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Purpose The aim of our prospective randomised trial was to demonstrate the efficacy and improvement in surgical skills of inexperienced surgeons in the balloon kyphoplasty procedures trained with virtual reality (VR) compared to untrained inexperienced surgeons. Methods Six orthopaedic residents were randomized to group VR1 (trained) and group VR0 (untrained, control group). At the beginning, all participants, after a theoretical lesson, performed a virtual kyphoplasty. Each resident of the Group VR1 did four training sessions in 1 month (2 h per week) and at the end of training was re-evaluated performing a virtual kyphoplasty. Residents were evaluated with global task completion time and rates subtask ability according to Global Rating Scale of Operative Performance adaptation (both in VR simulation and during the surgery). A percutaneous vertebral augmentation with balloon kyphoplasty was performed by all residents. Intraoperative parameters, complications and cumulative transfer effectiveness ratio (CTER) were analysed. Results Intraoperative scores revealed an improvement in the group VR1 between the first VR trial and the intraoperative phase (2.85 ± 0.65 vs. 4.09 ± 0.62, P  < 0.05), which was not seen in the group VR0 (2.71 ± 0.71 vs. 2.85 ± 0.75). Statistical analyses indicated significant differences in intraoperative scores between the two groups. The CTER was 0.85 and suggests that 10 training sessions could reduce the procedure time by approximately 8 min in a 15 min of surgery. Conclusion Our study about the balloon kyphoplasy reaffirms the potential of VR as an effective and cost-efficient training tool, bridging the gap between theoretical knowledge and practical execution.

Purpose The use of allografts in primary anterior cruciate ligament reconstruction (ACLR) is increasing although they are still supposed to be associated to greater risk of re-rupture due to a slower and less efficient graft maturation. The aim of this prospective randomized controlled study was to compare the graft maturation after ACLR with allograft and autograft by MRI at 6- and 12-month follow-up and integrate these data with the functional and clinical results observed at 6-, 12- and 60-month follow-up. Methods Fifty patients with indication to primary ACLR were randomly and equally divided into hamstring autograft or allograft tendon groups. The graft maturation was measured at 6- and 12-month follow-up by the SNQ score and other radiological parameters on MRI scans. Clinical and functional recovery was evaluated by Lysholm score, Visual Analogues Scale, Tegner activity scale and modified Cincinnati knee rating system at 6, 12 and 60 months after surgery to estimate the predictive value of the radiological parameters for clinical outcomes. Return-to-sport (ACL-RSI) was measured 60 months after surgery. Results Three patients had retear of the neo-ligament (two from Auto group and one from Allo group). All the clinical/functional parameters significantly improved over time, with no statistically significant difference between the groups. At 6 months, the SNQ value was significantly higher in the Auto than in the Allo group (12.9 vs 7.9, p  = 0.038), but at 12 months they were comparable (9.8 vs 10.4). The 6-month SNQ values did not correlate with the clinical scores, whereas the 12-month SNQ values significantly correlated with the Cincinnati score, Lysholm score and Tegner activity scale collected at 60-month follow-up. Conclusion No clinical or functional differences have been found between the two treatment groups, supporting the suitability of using allograft in primary ACLR, when available. The results at MRI scans showed a different graft maturation trend in the two groups, with allografts being more reactive in the first 6 months. MRI together with the subjective evaluation allows to evaluate objectively the status of the neo-ligamentization process and therefore helps the surgeon to dictate the individual time for return-to-sport. Level of evidence Level I.

A bstract A comprehensive set of azimuthal single-spin and double-spin asymmetries in semi-inclusive leptoproduction of pions, charged kaons, protons, and antiprotons from transversely polarized protons is presented. These asymmetries include the previously published HERMES results on Collins and Sivers asymmetries, the analysis of which has been extended to include protons and antiprotons and also to an extraction in a three-dimensional kinematic binning and enlarged phase space. They are complemented by corresponding results for the remaining four single-spin and four double-spin asymmetries allowed in the one-photon-exchange approximation of the semi-inclusive deep-inelastic scattering process for target-polarization orientation perpendicular to the direction of the incoming lepton beam. Among those results, significant non-vanishing cos ( ϕ−ϕ S ) modulations provide evidence for a sizable worm-gear (II) distribution, g 1 T q x p T 2 . Most of the other modulations are found to be consistent with zero with the notable exception of large sin ( ϕ S ) modulations for charged pions and K + .

(ProQuest: ... denotes formulae and/or non-USASCII text omitted; see image).Exclusive electroproduction of ... mesons on unpolarized hydrogen and deuterium targets is studied in the kinematic region of ... GeV..., 3.0 GeV ... 6.3 GeV, and ... GeV... Results on the angular distribution of the ... meson, including its decay products, are presented. The data were accumulated with the HERMES forward spectrometer during the 1996-2007 running period using the 27.6 GeV longitudinally polarized electron or positron beam of HERA. The determination of the virtual-photon longitudinal-to-transverse cross-section ratio reveals that a considerable part of the cross section arises from transversely polarized photons. Spin density matrix elements are presented in projections of ... or ... Violation of ...-channel helicity conservation is observed for some of these elements. A sizable contribution from unnatural-parity-exchange amplitudes is found and the phase shift between those amplitudes that describe transverse ... production by longitudinal and transverse virtual photons, ... and ..., is determined for the first time. A hierarchy of helicity amplitudes is established, which mainly means that the unnatural-parity-exchange amplitude describing the ... transition dominates over the two natural-parity-exchange amplitudes describing the ... and ... transitions, with the latter two being of similar magnitude. Good agreement is found between the HERMES proton data and results of a pQCD-inspired phenomenological model that includes pion-pole contributions, which are of unnatural parity.

Abstract Exclusiveρ ⁰ρ 0 -meson electroproduction is studied by the HERMES experiment, using the 27.6 GeV longitudinally polarized electron/positron beam of HERA and a transversely polarized hydrogen target, in the kinematic region 1.0 GeV²

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