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Introduction: During night flying operations, Night Vision Goggles (NVGs) help the aircrew to visualize by intensifying lights reflected from an object. Night sky illumination and image intensification mechanism are the two important factors that affect visual acuity (VA) through NVG. Hence, assessment of visual acuity through Gen 2++ and Gen 3 NVG under different illumination conditions and comparative analysis between the two NVGs was the desired objective of the study. Material and Methods: In a prospective repetitive measure design, a total of 60 volunteered subjects were examined for their VA through Gen 2++ and Gen 3 NVGs using USAF Tri-Bar Chart in the eye lane room of the NVG Lab. The VA was measured under four different illumination conditions; full moon (FM), half moon (HF)quarter moon (QM), and starlight (SL) conditions. The measured VA was converted to logMAR values and analyzed. Results: VA deteriorated significantly with decreasing illuminations through both Gen 2++ (χ2 = 149.9, P < 0.001) and Gen 3 NVGs (χ2 = 156.5, P < 0.001). For Gen 2++ NVG, the difference in VA was statistically significant in all conditions other than between FM and HM. Whereas, it was almost significant for all illumination conditions for Gen 3 NVG. The VA through Gen 2++ was better than Gen 3 in all conditions and the difference in VA widened with decreasing illuminations. Conclusion: VA declined with decreasing illuminations for Gen 2++ as well as Gen 3 NVG, even though, the difference was not significant between FM and HM for Gen 2++ NVG. VA was observed to be consistently better through Gen 2++ NVG compared to Gen 3 across all four illumination conditions. However, keeping in view the dynamic changes in night sky illuminations during flying operations, the findings of the study need to be validated in operational conditions.

To summarize the evolution of intramedullary nailing, highlight important milestones, introduce the atmosphere of the era concerning the first uses and development of intramedullary nailing, and present the status of nailing in modern international orthopaedics and traumatology. A thorough literature search was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize the literature on the history and evolution of intramedullary nailing. The first use of an intramedullary device was attested in ancient Egypt; however, the first use of intramedullary nailing was reported in 1524 in Mexico, and the first medical journals reported on intramedullary nailing around the mid-1800s. The evolutions of intramedullary nailing including approach, material, cross-section and shape, and reaming technique occurred in the twentieth century. During the 1960s, intramedullary nailing was abandoned in favour of plate and screws osteosynthesis; however, in the 1970s, 1980s, and 1990s, a surge of novelties including flexible reaming, interlocking, and use of image intensification and titanium nails led to the advent of the second-generation intramedullary nailing. Today, intramedullary nailing has become the standard treatment of long bone fractures with low infection rates, small scars, excellent stabilization of the fractures, and immediate mobilization of the patients. Intramedullary nailing has revolutionized the treatment of long bone fractures. However, with numerous nail designs, a lot of information on their efficacy is lacking. Considerably more work will need to be done to determine the optimal nail specifications.

This article focuses on the trends implying the creation and presentation of the image of a politician and his family in the media political discourse, as well as on their impact on shaping and maintaining an image status within predictive strategies of real action. The author defines the concept of the “personal brand” and offers an analysis of the degree of its dependence on the means of media presentation and self-presentation, as well as forecasting public authority. The goals of creating and promoting the politician’s image components, and its criteria in view of self-presentation are also identified here. Special attention is paid to the latest trends in the image representation related to Donald Trump and his family in public speeches in the media space. To this end, there has been an analysis carried out aimed at studying American Internet items about each of the family members of the US 45th President, which allows giving a clear idea of the development of a specific family image in the image of a political figure in the media, analyzing them, in order to intensify or compromise each of them, and describing the means by which the paradoxical effect of weakening the public authority in media discourse is achieved. The main method to discover the features of the family image influence degree on politician’s personal brand is discourse-analysis supplied with some techniques of linguocultural and social pragmatic linguistic modelling of communicative interaction. There is an identification of the degree to which the mass media influence the political image, and through it – the promotion of the politician’s personal brand and public authority. Based on the study outcomes, the author concludes that a politician’s image components depend on the degree of family relations accentuation within the concept-value space of the politician viewed as an individual, which is determined by the frequency and adequacy of media discursive means of intensification, whereas the personal brand, in turn, has a dominant impact on the politician’s public policies and credibility, as well as on his family image in the media. Given this dichotomous mutual effect, a positive or negative self-presentation of a political figure is performed.

The article deals with innovative-oriented approach to training of the future engineers and educators in the field of food technology. The necessity of introducing innovative-oriented approach as the effective means of improving training of the future specialists is proved, this approach enables the consolidation of the positive motivation to master the knowledge and skills of chosen profession, the formation of professional competence and steady need for activity, constant self-improvement of the professional image intensification of the future position of engineer-teacher in the field of food technology in educational purposes promotes awareness of his/her own capacities and abilities, willingness to change, improving his/her own «I». Innovation-oriented approach allows taking innovation criteria. This approach allows to realise the focus on the individual training of the future engineers-teachers in the field of food technology; focus teachers attention on the formation of professional and personal qualities that allow students to actively participate in innovation activities . The innovation-oriented approach is understood as the methodological orientation training of the future engineers-teachers on the development of demand for non-standard solutions of educational problems, ensuring the revitalization of their creative ability and readiness to use innovative technologies in practice. This approach ensures harmonization of pedagogical influence and action of students at school, gain experience creative problem solving and the use of innovative technologies for planned results.

Humans have always sought to enhance their ability to see during periods of low illumination and in adverse weather. Historically, natural nighttime illumination from the moon and stars was augmented with artificial illumination to enable people to perform tasks or to provide surveillance capability. Passive night vision systems based on thermal imaging technology operate by detecting infrared emission of objects in the scene. Thermal imaging theory is based on the fact that every object emits radiation. The nature of warfare and its corresponding peacetime training demands match well the operational capabilities of passive night vision systems. The ability to conduct nighttime operations and to provide undetected surveillance are major goals in most military scenarios. The placing of night vision devices on the helmet has significantly increased the amount of weight that must be supported by the head. The contrast and resulting image quality also are a function of the signal-to-noise ratio of the intensifier tube.

Objective To report our experience with a novel alternative method of freehand interlocking of intramedullary nails. This method requires the use of only anterior-posterior image intensification and an intramedullary guide wire to verify screw placement. Our results are compared with historical results in the literature. Methods A total of 815 patients were treated using this technique from January 2008 to December 2012; 603 patients had fractures of the tibia and 212 had fractures of the femur. Results The mean duration of surgery for tibial shaft fractures was 55.6 minutes (range 42–60 minutes) and that for fractures of the femur was 78 minutes (range 50–90 minutes). The mean time for each distal locking was 3.8 minutes (2.5–5.1 minutes), with 7.65 seconds of exposure to radiation during each block. Conclusions The surgical technique is simple, easy and reproducible. Mean time of surgery and radiation exposure was less than that in the literature. A comparative study should be performed.

Objective In this study, we evaluated the reliability, reproducibility and final outcome of our techniques for performing image independent tibial interlocking nailing. Design Prospective. Setting Tertiary teaching hospital (level I trauma center). Patients/participants A total of 29 patients were selected for the study (21 males and 8 females patients). Intervention Locked tibial intramedullary nailings were performed in the selected subjects, using the standard AO interlocking nail (SynthesTM, Switzerland), utilizing our improvisations of the standard technique. Main outcome measurements The successful completion of the technique was the prime parameter evaluated. Total surgical time, time taken for placement of each distal bolt, fluoroscopy time (when used) and postoperative alignment and reduction were evaluated. The patients were followed at 4 weekly intervals. Results The average duration of the surgery was 78.6 minutes. The mean distal locking time was 16.2 ± 1.4 minutes. Fluoroscopy had to be used in three cases, when the distal locking by the ‘nail-over-nail’ technique failed. In one case, the intra-medullary position of the guidewire had to be verified. Thus, 26 out of 30 (86.7%) cases were performed without any imaging assistance. In two cases, the fracture site had to be opened after difficulties were encountered in achieving closed reduction. Thus, 24 out of 30 procedures (80%) were successfully completed by our technique. The fractures were followed to union and the long-term results were comparable to the results of tibial fracture operated by image assistance. Conclusion The technique described here can come handy in situations of image intensifier failure. Routine use of part of the steps can assist in reducing radiation exposure during interlocking nailings. How to cite this article Mathew M, Dhillon MS, Gakhar H. A Technique for Closed Interlocking Nailing of Midshaft Tibial Fractures without Image Intensification. J Postgrad Med Edu Res 2014;48(3):111-116.

Osteochondromatas of bicipital tuberosity are rare, most commonly occurring as metaphyseal benign tumours of the long bones. The usual presenting symptoms are pain and reduced rotation of the elbow. A painful clunk in the wrist as a presenting symptom has not been described before.We present a young lady with a two-year history of a painful clunk in her wrist. Her case presented a diagnostic challenge, as the pain and the click originated from her elbow and radiated down her forearm to the wrist. She underwent several radiological studies, and examination under anaesthesia confirmed the diagnosis. Excision was performed resulting in complete resolution of her symptoms.Along with painful clunk in the wrist originating from the elbow, an enlarged radial tuberosity should raise a high index of suspicion, and MRI scans and examination under image intensification can aid in the diagnosis of radial tuberosity osteochondroma.

Intraoperative C-arm image intensification is required for primary total ankle replacement implantation. Significant radiation exposure has been linked to these procedures; however, the radiation exposure during revision total ankle replacement remains unknown. Therefore, we sought to evaluate the radiation exposure encountered during revision total ankle replacement. The data from 41 patients were retrospectively analyzed from a prospective database: 19 Agility(™) to Agility(™); 4 Agility(™) to Custom Agility(™); 9 Agility(™) to INBONE(®) II; 5 Agility(™) to Salto Talaris(®) XT; 2 Scandinavian Total Ankle Replacement Prosthesis to Salto Talaris(®) XT; and 2 INBONE(®) I to INBONE(®) II revision total ankle replacements were performed. Two broad categories were identified: partial revision (Agility(™) to Agility(™), Agility(™) to Custom Agility(™), INBONE(®) I to INBONE(®) II) and complete conversion (Agility(™) to INBONE(®) II, Agility(™) to Salto Talaris(®) XT, Scandinavian Total Ankle Replacement Prosthesis to Salto Talaris(®) XT). The mean radiation exposure per case was significant at 3.49 ± 2.21 mGy. Complete conversions, specifically Agility(™) to INBONE(®) II, exhibited the greatest radiation exposure and C-arm time. Revision implant selection and revision type (complete or partial) directly contributed to radiation exposure. Accordingly, revision systems requiring less radiation exposure are preferable. Surgeons should strive to minimize intraoperative complications and limit additional procedures to those necessary, because both lead to additional radiation exposure.

This chapter deals with the flight testing of electro-optical (EO) systems (e.g., day television [TV], image intensification [I2] systems, etc.) and infrared (IR) systems (e.g., forward-looking infrared [FLIR], IR line scanners, etc.). There have been vast improvements in both of these types of systems as a result of miniaturization, production techniques, and processing technology since their introduction to the military world in the 1960s. As accuracies in detection and identification improve, the method of testing these systems becomes more exact. As with radar testing, the evaluator must be cognizant of the target environment and how changes in this environment.

Current methods of distal interlocking of intramedullary femoral nails are dependent on image intensification. However, radiation exposure to the patient, the operating room staff, and the surgeon remains a concern. Proximally mounted, radiation-free aiming systems for distal interlocking of femoral nails have reportedly failed because of nail deformation with insertion. To better understand this deformation, a three-dimensional magnetic motion tracking system was used to determine the position of the distal interlocking hole following nail insertion. The amount and direction of deformation of commercially available small-diameter implants (unslotted 9-mm nails inserted without reaming) and large-diameter implants (slotted 13-mm nails inserted with reaming) from a single manufacturer were analyzed. Measurements of deformation (three translations and three angles), based on the center of the distal transverse locking hole, were performed on 10 paired intact human cadaveric femora before and after insertion. The technique produced the following results for the small and large-diameter nails, respectively: lateral translations of 18.1+/-10.0 mm (mean+/-SD, range: 47.8 mm) and 21.5+/-7.9 mm (range: 26.4 mm), dorsal translations of -3.1+/-4.3 mm (range: 15.2 mm) and 0.4+/-9.8 mm (range: 30.1 mm), and rotation about the longitudinal axes of -0.1+/-0.2 degrees (range: 0.7 degrees) and 10.0+/-3.1 degrees (range: 7.8 degrees). This technique is useful for measuring insertion-related femoral nail deformation. The data for the nails tested suggest that a simple aiming arm, mounted on the proximal end of the femoral nail alone, will not sufficiently provide accurate distal aiming.

Background We investigated the value of using contrast as an additional aid to confirm the accuracy of needle placement for caudal epidural injections under intraoperative image intensifier guidance. Methods A total of 252 consecutive patients were included in this study. Their mean age was 46.7 years (range, 32 to 76 years). There were 133 males (53%) and 119 females (47%) over a 12-month period. Results Of the 252 consecutive procedures, the contrast enhanced image intensifier confirmed accurate needle placement on first attempt in 252 cases (100%). Needle resiting following the infiltration of contrast was required in 0 case. Conclusions The results from this study demonstrate that a surgeon beyond the learning curve can accurately place caudal epidural injections using image intensification only, without the use of contrast.

18 patients representing 20 uncemented hydroxy-apatite-coated total ankle arthroplasties (2 bilateral cases) were reviewed for 1–4 years. The diagnoses were primary arthrosis in 4 ankles, secondary arthrosis (following malleolar fractures) in 14 ankles, and haemochromatosis in 2 ankles. The patients were assessed preoperatively and at every follow-up, according to an ankle score system, giving 100 points for a normal ankle (50 points for no pain, 30 points for normal everyday life function and 20 points for normal mobility). Image intensification was used to assess loosening or subsidence of the prosthetic components and of the subtalar joint radiologically. The mean preoperative ankle score was 27.5 ± 11.5 SE. At the latest follow-up the ankle score was 91.8 ± 10.2 SE ( P

Revision hip surgery for a loose or infected prosthesis is becoming more common as increasing numbers of total hip replacement are performed each year. The use of the image intensifier to aid in the removal of the femoral cement is described, and the results of eighteen cases perfomed in this fashion reported.

Postoperative CT examinations of an unselected group of 45 patients with fractures of the thoracolumbar and lumbar spine including 1 patient with traumatically activated spondylolisthesis were analyzed for the location of the 200 screws, the angles of insertion, and the screw vs pedicle diameters. In all cases transpedicular systems had been used for fixation, i.e., the AO-Fixateur Interne in 28 patients, a combination of Teinturier plates and USI screws in 11 patients, and the VSP system in 7 patients. Using a standardized surgical technique and image intensification in 2 planes throughout, 92 percent of all pedicles were instrumented with acceptable deviations from the anatomic axes. Mismatches between the pedicle and the screw diameters were found in 3 instances, and 2 screws were placed in the transverse processes only. Canal encroachment in 13 patients did not impede neural structures. Slight perforation of the anterior cortex of the vertebral body was recorded in 3 percent of cases, but did not cause any complications.

In 1963, by invitation, particle physicist George Reynolds (Princeton University) brought an image intensifier to Woods Hole Marine Biological Laboratory. Together, he and a group of biologists began experimenting with the device as a way to create images of cells in low-light level situations, especially in the study of bioluminescence. In this paper I am interested in how the scientists, a physicist and biologists in collaboration, assessed, interpreted and presented the pictures that they created with the aid of image intensification. In particular, I consider the problem of ‘noise’ in the image. The paper ends with an example of how Reynolds and a biologist at Woods Hole contended with the presence of noise in images used for publication. Here is an example of how data is modified, that is, enhanced, to serve as scientific evidence. By presenting an early and simple case of the altered image I reveal one way scientists addressed the potentiality of presenting inappropriately modified data – a concern that has garnered much attention in the current age of digital imaging technologies.

Images on developed photographic emulsions can be significantly intensified by making the image silver radioactive and exposing a second emulsion to this radiation. Because the print, an autoradiograph, reproduces the original with significant increases in density and contrast, the method can be used to enhance underexposed emulsions and to increase the limits of photographic detection. This paper reports a new, practical chemical method for activating the silver, using thiourea labeled with sulfur-35, a process convenient for use in photographic laboratories. Speed increases of 13 and contrast increases of 18 were achieved with Kodak Plus-X film in this initial phase.

The intra-articular anatomy of 103 equine tarsi was studied by contrast radiography with image intensification and computerized tomography. There was communication between the tarsometatarsal and distal intertarsal joints in 21 of 55 (38%) interpretable tarsometatarsal arthrograms, and in 11 of 48 (23%) interpretable distal intertarsal arthrograms. The difference was not significant. The volume of contrast agent and the pressure of injection did not correlate with communication. Forced injection caused subcutaneous leakage of contrast medium but not communication. Communication occurred via the tarsal canal and the space between the third and the combined first and second tarsal bones. Injection of the distal intertarsal joint from the dorsomedial aspect of the limb, distal to the palpable distal border of the medial branch of the tendon of the tibialis cranialis muscle and between the central, third, and combined first and second tarsal bones, provided reliable access except in the presence of severe periosteal proliferations.

A number of currently proposed helmet-mounted display (HMD) designs relocate image intensification (I 2 ) tubes to the sides of the helmet. Such a design approach induces a visual condition referred to as hyperstereo vision (or hyperstereopsis). This condition manifests itself to the user as an exaggerated sense of depth perception, causing near- to mid-range objects to appear closer than they actually are. Hyperstereopsis is potentially a major concern for helicopter operations that are conducted at low altitudes. As part of a limited flight study to investigate this phenomenon, five rated U.S. Army aviators, as technical observers, wore a hyperstereo HMD during the conduct of a series if 13 standard maneuvers. Two subject aviators acquired a total of eight hours and three aviators a single hour of flight. Using a post-flight questionnaire, these aviators were asked to compare their visual experiences to that of normal I2-aided flight. Depth perception at distances below 300 feet was identified as the greatest challenge. The two 8-hour aviators reported a 5-8 hour "adaptation" period for most maneuvers.

This study was conducted to evaluate the effect of offsetting the sensors in digital night vision goggles (NVGs) (thermal and image intensification [I2] sensors) from the eye. In addition to the digital prototype goggles, an enhanced NVG (ENVG), which optically combined thermal and I2 capabilities, was used as a baseline device. The experiment was executed over a period of a week with five groups of Soldiers, each of which contained six Soldiers acting as participants. Soldiers received familiarization training about the two prototype night vision devices (NVDs) and the baseline device, and they were briefed at the start of each exercise to explain what was required of them during the event. The exercises included a wide range of infantry activities to enable comprehensive assessment of features. These included grid location exercises, individual movement techniques (IMT) course trials, cross-country woodland patrols, target laser trials, and aim light mounting trials. The experiment was conducted in October 2005 during hours of darkness at various sites in Fort Benning, Georgia. The prototypes did not perform as well as the baseline in this study on the dismounted tasks. Soldiers preferred the baseline overwhelmingly to either of the prototypes because with the baseline goggle, they could see terrain features much better for navigation and walking, for firing a laser at targets, and for performing close tasks than they could with the prototypes with the offset sensors. The prototype goggles caused the Soldiers to experience problems such as eyestrain and disorientation. It may be that the use of NVGs with offset sensors will cause Soldiers difficulty when they perform dismounted tasks. However, this conclusion cannot be stated categorically because the devices with offset sensors used in this study were prototypes and had other problems that could also have impacted their performance.

Night vision devices provide enormous benefits. They enable personnel to carry out operations under conditions that would not otherwise be possible. However, these benefits carry considerable risks. For instance, individuals often become over confident about their ability to use image intensification and infrared devices. In consequence, the use of night vision equipment is an increasingly common factor in military incidents and accidents. This paper uses an analysis of incident and accident data to identify requirements for the successful deployment of night vision equipment. It is argued that these applications must be integrated more closely with existing navigational systems. The successful application of this technology also depends upon adequate risk assessment and team-based training.

Kodak recently introduced new packaging for its X-Omat V verification film, including a label on the exterior of the packet. Patient images taken using the film in an image intensification cassette showed artefacts which appeared to be related to the label. Investigation showed the effect was only observed in conditions of high-Z build-up or backscatter or when the film was used without additional backscatter. The label provides extra build up when in front of the film and an increase in optical density of up to 0.04 units. When the label is on the rear of the film it absorbs backscattered particles, causing a decrease in optical density. It is concluded that X-Omat V film packets with labels are unsuitable for use in imaging cassettes unless they are used in conditions of low-Z build-up. Alternatively the film must be removed from the labelled envelope if it is to be used in high-Z build-up conditions.

Triple arthrodesis is indicated for pain, deformity, and instability of the tritarsal complex. Although osseous consolidation is important to outcome, success depends primarily on appropriate realignment. A poorly positioned triple arthrodesis may result in continued pain and disability, gait disturbances, excessive stress in adjacent joints, and footwear problems. We present a protocol for intraoperative realignment of the triple arthrodesis guided by image intensification. This protocol for alignment evaluation was followed in nine patients who underwent triple arthrodesis for a variety of pathologies. (J Am Podiatr Med Assoc 95(1): 13–17, 2005)