ESL Based Cylindrical Shell Elements with Hierarchical Shape Functions for Laminated Composite Shells

We introduce higher-order cylindrical shell element based on ESL (equivalent single-layer) theory for the analysis of laminated composite shells. The proposed elements are formulated by the dimensional reduction technique from three-dimensional solid to two-dimensional cylindrical surface with plane stress assumption. It allows the first-order shear deformation and considers anisotropic materials due to fiber orientation. The element displacement approximation is established by the integrals of Legendre polynomials with hierarchical concept to ensure the C0-continuity at the interface between adjacent elements as well as C1-continuity at the interface between adjacent layers. For geometry mapping, cylindrical coordinate is adopted to implement the exact mapping of curved shell configuration with a constant curvature with respect to any direction in the plane. The verification and characteristics of the proposed element are investigated through the analyses of three cylindrical shell problems with different shapes, loadings, and boundary conditions

Correlation and comparison of Risser sign versus bone age determination (TW3) between children with and without scoliosis in Korean population

<p>Abstract</p> <p>Background</p> <p>Most studies comparing the Risser staging for skeletal maturity are representing the American or European standards which are not always applicable to Asian population who have relatively less height and body mass. There is no article available that compares the Risser sign and bone age correlation between patients with idiopathic scoliosis and patients without scoliosis.</p> <p>Materials and methods</p> <p>To analyze and compare the skeletal age with the Risser sign between scoliosis and non-scoliosis group, a cross-sectional study was done in 418 scoliosis (untreated, bracing or surgically) and 256 non-scoliosis children of Korean origin. Relationship was found in both groups using Pearson correlation test.</p> <p>Results</p> <p>In scoliosis group, Pearson correlation exhibited significant correlation (p < 0.01) between Risser sign and chronological age (r²= 0.791 for girls, 0.787 for boys) and Risser sign and TW3 age (r²= 0.718 for girls, 0.785 for boys). Non-scoliosis group also showed significant relationship (p < 0.01) between Risser sign and chronological age (r²= 0.893 for girls, 0.879 for boys) and Risser sign and TW3 age (r²= 0.913 for girls, 0.895 for boys). Similarly, comparing Cobb angles of each patient according to their Risser staging, exhibited that if scoliosis remains untreated Cobb angle will increase with the increase in their Risser staging (r²= 0.363 for girls, 0.443 for boys; p < 0.01).</p> <p>Conclusion</p> <p>Our results showed that chronological age is equally as reliable as skeletal age method to compare with Risser sign, and therefore, we do not mean to imply that only the Risser sign compared with skeletal age should be considered in the decision making in idiopathic as well as non-scoliosis patients of Korean ethnicity. Concomitant indicators such as menarchal period, secondary sex characteristics, and recent growth pattern will likely reinforce our data comparing Risser sign with skeletal age in decision making.</p

Intraoperative blood loss during different stages of scoliosis surgery: A prospective study

<p>Abstract</p> <p>Background</p> <p>There are a number of reasons for intraoperative blood loss during scoliosis surgery based on the type of approach, type of disease, osteopenia, and patient blood profile. However, no studies have investigated bleeding patterns according to the stage of the operation. The objective of this prospective study was to identify intraoperative bleeding patterns in different stages of scoliosis surgery.</p> <p>Methods</p> <p>We prospectively analyzed the estimated blood loss (EBL) and operation time over four stages of scoliosis surgery in 44 patients. The patients were divided into three groups: adolescent idiopathic (group 1), spastic neuromuscular (group 2) and paralytic neuromuscular (group 3). The per-level EBL and operation times of the groups were compared on a stage-by-stage basis. The bone marrow density (BMD) of each patient was also obtained, and the relationship between per-level EBL and BMD was compared using regression analysis.</p> <p>Results</p> <p>Per-level operation time was similar across all groups during surgical stage (p > 0.05). Per-level EBL was also similar during the dissection and bone-grafting states (p > 0.05). However, during the screw insertion stage, the per-level EBL was significantly higher in groups 2 and 3 compared to group 1 (p < 0.05). In the correction stage, per-level EBL was highest in group 3 (followed in order by groups 2 and 1) (p < 0.05). Preoperative BMD indicated that group 3 had the lowest bone quality, followed by groups 2 and 1 (in order), but the preoperative blood indices were similar in all groups. The differences in bleeding patterns in the screw insertion and correction stages were attributed to the poor bone quality of groups 2 and 3. Group 3 had the lowest bone quality, which caused loosening of the bone-screw interface during the correction stage and led to more bleeding. Patients with a T-score less than -2.5 showed a risk for high per-level EBL that was nine times higher than those with scores greater than -2.5 (p = 0.003).</p> <p>Conclusions</p> <p>We investigated the blood loss patterns during different stages of scoliosis surgery. Patients with poor BMD showed a risk of blood loss nine times higher than those with good BMD.</p

Intersite Coulomb Interactions in Charge Ordered Systems

Using {\it ab initio} approaches for extended Hubbard interactions coupled to phonons, we reveal that the intersite Coulomb interaction plays important roles in determining various distinctive phases of the paradigmatic charge ordered materials of Ba$_{1-x}$K$_x A$O$_3$ ($A=$ Bi and Sb). We demonstrated that all their salient doping dependent experiment features such as breathing instabilities, anomalous phonon dispersions, and transition between charge-density wave and superconducting states can be accounted very well if self-consistently obtained nearest neighbor Hubbard interaction are included, thus establishing a minimal criterion for reliable descriptions of spontaneous charge orders in solids.Comment: 4 pages, 2 additional pages for references and 4 pages supplementary materials, title and abstract are modifie

Unusual thermopower of inhomogeneous graphene grown by chemical vapor deposition

We report on thermopower (TEP) and resistance measurements of inhomogeneous graphene grown by chemical vapor deposition (CVD). Unlike the conventional resistance of pristine graphene, the gate-dependent TEP shows a large electron-hole asymmetry. This can be accounted for by inhomogeneity of the CVD-graphene where individual graphene regions contribute with different TEPs. At the high magnetic field and low temperature, the TEP has large fluctuations near the Dirac point associated with the disorder in the CVD-graphene. TEP measurements reveal additional characteristics of CVD-graphene, which are difficult to obtain from the measurement of resistance alone

Epidural cement leakage through pedicle violation after balloon kyphoplasty causing paraparesis in osteoporotic vertebral compression fractures - a report of two cases

Kyphoplasty is advantageous over vertebroplasty in terms of better kyphosis correction and diminished risk of cement extravasations. Literature described cement leakage causing neurological injury mainly after vertebroplasty procedure; only a few case reports show cement leakage with kyphoplasty without neurological injury or proper cause of leakage. We present a report two cases of osteoporotic vertebral compression fracture treated with kyphoplasty and developed cement leakage causing significant neurological injury. In both cases CT scan was the diagnostic tool to identify cause of cement leakage. CT scan exhibited violation of medial pedicle wall causing cement leakage in the spinal canal. Both patients displayed clinical improvement after decompression surgery with or without instrumentation. Retrospectively looking at stored fluoroscopic images, we found that improper position of trocar in AP and lateral view simultaneously while taking entry caused pedicle wall violation. We suggest not to cross medial pedicle wall in AP image throughout the entire procedure and keeping the trocar in the center of pedicle in lateral image would be the most important precaution to prevent such complication. Our case reports adds the neurological complications with kyphoplasty procedure and suggested that along with other precautions described in the literature, entry with trocar along the entire procedure keeping the oval shape of pedicle in mind (under C-arm) will probably help to prevent such complications