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Objective:This study aims to test the hypothesis that breathing can be directly linked to postural stability and psychological health. A protocol enabling the simultaneous analysis of breathing, posture, and emotional levels in university students is presented. This aims to verify the possibility of defining a triangular link and to test the adequacy of various measurement techniques.Participants and Procedure:Twenty-three subjects (9 females and 14 males), aged between 18 and 23 years, were recruited. The experiment consisted of four conditions, each lasting 3 minutes: Standard quiet standing with open eyes 1), with closed eyes 2), and relaxed quiet standing while attempting deep abdominal breathing with open eyes 3) and with closed eyes 4). These latter two acquisitions were performed after subjects were instructed to maintain a relaxed state.Main Outcome Measures:All subjects underwent postural and stability analysis in a motion capture laboratory. The presented protocol enabled the extraction of 4 sets of variables: Stabilometric data, based on the displacement of the center of pressure and acceleration, derived respectively from force plate and wearable sensors. Postural variables: angles of each joint of the body were measured using a stereophotogrammetric system, implementing the Helen Hayes protocol. Breathing compartment: optoelectronic plethysmography allowed the measurement of the percentage of use of each chest compartment. Emotional state was evaluated using both psychometric data and physiological signals. A multivariate analysis was proposed.Results:A holistic protocol was presented and tested. Emotional levels were found to be related to posture and the varied use of breathing compartments. Abdominal breathing proved to be a challenging task for most subjects, especially females, who were unable to control their breathing patterns. In males, the abdominal breathing pattern was associated with increased stability and reduced anxiety.Conclusion:In conclusion, difficulties in performing deep abdominal breathing were associated with elevated anxiety scores and decreased stability. This depicts a circular self-sustaining relationship that may reduce the quality of life, undermine learning, and contribute to muscular co-contraction and the development of musculoskeletal disorders. The presented protocol can be utilized to quantitatively and holistically assess the healthy and/or pathological condition of subjects.

This case report describes a novel procedure using the Isolock Intrauma® implant system for treating medial instability of the carpometacarpal and tarsometatarsal joints, as demonstrated in in two dogs. A 9-year-old spayed female Spanish greyhound presented with a non-weight-bearing right hindlimb following a trauma. The clinical and radiological findings confirmed medial tarsometatarsal instability consistent with valgus deviation of the tarsus and the opening of the joint line on the medial aspect from the first to the third tarsometatarsal joints. A 4-year-old female Drahthaar presented with a non-weight-bearing left forelimb, swelling of the carpus and valgus instability. Radiological examination revealed a widening of the spaces between the intermedioradial carpal bone, second carpal bone and metacarpal bone II, confirming the medial carpometacarpal instability. In both cases, the Isolock system, an implant including ultra-high-molecular-weight polyethylene suture (UHMWPE), was used to reinforce the medial joint structures. Minor short-term complications were observed, such as swelling of the tarsal surgical site and hyperextension of the carpus, but these resolved spontaneously. No lameness or major complications were reported five months postoperatively. Carpometacarpal and tarsometatarsal instabilities are rare diseases in dogs as compared to subluxations of the other joints of the carpus and tarsus. There are no previous reports regarding the use of a UHMPWE implant for the treatment of these rare joint injuries, though the present case report suggests the validity and efficacy of the Isolock Intrauma® implant for restoring carpal and tarsal stability and preserving joint mobility.

The current knowledge of the effects of the physical environment on learners' behaviour in collaborative problem-solving tasks is underexplored. This paper aims to critically examine the potential of multimodal learning analytics, using new data sets, in studying how the shapes of shared tables affect the learners' behaviour when collaborating in terms of patterns of participation and indicators related to physical social interactions. The research presented in this paper investigates this question considering the potential interplay with contextual aspects (level of education) and learning design decisions (group size). Three dependent variables (distance between students, range of movement and level of participation) are tested using quantitative and qualitative analyses of data collected using a motion capture system and video recordings. Results show that the use of round tables (vs rectangular tables) leads to higher levels of on-task participation in the case of elementary school students. For university students, different table shapes seem to have a limited impact on their levels of participation in collaborative problem solving. The analysis shows significant differences regarding the relationship between group size and the distance between students, but there is no substantial evidence that group size affects the level of participation. The findings support previous research highlighting the importance of studying the role of the physical environment as an element of learning design and the potential of multimodal learning analytics in approaching these studies.

Malignant hypertension (MH) is characterized by severe hypertension (usually grade 3) associated with fundoscopic changes (flame hemorrhages and/or papilledema), microangiopathy and disseminated intravascular coagulation. In addition encephalopathy, acute heart failure and acute deterioration in renal function may be present. The term “malignant” reflects the very poor prognosis for this condition if untreated. When severe hypertension is associated with hypertension-mediated organ damage (HMOD) a life-threatening situation that requires immediate but careful intervention occurs (hypertensive emergency). In the last few years an increase in the number of patients with malignant hypertension has been observed, especially among those patients with black ethnicity. Limited access to treatment and the poor adherence to anti-hypertensive therapy may contribute to the development of hypertensive emergencies. It is considered appropriate to study patients in order to rule out thrombotic thrombocytopenic purpura and hemolytic uremic syndrome. In fact, the microvascular damage caused by malignant hypertension can favor intravascular hemolysis like Thrombotic Microangiopathies (TMs). TMs may present in three different clinical conditions: typical hemolytic uremic syndrome (HUS), atypical hemolytic uremic syndrome (aHUS) and thrombotic thrombocytopenic purpura (TTP). TMs can arise in the context of other pathological processes, including malignant hypertension.

A 11-month-old male intact Shar-Pei (26. 5 kg) was presented for a bilateral sublingual swelling of 4 months duration. The exploration of the oral cavity highlighted the presence of bilateral sublingual swellings, primarily consistent with bilateral ranula. The bilateral disease was treated with two subsequent surgeries 4 weeks apart. During the surgery, after removing an elliptical portion of the mucosa of the sublingual swelling, the presence of gelatinous tissue was visualized, and no saliva was present. The result of histological exam was oral mucinosis. At the subsequent follow-up the dog was in excellent conditions, without any symptoms. 1 month after the last operation, the dog underwent a visit in sedation to better evaluate the oral cavity. Both surgical sites were well-healed and without the presence of relapses. Upon 8 months follow-up the patient remained free of disease. This is the first reported case of oral mucinosis in sublingual mucosa in dogs. In this case the surgical treatment was curative.

The aim of this retrospective study was to verify whether the radiographic morphologic differences detected within the first three grades of hip dysplasia (A, B, C) of each of the five selected breeds and within the same breeds were statistically significant enough to require a breed-specific evaluation. A total of 422 technical evaluation forms of hip dysplasia (HD) in Labrador Retrievers, Golden Retrievers, Rottweilers, Bernese Mountain dogs, and German Shepherd dogs were obtained from the Fédération Cynologique Internationale (FCI) archive. The data were evaluated using a descriptive statistical analysis. In Labrador Retrievers, the craniolateral acetabular rim and femoral head position were already altered in unaffected dogs; however, within the various FCI grades, the most severe changes involved the conformation of the femoral neck. All the radiographic parameters of the Golden Retriever hips changed progressively and evenly. Significant radiographic changes between FCI grades were found in the German Shepherd dogs, and the alterations involving the acetabulum were more severe and appeared earlier than in the femoral head and neck. In the Bernese Mountain dogs, the most severe alterations were in the position of the femoral head and joint space while the femoral head and neck showed no significant progression between grades. All the radiographic parameters of non-dysplastic Rottweilers were normal; however, the progression of the primary signs was similar to the other breeds, although with lower severity. In conclusion, no significant prevalence of the radiographic features was observed for any specific breed. However, significant individual breed variations in the primary radiographic parameters were found between dogs with and without dysplasia which could be useful for better understanding the consequences of biomechanical differences between breeds.

The aim of this study was to report the outcome of the use of an external fixator to treat a pelvic canal stenosis in a 5-month-old female cat. The cat was referred with a history of 3 weeks of intermittent signs of constipation refractory to the medical management, occurring after surgical treatment for a bilateral sacroiliac luxation and sacral fracture. The clinical examination revealed instability of the pelvis and a radiograph showed a pelvic canal stenosis and megacolon. External fixator was the method of choice to be used in this case. The manually applied tension on an external fixator resulted in a widening of the pelvic canal. At 45 days after surgery, there were no signs of constipation, and the radiological examination showed progressive bone healing. At 18 months post-op, the cat had no abnormalities both on the clinical examination and on the radiography. In conclusion, the use of an external fixator led to the widening of the pelvic canal using a minimally invasive procedure. To the authors' knowledge, this case report represents the first surgical description and clinical outcome of the widening of the pelvic canal in cats using an external skeletal fixator.

Objective: The objective of this study was to investigate the relationship between the choice of clinical treatment, gait functionality, and kinetics in patients with comparable knee osteoarthritis.Design: This was an observational case-control study.Setting: The study was conducted in a university biomechanics laboratory.Participants: Knee osteoarthritis patients were stratified into the following groups: clinical treatment (conservative/total knee replacement (TKR) planned), sex (male/female), age (60–67/68–75), and body mass index (BMI) (

Objetivo: El diagnóstico de osteoporosis se ha fundamentado en la medición de la densidad mineral ósea, si bien esta variable tiene una capacidad limitada en la discriminación de pacientes con o sin fracturas. La aplicación del análisis de elementos finitos (FE) sobre imágenes volumétricas de tomografía computarizada ha mejorado la clasificación de sujetos hasta 90%, aunque la dosis de radiación, complejidad y coste no aconsejan su práctica regular. Nuestro objetivo es aplicar el análisis FE a modelos tridimensionales con absorciometría radiológica dual (3D-DXA), para clasificar pacientes con fractura osteoporótica de fémur proximal y sin fractura. Material y métodos: Se seleccionó una cohorte de 111 pacientes con osteoporosis densitométrica: 62 con fractura y 49 sin ella. Se utilizaron modelos FE sujeto-específicos para el impacto, como la simulación estática de la caída lateral. Las simulaciones de impacto permiten identificar la región crítica en el 95% de los casos, y la respuesta mecánica a una fuerza lateral máxima. Se realizó un análisis mediante un clasificador discriminativo (Support Vector Machine) por tipo de fractura, tejido y género, utilizando las mediciones DXA y parámetros biomecánicos. Resultados: Los resultados mostraron una sensibilidad de clasificación del 100%, y una tasa de falsos negativos de 0% para los casos de fractura de cuello para el hueso trabecular en las mujeres. Se identifica la variable tensión principal mayor (MPS) como el mejor parámetro para la clasificación. Conclusión: Los resultados sugieren que el uso de modelos 3D-DXA podría ayudar a discriminar mejor a los pacientes con elevado riesgo de fracturarse.

Hip dysplasia is a disabling orthopedic disease in dogs. The aim of this retrospective study was to evaluate the morphological aspects and radiographic changes in the development of hip dysplasia in adult dogs, and to describe the frequency of each radiographic parameter according to each Fédération Cynologique Internationale (FCI) grade. Brass descriptive forms for the evaluation of hip dysplasia were obtained from the archive of the Italian Fondazione Salute Animale, and the radiographic evaluation of 642 hips were processed. Sixteen radiographic criteria were assessed, divided into six main parameters: acetabulum, femoral head and its position in the acetabulum, femoral neck, joint space, and Norberg angle. The initial mild alterations were shown in the craniolateral acetabular rim (31.8%), slightly divergent in the joint space in 58.6% of FCI-A. The spherical shape of the femoral head was mildly small/flattened in 56.9% of FCI-B, in addition to a slightly cylindrical-shaped femoral neck (60.5%) and slightly lost contours (55.0%). Changes in acetabular depth (45.0%), and in the cranial acetabular margin (56.7%) were found in FCI-C. The center of the femoral head was lateral to the dorsal acetabular rim in 70.0% of FCI-B; the Norberg angle appeared normal in 70.6% of FCI-B. Elaboration of the radiographic criteria from the Brass descriptive forms allowed for the extrapolation of accurate knowledge regarding morphologic changes in the development of dysplasia by providing detailed information for each individual. In particular, the present survey showed that the morphological alterations of the acetabulum prevailed over those of the femoral head only at the beginning of the development of canine hip dysplasia, and then worsened after the changes occurred in the femoral head and neck.

Auditory-guided vocal learning is a mechanism that operates both in humans and other animal species making us capable to imitate arbitrary sounds. Both auditory memories and auditory feedback interact to guide vocal learning. This may explain why it is easier for humans to imitate the pitch of a human voice than the pitch of a synthesized sound. In this study, we compared the effects of two different feedback modalities in learning pitch-matching abilities using a synthesized pure tone in 47 participants with no prior music experience. Participants were divided into three groups: a feedback group (N = 15) receiving real-time visual feedback of their pitch as well as knowledge of results; an equal-timbre group (N = 17) receiving additional auditory feedback of the target note with a similar timbre to the instrument being used (i.e., violin or human voice); and a control group (N = 15) practicing without any feedback or knowledge of results. An additional fourth group of violin experts performed the same task for comparative purposes (N = 15). All groups were posteriorly evaluated in a transfer phase. Both experimental groups (i.e., the feedback and equal-timbre groups) improved their intonation abilities with the synthesized sound after receiving feedback. Participants from the equal-timber group seemed as capable as the feedback group of producing the required pitch with the voice after listening to the human voice, but not with the violin (although they also showed improvement). In addition, only participants receiving real-time visual feedback learned and retained in the transfer phase the mapping between the synthesized pitch and its correspondence with the produced vocal or violin pitch. It is suggested that both the effect of an objective external reward, together with the experience of exploring the pitch space with their instrument in an explicit manner, helped participants to understand how to control their pitch production, strengthening their schemas, and favoring retention.

The production of good sound generation in the violin is a complex task that requires coordination and spatiotemporal control of bowing gestures. The use of motion-capture technologies to improve performance or reduce injury risks in the area of kinesiology is becoming widespread. The combination of motion accuracy and sound quality feedback has the potential of becoming an important aid in violin learning. In this study, we evaluate motion-capture and sound-quality analysis technologies developed inside the context of the TELMI, a technology-enhanced music learning project. We analyzed the sound and bow motion of 50 participants with no prior violin experience while learning to produce a stable sound in the violin. Participants were divided into two groups: the experimental group (N = 24) received real-time visual feedback both on kinematics and sound quality, while participants in the control group (N = 26) practiced without any type of external help. An additional third group of violin experts performed the same task for comparative purposes (N = 15). After the practice session, all groups were evaluated in a transfer phase without feedback. At the practice phase, the experimental group improved their bowing kinematics in comparison to the control group, but this was at the expense of impairing the sound quality of their performance. At the retention phase, the experimental group showed better results in sound quality, especially concerning control of sound dynamics. Besides, we found that the expert group improved the stability of their sound while using the technology. All in all, these results emphasize the importance of feedback technologies in learning complex tasks, such as musical instrument learning.

Range of motion (ROM) is a measure often reported as an indicator of joint functionality. Both the angle of extension and that of flexion were measured in 234 stifle joints of dogs with cranial cruciate ligament (CCL) rupture. The aims of this study were to investigate the correlation between CCL rupture and alterations in the range of stifle joint motion and to determine whether there was a prevalence modification of one of the two angles. All the extension and flexion angles were obtained from clinical records and were analysed in various combinations. A significant relationship was found between normal angles and abnormal angles; concerning the reduction in the ROM, a significant prevalence in the alteration extension angle was found. Of the 234 stifles, 33 (13.7%) were normal in both angles. These results could offer important insights regarding the influence of CCL rupture on compromising the ROM. This awareness could be a baseline for understanding the ability of surgical treatment to restore one angle rather than another angle, to address the choice of treatment and to help physiotherapists in their rehabilitation program.

OBJECTIVE:Transfemoral Transcatheter Aortic Valve Implantation (TAVI) has become a standard therapy for patients with aortic valve stenosis. Fluoroscopic imaging is essential for TAVI with the anesthesiologist's workplace close to patient's head side. While the use of lead-caps has been shown to be useful for interventional cardiologists, data are lacking for anesthesiologists. METHODS:A protective cap with a 0.35 lead-equivalent was worn on 15 working days by one anesthesiologist. Six detectors (three outside, three inside) were analyzed to determine the reduction of radiation. Literature search was conducted between April and October 2018. RESULTS:In the observational period, 32 TAVI procedures were conducted. A maximum radiation dose of 0.55 mSv was detected by the dosimeters at the outside of the cap. The dosimeters inside the cap, in contrast, displayed a constant radiation dose of 0.08 mSv. CONCLUSION:The anesthesiologist's head is exposed to significant radiation during TAVI and it can be protected by wearing a lead-cap.

Trabecular bone fracture is a traumatic and localized event studied worldwide in order to predict it. During the years, researchers focused over the mechanical characterization of the trabecular tissue to understand its mechanics. Several studies pointed out the very local nature of the trabecular failure, finally identifying the fracture zone with the aim to study it separately. The complexity of the three-dimensional trabecular framework and the local nature of the fracture event do not allow the direct evaluation of a single trabecula’s behavior within its natural environment. For this reason, micro-Finite Element Modeling has been seen as the best way to investigate this biomechanical issue. Mechanical strain analysis is adopted in the literature for the identification of micro fracture using criteria based on principal strains. However, it was never verified if the fracture zone is actually the zone where principal strains are concentrated. Here, we show how the maximum strain of the tissue might not be directly correlated to the fracture. In the present work, a previously validated technique was used to identify the fracture zone of 10 trabecular specimen mechanically tested in compression and scanned in micro-CT before and after the mechanical test. Before-compression datasets were used to develop 10 micro-FE models were the same boundary conditions of the mechanical test were reproduced. Our results show how the known linear behavior of the trabecular framework might not be directly related to the development of the fracture suggesting other non-linear phenomenon, like buckling or microdamage, as actual cause of the traumatic event. This result might have several implications both in micro-modeling and in clinical applications for the study of fracture related pathology, like osteoporosis.

Background: The TightRope System is a device developed to provide extracapsular stabilization of the cranial cruciate ligament (CCL) rupture in canine stifles. I was then also employed for the extra-articular treatment of shoulder instability and for the intra-articular treatment of hip luxation in dogs and cats. Objectives: To evaluate the feasibility of the Mini-TightRope (mTR) System for the intraarticular treatment of CCL rupture in small breed dogs. Methods: A cadaveric canine model was used to record the steps of the surgical procedure. Five client owned dogs weighing from 8 to 10 kg and from 2 to 12 years of age were enrolled in the prospective study in which the mTR device was implanted in the stifle joint to replace the ruptured CCL. The dogs were graded using the Bologna Healing Stifle Injury Index (BHSII) and radiographic osteoarthritis (OA) scores. Results: The outcomes obtained at the time of the surgery (T0) and for the following 12 months (T12) showed an improvement in the functional parameters (BHSII from a median of 74.3 [range, 58.1-82.4] at T0 to 95.6 [range, 94.1-99.3] at T12]). The OA did not change in 3 dogs and increased by only 1 point in 2 dogs. Conclusions: In this preliminary study, the mTR was a successful and repeatable intraarticular surgical procedure for all dogs. Additional studies related to the clinical application of the technique in medium-large dogs should be encouraged. [ABSTRACT FROM AUTHOR]

Background Mitral valve (MV) repair through a right minithoracotomy (RT) is technically more demanding than through a median sternotomy (MS) and has been cited for a higher rate of reoperation, increased postoperative bleeding, thromboembolic events, poor visualization, and longer operative times. Randomized studies are not available, however, and specific characteristics of patients who undergo operation with either technique are usually highly different. Therefore, a propensity matching study was performed to reduce selection bias. Methods A retrospective analysis was made of 745 patients, 501 in group RT (67%) and 244 in group MS (33%), who underwent isolated MV repair between 2000 and 2010. Propensity matching identified 97 matched patient pairs for comparison of functional outcome, survival, incidence of reoperation, and quality of life after MV repair. Results Propensity matched patients in group RT had longer cardiopulmonary bypass time (120 ± 28 versus 99 ± 30 minutes, p < 0.001) and cross-clamp time (86 ± 23.5 versus 74 ± 25 minutes, p < 0.001). Thirty-day mortality was similar for both groups (RT, 0%; MS, 1%; p = 0.13). There were no significant differences in other outcomes such as amount of red blood cell transfusion, ventilation time, and hospital stay. Five-year survival in group RT (93.5% ± 3.7%) versus group MS (87.4% ± 3.6%, p = 0.556) and freedom from MV reoperation (93.3% ± 2.9% versus 97.9% ± 1.5%, respectively; p = 0.157) were not different. Functional outcome and quality of life variables were similar. Conclusions Mitral valve surgery through a right minithoracotomy is a safe procedure associated with a very low operative mortality comparable to the standard sternotomy approach. In addition to improved cosmetics, minimally invasive MV surgery provides equally durable results as the standard sternotomy approach. [ABSTRACT FROM AUTHOR]