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Introduction: The aim of this study was to compare the results of single versus double row (TEO) in massive tears of the posterosuperior rotator cuff in patients older than 70 years old. Methods: Between October 2019 and July 2022, 46 patients, older than 70 years old, were operated on, in two centers, by one surgeon (FM), in one center, we performed a single-row repair, while in the other a double row, transosseous equivalent. Patients were paired by age and gender. All patients were studied with a preoperative MRI along with preoperative age and gender adjusted constant score. Postoperative patients were evaluated at the end of the FU. Mean time of FU for single row was 3.2 years (2–4.1) and for TOE was 3.5 years (2.4–3). Mean age for SR patients was 71.15 years (70–82) and for TOE was 74.8 years (70–81). We were able to evaluate 20 pairs of patients (15 pairs of females and five pairs of males). Results: CS differed in both groups of patients. Patients operated on with TOE had a better, but non-significant CS 81.3 (TOE) versus 75.7 (SR) p > 0.05. The patients operated own with TOE showed statistically significant better arm abduction strength than patients operated on with SR (p < 0.05). There was a trend for patients operated on with TOE to have a better ROM and less pain. Discussion: The results of our work show that patients older than 70 years old, with repairable RCT operated on with a transosseous equivalent, have a trend to have a better CS and a significantly better strength than patients operated on with SR. [ABSTRACT FROM AUTHOR]

In this study, we evaluate the soil moisture and precipitation products obtained from two reanalysis models: the National Centers for Environment Prediction (NCEP) and the European Center for Medium-Range Weather Forecasts (ECMWF). The study centers on Kuwait's semi-arid region, during the wet season (November to May) from 2008 to 2018. For the precipitation-related evaluation dataset, rain gauge records from the Kuwait Automatic Weather Observation System (KAWOS) were used, while the ground-truth soil moisture values were taken from the Climate Change Initiative (CCI-SM). Initially, to ensure CCI-SM reliability, we compare it with in-situ soil sensor measurements deployed at a desert site. The analysis revealed a maximum CCI-SM overestimation in winter, decreasing progressively throughout the year with 20% mean bias. The bias-corrected CCI-SM dataset is used for the comprehensive evaluation of the soil moisture reanalysis data. Accuracy metrics, such as mean bias (MB), correlation coefficient (R), and unbiased Root Mean Square Difference (ubRMSD), were used for this purpose. The results indicate that ERA5 consistently underestimates (~ 50% MB) soil moisture, but responds well under high soil moisture conditions. NCEP mostly overestimates soil moisture by a similar magnitude, providing even twice as high values during spring months. Mean monthly precipitation (MP) is also overestimated by NCEP, particularly during extreme episodes, yet found to be reliable enough regarding annual accumulated precipitation. ERA5 has shown strong (R ~ 0.6–0.9) predictive capabilities under both frontal and convective precipitation conditions, with ~ 3% median bias for MP, making it a promising alternative data source, particularly in regions with limited weather station coverage. [ABSTRACT FROM AUTHOR]

Background: Intraneural ganglion cysts of the peroneal nerve are rare, and there is lack of evidence for the surgical management of this entity. We performed this study to evaluate the imaging, diagnosis, treatment and outcome of seven patients with intraneural ganglion cysts of the peroneal nerve. Materials and methods: We retrospectively studied the files of seven patients with intraneural ganglion cysts of the peroneal nerve, diagnosed and treated from 2016 to 2019. Diagnostic approach included clinical examination of the leg and foot, magnetic resonance imaging, nerve conduction studies, surgical excision of the cyst and histological examination. The mean follow-up was 2 years (range 1–3.5 years). We evaluated the time and methods for surgical treatment, and the clinical outcomes of the patients. Results: All patients presented symptoms of peripheral compression neuropathy; three patients presented with foot drop. The intraneural ganglion cysts were excised in all cases in addition to knee articular nerve branch transection to avoid cysts recurrence. Postoperatively, all patients experienced complete neurological recovery without clinical evidence of intraneural ganglion cysts recurrences. Conclusion: The treating physicians should be aware of intraneural ganglion cysts of the peroneal nerve in patients presenting with limb weakness, sensory deficits at the lateral and anterior side of the leg and foot, paresis or paralysis of the foot and ankle. MR imaging is the imaging modality of choice for a clear and accurate preoperative diagnosis to avoid misdiagnosis and wrong treatment. In case of doubt, these patients should be managed in an orthopedic oncology setting with microsurgery facilities available for complete excision of the intraneural ganglion cyst. [ABSTRACT FROM AUTHOR]

Background: The optimal technique for the displaced greater tuberosity (GT) fractures remains unclear; those in favor of arthroscopic techniques emphasize on the feasibility of arthroscopic reduction and fixation, while others report that anatomic reduction and osteosynthesis of the fracture are optimal through open surgery. Therefore, we performed this study to evaluate the clinical results of arthroscopic fixation for displaced and/or comminuted GT fractures using a bridging arthroscopic technique. Materials and methods: We studied the files of 11 patients (4 men, 7 women; mean age, 55 years; range, 28–74 years), with an isolated, displaced GT fracture treated with arthroscopic reduction and double-row suture anchor fixation technique from December 2016 to October 2018. All patients were operated at a mean time from their injury of 23 days (range, 1–85 days) using an arthroscopic technique. Any concomitant pathology that was arthroscopically identified was identified and repaired after arthroscopic fixation of the GT fracture. The mean follow-up was 12 months (range, 6–18 months). We evaluated pain using a 0–10 point visual analog scale (VAS), shoulder range of motion, fracture healing, Constant-Murley Shoulder Outcome Score, and patients' satisfaction from the operation. Results: Postoperative radiographs showed anatomic reduction without any displacement of the GT fracture in eight patients and residual displacement of < 3 mm in three patients. All patients significantly improved in VAS score from 8.4 points (range, 7–10 points) preoperatively to 0.9 points (range, 0–3 points) postoperatively. Range of motion was 153 degrees forward flexion (range, 130–170 degrees), 149 degrees abduction (range, 120–170 degrees), 42 degrees external rotation (range, 20–70), and internal rotation between T10 and L3 spinal level. The final mean Constant-Murley Shoulder Outcome Score was 85.8 points (range, 76–94 points); correlation analysis showed that the patients with the higher greater tuberosity fracture displacement had the worst postoperative score (Pearson correlation coefficient –0,85; p = 0.0009), and the patients with nonanatomic reduction had close to average score. All patients were very satisfied with the end result of the operation, even the 3 patients with residual fracture displacement. No patient experienced any postoperative complications. Conclusions: Arthroscopic reduction and fixation of displaced GT fractures is a feasible minimally invasive procedure for optimal fracture healing and patients satisfaction. [ABSTRACT FROM AUTHOR]

Purpose: The optimal (SBJI) surgical treatment for acute acromioclavicular (AC) joint disruption remains controversial. What is being presented is the long-term functional outcomes of a double cross-looped coracoclavicular (CC) suture technique with the intention of restoring both anteroposterior and superior displacement of the clavicle. Methods: Between 2007 and 2016, 81 patients underwent surgical reconstruction for acute acromioclavicular joint (AC) disruption in two orthopaedic centers. Two patients died for reasons unrelated to the treatment, and seven missed the final follow-up appointment, leaving 72 patients (67 males; 5 females; age 37 ± 12.4; range 15–64 years) for clinical and radiological assessments. All cases were classified according to the Rockwood classification as type III (n = 34), IV (n = 14) or V (n = 24). The dislocation was repaired with double cross-looped CC fixation using four Ethibond sutures passing underneath the coracoid and through a 4.5 mm drill hole in the clavicle in opposing directions to control both anteroposterior and vertical displacement. Radiological investigation preoperatively and at the last follow-up included anteroposterior and/or Zanca views, axillary or Alexander views, and comparative stress radiography of both AC joints. Patients were evaluated clinically with the Constant-Murley score (CMS) and Acromio Clavicular Joint Instability Score (ACJIS). Loss of reduction, subluxation, CC ligament ossification, post-traumatic arthritis, and peri-implant fractures were also recorded. Results: Seventy-two patients were available for the last clinical and radiological evaluations. At a median follow-up period of 6.3 ± 2.1 years (range 3–12 years), the CMS and ACJIS were 92.1 ± 7.2 (range 60–100 points) and 90.4 ± 8.6 (range 45–100 points), respectively. Complications included 9 (12.5%) patients with slight loss of reduction, 2 (1.7%) with dislocation recurrence, 1 (1.3%) with superficial infection, 1 (1.3%) with a fracture of the lateral end of the clavicle, and 2 (1.7%) with persistent tenderness in the AC joint. The incidence of periarticular ossification was 22.4% and did not affect the final outcome. Conclusions: This technique represents an effective and low-cost treatment for acute AC joint separations. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

We investigate the temporal evolution of the planetary boundary-layer (PBL) height over the basin of Athens, Greece, during a 6-year period (2011–2016), using data from a Raman lidar system. The range-corrected lidar signals are selected around local noon (1200 UTC) and midnight (0000 UTC), for a total of 332 cases: 165 days and 167 nights. In this dataset, the extended-Kalman filtering technique is applied and tested for the determination of the PBL height. Several well-established techniques for the PBL height estimation based on lidar data are also tested for a total of 35 cases. The lidar-derived PBL heights are compared to those derived from radiosonde data. The mean PBL height over Athens is found to be 1617 ± 324 m at 1200 UTC and 892 ± 130 m at 0000 UTC for the period examined, while the mean PBL-height growth rate is found to be 170 ± 64 m h−1 and 90 ± 17 m h−1 during daytime and night-time, respectively. [ABSTRACT FROM AUTHOR]

High communicational standards have been set for the 5G mobile networks. Therefore, it is of great importance that technological solutions that include all the significant features, such as the high coverage and capacity and low round-trip delays, are adopted for the next generation of mobile networks. Except for their technical efficiency, these technologies should be profitable for providers as well. As a result, the need for limiting the costs spent for the development of these technologies emerges. In this papers, four models two for each one of the two solutions for 5G networks are developed, namely the Multiple Input Multiple Output (MIMO) and the Distributed Antenna System. The architectural models assumed for the techno-economic analyses are presented. The mathematical models for both technologies are developed. Experiments are conducted using prices of the Greek market and also Sensitivity Analysis (SA) is used to pinpoint, which cost parameters are the most expensive ones and therefore it is likely that they discourage providers to invest in them. To our knowledge there are not many studies comparing and contrasting these technologies and there is no SA for MIMO. Therefore, it is considered that research for these models is of vital importance for the next generation of mobile communication networks, as they are foundation stonesfor the formation of 5G. [ABSTRACT FROM AUTHOR]

This study applied the Systems Approach Framework (SAF) to address the issue of declining Atlantic cod fishery in coastal areas. Interviews of 58 fishers from 26 harbours and meetings with national fisheries organisations and managers revealed the perception of an offshore movement of coastal cod. Numerical modelling based on fishing survey data did not substantiate these perceptions in the data-poor coastal waters. However, Data Storage Tag (DST) information combined with bottom sea water temperature data from the spatio-temporal hydrodynamic Baltic Sea Ice-Ocean Model showed changes in potential cod habitat distribution in the Skagerrak-Kattegat and western Baltic from 1979 to 2016. Subsequently, cod habitats were defined in three categories: (i) potentially suitable (T ≤ 12 °C); (ii) episodic (12 < T ≤ 16 °C); and (iii) unsuitable (T > 16 °C). The environmental changes were linked to the socio-economic component of cod fishery. Cod catches (weight and monetary value) were retrieved using logbook information and data from the Vessel Monitoring System (VMS, 2005–2016) and the Automatic Identification System (AIS, 2006-2016). General additive modelling significantly showed the largest proportion of catches took place in the potentially suitable habitat whereas catches were lower in the episodic habitat and rare in the unsuitable habitat. The results of this first large-scale SAF application are highly valuable for adapting existing fisheries management by: (i) providing information on habitat shrinkage for Maximum Sustainable Yield (MSY) based stock assessments; (ii) adding a spatio-temporal dimension for coastal productivity relative to the vessel-based Individual Transferable Quota (ITQ) system; and (iii) providing a predictive scenario simulation tool for sustainable management under changing environmental conditions. [ABSTRACT FROM AUTHOR]

The lateral arm flap (LAF) is a popular flap transfer, which can be applied in many procedures. It was first described in 1982, and till then, even more clinical applications are suggested. It can be used as a free fasciocutaneous or fascial flap to cover small- to medium-sized soft tissue defects in head and neck but also in upper and lower extremity reconstruction, or as an osteocutaneous flap when vascularized bone graft is needed. We present the indications and contraindications, the advantages and disadvantages, as well as the step-by-step technique of harvesting a fasciocutaneous and an osteocutaneous flap and its complications. We conclude that the LAF is a reliable and versatile tool for reconstructive surgery, due to its anatomical characteristics and the low complication rate. [ABSTRACT FROM AUTHOR]

While free tissue transfer has long been established as a reliable microsurgical technique in the adult population, its application in pediatric reconstruction is a relatively recent phenomenon. Despite initial concerns regarding minute vessel diameters, increased propensity for vasospasm, and limited tissue availability, pediatric free tissue transfer is now a widely used technique that has demonstrated an acceptable level of donor and recipient site morbidity in children. Five flaps commonly used in the reconstruction of lower extremity trauma are discussed in this paper: the latissimus dorsi, rectus abdominis, anterolateral thigh, gracilis, and the subscapular and parascapular flaps. The indications, blood supply, advantages, and disadvantages of each are detailed. Incredible progress has been made in the application of microsurgical techniques to the pediatric population over the last several decades. With a healthy understanding of the anatomy and functionality of the donor site, the reconstructive surgeon can repair a variety of complex injuries with an acceptable morbidity and mortality rate. [ABSTRACT FROM AUTHOR]

Subtrochanteric fractures can result from high-energy trauma in young patients or from a fall or minor trauma in the elderly. Intramedullary nails are currently the most commonly used implants for the stabilization of these fractures. However, the anesthetic procedure for the patients, the surgical reduction and osteosynthesis for the fractures are challenging. The anesthetic management of orthopedic trauma patients should be based upon various parameters that must be evaluated before the implementation of any anesthetic technique. Surgery- and patient-related characteristics and possible comorbidities must be considered during the pre-anesthetic evaluation. Adequate fracture reduction and proper nail entry point are critical. Understanding of the deforming forces acting on various fracture patterns and knowledge of surgical reduction techniques are essential in obtaining successful outcomes. This article discusses the intraoperative reduction techniques for subtrochanteric fractures in adults and summarizes tips and tricks that the readers may find useful and educative. [ABSTRACT FROM AUTHOR]

Tumors of the hand comprise a vast array of lesions involving skin, soft tissue and bone. The majority of tumors in the hand are benign. Malignant tumors, although rare, do occur and frequently have unique characteristics in this specific anatomic location. Careful staging, histological diagnosis and treatment are essential to optimize clinical outcome. However, straightforward most of the time, hand tumor management does have pitfalls; caution is advised, as a missed or delayed diagnosis or an improperly executed biopsy may have devastating consequences. This article reviews the clinical spectrum of the most common benign and malignant bone and soft tissue tumors of the hand and discusses the clinicopathological findings, imaging features and current concepts in treatment for these tumors. [ABSTRACT FROM AUTHOR]

Posterior shoulder fracture-dislocation is a rare injury accounting for approximately 0.9 % of shoulder fracture-dislocations. Impression fractures of the articular surface of the humeral head, followed by humeral neck fractures and fractures of the lesser and grater tuberosity, are the more common associated fractures. Multiple mechanisms have been implicated in the etiology of this traumatic entity most commonly resulting from forced muscle contraction as in epileptic seizures, electric shock or electroconvulsive therapy, major trauma such as motor vehicle accidents or other injuries involving axial loading of the arm, in an adducted, flexed and internally rotated position. Despite its' scarce appearance in daily clinical practice, posterior shoulder dislocation is of significant diagnostic and therapeutic interest because of its predilection for age groups of high functional demands (35-55 years old), in addition to high incidence of missed initial diagnosis ranging up to 79 % in some studies. Several treatment options have also been proposed to address this type of injury, ranging from non-surgical methods to humeral head reconstruction procedures or arthroplasty with no clear consensus over definitive treatment guidelines, reflecting the complexity of this injury in addition to the limited evidence provided by the literature. To enhance the literature, this article aims to present the current concepts for the diagnosis, evaluation and treatment of the patients with posterior fracture-dislocation shoulder, and to present a treatment algorithm based on the literature review and our own experience. [ABSTRACT FROM AUTHOR]

Endovascular stents are widely used for the treatment of peripheral arterial disease (PAD). However, the development of in-stent restenosis and downstream PAD progression remain a challenge. Stent revascularisation of PAD causes arterial trauma and introduces abnormal haemodynamics, which initiate complicated biological processes detrimental to the arterial wall. The interaction between stent struts and arterial cells in contact, and the blood flow field created in a stented region, are highly affected by stent design. Spiral flow is known as a normal physiologic characteristic of arterial circulation and is believed to prevent the development of flow disturbances. This secondary flow motion is lost in atheromatous disease and its re-introduction after endovascular treatment of PAD has been suggested as a method to induce stabilised and coherent haemodynamics. Stent designs able to generate spiral flow may support endothelial function and therefore increase patency rates. This review is focused on secondary flow phenomena in arteries and the development of flow modification stent technologies for the treatment of PAD. [ABSTRACT FROM AUTHOR]

Oceans are exposed to anthropogenic climate change shifting marine systems toward potential instabilities. The physical, biological and social implications of such shifts can be assessed within individual scientific disciplines, but can only be fully understood by combining knowledge and expertise across disciplines. For climate change related problems these research directions have been well-established since the publication of the first IPCC report in 1990, however it is not well-documented to what extent these directions are reflected in published research. Focusing on the Nordic region, we evaluated the development of climate change related marine science by quantifying trends in number of publications, disciplinarity, and scientific focus of 1362 research articles published between 1990 and 2011. Our analysis showed a faster increase in publications within climate change related marine science than in general marine science indicating a growing prioritisation of research with a climate change focus. The composition of scientific disciplines producing climate change related publications, which initially was dominated by physical sciences, shifted toward a distribution with almost even representation of physical and biological sciences with social sciences constituting a minor constant proportion. These trends suggest that the predominantly model-based directions of the IPCC have favoured the more quantitatively oriented natural sciences rather than the qualitative traditions of social sciences. In addition, despite being an often declared prerequisite to successful climate science, we found surprisingly limited progress in implementing interdisciplinary research indicating that further initiatives nurturing scientific interactions are required. [ABSTRACT FROM AUTHOR]

Background: There is increasing evidence suggesting a high incidence of low-energy fractures of the diaphysis or the proximal femur in patients receiving bisphosphonates for a long time. Bisphosphonate-related femoral fractures occur after low-energy trauma and have a typical simple transverse or oblique radiographic pattern, with focal or generalized increased cortical thickness, cortical beaking, and medial spiking. Materials and methods: This article presents six female patients who experienced seven transverse femoral diaphysis and subtrochanteric fractures with cortical thickening and beaking; all patients had alendronate treatment for 4-10 years (average, 9 years) before their fracture. Results: The typical radiographic findings, long-term administration of alendronate, low-energy mechanism of fracture, and related literature support the fact that the fractures in the patients presented in this series should be related to alendronate treatment. Conclusion: Until definite evidence is available, alendronate treatment in patients with osteoporosis is not now prohibited by the healthcare authorities, probably because its beneficial influence outweighs the adverse effects. However, this adverse effect deserves attention of medical practitioners; physicians should be alert on alendronate's possible suppressive effect on bone turnover, which in turn may be responsible for the occurrence of femoral fractures. [ABSTRACT FROM AUTHOR]

Purpose: To compare modular monolateral external fixators with single monolateral external fixators for the treatment of open and complex tibial shaft fractures, to determine the optimal construct for fracture union. Materials and methods: A total of 223 tibial shaft fractures in 212 patients were treated with a monolateral external fixator from 2005 to 2011; 112 fractures were treated with a modular external fixator with ball-joints (group A), and 111 fractures were treated with a single external fixator without ball-joints (group B). The mean follow-up was 2.9 years. We retrospectively evaluated the operative time for fracture reduction with the external fixator, pain and range of motion of the knee and ankle joints, time to union, rate of malunion, reoperations and revisions of the external fixators, and complications. Results: The time for fracture reduction was statistically higher in group B; the rate of union was statistically higher in group B; the rate of nonunion was statistically higher in group A; the mean time to union was statistically higher in group A; the rate of reoperations was statistically higher in group A; and the rate of revision of the external fixator was statistically higher in group A. Pain, range of motion of the knee and ankle joints, rates of delayed union, malunion and complications were similar. Conclusion: Although modular external fixators are associated with faster intraoperative fracture reduction with the external fixator, single external fixators are associated with significantly better rates of union and reoperations; the rates of delayed union, malunion and complications are similar. [ABSTRACT FROM AUTHOR]

Purpose: To discuss when and how to operate on thoracic and lumbar spine fractures. Patients and methods: We retrospectively studied 77 consecutive patients with thoracic and lumbar spine fractures treated from 2000 to 2011; 28 patients experienced high-energy spinal trauma and 49 low-energy spinal trauma. Mean follow-up was 5 years (1-11 years). Surgical treatment was done in 15 patients with neurological deficits, and in 16 neurologically intact patients with fractures-dislocations, burst fractures and fractures with marked deformity. Non-surgical treatment was done in 46 neurologically intact patients with simple fracture configurations. Clinical and imaging examination and the Oswestry Disability Index (O.D.I.) questionnaire were obtained. Results: All patients treated surgically maintained spinal alignment; patients with long fusion maintained the best alignment; however, they experienced back stiffness and moderate low back pain. Patients with combined posterior fusion and kyphoplasty experienced earlier recovery and improved sagittal correction. Mean O.D.I. was 22.4 and 14.2 % at 3 and 12 months postoperatively. Thirty six (78 %) patients treated non-surgically were asymptomatic, 22 (48 %) experienced mild residual kyphosis, 10 (22 %) developed marked deformity during their follow-up and were finally operated; mean O.D.I. was 28.6 and 12.1 % at 3 and 12 months. No difference in O.D.I. was observed between patients who had surgical and non-surgical treatment. Conclusions: Progressive neurological deficits and/or mechanical instability of the spine are absolute indications for early surgical treatment. Younger patients with high-energy spinal trauma, unstable fractures and neurological deficits should be treated surgically in order to provide optimum conditions for neurologic recovery, early mobilization and possibly ambulation. Most cases can be adequately operated through a posterior only surgical approach; an anterior or combined approach is usually indicated for burst and thoracic spine fractures. Postoperative complications, more common infection and neurological deterioration may occur. Elderly, neurologically intact patients with low-energy, stable spinal fractures without marked spinal deformity may be successfully treated conservatively. Most of these patients will do well; however, follow-up for progressive posttraumatic deformity is required. [ABSTRACT FROM AUTHOR]

Metastases distal to the elbow and the knee (acrometastases) are rare, accounting for approximately 0.1 % of all cases. Acrometastases can appear in patients of every age, with men being twice as likely as women to be affected. The most common primary cancer site is the lung (>50 %), followed by the colon, breast and genito-urinary tract. They mainly appear in cancer patients with wide-spread disseminated disease. Rarely, they may be the first presentation of occult silent cancer, mimicking a benign condition. Current evidence supports that the tumor cells reach the bones of the hands through the circulation and not the lymphatic system; the malignant cells from the lungs have an easy access through the arterial circulation of the arms. The rare incidence of foot acrometastases is believed to be due to the lack of red marrow in these bones, a further distance from the primary cancer site, and the valveless paravertebral venous plexuses (Batson's plexuses), which allow retrograde tumor cell embolization through the iliofemoral venous system. Treatment depends on staging and tumor extent. Amputative surgery is the more common approach, especially for cancers with poor response to radiation therapy and chemotherapy. In the majority of cases, disarticulation of the ray is required to achieve wide margin resection. In the foot, amputation can be that of a ray, midfoot or transtibial, depending on the location and spread of the tumor. If unresectable, palliative treatment with radiation therapy, bisphosphonates and chemotherapy is recommended. The prognosis of the patients with acrometastatic cancer is poor; the mean survival time after diagnosis is <6 months. An exception seems to be the patients with renal cell carcinoma, if treated with radical surgical resection, and a long latency period between nephrectomy and metastasis has occurred. [ABSTRACT FROM AUTHOR]

Purpose: This paper presents a technique of ultrasound-guided localisation and block of the musculocutaneous nerve through the anterior wall of the axilla. Materials and methods: Twenty patients (7 males and 13 females; mean age, 35 years) had axillary nerve block for upper extremity trauma. With the arm adducted, the ultrasound probe was positioned on the anterior axillary wall; the axillary artery, coracobrachialis and pectoralis major muscles and lateral cord of brachial plexus were visualised in cross section. With continuous imaging of the axillary artery in cross section, the ultrasound probe was slowly moved towards the biceps muscle until the musculocutaneous nerve appeared crossing the coracobrachialis muscle. After ultrasound localisation of the musculocutaneous nerve, the arm was abducted and externally rotated, and the nerve was identified with nerve stimulation and blocked. The quality of sensory and motor nerve block, as well as of ultrasound imaging were evaluated. Results: Ultrasound-guided block of the musculocutaneous nerve was excellent and complete in 18 of the 20 patients. In two patients, the musculocutaneous nerve was fused with the median nerve and the nerve block was repeated successfully with the same technique. The quality of ultrasound imaging was excellent in all patients. No patient experienced pain or tourniquet discomfort during surgery, or any other nerve block-related complication. Conclusion: The anterior axillary ultrasound view provides for complete nerve block and imaging of the entire course of the musculocutaneous nerve and its relations with adjacent structures with excellent quality. [ABSTRACT FROM AUTHOR]

The evaluation of the contribution of natural sources to PM and PM concentrations is a priority especially for the countries of European south strongly influenced by Saharan dust transport events. Daily PM concentrations and composition were monitored at an urban site at 14 m above ground level, at the National Technical University of Athens campus from February to December 2010. The typical dust constituents Si, Al, Fe, K, Ca, Mg, and Ti were determined by wavelength dispersive X-ray fluorescence spectrometry (WDXRF). Sulfur, a tracer of anthropogenic origin and major constituent of PM, was determined by both WDXRF and ionic chromatography. The contribution of dust and sulfates in PM was calculated from the analytical determinations. An annual mean of 20 μg/m was calculated from the mean daily PM concentrations data. Twenty-two per cent of daily concentrations of PM reached or exceeded the EU annual target concentration of 25 μg/m. The exceedances occurred during 13 short periods of 1-4 days. Back-trajectory analysis was performed for these periods in order to identify the air masses origin. From these periods, ten periods were associated to Saharan dust transport events. The most intense dust transport event occurred between February 17th and 20th and was responsible for the highest recorded PM concentration of 100 μg/m where the dust contribution in PM reached 96 %. The other dust transport events were less intense and corresponded to less pronounced enhancements of PM concentrations, and their contribution ranged from 15 to 39 % in PM concentrations. Air masses originated from northwest Africa while the influence of central Sahara was quite smaller. [ABSTRACT FROM AUTHOR]

Purpose: To study speech and swallowing in patients who underwent microvascular free flap reconstruction after major surgery of the oral cavity. Patients and methods: Twenty patients, 17 men and 3 women, with a mean age of 58.5 years (range 27-79 years) were included in the study. Squamous cell carcinoma was the most common malignancy. Swallowing assessment was performed through videofluoroscopy, using three consistencies of barium meal. The recorded swallows were assessed for the ability to hold the bolus during the oral phase, lip seal, tongue movement, residue in the floor of the mouth, laryngeal penetration and aspiration. Speech function regarding intelligibility and articulation was objectively assessed. Results: Fifteen out of 20 patients (75%) had a good lip seal. Fourteen patients (73.6%) had adequate control of bolus, while in 89.4% the neotongue motility was satisfactory. Vallecular residue was noted in 25% of patients, laryngeal penetration in two (10%), while three patients (15%) continued to have significant aspiration, which necessitated continuous feeding through a gastrostomy. Postoperative speech intelligibility and articulation was satisfactory in 75 and 62.5% of the patients, respectively. Conclusions: Microvascular free flap reconstruction of major defects after oral resections rehabilitates the functions of swallowing and speech in acceptable levels, improving quality of life in these patients. [ABSTRACT FROM AUTHOR]

This paper presents the design of a fleet monitoring system, which consists of two main subsystems – the "base station" and the "mobile units". The aim of the system is to track the paths of a group of moving vehicles and present their tracks on a map on a computer screen. Also, data from past itineraries are being recorded on a database. The mobile unit is fully self-reliant and does not need any attention from the driver of the vehicle. The mobile unit acquires a number of vehicle positions at predefined time intervals by the aid of a global positioning system receiver, processes them and transmits them to the base station using the Short Message Service (SMS) of the Global System for Mobile (GSM) network. The base station translates the received data and depicts the vehicle positions. The presentation of the vehicle tracking takes place on a computer screen with the aid of low-cost scanned paper maps. The main objectives are to reduce the power consumption of the mobile unit while the vehicle idles, and also the operational costs of the system. A versatile client/server architecture has also been incorporated to enable the data collected by the base station to be presented everywhere via Internet connection. The whole management of the mobile system is based on a low-cost 8052-compatible microcontroller. In this paper, the appropriate circuitry for the power control and the operational cost are presented. We also present the flowcharts of the microcontroller software and base station software and give examples of vehicle tracking for a fleet of eight units. [ABSTRACT FROM AUTHOR]

The results of a Blade-Vortex Interaction (BVI) experiment are presented. The experiments were the second series to be carried out at Glasgow University (see Kokkalis and Galbraith 1986, 1987), and reflect improvement to the facility. These improvements have resulted in sufficient resolution to observe clear evidence of vortex passage and propagative disturbances caused by the BVI. Additionally the quality of the pressure data permitted a meaningful assessment of force and moment coefficients, and a clear correspondence between their detailed time histories was observed. The data obtained are also compared with the results of previous studies, and qualitative and quantitative similarities are discussed. [ABSTRACT FROM AUTHOR]

Breast reduction mammoplasty is becoming an increasingly common procedure. A baseline mammogram is recommended after 35 years of age as the most effective method for detection of small breast cancers. A prospective study was conducted for the evaluation of the mammographic findings after reduction mammoplasty. During the last 7 years, 113 patients over 35 years of age underwent bilateral reduction mammoplasty. All patients had a preoperative mammogram. A new mammogram was obtained at 6 and 18 months after the procedure. All films were reviewed by the same two radiologists. Breast reduction was performed with the vertical bipedicle flap technique (McKissock) and the inferior pedicle technique. There were no apparent differences in the findings between the two methods. Most common findings were parenchymal redistribution in 102 (90.2%) and elevation of the nipple in 96 (84.9%), produced by a shift of the breast tissue to a lower position. Calcifications were seen in 29 (25.6%), and ``oil cysts'' in 22 (19.4%), caused by localized fat necrosis. A retroareolar fibrotic band was found in 23 (20.3%), from the transposed flap. Areolar thickening was observed in six (5.3%), and skin thickening in only two (1.7%), from scar tissue. Mammographic findings after reduction mammoplasty are predictable, thus preventing unnecessary biopsies and making the diagnosis of lesions unrelated to the procedure easier. All patients over 35 years of age should have a preoperative and a postoperative mammogram for future reference. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 16-year-old girl presented with episodes of nausea, dizziness, and vomiting. Topics discussed include diagnosis of intracranial epidermoid tumors of the fourth ventricle; revealing mass lying within the fourth ventricle in magnetic resonance imaging; and surgical management of posterior fossa epidermoid tumors.