Power tool use in orthopaedic surgery: iatrogenic injury, its detection and technological advances

Background: Power tools are an integral part to orthopaedic surgery but have the capacity to cause iatrogenic injury. This systematic review aimed to investigate the prevalence of iatrogenic injury due to power tools in orthopaedic surgery and discuss the current methods 9that can be used to reduce this. Methods: A systematic review of all English language articles using a keyword search was undertaken in Medline, Embase, PubMed and Scopus databases. Exclusion criteria included injuries related to cast saw, temperature induced damage and complications not clearly related to power tool use. Results: 3694 abstracts were retrieved, and 88studies were included in the final analysis. Only a few studies and individual case reports directly looked at prevalence of injury due to power tools. This included 2 studies looking at frequency of vascular injury during femoral fracture fixation (0.49% and 0.2%),2 studies investigating frequency of vertebral artery injury during spinal surgery (0.5% and 0.08%)and 3 studies investigating vascular injury during total joint arthroplasty (124 vascular injuries involving 138 blood vessels,0.13% and 0.1% incidence)in addition to 1 questionnaire sent electronically to surgeons. There are multiple methods to prevent damage during the use of power tools. These include robotics, Revised Manuscript (Maximum 3000 Words) simulation, specific drill settings and real-time feedback techniques such as spectroscopy and electromyography. Conclusion: Power tools have the potential to cause iatrogenic injury to surrounding structures during orthopaedic surgery. Fortunately, the published literature suggests the frequency of iatrogenic injury using orthopaedic power tools is low. There are multiple technologies available to reduce damage using power tools. In high-risk operations the use of advanced technologies to reduce the chance of iatrogenic injury should be considered. Clinical Relevance: Power tools used during orthopaedic surgery have the potential to cause iatrogenic injury through mechanisms such as plunging or over-sawing. Understanding the prevalence of these injuries and mechanisms to increase safety would be useful to surgeons in their daily practice and have the potential to reduce iatrogenic injury in future

The design and in vivo testing of a locally stiffness-matched porous scaffold

An increasing volume of work supports utilising the mechanobiology of bone for bone ingrowth into a porous scaffold. However, typically during in vivo testing of implants, the mechanical properties of the bone being replaced are not quantified. Consequently there remains inconsistencies in the literature regarding ‘optimum’ pore size and porosity for bone ingrowth. It is also difficult to compare ingrowth results between studies and to translate in vivo animal testing to human subjects without understanding the mechanical environment. This study presents a clinically applicable approach to determining local bone mechanical properties and design of a scaffold with similar properties. The performance of the scaffold was investigated in vivo in an ovine model. The density, modulus and strength of trabecular bone from the medial femoral condyle from ovine bones was characterised and power-law relationships were established. A porous titanium scaffold, intended to maintain bone mechanical homeostasis, was additively manufactured and implanted into the medial femoral condyle of 6 ewes. The stiffness of the scaffold varied throughout the heterogeneous structure and matched the stiffness variation of bone at the surgical site. Bone ingrowth into the scaffold was 10.73 ± 2.97% after 6 weeks. Fine woven bone, in the interior of the scaffold, and intense formations of more developed woven bone overlaid with lamellar bone at the implant periphery were observed. The workflow presented will allow future in vivo testing to test specific bone strains on bone ingrowth in response to a scaffold and allow for better translation from in vivo testing to commercial implants

Prevalence and number of Salmonella in retail pork sausages

The aim of this study was to assess the prevalence of Salmonella in Irish pork sausage at retail level. Samples, comprising branded prepacked sausages, loose sausages from supermarket meat counters and butcher shops, were collected from selected retail sites in four cities from October to December 2001 and from June to August 2002. A 3-tube Most Probable Number (MPN) method was used to enumerate Salmonella in a selected number of samples, which were positive by enrichment. Salmonella serotypes were detected in 4.4% and 1.7% of samples at each of the respective sampling periods; a level similar to those reported in other U.S. and U.K. studies. Limited results available on enumeration suggest that contamination rates were low. This study revealed that Salmonella are present in a proportion of Irish sausages and further risk analysis work is necessary in order to quantify the risk posed to public health. Keywords: control programme, enumeration, serology, bacteriology, food safety

Transition from a maternal to external nitrogen source in maize seedlings

Maximizing NO3− uptake during seedling development is important as it has a major influence on plant growth and yield. However, little is known about the processes leading to, and involved in, the initiation of root NO3− uptake capacity in developing seedlings. This study examines the physiological processes involved in root NO3− uptake and metabolism, to gain an understanding of how the NO3− uptake system responds to meet demand as maize seedlings transition from seed N use to external N capture. The concentrations of seed‐derived free amino acids within root and shoot tissues are initially high, but decrease rapidly until stabilizing eight days after imbibition (DAI). Similarly, shoot N% decreases, but does not stabilize until 12–13 DAI. Following the decrease in free amino acid concentrations, root NO3− uptake capacity increases until shoot N% stabilizes. The increase in root NO3− uptake capacity corresponds with a rapid rise in transcript levels of putative NO3− transporters, ZmNRT2.1 and ZmNRT2.2 . The processes underlying the increase in root NO3− uptake capacity to meet N demand provide an insight into the processes controlling N uptake

Growth and thermal properties of Sr W O 4 single crystal

A strontium tungstate SrWO4 single crystal with dimensions of 25 40 mm2 has been grown by the Czochralski method using an iridium crucible. X-ray powder diffraction results show that as grown the SrWO4 crystal belongs to the tetragonal system in the scheelite structure. The effective segregation coefficients of elemental W and Sr in the crystal growth are measured by x-ray fluorescence, and the respective values are close to 1. The thermal properties of the SrWO4 crystal were systemically studied by measuring the thermal expansion, specific heat, and thermal diffusion coefficient. These results show that the crystal possesses a large anisotropic thermal expansion with thermal-expansion coefficients a=8.61 10−6/K, b=8.74 10−6/K, c=18.78 10−6 /K over the temperature range of 303.15–773.15 K. The measured value of the specific heat is 0.30–0.34 J g−1 K−1 when the temperature is increased from 323.15 to 1073.15 K. The thermal diffusion coefficient was measured over the temperature range of 303.15–543.15 K. The thermal conductivities of the SrWO4 crystal along the 100 and 001 directions are calculated to be 3.1326 W m−1 K−1 and 2.9477 W m−1 K−1, respectively, at 303.15 K. Then the thermal properties of some other Raman crystals were compared with these data, and the thermal focal lengths for these crystals were also estimated

An archival case study : revisiting the life and political economy of Lauchlin Currie

This paper forms part of a wider project to show the significance of archival material on distinguished economists, in this case Lauchlin Currie (1902-93), who studied and taught at Harvard before entering government service at the US Treasury and Federal Reserve Board as the intellectual leader of Roosevelt's New Deal, 1934-39, as FDR's White House economic adviser in peace and war, 1939-45, and as a post-war development economist. It discusses the uses made of the written and oral material available when the author was writing his intellectual biography of Currie (Duke University Press 1990) while Currie was still alive, and the significance of the material that has come to light after Currie's death

Climate vulnerability assessment for Pacific salmon and steelhead in the California Current Large Marine Ecosystem.

Major ecological realignments are already occurring in response to climate change. To be successful, conservation strategies now need to account for geographical patterns in traits sensitive to climate change, as well as climate threats to species-level diversity. As part of an effort to provide such information, we conducted a climate vulnerability assessment that included all anadromous Pacific salmon and steelhead (Oncorhynchus spp.) population units listed under the U.S. Endangered Species Act. Using an expert-based scoring system, we ranked 20 attributes for the 28 listed units and 5 additional units. Attributes captured biological sensitivity, or the strength of linkages between each listing unit and the present climate; climate exposure, or the magnitude of projected change in local environmental conditions; and adaptive capacity, or the ability to modify phenotypes to cope with new climatic conditions. Each listing unit was then assigned one of four vulnerability categories. Units ranked most vulnerable overall were Chinook (O. tshawytscha) in the California Central Valley, coho (O. kisutch) in California and southern Oregon, sockeye (O. nerka) in the Snake River Basin, and spring-run Chinook in the interior Columbia and Willamette River Basins. We identified units with similar vulnerability profiles using a hierarchical cluster analysis. Life history characteristics, especially freshwater and estuary residence times, interplayed with gradations in exposure from south to north and from coastal to interior regions to generate landscape-level patterns within each species. Nearly all listing units faced high exposures to projected increases in stream temperature, sea surface temperature, and ocean acidification, but other aspects of exposure peaked in particular regions. Anthropogenic factors, especially migration barriers, habitat degradation, and hatchery influence, have reduced the adaptive capacity of most steelhead and salmon populations. Enhancing adaptive capacity is essential to mitigate for the increasing threat of climate change. Collectively, these results provide a framework to support recovery planning that considers climate impacts on the majority of West Coast anadromous salmonids

Global Governance Behind Closed Doors : The IMF Boardroom, the Enhanced Structural Adjustment Facility, and the Intersection of Material Power and Norm Change in Global Politics

Up on the 12th floor of its 19th Street Headquarters, the IMF Board sits in active session for an average of 7 hours per week. Although key matters of policy are decided on in the venue, the rules governing Boardroom interactions remain opaque, resting on an uneasy combination of consensual decision-making and weighted voting. Through a detailed analysis of IMF Board discussions surrounding the Enhanced Structural Adjustment Facility (ESAF), this article sheds light on the mechanics of power in this often overlooked venue of global economic governance. By exploring the key issues of default liability and loan conditionality, I demonstrate that whilst the Boardroom is a more active site of contestation than has hitherto been recognized, material power is a prime determinant of both Executive Directors’ preferences and outcomes reached from discussions. And as the decisions reached form the backbone of the ‘instruction sheet’ used by Fund staff to guide their everyday operational decisions, these outcomes—and the processes through which they were reached—were factors of primary importance in stabilizing the operational norms at the heart of a controversial phase in the contemporary history of IMF concessional lending

Thermal and mechanical properties of BaWO4 crystal

A large single crystal of barium tungstate BaWO4 with dimensions of 22- mm diameter 80-mm length was grown by the Czochralski method using an iridium crucible. The melting point, molar enthalpy of fusion, and molar entropy of fusion of the crystal were determined to be 1775.10 K, 96 913.80 J mol−1, and 54.60 J K−1 mol−1, respectively. The average linear thermal-expansion coefficients are a=10.9526 10−6/K, b=10.8069 10−6 /K, and c =35.1063 10−6 /K in the temperature range from 303.15 to 1423.15 K along the three respective crystallographic axes. The density of the crystal follows an almost linear decrease from 6.393 103 to 6.000 103 kg m−3 when the temperature is increased from 303.15 to 1423.15 K. The measured specific heat are 115.56–130.96 J K−1 mol−1 in the temperature range of 323.15–1173.15 K. The thermal diffusion coefficient of the crystal was measured in the temperature range of 297.15–563.15 K. The calculated thermal conductivity is 2.256 W m−1 K−1 along the 001 direction and 2.324 W m−1 K−1 along the 100 direction at 323.15 K. The microhardness of the BaWO4 single crystal in the 001 and 100 planes is 1393 and 1814 MPa under a load of 0.050 kg

A Rapid Population Assessment Method for Wild Pigs Using Baited Cameras at 3 Study Site

Reliable and efficient population estimates are a critical need for effective management of invasive wild pigs (Sus scrofa). We evaluated the use of 10‐day camera grids for rapid population assessment (RPA) of wild pigs at 3 study sites that varied in vegetation communities and wild pig densities. Study areas included Buck Island Ranch, Florida; Tejon Ranch, California; and the Savannah River Site, South Carolina, USA, during 2016–2018. Rapid population assessments grids were composed of baited camera traps spaced approximately 500 or 750 m apart. Two RPA grids were deployed per study site and each grid was deployed twice (4–6 months apart) to assess changes in response to season or population control efforts. We assessed the ability of RPA grids to track population trends, how camera number influenced estimate precision, and how relative abundance indices related to density estimates. We detected changes in occupancy probability, detection probability, and N‐mixture estimates following removal operations and between seasons, but the ability of RPA grids to track population trends was dependent on the statistical method used and number of cameras traps. Increasing the number of cameras traps used in RPA grids increased precision, and these results can be used in determining survey design and estimate choice. We found that estimates of occupancy probability, detection probability, and N‐mixture estimates were positively correlated with spatially explicit capture-recapture density estimates. Thus, these less labor‐intensive estimates from RPA grids showed potential to index the relative abundance of wild pigs in some systems. Our evaluation of RPAs indicates that using study‐specific combinations of statistical method and number of cameras can provide a useful tool for monitoring wild pig presence, tracking population trends, and evaluating the effectiveness of management actions