The Effect of Severe Varus Deformity on Clinical and Radiographic Outcomes in Mechanical Aligned Total Knee Arthroplasty with Medial Stabilizing Technique.

Background: The purpose was to compare the clinical and radiographic outcomes between preoperative mild and severe varus deformity after total knee arthroplasty (TKA) with medial stabilizing technique (MST). Methods: We retrospectively analyzed 158 knees of 125 female patients with a 2-year follow-up who underwent mechanically aligned TKA with MST between April 2018 and February 2021. Patients were divided into two groups; the severe varus group was defined as one with preoperative hip-knee ankle (HKA) angle ≥ 15° and the mild varus group with HKA angle < 15°. Pre- and post-operative clinical outcomes (Western Ontario and McMaster University Osteoarthritis Index, Knee Society Knee Score) and radiographic outcomes (medial proximal tibial angle (MPTA), HKA angle, lateral distal femoral angle (LDFA), joint line distance, and femoral component rotation angle) were compared between the groups. Results: Among the 158 knees analyzed, 131 and 27 were allocated to the mild and severe varus groups, respectively. Preoperative data showed that the MPTA (84.7° ± 2.8° vs. 80.7° ± 3.2°, p < 0.001) was significantly less in the severe varus group. In postoperative data, clinical outcomes were not different between the groups. Joint line distance (18.4 mm ± 2.8 mm vs. 18.6 mm ± 2.7 mm, p = 0.676) was also not significantly different. Femoral component rotation angle (-1.7° ± 1.0° vs. -1.0° ± 1.3°, p = 0.018) was more externally rotated in the severe varus group. Conclusions: Severe varus group showed comparable clinical and radiographic outcomes to that of mild varus group after mechanically aligned TKA with MST.

Analysis of Factors Contributing to the Occurrence of Systemic Toxicity in Patients with Hydrofluoric Acid Skin Exposure Injury: An Individual Participant Data Meta-Analysis of 125 Clinical Cases from 1979 to 2020.

The purpose of this study is to analyze the factors contributing to the occurrence of systemic toxicity in patients injured after skin exposure to hydrofluoric acid (HFA) and to present guidelines for active treatment intervention based on this analysis. Data were acquired from EMBASE, PubMed, and Cochrane library for individual participant data (IPD) meta-analysis. Key searching terms included calcium gluconate (CAG), hydrofluoric acid, and case. This research consisted of case studies published between 1979 and 2020. Systemic toxicity was set as the main outcome. Data sets from 50 case studies (N = 125 participants) were analyzed. Multivariate binary logistic regression analyses of IPD found significant association effect of the total body surface area (TBSA) burned, indicating systemic toxicity [Regression coefficient estimate, 0.82; SE, 0.41; Odds ratio, 2.28; [95% confidence interval, 1.03-5.06], and p = 0.0424]. The optimal cutoff point (sensitivity; specificity) of the receiver operating characteristic curve of the total body surface area (TBSA) burned for contributing occurrence of systemic toxicity was 2.38(0.875; 0.959). IPD meta-analysis indicates that existing evidence supports the positive proportional association of the TBSA burned for systemic toxicity. If the TBSA burned (%) in patients exposed to hydrofluoric acid is greater than 2.38, early aggressive treatment intervention, including decontamination and various CAG application, should be recommended as the guideline.

Comparison Between Early and Late Retensioning of an Adjustable-Loop Cortical Suspension Device During Hamstring ACL Reconstruction.

BACKGROUND: Biomechanical studies have demonstrated significant loosening of the adjustable-loop device as compared with the fixed-loop device used in anterior cruciate ligament reconstruction. Retensioning of the adjustable loop has been recommended; however, the timing of the retensioning is unknown. HYPOTHESIS: Early (ER) and late retensioning (LR) will show similar gapping between the femoral tunnel and graft on follow-up magnetic resonance imaging (MRI) and similar clinical outcomes. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: This study included 101 patients who underwent hamstring anterior cruciate ligament reconstruction using the adjustable-loop device for femoral fixation between June 2016 and January 2018. All patients a had follow-up MRI on postoperative day 1. Patients with revision surgery and those with reinjury after reconstruction were excluded. In the ER group, retensioning and knot tying of the initially tightened adjustable loop were performed after the flip of the button and before the graft was fixed at the tibia. In the LR group, retensioning and knot tying were performed after initial tightening of the adjustable loop and graft fixation at the tibial side. The tunnel-graft gap measured on multiplanar reformatted images of MRI scans was compared between the groups, as were clinical outcomes. RESULTS: The mean age of the patients at the time of surgery was 30.3 years (range, 14-61 years). ER and knot tying were performed in 56 patients and LR and knot tying in 45. Preoperative characteristics of the 2 groups showed no significant differences. The mean ± SD tunnel-graft gap was 1.5 ± 2.0 mm in the ER group and 5.4 ± 4.0 mm in the LR group (P < .001). There were no significant differences in clinical outcomes between the groups. CONCLUSION: ER and knot tying demonstrated less tunnel-graft gap than that of LR. However, there were no differences in clinical outcomes according to the timing of retensioning.

Tunable colloidal quantum dot distributed feedback lasers integrated on a continuously chirped surface grating.

We report a colloidal quantum dot (CQD) distributed feedback (DFB) laser structure containing a chirped grating. The device exhibits single-mode DFB lasing, of which the wavelength is spatially dispersed in a single chip. A period-chirped surface grating is fabricated using a modified Lloyd-type laser interference lithography setup, where a flat Lloyd's mirror is replaced with a concave one. A dense red-emitting CdSe/CdS/ZnS CQD film is prepared on a temporary substrate by spin-coating, which is subsequently released and wet-transferred onto a period-chirped quartz surface grating. Upon optical excitation, the fabricated DFB laser device lases in a single mode at a laser threshold of ∼400 µJ cm-2, with its lasing wavelength shifted linearly (in proportion to the grating pitch) along the chirp direction from 613.4 nm to 623.2 nm over a distance of ∼5.6 mm.

Electrical modulation of a photonic crystal band-edge laser with a graphene monolayer.

The electrical control of photonic crystal (PhC) lasers has been an attractive but challenging issue. Laser operation by electrical injection is of key importance for the viability and applicability of the PhC lasers. Another key factor is the electrical modulation of the laser output. The Fermi level of a graphene monolayer can be controlled by electrical gating, which adjusts its optical absorption. In this study, a graphene monolayer sheet is integrated on top of a two-dimensional PhC structure composed of InGaAsP multiple-quantum-wells (MQWs) in order to demonstrate the electrical modulation of a high-power (microwatt-scale) PhC band-edge laser. The introduced dielectric spacer layer presets the delicate balance between the optical gain from the MQWs and optical loss at the graphene monolayer. The proposed device is covered by an ion-gel film, which enables a low-voltage laser modulation at |Vg|≤1 V. The modulation is extensively investigated experimentally, and the obtained results are confirmed by performing numerical simulations.

Period-chirped gratings fabricated by laser interference lithography with a concave Lloyd's mirror.

We developed a laser interference lithography (LIL) system for fabrication of period-chirped gratings, which would be useful for sophisticated optical components. Despite its simplicity, the developed LIL system, based on a Lloyd's mirror interferometer with a cylindrically concave mirror, can generate chirped gratings, yet over a large area at high throughput owing to the nature of LIL. We have derived exact theoretical equations needed for system design, built the LIL system, and subsequently realized period-chirped gratings. A fabricated sample whose center period is Λ≈600 nm exhibits a continuous period variation of ΔΛ=92 nm across 17 mm width.

Reduction of graphene oxide/alginate composite hydrogels for enhanced adsorption of hydrophobic compounds.

Carbon-based materials, consisting of graphene oxide (GO) or reduced GO (rGO), possess unique abilities to interact with various molecules. In particular, rGO materials hold great promise for adsorption and delivery applications of hydrophobic molecules. However, conventional production and/or usage of rGO in aqueous solution often causes severe aggregation due to its low water solubility and thus difficulties in handling and applications. In our study, to prevent the severe aggregation of GO during reduction and to achieve a high adsorption capacity with hydrophobic compounds, GO/alginate composite hydrogels were first prepared and then reduced in an aqueous ascorbic acid solution at 37 °C. Adsorption studies with a model hydrophobic substance, rhodamine B, revealed that the reduced composite hydrogels are more highly absorbent than the unreduced hydrogels. In addition, the adsorption properties of the composite hydrogels, which are consequences of hydrophobic and ionic interactions, could be modulated by controlling the degree of reduction for the adsorption of different molecules. The composite hydrogels embedding rGO can be very useful in applications related to drug delivery, waste treatment, and biosensing.

Browning control of fresh-cut lettuce by phytoncide treatment.

Phytoncide essential oil derived from pine leaves was applied for the control of enzymatic browning of fresh-cut lettuce. Changes in the browning characteristics of cut lettuce treated with phytoncide in an water or ethanol solution (1%, v/v) at 10°C were investigated for 12days at 4°C. Other samples dipped in distilled water or 95% ethanol were used as the controls. The samples treated with phytoncide in an ethanol solution showed significantly higher L* values and lower a* values, ΔE values, browning index, phenolic compounds, and enzyme activities (PPO, POD, PAL) related to browning. The samples dipped in distilled water showed the opposite tendency. On the basis of changes in the browning characteristics, anti-browning effects of each treatment, phytoncide in an ethanol solution was the most effective treatment applied. These results suggest that phytoncide treatment could be used as an effective method for controlling enzymatic browning in fresh-cut lettuce.

Electric field control of nonvolatile four-state magnetization at room temperature.

We find the realization of large converse magnetoelectric (ME) effects at room temperature in a magnetoelectric hexaferrite Ba0.52Sr2.48Co2Fe24O41 single crystal, in which rapid change of electric polarization in low magnetic fields (about 5 mT) is coined to a large ME susceptibility of 3200 ps/m. The modulation of magnetization then reaches up to 0.62µ(B)/f.u. in an electric field of 1.14 MV/m. We find further that four ME states induced by different ME poling exhibit unique, nonvolatile magnetization versus electric field curves, which can be approximately described by an effective free energy with a distinct set of ME coefficients.