This study aimed to quantify the elongation patterns of the collateral ligaments following TKA during functional activities of daily living. Using mobile video-fluoroscopy to capture radiographic ...images of the knee in a group of six patients, each with an ultra-congruent knee implant, tibiofemoral kinematics were reconstructed throughout complete cycles of level gait, downhill walking, stair descent, and squat activities. Kinematic data were then used to drive subject-specific multibody knee models to estimate length-change patterns of the LCL as well as three bundles of the MCL. In addition, a sensitivity analysis examined the role of the attachment site in the elongation patterns. Our data indicate a slackening of the LCL but non-uniform length-change patterns across the MCL bundles (ranging from lengthening of the anterior fibers to shortening of the posterior fibers) with increasing knee flexion angle. Near-isometric behavior of the intermediate fibers was observed throughout the entire cycle of the studied activities. These length-change patterns were found to be largely consistent across different activities. Importantly, length-change patterns were critically sensitive to the location of the femoral attachment points relative to the femoral component. Thus, in TKA with ultra-congruent implants, implantation of the femoral component may critically govern post-operative ligament function.
Extensive efforts have been made to understand joint kinematics and kinetics in total knee arthroplasty (TKA) in subjects with satisfactory outcomes during daily functional activities and clinical ...tests, but it remains unclear whether such movement characteristics hold the potential to indicate the underlying aetiology of unsatisfactory or bad TKA outcomes.
To investigate which kinematic and kinetic parameters assessed during passive clinical tests and functional activities of daily living are associated with poor functionality and underlying deficits after total knee replacement.
We focused on studies characterizing the kinematic or kinetic parameters of the knee joint that are associated with poor clinical outcome after TKA. Seventeen articles were included for the review, and kinematic and kinetic data from 719 patients with minimal follow up of 6 months were extracted and analyzed.
Passive posterior translation at 90°flexionexhibited good potential for differentiating stable and unstable TKAs. Anterior-posterior (A-P) translation of the medial condyle at 0–30° and 30–60° flexion, A-P translation of the lateral condyle at 60–90°during closed chain exercises, as well asknee extension moment during stair ascent and descent, knee abduction moment during stair descent, knee internal rotation moment and plantar flexion moment during walking, 2ndpeak ground reaction force during stair ascent and walkingshowed the greatest promise as functional biomarkers for a dissatisfied/poor outcome knee after TKA.
In this study, we systematically reviewed the state-of-the-art knowledge of kinematics and kinetics associated with functional deficits, and found 11 biomechanical parameters that showed promise for supportingdecision making in TKA.
Treatment of cystic fibrosis (CF) has been revolutionized by the use of cystic fibrosis transmembrane conductance regulator (CFTR) protein modulators such as elexacaftor/tezacaftor/ivacaftor (ETI) ...triple therapy. Prior studies support a role for type 2 (T2) inflammation in many people with CF (PwCF) and CF-asthma overlap syndrome (CFAOS) is considered a separate clinical entity. It is unknown whether initiation of ETI therapy impacts T2 inflammation in PwCF. We hypothesized that ETI initiation decreases T2 inflammation in PwCF.
A single center retrospective chart review was conducted for adult PwCF. As markers of T2 inflammation, absolute eosinophil count (AEC) and total immunoglobulin E (IgE) data were collected longitudinally 12 months prior to ETI therapy initiation and 12 months following therapy initiation. Multivariable analyses adjusted for the age, gender, CFTR mutation, disease severity, inhaled steroid use, and microbiological colonization.
There was a statistically significant reduction (20.10%, p < 0.001) in 12-month mean total IgE following ETI initiation; this change remained statistically significant in the multivariate model. The longitudinal analysis demonstrated no change in AEC following therapy initiation.
This study demonstrates that there is a statistically significant percent reduction in mean total IgE but no change in AEC following ETI initiation. ETI may lead to decreased antigen and superantigen load in the airway as a result of improved mucociliary clearance and these changes may drive the decline in total IgE, without influencing the epigenetic drivers of eosinophilic inflammation. Further studies are warranted to determine the underlying mechanism of ETI impact on T2 inflammation and possible role for asthma immunomodulator therapy post ETI initiation in CFAOS.
Total knee arthroplasty aims to mimic the natural knee kinematics by optimizing implant geometry, but it is not clear how loading relates to tibio-femoral anterior-posterior translation or ...internal-external pivoting. We hypothesised that the point of pivot in the transverse plane is governed by the location of the highest axial force. Tibio-femoral loading was measured using an instrumented tibial component in six total knee arthroplasty patients (aged 65-80y, 5-7y post-op) during 5-6 squat repetitions, while knee kinematics were captured using a mobile video-fluoroscope. In the range of congruent tibio-femoral contact the medial femoral condyle remained approximately static while the lateral condyle translated posteriorly by 4.1 mm (median). Beyond the congruent range, the medial and lateral condyle motions both abruptly changed to anterior sliding by 4.6 mm, and 2.6 mm respectively. On average, both the axial loading and pivot position were more medial near extension, and transferred to the lateral side in flexion. However, no consistent relationship between pivoting and load distribution was found across all patients throughout flexion, with R
values ranging from 0.00 to 0.65. Tibio-femoral kinematics is not related to the load distribution alone: medial loading of the knee does not necessarily imply a medial pivot location.
"In recent years, the food industry has made substantial advances in replacing partially hydrogenated oils, high in trans-fatty acids, in foods. Trait-modified oils were then developed to produce ...trans-fat free, low saturated functional oils. Trait-modified Oils in Foods offers top line information on the sources, composition, performance, health, taste, and availability of modified next generation oils. Coverage extends to public policy development, discussions of real world transition to healthy oils by food service and food processing industries and the future of trait-modified oils. The book provides solutions to food companies with the potential of improving the health benefits of foods through eliminating trans-fats and reducing saturated fats from formulations. A landmark resource on modified next-generation, trait-modified oils, this book is essential reading for oil processors, manufacturers and producers, as well as any professional involved in food quality assurance and public health"--
Biodiesel, an alternative fuel derived from vegetable oils or animal fats, continues to undergo rapid worldwide growth. Specifications mandating biodiesel quality, most notably in Europe (EN 14214) ...and the USA (ASTM D6751), have emerged that limit feedstock choice in the production of biodiesel fuel. For instance, EN 14214 contains a specification for iodine value (IV; 120 g I2/100 g maximum) that eliminates soybean oil as a potential feedstock, as it generally has an IV >120. Therefore, partially hydrogenated soybean oil methyl esters (PHSME; IV = 116) were evaluated as biodiesel by measuring a number of fuel properties, such as oxidative stability, low‐temperature performance, lubricity, kinematic viscosity, and specific gravity. Compared to soybean oil methyl esters (SME), PHSME were found to have superior oxidative stability, similar specific gravity, but inferior low‐temperature performance, kinematic viscosity, and lubricity. The kinematic viscosity and lubricity of PHSME, however, were within the prescribed US and European limits. There is no universal value for low‐temperature performance in biodiesel specifications, but PHSME have superior cold flow behavior when compared to other alternative feedstock fuels, such as palm oil, tallow and grease methyl esters. The production of PHSME from refined soybean oil would increase biodiesel production costs by US$ 0.04/L (US$ 0.15/gal) in comparison to SME. In summary, PHSME are within both the European and American standards for all properties measured in this study and deserve consideration as a potential biodiesel fuel.
We have conducted thermal and X-ray diffraction experiments on binary mixtures of symmetric stearic-oleic mixed-acid triacylglycerol (TAG) (1,3-distearoyl-2-oleoyl-glycerol: SOS) and asymmetric ...stearic-oleic mixed-acid TAG (1,2-dioleoyl-3-stearoyl-
sn
-glycerol: OOS), in which optically active
sn
-OOS was employed. We found that SOS–OOS mixtures exhibited immiscible monotectic or peritectic mixing behavior. This result was consistent with previous study on binary mixtures of 1,3-dipalmitoyl-2-oleoyl-glycerol (POP) and 1,2-dioleoyl-3-palmitoyl-
rac
-glycerol (OOP), in which racemic
rac
-OOP molecules were employed. The differences between the SOS–OOS and POP–OOP mixtures were in the polymorphic behavior of the fractions of POP and SOS. No effect was found from using an optically active (
sn
-OOS) or racemic mixture (
rac
-OOP) as an asymmetric oleic–oleic-saturated acid TAG. From the two results, we may conclude that an immiscible phase was formed in the binary mixtures of symmetric saturated-oleic-saturated TAGs and asymmetric oleic–oleic-saturated TAGs, of both racemic and optically active types. This result stands in contrast to mixtures of SOS–OSO (1,3-dioleoyl-2-stearoyl-glycerol), SOS–SSO (1,2-distearoyl-3-oleoyl-
rac
-glycerol), POP–OPO (1,3-dioleoyl-2-palmitoyl-glycerol), and POP–PPO (1,2-dipalmitoyl-3-oleoyl-
rac
-glycerol), all of which exhibited molecular-compound-forming behavior with molecular compound crystals at an equal ratio of the binary mixtures. Molecular-level mechanisms to explain this difference are discussed, based on possible roles of glycerol groups acting during the mixing processes of saturated–unsaturated mixed-acid TAGs.
Hydrogenation of vegetable oils under supercritical conditions can involve a homogeneous one‐phase system, or alternatively two supercritical components in the presence of a condensed phase ...consisting of oil and a solid catalyst. The former operation is usually conducted in flow reactors while the latter mode is more amenable to stirred, batch‐reactor technology. Although many advantages have been cited for the one‐phase hydrogenation of oils or oleochemicals using supercritical carbon dioxide or propane, its ultimate productivity is limited by the oil solubility in the supercritical fluid phase as well as unconventional conditions that affect the hydrogenation. In this study, a dead‐end reactor has been utilized in conjunction with a head‐space consisting of either a binary fluid phase consisting of varying amounts of carbon dioxide mixed with hydrogen or neat hydrogen for comparison purposes. Reaction pressures up to 2000 psi and temperatures in the range of 120–140°C have been utilized with a conventional nickel catalyst to hydrogenate soybean oil. Depending on the chosen reaction conditions, a wide variety of end products can be produced having different iodine values, percentage trans fatty acid content, and dropping points or solid fat indices. Although addition of carbon dioxide to the fluid phase containing hydrogen retards the overall reaction rate in most of the studied cases, the majority of products have low trans fatty acid content, consistent with a nonselective mode of hydrogenation.
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