54,464 research outputs found
Specchi e unicorni: l'ambiguità della percezione in 'Rosencrantz and Guildenstern are Dead' di Tom Stoppard
No full texta cura di M. Billi, L. Curti, E. Di Piazza, D. Coron
Free functional muscle transfers
No full textFree-functioning muscle transfer is done to replace lost muscle and tendon-unit function through microvascular anastomosis in the recipient area. Neural coaptation of the transferred muscle's motor nerve provides the ability of the muscle to contract, giving functionality to the transfer. It is a complex surgical technique with limited indications and prolonged patient recovery. Free functional muscle transfer represents the last chance after conservative approaches have been exhausted and functional deficiencies persist after a trauma, oncologic resection, congenital defect or acquired deficiencies. The manuscript is structured in paragraphs covering indications, patient selection, the surgical technique, complications and future prospective. It furthermore presents through detailed descriptions and photographic material clinical cases from our practice
The role of VFG in wrist arthrodesis: Long term results in a series of 11 patients and literature review
No full textBackground: Total wrist fusion (TWF) is indicated for longstanding degenerative, posttraumatic and/or post-oncological conditions to provide pain relief and wrist stability at partial expense of wrist motion. Patients and Methods: A total of 11 consecutive patients who had completed TWF with Vascularized Fibula Graft (VFG) for massive distal radius defects were identified retrospectively from our center using inpatient records. We evaluated bone fusion times and long term functional outcomes following the procedure. Post-operative grip strength (GS) and prono-supination were objectively measured. The new Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used to rate disability and symptoms; pre- and post- operative pain with the Visual Analog Scale (VAS) was assessed. A literature review of the present studies about TWF with VFG was performed, with the aim of comparing long-term functional results of the surgical techniques so far reported in the English literature. Results: Our experience with TWF using VFG appeared slightly better than that found in the literature. The procedure was successful in all the cases, achieving bone union in 4,8 months on average. Complication rate was 27,2%, no flap loss was recorded. There were no wrist instability, deformation or dislocation; mean pronation/supination (P/S) was 57,5°/61,2° Average grip strength resulted 59% of the contralateral side. Mean recorded levels of visual analog scale (VAS) for pain postoperatively were 2,32 ± 0,792, which improved significantly from the pre-operatively value of 7,90 ± 0,79. Mean overall satisfaction was good and all the patients comfortably returned to normal activities. Conclusions: Wrist arthrodesis by means of VFG resulted to be an effective and reliable option in dealing with massive defects of distal radius with involvement of radio-carpal joint. Although the cohort analyzed is relatively small and definitive conclusions cannot be drawn, the long term radiographs and the overall functional outcomes encourage to use the described surgical option over other techniques, such as prosthetic replacement and non-vascularized bone grafts
Pay Is Not Everything: Differential Effects of Monetary and Non-Monetary Rewards on Employees’ Attitudes and Behaviours
No full textMonetary and non-monetary rewards have rarely been considered together under the HRM perspective. Despite the vast literature on HRM, there is still a lack of studies that explicitly discuss the link between the adoption of a total reward system (TRS) and employee-related outcomes. The purpose of this paper is to investigate this important issue in order to provide insights that can help organisations devise compensation strategies that are effective in sustaining employees’ positive attitudes and behaviours. Using a survey of 1,092 employees, the authors examine the effect of the overall TRS on three outcome variables (i.e. job satisfaction, affective commitment, and innovative behaviour at work). Furthermore, the authors examine the impact that each component of the TRS (i.e. base pay, training and development opportunities, and positive work environment) has on the dependent variables. The results confirm that the adoption of a TRS exerts a positive influence on the aforementioned outcomes. However, interesting differences emerged when looking at the individual components in the overall sample.
This paper provides original insights into the complex relationship between TRS and the employee-related outcomes of job satisfaction, affective commitment, and innovative behaviour at work
A Fuzzy Guidance System for Rendezvous and Pursuit of Moving Targets
No full textThis article presents the development of a fuzzy guidance system (FGS) for unmanned aerial
vehicles capable of pursuing and performing rendezvous with static and mobile targets. The system is
designed to allow the vehicle to approach a maneuvering target from a desired direction of arrival and
to terminate the rendezvous at a constant distance from the target. In order to perform a rendezvous
with a maneuvering target, the desired direction of arrival is adjusted over time to always approach
the target from behind, so that the aircraft and target velocity vectors become aligned. The proposed
guidance system assumes the presence of an autopilot and uses a set of Takagi–Sugeno fuzzy controllers
to generate the orientation and speed references for the velocity and heading control loops, given the
relative position and velocity between the aircraft and the target. The FGS treats the target as a mobile
waypoint in a 4-D space (position in 2-dimensions, desired crossing heading and speed) and guides
the aircraft on suitable trajectories towards the target. Only when the vehicle is close enough to the
rendezvous point, the guidance law is complemented with an additional linear controller to manage
the terminal formation keeping phase. The capabilities of the proposed rendezvous-FGS are verified in
simulation on both maneuvering and non-maneuvering targets. Finally, experimental results using a
multi-rotor aerial system are presented for both fixed and accelerating targets
Possibilities and results of (free) vascularized bone graft of the hand and wrist
No full textThe vascularized bone transplantation or graft is a modern and successful treatment concept in segmental bone loss. Faster healing and higher union rates were shown in several studies. Using vascularized bone grafts, the adaption in mechanical conditions as well as stability are improved. The indications, however, must be critically considered in order to obtain an optimal result. Reconstruction of the bone defect should be performed as quickly as possible after the trauma, infection, or tumor resection. Amputation should always remain the method of last choice. Depending on the existing bone defect, there are various possible donor sites, e.g., fibula, scapula, ulna, femur, and hip bone. The advantages and disadvantages of each donor site has to be thoroughly discussed prior to the operation to assure an optimal postoperative result. In view of these issues, vascularized bone grafts should be performed in microvascular specialized plastic or hand surgery centers. © 2011 Springer
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