Sample records for vertical distraction case

  1. Vertical distraction osteogenesis of fibula transplant for mandibular reconstruction: a case report. (United States)

    Ortakoglu, Kerim; Suer, Berkay Tolga; Ozyigit, Aykut; Ozen, Tuncer; Sencimen, Metin


    Bone continuity defects in the mandible are caused by tumor surgery, trauma, infection, or osteoradionecrosis. Today, reconstruction of long-span mandibular defects with a free fibular flap is a routine procedure. However the bone height of the mandible after reconstruction is about half that of the dentulous mandible. Therefore, the deficiency in bone height makes implant placement impractical. In our case, because it was necessary to restore the mandibular height, a vertical distraction osteogenesis was performed on the grafted mandible of the patient who was referred to our clinic with a reconstructed mandible owing to a gunshot injury. As a result, the vertical discrepancy between the fibula and the native hemimandible of the patient was corrected. And the placement of dental implants was performed without any complications. In conclusion, we believe that the vertical distraction osteogenesis of free vascularized fibula flaps is a reliable technique that optimizes implant positioning for ideal prosthetic rehabilitation.

  2. Problems with dental implants that were placed on vertically distracted fibular free flaps after resection: a report of six cases. (United States)

    Lizio, Giuseppe; Corinaldesi, Giuseppe; Pieri, Francesco; Marchetti, Claudio


    We report the clinical outcome of dental implants placed on vertically distracted fibular free flaps that were used to reconstruct maxillary and mandibular defects after resection. Distraction osteogenesis (DO) of fibular free flaps was used for six patients (5 men, 1 woman) a mean of 19 months (range 11-38) after 5 mandibular and 1 maxillary reconstructions. A mean of 5 months (range 2-11) after removal of the distractor, 35 implants were inserted and loaded with implant-supported fixed prostheses. The mean (range) follow-up period was 39 (17-81) months. The course of the DO and the clinical and radiographic outcomes of the implants were assessed. Of six vertically distracted fibular free flaps, there was one case of vector lingual tipping during the consolidation phase and a fracture of the basal fibular cortex that necessitated additional grafting with iliac bone to stabilise the distracted area. The mean (range) vertical bone gain was 14 (12-15) mm. Four of 35 implants (11%) failed during the follow-up period. The mean peri-implant bone resorption was 2.5mm. Cumulative implant survival was 31/35 (89%) and survival after loading 31/33 (94%). Distraction osteogenesis of fibular free flaps caused a remarkable number of complications and pronounced resorption of bone around the implants, probably as a result of the formation of granulomatous tissue; a careful peri-implant follow-up and the maintenance of oral hygiene are essential.

  3. Vertical distraction osteogenesis of a free vascularized fibula flap in a reconstructed hemimandible for mandibular reconstruction and optimization of the implant prosthetic rehabilitation. Report of a case. (United States)

    Cho-Lee, Gui-Youn; Naval-Gías, Luis; Martos-Díaz, Pedro L; González-García, Raúl; Rodríguez-Campo, Francisco J


    Free vascularized fibular flap is considered the treatment of choice in mandibular reconstruction for extensive bone defects (over 6 centimeters) resulting from trauma, infections or tumor resections. But, when the reconstruction involves a dentate mandible, the fibula has the limit as it does not offer sufficient bone height to restore the alveolar arch up to the occlusal plane. Therefore, the deficiency in bone height makes implant placement impractical. We report a case of vertical distraction osteogenesis of a free vascularized fibula flap used to reconstruct a hemimandible after resection of an odontogenic myxoma, for optimization of the implant prosthetic rehabilitation. The distraction device was applied intraorally. After 10 days of latency period, distraction protocol was performed at a distraction rate of 0.5 mm per day. A consolidation period of 3 months followed. Afterwards the distraction device was removed and 3 osseointegrated dental implants were placed in the distracted area. As a result, the vertical discrepancy between the fibula and the native hemimandible was corrected. The amount of vertical height achieved after distraction was 17 milimeters. The increase of vertical bone height was stable and enabled placement of dental implants without any complications. In conclusion, we consider that vertical distraction osteogenesis of free vascularized flaps is a reliable technique that optimizes implant positioning for ideal prosthetic rehabilitation, after mandibular reconstruction following tumor surgery.

  4. Vertical distraction osteogenesis of fibular bone flap in reconstructed mandible. (United States)

    Eski, Muhitdin; Turegun, Murat; Deveci, Mustafa; Gokce, Hasan Suat; Sengezer, Mustafa


    Excellent functional and aesthetic results can be achieved in mandibular reconstructions with using free fibular bone flap. However, the vertical deficiency between the reconstructed segment and the occlusal plane made dental rehabilitation impossible in some cases. We encountered this problem in our 3 patients who had mandibular reconstruction with fibular flap due to extensive bone defect result from gunshot injury. To overcome this segmental vertical distraction of the reconstructed mandible was performed. Fibular bone segments (40-70 mm) were distracted with using extraoral distraction device after a latency period of 5-7 days. The rate of distraction was 1 mm/day, and the rhythm was 4 times (4 x 0.25 mm). Distraction was continued until the desired height was achieved, and the distractor left in place for 12 weeks for bony consolidation. No minor or major complications were encountered. The increase of vertical height was between 9 and 13 mm, and it was stable during the follow-up period (7-22 months). Following the vertical distraction and vestibuloplasty operations, the dental restoration of the patients was performed with mandibular removable partial dentures.

  5. Bilateral vertical segmental distraction in a patient with bilateral cleft of lip, alveolus, and palate. (United States)

    Pichelmayer, Margit; Zemann, Wolfgang


    In cases of bilateral clefts of lip and palate there is often a vertical and transversal deficit of the cleft segments. Ideally these problems can be solved orthodontically. In severe cases there is a need of surgical support. Distraction osteogenesis allows the correction of transversal, horizontal, and vertical deficits. A case of a 13-year-old girl with a bilateral cleft of lip and palate is presented. The patient had a severe deficit of the distal cleft segments concerning the vertical and transversal dimension. Osteotomy of the segments was performed and a vertical distraction followed by a transpalatal distraction procedure was used to correct the discrepancies.

  6. A Osteogenesis Distraction Device Enabling Control of Vertical Direction for Syndromic Craniosynostosis

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    Shinji Kobayashi, MD


    Conclusion: Our system can alter the cases and bring them into the planned position, by controlling the vertical vector of distraction. We believe that this system might be effective in infants with syndromic craniosynostosis as it involves 2 osteotomies and horizontal and vertical direction of elongation can be controlled.

  7. Vertical distraction osteogenesis in the human mandible: a prospective morphometric study

    NARCIS (Netherlands)

    Amir, Lisa R.; Becking, Alfred G.; Jovanovic, Andreas; Perdijk, Frits B. T.; Everts, Vincent; Bronckers, Antonius L. J. J.


    Vertical distraction osteogenesis has received considerable interest as a way to augment bone prior to implant placement. However, very little is known regarding the appropriate distraction protocols in the human mandible. In this study, we evaluate the effect of the distraction rate and the

  8. Combined use of alveolar distraction osteogenesis and segmental osteotomy in anterior vertical ridge augmentation. (United States)

    Öncü, Elif; Isik, Kubilay; Alaaddinoğlu, E Emine; Uçkan, Sina


    Vertical defects of the anterioral veolar ridge are challenging cases in implant dentistry. Various techniques, such as onlay bone grafting, segmental osteotomy (SO) oral veolar distraction osteogenesis (ADO), have been suggested to manage those situations. ADO has an advantage of being capable of enhancing both hard and soft tissue simultaneously. One of the possible complications of ADO is rotation ortilting the transport segment (TS). In this report, we present a 30-year old woman who had a severe anterior vertical deficiency. ADO was started to manage the case, but advancement of the TS lagged on the left side and the segment rotated. A SO was planned and the lagged side was corrected. Two years after the surgery, hard and soft tissue gains were found to be preserved. Vertical alveolar bone deficiencies are challenging cases for dental implantology. Alveolar DO promotes soft tissue along with hard tissue, and the bone regeneration process and shows lower infection rates and greater stability over the long term. However, the technique has some disadvantages and can lead to complications, such as breaking of the distraction device, nerve injury or paresthesia, fracture of transport bone, hematoma, wound dehiscence, severe bleeding, and even jaw fractures. Deviation of the TS from the distraction path is another undesired situation. The rigidity of the device, the width of the mucosa, the volume of the transport and anchor segments, and the amount of augmentation can affect vector deviation. We suggest that SO can be used in similar cases in which TS could not be distracted on a straight vector line. Copyright © 2015. Published by Elsevier Ltd.

  9. Vertical distraction osteogenesis of fibula transplants for mandibular reconstruction--a preliminary study. (United States)

    Klesper, Bernd; Lazar, Frank; Siessegger, Matthias; Hidding, Johannes; Zöller, Joachim E


    When reconstructing the mandible after tumour resection with a fibular graft, the mandible is often vertically deficient, making placement of dental implants impossible. Segmental vertical distraction of the reconstructed mandible was performed in nine patients following tumour surgery between February 1998 and 2001. Their age was 14-65 years (average 46.3); all underwent radiotherapy with a dose of up to 55.6 Gy prior to tumour resection. Mandibular discontinuity was repaired with a microvascular fibular bone graft. All grafts had a vertical bone deficit ranging from 9 to 12 mm when compared with the non-resected part of the mandibles. All patients underwent segmental vertical distraction of the transplants. The distraction devices were applied intraorally. Distraction of 1.0 mm/day was performed using a Martin distractor (TRACK 1.5) followed by 12 weeks retention time. The increase of vertical bone height was stable and enabled placement of dental implants without any complications. Vertical distraction osteogenesis may become a common procedure in the treatment of alveolar ridge deficiency resulting from transplanting fibulae for mandibular reconstruction following tumour surgery.

  10. Does functional appliance treatment truly improve stability of mandibular vertical distraction osteogenesis in hemifacial microsomia? (United States)

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


    After mandibular unilateral distraction osteogenesis (DO) a gradual reappearance of the vertical asymmetry during growth is observed. A pre- and post-surgical functional-orthodontic treatment was added to our distraction protocol in the attempt to increase long-term stability. In order to evaluate the actual efficacy of such a combined treatment, two samples of children affected by hemifacial microsomia were compared long-term. Ten children were treated by a combined orthodontic-distraction treatment, seven by distraction only. Only the vertical changes in the mandible and maxilla in the panoramic and postero-anterior cephalometric X-rays were measured. All of the patients showed a gradual return of the asymmetry with growth. Occlusal plane correction and, to a much lesser extent, mandibular vertical ramus height correction were better maintained over 5 years post-DO in the orthopaedic group. Although orthopaedic treatment allows for a more stable occlusal plane and for a slower return of the mandibular vertical asymmetry, it has mainly a dento-alveolar effect. Therefore, the decision of applying an orthopaedic treatment associated with distraction, should be taken by surgeon and orthodontist together, considering both the advantages and the disadvantages of this treatment.

  11. The effect of ultrasound on osteogenesis in the vertically distracted edentulous mandible. A double-blind trial

    NARCIS (Netherlands)

    Schortinghuis, J.; Bronckers, A. L. J. J.; Gravendeel, J.; Stegenga, B.; Raghoebar, G. M.


    Whether low intensity pulsed ultrasound therapy stimulates osteogenesis in mandibular distraction was investigated in a double-blind trial. Nine patients underwent a vertical mandibular distraction over a distance of 5.1 +/- 1.2 mm. Ultrasound or placebo therapy was started daily from the first day

  12. [Orthodontics and vertical distraction osteogenesis of the maxilla

    NARCIS (Netherlands)

    Breuning, K.H.; Lange, M.O. de; Strijen, P.J. van; Perdijk, F.B.T.; Bolouri, S.


    A female patient (age 26) visited the orthodontist for correction of the reduced exposure of the upper incisors during laughing. She also reported crowding of the lower incisors and an association between lisping and her open bite. The diagnosis in this case: a Class III malocclusion case with

  13. Study on vertical mandibular distraction osteogenesis using magnesium alloy on canine

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    Chengyue Wang


    Full Text Available The bone formation feasibility by a novel magnesium alloy device was evaluated using a canine vertical mandibular distraction osteogenesis (DO model. Osteotomies were performed in the area where last 3 star׳s teeth of left mandibular were pulled out before 3 months. Both AZ31 magnesium alloy (n=6 and 316L stainless steel (n=6 distraction devices were implanted. The distraction osteogenesis was carried out with a latency of 5 days after mandibular osteotomy. Distraction proceeded at a rate of 0.3 mm/8 h for 7 days and followed by 4 weeks of consolidations. The evaluations were conducted by scanning electron microscopy (SEM and histological examinations. There were osteoblasts and trabecular bones formations manifestly in both groups. There was no significant difference in the bone mineral density between the two groups. The surface of the magnesium alloy was much more cracked and uneven, resulting from the surface pitting corrosion. The crew nails were closely combined with the surrounding bone tissue. AZ31 magnesium alloy exhibited a certain degradation rate in mandibular and did not post a negative effect on the kidney and liver. The observations in magnesium alloys group is consistent with the stainless steel group.

  14. Premaxillary Distraction Osteogenesis Using an Intraoral Appliance for Unilateral Cleft Lip and Palate: Case Report. (United States)

    Terbish, Munkhdulam; Choi, Hye-Young; Park, Young-Chel; Yi, Choong Kook; Cha, Jung-Yul


    Premaxillary distraction osteogenesis was introduced using intraoral devices to correct maxillary hypoplasia and lengthen the alveolar bone horizontally in a patient with unilateral cleft lip and palate. For premaxillary distraction osteogenesis, Le Fort I osteotomy was performed. Vertical osteotomy lines were located distally of the upper right canine and left first premolar to separate the anterior segment of the maxilla. After a 7-day latency period, distraction was allowed to continue for 20 days at a rate of 0.5 mm/d, followed by a 3-month consolidation period. After consolidation, orthodontic treatment and bilateral intraoral vertical ramus osteotomy were performed for the mandibular setback. The implant and prosthodontic treatments were applied to the alveolar ridge area created by the distraction osteogenesis. The A-point moved 8.0 mm forward during the distraction osteogenesis period, and the recurrence rate was 25% after the retention period. The transverse dimension of the upper arch was expanded during orthodontic treatment. The quality of the alveolar bone created by distraction osteogenesis was acceptable for the prosthodontic implant. Premaxillary distraction osteogenesis and arch expansion is an effective treatment strategy, improving function, aesthetics, and stability for cleft patients with multiple missing teeth.

  15. Vector-controlled alveolar distraction osteogenesis using an implant-fixed provisional prosthesis: a case report. (United States)

    Kawashima, Wataru; Takayama, Kenichi; Fujii, Ryosuke; Matsubara, Yuuri; Kirita, Tadaaki


    This is a case report of anterosuperior alveolar distraction using an implant-fixed provisional prosthesis. Osteotomy and placement of a distraction device were performed in a healthy 69-year-old woman. To avoid lingual inclination during the distraction period, the device's rod was buried in the labial side of a provisional prosthesis supported by posterior implants. The mandibular bone was obliquely distracted by 0.3 mm every 2 days. Implant insertion was performed, and a good prognosis was anticipated. Inclination is thought to be caused by soft tissue on the lingual side. Many reports propose methods to avoid inclination, but these methods require established support from the teeth and cannot be adapted for an edentulous case. The method reported here is useful for distraction osteogenesis because it can be adapted for edentulous cases.

  16. Distraction osteogenesis in the irradiated mandible. A case report

    NARCIS (Netherlands)

    Raghoebar, GM; Jansma, J; Vissink, A; Roodenburg, JLN

    Background: Distraction osteogenesis has been suggested as a relatively simple method of mandibular reconstruction following ablative head and neck surgery. Some authors report good results in irradiated patients while other authors report limitations with this group of patients. Patient: In a

  17. [Vertical fractures: apropos of 2 clinical cases]. (United States)

    Félix Mañes Ferrer, J; Micò Muñoz, P; Sánchez Cortés, J L; Paricio Martín, J J; Miñana Laliga, R


    The aim of the study is to present a clinical review of the vertical root fractures. Two clinical cases are presented to demonstrates the criteria for obtaining a correct diagnosis of vertical root fractures.

  18. Nasolabial and Interincisal Angle Evaluation in Anterior Maxillary Distraction Osteogenesis: A Case Study

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    Tojan Chacko Thekkekara


    Full Text Available Maxillary hypoplasia is a common developmental problem in cleft lip and palate deformities. These deformities have traditionally been corrected by means of orthognathic surgery. Management of skeletal deformities in the maxillofacial region has been a challenge for maxillofacial surgeons and orthodontists. Distraction osteogenesis (DO is a surgical technique that uses body′s own repairing mechanisms for optimal reconstruction of the hard and soft tissues. We present four cases of anterior maxillary distraction osteogenesis with tooth-borne distraction device— Hyrax, which were analyzed retrospectively using cephalometrics. Changes in nasolabial angle and interincisal angle after distraction of anterior maxillary segment were studied to conclude that there was no much change in the the nasolabial angle while the interincisal angle showed marked improvement.

  19. Distraction osteogenesis in Goldenhar Syndrome: case report and 8-year follow-up. (United States)

    Lima, Marina de Deus Moura de; Marques, Yonara Maria Freire Soares; Alves, Sérgio de Melo; Ortega, Karem Lopez; Soares, Marcelo Melo; Magalhães, Marina Helena Cury Gallottini de


    Goldenhar syndrome is a well-known condition featuring the following triad of anomalies: ocular abnormalities, microtia and vertebral anomalies. This syndrome involves structures arising from the first and second branchial arches. Craniofacial anomalies, including mandibular, zygomatic and/or maxillary hypoplasias are found in 50% of patients with Goldenhar syndrome. Patients with this syndrome may present unilateral or bilateral underdevelopment of the mandible. Several treatments for the correction of the dento-facial deformity have been described, among them distraction osteogenesis is one that shows promising results. Distraction osteogenesis is the process of bone formation that occurs during slow separation of the segments of bone after an osteotomy and it has been used to alleviate facial asymmetry. Mandibular distraction osteogenesis has been applied for many years, but long-term reports present controversial results. The purpose of the case report is to describe the immediate and long-term effects of distraction osteogenesis used to treat mandible asymmetry in a 5-year-old boy with Goldenhar syndrome.

  20. Double Level Extension-Distraction Thoracic Spine Injuries with Concomitant Double Level Sternal Fractures: A Case Report

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    CK Lee


    Full Text Available Extension-distraction injury of the spine is rare. A majority of these cases occur in the cervical region and at an isolated level. Rare instances of this injury have been described in an ankylosed or fused spine. This case report describes a rare two level extension-distraction thoracic spine injury in an otherwise healthy adult resulting from a motor vehicle accident.

  1. [Juvenile paradental cysts in children after mandible distraction: case-control study and clinical cases presentation]. (United States)

    Korolenkova, M V


    Seventy-five children aged 6-17 years (mean age 9.8±4.1 years) that received mandible distraction (MD) at the age of 0-17 years (mean age at MD 6.1±4.3) were included in the study. Indication for MD were hemifacial microsomia (n=41), Goldenhar syndrome (n=4), Robin sequence (n=10), Treacher, Collins syndrome (n=7) or acquired mandible underdevelopment (n=13). Control groups consisted of 22 children aged 5-14 years (mean age 7.0±3.7 years) with mandible underdevelopment of similar origin (hemifacial microsomia (n=15), Goldenhar syndrome (n=2), Robin sequence (n=4), Treacher, Collins syndrome (n=1)) with no history of MD and 80 healthy children aged 6-10 years (mean age 7.1±2.2 years). Case-control study results proved MD to be the risk factor for juvenile paradental cysts (JPCs) with the risk more prominent in early MD cases. JPCs often do not manifest clinically and may resolve spontaneously but in refractory cases lesion curettage without endodontic treatment is an adequate approach, as JPCs are usually not associated with pulp necrosis.

  2. Comparative analysis of dental implant treatment outcomes following mandibular reconstruction with double-barrel fibula bone grafting or vertical distraction osteogenesis fibula: a retrospective study. (United States)

    Wang, Feng; Huang, Wei; Zhang, Chenping; Sun, Jian; Kaigler, Darnell; Wu, Yiqun


    The purpose of this study was twofold: (i) to compare vertical bone height (VBH) after tumor resection through grafting with either a double-barrel fibula (DBF) technique or vertical distraction osteogenesis of the fibula (VDOF); (ii) to compare the performance of loaded dental implants following either DBF or VDOF with special focus on implant survival, implant success, and bone resorption. This retrospective clinical study involved 19 patients who underwent implant placement following DBF (group A, n = 9) or VDOF (group B, n = 10) for mandibular reconstruction from March 2006 to May 2008. Clinical and radiographic assessments, including VBH, modified Plaque Index (mPI), modified Sulcus Bleeding Index (mSBI), and marginal bone level (MBL), were taken for both groups after delivery of the final prostheses and annually thereafter. Nine patients underwent DBF with 24 implants placed and 10 patients underwent VDOF with 27 implants placed for mandibular reconstruction after tumor resection. Overall, all DBF and VDOF procedures were successful for group A and group B. VBH for group A and group B were 20 and 17 mm. There was no statistically significant difference of mSBI scores between group A and group B in the 3-year follow-up (P = 0.40). In four cases with eight implants of group A and two cases with three implants of group B, granulomatous soft tissue grew. There was no statistically significant differences of MBL between group A and group B in the 3-year follow-up (p = 0.736). The cumulative survival and success rates of implants for group A were 100% and 87.5%, and for group B were 100% and 85.2% in 3-year follow-up, respectively. On the basis of the study of 19 patients who received a total of 51 implants, reconstruction of the mandible with DBF flap or VDOF flap, combined with dental implant therapy, was considered a predictable option. Compared with implants placed in VDOF bone, implants placed in DBF bone had a relative higher incidence of associated gingival

  3. Case study: videogame distraction reduces behavioral distress in a preschool-aged child undergoing repeated burn dressing changes: a single-subject design. (United States)

    Sil, Soumitri; Dahlquist, Lynnda M; Burns, Andrew J


    This single-subject design study evaluated the feasibility and efficacy of passive and interactive videogame distraction on behavioral distress for a preschool-aged child receiving repeated burn dressing changes. A 4-year-old girl underwent 3 baseline and 10 videogame distraction sessions (5 passive and 5 interactive) using a restricted alternating treatments design. Observed behavioral distress was coded, and parents and nurses rated the child's distress and cooperative behavior. Relative to baseline, behavioral distress decreased and cooperative behavior increased immediately after the onset of videogame distraction. Single Case Randomization Tests revealed significantly lower behavioral distress and greater cooperation during interactive videogame distraction relative to passive videogame distraction. Interactive videogame distraction appears to be a feasible and effective pain management strategy for a preschool-aged child undergoing repeated painful medical procedures.

  4. Reactivation of trigeminal neuralgia following distraction osteogenesis in an 8-year-old child: Report of a unique case

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    Ramanathan M


    Full Text Available Trigeminal neuralgia is extremely rare in children. No concrete treatment protocols seem to be available for management of this condition in the pediatric population. Although trigeminal neuralgia may achieve remission, the possibility of reactivation of a hitherto quiescent condition cannot be ruled out. We present a case of pediatric trigeminal neuralgia following distraction osteogenesis of the mandible.

  5. Reactivation of trigeminal neuralgia following distraction osteogenesis in an 8-year-old child: report of a unique case. (United States)

    Ramanathan, M; Parameshwaran, Anantanarayanan A; Jayakumar, N; Raghaviah, A M


    Trigeminal neuralgia is extremely rare in children. No concrete treatment protocols seem to be available for management of this condition in the pediatric population. Although trigeminal neuralgia may achieve remission, the possibility of reactivation of a hitherto quiescent condition cannot be ruled out. We present a case of pediatric trigeminal neuralgia following distraction osteogenesis of the mandible.

  6. The Effect of Altering the Mechanical Loading Environment on the Expression of Bone Regenerating Molecules in Cases of Distraction Osteogenesis

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    Mohammad M Alzahrani


    Full Text Available Distraction osteogenesis (DO is a surgical technique where gradual and controlled separation of two bony fragments following an osteotomy leads to the induction of new bone formation in the distracted gap. DO is used for limb lengthening, correction of bony deformities and the replacement of bone loss secondary to infection, trauma and tumors. Although DO gives satisfactory results in most cases, one major drawback of this technique is the prolonged period of time the external fixator has to be kept on until the newly formed bone consolidates thus leading to numerous complications. Numerous attempts at accelerating bone formation during DO have been reported. One specific approach is manipulation of the mechanical environment during DO by applying changes in the standard protocol of distraction. Attempts at changing this mechanical environment led to mixed results. Increasing the rate or applying acute distraction, led to poor bone formation in the distracted zone. On the other hand, the addition of compressive forces (such as weight bearing, alternating distraction with compression or by over-lengthening and then shortening has been reported to increase bone formation. It still remains unclear why these alterations may lead to changes in bone formation. While the cellular and molecular changes occurring during the standard DO protocol, specifically increased expression of transforming growth factor-β1, platelet derived growth factor, insulin-like growth factor, basic fibroblast growth factor, vascular endothelial growth factor, and bone morphogenic proteins have been extensively investigated, the literature is sparse on the changes occurring when this protocol is altered. It is the purpose of this article to review the pertinent literature on the changes in the expression of various proteins and molecules as a result of changes in the mechanical loading technique in DO and try to define potential future research directions.

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

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    Francesco Grecchi


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

  8. Distracción osteogénica vertical de injerto microvascularizado de peroné para reconstrucción mandibular y optimización de la rehabilitación implantológica Vertical distraction osteogenesis of microvascularised fibular grafts for mandibular reconstruction and optimisation of rehabilitation implantology

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    G.Y. Cho Lee


    restore the alveolar arch up to the occlusal plane. Therefore, the deficiency in bone height makes implant placement impractical. Materials and methods: We report a case of vertical distraction osteogenesis of a free vascularized fibula flap used to reconstruct a hemimandible after resection of an odontogenic myxoma. The distraction device was applied intraorally. Distraction of 0.5 mm per day was performed followed by 3 months of consolidation period. Results: The vertical discrepancy between the fibula and the native hemimandible was corrected. The increase of vertical bone height was stable and enabled placement of dental implants without any complications. Conclusions: We believe that vertical distraction osteogenesis of free vascularized flaps is a reliable technique that optimizes implant positioning for ideal prosthetic rehabilitation, after mandibular reconstruction following tumour surgery.

  9. Comparison of Dental Implant Performance Following Vertical Alveolar Bone Augmentation With Alveolar Distraction Osteogenesis or Autogenous Onlay Bone Grafts: A Retrospective Cohort Study. (United States)

    Zhao, Kai; Wang, Feng; Huang, Wei; Wang, XuDong; Wu, Yiqun


    The aim of this retrospective study was to compare the performance of implants placed after alveolar distraction osteogenesis (ADO) or autogenous onlay bone grafting (AOBG) based on implant survival, peri-implant bone resorption, and clinical parameters. From February 2008 to July 2012, 17 patients (6 women and 11 men) with implant placement after ADO (group 1, n = 8) or AOBG (group 2, n = 9) were included in this retrospective study. In all, 37 implants were placed in group 1 and 22 implants were placed in group 2. Implant survival rate, peri-implant bone resorption, probe depth (PD), modified plaque index (mPI), and modified sulcus bleeding index (mSBI) were analyzed to evaluate implant prognosis. Successful reconstruction of vertical alveolar defects and uneventful implant placement were achieved in all patients in the 2 groups. After a mean follow-up of 47.9 ± 13.3 months, implant survival was 97.3% (36 of 37) in group 1 and 95.5% (21 of 22) in group 2. No statistically relevant differences were observed. Peri-implant bone resorption was 1.29 ± 0.59 mm in group 1, which was slightly higher than 1.24 ± 0.87 mm in group 2 at last follow-up. The difference was not statistically relevant. Favorable peri-implant conditions were indicated by PD, mPI, and mSBI in the 2 groups. ADO and AOBG can be used for correction of vertical alveolar defects with a reliable implant prognosis. Comparably high implant survival rates and favorable peri-implant conditions were attained. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Distraction, Compression, Extension, and Reduction Combined With Joint Remodeling and Extra-articular Distraction: Description of 2 New Modifications for Its Application in Basilar Invagination and Atlantoaxial Dislocation: Prospective Study in 79 Cases. (United States)

    Chandra, P Sarat; Prabhu, Manik; Goyal, Nishant; Garg, Ajay; Chauhan, Avnish; Sharma, Bhawani Shankar


    Recent strategies for treatment of basilar invagination (BI) and atlantoaxial dislocation (AAD) are based on simultaneous posterior reduction and fixation. To describe new modifications of the procedure distraction, compression, extension, and reduction (DCER), ie, joint remodeling (JRM) and extra-articular distraction (EAD) in patients with "vertical" joints, and to quantify the improvement in joint indices, ie, sagittal inclination (SI), craniocervical tilt (CCT), and coronal inclination. Prospective study (May 2010 to September 2014). Joint indices measured included (normal values): SI (87.15 ± 5.65°), CCT (60.2 ± 9.2°), and coronal inclination (110.3 ± 4.23°). Surgical procedures included DCER alone (performed in SI 160°, group III). Seventy-nine patients were selected (mean, 22.5 years of age). All conventional indices improved significantly (P 100°). Joint indices provide useful information for surgical strategy and planning.

  11. Manufacturing: the new case for vertical integration

    NARCIS (Netherlands)

    Kumpe, Ted; Bolwijn, Piet


    The article argues that the solid corporation will continue to view vertical integration as a critical part of manufacturing reform. Manufacturing reform and backward integration are related in insidious ways to the three stages of production over which the big manufacturers preside. Without

  12. Use of virtual reality distraction to reduce claustrophobia symptoms during a mock magnetic resonance imaging brain scan: a case report. (United States)

    Garcia-Palacios, Azucena; Hoffman, Hunter G; Richards, Todd R; Seibel, Eric J; Sharar, Sam R


    The present case series with two patients explored whether virtual reality (VR) distraction could reduce claustrophobia symptoms during a mock magnetic resonance imaging (MRI) brain scan. Two patients who met DSM-IV criteria for specific phobia, situational type (i.e., claustrophobia) reported high levels of anxiety during a mock 10-min MRI procedure with no VR, and asked to terminate the scan early. The patients were randomly assigned to receive either VR or music distraction for their second scan attempt. When immersed in an illusory three-dimensional (3D) virtual world named SnowWorld, patient 1 was able to complete a 10-min mock scan with low anxiety and reported an increase in self-efficacy afterwards. Patient 2 received "music only" distraction during her second scan but was still not able to complete a 10-min scan and asked to terminate her second scan early. These results suggest that immersive VR may prove effective at temporarily reducing claustrophobia symptoms during MRI scans and music may prove less effective.

  13. Vertical leadership in a case company


    Nguyen, Ngan


    The thesis concentrated about vertical leadership. The topic clarifies leadership behaviours in different styles. Based on unique characteristics would build up different leadership styles. A good leader is not only be independence, responsibility, visionary, but also must be interpersonal. Creating network through the rest of organization, a leader establishes relationship with his or her employees. Building trust then would help an organization overcome obstacles in order to accomplish comm...

  14. Stable vertical distraction osteogenesis of highly atrophic mandibles after ablative tumour surgery of the oral cavity--a salvage pathway for mandibular reconstruction prior to oral rehabilitation with dental implants. (United States)

    Adolphs, Nicolai; Sproll, Christoph; Raguse, Jan-Dirk; Nelson, Katja; Heberer, Susanne; Scheifele, Christian; Klein, Martin


    Mandibular reconstruction is still a challenge for surgeons. Distraction osteogenesis (DO) might contribute in certain instances to solve this problem. A principal advantage of DO is the expansion of the surrounding soft tissues that accompanies the bony regeneration. In addition there is no donor site morbidity when compared with reconstruction by autologous bone grafting. However its application may be limited by the thinness of the mandible and the attendant fracture risk. This article describes a technique that combines stable internal fixation with vertical distraction of the alveolar ridge in six patients with critical mandibular thickness after ablative surgery for cancer of the oral cavity. Prior to implant insertion for further prosthodontic restoration stable vertical mandibular distraction produced an additional 11-20mm. Improvement of the surrounding soft tissues, especially intraorally was achieved and dental implants were inserted after bony consolidation. This method can be a useful salvage technique for the augmentation of the atrophic mandible in patients who are not able or willing to undergo the risks and disadvantages of established methods such as free autologous bone transfer or microsurgical techniques.

  15. The increased risk of road crashes in attention deficit hyperactivity disorder (ADHD adult drivers: driven by distraction? Results from a responsibility case-control study.

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    Kamal El Farouki

    Full Text Available Both distractions (external and internal and attention-deficit/hyperactivity disorder (ADHD are serious risk factors for traffic crashes and injuries. However, it is still unknown if ADHD (a chronic condition modifies the effect of distractions (irregular hazards on traffic crashes. The objective of this study was to assess the effects of distractions and ADHD on traffic crash responsibility.A responsibility case-control study was conducted in the adult emergency department of Bordeaux University Hospital, France. Subjects were recruited among drivers injured in a motor vehicle crash between April 2010 and August 2011. Responsibility levels were estimated using a standardized method. Frequencies of exposures were compared between drivers responsible and drivers not responsible for the crash. Independent risk factors were identified using a multivariate logistic regression including test interactions between distractions and ADHD.A total of 777 subjects were included in the analysis. Factors associated with responsibility were distraction induced by an external event (adjusted OR (aOR = 1.47; 95% confidence interval (CI [1.06-2.05], distraction induced by an internal thought (aOR = 2.38; CI: [1.50-3.77] and ADHD (aOR = 2.18 CI: [1.22-3.88]. The combined effect of ADHD and external distractions was strongly associated with responsibility for the crash (aOR = 5.79 CI: [2.06-16.32]. Interaction assessment showed that the attributable proportion due to the interaction among participants with both exposures was 68%.Adults with ADHD are a population at higher risk of being responsible for a road traffic crash when exposed to external distractions. This result reinforces the need to diagnose adult ADHD and to include road safety awareness messages delivered by the physician. Developing advanced driver assistance systems devoted to the management of attention lapses is also increasingly relevant for these drivers.

  16. Effect of distractions on operative performance and ability to multitask--a case for deliberate practice. (United States)

    Ahmed, Aadil; Ahmad, Mueen; Stewart, C Matthew; Francis, Howard W; Bhatti, Nasir I


    To measure the effect of distractions on the operative performance and analyze if practice and experience are the factors that can help to overcome the distractions. Prospective observational study. Ten postgraduate year (PGY) 2-6 residents and two faculty members from Johns Hopkins' otolaryngology department were recruited and asked to deepen the dissection at the sinodural angle on the Voxel-man mastoidectomy simulator. They were asked to perform the task under four conditions: 1) no distractors, 2) differentiation and counting of a specific alarm sound among different sounds played in the background while performing the surgical task, 3) simultaneous performance of simple arithmetic task of moderate difficulty, and 4) simultaneous performance of the task with both sets of distractors combined. Time taken for the task (P = .02) and error scores (P = .002) increased under the third and fourth conditions. The ability to multitask and response to surgical and cognitive tasks improved with increasing level of experience of the participants. Distractions lead to impaired dexterity and an increase in the incidence of errors. However, experience and deliberate practice can help achieve the ability to multitask without compromising the operative performance. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Distraction Arthroplasty (United States)

    ... older or have non-injury arthritis (such as rheumatoid arthritis), complete loss of joint space or severe deformities, ... physical therapy treatments also should avoid distraction arthroplasty. Arthritis that is ... from the leg bone (tibia) down to the foot. The frame is attached to the bone by ...

  18. Chiropractic Distraction Spinal Manipulation on Postsurgical Continued Low Back and Radicular Pain Patients: A Retrospective Case Series. (United States)

    Gudavalli, Maruti R; Olding, Kurt; Joachim, George; Cox, James M


    The purpose of this case series is to report on changes in pain levels experienced by 69 postsurgical continued pain patients who received Cox Technic Flexion Distraction (CTFD). Fifteen doctors of chiropractic collected retrospective data from the records of the postsurgical continued pain patients seen in their clinic from February to July 2012 who were treated with CTFD, which is a type of chiropractic distraction spinal manipulation. Informed consent was obtained from all patients who met the inclusion criteria for this study. Data recorded included subjective patient pain levels at the end of the treatments provided and at 24 months following the last treatment. Fifty-four (81%) of the patients showed greater than 50% reduction in pain levels at the end of the last treatment, and 13 (19%) showed less than 50% improvement of pain levels at the end of active care (mean, 49 days and 11 treatments). At 24-month follow-up, of 56 patients available, 44 (78.6%) had continued pain relief of greater than 50% and 10 (18%) reported 50% or less relief. The mean percentage of relief at the end of active care was 71.6 (SD, 23.2) and at 24 months was 70 (SD, 25). At 24 months after active care, 24 patients (43%) had not sought further care, and 32 required further treatment consisting of chiropractic manipulation for 17 (53%), physical therapy, exercise, injections, and medication for 9 (28%), and further surgery for 5 (16%). Greater than 50% pain relief following CTFD chiropractic distraction spinal manipulation was seen in 81% of postsurgical patients receiving a mean of 11 visits over a 49-day period of active care.

  19. Percutaneous dorsal instrumentation for thoracolumbar extension-distraction fractures in patients with ankylosing spinal disorders: a case series. (United States)

    Krüger, Antonio; Frink, Michael; Oberkircher, Ludwig; El-Zayat, Bilal Farouk; Ruchholtz, Steffen; Lechler, Philipp


    Thoracolumbar extension-distraction fractures are rare injuries mainly restricted to patients suffering from ankylosing spinal disorders. The most appropriate surgical treatment of these unstable spinal injuries remains to be clarified. To report on a cohort of 10 patients treated with closed reduction and percutaneous dorsal instrumentation. Case series. Ten consecutive patients with ankylosing spinal disorders and thoracolumbar extension-distraction fractures (Type B3 according to the AOSpine Thoracolumbar Spine Injury Classification System). Postoperative reduction, alignment, and implant position were analyzed by computed tomography. Loss of reduction was assessed on lateral radiographs by using the Cobb technique. Ambulation ability and pain were assessed at follow-up. Minimally invasive dorsal percutaneous instrumentation was performed in 10 consecutive patients (3 men, 7 women) with a mean age of 81.5 (range 72-90) years between May 2010 and December 2012. The mean postoperative follow-up time was 7.9 (range 4-28) months. All 10 patients were treated with closed reduction and dorsal instrumentation; in no case was conversion to an open approach required. The mean operation time was 60.2 (range 32-135) minutes. None of the patients presented neurologic deficits. Cement-augmented screws were implanted in two cases. Sufficient radiographic correction was achieved in all patients; no case of loss of reduction was noted at final follow-up. In one case, complete hardware removal was performed 9 months after the index operation because of persistent back pain at the level of the implant. One patient died of postoperative inferior vena cava obstruction. At discharge, all patients were able to ambulate without the need for crutches or opioid analgesics. At final follow-up, all patients ambulated with full weight bearing; four patients reported persistent back pain. In fragile patients with ankylosing spinal disorders and thoracolumbar extension-distraction fractures

  20. Surgical treatment of lumbar spinal stenosis with microdecompression and interspinous distraction device insertion. A case series

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    Ploumis Avraam


    Full Text Available Abstract Background Interspinous distraction devices (IPDD are indicated as stand-alone devices for the treatment of spinal stenosis. The purpose of this study is to evaluate the results of patients undergoing surgery for spinal stenosis with a combination of unilateral microdecompression and interspinous distraction device insertion. Methods This is a prospective clinical and radiological study of minimum 2 years follow-up. Twenty-two patients (average age 64.5 years with low-back pain and unilateral sciatica underwent decompressive surgery for lumbar spinal stenosis. Visual Analogue Scale, Oswestry Disability Index and walking capacity plus radiologic measurements of posterior disc height of the involved level and lumbar lordosis Cobb angle were documented both preoperatively and postoperatively. One-sided posterior subarticular and foraminal decompression was conducted followed by dynamic stabilization of the diseased level with an IPDD (X-STOP. Results The average follow-up time was 27.4 months. Visual Analogue Scale and Oswestry Disability Index improved statistically significantly (p Conclusions The described surgical technique using unilateral microdecompression and IPDD insertion is a clinically effective and radiologically viable treatment method for symptoms of spinal stenosis resistant to non-operative treatment.

  1. [Distraction osteogenesis in orthopaedics

    NARCIS (Netherlands)

    Baat, P. de; Baat, C. de; Bessems, J.H.


    For several decades, distraction osteogenesis has been applied in orthopaedics for lengthening limbs. Other indications for distraction osteogenesis in orthopaedics are nonunions, open fractures, oncologic defects, and ankle osteoarthritis. The main principle of distraction osteogenesis is that,

  2. Rushing, distraction, walking on contaminated floors and risk of slipping in limited-service restaurants: a case--crossover study. (United States)

    Verma, Santosh K; Lombardi, David A; Chang, Wen Ruey; Courtney, Theodore K; Huang, Yueng-Hsiang; Brennan, Melanye J; Mittleman, Murray A; Ware, James H; Perry, Melissa J


    This nested case-crossover study examined the association between rushing, distraction and walking on a contaminated floor and the rate of slipping, and whether the effects varied according to weekly hours worked, job tenure and use of slip-resistant shoes. At baseline, workers from 30 limited-service restaurants in the USA reported average work hours, average weekly duration of exposure to each transient risk factor and job tenure at the current location. Use of slip-resistant shoes was determined. During the following 12 weeks, participants reported weekly their slip experience and exposures to the three transient exposures at the time of slipping. The case-crossover design was used to estimate the rate ratios using the Mantel-Haenszel estimator for person-time data. Among 396 participants providing baseline information, 210 reported one or more slips with a total of 989 slips. Rate of slipping was 2.9 times higher when rushing as compared to working at a normal pace (95% CI 2.5 to 3.3). Rate of slipping was also significantly increased by distraction (rate ratio (RR) 1.7, 95% CI 1.5 to 2.0) and walking on a contaminated floor (RR 14.6, 95% CI 12.6 to 17.0). Use of slip-resistant shoes decreased the effects of rushing and walking on a contaminated floor. Rate ratios for all three transient factors decreased monotonically as job tenure increased. The results suggest the importance of these transient risk factors, particularly floor contamination, on rate of slipping in limited-service restaurant workers. Stable characteristics, such as slip-resistant shoes, reduced the effects of transient exposures.

  3. Distraction osteogenesis using combined locking plate and Ilizarov fixator in the treatment of bone defect: A report of 2 cases

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    John Mukhopadhaya


    Full Text Available Distraction osteogenesis and bone transport has been used to reconstruct bone loss defect by allowing new bone to form in the gap. Plate-guided bone transport has been successfully described in literature to treat bone loss defect in the femur, tibia, and mandible. This study reports two cases of fracture of femur with segmental bone loss treated with locking plate fixation and bone transport with Ilizarov ring fixator. At the time of docking, when the transport segment is compressed with bone fragment, the bone fragment is fixed with additional locking or nonlocking screws through the plate. The bone defect size was 7 cm in case 1 and 8 cm in case 2 and the external fixation indexes were 12.7 days/cm and 14 days/cm. No shortening was present in either of our cases. The average radiographic consolidation index was 37 days/cm. Both cases achieved infection-free bone segment regeneration and satisfactorily functional outcome. This technique reduces the duration of external fixation during the consolidation phase, allows correction of length and alignment and provides earlier rehabilitation.

  4. Ankylosis of temporomandibular joints after mandibular distraction osteogenesis in patients with Nager syndrome: Report of two cases and literature review. (United States)

    Wu, Cheng Chun; Sakahara, Daisuke; Imai, Keisuke


    Nager syndrome, also known as Nager acrofacial dysostosis, was first described by Nager and de Reynier in 1948. The patients commonly present with micrognathia, and a preventive tracheostomy is necessary when there are symptoms of upper airway obstruction. Mandibular distraction osteogenesis is considered as an effective procedure, which not only improves micrognathia but also minimizes the chances of tracheostomy. However, mandibular distraction osteogenesis has some complications such as relapse, teeth injury, infection, and injury of the temporomandibular joints (TMJs). In this study, the author reported two patients with Nager syndrome who suffered from ankylosis of TMJs after mandibular distraction osteogenesis. In addition, a comprehensive literature review of post-distraction ankylosis of TMJs in patients with Nager syndrome was performed. Few studies demonstrated the condition of TMJs after mandibular distraction osteogenesis, and three studies were identified from the review. One study reported ankylosis of bilateral coronoid processes, in which coronoidectomies were necessary. Another study reported the use of prostheses to replace the ankylosed joints in a patient who had undergone many surgeries of the joints, such as gap arthroplasties, reconstructions with costochondral grafts, etc. One other study raised the concept of unloading the condyles during the mandibular distraction to prevent subsequent ankylosis. It seems that multiple factors are related to the ankylosis of TMJs after mandibular distraction osteogenesis in patients with Nager syndrome. Prevention of post-distraction ankylosis of the joints is important because the treatment is difficult and not always effective. We should conduct more studies about protection of the joints during mandibular distraction in the future. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Cephalometric analysis for accurately determining the vertical dimension (case report

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    Wahipa Wiro


    Full Text Available Objective : Determination of the vertical dimension of occlusion (DVO tends to changes throughout the human life. The vertical dimension is determined by the interocclusal point of the upper and lower teeth contact so the application is limited when the natural teeth was missing. As the result, many functional and aesthetic changes are occurred in the whole orofacial region and stomatognathic system. DVO is one of the difficult stages in prosthodontic treatment. Most of the techniques to determine DVO in edentulous patients are based on the soft tissue references, which can cause the different measurements. Cephalometric analysis allows the evaluation of bone growth changes and can be used as a diagnostic tool in prosthodontics to evaluate the results of prosthodontic rehabilitation. Methods : The purpose of this case report was to find out the results of the vertical dimension of occlusion measurements in maxillomandibular relation by using cephalometric photo in patients who have been long lost their teeth and have never been using denture. Results : A 50 year old female patient, partially edentulous on the upper and lower jaw with the remaining teeth were 12 (residual root, 11,21,23,33 and 43. The remaining teeth were endodontically treated prior the complete denture procedure. Cephalometric photo was done in patients after making bite rim, upper and lower bite rim were given metal marker, the image was traced, then measured between metal to get the vertical dimension of occlusion. Conclusion : The measurement results of the vertical dimension of occlusion by using cephalometric photo on making full denture were more accurate, so it could improve and restore the masticatory function, aesthetic function and phonetics.

  6. Neocondyle distraction osteogenesis in the management of temporomandibular joint ankylosis: Report of five cases with review of literature

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    Ravi Sharma


    Full Text Available Introduction and Objectives: Management of temporomandibular joint (TMJ ankylosis is a challenging and rather daunting task owing to complex abnormal anatomy and its sequel to craniofacial structures. Various autogenous grafts and alloplastic materials have been tried with variable success for creation of a near-normal joint. In recent years, neocondyle distraction has added a new dimension to the management of TMJ ankylosis. The aim of this paper is to describe the role of neocondyle distraction in TMJ ankylosis. Materials and Methods: Neocondyle distraction was carried out in five patients with TMJ ankylosis following gap arthroplasty. Computed tomogram scans were taken before surgery and 1-year postdistraction for surgical planning and postoperative assessment, respectively. The intraoral distractors (KLS Martin, Jacksonville, FL, USA were used in this study. Results: All five patients reported with adequate mouth opening and functional jaw movements. The procedure was well tolerated by all the patients. None of the patients underwent reankylosis following neocondyle distraction. Conclusion: With proper surgical planning and distraction protocol, neocondyle distraction is an effective and safe technique for TMJ reconstruction and preventing reankylosis.

  7. Maxillary Expansion and Midline Correction by Asymmetric Transverse Distraction Osteogenesis in a Patient With Unilateral Cleft Lip/Palate: A Case Report. (United States)

    Shintaku, Yuko; Tanikawa, Chihiro; Iida, Seiji; Aikawa, Tomonao; Kogo, Mikihiko; Yamashiro, Takashi


    This case report presents the management of a female patient with unilateral cleft lip and palate presenting with skeletal Class III malocclusion and a narrow upper dental arch with a midline deviation. The treatment plan involved asymmetric transverse distraction osteogenesis of the maxilla to make the upper dental midline coincident with the facial midline. After the treatment, a good facial profile and a close intercuspation of teeth were achieved. Occlusion remained stable with normal overjet and overbite after 2-year retention.

  8. [Psychological impact of alveolar mandibular distraction]. (United States)

    Castry, G; Ella, B; Emparanza, A; Siberchicot, F; Zwetyenga, N


    Implant supported dental prostheses are the most up-to-date solution for edentulous patients. This technique requires and adequate bone quantity and quality. Bone distraction may allow compensating for some bone deficit, especially mandibulary. Few studies have been dedicated to how patients adjusted to this therapy (Int J oral Maxillofac Surg 34 [2005] 238-42, Int J oral Maxillofac Surg 36 [2007] 896-9, Med Oral Pathol Oral Cir Bucal 12 [2007] E225-8). We evaluated the psychological impact of alveolar mandibular distraction. Between 1999 and 2006, 31 patients aged 27 to 70 years underwent vertical alveolar mandibular distraction. Seventeen patients (54.8%) presented with complications. A questionnaire assessed the psychological impact by using notions used in healthcare psychology: perceived stress, perceived control, and social support. Twenty-three answers (74.2% of operated cases) were studied. In 87% of the cases, patients adjusted well the distraction procedure. Eighty-one percent felt no stress. Fifty-seven percent reported light to moderate pain, and 43% found the treatment painful. Confrontation to adverse events was mentioned only in 13% of the cases. In 17% of the cases, there was a slight alteration of sleep. Fifty-seven percent of the patients managed to forget the presence of the distractor. The most difficult stages were insertion of the distractor (48%) and the activation phase (17%). Seventy-one percent of the patients did not find the protocol restraining. The treatment length was not a problem for 65%. Two patients (9%) found it too long. Ninety-one percent of the patients activated the device on their own, for two (9% of the cases) the surgeon activated the device. Ninety-seven percent of the patients found supervision satisfactory. Medical information helped to adjust well to the procedure in 96% of the cases. Forty-three percent of the patients (10 cases) required specific help during the treatment: family support, attending physician, or

  9. Identification of common features of vehicle motion under drowsy/distracted driving: A case study in Wuhan, China. (United States)

    Chen, Zhijun; Wu, Chaozhong; Zhong, Ming; Lyu, Nengchao; Huang, Zhen


    Drowsy/distracted driving has become one of the leading causes of traffic crash. Only certain particular drowsy/distracted driving behaviors have been studied by previous studies, which are mainly based on dedicated sensor devices such as bio and visual sensors. The objective of this study is to extract the common features for identifying drowsy/distracted driving through a set of common vehicle motion parameters. An intelligent vehicle was used to collect vehicle motion parameters. Fifty licensed drivers (37 males and 13 females, M=32.5 years, SD=6.2) were recruited to carry out road experiments in Wuhan, China and collecting vehicle motion data under four driving scenarios including talking, watching roadside, drinking and under the influence of drowsiness. For the first scenario, the drivers were exposed to a set of questions and asked to repeat a few sentences that had been proved valid in inducing driving distraction. Watching roadside, drinking and driving under drowsiness were assessed by an observer and self-reporting from the drivers. The common features of vehicle motions under four types of drowsy/distracted driving were analyzed using descriptive statistics and then Wilcoxon rank sum test. The results indicated that there was a significant difference of lateral acceleration rates and yaw rate acceleration between "normal driving" and drowsy/distracted driving. Study results also shown that, under drowsy/distracted driving, the lateral acceleration rates and yaw rate acceleration were significantly larger from the normal driving. The lateral acceleration rates were shown to suddenly increase or decrease by more than 2.0m/s(3) and the yaw rate acceleration by more than 2.5°/s(2). The standard deviation of acceleration rate (SDA) and standard deviation of yaw rate acceleration (SDY) were identified to as the common features of vehicle motion for distinguishing the drowsy/distracted driving from the normal driving. In order to identify a time window for

  10. Treatment of severe maxillary cleft hypoplasia in a case with missing premaxilla with anterior maxillary distraction using tooth-borne hyrax appliance

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    Akshai Shetty


    Full Text Available Cleft orthodontics generally poses a challenge and a missing premaxilla adds to the difficulty in managing them. The lack of bone support and anterior teeth in a case with missing premaxilla accounts not only for difficulty in rehabilitation but also in increasing the maxillary hypoplasia. This article presents a case report where planned orthodontic and surgical management using distraction has helped treat a severe maxillary hypoplasia in a patient with missing premaxilla. The treatment plan and method can be used to treat severe maxillary hypoplasia and yield reasonably acceptable results for such patients.

  11. [Gastric adenocarcinoma following "silastic vertical ring gastroplasty": case report]. (United States)

    Belhaj, A; Memmo, L; Memo, L; Mehdi, A; Mboti, F; Closset, J


    Bariatric surgery is considered as the most effective therapy for morbid obesity. But, each procedure carries both short-and long-term complications. And, it remains unclear if the late occurrence of gastric adenocarcinoma could be linked to bariatric surgery. We described a case of a female who developed a gastric adenocarcinoma after a silastic ring vertical gastroplasty (SRVG). A 54-year-old female presented with postprandial vomiting, poor appetite, dysphagia and weight loss 10 year after a SRVG. A gastroscopy with biopsy disclosed a juxta-pyloric adenocarcinoma. No distant metastasis was found. After 3 cycles of neoadjuvant chemotherapy, a subtotal gastrectomy with Roux-en-Y anastomosis was performed. After the surgery, a minor anastomotic leak was treated conservatively and a parietal abscess was drained. The pathological studies demonstrated a T2bN1 adenocarcinoma with negative margins. Adjuvant chemotherapy was administered. At the last work up, the patient is disease-free. The association between a gastric adenocarcinoma and a bariatric procedure such as a SRVG is difficult to assess without a case-control or a cross-sectional study. Nevertheless, when new upper digestive tract complaints occur in any patient with an otherwise unremarkable bariatric surgery follow-up, the diagnosis of gastric cancer should be bear in mind.

  12. Rehabilitation of recurrent unicystic ameloblastoma using distraction ...

    African Journals Online (AJOL)

    Ameloblastoma is a true neoplasm of odontogenic epithelial origin. Surgical resection of the ameloblastoma is well documented and an accepted treatment modality. Vertical distraction of the alveolar process is an efficient method for augmentation. This method of providing additional bone and soft tissue for implant ...

  13. Long term results of mandibular distraction

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    Batra Puneet


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

  14. Long term results of mandibular distraction. (United States)

    Batra, Puneet; Ryan, F S; Witherow, H; Calvert, M L


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

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

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    Kristian Andersen


    Full Text Available Objectives: To compare stability of maxillary advancements in patients with cleft lip and palate following distraction osteogenesis or orthognathic surgery. Material and Methods: Inclusion criteria: 1 cleft lip and palate, 2 advancement > 8 mm. Eleven patients comprised the distraction osteogenesis group (DOG. Seven patients comprised the orthognathic treatment group (CONVG. Skeletal and soft tissue points were traced on lateral cephalograms: T1 (preoperatively, T2 (after surgery, T3 (follow-up. Group differences were analyzed using Students t-test. Results: At T1-T2, advancement of 6.98 mm (P = 0.002 was observed in DOG. Horizontal overjet increased 11.62 mm (P = 0.001. A point-nasion-B point (ANB angle increased 8.82° (P = 0.001. Aesthetic plane to upper lip was reduced 5.44 mm (P = 0.017 and the naso-labial angle increased 16.6° (P = 0.001. Vertical overbite (VOB increased 2.27 mm (P = 0.021. In T2-T3, no significant changes were observed in DOG. In T1-T2, horizontal overjet increased 8.45 mm (P = 0.02. The ANB angle, 9.33° (P = 0.009 in CONVG. At T2-T3, VOB increased, 2.35 mm (P = 0.046, and the ANB angle reduced, 3.83° (P = 0.003. In T2-T3, no parameters changed in CONVG. At follow-up (T3, VOB increased in CONVG compared with DOG, (P = 0.01. Vertical position of A point differed between the groups (P = 0.04. No significant intergroup differences between soft tissue parameters occurred. Conclusions: Distraction osteogenesis resulted in a stable position of the maxilla and movement upwards in vertical plane, however in case of orthognathic treatment sagittal relapse and a continued postoperatively downward movement was registered.

  16. Distraction in traffic.

    NARCIS (Netherlands)


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

  17. Outcomes of Surgical Treatment in Cases of Dissociated Vertical Deviation

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    Serpil Akar


    Full Text Available Objectives: To investigate the results of different surgical techniques for treating cases of dissociated vertical deviation (DVD. Materials and Methods: A retrospective review of medical records was performed, including 94 eyes of 47 patients who had undergone bilateral superior rectus (SR recessions (Group 1, bilateral SR recession with posterior fixation sutures (Group 2, or bilateral inferior oblique (IO anterior transposition surgery (Group 3 for treatment of DVD. Nineteen patients underwent secondary procedures (SR weakening or IO anterior transposition because of unsatisfactory results. The amount of the DVD in primary position before and after surgery, postoperative success ratios, and probable complications were evaluated. The Wilcoxon signed ranks test and chi-squared test were used for statistical evaluations. Results: In 69% of the 32 eyes in group 1, 65% of the 20 eyes in group 2, and 79% of the 42 eyes in group 3, satisfactory control of the DVD in primary position was achieved. All eyes undergoing both SR weakening and IO anterior transposition had a residual DVD of less than 5 prism diopters (pd. Of the total of 94 eyes, in 26 (89.6% of 29 eyes that had a preoperative DVD angle of more than 15 pd [ten eyes from group 1, seven eyes from group 2, and nine eyes from group 3], the residual DVD angle after surgery was more than 5 pd. However, in the 65 eyes with preoperative DVD of 15 pd or less (21from Group 1, 12 from Group 2, and 32 from Group 3, the residual DVD angle after the operation was less than 5 pd. Two eyes of 2 patients had -1 limitation to elevation after surgery. Conclusion: Only IO anterior transposition or SR weakening surgery appear to be a successful surgical approaches in the management of patients with mild- and moderate-angle (≤15 pd DVD. Weakening both the SR and IO muscles yield a greater success in the management of patients with large-angle (>15 pd DVD. (Turk J Ophthalmol 2014; 44: 132-7

  18. Metacarpal lengthening by distraction histiogenesis in adults

    Directory of Open Access Journals (Sweden)

    Das Sakti


    Full Text Available Background: Metacarpal lengthening in the hand is a new application for distraction neo-histiogenesis. Metacarpal lengthening with distraction helps in improvement in pinch function. Thumb lengthening is technically easy in comparison to other metacarpals. We present the operative treatment and post-operative outcome in nine patients with amputations and congenital anomalies. Materials and Methods: Nine patients underwent distraction osteogenesis for the treatment of amputations of the hand and other congenital anomalies. The dominant right hand was operated in eight cases and the left hand in one case. There were six males and three females. Improvement of function was always the aim of surgery. Age range was between 18 and 23 years. Thumb lengthening was performed in five patients and that of the index finger in four patients. Distraction started on the fifth post-operative day at the rate of 0.25 mm/day. Sensory function and bone consolidation was assessed before fixator removal. Results: The mean duration of distraction was 51 days (range, 42-60 days and the distractor was removed at a mean of 150 days (range, 140 and 160 days and the bones were lengthened by a mean of 24 mm (range, 20-28 mm There was improvement of function in all cases. Conclusion: The metacarpal lengthening by distraction histiogenesis in congenital and traumatic amputations is safe and simple method to improve pinch function of hand.

  19. Vertical fixation with fibrin glue-assisted secondary posterior chamber intraocular lens implantation in a case of surgical aphakia

    Directory of Open Access Journals (Sweden)

    Jeevan S Ladi


    Full Text Available We report the first case of vertical fixation by fibrin glue-assisted secondary posterior chamber intraocular lens implantation in a case of surgical aphakia. Advantages of vertical fixation are discussed.

  20. Hemimandibular hyperplasia: a rare case of vertical facial asymmetry. A case report. (United States)

    Bennett, Samuel C; Goonewardene, Mithran S


    Hemimandibular hyperplasia (HH), also known as hemimandibular hypertrophy, is characterised by excessive unilateral three-dimensional growth of the mandible after birth. Vertical elongation of the mandible on one side becomes clinically evident as a rare form of vertical facial asymmetry. Aberrant growth of the facial skeleton affects the developing dentition and dental compensation is usually unable to maintain optimal occlusal relationships. The resulting malocclusion is best managed surgically to address the various facial, skeletal and dental problems that confront clinicians. To present a case of hemimandibular hyperplasia treated using a combined surgical-orthodontic approach. Combined surgical-orthodontic treatment was accomplished in four phases: 1) presurgical orthodontic, 2) surgical, 3) post-surgical orthodontic and 4) orthodontic retention. Comprehensive records (including photographs, study models and radiographs) were taken at the pre-treatment, pre-surgery and debanding stages of treatment. A significant improvement in facial symmetry and a positive occlusal outcome were achieved. A more balanced gingival display has improved the patient's smile aesthetics. Hemimandibular hyperplasia is a rare condition causing vertical facial asymmetry and a resulting malocclusion. A combined surgical-orthodontic approach is able to accomplish sound facial, skeletal and dental treatment outcomes.

  1. Maxillo-mandibular distraction osteogenesis for hemifacial microsomia in children. (United States)

    Satoh, Kaneshige; Suzuki, Hiroyuki; Uemura, Tetsushi; Hosaka, Yoshiaki


    To obviate or lessen the long period of use of orthodontic appliances after distraction for hemifacial microsomia in the mixed dentition patients, simultaneous maxillo-mandibular distraction osteogenesis has been performed in 10 patients aged 7 to 12 years with hemifacial microsomia. In these patients, there were two cases of type I, five cases of type IIa, and three cases of type IIb. A uniplanar internal distraction device was used in all cases. After maxillary Le Fort I osteotomy and mandibular ramus osteotomy, a uniplanar internal distraction device was attached to the mandible. On days 5 to 6 after surgery, distraction of 1 mm per day was started. Rigid intermaxillary fixation (IMF) using soft wires was performed at the distraction and was retained for 1 hour. Except for this period, rigid IMF was released. Distraction length ranged from 10 to 21 mm. After the distraction, a slight lateral crossbite in one case and a slight occlusal change in two cases, which did not necessitate the particular orthodontic treatment, were noted. Postoperative follow-up ranged from 16 to 40 months. The postoperative clinical course was uneventful thereafter. Maxillary growth impairment after the osteotomy has been obscure because of the short postoperative period. This procedure is effective for obviating or lessening the long duration of use of orthodontic appliances in the mixed dentition period of 7 to 14 years of hemifacial microsomia.

  2. Electronic Gaming as Pain Distraction

    Directory of Open Access Journals (Sweden)

    Eleanor Jameson


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

  3. An Innovative Approach for Management of Vertical Coronal Fracture in Molar: Case Report

    Directory of Open Access Journals (Sweden)

    Ambica Kathuria


    Full Text Available Unlike anterior teeth, acute exogenous trauma is an infrequent cause of posterior coronal vertical tooth fractures. Endodontic and restorative management of such fractures is a great challenge for the clinician. Newer advancements in adhesive techniques can provide successful intracoronal splinting of such teeth to reinforce the remaining tooth structure. This paper describes the diagnosis and management of a case of complicated vertical coronal fracture in mandibular first molar induced by a traffic accident.

  4. Attention and Distraction

    DEFF Research Database (Denmark)

    Petersen, Anne Ring


    the fact that the behaviour of many visitors is characterised by a certain restlessness and distraction. The article suggests that, in contradistinction to traditional disciplines of art like painting and sculpture, video installations seem to stimulate a "reception in distraction" (Walter Benjamin......This article aims to examine the interrelationship between attention and distraction in the reception of video installation art, a genre which is commonly associated with "immersion" and an intensified feeling of presence in the discourses on new media art and installation art. This tends to veil......) that is at odds with the ideal of a reception in concentration that governs the institutions of fine art as well as aesthetic theory. It intends to demonstrate how the experience of video installation art can only be understood by recognising that the close connections between, on the one hand, video art and...

  5. Distracted shareholders and corporate actions

    NARCIS (Netherlands)

    Kempf, Elisabeth; Manconi, Alberto; Spalt, Oliver

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

  6. Case study: videogame distraction reduces behavioral distress in a preschool-aged child undergoing repeated burn dressing changes: a single-subject design

    National Research Council Canada - National Science Library

    Sil, Soumitri; Dahlquist, Lynnda M; Burns, Andrew J


    This single-subject design study evaluated the feasibility and efficacy of passive and interactive videogame distraction on behavioral distress for a preschool-aged child receiving repeated burn dressing changes...

  7. Horizontal and vertical changes in anchor molars after extractions in bimaxillary protrusion cases

    Directory of Open Access Journals (Sweden)

    Pratik Chandra


    Full Text Available Objective: To evaluate changes in the anchor molar position (horizontal, vertical after retraction in bimaxillary protrusion maximum anchorage cases. Materials and Methods: Thirty patients requiring maximum anchorage after extraction of the first premolars were selected for this study. The second molars were banded in both arches along with trans-palatal arch in the maxillary arch and lingual arch in the mandibular arch. En mass retraction was done using sliding mechanics. Horizontal and vertical positions of the anchor first molars were evaluated cephalometrically before and after orthodontic retraction. Results: In the horizontal plane, maxillary first molars showed net mesial movement of 1.72 mm, and there was a statistical difference between the pre- and post-values (P < 0.001. The mandibular molars showed a net horizontal movement of 2.26 mm, and there was a statistically significant difference between the pre- and post-values (P < 0.001. In the vertical plane, there was vertical movement of the maxillary anchor molars by a net value of 0.95 mm which was statistically significant (P < 0.001. The mandibular anchor molars moved vertically by a net value of 0.45 mm. This difference was statistically not significant. Conclusion: There was anchorage loss seen in both the planes (horizontal, vertical of the maxillary anchor molars. In the mandibular anchor molars, there was anchorage loss seen only in the horizontal plane. No anchorage loss was seen in the vertical plane.

  8. Distractions in Everyday Driving (United States)

    ... other daily activities, from eating dinner to returning phone calls. With today’s proliferation of mobile devices, dashboard technologies, and other tools that provide easy access to information, entertainment, and communications, in-vehicle distractions are increasing – as is the temptation to give ...


    Directory of Open Access Journals (Sweden)

    Hajime ITO


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

  10. Vertically Differentiating Environmental Standards: The Case of the Marine Stewardship Council

    NARCIS (Netherlands)

    Bush, S.R.; Oosterveer, P.J.M.


    This paper explores the externally-led vertical differentiation of third-party certification standards using the case of the Marine Stewardship Council (MSC). We analyze this process in two dimensions. First, fisheries employ strategies to capture further market value from fishing practices that go

  11. Bilateral dissociated vertical deviation in a case of congenital hereditary endothelial dystrophy

    Directory of Open Access Journals (Sweden)

    Bhola Rahul


    Full Text Available Dissociated vertical deviation (DVD is an intermittent anomaly of the non-fixing eye. Although association of DVD with sensory visual deprivation owing to congenital or acquired opacities of the ocular media has been reported, its association with congenital hereditary endothelial dystrophy (CHED has not been reported hitherto. We report a case having a bilateral asymmetric DVD, in a know case of bilateral CHED.

  12. Numerical case studies of vertical wall fire protection using water spray

    Directory of Open Access Journals (Sweden)

    L.M. Zhao


    Full Text Available Studies of vertical wall fire protection are evaluated with numerical method. Typical fire cases such as heated dry wall and upward flame spread have been validated. Results predicted by simulations are found to agree with experiment results. The combustion behavior and flame development of vertical polymethylmethacrylate slabs with different water flow rates are explored and discussed. Water spray is found to be capable of strengthening the fire resistance of combustible even under high heat flux radiation. Provided result and data are expected to provide reference for fire protection methods design and development of modern buildings.

  13. Description of an oral Chagas disease outbreak in Venezuela, including a vertically transmitted case. (United States)

    Noya, Belkisyolé Alarcón de; Pérez-Chacón, Gladymar; Díaz-Bello, Zoraida; Dickson, Sonia; Muñoz-Calderón, Arturo; Hernández, Carlos; Pérez, Yadira; Mauriello, Luciano; Moronta, Eyleen


    We describe the eleventh major outbreak of foodborne Trypanosoma cruzi transmission in urban Venezuela, including evidence for vertical transmission from the index case to her fetus. After confirming fetal death at 24 weeks of gestation, pregnancy interruption was performed. On direct examination of the amniotic fluid, trypomastigotes were detected. T. cruzi specific-polymerase chain reaction (PCR) also proved positive when examining autopsied fetal organs. Finally, microscopic fetal heart examination revealed amastigote nests. Acute orally transmitted Chagas disease can be life threatening or even fatal for pregnant women and unborn fetuses owing to vertical transmission. There is therefore an urgent need to improve national epidemiologic control measures.

  14. Quantitative study of new bone formation in distraction osteogenesis of craniofacial bones by bone scintigraphy. (United States)

    Rojvachiranonda, Nond; Tepmongkol, Supatporn; Mahatumarat, Charan


    Although distraction osteogenesis is widely accepted as a technique to augment the craniofacial skeleton, timing to start distraction after an osteotomy or to remove distractors is basically based on studies on long bones. Because bone scintigraphy is well known to be the gold standard for quantitative measurement of bone formation, we conducted this pilot study to evaluate its feasibility as a tool for assessing new bone formation by distraction osteogenesis. Five patients with midface hypoplasia and four with mandibular hypoplasia were studied. Each patient had five bone scans: before surgery, 3 and 30 days after stopping distraction, and 3 days before and 3 months after distractor removal. Radiotracer uptake values at distraction sites were measured at 1 and 3 hours. Each uptake value was compared with preoperative study as uptake ratio. A typical pattern of radiotracer uptake ratio was observed in all cases with successful distraction. Uptake rose to the maximum during the consolidation period and remained at or above the preoperative level until the study end point. In one patient who had mandibular distraction and nonunion of the right ramus, there was no uptake peak during early consolidation as seen in the successfully distracted body and in the other cases. Bone scintigraphy was found to be a useful investigation in craniofacial distraction. It showed the dynamic of new bone formation by demonstrating the osteoblastic activity, which is important objective information for determining distraction rate and consolidation duration in each case. It may also be a tool that can predict the outcome of distraction osteogenesis.

  15. Congenital vertical talus in Cri du Chat Syndrome: a case report. (United States)

    Khader, Amani; Huntley, James S


    Congenital vertical talus is a rare deformity of the foot which can cause substantial pain and disability. Its incidence is approximately 1 in 100,000 live births. It has an association with other neuromuscular abnormalities and identified genetic syndromes in 50% of cases [1-5]. This report presents a case of congenital vertical talus in an infant with Cri du Chat Syndrome (CdCS) which - to our knowledge - has not been previously reported. A 2 week-old Caucasian, male infant was referred for congenital feet abnormalities and a "clicky" hip at the post-natal baby check. The diagnosis was vertical talus of the right foot and oblique talus of the left foot. Treatment involved serial plaster casts in the "reverse-Ponseti" position until surgery 16 weeks later. The correction was maintained and the feet remain in good position at follow-up. General concern over the infant's development, failing to reach appropriate milestones, prompted paediatric referral. Genetic analysis was finally carried out, giving a diagnosis of Cri du Chat syndrome at two and a half years of age. In light of other reports of chromosomal anomalies causing congenital vertical talus, the learning point from this case is to investigate early for possible aetiologies, not only spinal/neuromuscular, but also those of a genetic basis.

  16. Pleasures of distraction

    DEFF Research Database (Denmark)

    Svabo, Connie; Bærenholdt, Jørgen Ole

    Actor-network theory, post-ANT material semiotic approaches, and related philosophical perspectives provide a way of conceptualizing visitor experiences which highlights shifting engagements and where interruption, shift and distraction form the course and content of a visit. Interruption, shift...... and distraction emerge between multiple coexisting sociomaterial enactments. Each sociomaterial enactment consists of characteristic entanglements of visitors, staff, mediating technologies and the material layout of an exhibition. Multiple enactments coexist, they overlap and sometimes interfere with and disturb....... Notions developed during ethnographic fieldwork at a modern museum of natural history are here stretched; can conceptualizations of the museum visit in terms of shift and interference be extended to other leisure, experience and tourism sites? Are these concepts useful for thinking about visits...

  17. Drawn to distraction

    DEFF Research Database (Denmark)

    Aagaard, Jesper


    Today's educational system increasingly integrates digital devices such as laptops and tablets in the classroom on the assumption that the use of these technologies will increase student motivation and learning. However, research shows that students often use technologies for distractive purposes...... like off-task activity and multitasking. Few studies address the processes involved in this activity. This article offers a postphenomenologically informed qualitative study of students' off-task use of technology during class. Building on interviews with students in a Danish business college about...... their off-task technology use, findings suggest that off-task activity is not always a conscious choice. Because of deeply sedimented bodily habits, students often experience habitual distraction in the form of prereflective attraction towards certain frequently visited websites (e.g., Facebook). Laptops...

  18. Two-stage reconstruction of the severely deficient alveolar ridge: bone graft followed by alveolar distraction osteogenesis. (United States)

    Rachmiel, A; Emodi, O; Aizenbud, D; Rachmiel, D; Shilo, D


    Distraction osteogenesis for the augmentation of severe alveolar bone deficiency has gained popularity during the past two decades. In cases where the vertical bone height is not sufficient to create a stable transport segment, performing alveolar distraction osteogenesis (ADO) is not possible. In these severe cases, a two-stage treatment protocol is suggested: onlay bone grafting followed by ADO. An iliac crest onlay bone graft followed by ADO was performed in 13 patients: seven in the mandible and six in the maxilla. Following ADO, endosseous implants and prosthetic restorations were placed. In all cases, the onlay bone graft resulted in inadequate height for implant placement, but allowed ADO to be performed. ADO was performed to a mean total vertical augmentation of 13.7mm. Fifty-two endosseous implants were placed. During a mean follow-up of 4.85 years, two implants failed, both during the first 6 months; the survival rate was 96.15%. In severe cases lacking the required bone for ADO, using an onlay bone graft as a first stage treatment increases the bone height thus allowing ADO to be performed. This article describes a safe and stable two-stage treatment modality for severely atrophic cases, resulting in sufficient bone for implant placement and correction of the inter-maxillary vertical relationship. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Over-bite and vertical changes following first premolar extraction in high angle cases. (United States)

    Ramesh, G C; Pradeep, M C; Kumar, G Arun; Girish, K S; Suresh, B S


    Orthodontists generally agree that nonextraction treatment is associated with downward and backward rotation of the mandible and an increase in the lower anterior face height (LAFH). They also agree that extraction line of treatment is associated with upward and forward rotation of the mandible and decrease in the LAFH. The intent of this cephalometric investigation was to examine the wedge hypothesis, that the vertical dimension collapses after first bicuspid extraction. The present study was undertaken to evaluate the cephalometric overbite and vertical changes following first premolar extraction in high angle cases. Forty-five adult patients having high mandibular plane angle, i.e. Gogn--SN more than or equal to 32° having class I molar and canine relation were included. Pre and post-treatment lateral cephalograms were measured and compared to analyze the cephalometric changes. There was no decrease in the overbite and vertical changes following first premolar extraction in high angle cases. The facial complex does increase in size with growth, but mandibular plane while moving inferiorly, remain essentially parallel to its pretreatment position due to residual growth and treatment mechanics. The study concluded that, There was no decrease in the vertical facial dimension, overbite and mandibular plane angle. However, it should be interpreted with caution, given the small sample size.

  20. Maxillary Tuberosity Reconstruction with Transport Distraction Osteogenesis

    Directory of Open Access Journals (Sweden)

    F. Ugurlu


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

  1. Mandibular Deformity Correction by Distraction Osteogenesis

    Directory of Open Access Journals (Sweden)

    Md Asaduzzaman


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

  2. The Use of Distraction Osteogenesis for treatment of the mandibular deformity in hemi facial microsomia: A case report of the double osteotomy technique

    Directory of Open Access Journals (Sweden)

    Krishna R


    Full Text Available A patient presenting with hemi facial microsomia with Grade IIB mandibular deformity was treated by distraction osteogenesis after double osteotomy of the ramus and the body. A satisfactory facial symmetry was achieved following the surgery without any complications.

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

    Directory of Open Access Journals (Sweden)

    Sesenna Enrico


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

  4. New treatment option for an incomplete vertical root fracture–a preliminary case report


    Hadrossek, P.H. (Paul); Dammaschke, T. (Till)


    Instead of extraction this case report presents an alternative treatment option for a maxillary incisor with a vertical root fracture (VRF) causing pain in a 78-year-old patient. After retreatment of the existing root canal filling the tooth was stabilized with a dentine adhesive and a composite restoration. Then the tooth was extracted, the VRF gap enlarged with a small diamond bur and the existing retrograde root canal filling removed. The enlarged fracture lin...

  5. A Case of Vertical Transmission of Chagas Disease Contracted via Blood Transfusion in Canada

    Directory of Open Access Journals (Sweden)

    Margaret A Fearon


    Full Text Available Chagas disease is caused by the protozoan parasite Trypanosoma cruzi and is endemic in many countries in Latin America, where infected bugs of the Triatominea subfamily carry the parasite in the gut and transmit it to humans through fecal contamination of a bite. However, vertical transmission and transmission through blood transfusion and organ transplantation is well documented. Increasing immigration from endemic countries to North America has prompted blood operators, including Canadian Blood Services and Hema Quebec, to initiate blood donor testing for Chagas antibody. In the present report, an unusual case of vertical transmission from a mother, most likely infected through blood transfusion, and detected as part of a concurrent seroprevalence study in blood donors is described.

  6. Use of a tip-edge stage-1 wire to enhance vertical control during straight wire treatment: two case reports. (United States)

    Taylor, Helen


    Vertical control is one of the problems occasionally encountered in Straight wire treatment. Two cases, one with deep overbite and one with anterior open-bite, demonstrate the use of a Tip-Edge stage-1 wire to enhance vertical control in conjunction with Straight wire brackets and superelastic main arch wires.

  7. Installing an original sleeve for rod unaccessible pain from a distraction device in a hemifacial microsomia patient. (United States)

    Shimo, Tsuyoshi; Nishiyama, Akiyoshi; Yoshioka, Norie; Sasaki, Akira


    Lengthening of the mandible by distraction osteogenesis using an internal device is the preferred method for the treatment of hemifacial microsomia. Despite its advantages, this technique can lead to various complications after the surgery. We report the case of an 8-yr-old Japanese girl whose case presented practical difficulties in device activation because of rod unaccessible pain after the initial mandibular distraction with an internal device, and this complication was addressed with the installation of an original sleeve. In the present patient, the region of the bend rod was located at the inferior border of the right mandible, causing rod unaccessible pain by contacting the surrounding tissue including a sensory nerve. Careful vertical ramus distractor position planning and tools to resolve complications are the key factors for accomplishing the scheduled elongation. Alternative techniques using a sleeve for safer and gentle distraction for rod unaccessible pain on activation should be considered. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Longitudinal results of mandibular distraction osteogenesis in hemifacial microsomia. (United States)

    Huisinga-Fischer, Clara E; Vaandrager, J Michiel; Prahl-Andersen, Birte


    The aim of this study was to evaluate mandibular distraction therapy by three-dimensional (3-D) computed tomography (CT) imaging so as to be able to improve the treatment results. The study group consisted of eight children (3 male and 5 female) with hemifacial microsomia. For each child, CT scans of the head were available (Pro Speed S Fast Spiral scanner; General Electric). Longitudinal measurements of the mandible, bony and soft tissue 3-D reconstructions, and masticatory muscles were demonstrated. Three-dimensional CT scans provide important data concerning the results of mandibular distraction therapy and should be used in treatment evaluation. In some patients and for some muscles only, a small increase in the volume of the affected side of the masticatory muscles in comparison to the normal side was found 3 years after mandibular distraction. In around 50% of the cases, there seems to be a relapse occurring 1 year after distraction osteogenesis, and this relapse has a progressive character when seen 3 years after distraction osteogenesis in comparison to 15 weeks after distraction osteogenesis.

  9. Context effects on auditory distraction (United States)

    Chen, Sufen; Sussman, Elyse S.


    The purpose of the study was to test the hypothesis that sound context modulates the magnitude of auditory distraction, indexed by behavioral and electrophysiological measures. Participants were asked to identify tone duration, while irrelevant changes occurred in tone frequency, tone intensity, and harmonic structure. Frequency deviants were randomly intermixed with standards (Uni-Condition), with intensity deviants (Bi-Condition), and with both intensity and complex deviants (Tri-Condition). Only in the Tri-Condition did the auditory distraction effect reflect the magnitude difference among the frequency and intensity deviants. The mixture of the different types of deviants in the Tri-Condition modulated the perceived level of distraction, demonstrating that the sound context can modulate the effect of deviance level on processing irrelevant acoustic changes in the environment. These findings thus indicate that perceptual contrast plays a role in change detection processes that leads to auditory distraction. PMID:23886958

  10. The epidemic of distraction. (United States)

    Weksler, Marc E; Weksler, Babette B


    Multitasking is a rapidly growing phenomenon affecting all segments of the population but is rarely as successful as its proponents believe. The use of mobile electronic devices contributes importantly to multitasking and cognitive overload. Although personal electronic devices provide many benefits, their adverse effects are frequently overlooked. Personal observation and a review of the scientific literature supports the view that overuse or misuse of personal electronic devices promotes cognitive overload, impairs multitasking and lowers performance at all ages but particularly in the elderly. This phenomenon appears to be rapidly increasing and threatens to become a tsunami as spreading electronic waves cause an 'epidemic of distraction'. Mobile electronic devices often bring benefits to their users in terms of rapid access to information. However, there is a dark side to the increasing addiction to these devices that challenges the health and well-being of the entire population, targeting, in particular, the aged and infirm. New approaches to information gathering can foster creativity if cognitive overload is avoided. Copyright © 2012 S. Karger AG, Basel.

  11. Distracción osteogénica alveolar con dispositivo simple: Revisión del tema a propósito de un caso Osteogenic alveolar distraction with simple appliance: Review of the topic apropos of a case

    Directory of Open Access Journals (Sweden)

    Oscar N. García-Roco Pérez


    Full Text Available Con el objetivo de validar un dispositivo simple con tornillos de distracción para aumentos del reborde alveolar deficitario mediante distracción osteogénica, se realiza la presentación de un caso y se revisa la literatura médica actual disponible sobre el tema, se describe su evolución histórica y bases fisiológicas. La paciente de 56 años presenta una atrofia alveolar mandibular, con una altura de 7 mm. Se realizó incisión en vestíbulo, despegamiento de colgajo mucoperióstico, marcado de la osteotomía y colocación del distractor. Previo período de latencia, que se observó durante 7 días, el período de distracción se realizó activando el distractor 1,0 mm al día, hasta alcanzar un aumento en la altura de 8 mm. Una vez finalizada la distracción se mantuvo el dispositivo durante 8 semanas, hasta que consolidó el callo de fractura. Posteriormente se retiró el distractor y se colocaron los implantes a las 10 semanas de finalizada la activación. El dispositivo intraoral de distracción en estudio es una técnica novedosa y los resultados obtenidos son todavía variables, pero en este caso resultó eficaz y fiable para conseguir un determinado volumen de masa ósea en una posición predeterminad sobre la cual insertar implantes osteointegrados y lograr una correcta rehabilitación protésica.In order to validate a simple appliance with distraction screws for the enlargement of the deficient alveolar crest by osteogenic distraction, a case is presented, the current medical literature available on this topic is reviewed and the historical evolution and physiological bases are described. The 56-year-old patient presents an alveolar mandibular atrophy with a height of 7 mm. An incision was made in the vestibule, followed by the detachment of the mucoperiosteal flap, the marking of the osteotomy and the placing of the distractor. After a previous period of latency that was observed during 7 days, the distractor was activated 1

  12. Acrodermatitis due to zinc deficiency after combined vertical gastroplasty with jejunoileal bypass: case report

    Directory of Open Access Journals (Sweden)

    Selma Freire de Carvalho Cunha

    Full Text Available CONTEXT: Nutritional complications may occur after bariatric surgery, due to restriction of food intake and impaired digestion or absorption of nutrients. CASE REPORT: After undergoing vertical gastroplasty and jejunoileal bypass, a female patient presented marked weight loss and protein deficiency. Seven months after the bariatric surgery, she presented dermatological features compatible with acrodermatitis enteropathica, as seen from the plasma zinc levels, which were below the reference values (34.4 mg%. The skin lesions improved significantly after 1,000 mg/day of zinc sulfate supplementation for one week. CONCLUSIONS: The patient's evolution shows that the multidisciplinary team involved in surgical treatment of obesity should take nutritional deficiencies into consideration in the differential diagnosis of skin diseases, in order to institute early treatment.

  13. New treatment option for an incomplete vertical root fracture--a preliminary case report. (United States)

    Hadrossek, Paul Henryk; Dammaschke, Till


    Instead of extraction this case report presents an alternative treatment option for a maxillary incisor with a vertical root fracture (VRF) causing pain in a 78-year-old patient. After retreatment of the existing root canal filling the tooth was stabilized with a dentine adhesive and a composite restoration. Then the tooth was extracted, the VRF gap enlarged with a small diamond bur and the existing retrograde root canal filling removed. The enlarged fracture line and the retrograde preparation were filled with a calcium-silicate-cement (Biodentine). Afterwards the tooth was replanted and a titanium trauma splint was applied for 12d. A 24 months clinical and radiological follow-up showed an asymptomatic tooth, reduction of the periodontal probing depths from 7 mm prior to treatment to 3 mm and gingival reattachment in the area of the fracture with no sign of ankylosis. Hence, the treatment of VRF with Biodentine seems to be a possible and promising option.

  14. Bone regeneration during distraction osteogenesis. (United States)

    Amir, Lisa R; Everts, Vincent; Bronckers, Antonius L J J


    Bone has the capacity to regenerate in response to injury. During distraction osteogenesis, the renewal of bone is enhanced by gradual stretching of the soft connective tissues in the gap area between two separated bone segments. This procedure has received much clinical attention as a way to correct congenital growth retardation of bone tissue or to generate bone to fill skeletal defects. The process of bone regeneration involves a complex system of biological changes whereby mechanical stress is converted into a cascade of signals that activate cellular behavior resulting in (enhanced) formation of bone. Over the last decade, significant progress has been made in understanding the bone regeneration process during distraction osteogenesis. The mechanical and biological factors that are important for the success of the distraction treatment have been partially characterized and are discussed in this review.

  15. Vertically Differentiating Environmental Standards: The Case of the Marine Stewardship Council

    Directory of Open Access Journals (Sweden)

    Simon R. Bush


    Full Text Available This paper explores the externally-led vertical differentiation of third-party certification standards using the case of the Marine Stewardship Council (MSC. We analyze this process in two dimensions. First, fisheries employ strategies to capture further market value from fishing practices that go beyond their initial conditions for certification and seek additional recognition for these activities through co-labelling with, amongst others, international NGOs. Second, fisheries not yet able to meet the requirements of MSC standards are being enrolled in NGO and private sector sponsored Fisheries Improvement Projects (FIPs, providing an alternative route to global markets. In both cases the credibility and authority of the MSC is challenged by new coalitions of market actors opening up new strategies for capturing market value and/or improving the conditions of international market access. Through the lens of global value chains, the results offer new insights on how such standards not only influence trade and markets, but are also starting to change their internal governance in response to threats to their credibility by actors and modes of coordination in global value chains.

  16. Distraction lengthening of the proximal phalanx in distal thumb amputations. (United States)

    Cansü, Eren; Ünal, Mehmet Bekir; Parmaksızoğlu, Fatih; Gürcan, Serkan


    Thumb amputation is a major cause of hand dysfunction, and the treatment for distal thumb amputations remains controversial. Although finger reconstruction methods using distraction lengthening are known to restore finger length and function, we found no reports in the literature regarding phalangeal lengthening in thumb amputations. We aimed to evaluate proximal phalangeal lengthening in thumb amputations at or near the interphalangeal (IP) joint. We retrospectively evaluated patients who had undergone distraction lengthening of the proximal phalanx of the thumb. All patients underwent osteotomy, either during the initial procedure or as a second-stage procedure. Distraction began 10 days after osteotomy with the use of an external fixator that remained in place until ossification of the gap occurred without bone grafting. Patients were evaluated using the QuickDASH score. Fourteen patients with a mean age of 27 years and a mean follow-up period of 7 years were enrolled. The mean phalangeal lengthening achieved was 20 mm. Ossification occurred at all distraction sites, and the fixators were maintained for a mean of 85 days. The mean healing index was 42.5 days/cm. All 14 patients achieved the desired amount of phalangeal lengthening without major complications such as nonunion, premature union, or gross infection. For reconstruction in cases of distal thumb amputations, distraction lengthening of the proximal phalanx can be used to improve absolute length, web space, and grip distance. The technique is safe and effective, improves functionality/cosmesis, and offers a low complication risk.

  17. Taking the guesswork out of mandibular symphyseal distraction osteogenesis. (United States)

    Braun, S; Hnat, W P; Hnat, T W; Legan, H L


    Mandibular symphyseal distraction osteogenesis has recently been introduced as a means of resolving arch length deficiencies in the anterior segment and as a method of reducing large vestibular spaces related to a narrow mandible. Accurately relating the required distraction for a given anterior tooth mass and desired future anteroposterior location of the central incisors has not been possible until recently. The relationship between these 3 controlling factors has been mathematically described by the hyperbolic cosine function and a computer program designed for easy use by the clinician. Two clinical cases illustrate the application of the program. A Web site where the program can be downloaded at no cost is mentioned.

  18. Distracted pedestrian sustains orbital fracture while on cell phone

    Directory of Open Access Journals (Sweden)

    Edell AR


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

  19. Bone regeneration during distraction osteogenesis

    NARCIS (Netherlands)

    Amir, L.R.; Everts, V.; Bronckers, A.L.J.J.


    Bone has the capacity to regenerate in response to injury. During distraction osteogenesis, the renewal of bone is enhanced by gradual stretching of the soft connec- tive tissues in the gap area between two separated bone segments. This procedure has received much clinical atten- tion as a way to

  20. Distraction osteogenesis for mandibular advancement

    NARCIS (Netherlands)

    van Strijen, P. J.; Perdijk, F. B.; Becking, A. G.; Breuning, K. H.


    The purpose of this study was to investigate the possibilities of distraction osteogenesis to correct mandibular hypoplasia. Fourteen young patients (mean age 14.1 years) with a proven resistance to initial, functional orthodontic therapy, were treated by means of bilateral intraoral distractors.

  1. Unfavourable results with distraction in craniofacial skeleton

    Directory of Open Access Journals (Sweden)

    Rajiv Agarwal


    Full Text Available Distraction osteogenesis has revolutionised the management of craniofacial abnormalities. The technique however requires precise planning, patient selection, execution and follow-up to achieve consistent and positive results and to avoid unfavourable results. The unfavourable results with craniofacial distraction stem from many factors ranging from improper patient selection, planning and use of inappropriate distraction device and vector. The present study analyses the current standards and techniques of distraction and details in depth the various errors and complications that may occur due to this technique. The commonly observed complications of distraction have been detailed along with measures and suggestions to avoid them in clinical practice.

  2. Conceptual and lexical effects on gestures : the case of vertical spatial metaphors for time in Chinese

    NARCIS (Netherlands)

    Gu, Yan; Mol, Elisabeth; Hoetjes, Marieke; Swerts, Marc


    The linguistic metaphors of time appear to influence how people gesture about time. This study finds that Chinese English bilinguals produce more vertical gestures when talking about Chinese time references with vertical spatial metaphors than (1) when talking about time conceptions in the English

  3. Blending vertical and web results: A case study using video intent

    NARCIS (Netherlands)

    Lefortier, D.; Serdyukov, P.; Romanenko, F.; de Rijke, M.


    Modern search engines aggregate results from specialized verticals into the Web search results. We study a setting where vertical and Web results are blended into a single result list, a setting that has not been studied before. We focus on video intent and present a detailed observational study of

  4. New treatment option for an incomplete vertical root fracture–a preliminary case report (United States)


    Instead of extraction this case report presents an alternative treatment option for a maxillary incisor with a vertical root fracture (VRF) causing pain in a 78-year-old patient. After retreatment of the existing root canal filling the tooth was stabilized with a dentine adhesive and a composite restoration. Then the tooth was extracted, the VRF gap enlarged with a small diamond bur and the existing retrograde root canal filling removed. The enlarged fracture line and the retrograde preparation were filled with a calcium-silicate-cement (Biodentine). Afterwards the tooth was replanted and a titanium trauma splint was applied for 12d. A 24 months clinical and radiological follow-up showed an asymptomatic tooth, reduction of the periodontal probing depths from 7 mm prior to treatment to 3 mm and gingival reattachment in the area of the fracture with no sign of ankylosis. Hence, the treatment of VRF with Biodentine seems to be a possible and promising option. PMID:24670232

  5. [Endoscopic treatment of a "gastric outlet syndrome" after Mason Vertical Banded Gastroplasty. Case report]. (United States)

    Geraci, Girolamo; Sciumè, Carmelo; Pisello, Franco; Volsi, Francesco Li; Facella, Tiziana; Modica, Giuseppe


    Mason's Vertical Banded Gastroplasty (VBG) is characterized by peculiar complications, related to surgical pitfalls, from "outlet syndrome" (5%) to complete outlet obstruction (3%), passing to reflux oesophagitis (45%), that require redo. We report a case of "outlet syndrome" treated by operative endoscopy with success. 40 yrs male, operated by VBG 2 years ago for morbid obesity (BMI > 40). After surgery, initial ponderal decrement as attended. Since about 2 months the patients reports epigastralgia and retrosternal pyrosis; since 10 days incoercibile vomiting. The EGDS visualized distal oesophagitis (Los Angeles C), mucosal prolapse of superior pouch leading to outlet obstruction and scalloping of Kerkring's fold in second part of duodenum. The patient was submitted to multiple elastic ligature of exuberant gastric mucosa with multiband ligator and indication to oral therapy with PPI and procinetics drugs at the dismission. after 30 days, at EGDS, oesophagitis is regressed to Los Angeles B stage, the outlet of pouch is patent and the transit is objectively regular. At oesophago-gastric radiologic control with gastrographin, the transit was satisfing. At 1 year follow-up the patient has a regular weight, no vomiting and is wellbeing and use irregularly PPI Follow-up EGDS confirmed the stabilization of endoscopic picture and the total regression of oesophagitis. the endoscopic elastic ligature of mucosal gastric prolapse with multiband after VBG, if confirmed and validated by randomized and prospective trials on a big sample of people, will constitute a valid alternative to surgical treatment of this rare complication.

  6. Interruptions and distractions in the gynaecological operating theatre: irritating or dangerous? (United States)

    Yoong, Wai; Khin, Ayemon; Ramlal, Navin; Loabile, Bogadi; Forman, Stephen


    Distractions and interference can include visual (e.g. staff obscuring monitors), audio (e.g. noise, irrelevant communication) and equipment problems. Level of distraction is usually defined as I: relatively inconsequential; II: > one member of the surgical team affected; III: the entire surgical team affected. The aim of this study was to observe the frequency and impact of distracting events and interruptions on elective gynaecology cases. Data from 35 cases were collected from 10 consecutive operating sessions. Mean number of interruptions was 26 episodes/case, while mean number of level II/III distractions was 17 episodes/case. Ninety per cent of interruptions occur in the first 30 minutes of the procedure and 80.9% lead to level II/III distraction. Although no complications were directly attributable to the observed distractions, the mean prolongation of operating time was 18.46 minutes/case. Understanding their effects on theatre environment enables appropriate measures to be taken so that theatre productivity and patient safety are optimised. This observational study of 35 elective cases shows a mean interruption rate of 26 episodes/case with 80.9% affecting > one member of operating team, leading to mean prolongation of 18.46 minutes/case. Theatre staff should be aware of these findings and appropriate measures taken to optimise theatre productivity and patient safety.

  7. Vaginal reconstruction with pedicled vertical deep inferior epigastric perforator flap (diep) after pelvic exenteration. A consecutive case series. (United States)

    Ferron, Gwénael; Gangloff, Dimitri; Querleu, Denis; Frigenza, Melanie; Torrent, Juan Jose; Picaud, Laetitia; Gladieff, Laurence; Delannes, Martine; Mery, Eliane; Boulet, Berenice; Balague, Gisele; Martinez, Alejandra


    Vaginal reconstruction after pelvic exenteration (PE) represents a challenge for the oncologic surgeon. Since the introduction of perforator flaps, using pedicled vertical DIEP (deep inferior epigastric perforator) flap allows to reduce the donor site complication rate. From November 2012 to December 2014, 27 PEs were performed in our institution. 13 patients who underwent PE with vaginal reconstruction and programmed DIEP procedure for gynecologic malignancies were registered. Nine patients underwent PE for recurrent disease and four for primary treatment. Six of the 13 patients have a preoperative fistula. Anterior PE was performed in 10 patients, and total PE in 3 patients. A vertical DIEP flap was performed in 10 patients using one or two medial perforators. The reasons for abortion of vertical DIEP flap procedure were: failure to localizing perforator vessels in two cases, and unavailability of plastic surgeon in one case. A vertical fascia-sparring rectus abdominis myocutaneous flap was then harvested. Median length of surgery was 335min, and 60min for DIEP harvesting and vaginal reconstruction. No flap necrosis occurred. One patient in the VRAM (vertical rectus abdominis myocutaneous) group experienced a late incisional hernia and one patient in the DIEP flap group required revision for vaginal stenosis. In our experience, DIEP flap represents our preferred choice of flap for circumferential vaginal reconstruction after PE. To achieve a high reproducibility, the technically demanding pedicled vertical DIEP flap has to be harvested by a trained surgeon, after strict evaluation of the preoperative imaging with identification and localization of perforator vessels. Copyright © 2015. Published by Elsevier Inc.

  8. Posterior distraction reduction and occipitocervical fixation for the treatment of basilar invagination and atlantoaxial dislocation. (United States)

    Meng, Yang; Chen, Hua; Lou, Jigang; Rong, Xin; Wang, Beiyu; Deng, Yuxiao; Ding, Chen; Hong, Ying; Liu, Hao


    To introduce a novel distraction technique for the treatment of basilar invagination (BI) and atlantoaxial dislocation (AAD) via a posterior-only approach. Twenty-one consecutive patients with BI and AAD who underwent posterior distraction reduction and occipitocervical fixation between January 2009 and June 2013 were enrolled in the present study. This novel distraction technique included two steps. First, the distraction between the occipitocervical junction of the rod (OCJR) and the occipital screws was performed to achieve horizontal and partial vertical reduction. Secondly, the distraction was performed between the C2 screws and OCJR to achieve complete vertical reduction. The pre- and postoperative JOA score, the extent of reduction, the fusion status, and the complications were recorded and analyzed. The mean follow-up was 18.3 months with a range of 10-32 months. No patient incurred neurovascular injury during surgery. The mean JOA score at the last follow-up (15.4) showed significant improvement (P<0.01) compared with the pre-operative parameters (11.2). Complete horizontal reduction was achieved in 18 patients (85.7%), and complete vertical reduction was achieved in 17 patients (80.9%). The rest patients are all received greater than 50% horizontal and vertical reduction. Solid fusion was achieved in 20 patients (95.2%). Mild dysphagia was observed in two patients. One patient suffered from postoperative fever and pulmonary infection. This novel distraction technique may provide satisfactory reduction via a posterior-only approach without exposure of the C1/2 facet joint. Therefore, it is a safe and effective method for the treatment of BI with AAD. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Analysis of Contribution of Vertical Gardens to Urban Sustainability: The Case Study of Antalya City, Turkey


    KAYNAKÇI ELİNÇ, Zuhal; KAYA, Latif Gürkan; ELİNÇ, Hakan


    Vertical garden's studies, having been defined a new perspective to the modern construction culture, has been application of the garden to a building facade or to a wall surface as a notion. Application of plants to the vertical surfaces make contributions to urban ecology due to its functions such as aesthetical and visual values as well as protection of the buildings, habilitating the climate effects for human beings, enhancing the environmental aspects and reducing certain ambient pro...

  10. Predominance of lateral over vertical mirror errors in reading: A case for neuronal recycling and inhibition. (United States)

    Ahr, Emmanuel; Houdé, Olivier; Borst, Grégoire


    We investigated whether lateral mirror errors could be more prevalent than vertical mirror errors (e.g., p/q vs. p/b confusions) because mirror generalization is harder to inhibit for the discrimination of a reversible letter and its lateral than its vertical mirror-image counterpart. Expert adult readers performed a negative priming task in which they determined on the prime whether two letters and on the probe whether two objects facing opposite directions were identical. We found in both experiments longer response times for objects facing opposite lateral orientations preceded by a reversible letter and its lateral mirror-image counterpart (e.g., p/q) than preceded by perceptually matched non-reversible letters (e.g., g/j). No negative priming effect was observed when objects that were vertical (Experiment 1 & 2) or lateral (Experiment 2) mirror images of each other were preceded by a letter and its vertical mirror-image counterpart (e.g. p/b). Finally, we observed longer response times for objects that were lateral mirror images of each other after lateral than after vertical reversible letters. These results suggest that lateral mirror errors are more prevalent than vertical ones because mirror generalization might be stronger and thus more difficult to inhibit in the context of the former than the latter. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. How Concentration Shields Against Distraction. (United States)

    Sörqvist, Patrik; Marsh, John E


    In this article, we outline our view of how concentration shields against distraction. We argue that higher levels of concentration make people less susceptible to distraction for two reasons. One reason is that the undesired processing of the background environment is reduced. For example, when people play a difficult video game, as opposed to an easy game, they are less likely to notice what people in the background are saying. The other reason is that the locus of attention becomes more steadfast. For example, when people are watching an entertaining episode of their favorite television series, as opposed to a less absorbing show, attention is less likely to be diverted away from the screen by a ringing telephone. The theoretical underpinnings of this perspective, and potential implications for applied settings, are addressed.

  12. The influence of vertical disparity gradient and cue conflict on EEG omega complexity in Panum's limiting case. (United States)

    Li, Huayun; Jia, Huibin; Yu, Dongchuan


    Using behavioral measures and ERP technique, researchers discovered at least two factors could influence the final perception of depth in Panum's limiting case, which are the vertical disparity gradient and the degree of cue conflict between 2D and 3D shapes. Although certain ERP components have been proved to be sensitive to the different levels of these two factors, some methodological limitations existed in this technique. In this study, we proposed that the omega complexity of EEG signal may serve as an important supplement of the traditional ERP technique. We found that the trials with lower vertical gradient disparity has lower omega complexity (i.e., higher global functional connectivity) of the occipital region, especially that of the right-occipital hemisphere. Moreover, for occipital omega complexity, the trials with low cue conflict have significantly larger omega complexity than those with medium and high cue conflict. It is also found that the electrodes located in the middle-line of occipital region (i.e., POz and Oz) are more crucial to the impact of different levels of cue conflict on omega complexity than the other electrodes located in the left- and right-occipital hemisphere. These evidences demonstrated that the EEG omega complexity could reflect distinct neural activities evoked by Panum's limiting case configurations with different levels of vertical disparity gradient and cue conflict. Besides, the influence of vertical disparity gradient and cue conflict on spatial omega complexity may be regional-dependent.

  13. Affective privilege: Asymmetric interference by emotional distracters

    Directory of Open Access Journals (Sweden)

    Crystal eReeck


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

  14. Complications with allogeneic, cancellous bone blocks in vertical alveolar ridge augmentation: prospective clinical case study and review of the literature. (United States)

    Draenert, Florian G; Kämmerer, Peer W; Berthold, Michael; Neff, Andreas


    Vertical bone augmentation in dental implantology is an indication for cancellous allogeneic bone blocks (ABB). However, these materials may lead to adverse reactions, which are known well in orthopedics but rarely published. Therefore, in this study, we performed an evaluation of the use of ABB in vertical bone augmentation in clinical dental implantology. The prospective clinical study included 20 cases with vertical augmentation using ABB and subsequent or simultaneous placement of implants in the lateral maxilla and mandible. Follow-up included panoramic radiography, tissue healing, and peri-implantitis. Because of the limited number of patients, the report was planned to be descriptive only. Loss of ABB or peri-implantitis of more than 30% of the intraosseous implant length was deemed to indicate failure. The study was cancelled after six cases because of an unexpectedly high number of complications (5 of 6; 83%). The average surveillance time was 1460 days. Three types of unsatisfying outcome were observed: type I, early complete loss of the augmentation with soft tissue defects after 3 to 8 weeks (n = 2); type II, early soft tissue maceration (up to 8 weeks) without loss of coverage and complete early bone healing with later peri-implantitis and bone loss after prosthetic loading (6 months or later; n = 2); and type III, complication-free bone healing with subsequent peri-implantitis after prosthetic loading (6 months or later; n = 1). Complications were observed in vertical augmentation with ABB and implant placement. After careful consideration, literature data were found to support these results and also suggest that tissue level implants may be advantageous in vertical bone augmentation with ABB. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. A roadside study of observable driver distractions. (United States)

    Sullman, Mark J M; Prat, Francesc; Tasci, Duygu Kuzu


    This study investigated the prevalence of observable distractions while driving and the effect of drivers' characteristics and time-related variables on their prevalence. Using roadside observation, 2 independent observers collected data at 4 randomly selected locations in St. Albans, UK. Of the 10,984 drivers observed, 16.8% were engaged in a secondary task, with talking to passengers being the most common distraction (8.8%), followed by smoking (1.9%) and talking on a hands-free mobile phone (1.7%). An additional 1.0% were observed talking on a handheld phone, and the rest of the distractions (e.g., texting, drinking) were recorded in less than 1% of the drivers observed. Gender-related differences were found for a number of different distractions (i.e., talking to passengers, drinking, and handheld mobile phone conversations), but age emerged as a significant predictor for most secondary tasks, including talking to passengers, smoking, hands-free mobile phone use, handheld mobile phone use, texting/keying numbers, drinking, and engagement in any type of distraction (all distractions combined). The overall pattern for age was that middle-aged and older drivers were less likely to be distracted than younger drivers. This work provides further evidence of the relatively high rate of distracted driving in the UK. The findings clearly indicate that younger drivers are more likely to drive distracted, which probably contributes to their higher crash rates.

  16. Honoring the Reality of Blocky Hillslopes: Case Study of a Vertical Dike at Shiprock, New Mexico (United States)

    Glade, R.; Anderson, R. S.


    Rocky hillslopes that exhibit large blocks of rock and thin, non-uniform cover of mobile regolith are common in both steep landscapes and arid environments, as well as on other planets. While the evolution of homogeneous, soil-mantled, convex hillslopes can be well modeled, the influence of lithology and geologic structure on hillslope form and evolution has yet to be properly addressed. As a first case, we study hillslopes developed during exhumation of a near-vertical several-meter wide mid-Tertiary basalt dike intruded into Cretaceous shale at Shiprock, New Mexico. The dike stands several to several tens of meters above the tops of adjacent hundred-meter long slopes that grade onto flats. Profiles of the hillslopes reveal steep 30° slopes adjacent to the dike, with a narrow (~5-10 m) convexity, beyond which the slopes become broadly concave. Field observations suggest that the dike deteriorates in two distinct ways: hard cm-scale flakes from both the dike and the adjacent rapidly heated shale peel off the wall, while meter-scale basalt blocks tumble onto the hillslope in rare events. Both of these products differ dramatically from the weak, fine-grained shale chips derived from weathering of the subjacent shale. The size and percent cover of both flakes and blocks decreases downslope away from the dike. We hypothesize that coverage of the surface by basalt clasts modulates both the velocity of the mobile regolith cover and the rate of weathering of the underlying shale. We employ a numerical model to explore the conditions required to capture the essence of the observed slopes. A continuum model tracks regolith production, regolith flux, and areal concentration of small surface clasts. Treated as discrete elements, large blocks are allowed to change size to mimic weathering decay, and their presence alters the flow of regolith. This acknowledgement of the roles of lithology and structure on hillslope evolution takes us one step toward models of other features

  17. Distracted by Your Mind? Individual Differences in Distractibility Predict Mind Wandering (United States)

    Forster, Sophie; Lavie, Nilli


    Attention may be distracted from its intended focus both by stimuli in the external environment and by internally generated task-unrelated thoughts during mind wandering. However, previous attention research has focused almost exclusively on distraction by external stimuli, and the extent to which mind wandering relates to external distraction is…

  18. Biofuels and Vertical Price Transmission: The Case of the US Corn, Ethanol, and Food Markets

    NARCIS (Netherlands)

    Drabik, D.; Ciaian, P.; Pokrivcak, J.


    This is the first paper to analyze the impact of biofuels on the price transmission along the food chain. We analyze the U.S. corn sector and its vertical links with food and ethanol (energy) markets. We find that biofuels affect the price transmission elasticity in the food chain compared to a no

  19. Vertical root fracture: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Abdullah Alsani


    Conclusion: The combination of comprehensive clinical and radiographic examination is essential to diagnose vertical root fracture. The effectiveness of different treatment options should be evaluated with long-term follow up. Treatment plan need to be discussed with the patient as part of evidence base practice.

  20. Reconstruction of the gastric passage by a side-to-side gastrogastrostomy after failed vertical-banded gastroplasty: a case report


    Soll Christopher; Müller Markus K; Wildi Stefan; Clavien Pierre-Alain; Weber Markus


    Abstract Introduction Vertical-banded gastroplasty, a technique that is commonly performed in the treatment of morbid obesity, represents a nonadjustable restrictive procedure which reduces the volume of the upper stomach by a vertical stapler line. In addition, a textile or silicone band restricts food passage through the stomach. Case presentation A 71-year-old woman presented with a severe gastric stenosis 11 years after vertical gastroplasty. We describe a side-to-side gastrogastrostomy a...

  1. Subtractive Fuzzy Classifier Based Driver Distraction Levels Classification Using EEG


    Wali, Mousa Kadhim; Murugappan, Murugappan; Ahmad, Badlishah


    [Purpose] In earlier studies of driver distraction, researchers classified distraction into two levels (not distracted, and distracted). This study classified four levels of distraction (neutral, low, medium, high). [Subjects and Methods] Fifty Asian subjects (n=50, 43 males, 7 females), age range 20?35 years, who were free from any disease, participated in this study. Wireless EEG signals were recorded by 14 electrodes during four types of distraction stimuli (Global Position Systems (GPS), ...

  2. Treatment of a Vertical Root Fracture Using Dual-Curing Resin Cement: A Case Report

    Directory of Open Access Journals (Sweden)

    Nima Moradi Majd


    Full Text Available Introduction. Vertical root fracture (VRF is one of the most frustrating complications of root canal treatment. The prognosis of the root with VRF is poor therefore tooth extraction and root amputation are usually the only treatment options. However, bonding of the fracture line with adhesive resin cement during the intentional replantation procedure was recently suggested as an alternative to tooth extraction. Methods. A vertically fractured left maxillary incisor was carefully extracted, fracture line was treated with adhesive resin cement, a retrograde cavity was produced and filled with calcium-enriched mixture (CEM cement, and tooth was replanted. Results. After 12 months the tooth was asymptomatic. The size of periapical radiolucency was noticeably reduced and there was no clinical sign of ankylosis. Conclusion. Using adhesive resin cement to bond the fracture lines extraorally in roots with VRF and intentional replantation of the reconstructed teeth could be considered as an alternative to tooth extraction, especially for anterior teeth.

  3. Anterior ankle arthroscopy, distraction or dorsiflexion?

    NARCIS (Netherlands)

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


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

  4. Distraction-related road traffic collisions. (United States)

    Eid, Hani O; Abu-Zidan, Fikri M


    We aimed to prospectively study distraction-related road traffic collision injuries, their contributory factors, severity, and outcome. Data were prospectively collected on all hospitalized road traffic collision trauma patients in Al-Ain City who were drivers at the collision time over one and half years. Driver's inattentive behaviors preceding the collision were collected by interviewing the admitted drivers. There were 444 drivers, 330 of them were fully oriented patients, out of them only 44 (13%) were distracted. Nineteen (5.8%) drivers were distracted by using mobile phones, 12 (3.6%) were pre-occupied with deep thinking, six (1.8%) were talking with other passengers, four (1.2%) were picking things in the vehicle, and three (0.9%) were using entertainment systems. The maximum distraction occurred during the time of 6 am - 12 noon when the traffic was crowded. There were no significant differences between distracted and non-distracted drivers in demographical and physiological factors, injured regions, and outcomes. Distraction of alert drivers causes 13% of road traffic collisions in Al-Ain city. About 40 percent of the distracted drivers involved in road traffic collisions (RTC) were using mobile phones. Our study supports the ban of use of cell phones while driving.

  5. Distraction osteogenesis of free flap reconstructed mandible following ameloblastoma resection for optimal functional rehabilitation (United States)

    Bousdras, V. A.; Kalavrezos, N.


    This case highlights the use of a custom-made distractor (Synthes GmbH, Oberdorf, Switzerland), used to increase bone height prior to rehabilitation with implant placement, in a patient following excision of an ameloblastoma and reconstruction of her mandible with a fibular flap. A 27-year-old patient had her mandible reconstructed following wide resection of an ameloblastoma. Although a 2.0 LOCK reconstruction plate (Synthes GmbH, Oberdorf, Switzerland) was used for fixation of the fibular bone, the vertical deficiency between the reconstructed segment and the occlusal plane made oral rehabilitation impossible. To overcome this, the fibular bone segment was vertically distracted following a latency period of 4 days. Distractor was left in place for 20 weeks for bone consolidation. Following device removal implants were placed. The novelty of this approach included fixation of the lower arm of the distractor on the LOCK plate. The distractor was unidirectional with two arms of different length. The lower arm composed of a 2.0 mini-plate to fit exactly on the 2.0 LOCK plate whereas the upper arm used a standard 1.5 mini-plate. Advantages of this custom-made distractor included: (i) No need for removal of the reconstruction plate, (ii) no need for an extraoral surgical approach, and (iii) no need for additional drilling to fit the lower arm of the distractor. Technical details and limitations are presented. PMID:25593885

  6. Treatment of Angle Class I Malocclusion with Severe Bimaxillary Protrusion using Miniscrew Implants and Periodontal Ligament Distraction

    Directory of Open Access Journals (Sweden)

    K C Prabhat


    Full Text Available Bimaxillary dentoalveolar protrusion is common in Asian population. In this patient with procumbent upper and lower lips, excessive lip strain, proclined and protruded maxillary and mandibular incisors with vertical growth pattern, an acceptable treatment result, was achieved with 4-first-premolar extractions. This case report is presented with the aim, to describe the treatment approach for bimaxillary dentoalveolar protrusion using miniscrew implants for anchorage in upper arch and periodontal ligament distraction for canine retraction in lower arch and then retraction of incisors into the newly formed bone distal to lateral incisor. Treatment was completed in 18 months. The patient profile was improved, with reduction in lip procumbency, decrease in lip eversion and protrusion, and decrease mentalis strain. Dentally, the interincisal angulation improved significantly because both the maxillary and mandibular incisors were uprighted after space closer.

  7. Use of Multidirectional Cranial Distraction Osteogenesis for Cranial Expansion in Syndromic Craniosynostosis

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    Ataru Sunaga, MD


    Full Text Available Summary:. Patients with syndromic craniosynostosis often require a large amount of cranial expansion to avoid intracranial hypertension, but the surgical procedure remains controversial. A patient of severe syndromic craniosynostosis with multiple bony defects and anomalous venous drainage at the occipital region was treated by multidirectional cranial distraction osteogenesis (MCDO at the age of 8 months. Distraction started 5 days after surgery and ceased on postoperative day 16. The distraction devices were removed 27 days after completing distraction. After device removal, the increase of intracranial volume was 155 ml and the cephalic index was improved from 115.5 to 100.5. The resultant cranial shape was well maintained with minimal relapse at postoperative 9 months. In cases of syndromic craniosynostosis with multiple bony defects and/or anomalous venous drainage at the occipital region, expansion of the anterior cranium by MCDO is a viable alternative to conventional methods.

  8. Vertical root fracture associated with prolonged use of calcium hydroxide during apexification. A case report.

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    Jennifer Ribadeneira


    Full Text Available Apexification is a procedure performed in young permanent teeth to promote apical closure and root elongation if Hertwig’s epithelial sheath has not been irreversibly damaged. The objective of this article is to describe vertical root fracture as a complication during apexification when using calcium hydroxide for extended periods of time. The patient was a 9-year-old female student who went to the Faculty of Dentistry of the Universidad Andres Bello in Concepcion. She presented strong and spontaneous pain and pressure and swelling on the left cheek. Clinically, the vestibule of the lower left first molar (3.6 was edematous and had pus. Radiographically, lesions and open apices were seen in the apical zone. Diagnosis was pulp necrosis and acute apical abscess. The tooth was trephined to perform intracanal drainage and an oral antibiotic was prescribed. Afterwards, she was referred to the endodontic specialty office. The selected treatment was apexification with calcium hydroxide until achieving the formation of an apical barrier. When the apical formation was observed, a vertical root fracture was discovered as well, confirming that the use of calcium hydroxide should not be prolonged because dehydration processes lead to weakening of the walls and therefore of the tooth

  9. Vertical Integration or Disintegration? A Bargaining Model of the Maquiladora's Case

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    Ikuho Kochi


    Full Text Available In this paper we present an analytical framework to study the demands of foreign and domestic factors of production of the maquiladora industry. We derive the net profitability of demanding high in72 9 Vol. 21 ¿ número 41 ¿ 2012 stead of low quality inputs. We argue that differences in the quality of inputs between foreign and domestic factors can explain the low vertical integration of the maquiladora with the Mexican industry. We show that if the difference in quality and its positive effect in marginal production compensates the difference in prices, then the maquiladora can be induced to integrate vertically with foreign suppliers of inputs, even if the unitary cost to demand foreign inputs is strictly higher than that of domestic inputs. We also show that a depreciation of the Mexican exchange rate does not necessarily increase the maquiladora's demand of Mexican inputs. This explains recent empirical evidence showing this phenomenon. Conversely, a depreciation of the exchange rate might increase the maquiladora's demand of imported inputs if foreign and domestic factors are complementary. The above holds even if the domestic supplier participates in a bargaining game offering an efficient contract.

  10. Condyle as the point of rotation for 3-D planning of distraction osteogenesis for hemifacial microsomia. (United States)

    Paeng, Jun-Young; Lee, Jee-Ho; Lee, Jong-Ho; Kim, Myung-Jin


    The purpose of this study is to present an exact simulation method for mandibular rotational movement in distraction osteogenesis for hemifacial microsomia. Three-dimensional (3-D) surgery simulation software programmes (V-Works and V-Surgery; Cybermed, Seoul, Korea) were used, based on 3-D CT data in addition to the conventional data, which included facial photography, panoramic radiograph, cephalogram, and dental models. After measuring the mandibular deficiency (horizontal and vertical) from a 3-D model reconstructed using the software, the angulation of the distraction device to the mandibular border (posterior or inferior) was determined. The rotation axis in the V-Works simulation was defined as the line perpendicular to the plane made by condylion and the distraction vector location on the mandible. The mandible moves along the plane around this rotational axis during distraction. After the 3-D simulation with the software programme, mock surgery on a rapid prototyping model was performed. This planning method was applied to models of two hemifacial microsomia patients. With this protocol, it was possible to simulate the rotational movement of the mandible on the axis passing through the condylar head of the unaffected side. The sequential planning procedure presented in this paper is considered to be helpful in performing effective preoperative simulation of distraction osteogenesis for hemifacial microsomia.

  11. Installing an original sleeve for rod unaccessible pain from a distraction device in a hemifacial microsomia patient


    Shimo, Tsuyoshi; Nishiyama, Akiyoshi; Yoshioka, Norie; Sasaki, Akira


    Introduction: Lengthening of the mandible by distraction osteogenesis using an internal device is the preferred method for the treatment of hemifacial microsomia. Despite its advantages, this technique can lead to various complications after the surgery. Presentation of case: We report the case of an 8-yr-old Japanese girl whose case presented practical difficulties in device activation because of rod unaccessible pain after the initial mandibular distraction with an internal device, and t...

  12. New palatal distraction device by both bone-borne and tooth-borne force application in a paramedian bone anchorage site: surgical and occlusal considerations on clinical cases. (United States)

    Cortese, Antonio; Savastano, Germano; Amato, Massimo; Cantone, Antonio; Boschetti, Ciro; Claudio, Pier Paolo


    Maxillary constriction is a very common pathology with implications on dental occlusion, temporomandibular joint dysfunction, nasal breathing, and impairment on the smile and face esthetic.New techniques for expansion of the maxillary bones are particularly useful in relation to the new esthetic ideals of smile and face beauty.To achieve a bodily expansion of the maxillary bones, we developed a new rigid palatal distractor device with both tooth-borne and paramedian bone-borne anchorages to achieve a safe and simple anchorage site suitable also for orthodontic appliances.The reported cases show good results, with bodily maxillary expansion and cross-bite correction without any problems or complications. Substantial advantages of this new device and technique, in comparison with other commonly used palatal distractors, consisting of bodily maxillary movements, avoidance of relapse risks, and safe and simple screw insertion site for bone anchorage also suitable for orthodontic movements, are discussed.

  13. Indian Board of Orthodontics case report: Orthodontic management of vertical excess using skeletal anchorage

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    Ajit J Kalia


    Full Text Available B.B., a 21-year-old girl, presented with the chief complaint of forwardly placed upper front teeth and gummy smile. Diagnosis revealed prognathic maxilla and average mandible, Class II skeletal base with vertical growth pattern, end-on molars and Class II canine relationship bilaterally, convex profile, potentially incompetent lips, gummy smile, and protrusive lower lip. The patient′s treatment plan was extraction of all first bicuspids and retraction using temporary anchorage devices. Anchorage was reinforced using microimplants in the maxillary arch and second molar banding in the mandibular arch. The implants were placed high up in the vestibule to have more of an intrusive component and to reduce gummy smile at the end of the treatment.

  14. Lateral heterogeneity and vertical stratification of cratonic lithospheric keels: a case study of the Siberian craton

    DEFF Research Database (Denmark)

    Artemieva, Irina; Cherepanova, Yulia; Herceg, Matija


    We present geophysical models for the lithospheric mantle of the Siberian craton, with focus on its structureand thermo-compositional heterogeneity as constrained by various geophysical data. The latter include thermalstructure of the lithosphere based on surface heat flow data and supported...... constrained independently by free-board and satellite gravityshows significant lateral variations, that are well correlated with crustal structure, surface tectonics, and regionalxenolith data. Proterozoic sutures and intracratonic basins are manifested by an increase in mantle density as comparedto light...... and lateralheterogeneity of the cratonic lithospheric mantle, with a pronounced stratification in many Precambrian terranes.We discuss lateral and vertical heterogeneity of the cratonic lithosphere discussed in connection to regionaltectono-thermal evolution....

  15. A novel technique to secure the Rigid External Distraction (RED) frame in a thin skull allowing sutural mid-face distraction. (United States)

    Dobbs, Thomas D; Wall, Steven A; Richards, Peter G; Johnson, David


    Distraction osteogenesis (DO) has revolutionised the treatment of mid-face hypoplasia in children, allowing advancement of the mid-face in excess of that achievable by traditional Le Fort III osteotomy. One method of performing DO is to use an externally applied frame, such as the Rigid External Distraction (RED) frame. However, at young ages the cranial bone is often too weak to support the frame, preventing its safe use. We present the case of a patient with Crouzon syndrome who required mid-face distraction at 4-months of age due to severe exorbitism, raised intracranial pressure and airway compromise. In order to allow safe application of an external distraction frame laminated bone grafts were secured to the cranium at the areas of frame pin insertion. We believe this to be the first reported case of the use of the patients own cranial bone to create laminated bone grafts and thicken the site of pin insertion. The method described adds to the armamentarium of the surgeon treating these patients who require placement of an external distraction frame for DO at a young age where the thickness of the cranial bone may otherwise prevent safe application. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  16. Traction Induced Vertical Displacement of Odontoid due to Type III Odontoid Fracture with Unrecognized Ligamentous Injury: A Case Report (United States)

    Jung, Min-Ho; Hur, Hyuk; Jang, Jae-Won; Kim, Jae-Hyoo; Kim, Soo-Han


    Dens fractures are a common traumatic cervical spine injury. Among them, a type III fracture is the second common fracture. Although there are several treatment options, it has been accepted that type III fracture is usually healed by non-surgical method. After adequate reduction with traction, subsequent external immobilization has been associated with successful union rates. However, in the review of literatures, there are some cases with neurological deterioration after application of skull traction. So, the authors report a case of type III dens fracture with initially unrecognized ligamentous injury in which vertical dissociation and quadriplegia occurred after only five-pound Gardner-Well tongs traction. And also, the authors raise awareness of this potentially injury. PMID:27169054

  17. The effects of distraction on metacognition and metacognition on distraction: evidence from recognition memory.

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    Philip eBeaman


    Full Text Available The effects of auditory distraction in memory tasks have been examined to date with procedures that minimize participants’ control over their own memory processes. Surprisingly little attention has been paid to metacognitive control factors which might affect memory performance. In this study, we investigate the effects of auditory distraction on metacognitive control of memory, examining the effects of auditory distraction in recognition tasks utilizing the metacognitive framework of Koriat and Goldsmith (1996, to determine whether strategic regulation of memory accuracy is impacted by auditory distraction. Results replicated previous findings in showing that auditory distraction impairs memory performance in tasks minimizing participants’ metacognitive control (forced-report test. However, the results revealed also that when metacognitive control is allowed (free-report tests, auditory distraction impacts upon a range of metacognitive indices. In the present study, auditory distraction undermined accuracy of metacognitive monitoring (resolution, reduced confidence in responses provided and, correspondingly, increased participants’ propensity to withhold responses in free-report recognition. Crucially, changes in metacognitive processes were related to impairment in free-report recognition performance, as the use of the ‘don’t know’ option under distraction led to a reduction in the number of correct responses volunteered in free-report tests. Overall, the present results show how auditory distraction exerts its influence on memory performance via both memory and metamemory processes.

  18. Maxillary-driven simultaneous maxillo-mandibular distraction for hemifacial microsomia. (United States)

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


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

  19. The persistence of distraction: a study of attentional biases by fear, faces, and context. (United States)

    Parks, Emily L; Kim, So-Yeon; Hopfinger, Joseph B


    Efficient processing of the visual world requires that distracting items be avoided, or at least rapidly disengaged from. The mechanisms by which highly salient, yet irrelevant, stimuli lead to distraction, however, are not well understood. Here, we utilized a particularly strong type of distractor--images of human faces--to investigate the mechanisms of distraction and the involuntarily biasing of attention. Across three experiments using a novel discrimination task, we provided new evidence that the robust distraction triggered by faces may not reflect enhanced attraction but, instead, may reflect an extended holding of attention. Specifically, the onset of a task-irrelevant distractor initially impaired target performance regardless of the identity of that distractor (fearful faces, neutral faces, or places). In contrast, an extended period of distraction was observed only when the distractor was a face. Our results thus demonstrate two distinct mechanisms contributing to distraction: an initial involuntary capture to any sudden event and a subsequent holding of attention to a potentially meaningful, yet task-irrelevant stimulus-in this case, a human face. Critically, the latter holding of attention by faces was not unique to fearful faces but also occurred for neutral faces. The present results dissociate attentional capture from hold in another way as well, since the capture occurred regardless of the nature of the distractors, but the extended holding of attention was dependent upon the ongoing distractor context.

  20. Vertical atlantoaxial dislocation


    Ramaré, S.; Lazennec, J. Y.; Camelot, C.; Saillant, G.; Hansen, S.; Trabelsi, R.


    An unusual case of vertical atlantoaxial dislocation without medulla oblongata or spinal cord injury is reported. The pathogenic process suggested occipito-axial dislocation. The case was treated surgically with excellent results on mobility and pain.

  1. Mobile telephones, distracted attention, and pedestrian safety. (United States)

    Nasar, Jack; Hecht, Peter; Wener, Richard


    Driver distraction is a major cause of traffic accidents, with mobile telephones as a key source of distraction. In two studies, we examined distraction of pedestrians associated with mobile phone use. The first had 60 participants walk along a prescribed route, with half of them conversing on a mobile phone, and the other half holding the phone awaiting a potential call, which never came. Comparison of the performance of the groups in recalling objects planted along the route revealed that pedestrians conversing recalled fewer objects than did those not conversing. The second study had three observers record pedestrian behavior of mobile phone users, i-pod users, and pedestrians with neither one at three crosswalks. Mobile phone users crossed unsafely into oncoming traffic significantly more than did either of the other groups. For pedestrians as with drivers, cognitive distraction from mobile phone use reduces situation awareness, increases unsafe behavior, putting pedestrians at greater risk for accidents, and crime victimization.

  2. The “Mobile Effect” on Screen Format: the Case of Vertical Videos

    Directory of Open Access Journals (Sweden)

    Maria Donata Napoli


    Full Text Available The videos made through mobile phones are probably changing the way we think of videos created to tell or show something, both imaginary tales or private movies, or even chronicles of events to spread rapidly through the web. A change has already occurred in the use, as the new digital portable devices allowed to concentrate on a single medium a variety of media with various functions. Therefore, a tool like the telephone has been enhanced with new features typically designed for other media.In this process of appropriation, new mobile devices changed the way these new features are being used, due, of course, to new conditions. Other than multiplying the production of images that one would call "dirty" due to the presence of rough movements, continuous zoom in and zoom out and, of course, broadcast sub-standard video quality, the new tools introduced the practice of vertical shooting, so inducing a habit.In the history of photography, however, the two formats, landscape and portrait, have always lived together. This paper aims to analyze, briefly, a situation in rapid and continuous evolution, also characterized by the presence of new paradigms responding to visual aesthetic rules that are gradually being defined.

  3. Two Cases of Lower Body Contouring with a Spiral and Vertical Medial Thigh Lift

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    Sang Wha Kim


    Full Text Available Massive weight loss results in skin excess, leading to an unsatisfying body contour. Various thigh lift procedures can correct flabby skin in the lower leg. We present a lower body contouring technique with a report on two patients. The procedure is determined by the body contour of the patient. As the skin excess in the thigh area tended to appear mostly on the medial side, a vertical medial thigh lift was considered. Moreover, for patients with a pear/guitar-shaped body contour, we added the spiral thigh lift for skin excess in the buttocks and the lateral thigh area. The extent of tissue to excise was determined by pinching the patient in a standing position. The inferior skin flap was fixed to non-movable tissue, which was helpful for lifting the tissue and preventing the widening of the scar. After the operation, a drain was kept for 3 to 4 days. A compressive garment was used after removing the drain. There were no complications. The patients were discharged 6 to 8 days after the operation. In conclusion, skin excess, especially in the lower body, can be corrected by a thigh lift combining several procedures, varying from person to person.

  4. Two cases of lower body contouring with a spiral and vertical medial thigh lift. (United States)

    Kim, Sang Wha; Han, Hyun Ho; Seo, Je Won; Lee, Jung Ho; Oh, Deuk Young; Ahn, Sang Tae; Rhie, Jong Won


    Massive weight loss results in skin excess, leading to an unsatisfying body contour. Various thigh lift procedures can correct flabby skin in the lower leg. We present a lower body contouring technique with a report on two patients. The procedure is determined by the body contour of the patient. As the skin excess in the thigh area tended to appear mostly on the medial side, a vertical medial thigh lift was considered. Moreover, for patients with a pear/guitar-shaped body contour, we added the spiral thigh lift for skin excess in the buttocks and the lateral thigh area. The extent of tissue to excise was determined by pinching the patient in a standing position. The inferior skin flap was fixed to non-movable tissue, which was helpful for lifting the tissue and preventing the widening of the scar. After the operation, a drain was kept for 3 to 4 days. A compressive garment was used after removing the drain. There were no complications. The patients were discharged 6 to 8 days after the operation. In conclusion, skin excess, especially in the lower body, can be corrected by a thigh lift combining several procedures, varying from person to person.

  5. Neonatal Sleep Predicts Attention Orienting and Distractibility. (United States)

    Geva, Ronny; Yaron, Hagit; Kuint, Jacob


    Children with sleep disorders tend to experience attention problems, yet little is known about the relationship between sleep and attention in early development. This prospective follow-up study investigated the longitudinal relationships between neonatal sleep, attention, and distraction in infants born preterm. We used actigraphy and sleep-wake diaries in the neonatal intensive care unit (NICU, N = 65), attention orienting in a visual-recognition-memory task (VRM) at age 4 months, and structured observation of attention and distractibility at age 18 months. Infants with poorer neonatal sleep (n = 31) exhibited longer first gaze durations in the VRM at 4 months and longer distraction episodes at 18 months relative to neonatal controls who slept well (p < .01). Hierarchical regression models support relations between neonatal sleep and gaze behavior at 4 months and distractibility at 18 months; moreover, alterations in orienting attention at 4 months predicted the likelihood of being distracted during the second year of life. Findings underscore the importance of early sleep-wake and attention regulation in the development of distraction in infants born preterm. © The Author(s) 2013.

  6. Vertical profile of branch CO2 efflux in a Norway spruce tree: a case study (United States)

    Acosta, M.; Pavelka, M.


    Despite woody-tissue CO2 effluxes having been recognized as an important component of forest carbon budget due to the fraction of assimilates used and the dramatic increase in woody with stand development, there is limited research to determine the CO2 efflux vertical variability of woody-tissue components. For a better understanding and quantification of branch woody-tissue CO2 efflux in forest ecosystems, it is necessary to identify the environmental factors influencing it and the role of the branch distribution within the canopy. The proper assessment of this forest component will improve the knowledge of the ratio between ecosystem respiration and gross primary production at forest ecosystem. In order to achieve this goal, branch CO2 efflux of Norway spruce tree was measured in ten branches at five different whorls during the growing season 2004 (from June till October) in campaigns of 3-4 times per month at the Beskydy Mts., the Czech Republic, using a portable infrared gas analyzer operating as a closed system. Branch woody tissue temperature was measured continuously in ten minutes intervals for each sample position during the whole experiment period. On the basis of relation between CO2 efflux rate and woody tissue temperature a value of Q10 and normalized CO2 efflux rate (E10 - CO2 efflux rate at 10° C) were calculated for each sampled position. Estimated Q10 values ranged from 2.12 to 2.89 and E10 ranged from 0.41 to 1.19 ?molCO2m-2 s-1. Differences in branch CO2 efflux were found between orientations; East side branches presented higher efflux rate than west side branches. The highest branch CO2 efflux rate values were measured in August and the lowest in October, which were connected with woody tissue temperature and ontogenetic processes during these periods. Branch CO2 efflux was significantly and positively correlated with branch position within canopy and woody tissue temperature. Branches from the upper whorls showed higher respiration activity

  7. Management of bimaxillary transverse discrepancy with vertical excess

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    Dinesh C Chaudhary


    Full Text Available A 14-year-old boy reported with a complaint of severe irregularity of lower teeth and forwardly placed upper teeth. History revealed snoring as an occasional complaint. The case was diagnosed as mild class II skeletally with increased lower anterior face height, bimaxillary transverse discrepancy leading to severe crowding in the lower arch, V-shaped upper arch with increased overjet and deep bite. Three phase treatment was planned. In the first phase, bimaxillary expansion with mid-symphyseal distraction osteogenesis and rapid maxillary expansion was carried out. After this phase of treatment, the episodes of snoring vanished. The second phase was 1 year of orthodontics to produce symmetric well-aligned arches in good function and aesthetics. Third, the treatment concluded with reduction-advancement genioplasty for correction of vertical excess and surgical camouflage.

  8. Evaluation of possible vertical fractures and therapeutic possibilities: A case report.

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    Luis Espinoza


    Full Text Available Restorative treatment of endontic teeth supossed certain complications, especially when the restoration is not adequate. Indications for treatment vary according to the remaining tooth . In cases of which this one is moderated, it is chosen to rehabilitate by a type of indirect obturation, this can be in resin, ceramics or metal. A bad indication of restoration will lead to certain complications due to the fact that the rehabilitation of a treated tooth endodónticamente supposes in the majority of the cases an important challenge for the odontologist since it must solve the loss of structure dentaria, the minor resistance to the fracture before the forces oclusales and the need to provide sufficient retention to the material restorer who will replace the dental lost matter.Dental cracks corresponds to one of the recurring problems, the clinical diagnosis of accounting for it, usually cannot be verified radiographically and clinical examination is necessary.In some cases it opt prematurely for the exodoncy, the implications of this option for the stomatognathic balance should guide the clinician to ensure proper diagnosis and more conservative treatment plan, using the wide variety of new materials and adhesive systems, which allow patient's and clinician's satisfaction.We report the case of a patient presenting a dental crack in the tooth 2.4, which was treated conservatively, obtaining optimal results in terms of aesthetics and functionality.

  9. Craniofacial Distraction Osteogenesis: Effects of rhythm of distraction on bone regeneration

    NARCIS (Netherlands)

    U.M. Djasim (Urville)


    textabstractDistraction osteogenesis is defined as the formation of new bone tissue between bone segments that are divided by an osteotomy and then gradually separated by exerting an external force to the mobile bone segment(s). The resulting callus tissue in the distraction gap will eventually

  10. Reflections of Distraction in Memory: Transfer of Previous Distraction Improves Recall in Younger and Older Adults (United States)

    Thomas, Ruthann C.; Hasher, Lynn


    Three studies explored whether younger and older adults' free recall performance can benefit from prior exposure to distraction that becomes relevant in a memory task. Participants initially read stories that included distracting text. Later, they studied a list of words for free recall, with half of the list consisting of previously distracting…

  11. Study on the influence of driving distraction on traffic flow considering the stochastic duration time of distraction (United States)

    Xiao, Yao; Shi, Jing


    This paper aims to study the traffic flow characteristics considering drivers’ distraction behavior, which is common and lasts for stochastic duration time. The distribution of distraction duration time and the influence of distraction on traffic flow are analyzed. The relationship among distraction duration time, probability of distraction occurrence and proportion of distraction is established by stochastic model. Then a modified optimal velocity model was proposed to simulate a two-lane road, taking the effect of distraction behavior into account. A survey was conducted to collect maximum speed, average speed, lane change frequency and headway of vehicle when distracted. The results suggest that distraction behavior has significant negative influence on traffic flow rate and increases the lane changing frequency. Short-time distraction seems to have smaller impact on traffic flow than long-time distraction. This model simulates the distraction behavior very well and distracted drivers have lower mean speed, lower lane changing frequency, longer headway and are overtaken by more vehicles in simulation. This study provided a good model to analyze distraction behavior in traffic flow and pointed out an important factor affecting the traffic flow efficiency.

  12. Vertical Axis Wind Turbine Design Load Cases Investigation and Comparison with Horizontal Axis Wind Turbine

    DEFF Research Database (Denmark)

    Galinos, Christos; Larsen, Torben J.; Aagaard Madsen, Helge


    and parked situations, from cut-in to cut-out and extreme wind conditions. The ultimate and 1 Hz equivalent fatigue loads of the blade root and turbine base bottom are extracted and compared in order to give an insight of the load levels between the two concepts. According to the analysis the IEC 61400-1 ed......The paper studies the applicability of the IEC 61400-1 ed.3, 2005 International Standard of wind turbine minimum design requirements in the case of an onshore Darrieus VAWT and compares the results of basic Design Load Cases (DLCs) with those of a 3-bladed HAWT. The study is based on aeroelastic...... computations using the HAWC2 aero-servo-elastic code A 2-bladed 5 MW VAWT rotor is used based on a modified version of the DeepWind rotor For the HAWT simulations the NREL 3-bladed 5 MW reference wind turbine model is utilized Various DLCs are examined including normal power production, emergency shut down...

  13. Reconstruction of the gastric passage by a side-to-side gastrogastrostomy after failed vertical-banded gastroplasty: a case report (United States)

    Soll, Christopher; Müller, Markus K; Wildi, Stefan; Clavien, Pierre-Alain; Weber, Markus


    Introduction Vertical-banded gastroplasty, a technique that is commonly performed in the treatment of morbid obesity, represents a nonadjustable restrictive procedure which reduces the volume of the upper stomach by a vertical stapler line. In addition, a textile or silicone band restricts food passage through the stomach. Case presentation A 71-year-old woman presented with a severe gastric stenosis 11 years after vertical gastroplasty. We describe a side-to-side gastrogastrostomy as a safe surgical procedure to restore the physiological gastric passage after failed vertical-banded gastroplasty. Conclusion Occasionally, restrictive procedures for morbid obesity cannot be converted into an alternative bariatric procedure to maintain weight control. This report demonstrates that a side-to-side gastrogastrostomy is a feasible and safe procedure. PMID:18513454

  14. Reconstruction of the gastric passage by a side-to-side gastrogastrostomy after failed vertical-banded gastroplasty: a case report

    Directory of Open Access Journals (Sweden)

    Soll Christopher


    Full Text Available Abstract Introduction Vertical-banded gastroplasty, a technique that is commonly performed in the treatment of morbid obesity, represents a nonadjustable restrictive procedure which reduces the volume of the upper stomach by a vertical stapler line. In addition, a textile or silicone band restricts food passage through the stomach. Case presentation A 71-year-old woman presented with a severe gastric stenosis 11 years after vertical gastroplasty. We describe a side-to-side gastrogastrostomy as a safe surgical procedure to restore the physiological gastric passage after failed vertical-banded gastroplasty. Conclusion Occasionally, restrictive procedures for morbid obesity cannot be converted into an alternative bariatric procedure to maintain weight control. This report demonstrates that a side-to-side gastrogastrostomy is a feasible and safe procedure.

  15. Driving drowsy also worsens driver distraction. (United States)

    Anderson, Clare; Horne, James A


    Laboratory-based studies show that drowsiness increases the propensity to become distracted. As this phenomenon has not been investigated in drowsy drivers, we underwent a pilot study under realistic monotonous driving conditions to see if distraction was more apparent when drowsy; if so, how does it affect driving performance? A repeated measures counterbalanced design whereby participants drove for two hours in a fully interactive car simulator during the bi circadian afternoon drive, after a night of either normal (baseline) or restricted sleep to five hours (sleep restriction). Videos of drivers' faces were analysed blind for short (3 s) distractions, in which drivers took their eyes off the road ahead. These results were compared with the likelihood of simultaneous lane-drifting incidents, when at least two wheels left the driving lane. More distractions occurred after restricted sleep (pdriving incidents for both conditions but with significantly more distraction-related incidents after sleep restriction (pdriving performance as evidenced by the car leaving the driving lane. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Happiness increases distraction by auditory deviant stimuli. (United States)

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


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

  17. Implant-associated Vertical Root Fracture in Adjacent Endodontically Treated Teeth: A Case Series and Systematic Review. (United States)

    Rosen, Eyal; Beitlitum, Ilan; Tamse, Aviad; Taschieri, Silvio; Tsesis, Igor


    This study aimed to report a possible effect of the presence of an adjacent implant on the development of a vertical root fracture (VRF) in endodontically treated teeth. A series of 8 cases in 7 patients with teeth diagnosed with VRF after the placement of implants in the adjacent area is described and analyzed. In addition, a comprehensive literature search with strict inclusion and exclusion criteria was undertaken to identify additional clinical studies that assessed this clinical scenario. The case series analysis revealed that the time from implant placement to the diagnosis of VRF was between 5 and 28 months (average = 11 months). The majority of cases occurred in female patients who received 2 or more implants. Six of the 7 patients were older than 40 years, with an average age of 54 years. The majority of teeth with VRF were premolar or mandibular molar teeth (6/8 teeth). All fractured teeth had been restored with a crown and had a post present, and the quality of the root canal filling was determined to be adequate. The systematic review revealed that implant-associated VRF has not been investigated or reported in the literature yet. Based on a systematic review of the literature, this case series, although limited in its extent, is the first clinical report of a possible serious adverse event of implant-associated VRF in adjacent endodontically treated teeth. Additional clinical studies are indicated to shed light on this potential phenomenon. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  18. Vertical platysma myocutaneous flap reconstruction for oral defects using three different incision designs: experience with 68 cases. (United States)

    Huang, L; Gao, X; Su, T; Jiang, C-H; Jian, X-C


    This study evaluated the effects of three different incision designs for the vertical platysma myocutaneous flap (VPMF): apron, MacFee, and T-shaped. This flap was used for the reconstruction of intraoral defects following cancer ablation in selected patients. Sixty-eight cases of VPMF reconstruction were assessed: the apron incision was used in 28, MacFee incision in 22, and T-shaped incision in 18. With regard to postoperative outcomes, there were 26 cases of flap survival and two of partial necrosis with the apron incision; 20 of survival and two of partial necrosis with the MacFee incision; 15 of survival and three of partial necrosis with the T-shaped incision. Success rates were 92.9%, 90.9% and 83.3%, respectively, for VPMF with the apron, MacFee, and T-shaped incisions. A wound healing disturbance in the neck was seen in three cases of VPMF with the apron incision and one case with the MacFee incision. The MacFee incision had the best aesthetic effect, and the postoperative neck scar was more obvious for the T-shaped incision. It is recommended that VPMF with the MacFee or apron incision be used for the reconstruction of larger buccal mucosa and floor of the mouth defects, while VPMF with the T-shaped incision should be used for smaller intraoral defects, especially tongue defects of the lateral surface. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Combined maxillary and mandibular distraction osteogenesis in patients with hemifacial microsomia. (United States)

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


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

  20. Distraction Reduces Both Early and Late Electrocutaneous Stimulus Evoked Potentials

    NARCIS (Netherlands)

    Blom, J.H.G.; Wiering, Caro H.; van der Lubbe, Robert Henricus Johannes


    Previous electroencephalography studies revealed mixed effects of sustained distraction on early negative and later positive event-related potential components evoked by electrocutaneous stimuli. In our study we further examined the influence of sustained distraction to clarify these discrepancies.

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

    Directory of Open Access Journals (Sweden)

    Fergus I. M Craik


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

  2. Facilitation and Distraction in Short-Term Memory (United States)

    Hagan, John W.; Kail, Robert V., Jr.


    Short-term memory in 7- and 11-year-old children was studied under two conditions: study period and distraction. Older children did better than younger children on study conditions and about the same on distraction condition. (ST)

  3. The Interfering Effect of Distracting Stimuli on the Infant's Memory (United States)

    McCall, Robert B.; And Others


    Infants 3 1/2 months of age were assessed for the possible role of the dissimilarity of the distracting stimulus to the originally learned standard in a modified familiarization-distraction-test paradigm. (Author/JMB)

  4. Sadness increases distraction by auditory deviant stimuli. (United States)

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


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

  5. Paleolatitudinal changes in vertical facies transitions recording late Paleozoic glaciations: a case study from eastern Australia (United States)

    Fielding, C. R.; Frank, T. D.; Shultis, A. I.


    Stratigraphic records of the complex and multi-phase late Paleozoic Ice Age (LPIA) have been examined over a 2000 km paleo-polar to paleo-mid latitude transect from Tasmania to Queensland, eastern Australia. In this presentation, we summarize changes in facies assemblages within glacial and nonglacial epochs and the transitions between them, within the coastal to shallow marine Permian succession. In the earliest Permian P1 glacial interval, facies represent proximal proglacial to locally glacial environments in Tasmania (TAS), and an array of mainly marine proglacial to glacimarine environments in New South Wales (NSW) and Queensland (QLD). A trend of more ice-proximal to less ice-proximal facies assemblages is evident from south to north. The end of P1 is represented both by abrupt flooding trends in some areas and by thicker intervals of more gradually fining-upward facies recording progressive deepening elsewhere. The onset of the Sakmarian/Artinskian P2 glacial interval is best-exposed in southern NSW, where an abrupt change to marine proglacial facies is accompanied by evidence for deepening, suggesting isostatic loading of the sedimentary surface. P2 glacial facies are more proximal in NSW than in QLD. Both P1 and P2 intervals preserve complex internal stratigraphy, in many cases recording multiple glacial-interglacial cycles. The close of P2 is again recorded in a variety of ways, with many sections showing a gradual fining-upward and decrease in indicators of glacial conditions. The Kungurian to Capitanian P3 and P4 glacial intervals are in general represented by less proximal facies than their predecessors, typically intervals of outsize clast-bearing mudrocks and sandstones. These in many areas show diffuse boundaries with the nonglacial facies that enclose them. Furthermore, no significant paleolatitudinal changes in the P3 and P4 facies assemblages are evident from TAS to QLD. The documented patterns support the view that the P1 glacial represents the

  6. Positive mood is associated with the implicit use of distraction


    Biss, Renée K.; Hasher, Lynn; Thomas, Ruthann C.


    Previous research demonstrates that individuals in a positive mood are differentially distracted by irrelevant information during an ongoing task (Rowe et al. in Proc Natl Acad Sci 104:383–388, 2007). The present study investigated whether susceptibility to distraction shown by individuals in a positive mood results in greater implicit memory for that distraction. Participants performed a similarity-judgment task on pictures that were superimposed with distracting words. When these previously...

  7. The Effects of Distraction on Cognitive Task Performance during Toddlerhood (United States)

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


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

  8. The ability of cone-beam computerized tomography to detect vertical root fractures in endodontically treated and nonendodontically treated teeth: a report of 3 cases

    NARCIS (Netherlands)

    Zou, X.; Liu, D.; Yue, L.; Wu, M.K.


    A definitive diagonosis of vertical root fracture (VRFs) is often a challenging task for clinicians. Twodimensional periapical radiographs (PRs) may be not helpful in such a diagnosis when the x-ray beam is not parallel to the plane of the fracture line. This report presents a set of 3 cases in

  9. Islam, Modernity, and the Liminal Space Between: A Vertical Case Study of the Institute of Traditional Islamic Art and Architecture in Amman, Jordan (United States)

    Meehan, Mark W.


    This dissertation investigates the development and function of the Institute of Traditional Islamic Art and Architecture in Amman, Jordan. A vertical case study using grounded theory methodology, the research attempts to create a rich and holistic understanding of the Institute. Specific areas of study include the factors involved in the founding…

  10. Poland Syndrome: Use of Vertical Expandable Prosthetic Titanium Rib System before Walking Age—A Case Report (United States)

    Drebov, Rosen S.; Katsarov, Atanas


    Aim  To present a new therapy for Poland syndrome (PS) using a novel surgical approach: the vertical expandable prosthetic titanium rib (VEPTR) system. Methods  The VEPTR system rib-to-rib variant was used to enhance the chest wall and vertebral column support in a young patient before walking age. Case Report  We present a 12-month-old infant diagnosed with left-sided PS at the age of 6 months associated with missing ribs, scoliosis, and absence of the left pectoral muscles. Because of four missing ribs, paradoxical breathing was present. In addition, the left scapula was protruding into the chest due to the missing rib support. Scoliosis was caused by a left-sided nonsegmented bar of the thoracic spine. Results  We decided to use the VEPTR system before the patient reached walking age to prevent progression of column deformation and future pulmonary problems. To improve the spinal deformity, to stabilize the thorax, and to improve thoracic function, we performed the operation at 1 year of age. At 10-month follow-up, the patient was reevaluated. The construction was still stable and scoliosis had not deteriorated. Conclusion  The VEPTR system is a choice of treatment in young patients with PS to prevent late complications after a child reaches walking age. PMID:28824998

  11. Poland Syndrome: Use of Vertical Expandable Prosthetic Titanium Rib System before Walking Age-A Case Report. (United States)

    Drebov, Rosen S; Katsarov, Atanas


    Aim  To present a new therapy for Poland syndrome (PS) using a novel surgical approach: the vertical expandable prosthetic titanium rib (VEPTR) system. Methods  The VEPTR system rib-to-rib variant was used to enhance the chest wall and vertebral column support in a young patient before walking age. Case Report  We present a 12-month-old infant diagnosed with left-sided PS at the age of 6 months associated with missing ribs, scoliosis, and absence of the left pectoral muscles. Because of four missing ribs, paradoxical breathing was present. In addition, the left scapula was protruding into the chest due to the missing rib support. Scoliosis was caused by a left-sided nonsegmented bar of the thoracic spine. Results  We decided to use the VEPTR system before the patient reached walking age to prevent progression of column deformation and future pulmonary problems. To improve the spinal deformity, to stabilize the thorax, and to improve thoracic function, we performed the operation at 1 year of age. At 10-month follow-up, the patient was reevaluated. The construction was still stable and scoliosis had not deteriorated. Conclusion  The VEPTR system is a choice of treatment in young patients with PS to prevent late complications after a child reaches walking age.

  12. Does Personality Have a Different Impact on Self-Rated Distraction, Job Satisfaction, and Job Performance in Different Office Types? (United States)

    Seddigh, Aram; Berntson, Erik; Platts, Loretta G; Westerlund, Hugo


    This study investigates the joint effect of office type (cell, shared room, open-plan, and flex) and personality, measured by the Big Five personality traits, on self-rated measures of distraction, job satisfaction, and job performance (measured by professional efficacy). Regression analyses with interactions between personality and office type were conducted on 1205 participants working in 5 organizations from both the private and public sectors. While few interactions were observed in the cases of professional efficacy and job satisfaction, several were observed between personality traits and office type on the level of distraction reported. Specifically, more emotionally stable participants reported lower distraction, particularly those working in flex offices. Both agreeableness and openness to experience were associated with higher levels of distraction among participants in open-plan compared to cell offices.

  13. Mandibular distraction in hemifacial microsomia is not a permanent treatment: a long-term evaluation. (United States)

    Ascenço, Adriana Sayuri Kurogi; Balbinot, Priscilla; Junior, Ivan Maluf; D'Oro, Ubiratan; Busato, Luciano; da Silva Freitas, Renato


    Hemifacial microsomia presents with abnormalities including short ramus, absence of condyle, abnormal canting, deviated chin, and facial asymmetry. Many studies about distraction osteogenesis have been published over the last 20 years, but without long-term follow-up. The aim of this study was to evaluate patients with unilateral craniofacial microsomia who were treated with mandible distraction and with follow-up of more than 5 years. The following retrospective study was evaluated and approved by the Assistance Center for Cleft Lip and Palate. Data were compiled from the charts of 33 patients with hemifacial microsomia who underwent unilateral mandible distraction. Average age at time of procedure was 7.3 years, with an average degree of distraction of 20 mm. Seventy percent of cases were treated with internal distraction, 30% external. Follow-up varied between 5 and 15 years, with a mean follow-up of 9 years. Ninety percent of the 33 patients in the study had recurrence of their asymmetry. Mean time to postsurgical recurrence was 44 months. Thirty patients were referred for orthognathic surgery. Six patients have already undergone corrective bimaxillary surgery. One patient underwent genioplasty only, and 1 patient underwent genioplasty with orthognathic jaw surgery. Twenty-two patients are awaiting orthognathic surgery, including one with temporomandibular joint ankylosis. Only 3 subjects had good outcomes, without signs of recurrence. Bone distraction once seemed a promising long-term option for treatment of craniofacial microsomia. However, this has not proven effective for all cases, and most patients needed subsequent orthognathic surgery.

  14. Distraction-related road traffic collisions

    African Journals Online (AJOL)

    is a sprouting serious road safety issue that causes a pro- portion of preventable deaths4,5. Pre-crash driver's dis- traction was reported to be responsible for about 80% of collisions and 65% of near-collisions6. We aimed to pro- spectively study distraction-related road traffic collision injuries, their contributory factors, ...

  15. [Distraction osteogenesis: principles, history and background

    NARCIS (Netherlands)

    Vissink, A.; Baat, C. de


    Distraction osteogenesis is a treatment in which new bone is created in the space which comes to exist between bone fragments that have slowly been driven apart by osteogenesis. This treatment, originally developed in orthopaedic surgery, is also commonly used for correcting deformities in the head

  16. One-step transversal palatal distraction and maxillary repositioning: technical considerations, advantages, and long-term stability. (United States)

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


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

  17. Auditory Distraction and Acclimatization to Hearing Aids. (United States)

    Dawes, Piers; Munro, Kevin J

    It is widely recognized by hearing aid users and audiologists that a period of auditory acclimatization and adjustment is needed for new users to become accustomed to their devices. The aim of the present study was to test the idea that auditory acclimatization and adjustment to hearing aids involves a process of learning to "tune out" newly audible but undesirable sounds, which are described by new hearing aid users as annoying and distracting. It was hypothesized that (1) speech recognition thresholds in noise would improve over time for new hearing aid users, (2) distractibility to noise would reduce over time for new hearing aid users, (3) there would be a correlation between improved speech recognition in noise and reduced distractibility to background sounds, (4) improvements in speech recognition and distraction would be accompanied by self-report of reduced annoyance, and (5) improvements in speech recognition and distraction would be associated with higher general cognitive ability and more hearing aid use. New adult hearing aid users (n = 35) completed a test of aided speech recognition in noise (SIN) and a test of auditory distraction by background sound amplified by hearing aids on the day of fitting and 1, 7, 14, and 30 days post fitting. At day 30, participants completed self-ratings of the annoyance of amplified sounds. Daily hearing aid use was measured via hearing aid data logging, and cognitive ability was measured with the Wechsler Abbreviated Scale of Intelligence block design test. A control group of experienced hearing aid users (n = 20) completed the tests over a similar time frame. At day 30, there was no statistically significant improvement in SIN among new users versus experienced users. However, levels of hearing loss and hearing aid use varied widely among new users. A subset of new users with moderate hearing loss who wore their hearing aids at least 6 hr/day (n = 10) had significantly improved SIN (by ~3-dB signal to noise ratio

  18. Distracting effect of TV watching on children's reactivity. (United States)

    Bellieni, Carlo V; Fontani, Giulio; Corradeschi, Franco; Iantorno, Lorenzo; Maffei, Marianna; Migliorini, Silvia; Perrone, Serafina; Buonocore, Giuseppe


    The experiment, aimed to evaluate the distracting effect of television, was carried out on 122 children, divided into three groups. All groups performed the auditory vigilance test (AVT) to assess reaction time (RT) to an auditory stimulus and the number of errors in responding to the stimulus. Children in group 1 performed the AVT while in front of a blank TV set and listening to the soundtrack of a movie (SO test), then watching a black and white cartoon (BW test). Children in group 2 performed the AVT while in front of a blank TV set and listening to the soundtrack of a movie (SO test), then watching a color cartoon (CC test). Group 3 performed SO, BW, and CC tests consecutively. RT and the number and type of errors were measured. In each group, 30 days separated one session from the following. A significant increase of median RTs (more than 10%) and errors (twice and more) was observed both in the case of BW and CC tests with respect to SO test. RT increased throughout all tests. During SO test, errors are mainly "false reactions", but in BW and CC tests, errors are more numerous, and they are mainly "omissions". TV movies have a significant distracting and attention-capturing effect, which increases throughout the vision of the show. No advantage in decreasing this effect is offered by removing color from the movie.

  19. Change of lip and occlusal cant after simultaneous maxillary and mandibular distraction osteogenesis in hemifacial microsomia. (United States)

    Balaji, S M


    The purpose of this study was to investigate the lip and occlusal cant changes in hemifacial microsomia (HFM) cases after simultaneous maxilla and mandibular distraction osteogenesis (DO) of the mandible. Retrospective analysis of all HFM cases at Balaji Dental and Craniofacial Hospital were performed. Patient of either gender with all medical imaging records and pre and post-operative (6 months) facial photographs in natural head position were included in the study. The lip cant change was assessed by the angle of each labial commissure and the bi-pupillary reference line. The line joining the frontozygomatic unions and a parallel line is drawn at the level of anterior nasal spine. The occlusal plane is then traced. A vertical line is traced perpendicular to the frontozygomatic union. The deviation of the occlusal plane from the horizontal is measured as the occlusal cant and a change, between pre and post-operative records was considered as the angle and linear measurements. With the linear measurement, the mean change in occlusal cant was 7.18 ± 1.47 mm while for the mean change in lip cant was 3.31 ± 0.52 mm (P = 0.120). For the angular measurement, the mean angle change in occlusal cant was 13.86 ± 2.69° and mean change in angle of lip cant was 8.54 ± 0.7° (P = 0.01). For type1HFM, DO corrects the occlusal and lip cant. In present study, the lip cant change relative to occlusal cant change was 47.54 ± 10.71% in linear measurements while for angular measurements it was 63.19 ± 10.07% (P = 0.476; Pearson's correlation coefficient = -0.241).

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

    Directory of Open Access Journals (Sweden)

    Judith Mwakalonge


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

  1. Biomechanical patterns of text-message distraction. (United States)

    Le, Peter; Hwang, Jaejin; Grawe, Sarah; Li, Jing; Snyder, Alison; Lee, Christina; Marras, William S


    The objective of this study was to identify biomechanical measures that can distinguish texting distraction in a laboratory-simulated driving environment. The goal would be to use this information to provide an intervention for risky driving behaviour. Sixteen subjects participated in this study. Three independent variables were tested: task (texting, visual targeting, weighted and non-weighted movements), task direction (front and side) and task distance (close and far). Dependent variables consisted of biomechanical moments, head displacement and the length of time to complete each task. Results revealed that the time to complete each task was higher for texting compared to other tasks. Peak moments during texting were only distinguishable from visual targeting. Peak head displacement and cumulative biomechanical exposure measures indicated that texting can be distinguished from other tasks. Therefore, it may be useful to take into account both temporal and biomechanical measures when considering warning systems to detect texting distraction.

  2. An alternative approach to extruding a vertically impacted lower third molar using an orthodontic miniscrew: A case report with cone-beam CT follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Cortes, Arthur Rodriguez Gonzales; Cavalcanti, Marcelo Gusmaeo Paraiso; Arita, Emiko Saito [Dept. of Oral Radiology, School of Dentistry, University of Saeo Paulo, Saeo Paulo (Brazil); No-Cortes, Julian [Orthodontic Clinic, Saeo Paulo (Brazil)


    One of the most common oral surgical procedures is the extraction of the lower third molar (LTM). Postoperative complications such as paresthesia due to inferior alveolar nerve (IAN) injury are commonly observed in cases of horizontal and vertical impaction. The present report discusses a case of a vertically impacted LTM associated with a dentigerous cyst. An intimate contact between the LTM roots and the mandibular canal was observed on a panoramic radiograph and confirmed with cone-beam computed tomographic (CBCT) cross-sectional cuts. An orthodontic miniscrew was then used to extrude the LTM prior to its surgical removal in order to avoid the risk of inferior alveolar nerve injury. CBCT imaging follow-up confirmed the success of the LTM orthodontic extrusion.

  3. Acceptance Versus Distraction for Unwanted Sexual Thoughts


    Sherwood, Joseph A.


    This on-line study examined 67 participants who rated their sexual thought distress level as moderately distressing or greater, on the successfulness of an acceptance-based strategy and a distraction-based strategy for dealing with unwanted sexual thoughts. The study began with the completion of an assessment battery, which measured attitudes about sexual thoughts. During a pre-intervention three minute time period, participants were asked to record/report occurrences a previously identified ...

  4. Instruction or distraction in the driving school?

    DEFF Research Database (Denmark)

    Andersen, Mike Kirk; Caglio, Agnese

    In this paper we report an ongoing study of driving school practice. We recorded several hours of driving lessons in different environments, which we analyze with the Interaction Analysis method. Our initial analysis suggests that looking at how teachers make use of different communicative resour...... resources to instruct students in driving, can provide insights for the development of technologies that support drivers in managing distractions....

  5. Distraction of lumbar vertebrae in gravitational traction. (United States)

    Tekeoglu, I; Adak, B; Bozkurt, M; Gürbüzoglu, N


    Experimental study of 30 patients diagnosed with low back pain resulting from lumbar disc herniation, disc degeneration, and segmental instability. Patients underwent gravitational traction, and widening of the intervertebral space and posterior facets was measured on radiographs. This same procedure was performed with a group of 30 healthy individuals. To determine the effect of gravitational traction on the widening of the intervertebral space and the other vertebral structures in patients with low back pain and in healthy individuals. Gravitational traction is performed by suspending the patient in a hanging, upright position for an extended period of time. In spite of disagreement among authors about the effect of lumbar traction, recent innovations have enabled the distraction of vertebrae. A specially designed apparatus was used to apply gravitational traction. Pre- and post-traction radiographs were obtained to study the changes in the L2-L3, L3-L4, L4-L5, and L5-S1 intervertebral spaces; Ferguson's angle; L1-S1 total distance; and blood pressure. Distraction was more than approximately 3 mm in each intervertebral space in both groups. Gravitational traction had a very apparent effect on intervertebral space and was found to be an effective method to distract lumbar vertebrae. Discomfort experienced by the patient during suspension may be overcome by making biomedical changes to the suspension corset.

  6. Mandibular symphyseal distraction osteogenesis--simplified. (United States)

    Chopra, S S; Sahoo, Nanda Kishore; Jayan, Balakrishna


    The limb lengthening technique of distraction osteogenesis (DO) used in orthopedic surgery is a well established procedure. DO has been adapted to the facial skeleton to change the anterior-posterior position of the jaws. Historically, the mandibular arch transverse dimension has been considered immutable. Mandibular arch expansion is done with a variety of methods including Schwarz plates, lingual arches, functional appliances and arch wires; these methods produce limited dimensional change with questionable long-term stability. Adapting the Ilizarov treatment protocol to the mandibular symphysis can produce a regenerate bone thereby adding dimension to the innate basal bone. This can then be used to produce a potentially greater effect than the conventional modes of mandibular expansion. The modified mandibular symphyseal distraction device used by the authors is a tooth borne device fabricated with a Schwartz screw and self cured acrylic resin coverage over all the erupted mandibular teeth. The appliance used by the authors has been found to be very economical, easy to fabricate and clinically efficient. The surgical approach used, requiring surgery under local anesthesia in the outpatient department obviates need of hospital admission and the cost and time factors associated with in-patient therapy Mandibular Symphyseal Distraction Osteogenesis (MSDO) with this innovative low cost approach may be compared in a multi centric study with other established methods of MSDO.

  7. Modulation of competing memory systems by distraction. (United States)

    Foerde, Karin; Knowlton, Barbara J; Poldrack, Russell A


    Different forms of learning and memory depend on functionally and anatomically separable neural circuits [Squire, L. R. (1992) Psychol. Rev. 99, 195-231]. Declarative memory relies on a medial temporal lobe system, whereas habit learning relies on the striatum [Cohen, N. J. & Eichenbaum, H. (1993) Memory, Amnesia, and the Hippocampal System (MIT Press, Cambridge, MA)]. How these systems are engaged to optimize learning and behavior is not clear. Here, we present results from functional neuroimaging showing that the presence of a demanding secondary task during learning modulates the degree to which subjects solve a problem using either declarative memory or habit learning. Dual-task conditions did not reduce accuracy but reduced the amount of declarative learning about the task. Medial temporal lobe activity was correlated with task performance and declarative knowledge after learning under single-task conditions, whereas performance was correlated with striatal activity after dual-task learning conditions. These results demonstrate a fundamental difference in these memory systems in their sensitivity to concurrent distraction. The results are consistent with the notion that declarative and habit learning compete to mediate task performance, and they suggest that the presence of distraction can bias this competition. These results have implications for learning in multitask situations, suggesting that, even if distraction does not decrease the overall level of learning, it can result in the acquisition of knowledge that can be applied less flexibly in new situations.

  8. Administrative integration of vertical HIV monitoring and evaluation into health systems: a case study from South Africa. (United States)

    Kawonga, Mary; Fonn, Sharon; Blaauw, Duane


    In light of an increasing global focus on health system strengthening and integration of vertical programmes within health systems, methods and tools are required to examine whether general health service managers exercise administrative authority over vertical programmes. To measure the extent to which general health service (horizontal) managers, exercise authority over the HIV programme's monitoring and evaluation (M&E) function, and to explore factors that may influence this exercise of authority. This cross-sectional survey involved interviews with 51 managers. We drew ideas from the concept of 'exercised decision-space' - traditionally used to measure local level managers' exercise of authority over health system functions following decentralisation. Our main outcome measure was the degree of exercised authority - classified as 'low', 'medium' or 'high' - over four M&E domains (HIV data collection, collation, analysis, and use). We applied ordinal logistic regression to assess whether actor type (horizontal or vertical) was predictive of a higher degree of exercised authority, independent of management capacity (training and experience), and M&E knowledge. Relative to vertical managers, horizontal managers had lower HIV M&E knowledge, were more likely to exercise a higher degree of authority over HIV data collation (OR 7.26; CI: 1.9, 27.4), and less likely to do so over HIV data use (OR 0.19; CI: 0.05, 0.84). A higher HIV M&E knowledge score was predictive of a higher exercised authority over HIV data use (OR 1.22; CI: 0.99, 1.49). There was no association between management capacity and degree of authority. This study demonstrates a HIV M&E model that is neither fully vertical nor integrated. The HIV M&E is characterised by horizontal managers producing HIV information while vertical managers use it. This may undermine policies to strengthen integrated health system planning and management under the leadership of horizontal managers.

  9. Distractibility in Learning-Disabled Children: The Role of Measurement Artifact. (United States)

    Harvey, Philip D.; And Others


    Two-digit span tasks compared the distraction performance of 32 learning disabled (LD) high schoolers and non LD Ss. No differential distraction effect was found on the first set (matching nondistraction and distraction conditions). In set two, (distraction condition was designed to be more discriminating), a differential distraction effect was…

  10. Joint Distraction Treatments of Intra-Articular Fracture-Induced Posttraumatic Osteoarthritis in a Large Animal Model (United States)


    immediate joint distraction did not have a therapeutic benefit. Our research team suffered a personal and professional loss with the death of our...Project Year 2 with the death of our histologist, Ms. Gail Kurriger. Ms. Kurriger suffered an accidental injury in April and passed away in July...location of the TIMP1 band is highlighted in blue. There are n=4 animals per group, separated by vertical black lines. TIMP-1 was most strongly

  11. Driver Cognitive Distraction Detection Using Driving Performance Measures

    Directory of Open Access Journals (Sweden)

    Lisheng Jin


    Full Text Available Driver cognitive distraction is a hazard state, which can easily lead to traffic accidents. This study focuses on detecting the driver cognitive distraction state based on driving performance measures. Characteristic parameters could be directly extracted from Controller Area Network-(CAN-Bus data, without depending on other sensors, which improves real-time and robustness performance. Three cognitive distraction states (no cognitive distraction, low cognitive distraction, and high cognitive distraction were defined using different secondary tasks. NLModel, NHModel, LHModel, and NLHModel were developed using SVMs according to different states. The developed system shows promising results, which can correctly classify the driver’s states in approximately 74%. Although the sensitivity for these models is low, it is acceptable because in this situation the driver could control the car sufficiently. Thus, driving performance measures could be used alone to detect driver cognitive state.


    Directory of Open Access Journals (Sweden)

    M. V. Stogov


    Full Text Available Purpose – to evaluate effect of protein extracted from lengthened skeletal muscles on callus formation in dogs after tibia lengthening using Ilizarov method.Materials and methods. The authors studied properties of distraction callus formation in three groups of dogs after tibia lengthening by Ilizarov method. In the first group (n = 10 distraction was achieved at a rate of 1 mm in four stages during 28 days. In the second (n = 4 and third (n = 4 groups distraction was done at a rate of 1.5 mm in 6 stages per day within 20 days. Mean lengthening value in all groups amounted to 14,64±0,67% of the overall segment length. At the 10th day of distraction the authors introduced to animals of the second group into anterior tibial and gastrocnemius muscles of the lengthened segment at callus level the extract of sarcoplasmic proteins in amount of 1.5ml based on 1 mg of lyophilizate per 1 kg of body weight (protein concentration in injectate amounted to 30±2 gr/l. Animals in the third group received natural saline solution in the same manner. Extract consisted of lyophilized sarcoplasmic proteins harvested from anterior tibial muscle of animal at 14th day of lengthening by Ilizarov method (rate of 1 mm per day in 4 stages. Extraction was performed according to patented method (Russian Federation patent for invention №2476234 by consecutive muscle proteins sedimentation in KCl solutions of varied ionic strength. The lyophilizate was sterilized after obtaining and dissolved in normal saline solution prior to introduction.Results. Radiographic signs of anatomically solid callus in the first group were observed in the average at 33±1 day of fixation; in the second group – at 24±2 day; in the third group – at 39±3. Difference in mean values of fixation in animals of second group as compared to first and third groups was significant (р = 0,04. After extract introduction the animals of the second group demonstrated a greater growth

  13. Associations between alveolar heights and vertical skeletal pattern in Moroccan adults: a cephalometric study of 127 clinical cases. (United States)

    Abdelali, Halimi; Benyahia, Hicham; Abouqal, Redouane; Azaroual, Mohammed-Faouzi; Zaoui, Fatima


    The aim of our study was to investigate vertical dentoalveolar compensation in untreated patients, in search of an association between vertical facial pattern and alveolar heights. This study involved the participation of 127 untreated Moroccan adults from the patient population of the ODF (Dentofacial Orthopedics) Department at the Center for Dental Treatment and Consultation (CCTD) in Rabat. Full adult dentition was the only criterion for inclusion. Patients with major syndromes and patients with facial clefts were excluded from the study. For the purposes of this analysis, we used profile teleradiography to measure vertical and sagittal skeletal variables as well as vertical dentoalveolar variables in the anterior and posterior maxillary and mandibular regions. We also measured the incisor axes. Analyses and statistical tests were performed with SPSS(®) statistics software (version 9.5 for Windows). Results indicate that: (i) upper posterior alveolar height (UPAH) does not correlate with skeletal variables of facial divergence, but correlates strongly with anterior facial height (AFH) and moderately with posterior facial height (PFH); (ii) lower anterior alveolar height (LAAH) correlates negatively with facial height index (FHI), positively with the FMA and AFH, but does not correlate with PFH; (iii) lower posterior alveolar height (LPAH) does not correlate with skeletal variables of facial divergence; (iv) upper anterior alveolar height (UAAH) changes inversely with FHI, correlates positively with the FMA and does not correlate with PFH. Copyright © 2011. Published by Elsevier Masson SAS.

  14. Ankle joint distraction arthroplasty for severe ankle arthritis


    Xu, Yang; Zhu, Yuan; Xu, Xiang-yang


    Background Ankle distraction arthroplasty is one option for the treatment of severe ankle arthritis in young patients. The outcomes and factors predicting success in distraction arthroplasty are poorly understood. Methods From January 2011 to May 2015, 16 patients who had undergone ankle distraction arthroplasty for ankle arthritis were operated, including six males and ten females. All patients were available for analysis. The main outcome measurements included joint space on weight bearing ...

  15. Modified Dento - Alveolar Distraction Osteogenesis Technique for Rapid Canine Retraction

    Directory of Open Access Journals (Sweden)

    Sameer Patil


    Full Text Available Distraction Osteogenesis claims to reduce the duration of treatment as well aid in conservation of anchorage. With the introduction of Dento- alveolar distraction retraction of canine can now be done in about 2-3 weeks with minimal loss of anchorage and little/no root resorption. However, surgical procedure required for dento-alveolar distraction can cause significant swelling and post operative discomfort. Our small modification in the surgical procedure drastically reduces the discomfort and improves patient compliance.

  16. The effect of cleft maxillary distraction osteogenesis on the levator veli palatini and velopharyngeal function. (United States)

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


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

  17. Body armour: the effect of load, exercise and distraction on landing forces. (United States)

    Dempsey, Paddy C; Handcock, Phil J; Rehrer, Nancy J


    We investigated the effect of added load and intense exercise on jump and landing performance and ground reaction force (GRF) during landings where attentional demand was varied. Fifty-two males (37 ± 9.2 years, 180.7 ± 6.1 cm, 90.2 ± 11.6 kg, maximal aerobic fitness (VO(₂max)) 50 ± 8.5 ml (.) kg(-1 .) min(-1), BMI 27.6 ± 3.1, mean ± s) completed a VO(₂max) test. Experimental sessions were completed (≥4 days in between) in a randomised counterbalanced order, one while wearing body armour and appointments (loaded) and one without load (unloaded). A vertical jump, a drop landing concentrating on safe touchdown, a drop jump and a drop landing with an attentional distraction were performed. These were repeated 1 min after a 5-min treadmill run. Mean jump height decreased by 12% (P < 0.001) with loading and a further by 6% following the running task. Peak GRFs were increased by 13-19% with loading (P < 0.001) depending on the landing task demands and a further by 4-9% following intense exercise. The distracted drop landing had significantly higher GRFs compared to all other landings. Results demonstrate that added load impacts on jumping and landing performance, an effect that is amplified by prior intense exercise, and distraction during landing. Such increases in GRF apply to police officer performance in their duties and may increase the risk of injury.

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

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


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

  19. Management of Late Onset Perthes: Evaluation of Distraction by External Fixator—5-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Ajai Singh


    Full Text Available Background. Hip distraction in Perthes’ disease unloads the joint, which negates the harmful effect of the stresses on the articular surfaces, which may promote the sound healing of the area of necrosis. We have examined the effect of arthrodiastasis on the preservation of the femoral head in older children with Perthes’ disease. Methods and Materials. Twelve children with age more than 8 years with Perthes’ disease of less than one year were treated with hip distraction by a hinged monolateral external fixator. Observation and Results. Mean duration of distraction was 13.9 days. These children were evaluated by clinicoradiological parameters for a mean period of 32.4 months. There was a significant improvement in the range of movements and mean epiphyseal index, but the change in the percentage of uncovered head femur was insignificant. There was significant improvement in Harris Hip score. Conclusions. Hip distraction by hinged monolateral external fixator seems to be a valid treatment option in cases with Perthes’ disease in the selected group of patients, where poor results are expected from conventional treatment.

  20. Effect of virtual reality distraction on pain among patients with hand injury undergoing dressing change. (United States)

    Guo, Chunlan; Deng, Hongyan; Yang, Jian


    To assess the effect of virtual reality distraction on pain among patients with a hand injury undergoing a dressing change. Virtual reality distraction can effectively alleviate pain among patients undergoing a dressing change. Clinical research has not addressed pain control during a dressing change. A randomised controlled trial was performed. In the first dressing change sequence, 98 patients were randomly divided into an experimental group and a control group, with 49 cases in each group. Pain levels were compared between the two groups before and after the dressing change using a visual analog scale. The sense of involvement in virtual environments was measured using the Pearson correlation coefficient analysis, which determined the relationship between the sense of involvement and pain level. The difference in visual analog scale scores between the two groups before the dressing change was not statistically significant (t = 0·196, p > 0·05), but the scores became statistically significant after the dressing change (t = -30·792, p virtual environment and pain level during the dressing was statistically significant (R(2) = 0·5538, p Virtual reality distraction can effectively alleviate pain among patients with a hand injury undergoing a dressing change. Better results can be obtained by increasing the sense of involvement in a virtual environment. Virtual reality distraction can effectively relieve pain without side effects and is not reliant on a doctor's prescription. This tool is convenient for nurses to use, especially when analgesics are unavailable. © 2014 John Wiley & Sons Ltd.

  1. Subtractive fuzzy classifier based driver distraction levels classification using EEG. (United States)

    Wali, Mousa Kadhim; Murugappan, Murugappan; Ahmad, Badlishah


    [Purpose] In earlier studies of driver distraction, researchers classified distraction into two levels (not distracted, and distracted). This study classified four levels of distraction (neutral, low, medium, high). [Subjects and Methods] Fifty Asian subjects (n=50, 43 males, 7 females), age range 20-35 years, who were free from any disease, participated in this study. Wireless EEG signals were recorded by 14 electrodes during four types of distraction stimuli (Global Position Systems (GPS), music player, short message service (SMS), and mental tasks). We derived the amplitude spectrum of three different frequency bands, theta, alpha, and beta of EEG. Then, based on fusion of discrete wavelet packet transforms and fast fourier transform yield, we extracted two features (power spectral density, spectral centroid frequency) of different wavelets (db4, db8, sym8, and coif5). Mean ± SD was calculated and analysis of variance (ANOVA) was performed. A fuzzy inference system classifier was applied to different wavelets using the two extracted features. [Results] The results indicate that the two features of sym8 posses highly significant discrimination across the four levels of distraction, and the best average accuracy achieved by the subtractive fuzzy classifier was 79.21% using the power spectral density feature extracted using the sym8 wavelet. [Conclusion] These findings suggest that EEG signals can be used to monitor distraction level intensity in order to alert drivers to high levels of distraction.

  2. Speech-Language Dissociations, Distractibility, and Childhood Stuttering. (United States)

    Clark, Chagit E; Conture, Edward G; Walden, Tedra A; Lambert, Warren E


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

  3. Speech-Language Dissociations, Distractibility, and Childhood Stuttering (United States)

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


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

  4. An investigation on distraction osteogenesis in maxillofacial surgery

    Directory of Open Access Journals (Sweden)

    Fariaby J


    Full Text Available Distraction osteogenesis (DO, firstly introduced to the medical world by Russian scientist Ilizarov"nfor long bone lenghtening in orthopedics can be considered as an appropriate substitute in the treatment of"nmaxillofacial deformities. Natural events occuring during the repair of a fractured bone segment not only lead"nto the desired bone length but also prevent from the undesired disadvantages of osteotomies and bone"ngrafting. Recently a lot of investigations have been conducted to evaluate the efficacy of DO in the treatment"nof maxillofacial deformities, which in some cases have lead to successful results. In the present article a lot of"nissues in maxillofacial surgery and different treatment goals associated with DO are discussed.

  5. Administrative integration of vertical HIV monitoring and evaluation into health systems: a case study from South Africa

    Directory of Open Access Journals (Sweden)

    Mary Kawonga


    Full Text Available Background: In light of an increasing global focus on health system strengthening and integration of vertical programmes within health systems, methods and tools are required to examine whether general health service managers exercise administrative authority over vertical programmes. Objective: To measure the extent to which general health service (horizontal managers, exercise authority over the HIV programme's monitoring and evaluation (M&E function, and to explore factors that may influence this exercise of authority. Methods: This cross-sectional survey involved interviews with 51 managers. We drew ideas from the concept of ‘exercised decision-space’ – traditionally used to measure local level managers’ exercise of authority over health system functions following decentralisation. Our main outcome measure was the degree of exercised authority – classified as ‘low’, ‘medium’ or ‘high’ – over four M&E domains (HIV data collection, collation, analysis, and use. We applied ordinal logistic regression to assess whether actor type (horizontal or vertical was predictive of a higher degree of exercised authority, independent of management capacity (training and experience, and M&E knowledge. Results: Relative to vertical managers, horizontal managers had lower HIV M&E knowledge, were more likely to exercise a higher degree of authority over HIV data collation (OR 7.26; CI: 1.9, 27.4, and less likely to do so over HIV data use (OR 0.19; CI: 0.05, 0.84. A higher HIV M&E knowledge score was predictive of a higher exercised authority over HIV data use (OR 1.22; CI: 0.99, 1.49. There was no association between management capacity and degree of authority. Conclusions: This study demonstrates a HIV M&E model that is neither fully vertical nor integrated. The HIV M&E is characterised by horizontal managers producing HIV information while vertical managers use it. This may undermine policies to strengthen integrated health system

  6. Unilateral asterixis, thalamic astasia and vertical one and half syndrome in a unilateral posterior thalamo-subthalamic paramedian infarct: An interesting case report

    Directory of Open Access Journals (Sweden)

    Subasree Ramakrishnan


    Full Text Available A 42-year-old young lady presented with acute onset of dizziness, drooping of left eye with binocular diplopia and inability to walk unassisted. She had past history of uncontrolled diabetes mellitus and hypertension. On examination, she had left fascicular type of third nerve palsy, vertical one and half syndrome (VOHS, left internuclear ophthalmoplegia and skew deviation with ipsilesional hypertropia. She also had thalamic astasia and right unilateral asterixis. Her MRI revealed T2 and Flair hyper intense signal changes with restricted diffusion in the left thalamus, subthalamus and left midbrain. MR Angiography was normal. Thalamic-subthalamic paramedian territory infarct is relatively uncommon. It can present with oculomotor abnormalities including vertical one and half syndrome, skew deviation, thalamic astasia and asterixis. This case is reported for the rarity of the presenting clinical findings in unilateral thalamo-mesencephalic infarcts.

  7. When should a trophically and vertically transmitted parasite manipulate its intermediate host? The case of Toxoplasma gondii. (United States)

    Lélu, Maud; Langlais, Michel; Poulle, Marie-Lazarine; Gilot-Fromont, Emmanuelle; Gandon, Sylvain


    Parasites with complex life cycles are expected to manipulate the behaviour of their intermediate hosts (IHs), which increase their predation rate and facilitate the transmission to definitive hosts (DHs). This ability, however, is a double-edged sword when the parasite can also be transmitted vertically in the IH. In this situation, as the manipulation of the IH behaviour increases the IH death rate, it conflicts with vertical transmission, which requires healthy and reproducing IHs. The protozoan Toxoplasma gondii, a widespread pathogen, combines both trophic and vertical transmission strategies. Is parasite manipulation of host behaviour still adaptive in this situation? We model the evolution of the IH manipulation by T. gondii to study the conflict between these two routes of transmission under different epidemiological situations. Model outputs show that manipulation is particularly advantageous for virulent strains and in epidemic situations, and that different levels of manipulation may evolve depending on the sex of the IH and the transmission routes considered. These results may help to understand the variability of strain characteristics encountered for T. gondii and may extend to other trophically transmitted parasites.

  8. Salt structures and vertical axis rotations; a case study in the Barbastro-Balaguer anticline, Southern Pyrenees. (United States)

    Pueyo, Emilio L.; Oliván, Carlota; Soto, Ruth; Rodríguez-Pintó, Adriana; Santolaria, Pablo; Luzón, Aránzazu; Casas, Antonio M.; Ayala, Conxi


    Vertical axis rotations are common in all deformation settings. At larger scales, for example in fold and thrust belts, they are usually related to differential shortening along strike and this may be caused by a number of reasons (interplay of plate boundaries, sedimentary wedges, detachment level distribution, etc.). At smaller scales, local stress fields, interference of non-coaxial deformation phases, development of non-cylindrical structures, etc. may play an important role to accommodate significant magnitudes of rotation. Apart from their implication in the truly 4D understanding of geological structures, the occurrence of vertical axis rotation usually precludes the application of most 3D restoration techniques and thus, increases the uncertainty in any 3D reconstruction. Salt structures may form in different geological settings, but focusing on compressive regimes, very little is known about the relation between their geometry and kinematics and their ability to accommodate vertical axis rotations (i.e. local or regional lateral gradients of shortening). The Barbastro-Balaguer anticline (BBA) is the southernmost structure of the Central Pyrenees. It is a large detachment fold spreading more than 150 km along the front. In contrast to most frontal Pyrenean structures, the BBA is detached in Priabonian evaporites and was folded during Oligocene times as witnessed by well exposed growth strata. Along strike changes in the fold axis trend may reach 50°, an overall the anticline displays a convex shape towards the foreland (south). A residual Bouguer anomaly map based on a densely sampled gravimetric surveying (10.000 stations) has helped delineating a heterogeneous distribution of the Eocene detachment level in the subsurface. In this contribution we explore the interplay between vertical axis rotations, detachment level distribution and the fold geometry (structural trend and style based on hundreds of data). Seventy paleomagnetic sites evenly and densely

  9. Distraction as a measure of presence

    DEFF Research Database (Denmark)

    Nordahl, Rolf; Korsgaard, Dannie


    ) to determine presence as immersion (Lombard and Ditton in At the heart of it all: the concept of presence, Department of Broadcasting, Telecommunications and Mass Media, Temple University, 1997) at selectable events (approximated real-time). Two experiments were conducted to investigate its applicability...... not proportional. We suspect that this was caused by the great variance found across the test participants' thresholds of perceivable vibration. Because of this, it is suggested that a thorough screening process is conducted pre-test if the AD method should apply vibration as the distracting stimulus....

  10. Mild Cognitive Impairment and driving: Does in-vehicle distraction affect driving performance? (United States)

    Beratis, Ion N; Pavlou, Dimosthenis; Papadimitriou, Eleonora; Andronas, Nikolaos; Kontaxopoulou, Dionysia; Fragkiadaki, Stella; Yannis, George; Papageorgiou, Sokratis G


    In-vehicle distraction is considered to be an important cause of road accidents. Drivers with Mild Cognitive Impairment (MCI), because of their attenuated cognitive resources, may be vulnerable to the effects of distraction; however, previous relevant research is lacking. The main objective of the current study was to explore the effect of in-vehicle distraction on the driving performance of MCI patients, by assessing their reaction time at unexpected incidents and accident probability. Thirteen patients with MCI (age: 64.5±7.2) and 12 cognitively intact individuals (age: 60.0±7.7), all active drivers were introduced in the study. The driving simulator experiment included three distraction conditions: (a) undistracted driving, (b) conversing with passenger and (c) conversing through a hand-held mobile phone. The mixed ANOVA models revealed a greater effect of distraction on MCI patients. Specifically, the use of mobile phone induced a more pronounced impact on reaction time and accident probability in the group of patients, as compared to healthy controls. On the other hand, in the driving condition "conversing with passenger" the interaction effects regarding reaction time and accident probability were not significant. Notably, the aforementioned findings concerning the MCI patients in the case of the mobile phone were observed despite the effort of the drivers to apply a compensatory strategy by reducing significantly their speed in this driving condition. Overall, the current findings indicate, for the first time, that a common driving practice, such as the use of mobile phone, may have a detrimental impact on the driving performance of individuals with MCI. Copyright © 2017. Published by Elsevier Ltd.

  11. 77 FR 15398 - Attentive Driving: Countermeasures for Distraction Forum (United States)


    ... SAFETY BOARD Attentive Driving: Countermeasures for Distraction Forum The National Transportation Safety Board (NTSB) will convene a forum, Attentive Driving: Countermeasures for Distraction, which will begin... the forum, and all five NTSB Board Members will serve as members of the Board of Inquiry. The forum is...

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

    NARCIS (Netherlands)

    Baas, E.M.


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

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

    African Journals Online (AJOL)

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

  14. Microvascular soft tissue changes in alveolar distraction osteogenesis

    NARCIS (Netherlands)

    Lindeboom, Jerome A.; Mathura, Keshen R.; Milstein, Dan M. J.; Ince, Can


    Objective. The aim of the study was to quantify the effect of distraction osteogenesis on the changes in vascular density in the human oral mucosa. Material and methods. Alveolar distraction was performed in 10 patients with alveolar ridge deficiencies, while in the contralateral nondistracted site

  15. Lower Face Asymmetry: Can We Distract the Mandibular Lower Border?


    Rao, Santhosh; Rao, Sruthi


    Orthognathic surgery and alloplastic grafting are the main stay in management in hemifacial microsomia. Distraction osteogenesis is used to increase the ramus and corpus length in the management, but here we have described a technique to increase the height of the body of the mandible using the principles of basal osteotomy and distraction osteogenesis.

  16. Lower Face Asymmetry: Can We Distract the Mandibular Lower Border? (United States)

    Rao, Santhosh; Rao, Sruthi


    Orthognathic surgery and alloplastic grafting are the main stay in management in hemifacial microsomia. Distraction osteogenesis is used to increase the ramus and corpus length in the management, but here we have described a technique to increase the height of the body of the mandible using the principles of basal osteotomy and distraction osteogenesis. PMID:26576240

  17. Implementation Intentions and Test Anxiety: Shielding Academic Performance from Distraction (United States)

    Parks-Stamm, Elizabeth J.; Gollwitzer, Peter M.; Oettingen, Gabriele


    College students whose test anxiety was measured completed a working memory-intensive math exam with televised distractions. Students were provided with implementation intentions (if-then plans; Gollwitzer, 1999) designed to either help them ignore the distractions (i.e., temptation-inhibiting plans) or focus more intently on the math exam (i.e.,…

  18. Interference by Process, Not Content, Determines Semantic Auditory Distraction (United States)

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


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

  19. Prediction of cartilaginous tissue repair after knee joint distraction

    NARCIS (Netherlands)

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


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

  20. Role of lumbar interspinous distraction on the neural elements. (United States)

    Alfieri, Alex; Gazzeri, Roberto; Prell, Julian; Scheller, Christian; Rachinger, Jens; Strauss, Christian; Schwarz, Andreas


    The interspinous distraction devices are used to treat variable pathologies ranging from facet syndrome, diskogenic low back pain, degenerative spinal stenosis, diskopathy, spondylolisthesis, and instability. The insertion of a posterior element with an interspinous device (ISD) is commonly judged responsive to a relative kyphosis of a lumbar segment with a moderate but persistent increase of the spinal canal and of the foraminal width and area, and without influence on low-grade spondylolisthesis. The consequence is the need of shared specific biomechanical concepts to give for each degenerative problem the right indication through a critical analysis of all available experimental and clinical biomechanical data. We reviewed systematically the available clinical and experimental data about kyphosis, enlargement of the spinal canal, distraction of the interspinous distance, increase of the neural foramina, ligamentous structures, load of the posterior annulus, intradiskal pressure, strength of the spinous processes, degeneration of the adjacent segment, complications, and cost-effectiveness of the ISD. The existing literature does not provide actual scientific evidence over the superiority of the ISD strategy, but most of the experimental and clinical data show a challenging potential. These considerations are applicable with different types of ISD with only few differences between the different categories. Despite--or because of--the low invasiveness of the surgical implantation of the ISD, this technique promises to play a major role in the future degenerative lumbar microsurgery. The main indications for ISD remain lumbar spinal stenoses and painful facet arthroses. A clear documented contraindication is the presence of an anterolisthesis. Nevertheless, the existing literature does not provide evidence of superiority of outcome and cost-effectiveness of the ISD strategy over laminectomy or other surgical procedures. At this time, the devices should be used in

  1. Internal distraction plating of distal radius fractures. (United States)

    Papadonikolakis, Anastasios; Ruch, David S


    Internal distraction plating can be used for the treatment of highly comminuted distal radius fractures especially in elderly patients. The technique involves the use of 3.5, 2.7, or 2.5 dynamic compression plates. The instrumentation is applied in distraction dorsally from the radial diaphysis, bypassing the comminuted segment, and fixed distally to the long metacarpal. The advantages of this technique are: a) it can be used as an alternative for managing difficult fractures in the elderly population; b) it is indicated in patients with osteoporotic bone; c) complications associated with external pins are avoided; and d) the stability of the plate allows patients to use the extremity for transfer and activities of daily living. On the other hand, possible disadvantages to be considered are: a) the need of a second operation to remove the plate; and b) the prolonged duration of immobilization. Elderly patients with osteoporotic bone who undergo treatment of comminuted distal radius fractures may result in poor outcomes with high rates of complications if external fixation or standard internal fixation is used. The current approach represents an alternative that provides union of the fracture with excellent alignment, functional range of motion, and minimal functional disability.

  2. Nicotine reduces distraction under low perceptual load. (United States)

    Behler, Oliver; Breckel, Thomas P K; Thiel, Christiane M


    Several studies provide evidence that nicotine alleviates the detrimental effects of distracting sensory stimuli. It is been suggested that nicotine may either act as a stimulus filter that prevents irrelevant stimuli entering awareness or by enhancing the attentional focus to relevant stimuli via a boost in processing capacity. To differentiate between these two accounts, we administered nicotine to healthy non-smokers and investigated distractor interference in a visual search task with low and high perceptual load to tax processing capacity. Thirty healthy non-smokers received either 7 mg transdermal nicotine or a matched placebo in a double blind within subject design 1 h prior to performing the visual search task with different fixation distractors. Nicotine reduced interference of incongruent distractors, but only under low-load conditions, where distractor effects were large. No effects of nicotine were observed under high-load conditions. Highly distractible subjects showed the largest effects of nicotine. The findings suggest that nicotine acts primarily as a stimulus filter that prevents irrelevant stimuli from entering awareness in situations of high distractor interference.

  3. Reconstruction of mandibular vertical defects for dental implants with autogenous bone block grafts using a tunnel approach: clinical study of 50 cases. (United States)

    Restoy-Lozano, A; Dominguez-Mompell, J L; Infante-Cossio, P; Lara-Chao, J; Espin-Galvez, F; Lopez-Pizarro, V


    The objective of this study was to evaluate the outcomes of mandibular vertical defect reconstruction with autologous bone and the use of a sub-periosteal tunnel approach in preparation for dental implant insertion. Forty-three consecutive patients with an atrophic posterior mandible were reconstructed using this method. Two thin laminae of cortical bone, obtained by splitting blocks harvested from the retromolar area, were fixed in a box-like framework containing cancellous and particulate bone. The goal was to achieve an alveolar ridge width of ≥5.5mm and an effective bone height (EBH) of ≥10.5mm for dental implant insertion (≥3.4mm diameter, ≥9.5mm length). Fifty reconstruction procedures were performed. The mean EBH was 7.1±1.3mm pre-treatment and 12.3±1.1mm post-treatment (mean increase 5.2±1.4mm). Complete graft loss was recorded in two cases; the remaining complications were minor. After a mean consolidation period of 3.5 months, 96 dental implants were placed. No failure of osseointegration was observed at follow-up (mean 32.9 months). The average bone height reduction was 0.9mm (graft vertical resorption 17.4%). Reconstruction of posterior mandibular vertical defects using two autogenous cortical bone blocks with particulate bone between them, combined with a tunnelling technique, provided good healing with no wound dehiscence and minimum resorption of the grafted bone, favouring a substantial vertical bone gain. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. Thoracolumbar spine clearance: Clinical examination for patients with distracting injuries. (United States)

    Cason, Ben; Rostas, Jack; Simmons, Jon; Frotan, Mohammed A; Brevard, Sidney B; Gonzalez, Richard P


    The purpose of this study was to prospectively assess the sensitivity of clinical examination to screen for thoracolumbar spine (TLS) injury in awake and alert blunt trauma patients with distracting injuries. From December 2012 to June 2014, all blunt trauma patients older than 13 years were prospectively evaluated as per standard TLS examination protocol at a Level 1 trauma center. Awake and alert patients with Glasgow Coma Scale (GCS) score of 14 or greater underwent clinical examination of the TLS. Clinical examination was performed regardless of distracting injuries. Patients with no complaints of pain or tenderness on examination of the TLS were considered clinically cleared of injury. Patients with distracting injuries, including those clinically cleared and those with complaints of TLS pain or tenderness, underwent computed tomographic scan of the entire TLS. Patients with minor distracting injuries were not considered to have a distracting injury. A total of 950 blunt trauma patients were entered, 530 (56%) of whom had at least one distracting injury. Two hundred nine patients (40%) with distracting injuries had a positive TLS clinical examination result, of whom 50 (25%) were diagnosed with TLS injury. Three hundred twenty-one patients (60%) with distracting injuries were initially clinically cleared, in whom 17 (5%) TLS injuries were diagnosed. There were no missed injuries that required surgical intervention, with only four injuries receiving TLS orthotic bracing. This yielded an overall clinical clearance sensitivity for injury of 75% and sensitivity for clinically significant injury of 89%. In awake and alert blunt trauma patients with distracting injuries, clinical examination is a sensitive screening method for significant TLS injury. Radiologic assessment may be unnecessary for safe clearance of the asymptomatic TLS in patients with distracting injuries. These findings suggest significant potential reduction of both health care cost and patient

  5. Distracted walking: cell phones increase injury risk for college pedestrians. (United States)

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


    Distraction on cell phones jeopardizes motor-vehicle driver safety, but few studies examine distracted walking. At particular risk are college students, who walk frequently in and near traffic, have increased pedestrian injury rates compared to other age groups, and frequently use cell phones. Using an interactive and immersive virtual environment, two experiments studied the effect of cell phone conversation on distraction of college student pedestrians. In the first, we examined whether pedestrians would display riskier behavior when distracted by a naturalistic cell phone conversation than when undistracted. We also considered whether individual difference factors would moderate the effect of the distraction. In a second experiment, we examined the impact of three forms of distraction on pedestrian safety: (a) engaging in a cell phone conversation, (b) engaging in a cognitively challenging spatial task by phone, and (c) engaging in a cognitively challenging mental arithmetic task by phone. Results revealed that cell phone conversations distracted college pedestrians considerably across all pedestrian safety variables measured, with just one exception. Attention to traffic was not affected by the naturalistic phone conversation in Experiment 1, but was altered by the cognitively-demanding content of some types of conversation in Experiment 2. The content of the conversation did not play a major role in distraction across other variables; both mundane and cognitively complex conversations distracted participants. Moreover, no significant associations between individual difference factors and susceptibility to distraction emerged. Results may inform researchers, policy makers, and pedestrians themselves. Educational campaigns might discourage telephone conversations in pedestrian environments. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Management of obstructive sleep apnea syndrome secondary to temporomandibular joint ankylosis by mandibular elongation using distraction osteogenesis

    Directory of Open Access Journals (Sweden)

    Yadavalli Guruprasad


    Full Text Available Obstructive sleep apnea syndrome (OSAS is associated with repetitive nocturnal upper airway obstruction leading to daytime sleepiness, cardiovascular derangements, and can be a debilitating, even life-threatening condition. The most favorable treatment for patients with OSAS is multidisciplinary care by a team that represents various dental and medical disciplines. Prescribed therapies might include weight loss, behavior modification, oral appliances, soft tissue surgery, skeletal surgery, or some combination of approaches. Osteogenesis by mandibular distraction has proved effective in children in the treatment of obstructive apnea syndrome associated with congenital malformations. In the adult, the possibility of using distraction osteogenesis in the management of OSAS remains to be defined. We report a case of an adult patient treated for OSAS secondary to temporomandibular joint ankylosis by mandibular distraction followed by interpositional arthroplasty.

  7. Combined simultaneous distraction osteogenesis of the maxilla and mandible using a single distraction device in hemifacial microsomia. (United States)

    Vu, H L; Panchal, J; Levine, N


    Facial asymmetry in hemifacial microsomia can be corrected by an effective procedure of gradual distraction of the mandible. In younger children with deciduous dentition, changes in dental occlusion secondary from mandibular distraction can be easily corrected with orthodontic treatment. In older patients, mandibular elongation through distraction osteogenesis can produce good aesthetics but can create a severe alteration in occlusion requiring complex orthodontic treatment during an extended period. A Le Fort I osteotomy was performed simultaneously with mandibular corticotomy to avoid this problem. We present an 11-year-old patient with grade II hemifacial microsomia with facial asymmetry that was corrected with a combined simultaneous distraction of the maxilla and mandible using a single mandibular distraction device and an interdental splint. Excellent facial symmetry was achieved while maintaining preexisting dental occlusion.

  8. Distraction osteogenesis versus bilateral sagittal split osteotomy for advancement of the retrognathic mandible : a review of the literature

    NARCIS (Netherlands)

    Schreuder, W. H.; Jansma, J.; Bierman, M. W. J.; Vissink, A.

    Bilateral sagittal split osteotomy (BSSO) and distraction osteogenesis (DO) are the most common techniques currently applied to surgically correct mandibular retrognathia. It is the responsibility of the maxillofacial surgeon to determine the optimal treatment option in each individual case. The aim

  9. 2D and 3D resistivity inversion of Schlumberger vertical electrical soundings in Wadi El Natrun, Egypt: A case study (United States)

    Khalil, Mohamed A.; Santos, Fernando A. Monteiro


    The Wadi El Natrun area is characterized by a very complicated geological and hydrogeological system. 45 vertical electrical soundings (Schlumberger array) were measured in the study area to elucidate the peculiarity of this unique regime, specifically the nature of waterless area. 2D and 3D resistivity inversion based on the finite element technique and regularization method were applied on the data set. 2D and 3D model resolution was investigated through the use of the Depth and Volume of Investigation Indexes. A very good matching was found between the zones of high resistivity, the waterless area, and the non-productive wells. The low resistivity zones (corresponding to Lower Pliocene clay) were also identified. The middle resistivity fresh water aquifer zones were recognized. Available results can assist in the aquifer management by selecting the most productive zone of groundwater.

  10. Intraoral vertical ramus osteotomy improved the stomatognathic function in an elderly patient with mandibular protrusion: a case report. (United States)

    Ishihara, Yoshihito; Kuroda, Shingo; Kawanabe, Noriaki; Takano-Yamamoto, Teruko; Yamashiro, Takashi


    This article reports the successful surgical-orthodontic treatment of an elderly patient with dentofacial deformity and signs and symptoms of temporomandibular disorder (TMD). The patient was a 63-year-old woman with a concave profile due to mandibular protrusion. To correct skeletal deformities, the mandible was posteriorly repositioned by employing intraoral vertical ramus osteotomy (IVRO) following presurgical orthodontic treatment. After active treatment for 31 months, the facial profile was significantly improved and satisfactory occlusion was achieved. In addition, TMD symptoms of clicking sounds on the left side and difficulty in mouth opening were resolved. Regarding the findings of magnetic resonance imaging, anterior disc displacement in the opening phase was improved in the temporomandibular joint on the left side. Furthermore, stomatognathic functions were also improved without any aggravation of age-related problems. In conclusion, surgical repositioning of the mandible using IVRO leads to both morphological and functional improvements even in elderly patients.

  11. Landslide Susceptibility Mapping in Vertical Distribution Law of Precipitation Area: Case of the Xulong Hydropower Station Reservoir, Southwestern China

    Directory of Open Access Journals (Sweden)

    Chen Cao


    Full Text Available This study focused on landslide susceptibility analysis mapping of the Xulong hydropower station reservoir, which is located in the upstream of Jinsha River, a rapidly uplifting region of the Tibetan Plateau region. Nine factors were employed as landslide conditioning factors in landslide susceptibility mapping. These factors included the slope angle, slope aspect, curvature, geology, distance-to-fault, distance-to-river, vegetation, bedrock uplift and annual precipitation. The rapid bedrock uplift factor was represented by the slope angle. The eight factors were processed with the information content model. Since this area has a significant vertical distribution law of precipitation, the annual precipitation factor was analyzed separately. The analytic hierarchy process weighting method was used to calculate the weights of nine factors. Thus, this study proposed a component approach to combine the normalized eight-factor results with the normalized annual precipitation distribution results. Subsequently, the results were plotted in geographic information system (GIS and a landslide susceptibility map was produced. The evaluation accuracy analysis method was used as a validation approach. The landslide susceptibility classes were divided into four classes, including low, moderate, high and very high. The results show that the four susceptibility class ratios are 12.9%, 35.06%, 34.11%and 17.92% of the study area, respectively. The red belt in the high elevation area represents the very high susceptibility zones, which followed the vertical distribution law of precipitation. The prediction accuracy was 85.74%, which meant that the susceptibility map was confirmed to be reliable and reasonable. This susceptibility map may contribute to averting the landslide risk in the future construction of the Xulong hydropower station.

  12. On the complexity of the boundary layer structure and aerosol vertical distribution in the coastal Mediterranean regions: a case study

    Directory of Open Access Journals (Sweden)

    Giandomenico Pace


    Full Text Available The planetary boundary layer structure in the coastal areas, and particularly in complex orography regions such as the Mediterranean, is extremely intricate. In this study, we show the evolution of the planetary boundary layer based on in situ airborne measurements and ground-based remote sensing observations carried out during the MORE (Marine Ozone and Radiation Experiment campaign in June 2010. The campaign was held in a rural coastal Mediterranean region in Southern Italy. The study focuses on the observations made on 17 June. Vertical profiles of meteorological parameters and aerosol size distribution were measured during two flights: in the morning and in the afternoon. Airborne observations were combined with ground-based LIDAR, SODAR, microwave and visible radiometer measurements, allowing a detailed description of the atmospheric vertical structure. The analysis was complemented with data from a regional atmospheric model run with horizontal resolutions of 12, 4 and 1 km, respectively; back-trajectories were calculated at these spatial resolutions. The observations show the simultaneous occurrence of dust transport, descent of mid-tropospheric air and sea breeze circulation on 17 June. Local pollution effects on the aerosol distribution, and a possible event of new particles formation were also observed. A large variability in the thermodynamical structure and aerosol distribution in the flight region, extending by approximately 30 km along the coast, was found. Within this complex, environment-relevant differences in the back-trajectories calculated at different spatial resolutions are found, suggesting that the description of several dynamical processes, and in particular the sea breeze circulation, requires high-resolution meteorological analyses. The study also shows that the integration of different observational techniques is needed to describe these complex conditions; in particular, the availability of flights and their timing

  13. Soft-tissue profile changes following early Le Fort III distraction in growing children with syndromic craniosynostosis. (United States)

    Shetye, Pradip R; Caterson, Edward J; Grayson, Barry H; McCarthy, Joseph G


    The purpose of this study was to characterize soft-tissue profile changes following Le Fort III (midface) distraction in growing patients with syndromic craniosynostosis. The cohort consisted of 20 syndromic patients who underwent Le Fort III osteotomy with midface advancement using a rigid external distraction device. The mean age at surgery was 5.7 years (range, 3 to 12.5 years). Lateral cephalograms were obtained preoperatively (time 1), after distraction device removal (time 2), and 1 year after distraction (time 3). Ten skeletal hard-tissue and 11 soft-tissue profile landmarks were identified and digitized at time points 1, 2, and 3. The x and y displacement of each landmark was studied to determine the ratios for soft- to hard-tissue change. The horizontal ratio of soft- to hard-tissue change for nasal dorsum to orbitale was 0.73:1 and the soft-tissue tip of nose to the anterior nasal spine was 0.86:1. The horizontal ratio of soft-tissue A point to hard-tissue A point was 0.88:1. The horizontal ratio of the upper lip position to the labial surface of maxillary incisor was 0.88:1. The ratio for nasal tip elevation to the anterior nasal spine advancement was 0.27:1. The result of this study supported the hypothesis that there exists a linear relationship between soft- and hard-tissue changes in the horizontal direction for the midface landmarks following Le Fort III distraction. However, there was a nonlinear relationship between soft- and hard-tissue changes in the vertical direction. Therapeutic, IV.

  14. Distracted Pedestrian Behavior on two Urban College Campuses. (United States)

    Wells, Hayley L; McClure, Leslie A; Porter, Bryan E; Schwebel, David C


    Pedestrian injuries injure about 180,000 individuals and kill 6000 each year in the United States, and pedestrian injury rates have increased each of the last several years. Distracted pedestrian behavior may play a role in the trend of increasing risk for pedestrian injury. Using in vivo behavioral coding over the course of  two weeks on two urban college campuses, this study aimed to (1) understand the type and rate of distractions engaged in by pedestrians on urban college campuses, and (2) investigate the impact of distraction on street-crossing safety and behavior. A total of 10,543 pedestrians were observed, 90% of them young adults. Over one-third of those pedestrians were distracted while actively crossing roadways. Headphones were the most common distraction (19% of all pedestrians), followed by text-messaging (8%) and talking on the phone (5%). Women were more likely to text and talk on the phone than men, and men were more likely to be wearing headphones. Distracted pedestrians were somewhat less likely to look for traffic when they entered roadways. As handheld device usage continues to increase, behavioral interventions should be developed and implemented. Changes to policy concerning distracted pedestrian behavior, including improvement of the built environment to reduce pedestrian risk, should be considered in busy pedestrian areas like urban college campuses.

  15. Distraction of clinicians by smartphones in hospitals: a concept analysis. (United States)

    McBride, Deborah L


    To report an analysis of the concept of distraction of clinicians by smartphones and other mobile devices in hospitals. In the healthcare literature, the concept of distraction of clinicians by smartphones and other mobile devices in hospitals has no consistent definition. Concept analysis. Journal articles published from 2003-2014. Rodgers' Evolutionary Concept Analysis Method was used to analyse the concept of distraction of clinicians by smartphones and other mobile devices in hospitals. This analysis led to a definition of distraction of clinicians by smartphones as the interruption of a hospital clinician's primary task by the internally or externally initiated use of their smartphone or other mobile device. There are six attributes of distraction by smartphones and other mobile devices in hospitals. These attributes are: (1) an experience by a clinician; (2) an intrusion into a primary clinical task; (3) discontinuity of the clinical task; (4) externally or internally initiated; (5) situated in a healthcare setting; and (6) mediated by a smartphone or other mobile device. Use of the definition and the defining attributes of distraction of clinicians by smartphones will increase the validity and reliability of future studies. It will be extended to form a classification system of distractions within a framework of clinical practice, which will be used to unify and standardize future research studies. © 2015 John Wiley & Sons Ltd.

  16. Experimental model of distraction osteogenesis in edentulous rats

    Directory of Open Access Journals (Sweden)

    Maria Montserrat Pujadas Bigi


    Full Text Available Distraction osteogenesis (DO is a surgical technique producing bone lengthening by distraction of the fracture callus. Although a large number of experimental studies on the events associated with DO of craniofacial skeleton have been reported, the few employing rat mandibular bone DO used complicated designs and produced a small volume of newly formed bone. Thus, this study aims to present an original experimental model of mandibular DO in edentulous rats that produces a sufficient quantity and quality of intramembranous bone. Eight male Wistar rats, weighing 75 g, underwent extraction of lower molars. With rats weighing 350 g, right mandibular osteotomy was performed and the distraction device was placed. The distraction device was custom made using micro-implants, expansion screws, and acrylic resin. Study protocol: latency: 6 days, distraction: ¼ turn (0.175 mm once a day during 6 d, consolidation: 28 d after distraction phase, sacrifice. DO-treated and contralateral hemimandibles were dissected and compared macroscopically and using radiographic studies. Histological sections were obtained and stained with H&E. A distraction gap filled with newly formed and mature bone tissue was obtained. This model of mandibular DO proved useful to obtain adequate quantity and quality of bone to study bone regeneration.

  17. Get the Message: A Teen Distracted Driving Program. (United States)

    Adeola, Ruth; Omorogbe, Ashleigh; Johnson, Abree

    Elimination of distracted driving is becoming a public health priority. Each day, an average of 8 people are killed due to a distracted driver in the United Sates. Although all drivers are at risk, research has indicated that teenage drivers are overrepresented in motor vehicle crashes due to distracted driving. Teenage drivers are hindered by limited driving experience, and the illusion of invincibility is a common phase in social and cognitive adolescent development. "Get the Message: A Teenage Distracted Driving Program" was established at the R Adams Cowley Shock Trauma Center to identify, define, and measure the factors that contribute to distracted driving in teens. A convenience sample of 1,238 teenagers in this study represented all 50 states in the United States, the District of Columbia, Puerto Rico, Canada, and 21 other countries. At the beginning of each program, a presurvey is administered to assess baseline behavior, attitude, and knowledge regarding distracted driving. After completing the program, teens complete a postsurvey to measure proposed changes in driving behaviors, attitude, and knowledge. The program employs the use of a slide presentation, hospital tour, video, and survivor's testimony to influence teen driving behaviors and increase knowledge. Research has indicated that an increase in the Health Belief Model constructs may enhance engagement in health-promoting behaviors, such as safe driving practices in teens. Based on the postsurvey results, the reduction in projected phone use while driving in this teen population indicates the effectiveness of this hospital-based teen distracted driving program.

  18. Effects of distraction on the development of satiety. (United States)

    Brunstrom, Jeffrey M; Mitchell, Gemma L


    Two experiments explored the hypothesis that distraction causes a reduced sensitivity to the physiological and sensory cues that signal when to terminate a meal. In Experiment 1, eighty-eight females ate five 'Jaffa Cakes' either while distracted by a computer game or while sitting in silence. Analysis of the difference in rated hunger, fullness and desire to eat (pre- to post-intake) revealed that distracted participants experienced smaller changes in their desire to eat and fullness than did non-distracted participants. Experiment 2 assessed whether changes in ratings are attenuated because sensory-specific satiety (or a related process) fails to develop. Using a similar procedure, eighty-four females provided desire to eat, pleasantness and intensity ratings for Jaffa Cakes and for two 'uneaten' foods, both before and at three time-points after consuming five Jaffa Cakes. Non-distracted participants reported a reduction in their desire to eat the eaten food relative to the uneaten food (food-specific satiety), whereas distracted participants maintained a desire to eat all foods. Moreover, this difference between distracted and non-distracted participants was evident 5 and 10 min after the eating episode had terminated. The present findings invite speculation that distraction attenuates the development of sensory-specific satiety, and that this effect persists (at least for a brief period) after the distractor has terminated. More generally, this kind of phenomenon warrants further scrutiny because it holds the potential to contribute towards overeating, either by prolonging an eating episode or by reducing the interval between meals.

  19. Conundrum on magmatic reservoir of Soufriere Hills volcano, Montserrat: enigmatic evidence and the case for a vertically-elongated reservoir (United States)

    Voight, B.; Widiwijayanti, C.; Mattioli, G.; Ammon, C.; Elsworth, D.; Foroozan, R.; Hidayat, D.; Humphreys, M.; Minshull, T.; Paulatto, M.; Shalev, E.; Sparks, S.


    the strongest constraints on reservoir details may be GPS imaging, with the most complete data sets (10 sites) post-2003. We examine the merits of a stratified single vertically-elongated crustal reservoir with top below 5km and centroid near 9 or 10km, supplied by a deep factory for hydrous andesites fractionated from mafic magma (with minor magma mixing) near the crust-mantle boundary. This model is an alternative to some others with simpler geometry that have been proposed. Deep reflections that might be Moho are revealed at ~10s (~30km) in SEA-CALIPSO shot gathers. The vertical reservoir elongation is supported by some GPS data (e.g., 2003- 05), which display a central dimple of vertical displacement. The upper part of the reservoir contains crystal- rich, highly viscous, gas-saturated, compressible, rhyolitic melt (similar to erupted lava), overlying a lower part of crystal-poor less-viscous hydrous andesite. The model is consistent with both mineralogical constraints indicating shallow storage of erupted lava, GPS indications of a deeper mean-pressure source when the full reservoir expands or contracts, and magma budget anomalies. The presence of an exsolved gas phase greatly increases magma compressibility and suggests that most of the magma volume transferred into or out of the reservoir is accommodated by compression or decompression of stored reservoir magma.

  20. Isolated Subtalar Distraction Arthrodesis Using Porous Tantalum: A Pilot Study. (United States)

    Papadelis, Eustratios A; Karampinas, Panagiotis K; Kavroudakis, Eustratios; Vlamis, John; Polizois, Vasilios D; Pneumaticos, Spiros G


    During reconstructive procedures of the hindfoot, a structural graft is often needed to fill gaps. To eliminate donor site morbidity and limited availability of autografts, porous tantalum was used. Eighteen patients who underwent subtalar joint distraction arthrodesis by means of trabecular metal augment were reviewed retrospectively. The results were evaluated clinically, with the American Orthopaedic Foot & Ankle Society (AOFAS) score and the visual analog scale (VAS) for pain, and were assessed radiologically. The mean follow-up period was 18 months. Computed tomography showed sound fusion. There was a marked increase in AOFAS scores and a decrease in VAS scores. Arthrodesis was achieved in all cases with no major postoperative complications. Radiographically, there was a marked increase in all measured parameters (talocalcaneal angle, talocalcaneal height, talar declination angle), and the intraoperatively achieved correction was maintained at the last follow-up visit. Our data suggest that porous tantalum may be used as a structural graft option for subtalar arthrodesis. Level IV, retrospective case series. © The Author(s) 2015.

  1. A research framework for studying transit bus driver distraction. (United States)


    The increase in transit bus ridership nationally during the past ten years, along with the : proliferation of personal electronic control and communication gadgets is causing more : distractions for the drivers. Earlier research studies have found dr...

  2. Complications in bilateral mandibular distraction osteogenesis using internal devices

    NARCIS (Netherlands)

    van Strijen, P. J.; Breuning, K. H.; Becking, A. G.; Perdijk, F. B. T.; Tuinzing, D. B.


    We sought to evaluate the possibility of distraction osteogenesis as an alternative to conventional bilateral sagittal split osteotomy. Complications (intraoperative, intradistraction, and postdistraction) were evaluated retrospectively. Seventy consecutive patients (40 males and 30 females,

  3. Distracted driving due to visual working memory load. (United States)


    In an attempt to understand the : specific mechanism by which distractions (such as cell : - : phone use) can interfere with : driving, this work tested the idea that driving performance depends on available space within visual short : - : term memor...

  4. Wavelet Packet Transform Based Driver Distraction Level Classification Using EEG


    Mousa Kadhim Wali; Murugappan Murugappan; Badlishah Ahmmad


    We classify the driver distraction level (neutral, low, medium, and high) based on different wavelets and classifiers using wireless electroencephalogram (EEG) signals. 50 subjects were used for data collection using 14 electrodes. We considered for this research 4 distraction stimuli such as Global Position Systems (GPS), music player, short message service (SMS), and mental tasks. Deriving the amplitude spectrum of three different frequency bands theta, alpha, and beta of EEG signals was ba...

  5. The influence of various distracting stimuli on spatial working memory


    Martina Starc; Grega Repovš


    Protecting information from distraction is essential for optimal performance of working memory. We examined how the presence of distracting stimuli influences spatial working memory and compared the effect of both task-similar and negatively emotionally salient distractors. We checked the effect of distractors on the accuracy of high-resolution representations, as well as the maintenance of spatial categories, and more precisely defined not only the existence but also the direction of the dis...

  6. Distracted pedestrian sustains orbital fracture while on cell phone


    Edell, Aim?e R; Jung, Jesse J; Solomon, Joel M; Palu, Richard N


    Aimée R Edell, Jesse J Jung, Joel M Solomon, Richard N Palu Department of Ophthalmology, New York University School of Medicine, New York, NY, USA Abstract: Use of cell phones in the general population has become increasingly commonplace. The distracting effects of cell phones among automobile drivers are well established, and legislation prohibits the use of handheld cell phones while driving in several states. Recent research has focused on the similar distracting effects of cel...

  7. Implementation intentions and test anxiety: Shielding academic performance from distraction


    Parks-Stamm, Elizabeth J.; Gollwitzer, Peter M.; Oettingen, Gabriele


    College students whose test anxiety was measured completed a working memory-intensive math exam with televised distractions. Students were provided with implementation intentions (if-then plans; Gollwitzer, 1999) designed to either help them ignore the distractions (i.e., temptation-inhibiting plans) or focus more intently on the math exam (i.e., task-facilitating plans). Regression analyses showed that as test anxiety increased, the effectiveness of temptation-inhibiting implementation inten...

  8. Early treatment of severe mandibular hypoplasia with distraction mesenchymogenesis and bilateral free fibula flaps. (United States)

    Stelnicki, E J; Boyd, J B; Nott, R L; Barnavon, Y; Uecker, C; Henson, T


    The technique of distraction has revolutionized the treatment of mandibular hypoplasia; however, presently large mandibular defects still require bone grafts. Microvascular grafting is commonly used in adults. Conversely, in pediatric reconstruction, nonvascularized rib grafts remain standard. Unfortunately, resorption of nonvascularized bone remains a major issue, particularly when soft tissue is hypoplastic. This case study represents a combination of techniques in the treatment of severe mandibular deficiency, and introduces the concept of distraction mesenchymogenesis. The patient was a 2 1/2-year-old boy with severe bilateral Pruzansky class III mandibular hypoplasia. He had a permanent open mouth posture, an overjet of 23 mm, and was unable to move the lower mandibular segment. His oropharyngeal airway diameter was 2.2 mm and he was tracheostomy dependent. The patient was treated with distraction of the lower jaw mesenchyme followed by bilateral functional free fibular microvascular flaps containing reinnervated muscle. This created a well-vascularized body, ramus, and condyle bilaterally within an adequate soft-tissue envelope. Postoperatively, the overjet was reduced to 5 mm. The patient can now actively move his mandible. Airway diameter increased to 10 mm, and the patient is able to tolerate intermittent tracheostomy plugging. This innovative combination of techniques allows early intervention, limits graft resorption, and improves airway control.

  9. Effect of platelet-rich plasma in alveolar distraction osteogenesis: a controlled clinical trial. (United States)

    Menezes, Diogo J B; Shibli, Jamil Awad; Gehrke, Sergio Alexandre; Beder, Andréa M; Sendyk, Wilson R


    We have evaluated the effect of the use of platelet-rich plasma in alveolar distraction osteogenesis. Fourteen patients who were partly edentulous in the anterior premaxilla region were selected and randomised into two groups (n=7 in each group). Those in the experimental group were give platelet-rich plasma at the time of distraction, and the control group had only distraction. Selected cases had defects in the alveolar ridge of more than 3mm, and a minimal bone height of 7 mm from the alveolar ridge crest to important anatomical structures. The plaque index and gingival index were recorded on days 3, 7, 14, 21, 28, 45, 60, 75, 90, and 105 postoperatively. There was a strong negative correlation between the gingival index and augmentation of bone, and a strong positive correlation between the mean gingival index and loss of bone from the transported segment. The addition of platelet-rich plasma had a protective effect on the mucosa around the distractor, which decreased the potential for complications. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. Memory load modulates graded changes in distracter filtering

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    Andria eShimi


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

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

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    Nicole Wetzel


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

  12. Traction Induced Vertical Displacement of Odontoid due to Type III Odontoid Fracture with Unrecognized Ligamentous Injury: A Case Report


    Jung, Min-Ho; Lee, Jung-Kil; Hur, Hyuk; Jang, Jae-Won; Kim, Jae-Hyoo; Kim, Soo-Han


    Dens fractures are a common traumatic cervical spine injury. Among them, a type III fracture is the second common fracture. Although there are several treatment options, it has been accepted that type III fracture is usually healed by non-surgical method. After adequate reduction with traction, subsequent external immobilization has been associated with successful union rates. However, in the review of literatures, there are some cases with neurological deterioration after application of skul...

  13. Quantitative assessment of mineralization in distraction osteogenesis

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    Hazra, Sunit; Biswal, Sandeep; Jang, Ki-Mo; Modi, Hitesh N. [Korea University, Guro Hospital, Department of Orthopedic Surgery, Seoul (Korea); Song, Hae-Ryong [Rare Diseases Institute, Korea University, Guro Hospital, Department of Orthopedic Surgery, Seoul (Korea); Lee, Suk-Ha [Konkuk University Hospital, Department of Orthopedics, Seoul (Korea); Lee, Seok Hyun [Dongguk University International Hospital, Department of Orthopedic Surgery, Ilsan (Korea)


    The most important decision in distraction osteogenesis is the timing of fixator removal. Various methods have been tried, such as radiographic appearance of callus and bone mineral density (BMD) assessment, but none has acquired gold standard status. The purpose of this study was to develop another objective method of assessment of callus stiffness to help clinicians in taking the most important decision of when to remove the fixator. We made a retrospective study of 70 patients to compare the BMD ratio and pixel value ratio. These ratios were calculated at the time of fixator removal, and Pearson's coefficient of correlation was used to show the comparability. Inter- and intra-observer variability of the new method was also tested. Good correlation was found between BMD ratio and pixel value ratio, with a Pearson's coefficient of correlation of 0.79. The interobserver variability was also low, with high intra-observer reproducibility, suggesting that this test was simple to perform. Pixel value ratio is a good method for assessing callus stiffness, and it can be used to judge the timing of fixator removal. (orig.)

  14. Case studies of the impact of orbital sampling on stratospheric trend detection and derivation of tropical vertical velocities: solar occultation vs. limb emission sounding

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    L. F. Millán


    Full Text Available This study investigates the representativeness of two types of orbital sampling applied to stratospheric temperature and trace gas fields. Model fields are sampled using real sampling patterns from the Aura Microwave Limb Sounder (MLS, the HALogen Occultation Experiment (HALOE and the Atmospheric Chemistry Experiment Fourier Transform Spectrometer (ACE-FTS. The MLS sampling acts as a proxy for a dense uniform sampling pattern typical of limb emission sounders, while HALOE and ACE-FTS represent coarse nonuniform sampling patterns characteristic of solar occultation instruments. First, this study revisits the impact of sampling patterns in terms of the sampling bias, as previous studies have done. Then, it quantifies the impact of different sampling patterns on the estimation of trends and their associated detectability. In general, we find that coarse nonuniform sampling patterns may introduce non-negligible errors in the inferred magnitude of temperature and trace gas trends and necessitate considerably longer records for their definitive detection. Lastly, we explore the impact of these sampling patterns on tropical vertical velocities derived from stratospheric water vapor measurements. We find that coarse nonuniform sampling may lead to a biased depiction of the tropical vertical velocities and, hence, to a biased estimation of the impact of the mechanisms that modulate these velocities. These case studies suggest that dense uniform sampling such as that available from limb emission sounders provides much greater fidelity in detecting signals of stratospheric change (for example, fingerprints of greenhouse gas warming and stratospheric ozone recovery than coarse nonuniform sampling such as that of solar occultation instruments.

  15. Vertically transmitted HPV-dependent squamous cell carcinoma of the external auditory canal. Case report of a child

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    Snietura, Miroslaw; Pakulo, Slawomir; Kopec, Agnieszka; Piglowski, Wojciech; Stanek-Widera, Agata [Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Tumor Pathology Department, Gliwice (Poland); Chelmecka-Wiktorczyk, Liliana [University Children' s Hospital of Cracow, Department of Oncology and Hematology, Cracow (Poland); Drabik, Grazyna [University Children' s Hospital of Cracow, Pathology Department, Cracow (Poland); Kosowski, Bogdan [NZOZ Prosmed, Cracow (Poland); Wyrobek, Lukasz [University Children' s Hospital of Cracow, Department of Radiology, Cracow (Poland); Balwierz, Walentyna [University Children' s Hospital of Cracow, Department of Oncology and Hematology, Cracow (Poland); Jagiellonian University in Cracow, Clinic of Oncology and Hematology, Polish-American Pediatric Institute, Cracow (Poland)


    There is much evidence that high-risk human papillomavirus (HPV) plays a causative role in a subset of head and neck squamous cell cancer (HNSCC) in adults. HPV-positive tumors behave differently even in their response to treatment and are therefore a distinct subset. Both HPV-positive and HPV-negative tumors of the head and neck region are usually in the domain of adults and cases in children are rare; thus when a 2-year-old child was diagnosed with this cancer in the external auditory canal, an in-depth assessment of the tumor was considered necessary. A 2-year-old girl was born to a HPV-positive mother who was diagnosed with cervical cancer during pregnancy. The child was delivered by caesarean section and the mother died of her cancer 7 months after delivery. After the diagnosis of locally invasive HPV-positive squamous cell cancer of the external auditory canal, the child was treated surgically, and with chemotherapy and radiotherapy. Full remission was obtained lasting up to 325 weeks since treatment was started, resulting in over 6 years of disease-free survival. This is the first case of advanced, HPV-related HNSCC in a 2-year-old child, in whom the tumor was located in the external auditory canal and who made a dramatic recovery after treatment with nonradical surgery, chemotherapy and radiotherapy. The child has currently been disease free for 6 years. This case supports the observation that HPV-related HNSCC tumors appear to respond favorably to treatment despite the patient's young age and the clinically advanced stage of the tumor. (orig.) [German] Es gibt reichlich Belege dafuer, dass das menschliche Papillomavirus vom Hochrisikotyp (HR-HPV) in einigen Faellen von Plattenepithelkarzinomen des Kopf- und Halsbereichs (HNSCC) eine Schluesselrolle spielt. HPV-positive Tumoren verhalten sich anders, auch bezueglich des Ansprechens auf die Behandlung. Deswegen stellen sie eine separate biologische Gruppe dar. Sowohl HPV-positive als auch HPV

  16. Near Zero Consumption Building as an Urban Acupuncture for a Vertical Slum. A Case Study in the City of Malaga, Spain (United States)

    Rosa-Jiménez, Carlos; Nebot, Nuria; García Moreno, Alberto; José Márquez Ballesteros, María


    A vertical slum is defined as a socially vulnerable community in a building, with serious problems of functionality, safety and habitability. It is related to an important level of physical degradation, and a precarious socioeconomic situation of its occupants. Their inability to create a real community for proper and mandatory maintenance increases the physical deterioration of the building. The abandonment of the original owners of the houses can cause a system of illegal occupation and illegal activities, and vice versa. In many cases, the new occupants are primarily interested in maintaining the building in a state of precariousness in order to avoid any attempt of renovation by administrations. These security and habitability problems often extend outside the building and they affect a whole community of neighbours within the neighbourhood who feel threatened and insecure, causing their rejection and a strong social segregation in the area. This article wants to show some of the results from a research work developed on a case study of vertical slum in the city of Malaga, in Spain. In this context of marginality previously described, the research project explores different alternatives for the renovation of a building, its vulnerable community and the neighbourhood in which it is inserted. The project establishes four major objectives: (a) a physical renovation of the building, (b) social transformation in a disadvantaged environment, (c) functional evolution-from a residential model to a new hybrid model with a mixed supply of social services, and (d) the incorporation of new parameters of environmental sustainability that improve the energetic behaviour of the building (transforming it into a building of almost zero consumption). The research closes with a series of strategies and results for the case study. However, the main contribution of the work is related to the research methodology that has been developed. This is structured according to the four

  17. Rapid Canine Retraction with Dentoalveolar Distraction Osteogenesis: An in vivo Study

    Directory of Open Access Journals (Sweden)

    Allwin Benjamin Raj


    Full Text Available The aim of this clinical study is to assess the effectiveness of a new technique of rapid canine retraction through distraction osteogenesis. The effects of dentoalveolar distraction on the dentofacial structures, the dental changes that has been produced by dentoalveolar distraction and the vitality of the distracted canine immediately after distraction and 3 months postdistraction using pulp vitality test were also evaluated. Custom made canine distractors were used for distraction. Pre and postdistraction lateral cephalogram, OPG, Model analysis and electrical pulp vitality testing is carried out and results were evaluated.

  18. [The effect of mandibular distraction on the maxilla growth in children with hemifacial microsomia]. (United States)

    Yang, Renkai; Tang, Xiaojun; Shi, Lei; Yin, Lin; Yang, Bin; Yin, Hongyu; Liu, Wei; Zhang, Zhiyong


    To analyze the effect of mandibular distraction on the maxilla growth in children with hemifacial microsomia through measurement with the posterior-anterior cephalometric X-ray films and Three-dimensional CT reconstruction images. The deviation angular of maxilla occlusion plane and nasal base plane from the infra-orbital plane were measured on the posterior-anterior cephalometric X-ray films in 22 patients before and half a year after operation. The vertical distance from the midpoint of 5th teeth alveolar and the lowest point of maxillary sinus to reference plane were measured on 3D reconstruction images in 15 patients. The data were statistically analyzed. On posterior-anterior cephalometric X-ray films, the cant of occlusion plane were significantly reduced (P mandible can promote the growth of the maxilla in children with HFM, the accelerated growth parts include alveolar bone and maxillary sinus.


    Directory of Open Access Journals (Sweden)

    M.V. Perilla


    Full Text Available The Luntian Multi-Purpose Cooperative located in Tiaong, Quezon, Philippines. The Luntian MultiPurposecooperative focuses more on feed production as well as hog fattening. The LMC applied thevertical integration to develop the cooperative. They have their members as their primary costumers of theirfeeds. The cooperative’s business activity includes also meat shop, granting of production loan, microfinance,mobilization of saving deposits, aside from feed milling and hog fattening. Different agencies, industryorganizations and private institutions provide trainings, seminars, assistance, as well as credit for thecooperative.The aims of the study was to determine the present and discuss a noteworthy business issue (sof Luntian Multipurpose Cooperative, evaluate the business environment prevailing at a particular time ofthis case , assess the cooperative’s performance in terms of the four business functions , define the problemrelevant to the business issue(s being studied. The study used primary and secondary data. Primary datawere gathered through interviews with the key personnel, managers, and other informants of the LuntianMultipurpose Cooperative in order to obtain responses regarding the overall status of the cooperative includingits problem and plans. Secondary data were taken from files and documents, especially the history, backgroundinformation and financial statements. Other data were taken through research materials such as book,unpublished special problems and from some government institutions. The recommendation of this researchshowed that Luntian MPC should engage in establishing a communal farm as to become the primary sourceof hybrid piglets that their members would raised. The alternatives solution was establishing a breeding farmthat would ask for initial investment.

  20. Influence of periosteal coverage on distraction osteogenesis with dental implant distractors. (United States)

    Yin, Xuelai; Zhang, Chenping; Hze-Khoong, Eugene Poh; Wang, Yang; Xu, Liqun


    The continuity and integrity of the enveloping nutritive periosteum can be compromised during installation of a dental implant distractor (DID) device. This novel animal experiment investigated the influence of the periosteum on the bony regenerate in 3 scenarios of periosteal coverage: whole periosteum (WP), half periosteum (HP), and no periosteum (NP). Twelve goat tibias were vertically osteotomized into 2 segments each and divided into 3 groups (WP, HP, and NP). A DID device was surgically installed onto each segment, followed by 10 days of distraction at a rate of 0.35 mm twice daily. Fluorescence labeling and trabecula count per high-power field (TBC/HPF) measurements were performed and statistically compared across groups. Implant stability quotients (ISQs) of all fixtures were performed. New bone formation occurred sooner in the WP and HP groups than in the NP group under fluoroscopy. The TBC/HPF values showed an obvious but not statistically significant decrease between the WP and HP groups (P = .500), WP and NP groups (P = .157), and HP and NP (P = .077). And the WP group showed no significantly higher ISQ values compared with the HP (P = .712) and NP (P = .958) groups, also between the HP and NP (P = .751) groups. Vertical distraction osteogenesis can be performed successfully with the DID to obtain bone of adequate stock and density. However, the enveloping periosteum should be preserved as much as possible during installation of the DID device. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Distraction osteogenesis after irradiation in a rabbit model

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    Uehara, Kenji [Kanazawa Univ. (Japan). Graduate School of Medical Science


    Little is known about how preoperative irradiation delays distraction osteogenesis. The purpose of this study is to investigate the effect of preoperative irradiation on distraction osteogenesis. A single dose of 15 Gy irradiation was applied in a medial-to-lateral direction to the right rear legs of Japanese white rabbits. This was followed immediately by application of a unilateral external fixator and diaphyseal osteotomy of the tibia. Seven days later, lengthening of the tibia was initiated at a rate of 0.5 mm/day and continued for 4 weeks, with a total elongation of 14 mm. Radiographic and histological findings and microangiography were examined. Radiographs of the legs were obtained once a week. The animals were sacrificed at 0 and 4 weeks after completion of lengthening, and the tibia were subjected to histological examination and microangiography. Routine staining was performed with hematoxyline and eosin, and immunostaining with a vascular endothelial growth factor (VEGF) antibody. The radiographs showed little regeneration during the elongation phase. Although the callus appeared very slowly during the maturation phase, it did not show the usual three distinct zones, but only spotty callus formation. Furthermore, regeneration was not completed until the 4th week of the maturation period. The histological examination at the end of distraction showed a gap in the distraction, consisting of loose connective tissue with part of the fibrous tissue oriented longitudinally. There was no evidence of new mineralization. Four weeks after completion of distraction, the major part of the radiolucent region consisted of cartilage. There was no evidence of the normal regeneration pattern described in many previous reports. The spotty osteogenesis was identified as endochondral ossification. Immunochemical examination of the regeneration area revealed that the blood vessels were extremely localized, and that expression of VEGF in the osteoblasts was very high

  2. A Driver Face Monitoring System for Fatigue and Distraction Detection

    Directory of Open Access Journals (Sweden)

    Mohamad-Hoseyn Sigari


    Full Text Available Driver face monitoring system is a real-time system that can detect driver fatigue and distraction using machine vision approaches. In this paper, a new approach is introduced for driver hypovigilance (fatigue and distraction detection based on the symptoms related to face and eye regions. In this method, face template matching and horizontal projection of top-half segment of face image are used to extract hypovigilance symptoms from face and eye, respectively. Head rotation is a symptom to detect distraction that is extracted from face region. The extracted symptoms from eye region are (1 percentage of eye closure, (2 eyelid distance changes with respect to the normal eyelid distance, and (3 eye closure rate. The first and second symptoms related to eye region are used for fatigue detection; the last one is used for distraction detection. In the proposed system, a fuzzy expert system combines the symptoms to estimate level of driver hypo-vigilance. There are three main contributions in the introduced method: (1 simple and efficient head rotation detection based on face template matching, (2 adaptive symptom extraction from eye region without explicit eye detection, and (3 normalizing and personalizing the extracted symptoms using a short training phase. These three contributions lead to develop an adaptive driver eye/face monitoring. Experiments show that the proposed system is relatively efficient for estimating the driver fatigue and distraction.

  3. Suppression of salient objects prevents distraction in visual search. (United States)

    Gaspar, John M; McDonald, John J


    To find objects of interest in a cluttered and continually changing visual environment, humans must often ignore salient stimuli that are not currently relevant to the task at hand. Recent neuroimaging results indicate that the ability to prevent salience-driven distraction depends on the current level of attentional control activity in frontal cortex, but the specific mechanism by which this control activity prevents salience-driven distraction is still poorly understood. Here, we asked whether salience-driven distraction is prevented by suppressing salient distractors or by preferentially up-weighting the relevant visual dimension. We found that salient distractors were suppressed even when they resided in the same feature dimension as the target (that is, when dimensional weighting was not a viable selection strategy). Our neurophysiological measure of suppression--the PD component of the event-related potential--was associated with variations in the amount of time it took to perform the search task: distractors triggered the PD on fast-response trials, but on slow-response trials they triggered activity associated with working memory representation instead. These results demonstrate that during search salience-driven distraction is mitigated by a suppressive mechanism that reduces the salience of potentially distracting visual objects.

  4. Using distraction to regulate emotion: insights from EEG theta dynamics. (United States)

    Uusberg, Andero; Thiruchselvam, Ravi; Gross, James J


    Distraction is a powerful and widely-used emotion regulation strategy. Although distraction regulates emotion sooner than other cognitive strategies (Thiruchselvam, Blechert, Sheppes, Rydstrom, & Gross, 2011), it is not yet clear whether it is capable of blocking the earliest stages of emotion generation. To address this issue, we capitalized on the excellent temporal resolution of EEG by focusing on occipital theta dynamics which were associated with distinct stages of visual processing of emotional stimuli. Individually defined theta band dynamics were extracted from a previously published EEG dataset (Thiruchselvam et al., 2011) in which participants attended to unpleasant (and neutral) images or regulated emotion using distraction and reappraisal. Results revealed two peaks within early theta power increase, both of which were increased by emotional stimuli. Distraction did not affect theta power during an early peak (150-350 ms), but did successfully decrease activity in a second peak (350-550 ms). These results suggest that although distraction acts relatively early in the emotion-generative trajectory, it does not block fast detection of emotional significance. Given that theta dynamics were uncorrelated with Late Positive Potential activity, the present results also encourage researchers to add the occipital theta to the growing toolkit of EEG-based measures of emotion regulation. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Miniature osmotic actuators for controlled maxillofacial distraction osteogenesis (United States)

    Li, Yu-Hsien; Su, Yu-Chuan


    We have successfully demonstrated miniature actuators that are capable of converting chemical potential directly into steady mechanical movements for maxillofacial distraction osteogenesis. Pistons and diaphragms powered by osmosis are employed to provide the desired linear and volumetric displacements for bone distraction and potentially the release of bone morphogenetic proteins, respectively. The cylindrical-shaped miniature actuators are composed of polymeric materials and fabricated by molding and assembly processes. In the prototype demonstration, vapor-permeable thermoplastic polyurethane was employed as the semi-permeable material. 3 cm long actuators with piston and diaphragm radii of 1 mm and 500 µm, respectively, were fabricated and characterized. The maximum distraction force from the piston-type actuator is found to be 6 N while the piston travels at a constant velocity of 32 µm h-1 (or 0.77 mm/day) for about 1 week. Meanwhile, the release rate from the diaphragm-type actuator is measured to be constant, 0.15 µl h-1 (or 3.6 µl/day), throughout the experiment. Moreover, the sizes and output characteristics of the self-regulating actuators could readily be tailored to realize optimal distraction rate, rhythm and osteogenic activity. As such, the demonstrated miniature osmotic actuators could potentially serve as versatile apparatuses for maxillofacial distraction osteogenesis and fulfill the needs of a variety of implantable and biomedical applications.

  6. Effects of individual differences on the efficacy of different distracters during visual sexual stimulation in women. (United States)

    Roberts, Verena M; Prause, Nicole


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


    Directory of Open Access Journals (Sweden)

    Pavlin Apostolov


    Full Text Available The authors represent a distraction external pelvic fixation technique, which they use in pelvic fractures caused by a lateral compression. They consider the indications and mounting techniques. The authors recommend the early movement activities (on the 3rd - 5th day after the external fixator placement. This method had been used in 8 patients and 3 cases are analyzed in details. The priority of this technique over open reduction and internal fixation (ORIF mainly are: (1 the implementation of good reduction of the fracture preventing the risk of ORIF; (2 the possibility for early movement activities for the patient.

  8. Long-term skeletodental stability of mandibular symphyseal distraction osteogenesis: Tooth-borne vs hybrid distraction appliances. (United States)

    Durham, Julia N; King, John W; Robinson, Quinton C; Trojan, Terry M


    To evaluate and compare the long-term skeletodental stability of mandibular symphyseal distraction osteogenesis (MSDO) achieved with the use of tooth-borne vs. hybrid distraction appliances. Posttreatment and follow-up orthodontic records were collected for 33 patients. The 14 patients who underwent distraction with a tooth-borne appliance had a mean follow-up of 5.08 years. The 19 patients who underwent distraction with a hybrid appliance had a mean follow-up of 6.07 years. Records included intraoral photographs, study models, postero-anterior cephalometric radiographs, and lateral cephalometric radiographs. Total changes of 16 measurements were analyzed to compare patients who underwent the tooth-borne vs. the hybrid distraction. Both groups shared several similar and significant (P < .05) changes from posttreatment to follow-up records. Cast analysis showed a decrease in intercanine width and arch length and an increase in irregularity index. The postero-anterior cephalometric radiograph showed an increase in the width of the interincisal apices. The lateral cephalometric radiograph showed a decrease in the MP-L1 angle. The only statistically significant difference between the two appliances was the intercentral incisor contact point. Changes found are consistent with those found in untreated and orthodontically treated individuals over time. The long-term changes in the current patient sample can be determined to be expected and acceptable. MSDO is a viable treatment option with the use of either a hybrid or tooth-borne appliance.

  9. Selectively Distracted: Divided Attention and Memory for Important Information. (United States)

    Middlebrooks, Catherine D; Kerr, Tyson; Castel, Alan D


    Distractions and multitasking are generally detrimental to learning and memory. Nevertheless, people often study while listening to music, sitting in noisy coffee shops, or intermittently checking their e-mail. The current experiments examined how distractions and divided attention influence one's ability to selectively remember valuable information. Participants studied lists of words that ranged in value from 1 to 10 points while completing a digit-detection task, while listening to music, or without distractions. Though participants recalled fewer words following digit detection than in the other conditions, there were no significant differences between conditions in terms of selectively remembering the most valuable words. Similar results were obtained across a variety of divided-attention tasks that stressed attention and working memory to different degrees, which suggests that people may compensate for divided-attention costs by selectively attending to the most valuable items and that factors that worsen memory do not necessarily impair the ability to selectively remember important information.

  10. The effect of different distractions on remembering delayed intentions. (United States)

    Schaper, Philipp; Grundgeiger, Tobias


    In safety-critical domains, frequently intentions need to be delayed until an ongoing task is completed. Research using the delay-execute paradigm showed that interruptions during the delay cause forgetting. However, staff members often handle an initial distraction not by interrupting the ongoing task but by acknowledging the distraction or multitasking. In Experiments 1a and 1b, we observed that, compared to a no distraction condition, multitasking significantly decreased remembering of intentions and interrupting decreased remembering even further. In Experiment 2, interruptions with context change reduced remembering of intentions compared to uninterrupted delays, and at the same time, interruptions without context change improved memory performance compared to uninterrupted delays. However, improved memory performance resulted in decreased interrupting task performance. Theoretically, the results support the contextual cueing mechanism of delay-execute tasks. Considering safety-critical domains, multitasking, interruptions and context changes can contribute to forgetting of tasks.

  11. An assessment of the agreement between the New Zealand Veterinary Association Hip Dysplasia Scoring System and the PennHIP Distraction Index in German Shepherd dogs. (United States)

    Worth, A J; Laven, R A; Erceg, V H


    To determine the level of agreement between the New Zealand Veterinary Association (NZVA) Hip Dysplasia Scoring System and the University of Pennsylvania Hip Improvement Program (PennHIP) Distraction Index in German Shepherd dogs, and whether using the NZVA subtotal score or its components affected the level of agreement. A prospective study was performed using 47 German Shepherd police dogs undergoing breeding evaluation. All dogs were scored using the NZVA system and the PennHIP index. The relationships between the individual hip-distraction index scores and the scores from the NZVA system, i.e. the total score, the subtotal score, and the scores for the categories making up the subtotal score, were analysed using correlation, followed by univariate ANOVA for the subtotal categories alone. The scores from the NZVA system and the distraction index were then dichotomised into either low or high risk of canine hip dysplasia (CHD). A sign test was then used to determine whether three NZVA thresholds identified the same proportion of 'at-risk' dogs as the distraction-index threshold. Where this was the case, the Kappa value was calculated to identify the degree of agreement between the NZVA measures and the distraction index. The left-hip distraction index was significantly correlated to both left-subtotal and left-total NZVA score, however for right-hip scores there was no such correlation. The individual categories of the subtotal NZVA score were not significantly associated with the distraction index except for the subluxation score of the left hip. The proportion of dogs identified as being 'at risk' for CHD identified using a distraction-index threshold of 0.3 was similar to that identified by an NZVA total or subtotal score of >2 (44/47 cf. 45/47, respectively). However, none of the dogs identified as low risk using the distraction index was identified as low risk by either of the NZVA scores. This poor agreement (Kappa value 1 in any of the categories used to

  12. Educating teenage drivers in the Pacific Northwest regarding the dangers of distracted driving (phase I). (United States)


    The goal of this outreach project was to examine driver distraction among teenagers in the Pacific Northwest. Specifically, to identify secondary tasks they consider distracting and determine their self-reported engagement in those same secondary tas...

  13. Complications of mandibular distraction osteogenesis for developmental deformities: a systematic review of the literature

    NARCIS (Netherlands)

    Verlinden, C.R.A.; van de Vijfeijken, S.E.C.M.; Tuinzing, D.B.; Jansma, E.P.; Becking, A.G.; Swennen, G.R.J.


    A systematic review of English and non-English articles on the complications of mandibular distraction osteogenesis (MDO) for patients with developmental deformities was performed, in accordance with the PRISMA statement. Search terms expressing distraction osteogenesis were used in 'AND'

  14. [Rational use of distraction osteogenesis in craniofacial surgery]. (United States)

    Guerreschi, P; Wolber, A; Bennis, Y; Vinchon, M; Martinot-Duquennoy, V


    Distraction osteogenesis, initially developed by Ilizarov for limb, is the tissular extension caused by the progressive space of the osseous pieces following an osteotomy. Distraction is osteogenesic and histogenic. Twenty-five years ago, at the instigation of McCarthy, this technique was used to handle the craniofacial malformations in the various floors of the face : mandibular, mediofacial and cranial. The most wide-spread protocols respect a latency period from 0 to 7 days, a rhythm of distraction from 1 to 2mm a day in 2 at 4 times and a period of consolidation from 4 to 8 weeks. Distraction is the result of the inventiveness of the pioneers then the work to always adapt to the multiple complex clinical situations. The surgeon has to choose between internal or external materials allowing a mono- or multi-vectorial extension, in osseous and/or dental anchoring. The mandibular distraction is very effective for the treatment of the secondary obstructive syndromes in the unilateral or bilateral severe hypomandibular malformations. She also allows desobstruction of the superior airways within the framework of the mediofacial hypoplasies as well as the secondary treatment of the growth defects in cleft lips and palates. Finally, the distraction osteogenesis enhanced reliability of the fronto-facial advancement in early and secondary treatment of craniofaciosynostosis. This is a real support of the facial growth, which has to be included in a plan of global treatment. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  15. Preventing distracted driving among college students: Addressing smartphone use. (United States)

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


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

  16. Perioperative outcomes of revisional laparoscopic gastric bypass after failed adjustable gastric banding and after vertical banded gastroplasty: experience with 107 cases and subgroup analysis. (United States)

    Apers, J A; Wens, C; van Vlodrop, V; Michiels, M; Ceulemans, R; van Daele, G; Jacobs, I


    A growing number of revision procedures are to be expected in bariatric surgery after failed restrictive procedures such as failed adjustable gastric banding (AGB) or vertical banded gastroplasty (VBG). Conversion to revisional laparoscopic Roux-en-Y gastric bypass (ReLRYGBP) has been advocated as the procedure of choice. The results of ReLRYGBP were reviewed in a retrospective chart review. A subgroup analysis compared perioperative results after VBG and after AGB. A second subgroup analysis compared perioperative results of ReLRYGBP immediately after AGB removal and after a delay as a two-step procedure. Between 2003 and 2009, ReLRYGBP was performed for 107 patients. Of these 107 operations, 21 were performed after failed VBG and 86 after failed AGB. The mean body mass index (BMI) was 42 kg/m(2). The causes of failure were mainly insufficient weight loss or reflux disease-related symptoms. During a median follow-up period of 44 months, there was no mortality, and morbidity was 34 %, including late complications. Major early complications occurred in 11 % of the cases (n = 12). Conversions and major early complications occurred significantly more frequently after VBG than after AGB (p 0.5). The perioperative outcomes of ReLRYGBP are worse after VBG than after AGB. The ReLRYGBP operation can be performed safely as a one-step procedure after AGB removal.

  17. Driver Distraction and Inattention : Advances in Research and Countermeasures, Volume 1


    REGAN, Michael A.; Lee, John D.; VICTOR, Trent W.; BRUSQUE, Corinne; Bruyas, Marie-Pierre; Martin, Jean-Louis


    Foreword; Part I Introduction: Introduction, Michael A. Regan and John D. Lee. Part II Distraction and Inattention - Theory, Philosophy and Definition: Driven to distraction and back again, Peter A. Hancock; Attention selection and multitasking in everyday driving: a conceptual model, Johan Engström, Trent Victor and Gustav Markkula; Driver distraction and inattention: a queuing theory approach, John W. Senders; The relationship between driver distraction and mental workload, Nina Schaap, Ric...

  18. Cognitive Distraction and African American Women's Endorsement of Gender Role Stereotypes (United States)

    Smith, Kalynda; Craig-Henderson, Kellina


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

  19. Homework Distraction Scale: Confirming the Factor Structure With Middle School Students (United States)

    Xu, Jianzhong; Fan, Xitao; Du, Jianxia


    The goal of the current investigation was to evaluate psychometric properties of the Homework Distraction Scale (HDS) using 796 middle school students. Results from confirmatory factor analyses (CFAs) supported the presence of two distinct yet related subscales for the HDS: Conventional Distraction and Tech-Related Distraction. Results of…

  20. Vertical Guided Bone Regeneration for a Single Missing Tooth Span with Titanium-Reinforced d-PTFE Membranes: Clinical Considerations and Observations of 10 Consecutive Cases with up to 36 Months Follow-up. (United States)

    Herzberg, Ran

    Vertical guided bone regeneration (GBR) using titanium-reinforced polytetrafluoroethylene (PTFE) membranes is a well-established technique and is considered technique sensitive. When using PTFE membranes, complications usually arise in the crestal incision or next to the neighboring tooth of the treated span. Most studies available describe either distal free end or multiple missing teeth span situations. Treating a single missing tooth span combines the challenge of two neighboring teeth and a smaller flap, which is more difficult to adapt to the augmented environment. This article describes 10 single span cases treated with vertical GBR using high-density PTFE membranes, highlighting clinical guidelines for preoperative care, flap design, and suturing.

  1. Técnica de cierre vertical en labio hendido: Reporte de 837 casos y revisión de la literatura Vertical closing in lip cleft: Report of 837 cases and review of the literature


    J.A. León Pérez; A.L. Sesman Bernal; G. Fernández Sobrino


    Ninguna otra deformidad congénita tiene el potencial de alterar la forma facial tan perceptiblemente como lo hace un labio y paladar hendido, en donde el tercio medio de la cara se modifica y supone un gran desafío para el cirujano plástico. Proponemos el cierre vertical de la piel tras la miorrafia, formando una línea y tratando de dar apariencia a la columna del filtrum que no se formó en el labio hendido. Presentamos el resultado en niños operados en el Servicio de Cirugía Plástica del Ins...

  2. Five-Year Follow-up of Knee Joint Distraction : Clinical Benefit and Cartilaginous Tissue Repair in an Open Uncontrolled Prospective Study

    NARCIS (Netherlands)

    van der Woude, Jan-Ton A D; Wiegant, Karen; Van Roermund, Peter M.; Intema, Femke; Custers, Roel J H; Eckstein, Felix; van Laar, Jaap M; Mastbergen, Simon C.|info:eu-repo/dai/nl/290932599; Lafeber, Floris P J G|info:eu-repo/dai/nl/073410071

    Objective In end-stage knee osteoarthritis, total knee arthroplasty (TKA) may finally become inevitable. At a relatively young age, this comes with the risk of future revision surgery. Therefore, in these cases, joint preserving surgery such as knee joint distraction (KJD) is preferred. Here we

  3. Distracting the mind improves performance : An ERP study

    NARCIS (Netherlands)

    Wierda, S.; van Rijn, Hedderik; Taatgen, N.A.; Martens, Sander


    Background: When a second target (T2) is presented in close succession of a first target (T1), people often fail to identify T2, a phenomenon known as the attentional blink (AB). However, the AB can be reduced substantially when participants are distracted during the task, for instance by a

  4. The Effects of Distraction on Preoperative Anxiety Level in Children. (United States)

    Aytekin, Aynur; Doru, Özlem; Kucukoglu, Sibel


    The purpose of this study was to investigate the effects of distraction on the preoperative anxiety levels of pediatric patients. A prospective, two-group experimental design was used. This study was conducted in the clinic of pediatric surgery of a university hospital in Turkey between November 20, 2013 and January 25, 2014. The population of the study was composed of a total of 83 children (40 in the study group and 43 in the control group) who met the inclusion. The data were collected using the "Personal Information Form," "Separation Scoring," and "State-Trait Anxiety Inventory for Children-State Form." Distraction was performed on the children in the study group during the preoperative period. No intervention was applied to the children in the control group. The results of this study demonstrated that the separation scores and State-Trait Anxiety Inventory for Children-State scores of the children in the study group, on whom distraction was applied, were lower than those of the control group. Distraction applied to children in the preoperative period significantly reduced anxiety and separation anxiety. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  5. Distraction by emotional sounds: Disentangling arousal benefits and orienting costs. (United States)

    Max, Caroline; Widmann, Andreas; Kotz, Sonja A; Schröger, Erich; Wetzel, Nicole


    Unexpectedly occurring task-irrelevant stimuli have been shown to impair performance. They capture attention away from the main task leaving fewer resources for target processing. However, the actual distraction effect depends on various variables; for example, only target-informative distractors have been shown to cause costs of attentional orienting. Furthermore, recent studies have shown that high arousing emotional distractors, as compared with low arousing neutral distractors, can improve performance by increasing alertness. We aimed to separate costs of attentional orienting and benefits of arousal by presenting negative and neutral environmental sounds (novels) as oddballs in an auditory-visual distraction paradigm. Participants categorized pictures while task-irrelevant sounds preceded visual targets in two conditions: (a) informative sounds reliably signaled onset and occurrence of visual targets, and (b) noninformative sounds occurred unrelated to visual targets. Results confirmed that only informative novels yield distraction. Importantly, irrespective of sounds' informational value participants responded faster in trials with high arousing negative as compared with moderately arousing neutral novels. That is, costs related to attentional orienting are modulated by information, whereas benefits related to emotional arousal are independent of a sound's informational value. This favors a nonspecific facilitating cross-modal influence of emotional arousal on visual task performance and suggests that behavioral distraction by noninformative novels is controlled after their motivational significance has been determined. (c) 2015 APA, all rights reserved).

  6. Prophylactic Riluzole Attenuates Oxidative Stress Damage in Spinal Cord Distraction. (United States)

    Shimizu, Eileen Nicole; Seifert, Jennifer L; Johnson, Kevin J; Romero-Ortega, Mario


    Spinal cord injury (SCI) without radiographic abnormalities (SCIWORA) presents a significant challenge due the loss of function despite an apparent normal anatomy. The cause of dysfunction is not understood and specific treatment options are lacking. Some scoliosis corrective surgeries result in SCIWORA, where stretching of the spinal cord can lead to vascular compromise and hypoxia. This procedure allows for the implantation of neuroprotective strategies designed to prevent iatrogenic SCI. We utilized a model of atraumatic SCI to evaluate the efficacy of the sodium channel blocker Riluzole, as a prophylactic neuroprotectant. As expected, the stretch injury caused a significant reduction in intraparenchymal oxygen in distraction (-53.09 ± 22.23 %) and Riluzole pre-treated distraction animals (-43.04 ±22.86%). However, in contrast to the oxidative stress and metabolic impairments observed in distraction animals, in which protein carbonylation increased significantly (5.88 ± 1.3 nmol/ml), Riluzole kept these levels within normal range (1.8 ± 1.0nmol/ml). This neurprotection also prevented ventral motor neuron hypoplasia and pyknosis, characteristic features of this atraumatic SCI model, and maintained normal gait function (e.g., stride length and stance time), otherwise observed as a result of distraction injury. This study provides evidence for the use of prophylactic neuroprotective strategies in which thoracic or spine surgeries present the risk of causing atraumatic SCI.

  7. Attentional bias, distractibility and short-term memory in anxiety. (United States)

    Lapointe, Marie-Laure B; Blanchette, Isabelle; Duclos, Mélanie; Langlois, Frédéric; Provencher, Martin D; Tremblay, Sébastien


    Cognitive effects of anxiety have been amply documented. Anxiety has been linked with an attentional bias toward threat, distractibility, and reductions in short-term memory (STM) capacity. These three functions have rarely been investigated jointly and permeability may account for some of the effects documented. In this experiment, we examine these three cognitive functions using one verbal and one visuospatial task. In the irrelevant speech paradigm, participants had to remember strings of letters while irrelevant neutral or threatening speech was presented. In the visuospatial sandwich paradigm, participants were asked to remember sequences of visuospatial targets sometimes presented within irrelevant distracters. We examined the links between state anxiety, worry, and indices of attentional bias toward threat, distractibility from neutral stimuli, and STM capacity. Results show that state anxiety was uniquely linked with impairments in STM while worry was more particularly related to distractibility, independently from permeability between the different cognitive functions. Attentional bias toward threat was linked with variance common to both anxiety and worry. An examination of clinical and non-clinical subgroups suggests that subjective threat perception and attentional bias toward threat are features that are particularly characteristic of clinical levels of anxiety. Our findings confirm the important links between anxiety and basic cognitive functions.

  8. Auditory Distraction in Semantic Memory: A Process-Based Approach (United States)

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


    Five experiments demonstrate auditory-semantic distraction in tests of memory for semantic category-exemplars. The effects of irrelevant sound on category-exemplar recall are shown to be functionally distinct from those found in the context of serial short-term memory by showing sensitivity to: The lexical-semantic, rather than acoustic,…

  9. Innovative approaches to reducing nurses' distractions during medication administration. (United States)

    Pape, Tess M; Guerra, Denise M; Muzquiz, Marguerite; Bryant, John B; Ingram, Michelle; Schranner, Bonnie; Alcala, Armando; Sharp, Johanna; Bishop, Dawn; Carreno, Estella; Welker, Jesusita


    Contributing factors to medication errors include distractions, lack of focus, and failure to follow standard operating procedures. The nursing unit is vulnerable to a multitude of interruptions and distractions that affect the working memory and the ability to focus during critical times. Methods that prevent these environmental effects on nurses can help avert medication errors. A process improvement study examined the effects of standard protocols and visible signage within a hospital setting. The project was patterned after another study using similar techniques. Rapid Cycle Testing was used as one of the strategies for this process improvement project. Rapid Cycle Tests have become a part of the newly adopted Define, Measure, Analyze, Improve, and Control steps at this particular hospital. As a result, a medication administration check-list improved focus and standardized practice. Visible signage also reduced nurses' distractions and improved focus. The results provide evidence that protocol checklists and signage can be used as reminders to reduce distractions, and are simple, inexpensive tools for medication safety.

  10. Patient satisfaction related to rigid external distraction osteogenesis

    NARCIS (Netherlands)

    van Eggermont, Bas; Jansma, J.; Bierman, M. W. J.; Stegenga, B.


    The aim of this study was to evaluate satisfaction with treatment among cleft lip and palate patients who underwent maxillary advancement using a rigid external distraction (RED) device. Nine patients (four boys, five girls), mean age 17.7 years (SD 4.0), were included in the study. Outcome measures

  11. Distraction Arthroplasty of the Trapeziometacarpal Joint Without Trapeziectomy

    Directory of Open Access Journals (Sweden)

    Kin Weng Wong


    Conclusion: Our technique (distraction arthroplasty without trapeziectomy preserves bony and adjacent structures. It is easier and quicker than traditional arthroplasties. It serves as another effective and stable method of tendon reconstruction with a less invasive approach. A larger series is needed for further observation of validity of the procedure.

  12. Musical Distracters, Personality Type and Cognitive Performance in School Children (United States)

    Furnham, Adrian; Stephenson, Rebecca


    The aim of this study was to ascertain the nature of the interaction between the affective value of musical distraction, personality type and performance on the cognitive tasks of reading comprehension, free recall, mental arithmetic and verbal reasoning in children aged 11-12 years. It was hypothesized that the cognitive performance of extraverts…

  13. Precise osteotomies for mandibular distraction in infants with Robin sequence using virtual surgical planning. (United States)

    Resnick, C M


    Mandibular distraction osteogenesis (MDO) has become the first-line operation in many centers for the management of obstructive sleep apnea (OSA) in infants with (Pierre) Robin sequence (RS) not relieved by non-surgical approaches. Preoperative virtual surgical planning (VSP) may improve precision and decrease complications for this operation. This article reports a retrospective study of RS infants who underwent MDO for OSA using preoperative VSP and three-dimensionally printed cutting guides performed by one surgeon. Seventeen subjects who had MDO at a mean age of 87±96days were included. Maxillofacial computed tomography scans were obtained 15±7days prior to MDO. Osteotomy designs included linear (n=4, 23.5%), inverted-L (n=11, 64.7%), and multi-angular (n=2, 11.8%). Cutting guides were used successfully and osteotomies were created as planned in all cases. Devices were removed 67±15.6days after placement. Bone formation in the distraction gap was seen in all cases at device removal. All patients had successful airway outcomes. There were no major and four minor complications during the follow-up period of 458±267 days. In conclusion, MDO is a successful procedure for the management of OSA associated with RS in infants, and VSP facilitates its precise design and execution. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  14. Técnica de cierre vertical en labio hendido: Reporte de 837 casos y revisión de la literatura Vertical closing in lip cleft: Report of 837 cases and review of the literature

    Directory of Open Access Journals (Sweden)

    J.A. León Pérez


    Full Text Available Ninguna otra deformidad congénita tiene el potencial de alterar la forma facial tan perceptiblemente como lo hace un labio y paladar hendido, en donde el tercio medio de la cara se modifica y supone un gran desafío para el cirujano plástico. Proponemos el cierre vertical de la piel tras la miorrafia, formando una línea y tratando de dar apariencia a la columna del filtrum que no se formó en el labio hendido. Presentamos el resultado en niños operados en el Servicio de Cirugía Plástica del Instituto Nacional de Pediatría de México DF desde enero de 1998 hasta diciembre de 2006, en total 837 pacientes. La técnica quirúrgica utilizada consistió en el cierre de labio hendido en forma vertical. Del total de pacientes, 310 fueron mujeres y 527 varones; el 13% (n=109 presentaban hendidura bilateral. El 95% de los pacientes (n= 795 tuvieron un resultado estético adecuado; no se presentaron complicaciones postoperatorias inmediatas y sólo en un paciente se produjo dehiscencia de la herida. Como ventajas de la técnica podemos citar el que produce una línea cicatricial que parece la columna del filtrum hendido, el que conlleva una disección anatómica de la piel (líneas de máxima tensión y el que evita las incisiones que cruzan el filtrum o el ala nasal, con lo que la cicatriz resultante es menos visible.No other congenital deformity has the potential to alter the face form as perceivably as it makes a cleft lip and palate. The middle third of the face is altered and it represents a great challenge for plastic surgeon. We propose the vertical closing of the skin after miorraphy forming a line and trying to appear like the filtrum column that was not formed in the cleft lip. We report the result in children operated on our Service of Plastic Surgery at the Instituto Nacional de Salud, México DF, from january 1998 to december 2006, total 837 patients. Surgical technique consisted of the closing of cleft lip in vertical way. Total number

  15. Selective modulation of nociceptive processing due to noise distraction. (United States)

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


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

  16. The emotional side of cognitive distraction: Implications for road safety. (United States)

    Chan, Michelle; Singhal, Anthony


    Driver distraction is estimated to be one of the leading causes of motor vehicle accidents. However, little is known about the role of emotional distraction on driving, despite evidence that attention is highly biased toward emotion. In the present study, we used a dual-task paradigm to examine the potential for driver distraction from emotional information presented on roadside billboards. This purpose was achieved using a driving simulator and three different types of emotional information: neutral words, negative emotional words, and positive emotional words. Participants also responded to target words while driving and completed a surprise free recall task of all the words at the end of the study. The findings suggest that driving performance is differentially affected by the valence (negative versus positive) of the emotional content. Drivers had lower mean speeds when there were emotional words compared to neutral words, and this slowing effect lasted longer when there were positive words. This may be due to distraction effects on driving behavior, which are greater for positive arousing stimuli. Moreover, when required to process non-emotional target stimuli, drivers had faster mean speeds in conditions where the targets were interspersed with emotional words compared to neutral words, and again, these effects lasted longer when there were positive words. On the other hand, negative information led to better memory recall. These unique effects may be due to separate processes in the human attention system, particularly related to arousal mechanisms and their interaction with emotion. We conclude that distraction that is emotion-based can modulate attention and decision-making abilities and have adverse impacts on driving behavior for several reasons. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. The influence of various distracting stimuli on spatial working memory

    Directory of Open Access Journals (Sweden)

    Martina Starc


    Full Text Available Protecting information from distraction is essential for optimal performance of working memory. We examined how the presence of distracting stimuli influences spatial working memory and compared the effect of both task-similar and negatively emotionally salient distractors. We checked the effect of distractors on the accuracy of high-resolution representations, as well as the maintenance of spatial categories, and more precisely defined not only the existence but also the direction of the distracting influences (towards or away from the position of the distractor. Participants (n = 25, 8 men, 19–31 years old were asked to remember the exact position of a target scrambled image and recall it with a joystick after a delay. In some trials an additional distracting image (scrambled, neutral or negative was shown during the delay. We measured the spread of responses (standard deviation of angular error and shifts of the average response towards the prototype angles (45° or towards the position of distractors. Distracting stimuli did not affect the spread of responses and decreased the tendency of participants to move the responses towards the prototype angle. Different types of distractors did not differ in this effect. Contrary to expectations, the participants moved their responses away from the position of distractors; this effect was more pronounced for negative distractors. In addition to memorizing the exact position and maintaining attention on the position of the stimulus, participants are likely to strategically use information about spatial category membership (quadrants and information about the position of the distractor. The repulsive effect of the distractor likely results from inhibition of its position and indicates the need to supplement computational models of spatial working memory and to take into account different strategies of working memory use.

  18. Grunting's competitive advantage: Considerations of force and distraction. (United States)

    Sinnett, Scott; Maglinti, Cj; Kingstone, Alan


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

  19. Orthodontic Considerations for Maxillary Distraction Osteogenesis in Growing Patients with Cleft Lip and Palate Using Internal Distractors (United States)

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


    The orthodontist plays a key role in the selection of the optimal treatment for patients followed by a craniofacial team. For patients with cleft lip and palate, the need for multidisciplinary treatment planning and sequentially staged treatment is essential for successful patient outcomes. The technique of Le Fort I distraction osteogenesis of the maxilla using an internal device is potentially a predictable, stable, and convenient option for the correction of severe maxillary hypoplasia. It is an alternative option for treatment of maxillary hypoplasia in growing patients. In this article, the authors describe the orthodontist's approach to the management of cleft patients with severe maxillary deficiency with the use of an internal distraction device. The information is presented with a focus on the clinical aspects of treatment, using case illustrations and appropriate literature. PMID:25383056

  20. Multistage bone-charged distraction osteogenesis for aesthetic reconstruction of an extensive bone deficiency in the mandible. (United States)

    Watanabe, Yorikatsu; Sasaki, Ryo; Ando, Tomohiro; Okano, Teruo; Akizuki, Tanetaka


    Alveolar and mandibular bone defects impair occlusion and affect the aesthetics of facial contouring, making it difficult to obtain a satisfactory outcome. Treatment with distraction osteogenesis (DO) is particularly difficult in cases in which the defective region extends to close to the inferior margin of the mandible. To overcome the limits of current DO, we developed a method as follows. In the first stage, a submucosal space necessary for bone grafting was prepared by soft tissue expansion through DO. In the second stage, an iliac corticocancellous bone was transplanted with its cancellous side in close contact with the new bone in the space formed on the labial side into this new space. In the third stage, the grafted bone was distracted. This technique requires time, but each surgery is of minimum invasiveness and does not leave a visible scar; use of this technique may expand the limited indication of current DO and dental implants.

  1. Acquired vertical accommodative vergence. (United States)

    Klein-Scharff, Ulrike; Kommerell, Guntram; Lagrèze, Wolf A


    Vertical accommodative vergence is an unusual synkinesis in which vertical vergence is modulated together with accommodation. It results from a supranuclear miswiring of the network normally conveying accommodative convergence. So far, it is unknown whether this condition is congenital or acquired. We identified an otherwise healthy girl who gradually developed vertical accommodative vergence between five to 13 years of age. Change of accommodation by 3 diopters induced a vertical vergence of 10 degrees. This observation proves that the miswiring responsible for vertical accommodative vergence must not necessarily be congenital, but can be acquired. The cause and the mechanism leading to vertical accommodative vergence are yet unknown.

  2. Rehabilitation of esthetics in advanced periodontal cases using orthodontics for vertical hard and soft tissue regeneration prior to implants - a report of 2 challenging cases treated with an interdisciplinary approach. (United States)

    Mankoo, Tidu; Frost, Laura


    The esthetic rehabilitation of advanced periodontal cases remains a challenge, despite the numerous advances in treatment of periodontitis and regenerative therapies. Whilst understanding of periodontal diseases deepens with advances in cell biology, cell signaling, and genomic research, the restoration of the gingival tissues to anatomical norms remains a considerable challenge in advanced cases. The improvements in diagnosis and treatment of disease certainly enable successful management of disease and stabilization of the compromised and failing dentition. Nonetheless, effective "esthetic" rehabilitation of patients with advanced disease affecting teeth in the esthetic zone, where significant asymmetrical bone loss and tissue recession are present, still constitutes a significant dilemma. An interdisciplinary approach involving vertical augmentation of bone and soft tissues by means of orthodontic extrusion of severely compromised periodontally involved teeth to reconstitute esthetics, as well as ideal bone and soft tissue volume prior to immediate implant placement and restoration, may be a particularly useful treatment option in patients suffering advanced periodontal disease with asymmetrical bone and tissue loss in the esthetic zone. This paper discusses the concepts and illustrates its use in two complex and demanding cases.

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

    Directory of Open Access Journals (Sweden)

    Prasanna Kumar


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

  4. Differential effects of performance demand and distraction on sexually functional and dysfunctional males. (United States)

    Abrahamson, D J; Barlow, D H; Abrahamson, L S


    Sexually functional and sexually dysfunctional male subjects viewed an erotic film while experiencing two different types of distraction. During a neutral distracting condition, subjects were asked to estimate the length and width of a straight line appearing on an adjacent video monitor. During the "performance demand" distraction condition, subjects viewed video feedback of their genital responses and were asked to estimate percentage of full erection. These conditions were compared to a no distraction control condition. Performance demand distraction significantly elevated the responding of functional subjects compared to the neutral distraction condition. The responding of dysfunctional subjects, on the other hand, decreased during the performance demand distraction and was significantly lower than arousal in functional subjects in this condition. Post hoc analyses examined possible cognitive and affective mediating factors of this differential response.

  5. Using iPads for distraction to reduce pain during immunizations. (United States)

    Shahid, Ramzan; Benedict, Christina; Mishra, Seetal; Mulye, Milan; Guo, Rong


    To determine if using an iPad as a distraction technique reduces the parent's perception of their child's pain and distress during immunizations. A total of 103 parents completed a survey regarding their perception of their child's pain during immunizations. Fifty-seven patients were in the group receiving no distraction intervention, and 46 patients were in the group that were allowed to use an iPad for distraction while receiving their vaccines. Regression analysis showed that the use of iPad distraction significantly reduced the parent's perception of their child's level of anxiety, need for being held, and amount of crying during immunizations compared to no distraction. Distraction by using an iPad during immunizations reduces the parent's perception of their child's pain and distress. This type of distraction tool can also improve the parent's satisfaction with the pain control provided for their child while receiving their vaccines. © The Author(s) 2014.

  6. Velopharyngeal changes after maxillary distraction in cleft patients using a rigid external distraction device: A retrospective study. (United States)

    Taha, Mahasen; Elsheikh, Yasser M


     To evaluate early and late velopharyngeal changes in cleft lip and palate (CLP) patients after use of the Rigid External Distractor (RED) device and to correlate these changes to the amount of maxillary advancement.  Thirty Class III CLP patients were included in the study. Maxillary advancement was performed using the RED device in combination with titanium miniplates and screws for anchorage. Lateral cephalograms, nasometer, and nasopharyngoscope records were taken before distraction, immediately after distraction, and 1 year after distraction. A paired t-test was used to detect differences at P < .05.  SNA angle and A point and ANS to Y axis were significantly increased after maxillary distraction (P  =  .0001). Statistically significant increases in nasopharyngeal and oropharyngeal depths, velar angle, and need ratio were also found (P  =  .0001). Nasalance scores showed a significant increase (P  =  .008 for nasal text and .044 for oral text). A significant positive correlation was observed between the amount of maxillary advancement and the increase in nasopharyngeal depth and hypernasality (P  =  .012 and .026, respectively).  Nasopharyngeal function was deteriorated after maxillary advancement in CLP patients. There was a significant positive correlation between the amount of maxillary advancement and the increase in nasopharyngeal depth and hypernasality.

  7. Can infection associated with rib distraction techniques be managed without implant removal? (United States)

    Smith, John T; Smith, Melissa S


    Retrospective clinical cohort study of infections in patients treated using rib distraction techniques. To determine if patients with early onset spinal deformity, who develop infection around their rib distraction implant, can be successfully managed without implant removal. Vertical Expandable Prosthetic Titanium Rib (VEPTR) has gained wide acceptance for the management of progressive complex spinal deformity in children. Many children in this population have significant comorbidities and low body mass index putting them at high risk for infection. Typically, the protocol for treating all but early infection recommends implant removal. The purpose of this study is to determine if a VEPTR infection can be managed effectively without implant removal. This is an institutional review board-approved retrospective review of medical records of all patients who had VEPTR procedures and developed infections at PCMC from 2002 to 2008. Ninety-seven patients underwent 678 VEPTR procedures. Nineteen infections developed in 16 patients, with a 2% overall rate of infection per procedure. The average body mass index (16.2) and absolute neutrophil count (8.2) were predictably low for this population. The diagnosis was varied. Infection was associated with initial implantation (31%), expansion (47%), exchange (5%), and revision (21%). Seventeen of 19 infections followed a wound dehiscence. Thirteen infections were classified as superficial and six deep. All patients were treated with initial irrigation and debridement (I&D) and intravenous antibiotics. The average duration of intravenous therapy was 58 days, followed by oral suppressive therapy for 34 days (2-126). Three patients required more than one debridement to control the infection (range, 2-4 I&D). No patient has required VEPTR removal to resolve the infection. These data suggest that infections involving VEPTR instrumentation without fusion procedures can be effectively managed without implant removal. Nutrition and

  8. A new method to assess long term small sea-bottom vertical displacement in shallow water from bottom pressure sensor: the case of Campi Flegrei, Southern Italy (United States)

    Malservisi, R.; Chierici, F.; Iannaccone, G.; Guardato, S.; Pignagnoli, L.; Locritani, M.; Embriaco, D.; Donnarumma, G. P.; Rodgers, M.; Beranzoli, L.


    We present a new methodology aimed at assessing long term small vertical seafloor deformation in shallow water environments by using Bottom Pressure Recorder (BPR) measurements jointly with ancillary sea level, water column and barometric data. These measurements are presently acquired only in areas where the amount of vertical deformation is large and in deep water environment, where the noise induced by the sea state and other near surface disturbances is low. We applied the method to the data acquired in 2011 by a BPR deployed at about 96 m depth in the marine sector of the Campi Flegrei Caldera, during a quasi-symmetric seafloor uplift episode of a few centimeters amplitude. The method provides an estimation of the vertical uplift of the caldera of 2.5 +/- 1.3 cm achieving an unprecedented level of precision in the measurement of the seafloor vertical deformation in shallow water. We reached this result by taking into account the contribution of the BPR instrumental drift and the contribution of the sea water density variations, which can affect the measurement on the order of tens of centimeters. The estimation of the vertical deformation obtained in this way compares favorably with data acquired by a land based GPS station, which is located at the same distance from the area of maximum deformation as the BPR

  9. Distração osteogênica da sínfise mandibular como opção de tratamento ortodôntico: relato de caso Mid-sagittal mandible osteogenetic distraction as an option for orthodontic treatment: case report

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    Luiz Guilherme Martins Maia


    esthetically benefit the patient. But this mandible separation treatment becomes unavailable since this bone has its suture fused at an early age. The expansion in this case is alveolar and its stability is questioned. OBJECTIVES: to relate a clinical case presenting a new alternative for the treatment of inferior crowding: the Osteogenetic Distraction of the Mandibular Symphysis (ODMS. In this procedure, a sagittal osteotomy of the mandibular symphysis is performed, creating an artificial suture so that a bone separation is obtained using the mechanics of a modified "Hyrax" separator. RESULTS: the patient showed an improvement in the arch, reduction of the buccal corridor, correction of the dental crowding and also a stability of the treatment without damage to the surrounding tissues. In this case, the ODMS showed to be an excellent treatment option.

  10. Effects of growth on maxillary distraction osteogenesis in cleft lip and palate. (United States)

    Doucet, Jean-Charles; Herlin, Christian; Bigorre, Michèle; Bäumler, Caroline; Subsol, Gérard; Captier, Guillaume


    The objective was to analyze the effects of growth on the long-term result of maxillary distraction osteogenesis (DO) in cleft lip and palate (CLP). Retrospective study of 24 CLP cases with long-term follow-up operated for maxillary DO using the Polley and Figueroa technique: 10 patients were distracted during growth, while 14 patients were operated after their growth spurt. Preoperative (T0), 6-12 months postoperative (T1), and ≥4 years postoperative (T2) cephalometric radiographs were evaluated. A classical cephalometric analysis was used to assess the treatment stability, and a Procrustes superimposition method was performed to assess local changes in the maxilla and the mandible. At T0, the mean age was of 11.9 ± 1.4 years for growing patient, and 17.9 ± 3.5 years for patient treated after their growth spurt (P palatal plane and mandibular plane. Maxillary DO in CLP does not correct the growth deficit inherent to the pathology. Overcorrection of at least 20% is advised during growth. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  11. Vertical Deformation Monitoring of the Suspension Bridge Tower Using GNSS: A Case Study of the Forth Road Bridge in the UK

    Directory of Open Access Journals (Sweden)

    Qusen Chen


    Full Text Available The vertical deformation monitoring of a suspension bridge tower is of paramount importance to maintain the operational safety since nearly all forces are eventually transferred as the vertical stress on the tower. This paper analyses the components affecting the vertical deformation and attempts to reveal its deformation mechanism. Firstly, we designed a strategy for high-precision GNSS data processing aiming at facilitating deformation extraction and analysis. Then, 33 months of vertical deformation time series of the southern tower of the Forth Road Bridge (FRB in the UK were processed, and the accurate subsidence and the parameters of seasonal signals were estimated based on a classic function model that has been widely studied to analyse GNSS coordinate time series. We found that the subsidence rate is about 4.7 mm/year, with 0.1 mm uncertainty. Meanwhile, a 15-month meteorological dataset was utilised with a thermal expansion model (TEM to explain the effects of seasonal signals on tower deformation. The amplitude of the annual signals correlated quite well that obtained by the TEM, with the consistency reaching 98.9%, demonstrating that the thermal effect contributes significantly to the annual signals. The amplitude of daily signals displays poor consistency with the ambient temperature data. However, the phase variation tendencies between the daily signals of the vertical deformation and the ambient temperature are highly consistent after February 2016. Finally, the potential contribution of the North Atlantic Drift (NAD to the characteristics of annual and daily signals is discussed because of the special geographical location of the FRB. Meanwhile, this paper emphasizes the importance of collecting more detailed meteorological and other loading data for the investigation of the vertical deformation mechanism of the bridge towers over time with the support of GNSS.

  12. Vertical axis wind turbines (United States)

    Krivcov, Vladimir [Miass, RU; Krivospitski, Vladimir [Miass, RU; Maksimov, Vasili [Miass, RU; Halstead, Richard [Rohnert Park, CA; Grahov, Jurij [Miass, RU


    A vertical axis wind turbine is described. The wind turbine can include a top ring, a middle ring and a lower ring, wherein a plurality of vertical airfoils are disposed between the rings. For example, three vertical airfoils can be attached between the upper ring and the middle ring. In addition, three more vertical airfoils can be attached between the lower ring and the middle ring. When wind contacts the vertically arranged airfoils the rings begin to spin. By connecting the rings to a center pole which spins an alternator, electricity can be generated from wind.

  13. Attention and working memory in elderly: the influence of a distracting environment. (United States)

    Rodrigues, Pedro F S; Pandeirada, Josefa N S


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

  14. Bending of the distraction site during mandibular distraction osteogenesis in the rabbit: a model for studying segment control and side effects. (United States)

    Yen, S L; Wei, S; Li, S; Shuler, C; Yamashita, D D


    The purpose of this investigation was to develop an animal model for studying and correcting mandibular distraction side effects. Twenty-nine rabbits underwent bilateral mandibular distraction. Bending of the mandible was accomplished by offsetting a linear distraction by 35 degrees from the occlusal plane (4 screws per distractor), rotating the anterior segment inferiorly (2 screws per distractor), and removing a 3- or 6-mm wedge of the distraction site. The amount of bite opening varied according to the surgical design. Direct measurements, radiographs, and histology samples were compared. Linear distraction produced a 4-mm anterior open bite and a Class III malocclusion after 2 weeks of distraction. Segmental rotation produced an 8-mm anterior open bite without complications. Removal of a wedge initiated rotation of the anterior segment. A large wedge (6 mm) produced fibrous union in the distraction site. The amount of bite opening or closure depended on the number of surgical screws and position of the distractor. Serial histologic sections showed bone formation at the rotated, triangular distraction site. Bite opening or closure can occur from loss of segment control or by altering surgical design. This information is needed to counter unwanted side effects or to plan segment rotations. Copyright 2001 American Association of Oral and Maxillofacial Surgeons

  15. Does attention capacity moderate the effect of driver distraction in older drivers? (United States)

    Cuenen, Ariane; Jongen, Ellen M M; Brijs, Tom; Brijs, Kris; Lutin, Mark; Van Vlierden, Karin; Wets, Geert


    With age, a decline in attention capacity may occur and this may impact driving performance especially while distracted. Although the effect of distraction on driving performance of older drivers has been investigated, the moderating effect of attention capacity on driving performance during distraction has not been investigated yet. Therefore, the aim was to investigate whether attention capacity has a moderating effect on older drivers' driving performance during visual distraction (experiment 1) and cognitive distraction (experiment 2). In a fixed-based driving simulator, older drivers completed a driving task without and with visual distraction (experiment 1, N=17, mean age 78 years) or cognitive distraction (experiment 2, N=35, mean age 76 years). Several specific driving measures of varying complexity (i.e., speed, lane keeping, following distance, braking behavior, and crashes) were investigated. In addition to these objective driving measures, subjective measures of workload and driving performance were also included. In experiment 1, crash occurrence increased with visual distraction and was negatively related to attention capacity. In experiment 2, complete stops at stop signs decreased, initiation of braking at pedestrian crossings was later, and crash occurrence increased with cognitive distraction. Interestingly, for a measure of lane keeping (i.e., standard deviation of lateral lane position (SDLP)), effects of both types of distraction were moderated by attention capacity. Despite the decrease of driving performance with distraction, participants estimated their driving performance during distraction as good. These results imply that attention capacity is important for driving. Driver assessment and training programs might therefore focus on attention capacity. Nonetheless, it is crucial to eliminate driver distraction as much as possible given the deterioration of performance on several driving measures in those with low and high attention capacity

  16. The potential roles of nanobiomaterials in distraction osteogenesis. (United States)

    Makhdom, Asim M; Nayef, Lamees; Tabrizian, Maryam; Hamdy, Reggie C


    Distraction osteogenesis (DO) technique is used worldwide to treat many orthopedic conditions. Although successful, one limitation of this technique is the extended period of fixators until the bone is consolidated. The application of growth factors (GFs) is one promising approach to accelerate bone regeneration during DO. Despite promising in vivo results, its use is still limited in the clinic. This is secondary to inherent limitations of these GFs. Therefore, a development of delivery systems that allow sustained sequential release is necessary. Nanoparticles and nanocomposites have prevailing properties that can overcome the limitations of the current delivery systems. In addition, their use can overcome the current challenges associated with the insufficient mechanical properties of scaffolds and suboptimal osteogenic differentiation of transplanted cells in the distraction gap. We discuss the clinical implications, and potential early applications of the nanoparticles and nanocomposites for developing new treatments to accelerate bone regeneration in DO. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. A case study for integrated STEM outreach in an urban setting using a do-it-yourself vertical jump measurement platform. (United States)

    Drazan, John F; Danielsen, Heather; Vercelletto, Matthew; Loya, Amy; Davis, James; Eglash, Ron


    The purpose of this study was to develop and deploy a low cost vertical jump platform using readily available materials for Science, Technology, Engineering, and Mathematics (STEM) education and outreach in the inner city. The platform was used to measure the jumping ability of participants to introduce students to the collection and analysis of scientific data in an engaging, accessible manner. This system was designed and fabricated by a student team of engineers as part of a socially informed engineering and design class. The vertical jump platform has been utilized in 10 classroom lectures in physics and biology. The system was also used in an after school program in which high school volunteers prepared a basketball based STEM outreach program, and at a community outreach events with over 100 participants. At present, the same group of high school students are now building their own set of vertical jump platform under the mentorship of engineering undergraduates. The construction and usage of the vertical jump platform provides an accessible introduction to the STEM fields within the urban community.

  18. Music preference as a factor of music distraction. (United States)

    Parente, J A


    The present study is an experimental analysis of music preference as a factor of music distraction measured by the Stroop tests. Significant differences were found amoung groups given, most preferred music, least preferred music, and no music (quiet). Each group of 10 subjects were randomly chosen from 42 screened subjects. Performance was better without music and better with most preferred than with least preferred music. The results were not consistent with those previously found for the effects of noise upon Stroop test performance.

  19. Composite Bone and Soft Tissue Loss Treated with Distraction Histiogenesis (United States)


    requiring removal. The first major complication included prema- ture fibular consolidation leading to syndesmosis sublux- ation during tibia...distraction. This required repeat fibular osteotomy and syndesmosis fixation. The second major complication was a scarred tibialis anterior tendon within the... deficiency after acute trauma: the role of bone transport. Orthop. Clin. North Am. 25:753– 763, 1994. 4. Watson, J. T., Anders, M., Moed, B. R. Management

  20. Prediction of cartilaginous tissue repair after knee joint distraction. (United States)

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


    For young patients (knee joint distraction (KJD) may be a joint-saving treatment option for end-stage knee osteoarthritis. Distracting the femur from the tibia by five millimeters for six to eight weeks using an external fixation frame results in cartilaginous tissue repair, in addition to clinical benefits. This study is a first attempt to predict the degree of cartilaginous tissue repair after KJD. Fifty-seven consecutive patients received KJD. At baseline and at one year of follow-up, mean and minimum joint space width (JSW) of the most-affected compartment was determined on standardized radiographs. To evaluate the predictive ability of baseline characteristics for JSW at one year of follow-up, multivariable linear regression analysis was performed. Mean JSW±SD of the most affected compartment increased by 0.95±1.23mm to 3.08±1.43mm at one year (P<0.001). The minimum JSW increased by 0.94±1.03mm to 1.63±1.21mm at one year of follow-up (P<0.001). For a larger mean JSW one year after KJD, only Kellgren & Lawrence grade (KLG) at baseline was predictive (Regression coefficient (β)=0.47, 95% CI=0.18 to 0.77, P=0.002). For a larger minimum JSW, KLG (β=0.46, 95% CI=0.19 to 0.73, P=0.001) and male gender (β=0.52, 95% CI=0.06 to 0.99, P=0.028) were statistically predictive. Eight weeks of distraction time neared significance (β=0.44, 95% CI=-0.05 to 0.93, P=0.080). In our cohort of patients treated with KJD, males with higher KLG had the best chance of cartilaginous tissue repair by distraction. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. U.S. State and Federal Laws Targeting Distracted Driving (United States)

    Catherine Chase, J.D.


    Distracted driving has burgeoned with the proliferation of cell phones, global positioning systems and other in-vehicle and personal electronic devices. Annually more than 3,300 people are killed and an additional 400,000 are injured in the United States in distracted driving crashes. The United States (U.S.) federal and state governments have responded to this public health problem with policies and laws; however, a more comprehensive and more effective approach is still needed. Some restrictions on the use of electronic devices while driving by federal employees and some voluntary guidelines and recommendations have been issued. Public opinion polls show support for addressing the issue of distracted driving with state laws. The majority of states have laws banning text messaging while driving and prohibiting the use of an electronic device by teenage or novice drivers. Some states prohibit all drivers from using a hand-held cellphone. Currently no state has a total ban on the use of personal electronic devices while driving. Successful past traffic safety campaigns changing driver behavior have demonstrated the necessity to adopt a “three Es” approach of Enactment of a law, Education of the public about the law, and rigorous Enforcement of the law. Experience reveals that this approach, along with future federal regulation of in-vehicle electronic devices and the employment of technology to limit the use of electronic devices while driving, is needed to alter personal behavior in order to reduce distractions and keep drivers focused on the driving task. PMID:24776229

  2. Mini External Fixator Assisted Metacarpal Lengthening With The Distraction Method

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    Kilinc Bekir Eray


    Full Text Available Phalangeal brachydactyly, which is caused by the abnormal development of the metacarpal, is characterized by shortness that can be seen in a single finger or in all fingers of the hands. Although brachydactyly is usually thought of as congenital, it can occur due to metabolic disorders or trauma. A twelve-year-old girl was admitted to our clinic with complaints of shortness in the fourth finger of the left hand. Osteotomy was applied with the drilling-osteotomy technique. The screws holding the upper and lower segments were adapted to the external fixator. Lengthening began one week after the osteotomy. The lengthening rate was organized as 0.25×2 mm/day. The amount of elongation was planned not to exceed 40% of the original bone length. Distraction was terminated after the planned elongation amount was reached, and the bone was allowed to heal. In patients under twenty years of age, the results from progressive distraction without bone grafting are close to perfect. Although the technique of successfully lengthening metacarpal fractures in children is simple, strict rules should not be ignored. Primarily, the external fixator and the distraction system should be sufficiently stable, lightweight, and should be appropriate for the size of a child’s hand.

  3. Naturalistic distraction and driving safety in older drivers. (United States)

    Aksan, Nazan; Dawson, Jeffrey D; Emerson, Jamie L; Yu, Lixi; Uc, Ergun Y; Anderson, Steven W; Rizzo, Matthew


    In this study, we aimed to quantify and compare performance of middle-aged and older drivers during a naturalistic distraction paradigm (visual search for roadside targets) and to predict older drivers performance given functioning in visual, motor, and cognitive domains. Distracted driving can imperil healthy adults and may disproportionally affect the safety of older drivers with visual, motor, and cognitive decline. A total of 203 drivers, 120 healthy older (61 men and 59 women, ages 65 years and older) and 83 middle-aged drivers (38 men and 45 women, ages 40 to 64 years), participated in an on-road test in an instrumented vehicle. Outcome measures included performance in roadside target identification (traffic signs and restaurants) and concurrent driver safety. Differences in visual, motor, and cognitive functioning served as predictors. Older drivers identified fewer landmarks and drove slower but committed more safety errors than did middle-aged drivers. Greater familiarity with local roads benefited performance of middle-aged but not older drivers.Visual cognition predicted both traffic sign identification and safety errors, and executive function predicted traffic sign identification over and above vision. Older adults are susceptible to driving safety errors while distracted by common secondary visual search tasks that are inherent to driving. The findings underscore that age-related cognitive decline affects older drivers' management of driving tasks at multiple levels and can help inform the design of on-road tests and interventions for older drivers.

  4. Susceptibility to distraction by social cues in borderline personality disorder. (United States)

    Krause-Utz, Annegret; Elzinga, Bernet M; Oei, Nicole Y L; Spinhoven, Philip; Bohus, Martin; Schmahl, Christian


    Individuals with borderline personality disorder (BPD) are highly sensitive to social rejection and show alterations in social perception. Increased susceptibility to social cues in patients with BPD might interfere with executive functions that play an important role in goal-directed behavior. The aim of this study was to investigate the influence of task-irrelevant (neutral vs. negatively arousing) social cues on working memory performance in BPD patients compared to healthy controls (HC). 28 unmedicated female BPD patients and 28 female HC (matched for age and education) performed a Sternberg item recognition task, while being distracted by neutral versus negatively arousing pictures from the International Affective Picture System (interpersonal scenes) and the Karolinska Directed Emotional Faces Set (faces). Additionally, self-ratings of aversive inner tension were assessed and correlated with task performance. Compared to HC, BPD patients showed significantly impaired accuracy after distraction by negatively arousing stimuli (both scenes and faces) and neutral faces (but not neutral scenes). Significant negative correlations between overall accuracy and self-reported aversive inner tension were observed in BPD patients. Findings of the present study suggest increased susceptibility to distracting (negatively arousing) social cues in individuals with BPD, which might interfere with cognitive functioning. © 2013 S. Karger AG, Basel.

  5. Intraoral distraction osteogenesis of the mandible in hemifacial microsomia. (United States)

    Rachmiel, A; Manor, R; Peled, M; Laufer, D


    Lengthening of the mandible by distraction osteogenesis is the preferred method for treatment of hemifacial microsomia in children. Use of an intraoral distraction technique and horizontal oblique ramus osteotomy in such patients is presented. Mandibular ramus lengthening was performed in 11 patients aged 6 to 12 years with hemifacial microsomia. During the age of mixed dentition in hemifacial microsomia patients with a hypoplastic mandible, the unerupted molars buds are located high in the retromolar region and are in danger of being damaged by the osteotomy. Therefore, an intraoral approach exposing the mandibular ramus and angle was performed, and a horizontal oblique ramus osteotomy was made, preserving the inferior alveolar nerve. An intraoral device was placed along the ramus, and distraction was started on the third postoperative day at the rate of 1 mm/d and continued for 2 to 3 weeks or as long as necessary. The device was maintained for retention an additional 6 weeks and was then removed. Clinically, the face became more symmetric. The postdistraction posteroanterior cephalometric radiographs demonstrated elongation of the affected ramus and improvement in facial symmetry. The advantages of this method are that it allows device placement along the ramus, permitting the ramus elongation necessary in treatment of hemifacial microsomia, that it prevents damage to the tooth buds which, during the age of mixed dentition, are in a higher position in the retromolar area, and that it prevents injury of the inferior alveolar nerve. Copyright 2001 American Association of Oral and Maxillofacial Surgeons

  6. Simultaneous Sinus Lifting and Alveolar Distraction of a Severely Atrophic Posterior Maxilla for Oral Rehabilitation with Dental Implants

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    Takahiro Kanno


    Full Text Available We retrospectively reviewed a new preimplantation regenerative augmentation technique for a severely atrophic posterior maxilla using sinus lifting with simultaneous alveolar distraction, together with long-term oral rehabilitation with implants. We also analyzed the regenerated bone histomorphologically. This study included 25 maxillary sinus sites in 17 patients. The technique consisted of alveolar osteotomy combined with simultaneous sinus lifting. After sufficient sinus lifting, a track-type vertical alveolar distractor was placed. Following a latent period, patient self-distraction was started. After the required augmentation was achieved, the distractor was left in place to allow consolidation. The distractor was then removed, and osseointegrated implants (average of 3.2 implants per sinus site, 80 implants were placed. Bone for histomorphometric analysis was sampled from six patients and compared with samples collected after sinus lifting alone as controls (n=4. A sufficient alveolus was regenerated, and all patients achieved stable oral rehabilitation. The implant survival rate was 96.3% (77/80 after an average postloading followup of 47.5 months. Good bone regeneration was observed in a morphological study, with no significant difference in the rate of bone formation compared with control samples. This new regenerative technique could be a useful option for a severely atrophic maxilla requiring implant rehabilitation.

  7. Potential distractions and unsafe driving behaviors among drivers of 1- to 12-year-old children. (United States)

    Macy, Michelle L; Carter, Patrick M; Bingham, C Raymond; Cunningham, Rebecca M; Freed, Gary L


    Driver distraction has been identified as a threat to individual drivers and public health. Motor vehicle collisions remain a leading cause of death for children, yet little is known about distractions among drivers of children. This study sought to characterize potential distractions among drivers of children. A 2-site, cross-sectional, computerized survey of child passenger safety practices was conducted among adult drivers of 1- to 12-year-old children who presented for emergency care between October 2011 to May 2012. Drivers indicated the frequency with which they engaged in 10 potential distractions in the past month while driving with their child. Distractions were grouped in 4 categories: (1) nondriving, (2) cellular phone, (3) child, and (4) directions. Information about other unsafe driving behaviors and sociodemographic characteristics was collected. Nearly 90% of eligible parents participated. Analysis included 570 drivers (92.2%). Non-driving-related and cellular phone-related distractions were disclosed by >75% of participants. Fewer participants disclosed child (71.2%) and directions-related distractions (51.9%). Child age was associated with each distraction category. Cellular phone-related distractions were associated with the child riding daily in the family car, non-Hispanic white, and higher education. Parents admitting to drowsy driving and being pulled over for speeding had over 2 times higher odds of disclosing distractions from each category. Distracted driving activities are common among drivers of child passengers and are associated with other unsafe driving behaviors. Child passenger safety may be improved by preventing crash events through the reduction or elimination of distractions among drivers of child passengers. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  8. Attentional distraction during exercise in overweight and normal-weight boys


    Benedicte Deforche; Ilse De Bourdeaudhuij


    The purpose of this study was to investigate the effect of attentional distraction on field running distance and activity intensity during an exercise session in normal-weight and overweight youngsters and to investigate potential mediators. Fifty-three 12–14 yr-old boys participated twice in a 12-min running test and a 20-min exercise session, once with attentional distraction (by listerning to music) and once without distraction (counterbalanced randomised controlled design). At the end of...

  9. Maternal Distraction During Breast- and Bottle Feeding Among WIC and non-WIC Mothers. (United States)

    Ventura, Alison K; Teitelbaum, Simone

    To explore the prevalence and correlates of maternal distraction during infant feeding within a sample of mothers enrolled or not in the Special Supplemental Nutrition Program for Woman, Infants, and Children (WIC). Mothers kept diaries of their infants' feeding patterns. Mothers (n = 75) with infants aged ≤6 months. Within the diaries, mothers recorded what else, if anything, they did during the feeding. Mothers also completed questionnaires on demographics, feeding styles, and infant temperament and eating behaviors. Mothers' responses were coded into thematic categories. Feedings were classified as distracted when the mothers reported doing something other than feeding and/or interacting with the infant. Logistic regression was used to explore whether mothers exhibited different levels of distraction when breastfeeding (BF) vs bottle feeding. The researchers used multiple stepwise regression to explore associations between distracted feeding and characteristics of mothers and infants. Distractions were reported during 43% of feedings; 26% involved technological distractors. Mothers who were multiparous and perceived that their infants had greater appetites reported greater levels of any distraction during feeding. Mothers who were of racial/ethnic minorities, adhered to laissez faire feeding style, had younger infants, and perceived their infants to have lower food responsiveness and greater appetite reported greater levels of technological distraction. Being enrolled in WIC was not associated with mothers' levels of distracted feeding. Mothers reported a wide variety of distractions during both BF and bottle feeding; higher levels of distraction were associated with characteristics of both mothers and infants. Further research is needed to understand whether and how maternal distraction affects feeding outcomes. Awareness of such distractions and their potential impact would be useful to practitioners working with pregnant and postpartum women. Copyright

  10. On the role of vertical electron density gradients in the generation of type II irregularities associated with blanketing ES (ESb) during counter equatorial electrojet events: A case study (United States)

    Devasia, C. V.; Jyoti, N.; Subbarao, K. S. V.; Tiwari, Diwakar; Reddi, C. Raghava; Sridharan, R.


    The characteristics of different types of Sporadic E (ES) layers and the associated plasma density irregularities over the magnetic equator have been studied in a campaign mode using VHF backscatter radar, digital ionosonde, and ground magnetometer data from Trivandrum (dip latitude 0.5°N, geographic latitude 8.5°N, geographic longitude 77°E), India. The presence of blanketing type ES (ESb) in the ionograms with varying intensity and duration were observed in association with afternoon Counter Equatorial Electrojet (CEEJ) events. ESb was associated with intense backscatter returns and with either very low zonal electric field and/or with distortions present in the altitude profile of the drift velocity of the type II irregularities. The results of the coordinated study indicate the possible role of vertical electron density gradients in ESb layers in addition to providing evidence for the local winds to be responsible for the vertical gradients themselves.

  11. A subcranial Le Fort III advancement with distraction osteogenesis as a clinical strategy to approach pycnodysostosis with midface retrusion and exorbitism. (United States)

    Raposo-Amaral, Cassio Eduardo; Tong, Anne; Denadai, Rafael; Yalom, Anisa; Raposo-Amaral, Cesar Augusto; Bertola, Debora; Li, Andrew; Jarrahy, Reza


    Pycnodysostosis is a rare autosomal recessive skeletal disorder involving a constellation of craniofacial manifestations including midface retrusion. We report the case of a 13-year-old girl with pycnodysostosis who presented with exorbitism, midface retrusion, malocclusion, and obstructive sleep apnea. Here, we describe the successful use of subcranial Le Fort III advancement using distraction osteogenesis with internal Kawamoto distracters. After a latency of 5 days, distraction for 10 days, and consolidation for 12 weeks, her midface was advanced by 10 mm with slight overcorrection at the occlusion level. At 2 years postoperatively, the patient had complete remission of her sleep apnea, resolution of her exorbitism, and amelioration of her class III malocclusion to class I. To the best of our knowledge, this is the first report of a successful subcranial Le Fort III midface advancement with distraction osteogenesis for craniofacial reconstruction of a pycnodysostosis. Our report highlights the surgical options that have been described for this craniofacial deformity and presents a novel and expedient approach for patients with pycnodysostosis presenting with exorbitism, midface retrusion, and/or sleep apnea.

  12. Greater priming for previously distracting information in young than older adults when suppression is ruled out. (United States)

    Ward, Emma V; de Mornay Davies, Paul; Politimou, Nina


    The use of previously distracting information on memory tests with indirect instructions is usually age-equivalent, while young adults typically show greater explicit memory for such information. This could reflect qualitatively distinct initial processing (encoding) of distracting information by younger and older adults, but could also be caused by greater suppression of such information by younger adults on tasks with indirect instructions. In Experiment 1, young and older adults read stories containing distracting words, which they ignored, before studying a list of words containing previously distracting items for a free recall task. Half the participants were informed of the presence of previously distracting items in the study list prior to recall (direct instruction), and half were not (indirect instruction). Recall of previously distracting words was age-equivalent in the indirect condition, but young adults recalled more distracting words in the direct condition. In Experiment 2, participants performed the continuous identification with recognition task, which captures a measure of perceptual priming and recognition on each trial, and is immune to suppression. Priming and recognition of previously distracting words was greater in younger than older adults, suggesting that the young engage in more successful suppression of previously distracting information on tasks in which its relevance is not overtly signaled.

  13. Knee joint distraction compared with high tibial osteotomy: a randomized controlled trial. (United States)

    van der Woude, J A D; Wiegant, K; van Heerwaarden, R J; Spruijt, S; van Roermund, P M; Custers, R J H; Mastbergen, S C; Lafeber, F P J G


    Both, knee joint distraction as a relatively new approach and valgus-producing opening-wedge high tibial osteotomy (HTO), are knee-preserving treatments for knee osteoarthritis (OA). The efficacy of knee joint distraction compared to HTO has not been reported. Sixty-nine patients with medial knee joint OA with a varus axis deviation of knee joint distraction (n = 23) or HTO (n = 46). Questionnaires were assessed at baseline and 3, 6, and 12 months. Joint space width (JSW) as a surrogate measure for cartilage thickness was determined on standardized semi-flexed radiographs at baseline and 1-year follow-up. All patient-reported outcome measures (PROMS) improved significantly over 1 year (at 1 year p knee joint distraction group (p = 0.001) and 0.4 ± 0.5 mm in the HTO group (p knee joint distraction (p = 0.05). The lateral compartment showed a small increase in the knee joint distraction group and a small decrease in the HTO group, leading to a significant increase in mean JSW for knee joint distraction only (p knee joint distraction and HTO. These findings suggest that knee joint distraction may be an alternative therapy for medial compartmental OA with a limited mechanical leg malalignment. Randomized controlled trial, Level I.

  14. Neuropsychological assessment of distractibility in mild traumatic brain injury and depression. (United States)

    Schnabel, Ralf; Kydd, Rob


    Traditional neuropsychological assessments are conducted exclusively in a quiet, distraction-free environment; clients' abilities to operate under busy and distracting conditions remain untested. Environmental distractions, however, are typical for a multitude of real-life situations and present a challenge to clients with frontal-temporal brain injury. In an effort to improve ecological validity, an extension of the traditional neuropsychological assessment was developed, comprising a standardized distraction condition. This allowed cognitive functions to be tested both in the traditional setting and with exposure to a specified audio-visual distraction. The present study (n = 240) investigated how clients with mild Traumatic Brain Injury (mTBI) (n = 80), Major Depression (MDE) (n = 80), and a healthy control sample (n = 80) performed on sub-tests of the Wechsler Adult Intelligence Scale-IV and the Wechsler Memory Scale-IV both in the standard and the distraction conditions. Test effort was controlled. Significant deterioration of performance in the distraction setting was observed among clients with mTBI. In contrast the performance of a healthy control sample remained unchanged. Significant improvement of performance in the distraction setting was documented for clients with MDE. Contrary to their improved performance, depressed clients experienced the distraction setting as more distressing than the control and mTBI group.

  15. The pathologic mechanisms underlying lumbar distraction spinal cord injury in rabbits. (United States)

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


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

  16. Mandibular distraction osteogenesis: a rabbit model using a novel experimental design. (United States)

    Al-Sebaei, Maisa O; Gagari, Eleni; Papageorge, Maria


    Distraction osteogenesis (DO) is a surgical procedure that targets bone regeneration and elongation, currently used in the treatment of many craniofacial deformities. The quest for optimization of DO clinical parameters has led to the development of a variety of animal models. Our study aims to establish a rabbit animal model of mandibular DO, in which the control osteotomy and distraction device are placed on the opposite hemimandible from the one being distracted, within the same animal host. Furthermore, we propose to histologically characterize the different stages or distraction and consolidation in the same animal model. Twenty-five rabbits underwent mandibular osteotomies and bilateral placement of distraction devices. After a latency of 3 days, the distraction device was activated on one side of each animal at a rate of 0.5 mm/12 hours for 7 days, while the other side remained inactive (control). This was followed by a consolidation period of 14 days. Five animals per time-point were killed on days 3, 7, 10, 17, and 24. Gross tissue analysis showed a 7-mm callus formation at the distracted side and a well-healed osteotomy in the non-distracted side. Clinically, a unilateral Class III malocclusion occurred in the distracted side. Histology at each time-point shows new bone formation and orientation of the bony spicules along the axis of the mechanical strain. We have established and characterized an animal model of mandibular DO that outlines valid biologic controls and provides thorough monitoring of the DO process.

  17. Probable transmisión vertical del virus de la influenza A (H1N1: a propósito de un caso Probable vertical transmission of the influenza virus A (H1N1: apropos of a case

    Directory of Open Access Journals (Sweden)

    Rubén D. Vásquez


    Full Text Available Se reporta el caso de un recién nacido varón, producto de embarazo de 36 semanas, con diagnóstico de neumonía congénita y examen confirmatorio de infección por el virus de la influenza A (H1N1, sin ningún otro tipo de contacto sospechoso. La madre ingresó al hospital con insuficiencia respiratoria y antecedente de proceso gripal de cinco días de evolución, durante los primeros días de la pandemia en el Perú. Por la evolución grave del proceso respiratorio, se le administró ventilación mecánica para luego ser sometida a cesárea por sufrimiento fetal agudo y oligoamnios. Se confirmó en la madre infección por el virus de la influenza A H1N1 epidémico y tuberculosis pulmonar.We report the case of a male newborn, product of a 36 week pregnancy, with diagnosis of congenital pneumonia and with a confirmatory test for influenza A (H1N1 virus, without any other suspicious contact. The mother was admitted to the hospital with respiratory failure and the history of a flu-like episode of 5 days of evolution, during the first days of the pandemic in Peru. Due to the severe evolution of the respiratory process, assisted ventilation was given to her and then a cesarean section was performed due to acute fetal distress and oligoamnios. The mother was later confirmed as a case of epidemic influenza A (H1N1 and pulmonary tuberculosis.

  18. The use of distraction and imagery with children during painful procedures. (United States)

    Broome, M E; Lillis, P P; McGahee, T W; Bates, T


    The effectiveness of a pediatric pain management program was examined using a multiple case study design. This study examined both the children's pain experience during cancer treatment, as well as their parents' anxiety and behavioral stress. Fourteen children were videotaped while receiving lumbar punctures during an 8-12 month period. Baseline data were obtained at the first of three visits prior to the introduction of relaxation, imagery, and distraction exercises. Self-ratings of child fear and parent anxiety, videotaped observations of child and parent behavior, and child pain ratings were obtained at all three visits. The children's behavioral responses to the procedure varied considerably, but their fear scores were stable and their reports of pain decreased over time. Parents reported high-trait, low-state anxiety scores that were stable over time. They were observed to be very supportive during the procedures. Implications for further research in this area and recommendations for practice are presented.

  19. [Reading poems to oneself affects emotional state and level of distraction]. (United States)

    Morita, Haruka; Sugamura, Genji


    Bibliotherapy has occasionally been used as a counseling technique. However, most reports are basically single-case studies and the psychological effect of this approach remains unclear. Two experiments using 96 healthy college volunteers were conducted to determine how the reading of emotionally positive, negative, or neutral passages affect one's mood and level of distraction. Study 1 revealed that participants felt more relaxed after reading positive poems with either personal or social content than after reading negativie ones, and they felt least refreshed and calm after reading negative poems with personal content. Study 2 showed that participants reported less depressed feelings, both after reading an excerpt from an explanatory leaflet and after a controlled rest period. These results were discussed in terms of the mood congruence effect. Future research may evaluate the effects of reading novels, manga, and life teachings on self-narratives and views of life in normal and clinical populations.

  20. Patient's perception of the events during and after osteogenic alveolar distraction. (United States)

    Allais, Marvis; Maurette, Paul Edward; Mazzonetto, Renato; Filho, Jose Rodrigues Laureano


    The aim of the study was to evaluate the patient s perception of the events during and after an osteogenic alveolar distraction (OAD) procedure A total of fifty-five (55) osteogenic alveolar distraction (OAD) procedures were performed in fifty (50) patients, who then were asked to answer ten (10) questions related to the treatment. Six (6) questions made reference to predefined values in a Visual Analogical Scale (VAS), three (3) questions could be answered by a predetermined answer, and only one (1) question had a free answer. In 76% of cases, the patient s description of the sensation felt during the surgery was good and bearable; 84% of the patients didn t feel pain after surgery. 4% of the patients felt pain during the activation period and 58% of the patients described the sensation during the activation period as pressure, felt most commonly, at the end of the period, and for about 20 minutes (66.6 %). In these cases the most frequently used analgesic was Paracetamol. Also, 46% expressed having had some difficulty to activate the device, with 10% of them in need of extra help. The presence of the activation rod caused discomfort in 52%. Finally, 78% of the patients treated with OAD would undergo this procedure again if it was necessary. A bone graft was performed in 27 out of the 50 treated patients, with 70% of them describing the bone graft surgery as more painful than the OAD. The OAD technique had a high degree of acceptance among the treated patients, however, some details as the interference of the activation rod continue to disturb them. The acceptance of the OAD technique is much better when compared with bone graft surgery technique as a second treatment.

  1. Condylar positions before and after bilateral mandibular distraction osteogenesis in children with Pierre Robin sequence. (United States)

    Liu, J; Chen, Y; Li, F; Wu, W; Hao, J; Luo, D; Wang, H


    This study aimed to analyze the changes in mandibular morphology after bilateral mandibular distraction osteogenesis (BMDO) in children with Pierre Robin sequence. The positions of the condyles were analyzed in reconstructed three-dimensional craniomaxillofacial images obtained for 18 children before and 8-12 weeks after BMDO. Differences between pre- and postoperative parameters were assessed using paired t-tests. After surgery, a significant decrease in superior joint space was detected (P<0.05), but no change in anterior joint space or posterior joint space was observed. The ratio of the distance between gonia and distance between condylion points (GoL-GoR/CoL-CoR) (P<0.001) and the distances between the condyle and midsagittal plane (P<0.001) increased after surgery, while the condylar horizontal angle decreased (P<0.05). No change in condylar vertical angle was noted. After BMDO, the condyle displayed an outward and upward shift, as well as outward rotation along the proximal segment. The mandible body exhibited forward movement with a more significant opening range. These changes were consistent with the extent of the newly formed bone tissue and the improvement in coordination and appearance of the children's facial structures. The long-term effects of changes in condylar position on the development of the maxillofacial structures needs to be studied further. Copyright © 2017. Published by Elsevier Ltd.

  2. The determinants of successful distraction osteogenesis of the mandible in hemifacial microsomia from longitudinal results. (United States)

    Baek, Seung-Hak; Kim, Sukwha


    The purpose of this study was to investigate sagittal, vertical, asymmetric skeletal characteristics that could determine successful distraction osteogenesis (DO) of the mandible in patients with hemifacial microsomia using longitudinal follow-up data. Lateral and posteroanterior cephalometric radiographs before DO (T0), after DO (T1), and after retention (T2) were analyzed to investigate initial skeletal characteristics, DO effect, and retention. From the measurements at T2, patients were classified into group 1 (good retention results, N = 10) and group 2 (poor results, N = 9). Sagittal, vertical, dental, and asymmetric variables were measured. The differences at each stage and during T0-T1 and T1-T2 between two groups were compared by Mann-Whitney u test, Wilcoxon signed rank test and ANOVA test. Pruzansky type significantly influenced the success or failure of DO. At T0, group 2 showed more retrognathic mandible, smaller ramus height, larger gonial angle, more inward ramus inclination of the affected side, and more chin point deviation to the affected side than did group 1. The major effects of DO on group 1 were lengthening of the ramus height, forward positioning of the mandible, increase of gonial angle, counterclockwise rotation caused by a decrease of the articular angle, increase of ramus inclination of the affected side, and improvement of occlusal canting and chin point deviation. However, by DO, group 2 showed clockwise rotation of the mandible, and less increase of the ramus height than did group 1. After retention, group 2 showed counterclockwise rotation of the mandible and little growth of the ramus height. Group 1 showed reverse tendency. These factors could contribute to the difference in long-term results between two groups.

  3. A new distraction arthroplasty device using magnetic force; a cadaveric study. (United States)

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


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

  4. Vertical bone growth following autotransplantation of the developing maxillary third molar to replace a retained mandibular permanent molar: a case report. (United States)

    Plakwicz, Paweł; Czochrowska, Ewa Monika; Milczarek, Anna; Zadurska, Malgorzata


    A retained permanent mandibular first molar caused arrested development and a defect of the alveolar bone in a 16-year-old girl. Extraction of the ankylosed tooth was immediately followed by autotransplantation of the developing maxillary third molar. At the 3-year follow-up examination the interproximal bone level at the autotransplanted molar was equal to that of the neighboring teeth. Cone beam computed tomography showed bone at the labial aspect of the transplant. The eruption of the autotransplanted tooth stimulated vertical alveolar bone development and repaired the bone defect. Additionally, there was closure of the posterior open bite that was initially present at the ankylosed molar site.

  5. Evaluation of distracting pain and clinical judgment in cervical spine clearance of trauma patients. (United States)

    Kamenetsky, Eric; Esposito, Thomas J; Schermer, Carol R


    The concept of distracting pain (DP) is a controversial subjective confounder that often impedes the efficient and timely clearance of the cervical spine (C-spine). This study attempted to define DP more objectively and assess its true potential to mask the presence of C-spine injury. It also evaluated reliability and safety of clinical judgment in discounting the significance of pain peripheral to the neck (PP). This prospective study included patients with a Glasgow Coma Score ≥14 at a level I trauma center presenting in a C-spine collar. Demographics, mechanism of injury, severity and location of all pain, and C-spine imaging data were obtained. Patient and examiner perception of DP were ascertained using the Verbal Numerical Rating Scale (VNRS) along with the examiner's clinical opinion as to the presence of a fracture. A total of 160 patients were studied: 65 % male, mean age 39 years, and 44 % presenting after a motor vehicle crash. In all, 16 % complained of neck pain (NP) and 82 % of PP. There were 134 patients without NP, 110 of whom (82 %) had PP. The mean VNRS in patients with no NP was 4.2; in patients with NP it was 4.8. When examined, 14 patients without NP exhibited posterior cervical tenderness, one of whom had a fracture (7 %). Of the patients with PP, 10 % stated it was DP. The mean VNRS described as DP by all patients was 7.5 but by clinician 6.5. VNRS described as not DP was 4.8 for both patients and clinicians. Overall, 8 of the 160 patients (5 %) had confirmed C-spine injuries. Regardless of NP or PP and its potentially distracting nature, clinicians believed no fracture was present in 95 % of all cases. Clinical impression was 98 % accurate. For patients with NP, clinical impression had a 91 % negative predictive value (NPV) and a 100 % a positive predictive value (PPV). In those without NP, the NPV was 99 % and the PPV 25 %. The concept of DP is subjective and unreliable as a method to mitigate missed C-spine injuries. If it is to be

  6. Anesthetizing a child for a large compressive mediastinal mass with distraction techniques and music therapies as the sole agents. (United States)

    Adler, Adam C; Schwartz, Emily R; Waters, Jennifer M; Stricker, Paul A


    Anesthetic management of the child with an anterior mediastinal mass is challenging. The surgical/procedural goal typically is to obtain a definitive tissue diagnosis to guide treatment; the safest approach to anesthesia is often one that alters cardiorespiratory physiology the least. In severe cases, this may translate to little or no systemic sedatives/analgesics. Distraction techniques, designed to shift attention away from procedure-related pain (such as counting, listening to music, non-procedure-related talk), may be of great benefit, allowing for avoidance of pharmaceuticals. In this report, we present an approach in children where the anesthetic risk is deemed excessive. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Music preference as a factor of music distraction. (United States)

    Parente, J A


    The present study is an experimental analysis of music preference as a factor of music distraction measured by the Stroop tests. Significant differences were found among groups given, most preferred music, least preferred music, and no music(quiet). Each group of 10 subjects were randomly chosen from 42 screened subjects. Performance was better without music and better with most preferred than with least preferred music. The results were not consistent with those previously found for the effects of noise upon Stroop test performance.

  8. Virtual Reality as a Distraction Technique in Chronic Pain Patients (United States)

    Gao, Kenneth; Sulea, Camelia; Wiederhold, Mark D.


    Abstract We explored the use of virtual reality distraction techniques for use as adjunctive therapy to treat chronic pain. Virtual environments were specifically created to provide pleasant and engaging experiences where patients navigated on their own through rich and varied simulated worlds. Real-time physiological monitoring was used as a guide to determine the effectiveness and sustainability of this intervention. Human factors studies showed that virtual navigation is a safe and effective method for use with chronic pain patients. Chronic pain patients demonstrated significant relief in subjective ratings of pain that corresponded to objective measurements in peripheral, noninvasive physiological measures. PMID:24892196

  9. Virtual reality as a distraction technique in chronic pain patients. (United States)

    Wiederhold, Brenda K; Gao, Kenneth; Sulea, Camelia; Wiederhold, Mark D


    We explored the use of virtual reality distraction techniques for use as adjunctive therapy to treat chronic pain. Virtual environments were specifically created to provide pleasant and engaging experiences where patients navigated on their own through rich and varied simulated worlds. Real-time physiological monitoring was used as a guide to determine the effectiveness and sustainability of this intervention. Human factors studies showed that virtual navigation is a safe and effective method for use with chronic pain patients. Chronic pain patients demonstrated significant relief in subjective ratings of pain that corresponded to objective measurements in peripheral, noninvasive physiological measures.

  10. Prevalence of and attitudes about distracted driving in college students. (United States)

    Hill, Linda; Rybar, Jill; Styer, Tara; Fram, Ethan; Merchant, Gina; Eastman, Amelia


    To identify current distracted driving (DD) behaviors among college students, primarily those involving cell phone use, and elucidate the opinions of the students on the most effective deterrent or intervention for reducing cell phone use. Students enrolled at 12 colleges and universities were recruited to participate in an online, anonymous survey. Recruitment was done via school-based list-serves and posters. School sizes ranged from 476 to over 30,000. The validated survey included 38 questions; 17 were specifically related to distracted driving. Four thousand nine hundred sixty-four participants completed the surveys; the average age was 21.8, 66% were female, 82.7% were undergraduates, and 47% were white/non-Hispanic. Additionally, 4,517 (91%) reported phoning and/or texting while driving; 4,467 (90%) of drivers said they talk on the phone while driving; 1,241 (25%) reported using a hands-free device "most of the time"; 4,467 (90%) of drivers reported texting while driving; 2,488 (50%) reported sending texts while driving on the freeway; 2,978 (60%) while in stop-and-go traffic or on city streets; and 4,319 (87%) at traffic lights. Those who drove more often were more likely to drive distracted. When asked about their capability to drive distracted, 46% said they were capable or very capable of talking on a cell phone and driving, but they felt that only 8.5% of other drivers were capable. In a multivariate model, 9 predictors explained 44% of the variance in DD, which was statistically significant, F (17, 4945) = 224.31; P college students who have higher confidence in their own driving skills and ability to multitask than they have in other drivers' abilities. Drivers' self-efficacy for driving and multitasking in the car, coupled with a greater likelihood of having witnessed DD behaviors in others, greatly increased the probability that a student would engage in DD. Most students felt that policies, such as laws impacting driving privilege and insurance

  11. The correction of occlusal vertical dimension on tooth wear

    Directory of Open Access Journals (Sweden)

    Rostiny Rostiny


    Full Text Available The loss of occlusal vertical dimension which is caused by tooth wear is necessarily treated to regain vertical dimension. Correctional therapy should be done as early possible. In this case, simple and relatively low cost therapy was performed. In unserve loss of occlusal vertical dimension, partial removable denture could be used and the improvement of lengthening anterior teeth using composite resin to improve to regain vertical dimensional occlusion.

  12. Vertical vergence adaptation produces an objective vertical deviation that changes with head tilt. (United States)

    Irsch, Kristina; Guyton, David L; Ramey, Nicholas A; Adyanthaya, Rohit S; Ying, Howard S


    To document the cyclovertical ocular motor mechanism used for vertical fusion in healthy subjects, and to explore whether vertical vergence training in healthy individuals can produce objectively confirmed vertical deviations that change with head tilt, revealing a basic mechanism that can produce a pattern of misalignment in an otherwise normal ocular motor system that is similar to superior oblique muscle paresis (SOP). Seven subjects with normal orthoptic examinations were adapted to vertical image disparities using our tilting haploscopic eye-tracking apparatus presenting concentric circle targets without torsional cues. Static eye positions were recorded with head straight and when tilted 45 degrees to the left and right, during both binocular and monocular viewing. Vertical fusional vergence was accompanied by a cycloversion, with the downward-moving eye intorting and the upward-moving eye extorting, implicating primary involvement of the oblique extraocular muscles. After adaptation to the slowly increasing vertical target separation, all subjects developed a temporary vertical deviation in the straight ahead position that increased with head tilt to one side and decreased with head tilt to the other side. These results not only show that head-tilt-dependent changes in vertical deviation are not necessarily pathognomonic for SOP, but also, and more importantly, suggest mechanisms that can mimic SOP and suggest a possible role for vertical vergence training in reducing deviations and thus the amount of head tilt required for fusion. Ultimately, vertical vergence training may provide an adjunct or alternative to extraocular muscle surgery in selected cases.

  13. Efficacy of Hummel (Modified Schlumberger Arrays of Vertical Electrical Sounding in Groundwater Exploration: Case Study of Parts of Ibadan Metropolis, Southwestern Nigeria

    Directory of Open Access Journals (Sweden)

    Micheal Oladunjoye


    Full Text Available This research compared the interpretation results of the Vertical Electrical Sounding data acquired using the conventional Schlumberger and modified Schlumberger arrays with a view to assessing the effectiveness of the modified Schlumberger arrays of vertical electrical sounding as an alternative to the conventional Schlumberger array at sites with space constraint during groundwater exploration. A total of thirty-seven (37 sounding locations were occupied and one hundred (100 sounding data for both conventional Schlumberger and modified Schlumberger arrays were collected across different rock units within Ibadan metropolis, south-western Nigeria, with electrode spacing (AB/2 ranging from 1 to 75 m. The field data were interpreted qualitatively by curve matching and computer iterative methods. Also, statistical analysis of subsurface units and the coefficient of correlation “R” of the statistical plots of the field data shows the relationship between the different arrays. The raw data plot of the different arrays shows significant similarities while statistical analysis of the geo-electric parameters obtained from the different arrays across varied lithologic units show that strong relationships exist between the different field methods. The coefficient of correlation R with values ranging from 0.7 to 0.99 implies that a good similarity exists between the different field methods employed in this study. Hence, modified Schlumberger arrays can be said to be a good alternative to the conventional Schlumberger array for groundwater exploration especially in urban settings where space constraint is a major challenge.

  14. A Retrospective Study of Cleft lip and palate Patients' Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla

    DEFF Research Database (Denmark)

    Andersen, Kristian; Nørholt, Sven Erik; Küseler, Annelise


    A Retrospective Study of Cleft lip and palate Patients' Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla......A Retrospective Study of Cleft lip and palate Patients' Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla...

  15. Please, do not disturb. telework, distractions, and the productivity of the knowledge worker

    NARCIS (Netherlands)

    D. van der Meulen (Nick); P.J. van Baalen (Peter); H.W.G.M. van Heck (Eric)


    textabstractAn unanswered question regarding telework is how differences in workplace distraction levels influence the effect of the extent of telework on productivity. Drawing from research and theory on cognitive overload and distraction conflict, we developed a quasi-field experiment to test the

  16. Distracted Driving, A Major Preventable Cause of Motor Vehicle Collisions: "Just Hang Up and Drive". (United States)

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


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

  17. Effects of the office environment on health and productivity 1: Auditory and visual distraction

    NARCIS (Netherlands)

    Korte, E. de; Kuijt-Evers, L.; Vink, P.


    A pilot experiment was conducted to evaluate the effects of visual or auditory distraction in an office environment on productivity, concentration and emotion. Ten subjects performed a simple, standardized computer task in five conditions (undisturbed, 3 variations of auditory distraction and visual

  18. Do as I say, not as I do: Distracted driving behavior of teens and their parents. (United States)

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


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

  19. Comparative study of different osteotomy modalities in maxillary distraction osteogenesis for cleft lip and palate. (United States)

    Yu, Hongbo; Wang, Xudong; Fang, Bing; Shen, Steve Guofang


    Conventional maxillary distraction osteogenesis and anterior maxillary segmental distraction were applied in the treatment of severe maxillary hypoplasia secondary to cleft clip and palate. The aim of the present study was to compare the difference between these 2 osteotomy modalities used for rigid external distraction. Ten patients with severe maxillary hypoplasia secondary to CLP were enrolled in our study. They were randomly divided into 2 groups. Conventional maxillary distraction osteogenesis was performed in 5 patients and anterior maxillary segmental distraction in 5 patients. The preoperative and postoperative lateral cephalograms were compared, and cephalometric analysis was performed. The independent sample t test was used to evaluate the differences between the 2 groups. All patients healed uneventfully, and the maxillae moved forward satisfactorily. The sella-nasion-point A angles, nasion-point A-Frankfort horizontal plane angles, overjets, and 0-meridian to subnasale distances had increased significantly after distraction osteogenesis. Significant differences were found in the changes in palatal length between the 2 groups (P palatal length was found in the anterior maxillary segmental distraction group. No significant difference in the changes in palatopharyngeal depth or soft palatal length was found. With the ability of increasing the palatal and arch length, avoiding changes in palatopharyngeal depth, and preserving palatopharyngeal closure function, anterior maxillary segmental distraction has great value in the treatment of maxillary hypoplasia secondary to CLP. It is a promising and valuable technique in this potentially complicated procedure. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Randomized clinical trial of musical distraction with and without headphones for adolescents' immunization pain. (United States)

    Kristjánsdóttir, Ólöf; Kristjánsdóttir, Guðrún


    Distraction has shown to be a helpful pain intervention for children; however, few investigations have studied the effectiveness of this method with adolescents. The aim of this study was to evaluate the usefulness of an easy and practical musical distraction in reducing adolescents' immunization pain. Furthermore, to examine whether musical distraction techniques (with or without headphones) used influenced the pain outcome. Hundred and eighteen 14-year-old adolescents, scheduled for polio immunization, participated. Adolescents were randomly assigned to one of three research groups; musical distraction with headphones (n=38), musical distraction without headphones (n=41) and standard care control (n=39). Results showed adolescents receiving musical distraction were less likely to report pain compared to the control group, controlling for covariates. Comparing musical distraction techniques, eliminating headphone emerged as a significant predictor of no pain. Results suggest that an easy and practical musical distraction intervention, implemented without headphones, can give some pain relief to adolescents during routine vaccination. © 2010 The Authors. Scandinavian Journal of Caring Sciences © 2010 Nordic College of Caring Science.

  1. The puzzle of joking: Disentangling the cognitive and affective components of humorous distraction

    NARCIS (Netherlands)

    Strick, M.A.; Holland, R.W.; Baaren, R.B. van; Knippenberg, A.F.M. van


    Studies in cognitive psychology, marketing, and education indicate that humor distracts attention from non-humorous information presented at the same time. Two experiments investigated why humor distracts attention. The two basic components of humor comprise (1) incongruency resolution, which poses

  2. From distraction to mindfulness : Psychological and neural mechanisms of attention strategies in self-regulation

    NARCIS (Netherlands)

    Van Dillen, Lotte F.; Papies, Esther K.


    The current chapter examines attention strategies that may facilitate self-regulation. In particular, we focus on the attention strategies of distraction and mindfulness. By distraction, we mean shifting attention from the original object of attention onto a different focal object. Mindfulness, on

  3. Cost, operation and hospitalization times in distraction osteogenesis versus sagittal split osteotomy

    NARCIS (Netherlands)

    van Strijen, P. J.; Breuning, K. H.; Becking, A. G.; Perdijk, F. B. T.; Tuinzing, D. B.


    Distraction osteogenesis in 'common' surgical orthodontics is mentioned as an alternative for conventional sagittal split osteotomy. After a 'learning curve' in the surgical skills of distraction, the two techniques can be compared concerning time and cost aspects. Forty-seven patients (male n=28,


    Directory of Open Access Journals (Sweden)

    Владимир Иванович Заварухин


    Full Text Available This article is a brief historical review of distraction osteogenesis development in hand surgery. It describes the key steps in the evolution of methods beginning with immobilization and external fixation up to the distraction method in orthopaedics and its introduction in hand surgery.

  5. Stability after distraction osteogenesis to lengthen the mandible: results in 50 patients

    NARCIS (Netherlands)

    van Strijen, P. J.; Breuning, K. H.; Becking, A. G.; Tuinzing, D. B.


    The purpose of this study was to investigate mandibular stability after lengthening the mandible by means of distraction. Fifty patients (mean age, 14.7 years; range, 11.2 to 37.3 years) with Angle Class II mandibular hypoplasia were treated by bilateral distraction osteogenesis to lengthen the

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

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    Shinji Kobayashi, MD


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

  7. Five- and Eight-Year-Old Children's Response to Auditory and Visual Distraction. (United States)

    Hale, Gordon A.; Stevenson, Edward E., Jr.

    An assessment was made of 5- and 8-year-old children's performance on a short-term memory task under two auditory and two visual distraction conditions, as well as under a nondistraction condition. Performance under nondistraction was found to be superior to that under distraction (p<.001), indicating that the extraneous stimuli had a generally…

  8. Why Does Working Memory Capacity Predict RAPM Performance? A Possible Role of Distraction (United States)

    Jarosz, Andrew F.; Wiley, Jennifer


    Current theories concerning individual differences in working memory capacity (WMC) suggest that WMC reflects the ability to control the focus of attention and resist interference and distraction. The current set of experiments tested whether susceptibility to distraction is partially responsible for the established relationship between…

  9. Selective Attention in Schizophrenic and Manic Psychoses: The Effect of Distraction on Information Processing (United States)

    Oltmanns, Thomas F.


    This study was designed to identify the general level of cognitive processing that is especially vulnerable to distraction in schizophrenia. Attempts to determine at what level auditory distraction interferes with schizophrenics' performance, as opposed to normals, on simple recall tasks. (Editor/RK)

  10. The Use of Choice-Based Distraction to Decrease the Distress of Children at the Dentist (United States)

    Filcheck, Holly A.; Allen, Keith D.; Ogren, Hilary; Darby, James Brandt; Holstein, Brian; Hupp, Steve


    This research was conducted to examine whether choice-based distraction provides an effective means of reducing the distress of children undergoing routine dental treatment. Sixty children between the ages of 5-12 who required restorative dental treatment were assigned randomly to either a Control group or a Distraction group in which the…

  11. Teens and distraction : an in-depth look at teens’ walking behaviors.



    This study found that one in five high school students and one in eight middle school students were observed crossing the street distracted. Students were most often texting on a phone (39 percent) or using headphones (39 percent). Girls were 1.2 times more likely than boys to be walking while distracted. (Author/publisher)

  12. 77 FR 15452 - Visual-Manual NHTSA Driver Distraction Guidelines for In-Vehicle Electronic Devices (United States)


    ... National Highway Traffic Safety Administration Visual-Manual NHTSA Driver Distraction Guidelines for In... proposed Visual-Manual Driver Distraction Guidelines for In-Vehicle Electronic Devices. NHTSA is announcing... language interpreter or translator or whether you plan to use technological aids (e.g., audio-visuals...

  13. Mindless feeding: Is maternal distraction during bottle-feeding associated with overfeeding? (United States)

    Golen, Rebecca B; Ventura, Alison K


    Mindless eating, or eating while distracted by surrounding stimuli, leads to overeating. The present study explored whether "mindless feeding," or maternal distraction during bottle-feeding, is associated with greater infant formula/milk intakes and lower maternal sensitivity to infant cues. Mothers and their ≤24-week-old bottle-feeding infants (N = 28) visited our laboratory for a video-recorded feeding observation. Infant intake was assessed by weighing bottles before and after the feedings. Maternal sensitivity to infant cues was objectively assessed by behavioral coding of video-records using the Nursing Child Assessment Feeding Scale. Maternal distraction was defined as looking away from the infant >75% of the feeding; using a mobile device; conversing with another adult; or sleeping. Twenty-nine percent (n = 8) of mothers were distracted. While differences in intakes for infants of distracted vs. not distracted mothers did not reach significance (p = 0.24), the association between distraction and infant intake was modified by two dimensions of temperament: orienting/regulation capacity (p = 0.03) and surgency/extraversion (p = 0.04). For infants with low orienting/regulation capacity, infants of distracted mothers consumed more (177.1 ± 33.8 ml) than those of not distracted mothers (92.4 ± 13.8 ml). Similar findings were noted for infants with low surgency/extraversion (distracted: 140.6 ± 22.5 ml; not distracted: 78.4 ± 14.3 ml). No association between distraction and intake was seen for infants with high orienting/regulation capacity or surgency/extraversion. A significantly greater proportion of distracted mothers showed low sensitivity to infant cues compared to not distracted mothers (p = 0.04). In sum, mindless feeding may interact with infant characteristics to influence feeding outcomes; further experimental and longitudinal studies are needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Profile changes and stability following distraction osteogenesis with rigid external distraction in adult cleft lip and palate deformities

    Directory of Open Access Journals (Sweden)

    Jaeson M Painatt


    Full Text Available Objectives: The objective of this study is to analyze the hard and soft-tissue profile changes as well as the upper airway changes after distraction osteogenesis (DO using rigid external distraction device in adult cleft lip and palate (CLP patients. The study also evaluates the stability of the surgical result. Materials and Methods: Three lateral cephalometric radiographs were taken: Predistraction (T1, postdistraction (T2, and 1 year after distractor removal (T3. The treatment changes (T1 vs. T2 and the stability (T2 vs. T3 were analyzed. The overall treatment changes after 1 year were also evaluated (T1 vs. T3. The lateral cephalograms were digitally analyzed with the help of software named Dolphin. Statistical Analysis Used: Wilcoxon Signed-Ranks test was used, and the probability value (P value of 0.05 was considered as statistically significant level. Results: Eleven adult patients with CLP were retrospectively analyzed. After distraction, there was a significant mean maxillary advancement of 14 mm (P < 0.01 from a T1 value of 73.54 ± 10.38 to a T2 value of 88.2 ± 10.49. The lower facial height and the incisor exposure were significantly increased. The nasolabial angle had a significant improvement of 24.5° (P < 0.01 from a T1 value of 56.6 ± 21.03 to a T2 value of 81.18 ± 14.4.The upper airway was significantly improved by 3.7 mm (P < 0.01 with a T1 value of 13.5 ± 3.8 to a T2 value of 17.2 ± 3.66. After 1-year follow-up, there was a significant maxillary relapse of 3.20 mm (P < 0.05 from a T2 value of 8.29 ± 6.84 to a T3 value of 5.09 ± 5.59. However, the soft-tissue profile and upper airway remained stable. Conclusion: The clinician should have an understanding of the related hard and soft tissues as well as airway changes which may assist him when planning for maxillary advancement for CLP patients with DO. There were significant improvements immediately after distraction, but during the 1-year follow-up, some relapse was

  15. Creating rigidly stabilized fractures for assessing intramembranous ossification, distraction osteogenesis, or healing of critical sized defects. (United States)

    Yu, Yan-yiu; Bahney, Chelsea; Hu, Diane; Marcucio, Ralph S; Miclau, Theodore


    Assessing modes of skeletal repair is essential for developing therapies to be used clinically to treat fractures. Mechanical stability plays a large role in healing of bone injuries. In the worst-case scenario mechanical instability can lead to delayed or non-union in humans. However, motion can also stimulate the healing process. In fractures that have motion cartilage forms to stabilize the fracture bone ends, and this cartilage is gradually replaced by bone through recapitulation of the developmental process of endochondral ossification. In contrast, if a bone fracture is rigidly stabilized bone forms directly via intramembranous ossification. Clinically, both endochondral and intramembranous ossification occur simultaneously. To effectively replicate this process investigators insert a pin into the medullary canal of the fractured bone as described by Bonnarens. This experimental method provides excellent lateral stability while allowing rotational instability to persist. However, our understanding of the mechanisms that regulate these two distinct processes can also be enhanced by experimentally isolating each of these processes. We have developed a stabilization protocol that provides rotational and lateral stabilization. In this model, intramembranous ossification is the only mode of healing that is observed, and healing parameters can be compared among different strains of genetically modified mice, after application of bioactive molecules, after altering physiological parameters of healing, after modifying the amount or time of stabilization, after distraction osteogenesis, after creation of a non-union, or after creation of a critical sized defect. Here, we illustrate how to apply the modified Ilizarov fixators for studying tibial fracture healing and distraction osteogenesis in mice.

  16. Current concepts in the management of pelvic fracture urethral distraction defects

    Directory of Open Access Journals (Sweden)

    Ramanitharan Manikandan


    Full Text Available Objectives : Pelvic fracture urethral distraction defect (PFUDD may be associated with disabling complications, such as recurrent stricture, urinary incontinence, and erectile dysfunction. In this article we review the current concepts in the evaluation and surgical management of PFUDD, including redo urethroplasty. Materials and Methods : A PubMedTM search was performed using the keywords "pelvic fracture urethral distraction defect, anastomotic urethroplasty, pelvic fracture urethral stricture, pelvic fracture urethral injuries, and redo-urethroplasty." The search was limited to papers published from 1980 to March 2010 with special focus on those published in the last 15 years. The relevant articles were reviewed with regard to etiology, role of imaging, and the techniques of urethroplasty. Results : Pelvic fracture due to accidents was the most common etiology of PFUDD that usually involved the membranous urethra. Modern cross-sectional imaging, such as sonourethrography and magnetic resonance imaging help assess stricture pathology better, but their precise role in PFUDD management remains undefined. Surgical treatment with perineal anastomotic urethroplasty yields a success rate of more than 90% in most studies. The most important complication of surgical reconstruction is restenosis, occurring in less than 10% cases, most of which can be corrected by a redo anastomotic urethroplasty. The most common complication associated with this condition is erectile dysfunction. Urinary incontinence is a much rarer complication of this surgery in the present day. Conclusions : Anastomotic urethroplasty remains the cornerstone in the management of PFUDD, even in previously failed repairs. Newer innovations are needed to address the problem of erectile dysfunction associated with this condition.

  17. Boiling and vertical mineralization zoning: a case study from the Apacheta low-sulfidation epithermal gold-silver deposit, southern Peru (United States)

    André-Mayer, Anne-Sylvie; Leroy, Jacques; Bailly, Laurent; Chauvet, Alain; Marcoux, Eric; Grancea, Luminita; Llosa, Fernando; Rosas, Juan


    The Au-Ag (±Pb-Zn) Apacheta deposit is located in the Shila district, 600 km southeast of Lima in the Cordillera Occidental of Arequipa Province, southern Peru. The vein mineralization is found in Early to Middle Miocene calc-alkaline lava flows and volcanic breccias. Both gangue and sulfide mineralization express a typical low-sulfidation system; assay data show element zoning with base metals enriched at depth and higher concentrations of precious metals in the upper part of the veins. Three main deposition stages are observed: (1) early pyrite and base-metal sulfides with minor electrum 1 and acanthite; (2) brecciation of this mineral assemblage and cross-cutting veinlets with subhedral quartz crystals, Mn-bearing calcite and rhombic adularia crystals; and finally (3) veinlets and geodal filling of an assemblage of tennantite/tetrahedrite + colorless sphalerite 2 + galena + chalcopyrite + electrum 2. Fluid inclusions in the mineralized veins display two distinct types: aqueous-carbonic liquid-rich Lw-c inclusions, and aqueous-carbonic vapor-rich Vw-c inclusions. Microthermometric data indicate that the ore minerals were deposited between 300 and 225 °C from relatively dilute hydrothermal fluids (0.6-3.4 wt% NaCl). The physical and chemical characteristics of the hydrothermal fluids show a vertical evolution, with in particular a drop in temperature and a loss of H2S. The presence of adularia and platy calcite and of co-existing liquid-rich and vapor-rich inclusions in the ore-stage indicates a boiling event. Strong H2S enrichment in the Vw-c inclusions observed at -200 m, the abundance of platy calcite, and the occurrence of hydrothermal breccia at this level may indicate a zone of intense boiling. The vertical element zoning observed in the Apacheta deposit thus seems to be directly related to the vertical evolution of hydrothermal-fluid characteristics. Precious-metal deposition mainly occurred above the 200-m level below the present-day surface, in response

  18. A Computational Framework for Vertical Video Editing


    Gandhi, Vineet; Ronfard, Rémi


    International audience; Vertical video editing is the process of digitally editing the image within the frame as opposed to horizontal video editing, which arranges the shots along a timeline. Vertical editing can be a time-consuming and error-prone process when using manual key-framing and simple interpolation. In this paper, we present a general framework for automatically computing a variety of cinematically plausible shots from a single input video suitable to the special case of live per...

  19. Understanding commercial truck drivers' decision-makin process concerning distracted driving. (United States)

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


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

  20. The temporal dynamics of emotion regulation: an EEG study of distraction and reappraisal. (United States)

    Thiruchselvam, Ravi; Blechert, Jens; Sheppes, Gal; Rydstrom, Anders; Gross, James J


    Distraction and reappraisal are two widely used forms of emotion regulation. The process model of emotion regulation (Gross, 1998) holds that they differ (1) in when they act on the emotion-generative process, and (2) in their impact on subsequent responses to regulated stimuli. We tested these two predictions by measuring electrocortical responses to neutral and emotional images during two phases. In the regulation phase, images were watched or regulated using distraction or reappraisal. During the re-exposure phase, the same images were passively watched. As predicted, during regulation, distraction reduced the late positive potential (LPP) earlier than reappraisal. Upon re-exposure, images with a distraction (but not reappraisal) history elicited a larger LPP than images with an attend history. This pattern of results suggests that distraction and reappraisal intervene at separate stages during emotion generation, a feature which may have distinct consequences that extend beyond the regulatory episode. Copyright © 2011 Elsevier B.V. All rights reserved.

  1. Do advertisements at the roadside distract the driver? (United States)

    Kettwich, Carmen; Klinger, Karsten; Lemmer, Uli


    Nowadays drivers have to get along with an increasing complex visual environment. More and more cars are on the road. There are not only distractions available within the vehicle, like radio and navigation system, the environment outside the car has also become more and more complex. Hoardings, advertising pillars, shop fronts and video screens are just a few examples. For this reason the potential risk of driver distraction is rising. But in which way do the advertisements at the roadside influence the driver's attention? The investigation which is described is devoted to this topic. Various kinds of advertisements played an important role, like illuminated and non-illuminated posters as well as illuminated animated ads. Several test runs in an urban environment were performed. The gaze direction of the driver's eye was measured with an eye tracking system. The latter consists of three cameras which logged the eye movements during the test run and a small-sized scene camera recording the traffic scene. 16 subjects (six female and ten male) between 21 and 65 years of age took part in this experiment. Thus the driver's fixation duration of the different advertisements could be determined.

  2. Wavelet Packet Transform Based Driver Distraction Level Classification Using EEG

    Directory of Open Access Journals (Sweden)

    Mousa Kadhim Wali


    Full Text Available We classify the driver distraction level (neutral, low, medium, and high based on different wavelets and classifiers using wireless electroencephalogram (EEG signals. 50 subjects were used for data collection using 14 electrodes. We considered for this research 4 distraction stimuli such as Global Position Systems (GPS, music player, short message service (SMS, and mental tasks. Deriving the amplitude spectrum of three different frequency bands theta, alpha, and beta of EEG signals was based on fusion of discrete wavelet packet transform (DWPT and FFT. Comparing the results of three different classifiers (subtractive fuzzy clustering probabilistic neural network, -nearest neighbor was based on spectral centroid, and power spectral features extracted by different wavelets (db4, db8, sym8, and coif5. The results of this study indicate that the best average accuracy achieved by subtractive fuzzy inference system classifier is 79.21% based on power spectral density feature extracted by sym8 wavelet which gave a good class discrimination under ANOVA test.

  3. Distracted driving on YouTube: implications for adolescents. (United States)

    Basch, Corey H; Mouser, Christina; Clark, Ashley


    For the first time in 50 years, traffic fatalities have increased in the United States (US). With the emergence of technology, comes the possibility, that distracted driving has contributed to a decrease in safe driving practices. The purpose of this study was to describe the content on the popular video sharing site, YouTube to ascertain the type of content conveyed in videos that are widely viewed. The 100 most widely viewed English language videos were included in this sample, with a collective number of views of over 35 million. The majority of videos were television-based and Internet-based. Pairwise comparisons indicated that there were statistically significant differences between the number of views of consumer generated videos and television-based videos (p = 0.001) and between television-based videos and Internet-based videos (p YouTube related to distracted driving are popular and that this medium could prove to be a successful venue to communicate information about this emergent public health issue.

  4. Mechanical behavior of an osteotomized mandible with distraction orthodontic devices. (United States)

    Boccaccio, A; Lamberti, L; Pappalettere, C; Carano, A; Cozzani, M


    This work analyzes the mechanical behavior of a human mandible when distraction orthodontic devices are used for correcting problems of dental overcrowding and/or arch shrinkage. The mandible 3D model is reconstructed from CT scan data and meshed into finite elements. The distractor is also modeled. FEM analysis included geometric non-linearity. Displacement field of healthy and osteotomized mandibles are compared. Progressive expansion of the distractor and effects of mastication are also analyzed. Finally, we compare two distraction protocols PROT1 and PROT2 where device is, respectively, expanded by 0.6 or 1.2mm/day. The global displacement is 6mm according to clinical recommendations. It came out that mastication forces generate displacements compatible with bone remodeling. However, parasitic rotations of the mandible arms due to mastication may counteract arch expansion induced by the device. Stress concentrations occurred where the device is fixed: stress peaks stay however below yield limit. Finally, PROT2 reduced by about 10% stresses in mandible and reproduces better than PROT1 the displacement field imposed by the device.

  5. Adaptive training diminishes distractibility in aging across species. (United States)

    Mishra, Jyoti; de Villers-Sidani, Etienne; Merzenich, Michael; Gazzaley, Adam


    Aging is associated with deficits in the ability to ignore distractions, which has not yet been remediated by any neurotherapeutic approach. Here, in parallel auditory experiments with older rats and humans, we evaluated a targeted cognitive training approach that adaptively manipulated distractor challenge. Training resulted in enhanced discrimination abilities in the setting of irrelevant information in both species that was driven by selectively diminished distraction-related errors. Neural responses to distractors in auditory cortex were selectively reduced in both species, mimicking the behavioral effects. Sensory receptive fields in trained rats exhibited improved spectral and spatial selectivity. Frontal theta measures of top-down engagement with distractors were selectively restrained in trained humans. Finally, training gains generalized to group and individual level benefits in aspects of working memory and sustained attention. Thus, we demonstrate converging cross-species evidence for training-induced selective plasticity of distractor processing at multiple neural scales, benefitting distractor suppression and cognitive control. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Attention, please. Negotiating Concentration and Distraction around 1970

    Directory of Open Access Journals (Sweden)

    Volker Pantenburg


    Full Text Available As has often been pointed out, museums and galleries have come to accommodate an ever growing number of moving image artworks in the past two decades. Contrasting the viewing conditions of conventional cinema and exhibition spaces, commentators have tended to emphasize the spatial parameters of installation works that allow the visitor to stroll freely, while spectatorship in the film-theatre traditionally means being fixed to your seat. This article suggests a reevaluation of this constellation by focusing on the different temporal protocols and regimes that the movie theater and exhibition spaces imply. Building on an essay by Georg Simmel and Peter Osborne’s concept of “distracted reception”, art exhibitions are characterized as places that confront the visitor with a multitude of options and synchronous stimuli, whereas the architecture of the film-theater provides, as Hollis Frampton claimed in 1968, “the only place left in our culture intended entirely for concentrated exercise of one, or at most two, of our senses”. Revisiting one of the canonical moments in the prehistory of “Artists’ Film”, the article investigates the early 1970s when Expanded Cinema and Structural Film suggested new answers to the question of concentration and distraction.

  7. Aging and distraction by irrelevant speech: does emotional valence matter? (United States)

    Van Gerven, Pascal W M; Murphy, Dana R


    From prior studies, we know that older adults are rarely more distracted by irrelevant speech than younger adults, which is remarkable in light of the inhibitory deficit view of aging. We tested the hypothesis that older adults are more distracted by emotional irrelevant speech during a visual cognitive task than younger adults. Forty-eight younger (mean age = 21.9 years) and 48 older individuals (mean age = 68.1 years) performed a visual counting task while being exposed to irrelevant speech consisting of random numbers intermixed with neutral, positive, or negative words. Performance in these conditions was compared with that in a silence condition. Irrelevant speech increased counting time and decreased accuracy similarly for younger and older adults. Furthermore, the emotional conditions did not elicit a stronger effect than the neutral condition. Finally, we found implicit memory for irrelevant speech, but its level was independent of emotional valence and age. We conclude that emotional irrelevant speech has no disproportionate impact on cognitive performance in older adults. This can be regarded as a challenge to the inhibitory deficit hypothesis.

  8. Coordination in vertical jumping

    NARCIS (Netherlands)

    Bobbert, Maarten F.; van Ingen Schenau, Gerrit Jan


    The present study was designed to investigate for vertical jumping the relationships between muscle actions, movement pattern and jumping achievement. Ten skilled jumpers performed jumps with preparatory countermovement. Ground reaction forces and cinematographic data were recorded. In addition,

  9. Computer tablet distraction reduces pain and anxiety in pediatric burn patients undergoing hydrotherapy: A randomized trial. (United States)

    Burns-Nader, Sherwood; Joe, Lindsay; Pinion, Kelly


    Distraction is often used in conjunction with analgesics to minimize pain in pediatric burn patients during treatment procedures. Computer tablets provide many options for distraction items in one tool and are often used during medical procedures. Few studies have examined the effectiveness of tablet distraction in improving the care of pediatric burn patients. This study examines the effectiveness of tablet distraction provided by a child life specialist to minimize pain and anxiety in pediatric burn patients undergoing hydrotherapy. Thirty pediatric patients (4-12) undergoing hydrotherapy for the treatment of burns participated in this randomized clinical trial. The tablet distraction group received tablet distraction provided by a child life specialist while those in the control group received standard care. Pain was assessed through self-reports and observation reports. Anxiety was assessed through behavioral observations. Length of procedure was also recorded. Nurses reported significantly less pain for the tablet distraction group compared to the control group. There was no significant difference between groups on self-reported pain. The tablet distraction group displayed significantly less anxiety during the procedure compared to the control group. Also, the tablet distraction group returned to baseline after the procedure while those in the control group displayed higher anxiety post-procedure. There was no difference in the length of the procedure between groups. These findings suggest tablet distraction provided by a child life specialist may be an effective method for improving pain and anxiety in children undergoing hydrotherapy treatment for burns. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  10. Sex differences in the response to emotional distraction: an event-related fMRI investigation. (United States)

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


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

  11. Hybrid vertical cavity laser

    DEFF Research Database (Denmark)

    Chung, Il-Sug; Mørk, Jesper


    A new hybrid vertical cavity laser structure for silicon photonics is suggested and numerically investigated. It incorporates a silicon subwavelength grating as a mirror and a lateral output coupler to a silicon ridge waveguide.......A new hybrid vertical cavity laser structure for silicon photonics is suggested and numerically investigated. It incorporates a silicon subwavelength grating as a mirror and a lateral output coupler to a silicon ridge waveguide....

  12. Composition of vertical gardens


    Sandeva, Vaska; Despot, Katerina


    Vertical gardens are fully functional gardens in areas where there is less oxygen and space, ideal for residential and urban cities where there is no vegetation; occupy a special place in interiors furniture. The gardens occupy an important aesthetic problem. Aesthetic task in vertical gardens can be achieved by forming sectors of identification in the urban landscape through the choice of a particular plant spatial composition and composition, to create comfort and representation in commu...


    Directory of Open Access Journals (Sweden)



    Full Text Available AIM OF THE STUDY: Effectiveness of Transpubic urethroplasty in recurrent (failed urethral strictures due to pelvic fracture urethral distraction defects. INTRODUCTION: Urethral distraction injuries occur upto 10% of pelvic fracture cases. The principle indication of Transpubic urethroplasty is length >3 c ms, recur rent (failed repairs of posterior urethral stricture. Though other procedures like primary anastomotic urethroplasty, rerouting of the urethra under the corporal body, urethral substitution with tubularised flaps, two stage urethroplasty are described, Tr anspubic urethroplasty is said to produce the best results especially when repeat procedures are required. MATERIALS & METHODS: This is a prospective study from 2004 to 2014 consisting of 17 patients having recurrent stricture urethra secondary to pelvic f racture urethral distraction defects (PFUDD. All the patients were males and their age ranged from 15year to 45 years. Pre - op evaluation included X - ray KUB, Ultrasound abdomen & pelvis, retrograde urethrogram (RGU, micturating cystourethrogram (MCU, up and down Cystoscopy, urine culture and renal biochemical parameters. Urethra was approched through progressive perineal and abdominal approach with total pubectomy, followed by excising fibrosed stricture and tension free end to end anastomosis. Post opera tively pericatheteral RGU was carried out after 4 weeks and Catheter removed if there was no leak. RGU, MCU uroflowmetry and PVR were done one month after removal of catheter. Subsequently UFR, PVR and obstructive symptoms were assessed periodically. RESUL TS: All 17 Cases were followed up for a period of 3 - 11 years. Out of 17patients, 14(80% patients maintained good uroflow (UFR and insignificant PVR and procedure was considered successful. In 3 patients procedure failed, of which 2 patients had pericathe ter leak and reduced urinary flow with significant PVR and were followed up with CIC and 1 patient remained on permanent

  14. Use of Rib-Based Distraction in the Treatment of Early-Onset Scoliosis Associated With Neurofibromatosis Type 1 in the Young Child. (United States)

    Heflin, John A; Cleveland, Andrew; Ford, Scott D; Morgan, Jessica V; Smith, John T


    This study was an institutional review board-approved retrospective review of a prospectively collected multicenter database for rib-based distraction systems used in the treatment of young children with early-onset scoliosis associated with neurofibromatosis type 1 (NF-1). To evaluate the effectiveness of rib-based distraction and associated complications in managing scoliosis in the growing child with NF-1. Patients with NF-1 commonly have scoliosis with curves that can be dysplastic and progressive and respond poorly to bracing. Rib-based distraction systems have recently been described in the management of these complex patients. The efficacy and complication rate using these systems have not previously been reported. Twelve children with NF-1 and scoliosis who were treated with rib-based distraction systems were identified from a prospectively collected multicenter registry. Preoperative and postoperative Cobb angle and T1-S1 spine height were measured from posteroanterior radiographs. The number of lengthenings, age at implantation, years of follow-up, and complications were also acquired from the registry or patient charts. Mean age at implantation of the Vertical Expandable Prosthetic Titanium Rib device was 6.34 years. Mean preoperative Cobb angle was 66.3°. Average follow-up was 5.2 years. Mean postoperative Cobb angle was 60.8° after an average of 7.75 lengthening procedures (range, 2-16 procedures). T1-S1 height increased in all patients. There were 17 complications in 8 patients (device migration in 6, wound dehiscence in 3, rod breakage in 2, medical issues in 5, and 1 revision for progression of curve). Of the 17 complications, 10 were grade I, 1 was grade II, and 6 were grade IIA; there were no grade III complications. The use of rib-based distraction is an effective and relatively safe method of stabilizing curve progression through growth in severe dysplastic scoliosis associated with NF-1. Copyright © 2015 Scoliosis Research Society. Published

  15. Audiovisual distraction as a useful adjunct to epidural anesthesia and sedation for prolonged lower limb microvascular orthoplastic surgery. (United States)

    Athanassoglou, Vassilis; Wallis, Anna; Galitzine, Svetlana


    Lower limb orthopedic operations are frequently performed under regional anesthesia, which allows avoidance of potential side effects and complications of general anesthesia and sedation. Often though, patients feel anxious about being awake during operations. To decrease intraoperative anxiety, we use multimedia equipment consisting of a tablet device, noise-canceling headphones, and a makeshift frame, where patients can listen to music, watch movies, or occupy themselves in numerous ways. These techniques have been extensively studies in minimally invasive, short, or minor procedures but not in prolonged orthoplastic operations. We report 2 cases where audiovisual distraction was successfully applied to 9.5-hour procedures, proved to be a very useful adjunct to epidural anesthesia + sedation, and made an important contribution to positive patients' outcomes and overall patients' experience with regional anesthesia for complex limb reconstructive surgery. In the era when not only patients' safety and clinical outcomes but also patients' positive experiences are of paramount importance, audiovisual distraction may provide a simple tool to help improve experience of appropriately informed patients undergoing suitable procedures under regional anesthesia. The anesthetic technique received a very positive appraisal by both patients and encouraged us to study further the impact of modern audiovisual technology on anxiolysis for major surgery under regional anesthesia. The duration of surgery per se is not a contraindication to the use of audiovisual distraction. The absolute proviso of successful application of this technique to major surgery is effective regional anesthesia and good teamwork between the clinicians and the patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Humeral lengthening: Case report

    Directory of Open Access Journals (Sweden)

    Gajdobranski Đorđe


    Full Text Available Introduction. Difference in length of upper extremities has mainly esthetic significance and is therefore not so often a subject of operative treatment, compared to lower extremities. Case Outline. We are presenting a case of a 16­year­old patient in whom a shortening of 9 cm of the right humerus was determined at the end of growth. This shortening was the result of surgical treatment of solitary bone cyst at the proximal end of the humerus done at the age of 10 years. In order to correct the length of the humerus we applied distraction osteogenesis with a compressive­distracting device according to Mitkovic (Traffix, and we achieved the lengthening of 7.5 cm. During the period of distraction we encountered the following complications: minimal suppuration at the site of the wedges that was successfully resolved with intensive local treatment, while pain and paresthesias along the N. radialis were resolved with a temporarily slowing of the distraction process. Fixation with a plate, i.e. bone grafting was not necessary, and final functional and esthetic result was excellent. Conclusion. Successful lengthening of the shortened humerus can be achieved with a unilateral compressive­distracting device according to Mitkovic as its application up to a complete bone reconstruction does not require additional plate fixation or bone grafting. The patient was capable of performing usual daily activities during application of the device.

  17. On the role of vertical electron density gradients in the generation of type II irregularities associated with blanketing Es during counter electrojet events - a case study (United States)

    Devasia, C.; Jyoti, N.; Sridharan, R.; Raghava Reddi, C.; Diwakar, T.; Subba Rao, K.

    The characteristics of different types of Sporadic E (ES) layers and the associated plasma density irregularities over the magnetic equator have been studied in a campaign mode, using VHF backscatter radar, digital ionosonde and ground magnetometer data from Trivandrum (dip lat. 0.5°N, geog. lat. 8.5°N, geog. long. 77°E), India. Blanketing type Es (ESb) with varying intensity and duration were observed in association with afternoon counter electrojet (CEJ). ESb was associated with intense backscatter returns and with either very low zonal electric fields and/or with distortion present in the altitude profile of the phase velocity of the type II irregularities. The results of the coordinator study indicate the possible role of electron density gradients and the role of local winds in their generation, eventually resulting in the ESb layers. Evidences for the local winds to be responsible for the generation of steep vertical gradients based on the VHF backscatter radar data are provided and discussed.

  18. Effects of Strength Training Combined with Specific Plyometric exercises on body composition, vertical jump height and lower limb strength development in elite male handball players: a case study. (United States)

    Carvalho, Alberto; Mourão, Paulo; Abade, Eduardo


    The purpose of the present study was to identify the effects of a strength training program combined with specific plyometric exercises on body composition, vertical jump (VJ) height and strength development of lower limbs in elite male handball players. A 12-week program with combined strength and specific plyometric exercises was carried out for 7 weeks. Twelve elite male handball players (age: 21.6 ± 1.73) competing in the Portuguese Major League participated in the study. Besides the anthropometric measurements, several standardized jump tests were applied to assess VJ performance together with the strength development of the lower limbs in an isokinetic setting. No significant changes were found in body circumferences and diameters. Body fat content and fat mass decreased by 16.4 and 15.7% respectively, while lean body mass increased by 2.1%. Despite small significance, there was in fact an increase in squat jump (SJ), counter movement jump (CMJ) and 40 consecutive jumps after the training period (6.1, 3.8 and 6.8%, respectively). After the applied protocol, peak torque increased in lower limb extension and flexion in the majority of the movements assessed at 90ºs-1. Consequently, it is possible to conclude that combining general strength-training with plyometric exercises can not only increase lower limb strength and improve VJ performance but also reduce body fat content.

  19. Recognizing Vertical and Lateral Variability in Terrestrial Landscapes: A Case Study from the Paleosols of the Late Pennsylvanian Casselman Formation (Conemaugh Group Southeast Ohio, USA

    Directory of Open Access Journals (Sweden)

    Daniel Hembree


    Full Text Available The Upper Pennsylvanian Casselman Formation of southeastern Ohio contains four distinct paleosol types that formed in alluvial systems within the distal Appalachian foreland basin. The properties of these paleosols as well as their small-scale lateral and vertical variations were studied to interpret the paleoenvironmental and paleoecological conditions within the alluvial settings in which they formed. The ichnofossils and pedogenic features preserved within the paleosols of the Casselman Formation record the local climactic, hydrologic, biotic, and topographic changes that occurred in the region during the Late Pennsylvanian. The four paleosols types of the Casselman Formation are interpreted as Alfisols (Type A, Type D, Vertisols (Type B, and Inceptisols (Type D. The four paleosol types indicate different degrees of changes in local moisture regimes including water table fluctuations due to seasonal precipitation and flooding events. The assemblages of ichnofossils within the paleosol types were produced by both soil arthropods and a diverse array of plants that formed part of the different soil ecosystems present within the alluvial environment. Although regional-scale studies are important for understanding the Late Pennsylvanian world, small-scale studies are also necessary to fully understand the local pedogenic, paleoenvironmental, and paleoecologic consequences of global scale changes in paleoclimate and paleogeography.

  20. Entropy-Based weighting applied to normal boundary intersection approach: the vertical turning of martensitic gray cast iron piston rings case

    Directory of Open Access Journals (Sweden)

    Luiz Célio Souza Rocha


    Full Text Available In practical situations, solving a given problem usually calls for the systematic and simultaneous analysis of more than one objective function. Hence, a worthwhile research question may be posed thus: In multiobjective optimization, what can facilitate the decision maker in choosing the best weighting? Thus, this study attempts to propose a method that can identify the optimal weights involved in a multiobjective formulation. Our method uses functions of Entropy and Global Percentage Error as selection criteria of optimal weights. To demonstrate its applicability, we employed this method to optimize the machining process for vertical turning martensitic gray cast iron piston rings, maximizing the productivity and the life of cutting tool and minimizing the cost, using feed rate and rotation of the cutting tool as the decision variables. The proposed optimization goals were achieved with feed rate = 0.35 mm rev-1 and rotation = 248 rpm. Thus, the main contributions of this study are the proposal of a structured method, differentiated in relation to the techniques found in the literature, of identifying optimal weights for multiobjective problems and the possibility of viewing the optimal result on the Pareto frontier of the problem. This viewing possibility is very relevant information for managing processes more efficiently.

  1. Combined application of vertical electrical sounding and 2D electrical resistivity imaging for geothermal groundwater characterization: Hammam Sayala hot spring case study (NW Tunisia) (United States)

    Chabaane, Achref; Redhaounia, Belgacem; Gabtni, Hakim


    The following work is an attempt to enhance and optimize the potential exploitation of the Hammam Sayala thermal spring (NW Tunisia). This hot spring is located at 10 km of South-western Béja city, with higher temperature values around 42 °C and a low discharge value of about 1 l s-1. The geological and structural settings of the study area are complex and associated with faults and Triassic intruded salt and evaporate. An integrated geophysical approach using Electrical Resistivity Tomography (ERT), Induced Polarization (IP) and Vertical Electrical Sounding (VES) techniques can provide a high-resolution subsurface image of the principal geothermal plume and associated pathways. These data were used to determine and understand the mechanisms responsible of the rise of hot water flowing out onto the surface. Our results add new information of the hydrothermal system's context in Hammam Sayala area, which can help to create a therapeutic center opening new perspectives in the Béja region and to encourage regional thermal tourism development.

  2. Individual differences in distraction by motion predicted by neural activity in MT/V5

    Directory of Open Access Journals (Sweden)

    Jennifer R Lechak


    Full Text Available Individuals differ substantially in their susceptibility to distraction by irrelevant visual information. Previous research has uncovered how individual variability in the goal-driven component of attentional control influences distraction, yet it remains unknown whether other sources of variability between individuals also predict distraction. In this fMRI study, we showed that an individual’s inherent sensitivity to passively viewed visual motion predicts his/her susceptibility to distraction by motion. Bilateral MT/V5 was localized in participants during passive viewing of moving stimuli, affording a baseline measure of motion sensitivity. Next, participants performed a visual search task with an irrelevant motion singleton distractor, and both behavioral and neural indices of distraction were recorded. Results revealed that both of these indices were predicted by the independent index of motion sensitivity. An additional analysis of moment-to-moment fluctuations in distraction within individuals revealed that distraction could be predicted by pretrial fMRI activity in several brain regions, including MT+, which likely reflected the observer’s momentary propensity to process motion. Together, these results shed light on how variability in factors other than goal-driven processing, both within and between individuals, affects attentional control and one’s perception of the visual world.

  3. Prevalence of distracted pedestrians while crossing: a study of Malaysia’s situation

    Directory of Open Access Journals (Sweden)

    Mohd Syazwan S.


    Full Text Available Pedestrian’s crashes account for approximately 7% of road death in Malaysia. Even though the percentage is smaller compared to motorcycle-related crashes, amount of road crashes involving pedestrians in Malaysia is a serious concern. The objective of this study is to establish the common type of distraction for Malaysian. Crashes among pedestrians usually highly recorded at straight road followed by inter-section road type. For that, study focusing on the type of distraction among pedestrians while crossing the road by using video recording method. Two type of road were selected observational field survey – signalized and non-signalized intersection. A video recording method was used to analyse the behaviour of pedestrians crossing with or without distraction. Approximately 375 samples were observed while crossing with various type of distraction such as eating, texting, mobile phone talking and others. The study found the highest distraction type observed among pedestrians is usage of electronic equipment-mobile phone with 84.8% followed by other type of distraction – smoking and talking with more that 5%. Mobile phone distraction cause a significant effect in term of time to cross which average time to cross was 14.77 second. The overall results provide a prevalence information that is useful in the development of countermeasures aimed at improving pedestrians’ safety.

  4. Hearing impairment affects older people's ability to drive in the presence of distracters. (United States)

    Hickson, Louise; Wood, Joanne; Chaparro, Alex; Lacherez, Philippe; Marszalek, Ralph


    To investigate the effects of hearing impairment and distractibility on older people's driving ability, assessed under real-world conditions. Experimental cross-sectional study. University laboratory setting and an on-road driving test. One hundred seven community-living adults aged 62 to 88. Fifty-five percent had normal hearing, 26% had a mild hearing impairment, and 19% had a moderate or greater impairment. Hearing was assessed using objective impairment measures (pure-tone audiometry, speech perception testing) and a self-report measure (Hearing Handicap Inventory for the Elderly). Driving was assessed on a closed road circuit under three conditions: no distracters, auditory distracters, and visual distracters. There was a significant interaction between hearing impairment and distracters, such that people with moderate to severe hearing impairment had significantly poorer driving performance in the presence of distracters than those with normal or mild hearing impairment. Older adults with poor hearing have greater difficulty with driving in the presence of distracters than older adults with good hearing.

  5. Virtual-Reality Distraction and Cold-Pressor Pain Tolerance: Does Avatar Point of View Matter? (United States)

    Herbert, Linda J.; Weiss, Karen E.; Jimeno, Monica


    Abstract This study tested the effects of distraction using virtual-reality (VR) technology on acute pain tolerance in young adults. Forty-one undergraduate students, aged 18–23 years, used a VR head-mounted display helmet, steering wheel, and foot pedal to play an auto racing video game while undergoing exposure to very cold water (cold pressor set at 1°C). Two different game views were tested that were hypothesized to affect the degree to which participants felt “present” in the virtual environment: a first-person view, in which the participant saw the virtual environment through the eyes of the game character being manipulated; and a third-person view, in which the participant viewed the game character from a distance. The length of time participants tolerated the cold-water exposure (pain tolerance) under each distraction condition was compared to a baseline (no distraction) trial. Subjects also rated the degree to which they felt “present” in the virtual environment after each distraction trial. Results demonstrated that participants had significantly higher pain tolerance during both VR-distraction conditions relative to baseline (no distraction) trials. Although participants reported a greater sense of presence during the first-person condition than the third-person condition, pain-tolerance scores associated with the two distraction conditions did not differ. The types of VR applications in which presence may be more or less important are discussed. PMID:20950186

  6. [Mandibular-driven simultaneous maxillo-mandibular distraction for hemifacial microsomia with rapid prototyping technology]. (United States)

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


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

  7. Combined maxillary and mandibular midline and mandibular ramus distraction osteogenesis for treatment of a Class II patient with implants as orthodontic anchorage. (United States)

    Takahashi, Ichiro; Kawamura, Hiroshi; Takano-Yamamoto, Teruko


    This case report describes the treatment of a woman with severe mandibular retrusion and maxillomandibular transverse deficiency. Her malocclusion was characterized by a large overjet, a deep overbite, and a V-shaped dental arch, and she had a skeletal Class II profile. Treatement included combined maxillary and mandibular midline expansion, maxillary downward repositioning, and mandibular ramus lengthening with distraction osteogenesis with implants as orthodontic anchorage. During the postdistraction orthodontic treatment period, some skeletal relapse occurred. Implants provided absolute orthodontic anchorage to overcome the unexpected skeletal changes. Combined orthodontic treatment with implants for anchorage and distraction osteogenesis successfully expanded the maxilla and the mandible and corrected the mandibular deficiency. Two-year follow-up records show a morphologically and functionally stable result. 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  8. Impaired laparoscopic performance of novice surgeons due to phone call distraction: a single-centre, prospective study. (United States)

    Yang, Cui; Heinze, Julia; Helmert, Jens; Weitz, Juergen; Reissfelder, Christoph; Mees, Soeren Torge


    Distractions such as phone calls during laparoscopic surgery play an important role in many operating rooms. The aim of this single-centre, prospective study was to assess if laparoscopic performance is impaired by intraoperative phone calls in novice surgeons. From October 2015 to June 2016, 30 novice surgeons (medical students) underwent a laparoscopic surgery training curriculum including two validated tasks (peg transfer, precision cutting) until achieving a defined level of proficiency. For testing, participants were required to perform these tasks under three conditions: no distraction (control) and two standardised distractions in terms of phone calls requiring response (mild and strong distraction). Task performance was evaluated by analysing time and accuracy of the tasks and response of the phone call. In peg transfer (easy task), mild distraction did not worsen the performance significantly, while strong distraction was linked to error and inefficiency with significantly deteriorated performance (P distraction, but surgical and cognitive errors were significantly increased when participants were distracted (P distraction, participants reported a more severe subjective disturbance when they were diverted by strong distraction (P phone call distractions result in impaired laparoscopic performance under certain circumstances. To ensure patient safety, phone calls should be avoided as far as possible in operating rooms.

  9. Automating skeletal expansion: An implant for distraction osteogenesis of the mandible (United States)

    Magill, John C.; Byl, Marten F.; Goldwaser, Batya; Papadaki, Maria; Kromann, Roger; Yates, Brent; Morency, Joseph R.; Kaban, Leonard B.; Troulis, Maria J.


    Background Distraction osteogenesis (DO) is a technique of bone lengthening that makes use of the body’s natural healing capacity. An osteotomy is created and a rigid distraction device is attached to the bone. After a latency period, the device is activated 2–4 times per day for a total of 1 mm/day of bone lengthening. This technique is used to correct a variety of congenital and acquired deformities of the mandible, midface and long bones. To shorten the treatment period and to eliminate the complications of patient activation of the device, an automated continuous distraction device would be desirable. It has been reported that continuous distraction generates adequate bone with lengthening at a rate of 2 mm/day, thereby reducing the treatment time. Method of Approach The device we describe here uses miniature high-pressure hydraulics, position feedback, and a digital controller to achieve closed-loop control of the distraction process. The implanted actuator can produce up to 40N of distraction force on linear trajectories as well as curved distraction paths. In the paper we detail the spring-powered hydraulic reservoir, controller, and user interface. Results Experiments to test the new device design were performed in a porcine cadaver head and in live pigs. In the cadaver head, the device performed an 11-day/11 mm distraction with a root-mean-squared position error of 0.09 mm. The device functioned for periods of several days in each of five live animals, though some component failures occurred, leading to design revisions. Conclusions The test series showed that the novel design of this system provides the capabilities necessary to automate distraction of the mandible. Further developments will focus on making the implanted position sensor more robust and then carrying out clinical trials. PMID:20740071

  10. Technical feasibility of personalized articulating knee joint distraction for treatment of tibiofemoral osteoarthritis. (United States)

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


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

  11. Circumplex Model of Affect: A Measure of Pleasure and Arousal During Virtual Reality Distraction Analgesia. (United States)

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


    Immersive virtual reality (VR) distraction provides clinically effective pain relief and increases subjective reports of "fun" in medical settings of procedural pain. The goal of this study was to better describe the variable of "fun" associated with VR distraction analgesia using the circumplex model (pleasure/arousal) of affect. Seventy-four healthy volunteers (mean age, 29 years; 37 females) received a standardized, 18-minute, multimodal pain sequence (alternating thermal heat and electrical stimulation to distal extremities) while receiving immersive, interactive VR distraction. Subjects rated both their subjective pain intensity and fun using 0-10 Graphic Rating Scales, as well as the pleasantness of their emotional valence and their state of arousal on 9-point scales. Compared with pain stimulation in the control (baseline, no VR) condition, immersive VR distraction significantly reduced subjective pain intensity (P < 0.001). During VR distraction, compared with those reporting negative affect, subjects reporting positive affect did so more frequently (41 percent versus 9 percent), as well as reporting both greater pain reduction (22 percent versus 1 percent) and fun scores (7.0 ± 1.9 versus 2.4 ± 1.4). Several factors-lower anxiety, greater fun, greater presence in the VR environment, and positive emotional valence-were associated with subjective analgesia during VR distraction. Immersive VR distraction reduces subjective pain intensity induced by multimodal experimental nociception. Subjects who report less anxiety, more fun, more VR presence, and more positive emotional valence during VR distraction are more likely to report subjective pain reduction. These findings indicate VR distraction analgesia may be mediated through anxiolytic, attentional, and/or affective mechanisms.

  12. The Effect of Distraction Techniques on the Pain of Venipuncture in Children: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Mohammad Sadegh Rezai


    Full Text Available Context Venipuncture has been reported as one of the major sources of pain in the children’s wards. Various distraction techniques have been used so far to reduce this pain. Distraction technique is one of the non-pharmacological methods of pain control that uses the five senses in order to focus the patient’s attention on other stimuli. Objectives This study aimed to determine the effect of distraction techniques on the pain of venipuncture in children. Data Sources In this systematic review study, all RCTs about distraction techniques were reviewed with no time limit. In order to find evidence in this context, English and Persian scientific databases (PubMed, Elsevier, SID, e.g. were searched by specified keywords like venipuncture, distraction, and pain. Study Selection All studies assessing the effect of distraction techniques on the pain of venipuncture in children were examined in our systematic review. A number of 148 articles were found in the initial investigation of titles, abstracts, and main-texts. After the elimination of duplicates and irrelevant ones, eventually 31 RCT studies and 2 review articles entered the study. Data Extraction A checklist was used to extract required data from relevant articles on name, year and type of study, sample size, age range of participants, type of intervention, employed method, and obtained results. Results Based on the findings, various techniques of distraction were used on pain control in children including music, virtual reality, audio-visual equipment such as cartoons, animation and video game, squeezing rubber balls, Filippits distraction cards, Hugo point ice massage, making bubbles, breathing exercise, Kaleidoscope color screen and touching the palm of the hand to reduce the pain of venipuncture. Conclusions Distraction techniques can reduce the pain of venipuncture in children. It is suggested to make these techniques more effective and apply them by considering the age and mental and

  13. Roadside advertising and the distraction of driver’s attention

    Directory of Open Access Journals (Sweden)

    Tarnowski Adam


    Full Text Available Distraction during driving is becoming a major problem in contemporary transport and traffic psychology. Concentration may deteriorate complex vehicle systems due to the provision of unnecessary information and use of mobile phones (the problem is not only talking but writing text messages and e-mails, browsing sites, etc.. A significant role is also played by advertisers who use aggressive ways to attract attention and communicate product information, especially because they compete with an already overloaded attention system. On the other hand, the need for stimulation is strong with people increasingly less tolerant to monotony. The RoAdvert project is aimed to develop evidence-based rules of placing roadside advertising with respect to safety and real possibilities of regulating the advertising market, including the optimal level of driver stimulation. The paper will present a preliminary analysis of the survey and experimental research.

  14. Periosteal Distraction Osteogenesis: An Effective Method for Bone Regeneration

    Directory of Open Access Journals (Sweden)

    Danyang Zhao


    Full Text Available The treatment of bone defects is challenging and controversial. As a new technology, periosteal distraction osteogenesis (PDO uses the osteogenicity of periosteum, which creates an artificial space between the bone surface and periosteum to generate new bone by gradually expanding the periosteum with no need for corticotomy. Using the newly formed bone of PDO to treat bone defects is effective, which can not only avoid the occurrence of immune-related complications, but also solve the problem of insufficient donor. This review elucidates the availability of PDO in the aspects of mechanisms, devices, strategies, and measures. Moreover, we also focus on the future prospects of PDO and hope that PDO will be applied to the clinical treatment of bone defects in the future.

  15. Dynamics of distraction: competition among auditory streams modulates gain and disrupts inter-trial phase coherence in the human electroencephalogram.

    Directory of Open Access Journals (Sweden)

    Karla D Ponjavic-Conte

    Full Text Available Auditory distraction is a failure to maintain focus on a stream of sounds. We investigated the neural correlates of distraction in a selective-listening pitch-discrimination task with high (competing speech or low (white noise distraction. High-distraction impaired performance and reduced the N1 peak of the auditory Event-Related Potential evoked by probe tones. In a series of simulations, we explored two theories to account for this effect: disruption of sensory gain or a disruption of inter-trial phase consistency. When compared to these simulations, our data were consistent with both effects of distraction. Distraction reduced the gain of the auditory evoked potential and disrupted the inter-trial phase consistency with which the brain responds to stimulus events. Tones at a non-target, unattended frequency were more susceptible to the effects of distraction than tones within an attended frequency band.

  16. Dynamics of distraction: competition among auditory streams modulates gain and disrupts inter-trial phase coherence in the human electroencephalogram. (United States)

    Ponjavic-Conte, Karla D; Hambrook, Dillon A; Pavlovic, Sebastian; Tata, Matthew S


    Auditory distraction is a failure to maintain focus on a stream of sounds. We investigated the neural correlates of distraction in a selective-listening pitch-discrimination task with high (competing speech) or low (white noise) distraction. High-distraction impaired performance and reduced the N1 peak of the auditory Event-Related Potential evoked by probe tones. In a series of simulations, we explored two theories to account for this effect: disruption of sensory gain or a disruption of inter-trial phase consistency. When compared to these simulations, our data were consistent with both effects of distraction. Distraction reduced the gain of the auditory evoked potential and disrupted the inter-trial phase consistency with which the brain responds to stimulus events. Tones at a non-target, unattended frequency were more susceptible to the effects of distraction than tones within an attended frequency band.

  17. Distracting the mind improves performance: an ERP Study.

    Directory of Open Access Journals (Sweden)

    Stefan M Wierda

    Full Text Available BACKGROUND: When a second target (T2 is presented in close succession of a first target (T1, people often fail to identify T2, a phenomenon known as the attentional blink (AB. However, the AB can be reduced substantially when participants are distracted during the task, for instance by a concurrent task, without a cost for T1 performance. The goal of the current study was to investigate the electrophysiological correlates of this paradoxical effect. METHODOLOGY/PRINCIPAL FINDINGS: Participants successively performed three tasks, while EEG was recorded. The first task (standard AB consisted of identifying two target letters in a sequential stream of distractor digits. The second task (grey dots task was similar to the first task with the addition of an irrelevant grey dot moving in the periphery, concurrent with the central stimulus stream. The third task (red dot task was similar to the second task, except that detection of an occasional brief color change in the moving grey dot was required. AB magnitude in the latter task was significantly smaller, whereas behavioral performance in the standard and grey dots tasks did not differ. Using mixed effects models, electrophysiological activity was compared during trials in the grey dots and red dot tasks that differed in task instruction but not in perceptual input. In the red dot task, both target-related parietal brain activity associated with working memory updating (P3 as well as distractor-related occipital activity was significantly reduced. CONCLUSIONS/SIGNIFICANCE: The results support the idea that the AB might (at least partly arise from an overinvestment of attentional resources or an overexertion of attentional control, which is reduced when a distracting secondary task is carried out. The present findings bring us a step closer in understanding why and how an AB occurs, and how these temporal restrictions in selective attention can be overcome.

  18. Midface distraction advancement in the canine without osteotomies. (United States)

    Staffenberg, D A; Wood, R J; McCarthy, J G; Grayson, B H; Glasberg, S B


    Midface hypoplasia, often associated with exorbitism and malocclusion, has been traditionally corrected by using Le Fort advancement osteotomies through wide surgical exposure. These procedures suffer the disadvantages of hemorrhage, unpredictable bone graft resorption, the need for retained hardware, and bone graft donor-site morbidity. We present an investigation of midface distraction in the canine without osteotomies. Five canines were the subjects of this study and were divided into two groups. At the time of placement of the lengthening devices, Group 1 animals were 10 weeks of age and Group 2 animals were 5 years of age. Under general anesthesia, four modified Hoffman bone distractors were mounted on 2-mm half pins placed individually across the nasofrontal and the zygomaticotemporal sutures on each side of the craniofacial skeleton. Distraction of all devices was begun on postoperative day 1 at the rate of 0.5 mm/day for 4 days and then 1.0 mm/day for 28 days, after which interval the devices were removed. The dogs were serially monitored and examined for 3 months. One dog in the first group served as a sham control. The results were assessed by standardized cephalograms, and craniofacial computed tomographic scans with three-dimensional reconstruction performed before device placement as well as after removal of the device. In one Group 1 animal, computed tomographic scanning was performed every 2 to 4 weeks for 3 months. Gross examination of the Group 1 animals demonstrated the development of enophthalmos, dolichocephaly, and a class II malocclusion-overbite.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Application of the MiniPanda test case ‘erosion of a stratified layer by a vertical jet’ for CFD validation

    Energy Technology Data Exchange (ETDEWEB)

    Kelm, Stephan, E-mail: [Forschungszentrum Juelich, Institute for Energy and Climate Research (IEK-6) (Germany); Ritterath, Martin; Prasser, Horst-Michael [ETH Zurich, Laboratory of Nuclear Energy Systems (LKE) (Switzerland); Allelein, Hans-Josef [Forschungszentrum Juelich, Institute for Energy and Climate Research (IEK-6) (Germany); RWTH Aachen University, Institute for Reactor Safety and Technology (LRST) (Germany)


    Highlights: • Small-scale experiment with innovative temperature wire mesh field measurements. • Discussion of benefits and limitations of small-scale setup regarding existing data base. • Systematic validation of a U-RANS model under consideration of best practice guidelines. • Quantitative point-to-point and phenomenological field-to-field comparison. - Abstract: In order to allow development and validation of CFD models for hydrogen mixing and transport in the containment, a comprehensive experimental test campaign was performed at the small scale MiniPanda facility at ETH Zurich. The considered test series aimed at studying the turbulent erosion of a stratified light gas by means of a vertical air jet with different momenta. Due to its new and innovative measurements, e.g., with temperature wire mesh sensors, the global mixing and the local interaction of jet and stratification are characterized in a high resolution in space and time. Both are essential for a detailed model assessment, to identify possible error sources and rate their effect on the global scenario evolution. Consequently, the tests are well suited for CFD model development and validation and complement the data basis gained before, e.g., in the frame of the joint OECD/NEA-SETH-2 Project (2007–2010) (OECD/NEA, 2012). Based on a description of the MiniPanda facility and the ‘layer erosion’ test series, the application of a U-RANS CFD approach, capable to be applied also for large scale application, is discussed. Numerical model uncertainties are minimized according to the best practice guidelines before a systematic comparison against the experimental data is performed and the capability of the model to predict the turbulent mixing at the interface and the inter-compartment mass transfer is successfully validated.

  20. External frame distraction osteogenesis of the midface in the cleft patient

    Directory of Open Access Journals (Sweden)

    Hussain Syed


    Full Text Available Distraction osteogenesis has established itself as an accepted form of treatment in the management of midface deficiency in cleft patients. However, it is well known that some amount of relapse is inevitable in patients who undergo this procedure. Like most surgical techniques, it has its specific indications, limitations, and complications. The problems are amplified in some patients because of severe fibrosis resulting from previous palate and lip operations. This article reviews treatment planning, pre- and postoperative orthodontic management, operative technique, and mechanics of distraction. It also discusses long-term changes following distraction and protocols to optimize the results and minimize complications.

  1. Bone Regeneration Is Promoted by Orally Administered Bovine Lactoferrin in a Rabbit Tibial Distraction Osteogenesis Model. (United States)

    Li, Wenyang; Zhu, Songsong; Hu, Jing


    Lactoferrin, an iron-binding glycoprotein which belongs to the transferrin family, has been shown to promote bone growth. However, reports regarding effects of lactoferrin on bone regeneration during distraction osteogenesis are limited. Our study was designed to investigate the effect of bovine lactoferrin treatment on bone formation of the distracted callus. We asked whether bovine lactoferrin enhances bone formation of the distraction callus as determined by (1) radiographic and histologic appearances; (2) dual-energy x-ray absorptiometry (DXA) analysis of bone mineral composition and bone mineral density; (3) micro-CT measures of trabecular architecture; and (4) biomechanical strength of the healing bone. Additionally, serology, reverse transcription (RT)-PCR, and immunohistochemistry were used to explore the possible mechanisms of bovine lactoferrin use on bone formation during distraction osteogenesis. Unilateral tibial osteodistraction was performed on 80 New Zealand White rabbits with a distraction rate of 1 mm per day for 10 days. Animals then were divided randomly into two groups: (1) vehicle and (2) bovine lactoferrin. At 4 and 8 weeks after completion of distraction, the animals were sacrificed. Lengthened tibias and serum samples were obtained and subjected to radiologic, DXA, micro-CT, histologic, and biomechanical examinations, and serum, RT-PCR and immunohistochemical analyses. Radiologic, DXA, micro-CT, histologic, and biomechanical examinations indicated that bovine lactoferrin treatment not only accelerated bone formation at early stages of distraction osteogenesis but also promoted bone consolidation at late stages. The ultimate force of the distracted calluses was increased by 37% (118.8 ± 6.65 N in the lactoferrin group and 86.5 ± 5.47 N in the vehicle group; p lactoferrin group and 209.0 ± 15.2 N in the vehicle group; p lactoferrin treatment significantly increased serum levels of bone alkaline phosphatase and decreased serum levels of

  2. Age-related changes in working memory and the ability to ignore distraction. (United States)

    McNab, Fiona; Zeidman, Peter; Rutledge, Robb B; Smittenaar, Peter; Brown, Harriet R; Adams, Rick A; Dolan, Raymond J


    A weakened ability to effectively resist distraction is a potential basis for reduced working memory capacity (WMC) associated with healthy aging. Exploiting data from 29,631 users of a smartphone game, we show that, as age increases, working memory (WM) performance is compromised more by distractors presented during WM maintenance than distractors presented during encoding. However, with increasing age, the ability to exclude distraction at encoding is a better predictor of WMC in the absence of distraction. A significantly greater contribution of distractor filtering at encoding represents a potential compensation for reduced WMC in older age.

  3. What drives technology-based distractions? A structural equation model on social-psychological factors of technology-based driver distraction engagement. (United States)

    Chen, Huei-Yen Winnie; Donmez, Birsen


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

  4. Forced eruption with miniscrews; inter-arch [corrected] method with vertical elastics versus intra-arch method using the Derton-Perini technique: two case reports. (United States)

    Derton, Nicola; Derton, Roberto; Perini, Alessandro


    Orthodontic preprosthetic treatment is an important feature of interdisciplinary dental therapy in the adult patient. Extrusion can be very useful to obtain successful prosthodontic results. The literature describes different ways to obtain forced dental eruption. Miniscrews represent a step towards resolving the problem of anchorage in orthodontics, including in forced eruption cases. The aim of this study is to report two cases of orthodontic preprosthetic extrusion by means of miniscrews and bone anchorage. We will describe and discuss the indications, orthodontic and surgical technique and the clinical advantages. In the first reported case, a decayed upper molar was extruded using miniscrews and an inter-arch technique (direct skeletal anchorage), which needs patient compliance to properly position the inter-arch elastics. In the second case, an upper premolar with an oblique corono-radicular fracture underwent forced eruption by means of intra-arch miniscrews (indirect bone anchorage with the "Derton-Perini" technique). Patient compliance was not required. Adequate extrusion of the treated teeth was obtained, with no undesired movement of the neighbouring teeth. Using the "Derton-Perini" technique, we reached our objectives without patient compliance. Miniscrews for skeletal anchorage proved to be an effective device to obtain extrusion for prosthetic purposes without undesired movements on other teeth and with no need for patient compliance when used in the same arch. Copyright © 2011. Published by Elsevier Masson SAS.

  5. Diel vertical migrat..

    African Journals Online (AJOL)


    Jan 24, 2002 ... crustacean zooplankton but also in a Wide array of different marine zooplankton groups. (Russell 1927, McLaren 1963). Thus there is no doubt that ..... cooperation during field work and for their fruitful discussion on the draft manuscript. REFERENCES. Bayly lAE 1986 Aspects of diel vertical migration in ...

  6. Vertical market participation

    DEFF Research Database (Denmark)

    Schrader, Alexander; Martin, Stephen


    Firms that operate at both levels of vertically related Cournot oligopolies will purchase some input supplies from independent rivals, even though they can produce the good at a lower cost, driving up input price for nonintegrated firms at the final good level. Foreclosure, which avoids this stra...... this strategic behavior, yields better market performance than Cournot beliefs...

  7. Hunting Voronoi vertices

    NARCIS (Netherlands)

    Ferrucci, V.; Overmars, Mark; Rao, A.; Vleugels, J.


    Given three objects in the plane, a Voronoi vertex is a point that is equidistant simultaneously from each. In this paper, we consider the problem of computing Voronoi vertices for planar objects of xed but possibly unknown shape; we only require the ability to query the closest point on an object

  8. Vertical shaft windmill (United States)

    Grana, D. C.; Inge, S. V., Jr. (Inventor)


    A vertical shaft has several equally spaced blades mounted. Each blade consists of an inboard section and an outboard section skew hinged to the inboard section. The inboard sections automatically adjust their positions with respect to the fixed inboard sections with changes in velocity of the wind. This windmill design automatically governs the maximum rotational speed of shaft.

  9. Maxillary reconstruction with bone transport distraction and implants after partial maxillectomy. (United States)

    Castro-Núñez, Jaime; González, Marcos Daniel


    Maxillary and mandibular bone defects can result from injury, congenital defect, or accident, or as a consequence of surgical procedures when treating pathology or defects affecting jaw bones. The glandular odontogenic cyst is an infrequent type of odontogenic cyst that can leave a bony defect after being treated by aggressive surgical means. First described in 1987 by Padayachee and Van Wyk, it is a potentially aggressive entity, having a predisposition to recur when treated conservatively, with only 111 cases having been reported hitherto. Most reports emphasize its clinical, radiographic, and histologic features, including a few considerations on rehabilitation for these patients. The aim of this article is to present the case of a 24-year-old male patient who, in 2001, was diagnosed with a glandular odontogenic cyst and to focus on the surgical approach and rehabilitation scheme. We performed an anterior partial maxillectomy. The osseous defect was treated using bone transport distraction. Dental and occlusal rehabilitation was achieved with titanium implants over transported bone and an implant-supported overdenture. A 9-year follow-up shows no evidence of recurrence of the pathology, adequate shape and amount of bone, functional occlusal and dental rehabilitation, and patient's satisfaction. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. National survey of distracted and drowsy driving attitudes and behaviors : 2002. Volume 1, Findings (United States)


    This report represents the findings on distracted driving (including cell phone use) and drowsy driving. The data come from a pair of studies undertaken by the National Highway Traffic Safety Administration (NHTSA) to better understand drivers' behav...

  11. National survey of distracted and drowsy driving attitudes and behavior : 2002. Volume 3, Methods (United States)


    This report represents the findings on distracted driving (including cell phone use) and drowsy driving. The data come from a pair of studies undertaken by National Highway Traffic Safety Administration (NHTSA) to better understand drivers behavio...


    National Research Council Canada - National Science Library

    Aligolbandi, Kobra; Siamian, Hasan; Balaghafari, Azita; Vahedi, Mohammad; Naeimi, Omolbanin


    .... This research studied classroom distractions factors among students of Faculty of Allied medical Sciences in year 2014-2015, so that with the findings of the research about classroom distractors...

  13. Driver distraction: a perennial but preventable public health threat to adolescents. (United States)

    Bingham, C Raymond


    Although public health efforts have made some progress in reducing risk of adolescent motor vehicle crashes over the last three decades, new technologies and evolving behavior patterns have focused attention on the risk of distracted driving. For many of the same reasons that alcohol-impaired driving represents a distinct risk for adolescents, distracted driving has an elevated impact on this age group. Similarly, many of the strategies used to reduce alcohol-impaired driving among adolescents might be applied to driver distraction, including adults serving as role models with high standards of behavior. The unique challenge posed by the proliferation of new technological distractions may accelerate this risk behavior and may lend itself to innovative prevention efforts. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  14. Stress Reduction through Audio Distraction in Anxious Pediatric Dental Patients: An Adjunctive Clinical Study. (United States)

    Singh, Divya; Samadi, Firoza; Jaiswal, Jn; Tripathi, Abhay Mani


    The purpose of the present study was to evaluate the eff-cacy of 'audio distraction' in anxious pediatric dental patients. Sixty children were randomly selected and equally divided into two groups of thirty each. The first group was control group (group A) and the second group was music group (group B). The dental procedure employed was extraction for both the groups. The children included in music group were allowed to hear audio presentation throughout the treatment procedure. Anxiety was measured by using Venham's picture test, pulse rate, blood pressure and oxygen saturation. 'Audio distraction' was found efficacious in alleviating anxiety of pediatric dental patients. 'Audio distraction' did decrease the anxiety in pediatric patients to a significant extent. How to cite this article: Singh D, Samadi F, Jaiswal JN, Tripathi AM. Stress Reduction through Audio Distraction in Anxious Pediatric Dental Patients: An Adjunctive Clinical Study. Int J Clin Pediatr Dent 2014;7(3):149-152.

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

    DEFF Research Database (Denmark)

    Rämö, Jussi; Christensen, Lasse; Bech, Søren


    This paper focuses on validating a perceptual distraction model, which aims to predict user’s perceived distraction caused by audio-on-audio interference, e.g., two competing audio sources within the same listening space. Originally, the distraction model was trained with music-on-music stimuli...... that the model performance is equally good in both zones, i.e., with both speech-on-music and music-on-speech stimuli, and comparable to the previous validation round (RMSE approximately 10%). The results further confirm that the distraction model can be used as a valuable tool in evaluating and optimizing...... using a simple loudspeaker setup, consisting of only two loudspeakers, one for the target sound source and the other for the interfering sound source. Recently, the model was successfully validated in a complex personal sound-zone system with speech-on-music stimuli. Second round of validations were...

  16. Visual attention distracter insertion for improved EEG rapid serial visual presentation (RSVP) target stimuli detection (United States)

    Khosla, Deepak; Huber, David J.; Martin, Kevin


    This paper† describes a technique in which we improve upon the prior performance of the Rapid Serial Visual Presentation (RSVP) EEG paradigm for image classification though the insertion of visual attention distracters and overall sequence reordering based upon the expected ratio of rare to common "events" in the environment and operational context. Inserting distracter images maintains the ratio of common events to rare events at an ideal level, maximizing the rare event detection via P300 EEG response to the RSVP stimuli. The method has two steps: first, we compute the optimal number of distracters needed for an RSVP stimuli based on the desired sequence length and expected number of targets and insert the distracters into the RSVP sequence, and then we reorder the RSVP sequence to maximize P300 detection. We show that by reducing the ratio of target events to nontarget events using this method, we can allow RSVP sequences with more targets without sacrificing area under the ROC curve (azimuth).

  17. Ultrasound control of magnet growing rod distraction in early onset scoliosis. (United States)

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


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

  18. The Differential Effects of Mindfulness and Distraction on Affect and Body Satisfaction Following Food Consumption

    Directory of Open Access Journals (Sweden)

    Alice Tsai


    Full Text Available This study investigated whether engaging in mindfulness following food consumption produced changes in affect and body satisfaction, as compared to a control distraction task. The moderating effects of eating pathology and neuroticism were also examined. A total of 110 female university students consumed food and water before engaging in either a mindfulness induction or a control distraction task. Participants completed trait measures of eating pathology and neuroticism at baseline, and measures of state affect and body satisfaction before and after food consumption, and after the induction. Results revealed that consuming food and water reduced positive affect. Unexpectedly, both the mindfulness group and distraction control group experienced similar improvements in negative affect and body satisfaction following the induction. Eating pathology and neuroticism did not moderate the observed changes. These findings suggest that both mindfulness and distraction may contribute to the effectiveness of treatments for disordered eating that incorporate both of these techniques, such as Dialectical Behavior Therapy.

  19. Multidirectional Cranial Distraction Osteogenesis with Simplified Modifications for Treating Sagittal Synostosis

    Directory of Open Access Journals (Sweden)

    Ataru Sunaga, MD


    Conclusions:. Simplified MCDO has a number of advantages over conventional distraction procedures such as discretionary reshaping/expansion of cranium and predictable osteogenesis and is a valid treatment option for patients with sagittal synostosis.

  20. Investigating the roles of touchscreen and physical control interface characteristics on driver distraction and multitasking performance. (United States)


    This study aimed to assess the potential of driver distraction, task performance, orientation of : attention, and perceived workload in a multitasking situation involving interaction with touchscreen : interface, compared to physical interface. Autho...

  1. Symptomatic venous thromboembolism in orthognathic surgery and distraction osteogenesis: a retrospective cohort study of 4127 patients

    NARCIS (Netherlands)

    Verlinden, C.R.A.; Tuinzing, D.B.; Forouzanfar, T.


    Venous thromboembolism is a common postoperative complication, and orthopaedic procedures are particularly at risk. We designed a retrospective, single centre, observational, cohort study of 4127 patients (mean (SD) age 27 (11) years) who had elective orthognathic operations or distraction

  2. Treatment of Decubitis Ulcer Stage IV in the Patient with Polytrauma and Vertical Share Pelvic Fracture, Diagnosed Entherocollitis and Deep Wound Infection with Clostridium Difficile with Combined Negative Pressure Wound Therapy (NPWT and Faecal Management System: Case Report

    Directory of Open Access Journals (Sweden)

    Slavcho Stojmenski


    CONCLUSION: When faecal incontinence as a result of enterocollitis with Clostridium difficile does occur, a limiting contact with the patient’s skin is extremely important as breakdown can occur rapidly. In addition to tissue injury, faecal incontinence can have a major impact on the patient’s dignity and result in prolonged hospital stay. The main outcomes assested in the case studies were resolution of of decubital ulcers as a result of faecal incontinence, patient comfort and ease of application of the FMS and NPWT. The soft flexible catheter was easily inserted without discomfort to the patients. It gently conformed to the rectal vault, reducing significantly the risk of necrosis, and the risk for prolonged necrosis in cases with previously developed necrosis. FMS was successful in diverting faecal fluid away from the perineal tissue and resolved any decubitus ulcer developed previously in combination with use of NPWT. So, we can recommend this combination in those cases especially with polytraumatismus, vertical share pelvis fracture combined with diarrhea and deep wound infection of decubital ulcers Grade IV infected with Cl. difficile.

  3. Vertical gastroplasty: evolution of vertical banded gastroplasty. (United States)

    Mason, E E; Doherty, C; Cullen, J J; Scott, D; Rodriguez, E M; Maher, J W


    The objective of this paper is to summarize the goals, technical requirements, advantages, and potential risks of gastroplasty for treatment of severe obesity. Gastroplasty is preferred to more complex operations, as it preserves normal digestion and absorption and avoids complications that are peculiar to exclusion operations. The medical literature and a 30-year experience at the University of Iowa Hospitals and Clinics (UIHC) provides an overview of vertical banded gastroplasty (VBG) evolution. Preliminary 10-year results with the VBG technique currently used at UIHC are included. At UIHC the VBG is preferred to other gastroplasties because it provides weight control that extends for at least 10 years and the required objective, intraoperative quality control required for a low rate of reoperation. It is recommended that modifications of the operative technique not be attempted until a surgeon has had experience with the standardized operation--and then only under a carefully designed protocol. Realistic goals for surgery and criteria of success influence the choice of operation and the optimum, lifelong risk/benefit ratio. In conclusion, VBG is a safe, long-term effective operation for severe obesity with advantages over complex operations and more restrictive simple operations.

  4. The potential effect of technology and distractions on undergraduate students’ concentration (United States)

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


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

  5. The potential effect of technology and distractions on undergraduate students' concentration. (United States)

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


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

  6. Causal evidence for frontal involvement in memory target maintenance by posterior brain areas during distracter interference of visual working memory. (United States)

    Feredoes, Eva; Heinen, Klaartje; Weiskopf, Nikolaus; Ruff, Christian; Driver, Jon


    Dorsolateral prefrontal cortex (DLPFC) is recruited during visual working memory (WM) when relevant information must be maintained in the presence of distracting information. The mechanism by which DLPFC might ensure successful maintenance of the contents of WM is, however, unclear; it might enhance neural maintenance of memory targets or suppress processing of distracters. To adjudicate between these possibilities, we applied time-locked transcranial magnetic stimulation (TMS) during functional MRI, an approach that permits causal assessment of a stimulated brain region's influence on connected brain regions, and evaluated how this influence may change under different task conditions. Participants performed a visual WM task requiring retention of visual stimuli (faces or houses) across a delay during which visual distracters could be present or absent. When distracters were present, they were always from the opposite stimulus category, so that targets and distracters were represented in distinct posterior cortical areas. We then measured whether DLPFC-TMS, administered in the delay at the time point when distracters could appear, would modulate posterior regions representing memory targets or distracters. We found that DLPFC-TMS influenced posterior areas only when distracters were present and, critically, that this influence consisted of increased activity in regions representing the current memory targets. DLPFC-TMS did not affect regions representing current distracters. These results provide a new line of causal evidence for a top-down DLPFC-based control mechanism that promotes successful maintenance of relevant information in WM in the presence of distraction.

  7. The validity of abdominal examination in blunt trauma patients with distracting injuries. (United States)

    Rostas, Jack; Cason, Benton; Simmons, Jon; Frotan, Mohammed A; Brevard, Sidney B; Gonzalez, Richard P


    Many trauma care providers often disregard the abdominal clinical examination in the presence of extra-abdominal distracting injuries and mandate abdominal computed tomographic scan in these patients. Ignoring the clinical examination may incur undue expense and radiation exposure. The purpose of this study was to assess the efficacy of abdominal clinical examination in patients with distracting injuries. During a 1-year period, all awake and alert blunt trauma patients with Glasgow Coma Scale (GCS) score of 14 or 15 were entered into a prospective study. Abdominal clinical examination was performed and documented prospectively on all patients. Abdominal clinical examination included four-quadrant anterior abdominal palpation, flank palpation, lower thoracic palpation, pelvis examination, and palpation of the thoracolumbar spine. Following examination documentation, all patients underwent computed tomographic scan of the abdomen and pelvis with intravenous contrast. A total of 803 patients were enrolled: 451 patients had distracting injuries, and 352 patients did not. Of the 352 patients without distracting injuries, 19 (5.4%) had intra-abdominal injuries, of whom 2 (10.5%) had negative clinical examination result. Of the 451 patients with distracting injuries, 48 (10.6%) were diagnosed with intra-abdominal injury, of whom 5 (10.4%) had negative clinical examination result. All five missed injuries in patients with distracting injuries were solid organ injuries, none of which required surgical intervention or blood transfusion. The sensitivity and negative predictive value of abdominal examination for patients with distracting injuries were 90.0% and 97.0%, respectively. The sensitivity and negative predictive value of abdominal examination for surgically significant and transfusion-requiring injuries were both 100%. Distracting injuries do not seem to diminish the efficacy of clinical abdominal examination for the diagnosis of clinically significant abdominal

  8. Effect of distraction techniques in behaviour responses to pain among toddlers receiving immunisation. (United States)

    Singh, Pankaj


    Pain and distress during immunisation of toddlers are reasons for non-immunisation of large number of toddlers. The present study was undertaken to assess the comparative effectiveness of distraction techniques in the process of immunisation i.e. toy and music. (The third group of study subjects was control group). It is concluded that distraction techniques are quite economical and safe in enhancing the magnitude of immunisation.

  9. Parathyroid hormone therapy mollifies radiation-induced biomechanical degradation in murine distraction osteogenesis. (United States)

    Deshpande, Sagar S; Gallagher, Katherine K; Donneys, Alexis; Tchanque-Fossuo, Catherine N; Sarhaddi, Deniz; Nelson, Noah S; Chepeha, Douglas B; Buchman, Steven R


    Descriptions of mandibular distraction osteogenesis for tissue replacement after oncologic resection or for defects caused by osteoradionecrosis have been limited. Previous work demonstrated radiation decreases union formation, cellularity and mineral density in mandibular distraction osteogenesis. The authors posit that intermittent systemic administration of parathyroid hormone will serve as a stimulant to cellular function, reversing radiation-induced damage and enhancing bone regeneration. Twenty male Lewis rats were randomly assigned to three groups: group 1 (radiation and distraction osteogenesis, n = 7) and group 2 (radiation, distraction osteogenesis, and parathyroid hormone, n = 5) received a human-equivalent dose of 35 Gy of radiation (human bioequivalent, 70 Gy) fractionated over 5 days. All groups, including group 3 (distraction osteogenesis, n = 8), underwent a left unilateral mandibular osteotomy with bilateral external fixator placement. Distraction osteogenesis was performed at a rate of 0.3 mm every 12 hours to reach a gap of 5.1 mm. Group 2 was injected with parathyroid hormone (60 µg/kg) subcutaneously daily for 3 weeks after the start of distraction osteogenesis. On postoperative day 40, all left hemimandibles were harvested. Biomechanical response parameters were generated. Statistical significance was considered at p ≤ 0.05. Parathyroid hormone-treated mandibles had significantly higher failure load and higher yield than did untreated mandibles. However, these values were still significantly lower than those of nonirradiated mandibles. The authors have successfully demonstrated the therapeutic efficacy of parathyroid hormone to stimulate and enhance bone regeneration in their irradiated murine mandibular model of distraction osteogenesis. Anabolic regimens of parathyroid hormone, a U.S. Food and Drug Administration-approved drug on formulary, significantly improve outcomes in a model of postoncologic craniofacial reconstruction.

  10. Designing feedback to mitigate teen distracted driving: A social norms approach. (United States)

    Merrikhpour, Maryam; Donmez, Birsen


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

  11. Functional outcome with special attention to the DASH questionnaire following callus distraction and phalangization of the thumb after traumatic amputation in the middle one-third. (United States)

    Zimmermann, R; Sailer, R; Pechlaner, S; Gabl, M


    Aim of this retrospective study was to obtain a functional outcome following callus distraction and phalangization of the thumb after traumatic amputation in the middle one-third. From January 1998 to June 2001, 12 patients were treated in a staged procedure starting with corticotomy and continuous distraction (1 mm/day) of the first metacarpal bone using a unilateral external fixator device. After distraction until day 31 (range 25-35 days), the first metacarpal bone was stabilized with a plate, and phalangization was performed. RESULTS. At follow-up 1 year after surgery, the thumb was lengthened to 25-35 mm (average 28 mm) in all but 1 patient. In 1 patient a bone graft from the iliac crest had to be interposed. Pinch grip improved by 45%; grip strength improved by 55%. The function/symptom score from the DASH questionnaire was 25 points (range 16-38 points). In a 'pick-up test' all patients were able to pick up a pencil, they were able to write and could hold a full cup of water. Nine patients were able to pick up a paper clip, and 8 patients could hold a 1-liter bottle of water. Callus distraction can be considered a suitable procedure to reconstruct an amputated thumb levelled at the middle one-third. Additional phalangization proved essential as it deepened the first web space, enabling good motion and grasp. Callus formation was delayed in elderly patients, but adequate lengthening and bone healing also occurred in this age group. The procedure will not be as beneficial in cases of osteoarthritis of the trapezometacarpal joint or when coverage of the stump is insufficient. The DASH questionnaire is very helpful in evaluating the effect of thumb reconstruction on the entire upper limb.

  12. What can the drivers' own description from combined sources provide in an analysis of driver distraction and low vigilance in accident situations? (United States)

    Tivesten, Emma; Wiberg, Henrik


    Accident data play an important role in vehicle safety development. Accident data sources are generally limited in terms of how much information is provided on driver states and behaviour prior to an accident. However, the precise limitations vary between databases, due to differences in analysis focus and data collection procedures between organisations. If information about a specific accident can be retrieved from more than one data source it should be possible to combine the available information sets to facilitate data from one source to compensate for limitations in the other(s). To investigate the viability of such compensation, this study identified a set of accidents recorded in two different data sources. The first data source investigated was an accident mail survey and the second data source insurance claims documents consisting predominantly of insurance claims completed by the involved road users. An analysis of survey variables was compared to a case analysis including word data derived from the same survey and filed insurance claims documents. For each accident, the added value of having access to more than one source of information was assessed. To limit the scope of this study, three particular topics were investigated: available information on low vigilance (e.g., being drowsy, ill); secondary task distraction (e.g., talking with passengers, mobile phone use); and distraction related to the driving task (e.g., looking for approaching vehicles). Results suggest that for low vigilance and secondary task distraction, a combination of the mail survey and insurance claims documents provide more reliable and detailed pre-crash information than survey variables alone. However, driving related distraction appears to be more difficult to capture. In order to gain a better understanding of the above issues and how frequently they occur in accidents, the data sources and analysis methods suggested here may be combined with other investigation methods such

  13. Cell Phone Calls in the Operating Theater and Staff Distractions: An Observational Study. (United States)

    Avidan, Alexander; Yacobi, Galel; Weissman, Charles; Levin, Phillip D


    Cell phones are the primary communication tool in our institution. There are no restrictions on their use in the operating rooms. The goal of this study was to evaluate the extent of cell phone use in the operating rooms during elective surgery and to evaluate whether they cause staff distractions. The following data on cell phone use were recorded anonymously: number of incoming and outgoing cell phone calls, duration of cell phone calls and their content (patient related, work related, private), who was distracted by the cell phone calls, and duration of distractions. We made observations during 52 surgeries. There were 205 cell phone calls, 197 (96.1%; median, 3 per surgery; interquartile range, 2-5) incoming and 8 (3.9%) outgoing. Incoming calls were answered on 110 (55.8%) of 197 (median, 2; interquartile range, 1-3) occasions. The mean duration of incoming calls (64 ± 40 seconds) was shorter than those of the outgoing calls (137 ± 242 seconds, P cell phones (24/30, 80.0%). The mean duration of the distractions was 43.6 ± 22.3 seconds. During all 8 outgoing calls, no other staff members were distracted. The number of cell phone calls in the operating rooms during elective surgery was lower than expected and caused short-lived distractions mainly to the operating surgeons. We recommend that operating surgeons turn off their cell phones before surgery.

  14. A mobile app offering distractions and tips to cope with cigarette craving: a qualitative study. (United States)

    Ploderer, Bernd; Smith, Wally; Pearce, Jon; Borland, Ron


    Despite considerable effort, most smokers relapse within a few months after quitting due to cigarette craving. The widespread adoption of mobile phones presents new opportunities to provide support during attempts to quit. To design and pilot a mobile app "DistractMe" to enable quitters to access and share distractions and tips to cope with cigarette cravings. A qualitative study with 14 smokers who used DistractMe on their mobiles during the first weeks of their quit attempt. Based on interviews, diaries, and log data, we examined how the app supported quitting strategies. Three distinct techniques of coping when using DistractMe were identified: diversion, avoidance, and displacement. We further identified three forms of engagement with tips for coping: preparation, fortification, and confrontation. Overall, strategies to prevent cravings and their effects (avoidance, displacement, preparation, and fortification) were more common than immediate coping strategies (diversion and confrontation). Tips for coping were more commonly used than distractions to cope with cravings, because they helped to fortify the quit attempt and provided opportunities to connect with other users of the application. However, distractions were important to attract new users and to facilitate content sharing. Based on the qualitative results, we recommend that mobile phone-based interventions focus on tips shared by peers and frequent content updates. Apps also require testing with larger groups of users to assess whether they can be self-sustaining.

  15. A Mobile App Offering Distractions and Tips to Cope With Cigarette Craving: A Qualitative Study (United States)

    Smith, Wally; Pearce, Jon; Borland, Ron


    Background Despite considerable effort, most smokers relapse within a few months after quitting due to cigarette craving. The widespread adoption of mobile phones presents new opportunities to provide support during attempts to quit. Objective To design and pilot a mobile app "DistractMe" to enable quitters to access and share distractions and tips to cope with cigarette cravings. Methods A qualitative study with 14 smokers who used DistractMe on their mobiles during the first weeks of their quit attempt. Based on interviews, diaries, and log data, we examined how the app supported quitting strategies. Results Three distinct techniques of coping when using DistractMe were identified: diversion, avoidance, and displacement. We further identified three forms of engagement with tips for coping: preparation, fortification, and confrontation. Overall, strategies to prevent cravings and their effects (avoidance, displacement, preparation, and fortification) were more common than immediate coping strategies (diversion and confrontation). Tips for coping were more commonly used than distractions to cope with cravings, because they helped to fortify the quit attempt and provided opportunities to connect with other users of the application. However, distractions were important to attract new users and to facilitate content sharing. Conclusions Based on the qualitative results, we recommend that mobile phone-based interventions focus on tips shared by peers and frequent content updates. Apps also require testing with larger groups of users to assess whether they can be self-sustaining. PMID:25099632

  16. Body Image in Dyadic and Solitary Sexual Desire: The Role of Encoding Style and Distracting Thoughts. (United States)

    Dosch, Alessandra; Ghisletta, Paolo; Van der Linden, Martial


    This study explored the link between body image and desire to engage in sexual activity (dyadic and solitary desire) in adult women living in a long-term couple relationship. Moreover, it considered two psychological factors that may underlie such a link: the occurrence of body-related distracting thoughts during sexual activity and encoding style (i.e., the tendency to rely on preexisting internal schemata versus external information at encoding). A total of 53 women (29 to 47 years old) in heterosexual relationships completed questionnaires assessing sexual desire (dyadic, solitary), body image, body-related distracting thoughts during sexual activity, and encoding style. Results showed that poor body image was associated with low dyadic and solitary sexual desire. Body-related distracting thoughts during sexual activity mediated the link between body image and solitary (but not dyadic) sexual desire. Finally, the mediation of body-related distracting thoughts between body image and solitary sexual desire was moderated by encoding style. A negative body image promoted the occurrence of body-related distracting thoughts during sexual activity, especially in internal encoders. Our study highlights the importance of body image, distracting thoughts, and encoding style in women's solitary sexuality and suggests possible factors that may reduce the impact of those body-related factors in dyadic sexual desire.


    Directory of Open Access Journals (Sweden)

    Farida Juanita


    Full Text Available Introduction: Circumcision is one of minor surgery that usually done for school age children. Most of the children appear to be anxious enough. Audio-visual distraction is one of the methods that researcher want to applied to decrease children’s anxiety level during circumcision. The objective of this study was to identify the effect of audio-visual distraction to decrease children’s anxiety level during circumcision. Method: Non randomized pretest-posttest control group design was used in this study. There were 21 children divided into two groups, control group (n=13 receive intervention as usual, otherwise the intervention group (n=8 receive audio-visual distraction during circumcision. By using self report (scale of anxiety and physiological measures of anxiety (pulse rate per minute, children are evaluated before and after the intervention. Result:  The result showed that audio-visual distraction is efective to decrease the anxiety level of school age children during cicumcision with significance difference on the decrease of anxiety level between control and intervention group (p=0.000 and significance difference on the pulse rate per minute between control and intervention group (p=0.006. Discussion: It can be concluded that by applying the audio-visual distraction during circumcision could be minimized the children’s anxiety. The audio visual is needed for children to manage and reduce anxiety during invasive therapy through mecanism of distraction.

  18. Do absorption and realistic distraction influence performance of component task surgical procedure? (United States)

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


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

  19. Mandibular deformities: single-vector distraction techniques for a multivector problem. (United States)

    Singh, Davinder J; Glick, Patricia H; Bartlett, Scott P


    Single-vector distraction devices have been criticized for creating a malocclusion in an attempt to correct a three-dimensional mandibular deficiency, resulting in the evolution of a multiplanar device. Although there are indications for the use of a multiplanar device, a vast number of patients with mandibular hypoplasia can be effectively treated with a single-vector device, producing a normal occlusion and an aesthetic result while minimizing facial scarring and simplifying postoperative care. The purpose of this review was to describe surgical techniques whereby a single-vector device is effectively used in treating a multivector mandibular deficiency.A retrospective analysis of all patients who underwent mandibular distraction at the Children's Hospital of Philadelphia between 1996 and 2005 with a semiburied, uniplanar device was conducted. Charts, photographs, graphs, operative reports, computed tomography scans, and cephalometrograms were reviewed for those patients undergoing uniplanar mandibular distraction.Ten unilateral and 4 bilateral distractions were performed. In these 14 patients, causes included hemifacial microsomia, Treacher Collins syndrome, posttraumatic hypoplasia, and temporomandibular joint ankylosis with hypoplasia. The average device distraction was 29 mm (range, 18-34 mm). The average age at distraction was 8.4 years (range, 4-15 years). Surgical techniques for these patients will be described in detail. The single-vector, semiburied device can be effectively used to aesthetically correct a three-dimensional problem and to produce or maintain a class I occlusion while simplifying postoperative management and minimizing facial scarring.

  20. The expression of endogenous hydrogen sulfide signal during distraction osteogenesis in a rabbit model. (United States)

    Jiang, X-W; Zhang, Y; Cheng, Y-Z; Fan, X-S; Deng, X; Peng, H-Y


    The hydrogen sulfide (H2S) signal system plays an important role in bone metabolism. However, the role of endogenous H2S during distraction osteogenesis (DO) remains unclear. Sixty-two male New Zealand White rabbits were subjected to right mandibular DO. Before distraction, the animals were divided randomly into two groups: group A, 0.5mm twice/day for 10 days; group B, 1.25mm twice/day for 4 days. Plasma and distraction gap tissue were harvested to determine the H2S signal. The osteogenesis effect was also evaluated. The newly regenerated bone in group A presented a higher level of mineralization and biomechanical strength than that in group B. The bone mineralization density in group A was 1.95-fold that in group B (P=0.028), while the biomechanical strength in group A was 1.26-fold that in group B (P=0.042) at the end of the experiment. The H2S signal was detected during the whole process of DO. The relative plasma H2S concentrations in group A were noticeably higher than those in group B at the middle of distraction (P<0.001), at the end of the distraction (P=0.034), and 2 weeks after the end of distraction (P=0.002). The results suggest that the endogenous H2S signal system plays a major role during DO. Copyright © 2017. Published by Elsevier Ltd.

  1. Effect of icariin on bone formation during distraction osteogenesis in the rabbit mandible. (United States)

    Wei, H; Zili, L; Yuanlu, C; Biao, Y; Cheng, L; Xiaoxia, W; Yang, L; Xing, W


    The aim of this study was to evaluate the effect of icariin on bone formation during mandibular distraction. 40 Rabbits were randomly divided into experimental and control groups. Mandibular distraction was performed 5 days after unilateral mandibular osteotomy using a custom-made external distractor at a rate of 0.5mm/12h for 10 days. From the first day of distraction, icariin (2.5mg/kg · day) was orally administered to the experimental group and placebo to the controls. 10 Rabbits were killed at the end of weeks 2 and 4 of the consolidation phase. The distracted hemimandible was harvested and newly formed bone was evaluated by soft radiography, histology and bone histomorphometry. Regenerated bone was evaluated for bone mineral density by dual-energy X-ray absorptiometry. The experimental group had fewer radiolucent areas on soft radiography. Bone mineral density of regenerated bone was higher in the experimental than in the control group at 2 and 4 weeks. At 4 weeks, the experimental group had greater volumes of new bone, higher trabecular number, and less trabecular separation than the controls. Oral administration of icariin could promote bone formation during mandibular distraction osteogenesis and might be a promising method for shortening the course of distraction osteogenesis. Copyright © 2010. Published by Elsevier Ltd.

  2. The Molecular and Cellular Events That Take Place during Craniofacial Distraction Osteogenesis

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    Adi Rachmiel, DMD, PhD


    Full Text Available Summary: Gradual bone lengthening using distraction osteogenesis principles is the gold standard for the treatment of hypoplastic facial bones. However, the long treatment time is a major disadvantage of the lengthening procedures. The aim of this study is to review the current literature and summarize the cellular and molecular events occurring during membranous craniofacial distraction osteogenesis. Mechanical stimulation by distraction induces biological responses of skeletal regeneration that is accomplished by a cascade of biological processes that may include differentiation of pluripotential tissue, angiogenesis, osteogenesis, mineralization, and remodeling. There are complex interactions between bone-forming osteoblasts and other cells present within the bone microenvironment, particularly vascular endothelial cells that may be pivotal members of a complex interactive communication network in bone. Studies have implicated number of cytokines that are intimately involved in the regulation of bone synthesis and turnover. The gene regulation of numerous cytokines (transforming growth factor-β, bone morphogenetic proteins, insulin-like growth factor-1, and fibroblast growth factor-2 and extracellular matrix proteins (osteonectin, osteopontin during distraction osteogenesis has been best characterized and discussed. Understanding the biomolecular mechanisms that mediate membranous distraction osteogenesis may guide the development of targeted strategies designed to improve distraction osteogenesis and accelerate bone regeneration that may lead to shorten the treatment duration.

  3. TVAR modeling of EEG to detect audio distraction during simulated driving (United States)

    Dahal, Nabaraj; (Nanda Nandagopal, D.; Cocks, Bernadine; Vijayalakshmi, Ramasamy; Dasari, Naga; Gaertner, Paul


    Objective. The objective of our current study was to look for the EEG correlates that can reveal the engaged state of the brain while undertaking cognitive tasks. Specifically, we aimed to identify EEG features that could detect audio distraction during simulated driving. Approach. Time varying autoregressive (TVAR) analysis using Kalman smoother was carried out on short time epochs of EEG data collected from participants as they undertook two simulated driving tasks. TVAR coefficients were then used to construct all pole model enabling the identification of EEG features that could differentiate normal driving from audio distracted driving. Main results. Pole analysis of the TVAR model led to the visualization of event related synchronization/desynchronization (ERS/ERD) patterns in the form of pole displacements in pole plots of the temporal EEG channels in the z plane enabling the differentiation of the two driving conditions. ERS in the EEG data has been demonstrated during audio distraction as an associated phenomenon. Significance. Visualizing the ERD/ERS phenomenon in terms of pole displacement is a novel approach. Although ERS/ERD has previously been demonstrated as reliable when applied to motor related tasks, it is believed to be the first time that it has been applied to investigate human cognitive phenomena such as attention and distraction. Results confirmed that distracted/non-distracted driving states can be identified using this approach supporting its applicability to cognition research.

  4. Distraction produces over-additive increases in the degree to which alcohol impairs driving performance. (United States)

    Van Dyke, Nicholas A; Fillmore, Mark T


    Research indicates that alcohol intoxication and increased demands on drivers' attention from distractions (e.g., passengers and cell phones) contribute to poor driving performance and increased rates of traffic accidents and fatalities. The present study examined the separate and combined effects of alcohol and distraction on simulated driving performance at blood alcohol concentrations (BrACs) below the legal driving limit in the USA (i.e., 0.08 %). Fifty healthy adult drivers (36 men and 14 women) were tested in a driving simulator following a 0.65-g/kg dose of alcohol and a placebo. Drivers completed two drive tests: a distracted drive, which included a two-choice detection task, and an undistracted control drive. Multiple indicators of driving performance, such as drive speed, within-lane deviation, steering rate, and lane exceedances were measured. Alcohol and distraction each impaired measures of driving performance. Moreover, the magnitude of alcohol impairment was increased by at least twofold when tested under the distracting versus the undistracted condition. The findings highlight the need for a clearer understanding of how common distractions impact intoxicated drivers, especially at BrACs that are currently legal for driving in the USA.

  5. The effect of distraction strategies on pain perception and the nociceptive flexor reflex (RIII reflex). (United States)

    Ruscheweyh, Ruth; Kreusch, Annette; Albers, Christoph; Sommer, Jens; Marziniak, Martin


    Distraction from pain reduces pain perception, and imaging studies have suggested that this may at least partially be mediated by activation of descending pain inhibitory systems. Here, we used the nociceptive flexor reflex (RIII reflex) to directly quantify the effects of different distraction strategies on basal spinal nociception and its temporal summation. Twenty-seven healthy subjects participated in 3 distraction tasks (mental imagery, listening to preferred music, spatial discrimination of brush stimuli) and, in a fourth task, concentrated on the painful stimulus. Results show that all 3 distraction tasks reduced pain perception, but only the brush task also reduced the RIII reflex. The concentration-on-pain task increased both pain perception and the RIII reflex. The extent of temporal summation of pain perception and the extent of temporal summation of the RIII reflex were not affected by any of the tasks. These results suggest that some, but not all, forms of pain reduction by distraction rely on descending pain inhibition. In addition, pain reduction by distraction seems to preferentially affect mechanisms of basal nociceptive transmission, not of temporal summation. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  6. Music versus distraction for procedural pain and anxiety in patients with cancer. (United States)

    Kwekkeboom, Kristine L


    To test the hypotheses that the effects of a music intervention are greater than those of simple distraction and that either intervention is better at controlling procedural pain and anxiety than treatment as usual. Randomized, controlled experiment. A midwestern comprehensive cancer center. 60 people with cancer having noxious medical procedures such as tissue biopsy or port placement or removal; 58 provided usable data. Participants completed measures of pain and anxiety before and after their medical procedures and provided a rating of perceived control over pain and anxiety after the procedure. Procedural pain, state anxiety, and perceived control over pain and anxiety. Contrary to hypotheses, outcomes achieved with music did not differ from those achieved with simple distraction. Moreover, outcomes achieved under treatment as usual were not significantly different from those obtained with music or distraction interventions. Some patients found that the interventions were bothersome and reported that they wanted to attend to the activities of the surgeon and the medical procedure itself. The effects of music, distraction, and treatment as usual are equivocal. In addition, patients have individual preferences for use of distraction during painful or anxiety-provoking procedures. Patients having noxious medical procedures should be asked about their desire to be distracted before and during the procedure and offered a strategy that is consistent with their preferences.

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

    Directory of Open Access Journals (Sweden)

    Joana S. Lourenço


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

  8. Distraction and Expressive Suppression Strategies in Regulation of High- and Low-Intensity Negative Emotions. (United States)

    Li, Ping; Wang, Wei; Fan, Cong; Zhu, Chuanlin; Li, Shuaixia; Zhang, Zhao; Qi, Zhengyang; Luo, Wenbo


    The current study compared the effectiveness of distraction, an antecedent-focused strategy that involves diverting an individual's attention away from affective terms, and expressive suppression, a response-focused strategy that involves inhibiting conscious emotion-expressive behavior during an emotionally aroused state, in the regulation of high- and low-intensity unpleasant stimuli, using event-related potentials (ERPs). Sixteen participants completed an emotion regulation experiment in which they passively viewed high- or low-intensity unpleasant images (view), solved a mathematical equation presented on high- or low-intensity negative images (distraction), or suppressed their emotional expression in response to high- or low-intensity unpleasant images (suppression). Their negative experiences after implementation of these strategies were rated by participants on a 1-9 scale. We mainly found that compared with expressive suppression, distraction yielded greater attenuation of the early phase of centro-parietal LPP when the participants responded to high-intensity stimuli. In the low-intensity condition, distraction, but not expressive suppression, effectively decreased the early phase of LPP. The findings suggest that expressive suppression works as early as distraction in the high-intensity condition; more importantly, distraction is superior to expressive suppression in regulating negative emotion, which is influenced by emotional intensity.

  9. Multi-modal distraction. Using technology to combat pain in young children with burn injuries. (United States)

    Miller, Kate; Rodger, Sylvia; Bucolo, Sam; Greer, Ristan; Kimble, Roy M


    The use of non-pharmacological pain management remains adhoc within acute paediatric burns pain management protocols despite ongoing acknowledgement of its role. Advancements in adult based pain services including the integration of virtual reality has been adapted to meet the needs of children in pain, as exemplified by the development of multi-modal distraction (MMD). This easy to use, hand held interactive device uses customized programs designed to inform the child about the procedure he/she is about to experience and to distract the child during dressing changes. (1) To investigate if either MMD procedural preparation (MMD-PP) or distraction (MMD-D) has a greater impact on child pain reduction compared to standard distraction (SD) or hand held video game distraction (VG), (2) to understand the impact of MMD-PP and MMD-D on clinic efficiency by measuring length of treatment across groups, and lastly, (3) to assess the efficacy of distraction techniques over three dressing change procedures. A prospective randomised control trial was completed in a paediatric tertiary hospital Burns Outpatient Clinic. Eighty participants were recruited and studied over their first three dressing changes. Pain was assessed using validated child report, caregiver report, nursing observation and physiological measures. MMD-D and MMD-PP were both shown to significantly relieve reported pain (pchildren when compared to standard practices or hand held video games. This device has the potential to improve clinic efficiency with reductions in treatment lengths.

  10. Using naturalistic driving study data to investigate the impact of driver distraction on driver's brake reaction time in freeway rear-end events in car-following situation. (United States)

    Gao, Jingru; Davis, Gary A


    The rear-end crash is one of the most common freeway crash types, and driver distraction is often cited as a leading cause of rear-end crashes. Previous research indicates that driver distraction could have negative effects on driving performance, but the specific association between driver distraction and crash risk is still not fully revealed. This study sought to understand the mechanism by which driver distraction, defined as secondary task distraction, could influence crash risk, as indicated by a driver's reaction time, in freeway car-following situations. A statistical analysis, exploring the causal model structure regarding drivers' distraction impacts on reaction times, was conducted. Distraction duration, distraction scenario, and secondary task type were chosen as distraction-related factors. Besides, exogenous factors including weather, visual obstruction, lighting condition, traffic density, and intersection presence and endogenous factors including driver age and gender were considered. There was an association between driver distraction and reaction time in the sample freeway rear-end events from SHRP 2 NDS database. Distraction duration, the distracted status when a leader braked, and secondary task type were related to reaction time, while all other factors showed no significant effect on reaction time. The analysis showed that driver distraction duration is the primary direct cause of the increase in reaction time, with other factors having indirect effects mediated by distraction duration. Longer distraction duration, the distracted status when a leader braked, and engaging in auditory-visual-manual secondary task tended to result in longer reaction times. Given drivers will be distracted occasionally, countermeasures which shorten distraction duration or avoid distraction presence while a leader vehicle brakes are worth considering. This study helps better understand the mechanism of freeway rear-end events in car-following situations, and

  11. Distracción osteogénica alveolar como método de aumento del reborde alveolar Alveolar osteogenic distraction as method to increase the alveolar ridge

    Directory of Open Access Journals (Sweden)

    Denia Morales Navarro


    , disadvantages and complications. A bibliographic review was made by database search of reference systems as MEDLINE and PubliMed using the descriptors "alveolar distraction" o "osteogenic distraction". The published bibliographic sources mainly over 5 years concluding that this technique is an excellent alternative for the bone and soft tissues formation in zones of alveolar atrophy including three stages: latency, distraction and consolidation; being a foreseeable method and with low rates of bone reabsorption compared to other techniques of increase of alveolar ridge. It has its main indication in implant therapy to provide bone volume. We must to individualize each case and to use the more appropriate method according the clinical and personal features of patient. A proper case selection and a better understand of technique are essential to achieve successful results by alveolar osteogenic distraction. In Cuba the alveolar distraction has been not much applied being necessary to expand the studies on this subject matter.

  12. Crave-Out: A Distraction/Motivation Mobile Game to Assist in Smoking Cessation. (United States)

    DeLaughter, Kathryn L; Sadasivam, Rajani S; Kamberi, Ariana; English, Thomas M; Seward, Greg L; Chan, S Wayne; Volkman, Julie E; Amante, Daniel J; Houston, Thomas K


    Smoking is still the number one preventable cause of death. Cravings-an intense desire or longing for a cigarette-are a major contributor to quit attempt failure. New tools to help smokers' manage their cravings are needed. To present a case study of the development process and testing of a distraction/motivation game (Crave-Out) to help manage cravings. We used a phased approach: in Phase 1 (alpha testing), we tested and refined the game concept, using a Web-based prototype. In Phase 2 (beta testing), we evaluated the distraction/motivation potential of the mobile game prototype, using a prepost design. After varying duration of abstinence, smokers completed the Questionnaire of Smoking Urge-Brief (QSU-Brief) measurement before and after playing Crave-Out. Paired t tests were used to compare pregame and postgame QSU-Brief levels. To test dissemination potential, we released the game on the Apple iTunes App Store and tracked downloads between December 22, 2011, and May 5, 2014. Our concept refinement resulted in a multilevel, pattern memory challenge game, with each level increasing in difficulty. Smokers could play the game as long as they wanted. At the end of each level, smokers were provided clear goals for the next level and rewards (positive reinforcement using motivational tokens that represented a benefit of quitting smoking). Negative reinforcement was removed in alpha testing as smokers felt it reminded them of smoking. Measurement of QSU-Brief (N=30) resulted in a pregame mean of 3.24 (SD 1.65) and postgame mean of 2.99 (SD 1.40) with an overall decrease of 0.25 in cravings (not statistically significant). In a subset analysis, the QSU-Brief decrease was significant for smokers abstinent for more than 48 hours (N=5) with a pregame mean of 2.84 (SD 1.16) and a postgame mean of 2.0 (SD 0.94; change=0.84; P =.03). Between December 22, 2011, and May 29, 2014, the game was downloaded 3372 times from the App-Store, with 1526 smokers visiting the online

  13. Treatment of Decubitis Ulcer Stage IV in the Patient with Polytrauma and Vertical Share Pelvic Fracture, Diagnosed Entherocollitis and Deep Wound Infection with Clostridium Difficile with Combined Negative Pressure Wound Therapy (NPWT) and Faecal Management System: Case Report. (United States)

    Stojmenski, Slavcho; Merdzanovski, Igor; Gavrilovski, Andrej; Pejkova, Sofija; Dzokic, Gjorge; Tudzarova, Smilja


    The aim of this paper was to present a case with the successful treatment of decubitis ulcer stage IV in the patient with polytrauma and vertical share pelvic fracture and diagnosed entherocollitis combined with deep wound infection with Clostridium difficile treated with combined Negative Pressure Wound Therapy (NPWT) and faecal management system. Patient D.S.1967 treated on Traumatology Clinic after tentamen suicide on 9.2.2015 with diagnosis: brain contusion; contusion of thoracal space; vertical share pelvic fracture; open fracture type II of the right calcaneus; fracture of the left calcaneus; fracture on the typical place of the left radius; fracture of the right radius with dislocation. As a first step during the treatment in Intensive care unit we perform transcondylar extension of the left leg, and in that time we cannot operate because of the brain contusion. Four weeks after this treatment we intent to perform stabilisation of the pelvic ring, fixation of both arms, and fixation of both calcanear bones. But at the time before performing the saurgery, the patient got an intensive enterocollitis from Escherichia colli and Clostridium difficile, and during the inadequate treatment of enterocollitis she got a big decubitus on both gluteal regia Grade IV and deep muscular necrosis. Several times we perform a necrectomy of necrotic tissue but the wound become bigger and the infection have a progressive intention. In that time we used VAK system for 6 weeks combined with faecal management system and with local necrectomy and system application of Antibiotics and Flagyl for enterocollitis in doses prescripted from specialists from Infective clinic. This new device to manage faecal deep decubital infection and enterocollitis with Clostridium difficile are considered as adequate. 8Flexi-Seal® FMS has been also used. After two months we succeed to minimize the gluteal wound on quoter from the situation from the beginning and we used for next two months wound

  14. Brain-computer interfacing under distraction: an evaluation study (United States)

    Brandl, Stephanie; Frølich, Laura; Höhne, Johannes; Müller, Klaus-Robert; Samek, Wojciech


    Objective. While motor-imagery based brain-computer interfaces (BCIs) have been studied over many years by now, most of these studies have taken place in controlled lab settings. Bringing BCI technology into everyday life is still one of the main challenges in this field of research. Approach. This paper systematically investigates BCI performance under 6 types of distractions that mimic out-of-lab environments. Main results. We report results of 16 participants and show that the performance of the standard common spatial patterns (CSP) + regularized linear discriminant analysis classification pipeline drops significantly in this ‘simulated’ out-of-lab setting. We then investigate three methods for improving the performance: (1) artifact removal, (2) ensemble classification, and (3) a 2-step classification approach. While artifact removal does not enhance the BCI performance significantly, both ensemble classification and the 2-step classification combined with CSP significantly improve the performance compared to the standard procedure. Significance. Systematically analyzing out-of-lab scenarios is crucial when bringing BCI into everyday life. Algorithms must be adapted to overcome nonstationary environments in order to tackle real-world challenges.

  15. Intradiscal Pressure Changes during Manual Cervical Distraction: A Cadaveric Study

    Directory of Open Access Journals (Sweden)

    M. R. Gudavalli


    Full Text Available The objective of this study was to measure intradiscal pressure (IDP changes in the lower cervical spine during a manual cervical distraction (MCD procedure. Incisions were made anteriorly, and pressure transducers were inserted into each nucleus at lower cervical discs. Four skilled doctors of chiropractic (DCs performed MCD procedure on nine specimens in prone position with contacts at C5 or at C6 vertebrae with the headpiece in different positions. IDP changes, traction forces, and manually applied posterior-to-anterior forces were analyzed using descriptive statistics. IDP decreases were observed during MCD procedure at all lower cervical levels C4-C5, C5-C6, and C6-C7. The mean IDP decreases were as high as 168.7 KPa. Mean traction forces were as high as 119.2 N. Posterior-to-anterior forces applied during manual traction were as high as 82.6 N. Intraclinician reliability for IDP decrease was high for all four DCs. While two DCs had high intraclinician reliability for applied traction force, the other two DCs demonstrated only moderate reliability. IDP decreases were greatest during moving flexion and traction. They were progressevely less pronouced with neutral traction, fixed flexion and traction, and generalized traction.

  16. Escaping capture: bilingualism modulates distraction from working memory. (United States)

    Hernández, Mireia; Costa, Albert; Humphreys, Glyn W


    We ask whether bilingualism aids cognitive control over the inadvertent guidance of visual attention from working memory and from bottom-up cueing. We compare highly-proficient Catalan-Spanish bilinguals with Spanish monolinguals in three visual search conditions. In the working memory (WM) condition, attention was driven in a top-down fashion by irrelevant objects held in WM. In the Identify condition, attention was driven in a bottom-up fashion by visual priming. In the Singleton condition, attention was driven in a bottom-up fashion by including a unique distracting object in the search array. The results showed that bilinguals were overall faster than monolinguals in the three conditions, replicating previous findings that bilinguals can be more efficient than monolinguals in the deployment of attention. Interestingly, bilinguals were less captured by irrelevant information held in WM but were equally affected by visual priming and unique singletons in the search displays. These observations suggest that bilingualism aids top-down WM-mediated guidance of attention, facilitating processes that keep separate representations in WM from representations that guide visual attention. In contrast, bottom-up attentional capture by salient yet unrelated input operates similarly in bilinguals and monolinguals. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. The effects of taboo-related distraction on driving performance. (United States)

    Chan, Michelle; Madan, Christopher R; Singhal, Anthony


    Roadside billboards containing negative and positive emotional content have been shown to influence driving performance, however, the impact of highly arousing taboo information is unknown. Taboo information more reliably evokes emotional arousal and can lead to greater attentional capture due to its inherent 'shock value.' The objective of the present study was to examine driver distraction associated with four types of information presented on roadside billboards: highly arousing taboo words, moderately arousing positive and negative words, and non-arousing neutral words. Participants viewed blocks of taboo, positive, negative and neutral words presented on roadside billboards while operating a driving simulator. They also responded to target (household-related) words by pressing a button on the steering wheel. At the end of the session, a surprise recall task was completed for all the words they saw while driving. Results showed that taboo words captured the most attention as revealed by better memory recall compared to all the other word types. Interestingly, taboo words were associated with better lane control compared to the other word types. We suggest that taboo-related arousal can enhance attentional focus during a complex task like simulated driving. That is, in a highly arousing situation, attention is selectively narrowed to the road ahead, resulting in better lane control. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Distraction osteogenesis for cleft palate closure: A finite element analysis

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    Majid Ghasemianpour


    Full Text Available Background: Current methods of closure of the cleft palate result in the formation of scars and impairment of growth. Distraction osteogenesis (DO might be an effective means to repair or at least reduce the size of wide clefts. This study investigates the biomechanical aspects of this process. Materials and Methods: DO simulation was applied to reduce the size of a unilateral hard palate cleft on a three-dimensional (3D model of the maxilla. For the position of osteotomy lines, two different models were assumed, with the osteotomy line on the affected side in model A and on the intact side in model B. In each model, DO screws were placed on two different positions, anteriorly (models A1 and B1 and posteriorly (models A2 and B2. Displacement pattern of the bony island in each of the four models, reaction forces at DO locations, and von Mises stress were estimated. Mesh generation and data processing were carried out in the 3D finite element analysis package (ABAQUS V6.7-1; Simulia Corp., Providence, RI, USA. Results: In model B2, the island moved almost evenly, assuring a more complete closure of the cleft. The most uniform stress distribution was found in model B1. Conclusion: The results suggest that the best positions for the DO screw and the osteotomy line for closure of the cleft palate are posteriorly and on the intact side, respectively.

  19. Learning Curve in Monitoring Magnetically Controlled Growing Rod Distractions With Ultrasound. (United States)

    Cheung, Jason P Y; Yiu, Karen K L; Bow, Cora; Cheung, Prudence W H; Samartzis, Dino; Cheung, Kenneth M C


    Prospective study. To determine whether a learning curve exists for ultrasound measurement of magnetically controlled growing rod (MCGR) distractions. For patients managed by MCGRs, close monitoring of interval distraction length gains is important to determine whether the distractions are translating into actual spine growth. Radiographs are the criterion standard for measuring length gains, but ultrasound has been shown to be effective in monitoring distraction lengths without radiation exposure. It is, however, an operator-dependent tool and thus the accuracy of ultrasound measurement of distracted length may improve with experience. This is a prospective correlation analysis of patients who underwent MCGR treatment for scoliosis. The study period was inclusive of 19th February 2013 to 31st March 2015. All subjects were consecutively recruited in a prospective manner. Data regarding date of the distraction visit, and the interval radiograph and ultrasound measurements of the distracted lengths were collected. Only those episodes with both radiograph and ultrasound performed were used for analysis. The mean differences in change of radiograph and ultrasound measurements were plotted to determine correlation differences and to observe for a learning curve. A total of 379 distraction episodes were analyzed. The mean differences between ultrasound and radiograph measurements per distraction episode were -0.3 mm for the right rod and -0.1 mm for the left rod. For learning curve analysis, there were three distinct timepoints in which the difference of correlation became significantly better and were described as clusters. The correlation in the first cluster (19th February 2013 to 15th October 2013) was 0.612 (right rod) and 0.795 (left rod), the second cluster (16th October 2013 to 20th May 2014) was 0.879 (right rod) and 0.918 (left rod), and the third cluster (21st May 2014 to 31st March 2015) was 0.956 (right rod) and 0.932 (left rod). Thus, a plateau was observed

  20. Purely Ligamentous Flexion-Distraction Injury in a Five-Year-Old Child Treated with Surgical Management. (United States)

    Schiedo, Ryan M; Lavelle, William; Ordway, Nathaniel R; Rustagi, Tarush; Sun, Mike H


    Chance fractures by definition are a type of flexion-distraction injury with concomitant vertebral body fracture. Although uncommon in the pediatric population, they are associated with motor vehicle accidents and typically involve the thoraco-lumbar spine. Injury occurs when the spine rotates about a fixed axis, such as a lap belt. Our case reports the management of a five-year-old girl involved in a head-on collision who suffered a purely ligamentous flexion-distraction injury (Chance-type injury, without bone involvement) at the L2-L3 vertebral level. Previously these injuries were managed conservatively with serial casting; however, we present a case in which surgical management was used. A five-year-old girl sustained multiple injuries after being involved in a high-speed motor vehicle accident. At presentation, there was obvious abdominal bruising with a seat-belt sign and marked kyphosis of the spine with severe tenderness at the L2-L3 level. She required immediate exploratory laparotomy for her intraabdominal injuries. After stabilization, an orthopedic consult was deemed necessary. She was found to have occipital-cervical injury with mild anterolisthesis of C2 on C3 and disruption of the apical ligament. There was evidence of bilateral dislocation of the L2-L3 facet joints with marked disruption of the posterior ligaments and a hematoma sack. She required open reduction and internal fixation with an L2-L3 laminectomy, pedicle screw and rod placement. The kyphotic deformity was reduced using a compression device and stable alignment was achieved intraoperatively. This was a rare and difficult case with limited evidence on the appropriate management of such an injury. Due to the severe instability of her injury, a surgical approach was taken. At two years postoperative, the patient is neurologically intact and pain free. Imaging revealed stable alignment of her lumbar hardware. Ultimately, this has resulted in an excellent outcome at the current follow-up.

  1. Evidence of cartilage repair by joint distraction in a canine model of osteoarthritis. (United States)

    Wiegant, Karen; Intema, Femke; van Roermund, Peter M; Barten-van Rijbroek, Angelique D; Doornebal, Arie; Hazewinkel, Herman A W; Lafeber, Floris P J G; Mastbergen, Simon C


    Knee osteoarthritis (OA) is a degenerative joint disorder characterized by cartilage, bone, and synovial tissue changes that lead to pain and functional impairment. Joint distraction is a treatment that provides long-term improvement in pain and function accompanied by cartilage repair, as evaluated indirectly by imaging studies and measurement of biochemical markers. The purpose of this study was to evaluate cartilage tissue repair directly by histologic and biochemical assessments after joint distraction treatment. In 27 dogs, OA was induced in the right knee joint (groove model; surgical damage to the femoral cartilage). After 10 weeks of OA development, the animals were randomized to 1 of 3 groups. Two groups were fitted with an external fixator, which they wore for a subsequent 10 weeks (one group with and one without joint distraction), and the third group had no external fixation (OA control group). Pain/function was studied by force plate analysis. Cartilage integrity and chondrocyte activity of the surgically untouched tibial plateaus were analyzed 25 weeks after removal of the fixator. Changes in force plate analysis values between the different treatment groups were not conclusive. Features of OA were present in the OA control group, in contrast to the generally less severe damage after joint distraction. Those treated with joint distraction had lower macroscopic and histologic damage scores, higher proteoglycan content, better retention of newly formed proteoglycans, and less collagen damage. In the fixator group without distraction, similarly diminished joint damage was found, although it was less pronounced. Joint distraction as a treatment of experimentally induced OA results in cartilage repair activity, which corroborates the structural observations of cartilage repair indicated by surrogate markers in humans. Copyright © 2015 by the American College of Rheumatology.

  2. An enjoyable distraction during exercise augments the positive effects of exercise on mood. (United States)

    Privitera, Gregory J; Antonelli, Danielle E; Szal, Abigail L


    The hypothesis that an enjoyable distraction during exercise will augment the intensity of positive mood post-exercise was tested. A sample of 84 undergraduate students rated their mood and arousal before and after a standardized exercise, which consisted of walking on a treadmill at a pace of 3.6 mph for 10 minutes. During the work out session, participants watched the same television show, which they previously rated as enjoyable, or not enjoyable. As added controls, a third group exercised with no distraction (the TV was turned off); a fourth group did not exercise, but watched the television show. The results showed that exercise alone was sufficient to increase pleasant mood (95% CI 0.61, 1.46) and that including an enjoyable distraction during exercise significantly augmented pleasant mood compared to all other groups (95% CI 1.58, 2.99; R(2) = 0.29). These results show that the enjoyment of a distraction is a key factor that can augment the intensity of positive mood following exercise. Key pointsThe hypothesis that an enjoyable distraction during exercise will augment the intensity of positive mood post-exercise was tested.The results support this hypothesis by showing for the first time that while exercise alone was sufficient to increase the intensity of positive mood; combining exercise with an enjoyable distraction resulted in significantly greater increases in pleasant mood compared to exercise alone.Accounting for the enjoyment of a distraction type in future studies can increase the sensitivity of research designs used to detect changes in positive mood post-exercise.

  3. Combined micro computed tomography and histology study of bone augmentation and distraction osteogenesis (United States)

    Ilgenstein, Bernd; Deyhle, Hans; Jaquiery, Claude; Kunz, Christoph; Stalder, Anja; Stübinger, Stefan; Jundt, Gernot; Beckmann, Felix; Müller, Bert; Hieber, Simone E.


    Bone augmentation is a vital part of surgical interventions of the oral and maxillofacial area including dental implantology. Prior to implant placement, sufficient bone volume is needed to reduce the risk of peri-implantitis. While augmentation using harvested autologous bone is still considered as gold standard, many surgeons prefer bone substitutes to reduce operation time and to avoid donor site morbidity. To assess the osteogenic efficacy of commercially available augmentation materials we analyzed drill cores extracted before implant insertion. In younger patients, distraction osteogenesis is successfully applied to correct craniofacial deformities through targeted bone formation. To study the influence of mesenchymal stem cells on bone regeneration during distraction osteogenesis, human mesenchymal stem cells were injected into the distraction gap of nude rat mandibles immediately after osteotomy. The distraction was performed over eleven days to reach a distraction gap of 6 mm. Both the rat mandibles and the drill cores were scanned using synchrotron radiation-based micro computed tomography. The three-dimensional data were manually registered and compared with corresponding two-dimensional histological sections to assess bone regeneration and its morphology. The analysis of the rat mandibles indicates that bone formation is enhanced by mesenchymal stem cells injected before distraction. The bone substitutes yielded a wide range of bone volume and degree of resorption. The volume fraction of the newly formed bone was determined to 34.4% in the computed tomography dataset for the augmentation material Geistlich Bio-Oss®. The combination of computed tomography and histology allowed a complementary assessment for both bone augmentation and distraction osteogenesis.

  4. Modeling safety risk perception due to mobile phone distraction among four wheeler drivers

    Directory of Open Access Journals (Sweden)

    Raghunathan Rajesh


    Full Text Available Nowadays, there is an increasing trend in the use of information and communication technology devices in new vehicles. Due to these increasing service facilities, driver distraction has become a major concern for transportation safety. To reduce safety risks, it is crucial to understand how distracting activities affect driver behavior at different levels of vehicle control. The objective of this work is to understand how the vehicle and driver characteristics influence mobile phone usage while driving and associated risk perception of road safety incidents. Based on literature review, a man–machine framework for distracted driving and a mobile phone distraction model is presented. The study highlights the findings from a questionnaire survey conducted in Kerala, India. The questionnaire uses a 5-point Likert scale. Responses from 1203 four-wheeler drivers are collected using random sampling approach. The questionnaire items associated with three driver-drive characteristics are: (i Human Factors (age, experience, emotional state, behavior of driver, (ii Driver space (meter, controls, light, heat, steering, actuators of vehicle, (iii Driving conditions (speed, distance, duration, traffic, signals. This mobile phone distraction model is tested using structural equation modeling procedure. The study indicates that among the three characteristics, ‘Human Factors’ has the highest influence on perceived distraction due to mobile phones. It is also observed that safety risk perception due to mobile phone usage while driving is moderate. The practical relevance of the study is to place emphasis on behavior-based controls and to focus on strategies leveraging perception of distraction due to mobile phones while driving.

  5. [Experimental study of the influence of mandibular distraction osteogenesis on inferior alveolar nerve function]. (United States)

    Wang, Xiaoxia; Wang, Xing; Li, Zili; Yang, Zhaohui


    To evaluate the influence of mandibular distraction osteogenesis on inferior alveolar nerve function. 16 young Macaca rhesus monkeys were used as experiment animals. 5 days after mandibular osteotomy under general anesthesia, 10 male monkeys were distracted at right side and 6 females were bilaterally distracted at a rate of 0.5 mm x 2/day, for 15 days. The mandible was lengthened to an average of 13.5 mm. The Sensory Nerve Action Potential (SNAP) test was successfully applied in 16 monkeys before operation and at 0, 2, 4, 6, 9 and 12 weeks after distraction finished. Eight-channel EMG equipment was used for SNAP wave recording. The recordings were made with needle electrodes at foramen ovale and the stimulation was done at the mental foramen with two surface electrodes. The metal ground electrode was fixed on the right forearm. The stimulation intensities were five times of thresholds of each animal. The latency was measured at the first wave peak and the amplitude was measured between two wave peaks. Just after distraction finished, the latency period was 22.18% longer than before operation and gradually shortened as time lapsed. When distraction finished, the amplitude of SNAP wave was only 28.54% of that before operation, and after 12 weeks, it increased to the level of 99.84% of that before operation. The mandibular distraction osteogenesis has temporary influence on the function of inferior alveolar nerve, but it is little and reversible, along with the regeneration of nerve sheath and axon, the nerve function can gradually return to normal level.

  6. CYP24A1-deficiency does not affect bone regeneration in distraction osteogenesis. (United States)

    Husseini, Abdallah; St-Arnaud, René


    The putative biological activity of 24,25-(OH) 2 D remains unclear. Previous studies showed an increase in the circulating levels of this metabolite following fracture in chicks. Our laboratory has generated a mouse model deficient for the Cyp24a1 gene for studying the role of 24,25-(OH) 2 D. We set out to study the role of CYP24A1 and 24,25-(OH) 2 D in intramembranous bone formation during distraction osteogenesis in wild-type and Cyp24a1-deficient mice. Distraction osteogenesis was applied to mouse tibiae using a miniature external fixator apparatus. Histomorphometric parameters and gene expression differences between the mutant mice and the wild-type controls were measured using micro computed tomography and reverse-transcription quantitative PCR.There were no statistically significant differences between genotypes when bone volume/tissue volume ratios were calculated at mid distraction, end of distraction, mid consolidation, or end of consolidation. We measured reduced expression of the Col10a1 gene in the mutant vs. wild-type mice at mid distraction (0.4±0.1 vs. 1.0±0.2 respectively, p=0.01). Similarly, we measured a significantly lower expression of the osteogenic marker Atf4 in mutant vs. wild-type mice at end of distraction (0.7±0.1 vs. 1.0±0.1 respectively, p=0.01) and at mid consolidation (0.6±0.1 vs. 1.0±0.1 respectively, p=0.0003). These results suggest moderate and restricted differences in chondrogenesis and osteogenesis that did not affect the volume of bone produced following distraction. We conclude that CYP24A1 activity is not essential for intramembranous bone formation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. GPS, su datum vertical.

    Directory of Open Access Journals (Sweden)

    Esteban Dörries


    Full Text Available La introducción de la metodología GPS en aplicaciones topográficas y geodésicas pone en notoria evidencia la clásica separación de sistemas de referencia en horizontal y vertical. Con GPS el posicionamiento es tridimensional, pero el concepto de altura difiere del clásico. Si se desea utilizar la información altimétrica debe contemplarse la ondulación del geoide.

  8. Repair of segmental bone defects in the maxilla by transport disc distraction osteogenesis: Clinical experience with a new device. (United States)

    Boonzaier, James; Vicatos, George; Hendricks, Rushdi


    The bones of the maxillary complex are vital for normal oro-nasal function and facial cosmetics. Maxillary tumor excision results in large defects that commonly include segments of the alveolar and palatine processes, compromising eating, speech and facial appearance. Unlike the conventional approach to maxillary defect repair by vascularized bone grafting, transport disc distraction osteogenesis (TDDO) stimulates new bone by separating the healing callus, and stimulates growth of surrounding soft tissues as well. Bone formed in this way closely mimics the parent bone in form and internal structure, producing a superior anatomical, functional and cosmetic result. Historically, TDDO has been successfully used to close small horizontal cleft defects in the maxilla, not exceeding 25 mm. Fujioka et al. reported in 2012 that "no bone transporter corresponding to the (large) size of the oro-antral fistula is marketed. The authors report the successful treatment of 4 cases involving alveolar defects of between 25 mm and 80 mm in length.

  9. Supermodernity, distraction, schizophrenia: walking in Tokyo & Hong Kong.

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    Ian Ho-Yin Fong


    Full Text Available The architecture in a supermodern city has no sense of the place where it is located. This paper discusses how schizophrenia and distraction, through walking, respond to supermodernity by referring to how three dislocated subjects, Fumiya Takemura, Aiichiro Fukuhara and Fai in Tokyo and Hong Kong, are respectively depicted in the novel, Adrift in Tokyo written by Fujita Yoshinaga in 1999, with a film adaptation by Satoshi Miki (2007, and the film To Live and Die in Mongkok directed by Wong Jing in 2009. It suggests that Hong Kong is more supermodern than Tokyo. After his release from prison, Fai in To Live and Die in Mongkok finds that Mongkok is a completely different place from the one in which he used to live. The living conditions are no better than those in the prison. He hallucinates about the past. Adrift in Tokyo can be read as a story about walking. Fukuhara, a debt collector, killed his wife; before surrendering to the police, he orders his debtor, Takemura, to walk with him in Tokyo in order to re-experience the walks he enjoyed with his wife. If Takemura agrees, the debt can be paid off. This paper discusses how the repressed heterogeneous time and place can be approached by walking in a way that the rhythm of life can be (re-experienced; in other words, when the body moves forward physically, the past appears as specter haunting the walker. This paper discusses how Adrift in Tokyo and To Live and Die in Mongkok read cities in distractive and schizophrenic ways. In the film version of Adrift in Tokyo, Takemura’s failed relationship with his father may unconsciously drive him to walk with Fukuhara. The novel may imply that the lost relationship with his mother drives him to walk. The film and the novel both address a kind of locality which should be inseparable from the birth parents. To Live and Die in Mongkok suggests that supermodernity kills mother and father. The Father-son relationship disappears at the very beginning of the

  10. Molding of the regenerate in mandibular distraction: Part 1: Laboratory study. (United States)

    Luchs, Johnathan S; Stelnicki, Eric J; Rowe, Norman M; Naijher, Navinderdeep S; Grayson, Barry H; McCarthy, Joseph G


    Distraction osteogenesis has evolved as a mainstream surgical technique for lengthening and augmentation of the hypoplastic mandible. As clinical experience accumulated, there developed the need to "mold" the bony regenerate to avoid the development of postdistraction malocclusion and to achieve the desired craniofacial form. Although the potential to mold the regenerate has important clinical implications, the safety and efficacy of such an acute manipulation of the bony regenerate form have not yet been investigated in the laboratory. The purpose of this study was to determine if the distraction regenerate could be molded and result in a bony union. Four adult female dogs underwent bilateral mandibular distraction with an external multiplanar device (Stryker, Osteonics). After a latency period of 5 days, the mandibles underwent linear (anteroposterior) and angular (superoinferior) distraction to produce an anterior open bite of approximately 30 degrees. At the conclusion of the distraction procedure, the distraction sites were molded to close the open bite. In two dogs, the maneuver was performed over 3 days by changing the angulation of the devices (gradual molding), and in the other two dogs, molding was achieved with a single movement (acute molding). In the latter, the distraction devices were adjusted and reapplied to allow for anatomical fixation during the consolidation period of 49 days. According to the research protocol, the mandibles were assessed serially by cephalograms and computed tomography (CT) scans. All dogs survived the study without complications. The bony regenerate was easily molded in both groups to close the surgically created open bite. After molding, all the regenerates showed CT scan evidence of solid bone (consolidation), which was classified as "extended" on the Hamanishi scale. After the dogs were killed and soft tissue was removed, the regenerate seemed to be robust on gross examination without any evidence of fibrous nonunion. In

  11. Dancing to distraction: mediating 'docile bodies' in 'Philippine Thriller video'. (United States)

    Mangaoang, Áine


    This essay examines the conditions behind the 'Philippine Prison Thriller' video, a YouTube spectacle featuring the 1,500 inmates of Cebu Provincial Detention and Rehabilitation Centre (CPDRC) dancing to Michael Jackson's hit song 'Thriller'. The video achieved viral status after it was uploaded onto the video-sharing platform in 2007, and sparked online debates as to whether this video, containing recorded moving images of allegedly forced dancing, was a form of cruel and inhumane punishment or a novel approach to rehabilitation. The immense popularity of the video inspired creative responses from viewers, and this international popularity caused the CPDRC to host a monthly live dance show held in the prison yard, now in its seventh year. The essay explores how seemingly innocuous products of user-generated-content are imbued with ideologies that obscure or reduce relations of race, agency, power and control. By contextualising the video's origins, I highlight current Philippine prison conditions and introduce how video-maker/programme inventor/prison warden Byron Garcia sought to distance his facility from the Philippine prison majority. I then investigate the 'mediation' of 'Thriller' through three main issues. One, I examine the commodification and transformation from viral video to a thana-tourist destination; two, the global appeal of 'Thriller' is founded on public penal intrigue and essentialist Filipino tropes, mixed with a certain novelty factor widely suffused in YouTube formats; three, how dance performance and its mediation here are conducive to creating Foucault's docile bodies, which operate as a tool of distraction for the masses and ultimately serve the interests of the state far more than it rehabilitates(unconvicted and therefore innocent) inmates.

  12. Taming Distraction: The Second Screen Assemblage, Television and the Classroom

    Directory of Open Access Journals (Sweden)

    Markus Stauff


    Full Text Available This article argues that television’s resilience in the current media landscape can best be understood by analyzing its role in a broader quest to organize attention across different media. For quite a while, the mobile phone was considered to be a disturbance both for watching television and for classroom teaching. In recent years, however, strategies have been developed to turn the second screen’s distractive potential into a source for intensified, personalized and social attention. This has consequences for television’s position in a multimedia assemblage: television’s alleged specificities (e.g. liveness become mouldable features, which are selectively applied to guide the attention of users across different devices and platforms. Television does not end, but some of its traditional features do only persist because of its strategic complementarity with other media; others are re-adapted by new technologies thereby spreading televisual modes of attention across multiple screens. The article delineates the historical development of simultaneous media use as a ‘problematization’—from alternating (and competitive media use to multitasking and finally complementary use of different media. Additionally, it shows how similar strategies of managing attention are applied in the ‘digital classroom’. While deliberately avoiding to pin down, what television is, the analysis of the problem of attention allows for tracing how old and new media features are constantly reshuffled. This article combines three arguments: (1 the second screen is conceived of as both a danger to attention and a tool to manage attention. (2 To organize attention, the second screen assemblage modulates the specific qualities of television and all the other devices involved. (3 While being a fragile and often inconsistent assemblage, the second screen spreads its dynamics—and especially the problem of attention—far beyond television, e.g. into the realm of

  13. Brain activity associated with selective attention, divided attention and distraction. (United States)

    Salo, Emma; Salmela, Viljami; Salmi, Juha; Numminen, Jussi; Alho, Kimmo


    Top-down controlled selective or divided attention to sounds and visual objects, as well as bottom-up triggered attention to auditory and visual distractors, has been widely investigated. However, no study has systematically compared brain activations related to all these types of attention. To this end, we used functional magnetic resonance imaging (fMRI) to measure brain activity in participants performing a tone pitch or a foveal grating orientation discrimination task, or both, distracted by novel sounds not sharing frequencies with the tones or by extrafoveal visual textures. To force focusing of attention to tones or gratings, or both, task difficulty was kept constantly high with an adaptive staircase method. A whole brain analysis of variance (ANOVA) revealed fronto-parietal attention networks for both selective auditory and visual attention. A subsequent conjunction analysis indicated partial overlaps of these networks. However, like some previous studies, the present results also suggest segregation of prefrontal areas involved in the control of auditory and visual attention. The ANOVA also suggested, and another conjunction analysis confirmed, an additional activity enhancement in the left middle frontal gyrus related to divided attention supporting the role of this area in top-down integration of dual task performance. Distractors expectedly disrupted task performance. However, contrary to our expectations, activations specifically related to the distractors were found only in the auditory and visual cortices. This suggests gating of the distractors from further processing perhaps due to strictly focused attention in the current demanding discrimination tasks. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Rumination and Cognitive Distraction in Major Depressive Disorder: An Examination of Respiratory Sinus Arrhythmia. (United States)

    LeMoult, Joelle; Yoon, K Lira; Joormann, Jutta


    Difficulty regulating emotions following stressful events is a hallmark of Major Depressive Disorder (MDD). Although individuals' ability to regulate their emotions is believed to have direct consequences for both emotional and physical wellbeing, few studies have examined the cardiovascular effects of different emotion regulation strategies in MDD. To the best of our knowledge, the current study is the first to examine the effects of two emotion regulation strategies, cognitive distraction and rumination, on both self-reported sadness and respiratory sinus arrhythmia (RSA) in individuals with MDD and healthy controls (CTLs). Following a forced-failure stressor, participants were randomly assigned to a rumination or cognitive distraction condition. As expected, rumination increased sadness and triggered RSA withdrawal for both MDDs and CTLs. Interestingly, although cognitive distraction reduced sadness, it also triggered RSA withdrawal. Moreover, cognitive distraction was associated with greater RSA withdrawal for MDDs than CTLs. Thus, although depressed individuals are able to use cognitive distraction to emotionally recover from stress, it may be associated with greater cognitive effort. Adding low-cost physiological measures such as RSA into assessments has the potential to offer new and important information about the effects of emotion regulation on mental and physiological health.

  15. Psychological factors for driver distraction and inattention in the Australian and New Zealand rail industry. (United States)

    Naweed, Anjum


    A signal passed at danger (SPAD) event occurs when a train moves past a stop signal into a section of unauthorised track. SPAD events are frequently attributed to driver distraction and inattention, but few studies have explored the failure mode from the perspective of task demand and the ability of the driver to self-regulate in response to competing activities. This study aimed to provide a more informed understanding of distraction, inattention and SPAD-risk in the passenger rail task. The research approach combined focus groups with a generative task designed to stimulate situational insight. Twenty-eight train drivers participated from 8 different rail operators in Australia and New Zealand. Data were analysed thematically and revealed several moderating factors for driver distraction. Time-keeping pressure and certain aspects of the driver-controller dynamic were considered to distort performance, and distractions from station dwelling and novel events increased SPAD-risk. The results are conceptualised in a succinct model of distraction linking multiple factors with mechanisms that induced the attentional shift. The commonalities and inter-dynamics of the factors revealed insight into driving anxiety in the passenger rail mode, and suggested that SPAD-risk was intensified when three or more factors converged. The paper discusses these issues in the context of misappropriated attention, taxonomic implications, and directions for future research. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Aging increases distraction by auditory oddballs in visual, but not auditory tasks. (United States)

    Leiva, Alicia; Parmentier, Fabrice B R; Andrés, Pilar


    Aging is typically considered to bring a reduction of the ability to resist distraction by task-irrelevant stimuli. Yet recent work suggests that this conclusion must be qualified and that the effect of aging is mitigated by whether irrelevant and target stimuli emanate from the same modalities or from distinct ones. Some studies suggest that aging is especially sensitive to distraction within-modality while others suggest it is greater across modalities. Here we report the first study to measure the effect of aging on deviance distraction in cross-modal (auditory-visual) and uni-modal (auditory-auditory) oddball tasks. Young and older adults were asked to judge the parity of target digits (auditory or visual in distinct blocks of trials), each preceded by a task-irrelevant sound (the same tone on most trials-the standard sound-or, on rare and unpredictable trials, a burst of white noise-the deviant sound). Deviant sounds yielded distraction (longer response times relative to standard sounds) in both tasks and age groups. However, an age-related increase in distraction was observed in the cross-modal task and not in the uni-modal task. We argue that aging might affect processes involved in the switching of attention across modalities and speculate that this may due to the slowing of this type of attentional shift or a reduction in cognitive control required to re-orient attention toward the target's modality.

  17. Improving Dental Experiences by Using Virtual Reality Distraction: A Simulation Study (United States)

    Tanja-Dijkstra, Karin; Pahl, Sabine; P. White, Mathew; Andrade, Jackie; Qian, Cheng; Bruce, Malcolm; May, Jon; Moles, David R.


    Dental anxiety creates significant problems for both patients and the dental profession. Some distraction interventions are already used by healthcare professionals to help patients cope with unpleasant procedures. The present study is novel because it a) builds on evidence that natural scenery is beneficial for patients, and b) uses a Virtual Reality (VR) representation of nature to distract participants. Extending previous work that has investigated pain and anxiety during treatment, c) we also consider the longer term effects in terms of more positive memories of the treatment, building on a cognitive theory of memory (Elaborated Intrusions). Participants (n = 69) took part in a simulated dental experience and were randomly assigned to one of three VR conditions (active vs. passive vs. control). In addition, participants were distinguished into high and low dentally anxious according to a median split resulting in a 3×2 between-subjects design. VR distraction in a simulated dental context affected memories a week later. The VR distraction had effects not only on concurrent experiences, such as perceived control, but longitudinally upon the vividness of memories after the dental experience had ended. Participants with higher dental anxiety (for whom the dental procedures were presumably more aversive) showed a greater reduction in memory vividness than lower dental-anxiety participants. This study thus suggests that VR distractions can be considered as a relevant intervention for cycles of care in which people’s previous experiences affect their behaviour for future events. PMID:24621518

  18. Improving dental experiences by using virtual reality distraction: a simulation study.

    Directory of Open Access Journals (Sweden)

    Karin Tanja-Dijkstra

    Full Text Available Dental anxiety creates significant problems for both patients and the dental profession. Some distraction interventions are already used by healthcare professionals to help patients cope with unpleasant procedures. The present study is novel because it a builds on evidence that natural scenery is beneficial for patients, and b uses a Virtual Reality (VR representation of nature to distract participants. Extending previous work that has investigated pain and anxiety during treatment, c we also consider the longer term effects in terms of more positive memories of the treatment, building on a cognitive theory of memory (Elaborated Intrusions. Participants (n = 69 took part in a simulated dental experience and were randomly assigned to one of three VR conditions (active vs. passive vs. control. In addition, participants were distinguished into high and low dentally anxious according to a median split resulting in a 3×2 between-subjects design. VR distraction in a simulated dental context affected memories a week later. The VR distraction had effects not only on concurrent experiences, such as perceived control, but longitudinally upon the vividness of memories after the dental experience had ended. Participants with higher dental anxiety (for whom the dental procedures were presumably more aversive showed a greater reduction in memory vividness than lower dental-anxiety participants. This study thus suggests that VR distractions can be considered as a relevant intervention for cycles of care in which people's previous experiences affect their behaviour for future events.

  19. Influence of emotional distraction on working memory performance in borderline personality disorder. (United States)

    Krause-Utz, A; Oei, N Y L; Niedtfeld, I; Bohus, M; Spinhoven, P; Schmahl, C; Elzinga, B M


    Emotion dysregulation, characterized by heightened emotional arousal and increased emotional sensitivity, is a core feature of borderline personality disorder (BPD). Although current theories emphasize the disruptive potential of negative emotions on cognitive functioning in BPD, behavioral and neurobiological data on this relationship are still lacking. Using functional magnetic resonance imaging (fMRI), neural activity was investigated in 22 unmedicated BPD patients and 22 healthy participants (matched for age, education and intelligence) performing an adapted Sternberg working memory task, while being distracted by emotional (negatively arousing) and neutral pictures from the International Affective Picture System (IAPS). Emotional distraction was associated with significantly higher activation in the amygdala and decreased activation in the dorsolateral prefrontal cortex (DLPFC), extending findings of previous studies in healthy individuals. Patients with BPD showed significantly longer reaction times (RTs) along with significantly higher activation in the amygdala and insula during emotional distraction compared to healthy participants, suggesting that they were more distracted by emotional pictures during the working memory task. Moreover, in the group of BPD patients, a significant negative correlation was found between activation in limbic brain regions and self-reports of current dissociative states. Our findings suggest hyper-responsiveness to emotionally distracting pictures in BPD patients that negatively affects working memory performance. This stresses the importance of emotion dysregulation in the context of cognitive functioning. Moreover, our findings suggest that dissociative states have a dampening effect on neural reactivity during emotional challenge in BPD.

  20. Association Between Cognitive Complaints and Vulnerability to Environmental Distraction in Multiple Sclerosis. (United States)

    Randolph, John J; Randolph, Jennifer S; Wishart, Heather A


    Individuals with multiple sclerosis (MS) often report cognitive dysfunction, although neuropsychological evaluation findings may not correlate with subjective concerns. One factor that may explain this lack of correspondence is the controlled testing environment, which differs from busier settings where cognitive lapses are noted to occur. This study used a novel environmental manipulation to determine whether individuals with MS who report cognitive dysfunction are more vulnerable to the effects of auditory distraction during neuropsychological testing. Twenty-four individuals with clinically definite MS or clinically isolated syndrome were administered a cognitive battery during two counterbalanced auditory conditions: quiet/standard condition, and distraction condition with random office background noise. Participants were divided into high versus low cognitive complaint groups using a median split analysis of Perceived Deficits Questionnaire responses. Participants with more cognitive complaints showed a decrement in performance on the oral Symbol Digit Modalities Test during the distraction condition while those with fewer cognitive complaints demonstrated stable performance across conditions. These findings remained significant after controlling for education, premorbid intellect, fatigue, and depressed mood. These results suggest that individuals with MS with more cognitive complaints are vulnerable to environmental distraction, particularly regarding processing speed. Incorporating random environmental noise or other distraction conditions during selected measures may enhance the ecological validity of neuropsychological evaluation results in MS. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: