Memristors with Tunable Volatility for Reconfigurable Neuromorphic Computing.

Neuromorphic computing promises an energy-efficient alternative to traditional digital processors in handling data-heavy tasks, primarily driven by the development of both volatile (neuronal) and nonvolatile (synaptic) resistive switches or memristors. However, despite their energy efficiency, memristor-based technologies presently lack functional tunability, thus limiting their competitiveness with arbitrarily programmable (general purpose) digital computers. This work introduces a two-terminal bilayer memristor, which can be tuned among neuronal, synaptic, and hybrid behaviors. The varying behaviors are accessed via facile control over the filament formed within the memristor, enabled by the interplay between the two active ionic species (oxygen vacancies and metal cations). This solution is unlike single-species ion migration employed in most other memristors, which makes their behavior difficult to control. By reconfiguring a single crossbar array of hybrid memristors, two different applications that usually require distinct types of devices are demonstrated - reprogrammable heterogeneous reservoir computing and arbitrary non-Euclidean graph networks. Thus, this work outlines a potential path toward functionally reconfigurable postdigital computers.

Comparing Diagnostic Accuracy of Radiologists versus GPT-4V and Gemini Pro Vision Using Image Inputs from Diagnosis Please Cases.

Background The diagnostic abilities of multimodal large language models (LLMs) using direct image inputs and the impact of the temperature parameter of LLMs remain unexplored. Purpose To investigate the ability of GPT-4V and Gemini Pro Vision in generating differential diagnoses at different temperatures compared with radiologists using Radiology Diagnosis Please cases. Materials and Methods This retrospective study included Diagnosis Please cases published from January 2008 to October 2023. Input images included original images and captures of the textual patient history and figure legends (without imaging findings) from PDF files of each case. The LLMs were tasked with providing three differential diagnoses, repeated five times at temperatures 0, 0.5, and 1. Eight subspecialty-trained radiologists solved cases. An experienced radiologist compared generated and final diagnoses, considering the result correct if the generated diagnoses included the final diagnosis after five repetitions. Accuracy was assessed across models, temperatures, and radiology subspecialties, with statistical significance set at P < .007 after Bonferroni correction for multiple comparisons across the LLMs at the three temperatures and with radiologists. Results A total of 190 cases were included in neuroradiology (n = 53), multisystem (n = 27), gastrointestinal (n = 25), genitourinary (n = 23), musculoskeletal (n = 17), chest (n = 16), cardiovascular (n = 12), pediatric (n = 12), and breast (n = 5) subspecialties. Overall accuracy improved with increasing temperature settings (0, 0.5, 1) for both GPT-4V (41% [78 of 190 cases], 45% [86 of 190 cases], 49% [93 of 190 cases], respectively) and Gemini Pro Vision (29% [55 of 190 cases], 36% [69 of 190 cases], 39% [74 of 190 cases], respectively), although there was no evidence of a statistically significant difference after Bonferroni adjustment (GPT-4V, P = .12; Gemini Pro Vision, P = .04). The overall accuracy of radiologists (61% [115 of 190 cases]) was higher than that of Gemini Pro Vision at temperature 1 (T1) (P < .001), while no statistically significant difference was observed between radiologists and GPT-4V at T1 after Bonferroni adjustment (P = .02). Radiologists (range, 45%-88%) outperformed the LLMs at T1 (range, 24%-75%) in most subspecialties. Conclusion Using direct radiologic image inputs, GPT-4V and Gemini Pro Vision showed improved diagnostic accuracy with increasing temperature settings. Although GPT-4V slightly underperformed compared with radiologists, it nonetheless demonstrated promising potential as a supportive tool in diagnostic decision-making. © RSNA, 2024 See also the editorial by Nishino and Ballard in this issue.

Implementation of Bayesian networks and Bayesian inference using a Cu0.1Te0.9/HfO2/Pt threshold switching memristor.

Bayesian networks and Bayesian inference, which forecast uncertain causal relationships within a stochastic framework, are used in various artificial intelligence applications. However, implementing hardware circuits for the Bayesian inference has shortcomings regarding device performance and circuit complexity. This work proposed a Bayesian network and inference circuit using a Cu0.1Te0.9/HfO2/Pt volatile memristor, a probabilistic bit neuron that can control the probability of being 'true' or 'false.' Nodal probabilities within the network are feasibly sampled with low errors, even with the device's cycle-to-cycle variations. Furthermore, Bayesian inference of all conditional probabilities within the network is implemented with low power (<186 nW) and energy consumption (441.4 fJ), and a normalized mean squared error of ∼7.5 × 10-4 through division feedback logic with a variational learning rate to suppress the inherent variation of the memristor. The suggested memristor-based Bayesian network shows the potential to replace the conventional complementary metal oxide semiconductor-based Bayesian estimation method with power efficiency using a stochastic computing method.

Tunable stochastic memristors for energy-efficient encryption and computing.

Information security and computing, two critical technological challenges for post-digital computation, pose opposing requirements - security (encryption) requires a source of unpredictability, while computing generally requires predictability. Each of these contrasting requirements presently necessitates distinct conventional Si-based hardware units with power-hungry overheads. This work demonstrates Cu0.3Te0.7/HfO2 ('CuTeHO') ion-migration-driven memristors that satisfy the contrasting requirements. Under specific operating biases, CuTeHO memristors generate truly random and physically unclonable functions, while under other biases, they perform universal Boolean logic. Using these computing primitives, this work experimentally demonstrates a single system that performs cryptographic key generation, universal Boolean logic operations, and encryption/decryption. Circuit-based calculations reveal the energy and latency advantages of the CuTeHO memristors in these operations. This work illustrates the functional flexibility of memristors in implementing operations with varying component-level requirements.

Multiphase Reset Induced Reliable Dual-Mode Resistance Switching of the Ta/HfO2/RuO2 Memristor.

Higher functionality should be achieved within the device-level switching characteristics to secure the operational possibility of mixed-signal data processing within a memristive crossbar array. This work investigated electroforming-free Ta/HfO2/RuO2 resistive switching devices for digital- and analog-type applications through various structural and electrical analyses. The multiphase reset behavior, induced by the conducting filament modulation and oxygen vacancy generation (annihilation) in the HfO2 layer by interacting with the Ta (RuO2) electrode, was utilized for the switching mode change. Therefore, a single device can manifest stable binary switching between low and high resistance states for the digital mode and the precise 8-bit conductance modulation (256 resistance values) via an optimized pulse application for the analog mode. An in-depth analysis of the operation in different modes and comparing memristors with different electrode structures validate the proposed mechanism. The Ta/HfO2/RuO2 resistive switching device is feasible for a mixed-signal processable memristive array.

In-hospital real-time prediction of COVID-19 severity regardless of disease phase using electronic health records.

Coronavirus disease 2019 (COVID-19) has strained healthcare systems worldwide. Predicting COVID-19 severity could optimize resource allocation, like oxygen devices and intensive care. If machine learning model could forecast the severity of COVID-19 patients, hospital resource allocation would be more comfortable. This study evaluated machine learning models using electronic records from 3,996 COVID-19 patients to forecast mild, moderate, or severe disease up to 2 days in advance. A deep neural network (DNN) model achieved 91.8% accuracy, 0.96 AUROC, and 0.90 AUPRC for 2-day predictions, regardless of disease phase. Tree-based models like random forest achieved slightly better metrics (random forest: 94.1% of accuracy, 0.98 AUROC, 0.95 AUPRC; Gradient boost: 94.1% of accuracy, 0.98 AUROC, 0.94 AUPRC), prioritizing treatment factors like steroid use. However, the DNN relied more on fixed patient factors like demographics and symptoms in aspect to SHAP value importance. Since treatment patterns vary between hospitals, the DNN may be more generalizable than tree-based models (random forest, gradient boost model). The results demonstrate accurate short-term forecasting of COVID-19 severity using routine clinical data. DNN models may balance predictive performance and generalizability better than other methods. Severity predictions by machine learning model could facilitate resource planning, like ICU arrangement and oxygen devices.

Visible-Light Communication with Lighting: RGB Wavelength Division Multiplexing OLEDs/OPDs Platform.

A multichannel/multicolor visible light communication (VLC) system using entirely organic components, including organic light emitting diodes (OLEDs) and organic photodiodes (OPDs), is developed to demonstrate indoor lighting applications where the integration of OLEDs and OPDs has significant potential. To achieve this, tricolor (Red/Green/Blue(R/G/B))-selective OPD arrays for the receiver and tricolor OLED arrays for the emitter are developed. For (R/G/B)-selective OPDs, a Fabry-Pérot electrode to enhance color selectivity and a thick junction structure to effectively accommodate a wide range of driving voltages are introduced. For tricolor OLEDs, fluorescent-emitting materials are used to enhance the operating frequency in addition to introducing a cavity structure to achieve narrow emission. Utilizing these spectrally refined tricolor OPDs/OLEDs, a VLC system is designed for indoor lighting applications, and a systematic analysis of their signal-to-interference ratio dependence on the distance or angle between the transmitter and receiver is performed. The study's findings indicate the importance of emission angle-dependent wavelength shift of the OLED and the luminosity function, which varies with wavelength, in the R/G/B mixed-white-light-based VLC systems. Finally, the feasibility of VLC using tricolor OPDs/OLEDs in the real-life context of indoor white-color lighting is demonstrated, showing that the transmitted data patterns well-matched the received data patterns.

Characterization of a novel mutant with inhibition of storage root formation in sweet potato.

Sweet potato is a widely cultivated crop with storage roots. Although many studies have been conducted on the mechanism of its storage root formation, the details have not been fully elucidated. We screened mutant lines with inhibition of storage root formation to clarify parts of the mechanism. In this study, the process of storage root formation in one of the mutant lines, C20-8-1, was investigated. The inhibition of storage root formation was observed during the early stages of growth. The roots in C20-8-1 did not show histological differences compared to those in wild type. The transition from fibrous roots to pencil roots, which are the developmental stages prior to mature storage root formation, was delayed or inhibited in C20-8-1. The upregulation of starch biosynthesis-related genes and downregulation of lignin biosynthesis genes with storage root swelling were not confirmed in the root of C20-8-1 during the developmental transition stage, suggesting that most of the roots in C20-8-1 are in the pre-transition state toward the storage root swelling. C20-8-1 showed a mutant phenotype during the critical period of storage root swelling initiation, and further clarification of this mutation is expected to provide new insights into storage root formation.

Efficacy of lazertinib for symptomatic or asymptomatic brain metastases in treatment-naive patients with advanced EGFR mutation-positive non-small cell lung cancer: Protocol of an open-label, single-arm phase II trial.

INTRODUCTION: Non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutation has a higher incidence of brain metastases than wild-type EGFR mutations. Osimertinib, a third-generation EGFR tyrosine kinase inhibitor (TKI), targets both EGFR-TKI sensitizing and T790M-resistance mutations and has a higher brain penetration rate relative to first- and second-generation EGFR-TKIs. Therefore, osimertinib has become a preferred first-line therapy for advanced EGFR mutation-positive NSCLC. However, lazertinib, an emerging EGFR-TKI, has shown higher selectivity toward EGFR mutations and improved penetration of the blood-brain barrier compared to osimertinib in preclinical studies. This trial will evaluate the efficacy of lazertinib as a first-line therapy in patients with EGFR mutation-positive NSCLC who have brain metastases, with or without additional local therapy. METHODS: This is a single-center, open-label, single-arm phase II trial. A total of 75 patients with advanced EGFR mutation-positive NSCLC will be recruited. Eligible patients will receive oral lazertinib 240 mg, once daily until disease progression or intolerable toxicity is detected. Patients with moderate to severe symptoms related to brain metastasis will simultaneously receive local therapy for the brain. The primary endpoints are progression-free survival and intracranial progression-free survival. DISCUSSION: Lazertinib, in combination with local therapy for the brain, if necessary, is expected to improve the clinical benefit in advanced EGFR mutation-positive NSCLC with brain metastases, as a first-line treatment.

Effect of Growth Stages on Anthocyanins and Polyphenols in the Root System of Sweet Potato.

The storage roots of purple-fleshed sweet potato contain a variety of anthocyanins and polyphenols. Little is known about changes in the total content and composition of anthocyanins and polyphenols in the early growth stages of the root system. In this study, we investigated the changes in anthocyanins and polyphenols in the root system of purple-fleshed sweet potato cultivars at 15, 30, 45, and 60 days after transplant (DAT). Unexpectedly, the highest percentage of acylated anthocyanins in three purple-fleshed cultivars among all growth stages was at 15 DAT. On the other hand, the total polyphenol content in the early growth stages of the root system increased rapidly toward 45 DAT, just before the beginning of storage root enlargement, and then decreased rapidly as the storage roots began to enlarge. These data indicate that the early growth stage of the root system is a critical time. This timing may present a strategy to maximize the accumulation of polyphenols with high antioxidant activity, as well as acylated anthocyanins, to protect against abiotic and biotic stresses.

Vibrationally Hot Reactants in a Plasmon-Assisted Chemical Reaction.

Recent studies on plasmon-assisted chemical reactions postulate that the hot electrons of plasmon-excited nanostructures may induce a non-thermal vibrational activation of metal-bound reactants. However, the postulate has not been fully validated at the level of molecular quantum states. We directly and quantitatively prove that such activation occurs on plasmon-excited nanostructures: The anti-Stokes Raman spectra of reactants undergoing a plasmon-assisted reaction reveal that a particular vibrational mode of the reactant is selectively excited, such that the reactants possess >10 times more energy in the mode than is expected from the fully thermalized molecules at the given local temperature. Furthermore, a significant portion (∼20%) of the excited reactant is in vibrational overtone states with energies exceeding 0.5 eV. Such mode-selective multi-quantum excitation could be fully modeled by the resonant electron-molecule scattering theory. Such observations suggest that the vibrationally hot reactants are created by non-thermal hot electrons, not by thermally heated electrons or phonons of metals. The result validates the mechanism of plasmon-assisted chemical reactions and further offers a new method to explore the vibrational reaction control on metal surfaces.

Genetic diversity assessment and genome-wide association study reveal candidate genes associated with component traits in sweet potato (Ipomoea batatas (L.) Lam).

The Korean sweet potatoes were bred by various cultivars introduced from Japanese, American, Porto Rico, China, and Burundi. This issue enriched their genetic diversity but also resulted in a mixture of cultivars. For genotyping, we collected and sequenced 66 sweet potato germplasms from different localities around Korea, including 36 modern cultivars, 5 local cultivars, and 25 foreign cultivars. This identified 447.6 million trimmed reads and 324.8 million mapping reads and provided 39,424 single nucleotide polymorphisms (SNPs) markers. Phylogenetic clustering and population structure analysis distinctly classified these germplasms into 5 genetic groups, group 1, group 2, group 3, group 4, and group 5, containing 20, 15, 10, 7, and 14 accessions, respectively. Sixty-three significant SNPs were selected by genome-wide association for sugar composition-related traits (fructose, glucose, and total sugars), total starch, amylose content, and total carotenoid of the storage root. A total of 37 candidate genes encompassing these significant SNPs were identified, among which, 7 genes were annotated to involve in sugar and starch metabolism, including galactose metabolism (itf04g30630), starch and sucrose metabolism (itf03g13270, itf15g09320), carbohydrate metabolism (itf14g10250), carbohydrate and amino acid metabolism (itf12g19270), and amino sugar and nucleotide sugar metabolism (itf03g21950, itf15g04880). This results indicated that sugar and starch are important characteristics to determine the genetic diversity of sweet potatoes. These findings not only illustrate the importance of component traits to genotyping sweet potatoes but also explain an important reason resulting in genetic diversity of sweet potato.

Comprehensive effects of heavy-ion beam irradiation on sweet potato (Ipomoea batatas [L.] Lam.).

Sweet potato is a major root crop with nutritious tuberous roots. The mechanism of tuberous root development has not yet been adequately elucidated. Genetic resources are required to develop the molecular understanding of sweet potato. Heavy-ion beams were applied to hexaploid sweet potato for an increase in genetic variation, after which the comprehensive effects of heavy-ion beam irradiation were investigated. In vitro cultured shoots with an axillary bud of 'Beniharuka' were irradiated with Ar-ions at a dose of 1-5 Gy and C-ions at a dose of 5-20 Gy, and three irradiated lines were separated from each irradiated shoot. The shoot regeneration was inhibited at high doses of each ion irradiation. Ar-ion irradiation had an especially high biological effect on shoot regeneration. A total of 335 lines were obtained, consisting of 104 and 231 lines derived from Ar- and C-ion irradiation, respectively. The change in the DNA content of the lines was analyzed by flow cytometry to evaluate the irradiation-induced damage to the DNA. The two lines demonstrated significant differences in the DNA content and changes at the chromosome level. The screening for the morphological mutants was conducted in the field. Some irradiated lines showed inhibited or no tuberous root phenotype as mutant candidates. Additionally, the high-yield mutant candidates were dominated by Ar-ion irradiation. It was indicated that heavy-ion beam mutagenesis is effective in broadening the range of the phenotypes corresponding to tuberous root formation in hexaploid sweet potato.

Association between misalignment of circadian rhythm and obesity in Korean men: Sixth Korea National Health and Nutrition Examination Survey.

Background: The disruption of circadian rhythm has been found to associate with obesity in vivo and in vitro. Sleep duration, eating habits, total feeding time, and nightshift work can also affect circadian rhythms. This study investigated the association between misalignment of circadian rhythm and obesity in Korean men, using a cross-sectional database.Methods: This study used data from the Korean National Health and Nutrition Examination Survey (KNHANES), whose study population was 3,658 men aged 18 to 60 years. General and abdominal obesity was defined as a body mass index (BMI) ≥ 25 kg/m2 and waist circumference ≥ 90 cm, respectively. Circadian rhythm factors were determined with a self-report questionnaire and included breakfast frequency, sleep duration, and work time. Frequency of breakfast was divided into regular breakfast (five to seven times a week) and irregular breakfast (less than five times a week). Sleep duration was divided into less than 7 hours, 7-9 hours, and over 9 hours. Working time was defined as day/evening, night shift, and other type. The adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for general and abdominal obesity were calculated using multivariable logistic regression according to the number of factors that disturb the circadian rhythm.Results: Participants with 1 (aOR 1.34, 95% Cl 1.10-1.61) and ≥2 (aOR 1.62, 95% Cl 1.29-2.05) factors disturbing circadian rhythms were associated with elevated risk for general obesity. Similarly, those with 1 (aOR 1.33, 95% Cl 1.09-1.63) and ≥2 (aOR 1.70, 95% Cl 1.32-2.20) factors had elevated risk for abdominal obesity.Conclusions: Factors disturbing the circadian rhythm were associated with general and abdominal obesity. Additional studies are needed, and associations with metabolic diseases should be investigated.

Effect of remifentanil during drug-induced sleep endoscopy in patients with obstructive sleep apnea.

PURPOSE: During drug-induced sleep endoscopy (DISE) in patients with obstructive sleep apnea, the increased depth of propofol anesthesia is related to the increased collapsibility of the upper airway with dose-dependent. We examined the effect of remifentanil on propofol concentration during DISE. METHODS: In a prospective randomized trial, 56 adult patients were divided into remifentanil-propofol (n = 28) and propofol alone (n = 28) groups. Anesthesia was administered using a target-controlled infusion system. In the remifentanil-propofol group, 0.5 ng/ml remifentanil was administered prior to propofol infusion and its concentration maintained; thereafter, in the propofol alone group, normal saline was injected instead of remifentanil. Propofol was infused at a concentration of 1.5 µg/ml after the target concentration of remifentanil was reached. In both groups, the concentration of propofol was increased by 0.5 µg/ml if the degree of sedation was not sufficient. The sedation level was targeted at observer's assessment of alertness/sedation (OAA/S) scale 3. RESULTS: The mean propofol concentration was 2.87 ± 0.60 µg/ml in the remifentanil-propofol group, which was lower than that in the propofol alone group (3.38 ± 0.72 µg/ml, P < 0.001). The time until sufficient sedation to perform DISE was shorter in the remifentanil-propofol group (P < 0.001). Apnea-hypopnea index and the lowest peripheral capillary oxygen saturation (SpO2) during polysomnography showed no statistical difference between groups (P > 0.05). The lowest SpO2 and VOTE classification during DISE were also not statistically different (P > 0.05). CONCLUSIONS: Use of remifentanil during DISE reduces the target concentration of propofol required for patient sedation to perform DISE without respiratory depression.

Palonosetron-Induced Anaphylaxis During General Anesthesia: A Case Report.

Palonosetron is a 5-hydroxytryptamine-3 (5-HT-3) receptor antagonist used for preventing postoperative nausea and vomiting. Compared with ondansetron and granisetron, it is a better drug because of prolonged action and minimal side effects. Some adverse effects of palonosetron have been reported. In this report, we describe a 37-year-old male who developed severe hypersensitivity reactions to palonosetron during surgery for kidney donation. His medical history was unremarkable, except for inguinal hernia with herniorrhaphy 8 years ago. The surgery was uneventful until 2 hours 20 minutes. After palonosetron injection, his blood pressure dropped to 80/50 mm Hg, and facial edema, rash, conjunctival swelling, and wheezing developed. The patient was resuscitated by administration of ephedrine, hydrocortisone, and peniramine. Following the surgery, the patient was monitored for 3 days, and there were no subsequent anaphylactic reactions or other complications. The skin test on postoperative day 54 was positive for hypersensitivity to palonosetron. Although palonosetron is known for its safety, other hypersensitivity events have been reported. Ondansetron is another widely used 5-HT-3 antagonist, which has been reported to cause anaphylaxis. Therefore, clinicians should be aware of the possibility of patients experiencing severe adverse reactions to palonosetron.

Identification of safety-critical events using kinematic vehicle data and the discrete fourier transform.

Recent technological advances have made it both feasible and practical to identify unsafe driving behaviors using second-by-second trajectory data. Presented in this paper is a unique approach to detecting safety-critical events using vehicles' longitudinal accelerations. A Discrete Fourier Transform is used in combination with K-means clustering to flag patterns in the vehicles' accelerations in time-series that are likely to be crashes or near-crashes. The algorithm was able to detect roughly 78% of crasjavascript:void(0)hes and near-crashes (71 out of 91 validated events in the Naturalistic Driving Study data used), while generating about 1 false positive every 2.7h. In addition to presenting the promising results, an implementation strategy is discussed and further research topics that can improve this method are suggested in the paper.

Molecular cloning and expression analysis of a new lily-type lectin in the rock bream, Oplegnathus fasciatus.

A new lily-type lectin RbLTL was identified from rock bream (Oplegnathus fasciatus) and its expression analysed. In this study, a new lily-type lectin gene (RbLTL) was cloned from rock bream using expressed sequence tag (EST) analysis. The full-length RbLTL cDNA was encoding a 117-amino acid protein. The deduced amino acid sequence of RbLTL contained all of the conserved features crucial for its fundamental structure, including B-lectin domain and three d-mannose binding sites. RbLTL mRNA was predominately expressed in the gills, with reduced expression noted in intestine tissue. Expression analysis of time series sampled fertilized eggs revealed that expression gradually increased 1, 3, 12, and 24 h: However, expression decreased at 36 h. RbLTL expression was differentially up-regulated in rock bream gills challenged with Streptococcus iniae, Edwardsiella tarda and RSIV. Our results revealed that novel rock bream lily-type lectin may be an important molecule involved in pattern recognition and pathogen elimination in the innate immunity of rock bream.

Ability of an intentionally smaller anterior than posterior gap to reduce the sagittal tibial slope in opening wedge high tibial osteotomy.

BACKGROUND: We utilized in vivo 3- dimensional (D) computed tomography (CT) to determine whether the preoperatively planned anterior and posterior opening gap heights correlated with the real gaps following opening wedge high tibial osteotomy (HTO), as well as the relationships between anterior and posterior gap heights and change in sagittal tibial slope. METHODS: This prospective study involved 41 patients (41 knees) undergoing navigation HTO for primary medial osteoarthritis. Mechanical axis (MA), weight-bearing line (WBL) ratio, and posterior tibial slope were measured on radiographs preoperatively and after 3 months. The anterior and posterior opening gaps created by osteotomy were measured using in vivo 3D CT and the patients were classified into a larger anterior or posterior gap group. RESULTS: Of the 41 patients, 24 (59 %) had larger anterior and 17 (41 %) had larger posterior gaps. There were no between group differences in preoperative and postoperative slopes, or in change in slope. The correlation between preoperatively planned and postoperative posterior gaps was good, whereas the correlation of anterior gaps was only fair. Bland-Altman plots showed poor agreement for both preoperative and postoperative anterior and posterior gaps. The mean systematic difference (bias) was 2.3 mm (p < 0.001) for anterior and -1.0 mm (p = 0.033) for posterior gaps. CONCLUSIONS: Preoperatively calculated opening gaps, which were planned to be larger posteriorly than anteriorly to minimize the change in slope after surgery, did not correspond with postoperative opening gaps on 3D CT. In addition, postoperative tibial slope did not increase, even when the anterior gap was larger than the posterior gap. TRIAL REGISTRATION NUMBER: KCT0001905 , April 29, 2016.

Unintended Rotational Changes of the Distal Tibia After Biplane Medial Open-Wedge High Tibial Osteotomy.

This study involved 35 knees undergoing biplane medial open-wedge high tibial osteotomy (OWHTO) to assess the axial rotation of the distal tibia. The distal tibiae were internally rotated by 3.0° ± 7.1° after OWHTO. The opening width showed a Pearson correlation coefficient of -0.743 (P < .001), and the tuberosity osteotomy angle showed that of -0.678 (P < .001) with distal tibial rotation. However, changes in hip-knee-ankle angle, medial proximal tibial angle, and posterior tibial slope were not significantly correlated with the change in distal tibial rotation. In conclusion, there was an unintended tendency of increasing internal rotation of the distal tibia after biplane medial OWHTO, and this tendency was positively related to the opening width and tuberosity osteotomy angle.