Objective- To compare the biomechanical properties of 3.5 locking compression plate (LCP) fixation to 3.5 limited contact dynamic compression plate (LC-DCP) fixation in a canine cadaveric, distal humeral metaphyseal gap model in static axial compression and cyclic axial compression and torsion. Study Design- Biomechanical in vitro study. Sample Population- 30 paired humeri from adult, medium to large breed dogs. Methods- Testing was performed monotonically to failure in axial compression on ten pairs of humeri, cyclically in axial compression for 10,000 cycles on ten pairs and cyclically in torsion for 500 cycles on the last ten pairs. Results- Humeral constructs stabilized with LCPs were significantly stiffer than those plated with LC-DCPs when loaded in axial compression (P=0.0004). When cyclically loaded in axial compression over 10,000 cycles, the LC-DCP constructs were significantly stiffer than those constructs stabilized with LCPs (P=0.0029). Constructs plated with LC-DCPs were significantly more resistant to torsion over 500 cycles than those plated with LCPs (P<0.0001), though no difference was detected during the first 280 cycles. Conclusions- The increased stiffness of LCP constructs in monotonic loading compared to constructs stabilized with non-locking plates may be attributed to the stability afforded by the plate-screw interface of locking plates. The LCP constructs demonstrated less stiffness in dynamic testing in this model, likely due to plate-bone offset secondary to non-anatomic contouring and occasional incomplete seating of the locking screws when using the torque-limiting screw driver. Clinical Relevance- LCPs yield less stiff fixation under dynamic loading than conventional LC-DCPs when applied to severely comminuted, metaphyseal fractures. Improving anatomical contouring of the plate and insuring complete screw insertion into the locking plate hole may improve stiffness when using LCPs in comminuted fractures. / Master of Science

Syfte: Att redogöra för sjuksköterskors erfarenhet av att vårda patienter i livets slutskede enligt Liverpool Care Pathway (LCP). Metod: Litteraturstudien baseras på tio vetenskapliga artiklar med kvalitativ ansats. De vetenskapliga artiklarna söktes i databaserna CINAHL, PubMed och World of Science. Inklusionskriterier var att artiklarna skulle vara primärkällor, vara skrivna på svenska eller engelska samt publicerade mellan år 2003-2013. Ytterligare inklusionskriterier var att sjuksköterskorna skulle ha erfarenhet av LCP, samt att de vetenskapliga artiklarna erhöll medel eller hög poäng vid granskningen och var godkänd av en etisk kommitté. Studier från hela världen inkluderades. Huvudresultat: Ett flertal studier visade att LCP bidrog till ett ökat självförtroende och tydligare riktlinjer för den palliativa vården. Sjuksköterskorna upplevde en förbättrad symtomkontroll och förbättrad vård efter införandet av LCP. Sjuksköterskorna var positiva till dokumentationen i LCP och det framgick också att LCP hade förbättrat och underlättat kommunikationen med närstående. LCP erbjöd stöd och vägledning i vården men det framgick också att det fanns oklarheter vad beträffar diagnostiserande av en patient som döende. Slutsats: Syftet med litteraturstudien var att undersöka sjuksköterskors erfarenhet av att vårda patienter i livets slutskede enligt Liverpool Care Pathway. Det framgick att det fanns bristande kunskaper om palliativ vård, men att införandet av LCP gett sjuksköterskor stöd och vägledning samt förbättrat kunskapen om palliativ vård. En vårdplan som LCP kan vara ett stöd för sjuksköterskan i omvårdnaden av patienter inom palliativ vård, men en sådan vårdplan kan aldrig ersätta sjuksköterskans kliniska kompetens. Det är därför viktigt att sjuksköterskor erbjuds fortlöpande utbildning inom palliativ vård, samt att en vårdplan som LCP används utifrån ett kritiskt förhållningssätt.

Fractures of the distal radius are the most common fractures treated at our clinics . It accounts for around 16 % of all fractures. Most often we meet them in two age groups - children and especially in postmenopausal women. In this group the fractures are frequently associated with osteoporosis. The most common cause of fracture is a fall on the outstretched extremity. Together with fractures of the proximal humerus, proximal femur and vertebral fractures they are the most common gerontotraumatologic fractures. The frequency of fractures of the distal radius gradually increasing. The reason is the increasing average age of the population and their active way of life. Our group consists of 5,359 patients treated for a fracture of the distal radius in 1998 and from 2001 to 2013 . During this time , the frequency of fractures increased by 19,7%. For women with distal radius fractures occur 3 times more frequently, the average age of treated was 59,1 years. About 80 % of distal radius fractures are treated conservatively. The surgical treatment of seniors decide not only the type and stability of the fracture, bone quality, but especially the overall condition of the patient and his claims to a final functional outcome. Long-term functional results after conservative treatment in the elderly are nearly the...

Fractures of the distal radius are the most common fractures treated at our clinics . It accounts for around 16 % of all fractures. Most often we meet them in two age groups - children and especially in postmenopausal women. In this group the fractures are frequently associated with osteoporosis. The most common cause of fracture is a fall on the outstretched extremity. Together with fractures of the proximal humerus, proximal femur and vertebral fractures they are the most common gerontotraumatologic fractures. The frequency of fractures of the distal radius gradually increasing. The reason is the increasing average age of the population and their active way of life. Our group consists of 5,359 patients treated for a fracture of the distal radius in 1998 and from 2001 to 2013 . During this time , the frequency of fractures increased by 19,7%. For women with distal radius fractures occur 3 times more frequently, the average age of treated was 59,1 years. About 80 % of distal radius fractures are treated conservatively. The surgical treatment of seniors decide not only the type and stability of the fracture, bone quality, but especially the overall condition of the patient and his claims to a final functional outcome. Long-term functional results after conservative treatment in the elderly are nearly the...

Fraturas do diastema mandibular são cirurgicamente mais desafiadoras porque, geralmente são bilaterais, instáveis e altamente contaminadas. Como cada fratura tem características particulares e são únicas, o conhecimento de diferentes técnicas de reparo permitirá que ao veterinário escolher um método de fixação mais adequado à configuração da fratura, considerando os equipamentos disponíveis, a expertise e preferências do cirurgião. O objetivo deste estudo foi avaliar 2 técnicas de fixação de fraturas do diastema mandibular por meio da mensuração de suas características biomecânicas. Mandíbulas osteotomizadas no diastema foram divididas em 2 grupos de fixação (n=8). As mandíbulas foram fixadas com placas bloqueadas (LCP) e por meio de implantes transdentários com placas LC-DCP. Oito mandíbulas intactas (não osteotomizadas) foram submetidas aos ensaios biomecânicos como controle. As mandíbulas foram submetidas à ensaios biomecânicos de flexão até ocorrer a falha. O deslocamento angular (radianos) foi derivado a partir contínua mensuração da largura da fenda com extensometros inseridos ao redor do local da osteotomia. Foram selecionados os dados da fenda da osteotomia a 50 e 100 N.m para comparação padronizada da largura da fenda antes dos pontos de limite elástico e limite de flexão máximo, respectivamente para as 2 técnicas de fixação testadas. Rigidez (N.m/radiano), limite elástico (N.m) e limite de flexão máximo (N.m) foram determinados a partir das curvas de deslocamento angular da flexão e foram comparadas por meio do teste estatístico ANOVA com testes adicionais quando indicado. Foram obtidas imagens radiográficas pré fixação das mandíbulas. Os dentes submetidos à implantes transdentários foram submetidos à exames tomográficos e foram obtidos cortes histológicos calcificados. As cargas de resistência à flexão, de limite elástico e de limite de flexão máximo foram maiores nas mandíbulas intactas. Nas mandíbulas osteotomizadas as cargas de resistência à flexão, de limite elástico, de limite de flexão máximo e da largura da osteotomia à 50 e 100 N.m não foram significantemente diferentes (P>0,05) nas fixações com placas LCP e implantes transdentários com placas LC-DCP. Estas técnicas foram biomecânicamente similares. A fixação com placas LCP transdentários com placas LC-DCP são uma forma estável de fixação de fraturas localizadas no diastema mandibular. Em alguns casos, a cavidade pulpar (71% em dentes incisivos e 43% em dentes pré molares) foi penetrada pelos implantes transdentários. Estudos adicionais com animais vivos devem ser realizados para determinar as consequências a longo prazo do uso de implantes transdentários. / Mandibular fractures of the interdental space are surgically more demanding because they are often bilateral, unstable, and heavily contaminated. Because each fracture is unique, knowledge of the different repair techniques will allow the practitioner to choose a repair method best suited to the fracture configuration, equipment available, and the skill level and preferences of the surgeon. The aim of this study was to evaluate 2 fixation techniques for equine interdental space fractures by mensuration their biomechanical characteristics. Mandibles with interdental osteotomies were divided into 2 fixation groups (n = 8/group). Fixation techniques were the locking compression plates (LCP) and (2) Trans-Dental low contact - dynamic compression-plate fixation (Trans dental LC-DCP). Eight intact (nonosteotomized) mandibles were tested as controls. Mandibles were subjected to monotonic cantilever bending until failure. Angular displacement data (radians) were derived from continuously recorded gap width measurements provided by extensometers placed across the osteotomy site. Osteotomy gap width data (mm) at 50 and 100 Nm were selected for standardized comparison of gap width before the yield point and failure point, respectively of all constructs tested. Stiffness (Nm/radian), yield strength (Nm), and failure strength (Nm) were determined from bending moment-angular displacement curves and were compared using ANOVA with appropriate post hoc testing when indicated. Radiographs were obtained prefixation. Axial tomography and calcified histological cuts were obtained of the teeth submited to trans dental screws implant. Bending stiffness, yield, and ultimate failure loads were greatest for intact mandibles. Among osteotomized mandibles, stiffness, yield, ultimate faluire, and osteotomy gap width at 50 and 100 Nm was not significantly different (P>0,05) among LCP and trans dental LC-DCP constructs. They were biomechanically similar. LCP and trans dental LC-DCP fixation are stable form of fixation for interdental space fractures. In some cases the pulp cavity was penetrated (incisors teeth, 71% and check teeth, 43%) by trans dental implants. Additional studies with live animals must be performed to determine the long term consequences of adhibition the trans dental implants.

La mise au point de nouveaux matériaux pour piéger les anions phosphate présents dans les eaux usées est une des clés pour lutter contre le phénomène d’eutrophisation des eaux de surface. Au cours de cette étude, les hydroxydes doubles lamellaires contenant des ions CaII et FeIII dans les feuillets cationiques et des anions chlorure et nitrate au sein de l’espace inter-feuillets (CaFe-HDL-Cl et CaFe-HDL-NO3) ont été utilisés pour piéger les phosphates. Ces deux variantes d’HDL ont été synthétisées par trois méthodes simples de co-précipitation. La capacité de piégeage de ces matériaux a été évaluée par des expériences de sorption en « batch » à l’équilibre et des mesures de cinétique dans une gamme de pH comprise entre 4 et 12. La cinétique de piégeage du phosphate par les HDL obéit à une loi du pseudo-second ordre. Les isothermes révèlent que les HDL synthétisés avec un rapport CaII : FeIII de 2 : 1 sont les plus efficaces pour piéger les phosphates. On mesure des capacités de piégeage très élevées de l’ordre de 385 et 402 mg g-1 pour les composés CaFe-HDL-Cl et CaFe-HDL-NO3, respectivement. Les données obtenues à l’équilibre ont pu être ajustées par des isothermes de type Langmuir et/ou Freundlich. Pour des concentrations en phosphate élevées ([PO43-] ≥ 100 mg L-1), la caractérisation des solides et des liquides par diverses techniques révèlent que la HDL se dissout et libèrent des cations solubles Ca2+ qui précipitent avec les phosphates pour former l’hydroxyapatite Ca5(PO4)3OH. A ce mécanisme principal s’ajoute un mécanisme de piégeage secondaire qui est l’adsorption des phosphates par un gel ferrique dopé en ions calcium qui est lui aussi issu de la transformation minéralogique de l’HDL. A faible concentration en phosphate ([PO43-] ≥ 100 mg L-1), l’hydroxyapatite ne se forme pas et l’adsorption des phosphates par ce gel ferrique dopé en ions calcium devient le mécanisme de piégeage principal. / The development of an efficient removal material for phosphate from wastewater to prevent the eutrophication in surface waters is very important. In this study, CaIIFeIII layered double hydroxide containing chloride and nitrate as intercalated anions (CaFe-LDH-Cl and CaFe-LDH-NO3) were used as removal materials for phosphate. Both forms were designed and synthesized at different CaII: FeIII molar ratios (2:1, 3:1, and 4:1) following three simple co-precipitation methods. The materials were evaluated for the removal of phosphate by batch equilibrium sorption experiments and kinetic measurements. The efficiency of the phosphate removal from aqueous solution was investigated in the range pH 4-12. As a result, it was found that pseudo-second-order kinetic model described well the phosphate removal. The isotherms of adsorption of PO43- ions showed that CaFe-LDH-Cl and CaFe-LDH-NO3 at CaII: FeIII molar ratio of 2:1 revealed the highest rate of phosphate uptake of 385 and 402 mg g-1, respectively, comparing to other CaII: FeIII molar ratios. Equilibrium data were well fitted with Freundlich and Langmuir isotherms. In the case of high phosphate concentration ([PO43-] ≥ 100 mg L-1), the comprehensive analysis of the phosphate-uptake products with different techniques revealed that CaFe-LDH dissolve first and then released Ca2+ ions reacting with PO43- anions to form Ca5(PO4)3OH (hydroxyapatite) which is the main mechanism for phosphate removal. Also, phosphate was removed partially via a subsidiary process other than precipitation of hydroxyapatite. The excess in phosphate removal was attributed to the formation of a disordered Ca doped ferrihydrite which removed phosphate via simple surface adsorption. In the case of initial low phosphate concentration ([PO43-] < 100 mg L-1), the analysis showed that PO43- removed mainly via simple surface adsorption over disordered Ca doped ferrihydrite which was the main component in the residual solid after partial Ca2+ releasing from LDH

Fraturas do diastema mandibular são cirurgicamente mais desafiadoras porque, geralmente são bilaterais, instáveis e altamente contaminadas. Como cada fratura tem características particulares e são únicas, o conhecimento de diferentes técnicas de reparo permitirá que ao veterinário escolher um método de fixação mais adequado à configuração da fratura, considerando os equipamentos disponíveis, a expertise e preferências do cirurgião. O objetivo deste estudo foi avaliar 2 técnicas de fixação de fraturas do diastema mandibular por meio da mensuração de suas características biomecânicas. Mandíbulas osteotomizadas no diastema foram divididas em 2 grupos de fixação (n=8). As mandíbulas foram fixadas com placas bloqueadas (LCP) e por meio de implantes transdentários com placas LC-DCP. Oito mandíbulas intactas (não osteotomizadas) foram submetidas aos ensaios biomecânicos como controle. As mandíbulas foram submetidas à ensaios biomecânicos de flexão até ocorrer a falha. O deslocamento angular (radianos) foi derivado a partir contínua mensuração da largura da fenda com extensometros inseridos ao redor do local da osteotomia. Foram selecionados os dados da fenda da osteotomia a 50 e 100 N.m para comparação padronizada da largura da fenda antes dos pontos de limite elástico e limite de flexão máximo, respectivamente para as 2 técnicas de fixação testadas. Rigidez (N.m/radiano), limite elástico (N.m) e limite de flexão máximo (N.m) foram determinados a partir das curvas de deslocamento angular da flexão e foram comparadas por meio do teste estatístico ANOVA com testes adicionais quando indicado. Foram obtidas imagens radiográficas pré fixação das mandíbulas. Os dentes submetidos à implantes transdentários foram submetidos à exames tomográficos e foram obtidos cortes histológicos calcificados. As cargas de resistência à flexão, de limite elástico e de limite de flexão máximo foram maiores nas mandíbulas intactas. Nas mandíbulas osteotomizadas as cargas de resistência à flexão, de limite elástico, de limite de flexão máximo e da largura da osteotomia à 50 e 100 N.m não foram significantemente diferentes (P>0,05) nas fixações com placas LCP e implantes transdentários com placas LC-DCP. Estas técnicas foram biomecânicamente similares. A fixação com placas LCP transdentários com placas LC-DCP são uma forma estável de fixação de fraturas localizadas no diastema mandibular. Em alguns casos, a cavidade pulpar (71% em dentes incisivos e 43% em dentes pré molares) foi penetrada pelos implantes transdentários. Estudos adicionais com animais vivos devem ser realizados para determinar as consequências a longo prazo do uso de implantes transdentários. / Mandibular fractures of the interdental space are surgically more demanding because they are often bilateral, unstable, and heavily contaminated. Because each fracture is unique, knowledge of the different repair techniques will allow the practitioner to choose a repair method best suited to the fracture configuration, equipment available, and the skill level and preferences of the surgeon. The aim of this study was to evaluate 2 fixation techniques for equine interdental space fractures by mensuration their biomechanical characteristics. Mandibles with interdental osteotomies were divided into 2 fixation groups (n = 8/group). Fixation techniques were the locking compression plates (LCP) and (2) Trans-Dental low contact - dynamic compression-plate fixation (Trans dental LC-DCP). Eight intact (nonosteotomized) mandibles were tested as controls. Mandibles were subjected to monotonic cantilever bending until failure. Angular displacement data (radians) were derived from continuously recorded gap width measurements provided by extensometers placed across the osteotomy site. Osteotomy gap width data (mm) at 50 and 100 Nm were selected for standardized comparison of gap width before the yield point and failure point, respectively of all constructs tested. Stiffness (Nm/radian), yield strength (Nm), and failure strength (Nm) were determined from bending moment-angular displacement curves and were compared using ANOVA with appropriate post hoc testing when indicated. Radiographs were obtained prefixation. Axial tomography and calcified histological cuts were obtained of the teeth submited to trans dental screws implant. Bending stiffness, yield, and ultimate failure loads were greatest for intact mandibles. Among osteotomized mandibles, stiffness, yield, ultimate faluire, and osteotomy gap width at 50 and 100 Nm was not significantly different (P>0,05) among LCP and trans dental LC-DCP constructs. They were biomechanically similar. LCP and trans dental LC-DCP fixation are stable form of fixation for interdental space fractures. In some cases the pulp cavity was penetrated (incisors teeth, 71% and check teeth, 43%) by trans dental implants. Additional studies with live animals must be performed to determine the long term consequences of adhibition the trans dental implants.

The objective of this PhD research was to design and implement novel microfluidic radio-frequency (RF) structures on multilayer organic substrates for cooling and tuning purposes. The different designs were implemented to target applications up to C-band (4 GHz – 8 GHz) frequencies. The system-on-package (SoP) solution adopted throughout this work is well adapted for such designs where there is a need to integrate the functionality of different sub-components into a single hybrid fully packaged system. The first part of the thesis is dedicated to the study of a specific liquid cooling scheme using integrated microchannels on organics placed beneath different types of heat sources. A 1 W gallium nitride (GaN) die was cooled using this method and an analysis is presented regarding the cases where the coolant is static or dynamic inside the microchannel. The second part of the thesis deals with microfluidically reconfigurable microstrip RF circuits, mainly bandpass filters and power amplifiers (PAs). The microfluidic tuning technique is based on the change in the effective dielectric constant that the RF signal “sees” when traveling above two microchannels with different fluids. This technique was used to shift the frequency response of an L-band microstrip bandpass filter by replacing DI water with acetone inside a 60 mil micro-machined cavity. This technique was also used to design reconfigurable matching networks which constitute the main part of the proposed tunable GaN-based PA for S- and C-band applications. The final part of the thesis expands the previous results by combining both cooling and tuning in a single RF design. To prove the concept, cooling and tuning microchannels were integrated into a single package to cool a GaN-based PA and tune its frequency response at the same time from 2.4 GHz to 5.8 GHz and vice versa.

The objective of the proposed research is to develop novel, fully-packaged voltage controlled oscillators (VCOs), concurrent oscillators, and multi-mode filters using Liquid Crystalline Polymer (LCP) dielectric material that are directly applicable to simultaneous multi-band radio communication. Integrated wireless devices of the near-future will serve more diverse range of applications (computing, voice/video/data communication) and hence, will require more functionality. This research is focused on providing cost-effective and area-efficient solutions for multi-band/multi-mode oscillators and filters using system-on-package (SOP) design methodology. Silicon-based integrated circuits (ICs) provide an economical method of miniaturizing modules and hence, are attractive for multi-band applications. However, fully monolithic solutions are limited, by its high substrate losses, and marginal quality factors (Qs) of the passives, to low profile applications. Furthermore, the VCOs made on conventional packaging technologies are not very cost-effective. This thesis is directed towards developing highly optimized VCOs and filters using LCP substrate for use in multi-mode radio systems. The thesis investigates and characterizes lumped passive components on new LCP based technology feasible for VCO and filter design. The dissertation then investigates design techniques for optimizing both power consumption and the phase noise of the VCOs to be employed in commercial wireless systems. This work then investigates the temperature performance of LCP-based VCOs satisfying military standards. Another aspect of the thesis is the development of dual-band (multi-mode) oscillators. The approach is to employ existing multi-band theories to demonstrate one of the first prototypes of the oscillator. Finally, the design of multi-mode, lumped-element type filters was investigated.

The objective of this thesis is to design RF circuits using silicon-germanium (SiGe) heterojunction bipolar transistors (HBTs) for communication system. The packaging effect for the SiGe chip using liquid crystal polymer (LCP) is presented and methodology to derive the model for the package is discussed. Chapter 1, we discuss the overview and benefits of SiGe HBT technology in high frequency circuit design. Chapter 2 presents the methodology of the low noise amplifier (LNA) design and discusses the trade-off between the noise and gain matching. The technique for achieving simultaneous noise and gain matching for the LNA is also presented. Chapter 3 presents an L-band cascaded feedback SiGe low noise amplifier (LNA) design for use in Global Position System (GPS) receivers. Implemented in a 200 GHz SiGe BiCMOS technology, the LNA occupies 1 x 1 millimeter square (including the bondpads). The SiGe LNA exhibits a gain greater than 23 dB from 1.1 to 2.0 GHz, and a noise figure of 2.7 to 3.3 dB from 1.2 to 2.4 GHz. At 1.575 GHz, the 1-dB compression point (P1dB) is 1.73 dBm, with an input third-order intercept point (IIP3) of -3.98 dBm. Lastly, Chapter 4 covers the packaging techniques for the SiGe monolithic integrated circuit (MMIC). We present the modeling of a liquid crystal polymer (LCP) package for use with an X-band SiGe HBT Low Noise Amplifier (LNA). The package consists of a 2 mil LCP laminated over an embedded SiGe LNA, with vias in the LCP serving as interconnects to the LNA bondpads. An accurate model for the packaging interconnects has been developed and verified by comparing to measurement results, and can be used in chip/package co-design.