The use of a non-biological, bridging, antiprotrusio cage in complex revision hip arthroplasty and periacetabular reconstructive oncologic surgery. Is still today a valid option?: A mid/long-term survival and complications’ analysis

Introduction: Burch–Schneider-like antiprotrusio cages (B-SlAC) still remain helpful implants to bridge severe periacetabular bone losses. The purpose of this study was to evaluate outcomes and estimate both cages’ failures and complication risks in a series of B-SlAC implanted in revision of failed total hip arthroplasties (THA) or after resection of periacetabular primary or secondary bone malignancies. Risk factors enhancing the chance of dislocations and infections were checked. Materials and methods: We evaluated 73 patients who received a B-SlAC from January 2008 to January 2018. Group A, 40 oncological cases (22 primary tumors; 18 metastases); Group B, 33 failed THAs. We compared both Kaplan–Meier estimates of risk of failure and complication with the cumulative incidence function, taking account the competing risk of death. Cox proportional hazards model was utilized to identify possible predictors of instability and infection. Harris hip score HHS was used to record clinical outcomes. Results: Medium follow-up was 80 months (24–137). Average final HHS was 61 (28–92), with no differences within the two groups (p > 0.05). The probabilities of failure and complications were 57% and 26%, respectively, lower in the oncologic group than in the rTHA group (p =0.176; risk 0.43) (p = 0.52; risk 0.74). Extended ileo-femoral approach and proximal femur replacement (p =0.02, risk ratio = 3.2; p = 0.04, rr = 2.1) were two significant independent predictors for dislocations, while belonging to group B (p = 0.04, rr = 2.6) was predictable for infections. Conclusion: Burch–Schneider-like antiprotrusio cages are a classical non-biological acetabular reconstruction method that surgeons should bear in mind when facing gross periacetabular bone losses, independently of their cause. However, dislocation and infection rates are high. Whenever possible, we suggest preserving the proximal femur in revision THA, and to use a less-invasive postero-lateral approach to reduce dislocation rates in non-oncologic cases

The Scaglia Toscana Formation of the Monti del Chianti: new lithostratigraphic and biostratigraphic data

The Scaglia Toscana Formation (Scisti Policromi Auctt.) is one of the most investigated formations of the Tuscan Nappe. The formation is widely exposed in the Chianti Mounts and despite the number of studies in this area, some aspects remain poorly known and debated.In this paper new litho- and bio-stratigraphic data from eight key-sections distributed over the entire area are provided and discussed in order to clarify the stratigraphic relationships among different lithostratigraphic members, as well as the depositional ages of each member. The formation was deposited in the Cretaceous-Oligo-cene time interval and it can be subdivided into five lithostratigraphic members: i) the “Argilliti di Brolio” (wine-red shales with sporadic siliceous calcilutites and rare interbedded cherts); ii) the “Marne del Sugame” (red and pink marls, calcareous marls and marly limestones with interbedded calcarenitic beds and ruditic lens-shaped bodies including calcareous-siliceous clasts); iii) the “Argilliti di Cintoia” (grey-green to black shales, locally with manganese-rich siliceous calcilutites and cherts); iv) the “Calcareniti di Montegrossi” (thin beds of calcilutites and calcarenites with varicoloured shaly-marly interbeds); and v) the “Argilliti e Calcareniti di Dudda” (alternating thin beds of calcilutites and calcarenites with varicoloured shaly-marly interbeds). These members were deposited in a marine environment and have been interpreted as deposited in a turbiditic system, in which shaly and calcareous turbiditic members have been attributed to a basin plain below the CCD, whereas the marls and marly limestones of the Marne del Sugame Member were deposited in a slope/ramp environment above or close to the CCD. Furthermore, the combination of these new data with structural informations coming from the literature allowed a better paleogeographic reconstruction of the paleobasin. In order to better explain these data, the paper is accompanied by two geological maps realized in the past but never distributed. The two geological maps, at the scale of 1:25,000, cover the whole area from the Cintoia (south of Florence) to the San Gusmè (north of Siena) villages

Nuclear techniques and the particulate matter pollution in big harbours

The impact of big harbours on the air quality is an important issue both from the environmental and the economical point of view. The harbour of Genoa is the largest in Italy and one of the major ports of the Mediterranean. We have determined the fraction of Particulate Matter (PM) concentration in town due to the heavy oil combustion of the diesel engines of the vessels in the harbour. This turned out to be 12% in PM10 and 25% in PM2.5 and PM1, with about 85% of the PM from this source concentrated in particles with aerodynamic diameter, Dae < 1 μm. We could also point out a link between concentration peaks of the tracers of heavy oil combustion (V and Ni) and the ferryboats traffic. The key tool in this work was the coupling between particular sampling devices and some Ion Beam Analysis (IBA) techniques, in particular Particle Induced X-ray Emission (PIXE), which belong to the broader category of nuclear techniques in applied physics

Central nervous system myeloma and unusual extramedullary localizations: real life practical guidance

Central nervous system localization of multiple myeloma (CNS-MM) accounts for about 1% of all MM during disease course or even rarer at diagnosis. A difference in the origin, i.e., osteodural or primary dural vs leptomeningeal/intraparenchymal, seems to define two distinct types of intracranial myeloma, with different clinical behavior. CNS-MM may occur also as a presentation of MM. Treatment is still unsatisfactory and many treatments have been reported: chemotherapy, intrathecal therapy, and radiotherapy, with dismal prognosis. Other sites of myeloma localization could be also of interest and deserve description. Because of the rarity and aggressiveness of the disease clinicians are often doubtful on how to treat it since there is no general agreement. Moreover, recent drugs such as the anti CD38 monoclonal antibody, immunomodulatory drugs, and proteasome inhibitors have changed the treatment of patients with MM with a significant improvement in overall response and survival. The role of novel agents in CNS MM management and unusual presentations will be discussed as well as the potential role of other new immunomodulatory drugs and proteasome inhibitors that seem to cross the blood-brain barrier. The purpose of this review is to increase awareness of the clinical unusual presentation and neuroradiological findings, give practical diagnostic advice and treatment options algorithm

Dorado and its member galaxies. Ha imaging of the group backbone

ABRIDGED: Dorado is a nearby, rich and clumpy galaxy group that extends for several degrees in the Southern Hemisphere. For the first time, we map the Ha distribution as a possible indicator of star formation (SF) activity of Dorado members a large fraction of which show interaction and merging signatures. With the 2.5m du Pont and the 1m Swope telescopes we obtained narrow-band, calibrated images of 14 galaxies, forming the backbone of the group, mapping Ha+[N II] down to few 10$^{-17}$ erg~cm$^{-2}$~s$^{-1}$~arcsec$^{-2}$. We estimated the galaxy star formation rate (SFR) from the Ha fluxes, corrected for Galaxy foreground extinction and [N II] contamination. Ha+[N II] emission has been detected in all galaxies. HII regions clearly emerge in late-type galaxies (LTGs) , while in early-type galaxies (ETGs) the Ha+[N II] emission is dominated by [N II], especially in the central regions. However, HII complexes are also revealed in four ETGs. Considering the Dorado group as a whole, we notice that the Ha+[N II] equivalent width, a measure of the specific SF, increases with the morphological type, from early to late-type members, although it remains lower that what observed in similar surveys of spiral galaxies. The SFR of the spiral members is in the range of what observed in similar galaxies surveys James+ (2004), although, in three spirals the SFR is well below the median for their morphological classes. The SFR of some early-type members tends, at odds, to be higher than the average derived from Ha+[N II] surveys of this morphological family. We detected in Ha+[N II] all the ETGs observed and half of them show HII regions. These findings suggest that ETGs in this group are not dead galaxies: their SF has not shut down yet. Mechanisms such as gas stripping and gas accretion, through galaxy-galaxy interaction, seem relevant in modifying the SF in this evolutionary phase of Dorado.Comment: 21 figures, 4 tables, accepted for publication on Astronomy & Astrophysic

A sensing architecture for empathetic data systems

Today's increasingly large and complex databases require novel and machine aided ways of exploring data. To optimize the selection and presentation of data, we suggest an unconventional approach. Instead of exclusively relying on explicit user input to specify relevant information or to navigate through a data space, we exploit the power and potential of the users' unconscious processes in addition. To this end, the user is immersed in a mixed reality environment while his bodily reactions are captured using unobtrusive wearable devices. The users' reactions are analyzed in real-time and mapped onto higher-level psychological states, such as surprise or boredom, in order to trigger appropriate system responses that direct the users' attention to areas of potential interest in the visualizations. The realization of such a close experience-based human-machine loop raises a number of technical challenges, such as the real-time interpretation of psychological user states. The paper at hand describes a sensing architecture for empathetic data systems that has been developed as part of such a loop and how it tackles the diverse challenges