Postoperative spine infections

Postoperative spinal wound infection is a potentially devastating complication after operative spinal procedures. Despite the uti- lization of perioperative prophylactic antibi- otics in recent years and improvements in sur- gical technique and postoperative care, wound infection continues to compromise patients’ outcome after spinal surgery. In the modern era of pending health care reform with increasing financial constraints, the financial burden of post-operative spinal infections also deserves consideration. The aim of our work is to give to the reader an updated review of the latest achievements in prevention, risk factors, diagnosis, microbiology and treatment of post- operative spinal wound infections. A review of the scientific literature was carried out using electronic medical databases Pubmed, Google Scholar, Web of Science and Scopus for the years 1973-2012 to obtain access to all publica- tions involving the incidence, risk factors, pre- vention, diagnosis, treatment of postoperative spinal wound infections. We initially identified 119 studies; of these 60 were selected. Despite all the measures intended to reduce the inci- dence of surgical site infections in spine sur- gery, these remain a common and potentially dangerous complication

Relationship of white and gray matter abnormalities to clinical and genetic features in myotonic dystrophy type 1

AbstractBackgroundMyotonic dystrophy type 1 (DM1) represents a multisystemic disorder in which diffuse brain white and gray matter alterations related to clinical and genetic features have been described. We aimed to evaluate in the brain of adult patients with DM1 (i) white and gray matter differences, including cortical-subcortical gray matter volume and cortical thickness and (ii) their correlation with clinical disability, global neuropsychological performance and triplet expansion.MethodsWe included 24 adult genetically-confirmed DM1 patients (14 males; age: 38.5±11.8years) and 25 age- and sex-matched healthy controls (14 males; age: 38.5±11.3years) who underwent an identical brain MR protocol including high-resolution 3D T1-weighted, axial T2 FLAIR and DTI sequences. All patients underwent an extensive clinical and neuropsychological evaluation. Voxel-wise analyses of white matter, performed by using Tract Based Spatial Statistics, and of gray matter, with Voxel-based Morphometry and Cortical Thickness, were carried out in order to test for differences between patients with DM1 and healthy controls (p<0.05, corrected). The correlation between MRI measures and clinical-genetic features was also assessed.ResultsPatients with DM1 showed widespread abnormalities of all DTI parameters in the white matter, which were associated with reduced gray matter volume in all brain lobes and thinning in parieto-temporo-occipital cortices, albeit with less extensive cortical alterations when congenital cases were removed from the analyses. White matter alterations correlated with clinical disability, global cognitive performance and triplet expansions.ConclusionIn patients with DM1, the combined smaller overall gray matter volume and white matter alterations seem to be the main morpho-structural substrates of CNS involvement in this condition. The correlation of white matter differences with both clinical and genetic findings lends support to this notion

Calcium mishandling in absence of primary mitochondrial dysfunction drives cellular pathology in Wolfram Syndrome

Wolfram syndrome (WS) is a recessive multisystem disorder defined by the association of diabetes mellitus and optic atrophy, reminiscent of mitochondrial diseases. The role played by mitochondria remains elusive, with contradictory results on the occurrence of mitochondrial dysfunction. We evaluated 13 recessive WS patients by deep clinical phenotyping, including optical coherence tomography (OCT), serum lactic acid at rest and after standardized exercise, brain Magnetic Resonance Imaging, and brain and muscle Magnetic Resonance Spectroscopy (MRS). Finally, we investigated mitochondrial bioenergetics, network morphology, and calcium handling in patient-derived fibroblasts. Our results do not support a primary mitochondrial dysfunction in WS patients, as suggested by MRS studies, OCT pattern of retinal nerve fiber layer loss, and, in fibroblasts, by mitochondrial bioenergetics and network morphology results. However, we clearly found calcium mishandling between endoplasmic reticulum (ER) and mitochondria, which, under specific metabolic conditions of increased energy requirements and in selected tissue or cell types, may turn into a secondary mitochondrial dysfunction. Critically, we showed that Wolframin (WFS1) protein is enriched at mitochondrial-associated ER membranes and that in patient-derived fibroblasts WFS1 protein is completely absent. These findings support a loss-of-function pathogenic mechanism for missense mutations in WFS1, ultimately leading to defective calcium influx within mitochondria

TRANSIENT/PERMANENT CHIRALITY: ROTATIONAL SPECTRA OF THE DIMERS OF ISOPROPANOL

Author Institution: Dipartimento di Chimica "G. Ciamician" dell'Universita, Via Selmi 2, I-40126 Bologna, Italy\begin{wrapfigure}[11]{r}{6cm} \vspace{-.5cm} \hspace*{-0cm} %\epsfig{file=Modello.eps} \vspace{3mm} enterline{\epsfig{figure=Modello.eps,width=6cm}} \end{wrapfigure} The two mirror images of gauche isopropanol are connected through the low energy barrier of the OH torsion potential energy surface. This produces large tunnelling splittings in the rotational spectrum, and we can talk of transient chirality. We assigned the rotational spectra of five conformers of the dimer of isopropanol, all of them involving at least one gauche monomer (see the Figure to the right). The inertial effects quench the tunneling and, in the time scale of MW spectroscopy, all these systems appear as made of a pair of "classical" enantiomers. From the relative intensities of the rotational transitions of the various conformers it has been possible to estimate their relative abundances. Some interesting features related to the molecular recognition, dynamic of formation of the dimers in the supersonic expansion and sizing of the Ubbelohde effect will be discussed

A new scanner for in situ digital radiography of paintings

X-ray radiography is one of the most widely used imaging techniques in the field of cultural heritage, both for conservation and for investigation purposes. Performing radiographies in museums, thus avoiding movements of works of art, has been recently made easy by digital acquisition of images, but when the whole scan of a large painting is required, technical solutions for a portable device are still not at hand. The inherent weight of the X-ray tube and of the high-voltage generator makes the design of a portable device very difficult. In this project, the solution of the puzzle was separating devices devoted to different tasks, in order to maintain each item under 60 kg weight, thus being transportable with reasonable effort

The Structure of Hydrogenated Amorphous Silicon-Carbon Alloys as Investigated by Exafs

ABSTRACTWe have studied the local structure of hydrogenated amorphous silicon-carbon alloy films, a-Si1−xCx:H, by measuring the extended x-ray absorption fine-structure (EXAFS) at the Si K edge.We find that first coordination shell average bond lengths are 2.35 Å for Si-Si and 1.86 Å for Si-C and are constant with concentration to within × 0.015 Å.By comparing the composition of the first coordination shell around Si with the average concentration we show that the alloy tends to be chemically ordered, in that heteroatomic bonds are preferred

Influence of visual aspects and other features on the soundscape assessment of a university external area

EU Environmental Noise Directive recognized the importance of identifying and preserving quiet areas. Even if the majority of EU member states have not yet defined what is a quiet area, many researchers have started to investigate the topic using the so-called soundscape approach. Designing or preserving a quiet area in urban settings can be a challenging task. Schools and universities located in urban areas are often surrounded by areas with high traffic and noise pollution that affect the overall and sonic quality of the external spaces, which should represent pleasant areas where students can relax or study. In this study, the assessment of the soundscape and of the overall environment of the external area of the Literature Department of Roma TRE University (Italy) was investigated and discussed by analysing the acoustic, psychoacoustic and perceptual data collected. The results obtained by a summer measurement campaign were compared with the previous winter outcomes. Moreover, it was investigated how natural features, visual aspects and thermal conditions can affect the users' judgment about the overall and the sonic environment; in particular, the Tranquility Rating Prediction Tool was evaluated, both in winter and summer. The measurements campaign revealed that the obtained values are comparable under winter and summer conditions. Due to this, the differences observed in the perception of the sonic and overall environment are ascribable to higher human voice component, more pleasant visual aspects and climate conditions during the summer. This trend was confirmed by tranquility rating values

A new scanner for in-situ digital radiography of paintings

X-ray radiography is one of the most widely used imaging techniques in the field of Cultural Heritage, both for conservation and investigation purposes. Performing radiographies in museums, thus avoiding movements of works of art, has been recently made easy by digital acquisition of images, but when the whole scan of a large painting is required, technical solutions for a portable device are still not at hand. The inherent weight of the X-ray tube, including protection shields, and of the high voltage generator makes the design of a “portable” device very difficult. In this project the solution of the puzzle was separating devices devoted to different tasks, in order to maintain each item under 50 kg weight, thus being transportable with minimum effort. The proper RX scanner is composed of two independent frames (Fig.1) in aluminium, carrying and moving the X-ray tube and the digital detector. For both units, a couple of DC servomotors (G5© by Omron Electronics Ltd, UK) are driving the movements on X and Y axis. A third frame is added, to support the painting. The distance between the two units is usually set at 1 m and the work of art is located as close as possible to the detector, to minimize magnification and penumbra effects. Both units may be moved or installed on a scaffold, to scan wider paintings. Levelling of the frames and alignment of X-ray beam with detector is performed by setting the levelling feet, collimating the beam with a small pinhole. Once aligned the units, the scan is automatically performed by remote control of motion, on horizontal and vertical axis, by dedicated software (NS-Runtime© rel.1.2 by Omron Co.). X-ray tube and detector move simultaneously and stop at the foreseen position for image acquisition. X-ray shot and digital acquisition follow, then the following position is reached. The scan is tailored to each painting, and the digital images are automatically stitched at the end of the scan. For instance, a painting of size 1 x 1 m2 requires 144 shots and about 3-hour scan. The stitching is a matter of few minutes. The X-ray tube is a Varian M-143T with tungsten anode, maximum anode voltage 49 kV, air cooled. The detector is a Teledyne DALSA (Canada) RadEye200, a two dimensional CMOS photodiode array combined with a Gd2O2S scintillator screen. It is composed of 1024 x 1000 pixel, of side length 96 µm. Depth of digitization is 12 bit/pixel. The scanning system has been designed, realized and tested. It has proved to recover each position in the scan within one pixel width and to be stable during all acquisitions

X-RAY IMAGING FOR CONTEMPORARY ART: "PAOLO E FRANCESCA" BY G. PREVIATI (FERRARA, 1909)

X-ray radiography provides information about the conservation state, the artistic technique and the presence of pentimenti or paintings underlying the visible one [1]. In recent times, the introduction of organic pigments and artistic materials with low Z elements has limited the use of radiography: the possibility to see something related to the pictorial layer is lower, due to the less radiopacity of the materials employed. However, in some cases, X-ray radiography can be helpful also for modern and contemporary art, not only for restoration purposes. It’s the case of “Paolo e Francesca”, depicted in 1909 by Gaetano Previati, the most important Italian divisionist artist. The canvas of big dimensions (2.60 x 2.30 m2) represents the two protagonists embraced in the whirl of the hell, described by Dante in the Canto V of the Divine Comedy. The request for the whole radiography has come for restoration purposes, in order to prepare the work of art for the exhibition in Ferrara in March 2018. The digital radiography of the painting has been performed directly in situ, by means of the portable radiographic scanner developed at the University of Ferrara [4]. The scanner is composed of two units, one dedicated to the digital detector and one to the X-ray source. It is easy transportable, thanks to its dimensions (1.40 x 1.53 x 0.74 m) and weight (55 kg each unit), and scans an area of 1 m2. However, it is possible to get the whole size radiography of paintings of any dimension, because there are no mechanical bound between the two units. Furthermore, the radiographic scanner is very adaptable: for “Paolo e Francesca” only the detector stage has been used, placing it in front of a new X-ray tube not yet included in the other stage. The detector moved in order to scan an area (74 x 94 cm or 74 x 63 cm) of the canvas, while the X-ray tube was stationary, illuminating the same area. To collect all the radiographic images needed to reconstruct the whole painting (1137), the acquisition has been divided in 12 squares (108 or 72 images per square): 3 rows and 4 columns. For the acquisition of the images of the central row, the detector unit and the X-ray tube have been lifted. The digital detector (a CMOS matrix of photodiodes coupled with a scintillator screen, 1024 x 1000 pixel, 96 µm side) allows the immediate control of the images setting the best parameters of exposure. Then, the depth of digitization at 12 bit/pixel involves a huge range of grey levels, which means more information achieved than films or fluorescent screens. Finally, the digital correction of images gives more uniformity in the final radiographic images, eliminating the contribution of the uneven irradiation in different areas of the paintings. Furthermore, no segmentation is visible thanks to the digital stitching between the images. But the biggest advantage of the digital images is that they can be processed in order to eliminate the contributions of stretchers on canvas paintings, which can make the radiography not easy to read. Having digital images with such a huge range of grey levels allows to choose the best contrast for the wooden areas, similar to the canvas ones, with no loss of information and with no counterfeit. The whole radiography of the Previati’s painting has been corrected in this way and the read ability of the radiographic pictorial layer is improved. The final radiography of “Paolo e Francesca” revealed a lot of pentimenti, through all the scene. Looking at the radiography, it’s possible to see the former edition depicted by Previati of “Paolo e Francesca”, so reconstructing the evolution of the artist’s creativity

Urban soundscape analysis: the case study of the Department of Human Arts of Roma Tre University

The European Directive 2002/49/CE, and the following Italian Legislative Decree 194/2005, are aimed to protect the acoustic quality of “quiet areas”, even though they do not identify any methodological criterion for the definition of these areas. Quiet areas have the unique function of resting places where the urban noise affecting people during daily life is temporarily interrupted and for this reason many soundscape studies have focused on these areas. This function should be protected also in the open spaces of schools and universities, which may assume the role of resting areas and places of discussion and education. Because of their urban settlement, schools and universities are often surrounded by areas with a high noise pollution that may compromise their good acoustic quality. The paper presents the methodology and the first results of a wide socio-acoustic survey performed in the external area of the Department of Languages, Philosophy and Human Arts of Roma Tre University, located in the Ostiense district, and surrounded by three streets characterized by high traffic flows. The area has various functions, is delimited by different University buildings, is frequently attended by students and characterized by a car park, some green areas and a courtyard with a fountain. The study included both the acquisition of data thanks to ad hoc polls and experimental measurements. The users of the external space of the Department, mainly students, were asked to answer a specific questionnaire on the acoustic and overall environmental quality of the area. The acoustics measurements, which consisted of noise recordings in various fixed positions and binaural registrations performed during the hours of utilization of the open space in different positions, allowed the description of the environmental noise through both the traditional indicators of environmental acoustics and psychoacoustic parameters, which are more linked to sound perception. The paper describes the adopted methodology, the results obtained thanks to questionnaires and measurements and gives finally the soundscape map of the area, along with some soundscape design solutions