Anterior cruciate ligament reconstruction with a quadrupled hamstrings tendon autograft does not restore tibial rotation to normative levels during landing from a jump and subsequent pivoting

Aim. Recent research suggested that the anterior curciate ligament (ACL) reconstruction does not restore tibial rotation to normal levels when a bone patellar tendon bone (BPTB) graft is used during high demanding activities. Our goal was to determine if the usage of an alternative graft, as the quadrupled semitendinosus-gracilis (ST/G), restore tibial rotation to normal values in a population of athletically active individuals while performing a usual for their sport activity. Methods. Eleven subjects, all reconstructed with an ST/G graft, were assessed in vivo, 9 months postoperatively, while they jumped off a 40 cm platform, landed on the ground and subsequently pivoted at 90 degrees. The evaluation period was identified from initial foot contact with the ground, included the pivoting of the ipsilateral leg, and was completed upon touch-down of the contralateral leg. By that time the patients had already returned to their sports activities. Results. The maximum range of motion of the tibial rotation for the pivoting leg, during the evaluation period was found significantly (P=0.0001) larger in the reconstructed leg as compared to the intact contralateral, although both clinical and arthrometer assessments revealed restoration of anterior translation. Conclusion. It was concluded that ACL reconstruction with an ST/G graft does not restore tibial rotation to normal levels during this high demanding activity. It seems that new surgical techniques are needed to better replicate the actual anatomy and function of the natural ACL in order to address this problem

Age- and Sex-Specific Nomographic CT Quantitative Plaque Data From a Large International Cohort.

With growing adoption of coronary computed tomographic angiography (CTA), there is increasing evidence for and interest in the prognostic importance of atherosclerotic plaque volume. Manual tools for plaque segmentation are cumbersome, and their routine implementation in clinical practice is limited. The aim of this study was to develop nomographic quantitative plaque values from a large consecutive multicenter cohort using coronary CTA. Quantitative assessment of total atherosclerotic plaque and plaque subtype volumes was performed in patients undergoing clinically indicated coronary CTA, using an Artificial Intelligence-Enabled Quantitative Coronary Plaque Analysis tool. A total of 11,808 patients were included in the analysis; their mean age was 62.7 ± 12.2 years, and 5,423 (45.9%) were women. The median total plaque volume was 223 mm <sup>3</sup> (IQR: 29-614 mm <sup>3</sup> ) and was significantly higher in male participants (360 mm <sup>3</sup> ; IQR: 78-805 mm <sup>3</sup> ) compared with female participants (108 mm <sup>3</sup> ; IQR: 10-388 mm <sup>3</sup> ) (P < 0.0001). Total plaque increased with age in both male and female patients. Younger patients exhibited a higher prevalence of noncalcified plaque. The distribution of total plaque volume and its components was reported in every decile by age group and sex. The authors developed pragmatic age- and sex-stratified percentile nomograms for atherosclerotic plaque measures using findings from coronary CTA. The impact of age and sex on total plaque and its components should be considered in the risk-benefit analysis when treating patients. Artificial Intelligence-Enabled Quantitative Coronary Plaque Analysis work flows could provide context to better interpret coronary computed tomographic angiographic measures and could be integrated into clinical decision making

Transcaval versus Supra-Aortic Vascular Accesses for Transcatheter Aortic Valve Replacement: A Systematic Review with Meta-Analysis.

A growing body of evidence suggests that extrathoracic vascular accesses for transcatheter aortic valve replacement (TAVR) yield favorable outcomes and can be considered as primary alternatives when the gold-standard transfemoral access is contraindicated. Data comparing the transcaval (TCv) to supra-aortic (SAo) approaches (transcarotid, transsubclavian, and transaxillary) for TAVR are lacking. We aimed to compare the outcomes and safety of TCv and SAo accesses for TAVR as alternatives to transfemoral TAVR. A systematic review with meta-analysis was performed by searching PubMed/MEDLINE and EMBASE databases for all articles comparing TCv-TAVR against SAo-TAVR published until September 2023. Outcomes included in-hospital or 30-day all-cause mortality (ACM) and postoperative complications. A total of three studies with 318 TCv-TAVR and 179 SAo-TAVR patients were included. No statistically significant difference was found regarding in-hospital or 30-day ACM (relative risk [RR] 1.04, 95% confidence interval [CI] 0.47-2.34, p = 0.91), major bleeding, the need for blood transfusions, major vascular complications, and acute kidney injury. TCv-TAVR was associated with a non-statistically significant lower rate of neurovascular complications (RR 0.39, 95%CI 0.14-1.09, p = 0.07). These results suggest that both approaches may be considered as first-line alternatives to transfemoral TAVR, depending on local expertise and patients' anatomy. Additional data from long-term cohort studies are needed

Correction of human phospholamban R14del mutation associated with cardiomyopathy using targeted nucleases and combination therapy

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Assessment of the methodology for establishing the EU list of critical raw materials : background report

This report presents the results of work carried out by the Directorate General (DG) Joint Research Centre (JRC) of the European Commission (EC), in close cooperation with Directorate-General for Internal Market, Industry, Entrepreneurship and SMEs (GROW), in the context of the revision of the EC methodology that was used to identify the list of critical raw materials (CRMs) for the EU in 2011 and 2014 (EC 2011, 2014). As a background report, it complements the corresponding Guidelines Document, which contains the "ready-to-apply" methodology for updating the list of CRMs in 2017. This background report highlights the needs for updating the EC criticality methodology, the analysis and the proposals for improvement with related examples, discussion and justifications. However, a few initial remarks are necessary to clarify the context, the objectives of the revision and the approach. As the in-house scientific service of the EC, DG JRC was asked to provide scientific advice to DG GROW in order to assess the current methodology, identify aspects that have to be adapted to better address the needs and expectations of the list of CRMs and ultimately propose an improved and integrated methodology. This work was conducted closely in consultation with the adhoc working group on CRMs, who participated in regular discussions and provided informed expert feedback. The analysis and subsequent revision started from the assumption that the methodology used for the 2011 and 2014 CRMs lists proved to be reliable and robust and, therefore, the JRC mandate was focused on fine-tuning and/or targeted incremental methodological improvements. An in depth re-discussion of fundamentals of criticality assessment and/or major changes to the EC methodology were not within the scope of this work. High priority was given to ensure good comparability with the criticality exercises of 2011 and 2014. The existing methodology was therefore retained, except for specific aspects for which there were policy and/or stakeholder needs on the one hand, or strong scientific reasons for refinement of the methodology on the other. This was partially facilitated through intensive dialogue with DG GROW, the CRM adhoc working group, other key EU and extra-EU stakeholders

Critical raw materials and the circular economy

This report is a background document used by several European Commission services to prepare the EC report on critical raw materials and the circular economy, a commitment of the European Commission made in its Communication ‘EU action plan for the Circular Economy’. It represents a JRC contribution to the Raw Material Initiative and to the EU Circular Economy Action Plan. It combines the results of several research programmes and activities of the JRC on critical raw materials in a context of circular economy, for which a large team has contributed in terms of data and knowledge developments. Circular use of critical raw materials in the EU is analysed, also taking a sectorial perspective. The following sectors are analysed in more detail: extractive waste, landfills, electric and electronic equipment, batteries, automotive, renewable energy, defence and chemicals and fertilisers. Conclusions and opportunities for further work are also presented

Collapse risk and residual drift performance of steel buildings using post-tensioned MRFs and viscous dampers in near-fault regions

The potential of post-tensioned self-centering moment-resisting frames (SC-MRFs) and viscous dampers to reduce the collapse risk and improve the residual drift performance of steel buildings in near-fault regions is evaluated. For this purpose, a prototype steel building is designed using different seismic-resistant frames, i.e.: moment-resisting frames (MRFs); MRFs with viscous dampers; SC-MRFs; and SC-MRFs with viscous dampers. The frames are modeled in OpenSees where material and geometrical nonlinearities are taken into account as well as stiffness and strength deterioration. A database of 91 near-fault, pulse-like ground motions with varying pulse periods is used to conduct incremental dynamic analysis (IDA), in which each ground motion is scaled until collapse occurs. The probability of collapse and the probability of exceeding different residual story drift threshold values are calculated as a function of the ground motion intensity and the period of the velocity pulse. The results of IDA are then combined with probabilistic seismic hazard analysis models that account for near-fault directivity to assess and compare the collapse risk and the residual drift performance of the frames. The paper highlights the benefit of combining the post-tensioning and supplemental viscous damping technologies in the near-source. In particular, the SC-MRF with viscous dampers is found to achieve significant reductions in collapse risk and probability of exceedance of residual story drift threshold values compared to the MRF. © 2016 Springer Science+Business Media Dordrech