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Purpose One method of predicting leg-length discrepancy at maturity is the Moseley straight-line graph. Beumer et al developed an alternative graph, using a more modern Dutch population. The purpose of this study was to compare the prediction accuracy of these two graphs in a cohort of patients treated at our institution using epiphysiodesis. Methods We identified 76 patients treated using epiphysiodesis for leg-length discrepancy who were followed to maturity and had adequate preoperative radiographic assessment for straight-line graph construction. We compared predicted long leg length (after epiphysiodesis), short leg length, and residual leg-length discrepancy to actual outcome for both methods, using both chronological and skeletal ages. Results Both methods were more accurate using skeletal age rather than chronological age. The Rotterdam graph showed modest improved accuracy compared to the Moseley graph in developmental aetiologies and in Hispanic patients. Using a difference of one centimetre in prediction error as clinically relevant (long leg [after epiphysiodesis], short leg, and leg-length discrepancy in each of the 76 patients, 228 predictions), we found comparable predictions in 171, more accurate prediction using the Rotterdam in 32, and using the Moseley in 25 predictions. Conclusion Straight-line graphs provide a generally more accurate prediction of leg lengths at maturity by virtue of multiple preoperative evaluations. The Rotterdam straight-line graph was equal to or superior to the Moseley graph in most patients in this cohort. Use of skeletal age resulted in more accurate predictions than chronological age. Clinicians should remain familiar with the concept and use of the straight-line graph. [ABSTRACT FROM AUTHOR]

Purpose The purpose of the study was to evaluate the reliability, review differences and assess patient satisfaction of electronic patient-reported outcome measures (PROMs) compared with paper PROMs. Methods Participants between 12 and 19 years of age with a knee-related primary complaint were randomized into two groups. Group 1 completed paper PROMs followed by electronic, while Group 2 received the electronic followed by paper. PROMs included the Pediatric International Knee Documentation Committee (Pedi-IKDC), Hospital for Special Surgery (HSS) Pediatric Functional Activity Brief Scale (HSS Pedi-FABS), Tegner Activity Level Scale, Visual Analogue Scale (VAS), PedsQL Teen and a satisfaction survey. Results In all, 87 participants were enrolled with one excluded due to incomplete PROMs. Of the 86 participants, 54 were female and 32 were male with an average age of 14.3 years (12 to 18). A high degree of reliability was found when comparing the paper and electronic versions of the Pedi-IKDC (0.946; p < 0.001), HSS Pedi-FABS (0.923; p < 0.001), PedsQL Teen (0.894; p < 0.001), Tegner Activity Level Scale before injury (0.848; p < 0.001) and the Tegner Activity Level Scale after (0.930; p < 0.001). Differences were noted between the VAS scores, with paper scores being significantly higher than electronic (5.3 versus 4.6; p < 0.001). While not significant, a trend was noted in which electronic PROMs took, overall, less time than paper (10.0 mins versus 11.2 mins; p = 0.096). Of all participants, 69.8% preferred the electronic PROMs, 67.4% felt they were faster, 93.0% stated they would complete forms at home prior to appointments and 91.8% were not concerned about the safety/privacy of electronic forms. Conclusion PROMs captured electronically were reliable when compared with paper. Electronic PROMs may be quicker, will not require manual scoring and are preferred by patients. [ABSTRACT FROM AUTHOR]

Purpose The Ponseti method of treatment is the standard of care for idiopathic clubfoot. Following serial casting, percutaneous tendo-Achilles tenotomy (TAT) is performed to correct residual equinus. This procedure can be performed in either the outpatient clinic or the operating room. The purpose of this study was to evaluate the expense of this procedure by examining hospital charges in both settings. Methods We retrospectively reviewed charts of 382 idiopathic clubfoot patients with a mean age of 2.4 months (0.6 to 26.6) treated with the Ponseti method at three institutions. Patients were divided into three groups depending on the setting for the TAT procedure: 140 patients in the outpatient clinic (CL), 219 in the operating room with discharge following the procedure (OR) and 23 in the operating room with admission to hospital for observation (OR+). Medical records were reviewed to analyze age, deformity, perioperative complications and specific time spent in each setting. Hospital charges for all three groups were standardized to one institution's charge structure. Results Charges among the three groups undergoing TAT (CL, OR, OR+) were found to be significantly different ($3840.60 versus $7962.30 versus $9110.00, respectively; p ≤ 0.001), and remained significant when separating unilateral and bilateral deformities (p < 0.001). There were nine total perioperative complications (six returns to the ER and three unexpected admissions to the hospital): five (2.3%) in the OR group, four (17.4%) in the OR+ group and none in the CL group. The OR+ group statistically had a higher rate of complications compared with the other two groups (p = 0.006). The total event time of the CL group was significantly shorter compared with the OR and OR+ groups (129.1, 171.7 and 1571.6 minutes respectively; p < 0.001). Conclusion Hospital charges and total event time were significantly less when percutaneous TAT was performed in the outpatient clinic compared with the operating room. In addition, performing the procedure in clinic was associated with the lowest rate of complications. [ABSTRACT FROM AUTHOR]

An electronic wedge brake (EWB) uses the wedge principle to provide a self-reinforcement mechanism, resulting in reduced current to the actuation motor. However, this mechanism can lead to an unstable open-loop system. In this study, an upper-wedge moving-type EWB is developed and a control algorithm is proposed to follow the target clamping force and to prevent jamming of the EWB system using the push-pull control of the actuator. The performance of the EWB is evaluated using a dynamometer and a simulator. Based on testing and simulation, the clamping force and braking time of the proposed EWB are shown to be satisfactory with respect to the required braking deceleration. [ABSTRACT FROM AUTHOR]

Introduction: A school-based obesity prevention program was designed using the community-based participatory approach to promote health-related behavioral changes. Methods: All physical education students in the middle school (6th, 7th, 8th graders) received the curriculum in a 9-week period as part of the normal class curriculum. A large subset of these students (pre-testing n = 226 and post-testing n = 214) agreed to participate in the research project evaluating its effectiveness. All subjects enrolled in the study were assessed on height, weight, nutritional knowledge, nutritional behaviors, physical activity behaviors, parental and peer support of nutrition and physical activity changes. A feedback questionnaire was completed by parents and students. Results: The program successfully impacted nutritional intake and physical activity as well as having a positive impact on both peer and parent support of behavioral change. Discussion: The positive results found in the present study are discussed in detail, along with limitations in this study and directions for future research to clarify effects. [ABSTRACT FROM AUTHOR]

Background Synovium is the only tissue that can produce hyaline cartilage in benign conditions, such as synovial chondromatosis and osteoarthritis, suggesting potential advantages in chondrogenesis using mesenchymal stromal cells. We performed surface characterization of cells isolated from the synovium of patients with osteoarthritis after different passages and induced chondrogenic differentiation. Methods Using cells obtained from synovium, colony-forming unit fibroblast assay and characterization of cell-surface markers by flow cytometry using 22 different Ab at different passages were performed. Cells were cultured under chondrogenic conditions and evaluated grossly, histologically, immunohistochemically and by [35S]sulfate incorporation and reverse transcription-PCR. Results The positive cell-surface markers of immediately isolated cells were CD10, CD13, CD14, CD34, CD44, CD45, CD49a, CD62e, CD73 and HLA-DR. After the first passage (P), CD14, CD34, CD45, CD62e and HLA-DR disappeared, whereas CD105 and CD166 appeared and CD10, CD13, CD44, CD49a and CD73 showed increased expression levels. The surface marker expression level did not vary much after P1 through to P8. The chondrogenic differentiation potential of cells from the synovium was confirmed using various evaluation methods. Discussion We have demonstrated that cells from synovium contain a mesenchymal stromal cell population capable of chondrogenic differentiation, which seems to increase with passage under our culture conditions. The cell-surface markers were found to change remarkably after the first passage and then remained stable. The results of this study may be helpful for sorting mesenchymal stromal cells from heterogeneous synovial cells for future studies. [ABSTRACT FROM AUTHOR]

Offshore pipelines are to be stabilized against external loading caused mainly by wave and currents. When pipelines are placed in a trench, the forces acting on them are reduced considerably. To investigate the stability in various trench sections, the flow over the pipeline is numerically simulated and compared with experimental results obtained from particle image velocimetry measurement. This paper consists of two parts: single pipe and dual pipe in various trench sections. Each part compares numerical results with experimental results, which include mean flow pattern, drag-force coefficient, and lift-force coefficient. For a single pipe, Smagainsky’s eddy viscosity model combined with a truncated deductive model is applied to represent the stress field in a quadrilateral structured grid system. In the numerical simulation for dual pipes, the Navier-Stokes equation and elliptic mesh generation method are used. The stability of various trench conditions is addressed in terms of mean amplitudes of oscillating lift and drag and reduction factors for each case. The results can be effectively applied to pipeline design. [ABSTRACT FROM AUTHOR]

The sound insulation properties of many structures mounted between adjacent rooms are known to be poor at low frequencies. The feasibility of using acoustic secondary sources in either the source room, or in the receiving room, to actively control the sound transmitted from one room to the other via a common panel has been investigated. A theoretical formulation for such low-frequency sound transmission was first developed. The effects of three different active control strategies were then investigated, using computer simulations with a pure-tone primary source, for a number of different room and panel arrangements. The first strategy involved minimizing the total acoustic potential energy in the source room using a secondary source in the source room. It was found that this could cause increases in the acoustic energy transmitted into the receiving room at some excitation frequencies. Second, the total acoustic potential energy in the receiving room was minimized using a secondary source in the receiving room. This strategy generally produced rather small reductions of sound energy in the receiving room. Finally, the approach of minimizing the total acoustic potential energy in the receiving room using a secondary acoustic source in the source room was investigated. This turned out to be the most successful strategy, giving significant reductions in transmitted sound energy, particularly for excitation frequencies at which only a few acoustic modes of the source room or structural modes of the panel were excited. These reductions in transmitted sound energy may, however, be accompanied by increases in the sound energy in the source room. [ABSTRACT FROM AUTHOR]