Preparation and Selective Adsorption Performance of the Carboxymethyl Salix psammophila Wood Powder-Imprinted Membrane for Tetracycline.

Carboxymethyl Salix psammophila wood powder-imprinted membranes (CMSM-MIPs) were prepared by using wet spinning technology and molecular-imprinting technology for the selective removal of tetracycline from wastewater. Scanning electron microscopy, X-ray diffraction, thermogravimetry, and X-ray photoelectron spectroscopy characterizations demonstrate that CMSM-MIPs retain the membranous structure of Carboxymethyl Salix psammophila wood powder membranes, successfully encapsulate thin layers of imprinted polymers on the membrane surface, and exhibit excellent thermal stability. The adsorption results showed that CMSM-MIPs had the highest selective adsorption capacity for tetracycline, which was 253.8 mg/g. In addition, the adsorption capacities for oxytetracycline and chlortetracycline were 208.8 and 188 mg/g, respectively. It can be observed that CMSM-MIPs not only exhibit a high adsorption capacity for tetracycline but also demonstrate good adsorption capacities for oxytetracycline and chlortetracycline. The experimental results showed that CMSM-MIPs were best fitted with pseudo-second-order kinetics and most consistent with Freundlich fitting. The regeneration experiment showed that CMSM-MIPs still had good regeneration performance after 5 regeneration cycles. In conclusion, the CMSM-MIPs can not only have the natural adsorption performance of Salix psammophila wood powder but also give it higher selectivity through molecular imprinting, so as to achieve efficient removal of target organic pollutants in water.

Low-Temperature Resistant Stretchable Micro-Supercapacitor Based on 3D Printed Octet-Truss Design.

Recently, stretchable micro-supercapacitors (MSCs) that can be easily integrated into electronic devices have attracted research and industrial attentions. In this work, three-dimensional (3D) stretchable MSCs with an octet-truss electrode (OTE) design have been demonstrated by a rapid digital light processing (DLP) process. The 3D-printed electrode structure is beneficial for electrode-electrolyte interface formation and consequently increases the number of ions adsorbed on the electrode surface. The designed MSCs can achieve a high capacitance as ≈74.76 mF cm-3 under 1 mA cm-3 at room temperature even under a high mechanical deformation, and can achieve 19.53 mF cm-3 under 0.1 mA cm-3 at a low temperature (-30 °C). Moreover, finite element analysis (FEA) reveals the OTE structure provides 8 times more contact area per unit volume at the electrode-electrolyte interface compared to the traditional interdigital electrode (IDE). This work combines structural design and 3D printing techniques, which provides new insights into highly stretchable MSCs for next-generation electronic devices.

Exploring Three Decades of Progress: A Comprehensive Visual Review of Intravoxel Incoherent Motion MRI Research (1988-2021).

BACKGROUND Despite an increasing number of published articles on intravoxel incoherent motion (IVIM) in the past decade, almost all have focused on the technique and clinical applications of IVIM, with little attention to the collective knowledge and scientific analysis of this field. The aim of the present study was to construct a knowledge framework and to explore hotspots and emerging trends concerning use of IVIM in humans. MATERIAL AND METHODS The articles concerning IVIM MRI published from 1988 to 2021 were retrieved from the Science Citation Index Expended of the Web of Science Core Collection on 17, August 2021. The downloaded data were imported into Excel 2016 and CiteSpace V for scientometric analysis. RESULTS A total of 921 articles were included in this study and most of them were published since 2012. China (n=392) was the most productive country and the Philips Healthcare (n=46) was the most productive institution. Christian Federau had the largest number of publications (n=18). An article by Andreou A et al (2013) was the most important reference with the most co-citations (n=100) and centrality (0.06). The 5 hotspots in IVIM were perfusion, diffusion-weighted imaging, intravoxel incoherent motion, apparent diffusion coefficient, and magnetic resonance imaging. The 2 frontier topics were "brain perfusion" and "accuracy". According to the clustering of co-citation analysis, "liver", "diffusion weighting", "pancreas", and "brain" were the main research directions. CONCLUSIONS Scientometric analysis of IVIM literature with CiteSpace software can provide researchers with valuable information about knowledge framework, hotspots, and emerging trends concerning IVIM in humans.

3D Printed High Performance Silver Mesh for Transparent Glass Heaters through Liquid Sacrificial Substrate Electric-Field-Driven Jet.

Transparent glass with metal mesh is considered a promising strategy for high performance transparent glass heaters (TGHs). However, the realization of simple, low-cost manufacture of high performance TGHs still faces great challenges. Here, a technique for the fabrication of high performance TGHs is proposed using liquid sacrificial substrate electric-field-driven (LS-EFD) microscale 3D printing of thick film silver paste. The liquid sacrificial substrate not only significantly improves the aspect ratio (AR) of silver mesh, but also plays a positive role in printing stability. The fabricated TGHs with a line width of 35 µm, thickness of 12.3 µm, and pitch of 1000 µm exhibit a desirable optoelectronic performance with sheet resistance (Rs ) of 0.195 Ω sq-1 and transmittance (T) of 88.97%. A successful deicing test showcases the feasibility and practicality of the manufactured TGHs. Moreover, an interface evaporator is developed for the coordination of photothermal and electrothermal systems based on the high performance TGHs. The vapor generation rate of the device reaches 10.69 kg m-2 h-1 with a voltage of 2 V. The proposed technique is a promising strategy for the cost-effective and simple fabrication of high performance TGHs.

Clinical efficacy of immunotherapy combined with chemotherapy in patients with advanced gastric cancer, its effect on nutritional status and Changes of peripheral blood T lymphocyte subsets.

OBJECTIVES: To evaluate the clinical efficacy of immunotherapy combined with chemotherapy in patients with advanced gastric cancer and its effect on nutritional status and changes of peripheral blood T lymphocyte subsets. METHODS: Sixty patients with locally advanced gastric cancer who were admitted by Affiliated Hospital of Hebei University from March 2020 to February 2021 were enrolled and randomly divided into two groups, with 30 cases in each group. The control group was treated with FOLFOX4 chemotherapy, while the experimental group was additively treated with cindilizumab on the basis of control group. The incidence of adverse reactions, clinical efficacy, improvement of nutritional and physical status, and changes in the levels of T lymphocyte subgroups in the two groups were compared and analyzed. RESULTS: The total effective rate was 70% in the experimental group, which was better than 43.3% of the control group (p=0.04). The improvement rate of performance status (ECOG) score and nutritional indicators in the experimental group was significantly better than that in the control group (p<0.05). Moreover, the indicators of CD3+, CD4+, CD4+/CD8+ in the experimental group were significantly higher than those in the control group after treatment, with statistically significant differences (CD3+, p=0.01; CD4 +, p= 0.02; CD4+/CD8+, p=0.01). CONCLUSION: Immunotherapy combined with chemotherapy has a significant effect on locally advanced gastric cancer patients, with significant improvement in physical strength and nutritional status, significant improvement in T lymphocyte function, and no obvious adverse reactions. It is worth promoting in clinical application.

Design framework for mechanically tunable soft biomaterial composites enhanced by modified horseshoe lattice structures.

Soft biomaterials have a wide range of applications in many areas. However, one material can only cover a specific range of mechanical performance such as the elastic modulus and stretchability. In order to improve the mechanical performance of soft biomaterials, lattice structures are embedded to reinforce the biomaterials. In this paper, rectangular and triangular lattice structures formed by modified horseshoe microstructures are used because their mechanical properties are tunable and can be tailored precisely to match the desired properties by adjusting four geometrical parameters, the length L, radius R, width w and arc angle θ0. A theoretical design framework for the modified horseshoe lattice structures is developed to predict the dependence of the mechanical behaviors on geometrical parameters. Both experiments and finite element simulations on lattice structures are conducted to validate the theoretical models. Results show that a wide range of design space for the elastic modulus (a few kPa to hundreds of MPa), stretchability (strain up to 180%) and Poisson ratio (ranging from -0.5 to 1.2) can be achieved. Experiments on lattice-hydrogel composites are also conducted to verify the reinforcement effect of lattice structures on the hydrogel. This work provides a theoretical method to predict the mechanical behaviors of the lattice structures and aid the rational design of reinforced biomaterials, which has applications in tissue engineering, drug delivery and intraocular lenses.

Constructing Solid-Gas-Interfacial Fenton Reaction over Alkalinized-C3N4 Photocatalyst To Achieve Apparent Quantum Yield of 49% at 420 nm.

Efficient generation of active oxygen-related radicals plays an essential role in boosting advanced oxidation process. To promote photocatalytic oxidation for gaseous pollutant over g-C3N4, a solid-gas interfacial Fenton reaction is coupled into alkalinized g-C3N4-based photocatalyst to effectively convert photocatalytic generation of H2O2 into oxygen-related radicals. This system includes light energy as power, alkalinized g-C3N4-based photocatalyst as an in situ and robust H2O2 generator, and surface-decorated Fe3+ as a trigger of H2O2 conversion, which attains highly efficient and universal activity for photodegradation of volatile organic compounds (VOCs). Taking the photooxidation of isopropanol as model reaction, this system achieves a photoactivity of 2-3 orders of magnitude higher than that of pristine g-C3N4, which corresponds to a high apparent quantum yield of 49% at around 420 nm. In-situ electron spin resonance (ESR) spectroscopy and sacrificial-reagent incorporated photocatalytic characterizations indicate that the notable photoactivity promotion could be ascribed to the collaboration between photocarriers (electrons and holes) and Fenton process to produce abundant and reactive oxygen-related radicals. The strategy of coupling solid-gas interfacial Fenton process into semiconductor-based photocatalysis provides a facile and promising solution to the remediation of air pollution via solar energy.

The complete chloroplast genome of the Syzygium buxifolium Hook. Et Arn.1833 and its phylogenetic analysis.

Syzygium buxifolium. Hook. Et Arn.1833 is a member of the Myrtaceae family. This species is used in traditional Chinese medicines. It possesses numerous synonyms, reflecting the ambiguity in its taxonomy. The chloroplast genome has been widely used for species identification and phylogenetic analysis. Regrettably, there is a lack of information regarding the chloroplast genome of S. buxifolium. Here, we intend to obtain the chloroplast genome of S. buxifolium to resolve its classification problems. In particular, we utilized Illumina sequencing technology to sequence, GetOrganelle to assemble, and CPGAVAS2 to characterize the chloroplast genome of S. buxifolium. The chloroplast genome of S. buxifolium had a length of 158,581 bp and consisted of 111 unique genes, comprising 78 protein-coding genes, 29 transfer RNA (tRNA) genes, and four ribosomal RNA (rRNA) genes. In addition, we identified 86 Simple Sequence Repeats, 345 tandem repetitive sequences, and 34 dispersed repetitive sequences using modules implemented in CPGAVAS2. Lastly, we carried out phylogenetic analysis using Phylosuite. The results indicated a close relationship between S. buxifolium and S. grijsii. This study offers novel genetic data for the molecular identification and subsequent phylogenetic analysis of the Syzygium genus.

Pipeline Elbow Corrosion Simulation for Strain Monitoring with Fiber Bragg Gratings.

This study addresses the limitation of traditional non-destructive testing methods in real-time corrosion monitoring of pipe elbows by proposing the utilization of fiber Bragg grating (FBG) strain sensors, renowned for their resilience in harsh environments. However, the current mathematical relationship model for strain representation of elbow corrosion is still lacking. This paper develops a finite element model to scrutinize the strain changes in the elbow due to corrosion under hydrostatic pressure and bending loads. To mitigate temperature loading effects, the corrosion degree is evaluated through the disparity between hoop and axial strains. Simulation outcomes reveal that, under hydrostatic pressure, the strain difference exhibits minimal changes with the increase in corrosion degree, while under bending moment loading, the strain difference escalates proportionally with corrosion progression. Consequently, strain induced by bending moment loading solely characterizes the corrosion degree. Moreover, the optimal placement for FBG sensors is identified at the extrados of the pipe elbow, where strain is most prominent. These insights enhance comprehension of strain-corrosion dynamics in pipe elbows, offering valuable guidance for developing an FBG-based monitoring system for real-time corrosion tracking and predictive maintenance of pipeline infrastructures.

Accurate wavelet thresholding method for ECG signals.

Current wavelet thresholding methods for cardiogram signals captured by flexible wearable sensors face a challenge in achieving both accurate thresholding and real-time signal denoising. This paper proposes a real-time accurate thresholding method based on signal estimation, specifically the normalized ACF, as an alternative to traditional noise estimation without the need for parameter fine-tuning and extensive data training. This method is experimentally validated using a variety of electrocardiogram (ECG) signals from different databases, each containing specific types of noise such as additive white Gaussian (AWG) noise, baseline wander noise, electrode motion noise, and muscle artifact noise. Although this method only slightly outperforms other methods in removing AWG noise in ECG signals, it far outperforms conventional methods in removing other real noise. This is attributed to the method's ability to accurately distinguish not only AWG noise that is significantly different spectrum of the ECG signal, but also real noise with similar spectra. In contrast, the conventional methods are effective only for AWG noise. In additional, this method improves the denoising visualization of the measured ECG signals and can be used to optimize other parameters of other wavelet methods to enhancing the denoised periodic signals, thereby improving diagnostic accuracy.

High-performance CuInS2 quantum dot sensitized solar cells through I-/MPA dual-ligands passivation.

High-efficiency quantum dot sensitized solar cells (QDSSCs) can be received by increasing quantum dot (QD) loading and mitigating QD surface trap states. Herein, the surface state of CuInS2 QDs is optimized through an I-/MPA dual-ligands passivation strategy. The steric hindrance and electrostatic repulsion between QDs can be effectively reduced, thereby enabling an increased QD loading capacity. Meanwhile, the I-/MPA dual-ligands passivation strategy can further lower the surface trap density, leading to substantially enhanced charge transfer efficiency of the solar cells. Interestingly, various iodized salts, including TBAI, MAI, and KI, are proved to possess comparable property, underscoring the versatility and broad applicability of this I-/MPA dual-ligands passivation strategy. Eventually, CuInS2 QDSSCs based on the NH4I/MPA dual-ligands exhibit a noteworthy enhancement in photovoltaic conversion efficiency, surpassing the benchmark of 5.71% to reach 7.03%.

Extraction and characterization of novel Prosopis Juliflora bark and Boehmeria nivea fibre for use as reinforcement in the hybrid composites with the effect of curing temperature, fibre length and weight percentages.

The hybrid composite sample based on Prosopis Juliflora (PJ) bark and ramie fibre with different length, weight percentage, and curing temperature were created for the first time in this work. Totally, 120 hybrid composite samples were tested in this study. There were five different fibre lengths: 10 mm, 15 mm, 20 mm, 25 mm, and 30 mm, weight percentages 10 %, 20 %, 30 %, 40 %, and 50 %, and different curing temperatures 80 °C, 90 °C, 100 °C, 110 °C, and 120 °C used to produce the hybrid composite samples. Due to the cross-linking ability with the epoxy matrix, the hybrid composite specimen shows high resistance up to 98 Shore D hardness. The high polarity of the epoxy matrix and the hydrogen bond strengthening effect, increased the composite sample flexural strength by 12 %. The curing temperature of 100 °C, 20 mm fibre length, and 30 % of the hybrid composite sample achieved the highest tensile strength (28.76 MPa), flexural strength (46.54 MPa), impact strength (4.5 J), and hardness strength properties (98 shore D). Thermo gravimetric analysis (TGA) revealed the composite samples initial decomposition temperature (Ti) at 98 °C, maximum decomposition temperature (Tmax) at 320 °C, and the final decomposition temperature (Tf) at 466 °C.

Improving the performance of perovskite solar cells using a dual-hole transport layer.

The energy loss (Eloss) caused by inefficient charge transfer and large energy level offset at the buried interface can easily restrict the performance of p-i-n perovskite solar cells (PVSCs). In this study, the utilization of poly-TPD and P3CT-N as a dual-hole transporting layer (HTLs) was implemented in a sequential manner. This approach aimed to improve the charge transfer efficiency of the HTL and mitigate charge recombination at the interface between the HTL and PVK. The results showed that this strategy also could achieve more suitable energy levels, improve the quality of the perovskite film layer, and ultimately enhance the device's stability. IPVSCs employing the dual-HTLs approach exhibited the highest power conversion efficiency of 19.85%, and the open-circuit voltage increased to 1.09 V from 1.00 V. This study offers a straightforward and efficient approach to boost the device performance by minimizing Eloss and reducing the buried interfacial defects. The findings underscore the potential of employing a dual-HTL strategy as a promising pathway for further advancements in PVSCs.

3D printing of thermochromic multilayer flexible film for multilevel information encryption.

Flexible thermal-responsive encryption devices are widely employed in information encryption and anti-counterfeiting due to their cost-effectiveness and dynamic data encryption and decryption capabilities. However, most current devices are limited to a single layer of encryption, resulting in restricted decryption methods and storage capacity, as well as reliance on external heating. In this study, we integrate multiple layers of encryption within a single device and introduce self-heating thermochromic technology along with infrared thermal imaging encryption to establish a novel concept of a multilayer flexible encryption system. By combining infrared encryption and thermochromic encryption in three-dimensional space enhances the difficulty level for decryption while achieving high storage capacity for information. The internally integrated conductive heating layer within the multilayer structure facilitates rapid and adjustable heating for thermochromic patterns, eliminating the need for external heat sources. Furthermore, we employ a low-cost customizable multi-material integrated 3D printing process for manufacturing multilayer flexible encryption devices. This research presents an innovative solution for designing and fabricating high-density multilevel flexible encryption devices.

Inner Doping of Carbon Nanotubes with Perovskites for Ultralow Power Transistors.

Semiconducting carbon nanotubes (CNTs) are considered as the most promising channel material to construct ultrascaled field-effect transistors, but the perfect sp2 C─C structure makes stable doping difficult, which limits the electrical designability of CNT devices. Here, an inner doping method is developed by filling CNTs with 1D halide perovskites to form a coaxial heterojunction, which enables a stable n-type field-effect transistor for constructing complementary metal-oxide-semiconductor electronics. Most importantly, a quasi-broken-gap (BG) heterojunction tunnel field-effect transistor (TFET) is first demonstrated based on an individual partial-filling CsPbBr3/CNT and exhibits a subthreshold swing of 35 mV dec-1 with a high on-state current of up to 4.9 µA per tube and an on/off current ratio of up to 105 at room temperature. The quasi-BG TFET based on the CsPbBr3/CNT coaxial heterojunction paves the way for constructing high-performance and ultralow power consumption integrated circuits.

Multimaterial Three-Dimensional Printing of Ultraviolet-Curable Ionic Conductive Elastomers with Diverse Polymers for Multifunctional Flexible Electronics.

Ionic conductive elastomers (ICEs) are emerging stretchable and ionic conductive materials that are solvent-free and thus demonstrate excellent thermal stability. Three-dimensional (3D) printing that creates complex 3D structures in free forms is considered as an ideal approach to manufacture sophisticated ICE-based devices. However, the current technologies constrain 3D printed ICE structures in a single material, which greatly limits functionality and performance of ICE-based devices and machines. Here, we report a digital light processing (DLP)-based multimaterial 3D printing capability to seemly integrate ultraviolet-curable ICE (UV-ICE) with nonconductive materials to create ionic flexible electronic devices in 3D forms with enhanced performance. This unique capability allows us to readily manufacture various 3D flexible electronic devices. To demonstrate this, we printed UV-ICE circuits into polymer substrates with different mechanical properties to create resistive strain and force sensors; we printed flexible capacitive sensors with high sensitivity (2 kPa-1) and a wide range of measured pressures (from 5 Pa to 550 kPa) by creating a complex microstructure in the dielectric layer; we even realized ionic conductor-activated four-dimensional (4D) printing by printing a UV-ICE circuit into a shape memory polymer substrate. The proposed approach paves a new efficient way to realize multifunctional flexible devices and machines by bonding ICEs with other polymers in 3D forms.

A Dynamic Parameter Noise-Tolerant Zeroing Neural Network for Time-Varying Quaternion Matrix Equation With Applications.

As a common and significant problem in the field of industrial information, the time-varying quaternion matrix equation (TV-QME) is considered in this article and addressed by an improved zeroing neural network (ZNN) method based on the real representation of the quaternion. In the light of an improved dynamic parameter (IDP) and an innovative activation function (IAF), a dynamic parameter noise-tolerant ZNN (DPNTZNN) model is put forward for solving the TV-QME. The presented IDP with the character of changing with the residual error and the proposed IAF with the remarkable performance can strongly enhance the convergence and robustness of the DPNTZNN model. Therefore, the DPNTZNN model possesses fast predefined-time convergence and superior robustness under different noise environments, which are theoretically analyzed in detail. Besides, the provided simulative experiments verify the advantages of the DPNTZNN model for solving the TV-QME, especially compared with other ZNN models. Finally, the DPNTZNN model is applied to image restoration, which further illustrates the practicality of the DPNTZNN model.

Clinical studies of magnetic resonance elastography from 1995 to 2021: Scientometric and visualization analysis based on CiteSpace.

Background: To assess the knowledge framework around magnetic resonance elastography (MRE) and to explore MRE research hotspots and emerging trends. Methods: The Science Citation Index Expanded of the Web of Science Core Collection was searched on 22 October 2021 for MRE-related studies published between 1995 and 2021. Excel 2016 and CiteSpace V (version 5.8.R3) were used to analyze the downloaded data. Results: In all, 1,236 articles published by 726 authors from 540 institutions in 40 countries were included in this study. The top 10 authors published 57.6% of all included articles. The 3 most productive countries were the USA (n=631), Germany (n=202), and France (n=134), and the 3 most productive institutions were the Mayo Clinic (n=240), Charité (n=131), and the University of Illinois (n=56). The USA and the Mayo Clinic had the highest betweenness centrality among countries and institutions, respectively, and played an important role in the field of MRE. In this study, the 24,347 distinct references were clustered into 48 categories via reasonable clustering using specific keywords, forming the knowledge framework. Among the 294 co-occurring keywords, "hepatic fibrosis", "stiffness", "skeletal muscle", "acoustic strain wave", "in vivo", and "non-invasive assessment" were research hotspots. "Diagnostic performance", "diagnostic accuracy", "hepatic steatosis", "chronic hepatitis B", "radiation force impulse", "children", and "echo" were frontier topics. Conclusions: Scientometric and visualized analysis of MRE can provide information regarding the knowledge framework, research hotspots, frontier areas, and emerging trends in this field.

How to select the quantitative magnetic resonance technique for subjects with fatty liver: A systematic review.

BACKGROUND: Early quantitative assessment of liver fat content is essential for patients with fatty liver disease. Mounting evidence has shown that magnetic resonance (MR) technique has high accuracy in the quantitative analysis of fatty liver, and is suitable for monitoring the therapeutic effect on fatty liver. However, many packaging methods and postprocessing functions have puzzled radiologists in clinical applications. Therefore, selecting a quantitative MR imaging technique for patients with fatty liver disease remains challenging. AIM: To provide information for the proper selection of commonly used quantitative MR techniques to quantify fatty liver. METHODS: We completed a systematic literature review of quantitative MR techniques for detecting fatty liver, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Studies were retrieved from PubMed, Embase, and Cochrane Library databases, and their quality was assessed using the Quality Assessment of Diagnostic Studies criteria. The Reference Citation Analysis database (https:// www.referencecitationanalysis.com) was used to analyze citation of articles which were included in this review. RESULTS: Forty studies were included for spectroscopy, two-point Dixon imaging, and multiple-point Dixon imaging comparing liver biopsy to other imaging methods. The advantages and disadvantages of each of the three techniques and their clinical diagnostic performances were analyzed. CONCLUSION: The proton density fat fraction derived from multiple-point Dixon imaging is a noninvasive method for accurate quantitative measurement of hepatic fat content in the diagnosis and monitoring of fatty liver progression.

Change in knee cartilage components in stroke patients with genu recurvatum analysed by zero TE MR imaging.

Genu recurvatum in stroke patients with hemiplegia causes readily cumulative damage and degenerative changes in the knee cartilage. It is important to detect early cartilage lesions for appropriate treatment and rehabilitation. The purpose of this cross-sectional study was to provide a theoretical basis for the early rehabilitation of hemiplegia patients. We used a zero TE double-echo imaging sequence to analyse the water content in knee joint cartilage at 12 different sites of 39 stroke patients with genu recurvatum and 9 healthy volunteers using a metric similar to the porosity index. When comparing the hemiplegic limb vs. the nonhemiplegic limb in patients, the ratios of the deep/shallow free water content of the femur cartilages at the anterior horn (1.16 vs. 1.06) and posterior horn (1.13 vs. 1.25) of the lateral meniscus were significantly different. Genu recurvatum in stroke patients with hemiplegia can cause changes in the moisture content of knee cartilage, and the changes in knee cartilage are more obvious as the genu recurvatum increases. The "healthy limb" can no longer be considered truly healthy and should be considered simultaneously with the affected limb in the development of a rehabilitation treatment plan.