Neutral Angle Research Articles

Effect of joint angle positioning on shearwave speed and variability with ultrasound shearwave elastography in asymptomatic Achilles and patellar tendons

This study investigated the impact of joint positioning on ultrasound shear wave elastography measurements in the Achilles and patellar tendons. Twenty-eight healthy adults underwent SWE assessment of shear wave speed (SWS) and coefficient of variation in SWS (CV-SWS) at three ankle positions (neutral, 10° plantar flexion, and 20° dorsiflexion) and two knee positions (90° flexion and full extension), at two academic sites. Participant positioning for ankle testing differed between sites (prone vs long-sitting)—while knee testing used consistent positioning. At the ankle, both joint and participant positioning significantly affected SWS. In the prone position, SWS was lower in neutral compared to dorsiflexed position (3.07 ± 1.13 m/s vs. 3.95 ± 1.03 m/s, p = 0.013). In long-sitting, SWS was lower in neutral compared to plantarflexed position (2.85 ± 0.53 m/s vs. 4.86 ± 1.92 m/s, p = 0.016); and SWS was higher in the plantarflexed position when participants were in long-sitting compared to prone (4.86 ± 1.92 m/s vs. 3.25 ± 1.13 m/s, p = 0.016). Participant positioning affected CV-SWS, with higher variability observed in prone compared to long-sitting in plantarflexed (29.3 ± 15.5 % vs 12.4 ± 9.12 %, p = 0.005) and neutral ankle angles (p = 0.03)At the knee, joint position significantly influenced SWS, with higher values in flexed versus extended positions (6.48 ± 3.1 m/s vs. 4.60 ± 2.3 m/s, p = 0.007). Extending the knee reduced CV-SWS compared to flexed position (14.5 ± 11.2 vs 19.2 ± 13.4, p = 0.044). In conclusion, joint position significantly affected SWS measurements in both the Achilles and patellar tendons, while participant positioning influenced measurement variability. Thus, standardizing joint and participant positioning is important to enhance the reliability of SWE assessments of tendon elasticity.

Muscle Compensation Strategies to Maintain Glenohumeral Joint Stability in Rotator Cuff Tears: A Cadaveric Study.

Superior translation of the humeral head is often identified in large and massive rotator cuff (RC) tears. However, the ability of the remaining RC muscles to compensate for the forces causing such superior translation in RC tears remains unclear. The purpose of this study was to investigate the impact of compensatory forces exerted by the remaining RC muscles on humeral head translation using a progressive RC tear model. Eight fresh-frozen cadaveric shoulders (mean donor age, 57 years) were tested using a custom shoulder testing system. In addition to an intact RC model, 3 RC tear models were created: a supraspinatus tear (Tear I); combined supraspinatus and infraspinatus tears (Tear II); and combined tears of the supraspinatus, infraspinatus, and superior one-third of the subscapularis (Tear III). Compensatory conditions were simulated by increasing the loading of the remaining RC muscles in each RC tear model. Humeral head translation was measured at different abduction and neutral rotation angles in each condition with normal and high deltoid muscle loading. Significant superior translation of the humeral head was observed in Tears II and III (but not Tear I), compared with the intact state, under high loading of the deltoid during abduction and during rotation. In Tear II, compensatory conditions involving increased loading of the teres minor and subscapularis muscles effectively reduced superior translation, so that no significant differences were observed compared with the intact state, even under high deltoid muscle loading. However, in Tear III, significant superior translation was still observed, regardless of the compensatory conditions. ompensation by the remaining RC muscles, particularly the teres minor and subscapularis, effectively reduced superior translation of the humeral head in the posterosuperior RC tear model, whereas this compensatory strategy was insufficient if tears also involved the superior one-third of the subscapularis. Patients with posterosuperior RC tears may find conservative treatment focusing on strengthening the remaining RC muscles, especially the subscapularis and teres minor, to be beneficial. Conversely, patients with repairable massive RC tears also involving the subscapularis tendon may benefit from surgical interventions aimed at primarily repairing the subscapularis tendon to restore the transverse force couple. Massive tears deemed not to be repairable should be evaluated for arthroplasty or other procedures.

Submaximal eccentric resistance training increases serial sarcomere number and improves dynamic muscle performance in old rats.

The age-related loss of muscle mass is partly accounted for by the loss of sarcomeres in series, contributing to declines in muscle mechanical performance. Resistance training biased to eccentric contractions increases serial sarcomere number (SSN) in young muscle, however, maximal eccentric training in old rats previously did not alter SSN and worsened performance. A submaximal eccentric training stimulus may be more conducive to adaptation for aged muscle. The purpose of this study was to assess whether submaximal eccentric training can increase SSN and improve mechanical function in old rats. Twelve 32-month-old male F344/BN rats completed 4 weeks of submaximal (60% maximum) eccentric plantar-flexion training 3 days/week. Pre- and post-training, we assessed in-vivo maximum isometric torque at a stretched and neutral ankle angle, the passive torque-angle relationship, and the isotonic torque-velocity-power relationship. The soleus and medial gastrocnemius (MG) were harvested for SSN measurements via laser diffraction, with the untrained leg as a control. SSN increased 11% and 8% in the soleus and MG, respectively. Training also shifted optimal torque production towards longer muscle lengths, reduced passive torque 42%, and increased peak isotonic power 23%. Submaximal eccentric training was beneficial for aged muscle adaptations, increasing SSN, reducing muscle passive tension, and improving dynamic contractile performance.

Combined axial load-biaxial bending interaction method for L-shaped CFSP shear walls

This paper reports the development of axial load and biaxial bending interaction method for L-shaped concrete-filled steel plate (CFSP) composite shear walls based on fiber section analysis model using the uniaxial constitutive relationship of materials. Owing to the complex interaction between the two perpendicular wall limbs (web and flange) of an L-shaped shear wall, the contour shape of the My-Mz curve is asymmetric. Linear transformation was employed to reduce the asymmetry of the contour shape, eliminate the influence of dimension, and perform parametric analysis. The analysis results indicate that when 0° ≤ θ(neutral axis angle) ≤ 90°, the influence of width-to-thickness ratio (hw1/bw) and shape coefficient (γ) on the coefficient that controls the contour shape (α) was negligible. The effect of shape coefficient (γ), steel content ratio (ρ), compressive strength of unconfined concrete (fc0), and yield strength of steel plate (fyp) on α is not significant for −180° ≤ θ ≤ −90°. Further, simplified equations were suggested to determine α. The axial load-moment interaction curve expressions for distinctive loading directions were determined by establishing the calculation method for the curve's characteristic points (axial load capacity, bending capacity, boundary points). Subsequently, the characteristic points were combined with the contour shape of the axial load-moment interaction curve derived by fitting the finite element simulation data to generate the axial load-moment interaction curve equations. A design approach was finally formulated based on the equations for the biaxial moment capacity curve and the axial load-moment interaction curves of the characteristic loading directions.

Impact of postoperative femorotibial axis on functional outcomes in unicompartmental knee arthroplasty.

This study aimed to compare the functional outcomes of patients undergoing fixed-bearing medial unicompartmental knee arthroplasty (UKA) classified as either varus or neutral based on their postoperative femorotibial angle (FTA), with the goal of evaluating the impact of FTA on functional results. A total of 38 knees of 35 patients (27 females, 8 males; mean age: 63.6±7.1 years; range, 52 to 75 years) were included in this retrospective study. The data was collected between December 15, 2020, and January 15, 2021. Patients were categorized into two groups based on their postoperative FTA. The neutral group consisted of patients with an FTA range of 5.1° to 7.4°, while the varus group included patients with an FTA range of 0.1° to 4.8°. Knee Outcome Osteoarthritis Score (KOOS), Visual Analog Scale (VAS) scores, sit to stand test results, and six minute walk test data were analyzed. The mean follow-up was 42.0±19.3 months. The postoperative VAS score for the varus group was 0.95±0.99, whereas the neutral group had a VAS score of 2.19±1.83 (p=0.021). The mean KOOS for the varus group was 88.01±7.88, whereas the neutral group had a mean KOOS score of 78.46±13.69 (p=0.006). In patients undergoing UKA, mild varus alignment could yield superior early and midterm functional outcomes compared to a neutral femorotibial angle.

Does Pelvic Tilt Angle Influence the Isokinetic Strength of the Hip and Knee Flexors and Extensors?

The purpose of this study was to examine the effect of pelvic tilt angle on maximum hip and knee muscles' strength and antagonist/agonist strength ratios. Twenty-one young males and females performed maximum isokinetic concentric knee extension-flexion and hip extension-flexion efforts at 60°·s-1, 120°·s-1, and 180°·s-1 from three positions: anterior, neutral, and posterior pelvic tilt. Peak torques and knee flexor-to-extensor and hip flexor-to-extensor torque ratios were analyzed. An analysis of variance showed that peak hip extensor torque was significantly greater in the anterior pelvic tilt condition compared to either neutral or posterior pelvic tilt angles (p > 0.05). No effects of changing pelvic tilt angle on hip flexor, knee flexor, or knee extension values were found (p > 0.05). The hip flexor-to-extensor torque ratio decreased (p < 0.05) in the anterior pelvic tilt position relative to the other positions, while no difference in the knee flexor-to-extensor ratio between pelvic positions was observed (p > 0.05). This study shows that an increased anterior pelvic tilt affects the maximum isokinetic strength of the hip extensors, supporting previous suggestions regarding the link between pelvic position and hip and knee muscle function. Isokinetic testing from an anterior pelvic tilt position may alter the evaluation of hip flexion/extension strength.

A Quality Improvement Project to Measure and Improve the Quality of Below-Knee Ankle Cast Application in Emergency Departments.

Background Ankle fractures are very common injuries seen in an emergency setting. Initial management involves the application of below-knee plaster casts. At our local trauma meetings, we have observed that below-knee casts are often applied incorrectly which can result in suboptimal outcomes for patients and increase the burden on plaster room services if re-application is required. This quality improvement project aimed to assess the quality of below-knee cast applications for ankle fractures in two local district general hospitals (DGHs). Methodology We performed a closed-loop audit utilising a retrospective analysis of patients who underwent casting for unstable ankle fractures. Two audit cycles were completed over a 90-day period across two DGHs. Working within our local orthopaedic unit, we created a targeted, multi-disciplinary educational programme led by experienced plaster technicians. Between audit cycles, we organised a single interactive session with specialist nurses in the urgent treatment centre (UTC) of our DGH while a second DGH did the same with junior doctors working in the emergency department. Both sessions demonstrated correct casting techniques and discussed the importance of a neutral ankle position for optimal patient recovery. Our audit criteria were based on AO Foundation guidance, which states that the ankle should be immobilised in a neutral plantigrade position. All patients with an unstable ankle fracture requiring immobilisation in a below-knee cast were included in the audit. We measured the angle of plantarflexion from neutral, with 90° representing a neutral angle. The angle between the axis of the tibia and the sole of the foot was measured and judged to be within an acceptable range if it was between 80° and 100°, representing a stable ankle position. The audit findings were presented in our local audit meeting. Results In our first audit cycle, we collected data from 65 patients across both sites (N = 32 for DGH 1 and N = 33 for DGH 2). The mean angle was 108.5° and 18 of the 65 (27.7%)patients had angles of ankle plantarflexion that were in the acceptable range (80°-100°). Following the intervention, we again collected data from 61 patients across both sites (N = 28 for DGH 1 and N = 33 for DGH 2). The mean angle was 106.2° and 23 of the 61 (37.7%)patients had an acceptable angle of ankle plantarflexion (80°-100°). Both of our outcome measures showed an improvement but were not statistically significant. The hospital that provided an educational session for the doctors showed an improvement in acceptable ankle casts of 3% while the hospital which provided an educational session for the UTC team improved by 22%. Conclusions We demonstrated a quantifiable approach to assess and improve the quality of below-knee cast application for ankle fractures via a single intervention that would be easily reproducible in other hospitals. We suggest further studies to investigate below-knee cast application quality and its association with patient outcomes as our data and other preliminary sources suggest that current standards are unsatisfactory.

Mathematical modeling and analysis of the tailor rolled blank manufacturing process

A tailor rolled blank (TRB) is a plate of continuously varying thickness with the advantages of lightweight, high strength, and good surface quality. However, it is required that the roll gap can be adjusted online, and the plate and roll produce large elastic deformation in the TRB manufacturing process. These characteristics make the modeling of the force and deformation parameters more difficult. A new mathematical model of roll separating force in the TRB manufacturing process is established taking into account the feature of deformation in this research. The elastic deformation of the strip and the flattening deformation of the roll are considered in order to improve the prediction accuracy of the results. The roll separating forces of the entrance elastic compression region and the exit elastic recovery region are computed using the generalized Hooke's law. A new velocity field is proposed based on the deformation characteristics of the plastic region and velocity boundary conditions, and the power functionals of the internal deformation, shear, friction, and tension are calculated. The analytical models of force and deformation parameters combined the elastic and plastic deformation regions are obtained through iterative operation, which satisfies the convergence condition of the roll separating force and roll flattening. The roll separating force data obtained by the model in this research are compared with the actual measured values in the laboratory, and the deviation value is small, which proves the computational precision of the present model. Additionally, the variations of the entrance velocity and flow volume per second during the TRB manufacturing process are shown, and the influences of the tension and friction factor on the neutral angle and roll separating force are illustrated.

Research on the analytical model of rolling force for TiAl alloy pack rolling

Pack rolling is a hot rolling process for metals with poor plastic forming. The rolling force model is an important model for pack rolling process. Based on the E. Orowan differential equation and the characteristics of pack rolling process, the analytical model of rolling force for pack rolling process was established. Based on the established rolling force model, the influence of roll diameter, reduction rate, metal layer thickness ratio and shear yield stress ratio on the distribution of rolling stress, neutral angle and connection angle was studied. The results indicate that as the increase of reduction rate and shear yield stress ratio, and the reduction of metal layer thickness ratio, the middle layer metal is more prone to plastic deformation. The basic assumptions of the analytical model were verified through a three-dimensional finite element model. The outer layer metal and the middle layer metal were selected as 304 stainless steel and Ti-Al-2Cr-2Nb alloy for pack rolling experiments, respectively. The error between the calculated results of the analytical model and the experimental results is within 15%. The analytical model of rolling force can accurately predict the rolling force and provide theoretical guidance for the formulation of the pack rolling process.

Influence of propeller fouling on propulsion performance of an actual ship: a long-term analysis focusing on the power for keeping propeller’s rotation of a controllable pitch propeller

This study focuses on the shaft power at the neutral angle of a controllable pitch propeller to analyze the change in the required power due to propeller fouling. It is named and defined as a power for keeping propeller’s rotation (RP) because a propeller does not generate the net thrust to push the hull but dissipates the power to keep its constant speed. Statistical analysis was conducted using a decade of the observed data from a research vessel. This study assumed that the change in RP can be considered as an indicator showing the state of propeller fouling. In addition, the state of fouling on the hull can be estimated indirectly based on RP because the data correlated the shaft power under several operating conditions with RP on the same voyage. The fouling state was classified into three conditions based on RP. The comparison of shaft power at the same ship speed between the clean condition and the serious fouled condition showed that the shaft power was increased by 35% on average due to fouling. When the ship navigates under 10 knots, propeller fouling has a larger impact on the increase in shaft power than hull fouling.

Analysis of the Varying Thickness Rolling Process Based on the Principle of Pre-Displacement

This paper conducts a comprehensive analysis of the varying thickness rolling process, grounded in the principle of pre-displacement. Within the rolling deformation zone, the subject is divided into three distinct areas: the backward slip zone, sticking zone, and forward slip zone. We propose a model that delineates the sticking-sliding motion between the rolled piece and the roller, all within the context of the rolling deformation zone, and derive a calculation method for determining the longitudinal lengths of both the sliding and sticking zones within this area. Unlike existing full sliding and full sticking models, our sticking-sliding model offers a novel perspective, overcoming inherent limitations when analyzing the rolling process. Furthermore, we establish models to describe the neutral angle and forward slip value and to predict the longitudinal length of the rolled piece during the varying thickness rolling process. A comparison of our calculated results with experimental data demonstrates the feasibility and effectiveness of the method, thereby laying a robust theoretical foundation for the varying thickness rolling process.

The silicone metacarpophalangeal joint arthroplasty: An in-vitro analysis

BackgroundSilicone is still the gold standard implant in metacarpophalangeal arthroplasty. Whereas the clinical results are acceptable, in follow-ups with >10 years, high rates of implant fracture are common, and 5 to 7% of implants required revision. This work's purpose is to analyse the hypothesis that the joint flexion amplitude has a relevant effect on bone strain level, implant stress and bone-implant micromotion, which can reflect an increase in the risk of bone resorption/fatigue failure, implant fracture and osteolysis. MethodsTo experimentally predict the cortical loading behaviour, composite metacarpals and proximal phalanges were used in intact and implanted states. A finite element model was developed to evaluate the structural behaviour of cancellous bone and implant. This model was validated by comparing cortical strain and load–displacement curve with experimental measurements. FindingsBone strain changes between the intact and the implanted states showed a load transfer effect from the cortical to the cancellous bone that increases significantly with the flexion's amplitude rise. The peak implant stress occurred in the flexion amplitudes further away from the implant neutral angle. The highest implant pistoning motion and the highest phalanx cancellous-bone strain occurred simultaneously at the maximum flexion amplitude. InterpretationLimiting joint flexion range will be helpful to reduce the strain-shielding effect on cortical bone, minimizing the overload effect on cancellous bone and decreasing the stress levels and the pistoning motion on the implant, ultimately contributing to the longevity of silicone arthroplasty.

Which Knee Phenotypes Exhibit the Strongest Correlation With Cartilage Degeneration?

Although articular wear has been thoroughly investigated, the effects of abnormal limb alignment on cartilage degeneration over time remain poorly understood. An exact assessment of the correlation between lower limb alignment abnormalities and MRI-observed articular degradation may be helpful for understanding the progression of osteoarthritis and planning future treatment. In patients with moderate to advanced osteoarthritis, (1) is there a correlation between overall alignment of the knee and the location of cartilage degradation over time, as measured by cartilage metrics on MRI? (2) Is there a correlation between tibial alignment and the location of cartilage degradation over time, as measured by cartilage metrics on MRI? (3) Is there a correlation between femoral alignment and the location of cartilage degradation over time, as measured by cartilage metrics on MRI? Between April 2020 and September 2022, we retrospectively evaluated 3106 patients aged 45 to 79 years who were at risk of experiencing knee osteoarthritis. Of those, we considered as potentially eligible 600 symptomatic index knees with radiographic evidence of osteoarthritis-Kellgren-Lawrence Grades 2 or 3-at the baseline visit. Of those, 22% (134 of 600) were excluded because of a lack of proper alignment measurements, leaving 466 knees with measurements of radiologic alignment angles and quantitative MRI cartilage measurements of 16 subregions of the femorotibial compartment at baseline and 12 and 24 months, and 64 knees at the 48-month visit for investigation in the current study. Data regarding cartilage measurements of the patellofemoral compartment were not available for analysis. The knees were categorized into one of the possible 25 different phenotypes of the lower extremity established by previous research, based on the neutral, valgus, or varus distal mechanical angle of the femur and proximal tibial mechanical angle on full-limb radiographs. We applied ANOVA to estimate the effect size of the overall, femoral, and tibial alignments on the location of cartilage degradation over time, as measured by cartilage metrics on MRI. We found that the overall combinations of a valgus femur with valgus tibia or a valgus femur with varus tibia were associated with the highest loss of cartilage in the internal medial tibial subregion and anterior lateral tibial subregion (η 2 p = 0.39 and 0.17, respectively). For the tibia, we found that the combination of a valgus femur with valgus tibia was associated with an increase in the area of subchondral bone denuded of cartilage in the central lateral tibial subregion (η 2 p = 0.2). For the femur, we found that the combination of a valgus femur with valgus tibia was associated with loss of cartilage thickness in the central weightbearing lateral femorotibial compartment (η 2 p = 0.15). We found that certain alignment patterns are associated with rapid deterioration of cartilage and exposure of subchondral bone, even over short time periods. In particular, the valgus femur with valgus tibia and valgus femur with varus tibia phenotypes deserve special attention, because they exhibited a strong, atypical correlation with the internal medial tibial subregion and anterior lateral tibial subregion, respectively. This is important because valgus and varus malalignment cause isolated lateral and medial compartment disease, respectively. Therefore, these findings suggest that a more individualized approach for limb axis deformities is valuable, and hint at a more meticulous radiologic and clinical investigation, perhaps using different imaging modalities, especially when assessing the exact cartilage state and planning an intervention. Future studies, ideally biomechanical, might help in assessing the long-term effects of the various phenotypes on cartilage degradation and their relevance in reconstructive surgery. Level II, prognostic study.

Axial Neck Pain after Cervical Laminoplasty with Preserving C7 Spinous Process Using C7 Arcocristectomy: A Prospective Study.

Single-blinded, randomized, single-center, prospective study. This study aims to compare the radiographical and clinical outcomes between C7 laminoplasty and C7 arcocristectomy, which preserves the C7 spinous process. Laminoplasty is a widely used surgical method that decompresses the cervical spinal cord. However, axial neck pain is one of the major factors of dissatisfaction, and still, it is not clearly solved the reduction method of postoperative axial neck pain. Thirty-one patients with multilevel cervical spondylotic myelopathy who required C6-C7 level decompression surgery were operated and followed up for 24 months. One group (15 patients) received C7 arcocristectomy without laminoplasty, and the other group (16 patients) received C7 laminoplasty. Flexion, neutral, and extension angles were measured using the Cobb method at C2-C7 to evaluate preoperative and postoperative radiographic parameters. Range of motion (ROM), ROM preservation rate of the cervical spine, C2-C7 sagittal vertical axis (SVA), and T1 slope were measured using C-spine lateral X-ray. The Visual Analog Scale (VAS) and modified Japanese Orthopedic Association (JOA) score were used to compare preoperative and postoperative clinical symptoms. Flexion, neutral, extension angles of the cervical spine, C2-C7 SVA, T1 slope, ROM, ROM preservation rate, and modified JOA score were not significantly different between the two groups (p>0.05). In the C7 arcocristectomy group, the average postoperative VAS for axial neck pain was increased in 13.3% (2/15) of the patients, whereas in the C7 laminoplasty group, the average postoperative VAS was increased in 43.8% (7/16) of the patients (p=0.018). C7 arcocristectomy, which preserves the C7 spinous process and posterior structures, is a useful technique for relieving axial neck pain.

Interacting effects of AFO stiffness, neutral angle and footplate stiffness on gait in case of plantarflexor weakness: A predictive simulation study

To maximize effects of dorsal leaf ankle foot orthoses (AFOs) on gait in people with bilateral plantarflexor weakness, the AFO properties should be matched to the individual. However, how AFO properties interact regarding their effect on gait function is unknown. We studied the interaction of AFO bending stiffness with neutral angle and footplate stiffness on the effect of bending stiffness on walking energy cost, gait kinematics and kinetics in people with plantarflexor weakness by employing predictive simulations.Our simulation framework consisted of a planar 11 degrees of freedom model, containing 11 muscles activated by a reflex-based neuromuscular controller. The controller was optimized by a comprehensive cost function, predominantly minimizing walking energy cost. The AFO bending and footplate stiffness were modelled as torsional springs around the ankle and metatarsal joint. The neutral angle of the AFO was defined as the angle in the sagittal plane at which the moment of the ankle torsional spring was zero. Simulations without AFO and with AFO for 9 bending stiffnesses (0–14 Nm/degree), 3 neutral angles (0–3-6 degrees dorsiflexion) and 3 footplate stiffnesses (0–0.5–2.0 Nm/degree) were performed.When changing neutral angle towards dorsiflexion, a higher AFO bending stiffness minimized energy cost of walking and normalized joint kinematics and kinetics. Footplate stiffness mainly affected MTP joint kinematics and kinetics, while no systematic and only marginal effects on energy cost were found.In conclusion, the interaction of the AFO bending stiffness and neutral angle in bilateral plantarflexor weakness, suggests that these should both be considered together when matching AFO properties to the individual patient.

Differences in Risk Factors for Decreased Cervical Lordosis after Multiple-Segment Laminoplasty for Cervical Spondylotic Myelopathy and Ossification of the Posterior Longitudinal Ligament: A Pilot Study.

Retrospective study. To compare the radiographic risk factors for decreased cervical lordosis (CL) after laminoplasty, focusing on the difference between cervical spondylotic myelopathy (CSM) and cervical ossification of the posterior longitudinal ligament (C-OPLL). A few reports compared the risk factors for decreased CL between CSM and C-OPLL although these two pathologies have their characteristics. This study included 50 patients with CSM and 39 with C-OPLL who underwent multi-segment laminoplasty. Decreased CL was defined as the difference between preoperative and 2-year postoperative neutral C2-7 Cobb angles. Radiographic parameters included preoperative neutral C2-7 Cobb angles, C2-7 sagittal vertical axis (SVA), T1 slope (T1S), dynamic extension reserve (DER), and range of motion. The radiographic risk factors were investigated for decreased CL in CSM and C-OPLL. Additionally, the Japanese Orthopedic Association (JOA) score was assessed preoperatively and 2 years postoperatively. C2-7 SVA (p =0.018) and DER (p =0.002) were significantly correlated with decreased CL in CSM, while C2-7 Cobb angle (p =0.012) and C2-7 SVA (p =0.028) were correlated with decreased CL in C-OPLL. Multiple linear regression analysis revealed that greater C2-7 SVA (B =0.22, p =0.026) and small DER (B =-0.53, p =0.002) were significantly associated with decreased CL in CSM. By contrast, greater C2-7 SVA (B =0.36, p =0.031) was significantly associated with decreased CL in C-OPLL. The JOA score significantly improved in both CSM and C-OPLL (p <0.001). C2-7 SVA was associated with a postoperative decreased CL in both CSM and C-OPLL, but DER was only associated with decreased CL in CSM. Risk factors for decreased CL slightly differed depending on the etiology of the condition.

Correlation Study Between Spinal Cord Function, Spinal Cord Morphology and Cervical Spine Alignments in Patients With Hirayama Disease.

This study aimed to explore the relationship between diffusion tensor imaging (DTI) parameters, cervical spine alignments, and spinal cord morphological parameters in patients with Hirayama disease (HD). In this retrospective cohort study, 41 HD patients were recruited from the Huashan hospital from July 2017 to November 2021. Patients received X-rays, conventional magnetic resonance (MR), and DTI scans in flexion and neutral positions. The DTI parameters assessed were calculated using the region of interest (ROI) method. Paired t-tests were performed on the DTI parameters of neck flexion and neutral position. Cervical spine alignments, including flexion and neutral Cobb angles, were measured, and range of motion (ROM) was calculated. Spinal cord morphological parameters were measured, including spinal cord atrophy (SCA) and loss of attachment (LOA). Spearman's correlation analysis between DTI parameters, cervical spine alignments, and spinal cord morphological parameters was performed. In comparing DTI parameters, segments of the C3/4, C4/5, C6/7, and lower cervical spine were significantly different, while segments of C5/6 were not significantly different. In Spearman's correlation analysis, the flexion Cobb angle was significantly correlated with the fractional anisotropy (FA) value (R2 = .111, P = .033) and apparent diffusion coefficient (ADC) value (R2 = .119, P = .027). Flexion FA values were correlated with SCA in C4/5 (R2 = .211, P = .003), C5/6 (R2 = .454, P < .001), and C6/7 (R2 = .383, P < .001) while flexion ADC values were correlated with SCA in the C4/5 (R2 = .178, P = .006), C5/6 (R2 = .388, P < .001) and C6/7 segments (R2 = .187, P = .005). The DTI parameters were correlated with the flexion Cobb angle and the SCA. These data support the dynamic cervical flexion compression hypothesis and indicate that the degree of SCA may be used to assess the condition of HD patients quantitatively.

Molecular mechanisms affecting the stability of high internal phase emulsions of zein-soy isoflavone complexes fabricated with ultrasound-assisted dynamic high-pressure microfluidization

In this study, zein-soy isoflavone complex (ZSI) emulsifiers were fabricated using ultrasound-assisted dynamic high-pressure micro fluidization to stabilise highinternal phase pickering emulsions. Ultrasound-assisted dynamic high-pressure micro-fluidization enhanced surface hydrophobicity, zeta potential, and soy isoflavone binding capacity, while it decreased particle size, especially during ultrasound and subsequent microfluidization. The treated ZSI could produce small droplet clusters and gel-like structures, with excellent viscoelasticity, thixotropy and creaming stability owing to their neutral contact angles. Ultrasound and subsequent micro fluidization treatment of the ZSI complexes were highly effective in preventing droplet flocculation and coalescence after long-term storage or centrifugation due to their higher surface load, thicker multi-layer interfacial structure, and stronger electronic repulsion between the oil droplets. This study provides insights and extends our current knowledge of how non-thermal technology affects the interfacial distribution of plant based particles and the physical stability of emulsions.

A Cross Sectional Study of Early Detection of Developmental Dysplasia of Hip Joint by Ultrasonography in Infants below 90 days of Age

Hip dysplasia is an abnormality of the hip joint where the acetabular socket portion does not fully cover the ball portion of femoral head, resulting in an increased risk for joint dislocation. DDH ranges from a simple flattening of the acetabular cavity to the complete dislocation of the femoral head. If untreated, DDH can cause early hip osteoarthritis and, in the most severe forms, the presence of a limp with severe functional limitations, since walking age5.In the past, the incidence of severe forms of the disease without an early diagnosis program, was reported to be 0.13% of all newborns. Aim: To assess the usefulness of ultrasonography in early detection of Developmental Dysplasia of Hip joint in infants below 90 days of age. Material and Methods: A Cross sectional study was carried out under department of Radiology at a Tertiary rural health care centre. All neonates born in labor room and infants below 90 days of age receiving outpatient and inpatient care at tertiary rural health care centre fulfilling the inclusion criteria. Thus total 630 neonates were studied. Data were entered in EXCEL sheet and analysed using SSPS software version 20.0. Risk factors were presented and assessed by chi-square. Results: Majority 96.5% neonates had age less than 5 days. Mean age was 3.03+5.5 days, ranging between 1 Day to 86 days. On coronal- neutral HIP angle, on right mean alpha was 61.1 and beta was 61.5 and on left side mean alpha was 60.2 and beta was 62.9. Prevalence of Developmental Dysplasia of Hip joint was found to be 1.6%. Conclusion: Present study showed significance for gender, family history and gestational age. Present study concludes that USG can do early detection of DDH because Clinical presentation of DDH is little late. So for early diagnosis and treatment USG can be used as a screening test for all the newborns for DDH.

Direct CFD simulations of standard maneuvering tests for DARPA Suboff

Maneuvering abilities of underwater vehicles are one of the primary concerns for navies and in the civil field they provide great flexibility in working in confined environments. Numerical simulations of the motions of these vessels may be conducted via system-based or direct CFD approaches. In this study, we focus on direct CFD simulations of the benchmark DARPA Suboff AFF8 Configuration. The paper starts by showing the submarine's lack of course-keeping stability using the C-index. After validation of the numerical approach by self-propulsion tests (and the determination of the propeller rotation rate to achieve the required velocity), the results of an extensive set of standard maneuvering tests are presented. Turning circle, pullout and zig-zag tests confirm that the DARPA Suboff does not have course-keeping ability. The submarine leans to the starboard side at neutral rudder angle. The maneuvering indices are investigated with respect to changing rudder angle with turning circle tests. High residual yaw rates are found in both side turnings in the pullout tests and the zig-zag tests show the submarine's inadequacy in making sharp turns. Numerical simulations reveal that the DARPA Suboff has high turning ability but no course-keeping ability.