Near-infrared spectroscopy study of tourniquet-induced forearm ischaemia in patients with coronary artery disease

Near-Infrared Spectroscopy (NIR) can be employed to monitor local changes in haemodynamics and oxygenation of human tissues. A preliminary study has been performed in order to evaluate the NIRS transmittance response to induced forearm ischaemia in patients with coronary artery disease (CAD). The population consists in 40 patients with cardiovascular risk factors and angiographically documented CAD, compared to a group of 13 normal subjects. By inflating and subsequently deflating a cuff placed around the patient arm, an ischaemia has been induced and released, and the patients have been observed until recovery of the basal conditions. A custom LAIRS spectrometer (IRIS) has been used to collect the backscattered light intensities from the patient forearm throughout the ischaemic and the recovery phase. The time dependence of the near-infrared transmittance on the control group is consistent with the available literature. On the contrary, the magnitude and dynamics of the NIRS signal on the CAD patients show deviations from the documented normal behavior, which can be tentatively attributed to abnormal vessel stiffness. These preliminary results, while validating the performance of the IRIS spectrometer, are strongly conducive towards the applicability of the NIRS technique to ischaemia analysis and to endothelial dysfunction characterization in CAD patients with cardiovascular risk factors.Publisher PD

Earthquake source characteristics from dynamic rupture with constrained stochastic fault stress

One of the challenging tasks in predicting near-source ground motion for future earthquakes is to anticipate the spatiotemporal evolution of the rupture process. The final size of an event but also its temporal properties (propagation velocity, slip velocity) depend on the distribution of shear stress on the fault plane. Though these incipient stresses are not known for future earthquakes, they might be sufficiently well characterized in a stochastic sense. We examine the evolution of dynamic rupture in numerical models of a fault subjected to heterogeneous stress fields with varying statistical properties. By exploring the parameter space of the stochastic stress characterization for a large number of random realizations we relate generalized properties of the resulting events to the stochastic stress parameters. The nucleation zone of the simulated earthquake ruptures in general has a complex shape, but its average size is found to be independent of the stress field parameterization and is determined only by the material parameters and the friction law. Furthermore, we observe a sharp transition in event size from small to system-wide events, governed mainly by the standard deviation of the stress field. A simplified model based on fracture mechanics is able to explain this transition. Finally, we find that the macroscopic rupture parameters ( e. g., moment, moment rate, seismic energy) of our catalog of model quakes are generally consistent with observational data

Bayesian imaging of the 2000 Western Tottori (Japan) earthquake through fitting of strong motion and GPS data

We image the rupture process of the 2000 Western Tottori earthquake (Mw = 6.6) through fitting of strong motion and GPS data. We consider an observational network consisting of 18 strong motion and 16 GPS stations, located within three fault lengths from the epicentre. We assume a planar fault and compute Green's functions for a 1-D velocity model. The earthquake rupture is described as a shear dislocation parameterized in terms of peak slip velocity, rake angle, rupture time and rise time, defined on a regular grid of nodes on the fault surface and derived at inner points through bilinear interpolation. Our inversion procedure is based on a Bayesian approach. The solution of the inverse problem is stated in terms of a posterior probability density function (pdf), representing the conjunction of prior information with information contained in the data and in the physical law relating model parameters with data. Inferences on model parameters are thus expressed in terms of posterior marginal pdfs. Due to the non-linearity of the problem, we use a Markov Chain Monte Carlo (MCMC) method, based on the Metropolis algorithm, to compute posterior marginals. Except for a few cases posterior marginals do not show a Gaussian-like distribution. This prevents us from providing a mean model and from characterizing uncertainties in terms of standard deviations only. Resolution on each single parameter is analysed by looking at the difference between prior and posterior marginal pdfs. Posterior marginals indicate that the best resolved feature is a major slip patch (peak value of 311 ± 140 cm), located between the hypocentre and the top edge of the fault, centered at a depth of 4.5 km. This shallow slip patch is triggered about 3 s after the earthquake nucleated and required about 4 s to reach its final slip value. The presence of this shallow slip patch is common to all previous studies. In contrast to some previous studies, we do not identify any significant slip (>1 m) at the bottom of the fault. We also compare inferences from both strong motion and GPS data with inferences derived from strong motion data only. In both cases the shallow slip patch is identified. At other locations, the main effect of the GPS data is in reducing the probability associated with high values of slip. GPS data reduce the presence of spurious fault slip and therefore strongly influence the resulting final seismic momen

Photoexcitation in thin films deposited on silicon substrates by reactive pulsed laser ablation

Reactive pulsed laser ablation is a very interesting method to deposit thin films of several materials and compounds such as oxides, nitrides, semiconductors and superconductors. This technique relies on photoablation of pure elements, or a mixture of materials, with simultaneous exposure to a reactive atmosphere. In the case of oxides, reactions between the laser vaporized metals and oxygen lead to the formation of intermediate complexes and finally to oxide thin films. The reactivity of the plume has been already studied by our group in other oxides and nitrides productions and ascertained by Time of Flight Mass Spectrometry measurements [1].Thin films of semiconducting oxides such asIn2O3,SnO2, and multilayers of these two compounds have been deposited by Reactive Pulsed Laser Ablation, with the aim to evaluate the behaviour of such films under variable halogen lamp illumination.Deposition of these thin films has been carried out by a frequency doubled Nd-YAG laser (wavelength = 532 nm) on Silicon (100) substrates. A comparison, among indium oxide, tin oxide, and multilayers of indium and tin oxides, has been performed. The influence of physical parameters, such as substrate temperature and oxygen pressure in the deposition chamber, has been investigated. The deposited films have been characterized by Electric Resistance measurements

An electrooptical muscle contraction sensor

An electrooptical sensor for the detection of muscle contraction is described. Infrared light is injected into the muscle, the backscattering is observed, and the contraction is detected by measuring the change, that occurs during muscle contraction, between the light scattered in the direction parallel and perpendicular to the muscle cells. With respect to electromyography and to optical absorption-based sensors, our device has the advantage of lower invasiveness, of lower sensitivity to electromagnetic noise and to movement artifacts, and of being able to distinguish between isometric and isotonic contractions

Capsular closure after hip arthroscopy: our experience

BACKGROUND AND AIM OF THE WORK: In the last decade, arthroscopic treatment of hip diseases has significantly spread and evolved and currently it represents the gold standard for the treatment of femoral- acetabular impingement. In the recent years, the function of the joint capsule (and therefore the results of an arthroscopic capsulotomy) has been hugely developed, opening a heated debate. The Literature is still torn about the need for a capsular suture, but more recent studies are more oriented in its execution at the end of the surgical procedure. According to these recent studies, the joint capsule performs an essential function of primary stability, and its closure is therefore necessary to restore the native anatomy and physiology. Nevertheless, capsular management remains a controversial topic. This is a retrospective study with the aim of assessing the influence of capsular suture on the patient's functional outcome in a cohort of patients with femoral-acetabular impingement arthroscopically treated. HYPOTHESIS: Our hypothesis is that an adequate capsular suture positively influences the patient's functional outcome. METHODS AND RESULTS: 50 patients treated with hip arthroscopy for femoral-acetabular impingement have been retrospectively enrolled at the Orthopaedic Clinic of Academic Hospital of Udine during a period of two-years (2017-2018); collected data have been analysed and compared with a retrospective model. Patients have been divided into two equivalent groups, 25 treated with capsular suture, 25 without performing the suture. Patient's post-operative functional outcome has been analysed using the modified Harris Hip Score (mHHS), the Non-Arthritic Hip Score (NAHS) and the Hip Outcome Score-Sport Scale (HOS-SS). The functional outcome in patients where capsular sutures were performed was better than in non-sutured patients, in all three analysed scales. CONCLUSIONS: Capsular suture with a single side-to-side stitch at the end of the procedure can positively influence the patient's functional outcome

Total knee revision arthroplasty: comparison between tibial tubercle osteotomy and quadriceps snip approach. Complication rate

BACKGROUND AND AIM OF THE WORK: The total knee arthroplasty (TKA) revision is not a second time of primary implant surgery but is a very complex issue for orthopedic surgeon. When local conditions make necessary a greater visualization, medial para-patellar access with quadriceps snip (QS) or the osteotomy of the tibial tuberosity (TTO) can be the solutions. This work aims to compare the quadriceps snip and the detachment of the tibial tubercle, focusing on possible complications. MATERIALS AND METHODS: At our institution, between January 2017 and February 2019 52 TKA revision for periprosthetic joint infection (PJI) or aseptic mobilization were performed. In 43 cases an extensive surgical approach was required: for patients with range of movement (ROM) 60\ub0 a QS was performed. Clinical and radiological follow-up was available for all the 43 cases. RESULTS: The data about clinical outcome in our study show that both groups have a positive trend in KSS score over time with similar ROM results. Two partial avulsions of patellar tendon during revision surgery were reported. Clinical outcome in both groups has shown good results at the end of follow-up with no post-operative incidence of complications. CONCLUSION: We can assert that both QS and TTO are good approach for TKA revision. Future studies will be needed to understand if preparatory ROM is a good way to decide which surgical approach to use.(www.actabiomedica.it)

Histological analysis of ACL reconstruction failures due to synthetic-ACL (LARS) ruptures

INTRODUCTION: Anterior Cruciate Ligament (ACL) reconstruction is an established surgical procedure. Synthetic ligaments represent an option for ACL reconstruction. Their popularity declined for the raising concerns due to re-ruptures, knee synovitis and early arthritis related to I and II generation artificial ligaments. The introduction of a III generation synthetic ligament (Ligament Advanced Reinforcement System-LARS) permitted renewed interest in the adoption of this kind of graft. Main purpose of our study was to describe the histological findings on samples obtained from a consecutive series of ACL revision surgeries due to LARS ACL reconstruction failures. Secondary aim was to determine the reason for LARS rupture. METHODS: In a period between 2016 and 2018 eleven patients underwent ACL revision surgery due to LARS ACL reconstruction failure. At the time of the arthroscopic procedure, samples of synovial membrane and remnants of the torn LARS were sent to the Pathological-Anatomy Institute of our Hospital for a histological analysis. RESULTS: Histological analysis of the synovial tissues confirmed the arthroscopic evidence of synovitis mainly characterized by chronic inflammation with predominance of multinucleated giant cells. The adoption of polarized light microscopy revealed the presence of brightly bi-refractive material (LARS wear particles) in the synovial tissue; at higher magnification wear debris were detected inside the cytoplasma of multi nucleated cells. The histological analysis of the removed LARS revealed a surrounding typical foreign body reaction with poor signs of fibrovascular ingrowth of the synthetic ligament. CONCLUSIONS: Our findings could not clearly advocate a unique mechanism of LARS-ACL reconstruction failure: biologic issues (poor tissue ingrowth) and mechanical issues (fibers properties and tunnel position) probably concur in a multi factorial manner. ACL reconstruction using artificial ligaments can not be considered a simple surgery. Artificial augments require some expertise and could therefore achieve better results if used by skilled sport surgeons other than trainees or low volume surgeons. The Authors believe that ACL reconstruction with synthetic devices still have restricted indications for selected patients (e.g. elderly patients who require a fast recovery, professional athlete, autologous tendons not available and/or refusing donor tendons). Our study arises additional suspicion on the unresponsiveness of synthetic fibers and claim some concern in the implantation of synthetic devices

Automatic seismic phase picking and consistent observation error assessment: application to the Italian seismicity

Accuracy of seismic phase observation and consistency of timing error assessment define the quality of seismic waves arrival times. High-quality and large data sets are prerequisites for seismic tomography to enhance the resolution of crustal and upper mantle structures. In this paper we present the application of an automated picking system to some 600 000 seismograms of local earthquakes routinely recorded and archived by the Italian national seismic network. The system defines an observation weighting scheme calibrated with a hand-picked data subset and mimics the picking by an expert seismologist. The strength of this automatic picking is that once it is tuned for observation quality assessment, consistency of arrival times is strongly improved and errors are independent of the amount of data to be picked. The application to the Italian local seismicity documents that it is possible to automatically compile a precise, homogeneous and large data set of local earthquake Pg and Pn arrivals with related polarities. We demonstrate that such a data set is suitable for high-precision earthquake location, focal mechanism determination and high-resolution seismic tomograph

Contribution of 3H-thymidine labelling index and flow cytometric S-phase in predicting survival of patients with non-Hodgkin's lymphoma.

The 3H-thymidine labelling index (3H-dT LI) of cell suspensions from fresh material and the flow cytometric S-phase (FCM-S) of nuclei recovered from paraffin blocks were determined on the same pathologic lymph node specimen for 190 non-Hodgkin's lymphomas (NHLs). FCM-S was defined by a planimetric method and by an optimization procedure. Poor correlation coefficients were observed among the three cell kinetic variables. All three cell kinetic variables were significant indicators of 8-year survival and median survival time. The life-regression procedure evidenced a significant relative contribution of 3H-dT LI and FCM-S, thus suggesting a different biologic meaning of the two cell kinetic variables. This finding was further supported by evidence that simultaneous use of 3H-dT LI and FCM-S can identify groups of patients with different survival better than when either modality is used alone. Multivariate analysis indicated that the risk groups as defined by cell kinetic variables are predictors of survival even in the presence of established factors such as histology and stage