Acute Deltoid Injury in Ankle Fractures: A Biomechanical Analysis of Different Repair Constructs.

BACKGROUND: The importance of the deltoid ligament in the congruency and coupling of the tibiotalar joint is well known. The current trend is to repair it in cases of acute injuries in the context of ankle fractures; however, there is limited information on how it should be reconstructed. The objective of this study was to compare different deltoid ligament repair types in an ankle fracture cadaveric model. METHODS: Sixteen cadaveric foot-ankle-distal tibia specimens were used. All samples were prepared as a supination external rotation ankle fracture model. Axial load and cyclic axial rotations were applied on every specimen using a specifically designed frame. This test was performed without deltoid injury, with deltoid injury, and after repair. The reconstruction was performed in 4 different ways (anterior, posterior, middle, and combined). Medial clear space (MCS) was measured for each condition on simulated weightbearing (WB) and gravity stress (GS) radiographs. Reflective markers were used in tibia and talus, registering the kinematics through a motion analysis system to record the tibiotalar uncoupling. RESULTS: After deltoid damage, in all cases the MCS increased significantly on GS radiographs, but there was no increase in the MCS on WB radiographs. After repair, in all cases, the MCS was normalized. Kinematically, after deltoid damage, the tibiotalar uncoupling increased significantly. All isolated repairs achieved a similar tibiotalar uncoupling value as its baseline condition. The combined repair resulted in a significant decrease in tibiotalar uncoupling. CONCLUSION: Our results show that deltoid repair recovers the tibiotalar coupling mechanism in an ankle fracture model. Isolated deltoid repairs recovered baseline MCS and tibiotalar uncoupling values. Combined repairs may lead to overconstraint, which could lead to postoperative stiffness. Clinical studies are needed to prove these results and show clinically improved outcomes. CLINICAL RELEVANCE: This study helps in finding the optimum deltoid repair to use in an acute trauma setting.

Low-Cost Portable System for Measurement and Representation of 3D Kinematic Parameters in Sport Monitoring: Discus Throwing as a Case Study.

Monitoring of sports practice has become an almost essential tool in high-level professional training. The knowledge of the exact movements performed by an athlete provides a great advantage over conventional training, since the best performance can be theoretically known in advance and the trainer will expect the real athlete's movements to approximate it. Following this trend, this article deals with the design and development of a low-cost wearable biofeedback system for the measurement and representation of kinematic parameters in 3D. To capture the athlete's movements, an inertial measurement unit (IMU) is used, whose data are processed in an microcontroller-based architecture. The kinematic parameters of the athlete's movement are sent via Bluetooth to a smart phone, where they are displayed graphically. Experimental examples show the effectiveness of the device developed and illustrate the key results derived.

Using the rDNA Internal Transcribed Spacer 1 to Identify the Invasive Pest Rhagoletis cerasi (Diptera: Tephritidae) in North America.

The cherry-infesting fruit fly Rhagoletis cerasi Loew is a significant commercial pest in Europe that has recently invaded North America. To date, it has been trapped only in Canada and northwestern counties of New York. It has the potential to spread further and threaten production and movement of cherry commodities. Timely diagnosis of the pest will facilitate surveys and quick response to new detections. Adult morphology of the pest is distinct from other flies in North America. However, when flies are significantly damaged on traps or the immature life stages are found in fruits, molecular methods of identification are important to confirm presence and host-use records. Other than DNA sequencing of genes from flies which takes over a day to complete, there are no timely methods of molecular identification for this pest. In this study, we report the first sequence record of the internal transcribed spacer 1 (ITS1) from R. cerasi and develop two diagnostic tests for the pest based on ITS1 differences among species in North America. The tests use loop-mediated isothermal amplification (LAMP) and multiplex, conventional polymerase chain reaction (mcPCR) technologies that target the same region of the R. cerasi ITS1 sequence. Both tests performed well when tested against collections of R. cerasi from North America and Europe, generating Diagnostic Sensitivity estimates of 98.4-99.5%. Likewise, the tests had relatively high estimates of Diagnostic Specificity (97.8-100%) when tested against Rhagoletis Loew species present in North America that also use cherry as a developmental host.

Aedes aegypti breeding ecology in Guerrero: cross-sectional study of mosquito breeding sites from the baseline for the Camino Verde trial in Mexico.

BACKGROUND: Understanding the breeding patterns of Aedes aegypti in households and the factors associated with infestation are important for implementing vector control. The baseline survey of a cluster randomised controlled trial of community mobilisation for dengue prevention in Mexico and Nicaragua collected information about the containers that are the main breeding sites, identified possible actions to reduce breeding, and examined factors associated with household infestation. This paper describes findings from the Mexican arm of the baseline survey. METHODS: In 2010 field teams conducted household surveys and entomological inspections in 11,995 households from 90 representative communities in the three coastal regions of Guerrero State, Mexico. We characterized Ae. aegypti breeding sites and examined the effect of two preventive measures: temephos application in water containers, and keeping the containers covered. We examined associations with household infestation, using bivariate and multivariate analysis adjusted for clustering effects. RESULTS: We conducted entomological inspections in 11,995 households. Among 45,353 water containers examined, 6.5% (2958/45,353) were positive for larvae and/or pupae. Concrete tanks (pilas) and barrels (tambos) together accounted for 74% of pupal productivity. Both covering water containers and inserting temephos were independently associated with a lower risk of presence of larvae or pupae, with the effect of covering (OR 0.22; 95% CIca 0.15-0.27) stronger than that of temephos (OR 0.66; 95% CIca 0.53-0.84). Having more than four water containers was associated with household infestation in both rural areas (OR 1.42; 95% CIca 1.17-1.72) and urban areas (1.81; 1.47-2.25), as was low education of the household head (rural: 1.27; 1.11-1.46, and urban: 1.39; 1.17-1.66). Additional factors in rural areas were: household head without paid work (1.31; 1.08-1.59); being in the Acapulco region (1.91; 1.06-3.44); and using anti-mosquito products (1.27; 1.09-1.47). In urban areas only, presence of temephos was associated with a lower risk of household infestation (0.44; 0.32-0.60). CONCLUSION: Concrete tanks and barrels accounted for the majority of pupal productivity. Covering water containers could be an effective means of Ae. aegypti vector control, with a bigger effect than using temephos. These findings were useful in planning and implementing the Camino Verde trial intervention in Mexico.

Dengue occurrence relations and serology: cross-sectional analysis of results from the Guerrero State, Mexico, baseline for a cluster-randomised controlled trial of community mobilisation for dengue prevention.

BACKGROUND: The Mexican arm of the Camino Verde trial of community mobilisation for dengue prevention covered three coastal regions of Guerrero state: Acapulco, Costa Grande and Costa Chica. A baseline cross-sectional survey provided data for community mobilisation and for adapting the intervention design to concrete conditions in the intervention areas. METHODS: Trained field teams constructed community profiles in randomly selected clusters, based on observation and key informant interviews. In each household they carried out an entomological inspection of water containers, collected information on socio-demographic variables and cases of dengue illness among household members in the last year, and gathered paired saliva samples from children aged 3-9 years, which were subjected to ELISA testing to detect recent dengue infection. We examined associations with dengue illness and recent dengue infection in bivariate and then multivariate analysis. RESULTS: In 70/90 clusters, key informants were unable to identify any organized community groups. Some 1.9% (1029/55,723) of the household population reported dengue illness in the past year, with a higher rate in Acapulco region. Among children 3-9 years old, 6.1% (392/6382) had serological evidence of recent dengue infection. In all three regions, household use of anti-mosquito products, household heads working, and households having less than 5 members were associated with self-reported dengue illness. In Acapulco region, people aged less than 25 years, those with a more educated household head and those from urban sites were also more likely to report dengue illness, while in Costa Chica and Costa Grande, females were more likely to report dengue illness. Among children aged 3-9 years, those aged 3-4 years and those living in Acapulco were more likely to have evidence of recent dengue infection. CONCLUSIONS: The evidence from the baseline survey provided important support for the design and implementation of the trial intervention. The weakness of community leadership and the relatively low rates of self-reported dengue illness were challenges that the Mexican intervention team had to overcome. The higher dengue illness occurrence among women in Costa Grande and Costa Chica may help explain why women participated more than men in activities during the Camino Verde trial.

Daniel Alcides Carrión: la teoría unicista / Daniel Alcides Carrión: Unicist theory

La enfermedad de Carrión presenta clásicamente dos fases clínicas: la fiebre de la Oroya y la verruga peruana. La teoría unicista reconoce que ambas formas clínicas pertenecen a la misma enfermedad, la obtención de este conocimiento representó un duro desafío para la ciencia peruana y mundial. A través de un histórico experimento en 1885, Daniel Alcides Carrión obtuvo la evidencia clínica-experimental que sentó las bases de la teoría unicista; el científico diseñó esta teoría solo hasta las horas finales de su experimento, por lo cual su hallazgo es considerado un acto de serendipia. La demostración bacteriológica de la teoría la realizaría Hideyo Noguchi en 1926; Carrión brindó además evidencia de la transmisibilidad de esta infección y debido a este aporte científico se convirtió en el símbolo de la medicina peruana.

Carrion's disease typically presents two clinical phases: Oroya fever and Peruvian wart. Unicist theory recognizes that both clinical forms belong to the same disease. Obtaining this knowledge represented a challenge for both the Peruvian and the world science. In 1885, through a historical experiment, Daniel Alcides Carrión obtained the clinical-experimental evidence that work as the foundations of this theory. Carrion did not design this theory but only in the final hours of his experiment; therefore his finding is considered as an act of serendipity. Bacteriological demonstration of the theory was made in 1926 by Hideyo Noguchi. Carrion also provided evidence showing the transmission of this infection. Due to its scientific contribution Carrión became the symbol of the Peruvian medicine.

Optimal sensor placement for multiple target positioning with range-only measurements in two-dimensional scenarios.

The problem of determining the optimal geometric configuration of a sensor network that will maximize the range-related information available for multiple target positioning is of key importance in a multitude of application scenarios. In this paper, a set of sensors that measures the distances between the targets and each of the receivers is considered, assuming that the range measurements are corrupted by white Gaussian noise, in order to search for the formation that maximizes the accuracy of the target estimates. Using tools from estimation theory and convex optimization, the problem is converted into that of maximizing, by proper choice of the sensor positions, a convex combination of the logarithms of the determinants of the Fisher Information Matrices corresponding to each of the targets in order to determine the sensor configuration that yields the minimum possible covariance of any unbiased target estimator. Analytical and numerical solutions are well defined and it is shown that the optimal configuration of the sensors depends explicitly on the constraints imposed on the sensor configuration, the target positions, and the probabilistic distributions that define the prior uncertainty in each of the target positions. Simulation examples illustrate the key results derived.

Sensor networks for optimal target localization with bearings-only measurements in constrained three-dimensional scenarios.

In this paper, we address the problem of determining the optimal geometric configuration of an acoustic sensor network that will maximize the angle-related information available for underwater target positioning. In the set-up adopted, a set of autonomous vehicles carries a network of acoustic units that measure the elevation and azimuth angles between a target and each of the receivers on board the vehicles. It is assumed that the angle measurements are corrupted by white Gaussian noise, the variance of which is distance-dependent. Using tools from estimation theory, the problem is converted into that of minimizing, by proper choice of the sensor positions, the trace of the inverse of the Fisher Information Matrix (also called the Cramer-Rao Bound matrix) to determine the sensor configuration that yields the minimum possible covariance of any unbiased target estimator. It is shown that the optimal configuration of the sensors depends explicitly on the intensity of the measurement noise, the constraints imposed on the sensor configuration, the target depth and the probabilistic distribution that defines the prior uncertainty in the target position. Simulation examples illustrate the key results derived.