Reverse shoulder arthroplasty in cases of glenoid defects using primary-revision metaglene

BACKGROUND: Reverse shoulder arthroplasty is one of the surgical treatment methods of the shoulder joint injuries and diseases accompanied by pronounced changes in the anatomy of the articular structures. Considering the positive aspects of reverse shoulder arthroplasty, the indications for this operation are expanding over time. However, during this operation, errors are possible that lead to early dislocation of the endoprosthesis, compression of the metaglene to the scapula, screw instability and migration of the scapular component. Given the lack of a generally recognized clear algorithm of actions in these complex cases, the problem of reversible shoulder arthroplasty in case of defects in the articular surface of the scapula are relevant. AIM: To develop and evaluate the effectiveness of the method of compensating for the lack of bone tissue of the scapula in the reverse shoulder arthroplasty MATERIALS AND METHODS: In the Department of Adult Orthopaedics of the N.N. Priorov National Research Medical Center, reverse shoulder arthroplasty was performed in patients with scapular bone mass deficiency, who needed to fill in both marginal defects for the installation of metaglene with the correct angle of inclination, and the replacement of extensive defects with the necessary level of glenosphere lateralization. RESULTS: Follow-up of patients who underwent glenoid remodeling using bone autoplasty and subsequent shoulder reverse artroplasty within a period of 6 to 24 months. Remodeling and osseointegration of the grafts were determined, without signs of metaglene instability by the end of the 3rd month after the operation. The complex of rehabilitation measures and the time of recovery of movements in the operated joint did not differ from those of conventional reverse arthroplasty. CONCLUSION: Given the high efficiency of the proposed algorithm, the method used to compensate for the lack of bone tissue of the scapula in shoulder reverse arthroplasty can be recommended for implementation in a wide clinical practice.

Configurable Salat oriented device for assisting disability person

The inability to perceive clearly with the eyes can affect the blind and visually impaired in doing daily activities, especially in determining direction and navigation. In order to provide a non-invasive device, a qibla finder has developed to help them to determine the desired direction. This paper presents the development of a low-cost and easy-to-handle device to detect the Qibla direction for Salat, especially the visually impaired and deafened person. A magnetic sensor used as the main component to detect the correct angle of Qibla direction. Once detected, indicators (i.e. buzzer, vibrator and LEDs) will alert the user with continuous sound, vibration and lighting sequences.

Skeletal changes produced by cervical and parietal headgears: a cephalometric evaluation

Introduction Extraoral strength is the most common strategy to correct Angle Class II malocclusion, restricting and redirecting the maxillary growth. Objective To evaluate the skeletal changes resulting from the use of headgear, with cervical and parietal anchorages, associated with a full fixed orthodontic appliance, in growing patients with Class II malocclusion (Angle) treated in the clinic of an orthodontic training center. Material and method The ages at the beginning and end of the treatment, anchorage type, and the values of some cephalometric variables were obtained from the clinical files. After applying the inclusion and exclusion criteria, 56 patient files were selected. Then, the sample was divided into two groups, according to the anchorage type: cervical (n=30) and parietal (n=26). The differences between the initial (T1) and final (T2) values of cephalometric measurements SNA, SNB, ANB, AO-BO, GoGn.SN and LHF (percentage of lower facial height to total facial height) were evaluated in both groups. Result Significant differences between T1 and T2 were found relative to SNB and ANB variables in both groups. The AO-BO variable presented a statistically significant difference only in the cervical group. The remaining variables did not show significant differences between T1 and T2. Conclusion The skeletal changes resulting from the use of cervical or parietal anchorage were very similar. There was a decrease in the sagittal discrepancy between the maxillary bones due to forward displacement of the mandible, without significant vertical changes.

Assessment of SARS-CoV-2 Nasopharyngeal Swab Technique Online: Blinded Expert Content Analysis of YouTube Videos (Preprint)

BACKGROUND Real-time polymerase chain reaction (RT-PCR) of nasopharyngeal swabs (NPS) is currently the most widely used method for testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, false negatives and the sensitivity of this mode of testing have been problematic for accurately estimating the prevalence of SARS-CoV-2 infection rates. OBJECTIVE The purpose of this study was to evaluate whether technical and, therefore, correctable errors were being made with regards to nasopharyngeal swab procedure. METHODS Online video database (Youtube) was queried for SARS-CoV-2 nasopharyngeal swab tests from January 1 to May 15, 2020. Videos were rated by three blinded rhinologists for accuracy of swab angle and depth. The overall score respectively for swab angle and swab depth for each NPS video was determined by the majority score with agreement among at least two out of three reviewers. Video data between YouTube videos with correct NPS technique and videos with incorrect NPS technique were compared. Categorical data were compared using chi-square test for independence and nominal or continuous data were compared using Mann-Whitney U test with statistical significance set at P=0.05. RESULTS 126 videos met inclusion and exclusion criteria. 52% (N=66) of total NPS videos were determined to have correct angle while 46% (N=58) showed appropriate depth. 44% (N=57) of videos had both correct NPS angle and appropriate depth while 48% (N=60) of videos had both incorrect NPS angle and inappropriate depth. Videos with correct NPS technique were associated with the swab operator identifying as a medical professional (96% vs 86%, 2 =4.4, P=0.04) and as an ENT-related medical professional (16% vs 0%, 2 =11.7, P<0.001 ). CONCLUSIONS Greater attention needs to be given towards educating frontline healthcare workers performing NPS, as this study shows that over half of videos documenting NPS show incorrect technique, which could elevate false negative rates.

Coronal Alignment Correction and Maintenance of Tibial Slope in Opening-Wedge Valgus High Tibial Osteotomy Using a 4-Reference Kirschner Wire Technique: A Cadaveric Study

Background: Opening-wedge valgus high tibial osteotomy (OWHTO) is a common surgical procedure used to treat symptomatic varus femorotibial malalignment in adults. Several intraoperative methods are available to determine the correct correction alignment, but achieving the desired alignment correction is difficult. Purpose/Hypothesis: The aim of this study was to assess a 4-reference K-wire technique that is relatively easy to apply and can reliably assess actual alignment correction during surgery after determination of the desired corrective angle. We hypothesized that this technique would accurately determine the coronal correction and properly maintain the tibial slope intraoperatively during OWHTO. Study Design: Descriptive laboratory study. Methods: This study was conducted using 12 fresh-frozen cadavers; 12 randomly chosen knees were corrected 5° and 12 knees were corrected 10° by use of 2 coronal and 2 sagittal K-wires. The first and second coronal K-wires were drilled at 4 cm and 1 to 2 cm below the medial joint line toward the tibiofibular joint, respectively. The angles of these 2 coronal K-wires were measured before and after the gap was opened via a modified goniometer. The difference in the angle formed by these 2 coronal K-wires from before to after opening of the gap was the alignment correction angle. In addition, 2 sagittal K-wires were drilled parallel to each other before the gap opening above and below the osteotomy site. Ensuring that these 2 sagittal K-wires remained parallel after the gap opening confirmed that the tibial slope had been maintained. The paired t test was used to compare the desired alignment corrections and the different angles measured between the pre- and postoperative radiographic alignments. Results: The mean ± SD differences in angles between the pre- and postoperative alignments of the 5° and 10° corrections were 5.04° ± 0.68° and 10.03° ± 0.68°, respectively, indicating no statistically significant differences between pre- and postoperative alignment in both groups. As well, no significant difference was noted between the pre- and postoperative medial tibial slope ( P = .54). Conclusion: The coronal alignment correction and maintenance of the tibial slope using the 4-reference K-wire technique was found to be highly accurate and reliable. Clinical Relevance: Achieving the correct angle in OWHTO is difficult, and the 4-reference K-wire technique provides an easier and more reliable way to obtain the correct angle. This technique can be used in most hospital settings, with no need for expensive equipment.

Integrated defect sensor for the inspection of fiber-reinforced plastics using air-coupled ultrasound

Air-coupled ultrasound (ACU) is a non-destructive testing (NDT) method with a rising significance in industrial use. Common cases where ACU is used are the testing of fiber-reinforced plastic or testing of weld joints between metal sheets. The advantage compared to contact ultrasound is the absence of a liquid, solid or gel-like couplant. The usage of a couplant is an obstacle for developers of automatic scanning systems for ultrasonic testing because it takes a huge effort to integrate a system that delivers a continuous flow of the couplant. In addition a further step of cleaning is often necessary. ACU needs specially adapted probes to compensate for the tremendous impedance difference between a solid and air. A standard method uses two ACU probes in a normal transmission mode. With slanted probes, it is possible to generate Lamb waves in plate-like materials. Because of the contact to the surrounding air, Lamb waves transmit ultrasound to the air on both sides of the plate continually. These so-called leaky Lamb waves can be used with only one accessible side, and by using a specific resonance angle, a higher signal-to-noise ratio (SNR) is achievable. In the past, the correct angle was determined using an iterative method, where the angle of incidence was changed manually while observing the amplitude level. With the stepper-motor-driven angle scanning system, introduced here, the determination of the resonance angle is possible automatically. The system allows changes of the incidence angle during the ultrasound scan too. This makes it possible to adapt the system to wall thickness changes and changes of the radii of the parts contour.

Spark ignition engine modeling for in-cylinder pressure and temperature prediction using simulink

Mathematical model for four-stroke gasoline engines based on a cylinder-by-cylinder engine modeling method that incorporates physical formulas such as engine geometry and empirical formulas such as combustion duration are applied in this study. In-cylinder pressure and temperature can be calculated for gasoline four-cycle engine. Modeling is done by treating each step in the cylinder as a volume control, solving the conservation equations of energy with submodules for combustion, heat transfer and dynamic analysis. Calculations in cycles are performed at each crank angle, so that the correct angle of ignition, variations in velocity, amount of intake mass and fuel burning speed can be predicted. Adjustment for the combustion parameter such as burn duration and form factor of the Wiebe function to increase the model accuracy was performed. It is shown that the optimization of the Wiebe function parameters able to improve the sum squared error of the engine pressure estimation by 58.17% compared to the result from generalized parameter functions, and the parameter of form factor and burn duration are influential by around twice of (1.86 and 2.55 times, respectively) the efficiency factor.

A ESCRITA DE CABEÇA PARA BAIXO: um estudo sobre a prática docente

THE HEAD DOWN WRITING: a study on the teaching practiceESCRITURA DE LA CABEZA ABAJO: un estudio sobre la práctica docenteEsse artigo refere-se à experiência vivenciada numa sala de aula multisseriada, de uma escola pública localizada na zona rural de um município do interior da Bahia, com um aluno que apresentava dificuldades de leitura e de escrita (escrevia de cabeça para baixo), durante o ano letivo de 2006. Foram utilizadas como instrumentos a observação e a entrevista. Através dos resultados, observou-se que foi preciso uma mudança na prática pedagógica da professora, envolvendo o aluno nas atividades desenvolvidas na sala de aula de forma que este pudesse interagir com os colegas. Durante a intervenção este aluno passou a escrever no ângulo correto do caderno, mas ainda não lia o que escrevia.Palavras-chave: Escrita; Problema de Aprendizagem; Formação Docente.ABSTRACTThis article refers to an experience lived in a multilevel classroom, a public school located in a rural town in the interior of Bahia, with a student who had difficulties in reading and writing (writing upside down ) During the 2006 school year. The instruments used were observation and interview. From these results, we found that it took a change in the teacher's practice, involving students in activities in the classroom so that it could interact with colleagues. During the intervention these students went on to write the book at the correct angle, but still did not read what she wrote.Keywords: Writing; Learning Problem; Formation Educational.RESUMENEse artículo se refiere a un experiencia vivenciada en un salón de clases de niveles múltiples, una escuela pública situada en un pueblo rural en el interior de Bahía, con un estudiante que había dificultades en la lectura y la escritura (escritura al revés) durante el año escolar 2006. Los instrumentos fueron utilizados como la observación y la entrevista. De estos resultados, encontramos que tuvo un cambio en la práctica del docente, participación de los estudiantes en las actividades en el aula para que pueda interactuar con sus colegas. Durante la intervención estos estudiantes se dedicaron a escribir el libro en el ángulo correcto, pero todavía no he leído lo que escribió.Palabras clave: Escritura; Problema de Aprendizaje; Formación Docente.