Muscle fatty infiltration in rotator cuff tears: Descriptive analysis of 1688 cases

SummaryIntroductionFatty infiltration (FI) is an important prognosis factor in the anatomical and functional outcomes of rotator cuff repairs. The objective of this study was to analyze the natural history of muscle FI and better evaluate its onset and aggravation time frame.Material and methodsA total of 1688 medical charts of patients operated on for rotator cuff tear and whit a preoperative CT arthrogram (82%) or an MRI (18%) were reviewed. Surgery was performed between 1988 and 2005. The FI of each muscle was assessed as minimal (in Goutallier's stages 0 and 1), intermediate (in stage 2), and severe (in stages 3 and 4). Regarding supraspinatus, we retained the mean FI observed in the sagittal, coronal, and axial planes; for the infraspinatus and the subscapularis, we retained the observed mean on two views at the upper and lower levels of the glenoid in the axial plane.ResultsWe found a statistically significant correlation (p<0.0005) between FI, the type of tendon lesion, and patient age for the supraspinatus, the infraspinatus, and the subscapularis. Statistically, the FI significantly increased (p<0.0005) with time elapsed for the supraspinatus and the infraspinatus but not significantly for the subscapularis. The mean time to tendon rupture observed for intermediate FI was three years for the supraspinatus and 2.5 years for the infraspinatus and the subscapularis when their tendons ruptured. The mean time observed to severe FI was five, four, and three years for the supraspinatus, the infraspinatus, and the subscapularis, respectively.Discussion and conclusionThe more extensive the lesion, the longer the time following rupture, and the older the patient is, the more severe the FI is. The objective of surgery is to intervene before intermediate FI sets in, which means irreversible functional loss.Level of evidence: Level IV. Diagnostic Retrospective Study

Complications and Intraoperative Fractures in Reverse Shoulder Arthroplasty: A Systematic Review

Introduction: The reverse shoulder arthroplasty is nowadays a treatment option for a variety of shoulder problems. As its incidence rose, also the number of complications increased, including intraoperative fractures. Significance: We performed a systematic review and critical analysis of the current literature following the PRISMA guidelines. Our purpose was to: 1) determine incidence, causes, and characteristics of intraoperative fractures; 2) evaluate their current treatment options, possible related complications, reoperation rates, and the patients’ outcome; and 3) determine the overall incidence of each complication related to reverse shoulder arthroplasty. The articles were selected from PubMed medical database in April 2020 using a comprehensive search strategy. Rayyan software was used to support the selection process of the records. A descriptive and critical analysis of the results was performed. Results: The study group included a total of 13,513 reverse shoulder arthroplasty procedures. The total number of complications was 1647 (rate 12.1%). The most common complication was dislocation (340 cases, rate 2.5%). Forty-six studies reported a total of 188 intraoperative fractures among the complications (rate 1.4%). The intraoperative fracture rate was 2.9% and 13.6% in primary and revision settings, respectively. There were 136 humeral fractures, 60% of them occurred in revision RSAs, during the removal of the previous implant, and involved the shaft in the majority of cases (39%). Glenoid fractures were 51 and occurred mostly during the reaming of the glenoid. We observed 7 further related complications (rate of 4%) and 3 reoperations (rate of 1.5%). The outcome was satisfactory in the majority of cases. Conclusions: A comprehensive review on intraoperative fractures in reverse shoulder arthroplasties is presented. Results suggest favorable outcomes for all treatment methods, with a modest further complication rate. This investigation may aid in the treatment decision-making for these complications

Diagnostic value of transvaginal 'tenderness-guided' ultrasonography for the prediction of location of deep endometriosis

BACKGROUND: The aim was to evaluate the diagnostic accuracy of transvaginal tenderness-guided ultrasonography in the identification of location of deep endometriosis. METHODS: Consecutive women scheduled for surgery in our Department for clinically suspected endometriosis were included in this prospective study. All women underwent modified transvaginal ultrasonography using a stand-off in the week before surgery, which also evaluated the painful sites evocated by a gentle pressure of the probe. Five locations of deep endometriosis were considered: vaginal walls, rectovaginal septum, rectosigmoid involvement, uterosacral ligaments and anterior compartment (anterior pouch and/or bladder). Sensitivity, specificity and likelihood ratios (LR1/2) were calculated with 95% confidence intervals (CIs). RESULTS: We included 88 women; surgery associated with histopathological evaluation revealed deep endometriosis in different pelvic locations in 72 patients. With respect to the vaginal walls, transvaginal ultrasonography had a sensitivity of 91% (95% CI, 79 –97%), specificity of 89% (95% CI, 81–93%), an LR1 of 8.2 and an LR2 of 0.09. For endometriosis of rectovaginal septum, transvaginal ultrasonography had a sensitivity of 74% (95% CI, 64–80%), specificity of 88% (95% CI, 4–8%), an LR1 of 6.2 and an LR2 of 0.3. For other locations, the sensitivity was lower (ranging from 67% to 33%) with a comparable specificity. CONCLUSIONS: This technique shows a high specificity and sensitivity in the detection of vaginal and rectovaginal endometriosis. Good specificity associated with a lower sensitivity was obtained in the diagnosis of deep endometriosis of uterosacral ligaments, rectosigmoid involvement or anterior deep endometriosis

WSN hardware for automotive applications: Preliminary results for the case of public transportation

The ubiquitous nature and great potential of Wireless Sensors Network has not yet been fully exploited in automotive applications. This work deals with the choice of the cost-effective hardware required to face the challenges and issues proposed by the new trend in the development of intelligent transportation systems. With this aim, a preliminary WSN architecture is proposed. Several commercially available open-source platforms are compared and the Raspberry Pi stood out as a suitable and viable solution. The sensing layer is designed with two goals. Firstly, accelerometric, temperature, and relative humidity sensors were integrated on a dedicated PCB to test if mechanical or environmental stresses during bus rides could be harmful to the device or to its performances. The physical quantities are monitored automatically to alert the driver, thus improving the quality of service. Then, the rationale and functioning of the management and service layer is presented. The proposed cost-effective WSN node was employed and tested to transmit messages and videos, while investigating if any quantitative relationship exists between these operations and the environmental and operative conditions experienced by the hardware

A wireless sensors network for monitoring the Carasau bread manufacturing process

This work copes with the design and implementation of a wireless sensors network architecture to automatically and continuously monitor, for the first time, the manufacturing process of Sardinian Carasau bread. The case of a traditional bakery company facing the challenge of the Food-Industry 4.0 competitiveness is investigated. The process was analyzed to identify the most relevant variables to be monitored during the product manufacturing. Then, a heterogeneous, multi-tier wireless sensors network was designed and realized to allow the real-time control and the data collection during the critical steps of dough production, sheeting, cutting and leavening. Commercial on-the-shelf and cost-effective integrated electronics were employed, making the proposed approach of interest for many practical cases. Finally, a user-friendly interface was provided to enhance the understanding, control and to favor the process monitoring. With the wireless senors network (WSN) we designed, it is possible to monitor environmental parameters (temperature, relative humidity, gas concentrations); cinematic quantities of the belts; and, through a dedicated image processing system, the morphological characteristics of the bread before the baking. The functioning of the WSN was demonstrated and a statistical analysis was performed on the variables monitored during different seasons

Cognitive conflicts in major depression : Between desired change and personal coherence

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposesThe notion of intrapsychic conflict has been present in psychopathology for more than a century within different theoretical orientations. However, internal conflicts have not received enough empirical attention, nor has their importance in depression been fully elaborated. This study is based on the notion of cognitive conflict, understood as implicative dilemma (ID), and on a new way of identifying these conflicts by means of the Repertory Grid Technique. Our aim was to explore the relevance of cognitive conflicts among depressive patientsPeer reviewedFinal Published versio

Environmental and Oceanographic Conditions at the Continental Margin of the Central Basin, Northwestern Ross Sea (Antarctica) since the Last Glacial Maximum

The continental margin is a key area for studying the sedimentary processes related to the advance and retreat of the Ross Ice Shelf (Antarctica); nevertheless, much remains to be investigated. The aim of this study is to increase the knowledge of the last glacial/deglacial dynamics in the Central Basin slope–basin system using a multidisciplinary approach, including integrated sedimentological, micropaleontological and tephrochronological information. The analyses carried out on three box cores highlighted sedimentary sequences characterised by tree stratigraphic units. Collected sediments represent a time interval from 24 ka Before Present (BP) to the present time. Grain size clustering and data on the sortable silt component, together with diatom, silicoflagellate and foraminifera assemblages indicate the influence of the ice shelf calving zone (Unit 1, 24–17 ka BP), progressive receding due to Circumpolar Deep Water inflow (Unit 2, 17–10.2 ka BP) and (Unit 3, 10.2 ka BP–present) the establishment of seasonal sea ice with a strengthening of bottom currents. The dominant and persistent process is a sedimentation controlled by contour currents, which tend to modulate intensity in time and space. A primary volcanic ash layer dated back at around 22 ka BP is correlated with the explosive activity of Mount Rittmann

An Information-Centric Communication Infrastructure for Real-Time State Estimation of Active Distribution Networks

© 2010-2012 IEEE.The evolution toward emerging active distribution networks (ADNs) can be realized via a real-time state estimation (RTSE) application facilitated by the use of phasor measurement units (PMUs). A critical challenge in deploying PMU-based RTSE applications at large scale is the lack of a scalable and flexible communication infrastructure for the timely (i.e., sub-second) delivery of the high volume of synchronized and continuous synchrophasor measurements. We address this challenge by introducing a communication platform called C-DAX based on the information-centric networking (ICN) concept. With a topic-based publish-subscribe engine that decouples data producers and consumers in time and space, C-DAX enables efficient synchrophasor measurement delivery, as well as flexible and scalable (re)configuration of PMU data communication for seamless full observability of power conditions in complex and dynamic scenarios. Based on the derived set of requirements for supporting PMU-based RTSE in ADNs, we design the ICN-based C-DAX communication platform, together with a joint optimized physical network resource provisioning strategy, in order to enable the agile PMU data communications in near real-time. In this paper, C-DAX is validated via a field trial implementation deployed over a sample feeder in a real-distribution network; it is also evaluated through simulation-based experiments using a large set of real medium voltage grid topologies currently operating live in The Netherlands. This is the first work that applies emerging communication paradigms, such as ICN, to smart grids while maintaining the required hard real-time data delivery as demonstrated through field trials at national scale. As such, it aims to become a blueprint for the application of ICN-based general purpose communication platforms to ADNs

A Spitzer Space Telescope Study of the Debris Disks around four SDSS White Dwarfs

We present Spitzer Space Telescope data of four isolated white dwarfs that were previously known to harbor circumstellar gaseous disks. IRAC photometry shows a significant infrared excess in all of the systems, SDSS0738+1835, SDSS0845+2257, SDSS1043+0855 and SDSS1617+1620, indicative of a dusty extension to those disks. The 4.5-micron excesses seen in SDSS0738, SDSS0845, and SDSS1617 are 7.5, 5.7 and 4.5 times the white dwarf contribution, respectively. In contrast, in SDSS1043, the measured flux density at 4.5 microns is only 1.7 times the white dwarf contribution. We compare the measured IR excesses in the systems to models of geometrically thin, optically thick disks, and find that we are able to match the measured SEDs to within 3 sigma of the uncertainties, although disks with unfeasibly hot inner dust temperatures generally provide a better fit than those below the dust sublimation temperature. Possible explanations for the dearth of dust around SDSS1043+0855 are briefly discussed. Including our previous study of SDSS1228+1040, all five white dwarfs with gaseous debris disks have significant amounts of dust around them. It is evident that gas and dust can coexist around these relatively warm, relatively young white dwarfs.Comment: 20 pages, including 4 figures. Accepted to Ap

Last Glacial Maximum to Holocene paleoceanography of the northwestern Ross Sea inferred from sediment core geochemistry and micropaleontology at Hallett Ridge

During the Late Pleistocene Holocene, the Ross Sea Ice Shelf exhibited strong spatial variability in relation to the atmospheric and oceanographic climatic variations. Despite being thoroughly investigated, the timing of the ice sheet retreat from the outer continental shelf since the Last Glacial Maximum (LGM) still remains controversial, mainly due to a lack of sediment cores with a robust chronostratigraphy. For this reason, the recent recovery of sediments containing a continuous occurrence of calcareous foraminifera provides the important opportunity to create a reliable age model and document the early deglacial phase in particular. Here we present a multiproxy study from a sediment core collected at the Hallett Ridge (1800 m of depth), where significant occurrences of calcareous planktonic and benthic foraminifera allow us to document the first evidence of the deglaciation after the LGM at about 20.2 ka. Our results suggest that the co-occurrence of large Neogloboquadrina pachyderma tests and abundant juvenile forms reflects the beginning of open-water conditions and coverage of seasonal sea ice. Our multiproxy approach based on diatoms, silicoflagellates, carbon and oxygen stable isotopes on N. pachyderma, sediment texture, and geochemistry indicates that abrupt warming occurred at approximately 17.8 ka, followed by a period of increasing biological productivity. During the Holocene, the exclusive dominance of agglutinated benthic foraminifera suggests that dissolution was the main controlling factor on calcareous test accumulation and preservation. Diatoms and silicoflagellates show that ocean conditions were variable during the middle Holocene and the beginning of the Neoglacial period at around 4 ka. In the Neoglacial, an increase in sand content testifies to a strengthening of bottom-water currents, supported by an increase in the abundance of the tycopelagic fossil diatom Paralia sulcata transported from the coastal regions, while an increase in ice-rafted debris suggests more glacial transport by icebergs