Snowboard traumatology: an epidemiological study

OBJECTIVE: To estimate the frequency of perioperative morbidities in patients who underwent anesthesia and a surgical procedure with no preoperative laboratory testing. MATERIAL AND METHODS: We conducted an electronic database search of medical records of 56,119 patients who underwent surgical or diagnostic procedures and anesthesia at Mayo Clinic Rochester in 1994 and found 5,120 who had no laboratory tests done within 90 days before the procedure. From this group, we randomly selected 1,044 patients (87 from each month) to document the absence of preoperative tests, the presence of preexisting disease (by organ system), the type of anesthetic agent, and the outcomes and tests intraoperatively and postoperatively. RESULTS: The 1,044 patients ranged in age from 0 to 95 years (median age, 21). No deaths or major perioperative morbidities occurred (0.0%; exact 95% confidence interval, 0.00 to 0.35%). Although 10 patients underwent blood typing and screening for antibodies immediately preoperatively, no blood transfusions were necessary. Intraoperatively, 17 laboratory tests and 1 electrocardiogram were obtained, and 3 results were abnormal. Postoperatively, 42 blood tests and 2 electrocardiographic procedures were performed. Five of the 42 blood tests showed abnormal results (hemoglobin levels in 3, serum sodium in 1, and arterial blood gases in 1). One electrocardiogram showed normal findings, and the other revealed normal results except for premature ventricular contractions. No laboratory test done intraoperatively or postoperatively was found to change surgical or medical management substantially. One patient who had unanticipated blood loss during an outpatient procedure was admitted to the hospital for observation. CONCLUSION: All 1,044 patients, 97% of whom were relatively healthy, with no recent laboratory testing safely underwent anesthesia and an operation. We conclude that patients who have been assessed by history and physical examination and determined to have no preoperative indication for laboratory tests can safely undergo anesthesia and operation with tests obtained only as indicated intraoperatively and post-operatively. Current anesthetic and medical practices rapidly identify perioperative indications for laboratory evaluation as they arise.     

In times of survival, the right of silence

The purpose of this study was to assess cortical and cancellous bone responses to unilateral limb immobilization and, subsequently, to remobilization with exercise, in a young adult canine model. Right forelimbs of 14 1-2-year old mongrel dogs were immobilized in a non-weight-bearing position by a bandage for 16 weeks. Six control dogs were untreated. At 16 weeks, seven immobilized and three control dogs were euthanized. The remaining seven immobilized dogs began a recovery protocol consisting of 16 weeks of kennel confinement (without the right forelimb bandaged) followed by 16 weeks of treadmill exercise conducted three times per week. These seven dogs and three control dogs were euthanized at 48 weeks. Bone mineral density of the proximal radii was determined with dual-energy X-ray absorptiometry and humeral middiaphyseal cross-sectional areas were determined with computed tomography. Humeri were tested in cranio-caudal three-point bending to failure. Cancellous bone cores from the lateral humeral condyles had wet apparent density determined and were tested to failure in compression. Mechanical properties, bone density, and cross-sectional areas were compared between immobilized (right forelimb), contralateral weight bearing (left forelimb), and control forelimbs with Kruskal-Wallis and post hoc tests. At 16 weeks, bone mineral density, cortical load, yield, and stiffness as well as cancellous bone failure stress, yield stress, and modulus were significantly lower (p < 0.02) for immobilized limbs than control limbs. Immobilized limb cancellous bone mechanical properties were 28%-74% of control values, and cortical bone mechanical properties were 71%-98% of control values. After 32 weeks of remobilization, cortical and cancellous bone mechanical properties were not different from control values except that cortical bone failure stress and modulus were significantly higher (p < 0.01) between remobilized and control limbs. In summary, 16 weeks of forelimb immobilization was associated with significantly lower mechanical properties, and with greater differences in cancellous than cortical bone properties. Mechanical properties were not different from control values after 32 weeks of recovery that included 16 weeks of treadmill exercise.     

Conditions for reliable dewatering systems based on voidless drainage in slightly permeable soils

Conclusions 1. Use of dewatering systems based on voidless drainage is most effective when dewatering slightly permeable soils in regions with a deep seasonal frost. 2. Two-story drainage with the upper and lower stories spaced 30 m apart accelerates the discharge of gravitational water from the arable layer. Results of observations on two-story drainage in experimental-production sections indicated that it discharges 2 – 3.8 times more water than systematic tubular drainage with an interdrain spacing of 10 m and a 0.2-m thick three-dimensional filter of a sandy-gravelly mixture. 3. It is recommended to use crushed stone and porous-clay gravel with a fineness of 10 – 20 mm as a filler. In that case, protection of the drain filler is, as a rule, required only from the intrusion of soil from above during construction in cohesive soils with a plasticity indexW _p≥7. 4. seepage rate in a voidless drain should be lower than the scouring velocity for the soil in which the voidless drainage is placed. In the opposite case, it is necessary to lower the grade of the drains or select a filler gradation such that the seepage rate in the drain be lower than the scouring velocity. Translated from Gidrotekhnicheskoe Stroitel’stvo, No. 8, pp. 41–43, August, 1998.     

Self and mutual admittance of slot antennas on a dielectric half-space

In this paper, an efficient implementation of the spectral domain moment technique is presented for computing the self and mutual coupling between slot antennas on a dielectric half-space. It is demonstrated that by the proper selection of the weighting functions in the method of moments, the analytic evaluation or simplification of the transverse moment integrals is enabled. This results into a significant reduction of the required computational labor. The method is then utilized in order to provide design data for the self and mutual admittances between two slot antennas on a dielectric substrate lens in the case of fused quartz (∈ _r =3.80), crystal quartz (∈ _r =4.53), silicon (∈ _r =11.9) and GaAs (∈ _r =12.8). The presented technique and associated results are useful when designing twin slot quasi-optical receivers, imaging arrays, phased arrays or power-combining arrays of slot elements at millimeter-wave frequencies.     

Processor membership in asynchronous distributed systems

Presents protocols for determining processor membership in asynchronous distributed systems that are subject to processor and communication faults. These protocols depend on the placement of a total order on broadcast messages. The types of systems for which each of these protocols is applicable are characterized by the properties of the communication mechanisms and by the availability of stable storage. In the absence of stable storage or of a mechanism for distinguishing promptly delivered messages, the authors show that no membership protocol can exist. They also discuss their experience in implementing these membership protocols     

Unstructured tree search on SIMD parallel computers

We present new methods for load balancing of unstructured tree computations on large-scale SIMD machines, and analyze the scalability of these and other existing schemes. An efficient formulation of tree search on an SIMD machine consists of two major components: a triggering mechanism, which determines when the search space redistribution must occur to balance the search space over processors, and a scheme to redistribute the search space. We have devised a new redistribution mechanism and a new triggering mechanism. Either of these can be used in conjunction with triggering and redistribution mechanisms developed by other researchers. We analyze the scalability of these mechanisms and verify the results experimentally. The analysis and experiments show that our new load-balancing methods are highly scalable on SIMD architectures. Their scalability is shown to he no worse than that of the best load-balancing schemes on MIMD architectures. We verify our theoretical results by implementing the 15-puzzle problem on a CM-2 SIMD parallel computer     

Quantization effects in digitally behaving circuit implementationsof Kohonen networks

Implementing a neural network on a digital or mixed analog and digital chip yields the quantization of the synaptic weights dynamics. This paper addresses this topic in the case of Kohonen's self-organizing maps. We first study qualitatively how the quantization affects the convergence and the properties, and deduce from this analysis the way to choose the parameters of the network (adaptation gain and neighborhood). We show that a spatially decreasing neighborhood function is far more preferable than the usually rectangular neighborhood function, because of the weight quantization. Based on these results, an analog nonlinear network, integrated in a standard CMOS technology, and implementing this spatially decreasing neighborhood function is then presented. It can be used in a mixed analog and digital circuit implementation.     

Bounded disorder file organization

The bounded disorder file organization proposed by W. Litwin and D.B. Lomet (1987) uses a combination of hashing and tree indexing. Lomet provided an approximate analysis with the mention of the difficulty involved in exact modeling of data nodes, which motivated this work. In an earlier paper (M.V. Ramakrishna and P. Mukhopadhyay, 1988) we provided an exact model and analysis of the data nodes, which is based on the solution of a classical sequential occupancy problem. After summarizing the analysis of data nodes, an alternate file growth method based on repeated trials using universal hashing is proposed and analyzed. We conclude that the alternate file growth method provides simplicity and significant improvement in storage utilization