Presence Of Deformity Research Articles

Subjectivity of the academic community in the conditions of managerialist management

The article analyzes the negative effects of managerialist management on the subjectivity of the academic community. The aim of the research: to establish a correlation between the decrease in the subjectivity of the academic community and the managerialist model of higher school management. Two methods were used to collect empirical information: a mass survey of teachers at four universities in Rostov region and the analysis of normative-legal documents regulating the application of managerialist norms to the higher education system. The result of the operationalization of basic concepts (subjectivity, academic community, managerialist management) was the definition of three empirical indicators: 1)perceptions of the academic community about the traditional goals of higher education; 2)resources of the academic community to achieve managerialist goals; 3)the presence of deformations in the professional ethics of academics and teachers. The study confirmed the hypothesis that the implemented managerialist policy has a negative impact on the academic community, reducing its subjectivity. Dysfunctions are manifested in two areas of professional activities of scientists and teachers. The first one is caused by the peculiarities of managerialism. Managerialism in any socio-cultural and socio-political conditions inevitably leads to the substitution of goals for the means of their achievement. This occurs due to the absence of reliable indicators for effective managers to assess the quality of reproducible results of their activities by scientists and teachers. The second direction is related to the loss of freedom in decision-making at meetings of historically established in universities sustainable social practices (meetings of the department, academic councils, dissertation councils, etc.). This is due to the administrative subordination of the academic community to the managerial tasks of the bureaucracy.

Quantum model in the context of six-level atom and deformed Lie algebra: Entanglement and statistical properties

In this work, we study the interplay between an atomic system with six levels configured in a cascade-type and one-mode fields in the framework of the f-coherent states. We explore the considered system dynamic properties under the effects of field nonlinearity and the number of photon transitions. In particular, we consider the quantum coherence, atomic upper level-occupation probability, and atom–field entanglement of a system when the effect of deformation is considered. Moreover, we analyze the dynamic of the Mandel parameter as a quantifier of the statistical properties of the field in the presence of deformation when the field is initially in coherent states.

Analysis of the functional state of the hip joints before total hip replacement in patients with ankylosing spondylitis: Data from a retrospective study

Coxitis belongs to the extraaxial manifestations of ankylosing spondylitis (AS) and is considered as an unfavorable prognostic factor that may play a significant role in the development of functional limitations. The aim of the study – to evaluate the functional status of the hip joints (HJ) before total hip replacement (THR) in AS patients. Materials and methods. The retrospective study included 170 patients with AS who met the modified New York criteria of 1984, who were hospitalized in the traumatology and orthopedics department of the V.A. Nasonova Research Institute of Rheumatology from 1998 to 2020, and all patients underwent scheduled THR. Most of them were males (80.6%). The average age of the patients was 38,1±11,3 years, duration of the disease from the moment of the first symptoms appearance – 17,0±8,5 years, duration of pain in HJ before THR – 7,4±4,8 years. Disability was established in 80% of cases: in 14,1% – group 1, in 50% – group 2, in 15,9% – group 3. Did not work due to the disease – 64% of patients. The preoperative functional state of HJ was determined using the modified Harris scale. Results and discussion. The preoperative total Harris score averaged 38.0±15.4 points and the pain score averaged 15.6±8.4 points. In the vast majority (82.9%) of patients it ranged from 10–20 points (“severe” and “moderate constantly”). The intensity of pain according to VAS was 72,3±14,0 mm. The median severity of lameness in the HJ was 5 [0; 5] points. Claudication was absent in 2.4% of patients, moderate in 42.9% of cases, severe in another 42.9%, and mild in 11.8%. Additional support was needed in the majority of patients (69.4%). One (29.4%) or two (26.5%) crutches were more frequently required. There was no need for additional support in 30.6% of patients. In 68.8% of cases, there were varying degrees of limitation in distance walking. Climbing stairs caused difficulties in 167 (98.2%) patients, only 3 (1.8%) of them did not use a handrail. Only 1 in 4 patients could use public transportation. Various anatomical deformities were determined in 88.8% of cases. Almost all patients were found to have pronounced restrictions in the volume of movements in the HJ. Conclusion. The result of function assessment according to the Harris scale, as well as the presence of deformities and significant limitation of the range of motion indicate a high degree of severity of the HJ lesion in patients with AS before THR.

Post Fire Dynamic Analysis of Steel Buildings Subject to Wind Loadings in South of Iraq

Post-fire analysis of a six-story square steel building under the action of dynamic wind forces in the south of Iraq is presented. The nonlinear time-history analysis using direct integration method is accomplished by SAP 2000 V16 program while geometric nonlinear parameters are included. The post fire deformations values and their configurations along building are based on available literature that related to post fire deformations of steel buildings at 550oCwith reducing of yield stress and modulus of elasticity) by 10% due to fire. In the present study, two post fire scenarios are considered, with wind speed of 42 m/s, according to Iraqi meteorological and IQS.301 standards. The aim of this study is to investigate the post-fire dynamic analysis of a multi-story steel moment-resisting building subjected to dynamic along-wind loads. Variations of base shear, base moment, drift ratio, and displacement are considered for discussion and comparison. Its concluded that the presence of deformation in building after fire and the reduction in yield stress and modulus of elasticity increased the base shear, base moment and drift ratio as average by about 12.5, 20& 64%respectively under the effect wind load. The fire deformations may be critical and the structural decision for the building safety should be done via structural analysis of the building taking into consideration different parameters related to post fire effects.

Finding a Proper Valproic Acid-Based Autism Spectrum Disorder Model in Zebrafish: Early and Long-term Neurobehavioral Studies

Background: Valproic acid (VPA), which is often used to treat epilepsy, causes a variety of neurobehavioral impairments that closely resemble the phenotype of autism spectrum disorder (ASD) in prenatally exposed individuals. Although the neurobehavioral effects of extremely low concentrations of VPA have received limited research attention, several investigations have shown that the impact of VPA is connected with the concentration and exposure length. Objectives: In the current study, the aim was to find the lowest dose of VPA with the fewest side effects to induce behavioral phenotypes related to ASD in zebrafish. Methods: Zebrafish embryos were first exposed to various concentrations of VPA (i.e., 1, 5, 15, 25, 48, and 75 µM) for 120 hours. Then, 42 days after conception, the survival rate, quality of hatching, and presence of deformity were assessed. Afterward, a 1 µM VPA was chosen based on observations, and behavioral experiments were carried out at 7, 21, and 42 days after fertilization (dpf). Additionally, 7dpf gene expression analysis was evaluated. Results: According to the obtained findings, behavioral abnormalities resembling ASD were induced in 7 and 21 dpf but not in 42 dpf after 120 hours of exposure to 1µM VPA. Real-time analysis in 7 dpf revealed significant changes in a number of genes linked to ASD, including lrp6, gsk3beta, chd8, and ctnnb. Conclusions: In conclusion, 120 hours of exposure of zebrafish embryos to 1 µM of VPA might produce suitable VPA induces autism-like behavior models in zebrafish larvae to research early and long-term neurobehavioral and gene expression alterations. Studies on drug development might adopt this approach.

Innovative distal bolt-locking screw tibial nailing method and conventional nailing: A comparison of outcomes

Objectives: Distal bolt-locking screw (DSBLS) tibial nailing offers an innovative method in which the nail is locked upon entering the
 screw. The current study compares the clinical, radiological, and functional outcomes of DSBLS tibial nails with conventional tibial
 nails.
 Patients and Methods: We retrospectively evaluated 38 tibial fractures of 37 patients treated with intramedullary nailing. In Group
 1, 21 fractures were treated with DSBLS nailing, while in Group 2, 17 fractures were treated with conventional nailing. Duration of
 surgery, time to weight-bearing, time to union, presence of deformity, return to work and sports, complications, American Orthopedic
 Foot and Ankle Society Score (AOFAS) and Olerud-Molander Ankle Score (OMAS) values were compared between the groups.
 Results: Group 1 patients had significantly shorter time to full weight-bearing than patients in Group 2 (P=0.032). There was no
 significant difference between the groups in functional comparisons according to the AOFAS. In contrast, the outcomes of Group 2
 were better than those of Group 1 according to the OMAS (P=0.475 and P=0.037). The outcomes for the other variables were similar.
 Conclusion: In this method, patients can bear weight in a shorter time. The results of DSBLS nailing are as good as conventional nails,
 and it can be safely preferred in treating tibial fractures with intramedullary nailing.

Risk Factors for Ulcer Recurrence in Diabetic Patients Managed by an Integrated Foot Care Protocol.

The aim of our study was to identify risk factors for the recurrence of diabetic foot ulcers (DFUs) in a selected population of patients in secondary prevention treated, according to International Guidelines, with an integrated foot care protocol by a referral diabetic foot clinic. A retrospective study was performed with the inclusion of selected outpatients with diabetes at higher risk for ulceration with a history of previous ulcer and/or amputation followed in our diabetic foot clinic between January 2015 and December 2021. According to the presence or absence of recurrence, patients were divided into 2 groups: ulcer recurrence and without ulcer recurrence. One hundred twenty-seven (127) patients were included, 47 patients (37%) developed an ulcer recurrence while 80 patients (63%) did not. The mean age was 71.7 years; 65% were male; 97% were affected by type 2 diabetes with a mean duration of 21.1 years, the mean HbA1c was 63 + 21 mmol/mol. Both groups of patients had foot deformities, such as claw and hammertoes; hallux valgus, and prominent metatarsal heads (MTHs). The presence of deformity was significantly associated with ulceration. The group with ulcer recurrence showed a higher rate of prominence MTHs in comparison to a group without ulcer recurrence. The MTHs resulted as the only independent predictor for recurrence. This study shows that the presence of the prominent MTH is a significant risk factor for ulcer recurrence in a selected population of diabetic foot patients treated in the best way with integrated foot care.

A simple artificial diet for feeding and sequestration assays for the milkweed bugsOncopeltus fasciatusandSpilostethus saxatilis

AbstractInsect artificial diets are not only an important tool for mass rearing, nutritional research, and maintaining laboratory colonies but also for studying insect‐plant interactions. For herbivorous insects able to sequester plant toxins, feeding and sequestration assays based on artificial diet allow for the investigation of physiological, ecological, and evolutionary questions which may be difficult to study using real plants representing complex chemical environments. We developed a simple artificial diet, consisting of sunflower meal pressed into pills, for the milkweed bugsOncopeltus fasciatus(Dallas) andSpilostethus saxatilis(Scopoli) (Heteroptera: Lygaeidae), which are capable of sequestering cardenolides and colchicum alkaloids, respectively. We assessed insect performance, suitability of the diet for sequestration assays, and its shelf life. Compared to sunflower seeds which are widely used as a laboratory maintenance diet for milkweed bugs, no differences were found in terms of weight development, presence of deformities, speed of development, or mortality. Importantly, after feedingO. fasciatusandS. saxatilissunflower pills enriched with crystalline ouabain (cardenolide) or colchicine (colchicum alkaloid), respectively, sequestration was observed in both species. Moreover, as a prerequisite to test ecological hypotheses, our method allows for adequate concentration control and homogenous distribution of toxins across the diet. Under relatively warm conditions (27 °C and 60% r.h.), the new diet was stable for up to 10 days when used for feeding assays with adult bugs. Therefore, studies focusing on the role of plant toxins in predator–prey interactions and plant defense, but also insecticide research could benefit from using this approach.

Surgical Management of Tophaceous Gout in the Upper Limb

Gouty tophi are a clinical manifestation of hyperuricemia in advanced stages. They can produce pain, functional limitation, and severe deformities. Patients with severe symptoms require short-term symptomatic solutions that standard medical management is not able to provide. The objective of this study was to present the results obtained with the surgical management of tophaceous gout in the upper limb, as well as present a detailed characterization of the disease in the upper limb. Databases of the hand surgery service of a quaternary care hospital were reviewed to identify patients aged >18 years old undergoing tophi resection in the upper limbs between 2014 and 2020. Medical history records were reviewed retrospectively, and the relevant data were extracted to establish demographic profile, clinical presentation, anatomic distribution, postoperative outcomes, and additional procedures required. The most frequent symptom was pain (83%), followed by limited range of motion (56%), deformity (50%), and daily living/occupational activity limitation (28%). The main indications for surgical management were the presence of deformity, pain, and/or limited range of motion. The most frequently affected anatomic sites were the metacarpophalangeal joints, followed by the elbows, proximal interphalangeal joints, and proximal phalanges. The postoperative complication rate was 28%. The most common complications were operative site infections and wound dehiscence. Decreased pain was associated with surgical resection. Additional procedures, such as extensor tenorrhaphy and local flaps, were required in 47.2% of patients. Surgical resection of tophi can decrease pain. Although surgery is associated with ahigh rate of complications, most are minor. Therapeutic IV.

Quantum coherence and entanglement of the system of a five-level atom in the presence of nonlinear fields

We investigate the atom-field system in the framework of harmonic oscillators based on deformed Heisenberg algebras. We explore the dynamic characteristics of the considered system under the effect of a nonlinear field. In particular, we consider the atomic population, atomic coherence, and atom-field entanglement for a system that comprises a single five-level atom interacting with a single-mode nonlinear field when the deformation effect is taken into account. We examine the time evolution of the quantum quantifiers in the presence of deformation when the initial state of the quantized field is defined to be a nonlinear coherent state (CS) or a superposition state.

Influence of deformed cavity field and atomic dipole interaction on the quantum correlations of two-qubit system

The possibility of generating of some quantum correlations of the entangled or separable initial two-qubit system interacting with a deformed cavity mode in the presence of dipole-dipole interaction is discussed. These quantum correlations are the coherence, non-separability and steering degrees which are quantifiers by using l_1 norm of coherence, Entanglement of Formation and Einstein–Podolsky–Rosen -steering. It is shown that maximizing or minimizing the quantum correlations depends on the initial setting states of the two-qubit system. To maximize the quantum correlations on the presence of deformation, one has to prepare the initial two-qubit system in an entangled state, setting large values of the coupling dipole and decreasing the effect of the deformation parameter.

Microscopic analysis of the ground state properties of the even-even Dy isotopes in the reflection-asymmetric relativistic mean-field theory

Reflection-asymmetric relativistic mean-field theory is used to explore the ground state properties for the even-even Dy isotopes. The results are compared with those from the finite-range droplet model (FRDM), the deformed relativistic Hartree-Bogoliubov theory in continuum (DRHBc), and the available data. The calculated binding energies and quadrupole deformations agree with the experimental data as well as the FRDM and DRHBc calculations. The obtained matter density distributions and potential energy surfaces clearly exhibit the ground state shapes and the presence of deformation in these nuclei. The experimental fingerprints of octupolarity in $^{148,154,156,160}\mathrm{Dy}$ around $N=88$ are convincing in the present calculations. The predictions on the octupole deformation in $^{190\text{--}194,200,202}\mathrm{Dy}$ around $N=134$ agree with the results from the FRDM calculations. In addition, we obtain more knowledge about the shape evolution and phase transition from oblate to pear shape and then to prolate shapes in the Dy isotopes.

Affronter l’islamophobie au sein de la profession médicale

<h3>Objective</h3> The use of cone beam imaging during neurointerventional procedure has been increasing rapidly. Initially used as a CT-scan for evaluation of intra-procedural complications such as hemorrhage, it has evolved to provide details of implanted devices such as flow diverters. The aim of this study is to present our experience using cone beam CTA with intra-arterial injection and provide a step-by-step approach for post-processing in a practical protocol for daily use. <h3>Methods</h3> After institutional IRB approval was obtained, the neurointerventional database of our institution was retrospectively reviewed from July of 2012 to March of 2015. All patients who underwent cone beam intra-arterial CTA for evaluations of implanted flow diverting devices were reviewed. The patient age and gender, aneurysm location (ICA-cavernous, ICA-paraclinoid and ICA-distal; MCA, ACA-acom, ACA-pericallosal, VA), type (saccular, dissecting fusiform or blister) and size, device used, injection technique (contrast dilution, rate and volume) and reconstruction protocol was included in the analysis. <h3>Results</h3> Among the patients in our neurointerventional database, 50 (39 women and 11 men) out of 80 patients met the inclusion criteria in our study. All procedures were performed under general anesthesia using biplane angiographic equipment (Philips Allure FD20/10). Patients’ ages ranged from 25 to 80 years old. The aneurysms treated were located in the ICA-cavernous in 6 cases, ICA-paraclinoid in 25 cases, ICA-distal in 9 cases, MCA in 4 cases, ACA-acom in 2 cases, ACA-pericallosal in 1 case and VA in 3 cases; 43 were saccular, 5 fusiform and 2 ruptured blister aneurysms. Overall, there were 31 small, 15 large, and 4 giant aneurysms. Pipeline (Covidien/Medtronic) was the predominant device used in 47 procedures. Two injection techniques were used: 2.5 mL/s for a total volume of 55 mL with a 2 s imaging delay or 3 mL/s for a total volume of 70 mL with a 3 s imaging delay; contrast (Ioxilan 300 mgI/mL) dilution was 10 to 20% in all cases. All acquired images were post-processed using our standardized protocol through the Philips Xtravision workstation. The devices landing zones, conformability to the arterial geometry, presence of deformities, and wall apposition were successfully and adequately visualized in all cases. In aneurysms that had been coiled as well (9 cases), the use of metal artifact reduction program was felt to enable satisfactorily the evaluation of the implanted devices. <h3>Conclusions</h3> The use of cone beam intra-arterial CTA after use of flow diverters is an extremely useful tool providing important information about the implanted device which may translate into better outcomes. <h3>Disclosures</h3> G. Dabus: 2; C; Covidien/Medtronic, Microvention/Terumo. 4; C; InNeuroCo, Medina Medical, Surpass/Stryker. I. Linfante: 2; C; Covidien/Medtronic. 4; C; InNeuroCo, Surpass/Stryker.

Method of quantitative assessment of the shape of the lumbar-thoracic spine

Introduction. The presence of deformation of the lumbar-thoracic spine in the sagittal plane is the main factor determining the health status of adult patients. The studies of the features of human posture with or without spinal deformities in statics and movement have been in the focus of clinician attention for a long time. Recent studies offer a unifi ed approach to assessing the position of the vertebrae. However, no such studies have been conducted to analyze the lumbar-thoracic junction. The purpose of the work — to develop a method of qualitative and quantitative assessment of the vertebra positions in lumbar-thoracic junction. Issues: to develop a schematic model of the lumbar-thoracic spine; to develop a typology of the lumbar-thoracic transition; to develop an objective indicator refl ecting the features of the lumbar-thoracic transition in the patient; to characterize the age characteristics of this area of the spine.Materials and methods. A study of digital radiographs for all spine parts in sagittal projection for 141 patients with dorsopathies, 57 men and 84 women aged from 21 to 88 years, was conducted. The study was performed on a personal computer screen, without patient participation. A single digital X-ray image of the spine in the sagittal projection was obtained for each patient. The occipital vertical and anteroposterior axes of TIX–LV (LVI) vertebrae (r axes) were applied to the combined radiograph. At the intersection points of the axes with the occipital vertical, the perpendiculars to the r axes were restored, and the angles between the perpendiculars and the occipital vertical (angles r) were measured. Statistical analysis was carried out using the Microsoft Offi ce Excel 2007 software package.Results. Schematic models of the lumbar-thoracic junction for all cases were constructed on the basis of the data obtained. The models were used to compare the vertebra positions and describe three form types of lumbar-thoracic junction: normal, straightened and reinforced. An aggregated ArTL indicator is proposed and the boundaries of this indicator were determined for the quantitative assessment of each case. It is demonstrated that the age features for this part of the spine are expressed not in a monotonous change in the average value of ArTL with age, but in an increase in the proportion of patients with straightened and enhanced kyphosis, and it is especially noticeable in the group of people over 75 years old.Conclusion. The proposed technology for assessing the position of the vertebrae of the lumbar-thoracic spine was developed to satisfy the needs of osteopaths and specialists in restorative medicine, and this technology is presented for the fi rst time. In the course of the study, schematic models of the spine of each patient were developed; an ArTL indicator was proposed to quantify the type of the lumbar-thoracic region shape. The boundaries for the diagnosis of each type were determined and a study was conducted to identify the age trend. The study revealed the absence of a linear age trend of changes in this part of the spine. Among people over 75 years of age, patients with straightened or enhanced kyphosis of this zone were more common.

Determining features of the deformed state of reinforced concrete beams of road bridges when strengthening the span structures

The technology of repairing reinforced concrete bridges typically involves closing traffic on one half of the structure and performing work on it when it is possible to move vehicles on the second part of this structure. The main process of interest to practitioners in terms of hardening concrete, which occurs in the beams of a span structure during the passage of a temporary moving load, is deformation. By the time the cement of freshly laid concrete of the overhead reinforcement slab is hardened, it is necessary to create the necessary conditions for this (temperature, humidity, immobility over time, etc.). Before concrete acquires strength, movements arising in the span structure cause the destruction of cement stone at the formation stage. It is necessary to investigate the presence of deformations, as well as their impact on the impossibility of forming a homogeneous structure of concrete and its adhesion to reinforcing elements that combine the existing slab with the new one. This study has established deformations induced by a temporary load from 1.61 to 5.83 mm, which have a negative impact on the process of solidification of concrete in the reinforcement slab for a span structure during the repair of a motorway bridge. The three-dimensional models were calculated by simulating a bridge of the M-04 highway. The results underlie the conclusions that the technology of repair work does not take into consideration the required conditions for high-quality concrete strength acquisition in an additional slab. The study results established that operations on concreting an additional overhead reinforcement slab in the presence of vibrational effects exerted by the temporary load on the span structure cannot be performed because of the destruction of concrete at the hardening stage. Given the above issue, several ways to address it have been devised and analyzed; the best of them is recommended

Mini-Open Lateral Approach for Corpectomy in the Thoracolumbar Spine.

The thoracolumbar spine poses unique challenges when considering surgical treatment options. In the era of modern medicine, nonoperative treatments have become more available for pathology of the thoracolumbar spine, including infectious, oncologic, traumatic, and degenerative etiologies. However, surgery is often warranted in the presence of deformity or with spinal cord compression resulting in neurologic deficits. Traditionally, posterior or anterior approaches were used for surgical treatment in the thoracolumbar spine. The mini-open lateral approach for corpectomy in the thoracolumbar spine is relatively new but not yet widely utilized, is less invasive, and is a less morbid surgical option for treating what has historically been a challenging surgical location. A thorough understanding of the anatomy associated with this approach is essential to perform safe and successful surgery with this technique. This review outlines the preoperative and anatomical considerations, surgical technique, contraindications, potential complications, and clinical outcomes associated with performing corpectomies in the thoracolumbar spine via the mini-open lateral approach. This is a safe, successful, and appealing surgical option for appropriately selected patients with diseases of the thoracolumbar region.

BPS indices, modularity and perturbations in quantum K-theory

We study a perturbation family of mathcal{N} = 2 3d gauge theories and its relation to quantum K-theory. A 3d version of the Intriligator-Vafa formula is given for the quantum K-theory ring of Grassmannians. The 3d BPS half-index of the gauge theory is connected to the theory of bilateral hypergeometric q-series, and to modular q-characters of a class of conformal field theories in a certain massless limit. Turning on 3d Wilson lines at torsion points leads to mock modular behavior. Perturbed correlators in the IR regime are computed by determining the UV-IR map in the presence of deformations.

Frequency and Structure of Lower Limbs Disorders in Preschool Children

The research was conducted on a sample of 266 respondents of preschool age, aged 4-6 years of both sexes in Preschool Institution “Zvjezdica” Banja Luka. Out of the total number of respondents, the male population consisted of 137 respondents, while female population consisted of 129 respondents. Disorders of the knee joint, X - legs, O - legs and hyperextension of the legs were used to assess the presence of lower extremity deformities. The main goal of the research was to determine the actual state of frequency and structure of lower extremity deformities in preschool subjects in relation to gender and age. The frequencies and structure of deformities of the lower extremities are shown in tabular relation to the sex and age of the subjects. The results of the research indicate a slightly higher frequency of lower extremity deformities in boys compared to girls, and the highest frequency of presence was found in subjects of both sexes aged 4 years, and slightly lower in subjects aged 5 years. It is surprising that the presence of deformities was not determined in subjects of both sexes aged 6 years. However, these results also oblige us to be careful and constantly and continuously monitor the postural status of children in order to timely identify physical disorders and take adequate activities in preventive and corrective work. The obtained results should initiate activities in order to timely diagnose, control and undertake effective programs of corrective exercise in preschool children.

Correctability of the knee joint observed under a stressed state

BackgroundWell-balanced postoperative knee joints are often based on subjective ‘feel’ of experienced surgeons rather than quantifiable references. Most alignment strategies continue to reference the bone despite the complexity in anatomical variations and presence of deformity. Categorical prescription of a singular alignment philosophy for all patients may not be appropriate. This study aims to characterize coronal alignment correctability in relation to anatomical measures to develop a mechanism for distinguishing patients for whom repeatable strategies are optimal in the form of alternative alignment techniques or advanced soft tissue balancing. MethodsA consecutive series of 103 pre-operative knees who underwent primary total knee arthroplasty (TKA) were analysed. Pre-operative supine computer tomography (CT) scans were segmented, with output STL bone models placed against several stressed positions determined by the TELOS SD-900 (METAX, Germany) device. Anatomical analysis using two-dimensional (2D) –3D image registration was performed. Statistical analysis was conducted for variations in anatomical morphology and regression modelling was used to determine the relationship between these measurements and correctability of a patient. ResultsThe mean preoperative supine hip–knee–ankle (HKA) angle was 5.1° and 2.3°, lateral distal femoral angle (LDFA) was 2.0° and 3.1°, medial proximal tibial angle (MPTA) was 3.7° and 3.0° varus for male and female, respectively. The mean laxity range was 4.3°. We found 36% of valgus patients and 55% of mild varus patients to be correctable. Supine HKA was a statistically significant predictor for correctability (P < 0.001). A statistically significant correlation between laxity and the HKA (P = 0.01) as well as LDFA angles (P = 0.01) exist for the mild varus cohort. ConclusionRelationship between HKA angle and the correctability of the knee joint to neutral in patients presenting with mild to moderate varus cannot be consistently predicted using bony anatomy. If there is a desire to avoid ligament release during TKA, careful consideration of both a patient’s bony anatomy and soft tissue laxity envelope must be made prior to surgery.

Visual Inspection and Toothbrush Care: A Mother-Baby Paired Cross-Sectional Study

Objective To evaluate the physical conditions and presence of residues of toothbrushes used by mothers and their babies and mothers' knowledge about toothbrush care. Material and Methods This was a cross-sectional study comprising a convenience sample represented by 60 mother-baby pairs. The mothers answered a questionnaire to evaluate their knowledge of toothbrush care. A calibrated dentist performed a visual inspection of the toothbrushes. Statistical analysis was performed using the chi-square and Fisher’s exact tests, with a significance level of 5%. Results It was found that 82% of the mothers had never received instructions regarding the care of toothbrushes after use (p=0.024). Most of them believed that their toothbrushes (70%) and their children’s toothbrushes (88%) were in good condition to use (p=0.043). However, most mother’s toothbrushes presented an unacceptable deformity of the bristles (65%) and the presence of residues (60%). In addition, babies’ toothbrushes also presented unacceptable deformities of the bristles (52%) and residues (55%). There was an association between the lack of instructions received by the mother and the presence of deformity and residues on the mother’s toothbrush bristles (p=0.037 and p=0.003, respectively). Conclusion Most mothers had never received instructions regarding toothbrush care, which is reflected in the condition of their and their baby’s toothbrushes, which presented unacceptable physical conditions concerning deformation and presence of residues.