bluuebunny/crossref_metadata_2025 huggingface dataset:
Using the Kalman Algorithm to Correct Data Errors of a 24-Bit Visible Spectrometer
Authors: Pham Son , Dinh Anh
Published: December 2017

To reduce cost, increase resolution, and reduce errors due to changing light intensity of the VIS SPEC, a new technique is proposed which applies the Kalman algorithm along with a simple hardware setup and implementation. In real time, the SPEC automatically corrects spectral data errors resulting from an unstable light source by adding a photodiode sensor to monitor the changes in light source intensity. The Kalman algorithm is applied on the data to correct the errors. The light intensity instability is one of the sources of error considered in this work. The change in light intensity is due to the remaining lifetime, working time and physical mechanism of the halogen lamp, and/or battery and regulator stability. Coefficients and parameters for the processing are determined from MATLAB simulations based on two real types of datasets, which are mono-changing and multi-changing datasets, collected from the prototype SPEC. From the saved datasets, and based on the Kalman algorithm and other computer algorithms such as divide-and-conquer algorithm and greedy technique, the simulation program implements the search for process noise covariance, the correction function and its correction coefficients. These components, which will be implemented in the processor of the SPEC, Kalman algorithm and the light-source-monitoring sensor are essential to build the Kalman corrector. Through experimental results, the corrector can reduce the total error in the spectra on the order of 10 times; for certain typical local spectral data, it can reduce the error by up to 60 times. The experimental results prove that accuracy of the SPEC increases considerably by using the proposed Kalman corrector in the case of changes in light source intensity. The proposed Kalman technique can be applied to other applications to correct the errors due to slow changes in certain system components.
Design and Performance Evaluation of an Electro-Hydraulic Camless Engine Valve Actuator for Future Vehicle Applications
Authors: Nam Kanghyun , Cho Kwanghyun , Park Sang-Shin , Choi Seibum
Published: December 2017

This paper details the new design and dynamic simulation of an electro-hydraulic camless engine valve actuator (EH-CEVA) and experimental verification with lift position sensors. In general, camless engine technologies have been known for improving fuel efficiency, enhancing power output, and reducing emissions of internal combustion engines. Electro-hydraulic valve actuators are used to eliminate the camshaft of an existing internal combustion engines and used to control the valve timing and valve duration independently. This paper presents novel electro-hydraulic actuator design, dynamic simulations, and analysis based on design specifications required to satisfy the operation performances. An EH-CEVA has initially been designed and modeled by means of a powerful hydraulic simulation software, AMESim, which is useful for the dynamic simulations and analysis of hydraulic systems. Fundamental functions and performances of the EH-CEVA have been validated through comparisons with experimental results obtained in a prototype test bench.
Integrity Testing of Pile Cover Using Distributed Fibre Optic Sensing
Authors: Rui Yi , Kechavarzi Cedric , O’Leary Frank , Barker Chris , Nicholson Duncan , Soga Kenichi
Published: December 2017

The integrity of cast-in-place foundation piles is a major concern in geotechnical engineering. In this study, distributed fibre optic sensing (DFOS) cables, embedded in a pile during concreting, are used to measure the changes in concrete curing temperature profile to infer concrete cover thickness through modelling of heat transfer processes within the concrete and adjacent ground. A field trial was conducted at a high-rise building construction site in London during the construction of a 51 m long test pile. DFOS cables were attached to the reinforcement cage of the pile at four different axial directions to obtain distributed temperature change data along the pile. The monitoring data shows a clear development of concrete hydration temperature with time and the pattern of the change varies due to small changes in concrete cover. A one-dimensional axisymmetric heat transfer finite element (FE) model is used to estimate the pile geometry with depth by back analysing the DFOS data. The results show that the estimated pile diameter varies with depth in the range between 1.40 and 1.56 m for this instrumented pile. This average pile diameter profile compares well to that obtained with the standard Thermal Integrity Profiling (TIP) method. A parametric study is conducted to examine the sensitivity of concrete and soil thermal properties on estimating the pile geometry.
Sulfophenyl-Functionalized Reduced Graphene Oxide Networks on Electrospun 3D Scaffold for Ultrasensitive NO2 Gas Sensor
Authors: Zou Bin , Guo Yunlong , Shen Nannan , Xiao Anshan , Li Mingjun , Zhu Liang , Wan Pengbo , Sun Xiaoming
Published: December 2017

Ultrasensitive room temperature real-time NO2 sensors are highly desirable due to potential threats on environmental security and personal respiratory. Traditional NO2 gas sensors with highly operated temperatures (200–600 °C) and limited reversibility are mainly constructed from semiconducting oxide-deposited ceramic tubes or inter-finger probes. Herein, we report the functionalized graphene network film sensors assembled on an electrospun three-dimensional (3D) nanonetwork skeleton for ultrasensitive NO2 sensing. The functional 3D scaffold was prepared by electrospinning interconnected polyacrylonitrile (PAN) nanofibers onto a nylon window screen to provide a 3D nanonetwork skeleton. Then, the sulfophenyl-functionalized reduced graphene oxide (SFRGO) was assembled on the electrospun 3D nanonetwork skeleton to form SFRGO network films. The assembled functionalized graphene network film sensors exhibit excellent NO2 sensing performance (10 ppb to 20 ppm) at room temperature, reliable reversibility, good selectivity, and better sensing cycle stability. These improvements can be ascribed to the functionalization of graphene with electron-withdrawing sulfophenyl groups, the high surface-to-volume ratio, and the effective sensing channels from SFRGO wrapping onto the interconnected 3D scaffold. The SFRGO network-sensing film has the advantages of simple preparation, low cost, good processability, and ultrasensitive NO2 sensing, all advantages that can be utilized for potential integration into smart windows and wearable electronic devices for real-time household gas sensors.
A Fast and Validated Reversed-Phase HPLC Method for Simultaneous Determination of Simvastatin, Atorvastatin, Telmisartan and Irbesartan in Bulk Drugs and Tablet Formulations
Authors: Alhazmi Hassan , Alnami Ahmed , Arishi Mohammed , Alameer Raad , Al Bratty Mohammed , Rehman Zia , Javed Sadique , Arbab Ismail
Published: December 2017

The aim of this study was to develop and validate a fast and simple reversed-phase HPLC method for simultaneous determination of four cardiovascular agents—atorvastatin, simvastatin, telmisartan and irbesartan in bulk drugs and tablet oral dosage forms. The chromatographic separation was accomplished by using Symmetry C18 column (75 mm × 4.6 mm; 3.5 μ) with a mobile phase consisting of ammonium acetate buffer (10 mM; pH 4.0) and acetonitrile in a ratio 40:60 v/v. Flow rate was maintained at 1 mL/min up to 3.5 min, and then suddenly changed to 2 mL/min till the end of the run (7.5 min). The data was acquired using ultraviolet detector monitored at 220 nm. The method was validated for linearity, precision, accuracy and specificity. The developed method has shown excellent linearity (R2 > 0.999) over the concentration range of 1–16 µg/mL. The limits of detection (LODs) and limits of quantification (LOQs) were in the range of 0.189–0.190 and 0.603–0.630 µg/mL, respectively. Inter-day and intra-day accuracy and precision data were recorded in the acceptable limits. The new method has successfully been applied for quantification of all four drugs in their tablet dosage forms with percent recovery within 100 ± 2%.
Do Adult Forms of Chronic Rhinosinusitis Exist in Children and Adolescents?
Authors: Hopp Russell
Published: December 2017

Pediatric chronic sinusitis is currently designated as pediatric chronic rhinosinusitis. In most pediatric cases, sinusitis is considered as infectious. In the adult literature, a wider repertoire of chronic rhinosinusitis conditions is recognized. In this review, the adult forms of chronic rhinosinusitis are used as a framework for identifying and defining the potential spectrum of pediatric chronic rhinosinusitis that exists beyond the most recognized condition, pediatric infectious chronic rhinosinusitis.
The Driving Force Analysis of NDVI Dynamics in the Trans-Boundary Tumen River Basin between 2000 and 2015
Authors: Kang CholHyok , Zhang Yili , Wang Zhaofeng , Liu Linshan , Zhang Huamin , Jo Yilgwang
Published: December 2017

Vegetation dynamics in relation to climatic changes and anthropogenic activities is critical for terrestrial ecosystem management. The objective of this study was to investigate spatiotemporal change of vegetation and their driving forces during growing seasons (between April and October and including the spring, summer and autumn) in the Tumen River Basin (TRB) using Normalized Difference Vegetation Index (NDVI) and climate data spanning from 2000 to 2015. A linear regression, Pearson correlation coefficients and the residual trend (RESTREND) was applied for this study. Our results demonstrate that vegetation increased during different periods of the growing season in most of the areas of the TRB over 16 years. Our results demonstrate that vegetation increased during different periods of the growing season in most of the areas of the TRB over 16 years; those in growing season (spring, summer, and autumn) were characterized by the increase in rates by 0.0012/year, 0.0022/year, 0.0011/year, and 0.0019/year, respectively. Forested regions are characterized by the largest increase (0.0021/year) in NDVI compared with other vegetation types across the entire study area. The trends in NDVI across the study area were influenced by both climatic variations and human disturbances. The human activities such as reforestation and agricultural practices are the primary driver, greater than climatic factors, during growing season, including summer and autumn. Temperature and precipitation has had a significant influence on NDVI in a limited area (temp = 0.86%, p < 0.05 and precipitation = 1.93%, p < 0.05) during growing season. The significant role of precipitation on NDVI change throughout growing season and the summer is larger than that of temperature across the TRB, although the influence of the latter becomes most significant during the spring and autumn. The RESTREND method shows that human activity during the growing season, including the spring, summer, and autumn, have led to enhancements in NDVI across more than 70% of the TRB over the last 16 years, with the most significant improvements seen in forested land and farmland. At the same time, a significant reduction in residual (i.e., degraded areas) NDVI values for different growing seasons had characterized farmland and urban land at low altitudes. This study provides important background information regarding the influence of human activities on land degradation and provides a scientific foundation for the development of ecological restoration policies within the TRB. We found that the RESTREND method can be used to detect human drivers of vegetation in the regions with semi-humid and humid monsoon, where the significant correlation between NDVI and climatic factors exists.
A Chaos Theory Perspective on International Migration
Authors: Tănasie Anca , Drăcea Raluca , Lădaru Georgiana
Published: December 2017

This paper aims at providing a different approach to international migration analysis, beyond classical models previously proposed by specialized literature. Chaos theory is getting more and more applied into macroeconomics once traditional linear models or even previous dynamic analysis become less suitable. Modern science sees chaos as unpredictable evolution, maybe even disorder. Still, chaos has got its own rules and can describe many dynamic phenomena within our world. Thus, we test whether international migration data falls under the rules of chaos and whether recent developments within the “European migration crisis” (the total daily migration inflows towards the coasts of Italy, by sea, from January 2014 to April 2017) could be described as chaotic.
The Key Driving Forces for Geo-Economic Relationships between China and ASEAN Countries
Authors: Wang Shufang , Xue Xiao , Zhu Axing , Ge Yuejing
Published: December 2017

With the rise of China and the implementation of the “21st Century Maritime Silk Road” strategy, research on geo-economics between China and ASEAN (Association of Southeast Asian Nations) countries has become increasingly important. Current studies mainly focus on influencing factors, while there is little consideration about how these influencing factors act on geo-economic relationships. Therefore, this paper explores the key driving forces for geo-economic relationships between China and ASEAN countries by use of the structural equation modeling based on Partial Lease Squares. There are three main findings: (1) Economic factors have the greatest impact on geo-economic relationships and the total path effect is 0.778. Geo-location, geopolitics and geo-culture act on geo-economic relationships directly and indirectly. Their total path effects are 0.731, 0.645 and 0.513, respectively. (2) Indirect effects of geo-location, geopolitics and geo-culture impacting geo-economic relationships are far greater than direct effects. Geo-culture, in particular, has a vital mediating effect on geo-economic relationships. (3) Economic drivers promote geo-economic relationships through market, industrial policy, technical, network and benefit-sharing mechanisms. Political drivers improve geo-economic relationships through cooperation, negotiation, coordination and institutional mechanisms. Cultural drivers enhance geo-economic relationships through transmission mechanism. Location drivers facilitate geo-economic relationships through selection mechanism. We provide new insights on the geo-economic relationships through quantitative analysis and enrich the existing literature by revealing the key driving forces and mechanisms for geo-economic relationships.
Landscape Optimization in a Highly Urbanized Tourism Destination: An Integrated Approach in Nanjing, China
Authors: Chen Lingling , Thapa Brijesh , Kim Jinwon , Yi Lin
Published: December 2017

Planning and developing urban tourism destinations must encompass landscape optimization to achieve healthy urban ecosystems, as well as for evolution sustainability. This study explored sustainable landscape planning by examining the optimization of landscape spatial distribution in an urban tourism destination–Nanjing, China—using an integrated approach that included remote sensing (RS), geographic information system (GIS), and landscape metrics in the context of an urban tourism destination evolution model. Least-cost modeling in GIS was also used to optimize decision-making from an ecological perspective. The results indicated that landscapes were more homogenous, fragmented, and less connected. Except for the eastern area, the landscape evolution showed characteristics of both degeneration and growth. A complete greenway network including sources, greenways, and nodes were constructed, and an increase in natural landscapes was strongly recommended. The findings provide geographic insights for sustainable urban tourism planning and development via comprehensive methodological applications.
Algebraic Aspects of the Supersymmetric Minimal Surface Equation
Authors: Grundland Alfred , Hariton Alexander
Published: December 2017

In this paper, a supersymmetric extension of the minimal surface equation is formulated. Based on this formulation, a Lie superalgebra of infinitesimal symmetries of this equation is determined. A classification of the one-dimensional subalgebras is performed, which results in a list of 143 conjugacy classes with respect to action by the supergroup generated by the Lie superalgebra. The symmetry reduction method is used to obtain invariant solutions of the supersymmetric minimal surface equation. The classical minimal surface equation is also examined and its group-theoretical properties are compared with those of the supersymmetric version.
Graph Cellular Automata with Relation-Based Neighbourhoods of Cells for Complex Systems Modelling: A Case of Traffic Simulation
Authors: Małecki Krzysztof
Published: December 2017

A complex system is a set of mutually interacting elements for which it is possible to construct a mathematical model. This article focuses on the cellular automata theory and the graph theory in order to compare various types of cellular automata and to analyse applications of graph structures together with cellular automata. It proposes a graph cellular automaton with a variable configuration of cells and relation-based neighbourhoods (r–GCA). The developed mechanism enables modelling of phenomena found in complex systems (e.g., transport networks, urban logistics, social networks) taking into account the interaction between the existing objects. As an implementation example, modelling of moving vehicles has been made and r–GCA was compared to the other cellular automata models simulating the road traffic and used in the computer simulation process.
Mutations in HPV18 E1^E4 Impact Virus Capsid Assembly, Infectivity Competence, and Maturation
Authors: Biryukov Jennifer , Myers Jocelyn , McLaughlin-Drubin Margaret , Griffin Heather , Milici Janice , Doorbar John , Meyers Craig
Published: December 2017

The most highly expressed protein during the productive phase of the human papillomavirus (HPV) life cycle is E1^E4. Its full role during infection remains to be established. HPV E1^E4 is expressed during both the early and late stages of the virus life cycle and contributes to viral genome amplification. In an attempt to further outline the functions of E1^E4, and determine whether it plays a role in viral capsid assembly and viral infectivity, we examined wild-type E1^E4 as well as four E1^E4 truncation mutants. Our study revealed that HPV18 genomes containing the shortest truncated form of E1^E4, the 17/18 mutant, produced viral titers that were similar to wild-type virus and significantly higher compared to virions containing the three longer E1^E4 mutants. Additionally, the infectivity of virus containing the shortest E1^E4 mutation was equivalent to wild-type and significantly higher than the other three mutants. In contrast, infectivity was completely abrogated for virus containing the longer E1^E4 mutants, regardless of virion maturity. Taken together, our results indicate for the first time that HPV18 E1^E4 impacts capsid assembly and viral infectivity as well as virus maturation.
On the Mechanics of Immediate Corrections and Aftereffects in Prism Adaptation
Authors: Pochopien Klaudia , Spang Karoline , Stemmler Torsten , Fahle Manfred
Published: December 2017

Prisms laterally shifting the perceived visual world cause arm movements to deviate from intended targets. The resulting error—the direct effect—both for pointing and throwing movements, usually corresponds to only around half of the prism’s optical power due to an “immediate correction effect”. We investigated the mechanisms of this immediate correction effect. In three experiments with 73 healthy subjects we find that the immediate correction effect is associated with a head and/or eye rotation. Since these rotations are subconscious they are not taken into account by the participants. These subconscious rotations compensate for a large portion of the prism’s optical effect and change the subjective straight ahead. These movements seem to be induced only in a rich visual environment and hence do not take place in the dark. They correspond to the difference between the direct effect and the optical power of the prisms and seem to cause the immediate correction effect. Hence, eye-hand adaptation only adapts to the prism’s optical power minus unconscious head rotation and hence is much smaller than the optical power of the prisms.
Permafrost Boundary Shift in Western Siberia May Not Modify Dissolved Nutrient Concentrations in Rivers
Authors: Vorobyev Sergey , Pokrovsky Oleg , Serikova Svetlana , Manasypov Rinat , Krickov Ivan , Shirokova Liudmila , Lim Artem , Kolesnichenko Larisa , Kirpotin Sergey , Karlsson Jan
Published: December 2017

Identifying the landscape and climate factors that control nutrient export by rivers in high latitude regions is one of the main challenges for understanding the Arctic Ocean response to ongoing climate change. This is especially true for Western Siberian rivers, which are responsible for a significant part of freshwater and solutes delivery to the Arctic Ocean and are draining vast permafrost-affected areas most vulnerable to thaw. Forty-nine small- and medium-sized rivers (10–100,000 km2) were sampled along a 1700 km long N–S transect including both permafrost-affected and permafrost-free zones of the Western Siberian Lowland (WSL) in June and August 2015. The N, P, dissolved organic and inorganic carbon (DOC and DIC, respectively), particular organic carbon (POC), Si, Ca, K, Fe, and Mn were analyzed to assess the role of environmental parameters, such as temperature, runoff, latitude, permafrost, bogs, lake, and forest coverage on nutrient concentration. The size of the watershed had no influence on nutrient concentrations in the rivers. Bogs and lakes retained nutrients whereas forests supplied P, Si, K, Ca, DIC, and Mn to rivers. The river water temperature was negatively correlated with Si and positively correlated with Fe in permafrost-free rivers. In permafrost-bearing rivers, the decrease in T northward was coupled with significant increases in PO4, Ptot, NH4, pH, DIC, Si, Ca, and Mn. North of the permafrost boundary (61° N), there was no difference in nutrient concentrations among permafrost zones (isolated, sporadic, discontinuous, and continuous). The climate warming in Western Siberia may lead to a permafrost boundary shift northward. Using a substituting space for time scenario, this may decrease or maintain the current levels of N, P, Si, K, Ca, DIC, and DOC concentrations in rivers of continuous permafrost zones compared to the present state. As a result, the export flux of nutrients by the small- and medium-sized rivers of the Western Siberian subarctic to the Arctic Ocean coastal zone may remain constant, or even decrease.
CF3SO2X (X = Na, Cl) as reagents for trifluoromethylation, trifluoromethylsulfenyl-, -sulfinyl- and -sulfonylation. Part 1: Use of CF3SO2Na
Authors: Guyon Hélène , Chachignon Hélène , Cahard Dominique
Published: December 2017

Sodium trifluoromethanesulfinate, CF3SO2Na, and trifluoromethanesulfonyl chloride, CF3SO2Cl, are two popular reagents that are widely used for the direct trifluoromethylation of a large range of substrates. Further, these two reagents are employed for the direct trifluoromethylsulfenylation and trifluoromethylsulfinylation, the introduction of the SCF3 and the S(O)CF3 group, respectively. In addition to the aforementioned reactions, the versatility of these two reagents is presented in other reactions such as sulfonylation and chlorination. This first part is dedicated to sodium trifluoromethanesulfinate.
Simulating Coronal Loop Implosion and Compressible Wave Modes in a Flare Hit Active Region
Authors: Sarkar Aveek , Vaidya Bhargav , Hazra Soumitra , Bhattacharyya Jishnu
Published: December 2017

There is considerable observational evidence of implosion of magnetic loop systems inside solar coronal active regions following high-energy events like solar flares. In this work, we propose that such collapse can be modeled in three dimensions quite accurately within the framework of ideal magnetohydrodynamics. We furthermore argue that the dynamics of loop implosion is only sensitive to the transmitted disturbance of one or more of the system variables, e.g., velocity generated at the event site. This indicates that to understand loop implosion, it is sensible to leave the event site out of the simulated active region. Toward our goal, a velocity pulse is introduced to model the transmitted disturbance generated at the event site. Magnetic field lines inside our simulated active region are traced in real time, and it is demonstrated that the subsequent dynamics of the simulated loops closely resemble observed imploding loops. Our work highlights the role of plasma β in regards to the rigidity of the loop systems and how that might affect the imploding loops’ dynamics. Compressible magnetohydrodynamic modes such as kink and sausage are also shown to be generated during such processes, in accordance with observations.
Methodological Framework for Operational Risk Assessment
Authors: Procházka Josef , Melichar Josef
Published: December 2017

The article brings a "Condition-If-Then" construct as a proven protocol for writing risk statement and its application into assessing risks related to capability gaps identified during the defense planning processAuthors discuss utility of "Common approach" and "Impact averse approach" to risk rank ordering as a tool for ordering risks according to their importance. Using the discussed tools enables the planners to run risk assessment that sets preconditions for prioritizing the Force Development Options (FDOs) and for minimizing the impact of capability gaps on conduct of future operations. The ORAMF and the application of the given protocol for writing risks are some of the building blocks of the defense planning process, offering a toolset for reinforcement of the defense planning of the Czech Republic.
Les horizons du futur en périnatalité
Authors: Darchis Élisabeth
Published: December 2017

Au temps de la grossesse, la famille rêve intensément pour construire son futur espéré. Elle recherche ses racines et trace ses destins. Les mages, les oracles et les rituels, les bonnes ou mauvaises fées ouvrent un horizon virtuel dans la famille. Le cas d’un couple qui attend des jumeaux et qui rêve à leur famille à venir illustre ce propos. Mais l’annonce d’un diagnostic anténatal péjoratif interrompt brusquement l’investissement futur et le processus onirique. L’acte médical de réduction embryonnaire in utero ne laisse qu’un fœtus vivant dans le ventre maternel. Le « bébé fantôme » éliminé semble envahir le futur et primer sur le bébé attendu. Une thérapie familiale périnatale avec ces futurs parents et les « bébés in utero  », l’un vivant et l’autre mort, pourra relancer la perspective d’une famille possible.
Obésité : un corps idéal pour tous ?
Authors: Schwailbold Marie-Anne
Published: December 2017

L’auteur présente l’évolution de la prise en charge d’une famille à problématique d’obésité. À travers l’étude de la dynamique familiale par le biais de l’épreuve du dessin libre de l’arbre généalogique ou « génographie projective », elle propose d’envisager le corps obèse de l’adolescent comme porteur des idéaux familiaux. Dans cet article, elle interroge la question de la perte pondérale et les conséquences du changement de l’adolescent sur l’équilibre familial.
Ronald Coase, un siècle d’économie
Authors: Bertrand Élodie
Published: December 2017

Nobel d’économie en 1991, Ronald Coase (1910-2013) est célèbre pour son « théorème », aussi souvent cité que mal compris. Ses travaux fondateurs sur les coûts de transaction, les droits de propriété et la régulation continuent aujourd’hui d’alimenter une riche réflexion, en économie et au-delà.
Culture de sécurité des soins dans les centres de soins primaires tunisiens : une étude multicentrique
Authors: Mallouli Manel , Aouicha Wiem , Tlili Mohamed Ayoub , Limam Manel , Ajmi Thouraya , Mtiraoui Ali , Zedini Chekib
Published: December 2017

Objectif : Évaluer la culture de la sécurité des soins dans les centres de soins primaires et d’explorer ses facteurs associés. Méthodes : Une étude descriptive transversale multicentrique, menée en 2016 dans 30 centres de soins primaires localisés dans le centre tunisien (trois gouvernorats), utilisant la version validée en français du questionnaire HSOPSC. Résultats : Au total, 214 professionnels ont participé, le taux de réponse était de 85 %. La dimension « travail d’équipe au sein des centres » avait le score le plus élevé (71,5 %). Cependant, deux dimensions avaient des scores très bas qui sont « fréquence de signalement des événements indésirables », « réponse non punitive à l’erreur » (31,4 % ; 35,4 %, respectivement). En ce qui concerne les facteurs associés, la dimension « fréquence de signalement des événements indésirables » a été significativement plus élevée chez les professionnels impliqués dans les comités de gestion des risques (p = 0,01). Conclusion : Cette étude a démontré que le niveau de la culture de la sécurité des soins doit être amélioré dans les centres de soins primaires en Tunisie. Ces résultats soulignent la nécessité de mettre en place une démarche qualité dans ces centres de soins primaires.
Monitoring of Callus Maturation and Measurement of Resistance Rates Using Bioelectrical Impedance for Patients Treated With an External Fixator
Authors: Yoshida Takashi , Kim Wook-Cheol , Oka Yoshinobu , Nakase Masashi , Nishida Atsushi , Fujiwara Hiroyoshi , Kubo Toshikazu
Published: December 2017

Evaluation of callus maturation and the decision to remove an external fixator depend on radiographic and clinical findings, which are subjective. Callus fracture or recurrent deformity may occur after premature removal of a fixator. The authors applied a technique to measure bioelectrical impedance to assess callus maturation. This study included 27 limbs that underwent deformity correction or callus distraction using a fixator. Mean patient age at the time of surgery was 17.2 years. Overall impedance during callus maturation was measured from after completion of correction or distraction to removal of the fixator. Temporal changes in impedance values were measured, and maximum and final values were compared with initial values. The resistance rates were compared by age (<15 or ≥15 years), correction site (femur or tibia), and treatment method (noncontact or contact). Mean overall impedance increased gradually. Compared with initial values, maximum and final impedance values were 1.21 times and 1.15 times higher, respectively. Resistance rates by age, correction site, and treatment method were significantly higher in patients 15 years and older, in the tibia, and in the contact group, respectively. Overall impedance tended to increase during callus maturation but varied among patients. Therefore, resistance rates were calculated to classify differences for individual patients. Age and treatment method were important predictors of resistance rates. These data by age, correction site, and treatment method, which assume overall impedance from after completion of correction or distraction, can serve as a useful index to determine when a fixator should be removed. [
Orthopedics.
2018; 41(1):54–58.]
Adverse Local Tissue Reaction After a Metal-on-Metal Total Hip Prosthesis Without Elevated Serum Metal Ion Levels
Authors: Tetreault Matthew W. , Jacobs Joshua J. , Mahmud Waqas , Nam Denis
Published: December 2017

In the 1990s, metal-on-metal (MoM) bearings were reintroduced in total hip arthroplasty (THA), having the proposed advantages of decreased wear and improved stability. However, catastrophic adverse local tissue reaction (ALTR) secondary to metal debris from both the bearing surface and the head–neck junction is a well-recognized complication. The measurement of metal ion levels in the serum is often a first-line test to identify failure of a MoM bearing. The authors describe a 70-year-old man who presented with a multiply revised MoM THA and a large periprosthetic fluid collection incidentally seen during computed tomography for renal nephrolithiasis. The patient reported painless, progressive swelling over the lateral aspect of the hip. An infectious workup including serum erythrocyte sedimentation rate, C-reactive protein, and intraarticular hip aspiration yielded negative results. Metal ion levels in the serum, including a minimally elevated cobalt level, were unremarkable, and metal-lymphocyte transformation testing yielded negative results. Radiographic imaging revealed progressive osteolysis around the proximal femur, and magnetic resonance imaging showed large fluid collections with irregular wall thickening surrounding the gluteal and iliopsoas musculature. At revision surgery, a large fluid collection and corrosion at the head–neck junction were present. Pathology specimens confirmed the presence of an ALTR. This report presents a previously undescribed case of an ALTR secondary to MoM THA in the absence of elevated serum metal ion levels. This indicates the necessity of considering all aspects of a patient's clinical presentation, imaging modalities, and laboratory testing in the evaluation and diagnosis of a symptomatic MoM THA. [
Orthopedics.
2018; 41(3):e438–e441.]
Critical Assessment of an Ocular Photoscreener
Authors: Williams Thomas , Morgan Linda A. , High Robin , Suh Donny W.
Published: December 2017

Purpose:

To determine the accuracy of the PlusoptiX A12 photoscreener (PlusoptiX, Inc., Atlanta, GA) in detecting amblyopia or ambylogenic risk factors in pediatric patients in Nebraska.

Methods:

Using the PlusoptiX A12 photoscreener, data were collected from pediatric patients seen at a single pediatric ophthalmology practice. Each patient was screened using the device and also received a comprehensive ophthalmic examination. The results of the PlusoptiX A12 photoscreener were compared to the gold standard, comprehensive ophthalmic examination findings. The assessment of amblyopia or amblyogenic risk factors in the patients was based on the updated American Association for Pediatric Ophthalmology and Strabismus (AAPOS) referral criteria guidelines.

Results:

Data were collected from 219 consecutive pediatric patients (438 eyes) during the 3-month study period. Among the patients, 87 (40%) children were determined to have amblyopia or ambylogenic risk factors after the comprehensive pediatric ophthalmology examination based on the AAPOS guidelines. The PlusoptiX A12 photoscreener was found to have a sensitivity of 93.02%, specificity of 84.96%, false-positive rate of 9.13%, false-negative rate of 2.74%, positive predictive value of 80.00%, and negative predictive value of 94.96%.

Conclusions:

The PlusoptiX A12 photoscreener is viable and comparable to various commercially available devices in the detection of refractive amblyogenic risk factors based on the Nebraska pediatric patient population. Future studies may show increased sensitivity by combining the use of the PlusoptiX A12 photoscreener with an alternate cover test.

[
J Pediatr Ophthalmol Strabismus
. 2018;55(3):194–199.]
The last stronghold of the Castle of Leiria and its constructive evidences: when Romanesque encloses Gothic
Authors: Ginja António
Published: December 2017

This paper contains part of the results gathered from the first architectonic study of the Castle of Leiria’s military structures, conducted within a master dissertation in Art History, from the University of Coimbra, combining Archaeology of Arquitecture and Art History. Among the several defensive structures of this castle, the so called último reduto (last stronghold), a small fortress within the castle itself, would reveal a complex and diachronic construction, unlike any other in the Castle of Leiria. In spite of its aparent modest architecture, awarding it classifications such as “conservative project” or “unfinished project”, it is demontrated how the último reduto, resulting of a four constructive phases sequence, is in fact an advanced project, a completely Gothic defensive system, although contained within a Romanic castle.
Sobre Arqueología y Arquitectura en Medina Azahara. Entrevista a Rafael Manzano Martos
Authors: Manzano Pérez de Guzmán Julia , Barrero Ortega Pedro , Gámiz Gordo Antonio
Published: December 2017

Rafael Manzano Martos, arquitecto y catedrático, dirigió Medina Azahara entre 1975 y 1985. La entrevista, ilustrada con fotos inéditas de su archivo privado, empieza recordando sus inicios en la arqueología y sus maestros Torres Balbás, Chueca Goitia, Gómez Moreno e Íñiguez Almech, con quienes se formó como restaurador de monumentos e historiador. Se comentan los criterios y el lenguaje de su importante intervención en el Salón Rico, tras hablar de su antecesor Félix Hernández y su contexto profesional. Se citan también sus intervenciones en el palacio de Yaafar, en la Dar al-Mulk, y en la Dar al-Yund. Se recuerdan sus inquietudes sobre la urbanística del conjunto, su jardinería, la traída de agua y electricidad, y la escasez de medios económicos o personales. Finalmente se comentan algunas singularidades de Medina Azahara, donde confluye su visión como arquitecto con la historia y la arqueología.
Unilateral Quadriceps Strengthening With Disinhibitory Cryotherapy and Quadriceps Symmetry After Anterior Cruciate Ligament Reconstruction
Authors: Kuenze Christopher M. , Kelly Adam R. , Jun Hyung-Pil , Eltoukhy Moataz
Published: December 2017

Context: 

The effect of unilateral cryotherapy-facilitated rehabilitation exercise on involved-limb quadriceps function and limb symmetry in individuals with quadriceps dysfunction after anterior cruciate ligament reconstruction (ACLR) remains unclear.

Objective: 

To measure the effect of a 2-week unilateral cryotherapy-facilitated quadriceps-strengthening program on knee-extension strength and quadriceps central activation ratio (CAR) in participants with ACLR.

Design: 

Controlled laboratory study.

Setting: 

Laboratory.

Patients or Other Participants: 

A total of 10 volunteers with unilateral ACLR (1 man, 9 women; age = 21.0 ± 2.8 years, height = 164.6 ± 5.0 cm, mass = 64.0 ± 6.1 kg, body mass index = 23.7 ± 2.7 kg/m2) and 10 healthy volunteers serving as control participants (1 man, 9 women; age = 20.8 ± 2.5 years, height = 169.1 ± 6.2 cm, mass = 61.1 ± 6.4 kg, body mass index = 21.4 ± 2.3 kg/m2) participated.

Intervention(s): 

Participants with ACLR completed a 2-week unilateral cryotherapy-facilitated quadriceps-strengthening intervention.

Main Outcome Measure(s): 

Bilateral normalized knee-extension maximal voluntary isometric contraction (MVIC) torque (Nm/kg) and quadriceps CAR (%) were assessed preintervention and postintervention. Limb symmetry index (LSI) was calculated at preintervention and postintervention testing. Preintervention between-groups differences in unilateral quadriceps function and LSI were evaluated using independent-samples t tests. Preintervention-to-postintervention differences in quadriceps function were evaluated using paired-samples t tests. Cohen d effect sizes (95% confidence interval [CI]) were calculated for each comparison.

Results: 

Preintervention between-groups comparisons revealed less knee-extension MVIC torque and quadriceps CAR for the ACLR limb (MVIC: P = .01, Cohen d = −1.31 [95% CI = −2.28, −0.34]; CAR: P = .004, Cohen d = −1.48 [95% CI = −2.47, −0.49]) and uninvolved limb (MVIC: P = .03, Cohen d = −1.05 [95% CI = −1.99, −0.11]; CAR: P = .01, Cohen d = −1.27 [95% CI = −2.23, −0.31]) but not for the LSI (MVIC: P = .46, Cohen d = −0.34 [95% CI = −1.22, 0.54]; CAR: P = .60, Cohen d = 0.24 [95% CI = −0.64, 1.12]). In the ACLR group, participants had improved knee-extension MVIC torque in the involved limb (P = .04, Cohen d = 0.32 [95% CI = −0.56, 1.20]) and uninvolved limb (P = .03, Cohen d = 0.29 [95% CI = −0.59, 1.17]); however, the improvement in quadriceps CAR was limited to the involved limb (P = .02, Cohen d = 1.16 [95% CI = 0.21, 2.11]). We observed no change in the LSI with the intervention for knee-extension MVIC torque (P = .74, Cohen d = 0.09 [95% CI = −0.79, 0.97]) or quadriceps CAR (P = .61, Cohen d = 0.26 [95% CI = −0.62, 1.14]).

Conclusions: 

Two weeks of cryotherapy-facilitated exercise may improve involved-limb quadriceps function while preserving between-limbs symmetry in patients with a history of ACLR.
The Role of Dynamic Magnetic Resonance Imaging in Cervical Spondylotic Myelopathy
Authors: Kolcun John Paul , Chieng Lee Onn , Madhavan Karthik , Wang Michael Y.
Published: December 2017

Dynamic spinal cord compression has been investigated for several years, but until the advent of open MRI, the use of dynamic MRI (dMRI) did not gain popularity. Several publications have shown that cervical cord compression is both static and dynamic. On many occasions the evaluation of cervical spondylotic myelopathy (CSM) is straightforward, but patients are frequently encountered with a significantly worse clinical examination than would be suggested by radiological images. In this paper, we present an extensive review of the literature in order to describe the importance of dMRI in various settings and applications. A detailed literature review was performed in the Medline and Pubmed databases using the terms “cervical spondylotic myelopathy”, “dynamic MRI”, “kinetic MRI”, and “myelomalalcia” for the period of 1980-2016. The study was limited to English language, human subjects, case series, retrospective studies, prospective reports, and clinical trials. Reviews, case reports, cadaveric studies, editorials, and commentaries were excluded. The literature search yielded 180 papers, 19 of which met inclusion criteria. However, each paper had evaluated results and outcomes in different ways. It was not possible to compile them for meta-analysis or pooled data evaluation. Instead, we evaluated individual studies and present them for discussion. We describe a number of parameters evaluated in 2661 total patients, including dynamic changes to spinal cord and canal dimensions, transient compression of the cord with changes in position, and the effects of position on the intervertebral disc. dMRI is a useful tool for understanding the development of CSM. It has found several applications in the diagnosis and preoperative evaluation of many patients, as well as certain congenital dysplasias and Hirayama disease. It is useful in correlating symptoms with the dynamic changes only noted on dMRI, and has reduced the incidence of misdiagnosis of myelopathy.
Computed Tomography-Based Occipital Condyle Morphometry in an Indian Population to Assess the Feasibility of Condylar Screws for Occipitocervical Fusion
Authors: Srivastava Abhishek , Nanda Geetanjali , Mahajan Rajat , Nanda Ankur , Mishra Nirajana , Karmaran Srinivasa , Batra Sahil , Chhabra Harvinder Singh
Published: December 2017

Study Design

A retrospective computed tomography (CT)-based morphometric study of 82 occipital condyles in the Indian population, focusing on critical morphometric dimensions with relation to placing condylar screws.

Purpose

This study focused on determining the feasibility of placing occipital condylar screws in an Indian population using CT anatomical morphometric data.

Overview of Literature

The occipital condylar screw is a novel technique being explored as one of the options in occipitocervical stabilization. Sex and ethnic variations in anatomical structures may restrict the feasibility of this technique in some populations. To the best of our knowledge, there are no CT-based data on an Indian population that assess the feasibility of occipital condylar screws.

Methods

We measured the dimensions of 82 occipital condyles in 41 adults on coronal, sagittal, and axial reconstructed CT images. The differences were noted between the right and left sides and also between males and females. Statistical analysis was performed using the t-test, with a p-value of <0.05 considered significant.

Results

Mean sagittal length and height were 17.2±1.7 mm and 9.1±1.5 mm, respectively. Mean condylar angle/screw angle was 38.0°±5.5° from midline, with mean condylar length and width of 19.6±2.6 mm and 9.5±1.0 mm, respectively. Average coronal height on the anterior and posterior hypoglossal canal was 10.8±1.4 mm and 9.0±1.4 mm, respectively. The values in females were significantly lower than those in males, except for screw angle and condylar width. Based on Lin et al.'s proposed criteria, eight of 82 condyles were not suitable for condylar screws.

Conclusions

Preliminary CT morphometry data of the occipital condyle shows that condylar screws are anatomically feasible in a large portion of the Indian population. However, because a small number of population may not be suitable for this technique, meticulous study of preoperative anatomy using detailed CT data is advised.
Evaluation of Two Novel Integrated Stand-Alone Spacer Designs Compared with Anterior and Anterior-Posterior Single-Level Lumbar Fusion Techniques: An In Vitro Biomechanical Investigation
Authors: Kuhns Craig A. , Harris Jonathan A. , Hussain Mir M. , Muzumdar Aditya , Bucklen Brandon S. , Khalil Saif
Published: December 2017

Study Design

In vitro biomechanical investigation.

Purpose

To compare the biomechanics of integrated three-screw and four-screw anterior interbody spacer devices and traditional techniques for treatment of degenerative disc disease.

Overview of Literature

Biomechanical literature describes investigations of operative techniques and integrated devices with four dual-stacked, diverging interbody screws; four alternating, converging screws through a polyether-ether-ketone (PEEK) spacer; and four converging screws threaded within the PEEK spacer. Conflicting reports on the stability of stand-alone devices and the influence of device design on biomechanics warrant investigation.

Methods

Fourteen cadaveric lumbar spines were divided randomly into two equal groups (n=7). Each spine was tested intact, after discectomy (injured), and with PEEK interbody spacer alone (S), anterior lumbar plate and spacer (AP+S), bilateral pedicle screws and spacer (BPS+S), circumferential fixation with spacer and anterior lumbar plate supplemented with BPS, and three-screw (SA3s) or four-screw (SA4s) integrated spacers. Constructs were tested in flexion-extension (FE), lateral bending (LB), and axial rotation (AR). Researchers performed one-way analysis of variance and independent t-testing (p≤0.05).

Results

Instrumented constructs showed significantly decreased motion compared with intact except the spacer-alone construct in FE and AR (p≤0.05). SA3s showed significantly decreased range of motion (ROM) compared with AP+S in LB (p≤0.05) and comparable ROM in FE and AR. The three-screw design increased stability in FE and LB with no significant differences between integrated spacers or between integrated spacers and BPS+S in all loading modes.

Conclusions

Integrated spacers provided fixation statistically equivalent to traditional techniques. Comparison of three-screw and four-screw integrated anterior lumbar interbody fusion spacers revealed no significant differences, but the longer, larger-diameter interbody spacer with three-screw design increased stabilization in FE and LB; the diverging four-screw design showed marginal improvement during AR.