Long-term clinical and radiographic results of acl reconstruction. Retrospective comparison between three techniques (hamstrings autograft, hamstrings autograft with extra-articular reconstruction, bone patellar tendon autograft)

Background. There is no consensus in the current literature on which surgical options render the best long-term results after ACL reconstruction in terms of clinical outcomes and development of radiographic osteoarthritis (AO). The aim of this study is to investigate clinical and radiological results at long-term follow up after ACL reconstruction using hamstring tendons autograft (Group HT), hamstrings autograft with extra-articular reconstruction (Group HT-ER), and bone patellar tendon bone autograft (Group BPTB). Methods. All patients were evaluated at final follow-up using Lysholm, Internation- al Knee Documentation Committee (IKDC), and Tegner scores. An arthrometric KT-1000 evaluation was also done. Comparative weight bearing radiographs were taken, including a skyline view for patellofemoral joint and analyzed according to Fair- bank, Kellgren, and IKDC classification. Sixty patients were selected for this retrospective study, 20 for each group. The mini- mum final follow-up was 10 years for each group. All patients were male and involved in sport activities (Tegner pre-injury >7). Results. Subjective scores improved significantly in all groups, with no significative differences between groups (P<0,05). The number of patients classified as C or D at the IKDC objective activity score was higher in Group HT (2/20, 10%), than in Group BTB (1/20, 5%) and Group HT-E (0/20, 0%). In term of failure-rate, there were no difference between the three groups (P<0,05). Radiologic evaluation shoved more arthritic changes in Group-BT in the patello-fem- oral joint (PMJ). Conclusions. All the three techniques showed satisfactory results at long term follow up with no differences in term of subjective scores. Finally, there was a statistically significant higher incidence of arthritic changes in PFJ as evaluated with x-ray in the BPTP group respect to HT and HT + ER groups (p<0.05)

Genetic diversity of wild-type measles viruses: implications for global measles elimination programs.

Wild-type measles viruses have been divided into distinct genetic groups according to the nucleotide sequences of their hemagglutinin and nucleoprotein genes. Most genetic groups have worldwide distribution; however, at least two of the groups appear to have a more limited circulation. To monitor the transmission pathways of measles virus, we observed the geographic distribution of genetic groups, as well as changes in them in a particular region over time. We found evidence of interruption of indigenous transmission of measles in the United States after 1993 and identified the sources of imported virus associated with cases and outbreaks after 1993. The pattern of measles genetic groups provided a means to describe measles outbreaks and assess the extent of virus circulation in a given area. We expect that molecular epidemiologic studies will become a powerful tool for evaluating strategies to control, eliminate, and eventually eradicate measles

Urban Heat Island (UHI) risk maps as innovative tool for urban regeneration strategies. The case of Parma

For the purposes of regeneration of the consolidated city it is increasingly important to have the knowledge of the micro-scale distribution of the vulnerability of the population to the consequences of climate change and increasing urbanization. The work to be presented starts with the creation of maps of the risk classification induced by the heat islands in the city of Parma, and aims to investigate which are the most effective strategies that a Public Administration can adopt. The maps that have been created allow to assess the risk for the fragile population at the level of the single building. They relate the climatic datum of thermal variation with the population residing within each building, and verify the causal relationship with the soil sealing and with the morphology of the urban fabric. The results of the study can help to identify the thermal hot spot, receivers of specific mitigation actions. The risk map is itself a tool to develop multilevel actions, designed according to the peculiarities of the sites, where the possible adaptive solutions are compared with the physical and morphological characteristics of the places. The positive function of green infrastructures (contrast of overheating, flood mitigation, creation of places and services with a recreational function) is acquired by research and urban planning practice. It is equally well known the difficulty faced by Local Authorities in the maintenance and increase of unbuilt public areas, fundamental for the connection of ecological networks

Efficient Quantum Tensor Product Expanders and k-designs

Quantum expanders are a quantum analogue of expanders, and k-tensor product expanders are a generalisation to graphs that randomise k correlated walkers. Here we give an efficient construction of constant-degree, constant-gap quantum k-tensor product expanders. The key ingredients are an efficient classical tensor product expander and the quantum Fourier transform. Our construction works whenever k=O(n/log n), where n is the number of qubits. An immediate corollary of this result is an efficient construction of an approximate unitary k-design, which is a quantum analogue of an approximate k-wise independent function, on n qubits for any k=O(n/log n). Previously, no efficient constructions were known for k>2, while state designs, of which unitary designs are a generalisation, were constructed efficiently in [Ambainis, Emerson 2007].Comment: 16 pages, typo in references fixe

Catalytic electrophilic halogenation of silyl-protected and terminal alkynes: trapping gold(I) acetylides vs. a bronsted acid-promoted reaction

In the presence of a cationic gold(I) catalyst and N-halosuccinimide, both trimethylsilyl-protected and terminal alkynes are converted into alkynyl halides. Further experiments showed that silyl-protected alkynes undergo electrophilic iodination and bromination under Brønsted acid catalysis, whilst terminal alkynes require a cationic gold catalyst. The former reactions probably proceed via activation of the electrophile, whilst the latter reactions proceed via a gold(I) acetylide intermediate. Gold-catalysed halogenation was further combined with gold-catalysed hydration and subsequent annulation to provide convenient routes to iodomethyl ketones and five-membered aromatic heterocycles

Legionella spp. and legionellosis in southeastern Italy: disease epidemiology and environmental surveillance in community and health care facilities

<p>Abstract</p> <p>Background</p> <p>Following the publication of the Italian Guidelines for the control and prevention of legionellosis an environmental and clinical surveillance has been carried out in Southeastern Italy. The aim of the study is to identify the risk factors for the disease, so allowing better programming of the necessary prevention measures.</p> <p>Methods</p> <p>During the period January 2000 - December 2009 the environmental surveillance was carried out by water sampling of 129 health care facilities (73 public and 56 private hospitals) and 533 buildings within the community (63 private apartments, 305 hotels, 19 offices, 4 churches, 116 gyms, 3 swimming pools and 23 schools). Water sampling and microbiological analysis were carried out following the Italian Guidelines. From January 2005, all facilities were subject to risk analysis through the use of a standardized report; the results were classified as <it>good </it>(G), <it>medium </it>(M) and <it>bad </it>(B). As well, all the clinical surveillance forms for legionellosis, which must be compiled by physicians and sent to the Regional Centre for Epidemiology (OER), were analyzed.</p> <p>Results</p> <p><it>Legionella </it>spp. was found in 102 (79.1%) health care facilities and in 238 (44.7%) community buildings. The percentages for the contamination levels < 1,000, 1,000-10,000, > 10,000 cfu/L were respectively 33.1%, 53.4% and 13.5% for samples from health care facilities and 33.5%, 43.3% and 23.2% for samples from the community. Both in hospital and community environments, <it>Legionella pneumophila </it>serogroup (<it>L. pn </it>sg) 2-14 was the most frequently isolate (respectively 54.8% and 40.8% of positive samples), followed by <it>L. pn </it>sg 1 (respectively 31.3% and 33%). The study showed a significant association between M or B score at the risk analysis and <it>Legionella </it>spp. positive microbiological test results (p < 0.001). From clinical surveillance, during the period January 2001 - August 2009, 97 cases of legionellosis were reported to the OER: 88 of community origin and 9 nosocomial. The most frequent symptoms were: fever (93.8%), cough (70.1%), dyspnea (58.8%), shivering (56.7%). Radiological evidence of pneumonia was reported in 68%. The laboratory diagnostic methods used were: urinary antigen (54.3%), single antibody titer (19.8%), only seroconversion (11.1%), other diagnostic methods (14.8%).</p> <p>Conclusions</p> <p>Our experience suggests that risk analysis and environmental microbiological surveillance should be carried out more frequently to control the environmental spread of <it>Legionella </it>spp. Furthermore, the laboratory diagnosis of legionellosis cannot be excluded only on the basis of a single negative test: some patients were positive to only one of the diagnostic tests.</p

Measuring Egyptian Farmers’ Attitude Towards Staying Organic

Organic agriculture (OA) in Egypt is well-developed and still fast growing. Improving the relation between organic farmers and the other agents in the chain can provide a positive contribution to the whole organic chain competitiveness. One possible approach to investigate the farmers’ perceived role and satisfaction within the organic system is to explore the factors influencing their decision to stay organic. In particular, the aim of the present study was to measure the farmers’ attitude towards staying organic. Organic agricultural experts and institutional stakeholders were interviewed to complete a literature review and to obtain information about the Egyptian context. The survey questionnaire was pre-tested (n = 13) and then administered to a different sample (n = 232). A split-half validation procedure was used to evaluate and then confirm the factor structure. Explorative and confirmatory factor analysis yielded a final 29-item measure consisting of 8 distinct factors showing how organic agriculture influences a broad range of farmers’ life dimensions (environmental, economic, social, psychological). The significant role played by psychological and social factors in defining the farmers’ decision to stay organic emerged as a relatively unexpected outcome. The study supports the sustainable development of small family farmers, providing a useful tool to support the growth of organic production and consumption, mostly in developing countries. By monitoring farmers’ attitudes and perception towards OA, the instrument proposed in the present study can support policy makers, farmers’ organizations, civil society organizations (NGOs) and organic chains focal companies when defining policies, advocating campaigns, and chain coordination strategies for farmers involved in the organic food system development

Time-ordering and a generalized Magnus expansion

Both the classical time-ordering and the Magnus expansion are well-known in the context of linear initial value problems. Motivated by the noncommutativity between time-ordering and time derivation, and related problems raised recently in statistical physics, we introduce a generalization of the Magnus expansion. Whereas the classical expansion computes the logarithm of the evolution operator of a linear differential equation, our generalization addresses the same problem, including however directly a non-trivial initial condition. As a by-product we recover a variant of the time ordering operation, known as T*-ordering. Eventually, placing our results in the general context of Rota-Baxter algebras permits us to present them in a more natural algebraic setting. It encompasses, for example, the case where one considers linear difference equations instead of linear differential equations

Nutritional Condition and Physiological Stress Levels of Elk in the Black Hills, South Dakota

Percent of body fat and physiological stress are important correlates to wildlife demographics. We studied winter percent of body fat and physiological stress levels for a declining elk (Cervus canadensis nelsoni) population in South Dakota, 2011–2013. We obtained percent of winter body fat, pregnancy status, lactation status, and physiological stress data from 58 adult females (2+ years old). We compared physiological stress level data from 2011 with data collected from this same herd when elk densities were much higher (1995–1997). Our objectives were to determine percent of body fat during winter, examine if winter body fat was correlated with pregnancy and lactation status, and quantify and compare physiological stress hormone values from elk in the mid-1990s. Probability of being pregnant increased with higher winter nutritional condition, or percent of body fat; whereas females with a higher probability of previously lactating were lower in winter body fat. Mean fecal glucocorticoid metabolite (FGM) levels in 2011 (mean = 47.78 ng/g, SE = 2.37) were higher during summer compared to data collected in 1995–1997 (mean = 34.21 ng/g, SE = 3.71); however, mean FGM levels during winter did not differ between the two time periods. Although summer levels of FGM have significantly increased since the mid-1990s, we caution against any interpretation of increased FGM levels on elk fitness, as it may not infer biological significance. Mean winter percent of body fat of elk was lower when compared to other populations in the west but this difference does not appear to be limiting vital rates and population growth for this elk herd. We recommend future research focus on summer/autumn data collection to provide a more comprehensive understanding of percent of body fat for elk in our region