Prospective Comparison of Postoperative Pain and Opioid Consumption Between Primary Repair and Reconstruction of the Anterior Cruciate Ligament.

Background: Anterior cruciate ligament (ACL) reconstruction (ACLR) is associated with postoperative pain and necessitates using perioperative nerve blocks and multimodal analgesic plans. Purpose: To assess postoperative pain and daily opioid use after ACL repair versus ACLR and to assess whether ACL repair could be performed successfully without using long-acting nerve blocks. Study Design: Cohort study; Level of evidence, 2. Methods: All eligible patients who underwent ACL surgery between 2019 and 2022 were prospectively enrolled. Patients were treated with primary repair if proximal tears with sufficient tissue quality were present; otherwise, they underwent single-bundle ACLR with either hamstring tendon or quadriceps tendon autograft. The patients were divided into 3 groups: ACLR with adductor canal nerve block (up to 20 mL of 0.25% bupivacaine with 2 mg dexamethasone), primary repair with nerve block, and primary repair without nerve block. Pain visual analog scale and number of opioids used were recorded during the first 14 postoperative days (PODs). Furthermore, patients completed the Quality of Recovery-15 (QoR-15) survey, and range of motion was assessed. Group differences were compared using Mann-Whitney U test and chi-square test. Results: Seventy-eight patients were included: 30 (39%) underwent ACLR, 19 (24%) ACL repair with nerve block, and 29 (37%) ACL repair without nerve block. Overall, the ACL repair group used significantly fewer opioids than the ACLR group on POD 1 (1 vs 3, P = .027) and POD 2 (1 vs 3, P = .014) while also using fewer opioids in total (3 vs 8, P = .038). This difference was even more marked when only analyzing those patients who received postoperative nerve blocks (1 vs 8, P = .029). Repair patients had significantly higher QoR-15 scores throughout the first postoperative week, and they had greater range of motion (all P < .05). There were no significant differences in pain scores, opioid usage, or QoR-15 scores between patients who underwent repair with versus without nerve block. Conclusion: The ACL repair group experienced less postoperative pain during the first 2 weeks after surgery and used significantly fewer opioids than the ACLR group. Furthermore, they had improved knee function and higher recovery quality than patients who underwent ACLR during the initial postoperative period. Postoperative nerve blocks may not be necessary after ACL repair.

How Amorphous Nanomaterials Enhanced Electrocatalytic, SERS, and Mechanical Properties.

There is ever-growing research interest in nanomaterials because of the unique properties that emerge on the nanometer scale. While crystalline nanomaterials have received a surge of attention for exhibiting state-of-the-art properties in various fields, their amorphous counterparts have also attracted attention in recent years owing to their unique structural features that crystalline materials lack. In short, amorphous nanomaterials only have short-range order at the atomic scale, and their atomic packing lacks long-range periodic arrangement, in which the coordinatively unsaturated environment, isotropic atomic structure, and modulated electron state all contribute to their outstanding performance in various applications. Given their intriguing characteristics, we herein present a series of representative works to elaborate on the structural advantages of amorphous nanomaterials as well as their enhanced electrocatalytic, surface-enhanced Raman scattering (SERS), and mechanical properties, thereby elucidating the underlying structure-function relationship. We hope that this proposed relationship will be universally applicable, thus encouraging future work in the design of amorphous materials that show promising performance in a wide range of fields.

Low-temperature anode-free potassium metal batteries.

In contrast to conventional batteries, anode-free configurations can extend cell-level energy densities closer to the theoretical limit. However, realizing alkali metal plating/stripping on a bare current collector with high reversibility is challenging, especially at low temperature, as an unstable solid-electrolyte interphase and uncontrolled dendrite growth occur more easily. Here, a low-temperature anode-free potassium (K) metal non-aqueous battery is reported. By introducing Si-O-based additives, namely polydimethylsiloxane, in a weak-solvation low-concentration electrolyte of 0.4 M potassium hexafluorophosphate in 1,2-dimethoxyethane, the in situ formed potassiophilic interface enables uniform K deposition, and offers K||Cu cells with an average K plating/stripping Coulombic efficiency of 99.80% at -40 °C. Consequently, anode-free Cu||prepotassiated 3,4,9,10-perylene-tetracarboxylicacid-dianhydride full batteries achieve stable cycling with a high specific energy of 152 Wh kg-1 based on the total mass of the negative and positive electrodes at 0.2 C (26 mA g-1) charge/discharge and -40 °C.

Recent Progress of Amorphous Nanomaterials.

Amorphous materials are metastable solids with only short-range order at the atomic scale, which results from local intermolecular chemical bonding. The lack of long-range order typical of crystals endows amorphous nanomaterials with unconventional and intriguing structural features, such as isotropic atomic environments, abundant surface dangling bonds, highly unsaturated coordination, etc. Because of these features and the ensuing modulation in electronic properties, amorphous nanomaterials display potential for practical applications in different areas. Motivated by these elements, here we provide an overview of the unique structural features, the general synthetic methods, and the potential for applications covered by contemporary research in amorphous nanomaterials. Furthermore, we discussed the possible theoretical mechanism for amorphous nanomaterials, examining how the unique structural properties and electronic configurations contribute to their exceptional performance. In particular, the structural benefits of amorphous nanomaterials as well as their enhanced electrocatalytic, optical, and mechanical properties, thereby clarifying the structure-function relationships, are highlighted. Finally, a perspective on the preparation and utilization of amorphous nanomaterials to establish mature systems with a superior hierarchy for various applications is introduced, and an outlook for future challenges and opportunities at the frontiers of this rapidly advancing field is proposed.

Age and Bone Bruise Patterns Predict Tear Location in the Anterior Cruciate Ligament.

Purpose: To assess the influence of demographic risk factors, anatomic risk factors, and injury mechanisms on anterior cruciate ligament (ACL) tear patterns. Methods: All patients undergoing knee magnetic resonance imaging at our institution for acute ACL tears (within 1 month of injury) in 2019 were retrospectively analyzed. Patients with partial ACL tears and full-thickness posterior cruciate ligament injuries were excluded. On sagittal magnetic resonance images, the proximal and distal remnant lengths were measured, and the tear location was calculated as the distal remnant length divided by the total remnant length. Previously reported demographic and anatomic risk factors associated with ACL injury were then reviewed, including the notch width index, notch angle, intercondylar notch stenosis, alpha angle, posterior tibial slope, meniscal slope, and lateral femoral condyle index. In addition, the presence and severity of bone bruises were recorded. Finally, risk factors associated with ACL tear location were further analyzed using multivariate logistic regression. Results: A total of 254 patients (44% male patients; mean age, 34 years; age range, 9-74 years) were included, of whom 60 (24%) had a proximal ACL tear (tear at the proximal quarter). Multivariate enter logistic regression analysis showed that older age (P = .008) was predictive of a more proximal tear location whereas open physes (P = .025), bone bruises in both compartments (P = .005), and posterolateral corner injury (P = .017) decreased the likelihood of a proximal tear (R 2 = 0.121, P < .001). Conclusions: No anatomic risk factors were identified to play a role in tear location. Although most patients have midsubstance tears, proximal ACL tears were more commonly found in older patients. Bone contusions involving the medial compartment are associated with midsubstance tears; these findings may indicate that different injury mechanisms play a role in the location at which the ACL tears. Level of Evidence: Level III, prognostic, retrospective cohort study.

Combining controlled-release urea with potassium chloride to reduce soil N/K leaching and promote growth of Italian ryegrass.

Nitrogen (N) and potassium (K) are essential nutrients for Italian ryegrass (Lolium multiflorum L.) growth. A 2-year field experiment with a split-plot design was conducted to study the effect of N fertilizer type combined with different K fertilizer rates on the soil mineral N and K availability, and growth characteristics of Italian ryegrass. The main plots were assigned to two N fertilizer types, controlled-release urea (CRU) and common urea. While low, moderate and high potassium chloride (KCl) rates (150, 300 and 450 kg ha-1, respectively) were assigned to the subplots. Compared with the common urea treatments, the CRU significantly increased the SPAD value, plant height, leaf area, and photosynthetic index of Italian ryegrass, which significantly prolonged the green stage of Italian ryegrass and prevented premature senescence. Moreover, the dry yields of the CRU increased by 4.5-12.5% in 2019 and 10.9-25.3% in 2020 compared with the urea, respectively. At the same time, compared with the KCl150 and KCl450 treatments, the KCl300 treatment resulted in better plant growth. Overall, the CRU × KCl300 maximized the soil inorganic N and different soil K forms, and reduced the soil N/K leaching. The root length, volume, surface area, average diameter, tips and branches were also improved, and there was a significant N × K interaction effect on the tips. The CRU combined with 300 kg ha-1 KCl fertilization enhanced crop growth by improving leaf photosynthesis, soil fertility, and yield and should be recommended as the best fertilizer ratio for Italian ryegrass production.

Early and Delayed Surgery for Isolated ACL and Multiligamentous Knee Injuries Have Equivalent Results: A Systematic Review and Meta-analysis.

BACKGROUND: Early surgery for acute ligamentous injuries has recently shown good clinical and functional outcomes. PURPOSE: To assess the advantages of early vs delayed surgery in patients undergoing isolated anterior cruciate ligament (ACL) or multiligament-injured knee (MLIK) surgery. STUDY DESIGN: Meta-analyses of Level 1, 2, and 3 studies; Level of evidence, 4. METHODS: A systematic search was performed via PubMed, EMBASE, and Cochrane for studies reporting outcomes of timing of surgery after isolated ACL injury or in the MLIK setting using accelerated rehabilitation protocols. Two analyses were conducted to differentiate early and delayed treatment (3- and 6-week cutoffs). Collected outcomes included meniscal or chondral lesions, failure and reoperation rates, range of motion (ROM) deficits, other complications, muscle strength, instrumented laxity, and functional outcomes. Outcomes were reported in risk ratios (RR) or mean differences with 95% CIs. RESULTS: For timing of isolated ACL surgery, 16 studies were included with 2093 patients. High-grade evidence indicated that there were no differences in meniscal or chondral lesions, failure and reoperation rates, stiffness, ROM deficits, complications, muscle strength, instrumented laxity, and functional outcomes between patients treated early and late (all P > .05). When including only studies that set no preoperative criteria for early surgery, the findings were similar. Regarding MLIK surgery, 14 studies were included with 1172 patients. Low evidence was noted for the following: patients treated early had significantly fewer meniscal injuries (RR, 0.7; P = .04) and chondral injuries (RR, 0.5; P < .001), while no differences were found in reoperation rates, complications, stiffness, ROM deficits, muscle strength, instrumented laxity, and functional outcomes between the groups. Other than higher Lysholm scores in the early group for the 3-week analysis (mean difference, 6.8; P = .01), there were no differences between cutoff analyses. CONCLUSION: This systematic review with meta-analysis found no differences in clinical and functional outcomes between early and delayed surgery for isolated ACL injuries. For MLIK injuries, there were also no differences in surgical outcomes between early and delayed surgery.

Treating Combined Anterior Cruciate Ligament and Medial Collateral Ligament Injuries Operatively in the Acute Setting Is Potentially Advantageous.

Combined injury of the anterior cruciate ligament (ACL) and medial collateral ligament (MCL) remains among the most common knee injury patterns in orthopaedics. Optimal treatment of grade III MCL injuries is still debated, especially when combined with ACL injury. Most patients with these severe injuries are treated conservatively for at least 6 weeks to allow for MCL healing, followed by delayed ACL reconstruction. Although acute treatment of the MCL was common in the 1970s, postoperative stiffness was frequently reported. Moreover, studies of such treatment failed to show clinical benefits of surgical over conservative treatment, and the MCL exhibited intrinsic healing capacity, leading to the consensus that all MCL injuries are treated conservatively. The current delayed treatment algorithm for ACL-MCL injuries has several disadvantages. First, MCL healing may be incomplete, resulting in residual valgus laxity that places the ACL graft at greater risk of failure. Second, delayed treatment lengthens the overall rehabilitation period, thereby prolonging the presence of atrophy and delaying return to preinjury activity levels. Third, the initial healing period leaves the knee unstable for longer and risks further intra-articular damage. Acute simultaneous surgical treatment of both ligaments has the potential to avoid these shortcomings. This article will review the evolution of treatment of ACL-MCL injuries and explain how it shifted toward the current treatment algorithm. We will (1) discuss why the consensus shifted, (2) discuss the shortcomings of the current treatment plan, (3) discuss the potential advantages of acute simultaneous treatment, and (4) present an overview of the available literature.

Au Atoms Anchored on Amorphous C3N4 for Single-Site Raman Enhancement.

From spanning bulks to nanoclusters, surface-enhanced Raman scattering (SERS) substrates of noble metals have frequently been explored for a long time. However, further downsizing nanoclusters to the atomic level, the surface plasmon resonance effect disappears, making the research on the SERS effect of atom-scale noble metal still lacking. Here, we discover a single-atom enhanced Raman scattering (SAERS) effect based on Au single atoms anchored on amorphous C3N4 nanosheets (Au1/ACNs). The Au1/ACN exhibits an excellent spectral stability and reproducibility, as the uniform dispersed Au single atoms avoid the agglomeration of Au atoms to generate nonuniformly dispersed "hotspots" that suffer from poor SERS stability and reproducibility. Even only ∼2.5% Au-coated area in the laser illuminated area can yield an enhancement factor of 2.5 × 104. The SAERS effect is attributed to the synergistic effect of Au single atoms anchored on amorphous C3N4, which increases the dipole moment and polarizability of molecules, enhancing the Raman signal of probe molecules. Furthermore, we propose a novel single-atom charge transfer mechanism that single-atom Au dominates higher electron delocalizability and higher electronic density of states near the HOMO level than the Au cluster. Our results will erect a new milepost for the application of single-atom materials in the field of enhanced Raman spectroscopy.

Role of Inorganic Amorphous Constituents in Highly Mineralized Biomaterials and Their Imitations.

A highly mineralized biomaterial is one kind of biomaterial that usually possesses a high content of crystal minerals and hierarchical microstructure, exhibiting excellent mechanical properties to support the living body. Recent studies have revealed the presence of inorganic amorphous constituents (IAC) either during the biomineralization process or in some mature bodies, which heavily affects the formation and performance of highly mineralized biomaterials. These results are surprising given the preceding intensive research into the microstructure design of these materials. Herein, we highlight the role of IAC in highly mineralized biomaterials. We focused on summarizing works demonstrating the presence or phase transformation of IAC and discussed in detail how IAC affects the formation and performance of highly mineralized biomaterials. Furthermore, we described some imitations of highly mineralized biomaterials that use IAC as the synthetic precursor or final strengthening phase. Finally, we briefly summarized the role of IAC in biomaterials and provided an outlook on the challenges and opportunities for future IAC and IAC-containing bioinspired materials researches.

Substance accumulation of a wetland plant, Leersia japonica, during senescence in the Yihe and Shuhe River Basin, North China.

Leersia japonica is a perennial Gramineae grass that is dominant in shallow wetlands of the Yihe and Shuhe River Basin, North China. Previous studies have shown that L. japonica recovers early (March), tillers strongly, and has an excellent ability to purify sewage in spring. This early revival might play a vital role in water purification function; however, whether the plant benefits from the physiological activities during senescence remains unclear. Therefore, in this study, an experiment was conducted during the winter of 2016 and in the following spring. Morphology (height, biomass, root morphology), physiology (root vitality, malondialdehyde [MDA], superoxide dismutase [SOD]), substance contents (soluble sugar, soluble protein) and substance transportation (activity of enzymes for transportation and energy supply) were determined during weeks 0, 2, 4, 6, and 8 of the senescence stage (October 11, 2016); as well as substance contents and bud increments during days 0,7, 14, 21, 31 and 41 of the revival period (February 22, 2017). The results revealed that (1) the root biomass of L. japonica increased significantly during senescence, even after the leaves withered. (2) The root diameter of L. japonica decreased significantly, while root weight per volume and root superficial area per volume increased significantly during senescence. The root vitality was relatively stable in winter, especially for root absorption area per volume. (3) No significant difference was observed in membrane stability of stems, rhizomes and roots of L. japonica in winter, with the MDA content remaining stable and SOD activity increasing significantly during senescence. (4) The soluble sugar content of all tissues of L. japonica increased sharply during senescence; while it decreased significantly in spring, especially for buds. (5) The enzymes for substance metabolism responded differently, with activities of H+-ATPase and pyruvate decarboxylase (PDC) decreasing, and alcohol dehydrogenase (ADH) increasing. Therefore, L. japonica has active morphological adaptation of roots, physiological regulation, and massive substance accumulation during senescence stage. The special life-history trait ensures L. japonica survival in winter and revival in early spring, which makes it being an excellent plant for purifying sewage in spring.

Bilateral simultaneous anterior cruciate ligament tears treated with single staged simultaneous primary repair: A case report.

INTRODUCTION AND IMPORTANCE: Simultaneous bilateral anterior cruciate ligament (ACL) injuries are a rare injury pattern within the literature. There is not a consensus optimal management of this injury. Bilateral primary ACL repair in a single stage surgery provides knee stability with a minimally morbid surgery in a single rehabilitation period. This case report offers another option for surgeons to consider in the treatment of this rare injury. CASE PRESENTATION: A 45-year-old female skier presented with simultaneous bilateral isolated proximal anterior cruciate ligament injuries. MRI demonstrated bilateral proximal ACL tear patterns which were amenable to primary ACL repair. The patient subsequently underwent acute single-staged arthroscopic primary ACL repair with suture augmentation of both knees. She attained rehabilitation milestones and was fully cleared to return to sporting activities one year post-operatively. Two years post-operatively the patient continues to do well with excellent clinical outcomes. CLINICAL DISCUSSION: The other treatment modalities reported in the literature were single staged and two staged ACL reconstruction with either autograft or allograft. While single staged procedures are more time and cost efficient, the primary concern is that simultaneous rehabilitation of bilateral ACL reconstructions may lead to severe quadriceps deconditioning. Primary ACL repair poses a potential solution as a minimally morbid surgery with faster rehabilitation from surgery. CONCLUSION: Due to the limited invasiveness and morbidity of ACL primary repair with suture augmentation, simultaneous primary repair surgery could be an excellent treatment option for this rare patient population, saving time and cost while providing appropriate knee stability. LEVEL OF EVIDENCE: Level IV, Case Report.

Primary Repair versus Reconstruction in Patients with Bilateral Anterior Cruciate Ligament Injuries: What Do Patients Prefer?

Purpose: The purpose is to evaluate knee preference and functional outcomes of patients with primary anterior cruciate ligament (ACL) repair in one knee and ACL reconstruction in the contralateral side. Methods: All patients who underwent both procedures were retrospectively reviewed at minimum two-year follow-up. Patients were asked to complete questionnaires regarding their operated knees' preferences during rehabilitation, daily activities, sports activities, and overall function. Furthermore, the Subjective International Knee Documentation Committee, Forgotten Joint Score-12, and Anterior Cruciate Ligament-Return to Sport after Injury were completed. Results: Twenty-one patients were included. All patients underwent ACL reconstruction first, which was displayed at younger age at surgery (24 vs. 33 years, p = 0.010) and longer follow-up (10.2 vs. 2.3 years, p < 0.001), respectively. Thirty-three percent preferred the repaired knee, 11% the reconstructed knee, and 56% had no preference; however, 78% indicated that their repaired knee was less painful during rehabilitation and 83% reported earlier range of motion (ROM) return following repair, which was similar for both knees in 17%. Eighty-three percent of patients indicated better function and progression during rehabilitation with their repaired knee and 11% with their reconstructed knees. No statistical differences were found in patient-reported outcomes between both procedures (all p > 0.4). Objective laxity assessment showed mean side-to-side difference of 0.6 mm between both sides in favor of the reconstructed knee. Conclusion: This study showed that ACL repair and ACL reconstruction lead to similar functional outcomes. However, patients undergoing both procedures may have less pain, earlier ROM return, and faster rehabilitation progression following primary repair.

Coaxially Fabricated Dual-Drug Loading Electrospinning Fibrous Mat with Programmed Releasing Behavior to Boost Vascularized Bone Regeneration.

In clinical treatment, the bone regeneration of critical-size defects is desiderated to be solved, and the regeneration of large bone segment defects depends on early vascularization. Therefore, overcoming insufficient vascularization in artificial bone grafts may be a promising strategy for critical-size bone regeneration. Herein, a novel dual-drug programmed releasing electrospinning fibrous mat (EFM) with a deferoxamine (DFO)-loaded shell layer and a dexamethasone (DEX)-loaded core layer is fabricated using coaxial electrospinning technology, considering the temporal sequence of vascularization and bone repair. DFO acts as an angiogenesis promoter and DEX is used as an osteogenesis inducer. The results demonstrate that the early and rapid release of DFO promotes angiogenesis in human umbilical vascular endothelial cells and the sustained release of DEX enhances the osteogenic differentiation of rat bone mesenchymal stem cells. DFO and DEX exert synergetic effects on osteogenic differentiation via the Wnt/ß-catenin signaling pathway, and the dual-drug programmed releasing EFM acquired perfect vascularized bone regeneration ability in a rat calvarial defect model. Overall, the study suggests a low-cost strategy to enhance vascularized bone regeneration by adjusting the behavior of angiogenesis and osteogenesis in time dimension.

Efficient TurboID-based proximity labelling method for identifying terminal sialic acid glycosylation in living cells.

TurboID, a proximity labelling method based on mutant biotin ligase, is an efficient new technique for recognizing protein-protein interactions and has been successfully applied to living cells. Sialic acid is typically the terminal monosaccharide attached to many glycoproteins and plays many important roles in many biological processes. However, the lack of enrichment methods for terminal sialic acid glycosylation in vivo hinders the identification and analysis of this glycosylation. Here, we introduce TurboID to identify terminal sialic acid glycosylation in living cells. SpCBM, the carbohydrate-binding domain of sialidase from Streptococcus pneumoniae, is fused with TurboID and overexpressed in HeLa cells. After streptavidin-based purification and detection by mass spectrometry, 31 terminal sialic acid N-glycosylated sites and 1359 putative terminal sialic acid glycosylated proteins are identified, many of which are located in the cytoplasm and nucleus.

Nano-CuO causes cell damage through activation of dose-dependent autophagy and mitochondrial lncCyt b-AS/ND5-AS/ND6-AS in SH-SY5Y cells.

Metal copper oxide nanoparticles (nano-CuO) are under mass production and have been widely utilized in many fields including catalysis, gas sensors, semiconductor materials, etc. The broad applications of nano-CuO have increased the possibility of risk to incidental exposure to the environment, and therefore, an in-depth investigation of their effects on live cells is required. This study investigated the impact of the nano-CuO on SH-SY5Y cells, and findings showed that the ratio of LC3-II/LC3-I was significantly increased in SH-SY5Y cells when the cells were treated with nano-CuO. However, if the autophagy inhibitor Bafilomycin A1 (Baf A1) was co-treated, the ratio of LC3-II/LC3-I was further improved. These outcomes might indicate that autophagy flux was permanently elevated by adding nano-CuO. Further results found highly activated levels of long noncoding RNAs (lncRNAs) under nano-CuO treatment. The data illustrate a mechanism that nano-CuO can promote autophagy and activate lncCyt b-AS/ND5-AS/ND6-AS in SH-SY5Y cells and have critical implications for nanoparticle biomedical applications.

Infra-adjacent Segment Disease After Lumbar Fusion: An Analysis of Pelvic Parameters.

STUDY DESIGN: Cross-sectional observational cohort study. OBJECTIVE: The aim of this study was to determine the incidence and risk factors associated with the development of sacroiliac joint (SIJ) dysfunction following lumbosacral fusion. SUMMARY OF BACKGROUND DATA: Adjacent segment degeneration to both proximal and distal areas of spinal fusion is a postoperative complication of lumbar fusion. Various studies examined supra-adjacent degeneration following lumbar fusion, but few focused on infra-adjacent degeneration. In lumbosacral fusion, fusion extends to the sacrum, placing increased stress on the SIJ. METHODS: A total of 2069 sequential patients who underwent lumbosacral fusion surgery from 2008 to 2018 at a single academic medical center were retrospectively reviewed. Patients who subsequently developed SIJ dysfunction were identified. SIJ dysfunction was defined as patients who met the diagnostic criteria with physical examination and received an SIJ injection with clinical evidence of improvement. Controls, without subsequent SIJ dysfunction, were matched with cases based on levels of fusion, age, sex, and body mass index. Pre-and postoperative pelvic parameters were measured, including pelvic incidence, pelvic tilt (PT), sacral slope, lumbar lordosis, lumbosacral angle, L4 incidence and L5 incidence. RESULTS: Of 2069 patients who underwent lumbosacral fusion, 81 patients (3.9%) met criteria for SIJ dysfunction. Measurements were made for 47 of 81 patients who had SIJ dysfunction, that had both pre- and post-operative imaging. Measurements for 44 matched controls were taken. Postoperative PT was significantly lower in SIJ dysfunction patients compared to controls (20.82°â€Š±â€Š2.19° vs. 27.28°â€Š±â€Š2.30°; P < 0.05), as was L5 incidence (28.64°â€Š±â€Š3.38° vs. 37.11°â€Š± 3.50°; P < 0.05). CONCLUSION: Incidence of the SIJ dysfunction after lumbosacral fusion surgery was 3.9% and these patients had a significantly lower PT and L5 incidence compared to the control group. Significantly low PT may be derived from weak hamstring muscles, predisposing a patient to SIJ dysfunction. Therefore, hamstring muscle strengthening exercise for patients with decreased PT after lumbosacral fusion may decrease the incidence of SIJ dysfunction.Level of Evidence: 3.

Antiviral Efficacy of Metal and Metal Oxide Nanoparticles against the Porcine Reproductive and Respiratory Syndrome Virus.

Porcine reproductive and respiratory syndrome viruses (PRRSV) are responsible for one of the most economically important diseases affecting the global pig industry. On-farm high-efficiency particulate air (HEPA) filtration systems can effectively reduce airborne transmission of PRRSV and the incidence of PRRS, but they are costly, and their adoption is limited. Therefore, there is a need for low-cost alternatives, such as antimicrobial filters impregnated with antiviral nanoparticles (AVNP). During the past 10 years, tailored intermetallic/multi-elemental AVNP compositions have demonstrated effective performance against human viruses. In this study, a panel of five AVNP was evaluated for viricidal activity against PRRSV. Three AVNP materials: AVNP2, copper nanoparticles (CuNP), and copper oxide nanoparticles (CuONP), were shown to exert a significant reduction (>99.99%) in virus titers at 1.0% (w/v) concentration. Among the three, CuNP was the most effective at lower concentrations. Further experiments revealed that AVNP generated significant reductions in viral titers within just 1.5 min. For an optimal reduction in viral titers, direct contact between viruses and AVNP was required. This was further explained by the inert nature of these AVNP, where only negligible leaching concentrations of Ag/Cu ions (0.06-4.06 ppm) were detected in AVNP supernatants. Real-time dynamic light scatting (DLS) and transmission electron microscopic (TEM) analyses suggested that the mono-dispersive hydrodynamic behavior of AVNPs may have enhanced their antiviral activity against PRRSV. Collectively, these data support the further evaluation of these AVNP as candidate nanoparticles for incorporation into antimicrobial air-filtration systems to reduce transmission of PRRSV and other airborne pathogens.

Reliable Internal Consistency and Adequate Validity of the Forgotten Joint Score-12 after Primary Anterior Cruciate Ligament Repair.

PURPOSE: To validate the Forgotten Joint Score-12 (FJS-12) as a subjective outcome metric for patients undergoing arthroscopic primary anterior cruciate ligament (ACL) repair. METHODS: In this retrospective study, all patients undergoing primary ACL repair for complete isolated proximal tears between 2008 and 2018 were eligible for inclusion. Patients were contacted and asked to complete the FJS-12, Lysholm Knee Score, modified Cincinnati score, Single Assessment Numeric Evaluation (SANE), Subjective International Knee Documentation Committee (IKDC), and Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) scale at a minimum of 1 year of follow-up. Internal consistency, convergent validity, and ceiling effects were analyzed. RESULTS: Ninety-six patients could be included (62%), with a mean FJS-12 score of 86.9 ± 14.0 (range, 31.3-100). The FJS-12 showed reliable internal consistency (Cronbach's alpha = 0.89). Construct validity was moderate to strong (r = 0. 621-0.702). Ceiling effect for the FJS-12 was 21.9%, which was lower than for the Lysholm (44.6%), modified Cincinnati (45.1%), equal to the IKDC subjective (21.9%), and SANE score (22.0%) but higher compared to the ACL-RSI (12.8%). Furthermore, internal consistency for the other scores was also good to excellent (range Cronbach's alpha = 0.627-0.953). CONCLUSION: The FJS-12 shows high internal consistency and construct validity after primary ACL repair. Furthermore, this metric showed equal or less ceiling effect than most other scores, although still notable. This study suggests that the FJS-12 is an easy and validated outcome metric to evaluate subjective primary repair outcomes. LEVEL OF EVIDENCE: Level III, diagnostic study.

Treatment of severe COVID-19 with convalescent plasma in Bronx, NYC.

Convalescent plasma with severe acute respiratory disease coronavirus 2 (SARS-CoV-2) antibodies (CCP) may hold promise as a treatment for coronavirus disease 2019 (COVID-19). We compared the mortality and clinical outcome of patients with COVID-19 who received 200 mL of CCP with a spike protein IgG titer ≥ 1:2430 (median 1:47,385) within 72 hours of admission with propensity score-matched controls cared for at a medical center in the Bronx, between April 13 and May 4, 2020. Matching criteria for controls were age, sex, body mass index, race, ethnicity, comorbidities, week of admission, oxygen requirement, D-dimer, lymphocyte counts, corticosteroid use, and anticoagulation use. There was no difference in mortality or oxygenation between CCP recipients and controls at day 28. When stratified by age, compared with matched controls, CCP recipients less than 65 years had 4-fold lower risk of mortality and 4-fold lower risk of deterioration in oxygenation or mortality at day 28. For CCP recipients, pretransfusion spike protein IgG, IgM, and IgA titers were associated with mortality at day 28 in univariate analyses. No adverse effects of CCP were observed. Our results suggest CCP may be beneficial for hospitalized patients less than 65 years, but data from controlled trials are needed to validate this finding and establish the effect of aging on CCP efficacy.