Walking with shorter stride length could improve knee kinetics of patients with medial knee osteoarthritis.

Walking with a shorter stride length (SL) was recently proposed for gait retraining in medial knee osteoarthritis; however it was never assessed in this patient population. This study tested the hypothesis that shortening SL while maintaining walking speed reduces knee adduction (KAM) and flexion (KFM) moments in patients with medial knee osteoarthritis. Walking trials with normal SL and SL reduced by 0.10 m and 0.15 m were recorded for 15 patients (10 men, 55.5 ± 8.7 years old, 24.6 ± 3.0 kg/m <sup>2</sup> ). SL was modified using an augmented reality system displaying target footprints on the floor. Repeated one-way ANOVAs and post-hoc paired t-tests were performed to compare gait measures between normal and reduced SL. The individual effects of SL reduction were analyzed using descriptive statistics. Group analysis indicated significant decreases in KAM impulse with both SL reductions (p < 0.05). No systematic change was observed in the first peaks KAM and KFM when walking with reduced SL (p > 0.05). Individually, 33 % of the patients decreased the peak KAM, whereas 20 % decreased the KAM impulse. Among these patients with a decrease in peak KAM or in KAM impulse, 0 % and 33 % had a simultaneous increase in peak KFM, respectively. In conclusion, this study showed that SL shortening can decrease kinetic measures associated with the progression of medial knee osteoarthritis in some patients, demonstrating the importance of considering SL modifications on an individual basis. While further research is necessary, notably regarding dose-response relationships and long-term effects, these findings are particularly encouraging because SL reductions could be easily integrated into rehabilitation protocols

Controle Alternativo De Pinta-preta Em Genótipos De Mamoeiro

To find control forms alternative to fungicides, this study aimed to evaluate the effect of products with potential to control black spot (Asperisporium caricae) in different papaya genotypes. Installed in a greenhouse, the experiment was conducted in randomized blocks (RB) with factorial arrangement 5x6, three replicates, and spraying of four products (Bion®, Bordeaux mixture, Ecolife®, and Bordasul®) in six papaya genotypes (‘Sunrise Solo PT’, ‘STZ 03’, ‘Golden’, ‘Tailândia’, ‘Maradol’ and ‘UENF-CALIMAN 01’), while control was sprayed only with water. The severity (BSS) and the incidence (BSI) of black spot on the leaves were quantified, as well as the area under the disease progress curve (AUDPC). There was variability among the evaluated genotypes, highlighting ‘STZ 03’, ‘Maradol’ and ‘UENF/ CALIMAN 01’ as the most resistant genotypes. ‘Tailândia’ (susceptible) showed greater response to the products. Plants sprayed with Bion®, Bordeaux mixture and Bordasul® had reduced black spot means. © 2017, Universidade Estadual Paulista (UNESP). All rights reserved.431606

Ten-year follow-up of a total knee prosthesis combining multi-radius, ultra-congruency, posterior-stabilization and mobile-bearing insert shows long-lasting clinically relevant improvements in pain, stiffness, function and stability.

There is a paucity of data available on total knee prostheses combining dual-radius, ultra-congruency, posterior-stabilization and mobile-bearing insert. This prospective cohort study aimed to assess the clinical evolution of the FIRST <sup>®</sup> prosthesis (Symbios Orthopédie, Yverdon, CH), the earliest prosthesis with this particular design. It was hypothesized that the primary outcomes, evaluating pain, stiffness, function and stability, would improve following arthroplasty and remain improved during the follow-up period of 10 years. All patients programmed for a total knee arthroplasty using a FIRST <sup>®</sup> prosthesis at our university hospital between 2006 and 2008 were invited to participate. Study knees were evaluated pre-operatively as well as one, five and ten years post-operatively. Patients filled out questionnaires at each evaluation point and had a radiographic assessment at the five-year and ten-year follow-ups. Primary outcomes were the total, pain, stiffness and function measures of the Western Ontario and McMaster Universities Osteoarthritis questionnaire (WOMAC) and the knee and function measures of the Knee Society Score (KSS). Friedman and Wilcoxon's rank-sum tests were used to compare measures across time points. Hundred and twenty four prostheses were included (baseline demographics: 69.9 ± 8.3 years old, 28.1 ± 4.3 kg/m <sup>2</sup> , 54% male) and 68 could be followed during ten years. Five prostheses underwent a revision. All other prostheses lost at follow-up were lost for reasons unrelated to the prosthesis. All primary measures reported statistically and clinically significant improvements between baseline and the three follow-up evaluations. Statistically significant improvements at the three follow-up evaluations were also observed for most secondary measures. There was no implant loosening. At ten-year follow-up, radiolucent lines were observed in 2.9% femoral implants and 1.5% tibial implants. The positive results observed in all domains of assessment and the small revision rate demonstrated an effective functioning of the FIRST <sup>®</sup> prosthesis during the ten-year follow-up period. The results, globally similar to those previously published for other prosthesis designs, encourage the development of assistive methods to select the most appropriate designs on an individual basis. IV, prospective cohort study

Sustainable management of olive rainfed orchards by the introduction of leguminous cover crops

The olive sector has a crucial economic, social, cultural and ecological relevance in the Mediterranean region, where tillage and herbicides application are still generalized practices. However, these practices oppose the recommendations of UE Common Agricultural Policy and thus, management methods that decrease requirement for agricultural chemicals are needed to reduce adverse environmental impacts. Moreover, they can play an important role in atmospheric C01 emission and fixation. We propose green manure legumes to reduce erosion, soil compaction and nih·ate pollution, to improve biodiversity, soil carbon sink and fertility, to save fossil fuels and to increase yield and the safety and nutritional value of food products. The 3-yearfield study carried out in Northeast Portugal revealed that self-reseeding annual legumes is a promising strategy since increase the summer soil water content, the vegetative growth and the physiological tree pe1jormance, that was reflected in a 38% higher cumulative yield then tillage techniques.PTDC-AGR-AAM/098326/200

New Results for the Correlation Functions of the Ising Model and the Transverse Ising Chain

In this paper we show how an infinite system of coupled Toda-type nonlinear differential equations derived by one of us can be used efficiently to calculate the time-dependent pair-correlations in the Ising chain in a transverse field. The results are seen to match extremely well long large-time asymptotic expansions newly derived here. For our initial conditions we use new long asymptotic expansions for the equal-time pair correlation functions of the transverse Ising chain, extending an old result of T.T. Wu for the 2d Ising model. Using this one can also study the equal-time wavevector-dependent correlation function of the quantum chain, a.k.a. the q-dependent diagonal susceptibility in the 2d Ising model, in great detail with very little computational effort.Comment: LaTeX 2e, 31 pages, 8 figures (16 eps files). vs2: Two references added and minor changes of style. vs3: Corrections made and reference adde

Hepatic Trauma: A 21-year Experience [trauma Hepático: Uma Experiência De 21 Anos]

Objective: To evaluate the epidemiological aspects, behavior, morbidity and treatment outcomes for liver trauma. Methods: We conducted a retrospective study of patients over 13 years of age admitted to a university hospital from 1990 to 2010, submitted to surgery or nonoperative management (NOM). Results: 748 patients were admitted with liver trauma. The most common mechanism of injury was penetrating trauma (461 cases, 61.6%), blunt trauma occurring in 287 patients (38.4%). According to the degree of liver injury (AAST-OIS) in blunt trauma we predominantly observed Grades I and II and in penetrating trauma, Grade III. NOM was performed in 25.7% of patients with blunt injury. As for surgical procedures, suturing was performed more frequently (41.2%). The liver-related morbidity was 16.7%. The survival rate for patients with liver trauma was 73.5% for blunt and 84.2% for penetrating trauma. Mortality in complex trauma was 45.9%. Conclusion: trauma remains more common in younger populations and in males. There was a reduction of penetrating liver trauma. NOM proved safe and effective, and often has been used to treat patients with penetrating liver trauma. Morbidity was high and mortality was higher in victims of blunt trauma and complex liver injuries.404318322Talving, P., Beckman, M., Häggmark, T., Iselius, L., Epidemiology of liver injuries (2003) Scand J Surg., 92 (3), pp. 192-194Diorio, A.C., Fraga, G.P., Dutra Jr., I., Joaquim, J.L., Mantovani, M., Predictive factors of morbidity and mortality in hepatic trauma (2008) Rev Col Bras Cir., 35 (6), pp. 397-405Smaniotto, B., von Bahten, L.C., Nogueira Filho, D.C., Tano, A.L., Thomaz Júnior, L., Fayad, O., Hepatic trauma: Analysis of the treatment with intrahepatic balloon in a university hospital of Curitiba (2009) Rev Col Bras Cir., 36 (3), pp. 217-222Croce, M.A., Fabian, T.C., Menke, P.G., Waddle-Smith, L., Minard, G., Kudsk, K.A., Nonoperative management of blunt hepatic trauma is the treatment of choice for hemodynamically stable patients. Results of a prospective trial (1995) Ann Surg., 221 (6), pp. 744-753Sriussadaporn, S., Pak-art, R., Tharavej, C., Sirichindakul, B., Chiamananthapong, S., A multidisciplinary approach in the management of hepatic injuries (2002) Injury., 33 (4), pp. 309-315Champion, H.R., Sacco, W.J., Copes, W.S., Gann, D.S., Gennarelli, T.A., Flanagan, M.E., A revision of the Trauma Score (1989) J Trauma., 29 (5), pp. 623-629Baker, S.P., O'Neill, B., Haddon Jr., W., Long, W.B., The injury severity score: A method for describing patients with multiple injuries and evaluating emergency care (1974) J Trauma., 14 (3), pp. 187-196Boyd, C.R., Tolson, M.A., Copes, W.S., Evaluating trauma care: The TRISS method. Trauma Score and the Injury Severity Score (1987) J Trauma., 27 (4), pp. 370-378Moore, E.E., Cogbill, T.H., Jurkovich, G.J., Shackford, S.R., Malangoni, M.A., Champion, H.R., Organ injury scaling: Spleen and liver (1994 revision) (1995) J Trauma., 38 (3), pp. 323-324Stalhschmidt, C.M., Formighieri, B., Marcon, D.M., Takejima, A.L., Soares, L.G.S., Hepatic trauma: Five years of epidemiology in an emergency service (2008) Rev Col Bras Cir., 35 (4), pp. 225-228Malhotra, A.K., Fabian, T.C., Croce, M.A., Gavin, T.J., Kudsk, K.A., Minard, G., Blunt hepatic injury: A paradigm shift from operative to nonoperative management in the 1990s (2000) Ann Surg., 231 (6), pp. 804-813Matthes, G., Stengel, D., Seifert, J., Rademacher, G., Mutze, S., Ekkernkamp, A., Blunt liver injuries in polytrauma: Results from a cohort study with the regular use of whole-body helical computed tomography (2003) World J Surg., 27 (10), pp. 1124-1130Krige, J.E., Bornman, P.C., Terblanche, J., Liver trauma in 446 patients (1997) S Afr J Surg., 35 (1), pp. 10-15Scollay, J.M., Beard, D., Smith, R., McKeown, D., Garden, O.J., Parks, R., Eleven years of liver trauma: The Scottish experience (2005) World J Surg., 29 (6), pp. 744-749Pachter, H.L., Knudson, M.M., Esrig, B., Ross, S., Hoyt, D., Cogbill, T., Status of nonoperative management of blunt hepatic injuries in 1995: A multicenter experience with 404 patients (1996) J Trauma., 40 (1), pp. 31-38Asensio, J.A., Demetriades, D., Chahwan, S., Gomez, H., Hanpeter, D., Velmahos, G., Approach to the management of complex hepatic injuries (2000) J Trauma, 48 (1), pp. 66-69Kozar, R.A., Moore, J.B., Niles, S.E., Holcomb, J.B., Moore, E.E., Cothren, C.C., Complications of nonoperative management of high-grade blunt hepatic injuries (2005) J Trauma., 59 (5), pp. 1066-1071Sikhondze, W.L., Madiba, T.E., Naidoo, N.M., Muckart, D.J., Predictors of outcome in patients requiring surgery for liver trauma (2007) Injury., 38 (1), pp. 65-70Fraga, G.P., Zago, T.M., Pereira, B.M., Calderan, T.R., Silveira, H.J., Use of Sengstaken-Blakemore intrahepatic balloon: An alternative for liver-penetrating injuries (2012) World J Surg., 36 (9), pp. 2119-2124Meredith, J.W., Young, J.S., Bowling, J., Roboussin, D., Nonoperative management of blunt hepatic trauma: The exception or the rule? (1994) J Trauma., 36 (4), pp. 529-534Bynoe, R.P., Bell, R.M., Miles, W.S., Close, T.P., Ross, M.A., Fine, J.G., Complications of nonoperative management of blunt hepatic injuries (1992) J Trauma., 32 (3), pp. 308-314Sherman, H.F., Savage, B.A., Jones, L.M., Barrette, R.R., Latenser, B.A., Varcelotti, J.R., Nonoperative management of blunt hepatic injuries: Safe at any grade? (1994) J Trauma., 37 (4), pp. 616-621Coimbra, R., Hoyt, D.B., Engelhart, S., Fortlage, D., Nonoperative management reduces the overall mortality of grades 3 and 4 blunt liver injuries (2006) Int Surg., 91 (5), pp. 251-257Norrman, G., Tingstedt, B., Ekelund, M., Andersson, R., Non-operative management of blunt liver trauma: Feasible and safe also in centres with a low trauma incidence (2009) HPB., 11 (1), pp. 50-56Zago, T.M., Pereira, B.M., Calderan, T.R., Hirano, E.S., Rizoli, S., Fraga, G.P., Blunt hepatic trauma: Comparison between surgical and nonoperative treatment (2012) Rev Col Bras Cir., 39 (4), pp. 307-313Zago, T.M., Tavares Pereira, B.M., Araujo Calderan, T.R., Godinho, M., Nascimento, B., Fraga, G.P., Nonoperative management for patients with grade IV blunt hepatic trauma (2012) World J Emerg Surg., 7 (SUPPL. 1), pp. S8Pereira, B.M., Non-operative management of hepatic trauma and the interventional radiology: An update review (2012) Indian J Surg., , [on line]Carrasco, C.E., Godinho, M., de Azevedo Barros Berti, M., Rizoli, S., Fraga, G.P., Fatal motorcycle crashes: A serious public health problem in Brazil (2012) World J Emerg Surg., 7 (SUPPL. 1), pp. S

Photoionization of ultracold and Bose-Einstein condensed Rb atoms

Photoionization of a cold atomic sample offers intriguing possibilities to observe collective effects at extremely low temperatures. Irradiation of a rubidium condensate and of cold rubidium atoms within a magneto-optical trap with laser pulses ionizing through 1-photon and 2-photon absorption processes has been performed. Losses and modifications in the density profile of the remaining trapped cold cloud or the remaining condensate sample have been examined as function of the ionizing laser parameters. Ionization cross-sections were measured for atoms in a MOT, while in magnetic traps losses larger than those expected for ionization process were measured.Comment: 9 pages, 7 figure

Tourniquet use for civilian extremity hemorrhage: Systematic review of the literature [Uso de torniquete nas hemorragias de extremidades na população civil: Revisão sistemática da literatura]

Introduction: extremity tourniquet (TQ) use has increased in the civilian setting; the beneficial results observed in the military has influenced acceptance by EMS and bystanders. This review aimed to analyze extremity TQ types used in the civilian setting, injury site, indications, and complications. Methods: a systematic review was conducted based on original articles published in PubMed, Embase, and Cochrane following PRISMA guidelines from 2010 to 2019. Data extraction focused on extremity TQ use for hemorrhage control in the civilian setting, demographic data, study type and duration, mechanism of injury, indications for use, injury site, TQ type, TQ time, and complications. Results: of the 1384 articles identified, 14 were selected for review with a total of 3912 civilian victims with extremity hemorrhage and 3522 extremity TQ placements analyzed. The majority of TQs were applied to male (79%) patients, with blunt or penetrating trauma. Among the indications for TQ use were hemorrhagic shock, suspicion of vascular injuries, continued bleeding, and partial or complete traumatic amputations. Upper extremity application was the most common TQ application site (56%), nearly all applied to a single extremity (99%), and only 0, 6% required both upper and lower extremity applications. 80% of the applied TQs were commercial devices, and 20% improvised. Conclusions: TQ use in the civilian setting is associated with trauma-related injuries. Most are single-site TQs applied for the most part to male adults with upper extremity injury. Commercial TQs are more commonly employed, time in an urban setting is under 1 hour, with few complications described. Introdução: o uso de torniquete em extremidades (TQ) aumentou no ambiente civil; os resultados benéficos observados nas forças armadas influenciaram a aceitação por equipes de pré-hospitalar (PH) assim como pela população leiga. Esta revisão teve como objetivo analisar os tipos de TQ de extremidades usados em ambiente civil, local da lesão, indicações e complicações. Métodos: revisão sistemática foi conduzida com base em artigos originais publicados no PubMed, Embase e Cochrane seguindo as diretrizes do PRISMA de 2010 a 2019. Extração de dados focada no uso de TQ de extremidade para controle de hemorragia em ambiente civil, dados demográficos, tipo de estudo e duração, mecanismo de lesão, indicações de uso, local da lesão, tipo de TQ, tempo de TQ e complicações. Resultados: dos 1.384 artigos identificados, 14 foram selecionados para revisão com total de 3.912 vítimas civis com hemorragia nas extremidades e 3.522 colocações de extremidades TQ analisadas. A maioria foi aplicado em pacientes do sexo masculino (79%), com trauma contuso ou penetrante. Entre as indicações estavam choque hemorrágico, suspeita de lesões vasculares, sangramento contínuo e amputações traumáticas parciais ou completas. A aplicação na extremidade superior foi o local de aplicação mais comum (56%), quase todos aplicados a uma única extremidade (99%), e apenas 0, 6% requereram aplicações nas extremidades superior e inferior. 80% dos TQs aplicados eram dispositivos comerciais e 20% improvisados. Conclusões: o uso de TQ em ambientes civis está associado a traumas. Os TQs comerciais são mais utilizados, com tempo menor que uma hora de uso e poucas complicações

Stillbirth risk prediction using machine learning for a large cohort of births from Western Australia, 1980–2015

Quantification of stillbirth risk has potential to support clinical decision-making. Studies that have attempted to quantify stillbirth risk have been hampered by small event rates, a limited range of predictors that typically exclude obstetric history, lack of validation, and restriction to a single classifier (logistic regression). Consequently, predictive performance remains low, and risk quantification has not been adopted into antenatal practice. The study population consisted of all births to women in Western Australia from 1980 to 2015, excluding terminations. After all exclusions there were 947,025 livebirths and 5,788 stillbirths. Predictive models for stillbirth were developed using multiple machine learning classifiers: regularised logistic regression, decision trees based on classification and regression trees, random forest, extreme gradient boosting (XGBoost), and a multilayer perceptron neural network. We applied 10-fold cross-validation using independent data not used to develop the models. Predictors included maternal socio-demographic characteristics, chronic medical conditions, obstetric complications and family history in both the current and previous pregnancy. In this cohort, 66% of stillbirths were observed for multiparous women. The best performing classifier (XGBoost) predicted 45% (95% CI: 43%, 46%) of stillbirths for all women and 45% (95% CI: 43%, 47%) of stillbirths after the inclusion of previous pregnancy history. Almost half of stillbirths could be potentially identified antenatally based on a combination of current pregnancy complications, congenital anomalies, maternal characteristics, and medical history. Greatest sensitivity is achieved with addition of current pregnancy complications. Ensemble classifiers offered marginal improvement for prediction compared to logistic regression