Significant Changes In Position Research Articles

Condylar position changes after three months of treatment with posterior bite turbo

Introduction: all orthodontic treatments must be safe in terms of temporomandibular joint health. No reports in the recent literature evaluate the association between the use of posterior bite turbos and condylar position changes. The aim of the present study was to evaluate condylar position changes occurring after three-month treatment with posterior bite turbo in patients from the Dental School of the Universidad del Valle. Methods: a sample of 15 hyperdivergent patients was randomly distributed into two groups: Bite Turbo and Control Group. Cone-Beam Computed Tomography (CB-CT) was used to assess the condyle position before the bite turbos bonding to first and second molars, and after three months of use of the appliances. Distances were taken from the CB-CT by a single operator, and the calibration was tested with intraclass correlation (> 0.9). Results: no statistical difference between the position of left and right condyles was detected. However, there was a significant difference in the upper space of the left condyle between the initial and final measurement. Patients reported satisfactory use of the occlusal bite turbo (85.8%) in three months of treatment. Conclusion: contrary to the expected, the simultaneous use of posterior occlusal appliances with balanced mandibular movements for 3 months did not cause significant changes in condylar position. The patients tolerate well the use of occlusal stops.

Frontalis Linkage Without Intraoperative Eyelid Elevation for the Management of Myopathic Ptosis.

To report the effect of frontalis linkage without intraoperative eyelid elevation for the management of myopathic ptosis. Retrospective analysis of 21 (42 eyelids) myopathic patients with bilateral ptosis who were operated between 1999 and 2017. All patients had orbicularis weakness and poor or absent Bell's phenomenon. Surgery consisted of using an autogenous fascia sling to link the tarsal plate to the frontalis muscle without any degree of intraoperative eyelid elevation. The main outcome measures were margin reflex distance, brow height and degree of brow excursion and degree of lagophthalmos, and exposure keratitis. After surgery, there were significant changes (p <0.0001) in both margin reflex distance and brow position. Mean margin reflex distance increased to 1.4 mm ± 1.34 DP and with full frontalis contraction, it reached 3.0 mm ± 1.73 DP, while mean brow position decreased 1.6 mm ± 1.59 SD, p < 0.0001. Postoperative lagophthalmos was not detected in 31 (74%) eyes. In the remaining 11 eyes (26%), lagophthalmos ranged from 1.2 to 5.2 mm (mean = 1.7 mm ± 0.74 DP). Mild inferior superficial keratitis was detected in 14 eyes (33.3%) of 7 patients only 3 of which had lagophthalmos. One patient needed additional surgery to correct unilateral eyelid retraction. Overall, 81.81% of the patients were pleased with the procedure. Myopathic ptosis can be alleviated with a minimal amount of lagophthalmos by just linking the tarsal plate to the frontalis muscle without lifting the eyelid margin intraoperatively.

The Impact of Scaphoid Malunion on Radioscaphoid Joint Contact: A Computational Analysis

The clinical relevance of scaphoid malunion is controversial because the biomechanical sequelae remain poorly understood. In this computational study, the effect of increasing scaphoid malunion on radioscaphoid joint contact was assessed. Six computational wrist models of active wrist flexion-extension were used to examine 6 scaphoid malunions of varying severities. The malunions were computationally created using 3-dimensional imaging software. Each scaphoid was shortened at the waist by 2 mm to simulate fracture comminution and the distal pole was angulated volarly from 15° to 55° in 10° intervals to create a total of 6 scaphoid malunion models per specimen. Each malunion model was then assessed at 3 wrist positions: neutral, 40° flexion, and 40° extension. The radioscaphoid contact area, as well as the contact centroid, was calculated. There was a statistically significant association between malunion severity and a wider area of contact at the radiocar: pal joint. The centroid of this radioscaphoid contact area also moved in an ulnar direction for all tested wrist positions. In the extended wrist position, the centroid also moved volarly. In this computational model, the amount of radioscaphoid joint contact was significantly increased with progressive scaphoid malunion severity. Furthermore, the position of the contact centroid had a significant change in position in the ulnar direction in all wrist positions with increasing scaphoid malunion. The clinical importance of this contact is yet to be elucidated, but this computational model serves as a basis for understanding the biomechanical consequences of scaphoid humpback deformities. This study provides a computational analysis examining changes at the radioscaphoid joint that may occur within the wrist with the scaphoid malunited.

Clinical and histopathological outcome of cervical and chest MRI involving non-MRI-conditional cardiac pacemakers: a study using sheep models.

To examine the clinical and histopathological consequences of MRI in sheep implanted with non-MRI-conditional cardiac pacemakers. Under general anesthesia, active fixation leads of two dual-chamber, non-MRI-conditional cardiac pacemakers (St. Jude Medical and Medtronic) were implanted either at the right ventricular apex or at the right atrium of two male sheep and connected to the V and A channels of the pacemakers, respectively. The generators were placed in cervical subcutaneous pockets. On day 5, both sheep underwent 1.5T cervical and chest MRI with continuous electrocardiogram monitoring. Obtained sequences were T1-weighted (T1W), T2-weighted (T2W), T2-gradient echo and diffusion weighted (DW). The employed modes were OVO, VOO and VVI for one sheep and OAO, AOO and AAI for the other (unipolar and bipolar configuration of pacing and sensing for both). Battery impedance, pacing lead impedance, intrinsic amplitude and capture thresholds were checked at baseline and after each sequence, as well as 48h after imaging. Histopathological examination of the cardiac tissue around the lead tip was performed 4weeks post-imaging. No significant changes in device position or configuration were observed during or after MRI. Clinical outcome was uneventful in both sheep. Minor inflammatory and necrotic changes were reported after histopathological examination of the cardiac tissue around the lead tip. 1.5T MRI of two implanted non-MRI-conditional pacemakers was found safe in terms of device configuration and stability, clinical outcome and cardiac tissue histopathological findings.

Changes in condylar position with maxillary expansion in growing patients. A systematic review of clinical studies

ABSTRACT Purpose:The aim of the present systematic review was to assess the association between maxillary expansion (ME) and changes in condylar position in growing patients, including patients with functional unilateral posterior crossbite (FUPC), patients with bilateral posterior crossbite (BPC) and patients who have maxillary transverse deficiency (MTD) without posterior crossbite (PC). Materials and methods: Indexed databases were searched up to March 2019, and the following eligibility criteria were imposed: (a) original clinical studies; (b) growing patients; (c) intervention: influence of ME on condylar position; (d) radiographic evaluation of condylar position before and after ME; and (e) statistical analysis. Experimental studies, historic reviews, case reports, cases-series, letters to the Editor, commentaries, studies that did not specify the type of posterior crossbite (PC), studies that included combined ME-facemask intervention, and studies in adult patients were excluded. Quality assessment was performed using the Methodological Index for Non-Randomized Studies (MINORS) guidelines. Results:Eleven clinical studies were selected for data extraction. In 3 studies, significant changes in condylar position were observed bilaterally with ME in patients with FUPC. One study showed significant changes in condylar position with ME only in the non-crossbite sides; and 2 studies found no significant changes in condylar position with ME in patients with FUPC. One study reported significant changes in condylar position in both sides with ME in patients with bilateral PC. In patients without PC, 1 study showed significant changes in condylar position bilaterally with ME; and 2 studies reported no significant changes in condylar position. The mean MINORS score was 13.82.89 (out of 24). Conclusion:The association between ME and changes in condylar position in growing patients remains debatable.

CBCT Analysis of Changes in Dental Occlusion and Temporomandibular Joints before and after MEAW Orthotherapy in Patients with Nonlow Angle of Skeletal Class III.

This study focus on the changes of the position and morphology of jaw and condyle after MEAW (the multiloop edgewise arch wire) treatment in adults with a nonlow angle (mean angle or high angle SN − MP > 27°) of skeletal class III (mild to moderate skeletal classs III means −5° < ANB < 0°) malocclusions measured by CBCT (cone beam computed tomography). Twenty adult patients (aged 17-26) with a nonlow angle of skeletal class III malocclusions were selected in this study taken orthodontic treatment by MEAW. CBCT was taken before and after the treatment to analyze the changes of the jaw and condyle. After treatment, the angle of L7-MP decreased 12.2°, L6-MP decreased 10.5°, L1-MP decreased 8.8° (P < 0.001 for each) and U1-SN increased (P < 0.05). There was no significant changes between anterior and posterior APDI index and between anterior and posterior spaces of the TMJ (temporomandibular joint) (P > 0.05). The linear ratio of the TMJ was the LR > 12 before treatment, while it was −12 < LR < 12 after treatment; however, there was no statistically significant difference between them (P > 0.05). There was also no significant change in anterior and posterior position and morphology of the condyle within the joint fossa after the treatment by MEAW in this study. MEAW technology in correcting the class III with nonlow angle patients mainly relies on the compensation of distally and posterior mandibular teeth, rather than the mandible and condyle moving backward to establish a neutral occlusal. This study was approved by the institutional ethics committee of the Second Hospital of Tianjin Medical University (No. KYJJ2013002).

Short-term impact of microimplant-assisted rapid palatal expansion on the nasal soft tissues in adults: A three-dimensional stereophotogrammetry study.

ObjectiveThe aim of this study was to evaluate changes in the nasal soft tissues, including movements of landmarks, changes in linear distances, and volumetric changes, using three-dimensional (3D) stereophotogrammetry after microimplant-assisted rapid palatal expansion (MARPE) in adult patients.MethodsFacial data were scanned using a white light scanner before and after MARPE in 30 patients. In total, 7 mm of expansion was achieved over a 4-week expansion period. We determined 10 soft tissue landmarks using reverse engineering software and measured 3D vector changes at those points. In addition, we calculated the distances between points to determine changes in the width of the nasal soft tissues. The volumetric change in the nose was also measured.ResultsAll landmarks except pronasale and subnasale showed statistically significant movement on the x-axis. Pronasale, subnasale, alar right, and alar left showed significant movement on the y-axis, while all landmarks except subnasale showed significant movement on the z-axis. The alar base width, alar width, and alar curvature width increased by 1.214, 0.932, and 0.987 mm, respectively. The average volumetric change was 993.33 mm3, and the amount of increase relative to the average initial volume was 2.96%.ConclusionsThe majority of soft tissue landmarks around the nasal region show significant positional changes after MARPE in adults. The nose tends to widen and move forward and downward. The post-treatment nasal volume may also exhibit a significant increase relative to the initial volume. Clinicians should thoroughly explain the anticipated changes to patients before MARPE initiation.

Suprarenal Inferior Vena Cava Filter Placement and Retrieval: Safety Analysis.

To evaluate safety and retrieval success of retrievable suprarenal inferior vena cava (IVC) filters. A retrospective chart review of patients who received a retrievable suprarenal IVC filter between January 2008 and December 2017 was conducted. Suprarenal IVC filters were placed in 24 female and 27 male patients. The most common indications for filter placement were IVC thrombus (n= 20; 39.2%) and iliofemoral venous thrombosis with contraindication to anticoagulation (n= 16; 31.3%). The most common indications for suprarenal placement were IVC thrombus (n= 20; 39.2%), anatomic variants (n= 17; 33.3%), and external IVC compression (n= 8; 15.8%). Duplicated IVC was the most common anatomic variant requiring suprarenal placement (n= 7; 13.7%). Günther Tulip (n= 40; 78.4%), Denali (n= 10; 19.6%), and Celect (n= 1; 2.0%) filters were used. Retrieval was attempted in 27 of the 51 filters placed (52.9%). Of the 27 attempted retrievals, the technical success rate was 100% (27/27). The median dwell time was 87.0 days (95% confidence interval, 28-137 d). One complication involving fractured struts during filter retrieval occurred. No significant change in craniocaudal filter position, lateral filter tilt, or renal function between placement and retrieval was observed (P < .05). There were no instances of indwelling filter fracture. Suprarenal IVC filters, when indicated, can be placed and retrieved with a low complication rate.

Nonlinear dynamics of a viscoelastic beam traveling with pulsating speed, variable axial tension under two-frequency parametric excitations and internal resonance

This paper investigates nonlinear combined parametric transverse vibrations of a traveling viscoelastic beam. The combined parametric excitations originate from the time dependency of axial velocity as well as axial tension. Two parametric excitations are enforced into the system amid the internal resonance. Two-frequency parametric resonance is assumed to be comprised of combination parametric resonance of first two modes due to the time dependency of axial velocity, and the principal parametric resonance of first mode due to the variable tension in the axial direction in the presence of internal resonance for viscoelastic beam is considered for the first time. The higher-order integro-partial differential equation of motion is solved through direct method of multiple scales. Continuation algorithm is employed to explore the stability and various bifurcations of the nonlinear dynamic system. Focus has been made to study the effect of variations of fluctuating tension component, fluctuating velocity component independently and when combined, internal and parametric frequency detuning parameters and damping on the system response. Frequency response equilibrium curves are complex and unique in shapes which are embodied with various bifurcations. Such steady-state behavior is not seen in the existent literature. With variation in fluctuating velocity component, the number of steady-state nontrivial equilibrium curves increases to three and with variation in fluctuating axial tension, they become four. In this process, significant changes in stability, number and position of various bifurcations like supercritical and subcritical pitchfork, Hopf and saddle node are observed. Unlike the previous study, the shape, stability and bifurcations of equilibrium curves under the combined effect of axial velocity and tension closely match with the case of fluctuating axial tension component. The effect of variation in internal and parametric frequency detuning parameter is more realized for second mode compared to first mode. A comparison of the present work with a previous one where axial tension is variable reveals many qualitative and quantitative similarities and dissimilarities. But when compared with earlier work where axial velocity is constant, significant dissimilarities are surfaced. The system displays a wide ranging dynamic behavior including stable periodic, quasiperiodic and unstable chaotic behavior. The numerical computation depicts various nonlinear characteristics and oscillatory behaviors which are not found so far in the existent literature.

Effect of Plasma Rich in Growth Factors Intra Articular Injection in Management of Patients with Internal Derangement of TMJ Using CT Guided Puncture versus Conventional Technique

Purpose: To evaluate effect of PRGF intra articular injection in patients with internal derangement of TMJ using CT guided versus conventional puncture technique. Materials and methods: Twenty patients with internal derangement without improvement by conservative treatment were divided into two groups: Group I: ten patients underwent arthrocentesis followed by PRGF injection using conventional puncture by anatomical landmarks. Group II: ten patients underwent arthrocentesis followed by PRGF injection using landmark and confirmed by CT. All patients were assessed preoperatively and postoperatively at 1week, 3 and 6 months for pain level, maximum interincisal opening, lateral, protrusive movements, joint tenderness and disk position with MRI after 6 months. Results: In both groups, all clinical variables showed statistical significant discrepancy postoperatively, the discrepancy between both groups was not statistically significant and MRI showed no statistical significant change in disc position. Conclusion: CT confirmed accurate position and depth within TMJ upper compartment in different views, allowed correction with less puncture trials and decreased learning curve of TMJ puncture but it is expensive, time consuming and not available in clinics. Anatomical landmarks is easy and representable method for TMJ puncture but blind technique and needs skill. Single injection of PRGF found efficient in the treatment of internal derangement of TMJ.

P1020Feasibility of pediatric probes in transesophageal echocardiography guiding of left atrial appendage closure in adults

Abstract Introduction Transesophageal echocardiography (TEE) is essential in the guidance of left atrial appendage closure (LAAC). Current practice often requires general anesthetics (GA) to endure a standard size probe during LAAC procedures. Smaller probes for pediatric purposes have been developed and might be useful for the guidance of LAAC in adults, eliminating the need for general anesthetics (GA) and reducing procedure times. Methods In this prospective observational registry study patients were analyzed retrospectively to determine feasibility of pediatric TEE probes in adults for LAAC guidance. A standard set of LAA measurements, device compression and peri-device leakage was evaluated during procedure and by a second observer. Follow-up imaging, performed between 1–6 months after LAAC, was viewed by two independent reviewers for device positioning, peri-device leakage and thrombus formation. Results A total of 85 patients (56 male, mean age 72±7 years) were included. All patients underwent LAAC (76 Watchman, 9 Amplatzer Amulet), in 28 patients (33%) LAAC was combined with pulmonary vein isolation (PVI). The S8–3t micro-probe was used in 41 patients (48%) and the S7–3t mini-probe was used in 44 (52%). In 76 (38 mini-TEE, 38 micro-TEE) LAAC was successful, 7 of 9 failed procedures were due to unsuitable anatomy. Complete closure was achieved in 61/76 (80%, 29 mini-TEE, 32 micro-TEE), minimal residual flow was seen in 15/76 (20%, 8 mini-TEE, 7 micro-TEE). Device compression was comparable for mini- and micro-TEE and in accordance with recommendations. No GA was needed in 93% of the patients, none of these procedures were prematurely terminated because of discomfort. No serious probe related complications were seen. Follow-up imaging was performed 80±24 days after LAAC. Most patients (95%) underwent TOE with a standard probe for follow-up imaging, 5% of the patients underwent cardiac CT. Follow-up imaging showed similar proportions of patients with complete LAA closure (74%) or minimal residual flow (23%), while 2 patients had significant peri-device flow: 1 due to significant change in device position and 1 due to increase of peri-device leakage present during implant. In 1 patient device-related thrombus was seen and in 1 patient device embolization to the abdominal aorta occurred. Conclusions The use of pediatric probes in the guidance for LAAC in adults is a safe, effective, and attractive alternative avoiding the need for general anesthesia.

Enhanced ~1.8 μm photoluminescence under blue light excitation in Tm[sbnd]Bi co-doped germanate glass and its temperature dependence

Tm-doped, Bi-doped, and TmBi co-doped barium aluminogermanate glasses were prepared and their optical properties, quantum yield and photoluminescence thermal quenching were studied under 460 nm excitation. A significant enhanced emission at ~1.8 μm is revealed in the TmBi co-doped glass, which was ~14 times stronger than that in the Tm-doped glass. Efficient energy transfer from Bi-related active center to Tm3+ ions with efficiency of 83.5% was assigned. The quantum yield for the TmBi co-doped glass was estimated to be 23.9% at room temperature. For the Tm-doped glass this value is 9.8%. When heated from 298 to 473 K, the emission intensity decreased monotonously without significant changes in emission shape and peak position. As a result, the final intensity became 44.4%. The emission intensity increased linearly when the laser excitation power increased from 60 to 270 mW. The TmBi co-doped glass could be suitable for blue light emitting diode pumped light source at 1.8 μm.

Changes in Apposition of Endograft Limbs in the Iliac Arteries After Endovascular Aneurysm Repair: Determination With New Computed Tomography–Applied Software

Purpose: To validate new computed tomography (CT)–applied software used to determine endograft limb position and apposition after endovascular aneurysm repair (EVAR). Materials and Methods: Twelve EVAR patients (mean age 81±6 years; 10 men) with distal stent-graft extensions for 15 (3 bilateral) type Ib endoleaks during follow-up were selected based on the availability of the following CT studies: pre-EVAR, 1 month, and the penultimate scan prior to the scan disclosing the type Ib endoleak. Twelve patients (mean age 82±7 years; 11 men) without endoleak and a similar interval between the primary EVAR procedure and the penultimate CT scan of the endoleak group were selected as controls using measurements from both endograft limbs (n=21, 3 excluded). Prototype Vascular Imaging Analysis software was adapted to calculate 6 parameters for the distal apposition zone: fabric distance, shortest apposition length, endograft diameter, iliac seal surface (ISS), iliac endograft apposition surface (IEAS), and percentage of iliac surface coverage (IEAS/ISS × 100). Measurements were performed on the preoperative, first postoperative, and penultimate/matched follow-up CT scans. Interobserver variability was assessed with the intraclass correlation coefficient (ICC). Continuous data are presented as the median [interquartile range (IQR) Q1, Q3]. Results: CTA follow-up was not significantly different between the endoleak and control groups [30 months (IQR 18, 58) vs 36 months (IQR 21, 59), p=0.843]. Interobserver agreement was good to excellent for all parameters (ICC 0.879–0.985). Preoperative anatomy and endograft dimensions on the first follow-up CTA scan did not differ significantly between the groups. When the penultimate CTA scan was compared with the first postoperative CT scan, endograft dimensions had significantly changed in the endoleak group; importantly, apposition was significantly decreased, and fabric distance was significantly increased, indicating limb retraction. Differences in changes in endograft dimensions were significant between the groups. Conclusion: New CT-applied software was introduced to visualize apposition and position changes of endograft limbs during follow-up. The software demonstrated good-to-excellent interobserver agreement and enabled accurate analysis of post-EVAR endograft dimensions. Significant changes in apposition and position were observed with the software on the penultimate CT scan prior to diagnosis of type Ib endoleak.

The acute response of the nucleus pulposus of the cervical intervertebral disc to three supine postures in an asymptomatic population

BackgroundThe dynamic disc model refers to the ability of a spinal disc's position to be manipulated by body postures and movements. Research on lumbar discs has indicated movement of the anterior and posterior disc that correlates with posture of the spine. The aim of this study was to assess whether, despite its structural differences, the cervical disc responds to flexed and extended postures in a similar fashion to the lumbar disc. MethodA repeated measures study. Twenty five asymptomatic participants (age: 33.7 ± 9.1 years) volunteered. Scans were performed in supine using an Esaote 0.2T magnetic resonance imaging scanner. Participants lay with their cervical spine initially placed in neutral, followed by flexion and finally extension. The position of the posterior disc nucleus pulposus at C5-6 and C6-7 was measured against a vertical line connecting the posterior vertebral bodies above and below each disc. ResultsChanges in cervical spine position were associated with significant changes in posterior disc nucleus pulposus position at both C5-6 and C6-7 (p < 0.01 for both). Post hoc testing showed a significant difference in posterior disc nucleus pulposus position at C5-6 between flexion and extension (p = 0.02). There was similarly a significant change at C6-7 between neutral and flexion (p = 0.001), and between flexion and extension (p = 0.02). ConclusionsThese results indicate that the cervical posterior nucleus pulposus is affected by spinal loading, consistent with the concept of the dynamic disc model.

Residents' journal review

Residents' journal review

Inter-rater reliability of the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) in the acute phase after stroke

ABSTRACTBackground: Before implementation of the new scale, the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS), to clinical practice, it is fundamental to analyze its measurement properties.Objective: To examine the inter-rater reliability of the SwePASS in the acute phase after stroke.Methods: Day 3 to day 7 after admission to a stroke unit, 64 persons with stroke were assessed twice, using the SwePASS, by two physiotherapists. Inter-rater reliability was determined using percentage-agreement and the rank-invariant method: relative position, relative concentration, and relative rank variance.Results: The raters showed a percentage agreement of ≥75% in the assessments using the SwePASS. For 9 of the 12 items, the percentage agreement was >80%. For 8 of the 12 items, there was a statistically significant change in position, revealed in relative position values between 0.08 and 0.15. Three items had statistically significant positive relative concentration values between −0.11 and 0.10. Except for a statistically significant negligible relative variance value of 0.01 for the items 1 and 8, there was no relative variance.Conclusions: The SwePASS shows an acceptable inter-rater reliability, albeit with potential for improvement. The reliability can be improved by a consensus how to interpret the scale between the raters prior to implementation in the clinic.

Age-related Changes in Globe Position.

To longitudinally evaluate for changes in globe position as part of the natural aging process. A Cleveland Clinic Foundation imaging database of all head imaging scans performed from 1995 to 2017 was used to identify adults with normal orbits undergoing imaging studies at least 20 years apart. A total of 100 patients (200 globes) who had CT or MRI scans were studied. Globe position was determined by measuring the distance from the anterior aspect of the cornea to the zygomaticofrontal processes baseline. Clinically significant changes in globe position were defined as changes of ≥2 mm posteriorly (enophthalmos) or anteriorly (exophthalmos). On average, globe projection decreased by 0.25 ± 2.3 and 0.26 ± 2.2 mm in the right and left eyes, respectively. Clinically significant enophthalmos with age was measured in 55 (27.5%) globes in 35 (35%) individuals, while clinically significant exophthalmos with age was measured in 43 (21.5%) globes in 26 (26%) individuals. The proportion of cases that developed enophthalmos, exophthalmos, or experienced no change were not significantly different from each other (p = 0.26). No patients developed clinically significant enophthalmos in one eye and exophthalmos in the other. Adults may develop clinically significant enophthalmos, exophthalmos, or no change in globe position over a 20-year period. This lack of uniform change in globe position with age impacts surgical considerations for treatment of the aging periocular region.

Comparison of two different designs of forefoot off-loader shoes and their influence on gait and spinal posture

BackgroundThe purpose of forefoot off-loader shoes (FOS) is to unload the operated region of the foot in order to allow early mobilization and rehabilitation. However, little is known about the actual biomechanical effects of different designs of FOS on gait, pelvis and spine. Research questionAim of this study was to analyse and compare the effects of two different designs of forefoot unloader shoes. MethodsOrtho-Wedge (FOS A) and Relief-Dual® (FOS B) were evaluated in this study during standing and while walking. Changes of the pelvic position and spinal posture were measured with a surface topography system and an instrumented treadmill. Gait phases were detected automatically by a built-in pressure plate. ResultsBoth FOS resulted in a significant increase of pelvic obliquity, pelvic torsion, lateral deviation and surface rotation (p < 0.001) while standing. Between both shoe models, pelvic obliquity and lateral deviation (p < 0.05) were significantly different. During walking, both FOS had a significant effect on spine and pelvis (p < 0.05), however only minor differences were found between the designs. All gait parameters were affected more, wearing FOS A than B. Step length were significantly longer by wearing FOS (p < 0.005). However stance phase raised and swing phase is reduced on the leg wearing FOS A (p < 0.001). SignificanceThe study showed that FOS lead to significant changes in pelvic position and spinal posture during standing and while walking. A compensating shoe on the contralateral side is therefore recommend. Gait parameters however were affected more by the traditional FOS A half-shoe. The sole- design and shape of FOS B leads to a more physiological roll-over of the foot.

Eu Activation in β-Ga2O3 MOVPE Thin Films by Ion Implantation

In this work, we have established the effects of Eu implantation and annealing on β-Ga2O3 thin films grown by metal organic vapor phase epitaxy (MOVPE) on sapphire substrate. The study is based on the combined information from structural and optical techniques: X-ray diffraction (XRD), Rutherford backscattering spectrometry (RBS), cathodoluminescence (CL), photoluminescence (PL), and photoluminescence excitation (PLE). The thin films were implanted with a fluence of 1 × 1015 Eu·cm−2 and annealed at 900°C. Neither significant changes in peak width or position nor additional peaks related to Eu complexes were detected in the XRD 2θ-ω scans. RBS results and SRIM simulation are in good agreement, revealing that no Eu diffusion to the surface occurs during annealing. For the used implantation/annealing conditions, the Eu ion penetration depth reached ∼130 nm, with a maximum concentration at ∼50 nm. Furthermore, CL and PL/PLE results evidenced the optical activation of the Eu3+ in the β-Ga2O3 host. The detailed study of the Eu3+ intra-4f shell transitions revealed that at least one active site is created by the Eu implantation/annealing in β-Ga2O3 thin films grown on sapphire. Independently of the β-Ga2O3 film thickness, well controlled optical activation of implanted Eu was achieved.

Historical shoreline trend analysis and drivers of coastal change along the Ravenna coast, NE Adriatic

One of the most important aspects of coastal zone management is the analysis of shoreline dynamics. Over the last years, beaches of the Ravenna coast (NE Italy) experienced large modifications, in some places narrowing or even being completely lost, thus threatening tourism, coastal assets and nature. Coastal erosion has direct consequences for Ravenna tourist-based economy, which largely depends on the attraction provided by sandy beaches. In this study, long-term (> 50 years) coastal analysis was used to identify the sectors along the coast where the shoreline position has changed, either advancing or retreating. Shoreline changes were measured on GIS environment by means of Digital Shoreline Analysis System (DSAS) extension. Net Shoreline Movement (NSM) and Linear Regression Rate (LRR) strategies were employed to examine shoreline variability and reveal erosional/accretional trends. The results show that significant shoreline changes affected the entire coastal region, with most of the study area under retreat, mainly in the most valuable tourist assets of the littoral. The effects were found to be worsened by impacts of land subsidence, presence of harbor infrastructure and deficit in sediment budget. A simple shoreline classification was performed over the DSAS results and cross-checked with local knowledge of the area. The measurement of erosion or accretion rates in each studied segment is found to be useful for land use planning and coastal management plans, especially regarding the prediction of future shoreline positions. Especially important is the potential of the classification to identify areas of significant position change, with current and future implications for the design of sustainable shoreline management and mitigation measures.