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Is there a negative correlation between screw length and correction rate via guided growth? A retrospective study of 138 limbs with genu varum
No full textPurpose: To identify factors that contribute to the speed of angular correction in skeletally immature patients with genu varum treated with paraphyseal tension band plates, hypothesizing that screw length and divergence, severity of deformity, and underlying pathology influence the rate and speed of genu varum correction. Methods: Fifty-three patients (38 males, 15 females) undergoing genu varum correction were included; a total of 138 physes (64 distal femur, 74 proximal tibia) were assessed. The median age at surgery was 37.83 ± 34.27 months (24.37-188.60), and the median follow-up was 11.03 ± 4.9 months (3.17-23). The severity of the deformity, the relative screw length, correction speed (degree per month), and initial screw divergence were calculated for comparison. Results: Patients close to skeletal maturity showed faster correction speed. Patients with genu varum secondary to metabolic disease had the slowest correction speed (0.76° per month), while there was no clinically significant difference with different etiologies. The distal femur showed a lower correction speed than that of proximal tibia in genu varum. The correction rate was negatively correlated with the relative screw length in genu varum deformity (linear regression coefficient: - 2.39; P < 0.01). The initial screw divergence had no statistically significant impact on the correction speed (P = 0.97). Conclusion: Screw length is an important parameter affecting the rate of genu varum correction with GG using paraphyseal tension band plates.Abstract
Purpose To identify factors that contribute to the speed of angular correction in skeletally immature patients with genu varum treated with paraphyseal tension band plates, hypothesizing that screw length and divergence, severity of deformity, and underlying pathology influence the rate and speed of genu varum correction.
Methods Fifty-three patients (38 males, 15 females) undergoing genu varum correction were included; a total of 138 physes (64 distal femur, 74 proximal tibia) were assessed. The median age at surgery was 37.83 ± 34.27 months (24.37–188.60), and the median follow-up was 11.03 ± 4.9 months (3.17–23). The severity of the deformity, the relative screw length, correction speed (degree per month), and initial screw divergence were calculated for comparison.
Results Patients close to skeletal maturity showed faster correction speed. Patients with genu varum secondary to metabolic disease had the slowest correction speed (0.76° per month), while there was no clinically significant difference with different etiologies. The distal femur showed a lower correction speed than that of proximal tibia in genu varum. The correction rate was negatively correlated with the relative screw length in genu varum deformity (linear regression coefficient: − 2.39; P < 0.01). The initial screw divergence had no statistically significant impact on the correction speed (P = 0.97).
Conclusion Screw length is an important parameter affecting the rate of genu varum correction with GG using paraphyseal tension band plates.
Level of evidence: IV
3D Solver for Viscous Fluids to Simulate Lava Flows
No full textIn this work, we present a new OpenFOAM solver, called interThermalRadConvFoam, to simulate free-surface viscous fluids with temperature changes due to radiative, convective, and conductive heat exchanges. The solver is based on interFoam (available in OpenFOAM) and thus on the Volume of Fluid technique used to describe the multiphase dynamics of two incompressible, viscous, and immiscible fluids (based on the Interface Capturing strategy). In our model, the two fluids are the fluid of interest with high viscosity and the surrounding atmosphere. Being interested in temperature effects, we added to the mass and momentum equations from interFoam an equation for energy that models the thermal exchanges between the fluid and the environment. Furthermore, a temperature-dependent viscoplastic model is used for the final application to lava flows. Here we present some results of numerical tests performed with interThermalRadConvFoam for a benchmark from literature based on a laboratory experiment and an application to a real lava flow by simulating the Pico do Fogo 2014–2015 Eruption. For the simulation of the laboratory experiment, we also present simulations executed using a dynamic mesh with adaptive refinement
Barriers for access and utilization of dementia care services in Europe: a systematic review
No full textBackground: Dementia is a group of chronic diseases characterised by cognitive impairment that progressively disrupts daily functioning and requires increasing levels of healthcare, social support, and long-term care. Support for people with dementia can be provided by formal support systems although most of the care process relies upon informal care givers. Despite the availability of formal support systems and healthcare workers, the utilization of dementia care services remains suboptimal. Factors such as non-compliance, lack of awareness, and poor care coordination contribute to this issue. Understanding these barriers is crucial for improving service utilization and alleviating the economic burden on families and national health systems. Methods: This systematic review analysed the literature, published from 2013 to 2023, on barriers in Alzheimer and other dementia healthcare system, conducted on people living with a dementia, their caregivers, or healthcare workers in dementia care settings in Europe, following PRISMA guidelines. Searches in PubMed, Embase, PsycINFO, Health Technology Assessment Database, and Web of Science used terms related to Alzheimer’s, dementia, and access barriers. Rayyan AI supported full-text review, with quality assessed via the Mixed Methods Appraisal Tool. Results: Over 1298 articles, 29 studies met the inclusion criteria. These studies highlighted several barriers to dementia care, categorised into information, organizational, cultural, stigma-related, financial, and logistical challenges. Informational and educational barriers included a lack of awareness and knowledge among caregivers. Organizational barriers involved poor care coordination and unclear access procedures. Cultural and stigma-related barriers were linked to societal attitudes towards dementia. Financial barriers were associated with the high costs of care, and logistical barriers included limited availability and accessibility of support services. Conclusions: To enhance the quality of life for individuals living with dementia, it is crucial to address these identified barriers through tailored interventions and management programs. Improving care coordination, communication, and training for healthcare professionals, alongside reducing systemic delays, are essential steps toward more effective dementia care. Easing the burden of care with tailored interventions and management programmes is mandatory to improve the quality of life of persons living with dementia and their families
Adhesion and friction patterns of CVD-grown WS2 monolayer flakes induced by vacancy-rich defect domains
No full textA comprehensive understanding of the relationship between defects concentration, optical properties and mechanical behavior of two-dimensional transition metal dichalcogenides (TMDs) is crucial for their integration as active components in micro- and nanomechanical devices. In this study we characterize the nanoscale contact adhesion and friction of WS2 flakes grown via chemical vapor deposition. We identify two domains named α and β with distinct mechanical properties, which are not apparent in morphological differences but mirror spatial variations of the optoelectronic properties. The α-domains exhibit high photoluminescence (PL) emission, strong Raman response, higher contact adhesion and lower friction, closely resembling the response of pristine WS2 flakes prepared by mechanical exfoliation. Conversely, the β-domains display very low PL emission, weak Raman response with blueshifted fingerprint peaks, lower adhesion and up to six-fold higher friction. Based on experimental evidence and general arguments, we attribute the mechanical heterogeneity between the α- and β-domains to the differentiated densities of sulfur and tungsten atomic vacancies, which are known to selectively populate the two domains. Our results indicate that the tungsten vacancies in the β-domains not only mediate non-radiative recombination processes but also drive a prominent friction enhancement, either by increasing the amplitude and disorder of the WS2 potential energy surface or by impacting the stress distribution within the growing flakes. These findings help identify the type of defects and mechanisms that most significantly affect the properties of TMD monolayer flakes prepared by scalable production routes
La giustizia costituzionale salverà il mondo? Obblighi positivi di protezione e discrezionalità politica nell’Antropocene
No full textCan courts without democratic legitimacy be charged with preserving the natural basis of life for present and future generations? This contribution investigates how, in the new geological era of the Anthropocene, the relations between judicial review and political discretion are shifting. To do so, it examines two European climate litigations to see how the ECHR and German doctrine of positive obligations has been applied to ground the state’s obligation to combat climate change and what standard of judgement has been employed to assess its compliance. In the end, it draws on Alexy’s distinction between structural and epistemic discretion to show that, in a state based on the rule of law, a certain degree of appreciation on the part of democratic authorities remains unavoidable
Digital quantification of somatostatin receptor subtypes 2 and 5 in growth hormone–secreting pituitary tumors
No full text: Immunohistochemistry (IHC) of somatostatin receptor subtype 2 can predict response to first-generation somatostatin receptor ligands (fg-SRLs) in acromegaly. Recently, we validated an open-source digital image analysis (DIA) to quantify somatostatin receptor subtype 2 (SSTR2) expression. We aimed to validate the DIA also on somatostatin receptor subtype 5 (SSTR5) in a new cohort of growth hormone (GH)-secreting pituitary tumors, with IHC performed in a different laboratory, and to correlate fg-SRL response with SSTs expression. Somatostatin receptor subtype 2 and SSTR5 were assessed in 42 GH-secreting pituitary tumors, using a semiquantitative immunoreactivity score (IRS) and the DIA by use of the open-access software CellProfiler. The DIA calculates the staining intensity and the percentage of positive cells (%PC). We found a good correlation between IRS and DIA for both SSTR2 and SSTR5 (P < .001), demonstrating the reliability of the DIA in this setting. Response to fg-SRL treatment correlated with SSTR2, but not SSTR5, expression. Somatostatin receptor subtype 2 expression predicted response to fg-SRL. In particular, the identified cut-offs were IRS ≥ 5 (area under the curve [AUC] 0.763; sensitivity 77%; specificity 83%); intensity/area ≥0.106 (AUC 0.833; sensitivity 92%; specificity 83%); and %PC-DIA ≥63.7% (AUC 0.917; sensitivity 92%; specificity 83%). The SSTR2 %PC correlated with treatment response only when evaluated using the DIA, showing a better performance of this method
Applicazione di RMANOVA su dati spettroscopici per valutare l’effetto delle condizioni ambientali e del substrato di deposizione sull’invecchiamento di macchie di sangue.
No full textDeterminare il tempo intercorso tra la deposizione e il rinvenimento di una traccia di sangue è uno strumento potente per il chimico forense nel risolvere casi legali. Questo argomento è stato spesso studiato, ma senza focalizzarsi sulle condizioni ambientali o sul substrato di deposizione del sangue, nonostante possano condizionarne l’invecchiamento.
In questo studio, macchie di sangue sono state invecchiate in condizioni di temperatura (T) e umidità (RH%) controllate, impostando due condizioni ambientali (fredda/umida; calda/secca) con alternanza giorno-notte, e ripetendole con o senza una finestra tra la fonte di luce e il campione. Novantasei gocce di sangue da 20μl da due donatori sono state depositate su cotone, tessuto idrofobico, vetro o metallo per seguirne l’invecchiamento per 12 giorni (14 misure – TC) con spettroscopia nel vicino infrarosso (MicroNIR, VIAVI) e Raman (InVia, Renishaw).
Per rappresentare l’invecchiamento con un solo segnale per campione, sono stati estratti gli scores con la regressione ai minimi quadrati parziali (PLS). Per ogni condizione (ambientale, illuminazione e materiale) è stato costruito un modello PLS, e gli scores sulle prime tre variabili latenti (LVs) a ogni TC sono stati concatenati. I segnali ottenuti sono stati sottoposti ad analisi multivariata della varianza (RMANOVA (Engel et al., 2020)), dimostrando come l’effetto del materiale e della combinazione T-RH% sia sempre significativo. Gli effetti di questi fattori sono risultati maggiori anche rispetto a quello del soggetto, sottolineando come, anche non potendo costruire un modello usando il sangue del sospettato, controllare le condizioni ambientali e riprodurle sia necessario per ottenere un modello accurato
