Total hip arthroplasty offset measurement: Is C T scan the most accurate option?

SummaryBackgroundFemoral offset is difficult to precisely evaluate with conventional X-ray techniques. Femoral offset characterizes the balance between body weight and the resistance provided by the abductor muscles. Total hip arthroplasties should respect this balance.HypothesisComputed tomodensitometry (CT-scan) is more accurate than conventional X-ray to evaluate femoral offset.Materials and methodsSixty-one patients who received unilateral total hip arthroplasties were prospectively included in the study. Femoral offset was measured by three-dimensional CT-scan reconstruction using the “Hip Plan” (Symbios™) software. Offset was also determined with conventional X-ray and results were compared. This software can be used to measure leg length by frontal telemetry. It was developed for preoperative-planning of cementless femoral stem implants with modular necks of various lengths and angles. All pre- and postoperative measurements were made according to the same protocol.ResultsFemoral offset values in this study were very similar to anatomical values found in the literature. They were significantly higher than values obtained by conventional X-ray by an average of 8%. Implantation of hip replacements resulted in a significant increase in offset (1.88±4.71mm) with a slight variation in leg length. Pre- and postoperative leg length increased slightly in the operated leg by an average of 1.66±5.63mm. Seventeen percent of these femurs had high offset associated with small or average sized proximal medullary canals. This preoperative planning software made it possible to identify these difficulties and to adapt implant components using modular long 8° varus necks to restore high offset. In most of these cases, only small femoral stems could be implanted because of the small size of the intramedullary femoral canal. These individual differences were identified with 3D CT-scan reconstruction and included in the preoperative planning. Moreover, leg length could also be evaluated with this method and included in the preplanning.DiscussionCompared to conventional X-ray, measurements obtained with this preoperative planning method using 3D CT-scan reconstruction are easy to obtain and not dependent upon test conditions because the frame is placed on the femoral axis. Measurements are not influenced by position inconsistencies or if the hip is fixed in external rotation. The significant number of cases with above average offset confirms the importance of obtaining these measurements and the necessity of adapting the strategy in these cases by using lateralized stems, or, as in our series, modular necks to adjust femoral offset and neck angle.Level of evidenceLevel III diagnostic prospective study

Le partage de la ressource en eau sur la Durance en 2050 : vers une évolution du mode de gestion des grands ouvrages duranciens ?

Congrès SHF: Water Tensions in Europe and in the Mediterranean: water crisis by 2050?, Paris, FRA, 08-/10/2015 - 09/10/2015International audienceUne vision prospective de la gestion de l'eau du bassin de la Durance et des territoires alimentés par ses eaux à l'horizon 2050 a été élaborée, appuyée par une chaine de modèles incluant des représentations du climat, de la ressource naturelle, des demandes en eau et du fonctionnement des grands ouvrages hydrauliques (Serre-Ponçon, Castillon et Sainte-Croix), sous contraintes de respect des débits réservés, de cotes touristiques dans les retenues et de restitution d'eau stockée pour des usages en aval. Cet ensemble, validé en temps présent, a été alimenté par des projections climatiques et paramétré pour intégrer les évolutions du territoire décrites par des scénarios de développement socio-économique avec une hypothèse de conservation des règles de gestion actuelles. Les résultats suggèrent à l'horizon 2050 : une hausse de la température moyenne de l'air impactant l'hydrologie de montagne ; une évolution incertaine des précipitations ; une réduction des stocks de neige et une fonte avancée dans l'année qui induisent une réduction des débits au printemps ; une diminution de la ressource en eau en période estivale ; une diminution de la demande globale en eau à l'échelle du territoire, cette demande étant fortement conditionnée par les scénarios territoriaux élaborés ici ; la satisfaction des demandes en eau en aval des ouvrages considérées comme prioritaires, au détriment de la production d'énergie en hiver (flexibilité moindre en période de pointe) et du maintien de cotes touristiques en été ;une diminution de la production d'énergie due notamment à la réduction des apports en amont des ouvrages hydroélectriques

Infiltration from the pedon to global grid scales: an overview and outlook for land surface modelling

Infiltration in soils is a key process that partitions precipitation at the land surface in surface runoff and water that enters the soil profile. We reviewed the basic principles of water infiltration in soils and we analyzed approaches commonly used in Land Surface Models (LSMs) to quantify infiltration as well as its numerical implementation and sensitivity to model parameters. We reviewed methods to upscale infiltration from the point to the field, hill slope, and grid cell scale of LSMs. Despite the progress that has been made, upscaling of local scale infiltration processes to the grid scale used in LSMs is still far from being treated rigorously. We still lack a consistent theoretical framework to predict effective fluxes and parameters that control infiltration in LSMs. Our analysis shows, that there is a large variety in approaches used to estimate soil hydraulic properties. Novel, highly resolved soil information at higher resolutions than the grid scale of LSMs may help in better quantifying subgrid variability of key infiltration parameters. Currently, only a few land surface models consider the impact of soil structure on soil hydraulic properties. Finally, we identified several processes not yet considered in LSMs that are known to strongly influence infiltration. Especially, the impact of soil structure on infiltration requires further research. In order to tackle the above challenges and integrate current knowledge on soil processes affecting infiltration processes on land surface models, we advocate a stronger exchange and scientific interaction between the soil and the land surface modelling communities

AdoPt Project - Adoptive families’ strengths, difficulties and service needs: A Portuguese follow-up study

Introduction:Together with many positive experiences, adoption brings stress and difficulties. In Portugal, about 1/15 preadoption placements is disrupted. In Europe, 1 in 25 adoptions fail. International data show that around 1/4 adoptions undergo major difficulties that threaten stability/permanence. Portuguese research on these matters is currently very limited. Aims: The goal of this poster is to present a recently funded project (AdoPt) aiming at identifying risk/protective factors of postadoption instability/permanence in variables related to adoptees, adopters, parent-child relationships, formal and informal sources of support, and developing, val- idating and sustaining an online survey system to monitor postadoption pathways and needs. Method:Using a cross-sequential design, 3 cohorts of 90 children each, adopted in 2013, 2016 and 2019, will be followed for 3 years with data collection times 12 months apart. Each cohort will include children adopted at ages 0-2, 3-5 and 6-10, ensuring a final age-span of adoptees between 2 and 20 years. Data will be collected online, using adopters and professionals as informants. At the end, data from a representative sub-sample of 90 families will be collected at in-home visits to cross-validate online data (adoptees will also participate). A user-friendly on- line monitoring and follow-up system will be set up. Families will be provided with feedback and educational resources. Annual sessions with adoption professionals will provide the opportunity to share ongoing findings and design new services. Expected Results:With ground-breaking innovations, AdoPt will respond to the need of sound knowledge/better practices for the development of urgently needed postadoption services in Portugal.info:eu-repo/semantics/publishedVersio

Lability of DOC transported by Alaskan rivers to the Arctic Ocean

Author Posting. © American Geophysical Union, 2008. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geophysical Research Letters 35 (2008): L03402, doi:10.1029/2007GL032837.Arctic rivers transport huge quantities of dissolved organic carbon (DOC) to the Arctic Ocean. The prevailing paradigm is that DOC in arctic rivers is refractory and therefore of little significance for the biogeochemistry of the Arctic Ocean. We show that there is substantial seasonal variability in the lability of DOC transported by Alaskan rivers to the Arctic Ocean: little DOC is lost during incubations of samples collected during summer, but substantial losses (20–40%) occur during incubations of samples collected during the spring freshet when the majority of the annual DOC flux occurs. We speculate that restricting sampling to summer may have biased past studies. If so, then fluvial inputs of DOC to the Arctic Ocean may have a much larger influence on coastal ocean biogeochemistry than previously realized, and reconsideration of the role of terrigenous DOC on carbon, microbial, and food-web dynamics on the arctic shelf will be warranted.This material is based on work supported by the National Science Foundation under grant numbers OPP-0436106, OPP- 0519840, and EAR-0403962, and is a contribution to the Study of Environmental Arctic Change (SEARCH)

GMD perspective: The quest to improve the evaluation of groundwater representation in continental- to global-scale models

Continental- to global-scale hydrologic and land surface models increasingly include representations of the groundwater system. Such large-scale models are essential for examining, communicating, and understanding the dynamic interactions between the Earth system above and below the land surface as well as the opportunities and limits of groundwater resources. We argue that both large-scale and regional-scale groundwater models have utility, strengths, and limitations, so continued modeling at both scales is essential and mutually beneficial. A crucial quest is how to evaluate the realism, capabilities, and performance of large-scale groundwater models given their modeling purpose of addressing large-scale science or sustainability questions as well as limitations in data availability and commensurability. Evaluation should identify if, when, or where large-scale models achieve their purpose or where opportunities for improvements exist so that such models better achieve their purpose. We suggest that reproducing the spatiotemporal details of regional-scale models and matching local data are not relevant goals. Instead, it is important to decide on reasonable model expectations regarding when a large-scale model is performing “well enough” in the context of its specific purpose. The decision of reasonable expectations is necessarily subjective even if the evaluation criteria are quantitative. Our objective is to provide recommendations for improving the evaluation of groundwater representation in continental- to global-scale models. We describe current modeling strategies and evaluation practices, and we subsequently discuss the value of three evaluation strategies: (1) comparing model outputs with available observations of groundwater levels or other state or flux variables (observation-based evaluation), (2) comparing several models with each other with or without reference to actual observations (model-based evaluation), and (3) comparing model behavior with expert expectations of hydrologic behaviors in particular regions or at particular times (expert-based evaluation). Based on evolving practices in model evaluation as well as innovations in observations, machine learning, and expert elicitation, we argue that combining observation-, model-, and expert-based model evaluation approaches, while accounting for commensurability issues, may significantly improve the realism of groundwater representation in large-scale models, thus advancing our ability for quantification, understanding, and prediction of crucial Earth science and sustainability problems. We encourage greater community-level communication and cooperation on this quest, including among global hydrology and land surface modelers, local to regional hydrogeologists, and hydrologists focused on model development and evaluation

ESM-SnowMIP: Assessing snow models and quantifying snow-related climate feedbacks

This paper describes ESM-SnowMIP, an international coordinated modelling effort to evaluate current snow schemes, including snow schemes that are included in Earth system models, in a wide variety of settings against local and global observations. The project aims to identify crucial processes and characteristics that need to be improved in snow models in the context of local- and global-scale modelling. A further objective of ESM-SnowMIP is to better quantify snow-related feedbacks in the Earth system. Although it is not part of the sixth phase of the Coupled Model Intercomparison Project (CMIP6), ESM-SnowMIP is tightly linked to the CMIP6-endorsed Land Surface, Snow and Soil Moisture Model Intercomparison (LS3MIP)