Failure Analysis of PHILOS Plate Construct Used for Pantalar Arthrodesis Paper II-Screws and FEM Simulations

A fractured stainless steel 3.5 mm proximal humerus internal locking system (PHILOS) plate and screws were investigated in this paper. This plate was used for ankle arthrodesis of a 68-year-old female with a right ankle deformity. Both the plate and screws were considered in this investigation. Optical and scanning electron microscopes (SEM) were used to document fracture surface characteristics, such as extensive scratching, plastic deformation, rubbed surfaces, discoloration, and pitting, along with cleavage, secondary cracking, deposits of debris, striations, and dimples. Indications of these features show that the plate failed by corrosion fatigue, however, overloading separated the screw(s) in two parts. Radiographic evidence shows that the screws failed ahead of the plate from the proximal end. Three-dimensional models of the plate and the screws: cortical, locking, and cannulated, were constructed using Solidworks and imported in ANSYS Workbench 16.2 to simulate the loading conditions and regions of stress development. Statistical analysis was conducted to understand the impact of different factors on the maximum von Mises stresses of the locking compression plate. These factors were the load, screw design pattern, coefficient of friction between the plate and screws, and cortical screw displacement. In summary, the finite element simulation of the plate validates the fractographic examination results. The following observations were made: (a) as the angle between the screws and the plates increased, the von Mises stresses increased in the cortical screws; and (b) the stress in the locking screws was lower than that of the cortical screws, which may be due to locking the screws with fixed angles onto the plate. Finally, fractographic examination of the cortical and locking screws supports the mechanism of corrosion-fatigue fracture from crack initiation sites, pits, due to the presence of inclusion bodies for this material (ASTM standards F138-03 and F139-03) documented for the plate in Paper I

Analysis of a Clinically Failed, Mechanically Intact, Hemi-Toe Implant

In this case study a clinically failed, mechanically intact, hemi-toe device was investigated. The clinical indication of the failure constitutes radiolucent line indicating loosening of the implant and possible interactions among the bone-implant initiated by osteolysis may become a factor, producing pain, inflammatory reactions, deformity and discomfort. The patient file was not available to determine these parameters. The device was titanium coated, Cobalt Chromium alloy used for making hemi-toe. Degeneration of hemi implant was due to spalling of the coating from the surface, causing loosening of stem from bone. However, pre-removal X-ray films were not available to confirm. Mechanism by which the clinical failure occurred likely due to lack of bony adhesion or other clinical reasons. Surface topographical features were documented using optical microscope. A method to classify various area of the articulating surface was proposed in this study that shows the anterior contacts were more damaging than the other areas where deeper scratches, pits and some debris were present. There is a need to converge mechanical and clinical failures together for these types of medical devices

Analysis of a Clinically Failed, Mechanically Intact, Reconstructive Compression Plate

A reconstructive orthopedic bone plate was submitted for analysis. Traditional failure analysis methods were used to assess the mode of the plate failure. Metallographic investigation of the plate was carried out in this report. Since limited data was available in the literature and clinical data related to subject demography, date of removal as well as reasons for removal unknown, in depth analysis was not possible. However, the plate was received in in-tact condition with minor biological deposits and scratches, it is speculated that the failure of the plate may have been due to biological/clinical reasons, likely infection, rejecting the device due to lack of union at the fracture site

Biomechanical Behavior of a Variable Angle Locked Tibiotalocalcaneal Construct

This paper examines the mechanics of the tibiotalocalcaneal construct made with a PHILOS plating system. A failed device consisting of the LCP plate and cortical, locking, and cannulated screws was used to perform the analysis. Visual, microstructure, and fractographic examinations were carried out to characterize the fracture surface topology. These examinations revealed the presence of surface scratching, inclusions, discoloration, corrosion pits, beach marks, and cleavage and striations on the fracture surface. Further examination of the material crystallography and texture revealed an interaction of S, Ni, and Mo-based inclusions that may have raised pitting susceptibility of the device made with Stainless Steel 316L. These features suggest that the device underwent damage by pitting the corrosion-fatigue mechanism and overloading towards the end to fail the plate and screws in two or more components. The screws failed via conjoint bending and torsion fatigue mechanisms. Computer simulations of variable angle locking screws were performed in this paper. The material of construction of the device was governed by ASTM F138-8 or its ISO equivalent 5832 and exhibited inconsistencies in chemistry and hardness requirements. The failure conditions were matched in finite element modeling and those boundary conditions discussed in this paper

Dietary Patterns and Cognitive Function among Older Community-Dwelling Adults.

Diet may be an important modifiable risk factor for maintenance of cognitive health in later life. This study aimed at examining associations between common dietary indices and dietary patterns defined by factor analysis and cognitive function in older community-dwelling adults. Dietary information for 1499 participants from the Rancho Bernardo Study was collected in 1988⁻1992 and used to calculate the alternate Mediterranean diet score, Alternate Healthy Eating Index (AHEI)-2010 score and factor scores derived from factor analysis of nutrients. Global cognitive function, executive function, verbal fluency and episodic memory were assessed at approximate four-year intervals from 1988⁻2016. Linear mixed models were used to examine associations between dietary patterns and cognitive trajectories. Estimates for the highest vs. lowest tertile in models adjusting for age, sex, education, energy intake, lifestyle variables and retest effect showed greater adherence to the Mediterranean score was associated with better baseline global cognitive function (β (95% CI) = 0.33 (0.11, 0.55)). The AHEI-2010 score was not significantly associated with cognitive performance. Higher loading on a plant polyunsaturated fatty acid (PUFA)/vitamin E factor was associated with better baseline global cognitive function and executive function (β = 0.22 (0.02, 0.42) and β = -7.85 (-13.20, -2.47)). A sugar/low protein factor was associated with poorer baseline cognitive function across multiple domains. Dietary patterns were not associated with cognitive decline over time. Adherence to a healthy diet with foods high in PUFA and vitamin E and a low sugar to protein ratio, as typified by a Mediterranean diet, may be beneficial for cognitive health in late life

DESAIN PENGEMBANGAN MODEL PEMBELAJARAN PENDIDIKAN KEWARGANEGARAAN MELALUI ADDIE MODEL UNTUK MENINGKATKAN KARAKTER MAHASISWA DI UNIVERSITAS SLAMET RIYADI SURAKARTA

Citizenship Education in Higher Education is one of the compulsory subjects that make up the character of students. Long-term goals to be achieved in this study are as follows: find a design development Citizenship Through Education Learning Model to Improve Character ADDIE Students At University Slamet Riyadi Surakarta. The method used in this research is the research and development that is supported by the study of literature and literary documents and supported with Data Triangulation techniques appropriate to the problems discussed. Design development in this research using ADDIE (Analyze, Design, Develop, Implement, Evaluation). The results showed as follows: First Analysis is to analyze needs, identify problems (needs), and analysis tasks. Second, Design, this design phase, formulate learning objectives are SMART. Third, Development is the process of realizing blue-print. Fourth, Implementation is a concrete step to implement a learning system that we are creating. Fifth, Evaluation is the process to see if the system is being built successful learning, in line with initial expectations or not. Evaluation is the final step of the ADDIE model of instructional systems design. Based on the ADDIE model of instructional development was later adopted in the development stage learning model Project Citizen (PC) with a new name "MPC" (Modification of Project Citizen)

Delocalization of electrons in a Random Magnetic Field

Delocalization problem for a two-dimensional non-interacting electron system is studied under a random magnetic field. With the presence of a random magnetic field, the Hall conductance carried by each eigenstate can become nonzero and quantized in units of $e^2/h$. Extended states are characterized by nonzero Hall conductance, and by studying finite-size scaling of the density of extended states, an insulator-metal phase transition is revealed. The metallic phase is found at the center of energy band which is separated from the localized states at the band tails by critical energies $\pm E_c$. Both localization exponent and the critical energy $E_c$ are shown to be dependent on the strength of random magnetic field.Comment: 9 pages, Revtex, 3 figures available upon reques

Reduction and Emergence in Bose-Einstein Condensates

A closer look at some proposed Gedanken-experiments on BECs promises to shed light on several aspects of reduction and emergence in physics. These include the relations between classical descriptions and different quantum treatments of macroscopic systems, and the emergence of new properties and even new objects as a result of spontaneous symmetry breaking

Evolution of protoplanetary disks: Constraints from DM Tauri and GM Aurigae

We present a one-dimensional model of the formation and viscous evolution of protoplanetary disks. The formation of the early disk is modeled as the result of the gravitational collapse of an isothermal molecular cloud. The disk's viscous evolution is integrated according to two parameterizations of turbulence: The classical $\alpha$ representation and a $\beta$ parameterization, representative of non-linear turbulence driven by the keplerian shear. We apply the model to DM Tau and GM Aur, two classical T-Tauri stars with relatively well-characterized disks, retrieving the evolution of their surface density with time. We perform a systematic Monte-Carlo exploration of the parameter space (i.e. values of the $\alpha$-$\beta$ parameters, and of the temperature and rotation rate in the molecular cloud) to find the values that are compatible with the observed disk surface density distribution, star and disk mass, age and present accretion rate. We find that the observations for DM Tau require $0.001<\alpha<0.1$ or $2\times 10^{-5}<\beta<5\times 10^{-4}$. For GM Aur, we find that the turbulent viscosity is such that $4\times 10^{-4}<\alpha<0.01$ or $2\times 10^{-6}<\beta<8\times 10^{-5}$. These relatively large values show that an efficient turbulent diffusion mechanism is present at distances larger than $\sim 10$AU. This is to be compared to studies of the variations of accretion rates of T-Tauri stars versus age that mostly probe the inner disks, but also yield values of $\alpha\sim 0.01$. We show that the mechanism responsible for turbulent diffusion at large orbital distances most probably cannot be convection because of its suppression at low optical depths.Comment: 24 pages, 22 figures, paper accepted for publication in A&

Correlation of Pain Scores, Analgesic Use, and Beck Anxiety Inventory Scores During Hospitalization in Lower Extremity Amputees

Post amputation pain can be debilitating for patients and families. Chronic pain is a common phenomenon after lower extremity amputation, occurring in up to 80% of this population. The purpose of this pilot study was to correlate post amputation pain scores to opioid analgesic consumption and Beck Anxiety Inventory (BAI) scores. Twenty-three patients with lower extremity amputation at an 827-bed acute care inner-city hospital were surveyed pre-operatively and post-operatively to determine if there was a significant correlation between anxiety and pain. A numeric scale was utilized by patients to rate their pain level, while the BAI was utilized to measure their anxiety levels