment illustrates the use of thermogravimetric analysis (TGA) to perform proximate analysis on a series of coal samples of different rank. Peat and coke are also examined. A total of four exercises are described. These are dry exercises as students interpret previously recorded scans. The weight percent moisture, volatile matter,…

  15. Proximity and Innovation : From Statics to Dynamics

    NARCIS (Netherlands)

    Balland, P.A.|info:eu-repo/dai/nl/330821369; Boschma, R.A.|info:eu-repo/dai/nl/123155541; Frenken, K.|info:eu-repo/dai/nl/207145253

    2015-01-01

    Despite theoretical and empirical advances, the proximity framework has remained essentially static. A dynamic extension of the proximity framework is proposed that accounts for co-evolutionary dynamics between knowledge networking and proximity. For each proximity dimension, how proximities might

  16. A Study on The Effectiveness of a Pilot Inquiry-Based Middle School Science Program on Non- Cognitive Outcomes and Academic Achievement

    Science.gov (United States)

    Dionisio, Rui Meira

    The randomized research study assessed the effect of an inquiry-based science (IBS) program on non-cognitive outcomes and academic achievement. The study was the result of a grant that was awarded by Professional Resources in Science and Mathematics (PRISM), a program affiliated with Montclair State University in conjunction with Bristol-Myers Squibb, and part of the New Jersey Statewide Systemic Initiative (NJSSI). The NJSSI is a partnership of schools, districts, colleges and universities, science centers, businesses, and museums dedicated to improving the teaching and learning of science, mathematics, and technology in New Jersey. The quantitative research study utilized an IBS instructional program titled Science and Technology Concepts for Middle Schools (STC/MS) and was implemented in two middle schools within the same suburban school district. This study examined the effect of IBS classrooms on learning outcomes specifically related to gender and special education. Evaluation of student learning outcomes was conducted through the administration of three instruments: the Academic Self-Concept (ASC) scale, unit assessments, and NJASK 8 Science. The ASC scale and unit assessments were administered as a pretest and posttest in IBS classrooms. NJASK 8 Science scale scores were obtained through reporting of student performance data from the New Jersey Department of Education to the district. The quantitative analysis in this study provided evidence that IBS classrooms had a positive effect on academic achievement. Overall, students in IBS classrooms performed better than students in traditional classrooms on unit assessments. Additionally, male students and special education students in IBS classrooms outperformed students in traditional classrooms on unit assessments.

  17. SU-F-T-107: Correlations Between Dosimetric Indices of Pharyngeal Constrictors and Proximal Esophagus with Associated Patient-Reported Outcomes Six Months After Radiation Therapy for Head and Neck Cancer

    International Nuclear Information System (INIS)

    Chera, B; Price, A; Kostich, M; Green, R; Das, S; Mavroidis, P; Amdur, R; Mendenhall, W; Sheets, N; Marks, L

    2016-01-01

    Purpose: To compare the correlations between different dosimetric indices derived from the pharyngeal constrictor muscles and proximal esophagus with patient-reported difficulty in swallowing 6 months post radiotherapy using a novel patient reported outcome version of CTCAE (PRO-CTCAE). Methods: Forty-three patients with oropharyngeal squamous cell carcinoma were treated on a prospective multi-institutional study. All patients received de-intensified 60 Gy intensity modulated radiotherapy. We investigated correlations of individual patient dosimetric data of the superior (SPC), middle (MPC), inferior (IPC) pharyngeal constrictor muscles, the superior esophagus (SES), and the inferior esophagus (IES) to their self-reported 6 month post-treatment swallowing difficulty responses. Mild (≥ Grade 1) swallowing difficulty responses were used as the clinical endpoint indicating response. The predictive efficacy of Dmean and dose-volume (VD) points were assessed through the area under the Receiver Operating Characteristic curve (ROC) and Odds Ratio (OR). Results: The SES and SPC had more favorable area under the curves (AUC) for the Dmean (0.62 and 0.70) while the Dmean to the IPC, MPC, and IES produced suboptimal AUCs (0.42, 0.48, and 0.52). Additionally, over the range of VD, the V54 and V55 for the SES and SPC demonstrated the highest AUCs: AUC(SES) = 0.76–0.73 and AUC(SPC) = 0.72–0.69, respectively. The IES, IPC, and MPC had worse AUC results over the range of VD. An optimal OR can be found when V54 = 96% for the SPC, where OR = 3.96 (1.07–14.62). Conclusion: The V45 and V55 of the SES and SPC had the highest correlation to the clinical endpoint compared to the commonly used dosimetric index, Dmean for both the esophagus and constrictor muscles. The reported dosimetric data demonstrates that new dosimetric indices may need to be considered in the setting of dose de-escalation and self-reported outcomes.

  18. SU-F-T-107: Correlations Between Dosimetric Indices of Pharyngeal Constrictors and Proximal Esophagus with Associated Patient-Reported Outcomes Six Months After Radiation Therapy for Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chera, B; Price, A; Kostich, M; Green, R; Das, S; Mavroidis, P [University of North Carolina, Chapel Hill, North Carolina (United States); Amdur, R; Mendenhall, W [University of Florida, Gainesville, FL (United States); Sheets, N [University of North Carolina, Raleigh, North Carolina (United States); Marks, L [UNC School of Medicine, Chapel Hill, NC (United States)

    2016-06-15

    Purpose: To compare the correlations between different dosimetric indices derived from the pharyngeal constrictor muscles and proximal esophagus with patient-reported difficulty in swallowing 6 months post radiotherapy using a novel patient reported outcome version of CTCAE (PRO-CTCAE). Methods: Forty-three patients with oropharyngeal squamous cell carcinoma were treated on a prospective multi-institutional study. All patients received de-intensified 60 Gy intensity modulated radiotherapy. We investigated correlations of individual patient dosimetric data of the superior (SPC), middle (MPC), inferior (IPC) pharyngeal constrictor muscles, the superior esophagus (SES), and the inferior esophagus (IES) to their self-reported 6 month post-treatment swallowing difficulty responses. Mild (≥ Grade 1) swallowing difficulty responses were used as the clinical endpoint indicating response. The predictive efficacy of Dmean and dose-volume (VD) points were assessed through the area under the Receiver Operating Characteristic curve (ROC) and Odds Ratio (OR). Results: The SES and SPC had more favorable area under the curves (AUC) for the Dmean (0.62 and 0.70) while the Dmean to the IPC, MPC, and IES produced suboptimal AUCs (0.42, 0.48, and 0.52). Additionally, over the range of VD, the V54 and V55 for the SES and SPC demonstrated the highest AUCs: AUC(SES) = 0.76–0.73 and AUC(SPC) = 0.72–0.69, respectively. The IES, IPC, and MPC had worse AUC results over the range of VD. An optimal OR can be found when V54 = 96% for the SPC, where OR = 3.96 (1.07–14.62). Conclusion: The V45 and V55 of the SES and SPC had the highest correlation to the clinical endpoint compared to the commonly used dosimetric index, Dmean for both the esophagus and constrictor muscles. The reported dosimetric data demonstrates that new dosimetric indices may need to be considered in the setting of dose de-escalation and self-reported outcomes.

  19. Association of Pattern of Bacteria Sensitivity During the Empirical Antibiotics Use to the Achievement of Clinical Outcome in Pediatric Patients with Pneumonia

    Directory of Open Access Journals (Sweden)

    Vesara A. Gatera

    2014-12-01

    Full Text Available Pneumonia is one of infectious diseases that require a comprehensive and effective effort in its treatment, including in the use of empirical antibiotics. The use of empirical antibiotics should be based on patterns of sensitivity toward bacteria. The aim of this study was to evaluate the use of antibiotics based on the sensitivity patterns by clinical outcomes as the goal of treatment. This study was conducted in Hasan Sadikin Hospital Bandung in October–December 2013 using a retrospective cross-sectional study design. Secondary data were obtained from medical records during January 2011–December 2012. This study consisted of 24 patients with positive culture test and received antibiotic prescription. The results showed the percentage of the use of cefotaxime-ampicillin (37.5%, cefotaxime (33.3%, ceftriaxone (20.8%, and Ampicillin (8.4%. The most influential antibiotics for achieving clinical outcome using 95% confidence level is combination of cefotaxime-ampiciline (P=0.044 with 77.7% sensitivity level. This study suggested that the pattern of antibiotic sensitivity affected the clinical outcomes of pediatric patients with pneumonia.

  20. Intramedullary nailing of proximal and distal one-third tibial shaft fractures with intraoperative two-pin external fixation.

    Science.gov (United States)

    Wysocki, Robert W; Kapotas, James S; Virkus, Walter W

    2009-04-01

    Fractures of the proximal and distal one thirds of the tibial shaft have historically higher malunion rates than those of the midshaft. This retrospective case series evaluates the postoperative radiographic outcome of intramedullary nailing of proximal and distal one-third tibial shaft fractures using intraoperative two-pin external fixation, often referred to as traveling traction. Between 2000 and 2005, 15 consecutive patients with proximal third and 27 consecutive patients with distal third displaced extra-articular fractures of the tibia were treated with statically locked intramedullary nailing and supplementary intraoperative two-pin rectangular frame external fixation. The external fixation was removed once the proximal and distal locking screws were in place. The alignment of the fractures was determined using standard postoperative anteroposterior and lateral radiographs. Postoperatively, 14 of 15 patients with proximal fractures and 25 of 27 patients with distal fractures had less than 5 degrees of angular deformity in both the coronal and sagittal planes and less than 1 cm shortening. Statically locked intramedullary nailing with simultaneous intraoperative traveling traction external fixation as treatment for proximal and distal one-third extra-articular tibial shaft fractures is successful in achieving a high rate of acceptable postoperative alignment.

  1. Proximal collagenous gastroenteritides:

    DEFF Research Database (Denmark)

    Nielsen, Ole Haagen; Riis, Lene Buhl; Danese, Silvio

    2014-01-01

    AIM: While collagenous colitis represents the most common form of the collagenous gastroenteritides, the collagenous entities affecting the proximal part of the gastrointestinal tract are much less recognized and possibly overlooked. The aim was to summarize the latest information through...... a systematic review of collagenous gastritis, collagenous sprue, and a combination thereof. METHOD: The search yielded 117 studies which were suitable for inclusion in the systematic review. Excluding repeated cases, 89 case reports and 28 case series were reported, whereas no prospective studies...... with or without control groups were identified. Further, no randomized, controlled trials were identified. The total number of patients with proximal collagenous gastroenteritides reported was 330. RESULTS: An overview of clinical presentations, prognosis, pathophysiology and histopathology, as well as management...

  2. Children's proximal societal conditions

    DEFF Research Database (Denmark)

    Stanek, Anja Hvidtfeldt

    2018-01-01

    This article will argue for and unfold the conceptualization of children’s proximal societal conditions. Through out different research project in which children’s everyday life in different day care settings and in schools has been studied, it becomes clear that ‘the societal’ is not something...... that is above or outside the institutional setting or the children’s everyday life, but something that is represented through societal structures and actual persons participating (in political ways) within the institutional settings, in ways that has meaning to children’s possibilities to participate, learn...... and develop. Understanding school or kindergarten as (part of) the children’s proximal societal conditions for development and learning, means for instance that considerations about an inclusive agenda are no longer simply thoughts about the school – for economic reasons – having space for as many pupils...

  3. Industrial Computed Tomography using Proximal Algorithm

    KAUST Repository

    Zang, Guangming

    2016-04-14

    In this thesis, we present ProxiSART, a flexible proximal framework for robust 3D cone beam tomographic reconstruction based on the Simultaneous Algebraic Reconstruction Technique (SART). We derive the proximal operator for the SART algorithm and use it for minimizing the data term in a proximal algorithm. We show the flexibility of the framework by plugging in different powerful regularizers, and show its robustness in achieving better reconstruction results in the presence of noise and using fewer projections. We compare our framework to state-of-the-art methods and existing popular software tomography reconstruction packages, on both synthetic and real datasets, and show superior reconstruction quality, especially from noisy data and a small number of projections.

  4. Hemiarthroplasty for proximal humeral fracture: restoration of the Gothic arch.

    Science.gov (United States)

    Krishnan, Sumant G; Bennion, Phillip W; Reineck, John R; Burkhead, Wayne Z

    2008-10-01

    Proximal humerus fractures are the most common fractures of the shoulder girdle, and initial management of these injuries often determines final outcome. When arthroplasty is used to manage proximal humeral fractures, surgery remains technically demanding, and outcomes have been unpredictable. Recent advances in both technique and prosthetic implants have led to more successful and reproducible results. Key technical points include restoration of the Gothic arch, anatomic tuberosity reconstruction, and minimal soft tissue dissection.

  5. Using optimal combination of teaching-learning methods (open book assignment and group tutorials) as revision exercises to improve learning outcome in low achievers in biochemistry.

    Science.gov (United States)

    Rajappa, Medha; Bobby, Zachariah; Nandeesha, H; Suryapriya, R; Ragul, Anithasri; Yuvaraj, B; Revathy, G; Priyadarssini, M

    2016-07-08

    Graduate medical students of India are taught Biochemistry by didactic lectures and they hardly get any opportunity to clarify their doubts and reinforce the concepts which they learn in these lectures. We used a combination of teaching-learning (T-L) methods (open book assignment followed by group tutorials) to study their efficacy in improving the learning outcome. About 143 graduate medical students were classified into low (75%: group 3, n = 46) achievers, based on their internal assessment marks. After the regular teaching module on the topics "Vitamins and Enzymology", all the students attempted an open book assignment without peer consultation. Then all the students participated in group tutorials. The effects on the groups were evaluated by pre and posttests at the end of each phase, with the same set of MCQs. Gain from group tutorials and overall gain was significantly higher in the low achievers, compared to other groups. High and medium achievers obtained more gain from open book assignment, than group tutorials. The overall gain was significantly higher than the gain obtained from open book assignment or group tutorials, in all three groups. All the three groups retained the gain even after 1 week of the exercise. Hence, optimal use of novel T-L methods (open book assignment followed by group tutorials) as revision exercises help in strengthening concepts in Biochemistry in this oft neglected group of low achievers in graduate medical education. © 2016 by The International Union of Biochemistry and Molecular Biology, 44(4):321-325, 2016. © 2016 The International Union of Biochemistry and Molecular Biology.

  6. Locking plate fixation for proximal humerus fractures.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2012-02-01

    Locking plates are increasingly used to surgically treat proximal humerus fractures. Knowledge of the bone quality of the proximal humerus is important. Studies have shown the medial and dorsal aspects of the proximal humeral head to have the highest bone strength, and this should be exploited by fixation techniques, particularly in elderly patients with osteoporosis. The goals of surgery for proximal humeral fractures should involve minimal soft tissue dissection and achieve anatomic reduction of the head complex with sufficient stability to allow for early shoulder mobilization. This article reviews various treatment options, in particular locking plate fixation. Locking plate fixation is associated with a high complication rate, such as avascular necrosis (7.9%), screw cutout (11.6%), and revision surgery (13.7%). These complications are frequently due to the varus deformation of the humeral head. Strategic screw placement in the humeral head would minimize the possibility of loss of fracture reduction and potential hardware complications. Locking plate fixation is a good surgical option for the management of proximal humerus fractures. Complications can be avoided by using better bone stock and by careful screw placement in the humeral head.

  7. Can paddock scale data integration achieve more cost effective outcomes in the Great Barrier Reef? A case study in the Fitzroy Basin.

    Science.gov (United States)

    Star, Megan; Rolfe, John; East, Miriam; Beutel, Terry; McCosker, Kevin; Ellis, Robin; Darr, Shaun; Coughlin, Tom

    2017-11-01

    The decline in health of the Great Barrier Reef and the pressure on allocating funds efficiently has increased efforts to prioritise where public funds are invested. The Fitzroy basin and coastal catchments is 152,000 square kilometres and geographically diverse. Past work has identified that sediment loads leaving the catchment are posing a high risk to the ongoing health of the Reef and that there is a need to prioritise funds to achieve cost effective outcomes. In this paper we aim to present an alternative approach to effective prioritisation of sediment reductions. The approach integrates spatial information regarding the sediment source and process, levels of adoption, bare ground cover, and cost into a function to rank neighbourhood catchments. The results demonstrate the complexity of the issue and the challenge the Fitzroy Basin Association faces when allocating funds. They also illustrate that there are effective opportunities in particular priority areas within the catchment in which on-ground actions could be undertaken, proving it to be a useful approach in prioritising future investments aimed at achieving cost effective sediment reductions to the Reef. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Proximity friction reexamined

    International Nuclear Information System (INIS)

    Krappe, H.J.

    1989-01-01

    The contribution of inelastic excitations to radial and tangential friction form-factors in heavy-ion collisions is investigated in the frame-work of perturbation theory. The dependence of the form factors on the essential geometrical and level-density parameters of the scattering system is exhibited in a rather closed form. The conditions for the existence of time-local friction coefficients are discussed. Results are compared to form factors from other models, in particular the transfer-related proximity friction. For the radial friction coefficient the inelastic excitation mechanism seems to be the dominant contribution in peripheral collisions. (orig.)

  9. Proximal translation of > 1 mm within the first two years of revision total hip arthroplasty correctly predicts whether or not an acetabular component is loose in 80% of cases: a case-control study with confirmed intra-operative outcomes.

    Science.gov (United States)

    Kim, Y S; Abrahams, J M; Callary, S A; De Ieso, C; Costi, K; Howie, D W; Solomon, L B

    2017-04-01

    The purpose of this study was to determine the sensitivity, specificity and predictive values of previously reported thresholds of proximal translation and sagittal rotation of cementless acetabular components used for revision total hip arthroplasty (THA) at various times during early follow-up. Migration of cementless acetabular components was measured retrospectively in 84 patients (94 components) using Ein-Bild-Rontgen-Analyse (EBRA-Cup) in two groups of patients. In Group A, components were recorded as not being loose intra-operatively at re-revision THA (52 components/48 patients) and Group B components were recorded to be loose at re-revision (42 components/36 patients). The mean proximal translation and sagittal rotation were significantly higher in Group B than in Group A from three months onwards (p 1.0 mm within 24 months had a positive predictive value (PPV) of 90% and a specificity of 94%, but a sensitivity of 64%. Proximal translation > 1.0 mm within the first 24 months correctly identified 76 of 94 (81%) of components to be either loose or not loose. However, ten components in Group B (24%) did not migrate proximally above 1.0 mm within the first 60 months. The high PPV of EBRA-Cup measurements of proximal translation (90%) shows that this can be used in early follow-up to identify patients at risk of aseptic loosening. The absence of proximal translation within the first 60 months indicates a component is not likely to be loose at re-revision THA although it does not exclude late aseptic loosening as a cause of failure. Cite this article: Bone Joint J 2017;99-B:465-74. ©2017 The British Editorial Society of Bone & Joint Surgery.

  10. Proximity Scanning Transmission Electron Microscopy/Spectroscopy

    OpenAIRE

    Hwang, Ing-Shouh

    2016-01-01

    Here a new microscopic method is proposed to image and characterize very thin samples like few-layer materials, organic molecules, and nanostructures with nanometer or sub-nanometer resolution using electron beams of energies lower than 20 eV. The microscopic technique achieves high resolution through the proximity (or near-field) effect, as in scanning tunneling microscopy (STM), while it also allows detection of transmitted electrons for imaging and spectroscopy, as in scanning transmission...

  11. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi

    2015-01-01

    BACKGROUND: In hip fracture surgery, the exact choice of implant often remains somewhat unclear for the individual surgeon, but the growing literature consensus has enabled publication of evidence-based surgical treatment pathways. The aim of this article was to review author pathways and national...... guidelines for hip fracture surgery and discuss a method for future pathway/guideline implementation and evaluation. METHODS: By a PubMed search in March 2015 six studies of surgical treatment pathways covering all types of proximal femoral fractures with publication after 1995 were identified. Also we......-displaced femoral neck fractures and prosthesis for displaced among the elderly; and sliding hip screw for stabile- and intramedullary nails for unstable- and sub-trochanteric fractures) but they are based on a variety of criteria and definitions - and often leave wide space for the individual surgeons' subjective...

  12. Proximity detection system underground

    Energy Technology Data Exchange (ETDEWEB)

    Denis Kent [Mine Site Technologies (Australia)

    2008-04-15

    Mine Site Technologies (MST) with the support ACARP and Xstrata Coal NSW, as well as assistance from Centennial Coal, has developed a Proximity Detection System to proof of concept stage as per plan. The basic aim of the project was to develop a system to reduce the risk of the people coming into contact with vehicles in an uncontrolled manner (i.e. being 'run over'). The potential to extend the developed technology into other areas, such as controls for vehicle-vehicle collisions and restricting access of vehicle or people into certain zones (e.g. non FLP vehicles into Hazardous Zones/ERZ) was also assessed. The project leveraged off MST's existing Intellectual Property and experience gained with our ImPact TRACKER tagging technology, allowing the development to be fast tracked. The basic concept developed uses active RFID Tags worn by miners underground to be detected by vehicle mounted Readers. These Readers in turn provide outputs that can be used to alert a driver (e.g. by light and/or audible alarm) that a person (Tag) approaching within their vicinity. The prototype/test kit developed proved the concept and technology, the four main components being: Active RFID Tags to send out signals for detection by vehicle mounted receivers; Receiver electronics to detect RFID Tags approaching within the vicinity of the unit to create a long range detection system (60 m to 120 m); A transmitting/exciter device to enable inner detection zone (within 5 m to 20 m); and A software/hardware device to process & log incoming Tags reads and create certain outputs. Tests undertaken in the laboratory and at a number of mine sites, confirmed the technology path taken could form the basis of a reliable Proximity Detection/Alert System.

  13. Some Properties of Fuzzy Soft Proximity Spaces

    Science.gov (United States)

    Demir, İzzettin; Özbakır, Oya Bedre

    2015-01-01

    We study the fuzzy soft proximity spaces in Katsaras's sense. First, we show how a fuzzy soft topology is derived from a fuzzy soft proximity. Also, we define the notion of fuzzy soft δ-neighborhood in the fuzzy soft proximity space which offers an alternative approach to the study of fuzzy soft proximity spaces. Later, we obtain the initial fuzzy soft proximity determined by a family of fuzzy soft proximities. Finally, we investigate relationship between fuzzy soft proximities and proximities. PMID:25793224

  14. Osteochondral Autograft Transplantation for Proximal Lunate Articular Defects.

    Science.gov (United States)

    Gaspar, Michael P; Jacoby, Sidney M; Marchetto, Paul A; DeLuca, Peter F; Culp, Randall W

    2017-11-01

     No consensus treatment option for focal osteochondral defects of the proximal lunate exist in the literature. Surgical management has thus far been limited to salvage procedures such as proximal row carpectomy and partial arthrodesis.  We report our experience using the osteochondral autograft transplantation surgery (OATS) procedure in two young, active patients with focal osteochondral defects of the proximal lunate. At mean follow-up of 6 years, sustained improvements in pain, motion, and function were observed. Both patients reported high levels of satisfaction and neither experienced any complications.  To our knowledge, this is the first report describing the use of OATS to treat proximal lunate defects.  OATS is a valuable surgical option for treating focal chondral defects of the proximal lunate, with positive outcomes at greater than 5 years postoperatively. This may be an especially useful technique for younger, active patients, and those wishing to maintain maximum functionality.

  15. Clinical evaluation of a new custom offset shoulder prosthesis for treatment of complex fractures of the proximal humerus

    DEFF Research Database (Denmark)

    Mehlhorn, Alexander T; Schmal, Hagen; Sudkamp, Norbert P

    2006-01-01

    A and only 33% in Group B. The least satisfying partial function was shoulder mobility in both groups. Radiographic evaluation did not correlate with the Constant Score. Patients secondarily treated with arthroplasty seem to have less chance to achieve a satisfying functional outcome compared to those......Primary hemiarthroplasty of the shoulder is an accepted procedure to treat complex proximal humeral fractures. The goal of this study was to assess the functional outcome in patients treated with hemiarthroplasty using a custom offset shoulder prosthesis, either for an acute four-part fracture...... of the proximal humerus or following failed primary treatment of a complex humeral fracture. Thirty seven patients were followed up for a mean of 17 months after shoulder replacement (Group A: four-part-fractures; n = 26, Group B: posttraumatic necrosis/non-union after failed primary treatment; n = 11...

  16. PROXIMITY MANAGEMENT IN CRISIS CONDITIONS

    Directory of Open Access Journals (Sweden)

    Ion Dorin BUMBENECI

    2010-01-01

    Full Text Available The purpose of this study is to evaluate the level of assimilation for the terms "Proximity Management" and "Proximity Manager", both in the specialized literature and in practice. The study has two parts: the theoretical research of the two terms, and an evaluation of the use of Proximity management in 32 companies in Gorj, Romania. The object of the evaluation resides in 27 companies with less than 50 employees and 5 companies with more than 50 employees.

  17. Evaluation of jejunal pouch interposition after proximal gastrectomy for early gastric cancer in the upper third of the stomach.

    Science.gov (United States)

    Yabusaki, Hiroshi; Nashimoto, Atsushi; Matsuki, Atsushi; Aizawa, Masaki

    2012-10-01

    Proximal gastrectomy has two problems, reflux esophagitis and curability. This study evaluates postoperative outcomes focusing on reflux esophagitis and curability of proximal gastrectomy with jejunal pouch interposition for early gastric cancer in the upper third of the stomach. One hundred and thirty nine patients who underwent jejunal pouch interposition between 1996 and 2011, 10 esophago-gastrostomy and 20 jejunal interposition at our institution were compared retrospectively to examine heart burn and reflux esophagitis. Furthermore, we examined the remote outcomes of jejunal pouch interposition patients. There were significantly fewer cases of heart burn; the numbers of cases of reflux esophagitis based on endoscopic findings were significantly small in jejunal pouch interposition. Carcinoma of the remnant stomach after jejunal pouch interposition was observed in 9 patients, curative treatment was possible with endoscopic therapy in 6 patients and surgical treatment in 3 patients. There are 119 survivals and 20 deaths at present Death caused primary disease is only 2 patients. Both recurrent patterns were peritoneal metastasis and the histopathological diagnosis was not indicated for proximal gastrectomy. Jejunal pouch interposition after proximal gastrectomy for early upper third gastric cancer proves beneficial and favorable modality achieving prevention of reflux esophagitis and high curability.

  18. Proximal Occlusion of Medium-Sized Vessels with the Penumbra Occlusion Device: A Study of Safety and Efficacy

    Energy Technology Data Exchange (ETDEWEB)

    Jambon, E.; Petitpierre, F. [Pellegrin Hospital, Department of Radiology (France); Brizzi, V.; Dubuisson, V. [Pellegrin Hospital, Department of Surgery (France); Bras, Y. Le; Grenier, N.; Cornelis, F., E-mail: cornelisfrancois@gmail.com [Pellegrin Hospital, Department of Radiology (France)

    2017-02-15

    PurposeTo retrospectively investigate the safety and efficacy of hybrid proximal coiling of various medium-sized vessels (4 to 8 mm) using the Penumbra Occlusion Device (POD).Materials and MethodsFrom October 2014 to February 2016, 37 proximal embolizations were performed with PODs in 36 patients (mean age: 50.8, range: 10–86; 29 male, 7 female). Vessel occlusions were achieved under fluoroscopic guidance using a 2.7 French microcatheter. Among the 36 vessels targeted, 16 were splenic arteries, 11 renal arteries, 4 mesenteric arteries, 3 arteriovenous fistulae, 1 iliac artery, and 1 gonadal vein. Intermittent follow-up angiography was performed to assess the flow for final occlusion. Outcomes and complications were assessed by clinical and/or imaging follow-up.ResultsTo produce proximal occlusion of the intended vessels, the POD was used alone in 19 embolizations (51.4 %). In 12 procedures (32.4 %), POD was used as a coil constrainer to secure the coil construct. In 6 procedures (16.2 %), additional embolic devices were used to achieve vessel occlusion after initial POD deployment. After a mean follow-up of 3.2 months, no POD migration was observed but two complications occurred (5.4 %): one post embolic syndrome and one extensive infarction with splenic abscess.ConclusionThe POD system allows safe and effective proximal embolization of medium-sized vessels in a variety of clinical settings.

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

    Science.gov (United States)

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

    2003-03-01

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

  20. Ulcers of stomach proximal section

    International Nuclear Information System (INIS)

    Oster, A.N.

    1986-01-01

    X-ray symptoms of the stomach proximal section ulcer are presented. Complexity and variety of the X-ray image of the ulcer are caused by anatomic properties of the stomach proximal section. Differential X-ray diagnosis of ulcers should be considered with regard to the system of properties

  1. Triplane fracture of the proximal tibial epiphysis.

    Science.gov (United States)

    Sinigaglia, Riccardo; Gigante, Cosimo; Basso, Giampaolo; Turra, Sisto

    2007-01-01

    Our purpose is to report a very rare case of proximal tibia triplane fracture, focusing the particular pattern of fracture and the long-term follow-up result. The triplane fracture is an exceptional fracture that occurs in the 3 planes (coronal, sagittal and transverse) close to the end of the growth period. A 15-year-old boy was admitted to our Center for a left femoral diaphyseal fracture and an ipsilateral lateral proximal tibia triplane fracture following a road accident. The femur was fixed with an intramedullary nail, the triplane fracture was anatomically reduced and percutaneously fixed. After 4 years follow-up, the knee was stable and with no complaints. Its range of motion was complete. Radiographs and MRI did not show any abnormality on the left leg and knee. In order to stabilize a proximal tibia triplane fracture a surgical internal fixation is usually required, with the possibility of a good long-term outcome also due to the growth potential remaining, if physeal arrest does not occur.

  2. Current concepts in treatment of fracture-dislocations of the proximal interphalangeal joint.

    Science.gov (United States)

    Haase, Steven C; Chung, Kevin C

    2014-12-01

    Proximal interphalangeal joint fracture-dislocations are common injuries that require expedient and attentive treatment for the best outcomes. Management can range from protective splinting and early mobilization to complex surgery. In this review, the current concepts surrounding the management of these injuries are reviewed. A literature review was performed of all recent articles pertaining to proximal interphalangeal joint fracture-dislocation, with specific focus on middle phalangeal base fractures. Where appropriate, older articles or articles on closely related injury types were included for completeness. The methodology and outcomes of each study were analyzed. When small avulsion fractures are present, good results are routinely obtained with reduction and early mobilization of stable injuries. Strategies for management of the unstable dorsal fracture-dislocation have evolved over time. To provide early stability, a variety of techniques have evolved, including closed, percutaneous, external, and internal fixation methods. Although each of these techniques can be successful in skilled hands, none has been subjected to rigorous, prospective, comparative trials. Volar dislocations fare less well, with significant loss of motion in many studies. Pilon fractures represent the most complicated injuries, and return of normal motion is not expected. The best outcomes can be achieved by (1) establishing enough stability to allow early motion, (2) restoring gliding joint motion rather than noncongruent motion, and (3) restoring the articular surface congruity when possible. Although the majority of literature on this topic consists of expert opinion and retrospective case series, the consensus appears to favor less invasive techniques whenever possible.

  3. The infrastructure of psychological proximity

    DEFF Research Database (Denmark)

    Nickelsen, Niels Christian Mossfeldt

    2015-01-01

    ). The experience of psychological proximity between patient and nurse is provided through confidence, continuity and the practical set-up. This constitutes an important enactment of skillfulness, which may render telemedicine a convincing health service in the future. Methodology: The study draws on a pilot...... (Langstrup & Winthereik 2008). This study contributes by showing the infrastructure of psychological proximity, which is provided by way of device, confidence, continuity and accountability....

  4. Dual-Fiberoptic Microcantilever Proximity Sensor

    International Nuclear Information System (INIS)

    Goedeke, S.M.

    2001-01-01

    Microcantilevers are key components of many Micro-Electro-Mechanical Systems (MEMS) and Micro-Optical-Electro-Mechanical Systems (MOEMS) because slight changes to them physically or chemically lead to changes in mechanical characteristics. An inexpensive dual-fiberoptic microcantilever proximity sensor and model to predict its performance are reported here. Motion of a magnetic-material-coated cantilever is the basis of a system under development for measuring magnetic fields. The dual fiber proximity sensor will be used to monitor the motion of the cantilever. The specific goal is to sense induction fields produced by a current carrying conductor. The proximity sensor consists of two fibers side by side with claddings in contact. The fiber core diameter, 50 microns, and cladding thickness, 10 microns, are as small as routinely available commercially with the exception of single mode fiber. Light is launched into one fiber from a light-emitting diode (LED). It emerges from that fiber and reflects from the cantilever into the adjacent receiving fiber connected to a detector. The sensing end is cast molded with a diameter of 3-mm over the last 20-mm, yielding a low profile sensor. This reflective triangulation approach is probably the oldest and simplest fiber proximity sensing approach, yet the novelty here is in demonstrating high sensitivity at low expense from a triangular microstructure with amorphous magnetic coatings of iron, cobalt, permalloy, etc. The signal intensity versus distance curve yields an approximate gaussian shape. For a typical configuration, the signal grows from 10% to 90% of maximum in traversing from 6 to 50 microns from a coated cantilever. With signal levels exceeding a volt, nanometer resolution should be readily achievable for periodic signals

  5. Proximity and Innovation: From Statics to Dynamics

    OpenAIRE

    Pierre-Alexandre Balland; Ron Boschma; Koen Frenken

    2013-01-01

    Despite theoretical and empirical advances, the proximity framework has remained essentially static in that the given proximity between actors explains the extent to which they interact in knowledge networks and profit from such interactions. We propose a dynamic extension of the proximity framework of Boschma in which we account for co-evolutionary dynamics between knowledge networking and proximity. For each proximity dimension, we describe how proximities might increase over time as a resu...

  6. Proximal to distal approach in the treatment of tandem occlusions causing an acute stroke.

    Science.gov (United States)

    Spiotta, Alejandro M; Lena, Jonathan; Vargas, Jan; Hawk, Harris; Turner, Raymond D; Chaudry, M Imran; Turk, Aquilla S

    2015-03-01

    A tandem occlusion is a rare presentation of acute stroke that involves an occlusion of the internal carotid artery at the bifurcation with an intracranial middle cerebral artery occlusion. This study describes the experience at our institution in treating tandem occlusions with a proximal to distal approach in the acute stroke setting. A retrospective review of acute strokes caused by tandem occlusions requiring thrombectomy were performed. 16 cases were identified with a mean National Institutes of Health Stroke Scale score at presentation of 13.1 ± 3.9. The proximal occlusion was crossed initially with a microwire in all cases. All carotid occlusions were treated with stenting, and intracranial vessel thrombectomy was performed with a variety of devices. Procedure related complications occurred in two (12.5%) patients. Eight patients (50%) achieved a good outcome (modified Rankin Scale score of 0-2). A tandem occlusion of the carotid artery at the bifurcation with a concomitant intracranial occlusion is a relatively rare and complex presentation of acute stroke. We have found that addressing the proximal lesion first and covering it with a stent prior to performing distal thrombectomy appears to be a safe and effective option in the treatment algorithm. 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. A modified deltoid splitting approach with axillary nerve bundle mobilization for proximal humeral fracture fixation.

    Science.gov (United States)

    Shin, Young Ho; Lee, Young Ho; Choi, Ho Sung; Kim, Min Bom; Pyo, Sung Hee; Baek, Goo Hyun

    2017-11-01

    The deltopectoral and the deltoid splitting approach are commonly used for the treatment of proximal humeral fractures. While the deltopectoral approach requires massive soft tissue devascularization, the deltoid splitting approach needs an additional skipped incision to avoid axillary nerve injury. The purpose of this study was to describe a modified anterolateral deltoid splitting approach with axillary nerve bundle mobilization in the treatment of proximal humeral fractures and to assess its radiologic and clinical outcomes. Twenty-two consecutive patients with proximal humeral fractures were treated with minimally invasive plate osteosynthesis by using a modified anterolateral deltoid splitting approach with axillary nerve bundle mobilization. The patients were divided into two groups: 10 patients of Neer type 2 or 3 fractures vs. 12 patients of Neer type 4 fractures. The mean age of the study population was 63.5 years (range: 30-80 years). Six patients had valgus impacted fractures, and nine had fractures with medial comminution. Fracture union was achieved in all cases. The mean time to union was 8.6 weeks (range: 6-12 weeks). Major complications, such as avascular necrosis of the humeral head and varus collapse at the fracture site, were not observed. No patients had clinically detectable sensory deficits in the axillary nerve distribution or paralysis of the anterior deltoid muscle. The mean neck-shaft angle at the final follow-up was 136.9° (range, 115°-159°). The mean visual analog score for patient satisfaction was 9.1 (range, 6-10), and the mean Neer scores were 93.5 (range, 84-100). There were no significant differences between the two groups with respect to radiologic and clinical outcomes except Neer scores: 95.8 (range: 86-100) in Neer type 2 or 3 fractures and 91.7 (range: 84-99) in Neer type 4 fractures. The use of a modified anterolateral deltoid splitting approach with axillary nerve bundle mobilization in the treatment of proximal humeral

  8. Avaliação dos resultados do tratamento cirúrgico das fraturas-luxações da extremidade proximal do antebraço no adulto Evaluation of the outcome in fracture-dislocation surgeries in the proximal end of the adult forearm

    Directory of Open Access Journals (Sweden)

    Sérgio Luiz Checchia

    2007-09-01

    Full Text Available OBJETIVO: Avaliar os resultados obtidos no tratamento das fraturas-luxações da extremidade proximal do antebraço (FLEPA, procurando identificar fatores que possam influenciar no prognóstico desse tipo de lesão traumática. MÉTODOS: De outubro de 1994 a dezembro de 2005, 30 pacientes com FLEPA foram submetidos ao tratamento cirúrgico. Em todos os casos, o seguimento ambulatorial mínimo foi de 12 meses. As lesões foram classificadas pelo método de Chick et al. A média de idade foi de 48 anos, com mínima de 25 e máxima de 76 anos. Os mecanismos de trauma foram: queda da própria altura em 17 pacientes (57%, acidentes de via pública em 11 casos (37%, trauma direto em um caso (3% e agressão física em um caso (3%. As fraturas expostas corresponderam a oito casos (27%. Realizou-se a análise estatística pelo teste exato de Fisher para avaliar os seguintes dados: exposição do foco de fratura e resultados; sexo e resultados; mecanismo de trauma e resultados; idade e mecanismo de trauma; sexo e mecanismo de trauma. RESULTADOS: Em 11 casos (37% os resultados foram satisfatórios e em 19 casos (63%, insatisfatórios. Estabeleceu-se apenas relação estatística significativa entre exposição da fratura e resultados. CONCLUSÃO: Os tratamentos das FLEPA têm, em sua maioria, resultados insatisfatórios, principalmente nas fraturas expostas, fato estatisticamente significativo neste estudo. Não foi possível definir outros fatores prognósticos. Encontrou-se tendência a melhores resultados nos pacientes do sexo feminino, nos idosos e nas vítimas de traumas de baixa energia.OBJECTIVE: To evaluate results obtained in the treatment of fracture-dislocation of the proximal end of the forearm (FLEPA, in an attempt at identifying factors that may influence the prognosis of this type of traumatic lesion. METHODS: From October 1994 to December 2005, 30 patients with FLEPA were submitted to surgical treatment. In all cases, minimum office follow

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

    Science.gov (United States)

    Vander Griend, Robert

    2017-02-01

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

  10. Preliminary study on leadership proximity

    Directory of Open Access Journals (Sweden)

    Ghinea Valentina Mihaela

    2017-07-01

    Full Text Available In general, it is agreed that effective leadership requires a certain degree of proximity, either physical or mental, which enables leaders to maintain control over their followers and communicate their vision. Although we agree with the leadership proximity principles which states that leaders are able to efficiently serve only those people with whom they interact frequently, in this article we focus instead on the disadvantages of being too close and the way in which close proximity can actually hurt the effectiveness of leadership. The main effects that we discuss regard the way in which proximity and familiarity allow followers to see the weaknesses and faults of the leader much more easily and thus diminish the leader’s heroic aura, and the emotional bias that results from a leader being too familiar with his followers which will impede the process of rational decision making. As a result, we argue that there exists a functional proximity which allows the leader the necessary space in which to perform effective identity work and to hide the backstage aspects of leadership, while also allowing him an emotional buffer zone which will enable him to maintain the ability to see clearly and make rational decisions.

  11. Can achievement emotions be used to better understand motivation, learning, and performance in medical education?

    Science.gov (United States)

    Artino, Anthony R; Holmboe, Eric S; Durning, Steven J

    2012-01-01

    In this article, we consider an emergent theory of human emotion. The overarching purpose of the article is to introduce medical education researchers to the notion of achievement emotions and provide a brief overview of how this work can inform the theory, research, and practice of medical education. First, we define achievement emotions and describe one of the leading contemporary theories of achievement emotions, control-value theory (Pekrun R. 2006. The control-value theory of achievement emotions: Assumptions, corollaries, and implications for educational research and practice. Educ Psychol Rev 18:315-341.). Next, we distinguish between different types of achievement emotions, their proximal causes, and their consequences for motivation, learning, and performance, and we discuss several implications for educational practice. Finally, we end with a call for more research on achievement emotions in medical education to facilitate our understanding of emotions and their impact on important educational outcomes.

  12. Cubesat Proximity Operations Demonstration (CPOD)

    Science.gov (United States)

    Villa, Marco; Martinez, Andres; Petro, Andrew

    2015-01-01

    The CubeSat Proximity Operations Demonstration (CPOD) project will demonstrate rendezvous, proximity operations and docking (RPOD) using two 3-unit (3U) CubeSats. Each CubeSat is a satellite with the dimensions 4 inches x 4 inches x 13 inches (10 centimeters x 10 centimeters x 33 centimeters) and weighing approximately 11 pounds (5 kilograms). This flight demonstration will validate and characterize many new miniature low-power proximity operations technologies applicable to future missions. This mission will advance the state of the art in nanosatellite attitude determination,navigation and control systems, in addition to demonstrating relative navigation capabilities.The two CPOD satellites are scheduled to be launched together to low-Earth orbit no earlier than Dec. 1, 2015.

  13. Improved current type proximity detector

    Energy Technology Data Exchange (ETDEWEB)

    Visioli, A.J. Jr.

    1976-04-29

    A proximity detection system for non-contact displacement and proximity measurement of static or dynamic metallic or conductive surfaces is provided wherein the measurement is obtained by monitoring the change in impedance of a flat, generally spiralwound, printed circuit coil which is excited by a constant current, constant frequency source. The change in impedance, which is detected as a corresponding change in voltage across th coil, is related to the eddy current losses in the distant conductive material target. The arrangement provides for considerable linear displacement range with increased accuracies, stability, and sensitivity over the entire range.

  14. The effect of inferomedial screw on postoperative shoulder function and mechanical alignment in proximal humerus fractures.

    Science.gov (United States)

    Erdoğan, Murat; Desteli, Engin Eren; İmren, Yunus; Üztürk, Ali; Kılıç, Mesut; Sezgin, Hicabi

    2014-10-01

    The aim of the study was to evaluate the clinical and radiologic results of locking plate fixation with or without inferomedial screw (IMS) in surgically treated proximal humerus fractures. Thirty-six patients with displaced proximal humerus fractures from two centers were operated using locking plate. All of the fractures were classified according to the Neer classification. In 18 of the cases, an additional IMS running through the medial curvature of the surgical neck was used. There was no significant difference among both groups in terms of height, gender, weight, and mechanism of injury. The fractures were evaluated according to the radiographic and functional findings during follow-up period of 14 months in average (range 8-32 months). At the end of first year, shoulder radiographs were received and shoulder examinations were performed using ASES scores. Humeral head-shaft angles were measured by true AP projections. Head-shaft angle measurements were categorized as varus if 145. Mean time for fracture healing was 18 weeks. Complete union was achieved in 35 patients by the end of 6 months. In one of the 18 displaced proximal humerus fractures of IMS (+) group, the head-shaft angle was measured to be <125, whereas six patients had varus deviation in IMS (-) group at follow-up (p < 0.05). Mean ASES scores of IMS (+) group and IMS (-) group were 58.21 ± 5.82 and 38.61 ± 3.44, respectively (p < 0.001). Use of inferomedial screw running through the medial curvature of surgical neck prevents varus deformity and improves functional outcome after surgical treatment for proximal humerus fractures.

  15. Conservative treatment, plate fixation, or prosthesis for proximal humeral fracture. A prospective randomized study

    Directory of Open Access Journals (Sweden)

    Launonen Antti P

    2012-09-01

    Full Text Available Abstract Background Proximal humerus fracture is the third most common fracture type after hip and distal radius fracture in elderly patients. A comprehensive study by Palvanen et al. demonstrated an increase in the annual fracture rate of 13.7% per year over the past 33 years. Should this trend continue, the fracture rate would triple over the next three decades. The increasing incidence of low-energy fractures raises questions about the optimal treatment in terms of functional outcome, pain, and rehabilitation time, as well as the economical impact. Despite the high incidence and costs of proximal humerus fractures, there is currently no valid scientific evidence for the best treatment method. Several publications, including a Cochrane review outline the need for high-quality, well-designed randomized controlled trials. Methods/Design The study is a prospective, randomized, national multi-center trial. The hypothesis of the trial is that surgical treatment of displaced proximal humerus fractures achieves better functional outcome, pain relief, and patient satisfaction compared to conservative treatment. The trial is designed to compare conservative and surgical treatment of proximal humerus fractures in patients 60 years and older. The trial includes two strata. Stratum I compares surgical treatment with locking plates to conservative treatment for two-part fractures. Stratum II compares multi-fragmented fractures, including three- and four-part fractures. The aim of Stratum II is to compare conservative treatment, surgical treatment with the Philos locking plate, and hemiarthroplasty with an Epoca prosthesis. The primary outcome measure will be the Disabilities of the Arm, Shoulder and Hand (DASH score and the secondary outcome measures will be the EuroQol-5D (EQ-5D value, OSS, Constant-Murley Score, VAS, and 15D. Recruiting time will be 3 years. The results will be analyzed after the 2-year follow-up period. Discussion This publication

  16. The validity of proximal caries detection using magnifying visual aids.

    Science.gov (United States)

    Haak, Rainer; Wicht, Michael J; Hellmich, Martin; Gossmann, Andrea; Noack, Michael J

    2002-01-01

    The purpose of this study was to determine the validity of proximal caries detection supported by a prism loupe and a surgical microscope used by examiners having different professional experience. One hundred and sixty extracted premolars and molars with varying degrees of proximal caries or sound surfaces were embedded in 10 pairs of models with proximal tooth contacts and a simulated gingiva mask. The proximal surfaces were visually evaluated by 14 observers (7 students, 7 dentists) according to a 5-point caries rating scale using a head-worn prism loupe (x4.5), a surgical microscope (x 14) and without any magnifying device (control). The validity of observations was expressed as ROC curves calculated for two gold standard thresholds: (a) the presence of caries and (b) macroscopic cavitation. Repeated measures analysis of variance was used to determine the effects of 'observer group' and 'diagnostic modality'. An influence of the observer group could not be demonstrated (p > 0.72), whereas significant differences were revealed between the diagnostic modalities (p caries detection with magnifying aids were smaller compared to the control group. It was concluded that the use of a prism loupe or a surgical microscope does not improve the validity of proximal caries detection if the operators, irrespective of being dental students or clinical instructors, are inexperienced in its utilisation. In general only moderate validity was achieved with visual inspection of proximal sites. Copyright 2002 S. Karger AG, Basel

  17. Understanding the Effect of KIPP as It Scales: Volume I, Impacts on Achievement and Other Outcomes. Final Report of KIPP's Investing in Innovation Grant Evaluation. Executive Summary

    Science.gov (United States)

    Tuttle, Christina Clark; Gleason, Philip; Knechtel, Virginia; Nichols-Barrer, Ira; Booker, Kevin; Chojnacki, Gregory; Coen, Thomas; Goble, Lisbeth

    2015-01-01

    KIPP (Knowledge is Power Program) is a national network of public charter schools whose stated mission is to help underserved students enroll in and graduate from college. Prior studies (see Tuttle et al. 2013) have consistently found that attending a KIPP middle school positively affects student achievement, but few have addressed longer-term…

  18. Paramedic Initiation of Neuroprotective Agent Infusions: Successful Achievement of Target Blood Levels and Attained Level Effect on Clinical Outcomes in the FAST-MAG Pivotal Trial (Field Administration of Stroke Therapy - Magnesium).

    Science.gov (United States)

    Shkirkova, Kristina; Starkman, Sidney; Sanossian, Nerses; Eckstein, Marc; Stratton, Samuel; Pratt, Frank; Conwit, Robin; Hamilton, Scott; Sharma, Latisha; Liebeskind, David; Restrepo, Lucas; Valdes-Sueiras, Miguel; Saver, Jeffrey L

    2017-07-01

    Paramedic use of fixed-size lumen, gravity-controlled tubing to initiate intravenous infusions in the field may allow rapid start of neuroprotective therapy for acute stroke. In a large, multicenter trial, we evaluated its efficacy in attaining target serum levels of candidate neuroprotective agent magnesium sulfate and the relation of achieved magnesium levels to outcome. The FAST-MAG phase 3 trial (Field Administration of Stroke Therapy - Magnesium) randomized 1700 patients within 2 hours of onset to paramedic-initiated, a 15-minute loading intravenous infusion of magnesium or placebo followed by a 24-hour maintenance dose. The drug delivery strategy included fixed-size lumen, gravity-controlled tubing for field drug administration, and a shrink-wrapped ambulance kit containing both the randomized field loading and hospital maintenance doses for seamless continuation. Among patient randomized to active treatment, magnesium levels in the first 72 hours were assessed 987 times in 572 patients. Mean patient age was 70 years (SD±14 years), and 45% were women. During the 24-hour period of active infusion, mean achieved serum level was 3.91 (±0.8), consistent with trial target. Mg levels were increased by older age, female sex, lower weight, height, body mass index, and estimated glomerular filtration rate, and higher blood urea nitrogen, hemoglobin, and higher hematocrit. Adjusted odds for clinical outcomes did not differ by achieved Mg level, including disability at 90 days, symptomatic hemorrhage, or death. Paramedic infusion initiation using gravity-controlled tubing permits rapid achievement of target serum levels of potential neuroprotective agents. The absence of association of clinical outcomes with achieved magnesium levels provides further evidence that magnesium is not biologically neuroprotective in acute stroke. © 2017 American Heart Association, Inc.

  19. Driven shielding capacitive proximity sensor

    Science.gov (United States)

    Vranish, John M. (Inventor); McConnell, Robert L. (Inventor)

    2000-01-01

    A capacitive proximity sensing element, backed by a reflector driven at the same voltage as and in phase with the sensor, is used to reflect the field lines away from a grounded robot arm towards an intruding object, thus dramatically increasing the sensor's range and sensitivity.

  20. Distal and variably proximal causes: education, obesity, and health.

    Science.gov (United States)

    Schafer, Markus H; Ferraro, Kenneth F

    2011-11-01

    Medical sociologists hold that social conditions generate disparities across a host of health conditions through exposure to a variety of more proximate risk factors. Though distal and proximal causes jointly influence disease, the nature of risk accumulation may differ appreciably by the link of a proximal cause to the outcome in question. This paper employs a representative sample of over 3000 American older adults to examine whether position in the educational gradient amplifies the effect of obesity on two health outcomes. Results indicate that educational inequalities amplify the effect of high body mass index on disability (unstandardized coefficients across education groups range from -.05 [ns] to .26 [p obese adults), but fail to amplify the consequences of severe obesity in the case of C-reactive protein (CRP) levels. Instead, educational gradients in CRP are most pronounced at lower levels of body mass. Sex-specific analyses further clarify these patterns, as the connections between CRP and body mass are particularly strong among women. We conclude that risk accumulation processes differ based on the proximity of causes to the health outcome under examination. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Modelling and Analysis of Proximity Effect in IGBT Fuses

    DEFF Research Database (Denmark)

    Iov, Florin; Blaabjerg, Frede; Rasmussen, Henrik

    2005-01-01

    . Even with an active protection, a high power IGBT still has a risk of exhibiting a violent rupture in the case of a fault if e.g. IGBT fuses are not protecting it. By introducing fuses into voltage source converters a better protection of IGBT's can be achieved. However, skin and proximity effects...... affect the current distribution in a fuse due to the high frequency currents and thus a need for de-rating the fuse. This paper shows an analytical model for studying the proximity effect into a fuse. The results obtained using this model are compared with experiments....

  2. The Impact of Supporting Family Caregivers Before Bereavement on Outcomes After Bereavement: Adequacy of End-of-Life Support and Achievement of Preferred Place of Death.

    Science.gov (United States)

    Aoun, Samar M; Ewing, Gail; Grande, Gunn; Toye, Chris; Bear, Natasha

    2018-02-01

    The investigation of the situation of bereaved family caregivers following caregiving during the end-of-life phase of illness has not received enough attention. This study investigated the extent to which using the Carer Support Needs Assessment Tool (CSNAT) intervention during the caregiving period has affected bereaved family caregivers' perceptions of adequacy of support, their grief and well-being, and achievement of their preferred place of death. All family caregivers who participated in a stepped-wedge cluster trial of the CSNAT intervention in Western Australia (2012-2014) and completed the pre-bereavement study (n = 322) were invited to take part in a caregiver survey by telephone four to six months after bereavement (2015). The survey measured the adequacy of end-of-life support, the level of grief, the current physical and mental health, and the achievement of the preferred place of death. The response rate was 66% (152, intervention; 60, control). The intervention group perceived that their pre-bereavement support needs had been adequately met to a significantly greater extent than the control group (d = 0.43, P death more often according to their caregivers (79.6% vs. 63.6%, P = 0.034). There was also a greater agreement on the preferred place of death between patients and their caregivers in the intervention group (P = 0.02). The results from this study provide evidence that the CSNAT intervention has a positive impact on perceived adequacy of support of bereaved family caregivers and achievement of preferred place of death according to caregivers. The benefits gained by caregivers in being engaged in early and direct assessment of their support needs before bereavement reinforce the need for palliative care services to effectively support caregivers well before the patient's death. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  3. Adoptees' Educational Achievements

    DEFF Research Database (Denmark)

    Olsen, Rikke Fuglsang

    This study analyses educational achievement at age 20 for 3,180 non-kin adoptees and at age 25 for 1,559 non-kin adoptees in Denmark by comparing them to non-adoptees. The study also analyses whether there are within-group differences in the educational achievement of non-kin adoptees according...... to country of origin. The results suggest that the relatively small gap between non-kin adoptees’ and non-adoptees’ educational achievements widens between ages 20 and 25. Moreover, the results show some differences in educational outcomes among non-kin adoptees with different countries of origin....

  4. Similar Clinical and Surgical Outcomes Achieved with Early Compared to Late Anti-TNF Induction in Mild-to-Moderate Ulcerative Colitis: A Retrospective Cohort Study.

    Science.gov (United States)

    Ma, Christopher; Beilman, Candace L; Huang, Vivian W; Fedorak, Darryl K; Wong, Karen; Kroeker, Karen I; Dieleman, Levinus A; Halloran, Brendan P; Fedorak, Richard N

    2016-01-01

    Background. Biologic agents targeting tumor necrosis factor alpha are effective in the management of ulcerative colitis (UC), but their use is often postponed until after failure of other treatment modalities. Objectives. We aim to determine if earlier treatment with infliximab or adalimumab alters clinical and surgical outcomes in UC patients. Methods. A retrospective cohort study was conducted evaluating UC outpatients treated with infliximab or adalimumab from 2003 to 2014. Patients were stratified by time to first anti-TNF exposure; early initiation was defined as starting treatment within three years of diagnosis. Primary outcomes were colectomy, UC-related hospitalization, and clinical secondary loss of response. Kaplan-Meier analysis was used to assess time to the primary outcomes. Results. 115 patients were included (78 infliximab, 37 adalimumab). Median follow-up was 175.6 weeks (IQR 72.4-228.4 weeks). Fifty-seven (49.6%) patients received early anti-TNF therapy; median time to treatment in this group was 38.1 (23.3-91.0) weeks compared to 414.0 (254.0-561.3) weeks in the late initiator cohort (p < 0.0001). Patients treated with early anti-TNF therapy had more severe endoscopic disease at induction (mean Mayo endoscopy subscore 2.46 (SD ± 0.66) versus 1.86 (±0.67), p < 0.001) and trended towards increased risk of colectomy (17.5% versus 8.6%, p = 0.16) and UC-related hospitalization (43.9% versus 27.6%, p = 0.07). In multivariate regression analysis, early anti-TNF induction was not associated with colectomy (HR 2.02 [95% CI: 0.57-7.20]), hospitalization (HR 1.66 [0.84-3.30]), or secondary loss of response (HR 0.86 [0.52-1.42]). Conclusions. Anti-TNF therapy is initiated earlier in patients with severe UC but earlier treatment does not prevent hospitalization, colectomy, or secondary loss of response.

  5. Similar Clinical and Surgical Outcomes Achieved with Early Compared to Late Anti-TNF Induction in Mild-to-Moderate Ulcerative Colitis: A Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Christopher Ma

    2016-01-01

    Full Text Available Background. Biologic agents targeting tumor necrosis factor alpha are effective in the management of ulcerative colitis (UC, but their use is often postponed until after failure of other treatment modalities. Objectives. We aim to determine if earlier treatment with infliximab or adalimumab alters clinical and surgical outcomes in UC patients. Methods. A retrospective cohort study was conducted evaluating UC outpatients treated with infliximab or adalimumab from 2003 to 2014. Patients were stratified by time to first anti-TNF exposure; early initiation was defined as starting treatment within three years of diagnosis. Primary outcomes were colectomy, UC-related hospitalization, and clinical secondary loss of response. Kaplan-Meier analysis was used to assess time to the primary outcomes. Results. 115 patients were included (78 infliximab, 37 adalimumab. Median follow-up was 175.6 weeks (IQR 72.4–228.4 weeks. Fifty-seven (49.6% patients received early anti-TNF therapy; median time to treatment in this group was 38.1 (23.3–91.0 weeks compared to 414.0 (254.0–561.3 weeks in the late initiator cohort (p<0.0001. Patients treated with early anti-TNF therapy had more severe endoscopic disease at induction (mean Mayo endoscopy subscore 2.46 (SD ± 0.66 versus 1.86 (±0.67, p<0.001 and trended towards increased risk of colectomy (17.5% versus 8.6%, p=0.16 and UC-related hospitalization (43.9% versus 27.6%, p=0.07. In multivariate regression analysis, early anti-TNF induction was not associated with colectomy (HR 2.02 [95% CI: 0.57–7.20], hospitalization (HR 1.66 [0.84–3.30], or secondary loss of response (HR 0.86 [0.52–1.42]. Conclusions. Anti-TNF therapy is initiated earlier in patients with severe UC but earlier treatment does not prevent hospitalization, colectomy, or secondary loss of response.

  6. Extensively coated revision stems in proximally deficient femur: Early results in 15 patients

    Directory of Open Access Journals (Sweden)

    Marya SKS

    2008-01-01

    intraoperative severe comminuted fracture extending into the supracondylar region while hammering in the stem. Post cerclage wiring, she was put on a long knee brace and her mobilization was delayed to 12 weeks. Conclusions: The extensively coated cementless ( ′Solution™′ femoral stem provides a reasonable ′solution′ to the deficient femur in hip revision. The proximal femoral deficiences can be relatively easily bypassed and distal fixation can be achieved with this stem. Extreme care needs to be taken to avoid fractures and penetration of the femoral shaft, which can, however, be managed by cerclage wiring. Principles of a successful outcome include preservation of the functional continuity of the abduction apparatus, care to recognize and prevent distal extension of fracture while inserting the stem (preemptive cerclage wiring and supervised rehabilitation.

  7. Proximity-dependent initiation of hybridization chain reaction

    Science.gov (United States)

    Koos, Björn; Cane, Gaëlle; Grannas, Karin; Löf, Liza; Arngården, Linda; Heldin, Johan; Clausson, Carl-Magnus; Klaesson, Axel; Hirvonen, M. Karoliina; de Oliveira, Felipe M. S.; Talibov, Vladimir O.; Pham, Nhan T.; Auer, Manfred; Danielson, U. Helena; Haybaeck, Johannes; Kamali-Moghaddam, Masood; Söderberg, Ola

    2015-01-01

    Sensitive detection of protein interactions and post-translational modifications of native proteins is a challenge for research and diagnostic purposes. A method for this, which could be used in point-of-care devices and high-throughput screening, should be reliable, cost effective and robust. To achieve this, here we design a method (proxHCR) that combines the need for proximal binding with hybridization chain reaction (HCR) for signal amplification. When two oligonucleotide hairpins conjugated to antibodies bind in close proximity, they can be activated to reveal an initiator sequence. This starts a chain reaction of hybridization events between a pair of fluorophore-labelled oligonucleotide hairpins, generating a fluorescent product. In conclusion, we show the applicability of the proxHCR method for the detection of protein interactions and posttranslational modifications in microscopy and flow cytometry. As no enzymes are needed, proxHCR may be an inexpensive and robust alternative to proximity ligation assays. PMID:26065580

  8. Impact of a social-emotional and character development program on school-level indicators of academic achievement, absenteeism, and disciplinary outcomes: A matched-pair, cluster randomized, controlled trial.

    Science.gov (United States)

    Snyder, Frank; Flay, Brian; Vuchinich, Samuel; Acock, Alan; Washburn, Isaac; Beets, Michael; Li, Kin-Kit

    2010-01-01

    This paper reports the effects of a comprehensive elementary school-based social-emotional and character education program on school-level achievement, absenteeism, and disciplinary outcomes utilizing a matched-pair, cluster randomized, controlled design. The Positive Action Hawai'i trial included 20 racially/ethnically diverse schools (mean enrollment = 544) and was conducted from the 2002-03 through the 2005-06 academic years. Using school-level archival data, analyses comparing change from baseline (2002) to one-year post trial (2007) revealed that intervention schools scored 9.8% better on the TerraNova (2 nd ed.) test for reading and 8.8% on math; 20.7% better in Hawai'i Content and Performance Standards scores for reading and 51.4% better in math; and that intervention schools reported 15.2% lower absenteeism and fewer suspensions (72.6%) and retentions (72.7%). Overall, effect sizes were moderate to large (range 0.5-1.1) for all of the examined outcomes. Sensitivity analyses using permutation models and random-intercept growth curve models substantiated results. The results provide evidence that a comprehensive school-based program, specifically developed to target student behavior and character, can positively influence school-level achievement, attendance, and disciplinary outcomes concurrently.

  9. Essays on Educational Achievement

    Science.gov (United States)

    Ampaabeng, Samuel Kofi

    2013-01-01

    This dissertation examines the determinants of student outcomes--achievement, attainment, occupational choices and earnings--in three different contexts. The first two chapters focus on Ghana while the final chapter focuses on the US state of Massachusetts. In the first chapter, I exploit the incidence of famine and malnutrition that resulted to…

  10. A STUDY ON PROXIMAL HUMERAL FRACTURES STABILISED WITH PHILOS PLATE

    Directory of Open Access Journals (Sweden)

    Praveen Sivakumar K

    2017-02-01

    Full Text Available BACKGROUND Techniques for treating complex proximal humeral fractures vary and include fixations using tension bands, percutaneous pins, bone suture, T-plates, intramedullary nails, double tubular plates, hemiarthroplasty, plant tan humerus fixator plates, Polaris nails and blade plates. Complications of these techniques include cutout or back out of the screws and plates, avascular necrosis, nonunion, malunion, nail migration, rotator cuff impairment and impingement syndromes. Insufficient anchorage from conventional implants may lead to early loosening and failure, especially in osteoporotic bones. In general, nonoperative treatment of displaced three and four-part fractures of the proximal humerus leads to poor outcome due to intraarticular nature of injury and inherent instability of the fragments. Comminuted fractures of the proximal humerus are at risk of fixation failure, screw loosening and fracture displacement. Open reduction and internal fixation with conventional plate and screws has been associated with unacceptably high incidence of screw pull out. PHILOS (the proximal humeral internal locking system plate is an internal fixation system that enables angled stabilisation with multiple interlocking screws for fractures of the proximal humerus. MATERIALS AND METHODS 30 patients with proximal humerus fractures who were admitted in the Department of Orthopaedics, Government General Hospital, Kakinada, during the period November 2014 - November 2016 were taken up for study according to inclusion criteria. All patients were treated with PHILOS plate. These proximal humerus fractures were classified according to Neer’s classification. Patients were followed up at 6 weeks, 12 weeks and 6 months’ interval. Functional outcomes for pain, range of motion and muscle power and function were assessed using the Constant-Murley scoring system. Collected data analysed with independent t-test and ANNOVA test. RESULTS The outcome of the study was 1

  11. Treatment of Unstable Trochanteric Femur Fractures: Proximal Femur Nail Versus Proximal Femur Locking Compression Plate.

    Science.gov (United States)

    Singh, Ashutosh Kumar; Narsaria, Nidi; G R, Arun; Srivastava, Vivek

    Unstable trochanteric femur fractures are common fractures that are difficult to manage. We conducted a prospective study to compare functional outcomes and complications of 2 different implant designs, proximal femur nail (PFN) and proximal femur locking compression plate (PFLCP), used in internal fixation of unstable trochanteric femur fractures. On hospital admission, 48 patients with unstable trochanteric fractures were randomly assigned (using a sealed envelope method) to treatment with either PFN (24 patients) or PFLCP (24 patients). Perioperative data and complications were recorded. All cases were followed up for 2 years. The groups did not differ significantly (P > .05) in operative time, reduction quality, complications, hospital length of stay, union rate, or time to union. Compared with the PFLCP group, the PFN group had shorter incisions and less blood loss. Regarding functional outcomes, there was no significant difference in mean Harris Hip Score (P = .48) or Palmer and Parker mobility score (P = .58). Both PFN and PFLCP are effective in internal fixation of unstable trochanteric femur fractures.

  12. Proximate composition of Oreochromis niloticus subjected to ...

    African Journals Online (AJOL)

    smoked method gave the highest level of stabilizing in the proximate composition on storage for 28 days. Keywords: Oreochromis niloticus, Preservation methods, Proximate status. Animal Research International (2012) 9(3): 1619 – 1624 ...

  13. Influence of pre- and post-transplantation responses on outcome of patients with multiple myeloma: sequential improvement of response and achievement of complete response are associated with longer survival.

    Science.gov (United States)

    Lahuerta, Juan José; Mateos, Maria Victoria; Martínez-López, Joaquin; Rosiñol, Laura; Sureda, Anna; de la Rubia, Javier; García-Laraña, José; Martínez-Martínez, Rafael; Hernández-García, Miguel T; Carrera, Dolores; Besalduch, Joan; de Arriba, Felipe; Ribera, José María; Escoda, Lourdes; Hernández-Ruiz, Belén; García-Frade, Javier; Rivas-González, Concepción; Alegre, Adrían; Bladé, Joan; San Miguel, Jesús F

    2008-12-10

    Complete response (CR) is considered an important goal in most hematologic malignancies. However, in multiple myeloma (MM), there is no consensus regarding whether immunofixation (IF)-negative CR, IF-positive near-CR (nCR), and partial response (PR) are associated with different survivals. We evaluated the prognostic influence on event-free survival (EFS) and overall survival (OS) of these responses pre- and post-transplantation in newly diagnosed patients with MM. We analyzed 632 patients from the prospective Grupo Español de Mieloma 2000 protocol who were uniformly treated with vincristine, carmustine, cyclophosphamide, melphalan, and predisone/vincristine, carmustine, adryamcine, and dexamethasone induction followed by high-dose therapy and autologous stem-cell transplantation. Post-transplantation response markedly influenced outcomes. Patients achieving CR had significantly longer EFS (median, 61 v 40 months; P < 10(-5)) and OS (medians not reached; P = .01) versus patients achieving nCR, who likewise had somewhat better outcomes compared with patients achieving PR (median EFS, 34 months, P = .07 v nCR; median OS, 61 months, P = .04). EFS and OS and influence of response were similar among older (age 65 to 70 years) and younger (age < 65 years) patients. Similar findings were observed with pretransplantation response, with trends toward EFS (P = .1; P = .05) and OS (P = .1; P = .07) benefit in patients achieving CR versus nCR and PR, respectively. Post-transplantation response was markedly influenced by pretransplantation response; improvements in response were associated with prolonged survival. Quality of response post-transplantation, notably CR, is significantly associated with EFS and OS prolongation in newly diagnosed patients with MM. There were trends toward similar associations with pretransplantation response status.

  14. Investigation of selected outcomes of the Dynamic Physics learning environment: Understanding of mechanics concepts and achievement by male and female students

    Science.gov (United States)

    Mackin, Joan E.

    The study investigated the Dynamic Physics learning environment to determine its effectiveness in promoting understanding of mechanics concepts and achievement as well as the differences between male and female students in understanding of physics concepts and progress in the course. The Dynamic Physics learning environment was chosen for research since it offered an opportunity to study an introductory calculus based physics that incorporated recommendations, goals, and strategies for effective learning outlined in recent reports on physics education. Data were collected using pretests and posttests, course assessments, surveys, students' evaluations, and midterm feedback interviews. The data from the pretest, posttest, and course assessments were analyzed using a difference of means t test (pphysics education studies. Analysis of interviews and evaluations of the course indicated students perceived they were understanding physics concepts in this learning environment and realized this understanding was important background for future courses. Students suggested that connections to real world applications, the format of the course, and collaborative learning were factors that helped them to understand physics concepts by making them more meaningful. Students' responses suggested that teaching strategies used in the course not only helped them to develop understanding, but confidence in their ability to learn physic. The sample of female students had significantly lower average scores in the pretest and posttest compared to male students; however, the sample of female students made the same or higher average gains in conceptual understanding when compared to the male students. Additional findings included that groups with one or more female member earned higher averages in group assessments than all male groups. Female students' perceptions of physics changed during the course; female students indicated an increase in relating personal experiences and real world

  15. Fulfilling Schmidt Ocean Institute's commitment to open sharing of information, data, and research outcomes: Successes and Lessons Learned from Proposal Evaluation to Public Repositories to Lasting Achievements

    Science.gov (United States)

    Miller, A.; Zykov, V.

    2016-02-01

    Schmidt Ocean Institute's vision is that the world's ocean be understood through technological advancement, intelligent observation, and open sharing of information. As such, making data collected aboard R/V Falkor available to the general public is a key pillar of the organization and a major strategic focus. Schmidt Ocean Institute supports open sharing of information about the ocean to stimulate the growth of its applications and user community, and amplify further exploration, discovery, and deeper understanding of our environment. These efforts are supported through partnerships with data management experts in the oceanographic community to enable standards-compliant sharing of scientific information and data collected during research cruises. To properly fulfill the commitment, proponents' data management plans are evaluated as part of the proposal process when applying for ship time. We request a thorough data management plan be submitted and expert reviewers evaluate the proposal's plan as part of the review process. Once a project is successfully selected, the chief scientist signs an agreement stating delivery dates for post-cruise data deliverables in a timely manner, R/V Falkor underway and meterological data is shared via public repositories, and links and reports are posted on the cruise webpage. This allows many more creative minds and thinkers to analyze, process, and study the data collected in the world ocean rather than privileging one scientist with the proprietary information, driving international and national scientific progress. This presentation will include the Institute's mission, vision, and strategy for sharing data, based on our Founders' passions, the process for evaluating proposed data management plans, and our partnering efforts to make data publically available in fulfillment of our commitment. Recent achievements and successes in data sharing, as well as future plans to improve our efforts will also be discussed.

  16. Equilibrium properties of proximity effect

    Energy Technology Data Exchange (ETDEWEB)

    Esteve, D.; Pothier, H.; Gueron, S.; Birge, N.O.; Devoret, M.

    1996-12-31

    The proximity effect in diffusive normal-superconducting (NS) nano-structures is described by the Usadel equations for the electron pair correlations. We show that these equations obey a variational principle with a potential which generalizes the Ginzburg-Landau energy functional. We discuss simple examples of NS circuits using this formalism. In order to test the theoretical predictions of the Usadel equations, we have measured the density of states as a function of energy on a long N wire in contact with a S wire at one end, at different distances from the NS interface. (authors). 12 refs.

  17. PRECON TOURED PLATE OSTEOSYNTHESIS IN PROXIMAL HUMERUS FRACTURES IN ADULTS

    Directory of Open Access Journals (Sweden)

    Arunim

    2016-02-01

    Full Text Available AIM To evaluate the reliability and safety, functional outcome & complication associated with proximal humerus locking plate in treatment of proximal humerus fracture in adult and old age patient. MATERIAL AND METHODS The present study evaluates the functional outcome of 40 patients with displaced proximal humerus fracture managed with proximal humerus locking plate via deltopectoral approach in a prospective manner. All male or female patients between 18- 60 years of age, with proximal humerus fractures and duration of injury less than 2 weeks, between May 2011 to May 2015 were evaluated. Patients were called for regular follow up for evaluation on the basis of constant shoulder Score (CSS with the parameters of pain, range of motion and strength of limb. RESULTS The age of all patients ranged from 25-69 yrs. with mean (±SD 49.70±12.16 yrs. Most of the patients were above 45 yrs. of age (65.0% and mostly males (60.0%. There were 18 patients with Neer classification part 2, 18 with part 3 and 4 were with part 4. The union time for all patients ranged from 8-12 wks. with mean (±SD 10.40±1.23 wks. Similarly, the duration of surgery of all patients ranged from 70-140 min with mean (± SD 100.00 ± 20.84 min. No wound infections, vascular injuries, avascular necrosis, or loss of fixation ensued. Two patients with axillary nerve palsy recovered spontaneously within 3 months. 28 patients did not have treatment related complications (70.0%. However, 12 patients have treatment related complication (30.0% with 5.0% screw perforation and 15.0% shoulder stiffness and 10 % varus mal-reduction. However, based on constant shoulder Score (CSS, at final evaluation, the functional outcome (i.e. efficacy of the treatment of most of the patients were found to be excellent (70.0%, good (15.0%, poor (10.0% and fair the least (5.0%. CONCLUSION Proximal humerus locking plate is a good modality for treatment of Neer type 2 and 3 displaced proximal humerus fractures

  18. Clavicula pro humero reconstruction after wide resection of the proximal humerus.

    Science.gov (United States)

    Tsukushi, Satoshi; Nishida, Yoshihiro; Takahashi, Mitsuru; Ishiguro, Naoki

    2006-06-01

    The optimal reconstruction procedure after resection of proximal humeral bone tumors is controversial. We performed clavicula pro humero reconstruction in seven consecutive patients after wide resection of malignant proximal humerus tumors to determine the functional outcomes and to clarify whether this procedure could reduce the occurrence of complications. The histologic diagnoses were conventional osteosarcoma in four patients, chondrosarcoma in two, and parosteal osteosarcoma in one. Postoperative function was assessed with the Musculoskeletal Tumor Society upper extremities scale and an evaluation chart for activities of daily living. The mean Musculoskeletal Tumor Society score was 69%. Stable results were obtained regardless of the extent of the resection, and the results as a flail shoulder were satisfactory. The mean daily activity rating was approximately 80%. The activities of daily living functional rating was better (92%) when the nondominant hand was affected compared with the dominant hand (69%). Bony union was achieved in all seven patients. We observed no instances of infection, fracture, or nonunion. The clavicula pro humero reconstruction is a useful procedure that could reduce the occurrence of complications, especially in young patients and in patients with involvement of the nondominant arm.

  19. Rehabilitation after proximal femur surgery in the elderly

    OpenAIRE

    Holečková, Kristýna

    2017-01-01

    of thesis This thesis deals with physiotherapy after proximal femur surgery in elderly people. The aim of the thesis is to show the particularities of physiotherapy for elderly people and to determine the influence of nutritional status on the progress and outcome of physiotherapy. The thesis is divided into theoretical and practical part. The theoretical part is focused on old age period, and changes associated with aging, geriatric physiotherapy and its components, namely classical physioth...

  20. Semiconductor detectors with proximity signal readout

    International Nuclear Information System (INIS)

    Asztalos, Stephen J.

    2012-01-01

    Semiconductor-based radiation detectors are routinely used for the detection, imaging, and spectroscopy of x-rays, gamma rays, and charged particles for applications in the areas of nuclear and medical physics, astrophysics, environmental remediation, nuclear nonproliferation, and homeland security. Detectors used for imaging and particle tracking are more complex in that they typically must also measure the location of the radiation interaction in addition to the deposited energy. In such detectors, the position measurement is often achieved by dividing or segmenting the electrodes into many strips or pixels and then reading out the signals from all of the electrode segments. Fine electrode segmentation is problematic for many of the standard semiconductor detector technologies. Clearly there is a need for a semiconductor-based radiation detector technology that can achieve fine position resolution while maintaining the excellent energy resolution intrinsic to semiconductor detectors, can be fabricated through simple processes, does not require complex electrical interconnections to the detector, and can reduce the number of required channels of readout electronics. Proximity electrode signal readout (PESR), in which the electrodes are not in physical contact with the detector surface, satisfies this need

  1. Digital camera resolution and proximal caries detection.

    Science.gov (United States)

    Prapayasatok, S; Janhom, A; Verochana, K; Pramojanee, S

    2006-07-01

    To evaluate the diagnostic accuracy of proximal caries detection from digitized film images captured by a digital camera at different resolution settings. Twenty-five periapical radiographs of 50 premolar and 25 molar teeth were photographed using a digital camera, Sony Cyber-shot, DSC-S75 at three different resolution settings: 640 x 480, 1280 x 960 and 1600 x 1200. Seventy-five digital images were transferred to a computer, saved and opened using ACDSee software. In addition, a PowerPoint slide was made from each digital image. Five observers scored three groups of images (the films, the displayed 1:1 digital images on the ACDSee software, and the PowerPoint slides) for the existence of proximal caries using a 5-point confidence scale, and the depth of caries on a 4-point scale. Ground sections of the teeth were used as the gold standard. Az values under the receiver operating characteristic (ROC) curve of each group of images and at different resolutions were compared using the Friedman and Wilcoxon signed rank tests. Mean different values between the lesions' depth interpreted by the observers and that of the gold standard were analysed. Films showed the highest Az values. Only the 1280 x 960 images on the ACDSee software showed no significant difference of the Az value from the films (P=0.28). The digital images from three resolution settings on the PowerPoint slides showed no significant differences, either among each other or between them and the films. For caries depth, the 1280 x 960 images showed lower values of mean difference in enamel lesions compared with the other two resolution groups. This study showed that in order to digitize conventional films, it was not necessary to use the highest camera resolution setting to achieve high diagnostic accuracy for proximal caries detection. The 1280 x 960 resolution setting of the digital camera demonstrated comparable diagnostic accuracy with film and was adequate for digitizing radiographs for caries

  2. Chemokines in tumor proximal fluids.

    Science.gov (United States)

    Kotyza, Jaromir

    2017-03-01

    Chemokines are chemotactic cytokines produced by leukocytes and other types of cells including tumor cells. Their action is determined by the expression of cognate receptors and subsequent signaling in target cells, followed by the modulation of cytoskeletal proteins and the induction of other responses. In tumors, chemokines produced by neoplastic/stroma cells control the leukocyte infiltrate influencing tumor growth and progression. Tumor cells also express functional chemokine receptors responding to chemokine signals, promoting cell survival, proliferation and metastasis formation. Chemokines may be detected in serum of cancer patients, but due to the paracrine nature of these molecules, more significant concentrations are found in the tumor adjacent, non-vascular fluids, collectively called tumor proximal fluids. This review summarizes the expression of CC and CXC chemokines in these fluids, namely in interstitial fluid, pleural, ascitic, and cyst fluids, but also in urine, saliva, cerebrospinal fluid, cervical secretions and bronchoalveolar lavage fluid. Most comparative clinical studies reveal increased chemokine levels in high-grade tumor proximal fluids rather than in low-grade tumors and benign conditions, indicating shorter survival periods. The data confirm peritumoral fluid chemokines as sensitive diagnostic and prognostic markers, as well as offer support for chemokines and their receptors as potential targets for antitumor therapy.

  3. Protein Neighbors and Proximity Proteomics*

    Science.gov (United States)

    Rees, Johanna S.; Li, Xue-Wen; Perrett, Sarah; Lilley, Kathryn S.; Jackson, Antony P.

    2015-01-01

    Within cells, proteins can co-assemble into functionally integrated and spatially restricted multicomponent complexes. Often, the affinities between individual proteins are relatively weak, and proteins within such clusters may interact only indirectly with many of their other protein neighbors. This makes proteomic characterization difficult using methods such as immunoprecipitation or cross-linking. Recently, several groups have described the use of enzyme-catalyzed proximity labeling reagents that covalently tag the neighbors of a targeted protein with a small molecule such as fluorescein or biotin. The modified proteins can then be isolated by standard pulldown methods and identified by mass spectrometry. Here we will describe the techniques as well as their similarities and differences. We discuss their applications both to study protein assemblies and to provide a new way for characterizing organelle proteomes. We stress the importance of proteomic quantitation and independent target validation in such experiments. Furthermore, we suggest that there are biophysical and cell-biological principles that dictate the appropriateness of enzyme-catalyzed proximity labeling methods to address particular biological questions of interest. PMID:26355100

  4. Modular endoprosthetic replacement for metastatic tumours of the proximal femur

    Directory of Open Access Journals (Sweden)

    Carter Simon R

    2008-11-01

    Full Text Available Abstract Background and aims Endoprosthetic replacements of the proximal femur are commonly required to treat destructive metastases with either impending or actual pathological fractures at this site. Modular prostheses provide an off the shelf availability and can be adapted to most reconstructive situations for proximal femoral replacements. The aim of this study was to assess the clinical and functional outcomes following modular tumour prosthesis reconstruction of the proximal femur in 100 consecutive patients with metastatic tumours and to compare them with the published results of patients with modular and custom made endoprosthetic replacements. Methods 100 consecutive patients who underwent modular tumour prosthetic reconstruction of the proximal femur for metastases using the METS system from 2001 to 2007 were studied. The patient, tumour and treatment factors in relation to overall survival, local control, implant survival and complications were analysed. Functional scores were obtained from surviving patients. Results and conclusion There were 45 male and 55 female patients. The mean age was 60.2 years. The indications were metastases. Seventy five patients presented with pathological fracture or with failed fixation and 25 patients were at a high risk of developing a fracture. The mean follow up was 15.9 months [range 0–77]. Three patients died within 2 weeks following surgery. 69 patients have died and 31 are alive. Of the 69 patients who were dead 68 did not need revision surgery indicating that the implant provided single definitive treatment which outlived the patient. There were three dislocations (2/5 with THR and 1/95 with unipolar femoral heads. 6 patients had deep infections. The estimated five year implant survival (Kaplan-Meier analysis was 83.1% with revision as end point. The mean TESS score was 64% (54%–82%. We conclude that METS modular tumour prosthesis for proximal femur provides versatility; low implant related

  5. Achieving Kaiser Permanente quality.

    Science.gov (United States)

    McHugh, Matthew D; Aiken, Linda H; Eckenhoff, Myra E; Burns, Lawton R

    2016-01-01

    The Kaiser Permanente model of integrated health delivery is highly regarded for high-quality and efficient health care. Efforts to reproduce Kaiser's success have mostly failed. One factor that has received little attention and that could explain Kaiser's advantage is its commitment to and investment in nursing as a key component of organizational culture and patient-centered care. The aim of this study was to investigate the role of Kaiser's nursing organization in promoting quality of care. This was a cross-sectional analysis of linked secondary data from multiple sources, including a detailed survey of nurses, for 564 adult, general acute care hospitals from California, Florida, Pennsylvania, and New Jersey in 2006-2007. We used logistic regression models to examine whether patient (mortality and failure-to-rescue) and nurse (burnout, job satisfaction, and intent-to-leave) outcomes in Kaiser hospitals were better than in non-Kaiser hospitals. We then assessed whether differences in nursing explained outcomes differences between Kaiser and other hospitals. Finally, we examined whether Kaiser hospitals compared favorably with hospitals known for having excellent nurse work environments-Magnet hospitals. Patient and nurse outcomes in Kaiser hospitals were significantly better compared with non-Magnet hospitals. Kaiser hospitals had significantly better nurse work environments, staffing levels, and more nurses with bachelor's degrees. Differences in nursing explained a significant proportion of the Kaiser outcomes advantage. Kaiser hospital outcomes were comparable with Magnet hospitals, where better outcomes have been largely explained by differences in nursing. An important element in Kaiser's success is its investment in professional nursing, which may not be evident to systems seeking to achieve Kaiser's advantage. Our results suggest that a possible strategy for achieving outcomes like Kaiser may be for hospitals to consider Magnet designation, a proven and

  6. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2016-01-01

    competitive, national customs and regional economic organizations are seeking to establish a standardized solution for digital reporting of customs data. However, standardization has proven hard to achieve in the socio-technical e-Customs solution. In this chapter, the authors identify and describe what has......International e-Customs is going through a standardization process. Driven by the need to increase control in the trade process to address security challenges stemming from threats of terrorists, diseases, and counterfeit products, and to lower the administrative burdens on traders to stay...... to be harmonized in order for a global company to perceive e-Customs as standardized. In doing so, they contribute an explanation of the challenges associated with using a standardization mechanism for harmonizing socio-technical information systems....

  7. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2014-01-01

    competitive, national customs and regional economic organizations are seeking to establish a standardized solution for digital reporting of customs data. However, standardization has proven hard to achieve in the socio-technical e-Customs solution. In this chapter, the authors identify and describe what has......International e-Customs is going through a standardization process. Driven by the need to increase control in the trade process to address security challenges stemming from threats of terrorists, diseases, and counterfeit products, and to lower the administrative burdens on traders to stay...... to be harmonized in order for a global company to perceive e-Customs as standardized. In doing so, they contribute an explanation of the challenges associated with using a standardization mechanism for harmonizing socio-technical information systems....

  8. Realities of proximity facility siting

    International Nuclear Information System (INIS)

    DeMott, D.L.

    1981-01-01

    Numerous commercial nuclear power plant sites have 2 to 3 reactors located together, and a group of Facilities with capabilities for fuel fabrication, a nuclear reactor, a storage area for spent fuel, and a maintenance area for contaminated equipment and radioactive waste storage are being designed and constructed in the US. The proximity of these facilities to each other provides that the ordinary flow of materials remain within a limited area. Interactions between the various facilities include shared resources such as communication, fire protection, security, medical services, transportation, water, electrical, personnel, emergency planning, transport of hazardous material between facilities, and common safety and radiological requirements between facilities. This paper will explore the advantages and disadvantages of multiple facilities at one site. Problem areas are identified, and recommendations for planning and coordination are discussed

  9. Radial shortening following a fracture of the proximal radius.

    Science.gov (United States)

    Duckworth, Andrew D; Watson, Bruce S; Will, Elizabeth M; Petrisor, Brad A; Walmsley, Phillip J; Court-Brown, Charles M; McQueen, Margaret M

    2011-06-01

    The Essex-Lopresti lesion is thought to be rare, with a varying degree of disruption to forearm stability probable. We describe the range of radial shortening that occurs following a fracture of the proximal radius, as well as the short-term outcome in these patients. Over an 18-month period, we prospectively assessed all patients with a radiographically confirmed proximal radial fracture. Patients noted to have ipsilateral wrist pain at initial presentation underwent bilateral radiography to determine whether there was disruption of the distal radio-ulnar joint suggestive of an Essex-Lopresti lesion. Outcome was assessed after a mean of 6 (1.5-12) months using clinical and radiographic results, including the Mayo elbow score (MES) and the short musculoskeletal function assessment (SMFA) questionnaire. One patient with a Mason type-I fracture was lost to follow-up after initial presentation. 60 patients had ipsilateral wrist pain at the initial assessment of 237 proximal radial fractures. Radial shortening of ≥ 2mm (range: 2-4mm) was seen in 22 patients (mean age 48 (19-79) years, 16 females). The most frequent mechanism of injury was a fall from standing height (10/22). 21 fractures were classified as being Mason type-I or type-II, all of which were managed nonoperatively. One Mason type-III fracture underwent acute radial head replacement. Functional outcome was assessed in 21 patients. We found an excellent or good MES in 18 of the 20 patients with a Mason type-I or type-II injury. The incidence of the Essex-Lopresti lesion type is possibly under-reported as there is a spectrum of injuries, and subtle disruptions often go unidentified. A full assessment of all patients with a proximal radial fracture is required in order to identify these injuries, and the index of suspicion is raised as the complexity of the fracture increases.

  10. outcome of plate osteosynthesis in the management of proximal

    African Journals Online (AJOL)

    a fall while in the younger patients it is associated with vehicular accidents or sporting activity. Osteoporosis predisposes the elderly to this fragility fracture. Osteoporosis ... There is need for arthroplasty in those with severe injury, particularly those with osteoporosis. Original .... increase was noted after menopause (16).

  11. Chemically induced proximity in biology and medicine.

    Science.gov (United States)

    Stanton, Benjamin Z; Chory, Emma J; Crabtree, Gerald R

    2018-03-09

    Proximity, or the physical closeness of molecules, is a pervasive regulatory mechanism in biology. For example, most posttranslational modifications such as phosphorylation, methylation, and acetylation promote proximity of molecules to play deterministic roles in cellular processes. To understand the role of proximity in biologic mechanisms, chemical inducers of proximity (CIPs) were developed to synthetically model biologically regulated recruitment. Chemically induced proximity allows for precise temporal control of transcription, signaling cascades, chromatin regulation, protein folding, localization, and degradation, as well as a host of other biologic processes. A systematic analysis of CIPs in basic research, coupled with recent technological advances utilizing CRISPR, distinguishes roles of causality from coincidence and allows for mathematical modeling in synthetic biology. Recently, induced proximity has provided new avenues of gene therapy and emerging advances in cancer treatment. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

  12. Dislocation of the proximal tibiofibular joint

    OpenAIRE

    Milankov Miroslav; Kecojević Vaso; Gvozdenović Nemanja; Obradović Mirko

    2013-01-01

    Introduction. Dislocation of the proximal tibiofibular joint is a rare injury. It occurs during a sports activity that includes rough twisting movements of the bent knee. The role of the proximal tibiofibular joint is to reduce torsional loads to the ankle, to distribute the bending moment of the outer side of tibia, and transfer the vertical load while standing. In the literature there is no larger series; only several cases of the proximal tibiofibular joint dislocation treated by dif...

  13. Dermal Fillers: Tips to Achieve Successful Outcomes

    OpenAIRE

    Vedamurthy, Maya; Vedamurthy, Amar

    2008-01-01

    Fillers have become a common aesthetic treatment for several cosmetic problems. Several types of fillers are available from different sources and of different longevities. It is important that the treating physician be aware of the different techniques of administration and their possible side effects. This article reviews the available literature on the subject.

  14. Proximate composition and antinutrient content of pumpkin ...

    African Journals Online (AJOL)

    Proximate composition and antinutrient content of pumpkin ( Cucurbita pepo ) and sorghum ( Sorghum bicolor ) flour blends fermented with Lactobacillus plantarum , Aspergillus niger and Bacillus subtilis.

  15. Multiple intramedullary nailing of proximal phalangeal fractures of hand

    Directory of Open Access Journals (Sweden)

    Patankar Hemant

    2008-01-01

    Full Text Available Background: Proximal phalangeal fractures are commonly encountered fractures in the hand. Majority of them are stable and can be treated by non-operative means. However, unstable fractures i.e. those with shortening, displacement, angulation, rotational deformity or segmental fractures need surgical intervention. This prospective study was undertaken to evaluate the functional outcome after surgical stabilization of these fractures with joint-sparing multiple intramedullary nailing technique. Materials and Methods: Thirty-five patients with 35 isolated unstable proximal phalangeal shaft fractures of hand were managed by surgical stabilization with multiple intramedullary nailing technique. Fractures of the thumb were excluded. All the patients were followed up for a minimum of six months. They were assessed radiologically and clinically. The clinical evaluation was based on two criteria. 1. total active range of motion for digital functional assessment as suggested by the American Society for Surgery of Hand and 2. grip strength. Results: All the patients showed radiological union at six weeks. The overall results were excellent in all the patients. Adventitious bursitis was observed at the point of insertion of nails in one patient. Conclusion: Joint-sparing multiple intramedullary nailing of unstable proximal phalangeal fractures of hand provides satisfactory results with good functional outcome and fewer complications.

  16. Imaging of rectus femoris proximal tendinopathies

    Energy Technology Data Exchange (ETDEWEB)

    Pesquer, Lionel; Poussange, Nicolas; Meyer, Philippe; Dallaudiere, Benjamin; Feldis, Matthieu [Clinique du Sport de Bordeaux, Centre d' Imagerie Osteo-articulaire, Merignac (France); Sonnery-Cottet, Bertrand [Groupe Ramsay Generale de Sante - Hopital Prive Jean Mermoz, Centre Orthopedique Santy, Lyon (France); Graveleau, Nicolas [Clinique du Sport de Bordeaux, Centre de Chirurgie Orthopedique et Sportive, Merignac (France)

    2016-07-15

    The rectus femoris is the most commonly injured muscle of the anterior thigh among athletes, especially soccer players. Although the injury pattern of the muscle belly is well documented, less is known about the anatomy and specific lesions of the proximal tendons. For each head, three distinctive patterns may be encountered according to the location of the injury, which can be at the enthesis, within the tendon, or at the musculotendinous junction. In children, injuries correspond most commonly to avulsion of the anteroinferior iliac spine from the direct head and can lead to subspine impingement. Calcific tendinitis and traumatic tears may be encountered in adults. Recent studies have shown that traumatic injuries of the indirect head may be underdiagnosed and that injuries of both heads may have a surgical issue. Finally, in the case of tears, functional outcome and treatment may vary if the rupture involves one or both tendons and if the tear is partial or complete. Thus, it is mandatory for the radiologist to know the different ultrasound and magnetic resonance imaging (MRI) patterns of these lesions in order to provide accurate diagnosis and treatment. The purpose of this article is to recall the anatomy of the two heads of rectus femoris, describe a reliable method of assessment with ultrasound and MRI and know the main injury patterns, through our own experience and literature review. (orig.)

  17. Imaging of rectus femoris proximal tendinopathies

    International Nuclear Information System (INIS)

    Pesquer, Lionel; Poussange, Nicolas; Meyer, Philippe; Dallaudiere, Benjamin; Feldis, Matthieu; Sonnery-Cottet, Bertrand; Graveleau, Nicolas

    2016-01-01

    The rectus femoris is the most commonly injured muscle of the anterior thigh among athletes, especially soccer players. Although the injury pattern of the muscle belly is well documented, less is known about the anatomy and specific lesions of the proximal tendons. For each head, three distinctive patterns may be encountered according to the location of the injury, which can be at the enthesis, within the tendon, or at the musculotendinous junction. In children, injuries correspond most commonly to avulsion of the anteroinferior iliac spine from the direct head and can lead to subspine impingement. Calcific tendinitis and traumatic tears may be encountered in adults. Recent studies have shown that traumatic injuries of the indirect head may be underdiagnosed and that injuries of both heads may have a surgical issue. Finally, in the case of tears, functional outcome and treatment may vary if the rupture involves one or both tendons and if the tear is partial or complete. Thus, it is mandatory for the radiologist to know the different ultrasound and magnetic resonance imaging (MRI) patterns of these lesions in order to provide accurate diagnosis and treatment. The purpose of this article is to recall the anatomy of the two heads of rectus femoris, describe a reliable method of assessment with ultrasound and MRI and know the main injury patterns, through our own experience and literature review. (orig.)

  18. Superior Biochemical Recurrence and Long-term Quality-of-life Outcomes Are Achievable with Robotic Radical Prostatectomy After a Long Learning Curve-Updated Analysis of a Prospective Single-surgeon Cohort of 2206 Consecutive Cases.

    Science.gov (United States)

    Thompson, James E; Egger, Sam; Böhm, Maret; Siriwardana, Amila R; Haynes, Anne-Maree; Matthews, Jayne; Scheltema, Matthijs J; Stricker, Phillip D

    2017-12-19

    Our earlier analysis suggested that robot-assisted radical prostatectomy (RARP) achieved superiority over open radical prostatectomy (ORP) in terms of positive surgical margin (PSM) rates and functional outcomes. With larger sample size and longer follow-up, the objective of this study update is to assess whether our previous findings are upheld and whether the improved PSM rates for RARP after an initial learning curve compared with ORP-as observed in our earlier analysis-ultimately resulted in improved biochemical control. Prospective observational study comparing two surgical techniques; 2271 consecutive men underwent RARP (1520) or ORP (751) at a single centre from 2006 to 2016. Demographic and clinicopathological data were prospectively collected. The EPIC-QOL questionnaire was administered at baseline and 1.5, 3, 6, 12, and 24 mo. Multivariate linear regression modelled the difference in quality of life (QOL) domains against case number; logistic and Cox regression modelled the differences in PSM and biochemical recurrence (BCR) hazard ratios (HR), respectively. A total of 2206 men were included in BCR/PSM analysis and 1045 consented for QOL analysis. Superior pT2 surgical margins, early and late sexual outcomes, and early urinary outcomes were upheld and became more robust (narrowing of 95% confidence intervals [CIs]). The risk of BCR was initially higher for RARP, improved after 191 RARPs, and was 35% lower (hazard ratio [HR] 0.65, 95% CI 0.47-0.90) at final RARP, plateauing after 226 RARPs. Improved late (12-24 mo) urinary bother scores (adjusted mean difference [AMD]=4.7, 95% CI 1.3-8.0) and irritative-obstructive scores (AMD=3.8, 95% CI 0.9-5.6) at final RARP were demonstrated. Limitations include observational single surgeon data, possible residual confounding, and short follow-up. The results from this updated analysis demonstrate that RARP can be beneficial for patients of high-volume surgeons, although more randomised studies and studies with

  19. From Headline to Hard Grind: The Importance of Understanding Public Administration in Achieving Health OutcomesComment on "Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities".

    Science.gov (United States)

    O'Flynn, Janine

    2016-04-30

    Many public policy programs fail to translate ambitious headlines to on-the-ground action. The reasons for this are many and varied, but for public administration and management scholars a large part of the gap between ambition and achievement is the challenge associated with the operation of the machinery of government itself, and how it relates to the other parties that it relies on to fulfill these outcomes. In their article, Carey and Friel set out key reasons why public health scholars should seek to better understand important ideas in public administration. In commenting on their contribution, I draw out two critical questions that are raised by this discussion: (i) what are boundaries and what forms do they take? and (ii) why work across boundaries? Expanding on these key questions extends the points made by Carey and Friel on the importance of understanding public administration and will better place public health scholars and practitioners to realise health outcomes. © 2016 by Kerman University of Medical Sciences.

  20. Surgical treatment of proximal humerus fractures using PHILOS plate

    Directory of Open Access Journals (Sweden)

    Vijay Sharma

    2014-10-01

    Full Text Available 【Abstract】Objective: To evaluate functional outcome and complications of open reduction and internal fixation with proximal humeral internal locking system (PHILOS plate for proximal humerus fractures. Methods: We reviewed 51 patients who underwent open reduction and internal fixation with PHILOS plate between the years 2007 to 2012. There were 35 men and 16 women with a mean age of 38 years (range 24-68. There were 41 patients in the age group of <60 years and 10 patients in the age group of >60 years. According to Neer classification system, 8, 15 and 23 patients had 2-part, 3-part, and 4-part fractures, respectively and 5 patients had 4-part fracture dislocation. All surgeries were carried out at our tertiary care trauma centre. Functional evaluation of the shoulder at final follow-up was done using Constant-Murley score. Results: The mean follow-up period was 30 months (range 12-44 months. Two patients were lost to followup. Of the remaining 49 patients, all fractures were united clinically and radiologically. The mean time for radiological union was 12 weeks (range 8-20 weeks. At the final follow-up the mean Constant-Murley score was 79 (range 50-100. The results were excellent in 25 patients, good in 13 patients, fair in 6 atients and poor in 5 patients. During the follow-up, four cases of varus malunion, one case of subacromial impingement, one case of deep infection, one case of intraarticular screw penetration and one case of failure of fi xation were noted. No cases of avascular necrosis, hardware failure, locking screw loosening or nonunion were noted. Conclusion: PHILOS provides stable fixation in proximal humerus fractures. To prevent potential complications like avascular necrosis, meticulous surgical dissection to preserve vascularity of humeral head is necessary. Key words: Proximal humerus fracture; Fracture fixation, internal; Proximal humeral internal locking system

  1. Monomelic amyotrophy with proximal upper limb involvement: a case report.

    Science.gov (United States)

    Al-Ghawi, Eman; Al-Harbi, Talal; Al-Sarawi, Adnan; Binfalah, Mohamed

    2016-03-17

    Monomelic amyotrophy is an uncommon, benign, unilateral disorder of the lower motor neurons, affecting predominantly the hand and forearm muscles. Proximal involvement of the arm and shoulder muscles is an unusual presentation that has been rarely reported in the literature. A 28-year-old white man presented with insidious-onset, slowly progressive, unilateral weakness and atrophy of his left shoulder girdle and deltoid muscles. A neurological examination revealed weakness and atrophy in his left deltoid, infraspinatus and supraspinatus muscles. Electromyography demonstrated an active and chronic neurogenic pattern affecting his left C5 and C6 myotomes; magnetic resonance imaging of his cervical spine was normal. He did well with conservative treatment. Upper limb proximal form of monomelic amyotrophy is a rare clinical entity with a wide differential diagnosis. Physicians, especially neurologists, should be familiar with this benign condition to avoid inappropriately labeling patients as having amyotrophic lateral sclerosis and other disorders with less favorable outcomes.

  2. Range gated strip proximity sensor

    Science.gov (United States)

    McEwan, T.E.

    1996-12-03

    A range gated strip proximity sensor uses one set of sensor electronics and a distributed antenna or strip which extends along the perimeter to be sensed. A micro-power RF transmitter is coupled to the first end of the strip and transmits a sequence of RF pulses on the strip to produce a sensor field along the strip. A receiver is coupled to the second end of the strip, and generates a field reference signal in response to the sequence of pulse on the line combined with received electromagnetic energy from reflections in the field. The sensor signals comprise pulses of radio frequency signals having a duration of less than 10 nanoseconds, and a pulse repetition rate on the order of 1 to 10 MegaHertz or less. The duration of the radio frequency pulses is adjusted to control the range of the sensor. An RF detector feeds a filter capacitor in response to received pulses on the strip line to produce a field reference signal representing the average amplitude of the received pulses. When a received pulse is mixed with a received echo, the mixing causes a fluctuation in the amplitude of the field reference signal, providing a range-limited Doppler type signature of a field disturbance. 6 figs.

  3. Transverse and Longitudinal proximity effect

    Science.gov (United States)

    Jalan, Pryianka; Chand, Hum; Srianand, Raghunathan

    2018-04-01

    With close pairs (˜1.5arcmin) of quasars (QSOs), absorption in the spectra of a background quasar in the vicinity of a foreground quasar can be used to study the environment of the latter quasar at kpc-Mpc scales. For this we used a sample of 205 quasar pairs from the Sloan Digital Sky-Survey Data Release 12 (SDSS DR12) in the redshift range of 2.5 to 3.5 by studying their H I Ly-α absorption. We study the environment of QSOs both in the longitudinal as well as in the transverse direction by carrying out a statistical comparison of the Ly-α absorption lines in the quasar vicinity to that of the absorption lines caused by the inter-galactic medium (IGM). This comparison was done with IGM, matched in absorption redshift and signal-to-noise ratio (SNR) to that of the proximity region. In contrast to the measurements along the line-of-sight, the regions transverse to the quasars exhibit enhanced H I Ly-α absorption. This discrepancy can either be interpreted as due to an anisotropic emission from the quasars or as a consequence of their finite lifetime.

  4. Grouping by proximity in haptic contour detection.

    Science.gov (United States)

    Overvliet, Krista E; Krampe, Ralf Th; Wagemans, Johan

    2013-01-01

    We investigated the applicability of the Gestalt principle of perceptual grouping by proximity in the haptic modality. To do so, we investigated the influence of element proximity on haptic contour detection. In the course of four sessions ten participants performed a haptic contour detection task in which they freely explored a haptic random dot display that contained a contour in 50% of the trials. A contour was defined by a higher density of elements (raised dots), relative to the background surface. Proximity of the contour elements as well as the average proximity of background elements was systematically varied. We hypothesized that if proximity of contour elements influences haptic contour detection, detection will be more likely when contour elements are in closer proximity. This should be irrespective of the ratio with the proximity of the background elements. Results showed indeed that the closer the contour elements were, the higher the detection rates. Moreover, this was the case independent of the contour/background ratio. We conclude that the Gestalt law of proximity applies to haptic contour detection.

  5. Preliminary phytochemical screening, proximate and elemental ...

    African Journals Online (AJOL)

    The seed powder of Moringa oleifera was analysed for its phytochemical, proximate and elemental composition using Folin-Denis spectrophotometric method, gravimetric method and energy dispersing X-ray fluorescence (EDXRF) transmission emission technique respectively. The seed powder had the following proximate ...

  6. [Proximal and distal rupture of the m. biceps brachii].

    Science.gov (United States)

    Lorbach, O; Kieb, M; Grim, C; Engelhardt, M

    2010-12-01

    Ruptures of the biceps tendon account for a high percentage of tendon ruptures. The aetiology of proximal ruptures of the long head of the biceps tendon is often degenerative and they are frequently associated with lesions of the rotator cuff. The clinical findings are often not specific and long lasting. Distal ruptures of the biceps tendon mostly occur during eccentric contraction of the biceps muscle.Clinical tests, the associated haematoma and a distalisation or proximalisation of the muscle belly in combination with ultrasound or MRI to rule out combined diseases lead to the diagnosis. The possible options include conservative and operative treatment. Tenotomy and tenodesis lead to comparable results in the literature. Therefore, conservative treatment is mostly recommended in proximal ruptures. Operative treatment is preferred in distal ruptures of the biceps tendon in order to achieve an anatomical reconstruction of the muscle function. Chronic ruptures of the distal biceps tendon can be successfully treated with free autografts or allografts.

  7. Hypospadias: Are we as good as we think when we correct proximal hypospadias?

    Science.gov (United States)

    Long, C J; Canning, D A

    2016-08-01

    Hypospadias surgery is a humbling art form. Although outcomes with distal hypospadias are favorable, recent publications have suggested that the complication rates are much higher than previously anticipated for proximal hypospadias. The present review examined the literature concerning proximal hypospadias, to explore some of the inadequacies and identify some of the reasons behind these shortfalls in the reported data. A systematic review of the published literature was conducted using keywords relevant to proximal hypospadias and long-term outcomes. The literature for hypospadias was reviewed, and outcomes for distal vs proximal variants were compared. The quality of the literature for proximal hypospadias was examined, and the shortcomings that led to underreporting of the surgical outcomes were identified. Special focus was on the lack of standardized documentation, the subsequent inability to objectify the severity of the phenotype, and the underestimation of complications due to lack of long-term follow-up. There was also a great deal of variability in the utilized techniques, and the literature was filled with small case series from single institutions. To enable scientific assessment of outcomes, it is proposed that the following be implemented: acceptance and incorporation of standardized phenotype assessment scores in the pre-operative period, objective intraoperative hypospadias characterization, and postoperative score assessment. Treatment of proximal hypospadias is much less successful than the distal variant. A specialty wide commitment to standardize the hypospadias language is required to make advancement in surgical outcomes. Boys need to be followed through puberty into adulthood, and honest reporting of outcomes must be discussed so that surgical techniques for this complicated disease process can be advanced. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  8. Proximity assays for sensitive quantification of proteins.

    Science.gov (United States)

    Greenwood, Christina; Ruff, David; Kirvell, Sara; Johnson, Gemma; Dhillon, Harvinder S; Bustin, Stephen A

    2015-06-01

    Proximity assays are immunohistochemical tools that utilise two or more DNA-tagged aptamers or antibodies binding in close proximity to the same protein or protein complex. Amplification by PCR or isothermal methods and hybridisation of a labelled probe to its DNA target generates a signal that enables sensitive and robust detection of proteins, protein modifications or protein-protein interactions. Assays can be carried out in homogeneous or solid phase formats and in situ assays can visualise single protein molecules or complexes with high spatial accuracy. These properties highlight the potential of proximity assays in research, diagnostic, pharmacological and many other applications that require sensitive, specific and accurate assessments of protein expression.

  9. Radiotherapy for Soft Tissue Sarcoma of the Proximal Lower Extremity

    Directory of Open Access Journals (Sweden)

    Brendan Prendergast

    2010-01-01

    Full Text Available Soft-tissue sarcoma (STS is a histopathologically diverse group of tumors accounting for approximately 10,000 new malignancies in the US each year. The proximal lower extremity is the most common site for STS, accounting for approximately one-third of all cases. Coordinated multimodality management in the form of surgery and radiation is often critical to local control, limb preservation, and functional outcome. Based on a review of currently available Medline literature and professional experience, this paper provides an overview of the treatment of STS of the lower extremity with a particular focus on the modern role of radiotherapy.

  10. A qualitative study of the activities and outcomes of domestic violence coordinating councils.

    Science.gov (United States)

    Allen, Nicole E; Watt, Kelly A; Hess, Jacob Z

    2008-03-01

    Efforts to promote systems change frequently involve the creation of councils, coalitions, and other collaborative settings. However, research, to date, reports limited empirical evidence that they achieve desired outcomes (Roussos and Fawcett, Annu Rev Public Health 21:369-402, 2000). The precise nature of this evidence base has received less attention. In particular, formal investigations into council effectiveness (a) rarely highlight the specific nature of collaborative efforts; (b) emphasize fairly distal markers as the "gold standard" for effectiveness; (c) focus largely on formative "outcomes" (e.g., action plan quality); and (d) utilize primarily quantitative research approaches. The current study extends previous research by employing a qualitative approach to investigate the particular activities and proximal outcomes of 41 domestic violence coordinating councils. Study findings suggest that councils engage in six primary activities: discussing issues, sharing information, identifying weaknesses in the system's response, providing training for key stakeholders, engaging in public/community education, and lobbying key stakeholders who are not council members. Three proximal outcomes were consistently identified in council efforts: the promotion of knowledge, relationships, and institutionalized change. Attending more directly to proximal outcomes and concrete activities in our research has important implications for conceptualizing and researching the effectiveness of councils and collaborative settings.

  11. Position Sensitive Proximity Charge Sensing Readout of HPGe Detectors

    Science.gov (United States)

    Priest, Anders Peterson

    Electrode segmentation is a necessity to achieve position sensitivity in semicon- ductor radiation detectors. Traditional segmentation requires decreasing electrode sizes while increasing channel numbers to achieve very fine position resolution. These electrodes can be complicated to fabricate, and many electrodes with individual electronic channels are required to instrument large detector areas. To simplify the fabrication process, we have moved the readout electrodes onto a printed circuit board that is positioned above the ionization type detection material. In this scheme, charge from radiation interactions will be shared amongst several electrodes, allowing for position interpolation. Because events can be reconstructed in between electrodes, fewer electrodes are needed to instrument large detector areas. The proximity charge sensing method of readout promises to simplify detector fabrication while maintaining the position resolution that is required by fields such as homeland security, astrophysics, environmental remediation, nuclear physics, and medical imaging. We performed scanning measurements on a proof of principle detector that we fabricated at Lawrence Berkeley National Laboratory (LBNL). These measurements showed that position resolution much finer than the strip pitch was achievable using the proximity charge readout method. We performed analytic calculations and Monte Carlo modeling to optimize the readout electrode geometry for a larger detector to test the limits of this technology. We achieved an average position resolution of 288 microm with eight proximity electrodes at a 5 mm pitch and 1 mm strip width, set 100 microm away from the detector surface by a Kapton spacer. To achieve this resolution using standard technologies, 300 microm pitch strips are necessary, and would require 100 channels to instrument the same area. Through our optimization calculations, we found that there is a trade-off between position resolution and energy resolution

  12. Reoperations following proximal interphalangeal joint nonconstrained arthroplasties.

    Science.gov (United States)

    Pritsch, Tamir; Rizzo, Marco

    2011-09-01

    To retrospectively analyze the reasons for reoperations following primary nonconstrained proximal interphalangeal (PIP) joint arthroplasty and review clinical outcomes in this group of patients with 1 or more reoperations. Between 2001 and 2009, 294 nonconstrained (203 pyrocarbon and 91 metal-plastic) PIP joint replacements were performed in our institution. A total of 76 fingers (59 patients) required reoperation (50 pyrocarbon and 26 metal-plastic). There were 40 women and 19 men with an average age of 51 years (range, 19-83 y). Primary diagnoses included osteoarthritis in 35, posttraumatic arthritis in 24, and inflammatory arthritis in 17 patients. There were 21 index, 27 middle, 18 ring, and 10 small fingers. The average number of reoperations per PIP joint was 1.6 (range, 1-4). A total of 45 joints had 1 reoperation, 19 had 2, 11 had 3, and 1 had 4. Extensor mechanism dysfunction was the most common reason for reoperation; it involved 51 of 76 fingers and was associated with Chamay or tendon-reflecting surgical approaches. Additional etiologies included component loosening in 17, collateral ligament failure in 10, and volar plate contracture in 8 cases. Inflammatory arthritis was associated with collateral ligament failure. Six fingers were eventually amputated, 9 had PIP joint arthrodeses, and 2 had resection arthroplasties. The arthrodesis and amputation rates correlated with the increased number of reoperations per finger. Clinically, most patients had no or mild pain at the most recent follow-up, and the PIP joint range-of-motion was not significantly different from preoperative values. Pain levels improved with longer follow-up. Reoperations following primary nonconstrained PIP joint arthroplasties are common. Extensor mechanism dysfunction was the most common reason for reoperation. The average reoperation rate was 1.6, and arthrodesis and amputation are associated with an increasing number of operations. Overall clinical outcomes demonstrated no

  13. Private and Flexible Proximity Detection in Mobile Social Networks

    DEFF Research Database (Denmark)

    Siksnys, Laurynas; Thomsen, Jeppe Rishede; Saltenis, Simonas

    2010-01-01

    A privacy-aware proximity detection service determines if two mobile users are close to each other without requiring them to disclose their exact locations. Existing proposals for such services provide weak privacy, give low accuracy guarantees, incur high communication costs, or lack flexibility......, in contrast to related work, can be of any shape and can be flexibly changed on the fly. Encryption and blind evaluation on the server ensures strong privacy, while low communication costs are achieved by an adaptive location-update policy. Experimental results show that the flexible functionality...

  14. Proximity and Collaboration in European Nanotechnology

    NARCIS (Netherlands)

    Cunningham, S.W.; Werker, C.

    2011-01-01

    Collaborations are particularly important for the development and deployment of technology. We analyze the influence of organizational, technological and geographical proximity on European nanotechnology collaborations with the help of a publication dataset and additional geographical information.

  15. The Life Saving Effects of Hospital Proximity

    DEFF Research Database (Denmark)

    Bertoli, Paola; Grembi, Veronica

    the exogenous variation in the proximity to cities that are allowed by law to have a hospital based on their population size. Our instrumental variable results, based on Italian municipalities data from 2000 to 2012, show that an increase by a standard deviation of distance to the nearest hospital (5 km......We assess the lifesaving effect of hospital proximity using data on fatality rates of road-traffic accidents. While most of the literature on this topic is based on changes in distance to the nearest hospital triggered by hospital closures and use OLS estimates, our identification comes from......) increases the fatality rate by 13.84% on the sample average. This is equal to a 0.92 additional death per every 100 accidents. We show that OLS estimates provide a downward biased measure of the real effect of hospital proximity because they do not fully solve spatial sorting problems. Proximity matters...

  16. Grouping by proximity in haptic contour detection

    OpenAIRE

    Overvliet, Krista; Krampe, Ralf; Wagemans, Johan

    2013-01-01

    We investigated the applicability of the Gestalt principle of perceptual grouping by proximity in the haptic modality. To do so, we investigated the influence of element proximity on haptic contour detection. In the course of four sessions ten participants performed a haptic contour detection task in which they freely explored a haptic random dot display that contained a contour in 50% of the trials. A contour was defined by a higher density of elements (raised dots), relative to the backgrou...

  17. Genetics Home Reference: proximal 18q deletion syndrome

    Science.gov (United States)

    ... Health Conditions Proximal 18q deletion syndrome Proximal 18q deletion syndrome Printable PDF Open All Close All Enable ... view the expand/collapse boxes. Description Proximal 18q deletion syndrome is a chromosomal condition that occurs when ...

  18. Proximity sensor system development. CRADA final report

    Energy Technology Data Exchange (ETDEWEB)

    Haley, D.C. [Oak Ridge National Lab., TN (United States); Pigoski, T.M. [Merrit Systems, Inc. (United States)

    1998-01-01

    Lockheed Martin Energy Research Corporation (LMERC) and Merritt Systems, Inc. (MSI) entered into a Cooperative Research and Development Agreement (CRADA) for the development and demonstration of a compact, modular proximity sensing system suitable for application to a wide class of manipulator systems operated in support of environmental restoration and waste management activities. In teleoperated modes, proximity sensing provides the manipulator operator continuous information regarding the proximity of the manipulator to objects in the workspace. In teleoperated and robotic modes, proximity sensing provides added safety through the implementation of active whole arm collision avoidance capabilities. Oak Ridge National Laboratory (ORNL), managed by LMERC for the United States Department of Energy (DOE), has developed an application specific integrated circuit (ASIC) design for the electronics required to support a modular whole arm proximity sensing system based on the use of capacitive sensors developed at Sandia National Laboratories. The use of ASIC technology greatly reduces the size of the electronics required to support the selected sensor types allowing deployment of many small sensor nodes over a large area of the manipulator surface to provide maximum sensor coverage. The ASIC design also provides a communication interface to support sensor commands from and sensor data transmission to a distributed processing system which allows modular implementation and operation of the sensor system. MSI is a commercial small business specializing in proximity sensing systems based upon infrared and acoustic sensors.

  19. Transformations through Proximity Flying: A Phenomenological Investigation

    Directory of Open Access Journals (Sweden)

    Maria Holmbom

    2017-10-01

    Full Text Available Participation in extreme sports has been linked to personal transformations in everyday life. Descriptions of lived experience resulting from transformative experiences are limited. Proximity flying, a relatively new discipline involving BASE jumping with a wingsuit where participants fly close to solid structures, is arguably one of the most extreme of extreme sports. The aim of this paper, part of a larger phenomenological study on the lived experience of proximity flying, is to explicate the ways in which participating in proximity flying influences the everyday lives of participants. Interpretative phenomenological analysis was used to explicate the lived experience of six proximity pilots. An analysis of interview transcripts revealed three significant themes describing the lived experience of participants. First, experiences of change were described as positive and skills developed through proximity flying were transferable into everyday life. Second, transformative experiences were considered fundamental to participants’ perspectives on life. Third, experience of transformation influenced their sense of personal identity and facilitated flourishing in other aspects of everyday life. Participants were clear that their experiences in proximity flying facilitated a profound process of transformation which manifest as changes in everyday capabilities and behaviors, values and sense of identity.

  20. Proximity sensor system development. CRADA final report

    International Nuclear Information System (INIS)

    Haley, D.C.; Pigoski, T.M.

    1998-01-01

    Lockheed Martin Energy Research Corporation (LMERC) and Merritt Systems, Inc. (MSI) entered into a Cooperative Research and Development Agreement (CRADA) for the development and demonstration of a compact, modular proximity sensing system suitable for application to a wide class of manipulator systems operated in support of environmental restoration and waste management activities. In teleoperated modes, proximity sensing provides the manipulator operator continuous information regarding the proximity of the manipulator to objects in the workspace. In teleoperated and robotic modes, proximity sensing provides added safety through the implementation of active whole arm collision avoidance capabilities. Oak Ridge National Laboratory (ORNL), managed by LMERC for the United States Department of Energy (DOE), has developed an application specific integrated circuit (ASIC) design for the electronics required to support a modular whole arm proximity sensing system based on the use of capacitive sensors developed at Sandia National Laboratories. The use of ASIC technology greatly reduces the size of the electronics required to support the selected sensor types allowing deployment of many small sensor nodes over a large area of the manipulator surface to provide maximum sensor coverage. The ASIC design also provides a communication interface to support sensor commands from and sensor data transmission to a distributed processing system which allows modular implementation and operation of the sensor system. MSI is a commercial small business specializing in proximity sensing systems based upon infrared and acoustic sensors

  1. The proximity effect around high redshift quasars

    International Nuclear Information System (INIS)

    Gallerani, Simona

    2011-01-01

    The term proximity effect refers to the relative lack of Lyα absorption in quasar spectra close to the ionizing source, produced by the enhanced photoionization rate due the local radiation field. This effect can be detected both by looking along the line of sight of the quasar, (proximity effect along the line of sight) and also by studying the effect produced in the Lyα forest of a bright quasar by a foreground source located close to the quasar line of sight (transverse proximity effect). The proximity effect has been appreciated as a tool to investigate on the ionization level of the Universe at redshifts approaching the reionization epoch, and to study the environment and properties of quasars. In this work we discuss the limits related to the use of the proximity effect along the lines of sight towards high-z quasars to measure the neutral hydrogen fraction at z ∼ 6. Moreover, we present the first-ever detection of the transverse proximity effect in the HI Lyα forest.

  2. Association between proximity to a health center and early childhood mortality in Madagascar.

    Directory of Open Access Journals (Sweden)

    Saori Kashima

    Full Text Available OBJECTIVE: To evaluate the association between proximity to a health center and early childhood mortality in Madagascar, and to assess the influence of household wealth, maternal educational attainment, and maternal health on the effects of distance. METHODS: From birth records of subjects in the Demographic and Health Survey, we identified 12565 singleton births from January 2004 to August 2009. After excluding 220 births that lacked global positioning system information for exposure assessment, odds ratios (ORs and their 95% confidence intervals (CIs for neonatal mortality and infant mortality were estimated using multilevel logistic regression models, with 12345 subjects (level 1, nested within 584 village locations (level 2, and in turn nested within 22 regions (level 3. We additionally stratified the subjects by the birth order. We estimated predicted probabilities of each outcome by a three-level model including cross-level interactions between proximity to a health center and household wealth, maternal educational attainment, and maternal anemia. RESULTS: Compared with those who lived >1.5-3.0 km from a health center, the risks for neonatal mortality and infant mortality tended to increase among those who lived further than 5.0 km from a health center; the adjusted ORs for neonatal mortality and infant mortality for those who lived >5.0-10.0 km away from a health center were 1.36 (95% CI: 0.92-2.01 and 1.42 (95% CI: 1.06-1.90, respectively. The positive associations were more pronounced among the second or later child. The distance effects were not modified by household wealth status, maternal educational attainment, or maternal health status. CONCLUSIONS: Our study suggests that distance from a health center is a risk factor for early childhood mortality (primarily, infant mortality in Madagascar by using a large-scale nationally representative dataset. The accessibility to health care in remote areas would be a key factor to achieve

  3. [High bone consolidation rates after humeral head-preserving revision surgery in non-unions of the proximal humerus].

    Science.gov (United States)

    Aytac, S D; Schnetzke, M; Hudel, I; Studier-Fischer, S; Grützner, P A; Gühring, T

    2014-12-01

    Fractures of the subcapital and proximal humerus shaft region are common fractures of the human skeleton. Their treatment should provide an early functional after-care of the shoulder joint, that is prone to arthrofibrosis. Although the upper extremity is not weight-bearing the occurrence of proximal humerus non-unions leads to severe impairment with inability to work and restrictions of activity of daily life. The aim of this study was to investigate whether an operative revision of proximal humerus non-unions with reosteosynthesis and application of distant autologous bone grafts can lead to sufficient bone healing. The second aim was to find out whether patients achieved an acceptable functional outcome, as alternatively patients could be treated by reconstruction with a shoulder prosthesis. 27 patients (female = 15, male = 12) with reosteosynthesis of the proximal humerus and proximal humeral shaft due to non-union after initially operative fracture treatment were included between 2008 and 2014. Average age of patients was 56 years (23-87), 48% had no comorbidities, while 52% of the patients had at least 1 comorbidity such as diabetes, hypertension or nicotine abusus. The mean number of prior surgical intervention was 1.2 (1-3). The mean time between initial surgery and re-osteosynthesis was 12.3 months. Patients with signs of infection pseudarthrosis were excluded. The initial type of osteosynthesis was with plates (n = 16; thereof PHILOS Plate n = 14), and intramedullary nails (T2, Targon Nail, PHN, Seidel Nail; n = 11). Revision surgery was done with plate osteosynthesis (n = 26; thereof PHILOS Plate n = 4; LC Plate n = 10; angle plate n = 12). In 23 patients (89%) a distant bone transplantation was done from the iliac crest, and 1 patient received allogenous bone. Three patients (11%) received bone morphogenetic protein 7 (BMP 7) in combination with distant bone graft. Intraoperative swabs from the pseudarthrosis area

  4. Proximity, network formation and inventive performance: in search of the proximity paradox

    OpenAIRE

    Cassi, Lorenzo; Plunket, Anne

    2013-01-01

    This paper investigates how network relations, proximity and their interplay affect collaboration and their inventive performance. Using patent citations as a proxy for patent quality, we investigate how the network and proximity characteristics of co-inventors enable them to access different sources of knowledge, in different geographical and organizational contexts, and finally affect the quality of inventive collaboration. Our findings enable to address the proximity paradox, which states ...

  5. Fracture of Proximal Humerus with dislocation of Glenohumeral joint in a 3 year old child: A case report

    Directory of Open Access Journals (Sweden)

    Rajul Gupta

    2013-01-01

    Full Text Available Introduction: Though proximal humeral physeal injuries are common in children, reports of proximal humeral physeal injuries with disruption of glenohumeral joint are exceedingly rare. We here report such a case.Case Report: A three year old male patient presented to us with proximal humeral physeal separation along with glenohumeral dislocation. Under general anaesthesia, closed reduction could be achieved. Thereafter, three Kirschner wires were used to fix the physeal injury. Wires were removed at six weeks and physiotherapy was started. Good range of motion was achieved, and follow up radiographs demonstrated no evidence of growth arrest at one year.Conclusion: In spite of significant displacement in cases of proximal humeral physeal injury with glenohumeral dislocation in children, closed reduction can be achieved and should be attempted.

  6. Treatment of humeroulnar subluxation with a dynamic proximal ulnar osteotomy: a review of 13 cases

    International Nuclear Information System (INIS)

    Gilson, S.D.; Piermattei, D.L.; Schwarz, P.D.

    1989-01-01

    Humeroulnar subluxation was treated surgically in 13 dogs with 18 affected elbows using a proximal osteotomy of the ulna that allowed the ulna to elongate dynamically. Distal humeroulnar subluxation was secondary to premature closure of the distal ulnar physis in 16 elbows. One distal subluxation was secondary to a radioulnar synostosis, and one proximal subluxation developed after premature closure of the distal radial physis. The mean follow-up time was 22 months. Twenty-eight percent of the elbows were judged to have excellent results, 22% good results, 50% fair results, and none was judged to have a poor outcome. The presenting lameness grade and the severity of preoperative and postoperative humeroulnar subluxation had significant correlations with the prognosis. Associated orthopedic abnormalities and complications of concurrent surgical procedures affected the outcome in several dogs. Overall, the dynamic proximal ulnar osteotomy was a simple and effective technique for the treatment of uncomplicated humeroulnar subluxation

  7. Vascularized proximal fibula epiphyseal transfer for distal radius reconstruction in children: A systematic review.

    Science.gov (United States)

    Aldekhayel, Salah; Govshievich, Alexander; Neel, Omar Fouda; Luc, Mario

    2016-11-01

    Reconstruction of the distal radius in children is cumbersome, requiring simultaneous restoration of joint function and axial growth. Vascularized proximal fibular epiphyseal transfers (VFET) have been popularized over non-vascularized transfers and prosthesis. This systematic review aims to evaluate the effectiveness of VFET and its associated complications. Electronic database of PubMed MEDLINE was searched between 1970 and 2014. Studies reporting VFET for distal radius reconstruction in children (<15 years old) with clear reporting of technique (vascular pedicle) and objective outcome measures were included. Outcomes of interest were rate of graft growth, bone union and complications. A one-way Analysis of Variance (ANOVA) test was used to compare growth rates between pedicle types. Fourteen studies met the inclusion criteria, representing 25 patients. Pedicles used were anterior tibial (44%), peroneal (16%), or bi-pedicled (40%) anastomosed in antegrade (64%) or reverse flow (36%) fashion. Among all pedicle types, best results were achieved using anterior tibial artery with reversed flow, yielding average growth rate of 0.83 cm/year (P = 0.01). Recipient complications included four premature epiphyseal plate closures, a flap loss, and six wrist radial deviations. Donor complications included six common peroneal nerve palsies (five temporary, a permanent), and a talocalcaneal instability. Overall complication rates between pedicle types were comparable (P = 0.062). VFET may be a surgical option capable of restoring joint function and axial growth potential in select patients. The reverse flow technique based on the anterior tibial artery may result in superior outcomes. However, the overall complication rate is high and permanent peroneal nerve palsy may result. IV © 2015 Wiley Periodicals, Inc. Microsurgery 36:705-711, 2016. © 2015 Wiley Periodicals, Inc.

  8. Achievement goal profiles and developments in effort and achievement in upper elementary school

    NARCIS (Netherlands)

    Hornstra, L.; Majoor, M.; Peetsma, T.

    2017-01-01

    Background The multiple goal perspective posits that certain combinations of achievement goals are more favourable than others in terms of educational outcomes. Aims This study aimed to examine longitudinally whether students’ achievement goal profiles and transitions between profiles are associated

  9. The Impact of Achieve3000 on Elementary Literacy Outcomes: Randomized Control Trial Evidence, 2013-14 to 2014-15. Eye on Evaluation. DRA Report No. 16.02

    Science.gov (United States)

    Hill, Darryl V.; Lenard, Matthew A.

    2016-01-01

    In 2013-14, the Wake County Public School System (WCPSS) launched Achieve3000 as a randomized controlled trial in 16 elementary schools. Achieve3000 is an early literacy program that differentiates non-fiction reading passages based on individual students' Lexile scores. Twoyear results show that Achieve3000 did not have a significant impact on…

  10. Mid-term results of EVAR in severe proximal aneurysm neck angulation

    NARCIS (Netherlands)

    Oliveira, N. F G; Bastos Gonçalves, F. M.; de Vries, J. P P M; Ultee, K. H J; Werson, D. A B; Hoeks, S. E.; Moll, F.; Van Herwaarden, J. A.; Verhagen, H. J M

    2015-01-01

    Objective To determine if mid-term outcome following endovascular aneurysm repair (EVAR) with the Endurant Stent Graft (Medtronic, Santa Rosa, CA, USA) is influenced by severe proximal neck angulation. Methods A retrospective case–control study was performed using data from a prospective multicenter

  11. Mid-term results of EVAR in severe proximal aneurysm neck angulation

    NARCIS (Netherlands)

    N.F. Oliveira (N.); F.M.V. Bastos Gonçalves (Frederico); J.-P.P.M. de Vries (Jean-Paul); K.H.J. Ultee (Klaas); D.A.B. Werson (Debora); S.E. Hoeks (Sanne); F.L. Moll (Frans); J.A. van Herwaarden (Joost); H.J.M. Verhagen (Hence)

    2015-01-01

    textabstractObjective To determine if mid-term outcome following endovascular aneurysm repair (EVAR) with the Endurant Stent Graft (Medtronic, Santa Rosa, CA, USA) is influenced by severe proximal neck angulation. Methods A retrospective case-control study was performed using data from a prospective

  12. Treatment of extra-articular proximal and middle phalangeal fractures of the hand: a systematic review

    NARCIS (Netherlands)

    D. Verver (Daniëlle); L. Timmermans (Lucas); Klaassen, R.A.; C.H. van der Vlies (Cornelis); D.I. Vos (Dagmar); N.W.L. Schep (Niels)

    2017-01-01

    textabstractThe aim of the study was to systematically review the patient reported and functional outcomes of treatment for extra-articular proximal or middle phalangeal fractures of the hand in order to determine the best treatment options. The review methodology was registered with PROSPERO. A

  13. Pasteurized autograft-prosthesis composite for proximal femoral reconstruction: an alternative to allograft composite.

    Science.gov (United States)

    Eid, Ahmed Shawky; Jeon, Dae-Geun; Song, Won Seok; Lee, Soo-Yong; Cho, Wan Hyeong

    2011-06-01

    Allograft-prosthesis composite (APC) for proximal femur reconstruction have shown favorable longevity and functional outcome compared to endoprosthesis, owing to restoration of bone stock, load-sharing property, and biological attachment of abductors and iliopsoas tendons. This study examined whether a pasteurized-prosthesis composite (PPC) is comparable to APC regarding implant survival, functional outcome, and complication rates. We retrospectively reviewed 18 patients with proximal femur malignancy that underwent reconstruction with a cemented pasteurized autograft-prosthesis composite between 1993 and 2008. We evaluated implant survival (Kaplan-Meier), functional outcome (MSTS score), complications and secondary operations. The estimated survival rate of the 18 composites was 86% at 5 and 10 years. Within a mean follow-up of 93 months (median 113, range 14-163) two composites (11%) were removed due to un-resolving infection. The mean MSTS functional score of surviving 16 composites was 80% (range 70-95). Non-union and stem loosening in host bone were identified in a single patient, while infection developed in two patients. THA conversion occurred in three composites due to secondary osteoarthritis in two, and subluxation in one case. Two of the six cases, with greater trochanter (GT) reconstruction, showed GT avulsion. No autograft was fractured. Pasteurized autograft-prosthesis composite (PPC) of the proximal femur has comparable survival rate, functional outcome, and complication rates to allograft-prosthesis composite (APC), thereby offering an alternative reconstructive option for proximal femoral reconstruction.

  14. Treatment of unstable trochanteric fractures. Randomised comparison of the gamma nail and the proximal femoral nail.

    NARCIS (Netherlands)

    Schipper, I.B.; Steyerberg, E.W.; Castelein, R.M.; Heijden, F.H. van der; Hoed, P.T. den; Kerver, A.J.; Vugt, A.B. van

    2004-01-01

    The proximal femoral nail (PFN) is a recently introduced intramedullary system, designed to improve treatment of unstable trochanteric fractures of the hip. In a multicentre prospective clinical study, the intra-operative use, complications and outcome of treatment using the PFN (n = 211) were

  15. Working in the Zone of Proximal Development (ZPD) in the English ...

    African Journals Online (AJOL)

    The concepts used include “mediation”, “the zone of proximal development,” “the double move”, and “the social situation of development”. The outcome of this teaching experiment was a high level of learner competence in working with South African fiction. Keywords: Vygotsky, Hedegaard, Cultural Historical Activity Theory, ...

  16. Rehabilitation of children with lesions of the proximal humeral metaepiphysis using transosseous distraction osteosynthesis technique

    Directory of Open Access Journals (Sweden)

    Юрий Евгеньевич Гаркавенко

    2015-09-01

    Full Text Available We present an analysis of the treatment of 39 children with a shortening of the humerus after sustained osteomyelitis. Variants of lesions of the proximal humerus metaepiphysis are highlighted, and the differentiated approach to therapeutic measures depending on the identified changes resulted in a positive outcome.

  17. [Disorders of sex development and proximal hypospadias].

    Science.gov (United States)

    Oswald, J

    2016-01-01

    Children with ambiguous genitalia due to different chromosome or gonadal sex are a particular challenge concerning the diagnostic and therapeutic implications. Proximal hypospadias patients with normal gonadal development should be distinguished from children with DSD (disorders of sex development) to guarantee normal gender identity and the best possible surgical therapy. This paper focuses on the terminology, embryology, and pathophysiology of the different manifestations of DSD. The state of knowledge about this disease pattern with particular emphasis on proximal hypospadias based on national and international scientific discussions is presented. The different clinical pictures as well as therapeutic options of DSD with a special focus on recent literature and giving particular attention to patients with proximal hypospadias are presented. Because of the complexity of patients suffering from disorders of sex development an interdisciplinary DSD healthcare team including a paediatric endocrinologist as well as paediatric urologist should be provided. These specialists enable an accurate diagnosis in severe hypospadias patients without reference to DSD diseases patterns.

  18. Endomedullar nail of metacarpal and proximal phalanges

    International Nuclear Information System (INIS)

    Mendez Olaya, Francisco Javier; Sanchez Mesa, Pedro Antonio

    2002-01-01

    Prospective study, series of cases; it included patients with diaphysis fractures and union diaphysis-neck or union diaphysis-base of metacarpal and proximal phalanges, in whom was practiced anterograde intramedullary nailing previous closed reduction of the fracture, using prevent intramedullary nail of 1.6 mm. (cem 16) for the metacarpal fractures, and two nail prevent of 1.0 mm. (cem 10) for the proximal phalangeal fractures. Indications: transverse and oblique short fractures, spiral and with comminuting bicortical. Pursuit average is 5.7 months. Frequency surgical intervened patient: 2.2 each month, using this surgical technique a total of 20 (twenty) patients have been operated, 21 (twenty one) fractures; 16 (sixteen) metacarcal fractures and 5 (five) proximal phalangeal fractures, all of them tested using clinical and radiological parameters. Results: good 82%, regular 18%, and bad 0% obtaining bony consolidation and early rehabilitation with incorporation to their habitual works

  19. Evaluation and Management of Proximal Humerus Fractures

    Directory of Open Access Journals (Sweden)

    Ekaterina Khmelnitskaya

    2012-01-01

    Full Text Available Proximal humerus fractures are common injuries, especially among older osteoporotic women. Restoration of function requires a thorough understanding of the neurovascular, musculotendinous, and bony anatomy. This paper addresses the relevant anatomy and highlights various management options, including indication for arthroplasty. In the vast majority of cases, proximal humerus fractures may be treated nonoperatively. In the case of displaced fractures, when surgical intervention may be pursued, numerous constructs have been investigated. Of these, the proximal humerus locking plate is the most widely used. Arthroplasty is generally reserved for comminuted 4-part fractures, head-split fractures, or fractures with significant underlying arthritic changes. Reverse total shoulder arthroplasty is reserved for patients with a deficient rotator cuff, or highly comminuted tuberosities.

  20. A comparison of proximal tibia, distal femur, and proximal humerus infusion rates using the EZ-IO intraosseous device on the adult swine (Sus scrofa) model.

    Science.gov (United States)

    Lairet, Julio; Bebarta, Vikhyat; Lairet, Kimberly; Kacprowicz, Robert; Lawler, Christopher; Pitotti, Rebecca; Bush, Anneke; King, James

    2013-01-01

    We sought to compare the flow rates of the proximal tibia, the distal femur, and the proximal humerus using high pressure (greater than 300 mmHg) through an intraosseous (IO) infusion needle in an adult swine model. We performed a prospective interventional study in 11 swine. After placement of central vein and arterial lines, blood was removed via the central line until the animal's mean arterial pressure decreased 25% from the recorded baseline. We inserted a 25-mm IO needle into the proximal tibia and 45-mm needles into the distal femur and proximal humerus. All extremities were utilized in each study animal. We infused normal saline at each site for 10 minutes with a pressure bag inflated to the highest achievable pressure (greater than 300 mmHg) as measured at the infusion site with a calibrated portable inline pressure gauge. We measured the volume of normal saline remaining and we calculated infusion rates for each site. We then compared infusion flow rates between the three locations. Statistical analysis and comparison of the infusion rates of all three study arms were as performed using analysis of variance (ANOVA). The average weight of the swine was 71 kg (range 64-84 kg). Successful placement of the IO needle was confirmed at all three sites. The mean infusion flow rate was 213 mL/min (standard deviation [SD] 53.2 mL/min) for the proximal humerus, 138 mL/min (SD 65.3 mL/min) for the distal femur, and 103 mL/min (SD 48.1 mL/min) for the proximal tibia (p IO placement, with a potential for higher flow rates than the proximal tibia and distal femur when resuscitating a patient.

  1. Knowledge networks in the Dutch aviation industry: The proximity paradox

    NARCIS (Netherlands)

    Broekel, T.; Boschma, R.A.

    2012-01-01

    The importance of geographical proximity for interaction and knowledge sharing has been discussed extensively in recent years. There is increasing consensus that geographical proximity is just one out of many types of proximities that might be relevant. We argue that proximity may be a crucial

  2. Transverse preputial onlay island flap urethroplasty for single-stage correction of proximal hypospadias.

    Science.gov (United States)

    Singal, Arbinder Kumar; Dubey, Manish; Jain, Viral

    2016-07-01

    Transverse preputial onlay island flap urethroplasty (TPOIF) was described initially for distal hypospadias, but has seen extended application for proximal hypospadias. We describe a set of modifications in the technique and results in a large series of proximal hypospadias. All children who underwent TPOIF repair for proximal hypospadias (proximal penile, penoscrotal and scrotal) from June 2006 to June 2013 by a single surgeon were prospectively followed till June, 2014. A standard technique and postoperative protocol were followed. Salient points to be emphasized in the technique: (1) dissection of the dartos pedicle till penopubic junction to prevent penile torsion, (2) incorporation of the spongiosum in the urethroplasty, (3) midline urethral plate incision in glans (hinging the plate), (4) Dartos blanket cover on whole urethroplasty. Out of 136 children with proximal hypospadias, 92 children who underwent TPOIF formed the study group. Out of 92 children, 48 (52 %) children required a tunica albuginea plication for chordee correction. In total, 16 (17 %) patients developed 24 complications and 11 children (12 %) required second surgeries: fistula closure in 7 (with meatoplasty in 5), glansplasty for glans dehiscence in 2 and excision of diverticulum in 2. Two children required a third surgery. Only 5 children had a noticeable penile torsion (less than 30 degree), and 7 had a patulous meatus. Transverse preputial onlay island flap urethroplasty can deliver reliable cosmetic and functional outcomes in proximal hypospadias.

  3. The developmental spectrum of proximal radioulnar synostosis

    International Nuclear Information System (INIS)

    Elliott, Alison M.; Kibria, Lisa; Reed, Martin H.

    2010-01-01

    Proximal radioulnar synostosis is a rare upper limb malformation. The elbow is first identifiable at 35 days (after conception), at which stage the cartilaginous anlagen of the humerus, radius and ulna are continuous. Subsequently, longitudinal segmentation produces separation of the distal radius and ulna. However, temporarily, the proximal ends are united and continue to share a common perichondrium. We investigated the hypothesis that posterior congenital dislocation of the radial head and proximal radioulnar fusion are different clinical manifestations of the same primary developmental abnormality. Records were searched for ''proximal radioulnar fusion/posterior radial head dislocation'' in patients followed at the local Children's Hospital and Rehabilitation Centre for Children. Relevant radiographic, demographic and clinical data were recorded. Ethics approval was obtained through the University Research Ethics Board. In total, 28 patients met the inclusion criteria. The majority of patients (16) had bilateral involvement; eight with posterior dislocation of the radial head only; five had posterior radial head dislocation with radioulnar fusion and two had radioulnar fusion without dislocation. One patient had bilateral proximal radioulnar fusion and posterior dislocation of the left radial head. Nine patients had only left-sided involvement, and three had only right-sided involvement.The degree of proximal fusion varied, with some patients showing 'complete' proximal fusion and others showing fusion that occurred slightly distal to the radial head: 'partially separated.' Associated disorders in our cohort included Poland syndrome (two patients), Cornelia de Lange syndrome, chromosome anomalies (including tetrasomy X) and Cenani Lenz syndactyly. The suggestion of a developmental relationship between posterior dislocation of the radial head and proximal radioulnar fusion is supported by the fact that both anomalies can occur in the same patient. Furthermore

  4. Proximity effects in ferromagnet/superconductor structures

    International Nuclear Information System (INIS)

    Yu, H.L.; Sun, G.Y.; Yang, L.Y.; Xing, D.Y.

    2004-01-01

    The Nambu spinor Green's function approach is applied to study proximity effects in ferromagnet/superconductor (FM/SC) structures. They include the induced superconducting order parameter and density of states (DOS) with superconducting feature on the FM side, and spin-dependent DOS within the energy gap on the SC side. The latter indicates an appearance of gapless superconductivity and a coexistence of ferromagnetism and superconductivity in a small regime near the interface. The influence of exchange energy in FM and barrier strength at interface on the proximity effects is discussed

  5. Unusual Complete Proximal Biceps Tendon Rupture

    Directory of Open Access Journals (Sweden)

    Abdullah F. Raizah

    2013-12-01

    Full Text Available Proximal biceps brachii tendon rupture is an unusual presentation in young individuals. This report is an extremely rare case of a complete rupture of the proximal biceps brachii tendon in a young patient as a result of a high-energy water-skiing injury. It was associated with displacement of the biceps muscle into the forearm with skin necrosis. The patient was treated successfully by débridement of the skin and complete resection of the biceps brachii muscle.

  6. Fast thermometry with a proximity Josephson junction

    Science.gov (United States)

    Wang, L. B.; Saira, O.-P.; Pekola, J. P.

    2018-01-01

    We couple a proximity Josephson junction to a Joule-heated normal metal film and measure its electron temperature under steady state and nonequilibrium conditions. With a timed sequence of heating and temperature probing pulses, we are able to monitor its electron temperature in nonequilibrium with effectively zero back-action from the temperature measurement in the form of additional dissipation or thermal conductance. The experiments demonstrate the possibility of using a fast proximity Josephson junction thermometer for studying thermal transport in mesoscopic systems and for calorimetry.

  7. The developmental spectrum of proximal radioulnar synostosis

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, Alison M. [University of Manitoba, Winnipeg Regional Health Association Program of Genetics and Metabolism, Winnipeg, MB (Canada); University of Manitoba, Department of Paediatrics and Child Health, Winnipeg, MB (Canada); University of Manitoba, Department of Biochemistry and Medical Genetics, Winnipeg, MB (Canada); University of Manitoba, WRHA Program of Genetics and Metabolism, Departments of Paediatrics and Child Health, Biochemistry and Medical Genetics, Winnipeg, MB (Canada); Kibria, Lisa [University of Manitoba, Department of School of Medical Rehabilitation, Winnipeg, MB (Canada); Reed, Martin H. [University of Manitoba, Department of Paediatrics and Child Health, Winnipeg, MB (Canada); University of Manitoba, Department of Biochemistry and Medical Genetics, Winnipeg, MB (Canada); University of Manitoba, Department of Diagnostic Imaging, Winnipeg, MB (Canada)

    2010-01-15

    Proximal radioulnar synostosis is a rare upper limb malformation. The elbow is first identifiable at 35 days (after conception), at which stage the cartilaginous anlagen of the humerus, radius and ulna are continuous. Subsequently, longitudinal segmentation produces separation of the distal radius and ulna. However, temporarily, the proximal ends are united and continue to share a common perichondrium. We investigated the hypothesis that posterior congenital dislocation of the radial head and proximal radioulnar fusion are different clinical manifestations of the same primary developmental abnormality. Records were searched for ''proximal radioulnar fusion/posterior radial head dislocation'' in patients followed at the local Children's Hospital and Rehabilitation Centre for Children. Relevant radiographic, demographic and clinical data were recorded. Ethics approval was obtained through the University Research Ethics Board. In total, 28 patients met the inclusion criteria. The majority of patients (16) had bilateral involvement; eight with posterior dislocation of the radial head only; five had posterior radial head dislocation with radioulnar fusion and two had radioulnar fusion without dislocation. One patient had bilateral proximal radioulnar fusion and posterior dislocation of the left radial head. Nine patients had only left-sided involvement, and three had only right-sided involvement.The degree of proximal fusion varied, with some patients showing 'complete' proximal fusion and others showing fusion that occurred slightly distal to the radial head: 'partially separated.' Associated disorders in our cohort included Poland syndrome (two patients), Cornelia de Lange syndrome, chromosome anomalies (including tetrasomy X) and Cenani Lenz syndactyly. The suggestion of a developmental relationship between posterior dislocation of the radial head and proximal radioulnar fusion is supported by the fact that both anomalies

  8. Infiltrating/sealing proximal caries lesions

    DEFF Research Database (Denmark)

    Martignon, S; Ekstrand, K R; Gomez, J

    2012-01-01

    This randomized split-mouth controlled clinical trial aimed at assessing the therapeutic effects of infiltration vs. sealing for controlling caries progression on proximal surfaces. Out of 90 adult students/patients assessed at university clinics and agreeing to participate, 39, each with 3...... differences in lesion progression between infiltration and placebo (P = 0.0012) and between sealing and placebo (P = 0.0269). The study showed that infiltration and sealing are significantly better than placebo treatment for controlling caries progression on proximal lesions. No significant difference...

  9. A COMPARATIVE STUDY OF PROXIMAL FEMUR LOCKING COMPRESSION PLATE VERSUS PROXIMAL FEMORAL NAILING IN THE MANAGEMENT OF COMMINUTED TROCHANTERIC AND SUBTROCHANTERIC FRACTURE

    Directory of Open Access Journals (Sweden)

    Satish Koti

    2016-11-01

    Full Text Available BACKGROUND Fractures of proximal femur and hip are relatively common injuries in elderly individuals constituting 11.6% of total fractures. The latest implant for management of intertrochanteric fracture is Proximal Femoral Locking Compression Plate (PF-LCP. In this study, we compare the clinical outcome of fractures treated by proximal femoral nail with that of proximal femur locking compression plate. MATERIALS AND METHODS The present study consists of 24 elderly patients of peritrochanteric factures of femur satisfying the inclusion criteria who were treated with PF-LCP or PFN in Department of Orthopaedics, S.V.R.R.G.G.H, Tirupati, during a period between December 2013 to October 2015. RESULTS 24 cases were treated with PF-LCP or PFN in a randomised pattern who satisfied inclusion criteria. Intraoperative complication were found to be more with PF-LCP in contrast to PFN. Postoperative rehabilitation was easier with PFN though not statistically significant functional and anatomical outcomes were found to be better with PFN. CONCLUSION Both PFN and PF-LCP have good effectiveness in the treatment of intertrochanteric fractures with the lateral unsubstantial femoral wall in the elderly patients. Each has its own advantages and disadvantages. Further studies with large number of patients and long-term follow up is needed to determine the optimal implant for the internal fixation of comminuted pertrochanteric femoral fractures.

  10. Displaced proximal humeral fractures: an Indian experience with locking plates

    Directory of Open Access Journals (Sweden)

    Aggarwal Sameer

    2010-08-01

    Full Text Available Abstract Background The treatment of displaced proximal humerus fractures, especially in elderly, remains controversial. The objective of this study was to evaluate functional outcome of locking plate used for fixation of these fractures after open reduction. We also attempted to evaluate the complications and predictors of loss of fixation for such an implant. Methods Over two and a half years, 56 patients with an acute proximal humerus fracture were managed with locking plate osteosynthesis. 47 of these patients who completed a minimum follow up of 1 year were evaluated using Constant score calculation. Statistical analysis was done using SPSS 16 and a p value of less than 0.05 was taken as statistically significant. Results The average follow up period was around 21.5 months. Outcomes were excellent in 17%, good in 38.5%, moderate in 34% while poor in 10.5%. The Constant score was poorer for AO-OTA type 3 fractures as compared to other types. The scores were also inferior for older patients (> 65 years old. Complications included screw perforation of head, AVN, subacromial impingement, loss of fixation, axillary nerve palsy and infection. A varus malalignment was found to be a strong predictor of loss of fixation. Conclusion Locking plate osteosynthesis leads to satisfactory functional outcomes in all the patients. Results are better than non locking plates in osteoporotic fractures of the elderly. However the surgery has steep learning curve and various complications could be associated with its use. Nevertheless we believe that a strict adherence to the principles of locking plate use can ensure good result in such challenging fractures.

  11. DO PROXIMAL AND DISTAL GASTRIC TUMOURS BEHAVE DIFFERENTLY?

    Science.gov (United States)

    Costa, Laurence Bedin da; Toneto, Marcelo Garcia; Moreira, Luis Fernando

    2016-01-01

    Although the incidence of gastric (adenocarcinoma) cancer has been decreasing over time, it is still one of the most common malignancies worldwide, and proximal tumours tend to have a worse prognosis. To compare surgical outcomes and prognosis between proximal - excluding tumours of the cardia - and distal gastric cancer. Out of 293 cases reviewed - 209 with distal and 69 with proximal gastric cancer - were compared for clinical and pathological features, stage, surgical outcome, mortality and survival. Statistically, there was no significant difference between patients in both groups regarding mortality (p=0.661), adjuvant chemotherapy (p 0.661), and radiation (p=1.000). However, there was significant difference in the degree of lymph node dissection employed (p=0.002) and the number of positive lymph nodes resected (p=0.038) between the two groups. The odds of death at five years for patients who had a D0 dissection was three times greater (odds ratio 2.78; (95%CI 1.33-5.82) than that for patients who had a D2 dissection, while for patients who had a D1 dissection the odds ratio was only 1.41 (95%CI 0.71-2.83) compared to D2-dissected patients. Although no significant differences were found between proximal and distal gastric cancer, the increased risk of death in D0- and D1-dissected patients clearly suggests an important role of radical D2 lymph node dissection in survival. Embora a incidência do câncer gástrico esteja diminuindo nas últimas décadas, ele ainda aparece como uma das neoplasias malignas mais comuns, e tumores proximais tendem a ter pior prognóstico. Comparar os resultados cirúrgicos e o prognóstico entre o câncer gástrico proximal, excluindo os tumores da cárdia e junção esofagogástrica, e o distal. De 293 casos revistos - 209 distais e 69 proximais - foram comparados quanto aos achados clínicos e patológicos, estágio, resultados cirúrgicos, mortalidade e sobrevida. Estatisticamente não houve diferença entre pacientes em ambos

  12. Phytochemical screening, proximate analysis and acute toxicity ...

    African Journals Online (AJOL)

    Phytochemical screening results indicate the presence of saponins, flavonoids, phytosterols and phenols. Acute toxicity study showed there was no mortality at 8000 mg/kg of the extract. The results indicate that the plant is rich in phytochemicals and is relatively safe. Key words: Phytochemicals, acute toxicity, proximate ...

  13. Proximate composition and mycological characterization of peanut ...

    African Journals Online (AJOL)

    SARAH

    2013-12-30

    Dec 30, 2013 ... ABSTRACT. Objective: The aim of this work was to contribute to the food safety of Ivorian consumers by investigating the proximate composition and the toxic fungal contamination of peanut butters offered for retail sale on the different markets of Abidjan. Methodology and results: Peanut butter samples (45) ...

  14. PROXIMATE ANALYSIS OF LEPIDIUM SATIVUM LEAVES

    African Journals Online (AJOL)

    HANIF BELLO

    fats and fiber. Therefore, this plant is recommended for consumers as vegetable in their diet so as to meet up the body nutrients demand. Keywords: Proximate .... they are useless as foods (Oliver, 2002). The crude fiber result showed L. sativum to contain 8.69±0.01% fiber content. As an important part of any diet, fiber.

  15. Proximate analysis on four edible mushrooms ADEDAYO ...

    African Journals Online (AJOL)

    Michael Horsfall

    ABSTRACT: Proximate study was conducted on four edible mushrooms commonly found in farmlands in. West Yagba ... dead organic matters in the soil may last for years. The fruit .... Table 1: Nutritional and chemical analyses of mushroom samples (TSC total soluble carbohydrate, TTA titratable acid, ASH ash content,.

  16. Modified Koyanagi Technique in Management of Proximal ...

    African Journals Online (AJOL)

    xp

    Modified Koyanagi Technique in Management of Proximal Hypospadias. Adham Elsaied, Basem Saied, and Mohammed El- ... All operations were performed by the authors,using fine instruments and under 3.5X loupe ... the other needed an operation to close the fistula six months later. The case with meatal recession had ...

  17. Phytochemical Screening, Proximate and Mineral Composition of ...

    African Journals Online (AJOL)

    Leaves of sweet potato (Ipomoea batatas) grown in Tepi area was studied for their class of phytochemicals, mineral and proximate composition using standard analytical methods. The phytochemical screening revealed the presence of alkaloids, flavonoid, terpenoids, saponins, quinones, phenol, tannins, amino acid and ...

  18. Proximate, chemical compositions and sulphur concentrations on ...

    African Journals Online (AJOL)

    0, 10, 20, 50, 100, 150, 200, 250 and 300 ppm) on the nutritional value and the proximate composition of six selected mango cultivars (Tommy Atkins, Peach, Saber, Sunshine, Keitt and Vhavenda) grown in South Africa. The study shows that ...

  19. Phytochemical screening, proximate and elemental analysis of ...

    African Journals Online (AJOL)

    Citrus sinensis was screened for its phytochemical composition and was evaluated for the proximate and elemental analysis. The phytochemical analysis indicated the presence of reducing sugar, saponins, cardiac glycosides, tannins and flavonoids. The elemental analysis indicated the presence of the following mineral ...

  20. Keldysh proximity action for disordered superconductors

    Indian Academy of Sciences (India)

    We review a novel approach to the superconductive proximity effect in disordered normal–superconducting (N–S) structures. The method is based on the multicharge Keldysh action and is suitable for the treatment of interaction and fluctuation effects. As an application of the formalism, we study the subgap conductance and ...

  1. Proximate composition, bread characteristics and sensory ...

    African Journals Online (AJOL)

    This study was carried out to investigate proximate composition, bread characteristics and sensory evaluation of cocoyam-wheat composite breads at different levels of cocoyam flour substitution for human consumption.A whole wheat bread (WWB) and cocoyam-composite breads (CCB1,CCB 2 and CCB 3) were prepared ...

  2. Preliminary Phytochemical Screening, Elemental and Proximate ...

    African Journals Online (AJOL)

    The study aimed at phytochemical screening, elemental and proximate composition of two varieties of Cyperus esculentus (tiger nut) big yellow and small brown nuts using standard methods. The phytochemicals tested for were alkaloid, saponin, tannin, glycoside, flavonoid, steroid and resin. All the aforementioned ...

  3. THE PROXIMATE COMPOSITION OF AFRICAN BUSH MANGO ...

    African Journals Online (AJOL)

    BIG TIMMY

    The proximate analysis (moisture, crude protein, crude fat, mineral ash and total carbohydrates) in the kernels and flour of African Bush Mango (. ) were investigated .... a Lovibond tintometer (Model - F, The. Tintometer Ltd., Salisbury, U.K.) and .... acid which metabolized faster through portal absorption. This has been earlier ...

  4. Goal-Proximity Decision-Making

    Science.gov (United States)

    Veksler, Vladislav D.; Gray, Wayne D.; Schoelles, Michael J.

    2013-01-01

    Reinforcement learning (RL) models of decision-making cannot account for human decisions in the absence of prior reward or punishment. We propose a mechanism for choosing among available options based on goal-option association strengths, where association strengths between objects represent previously experienced object proximity. The proposed…

  5. 182 179 Comparative Study on the Proximate

    African Journals Online (AJOL)

    2008-12-02

    Dec 2, 2008 ... Abstract: Proximate composition and mineral content of the seed and pulp of sugar apple (Annona squaumosa) was investigated. On dry weight ... Sugar apple (Annona squamosa) also called. “Gwanda masar” in Hausa belong to the ..... Creative Resource System Inc.,. Winterville, N.C., 28590, pp 69-72.

  6. Disability occurrence and proximity to death

    NARCIS (Netherlands)

    Klijs, Bart; Mackenbach, Johan P.; Kunst, Anton E.

    2010-01-01

    Purpose. This paper aims to assess whether disability occurrence is related more strongly to proximity to death than to age. Method. Self reported disability and vital status were available from six annual waves and a subsequent 12-year mortality follow-up of the Dutch GLOBE longitudinal study.

  7. Phytochemistry and proximate composition of ginger ( Zingiber ...

    African Journals Online (AJOL)

    The results of the phytochemical screening showed that alkaloids, carbohydrates, glycosides, proteins, saponins, steroids, flavonoids and terpenoids were present, while reducing sugars, tannins, oils and acid compounds were absent. Similarly, the results of the proximate analysis of the rhizome showed that ginger ...

  8. Proximate composition and mycological characterization of peanut ...

    African Journals Online (AJOL)

    Objective: The aim of this work was to contribute to the food safety of Ivorian consumers by investigating the proximate composition and the toxic fungal contamination of peanut butters offered for retail sale on the different markets of Abidjan. Methodology and results: Peanut butter samples (45) were collected from the main ...

  9. Large proximal ureteral stones: Ideal treatment modality?

    Directory of Open Access Journals (Sweden)

    B Kadyan

    2016-01-01

    Conclusion: Laparoscopic transperitoneal ureterolithotomy is a minimally invasive, safe and effective treatment modality and should be recommended to all patients of impacted large proximal stones, which are not amenable to URS or extracorporeal shock-wave lithotripsy or as a primary modality of choice especially if patient is otherwise candidate for open surgery.

  10. Controllable proximity effect in superconducting hybrid devices

    NARCIS (Netherlands)

    Bakurskiy, S.V.

    2015-01-01

    This thesis is devoted to the study of controllable proximity effects in superconductors, both in terms of fundamental aspects and applications. As a part of this thesis theoretical description was suggested for a number of structures with superconducting electrodes and multiple interlayers. These

  11. Proximate, Mineral and Phytochemical Composition of Dioscorea ...

    African Journals Online (AJOL)

    ADOWIE PERE

    Keywords: Dioscorea dumetorum, proximate composition, mineral analysis, phytochemical screening ... at the Plant Biology and Biotechnology Department .... Cocaine, a drug derived from an alkaloid is a local anaesthetic central nervous stimulant (Leung, 1980). Thus, presence of alkaloids in the tuber explains its use as ...

  12. Keldysh proximity action for disordered superconductors

    Indian Academy of Sciences (India)

    Abstract. We review a novel approach to the superconductive proximity effect in dis- ordered ... charge Keldysh action and is suitable for the treatment of interaction and fluctuation effects. As an application of the formalism, we study the subgap conductance and noise ..... (9) at the upper border of its applicability, ζ = ζ∗. Note ...

  13. Proximity focusing RICH with TOF capabilities

    International Nuclear Information System (INIS)

    Korpar, S.; Adachi, I.; Fujita, K.; Fukushima, T.; Gorisek, A.; Hayashi, D.; Iijima, T.; Ikado, T.; Ishikawa, T.; Kawai, H.; Kozakai, Y.; Krizan, P.; Kuratani, A.; Mazuka, Y.; Nakagawa, T.; Nishida, S.; Ogawa, S.; Pestotnik, R.; Seki, T.; Sumiyoshi, T.; Tabata, M.; Unno, Y.

    2007-01-01

    A proximity focusing RICH counter with a multi-channel micro-channel plate (MCP) PMT was tested as a time-of-flight counter. Cherenkov photons emitted in the radiator medium as well as in the entrance window of the PMT were used for the time-of-flight measurement, and an excellent performance of the counter could be demonstrated

  14. Proximate composition and nutritional characterization of Chia ...

    African Journals Online (AJOL)

    Besides having good gelling properties, chia seeds (Salvia hispanica L.) are a good source of proteins, omega-3 fatty acids, omega-6 fatty acids, minerals, soluble dietary fiber and phytochemicals. This study sought to develop and determine the proximate composition and nutritional (amino acids, fatty acids, and mineral ...

  15. Proximate composition and cholesterol concentrations of ...

    African Journals Online (AJOL)

    Proximate composition and cholesterol concentrations of Rhynchophorus phoenicis and Oryctes monoceros larvae subjected to different heat treatments. ... 514.63 mg/100g dry weight basis (DWB) for raw and fried samples, respectively, but decreased to 295.20 mg/100 g DWB in the smoke-dried samples. Similarly, the ...

  16. PROXIMATE AND ELEMENTAL COMPOSITION OF WHITE GRUBS

    African Journals Online (AJOL)

    DR. AMINU

    grubs are appreciable to meet nutritional requirements. Therefore, consumption of white grubs is advised. Keywords: White grubs, Proximate Analysis, Essential element, Nutrient. INTRODUCTION. Science of nutrition is concerned with various useful ingredients or nutrients of which food are composed, and the nutrient ...

  17. Phytochemical Screening and Proximate Analysis of Newbouldia ...

    African Journals Online (AJOL)

    The study was conducted to assess the phytochemical and proximate composition of Newboudia laevis leaves and Allium sativum bulb extracts. The leaves and bulbs extracts were analyzed for their chemical composition and antinutritional factors (ANFs) which include moisture, crude protein, crude fat, crude fiber, total ash ...

  18. Endoscopic removal of a proximal urethral stent using a holmium laser: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Francisco Botelho

    2012-01-01

    Full Text Available Urethral stents were initially developed for the management of urethral strictures and obstructive voiding disorders in select patients. Urethral stent complications are common and may require stent explantation, which is often quite challenging. We present our experience with endoscopic removal of an encrusted UroLume proximal urethral stent in a 72-year-old male using a holmium laser. The literature on various management options and outcomes for urethral stent removal is reviewed. Endoscopic removal of proximal urethral stents is feasible and safe and should be considered as the primary treatment option in patients requiring stent extraction.

  19. Enriching the hierarchical model of achievement motivation: autonomous and controlling reasons underlying achievement goals.

    Science.gov (United States)

    Michou, Aikaterini; Vansteenkiste, Maarten; Mouratidis, Athanasios; Lens, Willy

    2014-12-01

    The hierarchical model of achievement motivation presumes that achievement goals channel the achievement motives of need for achievement and fear of failure towards motivational outcomes. Yet, less is known whether autonomous and controlling reasons underlying the pursuit of achievement goals can serve as additional pathways between achievement motives and outcomes. We tested whether mastery approach, performance approach, and performance avoidance goals and their underlying autonomous and controlling reasons would jointly explain the relation between achievement motives (i.e., fear of failure and need for achievement) and learning strategies (Study 1). Additionally, we examined whether the autonomous and controlling reasons underlying learners' dominant achievement goal would account for the link between achievement motives and the educational outcomes of learning strategies and cheating (Study 2). Six hundred and six Greek adolescent students (Mage = 15.05, SD = 1.43) and 435 university students (Mage M = 20.51, SD = 2.80) participated in studies 1 and 2, respectively. In both studies, a correlational design was used and the hypotheses were tested via path modelling. Autonomous and controlling reasons underlying the pursuit of achievement goals mediated, respectively, the relation of need for achievement and fear of failure to aspects of learning outcomes. Autonomous and controlling reasons underlying achievement goals could further explain learners' functioning in achievement settings. © 2014 The British Psychological Society.

  20. Proximity Operations Nano-Satellite Flight Demonstration (PONSFD) Rendezvous Proximity Operations Design and Trade Studies

    Science.gov (United States)

    Griesbach, J.; Westphal, J. J.; Roscoe, C.; Hawes, D. R.; Carrico, J. P.

    2013-09-01

    The Proximity Operations Nano-Satellite Flight Demonstration (PONSFD) program is to demonstrate rendezvous proximity operations (RPO), formation flying, and docking with a pair of 3U CubeSats. The program is sponsored by NASA Ames via the Office of the Chief Technologist (OCT) in support of its Small Spacecraft Technology Program (SSTP). The goal of the mission is to demonstrate complex RPO and docking operations with a pair of low-cost 3U CubeSat satellites using passive navigation sensors. The program encompasses the entire system evolution including system design, acquisition, satellite construction, launch, mission operations, and final disposal. The satellite is scheduled for launch in Fall 2015 with a 1-year mission lifetime. This paper provides a brief mission overview but will then focus on the current design and driving trade study results for the RPO mission specific processor and relevant ground software. The current design involves multiple on-board processors, each specifically tasked with providing mission critical capabilities. These capabilities range from attitude determination and control to image processing. The RPO system processor is responsible for absolute and relative navigation, maneuver planning, attitude commanding, and abort monitoring for mission safety. A low power processor running a Linux operating system has been selected for implementation. Navigation is one of the RPO processor's key tasks. This entails processing data obtained from the on-board GPS unit as well as the on-board imaging sensors. To do this, Kalman filters will be hosted on the processor to ingest and process measurements for maintenance of position and velocity estimates with associated uncertainties. While each satellite carries a GPS unit, it will be used sparsely to conserve power. As such, absolute navigation will mainly consist of propagating past known states, and relative navigation will be considered to be of greater importance. For relative observations

  1. Sustainability-Oriented Innovation in the Minerals Industry: An Empirical Study on the Effect of Non-Geographical Proximity Dimensions

    Directory of Open Access Journals (Sweden)

    Babak Ghassim

    2018-01-01

    Full Text Available Minerals mining and processing companies (hereinafter referred to as “minerals industry” face the increasing demand for a comprehensive approach towards innovations aimed at sustainability. While the ability to learn from external sources of knowledge is at the core of this process, lack of geographical proximity and multiplicity of external sources impose challenges for mineral companies in this respect. The present study proposes that organizational, institutional and cognitive proximities could provide a platform for this industry to overcome those challenges, thereby achieving a superior innovation performance across various sustainability dimensions. Results of an analysis based on a sample of 101 mineral companies in Norway reveal that these dimensions of proximity are conducive to process, product and social innovation in different ways. More specifically, organizational proximity (diversity of non-local collaborations and informal institutional proximity (shared cultural norms and values spur social innovation. Furthermore, formal institutional proximity (similarity of rules and laws and cognitive proximity (familiarity of knowledge base support both process and product innovations. This paper provides some insights on the determinants of innovation in sustainability contexts, and contributes to the recent debate on the role of non-spatial proximity dimensions for innovation in the peripheral regions.

  2. Evaluation of upper-extremity function following surgical treatment of displaced proximal humerus fractures in children.

    Science.gov (United States)

    Canavese, Federico; Athlani, Lionel; Marengo, Lorenza; Rousset, Marie; Rouel-Rabiau, Nadege; Samba, Antoine; Andreacchio, Antonio

    2014-03-01

    This study aims to assess the functional outcome of children treated with elastic stable intramedullary nailing (ESIN) for displaced proximal humerus fractures using the short version of the disabilities of the arm, shoulder, and hand outcome questionnaire (Quick DASH). Fifty-eight consecutive children with displaced proximal humerus fractures were treated with ESIN. Fifty-two children (89.7%) were available for follow-up and responded to the questionnaire after hardware removal. Average age at time of injury was 11.1 ± 2.8 years (range, 4-15.9). Among the 52 patients available for evaluation, 37 had a Quick DASH score of 0 (71.1%), seven a score of 2.3 (13.5%), four a score of 4.5 (7.7%), and four a score of 6.5 (7.7%). Shoulder and elbow ranges of motion were comparable with the noninjured side. No skin irritation or local infections were observed. There was no radiographic evidence of delayed union, refracture, hardware migration, or secondary displacement. Mean follow-up was 18.3 ± 8.3 months (range, 6-39.5). Our study reports good functional outcomes in children with closed isolated fractures, both physeal and metaphyseal, of the proximal humerus treated with ESIN. The use of a standardized rating scale is recommended to homogeneously compare functional outcome and may facilitate the comparison of clinical outcome in different patient populations.

  3. Proximal tubular hypertrophy and enlarged glomerular and proximal tubular urinary space in obese subjects with proteinuria.

    Directory of Open Access Journals (Sweden)

    Ana Tobar

    Full Text Available BACKGROUND: Obesity is associated with glomerular hyperfiltration, increased proximal tubular sodium reabsorption, glomerular enlargement and renal hypertrophy. A single experimental study reported an increased glomerular urinary space in obese dogs. Whether proximal tubular volume is increased in obese subjects and whether their glomerular and tubular urinary spaces are enlarged is unknown. OBJECTIVE: To determine whether proximal tubules and glomerular and tubular urinary space are enlarged in obese subjects with proteinuria and glomerular hyperfiltration. METHODS: Kidney biopsies from 11 non-diabetic obese with proteinuria and 14 non-diabetic lean patients with a creatinine clearance above 50 ml/min and with mild or no interstitial fibrosis were retrospectively analyzed using morphometric methods. The cross-sectional area of the proximal tubular epithelium and lumen, the volume of the glomerular tuft and of Bowman's space and the nuclei number per tubular profile were estimated. RESULTS: Creatinine clearance was higher in the obese than in the lean group (P=0.03. Proteinuria was similarly increased in both groups. Compared to the lean group, the obese group displayed a 104% higher glomerular tuft volume (P=0.001, a 94% higher Bowman's space volume (P=0.003, a 33% higher cross-sectional area of the proximal tubular epithelium (P=0.02 and a 54% higher cross-sectional area of the proximal tubular lumen (P=0.01. The nuclei number per proximal tubular profile was similar in both groups, suggesting that the increase in tubular volume is due to hypertrophy and not to hyperplasia. CONCLUSIONS: Obesity-related glomerular hyperfiltration is associated with proximal tubular epithelial hypertrophy and increased glomerular and tubular urinary space volume in subjects with proteinuria. The expanded glomerular and urinary space is probably a direct consequence of glomerular hyperfiltration. These effects may be involved in the pathogenesis of obesity

  4. Proximal duodenal perforation in three dogs following deracoxib administration.

    Science.gov (United States)

    Case, J Brad; Fick, Jennifer L; Rooney, Matthew B

    2010-01-01

    The purpose of this study was to describe the clinical and gross pathological findings, treatment, and outcome in three dogs receiving deracoxib that developed proximal duodenal perforation and subsequent septic peritonitis. Clinical findings were acute vomiting and anorexia following initiation of deracoxib therapy. Deracoxib dosages ranged from 2 to 3 mg/kg per os q 24 hours. In each dog, exploratory laparotomy revealed duodenal perforations approximately 1 cm orad to the major duodenal papilla. Two out of three dogs survived following exploratory laparotomy. Two of three dogs in the present case series received the approved deracoxib dosage. Dogs receiving deracoxib, even at labeled dosages, should be monitored judiciously for signs of gastrointestinal disease.

  5. Restoring proximal cavities of molars using the proximal box elevation technique: Systematic review and report of a case.

    Science.gov (United States)

    Kielbassa, Andrej M; Philipp, Fabian

    2015-10-01

    For decades, dental restorative treatment of large and deep cavities of posterior teeth has been adequately ensured by amalgam or by indirect gold restorations; with the continuing advancements in material technology and clinical techniques, alternative and more esthetic types of restorations have become feasible. Proximal box elevation (PBE) using composite resins has been advocated for relocating subgingival cavity outlines; treatment success and effects of PBE require documentation. An electronic search was performed on several literature databases to identify relevant articles published in indexed journals until April 2015. The authors independently screened the relevant papers found (PBE with composite resins). This paper compiles the current knowledge about PBE (which is predominantly based on laboratory research, in particular with a focus on microleakage and marginal adaptation), revealing that flowable composites allow for a stepwise elevation of proximal cavity floors, thus simplifying treatment of deep lesions, and broadening the restorative spectrum. A case report revealing an advanced caries lesion and demonstrating the clinical application of the PBE technique together with an indirect computer-aided design/computer-assisted manufacture (CAD/CAM) all-ceramic restoration is presented, assuring the practitioner's familiarity with effective placement techniques. PBE represents a promising two-step treatment regimen, simultaneously encompassing the benefits of immediate dentin sealing and facilitating direct or indirect adhesive restorations of cavities with margins located beneath the gingival tissues. However, high-quality randomized clinical trials are required to confirm the laboratory outcomes.

  6. Flexor Digitorum Superficialis Tenodesis for Traumatic Digit Amputation at the Level of the Proximal Phalanx.

    Science.gov (United States)

    O'Shaughnessy, Maureen A; Kakar, Sanjeev

    2017-09-01

    Traumatic amputation of the digit requiring revision amputation at the level of the proximal phalanx provides the opportunity to improve flexor function via tenodesis of the remaining flexor digitorum superficialis (FDS) tendon. Salvage of the remaining FDS and performing flexor tenodesis to the proximal phalanx allows increased flexion at the metacarpophalangeal (MCP) joint. This series reviews FDS tenodesis, outlining its surgical technique with clinical and functional outcomes. Institutional review board-approved retrospective study was performed. Twelve digits in 8 patients were included. Average flexion-extension arc of affected MCP joint was 82°, and average grip strength was 70% of unaffected extremity. No patients required revision surgery or revision amputation. One patient had a minor wound infection treated successfully with oral antibiotics. FDS tenodesis is a reliable motion-preserving procedure for patients with amputations at the level of the proximal phalanx to maintain flexion at the MCP joint.

  7. Can social support protect bullied adolescents from adverse outcomes? A prospective study on the effects of bullying on the educational achievement and mental health of adolescents at secondary schools in East London

    Science.gov (United States)

    Rothon, Catherine; Head, Jenny; Klineberg, Emily; Stansfeld, Stephen

    2011-01-01

    This paper investigates the extent to which social support can have a buffering effect against the potentially adverse consequences of bullying on school achievement and mental health. It uses a representative multiethnic sample of adolescents attending East London secondary schools in three boroughs. Bullied adolescents were less likely to achieve the appropriate academic achievement benchmark for their age group and bullied boys (but not girls) were more likely to exhibit depressive symptoms compared to those not bullied. High levels of social support from family were important in promoting good mental health. There was evidence that high levels of support from friends and moderate (but not high) family support was able to protect bullied adolescents from poor academic achievement. Support from friends and family was not sufficient to protect adolescents against mental health difficulties that they might face as a result of being bullied. More active intervention from schools is recommended. PMID:20637501

  8. Children’s proximal societal conditions

    DEFF Research Database (Denmark)

    Stanek, Anja Hvidtfeldt

    Inspired from especially Danish/German critical psychology but also from John Dewey’s ethical, educational and psychological thoughts, this presentation will elaborate on an understanding of the dialectic between an ethical society, -school and -theory. To this aim I will argue for and unfold...... the conceptualization of children’s “proximal societal conditions”. Throughout different research projects in which children’s everyday life in different daycare settings and in schools has been studied, it becomes clear that ‘the societal’ is not something that is above or outside the institutional setting......) the children’s proximal societal conditions for development and learning, means for instance that considerations about an inclusive agenda in a (Danish) welfare state with well-developed school- and daycare system, are no longer simply thoughts about the school having space for as many pupils as possible...

  9. Disparity filtering: proximity detection and segmentation

    Science.gov (United States)

    Coombs, David; Horswill, Ian; von Kaenel, Peter

    1992-11-01

    Simple stereo disparity filters can provide `proximity detectors' shaped like concave shells in front of the observer. Ideally, these are isodisparity surfaces. In practice, a narrowly tuned filter results in a thin shell. The special case of the zero-disparity surface is called the horopter. A disparity filter can also be useful for distinguishing an object that lies on an isodisparity surface from its surroundings. These filters are much less expensive than stereographic scene interpretation since they are local operations. Similarly, they are also less general. We analyze the expected proximity sensitivity of one simple version of the disparity filter and compare this to its empirical performance. We also present some feature based and correlation based disparity filters and compare their `segmentation' performance on various scenes.

  10. Sciatic Nerve Injury After Proximal Hamstring Avulsion and Repair

    Science.gov (United States)

    Wilson, Thomas J.; Spinner, Robert J.; Mohan, Rohith; Gibbs, Christopher M.; Krych, Aaron J.

    2017-01-01

    Background: Muscle bellies of the hamstring muscles are intimately associated with the sciatic nerve, putting the sciatic nerve at risk of injury associated with proximal hamstring avulsion. There are few data informing the magnitude of this risk, identifying risk factors for neurologic injury, or determining neurologic outcomes in patients with distal sciatic symptoms after surgery. Purpose: To characterize the frequency and nature of sciatic nerve injury and distal sciatic nerve–related symptoms after proximal hamstring avulsion and to characterize the influence of surgery on these symptoms. Study Design: Cohort study; Level of evidence, 3. Methods: This was a retrospective review of patients with proximal partial or complete hamstring avulsion. The outcome of interest was neurologic symptoms referable to the sciatic nerve distribution below the knee. Neurologic symptoms in operative patients were compared pre- and postoperatively. Results: The cohort consisted of 162 patients: 67 (41.4%) operative and 95 (58.6%) nonoperative. Sciatic nerve–related symptoms were present in 22 operative and 23 nonoperative patients, for a total of 45 (27.8%) patients (8 [4.9%] motor deficits, 11 [6.8%] sensory deficits, and 36 [22.2%] with neuropathic pain). Among the operative cohort, 3 of 3 (100.0%) patients showed improvement in their motor deficit postoperatively, 3 of 4 (75.0%) patients’ sensory symptoms improved, and 17 of 19 (89.5%) patients had improvement in pain. A new or worsening deficit occurred in 5 (7.5%) patients postoperatively (2 [3.1%] motor deficits, 1 [1.5%] sensory deficit, and 3 [4.5%] with new pain). Predictors of operative intervention included lower age (odds ratio [OR], 0.952; 95% CI, 0.921-0.982; P = .001) and complete avulsion (OR, 10.292; 95% CI, 2.526-72.232; P hamstring avulsion are underrecognized. Currently, neurologic symptoms are not considered when determining whether to pursue operative intervention. Given the high likelihood of

  11. Long-term results after proximal thoracic aortic redo surgery.

    Directory of Open Access Journals (Sweden)

    Martin Czerny

    Full Text Available OBJECTIVE: To evaluate early and mid-term results in patients undergoing proximal thoracic aortic redo surgery. METHODS: We analyzed 60 patients (median age 60 years, median logistic EuroSCORE 40 who underwent proximal thoracic aortic redo surgery between January 2005 and April 2012. Outcome and risk factors were analyzed. RESULTS: In hospital mortality was 13%, perioperative neurologic injury was 7%. Fifty percent of patients underwent redo surgery in an urgent or emergency setting. In 65%, partial or total arch replacement with or without conventional or frozen elephant trunk extension was performed. The preoperative logistic EuroSCORE I confirmed to be a reliable predictor of adverse outcome- (ROC 0.786, 95%CI 0.64-0.93 as did the new EuroSCORE II model: ROC 0.882 95%CI 0.78-0.98. Extensive individual logistic EuroSCORE I levels more than 67 showed an OR of 7.01, 95%CI 1.43-34.27. A EuroSCORE II larger than 28 showed an OR of 4.44 (95%CI 1.4-14.06. Multivariate logistic regression analysis identified a critical preoperative state (OR 7.96, 95%CI 1.51-38.79 but not advanced age (OR 2.46, 95%CI 0.48-12.66 as the strongest independent predictor of in-hospital mortality. Median follow-up was 23 months (1-52 months. One year and five year actuarial survival rates were 83% and 69% respectively. Freedom from reoperation during follow-up was 100%. CONCLUSIONS: Despite a substantial early attrition rate in patients presenting with a critical preoperative state, proximal thoracic aortic redo surgery provides excellent early and mid-term results. Higher EuroSCORE I and II levels and a critical preoperative state but not advanced age are independent predictors of in-hospital mortality. As a consequence, age alone should no longer be regarded as a contraindication for surgical treatment in this particular group of patients.

  12. PROXIMATE ANALYSIS OF SELECTED SORGHUM CULTIVARS 285

    African Journals Online (AJOL)

    pc

    The results revealed that protein content ranged from 6.23 - 13.81%, carbohydrate. 65.57 - 76.28%, lipid 3.60 - 10.54, fibre 1.65 - 7.94%, ash 1.12 - 1.68%, and moisture 9.75 -. 16.32% . The proximate analysis revealed that sorghum samples contains appreciable nutrient contents. Also from the result, it has shown that the ...

  13. Capacitive Proximity Sensor Has Longer Range

    Science.gov (United States)

    Vranish, John M.

    1992-01-01

    Capacitive proximity sensor on robot arm detects nearby object via capacitive effect of object on frequency of oscillator. Sensing element part of oscillator circuit operating at about 20 kHz. Total capacitance between sensing element and ground constitutes tuning capacitance of oscillator. Sensor circuit includes shield driven by replica of alternating voltage applied to sensing element. Driven shield concentrates sensing electrostatic field in exterior region to enhance sensitivity to object. Sensitivity and dynamic range has corresponding 12-to-1 improvement.

  14. Proximal Row Carpectomy Combined with Wrist Hemiarthroplasty

    OpenAIRE

    Culp, Randall W.; Bachoura, Abdo; Gelman, Scott E.; Jacoby, Sidney M.

    2012-01-01

    Proximal row carpectomy (PRC) combined with distal radius hemiarthroplasty is a relatively novel procedure that rivals total wrist arthrodesis and offers a new surgical treatment option for select patients with painful, end-stage wrist disease. We present our early experience with this procedure. A retrospective chart review was conducted for nonrheumatoid patients diagnosed with wrist arthritis and subsequently treated with wrist hemiarthroplasty combined with PRC. The minimum follow-up dura...

  15. Isolated Proximal Tibiofibular Dislocation during Soccer

    Directory of Open Access Journals (Sweden)

    Casey Chiu

    2015-01-01

    Full Text Available Proximal tibiofibular dislocations are rarely encountered in the Emergency Department (ED. We present a case involving a man presenting to the ED with left knee pain after making a sharp left turn on the soccer field. His physical exam was only remarkable for tenderness over the lateral fibular head. His X-rays showed subtle abnormalities of the tibiofibular joint. The dislocation was reduced and the patient was discharged from the ED with orthopedic follow-up.

  16. Radiographic patterns of osteoporotic proximal humerus fractures.

    Science.gov (United States)

    Carbone, Stefano; Mezzoprete, Riccardo; Papalia, Matteo; Arceri, Valerio; Carbone, Andrea; Gumina, Stefano

    2018-03-01

    The objectives of the study were: a) to identify osteoporotic proximal humerus fractures in a large consecutive series of patients; b) to identify radiographic fracture patterns among osteoporotic and non-osteoporotic proximal humerus fractures; and c) to calculate intra- and inter-observer reliability of assessment of osteoporosis and of radiographic fracture patterns. This was a prospective observational study of patients admitted to the emergency department affected by a proximal humerus fracture between June 2014 and June 2016. Three researchers evaluated demographic data and comorbidities, x-rays and CT-scans. A new evaluation method for assessment of osteoporosis was proposed; 7 radiographic fracture patterns were studied. Reliabilities between intra- and inter-tester evaluations, and correlations between the presence of osteoporosis and the 7 radiologic fracture patterns were calculated. Two hundred twenty-five patients with a humeral fracture were recruited. Their mean (26-95, 32) age was 58. Of those, 163 (72.4%) were identified as osteoporotic. Among the three raters, the intra- and inter-observer agreement using the proposed methods were high or excellent. Significant correlations with diagnosis of osteoporosis were found with Codman-Lego type 12(p = 0.041), metaphyseal comminution(p patterns were high. Osteoporosis of the proximal humerus was identified in 72% of patients during a two year period; most of these patients were elderly females sustaining low energy trauma. These fractures showed to have specific radiographic patterns, as comminution of metaphysis and tuberosities, impaction of fragments, and inferior subluxation of the humeral head. These patterns can be assessed with the simple observation of a 2-plan view of a radiograph, without the use of specific software. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Bilateral, atraumatic, proximal tibiofibular joint instability.

    Science.gov (United States)

    Morrison, Troy D; Shaer, James A; Little, Jill E

    2011-01-01

    Dislocation of the tibiofibular joint is rare and usually results from a traumatic event. Only 1 case of atraumatic proximal tibiofibular joint instability in a 14-year-old girl has been reported in the literature, however this condition might occur more frequently than once thought. A wide range of treatment options exist for tibiofibular dislocations. Currently, the first choice is a conservative approach, and when this fails, surgical means such as resection of the fibula head, arthrodesis, and reconstruction are considered. However, no consensus exists on the most effective treatment. This article reports a unique case of bilateral, atraumatic, proximal tibia and fibular joint instability involving a 30-year-old man with a 20-year history of pain and laxity in the right knee. The patient had no trauma to his knees; he reported 2 immediate family members with similar complaints, which suggests that this case is likely congenital. After conservative approaches proved to be ineffective, the patient underwent capsular reconstruction using free autologous gracilis tendon. At 6-month postoperative follow-up, the patient was pain free with no locking and instability. He then underwent surgery on the left knee. At 1-year follow-up after the second surgery, the patient had no symptoms or restrictions in mobility. We provide an alternative surgical approach to arthrodesis and resection for the treatment of chronic proximal tibiofibular instability. In the treatment of chronic tibiofibular instability, we believe that reconstruction of the tibiofibular joint is a safe and effective choice. Copyright 2011, SLACK Incorporated.

  18. A flexible dual-mode proximity sensor based on cooperative sensing for robot skin applications

    Science.gov (United States)

    Huang, Ying; Cai, Xia; Kan, Wenqing; Qiu, Shihua; Guo, Xiaohui; Liu, Caixia; Liu, Ping

    2017-08-01

    A flexible dual-mode proximity sensor has been designed and implemented, which is capable of combining capacitive-resistive detection in this paper. The capacitive type proximity sensor detecting is defined as mode-C, and the resistive type proximity sensor detecting is defined as mode-R. The characteristics of the proximity sensor are as follows: (1) the theoretical mode is developed which indicates that this proximity sensor can reflect proximity information accurately; (2) both sensing modes are vertically integrated into a sandwich-like chip with an 8 mm × 12 mm unit area. The thickness of a mode-R sensing material (graphene nanoplatelets) and mode-C dielectric (the mixture of carbon black and silicone rubber) is 1 mm and 2.5 mm, respectively; (3) for mode-R, the linearity of temperature-resistance curve can achieve 0.998 in the temperature range from 25°C to 65°C. And for mode-C, various materials can be successfully detected with fast response and high reversibility. Meanwhile, the study compensated the influence of object temperature to ensure mode-C properly works. A cooperative sensing test shows that R-C dual modes sense effectively which can enlarge the sensing distance compared with the single mode proximity sensor. The fabrication of this sensor is convenient, and the integrity of a flexible sandwich-like structure based on dual modes is beneficial to form arrays, which is suitable to be used in skin-like sensing applications.

  19. A flexible dual-mode proximity sensor based on cooperative sensing for robot skin applications.

    Science.gov (United States)

    Huang, Ying; Cai, Xia; Kan, Wenqing; Qiu, Shihua; Guo, Xiaohui; Liu, Caixia; Liu, Ping

    2017-08-01

    A flexible dual-mode proximity sensor has been designed and implemented, which is capable of combining capacitive-resistive detection in this paper. The capacitive type proximity sensor detecting is defined as mode-C, and the resistive type proximity sensor detecting is defined as mode-R. The characteristics of the proximity sensor are as follows: (1) the theoretical mode is developed which indicates that this proximity sensor can reflect proximity information accurately; (2) both sensing modes are vertically integrated into a sandwich-like chip with an 8 mm × 12 mm unit area. The thickness of a mode-R sensing material (graphene nanoplatelets) and mode-C dielectric (the mixture of carbon black and silicone rubber) is 1 mm and 2.5 mm, respectively; (3) for mode-R, the linearity of temperature-resistance curve can achieve 0.998 in the temperature range from 25  ° C to 65  ° C. And for mode-C, various materials can be successfully detected with fast response and high reversibility. Meanwhile, the study compensated the influence of object temperature to ensure mode-C properly works. A cooperative sensing test shows that R-C dual modes sense effectively which can enlarge the sensing distance compared with the single mode proximity sensor. The fabrication of this sensor is convenient, and the integrity of a flexible sandwich-like structure based on dual modes is beneficial to form arrays, which is suitable to be used in skin-like sensing applications.

  20. A Regularized Algorithm for the Proximal Split Feasibility Problem

    Directory of Open Access Journals (Sweden)

    Zhangsong Yao

    2014-01-01

    Full Text Available The proximal split feasibility problem has been studied. A regularized method has been presented for solving the proximal split feasibility problem. Strong convergence theorem is given.

  1. Below the surface of sense of community within schools: an exploration of young people’s sense of community, personality, and achievement motivation in relation to educational outcomes and well-being

    OpenAIRE

    Sayer, Edward

    2012-01-01

    Contemporary psychology has linked humans’ societal nature to the need to feel part of a community. McMillan and Chavis (1986) conceptualised a sense of community (SoC), upon four factors: 1) membership; 2) influence; 3) integration and fulfilment of need; and, 4) shared emotional connection. SoC has been explored in a variety of contexts identifying distinct correlated outcome-variables. For adults and young people alike, a strong SoC is positively related to outcomes in personal performance...

  2. Predictors of antegrade flow at internal carotid artery during carotid artery stenting with proximal protection.

    Science.gov (United States)

    Harada, Kei; Kakumoto, Kosuke; Oshikata, Shogo; Fukuyama, Kozo

    2018-02-16

    Carotid artery stenting (CAS) with proximal occlusion effectively prevent distal cerebral embolism by flow arrest at internal carotid artery (ICA); however, the method can expose antegrade flow at ICA due to incomplete flow arrest. The aim of this study was to identify predictors of antegrade flow during CAS with proximal protection. We retrospectively analyzed clinical and angiographic data among 143 lesions treated with CAS with proximal protection by occluding the common carotid artery (CCA) and external carotid artery (ECA). Flow arrest or antegrade flow at ICA was confirmed by contrast injection during proximal protection. Antegrade flow at ICA was observed in 12 lesions (8.4%). Compared with lesions in which flow arrest of ICA was achieved, the diameter of the superior thyroid artery (STA) was significantly larger (2.4 ± 0.34 vs. 1.4 ± 0.68 mm, p flow. Distal filter protection should be combined with proximal protection for the lesions with antegrade flow to prevent distal migration of the carotid debris.

  3. School Size, Achievement, and Achievement Gaps

    Directory of Open Access Journals (Sweden)

    Bradley J. McMillen

    2004-10-01

    Full Text Available In order to examine the relationship between school size and achievement, a study was conducted using longitudinal achievement data from North Carolina for three separate cohorts of public school students (one elementary, one middle and one high school. Results revealed several interactions between size and student characteristics, all of which indicated that the achievement gaps typically existing between certain subgroups (i.e., more versus less-advantaged, lower versus higher-achieving were larger in larger schools. Results varied across the grade level cohorts and across subjects, but in general effects were more common in mathematics than in reading, and were more pronounced at the high school level. Study results are discussed in the context of educational equity and cost-effectiveness.

  4. Initial clinical experience using the two-stage aspiration technique (TSAT) with proximal flow arrest by a balloon guiding catheter for acute ischemic stroke of the anterior circulation.

    Science.gov (United States)

    Matsumoto, Hiroyuki; Nishiyama, Hirokazu; Tetsuo, Yoshiaki; Takemoto, Hideki; Nakao, Naoyuki

    2017-12-01

    Our initial experience using the two-stage aspiration technique (TSAT) with proximal flow arrest by a balloon guiding catheter is presented. In TSAT, aspiration is applied with the 5MAX ACE and also with the 3MAX catheter with a Penumbra aspiration pump, while arresting proximal flow by balloon inflation. In patients treated with TSAT, clinical data including National Institutes of Health Stroke Scale (NIHSS) score at admission and the modified Rankin Scale (mRS) score at discharge, as well as procedural data including the Thrombolysis in Cerebral Infarction (TICI) score, procedural time, and complications were analyzed. Thirty-four consecutive patients (19 men (56%); mean age 73 years) were treated with TSAT using a balloon guiding catheter. The patients presented with a mean NIHSS score of 17.4 and 23 (68%) patients received IV tissue plasminogen activator. Median time from groin puncture to successful recanalization was 41 min (range 15-160 min). All patients were successfully revascularized; TICI 2b or better recanalization was achieved in 30 (88%) patients. No patient required an additional procedure such as use of a stent retriever. Procedure-related complications occurred in two (5.9%) patients (vessel injury and guidewire perforation). Symptomatic intracranial hemorrhage occurred in one patient and asymptomatic hemorrhagic infarction occurred in two patients. There were no cases of embolization to new territory (ENT). The mean NIHSS score at discharge improved to 6.1. Sixteen patients (47%) achieved a good outcome with an mRS score of 0-2 at discharge (mean hospitalization period 20 days). TSAT with proximal flow arrest by a balloon guiding catheter is an effective and safe method to achieve good clinical and angiographic outcomes. This method may reduce ENT in the direct aspiration first-pass thrombectomy (ADAPT) technique. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  5. Proximal femur geometry in the adult Kenyan femur and its ...

    African Journals Online (AJOL)

    Background: Numerous orthopaedic procedures are carried out on the proximal femur. For optimal hip function, these procedures must restore the anatomy of the proximal femur to as near normal as possible. There are currently no local studies that have described in detail the normal anatomy of the proximal femur and its ...

  6. Proximity and Interactive Learning in University-Firm Relationships

    Science.gov (United States)

    Thune, Taran

    2009-01-01

    This paper addresses the question of whether proximity is always necessary for interactive learning, as proposed by recent European innovation theory. Recent research has provided a refined conceptualization of proximity, but there is little empirically-based knowledge about the actual role that proximity plays in relationships intended to foster…

  7. 14 CFR 135.153 - Ground proximity warning system.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Ground proximity warning system. 135.153... Equipment § 135.153 Ground proximity warning system. (a) No person may operate a turbine-powered airplane... equipped with an approved ground proximity warning system. (b) [Reserved] (c) For a system required by this...

  8. The regional dimension of intergenerational proximity in the Netherlands

    NARCIS (Netherlands)

    van der Pers, Marieke; Mulder, Clara H.

    Previous research has shown the impact of individual characteristics on intergenerational proximity but has largely ignored the regional dimension of such proximity. In this paper, we examine the regional variation in intergenerational proximity in the Netherlands. We address this issue by

  9. 75 FR 5009 - Proximity Detection Systems for Underground Mines

    Science.gov (United States)

    2010-02-01

    ... Proximity Detection Systems for Underground Mines AGENCY: Mine Safety and Health Administration, Labor... information regarding whether the use of proximity detection systems would reduce the risk of accidents where... . Information on MSHA-approved proximity detection systems is available on the Internet at http://www.msha.gov...

  10. Quality Assessment and Proximate Analysis of Amaranthus hybridus ...

    African Journals Online (AJOL)

    The aim of this research is to determine the quality and proximate composition of Amaranthus hybridus, Celosia argentea, and Talinum triangulare obtained from open markets in Benin City, Nigeria. Microbiological and proximate analysis were carried out using standard methods. Results of the proximate analysis revealed ...

  11. The role of partnership functioning and synergy in achieving sustainability of innovative programmes in community care.

    Science.gov (United States)

    Cramm, Jane M; Phaff, Sanne; Nieboer, Anna P

    2013-03-01

    This cross-sectional study (conducted in April-May 2011) explored associations between partnership functioning synergy and sustainability of innovative programmes in community care. The study sample consisted of 106 professionals (of 244 individuals contacted) participating in 21 partnerships that implemented different innovative community care programmes in Rotterdam, The Netherlands. Partnership functioning was evaluated by assessing leadership, resources administration and efficiency. Synergy was considered the proximal outcome of partnership functioning, which, in turn, influenced the achievement of programme sustainability. On a 5-point scale of increasing sustainability, mean sustainability scores ranged from 1.9 to 4.9. The results of the regression analysis demonstrated that sustainability was positively influenced by leadership (standardised regression coefficient β = 0.32; P Partnership synergy acted as a mediator for partnership functioning and significantly affected sustainability (β = 0.39; P partnerships. © 2012 Blackwell Publishing Ltd.

  12. Clinical outcome of 36 male patients with primary urethral carcinoma. A single center experience

    International Nuclear Information System (INIS)

    Thyavihally, Y.B.; Tongaonkar, H.B.; Srivastava, S.K.; Mahantshetty, U.; Kumar, P.; Raibhattanavar, S.G.

    2006-01-01

    The aim of this study was retrospective analysis of male urethral carcinoma to assess the best therapeutic approach to the management of this tumor. A review of 36 cases of male urethral carcinoma diagnosed and treated at our center was performed. Clinical features, treatment modality and outcomes were analysed. The overall median survival time was 55.16 months. The 5-year overall and disease-free survival rate for the cohort was 49% and 23%, respectively. The 5-year survival is 67% for low-stage versus 33% for high-stage tumors and is significantly different (P=0.001). The survival was 72% for tumors of the distal urethra versus 36% for tumors of the proximal, with a P-value of 0.02. The tumor location and clinicopathological stage were the most important predictors of the disease-free and overall survival. Multimodal approach is necessary for achieving local control especially for proximal and higher stage tumors. (author)

  13. Non-Verbal Reasoning Ability and Academic Achievement as Moderators of the Relation between Adverse Life Events and Emotional and Behavioural Problems in Early Adolescence: The Importance of Moderator and Outcome Specificity

    Science.gov (United States)

    Flouri, Eirini; Tzavidis, Nikos

    2011-01-01

    This study was carried out to model the functional form of the effect of contextual risk (number of adverse life events) on emotional and behavioural problems in early adolescence, and to test how intelligence and academic achievement compare as moderators of this effect. The effect of number of adverse life events on emotional and behavioural…

  14. Can Social Support Protect Bullied Adolescents from Adverse Outcomes? A Prospective Study on the Effects of Bullying on the Educational Achievement and Mental Health of Adolescents at Secondary Schools in East London

    Science.gov (United States)

    Rothon, Catherine; Head, Jenny; Klineberg, Emily; Stansfeld, Stephen

    2011-01-01

    This paper investigates the extent to which social support can have a buffering effect against the potentially adverse consequences of bullying on school achievement and mental health. It uses a representative multiethnic sample of adolescents attending East London secondary schools in three boroughs. Bullied adolescents were less likely to…

  15. Ultrasonography-guided PNL in comparison with laparoscopic ureterolithotomy in the management of large proximal ureteral stone.

    Science.gov (United States)

    Karami, Hossein; Mazloomfard, Mohammad Mohsen; Lotfi, Behzad; Alizadeh, Asghar; Javanmard, Babak

    2013-01-01

    The aim of study was to evaluate the clinical outcomes of PNL in comparison with laparoscopic ureterolithotomy (LUL) in proximal ureteral stones larger than 1 cm. A total of 80 patients who were candidates for treatment of large ureteral stones in our urology center were enrolled in the study between September 2004 and September 2008. By using patient randomization, they were assigned into two forty-patient groups (PNL and LUL). After evaluating the patients with laboratory tests and IVP, PNL was performed under sonography guidance in the prone position or the patients were submitted to classic laparoscopic ureterolithotomy (LUL) transperitoneally. All patients underwent postoperative assessments including KUB and ultrasonography. A hundred-percent success was achieved in both groups. The mean age of the patients were 39.4 (16-63) and 35.2 (18-57) years old in PNL and LUL groups, respectively. The mean stone size in PNL group was 14.2 (10-25) mm and in LUL group was 13.5 (10-28) mm. The duration of the operations were 54.35 (50-82) minutes, and 82.15 (73-180) minutes (P PNL and LUL, accordingly. The mean Hb decrease in PNL group was 0.9mg/dL and in LUL group was 0.4mg/dL (p = 0.001). No statistically significant differences in terms of blood transfusion, fever, ICU admission, and prolonged urinary leakage were detected in both groups. According to our study, percutaneous nephrolithotomy under ultrasonography guidance is comparable with the laparoscopic ureterolithotomy for the treatment of proximal ureteral stones larger than 1 cm.

  16. Ultrasonography-guided PNL in comparison with laparoscopic ureterolithotomy in the management of large proximal ureteral stone

    Directory of Open Access Journals (Sweden)

    Hossein Karami

    2013-01-01

    Full Text Available Purpose: The aim of study was to evaluate the clinical outcomes of PNL in comparison with laparoscopic ureterolithotomy (LUL in proximal ureteral stones larger than 1 cm. Materials and Methods: A total of 80 patients who were candidates for treatment of large ureteral stones in our urology center were enrolled in the study between September 2004 and September 2008. By using patient randomization, they were assigned into two forty-patient groups (PNL and LUL. After evaluating the patients with laboratory tests and IVP, PNL was performed under sonography guidance in the prone position or the patients were submitted to classic laparoscopic ureterolithotomy (LUL transperitoneally. All patients underwent postoperative assessments including KUB and ultrasonography. Results: A hundred-percent success was achieved in both groups. The mean age of the patients were 39.4 (16-63 and 35.2 (18-57 years old in PNL and LUL groups, respectively. The mean stone size in PNL group was 14.2 (10-25 mm and in LUL group was 13.5 (10-28 mm. The duration of the operations were 54.35 (50-82 minutes, and 82.15 (73-180 minutes (P < 0.0001; and the average hospital stay days were 2.6 (2-5 and 3.5 (3-8 days (p = 0.011 in groups PNL and LUL, accordingly. The mean Hb decrease in PNL group was 0.9mg/dL and in LUL group was 0.4mg/dL (p = 0.001. No statistically significant differences in terms of blood transfusion, fever, ICU admission, and prolonged urinary leakage were detected in both groups. Conclusion: According to our study, percutaneous nephrolithotomy under ultrasonography guidance is comparable with the laparoscopic ureterolithotomy for the treatment of proximal ureteral stones larger than 1 cm.

  17. The tridimensional geometry of the proximal femur should determine the design of cementless femoral stem in total hip arthroplasty.

    Science.gov (United States)

    Wegrzyn, Julien; Roux, Jean-Paul; Loriau, Charlotte; Bonin, Nicolas; Pibarot, Vincent

    2018-02-22

    Using a cementless femoral stem in total hip arthroplasty (THA), optimal filling of the proximal femoral metaphyseal volume (PFMV) and restoration of the extramedullary proximal femoral (PF) parameters (i.e., femoral offset (FO), neck length (FNL), and head height (FHH)) constitute key goals for optimal hip biomechanics, functional outcome, and THA survivorship. However, almost 30% of mismatch between the PF anatomy and implant geometry of the most widely implanted non-modular cementless femoral stem has been demonstrated in a computed tomography scan (CT scan) study. Therefore, this anatomic study aimed to evaluate the relationship between the intra- and extramedullary PF parameters using tridimensional CT scan reconstructions. One hundred fifty-one CT scans of adult healthy hips were obtained from 151 male Caucasian patients (mean age = 66 ± 11 years) undergoing lower limb CT scan arteriography. Tridimensional PF reconstructions and parameter measurements were performed using a corrected PF coronal plane-defined by the femoral neck and diaphyseal canal longitudinal axes-to avoid influence of PF helitorsion and femoral neck version on extramedullary PF parameters. Independently of the femoral neck-shaft angle, the PFMV was significantly and positively correlated with the FO, FNL, and FHH (r = 0.407 to 0.420; p tridimensional PF geometry measurement in the corrected coronal plane of the femoral neck can be useful to determine and optimize the design of a non-modular cementless femoral stem. Particularly, continuous homothetic size progression of the intra- and extramedullary PF parameters should be achieved to assure stem fixation and restore anatomic hip biomechanics.

  18. Impacted valgus fractures of the proximal humerus

    Directory of Open Access Journals (Sweden)

    Fabiano Rebouças Ribeiro

    2016-04-01

    Full Text Available Impacted valgus fractures of the proximal humerus are considered to be a special type fracture, since impaction of the humeral head on the metaphysis with maintenance of the posteromedial periosteum improves the prognosis regarding occurrences of avascular necrosis. This characteristic can also facilitate the reduction maneuver and increase the consolidation rate of these fractures, even in more complex cases. The studies included were obtained by searching the Bireme, Medline, PubMed, Cochrane Library and Google Scholar databases for those published between 1991 and 2013. The objective of this study was to identify the most common definitions, classifications and treatment methods used for these fractures in the orthopedic medical literature.

  19. Proximal iliotibial band syndrome: case report

    Directory of Open Access Journals (Sweden)

    Guilherme Guadagnini Falotico

    2013-08-01

    Full Text Available OBJECTIVE: The overuse injuries in the hip joint occur commonly in sports practitioners and currently due to technical advances in diagnostic imaging, especially magnetic resonance imaging (MRI, are often misdiagnosed. Recently, a group of people were reported, all female, with pain and swelling in the pelvic region.T2-weighted MRI showed increased signal in the enthesis of the iliotibial band (ITB along the lower border of the iliac tubercle. We report a case of a 34 year old woman, non-professional runner, with pain at the iliac crest with no history of trauma and whose MRI was compatible with the proximal iliotibial band syndrome.

  20. Keldysh proximity action for disordered superconductors

    International Nuclear Information System (INIS)

    Feigel'man, M.V.; Larkin, A.I.; Skvortsov, M.A.

    2005-01-01

    We review a novel approach to the superconductive proximity effect in disordered normal-superconducting (N-S) structures. The method is based on the multicharge Keldysh action and is suitable for the treatment of interaction and fluctuation effects. As an application of the formalism, we study the subgap conductance and noise in two-dimensional N-S system in the presence of the electron-electron interaction in the Cooper channel. It is shown that singular nature of the interaction correction at large scales leads to a nonmonotonous temperature, voltage and magnetic field dependence of the Andreev conductance. (author)

  1. Giant cell tumour of the proximal radius.

    Science.gov (United States)

    Singh, A P; Mahajan, S; Singh, A P

    2009-11-01

    A 52-year-old Indian woman presented with a progressively increasing swelling and pain in the right elbow for the past eight months, which was not associated with trauma or constitutional symptoms. The patient was diagnosed to have Campanacci grade III giant cell tumour of the proximal radius, and was treated with above elbow amputation. The patient has not shown any recurrence after five years of follow-up. The case was reported because of its rarity and the unusual site of occurrence of the tumour.

  2. Distal radius fracture after proximal row carpectomy

    OpenAIRE

    Igeta, Yuka; Naito, Kiyohito; Sugiyama, Yoichi; Obata, Hiroyuki; Aritomi, Kentaro; Kaneko, Kazuo; Obayashi, Osamu

    2015-01-01

    Introduction: We encountered a patient with distal radius fracture (DRF) after proximal row carpectomy (PRC). The mechanism of the DRF after PRC is discussed in this report. Presentation of case: The patient was a 73-year-old female who had undergone PRC due to Kienböck disease before. The wrist range of motion was: 45° on dorsiflexion and 20° on flexion. DRF has occurred at 3 years after PRC. The fracture type was extra-articular fracture. Osteosynthesis was performed using a volar lockin...

  3. Noise measurements on proximity effect bridges

    International Nuclear Information System (INIS)

    Decker, S.K.; Mercereau, J.E.

    1975-01-01

    Audio frequency noise density measurements were performed on weakly superconducting proximity effect bridges on using a cooled transformer and room temperature low noise preamplifier. The noise temperature of the measuring system is approximately 4 0 K for a 0.9 Ω resistor. Noise density was measured as a function of bias current and temperature for the bridges. Excess noise above that expected from Johnson noise for a resistor equal to the dynamic resistance of the bridges was observed in the region near the critical current of the device. At high currents compared to the critical current, the noise density closely approaches that given by Johnson noise

  4. Management of the proximal tibia fractures by mini external fixation: A case series of 30 cases

    Directory of Open Access Journals (Sweden)

    Samar K Biswas

    2014-01-01

    Full Text Available Background: Management of high velocity trauma is a challenging problem because of morbidity of trauma and sometime residual problems of failure of proper healing of fractures with the restriction of movements of knee, shortening, and added risk of compartment syndrome in the proximal tibia fracture. There is always risk of post-operative infection and infected non-union in extensive open surgical procedure and internal fixation. Hence, there is always look out for the middle path procedure for a solution to the above said problems with the added advantage of less hospital stay and early return to work by minimal invasive procedure and stabilization of fracture reduction by multiple K-wire fixation with a frame applied externally. Stabilization of fracture with reduced pain allows early movements of neighbouring joint knee and ankle; hence, reduces the chances of fracture diseases. With this we have been stimulated to take-up the study of managing the proximal tibia fracture by mini external fixator. Aim: The aim of this study was to manage proximal tibia fractures by mini external fixator and evaluate the results and efficacy of this method. Material and Method: A total of 30 patients having proximal tibial fractures admitted at our center between 2008 and 2010 were taken and the procedure carried out was closed manipulative reduction and stabilization with mini external fixator. All acute proximal tibia fractures including tibial plateau fractures above 17 years of age of either sex were included in the study. Fracture more than 3 weeks old were excluded from the study. Result: Out of 30 cases 13 were excellent, 14 cases good, and 3 showed fair. It was found that type 5 and 6 of Schatzker′s classification have lesser outcome type of fractures Conclusion: We have found that management of the proximal tibia fractures by mini external fixation method has a better outcome. Early mobilization of knee in the proximal tibia fractures after

  5. Pragmatic RCT on the Efficacy of Proximal Caries Infiltration.

    Science.gov (United States)

    Meyer-Lueckel, H; Balbach, A; Schikowsky, C; Bitter, K; Paris, S

    2016-05-01

    Proximal caries infiltration has been shown to be efficacious in hampering caries lesion progression when performed by dentists working in a university setting. The aim of this randomized split-mouth, placebo-controlled clinical trial was to assess the efficacy of resin infiltration of proximal caries lesions being performed by several dentists in private practices, in combination with individualized oral hygiene plus noninvasive measures compared with these alone. In this study, 87 children and young adults (with 238 pairs of proximal caries lesions radiographically extending into the inner half of the enamel [E2] or the outer third of the dentin [D1]) were randomly allocated to either 1 of 2 treatments. Test lesions were infiltrated, and a mock treatment was performed in control lesions by 5 German private practitioners. All patients received instructions for a noncariogenic diet, flossing and fluoridation, and individualized noninvasive interventions. The primary outcome was radiographic lesion progression (pairwise comparison) evaluated independently by 2 evaluators who were blinded to treatment allocation. After approximately 10 mo (mean ± SD 307 ± 43 d), 92 of 148 lesion pairs in 24 of 38 treated patients who were at high caries risk could be re-evaluated clinically as well as radiographically using individualized bitewing holders, as at baseline; 186 of 204 lesion pairs in 70 of 77 patients (35 of 38 high-risk patients) could be evaluated after 18 mo (mean 542 ± 110 d). No unwanted effects were observed. After 10 mo, progression was recorded in 2 of 92 test lesions (2%) and in 22 of 92 control lesions (24%) (P= 0.001, McNemar/Obuchowski test; relative risk reduction, 91; 95% confidence interval, 62%-98%). After 18 mo, lesion progression was recorded in all included patients in 10 of 186 test lesions (5%) and in 58 of 186 control lesions (31%) (P< 0.001; relative risk reduction, 83; 95% confidence interval, 67%-91%). Thus, resin infiltration seems to be

  6. Dual Antegrade Intramedullary Headless Screw Fixation for Treatment of Unstable Proximal Phalanx Fractures.

    Science.gov (United States)

    Gaspar, Michael P; Gandhi, Shiv D; Culp, Randall W; Kane, Patrick M

    2018-01-01

    Although intramedullary headless screw (IMHS) fixation is a promising minimally invasive surgical treatment option for unstable proximal phalanx fractures, a single IMHS may provide inadequate fixation for certain fracture patterns. The purpose of this study was to evaluate the short-term clinical outcomes in a pilot series of patients with proximal phalanx fractures treated with dual antegrade IMHS fixation. We performed a retrospective chart review of proximal phalanx fractures treated with dual antegrade IMHS fixation with a minimum 1 year of follow-up. Demographic information including patient age, sex, occupation, workers' compensation status, mechanism of injury, hand dominance, and injured digit were obtained. Postoperative outcomes measured included range of motion, grip strength, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) outcome scores, return to full-duty work interval, and complications. Ten fractures in 10 patients (4 male, 6 female) satisfied study inclusion. The mean age of patients was 39 years (range, 20-62), and average follow-up duration was 84 weeks (range, 61-106). Final postoperative total active motion was 258° (range, 245°-270°), mean grip strength was 97% (range, 84%-104%) of the uninjured side, and QuickDASH score was 3.9 (range, 0-13.6). No complications occurred, and no patients required additional intervention. Dual antegrade IMHS fixation of proximal phalanx fractures resulted in excellent postoperative motion, near-normal grip strength, positive self-reported patient outcomes, and no complications with follow-up of at least 1 year. Further study in a larger number of patients is warranted to determine if this promising technique is superior to other modes of fixation.

  7. Pediatric hydrocephalus outcomes: a review

    OpenAIRE

    Vinchon, Matthieu; Rekate, Harold; Kulkarni, Abhaya V

    2012-01-01

    Abstract The outcome of pediatric hydrocephalus, including surgical complications, neurological sequelae and academic achievement, has been the matter of many studies. However, much uncertainty remains, regarding the very long-term and social outcome, and the determinants of complications and clinical outcome. In this paper, we review the different facets of outcome, including surgical outcome (shunt failure, infection and independence, and complications of endoscopy), clinical outcome (neuro...

  8. Congenital anomalies and proximity to landfill sites.

    LENUS (Irish Health Repository)

    Boyle, E

    2004-01-01

    The occurrence of congenital anomalies in proximity to municipal landfill sites in the Eastern Region (counties Dublin, Kildare, Wicklow) was examined by small area (district electoral division), distance and clustering tendancies in relation to 83 landfills, five of which were major sites. The study included 2136 cases of congenital anomaly, 37,487 births and 1423 controls between 1986 and 1990. For the more populous areas of the region 50% of the population lived within 2-3 km of a landfill and within 4-5 km for more rural areas. In the area-level analysis, the standardised prevalence ratios, empirical and full Bayesian modelling, and Kulldorff\\'s spatial scan statistic found no association between the residential area of cases and location of landfills. In the case control analysis, the mean distance of cases and controls from the nearest landfill was similar. The odds ratios of cases compared to controls for increasing distances from all landfills and major landfills showed no significant difference from the baseline value of 1. The kernel and K methods showed no tendency of cases to cluster in relationship to landfills. In conclusion, congenital anomalies were not found to occur more commonly in proximity to municipal landfills.

  9. Are classifications of proximal radius fractures reproducible?

    Directory of Open Access Journals (Sweden)

    dos Santos João BG

    2009-10-01

    Full Text Available Abstract Background Fractures of the proximal radius need to be classified in an appropriate and reproducible manner. The aim of this study was to assess the reliability of the three most widely used classification systems. Methods Elbow radiographs images of patients with proximal radius fractures were classified according to Mason, Morrey, and Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation (AO/ASIF classifications by four observers with different experience with this subject to assess their intra- and inter-observer agreement. Each observer analyzed the images on three different occasions on a computer with numerical sequence randomly altered. Results We found that intra-observer agreement of Mason and Morrey classifications were satisfactory (κ = 0.582 and 0.554, respectively, while the AO/ASIF classification had poor intra-observer agreement (κ = 0.483. Inter-observer agreement was higher in the Mason (κ = 0.429-0.560 and Morrey (κ = 0.319-0.487 classifications than in the AO/ASIF classification (κ = 0.250-0.478, which showed poor reliability. Conclusion Inter- and intra-observer agreement of the Mason and Morey classifications showed overall satisfactory reliability when compared to the AO/ASIF system. The Mason classification is the most reliable system.

  10. Crown dimensions and proximal enamel thickness of mandibular second bicuspids

    Directory of Open Access Journals (Sweden)

    Sérgio Augusto Fernandes

    2011-08-01

    Full Text Available To achieve proper recontouring of anterior and posterior teeth, to obtain optimal morphology during enamel stripping, it is important to be aware of dental anatomy. This study aimed at evaluating crown dimensions and proximal enamel thickness in a sample of 40 extracted sound, human, mandibular, second bicuspids (20 right and 20 left. Mesiodistal, cervico-occlusal and buccolingual crown dimensions were measured using a digital caliper, accurate to 0.01 mm. Teeth were embedded in acrylic resin and cut along their long axes through the proximal surfaces to obtain 0.7 mm-thick central sections. Enamel thickness on the cut sections was measured using a perfilometer. Comparative analyses were carried out using the Student's-t test (α= 5%. The mean mesiodistal crown widths for right and left teeth were 7.79 mm (± 0.47 and 7.70 mm (± 0.51, respectively. Mean cervico-occlusal heights ranged from 8.31 mm (± 0.75 on the right to 8.38 mm (± 0.85 on the left teeth. The mean values for the buccolingual dimension were 8.67 mm (± 0.70 on the right and 8.65 mm (± 0.54 on the left teeth. The mean enamel thickness on the mesial surfaces ranged from 1.35 mm (± 0.22 to 1.40 mm (± 0.17, on the left and right sides, respectively. On the distal surfaces, the corresponding values were 1.44 mm (± 0.21 and 1.46 mm (± 0.12. No significant differences were found between measurements for right and left teeth. However, enamel thickness was significantly greater on the distal surfaces, compared with the mesial surfaces.

  11. Sex-related differences in outcomes after hallux valgus surgery.

    Science.gov (United States)

    Choi, Gi Won; Kim, Hak Jun; Kim, Tae Wan; Lee, Ji Wun; Park, Sung Bum; Kim, Jin Kak

    2015-03-01

    With differences between the sexes in foot bone anatomy and ligamentous laxity, there is the possibility that the results of hallux valgus surgery may also differ between the sexes. We aimed to compare the results of hallux valgus surgery between the sexes. The authors retrospectively reviewed 60 males (66 feet) and 70 females (82 feet) who underwent distal or proximal chevron osteotomy for the treatment of hallux valgus deformity between June 2005 and December 2011. We compared the clinical and radiologic outcomes between the sexes. There were no statistically significant differences in demographics between the sexes. The mean American Orthopedic Foot and Ankle Society score, visual analogue scale for pain, and patient satisfaction at the last follow-up did not differ significantly between the sexes. The mean preoperative hallux valgus angle (HVA) and inter-metatarsal angle (IMA) were not significantly different between the sexes. At the last follow-up, the mean HVA was significantly greater in females (p=0.003) than in males; mean IMA was not significantly different between the sexes. The mean correction of HVA in males was significantly greater than that in females (p=0.014). There were no significant differences between the sexes regarding clinical outcomes after distal and proximal chevron osteotomy. However, male patients achieved greater correction of HVA than female patients. There is a possibility that sexual dimorphism of the foot may affect postoperative HVA.

  12. A versatile proximity-dependent probe based on light-up DNA-scaffolded silver nanoclusters.

    Science.gov (United States)

    Ma, Jin-Liang; Yin, Bin-Cheng; Ye, Bang-Ce

    2016-02-21

    It is well-known that proximity-dependent probes containing an analyte recognization site and a signal formation domain could be assembled specifically into a sandwich-like structure (probe-analyte-probe) via introducing an analyte. In this work, using the design for zirconium ion (Zr(4+)) detection as the model, we develop a novel and reliable proximity-dependent DNA-scaffolded silver nanocluster (DNA/AgNC) probe for Zr(4+) detection via target-induced emitter proximity. The proposed strategy undergoes the two following processes: target-mediated emitter pair proximity as target recognition implement and the synthesis of DNA/AgNCs with fluorescence as a signal reporter. Upon combination of the rationally designed probe with Zr(4+), the intact templates were obtained according to the -PO3(2-)-Zr(4+)-PO3(2-)- pattern. The resultant structure with an emitter pair serves as a potent template to achieve highly fluorescent DNA/AgNCs. To verify the universality of the proposed proximity-dependent DNA/AgNC probe, we extend the application of the proximity-dependent probe to DNA and adenosine triphosphate (ATP) detection by virtue of a specific DNA complementary sequence and ATP aptamer as a recognition unit, respectively. The produced fluorescence enhancement of the DNA/AgNCs in response to the analyte concentration allows a quantitative evaluation of the target, including Zr(4+), DNA, and ATP with detection limits of ∼3.00 μM, ∼9.83 nM, and ∼0.81 mM, respectively. The proposed probe possesses good performance with simple operation, cost-effectiveness, good selectivity, and without separation procedures.

  13. Anatomical variations of the proximal radius and their effects on osteosynthesis.

    Science.gov (United States)

    Giannicola, Giuseppe; Manauzzi, Erica; Sacchetti, Federico M; Greco, Alessandro; Bullitta, Gianluca; Vestri, Annarita; Cinotti, Gianluca

    2012-05-01

    In fractures of the radial head and neck requiring open reduction and internal fixation, osteosynthesis may be safely applied in a limited zone. We conducted a morphometric study of the proximal radius at the level of the safe zone to identify different morphologic types of this anatomical region. We analyzed 44 dried cadaveric radii. We measured the whole length of the radius, the length of the neck and head, and the minimum and maximum diameter of the radial head. The morphologic aspect of the neck-head curvature of the safe zone was evaluated qualitatively and quantitatively. The proximal radius at the level of the safe zone exhibited different radii of bending. In particular, we identified a morphologic type A, which showed a flat profile (25% of cases), morphologic types B and C, which showed a low concave curvature (64%), and a marked concave curvature (11%), respectively, of the safe zone. The profile of the proximal radius in the safe zone shows substantial morphologic variations that should be taken into account when operating on fractures of the proximal radius, to avoid malunions, pain, and stiffness of the elbow joint. A preoperative radiograph of the contralateral uninjured radius may be helpful in selecting the most appropriate internal fixation device to reconstruct the proximal radius after comminuted fractures. Knowledge of the proper bending radius of the safe zone allows the surgeon to select the most appropriate plate, and to achieve good fracture reduction and anatomical restoration of the proximal radius. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  14. Glucagon-like peptide-1 receptor stimulation increases GFR and suppresses proximal reabsorption in the rat.

    Science.gov (United States)

    Thomson, Scott C; Kashkouli, Ali; Singh, Prabhleen

    2013-01-15

    The incretin hormone glucagon-like peptide-1 (GLP-1) is released from the gut in response to fat or carbohydrate and contributes to negative feedback control of blood glucose by stimulating insulin secretion, inhibiting glucagon, and slowing gastric emptying. GLP-1 receptors (GLP-1R) are also expressed in the proximal tubule, and possibly elsewhere in the kidney. Presently, we examined the effect of a GLP-1R agonist on single-nephron glomerular filtration rate (GFR; SNGFR), proximal reabsorption (Jprox), tubuloglomerular feedback (TGF) responses, and urine flow rate in hydropenic male Wistar and Wistar-Froemter rats. Micropuncture and whole-kidney data were obtained before and during infusion of the GLP-1 agonist exenatide (1 nmol/h iv). SNGFR and Jprox were measured by late proximal collection at both extremes of TGF activation, which was achieved by perfusing Henle's loop at 0 or 50 nl/min. Primary changes in Jprox were revealed by analysis of covariance for Jprox with SNGFR as a covariate. Effects on TGF activation were determined in a separate set of experiments by comparing early distal and late proximal collections. Exenatide increased SNGFR by 33-50%, suppressed proximal tubular reabsorption by 20-40%, doubled early distal flow rate, and increased urine flow rate sixfold without altering the efficiency of glomerulotubular balance, TGF responsiveness, or the tonic influence of TGF. This implies that exenatide is both a proximal diuretic and a renal vasodilator. Since the natural agonist for the GLP-1R is regulated by intake of fat and carbohydrate, but not by salt or fluid, the control of salt excretion by the GLP-1R system departs from the usual negative-feedback paradigm for regulating salt balance.

  15. Does lesser trochanter implication affect hip flexion strength in proximal femur fracture?

    Science.gov (United States)

    Aprato, A; Lo Baido, R; Crosio, A; Matteotti, R; Grosso, E; Massè, A

    2015-10-01

    In pertrochanteric and intertrochanteric femoral fractures, the avulsion of the lesser trochanter by the pull of the iliopsoas muscle is not uncommon. This fragment is not commonly fixed because the avulsion of the lesser is tough to not influence the clinical outcome but up to date there is no evidence to support this statement. The aim of this study is to evaluate if lesser trochanter implication affects psoas muscle strength in proximal femur fracture. Patients with a consolidated intertrochanteric or pertrochanteric fracture associated or not with lesser trochanter fracture were enrolled, respectively, in group A and group B. Criteria of inclusion were the achievement of an anatomic reduction with gamma nail and a complete consolidation of the fracture. Criteria of exclusion were a follow-up shorter than 6 months and age over 65 years old at surgery. Patients were retrospectively reviewed for the purpose of this study. Range of motion, modified Harris Hip Score (mHHS), flexion strength with hip in neutral position, at 90° of flexion and in "figure four" position were evaluated on injured and healthy side. On the pre-operative X-rays, the vertical displacement of the lesser trochanter was calculated. Groups A and B showed no significant difference in age and follow-up. No statistical difference between the two groups was found in range of motion, mean mHHS, hip flexion strength at 90° of hip flexion. Lesser trochanter fracture group showed a significantly reduced strength in flexion with hip in neutral flexion (mean difference between two groups was 18.5 kgf). Lesser trochanter displacement showed a significant correlation with strength at 90° of flexion. Our results showed that lesser trochanter implication may result in decreased hip flexion strength. Lesser trochanter displacement is directly correlated with flexion strength. Further studies will be necessary to understand if lesser trochanter fixation may be a good solution for those patients.

  16. Severity and Frequency of Proximal Tubule Injury Determines Renal Prognosis

    Science.gov (United States)

    Takaori, Koji; Nakamura, Jin; Yamamoto, Shinya; Nakata, Hirosuke; Sato, Yuki; Takase, Masayuki; Nameta, Masaaki; Yamamoto, Tadashi; Economides, Aris N.; Kohno, Kenji; Haga, Hironori; Sharma, Kumar

    2016-01-01

    AKI increases the risk of developing CKD, but the mechanisms linking AKI to CKD remain unclear. Because proximal tubule injury is the mainstay of AKI, we postulated that proximal tubule injury triggers features of CKD. We generated a novel mouse model to induce proximal tubule–specific adjustable injury by inducing the expression of diphtheria toxin (DT) receptor with variable prevalence in proximal tubules. Administration of high-dose DT in mice expressing the DT receptor consistently caused severe proximal tubule–specific injury associated with interstitial fibrosis and reduction of erythropoietin production. Mild proximal tubule injury from a single injection of low-dose DT triggered reversible fibrosis, whereas repeated mild injuries caused sustained interstitial fibrosis, inflammation, glomerulosclerosis, and atubular glomeruli. DT–induced proximal tubule–specific injury also triggered distal tubule injury. Furthermore, injured tubular cells cocultured with fibroblasts stimulated induction of extracellular matrix and inflammatory genes. These results support the existence of proximal-distal tubule crosstalk and crosstalk between tubular cells and fibroblasts. Overall, our data provide evidence that proximal tubule injury triggers several features of CKD and that the severity and frequency of proximal tubule injury determines the progression to CKD. PMID:26701981

  17. The non-operative resin treatment of proximal caries lesions.

    Science.gov (United States)

    Ekstrand, Kim; Martignon, Stefania; Bakhshandeh, Azam; Ricketts, David N J

    2012-11-01

    Epidemiological data show that the prevalence of caries on proximal surfaces in need of operative treatment is very high around the world, both in the primary and the permanent dentition. This article presents two new treatment methods: proximal sealing and proximal infiltration. The indications are progressing proximal caries lesions, radiographically with a depth around the enamel-dentine junction. A small number of studies regarding the effect of sealing and infiltration on proximal caries versus the use of fluoride varnish, placebo treatment and flossing instructions have been carried out. About half of the studies disclose a not significant difference between test and control treatment. In the other half, the therapeutic effect is significant and corresponds to about 30% reduction in lesion progression. However, longitudinal studies of longer duration are lacking. Proximal sealing and proximal infiltration may have a place in the treatment of non-cavitated proximal lesions. Proximal caries is a problem in both primary and permanent dentitions. Proximal sealants or lesion infiltration are possible treatments.

  18. Role of proximal tubules in the pathogenesis of kidney disease.

    Science.gov (United States)

    Nakhoul, Nazih; Batuman, Vecihi

    2011-01-01

    The proximal tubules make up a significant portion of the kidneys; proximal tubule epithelial cells are the most populous cell type in the kidney, and carry out diverse regulatory and endocrine functions where numerous transporters are located. Under normal circumstances, more than two thirds of filtered salt and water, and all filtered bicarbonate is reabsorbed in the proximal tubule. A number of inherited and acquired acid-base and tubule disorders are linked to impaired transporters in the proximal tubule cells. Equally important is the intrinsic immune characteristics of proximal tubule cells that give them the ability to also function as immune responders to a wide range of immunologic, ischemic or toxic injury. It is therefore not surprising that proximal tubule-related phenomena are closely related to the pathogenesis of a vast array of kidney diseases. Many kidney diseases, acute and chronic, first manifest with proximal tubule disorders. Recent insight into molecular characteristics of transport functions in the proximal tubules, and the recognition that proximal tubule cells possess intrinsic immune responses have contributed to an improved understanding of important areas in nephrology, such as Fanconi's syndrome, renal tubular acidosis, phosphate wasting syndromes, Dent's disease, cystinuria and other amino acid transport disorders, acute kidney injury, and the role of proximal tubules in progressive kidney disease. Megalin/ cubilin-mediated endocytosis by proximal tubule cells of increased quantities of filtered proteins (protein overloading) in glomerular diseases appears to evoke cell stress responses resulting in increased inflammatory cytokines leading to tubulointerstitial inflammation and fibrosis. Finally, the proximal tubule may be the site of both active vitamin D synthesis through the action of 1-α-hydroxylase, and the site where erythropoietin synthesis takes place. Thus, proximal tubule injury also contributes to two distressing

  19. Clinical evaluation of a new custom offset shoulder prosthesis for treatment of complex fractures of the proximal humerus

    DEFF Research Database (Denmark)

    Mehlhorn, Alexander T; Schmal, Hagen; Sudkamp, Norbert P

    2006-01-01

    Primary hemiarthroplasty of the shoulder is an accepted procedure to treat complex proximal humeral fractures. The goal of this study was to assess the functional outcome in patients treated with hemiarthroplasty using a custom offset shoulder prosthesis, either for an acute four-part fracture...

  20. Four-Corner Arthrodesis Versus Proximal Row Carpectomy: A Retrospective Study With a Mean Follow-Up of 17 Years

    NARCIS (Netherlands)

    Berkhout, Merel J. L.; Bachour, Yara; Zheng, Kang He; Mullender, Margriet G.; Strackee, Simon D.; Ritt, Marco J. P. F.

    2015-01-01

    To compare the long-term outcomes of proximal row carpectomy (PRC) and 4-corner arthrodesis (FCA) in a consecutive series of patients surgically treated between 1989 and 1998 in a single teaching hospital. We included 12 patients (14 wrists) in the PRC group and 8 patients (8 wrists) in the FCA

  1. Four-Corner Arthrodesis Versus Proximal Row Carpectomy. A Retrospective Study With a Mean Follow-Up of 17 Years

    NARCIS (Netherlands)

    Berkhout, M.J.L.; Bachour, Y.; Zheng, K.H.; Mullender, M.G.; Strackee, S.D.; Ritt, M.J.P.F.

    2015-01-01

    Purpose To compare the long-term outcomes of proximal row carpectomy (PRC) and 4-corner arthrodesis (FCA) in a consecutive series of patients surgically treated between 1989 and 1998 in a single teaching hospital. Methods We included 12 patients (14 wrists) in the PRC group and 8 patients (8 wrists)

  2. Parallel Proximity Detection for Computer Simulation

    Science.gov (United States)

    Steinman, Jeffrey S. (Inventor); Wieland, Frederick P. (Inventor)

    1997-01-01

    The present invention discloses a system for performing proximity detection in computer simulations on parallel processing architectures utilizing a distribution list which includes movers and sensor coverages which check in and out of grids. Each mover maintains a list of sensors that detect the mover's motion as the mover and sensor coverages check in and out of the grids. Fuzzy grids are includes by fuzzy resolution parameters to allow movers and sensor coverages to check in and out of grids without computing exact grid crossings. The movers check in and out of grids while moving sensors periodically inform the grids of their coverage. In addition, a lookahead function is also included for providing a generalized capability without making any limiting assumptions about the particular application to which it is applied. The lookahead function is initiated so that risk-free synchronization strategies never roll back grid events. The lookahead function adds fixed delays as events are scheduled for objects on other nodes.

  3. Parallel Proximity Detection for Computer Simulations

    Science.gov (United States)

    Steinman, Jeffrey S. (Inventor); Wieland, Frederick P. (Inventor)

    1998-01-01

    The present invention discloses a system for performing proximity detection in computer simulations on parallel processing architectures utilizing a distribution list which includes movers and sensor coverages which check in and out of grids. Each mover maintains a list of sensors that detect the mover's motion as the mover and sensor coverages check in and out of the grids. Fuzzy grids are included by fuzzy resolution parameters to allow movers and sensor coverages to check in and out of grids without computing exact grid crossings. The movers check in and out of grids while moving sensors periodically inform the grids of their coverage. In addition, a lookahead function is also included for providing a generalized capability without making any limiting assumptions about the particular application to which it is applied. The lookahead function is initiated so that risk-free synchronization strategies never roll back grid events. The lookahead function adds fixed delays as events are scheduled for objects on other nodes.

  4. The association between proximity to animal feeding operations and community health: a systematic review.

    Directory of Open Access Journals (Sweden)

    Annette M O'Connor

    2010-03-01

    Full Text Available A systematic review was conducted for the association between animal feeding operations (AFOs and the health of individuals living near AFOs.The review was restricted to studies reporting respiratory, gastrointestinal and mental health outcomes in individuals living near AFOs in North America, European Union, United Kingdom, and Scandinavia. From June to September 2008 searches were conducted in PUBMED, CAB, Web-of-Science, and Agricola with no restrictions. Hand searching of narrative reviews was also used. Two reviewers independently evaluated the role of chance, confounding, information, selection and analytic bias on the study outcome. Nine relevant studies were identified. The studies were heterogeneous with respect to outcomes and exposures assessed. Few studies reported an association between surrogate clinical outcomes and AFO proximity. A negative association was reported when odor was the measure of exposure to AFOs and self-reported disease, the measure of outcome. There was evidence of an association between self-reported disease and proximity to AFO in individuals annoyed by AFO odor.There was inconsistent evidence of a weak association between self-reported disease in people with allergies or familial history of allergies. No consistent dose response relationship between exposure and disease was observable.

  5. The Association between Proximity to Animal Feeding Operations and Community Health: A Systematic Review

    Science.gov (United States)

    O'Connor, Annette M.; Auvermann, Brent; Bickett-Weddle, Danelle; Kirkhorn, Steve; Sargeant, Jan M.; Ramirez, Alejandro; Von Essen, Susanna G.

    2010-01-01

    Background A systematic review was conducted for the association between animal feeding operations (AFOs) and the health of individuals living near AFOs. Methodology/Principal Findings The review was restricted to studies reporting respiratory, gastrointestinal and mental health outcomes in individuals living near AFOs in North America, European Union, United Kingdom, and Scandinavia. From June to September 2008 searches were conducted in PUBMED, CAB, Web-of-Science, and Agricola with no restrictions. Hand searching of narrative reviews was also used. Two reviewers independently evaluated the role of chance, confounding, information, selection and analytic bias on the study outcome. Nine relevant studies were identified. The studies were heterogeneous with respect to outcomes and exposures assessed. Few studies reported an association between surrogate clinical outcomes and AFO proximity. A negative association was reported when odor was the measure of exposure to AFOs and self-reported disease, the measure of outcome. There was evidence of an association between self-reported disease and proximity to AFO in individuals annoyed by AFO odor. Conclusions/Significance There was inconsistent evidence of a weak association between self-reported disease in people with allergies or familial history of allergies. No consistent dose response relationship between exposure and disease was observable. PMID:20224825

  6. The influence of interdental spacing on the detection of proximal caries lesions in primary teeth

    Directory of Open Access Journals (Sweden)

    Tatiane Fernandes Novaes

    2012-08-01

    Full Text Available The aim of this study was to investigate the influence of interdental spacing on the performance of proximal caries detection methods in primary molars. In addition, aspects related to temporary tooth separation with orthodontic separators were evaluated. The proximal spaces between the posterior primary teeth (n = 344 of 76 children (4-12 years old were evaluated before and after temporary separation. Stainless steel strips with different standardized thicknesses were used to measure the presence of biological spacing and the spacing obtained after temporary separation with orthodontic rubber rings. First, the presence of proximal caries lesions was assessed by visual inspection, bitewing radiographs and a pen-type laser fluorescence device (DIAGNOdent pen. Visual inspection after temporary separation with separators was the reference standard method in checking the actual presence of caries. Multilevel analyses were performed considering different outcomes: the performance of the methods in detecting caries lesions and the spacing after temporary separation. The spacing did not influence the performance of the caries detection methods. The maximum spacing obtained with temporary tooth separation was 0.80 mm (mean ± standard deviation = 0.46 ± 0.13 mm. The temporary separation was more effective in the upper arch and less effective when an initial biological interdental spacing was present. The biological interdental spacing does not influence the performance of proximal caries detection methods in primary molars, and temporary tooth separation provides spacing narrower than 1.0 mm.

  7. The influence of interdental spacing on the detection of proximal caries lesions in primary teeth.

    Science.gov (United States)

    Novaes, Tatiane Fernandes; Matos, Ronilza; Celiberti, Paula; Braga, Mariana Minatel; Mendes, Fausto Medeiros

    2012-01-01

    The aim of this study was to investigate the influence of interdental spacing on the performance of proximal caries detection methods in primary molars. In addition, aspects related to temporary tooth separation with orthodontic separators were evaluated. The proximal spaces between the posterior primary teeth (n = 344) of 76 children (4-12 years old) were evaluated before and after temporary separation. Stainless steel strips with different standardized thicknesses were used to measure the presence of biological spacing and the spacing obtained after temporary separation with orthodontic rubber rings. First, the presence of proximal caries lesions was assessed by visual inspection, bitewing radiographs and a pen-type laser fluorescence device (DIAGNOdent pen). Visual inspection after temporary separation with separators was the reference standard method in checking the actual presence of caries. Multilevel analyses were performed considering different outcomes: the performance of the methods in detecting caries lesions and the spacing after temporary separation. The spacing did not influence the performance of the caries detection methods. The maximum spacing obtained with temporary tooth separation was 0.80 mm (mean ± standard deviation = 0.46 ± 0.13 mm). The temporary separation was more effective in the upper arch and less effective when an initial biological interdental spacing was present. The biological interdental spacing does not influence the performance of proximal caries detection methods in primary molars, and temporary tooth separation provides spacing narrower than 1.0 mm.

  8. Dental flossing as a diagnostic method for proximal gingivitis: a validation study.

    Science.gov (United States)

    Grellmann, Alessandra Pascotini; Kantorski, Karla Zanini; Ardenghi, Thiago Machado; Moreira, Carlos Heitor Cunha; Danesi, Cristiane Cademartori; Zanatta, Fabricio Batistin

    2016-05-20

    This study evaluated the clinical diagnosis of proximal gingivitis by comparing two methods: dental flossing and the gingival bleeding index (GBI). One hundred subjects (aged at least 18 years, with 15% of positive proximal sites for GBI, without proximal attachment loss) were randomized into five evaluation protocols. Each protocol consisted of two assessments with a 10-minute interval between them: first GBI/second floss, first floss/second GBI, first GBI/second GBI, first tooth floss/second floss, and first gum floss-second floss. The dental floss was slid against the tooth surface (TF) and the gingival tissue (GF). The evaluated proximal sites should present teeth with established point of contact and probing depth ≤ 3mm. One trained and calibrated examiner performed all the assessments. The mean percentages of agreement and disagreement were calculated for the sites with gingival bleeding in both evaluation methods (GBI and flossing). The primary outcome was the percentage of disagreement between the assessments in the different protocols. The data were analyzed by one-way ANOVA, McNemar, chi-square and Tukey's post hoc tests, with a 5% significance level. When gingivitis was absent in the first assessment (negative GBI), bleeding was detected in the second assessment by TF and GF in 41.7% (p gingivitis in the second assessment (negative GBI), TF and GF detected bleeding in the first assessment in 38.9% (p = 0.004) and 58.3% (p gingivitis than GBI.

  9. A New Injectable Brushite Cement: First Results in Distal Radius and Proximal Tibia Fractures.

    Science.gov (United States)

    Ryf, Christian; Goldhahn, Sabine; Radziejowski, Marek; Blauth, Michael; Hanson, Beate

    2009-08-01

    The restoration of metaphyseal defects remains a challenge for the treating surgeon. Although injectable brushite cements may help to refill bone defects stabilized with internal fixation, human data remains unavailable. The main goal of this prospective multicenter study was to observe the performance of this material in a clinical setting. The study conducted in seven trauma units included closed metaphyseal distal radius and proximal tibia fractures with bone defects, stabilized with internal fixation and subsequent filling with brushite cement. At 6- and 12-month follow-ups, patient satisfaction (visual analog scale [VAS]) was recorded, as well as complications. Thirty-eight proximal tibia fractures and 37 patients with distal radius fractures were included. Overall patient satisfaction with the treatment was high (mean VAS = 92 and 91 for proximal tibia and distal radius, respectively), despite the loss of reduction being described in 11% of proximal tibia and 24% of distal radius fractures; the majority of them included severe fracture types. Radiological evaluation showed postoperative cement leakage in 20 cases, where the majority occurred at the distal radius (n = 15). In 13 distal radius fractures, the leakage was resorbed by the final examination. The tested material showed good outcome in the majority of patients and adequate resorption characteristics, even in the case of extravasation. Stable internal fixation, sufficient bone quality, and no contact between the cement and joint are essential requirements for chronOS Inject, which can be considered as an alternative to existing augmentation materials.

  10. Preoperative determination of appropriate cutting line for proximal gastrectomy to avoid postoperative jejunal ulcer.

    Science.gov (United States)

    Takahashi, Naoto; Kashimura, Hirotaka; Nimura, Hiroshi; Watanabe, Atsushi; Yano, Kentaro; Aoki, Hiroaki; Koyama, Tomoki; Sasaki, Toshiyuki; Shida, Atsuo; Mitsumori, Norio; Aoki, Teruaki; Kashiwagi, Hideyuki; Yanaga, Katsuhiko

    2012-01-01

    Although proximal gastrectomy has become a procedure of choice for patients' early cancer in the upper third of stomach, no clinical guide for optimal gastric resection in order to avoid postoperative jejunal ulcer is available. The aim of this study was to investigate whether determining the distribution of parietal and chief cells of the stomach using Congo red test is clinically relevant. The F-line was defined as a boundary line between fundic and intermediate area of the stomach according to the pathological findings in 29 patients who underwent total gastrectomy for early gastric cancer, whereas the f-line was regarded as a boundary line between intermediate and pyloric area. In the additional 6 patients undergoing vagus-preserving proximal gastrectomy with jejunal pouch interposition, endoscopic Congo red test was preoperatively performed to determine the F-f-line. The distances from the pyloric ring to f-line on the lesser and greater curvatures were variable. Long-term outcomes of proximal gastrectomy guided by preoperative endoscopic Congo red test were favorable. It is suggested that preoperative endoscopic Congo red test is useful to determine the appropriate cutting line in order to avoid postoperative jejunal ulcer after proximal gastrectomy.

  11. Role of Provisional Fixation of Fracture Fragments By Steinmann-Pin and Technical Tips in Proximal Femoral Nailing for Intertrochanteric Fracture.

    Science.gov (United States)

    Jain, Mohit J; Mavani, Kinjal J; Patel, Dhaval

    2017-06-01

    Proximal Femoral Nailing (PFN) in Intertrochanteric Fractures (IF) is becoming the choice of implant due to better biomechanics and prevention of varus collapse associated with Dynamic Hip Screw (DHS). Technical difficulties and implant related complications are yet to be addressed. To understand the technical difficulties involved in PFN and role of provisional fixation of fracture by Steinmann-pin. In this study, 55 patients presented to a tertiary trauma center in India with trochanteric fractures from April 2010 to March 2012 were included and treated with PFN. All patients were followed-up for two years and final outcome assessment included shortening, neck shaft angle and Harris Hip Score was done. In all except one, neck shaft angle greater than 130° was achieved and also maintained in the final follow up (Mean 131.1°). All fractures were united with mean shortening of 3.6 mm and average Harris Hip Score of 91 after two years. There were five complications which included one shortening, two varus collapses, one backed out screws and one reverse Z effect. Though PFN is technically challenging, with proper technique, gives excellent results with negligible varus collapse even in unstable fractures. Three most important technical aspects are achieving good non-varus reduction, inserting nail correctly and accurate placement of lag screws. The technique of provisional fixation of fracture fragments by Steinmann-pin significantly helps in achieving these and reduces the risk of implant failure.

  12. Avaliação funcional retrospectiva de pacientes com fratura proximal de úmero fixada com placa com parafusos de ângulo fixo para região proximal no úmero Retrospective functional assessment of patients with humerus proximal fractures internally fixed with a fixed-angle plate for proximal humerus area

    Directory of Open Access Journals (Sweden)

    Rafael Inácio Barbosa

    2008-01-01

    Full Text Available As fraturas do úmero proximal são lesões comuns, levando seus pacientes a importantes limitações funcionais além de algumas complicações. Atualmente existem algumas opções de tratamentos cirúrgicos visando à melhor estabilização da lesão através de técnicas de ostessíntese, dependendo do grau de gravidade da lesão. Dentre eles, tem-se utilizado a placa com parafusos de ângulo fixo para região proximal do úmero, a qual possui o intuito de preservar a integridade biológica da cabeça umeral associada à redução anatômica segura utilizando múltiplos parafusos de fixação com estabilidade angular, permitindo assim a mobilização precoce do membro fraturado. Foram estudados retrospectivamente 11 pacientes com fratura proximal do úmero, tratados com esse modelo de placa entre os anos de 2004 e 2005. Na avaliação funcional foram utilizados o questionário de Constant e o índice DASH. Os resultados sugerem o aparecimento de perda funcional residual no membro superior após esse tipo de trauma, apesar da fixação estável e o tratamento fisioterapêutico.Proximal humeral fractures are common injuries leading to severe functional restrictions and complications for patients. Today, there are several surgical alternatives aimed at achieving better injury stabilization by means of osteosynthesis techniques, depending on injury severity. One of these is the fixed-angle plate fixation of the proximal humerus. This bone fixation system is intended to preserve the biologic integrity of the humeral head associated with a safe anatomical reduction, employing several fixating screws with angle stability, thereby allowing an early mobilization of the fractured limb. Eleven patients with proximal humeral fractures treated with the method of fixed-angle plate fixation of the proximal humerus in the period of 2004 to 2005 were retrospectively studied. The patients were subjected to the Constant questionnaire and the DASH index for

  13. Proximal and distal muscle fatigue differentially affect movement coordination

    Science.gov (United States)

    Cowley, Jeffrey C.

    2017-01-01

    Muscle fatigue can cause people to change their movement patterns and these changes could contribute to acute or overuse injuries. However, these effects depend on which muscles are fatigued. The purpose of this study was to determine the differential effects of proximal and distal upper extremity muscle fatigue on repetitive movements. Fourteen subjects completed a repetitive ratcheting task before and after a fatigue protocol on separate days. The fatigue protocol either fatigued the proximal (shoulder flexor) or distal (finger flexor) muscles. Pre/Post changes in trunk, shoulder, elbow, and wrist kinematics were compared to determine how proximal and distal fatigue affected multi-joint movement patterns and variability. Proximal fatigue caused a significant increase (7°, p fatigue caused small but significant changes in trunk angles (2°, p fatigue protocols (p fatigue at either proximal or distal joints. The identified differences between proximal and distal muscle fatigue adaptations could facilitate risk assessment of occupational tasks. PMID:28235005

  14. Proximity of signallers can maintain sexual signal variation under stabilizing selection.

    Science.gov (United States)

    van Wijk, Michiel; Heath, Jeremy; Lievers, Rik; Schal, Coby; Groot, Astrid T

    2017-12-22

    How sexual communication systems can evolve under stabilizing selection is still a paradox in evolutionary biology. In moths, females emit a species-specific sex pheromone, consisting of a blend of biochemically related components, to which males are attracted. Although males appear to exert strong stabilizing selection on female pheromone, these blends seem to have evolved rapidly, as evidenced by ~120,000 moth species. Here we propose and test a "proximity model" wherein two females that vary in their relative attractiveness to males, can both benefit from calling in close proximity to each other. In a field study, we show that (1) artificially selected unattractive females can achieve mating rates comparable to attractive females if they signal in close proximity to attractive females, and (2) attractive females benefit from higher mating rates when signalling in close proximity to unattractive females. We propose that frequency-dependent behavioural and spatial interactions can sustain signal variation within populations even when these signals are under stabilizing selection.

  15. [Growth behaviour after fractures of the proximal radius: differences to the rest of the skeleton].

    Science.gov (United States)

    Hell, A K; von Laer, L

    2014-12-01

    Fractures of the proximal end of the radius in the growth phase have three characteristics: the head of the radius articulates with two joint partners and is therefore indispensable for an undisturbed function of the elbow. The blood supply of the proximal end of the radius is via periosteal vessels in the sense of a terminal circulation which makes it extremely vulnerable. Severe trauma caused either by accidents or treatment, can result in partial or complete necrosis with deformity of the head and neck region of the radius. Radioulnar synostosis and chronic epiphysiolysis are irreversible complications which can occur after excessive physiotherapy. Despite a low potency growth plate, in young patients the proximal end of the radius shows an enormous spontaneous correction of dislocations. Side to side shifts, however, will not be remodeled. Therapy should be as atraumatic as possible. Due to the blood supply situation, with the appropriate indications the spontaneous correction and a brief period of immobilization without physiotherapy should be integrated into the therapy concept. If an operation is necessary, repeated traumatic repositioning maneuvers should be avoided and in case of doubt closed or careful open repositioning can be achieved with intramedullary nailing. In order to take the special characteristics of the proximal radius into consideration, the vulnerability and correction potential must be weighed up against each other. Therapy must be as atraumatic as possible. The spontaneous correction potential should be integrated into the primary therapy without overestimating this potential with respect to the extent and age of the patient.

  16. Functional treatment of physeal and periphyseal injuries of the metacarpal and proximal phalangeal bones.

    Science.gov (United States)

    Ebinger, T; Roesch, M; Wachter, N; Kinzl, L; Mentzel, M

    2001-04-01

    Hand fractures are common injuries in infants. Complications are rare because of potent remodeling dimension and rapid healing of growing bone. There is limited remodeling capacity for angular and rotational deformity so displaced fractures often require open reduction and internal fixation. The authors present a splint system for a protected reduction and mobilization program of displaced proximal phalanx and metacarpal fractures. The custom-molded 2-component thermoplastic splint allows motion of the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints. It has been developed to allow bone healing and recovery of motion at the same time. In this study, the authors evaluated the clinical and radiologic results of a series of 11 consecutive infants with displaced metacarpal fractures and 13 displaced proximal phalanx fractures who received functional treatment. Fracture consolidation and full active motion was achieved simultaneously in 4 weeks in 21 children; 2 infants required physiotherapy, and 1 child was lost to follow-up. No further growth abnormality was seen within a 12-month observation period. When there is no damage of soft tissue the functional mobilization program can lead to good results treating displaced physeal and periphyseal hand injuries of proximal phalanx and metacarpal fractures. J Pediatr Surg 36:611-615. Copyright 2001 by W.B. Saunders Company.

  17. Relevance of the proximity potential to light-ion scattering

    International Nuclear Information System (INIS)

    Tabor, S.L.; Goldberg, D.A.; Hurizenga, J.R.

    1978-01-01

    Because optical-model potentials are relatively well determined by light-ion elastic scattering, we have compared such potentials with the proximity potential, which was developed for heavy-ion reactions. After the real, nuclear potentials determined by p, d, 3 He, and α scattering at 30--35 MeV/amu are transformed into the universal proximity form they are rather similar to each other and are in rough agreement with a theoretical proximity potential

  18. Diagnosis of Proximal Caries in Primary Molars with DIAGNOdent pen

    OpenAIRE

    Ermler, Romy

    2010-01-01

    Proximal surfaces, together with fissures, are the areas where most primary caries occur. Due to the anatomy of the deciduous molars, proximal caries cannot be detected at an early stage in crowded teeth by simply using a mirror and probe. Therefore, additional methods to find early proximal caries have to be used. KaVo uses laser fluorescence to detect caries. Originally, the DIAGNOdent devices were able to detect only occlusal caries (56, 61, 62, 65, 66). New results are now also available ...

  19. Restoration of the Active Forearm Rotation Using Vascularized Free Fibular Graft and Radial Head Arthroplasty for a Wide Defect of the Proximal Radius.

    Science.gov (United States)

    Sato, Ryosuke; Hamada, Yoshitaka; Hibino, Naohito; Nishisho, Toshihiko; Tonogai, Ichiro; Endo, Kenji; Sairyo, Koichi

    2017-12-01

    In this report we present a case of re-stabilization of the proximal radius using vascularized free fibular graft combined with anconeus arthroplasty to stabilize the transplanted fibula in a patient with large loss of the proximal radius due to Ewing's sarcoma. A 20-year-old woman had Ewing's sarcoma in the proximal three-fourths of the radius. The resection of large part of the radius containing radial head were necessary for removal of the sarcoma. Reconstruction of the proximal radius was performed using vascularized free fibular graft and the transplanted fibula was stabilized by attaching the anconeus to the proximal edge of the fibula. 2 years after surgery, she had neither recurrence nor metastasis, and achieved functional recovery. The combination anconeus arthroplasty with vascularized free fibular graft can be a good technique for re-stabilization of the elbow and recovery of the forearm function.

  20. Parental Involvement and Adolescents' Educational Success: The Roles of Prior Achievement and Socioeconomic Status.

    Science.gov (United States)

    Benner, Aprile D; Boyle, Alaina E; Sadler, Sydney

    2016-06-01

    Parental educational involvement in primary and secondary school is strongly linked to students' academic success; however; less is known about the long-term effects of parental involvement. In this study, we investigated the associations between four aspects of parents' educational involvement (i.e., home- and school-based involvement, educational expectations, academic advice) and young people's proximal (i.e., grades) and distal academic outcomes (i.e., educational attainment). Attention was also placed on whether these relations varied as a function of family socioeconomic status or adolescents' prior achievement. The data were drawn from 15,240 10th grade students (50 % females; 57 % White, 13 % African American, 15 % Latino, 9 % Asian American, and 6 % other race/ethnicity) participating in the Education Longitudinal Study of 2002. We observed significant links between both school-based involvement and parental educational expectations and adolescents' cumulative high school grades and educational attainment. Moderation analyses revealed that school-based involvement seemed to be particularly beneficial for more disadvantaged youth (i.e., those from low-SES families, those with poorer prior achievement), whereas parents' academic socialization seemed to better promote the academic success of more advantaged youth (i.e., those from high-SES families, those with higher prior achievement). These findings suggest that academic interventions and supports could be carefully targeted to better support the educational success of all young people.

  1. Distributed Autonomous Control of Multiple Spacecraft During Close Proximity Operations

    National Research Council Canada - National Science Library

    McCamish, Shawn B

    2007-01-01

    This research contributes to multiple spacecraft control by developing an autonomous distributed control algorithm for close proximity operations of multiple spacecraft systems, including rendezvous...

  2. Novel potential marker for native anteversion of the proximal femur.

    Science.gov (United States)

    Durgin, Chesley F; Spratley, E Meade; Satpathy, Jibanananda; Jiranek, William A; Wayne, Jennifer S

    2017-08-01

    Identifying native femoral version from proximal femoral landmarks would be of benefit both for preoperative assessment as well as intraoperatively. To identify potential markers for femoral anteversion, an empirical framework was developed for orientation-independent analysis of the proximal femur from pelvic CT to allow for segmentation of the proximal femur into five constituent regions: Femoral head, femoral neck, greater trochanter, lesser trochanter and femoral shaft. The framework is based on the identification of differences in the radius of curvature at anatomic zones of transition between regions of the proximal femur, followed by non-linear geometric shape fitting. The framework is applied to 86 proximal femurs segmented from pelvic CTs, with at least 2 cm of proximal femur remaining below the lesser trochanter, obtained for non-musculoskeletal pathology to investigate potential proximal femoral markers for native femoral version. The analysis of the proximal femur suggests a fixed relationship between the maximal femoral canal diameter 1 cm proximal to the base of the lesser trochanter from the center of the greater trochanter and the femoral neck axis of 4.13° +/- 4.99°. Further full-length femoral studies are needed to confirm the relationship of the maximal canal diameter as a proxy for native femoral anteversion. Published by Wiley Periodicals, Inc. J Orthop Res 35:1724-1731, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  3. Achieving Public Schools

    Science.gov (United States)

    Abowitz, Kathleen Knight

    2011-01-01

    Public schools are functionally provided through structural arrangements such as government funding, but public schools are achieved in substance, in part, through local governance. In this essay, Kathleen Knight Abowitz explains the bifocal nature of achieving public schools; that is, that schools are both subject to the unitary Public compact of…

  4. Towards the goal of achieving a normal duration and quality of life after Fontan operation: Creation of the International Fontan Interest group (I-FIG), an international collaborative initiative dedicated to improving outcomes.

    Science.gov (United States)

    d'Udekem, Yves; Rychik, Jack

    2017-10-15

    A growing population of patients are now surviving the Fontan procedure and face an uncertain future and a clear burden of disease. The best medical therapy and follow-up modalities for these patients have not yet been identified, indications for transplantation are unclear and we have not been successful in mechanically supporting their circulation. There has only been a limited number of trials to address these issues. An international group has now been created to launch the large scale multi-centric research needed to provide the best future to this growing population: the International Fontan Interest Group (I-FIG). Its mission is to "better understand the Fontan circulation, and improve treatment and long-term outcomes of the patients who have undergone the Fontan procedure". We intend to build a large platform which will attract researchers of other specialties such as gastro-enterology, neurology and psychology and reach in the field of genomics, molecular biology, pharmacology and bio-informatics. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Longitudinal Proximity Effect, Lateral Inverse Proximity Effect, and Nonequilibrium Superconductivity in Transition-edge Sensors

    Science.gov (United States)

    Sadleir, John E.

    2010-01-01

    We have recently shown that normal-metal/superconductor (N/S) bilayer TESs (superconducting Transition-Edge Sensors) exhibit weak-link behavior. Our measurements were explained in terms of a longitudinal proximity effect model in which superconducting order from the higher transition temperature leads is induced into the TES bilayer plane over remarkably long distances (up to 290 micron). Here we extend our understanding to include TESs with added noise-mitigating normal-metal structures (N structures). We explain our results of an effect converse to the longitudinal proximity effect (LoPE), the lateral inverse proximity effect (LaiPE), for which the order parameter in the N/S bilayer is reduced due to the neighboring N structures. We present resistance and critical current measurements as a function of temperature and magnetic field taken on square Mo/Au bilayer TESs with lengths ranging from 8 to 130 micron with and without added N structures. We observe the inverse proximity effect on the bilayer over in-plane distances many tens of microns and find the transition shifts to lower temperature scale approximately as the inverse square of the in-plane N-structure separation distance, without appreciable broadening of the transition width. We find TESs with added Au structures exhibit weak-link behavior as evidenced by exponential temperature dependence of the critical current and Josephson-like oscillations of the critical current with applied magnetic field. We also present evidence for nonequilbrium superconductivity and estimate a quasiparticle lifetime of 1.8 x 10(exp -10) s for the bilayer. The LoPE model is also used to explain the increased conductivity at temperatures above the bilayer's steep resistive transition

  6. Using the 2 x 2 Framework of Achievement Goals to Predict Achievement Emotions and Academic Performance

    Science.gov (United States)

    Putwain, David W.; Sander, Paul; Larkin, Derek

    2013-01-01

    Previous work has established how achievement emotions are related to the trichotomous model of achievement goals, and how they predict academic performance. In our study we examine relations using an additional, mastery-avoidance goal, and whether outcome-focused emotions are predicted by mastery as well as performance goals. Results showed that…

  7. Reconstruct the proximal radius with iliac graft and elastic intramedullary nail fixation after tumor resection.

    Science.gov (United States)

    Zhu, Bin; Yang, Jielai; Cheng, Dongdong; Yin, Xiaofan; Yang, Qingcheng

    2016-08-08

    This study aims to introduce a novel technique in treating benign bone tumors of the proximal radius by elastic intramedullary nail fixation and iliac graft after tumor resection. In this retrospective case series, the treatment outcomes of 17 patients with benign bone tumor involving the proximal radius were reported from January 2010 to August 2014. All the patients received reconstruction surgery with iliac graft and elastic intramedullary nail fixation after tumor resection. Pain scoring was assessed using the 0 to 10 numerical rating scale. The quality of life scoring was assessed using the SF-30 scoring system. In addition, functional outcome was assessed with the Musculoskeletal Tumor Society score and the Disabilities of the Arm, Shoulder, and Hand score. The mean follow-up was 16 months (range, 10-22). The average bone consolidate time was 19.2 weeks (range, 16-24 weeks). The pre- and postoperative pain scores were 5.47 ± 1.58 and 1.18 ± 0.39, respectively. The pain symptom was significantly ameliorated after the operation (t = 13.50, p proximal radius.

  8. PROXIMAL DISABILITY AND SPINAL DEFORMITY INDEX IN PATIENTS WITH PROXIMAL FEMUR FRACTURES

    Directory of Open Access Journals (Sweden)

    Sylvio Mistro Neto

    2015-12-01

    Full Text Available Objective : To evaluate the quality of life related to the spine in patients with proximal femoral fractures. Methods : Study conducted in a tertiary public hospital in patients with proximal femoral fractures caused by low-energy trauma, through the Oswestry Disability Index questionnaire to asses complaints related to the spine at the time of life prior to the femoral fracture. The thoracic and lumbar spine of patients were also evaluated applying the radiographic index described by Gennant (Spinal Deformity Index, which assesses the number and severity of fractures. Results : Seventeen subjects completed the study. All had some degree of vertebral fracture. Patients were classified in the categories of severe and very severe disability in the questionnaire about quality of life. It was found that the higher SDI, the better the quality of life. Conclusion : There is a strong association of disability related to the spine in patients with proximal femoral fracture, and this complaint must be systematically evaluated in patients with appendicular fracture.

  9. Laparoscopic proximal gastrectomy with jejunal interposition for gastric cancer in the proximal third of the stomach: a retrospective comparison with open surgery.

    Science.gov (United States)

    Kinoshita, Takahiro; Gotohda, Naoto; Kato, Yuichiro; Takahashi, Shinichiro; Konishi, Masaru; Kinoshita, Taira

    2013-01-01

    The incidence of cancer in the proximal third of the stomach is increasing. Laparoscopic proximal gastrectomy (LPG) seems an attractive option for the treatment of early-stage proximal gastric cancer but has not gained wide acceptance because of technical difficulties, including the prevention of severe reflux. In this study, we describe our technique for LPG with jejunal interposition (LPG-IP) and evaluate its safety and feasibility. In this retrospective analysis, we reviewed the data of patients with proximal gastric cancer who underwent LPG-IP (n = 22) or the same procedure with open surgery (OPG-IP; n = 68) between January 2008 and September 2011. Short-term surgical variables and outcomes were compared between the groups. The reconstruction method was the same in both groups, with creation of a 15 cm, single-loop, jejunal interposition for anastomosis. There were no differences in patient or tumor characteristics between the groups. Operation time was longer in the LGP-IP group (233 vs. 201 min, p = 0.0002) and estimated blood loss was significantly less (20 vs. 242 g, p < 0.0001). The average number of harvested lymph nodes did not differ between the two groups (17 vs. 20). There also were no differences in the incidence of leakage at the esophagojejunostomy anastomosis (9.1 vs. 7.4%) or other postoperative complications (27 vs. 32%). The number of times additional postoperative analgesia was required was significantly less in the LPG-IP group compared with the OPG-IP group (2 vs. 4, p < 0.0001). LPG-IP has equivalent safety and curability compared with OPG-IP. Our results imply that LPG-IP may lead to faster recovery, better cosmesis, and improved quality of life in the short-term compared with OPG-IP. Because of the limitations of retrospective analysis, a further study should be conducted to obtain definitive conclusions.

  10. Proximity Operations and Docking Sensor Development

    Science.gov (United States)

    Howard, Richard T.; Bryan, Thomas C.; Brewster, Linda L.; Lee, James E.

    2009-01-01

    The Next Generation Advanced Video Guidance Sensor (NGAVGS) has been under development for the last three years as a long-range proximity operations and docking sensor for use in an Automated Rendezvous and Docking (AR&D) system. The first autonomous rendezvous and docking in the history of the U.S. Space Program was successfully accomplished by Orbital Express, using the Advanced Video Guidance Sensor (AVGS) as the primary docking sensor. That flight proved that the United States now has a mature and flight proven sensor technology for supporting Crew Exploration Vehicles (CEV) and Commercial Orbital Transport Systems (COTS) Automated Rendezvous and Docking (AR&D). NASA video sensors have worked well in the past: the AVGS used on the Demonstration of Autonomous Rendezvous Technology (DART) mission operated successfully in spot mode out to 2 km, and the first generation rendezvous and docking sensor, the Video Guidance Sensor (VGS), was developed and successfully flown on Space Shuttle flights in 1997 and 1998. 12 Parts obsolescence issues prevent the construction of more AVGS units, and the next generation sensor was updated to allow it to support the CEV and COTS programs. The flight proven AR&D sensor has been redesigned to update parts and add additional capabilities for CEV and COTS with the development of the Next Generation AVGS at the Marshall Space Flight Center. The obsolete imager and processor are being replaced with new radiation tolerant parts. In addition, new capabilities include greater sensor range, auto ranging capability, and real-time video output. This paper presents some sensor hardware trades, use of highly integrated laser components, and addresses the needs of future vehicles that may rendezvous and dock with the International Space Station (ISS) and other Constellation vehicles. It also discusses approaches for upgrading AVGS to address parts obsolescence, and concepts for minimizing the sensor footprint, weight, and power requirements

  11. Proximal interphalangeal joint dislocations and treatment: an evolutionary process.

    Science.gov (United States)

    Joyce, Kenneth Michael; Joyce, Cormac Weekes; Conroy, Frank; Chan, Jeff; Buckley, Emily; Carroll, Sean Michael

    2014-07-01

    Proximal interphalangeal joint (PIPJ) dislocations represent a significant proportion of hand clinic visits and typically require frequent follow-ups for clinical assessment, orthotic adjustments, and physiotherapy. There are a large number of treatment options available for PIPJ dislocations, yet no prospective or controlled studies have been carried out, largely due to the diversity of the various types of injuries. We retrospectively reviewed all the PIPJ dislocations in our institution over a five-year period and directly compared the different splinting techniques that we have used over this time frame. There were a total of 77 dislocations of the PIPJ (57 men and 20 women) that were included in our study. We found that our management has shifted gradually from complete immobilisation to controlled early mobilisation with figure-of-eight splints. Following treatment, the range of motion of the PIPJ in the figure-of-eight group was significantly greater than that in the other three methods (Ptreatment groups. The treatment of PIPJ dislocations has undergone a significant evolution in our experience. Early controlled mobilisation has become increasingly important, and therefore, splints have had to be adapted to allow for this. The figure-of-eight splint has yielded excellent results in our experience. It should be considered for all PIPJ dislocations, but careful patient selection is required to achieve optimum results.

  12. Proximal Interphalangeal Joint Dislocations and Treatment: An Evolutionary Process

    Directory of Open Access Journals (Sweden)

    Kenneth Michael Joyce

    2014-07-01

    Full Text Available Background Proximal interphalangeal joint (PIPJ dislocations represent a significant proportion of hand clinic visits and typically require frequent follow-ups for clinical assessment, orthotic adjustments, and physiotherapy. There are a large number of treatment options available for PIPJ dislocations, yet no prospective or controlled studies have been carried out, largely due to the diversity of the various types of injuries. Methods We retrospectively reviewed all the PIPJ dislocations in our institution over a five-year period and directly compared the different splinting techniques that we have used over this time frame. Results There were a total of 77 dislocations of the PIPJ (57 men and 20 women that were included in our study. We found that our management has shifted gradually from complete immobilisation to controlled early mobilisation with figure-of-eight splints. Following treatment, the range of motion of the PIPJ in the figure-of-eight group was significantly greater than that in the other three methods (P<0.05 used. There were significantly fewer hospital visits in the figure-of-eight splint group than in the other treatment groups. Conclusions The treatment of PIPJ dislocations has undergone a significant evolution in our experience. Early controlled mobilisation has become increasingly important, and therefore, splints have had to be adapted to allow for this. The figure-of-eight splint has yielded excellent results in our experience. It should be considered for all PIPJ dislocations, but careful patient selection is required to achieve optimum results.

  13. Proximity and touch sensing using deformable ionic conductors (Conference Presentation)

    Science.gov (United States)

    Madden, John D. W.; Dobashi, Yuta; Sarwar, Mirza S.; Preston, Eden C.; Wyss, Justin K. M.; Woehling, Vincent; Nguyen, Tran-Minh-Giao; Plesse, Cedric; Vidal, Frédéric; Naficy, Sina; Spinks, Geoffrey M.

    2017-04-01

    There is increasing interest in creating bendable and stretchable electronic interfaces that can be worn or applied to virtually any surface. The electroactive polymer community is well placed to add value by incorporating sensors and actuators. Recent work has demonstrated transparent dielectric elastomer actuation as well as pressure, stretch or touch sensing. Here we present two alternative forms of sensing. The first uses ionically conductive and stretchable gels as electrodes in capacitive sensors that detect finger proximity. In this case the finger acts as a third electrode, reducing capacitance between the two gel electrodes as it approaches, which can be detected even during bending and stretching. Very light finger touch is readily detected even during deformation of the substrate. Lateral resolution is achieved by creating a sensor array. In the second approach, electrodes placed beneath a salt containing gel are able to detect ion currents generated by the deformation of the gel. In this approach, applied pressure results in ion currents that create a potential difference around the point of contact, leading to a voltage and current in the electrodes without any need for input electrical energy. The mechanism may be related to effects seen in ionomeric polymer metal composites (IPMCs), but with the response in plane rather than through the thickness of the film. Ultimately, these ionically conductive materials that can also be transparent and actuate, have the potential to be used in wearable devices.

  14. Dental flossing as a diagnostic method for proximal gingivitis: a validation study

    Directory of Open Access Journals (Sweden)

    Alessandra Pascotini GRELLMANN

    2016-01-01

    Full Text Available ABSTRACT This study evaluated the clinical diagnosis of proximal gingivitis by comparing two methods: dental flossing and the gingival bleeding index (GBI. One hundred subjects (aged at least 18 years, with 15% of positive proximal sites for GBI, without proximal attachment loss were randomized into five evaluation protocols. Each protocol consisted of two assessments with a 10-minute interval between them: first GBI/second floss, first floss/second GBI, first GBI/second GBI, first tooth floss/second floss, and first gum floss-second floss. The dental floss was slid against the tooth surface (TF and the gingival tissue (GF. The evaluated proximal sites should present teeth with established point of contact and probing depth ≤ 3mm. One trained and calibrated examiner performed all the assessments. The mean percentages of agreement and disagreement were calculated for the sites with gingival bleeding in both evaluation methods (GBI and flossing. The primary outcome was the percentage of disagreement between the assessments in the different protocols. The data were analyzed by one-way ANOVA, McNemar, chi-square and Tukey’s post hoc tests, with a 5% significance level. When gingivitis was absent in the first assessment (negative GBI, bleeding was detected in the second assessment by TF and GF in 41.7% (p < 0.001 and 50.7% (p < 0.001 of the sites, respectively. In the absence of gingivitis in the second assessment (negative GBI, TF and GF detected bleeding in the first assessment in 38.9% (p = 0.004 and 58.3% (p < 0.001 of the sites, respectively. TF and GF appears to be a better diagnostic indicator of proximal gingivitis than GBI.

  15. Automated detection and classification of the proximal humerus fracture by using deep learning algorithm.

    Science.gov (United States)

    Chung, Seok Won; Han, Seung Seog; Lee, Ji Whan; Oh, Kyung-Soo; Kim, Na Ra; Yoon, Jong Pil; Kim, Joon Yub; Moon, Sung Hoon; Kwon, Jieun; Lee, Hyo-Jin; Noh, Young-Min; Kim, Youngjun

    2018-03-26

    Background and purpose - We aimed to evaluate the ability of artificial intelligence (a deep learning algorithm) to detect and classify proximal humerus fractures using plain anteroposterior shoulder radiographs. Patients and methods - 1,891 images (1 image per person) of normal shoulders (n = 515) and 4 proximal humerus fracture types (greater tuberosity, 346; surgical neck, 514; 3-part, 269; 4-part, 247) classified by 3 specialists were evaluated. We trained a deep convolutional neural network (CNN) after augmentation of a training dataset. The ability of the CNN, as measured by top-1 accuracy, area under receiver operating characteristics curve (AUC), sensitivity/specificity, and Youden index, in comparison with humans (28 general physicians, 11 general orthopedists, and 19 orthopedists specialized in the shoulder) to detect and classify proximal humerus fractures was evaluated. Results - The CNN showed a high performance of 96% top-1 accuracy, 1.00 AUC, 0.99/0.97 sensitivity/specificity, and 0.97 Youden index for distinguishing normal shoulders from proximal humerus fractures. In addition, the CNN showed promising results with 65-86% top-1 accuracy, 0.90-0.98 AUC, 0.88/0.83-0.97/0.94 sensitivity/specificity, and 0.71-0.90 Youden index for classifying fracture type. When compared with the human groups, the CNN showed superior performance to that of general physicians and orthopedists, similar performance to orthopedists specialized in the shoulder, and the superior performance of the CNN was more marked in complex 3- and 4-part fractures. Interpretation - The use of artificial intelligence can accurately detect and classify proximal humerus fractures on plain shoulder AP radiographs. Further studies are necessary to determine the feasibility of applying artificial intelligence in the clinic and whether its use could improve care and outcomes compared with current orthopedic assessments.

  16. Achieving excellence in training

    International Nuclear Information System (INIS)

    Mangin, A.M.; Solymossy, J.M.

    1983-01-01

    Operating a nuclear power plant is a uniquely challenging activity, requiring a high degree of competence from all who are involved. Achieving and maintaining this competence requires excellence in training. But what does excellence mean, and how do we achieve it. Based on the experience gained by INPO in plant training evaluations and accreditation activities, this paper describes some of the actions that can be taken to achieve the quality appropriate for nuclear power plant training. These actions are discussed in relation to the four phases of a performance-based training system: (1) needs analysis, (2) program design and development, (3) implementation, and (4) evaluation and improvement

  17. [Achievement of therapeutic objectives].

    Science.gov (United States)

    Mantilla, Teresa

    2014-07-01

    Therapeutic objectives for patients with atherogenic dyslipidemia are achieved by improving patient compliance and adherence. Clinical practice guidelines address the importance of treatment compliance for achieving objectives. The combination of a fixed dose of pravastatin and fenofibrate increases the adherence by simplifying the drug regimen and reducing the number of daily doses. The good tolerance, the cost of the combination and the possibility of adjusting the administration to the patient's lifestyle helps achieve the objectives for these patients with high cardiovascular risk. Copyright © 2014 Sociedad Española de Arteriosclerosis y Elsevier España, S.L. All rights reserved.

  18. Proximity-based frameworks for generating embeddings from multi-output data.

    Science.gov (United States)

    Mu, Tingting; Goulermas, John Yannis; Tsujii, Jun'ichi; Ananiadou, Sophia

    2012-11-01

    This paper is about supervised and semi-supervised dimensionality reduction (DR) by generating spectral embeddings from multi-output data based on the pairwise proximity information. Two flexible and generic frameworks are proposed to achieve supervised DR (SDR) for multilabel classification. One is able to extend any existing single-label SDR to multilabel via sample duplication, referred to as MESD. The other is a multilabel design framework that tackles the SDR problem by computing weight (proximity) matrices based on simultaneous feature and label information, referred to as MOPE, as a generalization of many current techniques. A diverse set of different schemes for label-based proximity calculation, as well as a mechanism for combining label-based and feature-based weight information by considering information importance and prioritization, are proposed for MOPE. Additionally, we summarize many current spectral methods for unsupervised DR (UDR), single/multilabel SDR, and semi-supervised DR (SSDR) and express them under a common template representation as a general guide to researchers in the field. We also propose a general framework for achieving SSDR by combining existing SDR and UDR models, and also a procedure of reducing the computational cost via learning with a target set of relation features. The effectiveness of our proposed methodologies is demonstrated with experiments with document collections for multilabel text categorization from the natural language processing domain.

  19. The reliability and accuracy of two methods for proximal caries detection and depth on directly visible proximal surfaces: an in vitro study.

    Science.gov (United States)

    Ekstrand, K R; Luna, L E; Promisiero, L; Cortes, A; Cuevas, S; Reyes, J F; Torres, C E; Martignon, S

    2011-01-01

    This study aimed to determine the reliability and accuracy of the ICDAS and radiographs in detecting and estimating the depth of proximal lesions on extracted teeth. The lesions were visible to the naked eye. Three trained examiners scored a total of 132 sound/carious proximal surfaces from 106 primary teeth and 160 sound/carious proximal surfaces from 140 permanent teeth. The selected surfaces were first scored visually, using the 7 classes in the ICDAS. They were then assessed on radiographs using a 5-point classification system. Reexaminations were conducted with both scoring systems. Teeth were then sectioned and the selected surfaces histologically classified using a stereomicroscope (×5). Intrareproducibility values (weighted kappa statistics) for the ICDAS for both primary and permanent teeth were >0.9, and for the radiographs between 0.6 and 0.8. Interreproducibility values for the ICDAS were >0.85, for the radiographs >0.6. For both primary and permanent teeth, the accuracy of each examiner (Spearman's correlation coefficient) for the ICDAS was ≥0.85, and for the radiographs ≥0.45. Corresponding data were achieved when using pooled data from the 3 examiners for both the ICDAS and the radiographs. The associations between the 2 detection methods were measured to be moderate. In particular, the ICDAS was accurate in predicting lesion depth (histologically) confined to the enamel/outer third of the dentine versus deeper lesions. This study shows that when proximal lesions are open for inspection, the ICDAS is a more reliable and accurate method than the radiograph for detecting and estimating the depth of the lesion in both primary and permanent teeth. Copyright © 2011 S. Karger AG, Basel.

  20. Threat of Deportation as Proximal Social Determinant of Mental Health Amongst Migrant Workers.

    Science.gov (United States)

    Harrigan, Nicholas M; Koh, Chiu Yee; Amirrudin, Amirah

    2017-06-01

    While migration health studies traditionally focused on socioeconomic determinants of health, an emerging body of literature is exploring migration status as a proximate cause of health outcomes. Study 1 is a path analysis of the predictors of mental health amongst 582 documented migrant workers in Singapore, and shows that threat of deportation is one of the most important proximate social determinants of predicted mental illness, and a mediator of the impact of workplace conflict on mental health. Study 2 is a qualitative study of the narratives of 149 migrant workers who were in workplace conflict with their employers, and demonstrates that workers believed threats were used as a negotiating strategy during workplace conflicts. Findings suggest that migration status places workers who come into workplace conflict with their employers at heightened risk of mental illness because migration status can be used as a tool by employers in workplace negotiations.

  1. Proximity coupling in superconductor-graphene heterostructures.

    Science.gov (United States)

    Lee, Gil-Ho; Lee, Hu-Jong

    2018-02-16

    This review discusses the electronic properties and the prospective research directions of superconductor-graphene heterostructures. The basic electronic properties of graphene are introduced to highlight the unique possibility of combining two seemingly unrelated physics, superconductivity and relativity. We then focus on graphene-based Josephson junctions, one of the most versatile superconducting quantum devices. The various theoretical methods that have been developed to describe graphene Josephson junctions are examined, together with their advantages and limitations, followed by a discussion on the advances in device fabrication and the relevant length scales. The phase-sensitive properties and phase-particle dynamics of graphene Josephson junctions are examined to provide an understanding of the underlying mechanisms of Josephson coupling via graphene. Thereafter, microscopic transport of correlated quasiparticles produced by Andreev reflections at superconducting interfaces and their phase-coherent behaviors are discussed. Quantum phase transitions studied with graphene as an electrostatically tunable 2D platform are reviewed. The interplay between proximity-induced superconductivity and the quantum-Hall phase is discussed as a possible route to study topological superconductivity and non-Abelian physics. Finally, a brief summary on the prospective future research directions is given.

  2. [Ophthalmologists in the proximity of Adolf Hitler].

    Science.gov (United States)

    Rohrbach, J M

    2012-10-01

    Adolf Hitler met or at least knew about 5 ophthalmologists. The chair of ophthalmology in Berlin, Walther Löhlein, personally examined Hitler's eyes at least two times. The chair of ophthalmology in Breslau, Walter Dieter, developed "air raid protection spectacles" with the aid of high representatives of the NS-system and probably Adolf Hitler himself. Heinrich Wilhelm Kranz became rector of the universities of Giessen and Frankfurt/Main. He was known as a very strict advocate of the NS-race hygiene. Werner Zabel made plans for Hitler's diet and tried to interfere with Hitler's medical treatment. Finally, Hellmuth Unger was an influential representative of the medical press and a famous writer. Three of his novels with medical topics were made into a film which Hitler probably saw. Hitler had, so to say, a small "ophthalmological proximity" which, however, did not play a significant role for himself or the NS-state. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Proximal spinal muscular atrophy: current orthopedic perspective

    Directory of Open Access Journals (Sweden)

    Haaker G

    2013-11-01

    Full Text Available Gerrit Haaker, Albert Fujak Department of Orthopaedic Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany Abstract: Spinal muscular atrophy (SMA is a hereditary neuromuscular disease of lower motor neurons that is caused by a defective "survival motor neuron" (SMN protein that is mainly associated with proximal progressive muscle weakness and atrophy. Although SMA involves a wide range of disease severity and a high mortality and morbidity rate, recent advances in multidisciplinary supportive care have enhanced quality of life and life expectancy. Active research for possible treatment options has become possible since the disease-causing gene defect was identified in 1995. Nevertheless, a causal therapy is not available at present, and therapeutic management of SMA remains challenging; the prolonged survival is increasing, especially orthopedic, respiratory and nutritive problems. This review focuses on orthopedic management of the disease, with discussion of key aspects that include scoliosis, muscular contractures, hip joint disorders, fractures, technical devices, and a comparative approach of conservative and surgical treatment. Also emphasized are associated complications including respiratory involvement, perioperative care and anesthesia, nutrition problems, and rehabilitation. The SMA disease course can be greatly improved with adequate therapy with established orthopedic procedures in a multidisciplinary therapeutic approach. Keywords: spinal muscular atrophy, scoliosis, contractures, fractures, lung function, treatment, rehabilitation, surgery, ventilation, nutrition, perioperative management

  4. Proximity coupling in superconductor-graphene heterostructures

    Science.gov (United States)

    Lee, Gil-Ho; Lee, Hu-Jong

    2018-05-01

    This review discusses the electronic properties and the prospective research directions of superconductor-graphene heterostructures. The basic electronic properties of graphene are introduced to highlight the unique possibility of combining two seemingly unrelated physics, superconductivity and relativity. We then focus on graphene-based Josephson junctions, one of the most versatile superconducting quantum devices. The various theoretical methods that have been developed to describe graphene Josephson junctions are examined, together with their advantages and limitations, followed by a discussion on the advances in device fabrication and the relevant length scales. The phase-sensitive properties and phase-particle dynamics of graphene Josephson junctions are examined to provide an understanding of the underlying mechanisms of Josephson coupling via graphene. Thereafter, microscopic transport of correlated quasiparticles produced by Andreev reflections at superconducting interfaces and their phase-coherent behaviors are discussed. Quantum phase transitions studied with graphene as an electrostatically tunable 2D platform are reviewed. The interplay between proximity-induced superconductivity and the quantum-Hall phase is discussed as a possible route to study topological superconductivity and non-Abelian physics. Finally, a brief summary on the prospective future research directions is given.

  5. Proximal Row Carpectomy Combined with Wrist Hemiarthroplasty

    Science.gov (United States)

    Culp, Randall W.; Bachoura, Abdo; Gelman, Scott E.; Jacoby, Sidney M.

    2012-01-01

    Proximal row carpectomy (PRC) combined with distal radius hemiarthroplasty is a relatively novel procedure that rivals total wrist arthrodesis and offers a new surgical treatment option for select patients with painful, end-stage wrist disease. We present our early experience with this procedure. A retrospective chart review was conducted for nonrheumatoid patients diagnosed with wrist arthritis and subsequently treated with wrist hemiarthroplasty combined with PRC. The minimum follow-up duration was 12 months. Preoperative and postoperative flexion, extension, and grip strength were recorded. Postoperative radiographic findings were assessed. The Patient-Rated Wrist Evaluation (PRWE) questionnaire was administered to gauge postoperative pain and function. The records of 10 patients were reviewed. The mean age was 64 years and the mean postoperative follow-up duration was 19 months. Postoperative flexion, extension, and grip strength were all found to be less than the preoperative levels. The mean postoperative PRWE score for pain and function were 26 and 23, respectively. The complications were diverse and occurred at a relatively high rate. PRC combined with distal radius hemiarthroplasty is a novel procedure that offers a potential surgical option for the treatment of wrist arthritis in select patients. Our early experience has lead us to modify our technique with regard to the implant material, and at this stage, the surgical technique and the most appropriate implant may require further optimization. The level of evidence for this study is IV (therapeutic). PMID:23904978

  6. Distal radius fracture after proximal row carpectomy.

    Science.gov (United States)

    Igeta, Yuka; Naito, Kiyohito; Sugiyama, Yoichi; Obata, Hiroyuki; Aritomi, Kentaro; Kaneko, Kazuo; Obayashi, Osamu

    2015-01-01

    We encountered a patient with distal radius fracture (DRF) after proximal row carpectomy (PRC). The mechanism of the DRF after PRC is discussed in this report. The patient was a 73-year-old female who had undergone PRC due to Kienböck disease before. The wrist range of motion was: 45° on dorsiflexion and 20° on flexion. DRF has occurred at 3 years after PRC. The fracture type was extra-articular fracture. Osteosynthesis was performed using a volar locking plate. No postoperative complication developed, the Mayo score was excellent at 6 months after surgery, and the daily living activity level recovered to that before injury. Since the wrist range of motion decreased and the lunate fitted into the joint surface after PRC, making the forearm join with the hand like a single structure, pressure may have been loaded on the weak distal end of the radius from the dorsal side, causing volar displacement and fracture. The pressure distribution and range of motion of the radiocarpal joint after PRC are different from those of a normal joint, and the mechanism of fracture also changes due to PRC. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Proximal relationships between PTSD and drinking behavior

    Directory of Open Access Journals (Sweden)

    Debra Kaysen

    2014-12-01

    Full Text Available Co-morbid PTSD and alcohol use disorders are both common and debilitating. However, many of these studies rely on cross-sectional studies that obscure more complex relationships between PTSD and drinking. Event-level studies allow for examination of proximal relationships between PTSD and drinking. Among women (n=136 with past sexual victimization, n=40 no past trauma history, a two-part mixed hurdle model was used to examine daily PTSD and drinking. On days women experienced more intrusive and behavioral avoidance symptoms, they were more likely to drink. For a 2 SD increase in symptoms, there was a 5% increased likelihood of drinking, and for a 2 SD increase in dysphoric symptoms or negative affect, women drank approximately half drink less. Daily-level coping self-efficacy moderated the association between distress and drinking (IRR=0.91, p<0.01. Women who reported less coping drank more as their distress increased on a certain day whereas women who reported more coping drank about the same regardless of distress. Overall, findings suggest that specific PTSD symptoms are associated with higher alcohol use and that these relationships are moderated by daily coping self-efficacy. Implications of these findings for informing models of PTSD/AUD comorbidity, as well as clinical implications will be discussed.

  8. Educational Achievement and Black-White Inequality. Statistical Analysis Report.

    Science.gov (United States)

    Jacobson, Jonathan; Olsen, Cara; Rice, Jennifer King; Sweetland, Stephen

    This study explored relationships between black-white differences in educational achievement and black-white differences in various educational and economic outcomes. Three data sets examined the extent to which black-white differences in labor market outcomes, in educational attainment, and in mathematics and reading achievement were present for…

  9. Effect of proximal box elevation with resin composite on marginal quality of ceramic inlays in vitro.

    Science.gov (United States)

    Frankenberger, Roland; Hehn, Julia; Hajtó, Jan; Krämer, Norbert; Naumann, Michael; Koch, Andreas; Roggendorf, Matthias J

    2013-01-01

    The objective of this study was to evaluate the marginal quality and resin-resin transition of milled CAD/CAM glass-ceramic inlays in deep proximal cavities with and without 3-mm proximal box elevation (PBE) using resin composites before and after thermomechanical loading. MOD cavities with one proximal box beneath the cementoenamel junction were prepared in 48 extracted human third molars. Proximal boxes ending in dentin were elevated for 3 mm with different resin composites (RelyX Unicem, G-Cem, and Maxcem Elite as self-adhesive resin cements and Clearfil Majesty Posterior as restorative resin composite in one or three layers bonded with AdheSE) or left untreated. IPS Empress CAD inlays were luted with Syntac and Variolink II (n = 8). Marginal quality as well as the PBE-ceramic interface were analyzed under an SEM using epoxy resin replicas before and after thermomechanical loading (100,000 × 50 N and 2,500 thermocycles between +5°C and +55°C). Bonding glass-ceramic directly to dentin showed the highest amounts of gap-free margins in dentin (92%, p resin composite applied in three layers achieved 84% gap-free margins in dentin; PBE with self-adhesive resin cements exhibited significantly more gaps in dentin (p resin composite, PBE may be an alternative to ceramic bonding to dentin. Self-adhesive resin cements seem not suitable for this indication. For deep proximal boxes ending in dentin, a PBE may be an alternative to conventional techniques.

  10. Outcome of reconstruction of cutaneous limb defects in dogs using hygroscopic "self-inflating" tissue expanders.

    Science.gov (United States)

    De Lorenzi, M; Swan, M C; Easter, C; Chanoit, G P A

    2018-02-01

    To describe the placement of self-inflating tissue expanders and clinical outcomes in 12 consecutive cases of reconstruction of distal cutaneous limb defects in dogs. Cases of distal cutaneous limb defect were divided into three groups based on the location of the placement of the self-inflating tissue expanders: Group A (n=4): on, or proximal to, the elbow and stifle; Group B (n=4): distal to the elbow or stifle and proximal to the carpus or tarsus; and Group C (n=4): distal to the carpus or tarsus. Owner satisfaction and clinical outcome were documented. Thirteen cases were originally included, but one was excluded because of incomplete follow-up. In one case, the self-inflating tissue expanders were removed before expansion started. A mean of five expanders were implanted per dog (range 2 to 9). Devices were removed after a mean of 24 days (range 13 to 42 days). Primary closure was achieved in eight of 11 cases, including all cases from Group A and 75% and 33% of cases from Groups B and C, respectively. All incompletely reconstructed defects or areas of wound dehiscence healed by second intention. Eight of 12 owners were satisfied. Self-inflating tissue expanders can be used as an alternative for the reconstruction of limb defects in dogs in which direct primary closure would otherwise not be achievable. Defects below the carpus and tarsus are more challenging to treat with this method. © 2017 British Small Animal Veterinary Association.

  11. Proximate Composition, Macro and Trace Mineral Compositions of ...

    African Journals Online (AJOL)

    The proximate and mineral composition of Macrobrachium vollenhovenii collected from Ovia River in Edo State was determined using methods of the Association of Analytical Chemists. All parameters analyzed were present in all the body parts of the prawn. The proximate composition of the whole portion was significantly ...

  12. Levels and proximate determinants of fertility in Butajira District ...

    African Journals Online (AJOL)

    admin

    analysis. Total fertility rate was used to measure the magnitude of fertility. Moreover, the Bongaarts' method of measuring the fertility inhibition effect of each proximate determinant was applied (10). Fertility determinants were categorized as indirect (distal) and proximate (direct) factors as shown in the following diagram.

  13. proximal femur geometry in the adult kenyan femur and its ...

    African Journals Online (AJOL)

    It would be prudent to avail a range of implants with different angles to improve the choices available to the surgeon when faced with a patient who requires an operation on the proximal femur. Research article. INTRODUCTION. Operations on the proximal femur are very common in the practice of the orthopaedic surgeon.

  14. Proximity and inter-organizational collaboration: a literature review

    NARCIS (Netherlands)

    Knoben, J.; Oerlemans, L.A.G.

    2006-01-01

    The proximity concept is used in many different ways in the literature. These dimensions of proximity are, however, defined and measured in many different (sometimes even contradictory) ways, show large amounts of overlap, and often are under- or over-specified. The goal of this paper is to specify

  15. Proximate analysis of Lentinus squarrosulus (Mont.) Singer and ...

    African Journals Online (AJOL)

    Each of the mushroom species was separated into its stipe and pileus and used for proximate analysis. There was a highly significant difference (p<0.01) in the proximate composition of the two species. P. atroumbonata had significantly higher crude protein, crude fibre and moisture content than L. squarrosulus while the ...

  16. Epistemic proximity and knowledge exchange among IT-entrepreneurs

    NARCIS (Netherlands)

    Bahlmann, M.D.; Huysman, M.H.; Elfring, T.; Groenewegen, P.; Boari, C.; Elfring, T.; Molina-Morales, X.

    2016-01-01

    In this study, we seek to understand to what extent epistemic proximity affects knowledge exchange among Amsterdam-based IT-entrepreneurs. Epistemic proximity is defined as the extent to which two people share a similar world view enhanced by shared meanings and language. We explore the influence of

  17. Function of the proximal stomach after Nissen fundoplication

    NARCIS (Netherlands)

    Wijnhoven, B. P.; Salet, G. A.; Roelofs, J. M.; Smout, A. J.; Akkermans, L. M.; Gooszen, H. G.

    1998-01-01

    BACKGROUND: After Nissen fundoplication patients frequently report upper abdominal (dyspeptic) symptoms. Theoretically, these symptoms may be the result of changes in function of the proximal stomach as induced by fundoplication. METHODS: In this case-control study the response of the proximal

  18. Water Balance and Proximate Composition in Cowpea ( vigna ...

    African Journals Online (AJOL)

    Studying the water balance and proximate composition in plants subjected to these stresses compared the influence of drought and flooding on cowpea seedlings. In drought plants the leaf water potential, its components and the proximate composition were markedly reduced by the end of the experimental period.

  19. 29 CFR 452.104 - Proximity of notice to election.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Proximity of notice to election. 452.104 Section 452.104 Labor Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR... AND DISCLOSURE ACT OF 1959 Election Procedures; Rights of Members § 452.104 Proximity of notice to...

  20. Proximal Focal Femoral Deficiency in Ibadan a Developing ...

    African Journals Online (AJOL)

    The cultural aversion to amputation in our environment makes it difficult to employ that option of treatment. Proximal focal femoral deficiency in Ibadan a developing country's perspective and a review of the literature. Keywords: Proximal focal femoral deficiency , congenital malformations , limb malformations , lower limb ...

  1. Proximal soil sensors and data fusion for precision agriculture

    NARCIS (Netherlands)

    Mahmood, H.S.

    2013-01-01

    different remote and proximal soil sensors are available today that can scan entire fields and give detailed information on various physical, chemical, mechanical and biological soil properties. The first objective of this thesis was to evaluate different proximal soil sensors available today and to

  2. Inexact proximal Newton methods for self-concordant functions

    DEFF Research Database (Denmark)

    Li, Jinchao; Andersen, Martin Skovgaard; Vandenberghe, Lieven

    2016-01-01

    We analyze the proximal Newton method for minimizing a sum of a self-concordant function and a convex function with an inexpensive proximal operator. We present new results on the global and local convergence of the method when inexact search directions are used. The method is illustrated...

  3. Two Stages repair of proximal hypospadias: Review of 33 cases

    African Journals Online (AJOL)

    HussamHassan

    Background/Purpose: Proximal hypospadias with chordee is the most challenging variant of hypospadias to reconstruct. During the last 10 years, the approach to sever hypospadias has been controversial. Materials & Methods: During the period from June 2002 to December 2009, I performed 33 cases with proximal.

  4. Treatment of proximal humeral fractures using anatomical locking plate: correlation of functional and radiographic results

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Tenor Junior

    2016-06-01

    Full Text Available ABSTRACT OBJECTIVE: To correlate the functional outcomes and radiographic indices of proximal humerus fractures treated using an anatomical locking plate for the proximal humerus. METHODS: Thirty-nine patients with fractures of the proximal humerus who had been treated using an anatomical locking plate were assessed after a mean follow-up of 27 months. These patients were assessed using the University of California Los Angeles (UCLA score and their range of motion was evaluated using the method of the American Academy of Orthopedic Surgeons on the operated shoulder and comparative radiographs on both shoulders. The correlation between radiographic measurements and functional outcomes was established. RESULTS: We found that 64% of the results were good or excellent, according to the UCLA score, with the following means: elevation of 124°; lateral rotation of 44°; and medial rotation of thumb to T9. The type of fracture according to Neer's classification and the patient's age had significant correlations with the range of motion, such that the greater the number of parts in the fracture and the greater the patient's age were, the worse the results also were. Elevation and UCLA score were found to present associations with the anatomical neck-shaft angle in anteroposterior view; fractures fixed with varus deviations greater than 15° showed the worst results (p < 0.001. CONCLUSION: The variation in the neck-shaft angle measurements in anteroposterior view showed a significant correlation with the range of motion; varus deviations greater than 15° were not well tolerated. This parameter may be one of the predictors of functional results from proximal humerus fractures treated using a locking plate.

  5. Radiocapitate congruency as a predictive factor for the results of proximal row carpectomy.

    Science.gov (United States)

    Lenoir, Hubert; Toffoli, Adriano; Coulet, Bertrand; Lazerges, Cyril; Waitzenegger, Thomas; Chammas, Michel

    2015-06-01

    To evaluate whether the congruency between the joint surfaces of the lunate fossa of the distal radius and the proximal capitate might be a prognostic factor for functional, clinical, or radiographic results after proximal row carpectomy (PRC). After reconstructing the computed tomographic arthrogram of patients with PRC, we evaluated the shape of the proximal capitate by measuring the radius of curvature of the tip of the capitate. The congruency of the future radiocapitate joint was then evaluated by the radiocapitate index in the frontal and sagittal planes. This was calculated by dividing the radius of curvature of the tip of the capitate by the mean radius of curvature of the lunate fossa. We determined the relationship between these morphological results and the functional (Disabilities of the Arm, Shoulder, and Hand [DASH] score, Mayo Wrist score, and pain relief), clinical (mobility and strength) and x-ray results (radiocapitate arthrosis). A total of 27 patients were reviewed at a mean follow-up of 59 months. The shape of the proximal capitate did not affect outcomes. In the frontal plane, a better radiocapitate congruency was significantly associated with an increase in wrist flexion and better functional results for the DASH. There was a non-significant relationship between congruency and improvement of Mayo Wrist score and pain relief. In the sagittal plane, the DASH score tended to improve when congruency was better. The shape of the capitate was not a prognostic factor for functional outcome after PRC. The radiocapitate index seems more relevant in predicting results at last follow-up. Prognostic II. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  6. Efficacy of prophylactic splenectomy for proximal advanced gastric cancer invading greater curvature.

    Science.gov (United States)

    Ohkura, Yu; Haruta, Shusuke; Shindoh, Junichi; Tanaka, Tsuyoshi; Ueno, Masaki; Udagawa, Harushi

    2017-05-25

    For proximal gastric cancer invading the greater curvature, concomitant splenectomy is frequently performed to secure the clearance of lymph node metastases. However, prognostic impact of prophylactic splenectomy remains unclear. The aim of this study was to clarify the oncological significance of prophylactic splenectomy for advanced proximal gastric cancer invading the greater curvature. Retrospective review of 108 patients who underwent total or subtotal gastrectomy for advanced proximal gastric cancer involving the greater curvature was performed. Short-term and long-term outcomes were compared between the patients who underwent splenectomy (n = 63) and those who did not (n = 45). Patients who underwent splenectomy showed higher amount of blood loss (538 vs. 450 mL, p = 0.016) and morbidity rate (30.2 vs. 13.3, p = 0.041) compared with those who did not undergo splenectomy. In particular, pancreas-related complications were frequently observed among patients who received splenectomy (17.4 vs. 0%, p = 0.003). However, no significant improvement of long-term outcomes were confirmed in the cases with splenectomy (5-year recurrence-free rate, 60.2 vs. 67.3%; p = 0.609 and 5-year overall survival rates, 63.7 vs. 73.6%; p = 0.769). On the other hand, splenectomy was correlated with marginally better survival in patients with Borrmann type 1 or 2 gastric cancer (p = 0.072). For advanced proximal gastric cancer involving the greater curvature, prophylactic splenectomy may have no significant prognostic impact despite the increased morbidity rate after surgery. Such surgical procedure should be avoided as long as lymph node involvement is not evident.

  7. Long-range superconducting proximity effect in polycrystalline Co nanowires

    International Nuclear Information System (INIS)

    Kompaniiets, M.; Porrati, F.; Huth, M.; Dobrovolskiy, O. V.; Neetzel, C.; Brötz, J.; Ensinger, W.

    2014-01-01

    We report experimental evidence of a long-range superconducting proximity effect in polycrystalline Co nanowires in contact with a superconducting W-based floating electrode (inducer). For electrical resistance measurements, voltage leads were connected to the Co nanowire on both sides of the superconducting inducer at a distance of 7.2 μm. We observed a 28% reduction of the nanowire resistance when sweeping the temperature below the inducer's transition temperature T c = 5.2 K. Our analysis of the resistance data shows that the superconducting proximity length in polycrystalline Co is as large as 1 μm at 2.4 K, attesting to a long-range proximity effect. Moreover, this long-range proximity effect is insusceptible to magnetic fields up to 11 T, which is indicative of spin-triplet pairing. Our results provide evidence that magnetic inhomogeneity of the ferromagnet enlarges the spatial extend of the spin-triplet superconducting proximity effect

  8. A PROSPECTIVE STUDY ON TREATMENT OF PROXIMAL HUMERUS FRACTURES IN ADULTS

    Directory of Open Access Journals (Sweden)

    Bhavani Prasad

    2015-10-01

    Full Text Available BACKGROUND: Treatment of proximal humerus has been subject of much controversy and confusion with diversity of opinion regarding the care of fractures of proximal end of humerus. The aim of this study was to review the outcome, results and complications of the operat ive procedure in a series of thirty patients. INTRODUCTION: Proximal humerus fractures are one of the commonest fractures occurring in the skeleton. They account for approximately 4 - 5% of the fracture attendance at the hospital . 1,2 They occur more commonly in elderly patients, after cancellous bone of the humeral neck has weakened by senility but these fracture are seen in patients of all ages & merge with epiphyseal separations. The most serious fractures and fracture dislocations are often seen in active, middle aged patients. These fractures can be extremely disabling and their management often demands experienced surgical skills and judgment . 2 Because of increasing incidence of high velocity trauma, complicated fracture pattern in proximal humerus are be coming increasingly common. It has been always engima of management because of numerous muscles attachment and paucity of space for fixing implant in fracture of proximal humerus. Voluminous literature is available on this topic and treatment pattern diffe rs very much. The preferred treatment varies depend on the patient’s age and bone quality, the expertise , surgical team and the patients expectations. Although a number of reports have described the outcome of treatment of proximal humeral fractures, compa rison of these fractures is hampered by inconsistence in fracture classification, treatment and evaluation method. The surgery should be carried out as soon as the patient’s general condition permits. A delay of several days makes reduction more difficult and a significant delay results in absorption of bone, making secure internal fixation impossible . 3 The object of the osteosynthesisis is to reduce the

  9. Selective proximal vagotomy with and without pyloroplasty

    International Nuclear Information System (INIS)

    Brodersen, E.

    1984-01-01

    It was the aim of the study described here to gain information relevant to the well-being of patients subjected to selective proximal vagotomy with or without pyroloplasty as soon as possible after surgery. For this purpose, particular care was taken to ascertain the frequency of recidivation and the post-operative occurrence of disturbances in the emptying of gastric contents. In 35 patients solely undergoing SPV and a further 12 individuals, where both SPV and pyroloplasty had been performed, gastric emptying was monitored using a gamma camera and computer system. All patients were given a standardised test meal consisting of 500 ml ready-made milk labeled with 2 mCi 99mTc-HSA. After the patients had been assigned to different study groups according to the gastric emptying rates established in the individual cases, it became evident that there was a correlation between gastric emptying time (T/2) and the occurrence of post-operative discomfort. In the majority of patients the gastric emptying rate was found to be increased as compared to individuals with a healthy stomach. Among a total of 8 patients showing delayed gastric emptying only one, who solely underwent SPV, reported post-operative discomfort. Markedly increased rates of gastric emptying (T/2 ≤ 5 min) were predominantly determined in patients subjected to SPV in conjunction with pyroloplasty. A dumping syndrome and diarrhea were diagnosed in every third patient. Clinical follow-up studies and questionnaires distributed among the study patients showed relapses to occur with a frequency of 6.7%, the recidivation of ulcera being confined to the group of patients merely undergoing SPV. (TRV) [de

  10. Hypospadias and residential proximity to pesticide applications.

    Science.gov (United States)

    Carmichael, Suzan L; Yang, Wei; Roberts, Eric M; Kegley, Susan E; Wolff, Craig; Guo, Liang; Lammer, Edward J; English, Paul; Shaw, Gary M

    2013-11-01

    Experimental evidence suggests pesticides may be associated with hypospadias. Examine the association of hypospadias with residential proximity to commercial agricultural pesticide applications. The study population included male infants born from 1991 to 2004 to mothers residing in 8 California counties. Cases (n = 690) were ascertained by the California Birth Defects Monitoring Program; controls were selected randomly from the birth population (n = 2195). We determined early pregnancy exposure to pesticide applications within a 500-m radius of mother's residential address, using detailed data on applications and land use. Associations with exposures to physicochemical groups of pesticides and specific chemicals were assessed using logistic regression adjusted for maternal race or ethnicity and age and infant birth year. Forty-one percent of cases and controls were classified as exposed to 57 chemical groups and 292 chemicals. Despite >500 statistical comparisons, there were few elevated odds ratios with confidence intervals that excluded 1 for chemical groups or specific chemicals. Those that did were for monochlorophenoxy acid or ester herbicides; the insecticides aldicarb, dimethoate, phorate, and petroleum oils; and adjuvant polyoxyethylene sorbitol among all cases; 2,6-dinitroaniline herbicides, the herbicide oxyfluorfen, and the fungicide copper sulfate among mild cases; and chloroacetanilide herbicides, polyalkyloxy compounds used as adjuvants, the insecticides aldicarb and acephate, and the adjuvant nonyl-phenoxy-poly(ethylene oxy)ethanol among moderate and severe cases. Odds ratios ranged from 1.9 to 2.9. Most pesticides were not associated with elevated hypospadias risk. For the few that were associated, results should be interpreted with caution until replicated in other study populations.

  11. Nanocrystal Bioassembly: Asymmetry, Proximity, and Enzymatic Manipulation

    Energy Technology Data Exchange (ETDEWEB)

    Claridge, Shelley A. [Univ. of California, Berkeley, CA (United States)

    2008-05-01

    Research at the interface between biomolecules and inorganic nanocrystals has resulted in a great number of new discoveries. In part this arises from the synergistic duality of the system: biomolecules may act as self-assembly agents for organizing inorganic nanocrystals into functional materials; alternatively, nanocrystals may act as microscopic or spectroscopic labels for elucidating the behavior of complex biomolecular systems. However, success in either of these functions relies heavily uponthe ability to control the conjugation and assembly processes.In the work presented here, we first design a branched DNA scaffold which allows hybridization of DNA-nanocrystal monoconjugates to form discrete assemblies. Importantly, the asymmetry of the branched scaffold allows the formation of asymmetric2assemblies of nanocrystals. In the context of a self-assembled device, this can be considered a step toward the ability to engineer functionally distinct inputs and outputs.Next we develop an anion-exchange high performance liquid chromatography purification method which allows large gold nanocrystals attached to single strands of very short DNA to be purified. When two such complementary conjugates are hybridized, the large nanocrystals are brought into close proximity, allowing their plasmon resonances to couple. Such plasmon-coupled constructs are of interest both as optical interconnects for nanoscale devices and as `plasmon ruler? biomolecular probes.We then present an enzymatic ligation strategy for creating multi-nanoparticle building blocks for self-assembly. In constructing a nanoscale device, such a strategy would allow pre-assembly and purification of components; these constructs can also act as multi-label probes of single-stranded DNA conformational dynamics. Finally we demonstrate a simple proof-of-concept of a nanoparticle analog of the polymerase chain reaction.

  12. Coupled water transport by rat proximal tubule.

    Science.gov (United States)

    Green, R; Giebisch, G; Unwin, R; Weinstein, A M

    1991-12-01

    Simultaneous microperfusion of proximal tubules and peritubular capillaries in kidneys of rats anesthetized with Inactin was used to examine water reabsorption by this epithelium. Osmolality of the luminal solution was varied with changes in NaCl concentration and by the addition of raffinose. Capillary perfusates contained either low (2 g/dl) or high (16 g/dl) concentrations of albumin. We used low-bicarbonate perfusates for both lumen and capillary so that we might apply the nonequilibrium thermodynamic model of transport for a single solute (NaCl) to interpret our observations. Linear regression with the volume flux equation Jv = -Lp delta II - Lp sigma delta C + Jav (where Jv is volume flux, Lp is hydraulic conductance, delta II is oncotic force, sigma is osmotic reflection coefficient, delta C is salt concentration difference, and Jav is the component of Jv not attributed to transepithelial hydrostatic or osmotic forces) revealed a tubule water permeability (Pf = 0.11 +/- 0.01 cm/s) and a sigma (0.74 +/- 0.08) in agreement with previous determinations. These transport parameters were unaffected by changes in peritubular protein. We also found that Jav was substantial, approximately three-fourths of the rate of isotonic transport under these perfusion conditions. Further, this component of water transport nearly doubled with the transition from low- to high-protein peritubular capillary perfusion. When expressed as a capacity for water reabsorption against an osmotic gradient, the salt concentration differences required to null volume flux were 13.2 +/- 2.4 and 29.4 +/- 4.0 mosmol/kgH2O under low and high peritubular protein. Our data suggest that this protein effect is, most likely, an increase in solute transport by the tubule epithelial cells.

  13. Observer differentiation of proximal enamel mechanical defects versus natural proximal dental caries with computed dental radiography.

    Science.gov (United States)

    Kang, B C; Farman, A G; Scarfe, W C; Goldsmith, L J

    1996-10-01

    Various models have been used to study the accuracy of imaging systems for detection of dental caries. This study compares the ability of dentists to detect mechanically created defects versus natural dental caries cavitations on the proximal surfaces of extracted teeth with Computed Dental Radiography (Schick Industries, Long Island City, N.Y.). Detection rates are investigated according to lesion depth to permit comparisons to be made between studies in the literature with other mechanical defects or natural caries models. Discrimination of natural caries versus artificial defects with Computed Dental Radiography is also compared with a previous report that used standard dental film. Fifty-two extracted molar and premolar teeth were mounted into representative sets of maxillary and mandibular posterior arches for bite-wing radiography. There were 16 proximal surfaces with natural caries and 28 proximal surfaces with mechanical defects. An optical bench was used to ensure constant beam geometry. A 1.8 cm acrylic soft tissue equivalent attenuator was placed in front of the receptor. Thirty dentists acted independently as observers to differentiate between sound proximal tooth surfaces, natural dental caries, and mechanical defects. Evaluation of intra- and interobserver variability was made with use of the kappa statistic. The Zelen test of odds ratios was used to test for homogeneity, and the Mantel-Haenszel analysis plus stratified logistic regression were used for inference about the common odds ratio. Significance was set at p detection was 74% for mechanical defects and 67% for natural caries. The odds of detecting a mechanical defect were 1.40 times the odds of finding natural dental caries cavitation of the same depth. Lesion depth did influence the probability of correctly identifying the presence of a lesion; the odds of identifying cavitation increased 1.41 times with every 0.1 mm increase in lesion depth. Correct designation of lesion type was 1.42 times

  14. Achieve Together: Evaluation Report and Executive Summary

    Science.gov (United States)

    Greaves, Ellen; Sianesi, Barbara; Sibieta, Luke; Amin-Smith, Neil; Callanan, Meg; Hudson, Ruth

    2017-01-01

    Achieve Together aims to improve pupil outcomes by supporting leadership development and collaboration within schools in disadvantaged areas. The programme was devised and delivered by three education charities: Teach First, Teaching Leaders, and The Future Leaders Trust. Participants on these individual programmes also collaborate on a school…

  15. Optimism versus Pessimism and Academic Achievement Evaluation

    Science.gov (United States)

    Harpaz-Itay, Yifat; Kaniel, Shlomo

    2012-01-01

    This article integrates three central theories of optimism-pessimism (OP). The combination of the shared components of these theories--outcome expectancies, emotions, and behavioral intention--may produce an integrative academic achievement evaluation. Little has been written regarding the differentiation between general and domain-specific OP, a…

  16. The Methodological Nettle: ICT and Student Achievement

    Science.gov (United States)

    Chandra, Vinesh; Lloyd, Margaret

    2008-01-01

    A major challenge for researchers and educators has been to discern the effect of ICT use on student learning outcomes. This paper maps the achievements in Year 10 Science of two cohorts of students over two years where students in the first year studied in a traditional environment while students in the second took part in a blended or e-learning…

  17. FORMATIVE ASSESSMENT MODEL OF LEARNING SUCCESS ACHIEVEMENTS

    Directory of Open Access Journals (Sweden)

    Mikhailova Elena Konstantinovna

    2013-05-01

    Full Text Available The paper is devoted to the problem of assessment of the school students’ learning success achievements. The problem is investigated from the viewpoint of assessing the students’ learning outcomes that is aimed to ensure the teachers and students with the means and conditions to improve the educational process and results.

  18. The principle and problem of proximity in ethics.

    Science.gov (United States)

    Nortvedt, P; Nordhaug, M

    2008-03-01

    The normative significance of proximity in ethics is considered, giving an overview of the contemporary debates about proximity in ethics and focusing on three main perspectives that take proximity to have normative significance. The first perspective is represented by meta-ethical positions, where a basic moral claim is said to originate from an irreducible, particular and unique otherness that shows up in human vulnerability. The second perspective presents a psychologically and philosophically based analysis of human emotions, which is taken to form a basis for rudimentary moral sensitivity and care. The third version of an ethics of proximity claims that personal relationships and partiality override impartialist and universalist ethical considerations. On the basis of this analysis, the sources of normativity and the essence of proximity as a normative consideration are elaborated. Finally, the relevance of an ethics of proximity to professional ethics in healthcare is discussed. From an ethics of proximity, it might be argued that institutions must attempt to organise medical care and nursing care so that a certain partiality and patient-centred care might be favoured and trump distributivist considerations of justice in healthcare.

  19. Effect of age on proximal esophageal response to swallowing

    Directory of Open Access Journals (Sweden)

    Roberto Oliveira Dantas

    2010-12-01

    Full Text Available CONTEXT: It has been demonstrated that the ageing process affects esophageal motility. OBJECTIVES: To evaluate the effect of the age on the proximal esophageal response to wet swallows. METHOD: We measured the proximal esophageal response to swallows of a 5 mL bolus of water in 69 healthy volunteers, 20 of them aged 18-30 years (group I, 27 aged 31-50 years (group II, and 22 aged 51-74 years (group III. We used the manometric method with continuous perfusion. The proximal esophageal contractions were recorded 5 cm from a pharyngeal recording site located 1 cm above the upper esophageal sphincter. The time between the onset of the pharyngeal and of the proximal esophageal recording (pharyngeal-esophageal time and the amplitude, duration and area under the curve of the proximal esophageal contraction were measured. RESULTS: The pharyngeal-esophageal time was shorter in group I subjects than in group II and III subjects (P<0.05. The duration of proximal esophageal contractions was longer in group I than in groups II and III (P<0.001. There was no differences between groups in the amplitude or area under the curve of contractions. There were no differences between groups II and III for any of the measurements. CONCLUSION: We conclude that the age may affects the response of the proximal esophagus to wet swallows.

  20. Dual pathology proximal median nerve compression of the forearm.

    LENUS (Irish Health Repository)

    Murphy, Siun M

    2013-12-01

    We report an unusual case of synchronous pathology in the forearm- the coexistence of a large lipoma of the median nerve together with an osteochondroma of the proximal ulna, giving rise to a dual proximal median nerve compression. Proximal median nerve compression neuropathies in the forearm are uncommon compared to the prevalence of distal compression neuropathies (eg Carpal Tunnel Syndrome). Both neural fibrolipomas (Refs. 1,2) and osteochondromas of the proximal ulna (Ref. 3) in isolation are rare but well documented. Unlike that of a distal compression, a proximal compression of the median nerve will often have a definite cause. Neural fibrolipoma, also called fibrolipomatous hamartoma are rare, slow-growing, benign tumours of peripheral nerves, most often occurring in the median nerve of younger patients. To our knowledge, this is the first report of such dual pathology in the same forearm, giving rise to a severe proximal compression of the median nerve. In this case, the nerve was being pushed anteriorly by the osteochondroma, and was being compressed from within by the intraneural lipoma. This unusual case highlights the advantage of preoperative imaging as part of the workup of proximal median nerve compression.