ICR in human cadaveric specimens: An essential parameter to consider in a new lumbar disc prosthesis design

[EN] Study design Biomechanical study in cadaveric specimens. Background The commercially available lumbar disc prostheses do not reproduce the intact disc's Instantaneous centre of Rotation (ICR), thus inducing an overload on adjacent anatomical structures, promoting secondary degeneration. Aim To examine biomechanical testing of cadaveric lumbar spine specimens in order to evaluate and define the ICR of intact lumbar discs. Material and Methods Twelve cold preserved fresh human cadaveric lumbosacral spine specimens were subjected to computerized tomography (CT), magnetic resonance imaging (MRI) and biomechanical testing. Kinematic studies were performed to analyse range of movements in order to determine ICR. Results Flexoextension and lateral bending tests showed a positive linear correlation between the angle rotated and the displacement of the ICR in different axes. Discussion ICR has not been taken into account in any of the available literature regarding lumbar disc prosthesis. Considering our results, neither the actual ball-and-socket nor the withdrawn elastomeric nucleus models fit the biomechanics of the lumbar spine, which could at least in part explain the failure rates of the implants in terms of postoperative failed back syndrome (low back pain). It is reasonable to consider then that an implant should also adapt the equations of the movement of the intact ICR of the joint to the post-surgical ICR. Conclusions This is the first cadaveric study on the ICR of the human lumbar spine. We have shown that it is feasible to calculate and consider this parameter in order to design future prosthesis with improved clinical and biomechanical characteristics.Vanaclocha-Saiz, A.; Atienza Vicente, CM.; Vanaclocha, V.; Belloch, V.; Santabarbara, JM.; Jordá-Gómez, P.; Vanaclocha, L. (2020). ICR in human cadaveric specimens: An essential parameter to consider in a new lumbar disc prosthesis design. North American Spine Society Journal. 2:1-8. https://doi.org/10.1016/j.xnsj.2020.100016S18

Bionate Lumbar Disc Nucleus Prosthesis : Biomechanical Studies in Cadaveric Human Spines

Design: cadaveric spine nucleus replacement study. Objective: determining Bionate 80A nucleus replacement biomechanics in cadaveric spines. Methods: in cold preserved spines, with ligaments and discs intact, and no muscles, L3-L4, L4-L5, and L5-S1 nucleus implantation was done. Differences between customized and overdimensioned implants were compared. Flexion, extension, lateral bending, and torsion were measured in the intact spine, nucleotomy, and nucleus implantation specimens. Increasing load or bending moment was applied four times at 2, 4, 6, and 8 Nm, twice in increasing mode and twice in decreasing mode. Spine motion was recorded using stereophotogrammetry. Expulsion tests: cyclic compression of 50-550 N for 50,000 cycles, increasing the load until there was extreme flexion, implant extrusion, or anatomical structure collapse. Subsidence tests were done by increasing the compression to 6000 N load. Results: nucleotomy increased the disc mobility, which remained unchanged for the adjacent upper level but increased for the lower adjacent one, particularly in lateral bending and torsion. Nucleus implantation, compared to nucleotomy, reduced disc mobility except in flexion-extension and torsion, but intact mobility was no longer recovered, with no effect on upper or lower adjacent segments. The overdimensioned implant, compared to the customized implant, provided equal or sometimes higher mobility. Lamina, facet joint, and annulus removal during nucleotomy caused more damaged than that restored by nucleus implantation. No implant extrusion was observed under compression loads of 925-1068 N as anatomical structures collapsed before. No subsidence or vertebral body fractures were observed under compression loads of 6697.8-6812.3 N. Conclusions: nucleotomized disc and L1-S1 mobility increased moderately after cadaveric spine nucleus implantation compared to the intact status, partly due to operative anatomical damage. Our implant had shallow expulsion and subsidence risks

Nucleus disc replacement : designs and material selection FEA analysis

Study design. Material selection, implant design and Finite Element Analysis (FEA) studies. Background. Nucleus disc replacements, implanted since 1960, have undergone continuous evolution in materials and designs, but subsidence, extrusion, and in vivo degradation limit widespread use. Aim: To create a new nucleus disc replacement that avoids the abovementioned drawbacks. Material and Methods. We created eighteen designs with varied materials and analyzed them with FEA in compression and shear tests in a lumbar spine model programmed in Ansys Parametric Design Language. Results. Bionate® 80A had the closest mechanical characteristics to the intact disc nucleus. Monobloc designs bore the physiological stresses correctly but suffered significant deformations with permanent damage during surgical insertion through the annulus opening. In addition, sandwich designs were too rigid and had an unreliable curing process. Therefore, we chose an oval doughnut-like 5 mm wall monobloc Bionate® 80A nucleus replacement. It minimized implant stress in loading, distributed the loads uniformly, and tolerated the lateral compression during implantation. Conclusions. Out of the eighteen designs we analyzed with FEA, we found that the monobloc oval doughnut-like Bionate 80A nucleus replacement reproduced best the biomechanics of the natural disc nucleus and had the lowest subsidence risk as it transmits the load to the ring apophysis. Furthermore, due to its elasticity implanting it through the average annulotomy required to perform a lumbar microdiscectomy should be possible

A Large Multicenter Prospective Study of Community-Onset Healthcare Associated Bacteremic Urinary Tract Infections in the Era of Multidrug Resistance: Even Worse than Hospital Acquired Infections?

Introduction: Healthcare-associated (HCA) infections represent a growing public health problem. The aim of this study was to compare community-onset healthcare associated (CO-HCA) bacteremic urinary tract infections (BUTI) and hospital-acquired (HA)-BUTI with special focus on multidrug resistances (MDR) and outcomes. Methods: ITUBRAS-project is a prospective multicenter cohort study of patients with HCA-BUTI. All consecutive hospitalized adult patients with CO-HCA-BUTI or HA-BUTI episode were included in the study. Exclusion criteria were: patients \ 18 years old, non-hospitalized patients, bacteremia from another source or primary bacteremia, non-healthcare related infections and infections caused by unusual pathogens of the urinary tract. Th main outcome variable was 30-day all-cause mortality with day 1 as the first day of positive blood culture. Logistic regression was used to analyze factors associated with clinical cure at hospital discharge and with receiving inappropriate initial antibiotic treatment. Cox regression was used to evaluate 30-day all-cause mortality. Results: Four hundred forty-three episodes were included, 223 CO-HCA-BUTI. Patients with CO-HCA-BUTI were older (p \ 0.001) and had more underlying diseases (p = 0.029) than those with HA-BUTI. The severity of the acute illness (Pitt score) was also higher in CO-HCABUTI (p = 0.026). Overall, a very high rate of MDR profiles (271/443, 61.2%) was observed, with no statistical differences between groups. In multivariable analysis, inadequate empirical treatment was associated with MDR profile (aOR 3.35; 95% CI 1.77?6.35), Pseudomonas aeruginosa (aOR 2.86; 95% CI 1.27?6.44) and Charlson index (aOR 1.11; 95% CI 1.01?1.23). Mortality was not associated with the site of acquisition of the infection or the presence of MDR profile. However, in the logistic regression analyses patients with CO-HCA-BUTI (aOR 0.61; 95% CI 0.40?0.93) were less likely to present clinical cure. Conclusion: The rate of MDR infections was worryingly high in our study. No differences in MDR rates were found between CO-HCA-BUTI and HA-BUTI, in the probability of receiving inappropriate empirical treatment or in 30-day mortality. However, CO-HCA-BUTIs were associated with worse clinical cure.Funding. This study and the journal’s Rapid Service Fee are sponsored and funded by MSD Spain. The study was also supported by Plan Nacional de I+D+i 2013–2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía, Industria y Competitividad, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0004, RD16/ 0016/0005, RD16/0016/0007, RD16/0016/0010, RD16/0016/0011 and RD16/0016/0015), co-financed by the European Development Regional Fund ‘A way to achieve Europe’ (ERDF), Operative program Intelligent Growth 2014–2020

CMS tracking performance results from early LHC operation

The first LHC pp collisions at centre-of-mass energies of 0.9 and 2.36 TeV were recorded by the CMS detector in December 2009. The trajectories of charged particles produced in the collisions were reconstructed using the all-silicon Tracker and their momenta were measured in the 3.8 T axial magnetic field. Results from the Tracker commissioning are presented including studies of timing, efficiency, signal-to-noise, resolution, and ionization energy. Reconstructed tracks are used to benchmark the performance in terms of track and vertex resolutions, reconstruction of decays, estimation of ionization energy loss, as well as identification of photon conversions, nuclear interactions, and heavy-flavour decays

First measurement of the underlying event activity at the LHC with √ = 0.9 TeV

A measurement of the underlying activity in scattering processes with p T scale in the GeV region is performed in proton?proton collisions at s?=0.9?=0.9 TeV, using data collected by the CMS experiment at the LHC. Charged particle production is studied with reference to the direction of a leading object, either a charged particle or a set of charged particles forming a jet. Predictions of several QCD-inspired models as implemented in PYTHIA are compared, after full detector simulation, to the data. The models generally predict too little production of charged particles with pseudorapidity |?|0.5 GeV/c, and azimuthal direction transverse to that of the leading object

Measurement of the charge ratio of atmospheric muons with the CMS detector

We present a measurement of the ratio of positive to negative muon fluxes from cosmic ray interactions in the atmosphere, using data collected by the CMS detector both at ground level and in the underground experimental cavern at the CERN LHC. Muons were detected in the momentum range from 5 GeV/c to 1 TeV/c. The surface flux ratio is measured to be 1.2766 ± 0.0032 (stat.) ± 0.0032 (syst.), independent of the muon momentum, below 100 GeV/c. This is the most precise measurement to date. At higher momenta the data are consistent with an increase of the charge ratio, in agreement with cosmic ray shower models and compatible with previous measurements by deep-underground experimentsWe thank the technical and administrative staff at CERN and other CMS institutes. This work was supported by the Austrian Federal Ministry of Science and Research; the Belgium Fonds de la Recherche Scientifique, and Fonds voor Wetenschappelijk Onderzoek; the Brazilian Funding Agencies (CNPq, CAPES, FAPERJ, and FAPESP); the Bulgarian Ministry of Education and Science; CERN; the Chinese Academy of Sciences, Ministry of Science and Technology, and National Natural Science Foundation of China; the Colombian Funding Agency (COLCIENCIAS); the Croatian Ministry of Science, Education and Sport; the Research Promotion Foundation, Cyprus; the Estonian Academy of Sciences and NICPB; the Academy of Finland, Finnish Ministry of Education, and Helsinki Institute of Physics; the Institut National de Physique Nucléaire et de Physique des Particules/CNRS, and Commissariat à l'Énergie Atomique, France; the Bundesministerium für Bildung und Forschung, Deutsche Forschungsgemeinschaft, and Helmholtz–Gemeinschaft Deutscher Forschungszentren, Germany; the General Secretariat for Research and Technology, Greece; the National Scientific Research Foundation, and National Office for Research and Technology, Hungary; the Department of Atomic Energy, and Department of Science and Technology, India; the Institute for Studies in Theoretical Physics and Mathematics, Iran; the Science Foundation, Ireland; the Istituto Nazionale di Fisica Nucleare, Italy; the Korean Ministry of Education, Science and Technology and the World Class University program of NRF, Korea; the Lithuanian Academy of Sciences; the Mexican Funding Agencies (CINVESTAV, CONACYT, SEP, and UASLP-FAI); the Pakistan Atomic Energy Commission; the State Commission for Scientific Research, Poland; the Fundação para a Ciência e a Tecnologia, Portugal; JINR (Armenia, Belarus, Georgia, Ukraine, Uzbekistan); the Ministry of Science and Technologies of the Russian Federation, and Russian Ministry of Atomic Energy; the Ministry of Science and Technological Development of Serbia; the Ministerio de Ciencia e Innovación, and Programa Consolider-Ingenio 2010, Spain; the Swiss Funding Agencies (ETH Board, ETH Zurich, PSI, SNF, UniZH, Canton Zurich, and SER); the National Science Council, Taipei; the Scientific and Technical Research Council of Turkey, and Turkish Atomic Energy Authority; the Science and Technology Facilities Council, UK; the US Department of Energy, and the US National Science Foundation. Individuals have received support from the Marie-Curie IEF program (European Union); the Leventis Foundation; the A.P. Sloan Foundation; the Alexander von Humboldt Foundation; and the Associazione per lo Sviluppo Scientifico e Tecnologico del Piemonte (Italy)

Transverse-Momentum and Pseudorapidity Distributions of Charged Hadrons in pp Collisions at √s=7 TeV

Charged-hadron transverse-momentum and pseudorapidity distributions in proton-proton collisions at √s=7  TeV are measured with the inner tracking system of the CMS detector at the LHC. The charged-hadron yield is obtained by counting the number of reconstructed hits, hit pairs, and fully reconstructed charged-particle tracks. The combination of the three methods gives a charged-particle multiplicity per unit of pseudorapidity dNch/dηη|<0.5=5.78±0.01(stat)±0.23(syst) for non-single-diffractive events, higher than predicted by commonly used models. The relative increase in charged-particle multiplicity from √s=0.9 to 7 TeV is [66.1±1.0(stat)±4.2(syst)]%. The mean transverse momentum is measured to be 0.545±0.005(stat)±0.015(syst)  GeV/c. The results are compared with similar measurements at lower energies

Transverse-momentum and pseudorapidity distributions of charged hadrons in pp collisions at √s = 0.9 and 2.36TeV

Measurements of inclusive charged-hadron transverse-momentum and pseudorapidity distributions are presented for proton-proton collisions at s?=0.9?=0.9 and 2.36 TeV. The data were collected with the CMS detector during the LHC commissioning in December 2009. For non-single-diffractive interactions, the average charged-hadron transverse momentum is measured to be 0.46 ± 0.01 (stat.) ± 0.01 (syst.) GeV/c at 0.9 TeV and 0.50 ± 0.01 (stat.) ± 0.01 (syst.) GeV/c at 2.36 TeV, for pseudorapidities between --2.4 and +2.4. At these energies, the measured pseudorapidity densities in the central region, dN ch/d?||?|<0.5, are 3:48 ± 0:02 (stat.) ± 0.13 (syst.) and 4:47 ± 0:04 (stat.) ± 0.16 (syst.), respectively. The results at 0.9 TeV are in agreement with previous measurements and confirm the expectation of near equal hadron production in p¯¯¯p?¯? and pp collisions. The results at 2.36 TeV represent the highest-energy measurements at a particle collider to date

El Castru (Vigaña, Balmonte de Miranda, Asturias): un pequeño poblado fortificado de las montañas occidentales cantábricas durante la Edad del Hierro

p. 211-237Este artículo presenta los datos arqueológicos recuperados en las excavaciones del poblado castreño de El Castru, en Vigaña (Balmonte de Miranda, Asturias) realizadas en 2012 y 2013. Dicho yacimiento constituye un buen ejemplo de los pequeños castros de la Edad del Hierro en las montañas del área occidental cantábrica. Por ello, el análisis de las informaciones obtenidas y su contextualización a escala regional ofrecen interesantes aportaciones al debate sobre las formas de poblamiento y subsistencia adoptadas por las comunidades del I milenio a.C. en el Noroeste ibérico.S