22 research outputs found

    Arthroscopic partial meniscectomy for a degenerative meniscus tear : a 5 year follow-up of the placebo-surgery controlled FIDELITY (Finnish Degenerative Meniscus Lesion Study) trial

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    Objectives To assess the long-term effects of arthroscopic partial meniscectomy (APM) on the development of radiographic knee osteoarthritis, and on knee symptoms and function, at 5 years follow-up. Design Multicentre, randomised, participant- and outcome assessor-blinded, placebo-surgery controlled trial. Setting Orthopaedic departments in five public hospitals in Finland. Participants 146 adults, mean age 52 years (range 35-65 years), with knee symptoms consistent with degenerative medial meniscus tear verified by MRI scan and arthroscopically, and no clinical signs of knee osteoarthritis were randomised. Interventions APM or placebo surgery (diagnostic knee arthroscopy). Main outcome measures We used two indices of radiographic knee osteoarthritis (increase in Kellgren and Lawrence grade >= 1, and increase in Osteoarthritis Research Society International (OARSI) atlas radiographic joint space narrowing and osteophyte sum score, respectively), and three validated patient-relevant measures of knee symptoms and function ( Western Ontario Meniscal Evaluation Tool (WOMET), Lysholm, and knee pain after exercise using a numerical rating scale). Results There was a consistent, slightly greater risk for progression of radiographic knee osteoarthritis in the APM group as compared with the placebo surgery group (adjusted absolute risk difference in increase in Kellgren-Lawrence grade >= 1 of 13%, 95% CI -2% to 28%; adjusted absolute mean difference in OARSI sum score 0.7, 95% CI 0.1 to 1.3). There were no relevant between-group differences in the three patient-reported outcomes: adjusted absolute mean differences (APM vs placebo surgery), -1.7 (95% CI -7.7 to 4.3) in WOMET, -2.1 (95% CI -6.8 to 2.6) in Lysholm knee score, and -0.04 (95% CI -0.81 to 0.72) in knee pain after exercise, respectively. The corresponding adjusted absolute risk difference in the presence of mechanical symptoms was 18% (95% CI 5% to 31%); there were more symptoms reported in the APM group. All other secondary outcomes comparisons were similar. Conclusions APM was associated with a slightly increased risk of developing radiographic knee osteoarthritis and no concomitant benefit in patient-relevant outcomes, at 5 years after surgery.Peer reviewe

    Tuning Nitric Oxide Adsorption in Cobalt–Triazolate Frameworks

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    Nitric oxide (NO) is an important signaling molecule in biological systems, and as such the ability of certain porous materials to reversibly adsorb NO is of interest for medical applications. Metal–organic frameworks have been explored for their ability to reversibly bind NO at coordinatively-unsaturated metal sites, however the influence of metal coordination environment on NO adsorption has yet to be studied in detail. Here, we examine NO adsorption in the frameworks Co2Cl2(bbta) and Co2(OH)2(bbta) (H2bbta = 1H,5H-benzo(1,2-d:4,5-dâ€Č)bistriazole) via gas adsorption, infrared spectroscopy, powder X-ray diffaction, and magnetometry measurements. While NO adsorbs reversibly in Co2Cl2(bbta) without electron-transfer, adsorption of low pressures of NO in Co2(OH)2(bbta) is accompanied by charge transfer from the cobalt(II) centers to form a cobalt(III)–NO− adduct, as supported by diffraction and infrared spectroscopy data. At higher pressures of NO, characterization data support additional uptake of the gas and disproportionation of the bound NO to form a cobalt(III)–nitro (NO2−) species and N2O gas, a transformation that appears to be facilitated in part by stabilizing hydrogen bonding interactions between the bound NO2− and framework hydroxo groups. This reactivity represents a rare example of reductive NO-binding in a metal–organic framework and demonstrates that NO binding can be tuned by changing the coordination environment of the framework metal centers.</p

    Influence of Metal Substitution on the Pressure-Induced Phase Change in Flexible Zeolitic Imidazolate Frameworks

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    Metal–organic frameworks that display step-shaped adsorption profiles arising from discrete pressure-induced phase changes are promising materials for applications in both high-capacity gas storage and energy-efficient gas separations. The thorough investigation of such materials through chemical diversification, gas adsorption measurements, and in situ structural characterization is therefore crucial for broadening their utility. We examine a series of isoreticular, flexible zeolitic imidazolate frameworks (ZIFs) of the type M(bim)2 (SOD; M = Zn (ZIF-7), Co (ZIF-9), Cd (CdIF-13); bim– = benzimidazolate), and elucidate the effects of metal substitution on the pressure-responsive phase changes and the resulting CO2 and CH4 step positions, pre-step uptakes, and step capacities. Using ZIF-7 as a benchmark, we reexamine the poorly understood structural transition responsible for its adsorption steps and, through high-pressure adsorption measurements, verify that it displays a step in its CH4 adsorption isotherms. The ZIF-9 material is shown to undergo an analogous phase change, yielding adsorption steps for CO2 and CH4 with similar profiles and capacities to ZIF-7, but with shifted threshold pressures. Further, the Cd2+ analogue CdIF-13 is reported here for the first time, and shown to display adsorption behavior distinct from both ZIF-7 and ZIF-9, with negligible pre-step adsorption, a ~50% increase in CO2 and CH4 capacity, and dramatically higher threshold adsorption pressures. Remarkably, a single-crystal-to-single-crystal phase change to a pore-gated phase is also achieved with CdIF-13, providing insight into the phase change that yields step-shaped adsorption in these flexible ZIFs. Finally, we show that the endothermic phase change of these frameworks provides intrinsic heat management during gas adsorption. </p
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