Radiographic analysis of Müller-Weiss disease.

BACKGROUND: The only classification of Müller-Weiss disease (MWD) is based primarily on Méary's talo-first metatarsal angle. It describes increasing sag of the medial longitudinal arch with greater degrees of compression and fragmentation of the navicular. Purportedly, the talar head pushes the subtalar joint into varus and drives the medial pole of the navicular medially, as it protrudes inferiorly and laterally. Its authors stipulated heel varus as a pre-requisite, coining the term 'paradoxical pes planus varus' to define heel varus and flatfoot as hallmark deformities of the condition. METHODS: We measured Méary's and Kite's talocalcaneal angles, heel offset, anteroposterior thickness of the navicular at each naviculocuneiform (NC) joint, medial extrusion of the navicular and calculated percentage compression at each NC joint in 68 consecutive feet presenting with MWD. Morphology and activity at the various peri-navicular joints were studied using SPECT-CT in 45 feet. RESULTS: Inverse relationships between Méary's angle and degree of navicular compression reach statistical significance at NC2 but not at NC3. Strong correlation exists between medial extrusion and percentage compression at NC2 and NC3. Medial extrusion is significantly greater on the affected side in unilateral cases and on the more compressed side in bilateral cases. Significant inverse relationships exist between Kite's angle and percentage compression at both NC2 and NC3 and degree of medial extrusion of the navicular. No correlation was detected between Kite's angle and either heel offset or Méary's angle. Varus heel offset was present in only 33% of cases. The combination of heel varus and negative Méary's angle was present in just 26% of cases, the commonest combination being heel valgus with sagging at 56%. CONCLUSION: Our findings confirm part of Maceira's hypothesized pathomechanism of MWD. Reductions in Kite's talocalcaneal angle confirm that lateral and inferior protrusion of the talar head causes increasing compression and medial extrusion of the navicular. However, such shift of the talar head does not always lead to heel varus. As such, we caution against universal advocacy of lateral displacement calcaneal osteotomy, as the heel is not always in varus in MWD.

Engineering inclined orientations of piezoelectric films for integrated acoustofluidics and lab-on-a-chip operated in liquid environments.

Different acoustic wave modes are required for effective implementation of biosensing and liquid actuation functions in an acoustic wave-based lab-on-a-chip. For efficient sensing in liquids, shear waves (either a thickness-shear bulk wave or a shear-horizontal surface acoustic wave) can achieve a high sensitivity, without significant loss of acoustic wave energy. On the other hand, longitudinal bulk waves or out-of-plane displacement waves (such as Rayleigh waves) enable efficient sampling functions and liquid manipulation. However, there are significant challenges in developing a lab-on-a-chip to efficiently generate multiple wave modes and perform both these functions on a single piezoelectric substrate, especially when a single crystalline orientation is available. This paper highlights the latest progress in the theories and techniques to deliver both sensing and microfluidic manipulation functions using engineered inclined-angled piezoelectric films, allowing for the simultaneous generation of longitudinal (or Rayleigh) and thickness-shear bulk (or shear-horizontal surface acoustic) waves. Challenges and theoretical constraints for generating various wave modes in the inclined films and techniques to efficiently produce inclined columnar and inclined crystalline piezoelectric films using sputtering deposition methods are presented. Applications of different wave modes in the inclined film-based lab-on-chips with multiple sensing and acoustofluidic functions are also discussed.

Miniaturised Infrared Spectrophotometer for Low Power Consumption Multi-Gas Sensing.

Concept, design and practical implementation of a miniaturized spectrophotometer, utilized as a mid-infrared-based multi gas sensor is described. The sensor covers an infrared absorption wavelength range of 2.9 to 4.8 um, providing detection capabilities for carbon dioxide, carbon monoxide, nitrous oxide, sulphur dioxide, ammonia and methane. A lead selenide photo-detector array and customized MEMS-based micro-hotplate are used as the detector and broadband infrared source, respectively. The spectrophotometer optics are based on an injection moulded Schwarzschild configuration incorporating optical pass band filters for the spectral discrimination. This work explores the effects of using both fixed-line pass band and linear variable optical filters. We report the effectiveness of this low-power-consumption miniaturized spectrophotometer as a stand-alone single and multi-gas sensor, usage of a distinct reference channel during gas measurements, development of ideal optical filters and spectral control of the source and detector. Results also demonstrate the use of short-time pulsed inputs as an effective and efficient way of operating the sensor in a low-power-consumption mode. We describe performance of the spectrometer as a multi-gas sensor, optimizing individual component performances, power consumption, temperature sensitivity and gas properties using modelling and customized experimental procedures.

The lateral malleolar bony fleck classified by size and pathoanatomy: The IOFAS classification.

BACKGROUND: This study analyzes position of the peroneal tendons and status of the superior peroneal retinaculum (SPR) whenever a lateral malleolar bony flake fracture occurs. METHODS: Twenty-four patients had a lateral malleolar bony fleck on anteroposterior ankle radiographs, either in isolation or associated with other hindfoot injuries. We studied size of the bony flecks, presence or absence of peroneal tendon dislocation and pathoanatomy on CT scans. RESULTS: In 11 patients, a small bony fleck lies within the superior peroneal retinaculum and contiguous periosteum, which are stripped off the lateral fibula (Class II lesions). Tendons dislocate into the subperiosteal pouch thus formed, resembling Class I lesions without associated bony avulsion. Treatment for Class II is same as for Class I injuries. In 8 patients with a big bony fleck, tendons dislocate into the fracture site and SPR is intact (Class III lesions). In Class IV lesions, observed in 5 patients with 2-part calcaneal fracture/dislocation, SPR remains intact and peroneal tendons are not dislocated. The invariably large fleck results from the displacing lateral calcaneal fragment abutting against the fibula, whereas the dislocating tendons cause the bony avulsions in Classes II and III. CONCLUSIONS: Due to pathoanatomical differences, surgical approach and natural history of neglected lesions differ depending on size of the bony fleck. The SPR must not be incised in case of big Class III flecks.

In-situ microfluidic controlled, low temperature hydrothermal growth of nanoflakes for dye-sensitized solar cells.

In this paper, an in-situ microfluidic control unit (MCU) was designed and applied in a hydrothermal synthesis process, which provides an easy way to localize liquid-phase reaction and realize selective synthesis and direct growth of nanostructures as well as their morphology, all in a low-temperature and atmospheric environment. The morphology was controlled through controlling the amount of additivities using the MCU. This achieved a facile fabrication of Al doped ZnO (AZO) nanoflakes vertically grown on flexible polymer substrates with enhanced light scattering and dye loading capabilities. Flexible DSSCs with a significant enhancement (410% compare to ZnO NRs based devices) in power conversion efficiency were obtained using AZO nanoflake photoanodes of 6 µm thick, due to the enhancement in electron mobility and reduction in recombination. This hydrothermal synthesis using the in-situ MCU provides an efficient and scalable technique to synthesize controllable nanostructures with characteristics of easy set-up, low energy consumption and low cost.

Reconstruction of healed elongated anterior tibial and extensor hallucis longus tendons in a young active farmer.

A case of open traumatic lacerations of the anterior tibial tendon (ATT) and extensor hallucis longus (EHL) tendon that both healed in continuity but significantly elongated position following primary repair, resulting in foot drop and sagging of the great toe affecting gait and function, is presented. An adequate immobilization and protection in the early post-operative period is very important and a secure technique for reconstructing a healed elongated anterior tibial tendon is described.

Increasing Melanoma Screening Among Hispanic/Latino Americans: A Community-Based Educational Intervention.

Melanoma incidence is increasing among Hispanics/Latinos in California. This community-based project reached out to a rural Hispanic/Latino community in North San Diego County to provide melanoma prevention and screening education. At a local community health fair, bilingual volunteer lay health workers led 10- to 15-minute-long information sessions on melanoma disease, risk factors, and skin self-examination techniques. Pearson chi-square analyses of participants' (N = 34) responses to pre- and postintervention evaluation surveys indicate significant increases in knowledge, risk awareness, and self-efficacy for self-screening. The results revealed that Hispanics/Latinos in a low socioeconomic stratum might be at moderate to high risk for developing melanoma. Their low annual income, low level of education, occupational sun-exposure, and lack of access to health care are likely factors that deter at-risk Hispanics/Latinos from seeking health care.

A novel solid state non-dispersive infrared CO2 gas sensor compatible with wireless and portable deployment.

This paper describes development of a novel mid-infrared light emitting diode (LED) and photodiode (PD) light source/detector combination and use within a non-dispersive infrared (NDIR) carbon dioxide gas sensor. The LED/PD based NDIR sensor provides fast stabilisation time (time required to turn on the sensor from cold, warm up, take and report a measurement, and power down again ≈1 second), longevity (>15 years), low power consumption and low cost. Described performance is compatible with "fit and forget" wireless deployed sensors in applications such as indoor air quality monitoring/control & energy conservation in buildings, transport systems, horticultural greenhouses and portable deployment for safety, industrial and medical applications. Fast stabilisation time, low intrinsic power consumption and cycled operation offer typical energy consumption per measurement of mJ's, providing extended operation using battery and/or energy harvesting strategies (measurement interval of ≈ 2 minutes provides >10 years operation from one AA battery). Specific performance data is provided in relation to measurement accuracy and noise, temperature performance, cross sensitivity, measurement range (two pathlength variants are described covering ambient through to 100% gas concentration), comparison with NDIR utilizing thermal source/pyroelectric light source/detector combination and compatibility with energy harvesting. Semiconductor based LED/PD processing together with injection moulded reflective optics and simple assembly provide a route to low cost high volume manufacturing.

Large-aperture plasma-assisted deposition of inertial confinement fusion laser coatings.

Plasma-assisted electron-beam evaporation leads to changes in the crystallinity, density, and stresses of thin films. A dual-source plasma system provides stress control of large-aperture, high-fluence coatings used in vacuum for substrates 1m in aperture.