scholarly journals 1686 Are We Addressing the Syndesmosis in All Ankle Fractures – 2nd Cycle Audit at an MTC

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N Arora
Keyword(s):  
Patient Outcomes ◽  
Ankle Fractures ◽  
Audit Review ◽  
Malleolar Fractures ◽  
The Stability ◽  
Bony Fixation ◽  
Stability Results

Abstract Aim Assess compliance with BOAST guidelines – “Surgery should aim to achieve reduction and stabilisation of the ankle mortise. The syndesmosis should then be assessed and stabilised if unstable.” Method 103 Ankle ORIF procedures done for closed malleolar fractures in skeletally mature induviduals over a 12-month period used for first audit. Review of Op notes and intra-operative images was done looking for evidence of assessment of syndesmotic stability. Results were presented to the department and specific guidance on assessment of syndesmosis distributed. 84 Ankle ORIF procedures performed in next 12-month period used to re-audit. Results In the first audit, 34% cases had inadequate documentation regarding the stability of syndesmosis. This is similar to finding of 32% in a previous audit in 2018. Re-audit after presentation and review of guidelines, showed improved compliance with only 14.3% cases having no documentation of syndesmosis status. Conclusions Distribution of evidence supporting assessment of syndesmosis and making all grades of surgeons aware of the relevant guideline led to an improved compliance of more than 85%. There always remains the vulnerability to miss syndesmotic injuries and potentially adversely affect patient outcomes, if not explicitly assessed on table after bony fixation. All surgeons and rotating trainees need to be aware of this requirement.

Epitaxial Growth in Dislocation-Free Strained Alloy Films

2002 ◽  
Vol 715 ◽  
Author(s):  
Zhi-Feng Huang ◽  
Rashmi C. Desai
Keyword(s):  
Deposition Rate ◽  
Elastic Moduli ◽  
Composition Dependence ◽  
Critical Thickness ◽  
Lattice Misfit ◽  
Misfit Strain ◽  
Joint Stability ◽  
Alloy Films ◽  
The Stability ◽  
Stability Results

AbstractThe morphological and compositional instabilities in the heteroepitaxial strained alloy films have attracted intense interest from both experimentalists and theorists. To understand the mechanisms and properties for the generation of instabilities, we have developed a nonequilibrium, continuum model for the dislocation-free and coherent film systems. The early evolution processes of surface pro.les for both growing and postdeposition (non-growing) thin alloy films are studied through a linear stability analysis. We consider the coupling between top surface of the film and the underlying bulk, as well as the combination and interplay of different elastic effects. These e.ects are caused by filmsubstrate lattice misfit, composition dependence of film lattice constant (compositional stress), and composition dependence of both Young's and shear elastic moduli. The interplay of these factors as well as the growth temperature and deposition rate leads to rich and complicated stability results. For both the growing.lm and non-growing alloy free surface, we determine the stability conditions and diagrams for the system. These show the joint stability or instability for film morphology and compositional pro.les, as well as the asymmetry between tensile and compressive layers. The kinetic critical thickness for the onset of instability during.lm growth is also calculated, and its scaling behavior with respect to misfit strain and deposition rate determined. Our results have implications for real alloy growth systems such as SiGe and InGaAs, which agree with qualitative trends seen in recent experimental observations.

scholarly journals Analysis of dengue model with fractal-fractional Caputo–Fabrizio operator

2020 ◽  
Vol 2020 (1) ◽  
Author(s):  
Fatmawati ◽  
Muhammad Altaf Khan ◽  
Cicik Alfiniyah ◽  
Ebraheem Alzahrani
Keyword(s):  
Statistical Data ◽  
Dengue Infection ◽  
Fractional Operator ◽  
Novel Approach ◽  
Reduction Number ◽  
Best Fitting ◽  
The Stability ◽  
Parameter Values ◽  
Graphical Illustration ◽  
Stability Results

AbstractIn this work, we study the dengue dynamics with fractal-factional Caputo–Fabrizio operator. We employ real statistical data of dengue infection cases of East Java, Indonesia, from 2018 and parameterize the dengue model. The estimated basic reduction number for this dataset is $\mathcal{R}_{0}\approx2.2020$ R 0 ≈ 2.2020 . We briefly show the stability results of the model for the case when the basic reproduction number is $\mathcal{R}_{0} <1$ R 0 < 1 . We apply the fractal-fractional operator in the framework of Caputo–Fabrizio to the model and present its numerical solution by using a novel approach. The parameter values estimated for the model are used to compare with fractal-fractional operator, and we suggest that the fractal-fractional operator provides the best fitting for real cases of dengue infection when varying the values of both operators’ orders. We suggest some more graphical illustration for the model variables with various orders of fractal and fractional.

scholarly journals Boundary Stabilization of a Semilinear Wave Equation with Variable Coefficients under the Time-Varying and Nonlinear Feedback

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Bei Gong ◽  
Xiaopeng Zhao
Keyword(s):  
Wave Equation ◽  
Riemannian Geometry ◽  
Nonlinear Term ◽  
Variable Coefficients ◽  
Time Varying ◽  
Nonlinear Feedback ◽  
Boundary Stabilization ◽  
Semilinear Wave Equation ◽  
The Stability ◽  
Stability Results

We study the boundary stabilization of a semilinear wave equation with variable coefficients under the time-varying and nonlinear feedback. By the Riemannian geometry methods, we obtain the stability results of the system under suitable assumptions of the bound of the time-varying term and the nonlinearity of the nonlinear term.

scholarly journals On the probabilistic stability of some functional equations

2013 ◽  
Vol 29 (1) ◽  
pp. 125-132
Author(s):  
CLAUDIA ZAHARIA ◽  
◽  
DOREL MIHET ◽  
Keyword(s):  
Fixed Point ◽  
Functional Equations ◽  
Fixed Point Theory ◽  
Point Theory ◽  
Quadratic Functional ◽  
Normed Spaces ◽  
Stability Of Functional Equations ◽  
The Stability ◽  
Stability Results

We establish stability results concerning the additive and quadratic functional equations in complete Menger ϕ-normed spaces by using fixed point theory. As particular cases, some theorems regarding the stability of functional equations in β - normed and quasi-normed spaces are obtained.

Percutaneous fixation of posterior malleolar fractures in patients with unstable ankle fractures treated with a fibular intramedullary nail

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sarah J. Wordie ◽  
Thomas H. Carter ◽  
Deborah MacDonald ◽  
Andrew D. Duckworth ◽  
Timothy O. White
Keyword(s):  
Intramedullary Nail ◽  
Ankle Fractures ◽  
Percutaneous Fixation ◽  
Malleolar Fractures

scholarly journals On Cauchy’s Interlacing Theorem and the Stability of a Class of Linear Discrete Aggregation Models Under Eventual Linear Output Feedback Controls

Symmetry ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 712 ◽  
Author(s):  
Manuel De la Sen
Keyword(s):  
Dynamic System ◽  
Output Feedback ◽  
Iteration Step ◽  
Stability And Convergence ◽  
Feedback Controls ◽  
Time Aggregation ◽  
The Stability ◽  
The Given ◽  
Stability Results

This paper links the celebrated Cauchy’s interlacing theorem of eigenvalues for partitioned updated sequences of Hermitian matrices with stability and convergence problems and results of related sequences of matrices. The results are also applied to sequences of factorizations of semidefinite matrices with their complex conjugates ones to obtain sufficiency-type stability results for the factors in those factorizations. Some extensions are given for parallel characterizations of convergent sequences of matrices. In both cases, the updated information has a Hermitian structure, in particular, a symmetric structure occurs if the involved vector and matrices are complex. These results rely on the relation of stable matrices and convergent matrices (those ones being intuitively stable in a discrete context). An epidemic model involving a clustering structure is discussed in light of the given results. Finally, an application is given for a discrete-time aggregation dynamic system where an aggregated subsystem is incorporated into the whole system at each iteration step. The whole aggregation system and the sequence of aggregated subsystems are assumed to be controlled via linear-output feedback. The characterization of the aggregation dynamic system linked to the updating dynamics through the iteration procedure implies that such a system is, generally, time-varying.

scholarly journals Do weight bearing radiographs estimate the stability of an isolated distal fibula fracture?

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0052
Author(s):  
Sohail Yousaf ◽  
Daniel Hay
Keyword(s):  
Systematic Review ◽  
External Rotation ◽  
Weight Bearing ◽  
Ankle Fractures ◽  
Controlled Trials ◽  
Distal Fibula ◽  
Fibula Fracture ◽  
Stress Radiographs ◽  
The Stability ◽  
Supination External Rotation

Category: Trauma Introduction/Purpose: Differentiating stable isolated fibula fractures consistent with supination external rotation (SER) II ankle fractures from unstable SER IV fractures is essential in determining the need for surgical stabilisation. Stress radiographs are usually required to assess stability including gravity stress views (GSV) and external rotation views (ER). There is no clear consensus as to which modality is most useful to determine stability in a fracture clinic or emergency setting. In last, few years clinical uncertainty about the reliability has led researcher to focus on weight bearing radiographs (WB) .We aim to review recent literature regarding reliability of WB radiographs to estimate the stability of supination external rotation ankle fractures. Methods: A systematic review of the literature relating to radiological assessment of stability of supination external rotation ankle fractures was conducted according to PRISMA guidelines. The systematic review was prospectively registered with PROSPERO. It involved the following steps: Researching the question-Do weight bearing radiographs estimate the stability of an isolated distal fibula fracture? Setting inclusion and exclusion criteria-All English language articles published in the including any Randomised controlled trials (RCT’s) and cohort studies. Data collection)– A literature search of Medline (PubMed), the Cochrane Bone, Joint, and Muscle Trauma Group trial register, the Cochrane central register of controlled trials, Embase and CINAHL was undertaken. The grey literature was searched. Key terms ‘supination external rotation fracture’, ‘stability’. Other variations to the key words were ‘weight bearing’, “axial load”, ‘stress x-rays’, ‘systematic reviews’ and ‘meta-analysis’. Results: A total of six studies met the inclusion criteria including 601 patients. No previous systematic review on stress radiographs including weight bearing was published. All studies concluded weight bearing radiographs is an easy, pain-free, safe and reliable method to estimate stability of isolated distal fibula fractures. No serious concerns or complications were reported. Conclusion: The evidence base contained many methodological limitations and most of the evidence was either level III or IV, and so any conclusion drawn from the research must be done so with caution. The studies suggest that GSV overestimates the instability which should be assessed with studies should focus on randomized controlled trials with narrow range of clinically useful outcome measures.

Complexity factor for dynamical spherically symmetric fluid distributions in f(R) gravity

2019 ◽  
Vol 16 (11) ◽  
pp. 1950170
Author(s):  
H. Nazar ◽  
G. Abbas
Keyword(s):  
Physical Nature ◽  
The Self ◽  
Fluid Distribution ◽  
Spherically Symmetric ◽  
Static Case ◽  
System Configuration ◽  
Prior Investigation ◽  
Text Model ◽  
The Stability ◽  
Stability Results

In this study, we analyze the complexity factor that is extended up to the dynamical spherically symmetric non-static case with anisotropic dissipative self-gravitating fluid distribution in context of [Formula: see text] theory of gravity. For this evaluation we choose the particular [Formula: see text] model that signifies the physical nature of the self-gravitating system. The proposed work discusses not only the complexity factor of the structure of the fluid distribution, but also defines the minimization rate of complexity of the pattern of evolution. Here, first we have applied similar approach for obtaining the structure scalar [Formula: see text] of the complexity factor as used for in the static case, and next we have described explicitly the dissipative and non-dissipative cases by assuming the simplest pattern of evolution (homologous condition). It has been found that the system configuration fulfills the vanishing condition of complexity factor and emerging homologously, corresponds to a energy density homogeneity, shearfree and geodesic, isotropic in pressure. Moreover, we define the stability results for the vanishing complexity factor condition. Finally, we would like to mention that these results are satisfying the prior investigation about complexity factor in General Relativity (GR) by setting [Formula: see text].

Development of Microemulsions Containing Carthamus tinctorius Extract for 5α-Reductase Inhibition

2019 ◽  
Vol 819 ◽  
pp. 92-97
Author(s):  
Sitthiphong Soradech ◽  
Khaunnapa Panapong ◽  
Surada Soonthornsatitwong ◽  
Somkamol Manchun ◽  
Sirinan Tubtimted ◽  
...  
Keyword(s):  
Transdermal Delivery ◽  
Reductase Activity ◽  
Skin Permeation ◽  
Carthamus Tinctorius ◽  
Permeation Rate ◽  
Du145 Cells ◽  
Thai Medicinal Plants ◽  
The Stability ◽  
Stability Results

The purpose of this study was to develop micromeulsion consisting of Carthamus tinctorius floret extract (CT) as an ingredient to inhibit 5α-reductase activity. CT was extracted using a simple maceration technique with ethanol and inhibition of 5α-reductase activities was determined. Solutions of 2% CT extract were loaded into four microemulsion (ME) formulas (F1, F2, F3 and F4) and investigated for their physical properties, skin permeation and stability. Results showed that crude CT extract had no toxic effects on DU145 cells at concentrations of 0.0001-1.0 mg/mL. For reduction of 5α-reductase activities, concentration of CT extract at 0.05 mg/mL exhibited highest 5-reductase type-1 inhibition activity on the DU-145 cell line at 89.96% of the control, higher than standard finasteride (31.39%) and dutasteride (38.58%). The results indicated that a thermodynamically stable microemulsion improved the stability and permeation rate of CT extract. Among the ME formula, F3 was most appropriate for ME formulation with highest permeation rate and good stability during 30 days of storage. Therefore, using nanotechnology for stable transdermal delivery systems of bioactive compounds from Thai medicinal plants is one approach to improve skin and hair follicle permeation.

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