Self-reported outcomes are associated with knee strength and functional symmetry in individuals who have undergone anterior cruciate ligament reconstruction with hamstring tendon autograft

Background: The aim of this study was to investigate the relationship between self-reported knee outcomes and limb symmetry indices (LSIs) for hip and knee strength, postural control and single leg hop distance in individuals who had undergone an ACL reconstruction with hamstring tendon autograft (HTG). Methods: A total of 72 participants with a history of unilateral ACL reconstruction with HTG (Mean ± SD age, 28.0 ± 7.6 years; height, 178.4 ± 6.7 cm; mass, 76.9 ± 14.9 kg) were included. IKDC, Lysholm, KOOS and TAMPA scores were used to evaluate self-reported outcomes. Concentric and eccentric knee extensor and flexor strength, and hip abductor strength were measured with an isokinetic dynamometer. Postural control was assessed using the modified star excursion balance test and hop performance using the single leg hop test. The relationships between the LSI scores and the performance measures were explored using the Pearson correlation coefficient. Results: The IKDC, Lysholm and KOOS scores were positively correlated with knee extensor and flexor strength LSIs (p0.05). Conclusions: Self-reported scores were correlated with knee extensor and flexor strength, postural control and hop performance in individuals who have undergone ACLR with HTG. Compared to Lysholm and TAMPA scores, KOOS and IKDC scores were more likely to be correlated with performance-based outcomes. Therefore, KOOS and IKDC scores may help clinicians in RTS decision making when there is a limited time to perform extensive evaluations or access equipment

External Supports Improve Knee Performance In Anterior Cruciate Ligament Reconstructed Individuals With Higher Kinesiophobia Levels

Background: The objectives of this studywere to investigate the effects of knee brace (KB) and kinesiotaping (KT) on functional performance and self-reported function in individuals sixmonths post-ACLRwho desired to return to their pre-injury activity levels but felt unable to do so due to kinesiophobia. Methods: This was a cross-sectional study involving 30 individuals six months post-ACLR with Tampa Kinesiophobia Scores N37. Individuals were tested under three conditions: no intervention, KB and KT in a randomized order. Isokinetic concentric quadriceps and hamstring strength tests, one leg hop test, star excursion balance test and global rating scale were assessed under the three conditions. Results: The involved side showed that KT and KB significantly increased the hop distance (P=0.01, P = 0.04) and improved balance (P = 0.01, P = 0.04), respectively, but only KB was found to increase the quadriceps and hamstring peak torques compared to no intervention (P b 0.05). Individuals reported having better knee function with KB when compared to no intervention (P b 0.001) and KT (P=0.03). Conclusions: Both KB and KT have positive effects in individuals post-ACLR which may assist in reducing kinesiophobia when returning to their pre-injury activity levels, with the KB appearing to offer the participants better knee function compared to KT

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

25th annual computational neuroscience meeting: CNS-2016

The same neuron may play different functional roles in the neural circuits to which it belongs. For example, neurons in the Tritonia pedal ganglia may participate in variable phases of the swim motor rhythms [1]. While such neuronal functional variability is likely to play a major role the delivery of the functionality of neural systems, it is difficult to study it in most nervous systems. We work on the pyloric rhythm network of the crustacean stomatogastric ganglion (STG) [2]. Typically network models of the STG treat neurons of the same functional type as a single model neuron (e.g. PD neurons), assuming the same conductance parameters for these neurons and implying their synchronous firing [3, 4]. However, simultaneous recording of PD neurons shows differences between the timings of spikes of these neurons. This may indicate functional variability of these neurons. Here we modelled separately the two PD neurons of the STG in a multi-neuron model of the pyloric network. Our neuron models comply with known correlations between conductance parameters of ionic currents. Our results reproduce the experimental finding of increasing spike time distance between spikes originating from the two model PD neurons during their synchronised burst phase. The PD neuron with the larger calcium conductance generates its spikes before the other PD neuron. Larger potassium conductance values in the follower neuron imply longer delays between spikes, see Fig. 17.Neuromodulators change the conductance parameters of neurons and maintain the ratios of these parameters [5]. Our results show that such changes may shift the individual contribution of two PD neurons to the PD-phase of the pyloric rhythm altering their functionality within this rhythm. Our work paves the way towards an accessible experimental and computational framework for the analysis of the mechanisms and impact of functional variability of neurons within the neural circuits to which they belong

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Light Manipulations with Metasurfaces in Visible and Infrared Spectrum: Asymmetric Transmission and Tunability with Phase Change Materials

20th International Conference on Transparent Optical Networks, ICTON (2018 ; Bucharest, Romani)Metasurfaces are two dimensional planar photonic structures, which were recently proposed to alter amplitude, phase, and polarization of the light. Plasmonic and all-dielectric metasurfaces are two different types of structures with comparable advantageous and drawbacks. Three-dimensional nano array of trapezoidal shaped aluminium on a sapphire substrate is designed to construct metasurface for altering the optical behaviour of oppositely propagating light. We show that broadband and polarization independent asymmetric light propagation mechanism in metasurface configuration is feasible in the visible spectrum. The underlying physical concept is associated with the Wood Rayleigh Anomaly such that different number of higher order modes appear upon oppositely incident light. Introducing vanadium dioxide as phase change material into the metasurface structure allows dynamic control over the transmitted light within the mid-infrared spectrum. Proposed structure can be fabricated with the current nano and micro fabrication techniques and can be utilized in smart front IR windows for protecting delicate sensors used for imaging and target detecting systems

Tunable optical behavior of infrared filters with phase change material

We propose an asymmetric to quasisymmetric behavioral tunability of a structured filter operating in the mid-infrared (IR) spectral region, where the atmospheric transparency is high. The structure is designed through electromagnetic wave analysis using finite-difference time-domain computations. The behavioral tunability provides dynamic control of the optical behavior of the IR filter without geometric and structural changes and opens up a field of research area in the tunable IR devices. It is shown that optical characteristic can be switched from an optical diode (unidirectional isolator or asymmetric light transmission) to the bidirectional isolator (quasisymmetric behavior) based on the phase transition of vanadium dioxide in the entire mid-IR spectrum. The proposed structure can be fabricated with the current nano and microfabrication techniques and can be utilized in smart front IR windows for protecting delicate sensors in the IR imaging systems and IR missile seekers under strong IR laser radiation

Long-term functional and sonographic outcomes in Osgood-Schlatter disease

WOS: 000317978400020PubMed ID: 22751942To evaluate the sonographic characteristics, functional aspects and life quality of a group of adolescent patients 2 years after having been diagnosed with Osgood-Schlatter disease and compare them with an age-matched healthy control group. The study was conducted on eighteen Osgood-Schlatter patients with unilateral involvement and 14 age-matched healthy controls. The Flaviis classification and patellar tendon characteristics were observed using a GE Logiq 9 scanner. Broad and vertical jump tests were used for jumping performance. The coordination, proprioception, strength and endurance functions were assessed with the Functional Squat System. For the quality of life, the SF-36 questionnaire was used. The Wilcoxon test for the patients' initial and second-year assessment and Mann-Whitney U test for the comparison between the patient and control groups were used. By the end of second year, 38.9 % of the patients had totally recovered. The patellar tendon lengthened, distal diameter and distal area of the tendon had lessened, and no significant difference was observed between patient and control groups (n.s). Improvements were detected for the bilateral broad jump test scores, the quality of life and coordination of the patients after 2 years (p < 0.05). The average power of endurance and the total work of strength were significantly higher in control group (p < 0.05). According to the sonography results 2 years after diagnosis, nearly half of the patients had totally recovered. Coordination was the only parameter that improved over the 2-year period. The patient group strength and endurance function remained lower than the control group. III

Vortex beam generation using all dielectric metasurface

Metamaterials, Metadevices, and Metasystems (2018: San Diego; United States)Refractive and conventional optical elements such as prisms and lenses are heavy, large-sized and have limited performance in light-material interactions. Due to these severe constraints, new types of structures called metasurfaces, which are composed of subwavelength structural elements with subwavelength thicknesses, are used instead of conventional and refractive based optical elements. Metasurfaces enable unprecedented control of phase, polarization, amplitude and impedance of incident light. Thanks to these very effective features, metasurfaces have gathered remarkable attention in wavefront manipulation of photons for various applications. Earlier attempts have deployed plasmonic metasurfaces in the designs. However, the light coupled to plasmons suffers from great optical loss, which restricts high transmission efficiency, at visible wavelengths due to intrinsic heat dissipation. This problem can be overcome using all dielectric structures operating mainly in the transmission mode. Here, we numerically demonstrate vortex beam generation having donut-like intensity profile and 60% transmission efficiency. In this study, we use all dielectric metasurface that is composed of thick glass substrate and crystalline silicon which is shaped as trapezoid structure at 532 nm visible wavelength. The refractive indices of glass substrate and crystalline silicon are 1.46 and 4.15 with height of 220 nm, respectively at the designed wavelength. We have achieved 0-2? phase distribution by scaling trapezoid shaped silicon at fixed height. The interface of metasurface segmented 8 regions is filled with trapezoid shaped silicon with a ?/4 phase increment in an azimuthal pattern. The obtained vortex beam can be used in various applications such as light trapping, optical tweezers, and laser beam forming. © 2018 SPIE

Polarization-insensitive beam splitters using all-dielectric phase gradient metasurfaces at visible wavelengths

Beam splitters play important roles in several optical applications, such as interferometers, spectroscopy, and optical communications. In this study, we propose and numerically examine polarization-insensitive beam splitters utilizing two-step phase gradient all-dielectric metasurfaces in the visible spectrum. The metasurface is made of periodically arranged binary unit cells, and phase difference between neighboring unit cells on the surface is 180 deg. The metasurface is shown to have a special phase gradient whose sign changes periodically. The angle of the split beams on both sides and the corresponding total transmission value at 532 nm wavelength are found to be 46.8° and 0.90, respectively