Longitudinal Changes in Ultrasound-Assessed Femoral Cartilage Thickness in Individuals from 4 to 6 Months Following Anterior Cruciate Ligament Reconstruction

Objective: Diagnostic ultrasound provides a valid assessment of cartilage health that has been used to observe cross-sectional cartilage thickness differences post-ACLR (anterior cruciate ligament reconstruction), but has not been used longitudinally during early recovery post-ACLR. Design: The purpose of this study was to assess longitudinal changes in femoral cartilage thickness via ultrasound in individuals at 4 to 6 months post-ACLR and compared to healthy controls. Twenty participants (50% female, age = 21.1 ± 5.7 years) completed testing sessions 4 and 6 months post-ACLR. Thirty healthy controls (57% female, age = 20.8 ± 3.8 years) without knee injury history completed 2 testing sessions (>72 hours apart). Femoral cartilage ultrasound images were captured bilaterally in ACLR participants and in the dominant limb of healthy controls during all sessions. Average cartilage thicknesses in the medial, intercondylar, and lateral femoral regions were determined using a semi-automated processing technique. Results: When comparing cartilage thickness mean differences or changes over time, individuals post-ACLR did not demonstrate between limb differences (P-range = 0.50-0.92), limb differences compared to healthy controls (P-range = 0.19-0.94), or changes over time (P-range = 0.22-0.72) for any femoral cartilage thickness region. However, participants demonstrated cartilage thickening (45%) or thinning (35%) that exceeded minimal detectable change (MDC) from 4 to 6 months post-ACLR, respectively. Conclusions: Using MDC scores may help better identify within-subject femoral cartilage thickness changes longitudinally post-ACLR due to bidirectional cartilage thickness changes

Additive manufacturing: Fused deposition modeling advances

The paradigm of the manufacturing systems was broken in 1980 with the beginning of the Additive Manufacturing (AM). This technology has been considered as the complement of the classic manufacturing technology, where the material is removed from a raw material until getting the final product. The addition of material in layers have been considered the new alternative to face the impact in the environment, the economy of materials and process, and the opportunity to generate new complex shapes limited by the classic manufacturing technology. The present chapter exposes the advances of the Fused Deposition Modeling (FDM), one of the seven technologies of AM which is mostly used during the past three decades. In this field, different adaptations and investigations of the technology have been focused on the increment of the capacity of the production system and improve the quality generated by this technique. The methodology used to determine the advance of AM was to employ a Systematic Literature Review using databases. The search was developed considering the keywords of AM for the construction of specific search syntax of documents associated with this technology. The documents obtained were analyzed to identify the progress in this technology. The results present the advancements of the FDM as a technology that change the industrial processing to customize the process, where the globalization makes possible to have this technology available at each desk

Prevalence of Clinical and Subclinical Myocarditis in Competitive Athletes With Recent SARS-CoV-2 Infection: Results From the Big Ten COVID-19 Cardiac Registry

Importance: Myocarditis is a leading cause of sudden death in competitive athletes. Myocardial inflammation is known to occur with SARS-CoV-2. Different screening approaches for detection of myocarditis have been reported. The Big Ten Conference requires comprehensive cardiac testing including cardiac magnetic resonance (CMR) imaging for all athletes with COVID-19, allowing comparison of screening approaches. Objective: To determine the prevalence of myocarditis in athletes with COVID-19 and compare screening strategies for safe return to play. Design, Setting, and Participants: Big Ten COVID-19 Cardiac Registry principal investigators were surveyed for aggregate observational data from March 1, 2020, through December 15, 2020, on athletes with COVID-19. For athletes with myocarditis, presence of cardiac symptoms and details of cardiac testing were recorded. Myocarditis was categorized as clinical or subclinical based on the presence of cardiac symptoms and CMR findings. Subclinical myocarditis classified as probable or possible myocarditis based on other testing abnormalities. Myocarditis prevalence across universities was determined. The utility of different screening strategies was evaluated. Exposures: SARS-CoV-2 by polymerase chain reaction testing. Main Outcome and Measure: Myocarditis via cardiovascular diagnostic testing. Results: Representing 13 universities, cardiovascular testing was performed in 1597 athletes (964 men [60.4%]). Thirty-seven (including 27 men) were diagnosed with COVID-19 myocarditis (overall 2.3%; range per program, 0%-7.6%); 9 had clinical myocarditis and 28 had subclinical myocarditis. If cardiac testing was based on cardiac symptoms alone, only 5 athletes would have been detected (detected prevalence, 0.31%). Cardiac magnetic resonance imaging for all athletes yielded a 7.4-fold increase in detection of myocarditis (clinical and subclinical). Follow-up CMR imaging performed in 27 (73.0%) demonstrated resolution of T2 elevation in all (100%) and late gadolinium enhancement in 11 (40.7%). Conclusions and Relevance: In this cohort study of 1597 US competitive athletes with CMR screening after COVID-19 infection, 37 athletes (2.3%) were diagnosed with clinical and subclinical myocarditis. Variability was observed in prevalence across universities, and testing protocols were closely tied to the detection of myocarditis. Variable ascertainment and unknown implications of CMR findings underscore the need for standardized timing and interpretation of cardiac testing. These unique CMR imaging data provide a more complete understanding of the prevalence of clinical and subclinical myocarditis in college athletes after COVID-19 infection. The role of CMR in routine screening for athletes safe return to play should be explored further