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Rotator cuff tears are among the most common orthopaedic injuries. If not treated, they can result in a massive irreparable tear because of tendon retraction and muscle atrophy. Mihata et al. in 2012 described the technique of superior capsular reconstruction (SCR) using fascia lata autograft. This has been considered an acceptable and effective method for treating irreparable massive rotator cuff tears. We describe an arthroscopically assisted superior capsular reconstruction (ASCR) technique using all soft anchors to preserve the bone stock and reduce possible hardware complications. Moreover, knotless anchors for the lateral fixation make the technique easier to reproduce.

The main objective of the study is to assess whether there is an increased risk of mortality in the days following the administration of COVID-19 vaccines in Bologna Health Authority in the first year of COVID-19 vaccination campaign. A secondary objective was to describe causes of deaths occurred in the days after vaccination. We conducted a retrospective observational study on all residents of Bologna Health Authority who received at least one COVID-19 vaccination dose from December 27, 2020 to December 31, 2021 and compared mortality in the 3, 7, 14 30 days after vaccination (risk interval) with the mortality in the period of the same length (3, 7, 14 and 30 days) beyond the 30th day after the last dose of vaccination (control interval). The cohort included 717,538 people. The mortality rate was 2.24 per 100 person-years during the 30 days risk interval vs 2.72 in the control interval with an adjusted incidence rate ratio equal to 0.76 (95% CI: 0.70-0.83, p 0.001). The risk of mortality is significantly lower (p 0.001) also in the 3, 7, 14 days risk intervals than in the control intervals. This study shows that there is no increase in mortality in the short-term period after COVID-19 vaccines.

To evaluate the anatomic integrity of rotator cuff repair performed by medialized single row and augmented by a porcine dermal patch, in comparison with a nonaugmented group.We conducted a single-center, prospective, double-blinded, randomized controlled trial. The sample size was predefined, and patients were divided into a study group and a control group, assessed preoperatively and at 1, 3, 6, 12, and 24 months. The EuroQol-visual analog scale; Constant-Murley questionnaire; Disabilities of the Arm, Shoulder and Hand Score; and Simple Shoulder Test were administered. The humeral-acromial distance was calculated on radiographs. Tendon thickness, tear extension, and tendon signal intensity were all measured on magnetic resonance images (MRIs) along with an evaluation of footprint extension and a classification into one of 4 healing grades-healed, thinned, partially healed, not healed.The study population consisted of 92 patients who were equally randomized into 2 homogenous groups. Sixty-nine patients completed the 24-month follow-up. The study group showed a healing rate of 97.6% compared with 59.5% for the standard repair group. The study group showed better results in terms of repaired tendon thickness and footprint coverage, with a P value.05, although the tendon density was comparable. The study group showed better strength recovery and functionality with the outcome scores submitted. During the entire study, only 2 patients reported complications, calling for a biopsy during revision surgery.Rotator cuff repairs augmented with a porcine dermal patch resulted in excellent clinical outcomes with a higher healing rate and close-to-normal MRI findings. The technique is safe and effective; in addition, it is reproducible and allows for better outcomes compared with those of standard medialized single-row repairs.

Water pollution by heavy metals is a matter of growing concern due to their potential toxicity for biota. The development of new and cost-effective remediation strategies is a priority in this field. For this purpose, a green technology, consisting of organic waste made up of a composite of water hyacinth dry matter and sodium alginate in microsphere form, was tested for its potential to adsorb lead and cadmium in river water samples. The water hyacinth‑sodium alginate composite molecular conformation was analysed first in order to obtain the potential energy surfaces. A high dipole moment, useful for the adsorption of heavy metals, was found. Accordingly, the cross-linked microspheres were prepared by combining water hyacinth dry matter and sodium alginate in a 1:1 ratio. Their metal adsorption and any effect on the natural microbial river community were verified with laboratory microcosm experiments lasting 11 days, using river water spiked with lead and cadmium (1 mg/L each). For this purpose, chemical (metal concentrations) and microbial (microbial abundance, viability and taxonomic composition) analyses were performed. Moreover, the ecotoxicity (with Vibrio fischeri - ISO 11348-3:2007) of water samples from microcosms in the presence/absence of the microspheres and metals was assessed. Effective concentrations (EC20 and EC50) of Pb and Cd were also determined. Finally, electron microscopy analyses were performed with a Field Emission Scanning Electron Microscope (FE-SEM) to visualize the metal adsorption capacity of the microspheres and investigate the metal distribution on the spheres (adsorbed on the surface or inside). The overall results showed that the microspheres were able to remove high heavy metal concentrations (about 1 mg/L) from river water in a short time (at 96 h just 1.3% and 5.8% of the Pb and Cd initial concentrations were detected) and no ecotoxicological effects were recorded. Moreover, the microspheres had a positive effect on the microbial community by promoting an increase in live cell numbers, probably through the release of organic carbon. Further analyses (at about four months) showed that the microspheres were able to keep metals adsorbed for a long time. These results show that the green technology proposed is an effective remediation method for Pb and Cd removal from river water and is very promising, not least because of its low cost.

The anionic surfactant sodium lauryl ether sulphate (SLES) is the main component in most foaming agents used for mechanized tunneling excavation. The process produces huge amounts of soil debris that can have a potential impact on ecosystems. The lack of accurate information about SLES persistence in excavated soil has aroused increasing concern about how it is recycled. The objective of this study was to assess SLES biodegradability in two commercial foaming agents (P1 and P2). Microcosm experiments were performed with two different soils collected from a tunnel construction site and conditioned with P1 or P2 (85.0 or 83.0 mg kg −1 of SLES, respectively). At selected times soil samples were collected for assessing the SLES residual concentration using Pressured Liquid Extraction followed by methylene blue active substance analysis (MBAS). Simultaneously, soil microbial abundance (DAPI counts), viability (Live/Dead method), activity (dehydrogenase analysis) and phylogenetic structure (Fluorescent In Situ Hybridization) were evaluated. SLES halved faster in the silty-clay soil (6 d) than in the gravel in a clay-silty-sand matrix (8–9 days). At day 28 it was degraded in both soils. Its biodegradation was ascribed to the significant increase in Gamma-Proteobacteria. At this time, the spoil material can be considered as a by-product.

The widespread detection of antibiotics in terrestrial and aquatic systems has engendered significant scientific and regulatory concern. Overall, knowledge concerning the ecotoxicology and sub-lethal effects in water is scarce, but some experimental studies show that antibiotics can induce pathogen resistance and they can also have detrimental effects on natural microbial communities and their key functions. The main aim of this study was to investigate the occurrence of the biodegradation and photodegradation processes of the fluoroquinolone ciprofloxacin (CIP) in the River Tiber waters, in a stretch highly impacted from human pressure. Two set of microcosms consisting of river water containing the natural microbial community and treated with 500 μg/L of CIP in absence or presence of UV-light were performed. Moreover, some microcosms were filled with river water previously sterilized and then treated with the antibiotic. The combined experimental set made it possible to evaluate if the antibiotic CIP could be photodegraded and/or biodegraded. CIP residual concentrations were measured over time by using HPLC coupled to fluorescence detection (FLD) and the effects of the antibiotic on the natural microbial community were assessed in terms of live cell abundance. The key role of light in CIP disappearance was confirmed, but also its biodegradation in natural river water was demonstrated. In fact, differently from other experiments we found a higher degradation rate (DT 50 = 10.4 d), in presence of both light and the natural river bacterial populations than in the same sterilized river water (DT 50 = 18.4 d). Moreover, even in the dark, a partial CIP biodegradation was also observed (DT 50 = 177 d). The overall results were supported by the increase in live cell numbers with the decrease of CIP concentrations both in the dark and light condition.

The Pampean agroecosystems are oriented to providing a few Ecosystem Services (ES) with undesired consequences on the environment, particularly the loss of biodiversity and cultural ES. In this context, it is necessary to find ways to make agricultural production compatible with biodiversity conservation through sustainable practices. Rural tourism is a form of productive diversification that generates additional economic income for farmers and may encourage the conservation of uncultivated semi-natural environments. Thus, agroecosystems could provide a greater variety of ES, achieving their multifunctionality. For this, it is necessary to understand the link between land use and biodiversity and the psycho-social factors that stimulate or limit farmers to conserve their field’s semi-natural environments. To this end, we conducted a study with three approaches: 1) we evaluated the intentions of rural Pampa’s farmers of conserving uncultivated environments through surveys analyzed under the framework of the Theory of Planned Behavior, 2) we explored the preferred environments for recreation through a self-administered survey to rural tourists, and 3) we conducted bird surveys to associate land use with biodiversity. The results showed a trend of greater intention to conserve uncultivated environments in farmers with rural tourism than without rural tourism. These intentions were related to more positive attitudes due to the intrinsic and utilitarian values of conserving uncultivated environments and less identification with agriculture only as a source of economic income. Tourists preferred semi-natural environments for recreation, which also sustain higher bird diversity. Results allowed to detect key aspects to influence farmers to achieve a greater intention to conserve uncultivated environments and manage them to supply multiple ES.

Ultrasound has been widely investigated for food processing applications. To date studies have been mainly carried out using contact-type ultrasound systems. Recently it has been demonstrated that ultrasonic waves propagated via gases including air using non-contact ultrasound devices may also be employed to enhance various food processes with minimal impact on food quality. Airborne acoustic ultrasound has been shown to be suitable for various food and non-food applications including drying, defoaming and decontamination. This novel technology is currently being actively investigated to increase the limited knowledge on the specific mechanisms involved in airborne ultrasound assisted operations. Some of the main challenges that have hampered efficient energy transmission through air have been addressed by the development of new types of transducers. The objective of this review is to outline various potential applications of airborne ultrasound including drying, defoaming and inactivation of microorganisms. Equipment types, mechanisms and challenges encountered are also discussed.

The anionic surfactant sodium lauryl ether sulphate (SLES) is the main component of most commercial products used for soil conditioning in the excavation industry, in particular as lubricants for mechanized tunnelling. Its use during the excavation processes can result in either the subsequent possible re-use of the huge amount of soil debris as by-products (e.g. land covering) or its discharge as waste. Currently, there are neither SLES soil threshold limits in European legislation, nor comprehensive studies on the environmental risk for soil ecosystems in these exposure scenarios. In this context, the present paper reviews the available data on the intrinsic characteristics of persistence and the ecotoxicological effects of the anionic surfactant SLES. Although SLES is generally reported to be biodegradable in standard tests, with degradation rates between 7 h and 30 days, depending on the initial conditions, data on its biodegradation in environmental studies are quite scarce. Consequently, assessing SLES biodegradation rates in field conditions is crucial for evaluating if in residual concentrations (typically in the range 40–500 mg/kg in excavated soils) it can or not be a potential hazard for terrestrial and water organisms. Laboratory ecotoxicological tests pointed out detrimental effects of SLES for aquatic organisms, while data on the terrestrial species are rather poor so far and further studies at the expected environmental concentrations are necessary. Finally, the review reports the main analytical methods available for detecting anionic surfactants in solid matrices and the future research needed to improve knowledge on the possible environmental risks posed by the use of SLES in foaming agents for mechanized tunnelling.

Due to the increasing frequency of disastrous events, the challenge of creating large-scale simulation models has become of major significance. Indeed, several simulation strategies and methodologies have been recently developed to explore the response of communities to natural disasters. Such models can support decision-makers during emergency operations allowing to create a global view of the emergency identifying consequences. An integrated platform that implements a community hybrid model with real-time simulation capabilities is presented in this paper. The platform's goal is to assess seismic resilience and vulnerability of critical infrastructures (e.g., built environment, power grid, socio-technical network) at the urban level, taking into account their interdependencies. Finally, different seismic scenarios have been applied to a large-scale virtual city model. The platform proved to be effective to analyze the emergency and could be used to implement countermeasures that improve community response and overall resilience.

It is well known that power ultrasonic devices whilst driven under elevated excitation levels exhibit nonlinear behaviors. If no attempt is made to understand and subsequently control these behaviors, these devices can exhibit poor performance or even suffer premature failure. This paper presents an experimental method for the dynamic characterization of a commercial ultrasonic transducer for bone cutting applications (Piezosurgery® Device) operated together with a variety of rod horns that are tuned to operate in a longitudinal mode of vibration. Near resonance responses, excited via a burst sine sweep method were used to identify nonlinear responses exhibited by the devices, while experimental modal analysis was performed to identify the modal parameters of the longitudinal modes of vibration of the assemblies between 0-80 kHz. This study tries to provide an understanding of the effects that geometry and material choices may have on the nonlinear behavior of a tuned device.

Airborne power ultrasound is a green technology with a great potential for food and environmental applications, among others. This technology aims at producing permanent changes in objects and substances by means of the propagation of high-intensity waves through air and multiphase media. Specifically, the nonlinear effects produced in such media are responsible for the beneficial repercussions of ultrasound in airborne applications. Processing enhancement is achieved through minimizing the impedance mismatch between the ultrasonic radiator source and the medium by the generation of large vibration displacements and the concentration of energy radiation thus overcoming the high acoustic absorption of fluids, and in particular of gases such as air. Within this work the enhancing effects of airborne power ultrasound in various solid/liquid/gas applications including drying of solid and semi-solid substances, and the agglomeration of tiny particles in air cleaning processes are presented. Moreover, the design of new ultrasonic devices capable of generating these effects are described along with practical methods aimed at maintaining a stable performance of the tuned systems at operational powers. Hence, design strategies based on finite element modelling (FEM) and experimental methods consolidated through the years for material and tuned assembly characterizations are highlighted.

Accurate identification of aquatic species is fundamental to freshwater research. In this paper, we targeted Ephemeroptera, a key taxonomic insect group for biomonitoring of water bodies and present an overview on the efficacy of the DNA barcoding approach to document species identity in the Mediterranean region. We sequenced the mitochondrial cytochrome c oxidase (COI) in 39 nominal species. Sample discrimination and species identification were investigated by evaluating haplotype identity and similarity, intra-/interspecific genetic distances, optimal identification of barcoding gap thresholds, estimates of species monophyly and comparative species matches on available reference libraries. The resolving power of the obtained data was discussed in the light of statistical tools such as Spider R-package and Poisson Tree Processes. High levels of species identification were achieved with all the used methodologies, and the occurrence of cryptic species was suggested. We conclude that DNA barcoding is a powerful tool for taxonomic research in Mediterranean mayflies, with great promise to ameliorate biodiversity inventories of freshwater ecosystems and to provide the necessary accuracy for water quality assessment programs. Our results further indicated we need to upgrade the current regional mayfly diversity knowledge. The development of a Mediterranean reference library could integrate this new information system.

Power ultrasound (PU) is an emerging, innovative, energy saving and environmental friendly technology that is generating a great interest in sectors such as food and pharmaceutical industries, green chemistry, environmental pollution, and other processes, where sustainable and energy efficient methods are required to improve and/or produce specific effects. Two typical effects of PU are the enhancement of mass transfer in gases and liquids, and the induction of particle agglomeration in aerosols. These effects are activated by a variety of mechanisms associated to the nonlinear propagation of high amplitude ultrasonic waves such as diffusion, agitation, entrainment, turbulence, etc. During the last years a great effort has been jointly made by the Spanish National Research Council (CSIC) and the company Pusonics towards introducing novel processes into the market based on airborne ultrasonic plate transducers. This technology was specifically developed for the treatment of gas and multiphasic media characterized by low specific acoustic impedance and high acoustic absorption. Different strategies have been developed to mitigate the effects of the nonlinear dynamic behavior of such ultrasonic piezoelectric transducers in order to enhance and stabilize their response at operational power conditions. This work deals with the latter advances in the mitigation of nonlinear problems found in power transducers; besides it describes two applications assisted by ultrasound developed at semi-industrial and laboratory scales and consisting in extraction via dense gases and particle agglomeration. Dense Gas Extraction (DGE) assisted by PU is a new process with a potential to enhance the extraction kinetics with supercritical CO 2 . Acoustic agglomeration of fine aerosol particles has a great potential for the treatment of air pollution problems generated by particulate materials. Experimental and numerical results in both processes will be shown and discussed.

Longitudinal-torsional vibration is used and proposed for a variety of ultrasonic applications including motors, welding, and rock-cutting. To obtain this behavior in an ultrasonic step horn one can either, (i) couple the longitudinal and torsional modes of the horn by incorporating a ring of diagonal slits in the thick base section or, (ii) place helical flutes in the thin stem section to degenerate the longitudinal mode into a modified behavior with a longitudinal-torsional motion. This paper compares the efficacy of these two design approaches using both numerical and experimental techniques.

Traditional rotary corers and sample retrieval mechanisms for planetary drilling suffer from a variety of technical difficulties. A heavy and rigid drillstring must be assembled on-site and deployed with considerable applied preload and torque, and these mechanical loadings are difficult to react in a low gravity environment. Furthermore the entire drillstring must often be removed to retrieve samples, unless an augering approach is taken, in which case stratigraphic sequencing is lost. Ultrasonic tools which operate by converting an ultrasonic frequency to a low impacting frequency at the tool end can resolve the mechanical problems because they require very low applied preload and no torque to operate. In developing such a tool, however, several fundamental design decisions must be taken regarding the architecture of the transducer, horn and stack. These include the choice of solid or hollow transducers and the employment of single or multiple free-masses at the ultrasonic to low frequency conversion location. This paper addresses the layout of such a system by contrasting the pros and cons of these architectural choices and concludes that a solid system with a single free-mass provides the best performance in the parameter range here discussed.

In recent years several European and US space projects have been focused on the development of surface rovers for planetary missions, such as ExoMars and Mars Exploration Rovers. The main function of these vehicles consists of moving across planet surfaces, and drilling and retrieving samples for in-situ analysis.Recent research has shown that drilling of rock materials can be achieved using axially oscillating tuned devices which, compared with conventional rotary drills, operate at lower power and highly reduced preload requirements. As a result, at present, ultrasonics is considered a very promising technology for exobiological prospecting.In this work, two novel ultrasonic rock samplers, both operating in a longitudinal-torsional composite mode, are proposed along with the conceptual design of a full coring apparatus, for preload delivery and core removal. To assess the penetration capability of the excited composite vibrations, preliminary drilling trials were conducted. Since sand constitutes a significant portion of the Martian surface, sandstone was used in the trials.

The increasing popularity of outdoor recreational activities in recent years has resulted in elevated human disturbance of waterbird communities. Anthropogenic disturbance is defined as any human activity that constitutes a stimulus sufficient to disrupt normal activities and/or distribution of animals relative to the situation in the absence of that activity. The goals of this study were (1) to quantify changes in habitat use by waterbirds caused by the proximity of people’s activities to the shoreline, in Los Padres Lagoon Reserve (Argentina), (2) to evaluate differential responses of waterbird groups caused by this human disturbance, and (3) to propose management guidelines to improve waterbird conservation in Pampas lagoon. We performed bird surveys monthly in areas with high levels of disturbance (HD areas) and with no or low levels of disturbance (LD areas) via recreational activities during days with (weekends) and without (weekdays) presence of people close to the lagoon. We recorded 34 bird species using the lagoon. The bird richness and abundance in HD areas was higher in days without recreational activities, conversely, in LD areas we found no differences in these parameters between days. Waders were found to be the group most vulnerable to disturbance, since these birds were only recorded in HD areas in days without human activity. Podicipedidae, as a group were less affected by recreational activities. We detected changes in the waterbird assembles and structure in relation to the presence of people on the shoreline. Our results in this study suggest direct effects of recreational activities on the habitat use of waterbirds. The buffer area defined by the current Reserve management strategy is working properly, and the impact of recreational activities on transitional area has only instantaneous effects on waterbirds because they return to that area in absence of disturbance. However, it should be considered that we only estimated the response to short-term effects of these activities on the waterbird community. Further studies should assess long-term effects.

This paper investigates the relationship between ultrasonic cutting parameters and temperature around the cutting site for wood and bone, with the aim of reducing thermal damage in natural materials. Two ultrasonic cutting blades, tuned at two different frequencies but with identical cutting edge and surface profiles, are used in the experiments. Temperature is monitored close to the cutting site and the effects of applied load and blade tip vibration velocity are studied. Results indicate that ultrasonic cutting blade design can incorporate cutting parameters to reduce or eliminate thermal damage in these natural materials without using an additional blade cooling system.

In ultrasonic devices consisting of serially coupled tuned components, components whose tuned length dimension is large compared to other dimensions, or components with profiles designed for high gain, the response of the device during operation is often characterised by modal interactions, and especially the excitation of combination resonances. The effects on ultrasonic devices are high noise levels, component failures and poor operating performance. In this paper, energy exchanges between modes are characterised to illustrate the adverse effects of combination resonances. Design solutions are proposed to eliminate these effects which concentrate on reducing the number of modes. In particular, a novel half-wavelength three-blade cutting system tuned to the first longitudinal mode has been designed by finite element modelling. An experimental investigation demonstrates that the measured response does not show evidence of modal interactions.

Mother-to-child transmission of intracellular parasites could be related to the production of immunoregulatory cytokines. The levels of gamma interferon (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha) and lnterleukin (IL)-10 were evaluated during pregnancy in sera of women chronically infected with Trypanosoma cruzi that delivered infected or non-infected children. The levels of IL-10 increased in both, women only pregnant and only infected, compared to non-infected non-pregnant women. However, in pregnant women chronically infected with T. cruzi, IL-10 did not increase significantly, neither in the mothers of infected nor in the mothers of non-infected children. The levels of the inflammatory cytokine TNF-alpha were not affected in normal pregnancy but increased in the infected mothers of non-infected children. The levels of IFN-gamma did not increase in the groups studied, indicating that the production of this pro-inflammatory cytokine was controlled, even when the levels of IL-10 did not increase, as in pregnant women chronically infected with T. cruzi.