A unique quadrifurcation of the sciatic nerve in the lower leg

Sciatic nerve is the largest nerve of the body supplying the entire posterior aspect of the lower limb. Taking its origin from the lumbosacral plexus, the nerve divides into its terminal branches at the superior angle of the popliteal fossa. Variant division patterns of the nerve especially those occurring in the thigh and the popliteal fossa are common. Divisions of the nerve occurring in the leg are rare. Even much rarer are terminations involving multiple branching patterns. Variations in the course and distribution of the sciatic nerve are of great importance in neurology, orthopedics, rehabilitation, anesthesia and many other clinical procedures. In the present study, we report a unique quadrifurcation termination of the sciatic nerve occurring deep in the distal half of the leg as observed during routine dissection by the medical students. Due to its variant muscular innervations, quadrifurcation and low divisions of the sciatic nerve may be of great importance in procedures such fracture management of the leg and foot, physiotherapy, limb amputation and in sports medicine. Embryologically, late separation of the common nerve sheath into individual terminal branches may lead to the lower division of the nerve.KEY WORDS: Sciatic nerve, quadrifurcation, lower division, fractur

Gap junctions and connexin hemichannels in the regulation of haemostasis and thrombosis

Platelets are involved in the maintenance of haemostasis but their inappropriate activation leads to thrombosis, a principal trigger for heart attack and ischemic stroke. Although platelets circulate in isolation, upon activation they accumulate or aggregate together to form a thrombus, where they function in a coordinated manner to prevent loss of blood and control wound repair. Recent reports indicate that the stability and functions of a thrombus are maintained through sustained, contact dependent signalling between platelets. Given the role of gap junctions in the coordination of tissue responses, it was hypothesized that gap junctions may be present within a thrombus and mediate intercellular communication between platelets. Therefore studies were performed to explore the presence and functions of connexins in platelets. In this brief review, the roles of hemichannels and gap junctions in the control of thrombosis and haemostasis and the future directions for this research will be discussed

Development of weight and cost estimates for lifting surfaces with active controls

Equations and methodology were developed for estimating the weight and cost incrementals due to active controls added to the wing and horizontal tail of a subsonic transport airplane. The methods are sufficiently generalized to be suitable for preliminary design. Supporting methodology and input specifications for the weight and cost equations are provided. The weight and cost equations are structured to be flexible in terms of the active control technology (ACT) flight control system specification. In order to present a self-contained package, methodology is also presented for generating ACT flight control system characteristics for the weight and cost equations. Use of the methodology is illustrated

A simplified approach for the seismic loss assessment of rc buildings at urban scale: The case study of Potenza (Italy)

Comprehensive methodologies based on a fully probabilistic approach (i.e., the performance- based earthquake engineering approach, PBEE), represent a refined and accurate tool for the seismic performance assessment of structures. However, those procedures are suitable for building-specific evaluations, appearing extremely time-consuming if applied at the urban scale. In the proposed contribution, simplified loss assessment procedure will be applied at the urban scale with reference to the residential building stock of the center of Potenza. After the identification of the main reinforced concrete (RC) structural typologies and the definition of specific archetype building numerical models, the direct estimation of expected annual loss (DEAL) methodology will be applied to derive the EAL (i.e., expected annual loss) of RC buildings, deriving information on the effectively seismic quality (or seismic resilience) of the aforementioned built heritage at urban scale. Similarly, the monetary losses associated with downtime are evaluated. Preliminary considerations on the socio-economic effects of seismic scenarios on the territorial scale are also proposed

Impact of Level of Effort on the Effects of Compliance with the 3-Hour Rule

Objective To determine if patients’ level of effort (LOE) in therapy sessions during traumatic brain injury (TBI) rehabilitation modifies the effect of compliance with the 3-Hour Rule of the Centers for Medicare & Medicaid Services. Design Propensity score methodology applied to the TBI-Practice-Based Evidence (TBI-PBE) database, consisting of multi-site, prospective, longitudinal observational data. Setting Acute inpatient rehabilitation facilities (IRF). Participants Patients (n=1820) who received their first IRF admission for TBI in the US and were enrolled for 3 and 9 month follow-up. Main Outcome Measures Participation Assessment with Recombined Tools-Objective-17, FIMTM Motor and Cognitive scores, Satisfaction with Life Scale, and Patient Health Questionnaire-9. Results When the full cohort was examined, no strong main effect of compliance with the 3-Hour Rule was identified and LOE did not modify the effect of compliance with the 3-Hour Rule. In contrast, LOE had a strong positive main effect on all outcomes, except depression. When the sample was stratified by level of disability, LOE modified the effect of compliance, particularly on the outcomes of participants with less severe disability. For these patients, providing 3 hours of therapy for 50%+ of therapy days in the context of low effort resulted in poorer performance on select outcome measures at discharge and up to 9 months post discharge compared to patients with <50% of 3-hr therapy days. Conclusions LOE is an active ingredient in inpatient TBI rehabilitation, while compliance with the 3-Hour Rule was not found to have a substantive impact on the outcomes. The results support matching time in therapy during acute TBI rehabilitation to patients’ LOE in order to optimize long-term benefits on outcomes

Design definition study of a NASA/Navy lift/cruise fan technology V/STOL airplane: Risk assessment addendum to the final report

An assessment of risk, in terms of delivery delays, cost overrun, and performance achievement, associated with the V/STOL technology airplane is presented. The risk is discussed in terms of weight, structure, aerodynamics, propulsion, mechanical drive, and flight controls. The analysis ensures that risks associated with the design and development of the airplane will be eliminated in the course of the program and a useful technology airplane that meets the predicted cost, schedule, and performance can be produced

Reproductive Biology of Pterygoplichthys Pardalis in the Air Hitam River Payung Sekaki District, Riau Province

Pterygoplichtys pardalis has known as sapu-sapu fish. It is commonly present in the Air Hitam River. To understand the reproductive biology of this fish, a research has been conducted on February to May and November 2015. Fish samples were obtained from the Air Hitam River. Parameters investigated were fish morphology, sex ratio, maturity level, fecundity and the relationship between fecundity, length and weight. Samplings were done at three stations, in the in the upstream (Station I), middle (Station II), and downstream (Station III) of the river. Totally 169 fishes (75 males and 94 females) were captured. Sex ratio between male and female was 1:1.2. The Gonado Somatic Index (GSI) of male was 0.0022% -2.6% and that of the female was 0.03-3.4%. Egg diameter was 1.5 -3.2 mm. The fecundity is around 5,351-48,980 eggs/fish. The relationship between fecundity and standart length was y= 2.056x -0.548, fecundity and body weight was y= 0.863x +2.290. The water quality parameters are as follows: temperature 27-28.5°C, turbidity 15-22 NTU, the depth of the water 0.75-0.80 m, the width of the river 8.06 m, current speed 0.15-0.44 m/s, pH 6-9, DO 2.5-3 mg/L. Data on water quality parameters indicate that water quality in the Air Hitam River is able to support the life of the fish and the fish may reproduce well

Game On? Smoking Cessation Through the Gamification of mHealth: A Longitudinal Qualitative Study

BACKGROUND: Finding ways to increase and sustain engagement with mHealth interventions has become a challenge during application development. While gamification shows promise and has proven effective in many fields, critical questions remain concerning how to use gamification to modify health behavior. OBJECTIVE: The objective of this study is to investigate how the gamification of mHealth interventions leads to a change in health behavior, specifically with respect to smoking cessation. METHODS: We conducted a qualitative longitudinal study using a sample of 16 smokers divided into 2 cohorts (one used a gamified intervention and the other used a nongamified intervention). Each participant underwent 4 semistructured interviews over a period of 5 weeks. Semistructured interviews were also conducted with 4 experts in gamification, mHealth, and smoking cessation. Interviews were transcribed verbatim and thematic analysis undertaken. RESULTS: Results indicated perceived behavioral control and intrinsic motivation acted as positive drivers to game engagement and consequently positive health behavior. Importantly, external social influences exerted a negative effect. We identified 3 critical factors, whose presence was necessary for game engagement: purpose (explicit purpose known by the user), user alignment (congruency of game and user objectives), and functional utility (a well-designed game). We summarize these findings in a framework to guide the future development of gamified mHealth interventions. CONCLUSIONS: Gamification holds the potential for a low-cost, highly effective mHealth solution that may replace or supplement the behavioral support component found in current smoking cessation programs. The framework reported here has been built on evidence specific to smoking cessation, however it can be adapted to health interventions in other disease categories. Future research is required to evaluate the generalizability and effectiveness of the framework, directly against current behavioral support therapy interventions in smoking cessation and beyond

Position of the mandibular foramen in adult male Tanzania mandibles

Failure of the inferior alveolar nerve block anesthesia is common in various dental operations. Anatomical variations of the location of the inferior alveolar nerve as it enters the mandibular foramen have been implicated as a main cause of these anesthesia failures. The aim of this work was to determine the location of the mandibular foramen in relation to the occlusal plane at the level of mandibular first molar and second premolar - often used as landmarks during the blocking procedure - and to different landmarks on the ramus of the mandible. The study was performed using mandibles from adult black male Tanzanians aged 30-45 years. Measurements were accomplished using two-digit electronic Vernier calipers. The distances were determined from the center of the mandibular foramen to the different reference points. The mandibular foramen was above the occlusal plane at the M1 and PM2 reference points in all the mandibles studied. It was also located about 20 mm and 12 mm from the anterior and posterior borders of the ramus respectively. There was no significant difference between the left and right side in any of the measurements. These results indicate that during anesthetic or other clinical procedures, the clinician can precisely determine the position of neurovascular bundle of the inferior alveolar nerve above the occlusal plane

Interannual analysis of high spatially-resolved δ18O and δ2H data in precipitation across North-East Italy

Stable water isotopes are widely-used tracers to investigate hydrological processes occurring in the atmosphere and to determine the geospatial origin of water, i.e. to acquire useful information about the hydrological cycles over catchment basins and to find the origin of water recharging rivers, aquifers, and springs. Mapping the isotopic composition of precipitation provides hydrological and climate information at regional and global scales. However, the isotopic composition of precipitation is usually analyzed at large scales with a limited spatial resolution. In Italy, a few studies mapped the oxygen stable isotopes using annually-averaged data, not accounting for the strong seasonality of the isotopic composition linked to climatic and weather factors. To partially fill this gap, the present study proposes a detailed analysis of more than 2250 isotope data (δ18O, δ2H, and deuterium excess) related to precipitations collected in the Friuli Venezia Giulia (FVG) region (Italy) with monthly or seasonal frequency in 36 sites between 1984 and 2015. The FVG region lies at the north-eastern end of Italy, bordering Austria in the North and Slovenia in the East, and extends over ~7.9·103 km2. From a hydrogeological point of view, FVG is an interesting case study. Large highly-permeable carbonate aquifers are present in the Alps and Prealps, while the southern part of the region is characterized by an alluvial plain, split by the spring belt into two sectors: the High Plain in the North, characterized by an highly-permeable unconfined aquifer, and the Low Plain in the South, characterized by a system of confined and artesian aquifers. All the aquifers are recharged by the effective precipitations which in the FVG exhibits among the highest annual precipitation rates in Italy (with peaks &gt;3000 mm/year). For the present research, the isotopic data were used: (i) to analyze the spatial and seasonal variability of isotopic composition; (ii) to relate water isotopes with orography and weather parameters collected from meteorological stations as well as using ECMWF ERA5 reanalysis; (iii) to reconstruct the local meteoric water lines across the FVG at annual and seasonal bases; (iv) to quantify interannual trends and analyze their spatial distribution; and (iv) to model the spatial distribution of isotope content in precipitation and create annual and seasonal maps