Patient-specific instrumentation in total ankle arthroplasty

The recent increase in the adoption of total ankle arthroplasty (TAA) reflects the improvements in implant designs and surgical techniques, including the use of preoperative navigation system and patient-specific instrumentation (PSI), such as custom-made cutting guides. Cutting guides are customized with respect to each patient's anatomy based on preoperative ankle computed tomography scans, and they drive the saw intra-operatively to improve the accuracy of bone resection and implant positioning. Despite some promising results, the main queries in the literature are whether PSI improves the reliability of achieving neutral ankle alignment and more accurate implant sizing, whether it is actually superior over standard techniques, and whether it is cost effective. Moreover, the advantages of PSI in clinical outcomes are still theoretical because the current literature does not allow to confirm its superiority. The purpose of this review article is therefore to assess the current literature on PSI in TAA with regard to current implants with PSI, templating and preoperative planning strategies, alignment and sizing, clinical outcomes, cost analysis, and comparison with standard techniques

Investigation on performances of asphalt mixtures made with Reclaimed Asphalt Pavement: Effects of interaction between virgin and RAP bitumen

According to most recent surveys, the European area produced 265 mil tonnes of asphalt for road applications in 2014. In the same year, the amount of available RAP was more than 50 mil tonnes. The use of RAP in new blended mixes reduces the need of neat bitumen, making RAP recycling economically attractive. Despite the economic and environmental benefits, road authorities tend to limit the use of RAP in asphalt mixes due to uncertainty about field performances. The present study focuses on the interaction between neat and RAP bitumen in asphalt mixes made with different RAP content. The effects of RAP on physical and rheological properties of the final bituminous blend were investigated. This study is part of a wider research, where a specific type of asphalt mixture was produced with different RAP contents being 10%, 20% and 30% by mass of the mix. Bitumen was extracted and recovered from asphalt mixes, then it was subjected to the following laboratory tests: standard characterization, dynamic viscosity and rheological analysis with DSR. Findings showed that the effects of RAP bitumen on the final blend varied in proportion to RAP content. A threshold value of RAP content was found, below which bitumen was not subjected to significant changes in physical and rheological properties. Practical implications on production methods and paving of RAP mixes are also proposed. Keywords: Reclaimed Asphalt Pavement (RAP), Recycling, Bitumen blending, Bitumen rheolog

The Association of High-Molecular-Weight Hyaluronic Acid (HMWHA), Alpha Lipoic Acid (ALA), Magnesium, Vitamin B6, and Vitamin D Improves Subchorionic Hematoma Resorption in Women with Threatened Miscarriage: A Pilot Clinical Study

Background-We evaluated whether the oral intake of high-molecular-weight hyaluronic acid (HMWHA) in association with alpha lipoic acid (ALA), magnesium, vitamin B6, and vitamin D can improve the resorption of subchorionic hematoma in cases of threatened miscarriage. Methods-In this study, we enrolled 56 pregnant women with threatened miscarriage (i.e., subchorionic hematomas, pelvic pain/uterine contractions, and/or vaginal bleeding) between the 6th and the 13th week of gestation. They were treated with vaginal progesterone (200 mg/twice a day) (control group; n = 25) or vaginal progesterone plus oral 200 mg HMWHA, 100 mg ALA, 450 mg magnesium, 2.6 mg vitamin B6, and 50 mcg vitamin D (treatment group; n = 31; DAV (R)-HA, LoLi Pharma srl, Rome, Italy). An ultrasound scan was performed at the first visit (T0) and after 7 days (T1) and 14 days (T2) until hematoma resorption. Results-At the ultrasound scan, the treatment group showed faster resorption of the subchorionic hematoma compared with the control group, both at T1 (control group 140 (112-180), treated group 84 (40-112), p < 0.0031), and T2 (control group: 72 (48-112), treated group: 0 (0-0), p < 0.0001). Moreover, subjective symptoms, such as vaginal bleeding, abdominal pain, and uterine contractions, showed a faster decrease in the treatment group than in the control group. Conclusions-The association may more rapidly improve the resolution of threatened miscarriage and related symptoms compared to the standard local protocol

Felid Cardiopulmonary Nematodes: Dilemmas Solved and New Questions Posed

In the past decade cardiopulmonary nematodes affecting felids have become a core research topic in small animal parasitology. In the late 2000s, an increase in studies was followed by unexpected findings in the early 2010s, which have stimulated research teams to start investigating these intriguing parasites. Prolific scientific debate and exchanges have then fostered field and laboratory studies and epi-zootiological surveys. New data have improved basic and applied knowledge, solved dilemmas and posed new questions. This article discusses the past and present background to felid cardiopulmonary nematodes after the last few years of intense scientific research. New data which have demonstrated the key role of Aelurostrongylus abstrusus and Troglostrongylus brevior in causing respiratory infections in domestic cats, and on the nil to negligible current importance of other species, i.e., Troglostrongylus subcrenatus, Oslerus rostratus and Angiostrongylus chabaudi, are presented. Biological information and hypothesized alternative routes of infection are analysed and discussed. Novel identification and taxonomical data and issues are reported and commented upon. On the whole, recent biological, ecological and epi-zootiological information on felid meta-strongyloids is critically analysed, with the aim to answer outstanding questions, stimulate future studies, and underline new research perspectives

La grandiosa rosa di pietra. Analisi litologica del rosone del Duomo di Modena

L'analisi litologica del rosone del Duomo di Modena ha permesso di identificare 5 diversi litotipi: Arenaria della Formazione di Pantano, Arenaria di Scabiazza, Pietra di Aurisina varietà granitello, Rosso Ammonitico e Marmo Proconnesio.Lo studio del rosone ha dimostrato come il Duomo sia l’unico monumento modenese in cui si sia utilizzata pietra locale. Nel contesto della Cattedrale la rosa si contraddistingue in quanto non presenta reimpiego di materiali antichi, come testimoniato nelle fasi precedenti, e nemmeno di Rosso Ammonitico veronese, litotipo principale utilizzato dai Campionesi. L’arenaria impiegata nel rivestimento lapideo esterno si è rivelata del tutto inadeguata, come dimostrato sulla Ghirlandina dalle sostituzioni col Rosso Ammonitico effettuate a partire dal XVI secolo. La pratica del restauro dei materiali degradati è stata affrontata diversamente nel corso dei secoli, e progressivamente si è giunti alla consapevolezza del rispetto dei materiali. Solo alla fine del ‘800, quando vennero condotti i risanamenti sulla Cattedrale, la cultura del restauro impose di impiegare lo stesso materiale nel ricostruire gli elementi danneggiati dal tempo. Una nuova attenzione, specchio della sensibilità artistica del momento storico, ha permesso di conservare questo unicum all’interno del panorama architettonico modenese

Magnetar central engines in gamma-ray busts follow the universal relation of accreting magnetic stars

Gamma-ray bursts (GRBs), both long and short, are explosive events whose inner engine is generally expected to be a black hole or a highly magnetic neutron star (magnetar) accreting high density matter. Recognizing the nature of GRB central engines, and in particular the formation of neutron stars (NSs), is of high astrophysical significance. A possible signature of NSs in GRBs is the presence of a plateau in the early X-ray afterglow. Here we carefully select a subset of long and short GRBs with a clear plateau, and look for an additional NS signature in their prompt emission, namely a transition between accretion and propeller in analogy with accreting, magnetic compact objects in other astrophysical sources. We estimate from the prompt emission the minimum accretion luminosity below which the propeller mechanism sets in, and the NS magnetic field and spin period from the plateau. We demonstrate that these three quantities obey the same universal relation in GRBs as in other accreting compact objects switching from accretion to propeller. This relation provides also an estimate of the radiative efficiency of GRBs, which we find to be several times lower than radiatively efficient accretion in X-ray binaries and in agreement with theoretical expectations. These results provide additional support to the idea that at least some GRBs are powered by magnetars surrounded by an accretion disc.Comment: 15 pages, 5 figures, accepted for publication in The Astrophysical Journal Letter