A Scheduler for Smart Home Appliances Based on a Novel Concept of Tariff Space.

The background of this work is related to the scheduling of household appliances, taking into account variations in energy costs during the day from official Brazilian domestic tariffs: constant and white. The white tariff can reach an average price of around 17% lower than the constant, but charges twice its value at peak hours. In addition to cost reduction, we propose a methodology to reduce user discomfort due to time-shifting of controllable devices, presenting a balanced solution through the analytical analysis of a new method referred to as tariff space, derived from white tariff posts. To achieve this goal, we explore the geometric properties of the movement of devices through the tariff space (geometric locus of the load), over which we can define a limited region in which the cost of a load under the white tariff will be equal to or less than the constant tariff. As a trial for the efficiency of this new methodology, we collected some benchmarks (such as execution time and memory usage) against a classic multi-objective algorithm (hierarchical) available in the language portfolio in which the project has been executed (the Julia language). As a result, while both methodologies yield similar results, the approach presented in this article demonstrates a significant reduction in processing time and memory usage, which could lead to the future implementation of the solution in a simple, low-cost embedded system like an ARM cortex M.

Traditional distance "tip-apex" vs. new calcar referenced "tip-apex" - which one is the best peritrochanteric osteosynthesis failure predictor?

INTRODUCTION: In the treatment of trochanteric fractures, the distance between the tip of the screw and the apex of the femoral head or tip-to-apex distance (TAD) was popularized by Baumgaertner about 20 years ago as an important predictor of failure. Recently, a new reference point for determining the apex has been advocated. In this new calcar tip-to-apex (calTAD) the femoral head apex is referenced to the femoral calcar and not the center of the neck. The aim of this study is to evaluate which of these two indexes is better in predicting failure of pertrochanteric fracture fixation. MATERIALS AND METHODS: We conducted a retrospective study focusing on pertrochanteric fractures operated in our institution between 2010-2013. Radiographic measurement of both indexes was performed. Demographic information, as well as several variables with recognized influence on the rate of failure, were collected. Finally, logistic regression analysis was used to identify variables independently associated with fixation failure. RESULTS: A total of 463 pertrochanteric fractures were operated during this time period. One hundred and seventy cases were excluded because of early loss of follow-up (n = 143) or inadequate fluroscopic imaging (n = 27) control precluding accurate measurements. Two hundred and ninety-three fractures were included. Traditional TAD and calTAD were significantly different in the failure group: 24.9 vs. 18.0 mm (p < 0.001) and 29.2 vs. 22.6 mm (p < 0.001) respectively. No other registered variable was significantly different. Multivariate analysis confirms traditional TAD (p = 0.003; OR = 1.10) and calTAD (p = 0.002; OR = 1.12) as independent risk factors for failure. DISCUSSION/CONCLUSION: Both the traditional TAD and the new calTAD have shown to be relevant indexes and independently predictive of the likelihood of failure of pertrochanteric fracture fixation. Interestingly, we found the optimal threshold for the traditional TAD to be lower (<20 mm) than the traditional cutoff (<25 mm). Our study did not confirm calTAD to be superior to the traditional TAD. From the surgical practice point of view, the authors argue that the ideal position of the screw is the central region of the femoral head (minimal traditional TAD). In case of deviation, it must be infero-central in order to maintain a low calTAD thus minimizing the risk of fixation failure.

Carpal Tunnel Syndrome as the Initial Manifestation of Wrist Bone Tuberculosis: A Case Report.

CASE: We report the case of a patient with bone tuberculosis (TB) of the wrist, whose initial manifestation mimicked the typical clinical presentation of carpal tunnel syndrome. This misdiagnosis lead to surgical mistreatment. After no clinical improvement, thorough study was carried out, and bone TB was diagnosed. Tuberculostatic treatment was performed for 12 months. Wrist arthrodesis was performed after 6 months because of pain and very limited flexion-extension range of motion. CONCLUSION: Our case highlights the importance of differential diagnoses in the face of such frequent and suggestive symptoms of carpal tunnel syndrome.

Can Denosumab cure giant cell tumors of the spine? A case report and literature review.

BACKGROUND: Bone giant cell tumors, although benign, may be locally aggressive and cause severe morbidity; in some cases, they can also disseminate at distance and cause death. Denosumab has been approved to treat unresectable bone giant cell tumors or when surgery is likely to result in severe morbidity. Furthermore, its curative potential has been recently suggested. CASE: An 18-year-old girl presented with a spinal giant cell tumor at T9. Neo-adjuvant denosumab was administered for 9 months with great clinical and analytical tolerance. A posterior left T9 costo-transversectomy and vertebral body curettage was performed and the spine stabilized. Interestingly, histopathology examination of the surgical specimens found no evidence of tumoral cells. Denosumab was reinstated until completion of 12 months of treatment. CONCLUSION: Denosumab has an important but still limited role in the treatment of spinal giant cell tumors. Here, it resulted in complete histological resolution of the tumor, potentially widening its applicability from a strictly neo-adjuvant to a curative role.

Surgical Treatment for Congenital Dislocation of the Patella in a Young Adult: A Case Report.

CASE: We present an 18-year-old man with poor alignment of the lower limbs, marked by congenital dislocation of the left patella, with gait impairment, and an associated 20° flexion contracture. Surgical treatment was performed with a single complex procedure with the release of the lateral retinaculum, capsule, and iliotibial tract, followed by a subtraction trochleoplasty, tibial tubercle transfer, elongation of the quadriceps tendon, and anatomical reconstruction of the medial patellofemoral ligament. At the 5-year follow-up, the patient had a significant improvement in gait pattern, with the patella centered on the new trochlear groove without any signs of patellar instability. CONCLUSIONS: The approach of congenital dislocation of the patella is controversial, and although numerous procedures have been described in children, the approach in adults should be individually tailored. In this case, trochlear deepening and preserving the trochlear cartilage proved to be an effective option for treating a congenital dislocation.

Anatomic and non-anatomic reconstruction improves post-operative outcomes in chronic acromio-clavicular instability: a systematic review.

PURPOSE: To systematize the surgical outcomes of anatomic and non-anatomic reconstruction in patients with chronic acromio-clavicular joint (ACJ) instability and determine which technique is superior. METHODS: This review was conducted according to the PRISMA guidelines. PubMed and Cochrane Library databases were searched up to April 30th, 2018 for original articles that assessed the outcomes of one or more surgical techniques of anatomic and non-anatomic reconstruction in patients with chronic ACJ instability. The Methodological Index for Non-randomized Studies (MINORS) was used to assess study quality. Pre-to-post meta-analysis was performed for both anatomic and non-anatomic reconstructions. RESULTS: Twenty-eight studies were included comprising 799 patients (mean age of 36.6 years old and 84% males) with a mean follow-up of 34.6 months (range 13 to 74). Surgical techniques included anatomic (tendinous or synthetic grafts/constructs) and non-anatomic reconstruction (Weaver-Dunn or Modified Weaver-Dunn, conjoined tendon transfer, or temporary hook plate). There were significant pre-to-post improvements on the constant score with an average improvement ranging from 11.1 to 50.7 (p < 0.01). Average failure rate was 7.6% (7.5% for anatomic and 8.5% for non-anatomic reconstruction). Non-comparative studies had a mean MINORS score of 9 points (out of 16) and comparative studies 17 (out of 24) with excellent interrater agreement (k = 0.910). CONCLUSION: Both anatomic and non-anatomic ACJ reconstructions provide significant post-operative improvements, but definitive conclusions on optimal technique remain elusive. Notwithstanding, comparative studies support the use of anatomic ACJ reconstruction which should be preferably used. However, until superiority is demonstrated by robust studies, surgeons should supplement their decision-making with experience and patient preference. LEVEL OF EVIDENCE: IV.

Evaluation of monocot and eudicot divergence using the sugarcane transcriptome.

Over 40,000 sugarcane (Saccharum officinarum) consensus sequences assembled from 237,954 expressed sequence tags were compared with the protein and DNA sequences from other angiosperms, including the genomes of Arabidopsis and rice (Oryza sativa). Approximately two-thirds of the sugarcane transcriptome have similar sequences in Arabidopsis. These sequences may represent a core set of proteins or protein domains that are conserved among monocots and eudicots and probably encode for essential angiosperm functions. The remaining sequences represent putative monocot-specific genetic material, one-half of which were found only in sugarcane. These monocot-specific cDNAs represent either novelties or, in many cases, fast-evolving sequences that diverged substantially from their eudicot homologs. The wide comparative genome analysis presented here provides information on the evolutionary changes that underlie the divergence of monocots and eudicots. Our comparative analysis also led to the identification of several not yet annotated putative genes and possible gene loss events in Arabidopsis.

QTL affecting body weight in a candidate region of cattle chromosome 5

The objective of this work was to identify QTLs for liveweight in a candidate region of bovine chromosome 5. Half-sib families from two lines, one traditional and the other new, of Canchim beef cattle (5/8 Charolais + 3/8 Zebu) were genotyped for four microsatellite markers, including the microsatellite in the IGF-1 (insulin-like growth factor-1) promoter region. Significant differences in allele distribution between the two lines were found for three markers. Interval mapping analyses in this region indicated the presence of a QTL controlling birth weight (p < 0.05) and of a QTL influencing breeding value for yearling weight (p < 0.01) in the newer line of the breed. The previously identified interaction between the IGF-1 genotype and genetic group strengthens the hypothesis of a linked QTL rather than an IGF-1 effect on growth traits in the Canchim cattle