Referencing the trochlear groove based on three-dimensional computed tomography imaging improves the reliability of the measurement of the tibial tuberosity–trochlear groove distance in patients with higher grades of trochlea dysplasia

BackgroundTo determine whether 3D-CT imaging technique is valid and reproducible compared to conventional CT measurement technique (CCT) for the detection of a femoropatellar instability.MethodsPatients who had undergone surgery for femoropatellar instability (patellar instability group) between 2010 and 2016 (n = 37 knees of 35 patients) were retrospectively enrolled. For the matched control group, patients who had acute anterior cruciate ligament injury (< 4 weeks previously; n = 30) were recruited. Preoperative CT data had been obtained in all patients. Inter-rater reliability was calculated for both measurement protocols, and inter-method reliability was calculated between the two imaging modalities. The results are reported using intraclass correlation coefficients (ICCs) and Bland–Altman 95% limits of agreement.ResultsAll patients in the patellar instability group had femoral trochlear dysplasia (Dejour types A: four, B: 19, C: seven, and D: six), but no dysplasia was noted in the control group. In the patellar instability group, the CCT technique showed a poor inter-rater agreement (ICC = 0.74), and the 3D-CT technique still showed excellent inter-rater agreement (ICCs = 0.91). In the sub-analysis of the patellar instability group according to the trochlear dysplasia grade, ICCs were markedly decreased with severe trochlear dysplasia when using CCT technique; however, the 3D-CT technique could provide excellent reliability even with severe trochlear dysplasia.ConclusionThe 3D-CT imaging technique for the measurement of the TT–TG distance can be suggested as a better measurement technique for patellar instability patients with bone abnormality.     

The midterm results of a cohort study of patellofemoral arthroplasty from a non-designer centre using an asymmetric trochlear prosthesis

PurposePatellofemoral arthroplasty (PFA) prosthesis with asymmetric trochlear component was introduced as an improvement from existing designs for surgical treatment of symptomatic isolated patellofemoral arthritis. The purpose of this study was to evaluate midterm results in patients who underwent PFA procedure using such prosthesis.MethodsOur study involved a continuous retrospective cohort of patients who underwent PFA using Journey PFA prosthesis with an asymmetric trochlear component, performed between June 2007 and July 2016 at a non-designer centre. The Patient Reported Outcome Measures and patient satisfaction questionnaires were collected for final evaluation.ResultsA total of 103 PFA performed on 79 patients were evaluated. Median age at the time of surgery was 58 years (range 42 to 78 years); the mean follow-up period was 6 years (range 2 to 11 years). Four knees were revised to Total Knee Arthroplasty for reasons not related to the implant. The cumulative survival estimated by the Kaplan–Meier method was 94.3% (95% confidence interval: 88.4%–100%). There were statistically significant improvements in functional outcome scores.ConclusionThis series of patients who underwent PFA with the asymmetric trochlear component has shown promising mid-term results with no implant-related complications.     

Aligned Tubular Conjugated Microporous Polymer Films for the Aggregation‐Induced Emission‐Based Sensing of Explosives

This work shows the sensing performance of conjugated microporous polymer (CMP) tubes. Aligned tubular CMP films (CMP‐AT) are synthesized by a template method. The Sonogashira coupling of tetra(4‐ethynyl)phenylethylene with 1,4‐diiodobenzene in the cylindrical pores of anodic aluminum oxide (AAO) plates and the etching of templates result in the CMP‐AT films. Due to the tetraphenylethylene moieties in the materials, the CMP‐AT films show aggregation‐induced emission (AIE). Based on emission‐quenching behavior, the sensing performance of CMP‐AT films toward model explosives, nitrotoluenes, is studied. The CMP‐AT films having longer CMP tubes with thinner wall thickness show better sensing performance with the Stern–Volmer constant (K_sv) values up to 92 400 M^?1 toward 2,4‐dinitrotoluene. The reduced diffusion pathway of substrates by the thin wall of the CMP tubes is critical for the AIE quenching‐based sensing of nitrotoluenes. These observations indicate that the functionality of CMP materials can be further enhanced by their morphological engineering. Due to the chemical stability of CMP materials, the CMP‐AT‐5 film can be recycled at least five times, maintaining the original sensing performance and tubular morphology.     

Satiety and memory enhancing effects of a high-protein meal depend on the source of protein

Objective: High- protein diets have become increasingly popular with various touted benefits. However, the extent to which protein quantity and source affects cognitive functioning through altering postprandial amino acid profiles has not been investigated. Further, whether all protein sources are similarly anorexigenic is uncertain. The objective of this study was to determine the influence of protein level and source on Barnes maze performance, satiety and plasma amino acid levels in male Sprague-Dawley rats.

Methods: Rats were entrained to a meal-feeding schedule consisting of a 30 minutes meal, equivalent to 20% of average daily intake, one hour into the dark phase then ad libitum access to food for 5 h. On test days, rats received one of three isocaloric diets as their first meal, hereafter referred to as Egg White (EW), Wheat Gluten (WG), or Basal, and then were measured for cognitive performance, feeding behavior, or plasma amino acid levels via jugular catheter. Percentage energy from protein was 35% for both EW and WG and 20% for Basal with equal amounts provided by EW and WG proteins.

Results: Rats provided EW performed similarly to Basal on the Barnes maze, whereas WG performed worse. EW increased satiety, whereas WG reduced satiety relative to Basal. Both EW and WG increased postprandial concentrations of large neutral and branched chain amino acids relative to Basal, but in EW, concentrations were slower to peak, and peaked to a higher level than WG.

Discussion: Results demonstrate the importance of protein source for cognition and satiety enhancing effects of a high-protein meal.     

What Impact Does Venous Thromboembolism and Bleeding Have on Cancer Patients’ Quality of Life?

Background

Venous thromboembolism (VTE) is common in cancer patients and its treatment is associated with a high risk of recurrent VTE (rVTE) and bleeding.

Grouping schemes of welding fume exposure in shipyard welders

Welding fume exposure can increase the risk of chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the optimal grouping schemes of welding fume exposure in shipyard welders for future accurate examination of the association between welding fume exposure and COPD. Industrial hygiene records, including welding fume measurements between 2002 and 2009 were collected from a shipyard. A total of 2,360 personal welding fume measurements was compiled with a geometric mean of 1.66 mg/m³ and a geometric standard deviation of 4.02. Welding jobs were categorized into 8 groups. There were 9 working areas. To obtain the optimal grouping scheme, various grouping schemes were created using job, area, and job^*area combination. To compare various grouping schemes, contrast and precision were calculated for each grouping scheme. For all measurement data, group mean ranking method created by ranking geometric means of the job^*area combination into 3 groups (group mean ranking method) showed the best contrast and precision values among various grouping schemes, followed by grouping based on the job. For a subset of the data excluding job^*area combinations with less than 10 measurements, grouping based on the job showed greater contrast than group mean ranking method, while for other subsets, including only repeated measurement data or further excluding job^*area combinations with less than 10 measurements from the repeated measurement subset, group mean ranking method showed greater contrast than grouping based on the job. Our results showed that group mean ranking or grouping based on the job could be a candidate for the optimal grouping schemes in this shipyard. Our efforts for optimal grouping scheme may aid future cohort study to elucidate the association between welding fume exposure and COPD.     

Clinical and laboratory factors contributing to uninterpretable beryllium lymphocyte proliferation tests (BeLPT)

Background

The beryllium lymphocyte proliferation test (BeLPT), has become the principal clinical test for detecting beryllium sensitization and chronic beryllium disease. Uninterpretable BeLPT results can occur in a small but significant proportion of tests from poor lymphocyte growth (PG) or over proliferation of lymphocytes (OP). The clinical and laboratory causes of uninterpretable results are not known.

Methods

BeLPT data from the US Department of Energy‐supported Former Worker Screening Program were analyzed for a 10‐year period. Drivers of uninterpretable BeLPTs were investigated using multivariable models and classification techniques.

Results

Three participant attributes were significantly associated with PG, while OP showed no significant associations. Serum lot for the lymphocyte growth medium accounted for 21% of the variation in PG and 16% in OP.

Conclusion

Serum lots influence the likelihood of having uninterpretable BeLPT. To better understand uninterpretable results and possibly reduce their occurrence, additional laboratory‐related factors should be addressed.