Search

Since one of the most crucial elements in crashes is related to human factors, driver behavior significantly impacts road safety. Driver behavior is influenced by many factors, including driving characteristics, experience, and the road environment. In this study, the effect of combining different elements including shoulder width (left shoulder width up to 0.6 m and more than 0.6 m as well as right shoulder width up to 1 m and more than 1 m), type and height of barriers (guardrail with a height 0.7 m, New Jersey with a height of 1.1 m, and retaining walls with heights of 5 and 10 m) on driver behavior on urban highways (in both upgrade and downgrade scenarios) was investigated. For this purpose, 20 urban highway segments were selected for filming and speed recording using the laser gun camera. The results revealed that New Jerseys on the left shoulders had caused driver workload and concentration more than guardrails. An average of 5% reduction in speed and a 25% increase in the lateral offset of the barriers were recorded to reduce the driver's workload. A 10-m retaining wall has caused more driver workload and concentration on the right shoulder than the curbs. An average of 8% reduction in speed and a 36% increase in the lateral offset of the barriers were recorded to reduce the driver's workload. It was also concluded that increasing the shoulder width can reduce the driver's workload. Finally, the movement methods model was predicted by using the nonlinear regression model for different car wheel positions from lateral lanes to various road barriers.

Segmental lining is a new supporting structure for mine tunnels, but the applicability of the existing protective coal pillar design method to this structure is uncertain. In this paper, based on TBM-inclined tunnels in Xinjie Coalmine, China, a 1:35 scale 2D physical model with a 4 m width and 1.8 m height was constructed to simulate the complete engineering process. The effects of coal mining on the safety of segmental linings were assessed to determine the optimal size of the coal pillar under inclined tunnels. The results indicate that a reasonable pillar width can maintain the inclined tunnel and its segmental lining stable under deep mining activities. During the coal excavation process, the tangential force around the lining will gradually increase; the left shoulder, crown, and right shoulder of the lining are the positions where the highest forces are expected, which are two or three times those of other positions; and the maximum displacement of the tunnel in the vertical direction is approximately triple that in the horizontal direction. Mining-induced rock bursts are the key factor in lining instability, especially under excessive amplitudes and high-frequency vibrations, which promote segment cracking. For the Xinjie Coalmine, damage to the tunnel lining can be initiated when the coal pillar width below the pair of tunnels reaches 120 m, and visible cracks appear when the pillar width is below 100 m. Thus, it is recommended that the optimum pillar width for mining should be set at 120 m.

Masking effects have been demonstrated in which tactile sensitivity is affected when one touch is close to another on the body surface. Such effects are likely a result of local lateral inhibitory circuits that sharpen the spatial tuning of a given tactile receptor. Mutually inhibitory pathways have also been demonstrated between cortical tactile maps of the two halves of the body. Occasional reports have indicated that touches on one hand or forearm can affect tactile sensitivity at contralateral locations. Here, we measure the spatial tuning and effect of posture on this contralateral masking effect. Tactile sensitivity was measured on one forearm, while vibrotactile masking stimulation was applied to the opposite arm. Results were compared to sensitivity while vibrotactile stimulation was applied to a control site on the right shoulder. Sensitivity on the forearm was reduced by over 3 dB when the arms were touching and by 0.52 dB when they were held parallel. The masking effect depended on the position of the masking stimulus. Its effectiveness fell off by 1 STD when the stimulus was 29 % of arm length from the corresponding contralateral point. This long-range inhibitory effect in the tactile system suggests a surprisingly intimate relationship between the two sides of the body.

Aiming to get the strata behavior and stability rules of surrounding rock of the main return airway of Yushujing Coal Mine, convergence deformation of two sides and force of U-shaped steel yieldable support and bolt were monitored, and deformation of surrounding rock and mechanical characteristics of support structure were timely obtained to guide the information construction and optimize supporting parameters in water-rich soft rock roadway. The field monitoring results indicate the following. (1) Convergence displacement of rock surface increases with time continuity and shows surrounding rock’s intense rheological behavior. The original support scheme cannot control the large deformation and strongly rheological behavior; (2) Without backfilling, the U-shaped steel support begins to bear load after erecting for 4–7 days and increases rapidly in the first 30 days. The U-shaped steel support at the right shoulder and top of roadway bears a larger force and the left side and shoulder bears a smaller force; (3) The stress of bolt increasing over time and at the right shoulder of roadway has larger growth and value. The mechanism of rock deformation and the failure and strata behavior in water-rich soft rock roadway are revealed based on the results of the measured relaxation zone of surrounding rock, measured stresses, and the rock mechanics tests.

A case of an 18-year-old gardener who sustained an anterior-superior dislocation of the sternoclavicular joint while playing handball and falling on his right shoulder is presented. Non-surgical treatment failed, and the patient could willingly dislocate the right clavicle while abduction and external rotation of the arm. This painful condition was finally treated with surgical reconstruction of the sternoclavicular joint using gracilis tendon autograft and repair of the discus. Level of evidence Therapeutic study, case report and technical note, Level IV.

We report a case of a 15-year-old girl who presented with pain and swelling in the right shoulder. Imaging studies showed an inflammatory process well limited at the rotator interval. Open biopsy showed an osteogenic process that was evident in the postoperative X-rays. Two-year follow-up showed a mature ossification at the rotator interval.

The electrophysiological basis underlying the genesis of the U wave remains uncertain. Previous U wave modeling studies have generally been restricted to one or two dimensional geometries, and it is not clear whether the U waves generated by these models would match clinically observed U wave body surface potential distributions (BSPDs). We investigated the role of M cells and transmural dispersion of repolarization (TDR) in a two dimensional, fully ionic heart tissue slice model and a realistic three dimensional (3-D) heart/torso model. In the 2-D model, while a U wave was present in the ECG with dynamic gap junction conductivity, the ECG with static gap junctions did not exhibit a U wave. In the 3-D model, TDR was necessary to account for the clinically observed potential minimum in the right shoulder area during the U wave peak. Peak T wave simulations were also run. Consistent with clinical findings, the body surface maximum of the U wave was shifted to the right compared to the T wave maximum. We conclude that TDR can account for the clinically observed U wave BSPD, and that dynamic gap junction coupling of M cells is required to produce realistic U waves generated by M cells.

Malignant fibrous histiocytoma (MFH) is a pleomorphic sarcoma, occurring most frequently in the deep soft tissues of the extremities, and it is most frequently seen in elderly patients. A primary MFH of the diaphragm is very rare, and to the best of our knowledge, a multi-phased spiral CT appearance of this tumour has not been previously reported. In this report, we describe the clinical and multi-phase CT features of a primary MFH of the diaphragm.

The present study reports on a case of a 10-year-old patient with recurrent right shoulder instability after a traumatic event leading to a mid-substance tear of the anterior band of the inferior glenohumeral ligament complex in an L-shaped pattern. Arthroscopic repair consisting of a 2.4 mm bioabsorbable suture anchor at the apex and a four PDS sutures placed through the capsulolabral junction leads to an anatomic repair with excellent short-term results similar to those found in other studies. The injury pattern is thought to be about 1% of shoulder dislocations, but tear pattern recognition is critical for a successful repair and clinical result.

The gold standard for the treatment of large displaced glenoid rim fractures has been open reduction and internal fixation using cannulated screws. With the advancement in arthroscopic techniques there has been a growing trend towards arthroscopic treatment of glenoid rim fractures. This report outlines the case of 39-year-old health men who sustained a complex multifragmented displaced glenoid rim fracture after a fall on the right shoulder. The injury was diagnosed by standard radiographs and 3D-CT. An arthroscopic reconstruction including closed reduction and internal fixation using suture anchors was performed. After a follow-up of 1 year the Constant Score was 94 points, the Rowe Score 100 points and the Western Ontario Shoulder Instability Index was 99.9 points. In the Simple Shoulder Test all questions were answered with “yes”. At the latest follow-up the patient was completely painfree and regained a full work activity level. On postoperative 3D-CT imaging the fracture was consolidated in an almost anatomic position with a nearly complete reconstruction of the inferior glenoid circle. In cases of displaced glenoid rim fractures closed reduction and arthroscopic reconstruction using suture anchors can lead to excellent clinical and radiological results.

Background A 46-year-old, nonsmoking, nulliparous woman with a 23-year history of rheumatoid arthritis presented with severely destructed right shoulder, right elbow, and right wrist joints, which resulted in a complete loss of working ability. Investigations Physical examination, X-ray, MRI, ultrasound, functional staging using the Shoulder Pain and Disability Index, the Patient Rated Elbow Evaluation, the Disabilities of the Arm, Shoulder and Hand, and the health-related quality-of-life Short Form 36 questionnaire, determination of the c-reactive protein level, erythrocyte sedimentation rate, Disease Activity Score 28 and the metalloproteinase profile, and histology of removed synovial tissue. Diagnosis Severe destruction of the right shoulder and elbow (Larsen grade IV) resulting from late-stage seropositive rheumatoid arthritis. Management Reconstruction of the elbow and ipsilateral shoulder in a two-step procedure: replacement of the elbow joint with a semiconstrained Gschwend-Scheier-Bahler III (GSB III™) elbow prosthesis (Zimmer, Inc., Warsaw, IN) followed by replacement of the shoulder with the Promos® Modular Shoulder System (Plus Orthopedics AG, Rotkreuz, Switzerland) 1 month later. The patient received 4 weeks of inpatient rehabilitation.

Bilateral anterior shoulder dislocation is an uncommon injury with around 30 cases reported in literature [1]. Chronic undiagnosed bilateral anterior shoulder dislocation is extremely rare with only five cases (Table 1) identified in literature [2–6]. Of 32 cases of chronic shoulder [7] dislocation, all were unilateral (31 anterior subcoracoid and one posterior) dislocations. The patients in this case report of chronic bilateral anterior shoulder dislocation presentedwith pain and shoulder dysfunction. Partial collapse of the posterior humeral head had occurred and in the right shoulder this mimicked a large Hill–Sachs defect. To our knowledge, such a case has never been reported in literature.

The multifocal form of skeletal tuberculosis is rare, even in endemic countries. We report an unusual case of multifocal tuberculosis in a 29-year-old immunocompetent female, presenting as periarthritis of the right shoulder. Multiple bone involvement was detected on bone scintigraphy. Diagnosis was confirmed after open biopsy and satisfactorily treated with antitubercular drugs.

We describe a case of a missed posterior dislocation of the right shoulder with a large reverse Hillsach’s lesion wherein we had to modify the commonly used Neer’s modification of McLaughlin’s procedure as there was severe communition of the lesser tuberosity. This case also illustrates the pitfalls associated with identification and management of these relatively rare injuries.

A 32-year-old male sustained penetrating injury of the right shoulder with an angled iron rod in a road side accident. He presented with the rod in situ in his shoulder. Fortunately there was no neurovascular deficit. The metal rod was carefully removed with success, after cutting the rod with hacksaw to avoid neurovascular damage during removal.

A fatal gunshot wound to the thorax from a .357 Magnum revolver is reported. The entrance wound was located dorsally at the transition of the right shoulder and the upper arm, the exit wound below the left axilla and a re-entry at the medial aspect of the left upper arm. A friend of the victim, who was present when the gunshot was fired, stated that it was a self-inflicted accident. But the inclusion of both upper arms in the trajectory allowed a comparison between the posture of the upper arms at the moment the gunshot was fired and the posture of the upper arms necessary for a self-inflicted gunshot wound. This reconstruction, which is presented in detail, definitely excluded a self-inflicted wound. The friend then confessed that he had fired the gun accidentally.

This work describes a severe case of myiasis by Cochliomyia hominivorax (Coquerel) in a 59-year-old patient living in an urban area of São Gonçalo, Rio de Janeiro. The patient had an open wound on the right shoulder parasitized by 287 larvae. In order to remove the larvae, the wound was washed with NaCl and solid vaseline was applied onto the wound and covered with gauze and adhesive tape. After 90 min, the larvae were killed by asphyxiation and were removed using sterile forceps and NaCl. This procedure left the wound completely clean.

A 48-year-old man presented to the orthopedic surgery clinic for evaluation of significant right shoulder pain, weakness, and numbness on the anterior aspect of his right shoulder. Eleven months previously, the patient fell off a ladder and sustained an anterior right shoulder dislocation. The patient was able to reduce his shoulder himself within 5 min. MRI of the shoulder was performed (Fig. 1).

Extrarenal malignant rhabdoid tumour is a rare neoplasm of childhood. A congenital example has only been reported once previously, presenting as a facial mass. We report a second congenital case with the tumour over the right shoulder in which postoperative investigations revealed multiple hepatic metastases proving fatal at 51 days, with adjuvent therapy felt inappropriate.

ON November 30, at 8.27 p.m., a large meteor passed from Dubhe, in the Plough, through the lower part of Auriga, exploding in sparkling reddish light; and at 9 another described nearly the same line, but without explosion. The latter left a very vivid bluish light in its path, which lasted about ten seconds. At 10.55 a very large meteor dropped right down from Psi Ursae Majoris, and disappeared in a black cloud a few degrees above the horizon. At 11.10 one sped rapidly from Beta Ursae Minoris through between Epsilon and Zeta (Mizar) Ursae Majoris, and exploded in very brilliant white light. At 11.20 one proceeded from a point about 1° below Benetnasch, and disappeared in the right shoulder of Hercules without explosion. At 11.25 one blazed out from a point 2° above Etanin, and disappeared near Beta Cygni. At 11.30 a large and brilliant but a transient meteor went from Omicron Ursae Majoris, and disappeared in the tail of the Dragon. At 11.35 one dashed out from a point about 1° above Pi Ursae Majoris, and I thought that it would go through Merak, but just before it reached Merak it curved suddenly from it and exploded. About 12 a number of small ones were seen. December 1—Meteors seen at 0.13 a.m., 0.18, 1.12, 1.23, 1.45, 3.30, 3.40, 4, 4.23, 4.40, 4.55, 5.7, 5.10, 5.18. December 4—At 2.15 a.m., 2.20, 2.25, 2.28; and a number of meteors were observed between 5 and 6 p.m. December 5—A goodly number of meteors seen from 1 a.m. to 6, and from 8 p.m. to 10. December 6—1.12 a.m., 1.15, 1.22, 2.10, 2.30, 3.40, 5.21, 5.25. December 7—Three meteors seen. December 8, 9, 10, and 12—Only a few meteors were observed here; and from the unfavourable state of the weather, not a meteor could I manage to see since. I have ascertained the paths of all the above meteors, but to give them all would encroach too much on your space. I will supply particulars if required. On November 30 and December 1 last there was a brilliant display of meteors. A few Leonids, Leo Minorids, Taurids, and Geminids were seen. Six Andromedes made their appearance from December 4 to 8. On December 8 a beautiful bolide rushed through the clouds from south-west to south-east, at 6 p.m. Not a star in that part of the heavens could be seen at the time, but the moon shone dimly a little to the left of it. The point at which it appeared was a few degrees higher than the moon, and it disappeared a few degrees above the earth. It blazed in and out three different times on its way through the black clouds, and a little before the end of its journey it swelled cut into a huge magnificent ball of red fire, and by its explosion it illumined the western heavens and earth with its bright crimson light. A few of the spectators were alarmed at the unusual apparition. No intonation. Left in its wake a red belt of fire. The light of most of the meteors was blue, or the colour of electric light. A number of the meteors curved suddenly round just before disappearing. Numbers of meteors were seen dropping into black clouds, others seen dropping out of them down to the horizon.

I HAVE observed a curious optical effect which I have not seen described anywhere. If an open book is illuminated fairly strongly from one side, for example, from over one shoulder, the general colour of the white paper is different for the two eyes when one or the other is closed. The effect has been tried with several subjects with the same result. When the light comes over the left shoulder and the left eye is open the pages have a bluish tinge ; when the right eye is open and the left closed the tinge is reddish. If the light comes over the right shoulder the above effects are reversed. If the light is centrally placed above and behind the head there is no difference.