A night of sleep deprivation alters brain connectivity and affects specific executive functions

Neurological Sciences - Sleep is a fundamental physiological process necessary for efficient cognitive functioning especially in relation to memory consolidation and executive functions, such as...     

Occurrence of inadequate ACL healing after Dynamic Intraligamentary Stabilization and functional outcome—a multicentre case series

Introduction

Dynamic Intraligamentary Stabilization (DIS) is a technique for preservation, anatomical repair and stabilization of a freshly injured anterior cruciate ligament (ACL). The main purpose of this study was to evaluate the short-term re-operation rate when compared to traditional autograft reconstruction.

Methods

Four, from the developer independent, centres enrolled patients that underwent ACL repair by DIS, according to the specific indications given by MRI imaging at a minimum follow-up of 12 months. The re-operation rate was recorded as primary outcome. Secondary outcome measures were the postoperative antero-posterior knee laxity (using a portable Rolimeter®), as well as the Tegner, Lysholm and IKDC Scores.

Results

A total of 105 patients were investigated with a median follow-up of 21 months. Thirteen patients were lost to follow-up. Of the remaining 92 patients 15 (16.3%) had insufficient functional stability and required subsequent ACL reconstruction. These patients were excluded from further analysis, leaving 77 consecutive patients for a 12 months follow-up. The median age at time of surgery was 30 years for that group. At time of follow-up a median antero-posterior translation difference of 2 mm was measured. None of these patients reported subjective insufficiency (giving way), but in 14 patients (18.2%), the difference of antero-posterior translation was more than 3 mm. We found a median Tegner Score of 5.5, a median Lysholm Score of 95.0 and a median IKDC Score of 89.4.

Conclusion

The main finding of this multicentre study is a relevant re-operation rate of 16.3%. Another 18.2% showed objective antero-posterior laxity (≥ 3 mm) during testing raising the suspicion of postoperative non-healing. The failure rate of DIS in this study is higher than for reconstruction with an autologous tendon graft. However, our successfully treated patients had a good clinical and functional outcome based on antero-posterior knee laxity and clinical scores, comparable to patients treated by autograft reconstruction.

     

Resistance exercise in chronic heart failure: hemodynamic and metabolic adjustments

The aim of this study was to characterize hemodynamic and metabolic responses to dynamic resistance exercise in chronic heart failure patients (CHF) compared to healthy older men (CTR). We hypothesized that in controlled conditions; pharmacologically treated CHF should show the adaptations to the strength exercises similar to healthy subjects, demonstrating therefore the compatibility with the practical on field. We addressed the acute effects of dynamic resistance exercise in eight CHF patients and eleven age-matched CTRs, instrumented for expiratory gas and cardiovascular analysis. All subjects performed two series with up to twelve repetitions at 70 % of 1RM on a leg press machine. Arterial pressure and heart rate progressively increased throughout the movements and decreased on cessation, while stroke volume (Modelflow software) decreased by 30 % at the start and increased by 10 % at cessation. Cardiac output increased at cessation only. All values were lower in CHF, but the changes during the exercises were not significantly different from those of CTR. Oxygen consumption increased during the exercises and continued increasing thereafter up to 60–70 % V’O_2max (absolute changes were smaller in CHF). We concluded that the response to dynamic resistance exercise is characterized by a sharp hindrance to the output of blood from the heart, which reduces stroke volume and enhances arterial pressure in CHF as well as in CTR. The simultaneous increase in heart rate kept cardiac output unaltered. The most important differences concerned a reduced metabolic response during exercise in CHF, even more evident in rest. Chronic heart failure syndrome and its treatment do not interfere with the cardiovascular responses to these kinds of physical activities. This finding can be considered a step forward in demonstrating that patients with chronic heart failure can, in controlled conditions, safely practice these essential exercises to preserve their muscle integrity.     

Validation of temperature methods for the estimation of pre-appearance interval in carrion insects

The pre-appearance interval (PAI) is an interval preceding appearance of an insect taxon on a cadaver. It decreases with an increase in temperature in several forensically-relevant insects. Therefore, forensic entomologists developed temperature methods for the estimation of PAI. In the current study these methods were tested in the case of adult and larval Necrodes littoralis (Coleoptera: Silphidae), adult and larval Creophilus maxillosus (Coleoptera: Staphylinidae), adult Necrobia rufipes (Coleoptera: Cleridae), adult Saprinus semistriatus (Coleoptera: Histeridae) and adult Stearibia nigriceps (Diptera: Piophilidae). Moreover, factors affecting accuracy of estimation and techniques for the approximation and correction of predictor temperature were studied using results of a multi-year pig carcass study. It was demonstrated that temperature methods outperform conventional methods. The accuracy of estimation was strongly related to the quality of the temperature model for PAI and the quality of temperature data used for the estimation. Models for larval stage performed better than models for adult stage. Mean temperature for the average seasonal PAI was a good initial approximation of predictor temperature. Moreover, iterative estimation of PAI was found to effectively correct predictor temperature, although some pitfalls were identified in this respect. Implications for the estimation of PAI are discussed.     

Identifying a hunter responsible for killing a hunting dog by individual-specific genetic profiling of wild boar DNA transferred to the canine during the accidental shooting

While genetic profiling can be a powerful tool to solve wildlife crime, comparably few examples of individual identification in wildlife forensics are available in the literature. Here, we report a case of an accidental shooting of a hunting dog during a wild boar drive hunt. The market value of trained hunting dogs can reach several thousand euro. No one admitted to killing the dog. Wild boar hairs were found in the dog’s wound, suggesting that the bullet first hit a wild boar and then the dog. Since it was known who harvested each boar, we aimed to use individual-specific genetic profiles to link these hairs to a bagged animal and to identify the culprit. We genotyped 19 harvested boar and the unknown hair sample using 13 STRs. In the case of the hair sample, we performed multiple genotyping to ensure the reliability of the genetic profile. We showed that we genotyped sufficient loci to distinguish between separate individuals with certainty. While the three most informative loci were enough to differentiate the 19 reference individuals, we did find a perfect match at all 13 STRs between the hair DNA and one tissue sample. Since our methods were reliable and reproducible, we passed the relevant information on to forestry officials who will use the information we have provided to attempt to find an amicable solution.     

Estimation of optical properties of neuroendocrine pancreas tumor with double-integrating-sphere system and inverse Monte Carlo model

The investigation of laser-tissue interaction is crucial for diagnostics and therapeutics. In particular, the estimation of tissue optical properties allows developing predictive models for defining organ-specific treatment planning tool. With regard to laser ablation (LA), optical properties are among the main responsible for the therapy efficacy, as they globally affect the heating process of the tissue, due to its capability to absorb and scatter laser energy. The recent introduction of LA for pancreatic tumor treatment in clinical studies has fostered the need to assess the laser-pancreas interaction and hence to find its optical properties in the wavelength of interest. This work aims at estimating optical properties (i.e., absorption, μ _a , scattering, μ _s , anisotropy, g, coefficients) of neuroendocrine pancreas tumor at 1064 nm. Experiments were performed using two popular sample storage methods; the optical properties of frozen and paraffin-embedded neuroendocrine tumor of the pancreas are estimated by employing a double-integrating-sphere system and inverse Monte Carlo algorithm. Results show that paraffin-embedded tissue is characterized by absorption and scattering coefficients significantly higher than frozen samples (μ _a of 56 cm^?1 vs 0.9 cm^?1, μ _s of 539 cm^?1 vs 130 cm^?1, respectively). Simulations show that such different optical features strongly influence the pancreas temperature distribution during LA. This result may affect the prediction of therapeutic outcome. Therefore, the choice of the appropriate preparation technique of samples for optical property estimation is crucial for the performances of the mathematical models which predict LA thermal outcome on the tissue and lead the selection of optimal LA settings.     

Reliability of measurements performed on two dimensional and three dimensional computed tomography in glenoid assessment for instability

Purpose

The main purpose of this study is to establish which of two methods is more reliable in glenoid assessment for instability in pre-operative planning. Accordingly, we have studied the intra- and inter-observer reliability of glenoid parameters with the use of two-dimensional (2D) and three-dimensional (3D) reconstructed computed tomography (CT) images.

Methods

One hundred glenoids were measured with the use of 2D-CT and 3D-CT (in 3D orientation) by two independent observers (one experienced and one inexperienced). Measurements were repeated after one week for 30 randomly selected glenoids.

Results

The intra-class correlation coefficient (ICC) for inter-observer reliability was significantly greater for 3D-CT (0.811 to 0.915) than for 2D-CT (0.523 to 0.925). All intra-observer reliability values for 3D-CT were near perfect (0.835 to 0.997), while those for 2D-CT were less reliable (0.704 to 0.960). A dependent t-test showed that, for both observers, almost all glenoid parameters (except R and d) differed significantly (p?<?0.05) between 2D and 3D measurement methods.

Conclusions

Therefore, it can be concluded that 3D glenoid reconstructions are more reliable for glenoid bone loss assessment than 2D-CT. The results suggest that quantifying a glenoid defect with the use of 2D image only—even if performed by an experienced orthopaedic surgeon—is prone to errors. Differences in measurements between and within observers can be explained by plane setting and identifying glenoid rim in 2D-CT. Accordingly, we recommend that glenoid measurements should be performed in 3D orientation using 3D reconstruction obtained from CT images for pre-operative assessments, which are crucial for surgical planning.