Predictive Reliability of the Phoenix Sign for the Outcome of Common Fibular (Peroneal) Nerve Decompression Surgery

A positive Phoenix sign occurs when a patient, with a suspected focal nerve entrapment of the Common Fibular (Peroneal) Nerve (CFN) at the level of the fibular neck, demonstrates an improvement in dorsifexion after an ultrasound guided infiltration of a sub-anesthetic dose of lidocaine. Less than 5 cc’s of 1% or 2% lidocaine is utilized and the effect is seen within minutes after the infiltration, but usually lasts only 10 minutes. This effect may be due to the vasodilatory action of lidocaine on the microcirculation in the area of infiltration. This nerve block has significant diagnostic utility as it is highly specific in the confirmation of true focal entrapment of the CFN, has high predictive value for a patient who may undergo surgical nerve decompression if they have demonstrated a positive Phoenix Sign, and may help in the surgical decision-making process in patients who have had a drop foot for many years but still may regain some motor function after decompression. In this retrospective review, 26 patients were tested, and 25 of this cohort demonstrated a Positive Phoenix Sign (an increase in dorsiflexion strength of the Extensor Hallucis Longus muscle (EHL)). One patient had no response to the peripheral nerve block. Of the 25 patients who demonstrated a positive “Phoenix Sign” and underwent nerve decompression of the CFN, and 25 (100%) showed an increase in dorsiflexion strength of the EHL after nerve decompression surgery of the CFN. The one patient in this cohort who did not demonstrate any improvement in dorsiflexion of the EHL after the nerve block did not have any improvement after surgery.

Vegetation-environment relationship in conifer dominating forests of the mountainous range of Indus Kohistan in northern Pakistan

Environmental variables play a crucial role in shaping vegetation structure,mainly in mountainous ecosystems.Different studies have attempted to identify the environment-vegetation relationship of Conifer Dominating Forests(CDF)worldwide.However,due to differences in local climate and soil composition,different environmental drivers can be found.By applying multivariate analysis techniques,this study investigated the vegetation-environment relationship of CDF of Indus Kohistan in northern Pakistan.Our results showed that CDF of Indus Kohistan are distributed in five distinct ecological groups,which are dominated by different trees and understory species.A total of 7 trees and 71 understory species were recorded from the sampling sites.Cedrus deodara was the leading species among four groups,having the highest importance value(IV),density and basal area.Group I was dominated by Pinus wallichiana with the second highest importance value,density and basal area.In addition,elevation,slope,maximum water holding capacity(MWHC),soil moisture(SM),total organic matter(TOM),sodium,phosphorus and nickel showed highly significant influence on composition and distribution pattern of Indus Kohistan vegetation.Therefore,this study shows a new evidence of vegetation-environment relationship,pointing out specific drivers of vegetation structure in CDF of Indus Kohistan region in northern Pakistan.

Carbon nanotube cuprous oxide composite based pressure sensors

In this paper, we present the design, the fabrication, and the experimental results of carbon nanotube （CNT） and Cu20 composite based pressure sensors. The pressed tablets of the CNT Cu20 composite are fabricated at a pressure of 353 MPa. The diameters of the multiwalled nanotubes （MWNTs） are between 10 nm and 30 nm. The sizes of the Cu20 micro particles are in the range of 3-4 μm. The average diameter and the average thickness of the pressed tablets are 10 mm and 4.0 mm, respectively. In order to make low resistance electric contacts, the two sides of the pressed tablet are covered by silver pastes. The direct current resistance of the pressure sensor decreases by 3.3 times as the pressure increases up to 37 kN/m^2. The simulation result of the resistance-pressure relationship is in good agreement with the experimental result within a variation of ±2%.