Is clinically measured knee range of motion after total knee arthroplasty ‘good enough?’: A feasibility study using wearable inertial measurement units to compare knee range of motion captured during physical therapy versus at home

Total knee arthroplasty is highly successful, in part due to range of motion (RoM) recovery. This is typically estimated goniometrically/visually by physical therapists (PTs) in the clinic, which is imprecise. Accordingly, a validated inertial measurement unit (IMU) method for capturing knee RoM was deployed assessing postoperative RoM both in and outside of the clinical setting. The study\u27s objectives were to evaluate the feasibility of continuously capturing knee RoM pre-/post-op via IMUs, dividing data into PT/non-PT portions of each day, and comparing PT/non-PT metrics. We hypothesized IMU-based clinical knee RoM would differ from IMU-based knee RoM captured outside clinical settings. 10 patients (3 M, 69 ± 13 years) completed informed consent documents following ethics board approval. A validated IMU method captured long duration (8–12 h/day, ~50 days) knee RoM pre-/post-op. Post-op metrics were subdivided (PT versus non-PT). Clinical RoM and patient reported outcome measures were also captured. Compliance and clinical disruption were evaluated. ANOVA compared post-op PT and non-PT means and change scores. Maximum flexion during PT was less than outside PT. PT stance/swing RoM and activity level were greater than outside PT. No temporal variable differences were found PT versus non-PT. IMU RoM measurements capture richer information than clinical measures. Maximum PT flexion was likely less than non-PT due to the exercises completed (i.e. high passive RoM vs. low RoM gait). PT gait flexion likely exceed non-PT because of ‘white coat effects’ wherein patients are closely monitored clinically. This implies data captured clinically represents optimum performance whereas data captured non-clinically represents realistic performance

A survey of the main technology, biochemical and microbiological features influencing the concentration of biogenic amines of twenty Apulian and Sicilian (Southern Italy) cheeses

Abstract Twenty Apulian and Sicilian cheeses were analysed for their concentrations of eight biogenic amines (BAs), free amino acids, pH, water activity, and subjected to microbiological characterisation. In addition, lactic acid bacteria isolated from cheeses were assayed for their capacity to generate BAs. Principal component analysis was performed to find the effect of different parameters on the distribution of the cheeses. Although short-ripened (≤30 d) cheeses did not show significant BA concentrations, the only BA showing high positive correlation with time of ripening was histamine. Concentration of histidine and, especially, percentage of histidine-decarboxylase bacteria presumably affected histamine concentration. High pH values were negatively correlated to the concentration of tyramine, putrescine, and cadaverine. Fifty percent of the cheeses contained at least one BA at potentially toxic concentrations. Unambiguous and ever-valid relations among parameters and BAs are difficult to determine, because BAs are the result of combined and varied factors

Assessment of SAR Image Filtering using Adaptive Stack Filters

Stack filters are a special case of non-linear filters. They have a good performance for filtering images with different types of noise while preserving edges and details. A stack filter decomposes an input image into several binary images according to a set of thresholds. Each binary image is then filtered by a Boolean function, which characterizes the filter. Adaptive stack filters can be designed to be optimal; they are computed from a pair of images consisting of an ideal noiseless image and its noisy version. In this work we study the performance of adaptive stack filters when they are applied to Synthetic Aperture Radar (SAR) images. This is done by evaluating the quality of the filtered images through the use of suitable image quality indexes and by measuring the classification accuracy of the resulting images

Resistance Patterns, mcr-4 and OXA-48 Genes, and Virulence Factors of Escherichia coli from Apennine Chamois Living in Sympatry with Domestic Species, Italy

The aim of this study was to determine and characterize potential resistance mechanisms against selected Critically Important Antibiotics in Escherichia coli isolates collected from wild and domestic ruminants living in the Maiella National Park, in Central Italy. A total of 38 isolates were obtained from red deer, Apennine chamois, cattle, sheep, and goats grazing in lands with different levels of anthropic pressure. Antimicrobial susceptibility was determined by Minimal Inhibitory Concentration testing, showing phenotypic resistance to colistin, meropenem, or ceftazidime in 9 isolates along with one bacterial strain being resistant to three of the tested antibiotics. In addition, the biomolecular assays allowed the amplification of the genes conferring the colistin (mcr-4), the carbapenems (OXA-48), penicillins and cephalosporins (TEM, SHV, CMY-1, CMY-2) resistance. In order to describe the potential pathogenicity of isolates under study, virulence genes related to Shiga toxin-producing (STEC) and enteropathogenic (EPEC) pathovars were identified. This study is the first report of mcr-4 and OXA-48 genes in resistant E. coli harboring virulence genes in Italian wildlife, with special regard to Apennine chamois and red deer species. The multidisciplinary approach used in this study can improve the early detection of emerging antibiotic resistance determinants in human-animal-environment interfaces by means of wildlife monitoring

Spatially self-similar spherically symmetric perfect-fluid models

Einstein's field equations for spatially self-similar spherically symmetric perfect-fluid models are investigated. The field equations are rewritten as a first-order system of autonomous differential equations. Dimensionless variables are chosen in such a way that the number of equations in the coupled system is reduced as far as possible and so that the reduced phase space becomes compact and regular. The system is subsequently analysed qualitatively with the theory of dynamical systems.Comment: 21 pages, 6 eps-figure

Impact of two new non-conventional yeasts, Candida oleophila and Starmerella lactis-condensi, isolated from sugar-rich substrates, on Frappato wine aroma

The interest of non-Saccharomyces yeasts in wine fermentation increased constantly in last years. This study reports for the first time the enological potential of two strains Starmerella lactis-condensi MN412 and Candida oleophila YS209. In an innovative way, these strains were used in winemaking to improve floral and fruity aroma of Frappato red wine, which has not been explored. The enological performances of the two non-Saccharomyces strains were compared to a wine strain of Starmerella bacillaris, namely Cz3, previously characterized in winemaking conditions. In these three cases, the non-Saccharomyces strain was sequentially inoculated with S. cerevisiae wine strain NF213, used as control. The St. lactis-condensi MN412 was isolated from Sicilian manna, a sugar-rich matrix, extracted from Fraxinus angustifolia trees (Oleaceae). The strain C. oleophila YS209 was isolated from honey by-products. Microbiological counts showed the ability of MN412 and YS209 to maintain high counts up to 6 days of alcoholic fermentation. Regarding chemical parameters, Cz3 showed the highest glycerol production. Analysis of VOCs revealed that the trials with non-Saccharomyces yeasts were characterized by a higher concentration of esters that contributed positively to the fruity aroma of the wines. The sensory analysis confirmed that the use of MN412 and YS209 impacted positively the final wines in terms of fruity and floral intensity, respectively, while did not generate sensory defects. In conclusion, non-conventional yeasts represent strategy to improve floral-fruity freshness of wine aroma and sugar-rich matrices such as manna ash and honey might represent novel ecological niches as source of potential oenological yeast

Intracardiac left atrial tuberculoma in an eleven-month-old infant: case report

<p>Abstract</p> <p>Background</p> <p>Cardiac tuberculosis is rare and usually manifests as tuberculous pericarditis. Involvement of other part of the heart is unusual and descriptions in the pediatric literature are confined to few case reports regarding mainly myocardial tuberculosis.</p> <p>Case presentation</p> <p>We describe a case of pulmonary miliary tuberculosis associated with intracardiac left atrial tuberculoma in an immunocompetent eleven-month-old infant successfully treated with surgery and antituberculous therapy.</p> <p>Conclusion</p> <p>Although unusual, involvement of endocardium in disseminated tuberculosis should be kept in mind.</p

Association between income and control of cardiovascular risk factors after acute coronary syndromes: an observational study.

The role of income in cardiovascular disease prevention after an acute coronary syndrome (ACS) remains unclear. We aimed to assess the association between income and control of cardiovascular risk factors one year after an ACS in a country with universal health insurance. Between 2013 and 2014, we studied 255 consecutive patients with ACS in an observational study in a university hospital in Switzerland in which self-reported household income was assessed. We classified patients into two categories based on the median income in Switzerland: higher than CHF 6000 (&amp;euro; 5300) or less than or equal to CHF 6000 (&amp;euro; 5300) per month. One year after discharge, patients were evaluated for the achievement of lipid and blood pressure targets, smoking cessation and drug adherence. Multivariate odds ratios (OR) were adjusted for age, sex, education, living status and working status. Overall, 52.2% (n = 133) of patients with ACS were in the low-income category and 47.8% (n = 122) were in the high-income category. One year after discharge, high-income patients had higher rates of smoking cessation (64.2 vs 30.1%, multivariate-adjusted odds ratio (OR) 3.82, 95% confidence interval (CI) 1.58&amp;ndash;9.24) and blood pressure target achievement (78.6 vs 60.2%, multivariate-adjusted OR 2.19, 95% CI 1.09&amp;ndash;4.41) compared to those in the low-income category. There were no differences regarding adherence to drugs or lipid control between the two income groups. A high household income was associated with a higher rate of smoking cessation and better control of blood pressure one year after ACS, independently of education, living status and working status