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In patients with severe aortic stenosis, the presence of left ventricular systolic dysfunction is one of the main predictors of adverse events after valve replacement surgery. However, more and more patients are being referred for surgery early and have preserved systolic function at the time of surgery. Within this category, global longitudinal strain (GLS) has been proposed as a marker of ventricular remodeling after cardiac surgery. Our study aims to identify the variation of Global longitudinal strain (GLS) in patients undergoing aortic valve replacement and any differences compared to classes of diastolic dysfunction. Methods From June 2020 to June 2022 we analyzed patients with severe aortic stenosis with an indication for cardiac surgery treatment admitted to the cardiac surgery department of our AOU. All patients underwent an echocardiogram immediately before surgery and in the early postoperative period (mean 7 days). In all cases, the GLS of the left ventricle was calculated and patients were divided into four classes according to the degree of diastolic dysfunction (0–III) according to the most recent international guidelines. The data were analyzed with SPSS 28 software. Analysis of variance was performed with a t–test and ANOVA test. Results In the final analysis, 63 patients were included, with a mean age of 70.5±8.2%, of whom 28 were women (44.4%) and 35 were men (55.6%). In 12 patients (19%) ischaemic heart disease with an indication for coronary revascularization was also present. The mean preoperative ejection fraction was 59±9.5%. The mean GLS values before surgery were 15.26±4.3% vs. early postoperative 12.52±2.6%, p Conclusions In our case series, patients with severe aortic stenosis undergoing aortic valve replacement with or without myocardial revascularization show a significant early reduction in GLS regardless of the degree of diastolic dysfunction. An extension of follow–up is needed to assess any differences in the intervention‘s benefit in different diastolic dysfunction subgroups.

Group B streptococcus (GBS) remains a leading cause of invasive disease, mainly sepsis and meningitis, in infants 3 months of age and of mortality among neonates. This study, a major component of the European DEVANI project (Design of a Vaccine Against Neonatal Infections) describes clinical and important microbiological characteristics of neonatal GBS diseases. It quantifies the rate of antenatal screening and intrapartum antibiotic prophylaxis among cases and identifies risk factors associated with an adverse outcome.Clinical and microbiological data from 153 invasive neonatal cases (82 early-onset [EOD], 71 late-onset disease [LOD] cases) were collected in eight European countries from mid-2008 to end-2010.Respiratory distress was the most frequent clinical sign at onset of EOD, while meningitis is found in 30% of LOD. The study revealed that 59% of mothers of EOD cases had not received antenatal screening, whilst GBS was detected in 48.5% of screened cases. Meningitis was associated with an adverse outcome in LOD cases, while prematurity and the presence of cardiocirculatory symptoms were associated with an adverse outcome in EOD cases. Capsular-polysaccharide type III was the most frequent in both EOD and LOD cases with regional differences in the clonal complex distribution.Standardizing recommendations related to neonatal GBS disease and increasing compliance might improve clinical care and the prevention of GBS EOD. But even full adherence to antenatal screening would miss a relevant number of EOD cases, thus, the most promising prophylactic approach against GBS EOD and LOD would be a vaccine for maternal immunization.

Dynamic field of view (FOV) restrictors have been successfully used to reduce visually induced motion sickness (VIMS) during continuous viewpoint motion control (virtual travel) in virtual reality (VR). This benefit, however, comes at the cost of losing peripheral awareness during provocative motion. Likewise, the use of visual references that are stable in relation to the physical environment, called rest frames (RFs), has also been shown to reduce discomfort during virtual travel tasks in VR. We propose a new RF-based design called Granulated Rest Frames (GRFs) with a soft-edged circular cutout in the center that leverages the rest frames’ benefits without completely blocking the user’s peripheral view. The GRF design is application-agnostic and does not rely on context-specific RFs, such as commonly used cockpits. We report on a within-subjects experiment with 20 participants. The results suggest that, by strategically applying GRFs during a visual search session in VR, we can achieve better item searching efficiency as compared to restricted FOV. The effect of GRFs on reducing VIMS remains to be determined by future work.

BackgroundSeveral adverse events (AEs) occurring during immune checkpoint inhibitors (ICIs) therapy are clearly related to their mechanisms of action, and in this case they are indicated as immune-related AEs (irAEs). Every organ may be affected, including the musculoskeletal system; myositis, polymyalgia rheumatica, arthritis or arthritis have been reported in several retrospective and prospective case series and cohorts, with an incidence between 1.5% and 22%. While arthritis, vasculitis, myositis, and polymyalgia rheumatica are usually defined as “irAE” in RCTs, other rheumatic musculoskeletal conditions such as arthralgia, myalgia, back pain and muscular pain are often reported under the umbrella of “general” AEs.ObjectivesWe aimed to analyze rheumatic irAE and non-irAE due to immune-checkpoint inhibitors (ICIs) targeting programmed cell death-1 or its ligand PD-(L)1 in lung cancer patients from the available literature.MethodsWe performed a systematic review and meta-analysis of phase III randomized clinical trials (RCTs) assessing PD-(L)1 -ICIs in lung cancer patients, from inception until January 12th, 2021. We extracted data of each trial to estimate odds ratio (OR) for rheumatic ir or non-irAE as classified in RCTs safety data. Sensitivity analyses (by ICI, treatment group and histology) were performed.ResultsEighteen RCTs met the inclusion criteria (n=12172 subjects). The OR [95%IC] for rheumatic irAE in ICIs versus controls (either placebo or chemotherapy) was 2.20 [0.85,5.72].Among rheumatic non-irAEs, both overall (any grade, Figure 1A) and severe (grade≥3, Figure 1B) back pain were significantly more frequent in ICIs versus controls (2.01 [1.09;3.73] and 2.90 [1.18;7.08], respectively).Figure 1.Forest plot showing pooled odds ratio (OR) for back pain (5 phase III trials) (A) and severe back pain (4 phase III trials) (B), respectively.The overall frequency of arthralgia and severe arthralgia was similar between ICIs and controls (1.13 [0.86, 1.47] and 1.69 [0.68, 4.20], respectively). By sensitivity analysis RCTs assessing ICIs in combination with chemotherapy versus chemotherapy alone showed a significant association with arthralgia (1.55 [1.15;2.10]). Similarly, the frequency of myalgia did not differ between ICIs and controls, but was significantly lower in RCTs assessing ICIs alone versus chemotherapy (OR 0.32 [0.24;0.42]). Muscular pain was not significantly increased with ICI.ConclusionRheumatic irAEs are not increased in RCTs assessing PD-(L)1 inhibitors, not reflecting the real-life incidence, therefore likely underreported or misclassified. Back pain is significantly associated with PD-(L)1-ICIs regardless its severity, suggesting a possible implication of the PD-(L)1 axis in the development of inflammatory back pain in some patients.In addition, PD-(L)1-ICIs added on conventional chemotherapy are associated with a significantly higher frequency of arthralgia than ICI alone. This trend was seen in the other rheumatic AEs, suggesting that conventional chemotherapy might be a confounder in the interpretation of the occurrence of rheumatic AEs.Disclosure of InterestsAntonello Veccia: None declared, Marie Kostine: None declared, Alice Tison: None declared, Mariachiara Dipasquale: None declared, Stefania Kingspergher: None declared, Guido Grandi: None declared, Orazio Caffo: None declared, Sandro Inchiostro: None declared, Giuseppe Paolazzi: None declared, Roberto Bortolotti: None declared, Divi Cornec: None declared, Alvise Berti Consultant of: GSK

This study reports on a multivariate complexity assessment for cardiovascular dynamics during REM sleep leading to a dream recall. Heart rate variability, as well as systolic and diastolic time interval variability series were gathered from eight volunteers during night sleep, and were considered input of a trivariate Multichannel Complexity Index (MCI) analysis. MCI is a recently proposed index based on a multivariate phase space reconstruction accounting for the intrinsic nonlinearity of the autonomic nervous system dynamics. Results show a significant MCI decrease during REM sleep epochs followed by a dream recall as compared to those associated with no dream recall (p < 10−18). This implies a lower interplay between complex cardiovascular subcomponents during dreaming, complementing current psychophysiological correlates of sleep.

We present the design of a next-generation user interface for law enforcement officers, developed to assist with current traffic procedures. Our design leverages the futuristic capabilities of augmented reality displays, integrating real and virtual elements. Our team has created a traffic stop scenario in immersive virtual reality, where the participant assumes the role of a police officer and interacts with a simulated augmented user interface and a virtual driver.

This research aims at validating the SIMULATE-3K code and complementing the results with the quantification of nuclear data uncertainties against the Special Power Excursion Reactor Test III (SPERT-III) experiments. To that aim, the SHARK-X methodology, under development at PSI, for the propagation of nuclear data uncertainties in CASMO5 2-D lattice calculations to 3-D core transient simulations is applied for the analysis of a SPERT-III super-prompt critical test conducted at cold startup conditions. Concerning transient results, both total power and reactivity show a good agreement with the measurements at the initial phase of power excursion, while a slight discrepancy is obtained at the final phase of the transient. The estimated uncertainties regarding both steady-state parameters such as k-eff and static reactivity worth, as well as dynamical quantities such as power pulse width and enthalpies are presented. Results show non-negligible sensitivity upon the employed nuclear data library. The uncertainty quantification results show relatively small biases for k-eff and reactivity. The uncertainty in peak power is around 3%, while it is negligible for the time to peak power and the pulse width. The time evolution of the standard deviation and skewness of the total power showed special shapes with relatively high maximum values. In addition, the uncertainty due to nuclear data in the two important safety parameters, i.e. maximum nodal fuel temperature and enthalpy reaches maximum value around 2% and 10%, respectively.

This paper describes the coupled code system TRACE/SIMULATE-3 K/VIPRE and the application of this code system to the OECD PWR Main Steam Line Break. A short description is given for the application of the coupled system to analyze DNBR and the flexibility the system creates for the user. This includes the possibility to compare and evaluate the result with the TRACE/SIMULATE-3K (S3K) coupled code, the S3K standalone code (core calculation) as well as performing single-channel calculations with S3K and VIPRE. This is the typical separate-effect-analyses required for advanced calculations in order to develop methodologies to be used for safety analyses in general. The models and methods of the code systems are presented. The outline represents the analysis approach starting with the coupled code system, reactor and core model calculation (TRACE/S3K). This is followed by a more detailed core evaluation (S3K standalone) and finally a very detailed thermal-hydraulic investigation of the hot pin condition (VIPRE).

We present an assessment of asymmetric interactions in Collaborative Virtual Environments (CVEs). In our asymmetric setup, two co-located users interact with virtual 3D objects, one in immersive Virtual Reality (VR) and the other in mobile Augmented Reality (AR). We conducted a study with 36 participants to evaluate performance and collaboration aspects of pair work, and compare it with two symmetric scenarios, either with both users in immersive VR or mobile AR. To perform this experiment, we adopt a collaborative AR manipulation technique from literature and develop and evaluate a VR manipulation technique of our own. Our results indicate that pairs in asymmetric VR-AR achieved significantly better performance than the AR symmetric condition, and similar performance to VR symmetric. Regardless of the condition, pairs had similar work participation indicating a high cooperation level even when there is a visualization and interaction asymmetry between the participants.

Las especies exóticas son la segunda causa de la crisis de biodiversidad mundial, precedida por la pérdida y la fragmentación del hábitat. Algunas especies populares como mascotas, como los loros y las cotorras (Aves, Psittaciformes) suelen introducirse fuera de su área de distribución nativa a consecuencia del comercio de animales de compañía. Si escapan de su cautiverio, algunas de estas especies, como la cotorra de Kramer y la cotorra argentina, son sumamente invasivas y compiten con las especies autóctonas. Las poblaciones de loros del género Amazona pueden encontrarse en todo el mundo, pero los datos relativos a su estado, distribución y efectos son incompletos. Recopilamos y examinamos la información disponible relativa a la ecología, la abundancia, la distribución y el comercio en el mundo de los loros del género Amazona fuera de su área de distribución nativa. Nuestro examen revela que al menos nueve especies de loros de este género han establecido poblaciones fuera de su área de distribución original en todo el mundo (en Europa, Sudáfrica, las islas del Caribe, Hawaii y América del Norte y del Sur). Su comportamiento esquivo y el reducido tamaño de la población sugieren que se podría haber infravalorado el número de núcleos introducidos o que podrían no haberse detectado todos. Pese a las prohibiciones impuestas al comercio internacional, parece que el gran volumen de loros Amazona capturados en libertad que se ha comerciado en los últimos decenios ha contribuido al establecimiento de poblaciones foráneas en todo el mundo. Parece que el éxito del establecimiento varía en función de la zona geográfica. Mientras que las poblaciones europeas siguen siendo de pequeño tamaño y de crecimiento lento, las de los Estados Unidos son numerosas y están en expansión. Esta diferencia no guarda relación con una elevada presión del propágulo (comercio), pero sí lo haga posiblemente con una mejor correspondencia de nichos entre las áreas de distribución originales y las de introducción. Amazona aestiva es la especie del género que se observa con mayor frecuencia y hasta la fecha se han notificado al menos ocho poblaciones foráneas. Todas estas poblaciones, salvo aquellas que se encuentran en zonas de los Estados Unidos donde el clima les es más propicio, están formadas por unos pocos individuos, a pesar de que lleven establecidas un largo período de tiempo. Es necesario seguir estudiando sobre la ecología de estas especies exóticas y sus posibles repercusiones debido a la escasa información disponible al respecto., Alien species are the second leading cause of the global biodiversity crisis, after habitat loss and fragmentation. Popular pet species, such as parrots and parakeets (Aves, Psittaciformes), are often introduced outside their native range as a result of the pet trade. On escape from captivity, some such species, such as the ring–necked parakeet and the monk parakeet, are highly invasive and successfully compete with native species. Populations of Amazon parrots (Amazona spp.) can be found throughout the world, but data on their status, distribution and impact are incomplete. We gathered and reviewed the available information concerning global trade, distribution, abundance and ecology of Amazon parrots outside their native range. Our review shows that at least nine species of Amazon parrots have established populations outside their original range of occurrence throughout the world (in Europe, South Africa, the Caribbean islands, Hawaii, and North and South America). Their elusive behaviour and small population size suggest that the number of alien nuclei could be underestimated or at undetected. Despite international trade bans, the large trade of wild–caught Amazon parrots in past decades appears to have contributed to the establishment of alien populations worldwide. Establishment success seems to differ geographically. While European populations are still small and growing slowly, USA populations are large and expanding geographically. This difference is not related to large propagule pressure (trade) but possibly to a better niche match between native and introduced ranges. Amazona aestiva is the most frequently encountered Amazona parrot, with at least eight alien populations reported to date. All these populations, with the exception of those in the USA where the climate is more suitable for their establishment, are composed of a low number of individuals even though they have been established for a long period of time. Further research is required as little information is available on the ecology and potential impact of these alien populations.

Combined anteversion in total hip arthroplasty influences both dislocation risk and range of motion. One of its components, stem version (SV), could be dictated by many factors, from native femoral anatomy to stem geometry and surgeon's choice. In the present multicenter study, robotic technology was used to assess the influence of native femoral version on final SV and combined anteversion using a straight, uncemented stem.Three hundred sixty-two patients undergoing total hip arthroplasty were enrolled from 3 different orthopedic centers from 2012 and 2016. All patients underwent computed tomography planning with measurement of femoral neck version (FNV) and intraoperative measurement of stem version (SV), acetabular component version (AV), and combined version (CV) with robotic instrumentation.Mean FNV was 5.0° ± 9.6°, and SV was 6.4° ± 9.7°. The average difference between FNV and SV was 1.6° ± 9.8°. A moderate correlation was found between FNV and SV (R = 0.48, P.001). SV was between 5° and 20° in 174 patients (48%). Mean CV was 28.2° ± 7.9°. A strong correlation was found between SV and CV (R = 0.89, P.001). A significant difference in SV was found between the 3 centers (P .001). CV was25° in 109 patients (30.1%). Relative risk of CV25° was 8.6 times greater with SV 5° (P.001).With the use of an uncemented, single-wedge, straight stem, SV is highly variable. Despite being moderately correlated with native FNV, SV can be partially influenced by the surgeon. A low SV could be hardly corrected, bringing high risk of low CV.

Uncovering the physiological correlates of dreams is one of the most ambitious aim of multidisciplinary neuroscientific research. Here we investigated Autonomic Nervous System (ANS) dynamics associated with a dream recall, with a particular focus on the complexity assessment on cardiovascular control. We recorded electrocardiogram and arterial blood pressure signals from eight healthy subjects during rapid-eye-movement sleep before awakenings. Recordings were then split into two groups: the ones with a dream experience, and the ones without recall of dream experiences. The randomness of cardiovascular variability series was assessed through Sample Entropy metrics, which did not show any statistical difference between groups. On the other hand, a multiscale complexity analysis based on Distribution Entropy and Fuzzy Entropy revealed that a higher cardiovascular complexity is associated with a dreaming experience.

We present the design of a handheld-based interface for collaborative manipulations of 3D objects in mobile augmented reality. Our approach combines touch gestures and device movements for fast and precise control of 7-DOF transformations. Moreover, the interface creates a shared medium where several users can interact through their point-of-view and simultaneously manipulate 3D virtual augmentations. We evaluated our collaborative solution in two parts. First, we assessed our interface in single user mode, comparing the user task performance in three conditions: Touch gestures, device movements and hybrid. Then, we conducted a study with 30 participants to understand and classify the strategies that arise while working in pairs, when partners are free to make their task organization. Furthermore, we investigated the effectiveness of simultaneous manipulations compared with the individual approach.

In the context of the 3DUI Contest promoted by the IEEE VR 2018, we propose 3D interaction techniques that address three distinct tasks in a virtual environment setup: climbing a ladder, controlling a quadcopter in a first-person view flight, and building a tower by stacking a series of objects. The interaction techniques were developed so the player, our 3D-Athlete, has control over the events in each task, following metaphors that facilitate the use of the interface, and having status and spatial awareness supported by clear feedback cues. Thus, the player should be able to execute the tasks with precision and agility.

Objectives The recent guideline for the evaluation and management of Chronic Kidney Disease recommends assessing GFR employing equations based on serum creatinine; despite this, creatinine clearance 24-hour urine collection is used routinely in many settings. In this study we compared the classification assessed from CrCl (creatinine clearance 24 h urine collection) and e-GFR calculated with CKD-EPI or MDRD formulas. Design and methods In this retrospective study we analyze consecutive laboratory data: creatinine clearance 24 h urine collection, serum creatinine and demographic data such as sex and age from 15,777 patients > 18 years of age collected from 2011 to 2013 in our laboratory at Careggi Hospital. The results were then compared to the estimated GFR calculated with the equations according to the recent treatment guidelines. Consecutive and retrospective laboratory data (creatinine clearance 24 h urine collection, serum creatinine and, demographic data such as sex and age) from 15,777 patients > 18 years of age seen at Careggi Hospital were collected. Results Comparison between e-GFR calculated with CKD-EPI or MDRD formulas and GFR according CrCl determinations and bias [95% CI] were 11.34 [− 47,4/70.1] and 11.4 [− 50.2/73] respectively. The concordance for 18/65 years aged group when compared with e-GFR classification between MDRD vs CKDEPI, MDRD vs CrCl and CKD-EPI vs CrCl were 0.78, 0.34, and 0.41 respectively, while in the 65/110 years aged group the concordance Kappas were 0.84, 0.38, and 0.36 respectively. Conclusions The use of CrCl provides a different classification than the estimation of GFR using a prediction equation. The CrCl is unreliable when it is necessary to identify CKD subjects with decrease of GFR of 5 ml/min/1.73 m 2 /year.

According to the situations and cases presented here, organisms belonging to tick and house dust mite groups can be included within alien invasive pests representing a risk for human health. Rhipicephalus sanguineus, the brown dog tick, a vector for many tick-borne pathogens, is able to efficiently colonize households at quite wide ranges in temperature and relative humidity. Cases of the spread of this tick by movements of pets and people are reported. House dust mites and main storage mites - although not strictly alien species - can act not only as allergens' disseminators but even as potential indicators of environmental quality in different settings (newly colonized areas, both geographic and within human dwellings). The impact of alien mites affecting agricultural production has been generally measured by the ecological consequences on biodiversity, but the evaluation of the effects of these species on human health has been mostly neglected. Trading, travelling and modified home conditions can increase the chance for diffusion of ticks and mites affecting human health, i.e. causing higher exposures to vector-borne pathogens and allergens, respectively. A more interdisciplinary approach that takes into account both the dynamics in ecological evaluation and the consequences on human health of these organisms is needed.

Interaction in augmented reality environments may be very complex, depending on the degrees of freedom (DOFs) required for the task. In this work we present a 3D user interface for collaborative manipulation of virtual objects in augmented reality (AR) environments. It maps position - acquired with a camera and fiducial markers - and touchscreen input of a handheld device into gestures to select, move, rotate and scale virtual objects. As these transformations require the control of multiple DOFs, collaboration is proposed as a solution to coordinate the modification of each and all the available DOFs. Users are free to decide their own manipulation roles. All virtual elements are displayed directly on the mobile device as an overlay of the camera capture, providing an individual point of view of the AR environment to each user.

We present a 3D user interface for collaborative manipulation of three-dimensional objects in virtual environments. It maps inertial sensors, touch screen and physical buttons of a mobile phone into well-known gestures to alter the position, rotation and scale of virtual objects. As these transformations require the control of multiple degrees of freedom (DOFs), collaboration is proposed as a solution to coordinate the modification of each and all the available DOFs. Users are free to decide their own manipulation roles. All virtual elements are displayed in a single shared screen, which is handy to aggregate multiple users in the same physical space.

This paper describes the coupled code system S3K-RELAP5 and the application of the code system to BWR transients without scram. In addition short descriptions are given for application of the coupled system to fast transients and rod drop accidents. The models and methods of the code system are presented. Validation results are shown for a recorded transient event in the Forsmark 3 reactor. It is concluded that S3K-RELAP5 adequately captures the complicated interaction between physical processes in the reactor as well as the essential reactor protection and control systems, which qualifies it for applications to fast and slow transients, with or without scram, and Reactivity Initiated Accidents (RIA). SWR Transientenanalyse mit dem gekoppelten Programmsystem S3K/RELAP5. Dieser Beitrag beschreibt das gekoppelte Programmsystem S3K-RELAP5 und seine Anwendung auf SWR Transienten ohne Reaktorschnellabschaltung (RESA). Daruber hinaus wird kurz die Anwendung des gekoppelten Systems auf schnelle Transienten und auf einen Reaktivitatsstorfall durch Ausfall eines Steuerstabs aufgezeigt. Die Methoden und Modelle des Programmsystems werden dargestellt. Ergebnisse der Validierung fur ein Ereignis in Forsmark 3 werden prasentiert. Es wird gezeigt, dass S3K-RELAP5 die komplexen Interaktionen zwischen den physikalischen Prozessen im Reaktor und den wesentlichen Systemen des Reaktorschutzsystems und der Steuerung adaquat wiedergibt. Diese Validierung qualifiziert das System fur die Anwendungen auf schnelle und langsame Transienten mit und ohne RESA und auf Reaktivitatsstorfalle.

Surgical treatment of a unusual acetabular fracture is described. This fracture was characterized by impaction and breaking down of the posterior articular surface and comminution of lamina quadrilatera lower portion, without cortical fracture of both columns. The fracture was treated surgically through the Kocher–Langenbeck approach. A small hole was created in the acetabulum posterior wall, the impacted fragment was reduced, and the bone defect was filled with autologous bone from the greater trochanter. A plate was shaped in order to fix both bone graft and fractured fragment.

Antigens of both Dirofilaria immitis and Wolbachia symbiont bacteria are implicated in the inflammatory pathology of heartworm infection. The aim of the present study was to compare the stimulatory capacity of in vitro cultures of vascular endothelial cells by the adult somatic antigens of D. immitis (DiSA) and the recombinant form of the Wolbachia surface protein (rWSP), during the first 24 h of stimulation. Our results indicate a different stimulatory activity of the two antigens. Both the DiSA and rWSP stimulate the production of the enzymes responsible of the arachidonic acid metabolism, cyclooxygenase-2, 5-lipoxygenase (5-LO), and leukotriene B4. Only DiSA stimulates the production of prostaglandin E2. Related to the adhesion molecules, the DiSA stimulates the expression of intercellular adhesion molecule-1 (ICAM-1) and platelet endothelial cell adhesion molecule-1 (PECAM-1), whereas rWSP stimulates ICAM-1, PECAM-1, and vascular cell adhesion molecule-1 (VCAM-1). Expression of E-cadherin and vascular endothelial growth factor also were stimulated by rWSP. Neither of the two antigens altered the basic physiological mechanisms of endothelial cells, such as cell proliferation, cell cycle, or apoptosis. The biological and pathological significance of these finding are discussed.

Posttraumatic ankle arthritis consists of a progressive alteration of the hyaline cartilage, sclerosis of the subchondral bone, and osteophyte and loose-body formation as a result of an ankle injury. It may develop after nonoperative or surgical repair of an ankle injury in the form of cartilage damage, lateral malleolus malunion with shortening and valgus deformity, tibial plafond disruption and cartilage damage, malunion or necrosis of the talus, or joint instability1-5. The aim of the current study was to present our treatment guidelines for severe posttraumatic stage-2 or 3 ankle arthritis6 on the basis of the results for a series of 190 patients. One hundred and ninety patients ranging from seventeen to seventy years of age who had stage-2 or 3 posttraumatic ankle arthritis (Table I) were managed between 1994 and 2004. View this table: TABLE I Ankle Arthritis Classification System Surgical strategies were decided according to the stage of arthritis, the age of the patient, the quality of joint alignment, and the range of motion of the adjacent foot joints (the midtarsal, Lisfranc, and subtalar joints) according to the algorithm described in Table II. View this table: TABLE II Decision-Making Algorithm All patients were examined clinically and radiographically, and the American Orthopaedic Foot and Ankle Society (AOFAS) clinical rating score7 was calculated both preoperatively and at the time of follow-up. The AOFAS score was graded as excellent (80 to 100), good (70 to 79), fair (60 to 69), or poor (≤59). Patients who were managed with allograft were also studied with computed tomography and magnetic resonance imaging. A cartilage biopsy was performed during hardware removal at 1.5 years of follow-up. ### Surgical Strategies #### Stage-2 Arthritis with Preserved Ankle Anatomy: Arthroscopic Debridement and Ankle Arthrodiastasis (Fig. 1) Twelve patients ranging from twenty-one to forty-eight years of age were managed with arthroscopic debridement and arthrodiastasis with an external fixator8. Standard arthroscopic approaches were used, and debridement of degenerated cartilage …

Concerns exist regarding prosthetic positioning and post-operative limb alignment in unicompartmental knee arthroplasty (UKA). In this study, we hypothesized deviations of the post-op anatomical femoro-tibial angle (aFTA) and the tibial component alignment to be factors influencing UKA survivorship. Moreover, by a comparison between all-poly and metal back UKAs, we hypothesized that prosthetic design plays a role in implant survivorship.One hundred ninety-five medial UKAs were performed on 176 patients by two experienced surgeons and one low-UKA user. One hundred and forty-seven UKAs were included in the study: 72 all-poly and 75 metal back. Measurements were performed on radiographs: mechanical femoro-tibial angle, Cartier angle, aFTA and tibial posterior slope (PS) on pre-op radiographs; femoral and tibial component varus/valgus, aFTA and tibial component PS on post-op radiographs.At an average follow-up of 61 months (min. 30, max. 107), 147 UKAs were evaluated: The reported survivorship rate was 93.1 %. Eleven implants underwent revision: ten all-poly and one metal back. No differences were reported between the two groups in the radiographic measurements. Significant radiographic differences were reported between revised and not revised UKAs: Revised UKAs were associated with overcorrection of the pre-op Cartier angle and under correction of pre-op aFTA. Most of revised UKAs were performed by the low-volume UKA surgeon.Surgeon's experience is essential to achieve good results in UKA: Preserving the tibial epiphyseal axis and avoiding excessive or insufficient corrections of the pre-operative limb alignment are predictor of successful replacement, while prosthetic designs, models and fixation geometry do not affect UKA outcome.IV.

While medical images are fundamental in the surgery planning procedure, the process of analysis of such images slice-by-slice is still tedious and inefficient. In this work we introduce a system for exploration of the internal anatomy structures directly on the surface of the real body using a mobile display device as a window to the interior of the patient's body. The method is based on volume visualization of standard computed tomography datasets and augmented reality for interactive visualization of the generated volume. It supports our liver surgery planner method in the analysis of the segmented liver and in the color classification of the vessels. We present a set of experiments showing the system's ability to operate on mobile devices. Quantitative performance results are detailed, and applications in teaching anatomy and doctor-patient communication are discussed.

Doze modelos matemáticos (seis bi-paramétricos e seis tri-paramétricos), amplamente utilizados na predição de isotermas, foram estudados, com o objetivo de predizer isotermas de adsorção de umidade do guaraná (Paullinia cupana) em pó, obtido em "sprey dryer". As isotermas de adsorção de umidade do produto à 15° C, 25° C e 35° C, foram ajustadas por análise de regressão não-linear, usando o aplicativo STATGRAPHICS 5.1. Entre os modelos testados os que apresentaram melhores resultados nos ajustes foram as equações tri-paramétricas de GAB, BET modificada e Anderson, e as equações bi-paramétricas de Handerson e Oswin.In this study, twelve mathematic models (six biparametrics and six triparametrics), applied in the prediction of isotherms, were studied on prediction of moisture adsorption isoterms of guarana (Paullinia cupana) powder obtained in spray dryer. The moisture adsorption isotherms of the product were fitted at 15° C, 25° C and 35° C, by nonlinear regression analysis, using the software STATGRAPHICS 5.1. The best results among studied models on prediction of moisture adsorption isotherms were GAB, modified BET and Anderson equations (triparametric), Handerson and Oswin equations (biparametric).

Oito modelos matemáticos bi-paramétricos, existentes na literatura e com larga aplicação na predição de isotermas de adsorção foram submetidos à análise. O guaraná (Paullinia cupana) em pó objeto deste estudo, foi obtido em "spray dryer", a partir de um extrato hidroalcoólico. Ajustaram-se os pontos experimentais das isotermas de adsorção de umidade do produto à 15°C, 25°C e 35°C, por análise de regressão não-linear. Para estudar o efeito da temperatura nos parâmetros dos modelos utilizaram-se regressões dos tipos: linear, exponencial, logarítmica e inversa. Utilizou-se para fazer os ajustes o aplicativo STATGRAPHICS 5.1. Entre os modelos testados os que apresentam melhores resultados foram as equações de Handerson, Oswin e Mizrahi.Eight biparametric mathematic models of the literature and widely applied in the prediction of moisture adsorption isoterms were analised. The guarana (Paullinia cupana) powder used in this study, was obtained in spray dryer from a hidroalcoholic extract. The experimental points of the moisture adsorption isotherms of the product at 15°C, 25°C and 35°C were fitted by non-linear regression analysis. To study temperature effect in the parameters of the models were used linear, exponential, logarithmic and inverse regressions. They were also used to fit the software STATGRAPHICS 5.1. The Handerson, Oswin and Mizrahi equations presented the best results among tested models.

We present Disambiguation canvas, a technique for selection by progressive refinement using a mobile device and consisting of two steps. During the first, the user defines a subset of objects through the orientation sensors of the device and a volume-casting pointing technique. The subsequent step consists of the disambiguation of the desired target among the previously-defined subset of objects, and is accomplished using the mobile device touchscreen. By relying on the touchscreen for the last step the user can disambiguate among hundreds of objects at once, previous progressive refinement techniques do not scale as well as ours. Disambiguation canvas is mainly developed for easy, accurate and fast selection of small objects, or objects inside cluttered virtual environments. User tests show that our technique performs faster than ray-casting for targets with approximate to 0 : 53 degrees of angular size, and is also much more accurate for all the tested target sizes.

Il saggio ricostruisce alcune delle amicizie significative di Jacques Maritain rileggendole attraverso gli strumenti interpretativi e teorici messi a punto dall'autore stesso