Medial-pivot total knee arthroplasty enhances tibiofemoral axial rotation stability in weight-bearing mid-range flexion compared to posterior-stabilised system.

PURPOSE: Total knee arthroplasty (TKA) stands as a primary intervention for severe knee ailments, yet concerns remain regarding postoperative patient satisfaction and flexion instability. This study aims to evaluate the in-vivo kinematics of medial-pivot (MP) and posterior-stabilised (PS) designs during step-up activity, in comparison to the kinematics of the nonoperated contralateral knee. METHODS: Sixteen patients with PS-TKA and 14 with MP-TKA were retrospectively examined. Clinical outcomes were assessed using patient-completed questionnaires. Motion during step-up was captured using a dual fluoroscopic system. Statistical analysis was applied to evaluate the in-vivo tibiofemoral six-degree-of-freedom kinematics and articular contact positions between the two groups. RESULTS: Despite being older, patients in the MP group reported higher postoperative subjective scores for weight-bearing functional activities. The axial rotation centres of MP-TKA located on the medial tibial plateau exhibited less variance compared to PS-TKA and contralateral knees. Compared to the contralateral knee (contralateral to medial-pivot [C-MP] or contralateral to posterior-stabilised [C-PS]), the MP group exhibited limited range of motion in terms of anteroposterior translation (MP: 3.6 ± 1.3 mm vs. C-MP: 7.4 ± 2.5 mm, p < 0.01) and axial rotation (MP: 6.6 ± 1.9° vs. C-MP: 10.3 ± 4.9°, p = 0.02), as well as in the PS group for anteroposterior translation (PS: 3.9 ± 1.7 mm vs. C-PS: 7.2 ± 3.7 mm, p < 0.01). CONCLUSION: The MP group with better postoperative ratings demonstrated a more stable MP axial rotation pattern during step-up activity compared to the PS group, underscoring the pivotal role of prosthetic design in optimising postoperative rehabilitation and functional recovery. LEVEL OF EVIDENCE: Level III.

Analyzing driver injury severity in two-vehicle rear-end crashes considering leading-following configurations based on passenger car and light truck involvement.

Rear-end crash is a major type of traffic crashes leading to a large number of injuries and fatalities each year, and passenger cars and light trucks are two main vehicle types in rear-end crashes on US roadways. Passenger cars and light trucks are different in size, vehicle mass and driver's vision. It is necessary to investigate the driver injury outcome patterns in rear-end crashes between passenger cars and light trucks considering crash configurations regarding the leading and following vehicle types. This study employs latent class multinomial logit (MNL) model to examine the risk factors on driver injury severity along with heterogeneity in variable effects presented by the cluster pattern in two-vehicle rear-end crashes involving passenger cars and light trucks, considering four crash configuration types, i.e., a passenger car struck by a passenger car, a light truck struck by a light truck, a passenger car struck by a light truck, and a light truck struck by a passenger car as exploratory variables. A model with two latent classes, which indicates the heterogeneity in variable effects among all the observations, is found to best fit the 7-year crash dataset from Washington State. The pseudo-elasticities are calculated to quantify the marginal effects of the contributing factors. The risk factors curve and sloping road condition, driver without seatbelt, and driver age of 65 and above increase driver fatality and serious injury risk greatly, and these three factors contribute from different latent classes. The crash configuration of a passenger car struck by a light truck is found to be one of class characteristics factors, which indicates that the heterogeneity exists between these two vehicle types. This factor is also a risk factor of injury. Furthermore, the leading vehicle is found to be much more vulnerable and closely related to injury, especially when it is in the crash of a passenger car struck by a light truck. The latent classes discovered give theoretical evidence of how to appropriately select subset data for further model construction for practical interest of serious injury prevention. The risk factors and their influence on injury severity provide beneficial insights on developing relevant countermeasures and strategies for injury severity mitigation on rear-end crashes involving passenger cars and light trucks.

Kangfuxin alleviates ulcerative colitis in rats by inhibiting NF-κB p65 activation and regulating T lymphocyte subsets.

Objectives: Ulcerative colitis (UC) remains an enduring, idiopathic inflammatory bowel disease marked by persistent mucosal inflammation initiating from the rectum and extending in a proximal direction. An ethanol extract of Periplaneta americana L., namely Kangfuxin (KFX), has a significant historical presence in Traditional Chinese Medicine and has been broadly utilized in clinical practice for the treatment of injury. Here, we aimed to determine the effect of KFX on 2,4,6-trinitro'benzene sulfonic acid (TNBS)-induced UC in Sprague-Dawley rats. Materials and Methods: We established the UC model by TNBS/ethanol method. Then, the rats were subject to KFX (50, 100, 200 mg/kg/day) for 2 weeks by intragastric gavage. The body weight, disease activity index (DAI), colonic mucosal injury index (CMDI), and histopathological score were evaluated. The colonic tissue interleukin (IL)-1ß, IL-6, tumor necrosis factor-α (TNF-α), IL-10, transforming growth factor-1 (TGF-ß1), and epidermal growth factor (EGF) were determined by Elisa. To study T-lymphocyte subsets, flow cytometry was performed. In addition, the expression level of NF-κB p65 was evaluated by immunohistochemistry and western blot analysis. Results: Compared with the TNBS-triggered colitis rats, the treatment of rats with KFX significantly increased the body weight, and decreased DAI, CMDI, and histopathological score. Also, KFX elicited a reduction in the secretion of colonic pro-inflammatory cytokines, namely IL-1ß, IL-6, and TNF-α, concomitant with up-regulation of IL-10, TGF-ß1, and EGF levels. Upon KFX treatment, the CD3+CD4+/CD3+CD8+ ratio in the spleen decreased, while the CD3+CD8+ subset and the CD3+CD4+CD25+/CD3+CD4+ ratio demonstrated an increase. In addition, the expression of NF-κB p65 in the colon was decreased. Conclusion: KFX effectively suppresses TNBS-induced colitis by inhibiting the activation of NF-κB p65 and regulating the ratio of CD4+/CD8+.

Larger Medial Contact Area and More Anterior Contact Position in Medial-Pivot than Posterior-Stabilized Total Knee Arthroplasty during In-Vivo Lunge Activity.

This study aimed to compare the in-vivo kinematics and articular contact status between medial-pivot total knee arthroplasty (MP-TKA) and posterior stabilized (PS) TKA during weight-bearing single-leg lunge. 16 MP-TKA and 12 PS-TKA patients performed bilateral single-leg lunges under dual fluoroscopy surveillance to determine the in-vivo six degrees-of-freedom knee kinematics. The closest point between the surface models of the femoral condyle and the polyethylene insert was used to determine the contact position and area. The nonparametric statistics analysis was performed to test the symmetry of the kinematics between MP-TKA and PS-TKA. PS-TKA demonstrated a significantly greater range of AP translation than MP-TKA during high flexion (p = 0.0002). Both groups showed a significantly greater range of lateral compartment posterior translation with medial pivot rotation. The contact points of PS-TKA were located significantly more posterior than MP-TKA in both medial (10°-100°) and lateral (5°-40°, 55°-100°) compartments (p < 0.0500). MP-TKA had a significantly larger contact area in the medial compartment than in the lateral compartment. In contrast, no significant differences were observed in PS-TKA. The present study revealed no significant differences in clinical outcomes between the MP and PS groups. The PS-TKA demonstrated significantly more posterior translations than MP-TKA at high flexion. The contact points are located more posteriorly in PS-TKA compared with MP-TKA. A larger contact area and medial pivot pattern during high flexion in MP-TKA indicated that MP-TKA provides enhanced medial pivot rotation.

Enhancement Effect of the C60 Derivative on the Thermoelectric Properties of n-Type Single-Walled Carbon Nanotube-Based Films.

Obtaining air-stable and high-performance flexible n-type single-walled carbon nanotube (SWCNT)-based thermoelectric films used in wearable electronic devices is a challenge. In this work, the microstructure and thermoelectric properties of n-type SWCNT-based films have been optimized via doping C60 and its derivative into polyethylenimine/single-walled carbon nanotube (PEI/SWCNT) films. The result demonstrated that the dispersity of triethylene glycol-modified C60 (TEG-C60) was better in PEI/SWCNT films than that of pure C60. Among the prepared composite films, TEG-C60-doped PEI/SWCNT (TEG-C60/PEI/SWCNT) films exhibited the highest TE performance, achieving a peak electrical conductivity of 923 S cm-1 with a Seebeck coefficient of -42 µV K-1 at a TEG-C60/SWCNT mass ratio of 1:100. Compared to that of PEI/SWCNT, the power factor was increased significantly from 40 to 162 µW m-1 K-2 after the addition of TEG-C60, which was higher than that of films after the addition of C60. In addition, the n-type doped SWCNT films had good air stability at high temperatures, and the Seebeck coefficients of C60/PEI/SWCNT and TEG-C60/PEI/SWCNT at 120 °C were still negative and remained at 92% and 85%, respectively, after 20 days. Furthermore, a flexible TE device consisting of five pairs of p-n junctions was assembled using the optimum hybrid film, which generated a maximum output power of 3.6 µW at a temperature gradient of 50.2 K. Therefore, this study provides a facile way to enhance the thermoelectric properties of n-type carbon nanotube-based materials, which have potential application in flexible power generators.

Glenoid Track Width Is Smaller Under Dynamic Conditions: An In Vivo Dual-Fluoroscopy Imaging Study.

BACKGROUND: The glenoid track concept has been widely used to assess the risk of instability due to bipolar bone loss. The glenoid track width was commonly used as 83% of the glenoid width to determine if a lesion was on-track or off-track. However, the value was obtained under static conditions, and it may not be able to reflect the actual mechanism of traumatic dislocation during motion. PURPOSE: To compare the glenoid track width under dynamic and static conditions using a dual-fluoroscopic imaging system. STUDY DESIGN: Controlled laboratory study. METHODS: In total, 40 shoulders of 20 healthy volunteers were examined for both dynamic and static tests within a dual-fluoroscopic imaging system at 5 different arm positions: 30°, 60°, 90°, 120°, and 150° of abduction, keeping the shoulder at 90° of external rotation. The participants performed a fast horizontal arm backswing for dynamic tests while keeping their arm in maximum horizontal extension for static tests. Computed tomography scans were used to create 3-dimensional models of the humerus and scapula for 2-dimensional to 3-dimensional image registration. Magnetic resonance imaging scans were obtained to delineate the medial margin of the rotator cuff insertion. The glenoid track width was measured as the distance from the anterior rim of the glenoid to the medial margin of the rotator cuff insertion and compared between static and dynamic conditions. RESULTS: The mean glenoid track widths at 30°, 60°, 90°, 120°, and 150° of abduction were significantly smaller under dynamic conditions (88%, 81%, 72%, 69%, and 68% of the glenoid width) than those under static conditions (101%, 92%, 84%, 78%, and 77% of the glenoid width) (all P < .001). The glenoid track width significantly decreased with the increasing abduction angles in the range of 30° to 120° under static conditions (all P < .003) and 30° to 90° under dynamic conditions (all P < .001). CONCLUSION: A smaller dynamic-based value should be considered for the glenoid track width when distinguishing on-track/off-track lesions. Clinical evidence is needed to establish the superiority of the dynamic-based value over the static-based value as an indicator for augmentation procedures. CLINICAL RELEVANCE: Some off-track lesions might be misclassified as on-track lesions when the original commonly used static-based value of 83% is used as the glenoid track width.

Multi-Agent Reinforcement Learning for Joint Cooperative Spectrum Sensing and Channel Access in Cognitive UAV Networks.

This paper studies the problem of distributed spectrum/channel access for cognitive radio-enabled unmanned aerial vehicles (CUAVs) that overlay upon primary channels. Under the framework of cooperative spectrum sensing and opportunistic transmission, a one-shot optimization problem for channel allocation, aiming to maximize the expected cumulative weighted reward of multiple CUAVs, is formulated. To handle the uncertainty due to the lack of prior knowledge about the primary user activities as well as the lack of the channel-access coordinator, the original problem is cast into a competition and cooperation hybrid multi-agent reinforcement learning (CCH-MARL) problem in the framework of Markov game (MG). Then, a value-iteration-based RL algorithm, which features upper confidence bound-Hoeffding (UCB-H) strategy searching, is proposed by treating each CUAV as an independent learner (IL). To address the curse of dimensionality, the UCB-H strategy is further extended with a double deep Q-network (DDQN). Numerical simulations show that the proposed algorithms are able to efficiently converge to stable strategies, and significantly improve the network performance when compared with the benchmark algorithms such as the vanilla Q-learning and DDQN algorithms.

Untargeted and targeted gingival metabolome in rodents reveal metabolic links between high-fat diet-induced obesity and periodontitis.

AIM: To characterize gingival metabolome in high-fat diet (HFD)-induced obesity in mice with/without periodontitis. METHODS: HFD-induced obesity mouse model was established by 16-week feeding, and a lean control group was fed with low-fat diet (n = 21/group). Both models were induced for periodontitis on the left sides by molar ligation for 10 days, whereas the right sides were used as controls. Gingival metabolome and arginine metabolism were analysed by non-targeted/targeted liquid chromatography-mass spectrometry. RESULTS: Of 2247 reference features, presence of periodontitis altered 165 in lean versus 885 in HFD mice; and HFD altered 525 in absence versus 1435 in presence of periodontitis. Compared with healthy condition, periodontitis and HFD had distinct effects on gingival metabolome. Metabolomic impacts of periodontitis were generally greater in HFD mice versus lean controls. K-medoids clustering showed that HFD amplified the impacts of periodontitis on gingival metabolome in both intensity and extensity. Ten metabolic pathways were enriched, including 2 specific to periodontitis, 5 specific to HFD and 3 shared ones. Targeted validation on arginine metabolism confirmed the additive effects between HFD and periodontitis. CONCLUSION: The obese population consuming excessive HFD display amplified metabolic response to periodontitis, presenting a metabolic susceptibility to exacerbated periodontal destruction.

Micro-CT analysis of hyperuricemia on alveolar bone destruction caused by short-term periodontal infection in mice / 口腔疾病防治

Objective@# Establish a murine model for hyperuricemia (HU) and periodontitis to explore whether there is correlation between them and provide a basis for periodontal treatment.@*Methods@#Fourteen male KM mice were divided into 2 groups; the HU group (n=7) was fed food supplemented with potassium oxonate and uric acid, the NC group (n=7) was fed standard food, and the induction period was 35 days. On the 25th day, the molars on one side were ligated to induce periodontitis (P side), while the opposite was true for the control (C side). Baseline and terminal serum uric acid (UA) levels were detected, and alveolar bone resorption was analyzed by micro-CT.@*Results@#The serum UA level of HU mice was (112.94 ± 26.82 )mol/L, that of the NC group was (72.21 ± 19.95) μmol/L, and the difference in UA level was statistically significant (P < 0.05). The P side bone volume fractions of the HU and NC groups were( 29.01 ± 11.09)% and (29.56 ± 15.27)%, respectively, which were not significantly different (t=-0.072, P=0.944). The P side bone mineral densities of the HU and NC groups were(0.53 ± 0.16) g/cm3 and (0.52 ± 0.14) g/cm3, respectively, which were not significantly different (t=0.038, P=0.970). Additionally, there was no correlation between HU or serum UA and alveolar bone resorption (P > 0.05). @* Conclusion @#This research established a murine model for HU and periodontitis, but based on micro-CT analysis of alveolar bone, no relationship between HU or UA levels and periodontitis was found.

Wasp Venom Possesses Potential Therapeutic Effect in Experimental Models of Rheumatoid Arthritis.

Rheumatoid arthritis (RA) is an autoimmune disease. Wasp venom (WV), which is considered as a traditional folk medicine in Jingpo nationality in Yunnan, China, relieves rheumatoid arthritis. The current study aimed to investigate the effect of wasp venom ameliorating rheumatoid arthritis symptoms in experimental rats. We established a model of type II collagen- (CII-) induced arthritis (CIA) in SD rats and examined the inhibition of inflammation and autoimmune response. The antiarthritic effects of WV were evaluated through the paw swelling, and histopathological score and histopathology changes of the affected paw were assessed. The anti-inflammation effects were assayed by the level of IL-6, TNF-α, IL-1ß, and the number of inflammatory cells in peripheral blood. The alteration of the T cell subset ratio in the spleen of rats was detected by flow cytometry, and at the same time, the viscera index and immune serum globulin levels were evaluated. The results suggested that various doses of WV (0.125, 0.25, and 0.5 mg/kg) significantly alleviated paw swelling and arthritis score in CIA rats with the untreated control (P < 0.05). WV (0.25 and 0.5 mg/kg) relieved synovial tissue lesions of ankle joints and histopathology scores of synoviocyte hyperplasia and inflammatory cell infiltration with vehicle group (P < 0.05). Regarding immunological regulation, 0.5 mg/kg WV lowered the immune serum globulin levels (P < 0.05), and we further found that WV (0.5 mg/kg) suppressed the immune response of Th cells, while enhancing the functions of Tc cells and Treg cells in spleen cells markedly (P < 0.05). The immunosuppressive action of WV displayed was analogous to its inhibitory effect on IL-1ß, TNF-α, IL-8, IL-6, COX-2, and PGE2 levels in rat serum. In conclusion, these findings demonstrated that WV exhibited antiarthritic activity, which might be associated with their inhibitory effects on immunoregulation and anti-inflammatory action.