A BMI above 30 results in satisfying outcomes in patients undergoing fixed-bearing lateral unicompartmental knee arthroplasty

Purpose: The purpose of this study is to analyse the effect of BMI on clinical outcomes of cemented fixed-bearing lateral unicompartmental knee arthroplasty (UKA) on a 2- to 12-year follow-up. Methods: Between January 2010 and January 2020, a total of 103 lateral UKAs were implanted. The Oxford Knee Score (OKS) and the Western Ontario and McMaster University Osteoarthritis Index for pain, stiffness, function, and total score were administered to estimate patients' overall health status pre- and post-operatively. Results were considered good or excellent for WOMAC values > 85 points and OKS > 40 points. Survivorship, described with Kaplan-Meier method, was defined as the lack of revision at the latest follow-up. Complications or further operations were recorded. p values of < 0.05 were considered significant. Results: One hundred one lateral UKAs were assessed at a mean follow-up of 77.8 months. No patients underwent revision, but 2 patients (2, 0%) developed aseptic loosening of the implant 2 and 5 years after surgery but for clinical reasons neither undergo revision (5-year survivor 97.2%). Overall satisfaction was generally high, with excellent scores in all WOMAC subscales and OKS for all BMI groups. Considering the pain subscale (WOMAC pain), patients with normal weight and overweight achieve excellent results more frequently [10 (25.64%) vs 10 (23.81%) p = 0.026] than obese patients (n = 0); on the other hand, considering the quality of life (WOMAC QoL), obese patients most frequently reach excellent values, even statistically significant [n = 15 (75.00%) p = 0.040]. Conclusion: Although obesity has historically been described as a contraindication to UKA, improved outcomes with modern UKA implant designs have challenged this perception. Therefore, the classic contraindication of UKAs in patients with BMI > 30 kg/m2 may not be justified. According to the present study, lateral UKA patients with BMI > 30 kg/m2 had satisfactory patient-reported outcome measures compared to non-obese patients on a long term with survival rates comparable to medial UKA. Obese patients should not be excluded from the benefit of lateral UKA surgery

CONTREX: Design of embedded mixed-criticality CONTRol systems under consideration of EXtra-functional properties

The increasing processing power of today’s HW/SW platforms leads to the integration of more and more functions in a single device. Additional design challenges arise when these functions share computing resources and belong to different criticality levels. CONTREX complements current activities in the area of predictable computing platforms and segregation mechanisms with techniques to consider the extra-functional properties, i.e., timing constraints, power, and temperature. CONTREX enables energy efficient and cost aware design through analysis and optimization of these properties with regard to application demands at different criticality levels. This article presents an overview of the CONTREX European project, its main innovative technology (extension of a model based design approach, functional and extra-functional analysis with executable models and run-time management) and the final results of three industrial use-cases from different domain (avionics, automotive and telecommunication).The work leading to these results has received funding from the European Community’s Seventh Framework Programme FP7/2007-2011 under grant agreement no. 611146

No difference at two years between all inside transtibial technique and traditional transtibial technique in anterior cruciate ligament reconstruction

Background: one of the most recent technique is the “all inside” anterior cruciate ligament (ACL) reconstruction. One of the main characteristic ofthis procedure is the sparing of the tibial cortex. Furthermore, the all-inside technique requires only one tendon harvested. Purpose: the present study describes two year clinical outcomes of the all-inside method for ACL reconstruction, and compares them with clinical results of a group of patients treated with the traditional transtibial single-bundle ACL reconstruction technique using the semitendinosus and gracilis tendons (ST-G). Study design: pilot study, using historical controls. Methods: ACL reconstruction was performed on two groups of 20 patients each. The patients in one group underwent the all-inside transtibial technique with ST tendon alone. The second group underwent ACL reconstruction with the traditional transtibial single-bundle procedure using quadrupled ST-G tendons. Follow up at 24 months was undertaken using the IKDC, VAS pain score, Lysholm and Tegner scales. Results: the VAS pain score for the traditional ACL group was 84.6 ± 12.6; whereas the score for the all-inside group was 81.6 ± 13.1, with no statistically significant differences between the two groups. In the traditional ACL reconstruction group the Lysholm scale gave a “good results” for 7 patient (35%) and “excellent results” for 13 patients (65%) and the all-inside group gave “sufficient results” for 4 patients (20%), “good results” for 7 patients (35%) and “excellent results” for 9 patients (45%) (n.s.). The median of Tegner score was 6.5 (2-10) for the standard method group and 6 (1-9) for the all-inside group (n.s). The IKDC evaluated 50% of patients from the standard technique group as class A, and 45% as class B and 5% as class C. As regards patients of the all inside technique 55% were class A, 40% class B and, here too, just 5% scored as class C. No patients were classed as group D in each group. Conclusions: this study suggests that, in respect to return to sports and adequate articular function, there are no differences between the all-inside transtibial ACL reconstruction technique and the traditional transtibial ACL reconstruction using ST-G. The role of all-inside transtibial ACL reconstruction remains dubious. Level of evidence: III or Level C according with Oxford Center of EB

Hardware-Transactional-Memory Based Speculative Parallel Discrete Event Simulation of Very Fine Grain Models

This article presents an innovative runtime support for speculative parallel processing of discrete event simulation models on multi-core architectures, which exploits Hardware-Transactional-Memory (HTM) facilities for the purpose of state recoverability. In this proposal, the speculative updates on the state of the simulation model are executed as concurrent HTM-based transactions that are also in charge of detecting whether the update is consistent with the advancement of logical-time along model execution. Our proposal is fully transparent to the application code. Hence, our HTM-based run-time support can host conventionally developed discrete event models relying on the concept of event-handlers to be dispatched by an underlying simulation engine. Experimental data show that our proposal provides 75% to 92% of the ideal speedup on an Intel Haswell based platform (equipped with 4 physical cores and HTM support) for discrete event models with event granularity ranging between 2 and 12 microseconds. The data also show that these same models cannot be executed efficiently on top of a last generation parallel discrete event simulation platform employing software-based recoverability

Advances on Theory and Practice of Robots and Manipulators

This paper presents the functional design and the related detailed mechanical design embodiment of UGV Epi.q-Mod, which is a new version of the Unmanned ground vehicles Epi.q. UGVs Epi.q are mobile robots used for surveillance/reconnaissance/transport operations and they are based on a hybrid wheeled-legged locomotion system. The locomotion system consists of three-wheeled units with epicyclical mechanism capable of switching between wheeled and legged locomotion even without an active control intervention, depending on the dynamic condition of the vehicle. The main characteristic of this robot is the application of the modular approach that allows to generate different architectures based on functional requirement

Hardware-assisted Incremental Checkpointing in Speculative Parallel Discrete Event Simulation

Nowadays hardware platforms offer a plethora of innovative facities for profiling the execution of programs. Most of them have been exploited as tools for program characterization, thus being used as kind of program-external observers. In this article we take the opposite perspective where hardware profiling facilities are exploited to execute core functional tasks for the correct and efficient execution of speculative Parallel Discrete Event Simulation (PDES) applications. In more detail we exploit them—specifically, the ones offered by Intel x86-64 processors—to build a hardware-supported incremental checkpointing solution that enables the reduction of the event-execution cost in speculative PDES compared to the software-based counterpart. We integrated our solution in the open source ROOT-Sim runtime environment, thus making it available for exploitation