Controversies in ACL revision surgery: Italian expert group consensus and state of the art

Background: Revision ACL reconstruction is a complex topic with many controversies and not-easy-to-make decisions. The authors’ aim is to provide some feasible advice that can be applied in daily clinical practice with the goal of facilitating the decision-making process and improving the outcomes of patients subjected to revision ACL reconstruction. Methods: A national survey with seven questions about the most controversial topics in revision ACL reconstruction was emailed to members of two societies: SIOT and SIAGASCOT. The participants’ answers were collected, the most recent literature was analyzed, and a consensus was created by the authors, according to their long-term surgical experience. Conclusions: The decision-making process in revision ACL reconstruction starts with a standardized imaging protocol (weight-bearing radiographs, CT scan, and MRI). One-stage surgery is indicated in almost all cases (exceptions are severe tunnel enlargement and infection), while the choice of graft depends on the previously used graft and the dimensions of the tunnels, with better clinical outcomes obtained for autografts. Additional procedures such as lateral extra-articular tenodesis in high-grade pivot-shift knees, biplanar HTO in the case of severe coronal malalignment, and meniscal suture improve the clinical outcome and should be considered case by case. Level of evidence: V (Expert opinion)

The Low-redshift Lyman Continuum Survey: Radio continuum properties of low-zz Lyman continuum emitters

The sources that leak Lyman-continuum (LyC) photons and lead to the reionisation of the universe are intensely studied using multiple observing facilities. Recently, the Low-redshift LyC Survey (LzLCS) has found the first large sample of LyC emitting galaxies at low redshift ($z\sim 0.3$) with the Hubble Space Telescope/Cosmic Origins Spectrograph. The LzLCS sample contains a robust estimate of the LyC escape fraction ($f_\mathrm{esc}^\mathrm{LyC}$) for 66 galaxies spanning a wide range of $f_\mathrm{esc}^\mathrm{LyC}$. Here we, for the first time, aim to study the radio continuum (RC) properties of LzLCS sources and their dependence on $f_\mathrm{esc}^\mathrm{LyC}$. We present Karl G. Jansky Very Large Array RC observations at C (4-8 GHz), S (2-4 GHz) and L (1-2 GHz) bands for a sub-sample of the LzLCS sources. The radio spectral index ($\alpha^{\mathrm{3GHz}}_\mathrm{6GHz}$) spans a wide range from being flat ( $\geq -0.1$) to very steep ($\leq -1.0$). We find that the strongest leakers in our sample show flat $\alpha^{\mathrm{3GHz}}_\mathrm{6GHz}$, weak leakers have $\alpha^{\mathrm{3GHz}}_\mathrm{6GHz}$ close to normal star-forming galaxies, and non-leakers are characterized by steep $\alpha^{\mathrm{3GHz}}_\mathrm{6GHz}$. We argue that a combination of young ages, free-free absorption, and a flat cosmic-ray energy spectrum can altogether lead to a flat $\alpha^{\mathrm{3GHz}}_\mathrm{6GHz}$ for strong leakers. Non-leakers are characterized by steep spectra which can arise due to break/cutoff at high frequencies. Such a cutoff in the spectrum can arise in a single injection model of CRs characteristic of galaxies which have recently stopped star formation. Such a relation between $\alpha^{\mathrm{3GHz}}_\mathrm{6GHz}$ and $f_\mathrm{esc}^\mathrm{LyC}$ hints at the interesting role of supernovae, CRs, and magnetic fields in facilitating the escape (and/or the lack) of LyC photons.Comment: 25 pages, 14 figures, 3 tables, Submitted to Astronomy & Astrophysic

Italian consensus conference on guidelines for conservative treatment on lower limb muscle injuries in athlete.

Provide the state of the art concerning (1) biology and aetiology, (2) classification, (3) clinical assessment and (4) conservative treatment of lower limb muscle injuries (MI) in athletes. Seventy international experts with different medical backgrounds participated in the consensus conference. They discussed and approved a consensus composed of four sections which are presented in these documents. This paper represents a synthesis of the consensus conference, the following four sections are discussed: (i) The biology and aetiology of MIs. A definition of MI was formulated and some key points concerning physiology and pathogenesis of MIs were discussed. (ii) The MI classification. A classification of MIs was proposed. (iii) The MI clinical assessment, in which were discussed anamnesis, inspection and clinical examination and are provided the relative guidelines. (iv) The MI conservative treatment, in which are provided the guidelines for conservative treatment based on the severity of the lesion. Furthermore, instrumental therapy and pharmacological treatment were discussed. Knowledge of the aetiology and biology of MIs is an essential prerequisite in order to plan and conduct a rehabilitation plan. Another important aspect is the use of a rational MI classification on prognostic values. We propose a classification based on radiological investigations performed by ultrasonography and MRI strongly linked to prognostic factors. Furthermore, the consensus conference results will able to provide fundamental guidelines for diagnostic and rehabilitation practice, also considering instrumental therapy and pharmacological treatment of MI. Expert opinion, level IV

Diversity, distribution and conservation of the terrestrial reptiles of Oman (Sauropsida, Squamata)

All authors: Salvador Carranza , Meritxell Xipell, Pedro Tarroso, Andrew Gardner, Edwin Nicholas Arnold, Michael D. Robinson, Marc Simó-Riudalbas, Raquel Vasconcelos, Philip de Pous, Fèlix Amat, Jiří Šmíd, Roberto Sindaco, Margarita Metallinou †, Johannes Els, Juan Manuel Pleguezuelos, Luis Machado, David Donaire, Gabriel Martínez, Joan Garcia-Porta, Tomáš Mazuch, Thomas Wilms, Jürgen Gebhart, Javier Aznar, Javier Gallego, Bernd-Michael Zwanzig, Daniel Fernández-Guiberteau, Theodore Papenfuss, Saleh Al Saadi, Ali Alghafri, Sultan Khalifa, Hamed Al Farqani, Salim Bait Bilal, Iman Sulaiman Alazri, Aziza Saud Al Adhoobi, Zeyana Salim Al Omairi, Mohammed Al Shariani, Ali Al Kiyumi, Thuraya Al Sariri, Ahmed Said Al Shukaili, Suleiman Nasser Al Akhzami.In the present work, we use an exceptional database including 5,359 records of 101 species of Oman’s terrestrial reptiles together with spatial tools to infer the spatial patterns of species richness and endemicity, to infer the habitat preference of each species and to better define conservation priorities, with especial focus on the effectiveness of the protected areas in preserving this unique arid fauna. Our results indicate that the sampling effort is not only remarkable from a taxonomic point of view, with multiple observations for most species, but also for the spatial coverage achieved. The observations are distributed almost continuously across the two-dimensional climatic space of Oman defined by the mean annual temperature and the total annual precipitation and across the Principal Component Analysis (PCA) of the multivariate climatic space and are well represented within 17 out of the 20 climatic clusters grouping 10% of the explained climatic variance defined by PC1 and PC2. Species richness is highest in the Hajar and Dhofar Mountains, two of the most biodiverse areas of the Arabian Peninsula, and endemic species richness is greatest in the Jebel Akhdar, the highest part of the Hajar Mountains. Oman’s 22 protected areas cover only 3.91% of the country, including within their limits 63.37% of terrestrial reptiles and 50% of all endemics. Our analyses show that large areas of the climatic space of Oman lie outside protected areas and that seven of the 20 climatic clusters are not protected at all. The results of the gap analysis indicate that most of the species are below the conservation target of 17% or even the less restrictive 12% of their total area within a protected area in order to be considered adequately protected. Therefore, an evaluation of the coverage of the current network of protected areas and the identification of priority protected areas for reptiles using reserve design algorithms are urgently needed. Our study also shows that more than half of the species are still pending of a definitive evaluation by the International Union for Conservation of Nature (IUCN).This work was funded by grants CGL2012-36970, CGL2015-70390-P from the Ministerio de Economía y Competitividad, Spain (cofunded by FEDER) to SC, the project Field study for the conservation of reptiles in Oman, Ministry of Environment and Climate Affairs, Oman (Ref: 22412027) to SC and grant 2014-SGR-1532 from the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement de la Generalitat de Catalunya to SC. MSR is funded by a FPI grant from the Ministerio de Economía y Competitividad, Spain (BES-2013-064248); RV, PT and LM were funded by Fundação para a Ciência e Tecnologia (FCT) through post-doc grants (SFRH/BPD/79913/2011) to RV, (SFRH/BPD/93473/2013) to PT and PhD grant (SFRH/BD/89820/2012) to LM, financed by Programa Operacional Potencial Humano (POPH) – Quadro de Referência Estrategico Nacional (QREN) from the European Social Fund and Portuguese Ministerio da Educação e Ciência

Italian consensus conference on guidelines for conservative treatment on lower limb muscle injuries in athlete

Provide the state of the art concerning (1) biology and aetiology, (2) classification, (3) clinical assessment and (4) conservative treatment of lower limb muscle injuries (MI) in athletes. Seventy international experts with different medical backgrounds participated in the consensus conference. They discussed and approved a consensus composed of four sections which are presented in these documents. This paper represents a synthesis of the consensus conference, the following four sections are discussed: (i) The biology and aetiology of MIs. A definition of MI was formulated and some key points concerning physiology and pathogenesis of MIs were discussed. (ii) The MI classification. A classification of MIs was proposed. (iii) The MI clinical assessment, in which were discussed anamnesis, inspection and clinical examination and are provided the relative guidelines. (iv) The MI conservative treatment, in which are provided the guidelines for conservative treatment based on the severity of the lesion. Furthermore, instrumental therapy and pharmacological treatment were discussed. Knowledge of the aetiology and biology of MIs is an essential prerequisite in order to plan and conduct a rehabilitation plan. Another important aspect is the use of a rational MI classification on prognostic values. We propose a classification based on radiological investigations performed by ultrasonography and MRI strongly linked to prognostic factors. Furthermore, the consensus conference results will able to provide fundamental guidelines for diagnostic and rehabilitation practice, also considering instrumental therapy and pharmacological treatment of MI. Expert opinion, level IV

Computation of metallic nanofluid natural convection in a two-dimensional solar enclosure with radiative heat transfer, aspect ratio and volume fraction effects

As a model of nanofluid direct absorber solar collectors (nano-DASCs), the present article describes recent numerical simulations of steady-state nanofluid natural convection in a two-dimensional enclosure. Incompressible laminar Newtonian viscous flow is considered with radiative heat transfer. The ANSYS FLUENT finite volume code (version 19.1) is employed. The enclosure has two adiabatic walls, one hot (solar receiving) and one colder wall. The Tiwari-Das volume fraction nanofluid model is used and three different nanoparticles are studied (Copper (Cu), Silver (Ag) and Titanium Oxide (TiO2)) with water as the base fluid. The solar radiative heat transfer is simulated with the P1 flux and Rosseland diffusion models. The influence of geometrical aspect ratio and solid volume fraction for nanofluids is also studied and a wider range is considered than in other studies. Mesh-independence tests are conducted. Validation with published studies from the literature is included for the copperwater nanofluid case. The P1 model is shown to more accurately predict the actual influence of solar radiative flux on thermal fluid behaviour compared with Rosseland radiative model. With increasing Rayleigh number (natural convection i.e. buoyancy effect), significant modification in the thermal flow characteristics is induced with emergence of a dual structure to the circulation. With increasing aspect ratio (wider base relative to height of the solar collector geometry) there is a greater thermal convection pattern around the whole geometry, higher temperatures and the elimination of the cold upper zone associated with lower aspect ratio. Titanium Oxide nano-particles achieve slightly higher Nusselt number at the hot wall compared with Silver nano-particles. Thermal performance can be optimized with careful selection of aspect ratio and nano-particles and this is very beneficial to solar collector designers

Development of a Real-Time PCR for Identification of Brachyspira Species in Human Colonic Biopsies

Background: Brachyspira species are fastidious anaerobic microorganisms, that infect the colon of various animals. The genus contains both important pathogens of livestock as well as commensals. Two species are known to infect humans: B. aalborgi and B. pilosicoli. There is some evidence suggesting that the veterinary pathogenic B. pilosicoli is a potential zoonotic agent, however, since diagnosis in humans is based on histopathology of colon biopsies, species identification is not routinely performed in human materials. Methods: The study population comprised 57 patients with microscopic evidence of Brachyspira infection and 26 patients with no histopathological evidence of Brachyspira infection. Concomitant faecal samples were available from three infected patients. Based on publically available 16S rDNA gene sequences of all Brachyspira species, species-specific primer sets were designed. DNA was extracted and tested by real-time PCR and 16S rDNA was sequenced. Results: Sensitivity and specificity for identification of Brachyspira species in colon biopsies was 100% and 87.7% respectively. Sequencing revealed B. pilosicoli in 15.4% of patients, B. aalborgi in 76.9% and a third species, tentatively named ‘‘Brachyspira hominis’’, in 26.2%. Ten patients (12.3%) had a double and two (3.1%) a triple infection. The presence of Brachyspira pilosicoli was significantly associated with inflammatory changes in the colon-biopsy (p = 0.028). Conclusions: This newly designed PCR allows for sub-differentiation of Brachyspira species in patient material and thus allows large-scaled surveillance studies to elucidate the pathogenicity of human Brachyspira infections. One-third of affected patients appeared to be infected with a novel species

Conversations on Utopia : Cultural and Communication Practices

This book offers an interdisciplinary conversation on utopia clustered around cultural and communication practises in terms of political and ethical projects. The contributions shed light on cultural and discursive aspects characterising the polysemous concept of utopia conceived as an ongoing process that is put into practice in the present. Against this backdrop, the book raises questions for intellectual work, seeks out an enlightening breach in academic field boundaries, invites a revision of the forms of knowledge production, and encourages pedagogical actions for the development of critical thinking

CBF changes after (-)eburnamonine infusion in patients with cerebrovascular insufficiency

The authors have made a study of CBF after (-)eburnamonine infusion, during angiographic examination of 6 patients with cerebrovascular insufficiency, for a hemodynamic evaluation of the drug efficacy on CBF. The measurement of CBF was done by 133Xe according to the method of Lassen and Ingvar. A correlation between clinical findings, angiographic findings and CBF changes was done to state the employment of (-)eburnamonine in patients with cerebrovascular insufficiency