Atlantoaxial dislocation due to Os odontoideum in down syndrome: Literature review and case reports.

INTRODUCTION AND IMPORTANCE: Os odontoideum is a rare condition commonly associated with atlantoaxial instability (AAI) and leading to atlantoaxial dislocation. The incidence of Os odontoideum is higher in patients with Down syndrome. Similar to odontoid fractures, atlantoaxial dislocation in patients with Os odontoideum can result in neurological deficits, disability, and even mortality. CASE PRESENTATION: We present two cases of Os odontoideum accompanied by Down syndrome. Both patients were hospitalized due to progressive tetraparesis after falls several months prior. Upon examination, the patients exhibited myelopathy and were unable to walk or stand. MRI revealed spinal stenosis at the C1-C2 level due to atlantoaxial dislocation. C1-C2 fixation using Harms' technique was performed in both cases. One case experienced a complication involving instrument failure, necessitating revision surgery. CLINICAL DISCUSSION: Due to the characteristics of transverse ligament laxity, low muscle tone, excessive joint flexibility, and cognitive impairment, children with both Down syndrome and Os odontoideum are at a high risk of disability and even mortality from spinal cord injury. Most authors recommend surgical management when patients exhibit atlantoaxial instability. Additional factors such as low bone density, cognitive impairment, and a high head-to-body ratio may increase the risk of surgical instrument failure and nonunion postoperatively in patients with Down syndrome. CONCLUSION: Os odontoideum is a cause of AAI in patients with DS. Indication of surgery in the presence of AAI helps to resolve neurological injury and prevent further deterioration. The use of a cervical collar is considered to prevent instrument failure postoperatively.

Thermal Conductivity and Mechanical Properties of Polymer Composites with Hexagonal Boron Nitride-A Comparison of Three Processing Methods: Injection Moulding, Powder Bed Fusion and Casting.

Materials providing heat dissipation and electrical insulation are required for many electronic and medical devices. Polymer composites with hexagonal boron nitride (hBN) may fulfil such requirements. The focus of this study is to compare composites with hBN fabricated by injection moulding (IM), powder bed fusion (PBF) and casting. The specimens were characterised by measuring thermal conductivity, tensile properties, hardness and hBN particle orientation. A thermoplastic polyurethane (TPU) was selected as the matrix for IM and PBF, and an epoxy was the matrix for casting. The maximum filler weight fractions were 65%, 55% and 40% for IM, casting and PBF, respectively. The highest thermal conductivity (2.1 W/m∙K) was measured for an IM specimen with 65 wt% hBN. However, cast specimens had the highest thermal conductivity for a given hBN fraction. The orientation of hBN platelets in the specimens was characterised by X-ray diffraction and compared with numerical simulations. The measured thermal conductivities were discussed by comparing them with four models from the literature (the effective medium approximation model, the Ordóñez-Miranda model, the Sun model, and the Lewis-Nielsen model). These models predicted quite different thermal conductivities vs. filler fraction. Adding hBN increased the hardness and tensile modulus, and the tensile strength at high hBN fractions. The strength had a minimum as the function of filler fraction, while the strain at break decreased. These trends can be explained by two mechanisms which occur when adding hBN: reinforcement and embrittlement.

Black Silicon as Anti-Reflective Structure for Infrared Imaging Applications.

For uncooled infrared cameras based on microbolometers, silicon caps are often utilized to maintain a vacuum inside the packaged bolometer array. To reduce Fresnel reflection losses, anti-reflection coatings are typically applied on both sides of the silicon caps.This work investigates whether black silicon may be used as an alternative to conventional anti-reflective coatings. Reactive ion etching was used to etch the black silicon layer and deep cavities in silicon. The effects of the processed surfaces on optical transmission and image quality were investigated in detail by Fourier transform infrared spectroscopy and with modulated transfer function measurements. The results show that the etched surfaces enable similar transmission to the state-of-the-artanti-reflection coatings in the 8-12 µm range and possibly obtain wider bandwidth transmission up to 24 µm. No degradation in image quality was found when using the processed wafers as windows. These results show that black silicon can be used as an effective anti-reflection layer on silicon caps used in the vacuum packaging of microbolometer arrays.