Application of advanced computational procedures for modeling solar-wind interactions with Venus: Theory and computer code

Computational procedures are developed and applied to the prediction of solar wind interaction with nonmagnetic terrestrial planet atmospheres, with particular emphasis to Venus. The theoretical method is based on a single fluid, steady, dissipationless, magnetohydrodynamic continuum model, and is appropriate for the calculation of axisymmetric, supersonic, super-Alfvenic solar wind flow past terrestrial planets. The procedures, which consist of finite difference codes to determine the gasdynamic properties and a variety of special purpose codes to determine the frozen magnetic field, streamlines, contours, plots, etc. of the flow, are organized into one computational program. Theoretical results based upon these procedures are reported for a wide variety of solar wind conditions and ionopause obstacle shapes. Plasma and magnetic field comparisons in the ionosheath are also provided with actual spacecraft data obtained by the Pioneer Venus Orbiter

3D printed fracture reduction guides planned and printed at the point of care show high accuracy - a porcine feasibility study.

PURPOSE After surgical treatment of comminuted diaphyseal femoral and tibial fractures, relevant malalignment, especially rotational errors occur in up to 40-50%. This either results in a poor clinical outcome or requires revision surgery. This study aims to evaluate the accuracy of reduction if surgery is supported by 3D guides planned and printed at the point of care. METHODS Ten porcine legs underwent computed tomography (CT) and 3D models of femur and tibia were built. Reduction guides were virtually constructed and fitted to the proximal and distal metaphysis. The guides were 3D printed using medically approved resin. Femoral and tibial comminuted diaphyseal fractures were simulated and subsequently reduced using the 3D guides. Postoperative 3D bone models were reconstructed to compare the accuracy to the preoperative planning. RESULTS Femoral reduction showed a mean deviation ± SD from the plan of 1.0 mm ± 0.9 mm for length, 0.9° ± 0.7° for varus/valgus, 1.2° ± 0.9° for procurvatum/recurvatum and 2.0° ± 1.7° for rotation. Analysis of the tibial reduction revealed a mean deviation ± SD of 2.4 mm ± 1.6 mm for length, 1.0° ± 0.6° for varus/valgus, 1.3° ± 1.4° for procurvatum/recurvatum and 2.9° ± 2.2° for rotation. CONCLUSIONS This study shows high accuracy of reduction with 3D guides planned and printed at the point of care. Applied to a clinical setting, this technique has the potential to avoid malreduction and consecutive revision surgery in comminuted diaphyseal fractures. LEVEL OF EVIDENCE Basic Science

It's a Performance, Not an Orchestra! Rethinking Soft Coordination in Global Climate Governance

Global climate governance is in transition. As the focus shifts from negotiations to implementation, the quest for ways to effectively coordinate ambitious climate action has become a key concern. While existing studies frame this problem mostly in terms of institutional design (to "facilitate" state ambition) and strategic delegation of authority (to "orchestrate" nonstate action), this article builds on dramaturgical policy analysis to examine soft coordination in practice. Using ethnographic methods, we analyze public performances at the twenty-fifth Conference of the Parties (COP25) in Madrid. We find that these were shaped by preestablished governance scripts and social roles available to participants, but also by creative improvisations and interventions. The United Nations Framework Convention on Climate Change Secretariat and COP Presidency intervened to configure the physical setting of the conference, mold its narrative arch, and shape available roles. We conclude that performances and dramaturgical interventions are important tools of soft coordination in global climate governance. Their analysis constitutes a productive entry point for grasping contemporary transformations in global politics

Staged treatment of a comminuted femoral fracture with Masquelet technique and 3D printed reposition guides.

Background Comminuted femoral fractures pose a challenge to the trauma surgeon due to the absence of bony references during surgery. Therefore, malalignment of length and axis can occur and necessitate revision surgery. During the last decade, 3D-planning has evolved as a surgical aid in difficult cases. Case report An 18-year-old male patient suffered a polytrauma following a motorcycle accident. This report is about the treatment of a 3rd degree open and comminuted fracture of the left distal femur. The fracture was treated with Masquelet's two-staged technique. With the intent of avoiding malalignment, the second stage surgery was performed with the aid of 3D-planned reduction guides. Despite complex fracture pattern, complete fracture union was achieved with acceptable final alignment (side-to-side comparison of length, axis and femoral torsion). Conclusion In this case, performing Masquelet's two-staged surgery with the aid of 3D-printed reposition guides yielded favorable results in regards to rotational malalignment. The malrotation of the femur was reduced after the second operation to a clinically acceptable side-to-side difference (10°). This technique remains technically challenging due to soft tissue tension and limited possibility of soft tissue release

Indications, clinical outcome and survival of rotating hinge total knee arthroplasty in a retrospective study of 63 primary and revision cases.

PURPOSE The purpose of this study is to report and compare outcome data of both primary and revision cases using a rotating hinge knee (RHK) implant. METHODS This study retrospectively analyzed 63 cases (19 primary, 44 revisions) at a mean follow-up of 34 ± 8 months after RHK implantation. Outcome parameters were stability, range of motion (ROM), loosening, Hospital of Special Surgery Score (HSS), Knee Society Score (KSS), Oxford Knee Score (OKS), EQ-5D-3L, and Visual Analog Scale (VAS) for overall function. Revision rates and implant survival are reported. RESULTS Eleven percent showed medio-lateral instability < 5 mm, a mean ROM of 115° ± 17° and radiologic loosening occurred in 8% (2% symptomatic). PROMS showed the following results: HSS 79 ± 18, KSS 78 ± 27, OKS 26 ± 10, EQ-5D index 0.741 ± 0.233 and VAS 70 ± 20. Primary cases revealed better outcomes in HHS (p = .035) and OKS (p = 0.047). KSS, EQ-5D index and VAS did not differ between primary and revision cases (p = 0.070; p = 0.377; p = 0.117). Revision rate was 6.3% with an implant survival of 96.8%. CONCLUSIONS RHK arthroplasty can be performed with good clinical outcome and low revision rate in revision and complex primary cases. RHK is an option in cases where standard arthroplasty and even implants with a higher degree of constraint have reached their limits. LEVEL OF EVIDENCE Level III, retrospective cohort study

Collagen wrapping and local platelet-rich fibrin do not improve the survival rates of ACL repair with dynamic intraligamentary stabilization: a retrospective case series after ≥5 years postoperatively.

PURPOSE Anterior cruciate ligament (ACL) repair has been recommended as a treatment principle for ACL tears. Several authors have advocated a potential role for primary repair techniques in the ACL decision tree. However, long-term results have been controversial. This study aims to determine the survival of the primarily repaired ACL after dynamic intraligamentary stabilization (DIS) with and without augmentation. METHODS Between 2014 and 2019, 102 patients with isolated proximal ACL ruptures underwent DIS repair within 21 days from injury and were available for follow-up either clinically or telephonically after ≥5 years postoperatively. In 45 cases, DIS repair was augmented with collagen fleece wrapping, platelet-rich fibrin (PRF) or both. Failure was defined as traumatic re-rupture or conversion to ACL reconstruction. The patients being available for physical examination underwent a.-p. stability measurement with a KT-1000 device. Functional outcome was measured with the IKDC, Tegner and Lysholm scores. Kaplan-Meier survival analysis, Log-Rank Test and Binominal logistic regression were performed. RESULTS After a minimum 5-year follow-up, 71/102 (69.6%) DIS repairs were not re-reptured and clinically and/or subjectively stable. Augmentation did not improve survival rates (p = 0.812). The identified factors influencing failure were a younger age and a pre-injury Tegner activity level of ≥7. 95.7% of those patients with an intact ACL repair had normal or near normal knee function based on the IKDC scoring system. CONCLUSIONS The 5-year overall survival rate of DIS was 69.6%. Collagen fleece wrapping and local PRF application did not improve survival. Patients not suffering failure of repair demonstrated high satisfaction. Nevertheless, the results are inferior to those of established ACL reconstruction procedures. LEVEL OF EVIDENCE Case series, Level IV

Quantitative determination of the femoral offset templating error in total hip arthroplasty using a new geometric model.

AIMS Traditionally, total hip arthroplasty (THA) templating has been performed on anteroposterior (AP) pelvis radiographs. Recently, additional AP hip radiographs have been recommended for accurate measurement of the femoral offset (FO). To verify this claim, this study aimed to establish quantitative data of the measurement error of the FO in relation to leg position and X-ray source position using a newly developed geometric model and clinical data. METHODS We analyzed the FOs measured on AP hip and pelvis radiographs in a prospective consecutive series of 55 patients undergoing unilateral primary THA for hip osteoarthritis. To determine sample size, a power analysis was performed. Patients' position and X-ray beam setting followed a standardized protocol to achieve reproducible projections. All images were calibrated with the KingMark calibration system. In addition, a geometric model was created to evaluate both the effects of leg position (rotation and abduction/adduction) and the effects of X-ray source position on FO measurement. RESULTS The mean FOs measured on AP hip and pelvis radiographs were 38.0 mm (SD 6.4) and 36.6 mm (SD 6.3) (p < 0.001), respectively. Radiological view had a smaller effect on FO measurement than inaccurate leg positioning. The model showed a non-linear relationship between projected FO and femoral neck orientation; at 30° external neck rotation (with reference to the detector plane), a true FO of 40 mm was underestimated by up to 20% (7.8 mm). With a neutral to mild external neck rotation (≤ 15°), the underestimation was less than 7% (2.7 mm). The effect of abduction and adduction was negligible. CONCLUSION For routine THA templating, an AP pelvis radiograph remains the gold standard. Only patients with femoral neck malrotation > 15° on the AP pelvis view, e.g. due to external rotation contracture, should receive further imaging. Options include an additional AP hip view with elevation of the entire affected hip to align the femoral neck more parallel to the detector, or a CT scan in more severe cases.Cite this article: Bone Jt Open 2022;3(10):795-803

Treatment of Knee Dislocation With Primary Repair and Suture Augmentation: A Viable Solution.

BACKGROUND Different surgical techniques have been described for the treatment of knee dislocation (KD). Nonoperative approaches are frequently combined with surgical reconstruction using auto- or allograft. PURPOSE To evaluate the midterm results of primary surgical repair and suture augmentation to treat KD. STUDY DESIGN Case series; Level of evidence, 4. METHODS A total of 22 patients (5 women, 17 men; mean age, 45 ± 15 years) with KD were evaluated at a mean of 49 ± 16 months after surgical treatment that included primary repair and suture augmentation. Magnetic resonance imaging, stress radiographs, and outcome scores were obtained at the follow-up. Clinical examination including hop tests and force measurements for flexion and extension was performed. RESULTS The mean difference in pre- to postinjury Tegner scores was -2 ± 1. The outcome scores showed mean values of 84 ± 15 (Lysholm), 73 ± 15 (International Knee Documentation Committee) and 65 ± 25 (Anterior Cruciate Ligament-Return to Sport after Injury scale). Compared with the uninjured knee, the range of motion of the injured knee was reduced by 21° ± 12°. Twelve patients felt fit enough to perform hop tests and showed a mean deficit of 7% ± 17%° compared with the uninjured leg. The mean force deficit was 19% ± 18% for extension and 8% ± 16% for flexion. Stress radiographs revealed an 11 ± 7-mm higher anteroposterior translation on the injured side. Four patients had secondary ligament reconstructions due to persistent instability and 7 underwent arthroscopic arthrolysis due to stiffness. A significant increase of osteoarthritis was found for the medial, lateral, and patellofemoral compartments (P = .007, .004, and .006, respectively). CONCLUSION Primary repair and suture augmentation of KD led to satisfactory clinical midterm results despite persistent radiological instability and a significant increase in osteoarthritis. This technique allows the return to activities of daily living without subjective instability in most nonathletic patients. Secondary ligament reconstructions should be performed if relevant instability persists to decrease the risk of secondary meniscal and cartilage damage

The Vibration Virtual Environment for Test Optimization (VETO)

A new test simulation tool is being developed to support vibration test design and to evaluate the overall testability of a component or system. This environment, the Vibration Virtual Environment for Test Optimization (VETO), is utilized to optimally place vibration control and response transducers and to investigate the selection of test parameters needed in the design and performance of a vibration experiment. The engineer can investigate the effects of different control parameters prior to performing an actual vibration test. Additionally, new and existing fixture designs can be evaluated through the development of analytical or experimental models that can be integrated into the simulation environment. This test design environment also provides the engineer with the ability to combine analytically or experimentally derived models of the vibration test hardware, instrumentation and equipment into a simulation model that represents the vibration testing capability. Hardware-in-the-loop simulations can be conducted using this model to examine multiple facets of the test design. This paper presents a new tool that will assist test engineers in maximizing the value of vibration tests through the use of hardware-in-the-loop simulations

Modal test optimization using VETO (Virtual Environment for Test Optimization)

We present a software environment integrating analysis and test based models to support optimal modal test design through a Virtual Environment for Test Optimization (VETO). The VETO assists analysis and test engineers in maximizing the value of each modal test. It is particularly advantageous for structural dynamics model reconciliation applications. The VETO enables an engineer to interact with a finite element model of a test object to optimally place sensors and exciters and to investigate the selection of-data acquisition parameters needed to conduct a complete modal survey. Additionally, the user can evaluate the use of different types of instrumentation such as filters, amplifiers and transducers for which models are available in the VETO. The dynamic response of most of the virtual instruments (including the device under test) are modeled in the state space domain. Design of modal excitation levels and appropriate test instrumentation are facilitated by the VETO`s ability to simulate such features as unmeasured external inputs, A/D quantization effects, and electronic noise. Measures of the quality of the experimental design, including the Modal Assurance Criterion, and the Normal Mode indicator Function are available. The VETO also integrates tools such as Effective Independence and minamac to assist in selection of optimal sensor locations. The software is designed about three distinct modules: (1) a main controller and GUI written in C++, (2) a visualization model, taken from FEAVR, running under AVS, and (3) a state space model and time integration module, built in SIMULINK. These modules are designed to run as separate processes on interconnected machines. MATLAB`s external interface library is used to provide transparent, bidirectional communication between the controlling program and the computational engine where all the time integration is performed