111,994 research outputs found
Osteochondrale Läsionen am Talus : anatomische, biomechanische und klinische Analyse
No full textOsteochondrale Läsionen am Talus betreffen in der Regel junge, sportlich sehr aktive Patienten im Alter von 20 bis 40 Jahren. Sie beklagen Schmerzen, Schwellungszustände und Blockaden des Gelenks. Sehr oft liegt eine traumatische Ursache als Folge einer OSG-Distorsion vor. Am häufigsten liegen diese medial oder lateral an der Taluskante.
Verschiedene Faktoren sind für die therapeutischen Überlegungen wichtig, die jedoch im einzelnen noch viel zu wenig verstanden sind:
(I) Stabilität; die Rekonstruktion muss stabil sein, um einen Krafttransfer zu ermöglichen. Insbesondere auch darum, weil die Läsionen an den Orten der höchsten biomechanischen Belastung liegen.
(II) Vitalität; alle avitalen und sklerotischen Areal müssen entfernt und ersetzt werden. Wichtige biologische Informationen zur Vitalität gibt uns das SPECT-CT.
(III) Anatomie; das OSG ist das kongruenteste der grossen Gelenke des Menschen. Um ein perfektes Gleiten der beiden Gelenksflächen zu ermöglichen, ist eine optimale anatomische Rekonstruktion notwendig.
(IV) Biomechanik des gesamten Gelenks; Um eine möglichst normale Biomechanik des Gelenks wiederherzustellen ist das Adressieren möglicher Co-Faktoren wichtig: Muskeln – Atrophie; Ligamente – Instabilität; Sehnen – Tendinopathie; Gelenk – Synovitis. Das Gelenk ist ein Organ, das über eine Homöostase in einer fein regulierten Balance gehalten wird. Dieser Faktor wurde in einem Modell adressiert, welches den Einfluss einer Muskelatrophie auf andere für die Gelenkhomöostase wichtige Gewebe untersuchte, und das Zusammenspiel und die Abhängigkeit der einzelnen biomechanischen Faktoren aufzeigen konnte.
Basierend auf diesen vier Faktoren wurden vier unabhängige Studien durchgeführt, die jeweils einen Aspekt dieser Faktoren adressierten und isoliert publiziert wurden.
Mineralisationsdichte und Penetrationskraft der subchondralen Knochenplatte des Talusdoms: hohe Korrelation und spezifische Verteilungsmuster
Mit der CT Osteoabsorptionsmetrie (CT-OAM) wurde bei 10 Leichensprunggelenken die Mineralisationsdichte und die Penetrationskraft der subchondralen Knocenplatte gemessen. Dabei zeigten sich zwei Verteilungsmuster: Bizentrisches Maximum (anteromedial und anterolateral), 60%; monozentrisches Maximum (anteromedial oder anterolateral), 40%. Es gab eine sehr hohe Korrelation zwischen beiden Messmethoden. Mit dem CT-OAM können biomechanische Eigenschaften der subchondralen Knochenplatte dargestellt werden.
SPECT-CT: eine neue Bildgebung bei osteochondralen Läsionen des Talus
Von 25 Patienten wurden MRI, SPECT-CT und die Kombination von beidem von drei unabhängigen Beurteilern hinsichtlich Eigenschaften der Bilder und daraus resultierender Therapiewahl evaluiert. Die Therapiewahl alleine änderte mit dem SPECT-CT in 48% zum MRI und in 52% von SPECT-CT und MRI im Vergleich zum MRI alleine. Die genaue Bedeutung dieser veränderten Therapiewahl muss in weiteren Studien untersucht werden.
Radiologische Evaluation der frontalen Talusanatomie in Hinblick auf osteochondrale Transplantationen
Anhand von 81 Röntgenbildern ohne Pathologie wurden die Winkel und Radii zwischen den einzelnen Gelenksflächen des Talus in der frontalen Aufsicht ausgemessen. Es konnte keine Korrelation zwischen Winkeln und Radii gefunden werden. Insbesondere zeigt sich ein relevanter Unterschied zwischen medialer und lateraler Taluskante. Diese Werte müssen adressiert werden bei der Rekonstruktion osteochondraler Läsionen.
Veränderter Zellmetabolismus von verschiedenen Geweben aus dem Kniegelenk im Kaninchenmodell bei mit Botox A induzierter Quadrizepsmuskelatrophie
Während sechs Monaten wurde bei 6 Kaninchen eine Quadricepsmuskelatrophie mit Botox A induziert. Muskelkraftverlust und Histologie des Quadriceps wurden gemessen und dazu mit dem RNA-Zellmetabolismus (totaler RNA Level und spezifische mRNA Level) von Patellarsehne, medialem und lateralem Seitenband und medialem und lateralem Meniskus verglichen. Es zeigte sich, dass ein neuer Steady State erreicht wurde, bei dem sowohl anabole wie katabole Faktoren downreguliert wurden bei unveränderter Gesamt-RNA-Aktivität
Biomechanical and neuromuscular adaptations before and after realignment surgery for ankle osteoarthritis
No full textOsteoarthritis (OA) of the ankle joint develops mainly after trauma. It is less frequent than OA of the knee or hip joint but often affects younger and physically active people. More than half of the patients present with a malalignment of the hindfoot, more frequently into varus. Such patients with asymmetric ankle OA often have partially intact articular cartilage and may thus benefit from joint preserving realignment surgery. With supramalleolar and hindfoot osteotomies, the ankle is surgically realigned to unload the degenerated cartilage and improve the joint congruency. While clinical outcome studies already showed a reduction of pain, as well as improvements in the joint function and the patients’ general well-being, the effects of supramalleolar osteotomies on the patients’ gait patterns are largely unknown. The aim of this thesis was therefore to first identify and quantify the gait patterns of patients with asymmetric (varus or valgus) ankle OA and secondly to assess the biomechanical and neuromuscular rehabilitation potential after joint preserving realignment surgery.
The results of the gait analyses in patients with early- to mid-stage asymmetric ankle OA showed that these patients had a lower hindfoot dorsiflexion and rotation range of motion, as well as reduced peak ground reaction forces, external ankle dorsiflexion moment, and ankle joint power. Additionally, the application of a principal component analysis on the temporal waveforms of the hindfoot dorsiflexion angle and the vertical ground reaction force resolved features that influenced the amplitudes and timing of the waveforms. Using selected principal component scores of patients and healthy subjects in a linear support vector machine classifier resulted in a successful classification (recognition rate: > 95%). Regarding the neuromuscular changes, patients with asymmetric ankle OA produced lower isometric torques in plantarflexion and dorsiflexion compared to healthy subjects. This weakness of the lower leg muscles was also associated with changes in the muscle activation patterns. For the tibialis anterior the wavelet power spectrum (maximal isometric contraction) and the wavelet pattern (walking) contained more low frequency components than those of healthy subjects. During walking, the calf muscles were active with a lower intensity and over a broader time-frequency region. Additionally, it seemed that a valgus hindfoot alignment led to an altered intermuscular coordination between the calf muscles. While the gastrocnemius medialis was maximally active before the gastrocnemius lateralis and soleus in healthy subjects and patients with varus ankle OA, it lagged behind in patients with valgus ankle OA. This altered coordination could be due to a reduced or missing varisation of the hindfoot during push off from the floor. Further changes were seen in the wavelet patterns of peroneus longus that contained more low frequency components in patients with a valgus hindfoot alignment than in those with a varus alignment. This could be related to a lower muscle activation level that has previously been described for healthy subjects with flat-arched feet.
Based on the described gait adaptations in patients with asymmetric ankle OA, we further investigated the effects of the joint preserving realignment surgery and the following rehabilitation on the biomechanical and neuromuscular gait patterns. In patients measured at least seven years after surgery, the spatiotemporal, kinematic, and kinetic gait parameters showed fewer differences to controls than to patients with asymmetric ankle OA. The postoperative patients walked faster, with a higher cadence, and a slightly higher ankle dorsiflexion moment. However, the range of motion in hindfoot and hallux dorsiflexion remained reduced compared to healthy subjects. Additionally, prospective gait data for patients before and after realignment surgery were collected and presented together with data on long-term follow-up patients. Patients with ankle OA, short-term (prospective) and long-term follow-up patients had similar changes in the foot kinematics. Principal component scores that affected the range of motion of the sagittal hindfoot and hallux movement were reduced compared to healthy subjects in all patient groups. For the forefoot dorsiflexion angle (range of motion) and the temporal muscle activation of gastrocnemius medialis and soleus (peak activity), the principal component scores were only altered in the patients with ankle OA and the short-term follow-up patients. However, both studies showed that despite remaining changes in the gait patterns, patients had less pain, higher functional ankle scores, and a better general health after supramalleolar osteotomies. Thus, our results indicated that joint preserving realignment surgeries are a promising alternative treatment for asymmetric ankle OA
author-bios-SRD-19-0063.R1 – Supplemental material for The Network Structure of Police Misconduct
No full textSupplemental material, author-bios-SRD-19-0063.R1 for The Network Structure of Police Misconduct by George Wood, Daria Roithmayr and Andrew V. Papachristos in Socius</p
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
The use of structural and non structural bone grafts and substitutes in osteotomies and arthrodesis of the hindfoot and ankle
No full textIntroduction: Hindfoot fusions and osteotomies implicate the decision whether to use an autologous bone graft or an osteoconductive or –inductive substitute material in order to promote bony union and/or to support the correction of an additional hindfoot deformity. Evidence directing this decision is missing. The goal of this thesis is to retrospectively quantify the use of structural and non structural bone grafts in the foot and ankle clinic of the University of Basel over a one year period and to assess the time to union achieved with each different type of graft in specific hindfoot fusions or osteotomies carried out at level of the ankle, subtalar, chopart und Lisfranc joint.
Methods: We retrospectively identified all patients who underwent fusions or osteotomies of the hindfoot from January 2006 until December 2006 using the in house electronic database „opdz“ recording all surgical procedures carried out at the institution of the University of Basel. Patients were then allocated to four treatment groups including: 1) ankle fusion and osteotomies 2) hindfoot (talonavicular, subtalar and triple) arthrodesis 3) calcaneal osteotomy and 4) midfoot arthrodesis and osteotomies. Within these major treatment categories, patients who received the same or no bone graft were further pooled in subgroups. Average time to union, rates of non - and delayed was calculated for each of the above mentioned subgroups and compared to each other within the respective treatment categories.
Results: We identified 108 patients (50 male, 58 female, mean age 56.5 +/- 15.3 years) undergoing 90 fusions and 36 osteotomies at the level of the ankle, subtalar, Chopart or Lisfranc joint from January to December 2006. Thereby, 3 patients underwent revision of their arthrodesis within the follow up time. Another 15 underwent combined osteotomies or arthrodesis during the same procedure. Acellular allografts (Tutoplast®) and demineralised bone matrix (DBM) were the most often used structural and non structural bone graft respectively. Given the limited number of patients receiving the same graft in a specific procedure, comparison of time to union could only performed for structural and non structural bone grafts in triple/subtalar arthrodesis. In this category, there was no difference between acellular allograft mediated arthrodeses carried out either with or without DBM. Furthermore, there was no difference between in situ arthrodeses carried out without any graft or with the application of DBM.
Conclusion: Many different structural and non structural bone grafts and substitutes are used in fusions and osteotomies in today’s foot and ankle surgery for structural support or acelleration of bony healing. The current literature only provides sparse data on the efficacy of both natural bone grafts and their substitutes. Their true efficacy must further be evaluated in prospective randomized studies
Variations on the Author
No full text“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Využití sociálních médií v B2B prodeji
No full textTato diplomová práce se zabývá tím, jak mohou B2B obchodníci využívat sociální média v prodeji. Na základě systematické rešerše literatury, autor zjistil, že akademici, zkoumající danou problematiku, navrhují další výzkum, a to: v kterých konkrétních krocích se dají využít sociální média v prodeji (Salo, 2017). Autor se na základě toho rozhodl zjistit, jaké sociální sítě, různé technologie a pluginy se dají využít v B2B prodeji - tzv. social sellingu. Social selling se v této práci týká primárně procesu akvizice a okrajově péčí o stávající zákazníky. Autor si vybral kvalitativní průzkum pomocí 10 hloubkových polo-strukturovaných rozhovorů, aby odhalil jak, která sociální média to jsou, tak i motivaci prodejců, proč tato média používat/nepoužívat. Aby autor dodržel správnost vyhodnocení výsledků, data byla analyzována pomocí Tématické analýzy, která v této studii vykrystalizovala 2 hlavní strategické přístupy v social sellingu. Tyto přístupy (tzv. Push a Pull strategie) obsahují praktické příklady a konkrétní aktivity, které mohou prodejci využívat v každodenní praxi. Tyto výsledky jsou prezentovány s důrazem na praktičnost a jednoduchost implementace. Tvoří proto hlavní přínos autorovo výzkumu. V poslední části autor zmiňuje výzvy a manažerská doporučení, které mohou obchodníci využít v každodenním pracovním životě.This diploma thesis focuses on social media usage in B2B sales. Based on the systematic literature review conducted by the author, he has found out that recent researchers (Salo, 2017) suggest further research in the area of how and in which sales phase should various social networking sites, technologies and plugins used. To further fill this research gap, author decided to identify these social media and their usage among B2B salespeople in the so-called social selling process. The social selling process in this thesis applies mainly to acquiring new prospects and tangentially to taking care of existing clients (follow-up step). Author has chosen a qualitative research method via conducting 10 in-depth semi-structured interviews to reveal these instruments as well as motivation of a sales person on why to use social media in the selling process. The collected data was analyzed using Thematic analysis to ensure the right procedure and to identify main themes which crystalized into 2 main strategic approaches in social selling. These approaches (Push and Pull) include practical examples of concrete activities which sales people can use in their daily jobs and are presented with focus on practicality and ease of implementation. These also form the main contribution of author`s research. In the last part, author mentions challenges in social selling and recommended managerial implications for salesforce
TeX v jednoduchém unixovém prostředí
No full textsummary:Při ladění TeXového dokumentu potřebujeme mnohokrát opakovaně pouštět TeX, podívat se, jak dopadl výsledek v prohlížeči DVI nebo PDF souboru, mrknout na výpis TeXu na terminálu, podívat se případně do logu a celou činnost opakovat. V tomto článku je ukázáno, jak tuto práci dělá autor článku. Proces "editor-TeX-kuk" je zde podporován jednoduchými unixovými nástroji: bashovým skriptem texloop, který si autor pro tyto účely vytvořil, dále terminálem Xterm a jednoduchým editorem, který umí navázat na klávesovou zkratku spuštění příkazu v systému. Čtenář se zde může inspirovat a přizpůsobit tyto nástroje svým vlastním potřebám. V článku je popsána funkce skriptu texloop, dále je neformálně rozveden dlouholetý vývoj autorova vztahu k textovým editorům a konečně je zde uvedena konfigurace terminálu Xterm, aby vyhovoval českému prostředí jak v kódování ISO-8859-2, tak v kódování UTF-8. Pro kódování UTF-8 si v závěru článku vygenerujeme TeXový formát csplain.summary:By debugging a TeX document it is necessary many times repeatedly to run TeX, to look for the result in DVI or PDF file, to gander the TeX output on the terminal, or eventually to have a look in the log-file, and all that action to repeat. In the paper it is show, how this work is made by author. The process '‘'editor-TeX-look' is supported by simple Unix tools: bash script texloop, created by author for these purposes, Xterm terminal and a simple editor, which is able to link to the shortcut key the activation of a system command. The reader could be inspired with the solution and to adapt these tools to his/her own needs. In the paper the function of the texloop script is described, and further the longstanding evolution of the author's relation to text editors is informal elaborated and finally a configuration of Xterm terminal, suitable for the czech environment with both ISO-8859-2 and UTF-8 encoding is introduced. For UTF-8 encoding the TeX format csplain is generated at the end of the paper
Analýza perspektivy vedoucích prodeje na řízení pojišťovacích agentů v etnicky různorodých zastoupeních v Organizaci G, Malajsie.
No full textCílem této práce je odhalit klíčové faktory a výzvy spojené s řízením etnicky různorodého pojišťovacího zastoupení v oboru životního pojištění v Malajsii. Autor si klade za cíl zkoumat pohled vedoucích prodeje v Organizaci G v Malajsii na jejich způsob řízení agentů. Kombinované kvantitativní a kvalitativní metody budou použity prostřednictvím průzkumu a rozhovorů se 79 agenty a 12 vedoucími prodeje. Odpovědi budou analyzovány za účelem porozumění výzvám, kterým čelí vedoucí prodeje při řízení etnicky různorodého zastoupení, a zkoumat potenciální řešení. Autor navrhuje iniciativy a metody k posílení stylů vedení a zlepšení procesů pro udržení úspěšného zastoupení v kontextu etnické rozmanitosti.The goal of this thesis is to uncover the key factors and challenges in managing an ethnically diverse insurance agency in Malaysia's life insurance industry. The author aims to examine the sales managers' perspective in Organisation G, Malaysia, regarding their expression of managing their agents. Quantitative and qualitative methods will be employed through surveys and interviews among 79 agents and 12 sales managers. The responses will be analysed to understand the challenges sales managers face in managing a multi-ethnic agency and explore potential solutions. The author proposes initiatives and methods to enhance leadership styles and improve the processes for maintaining a successful agency in the context of multi-ethnicity
AUTHOR BOOK
No full textVytvořil jsem autorskou knihu o čtyřiceti stránkách s ilustracemi a minimem textu. Kniha je černobílá, dominuje v ní tušová kresba štětcem a perem. Kromě té je v knize ale i text, který slouží jako poetické doplnění ilustrací.
Obsah knihy se zaměřuje na úzký kruh přátel a zároveň vypovídá o autorovi jak vybranými motivy, situacemi tak linkou.
Vyznění knihy je spíše pocitové, má zanechat dojem, ne popisně vysvětlovat.ObhájenoI have created author book that has 40 pages with ilustrations and minimum of text. The book is black and white and contains ink drawings. There is also text poetically coresponding with pictures
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