"But it feels swollen!": the frequency and clinical characteristics of people with knee osteoarthritis who report subjective knee swelling in the absence of objective swelling.

INTRODUCTION: There are complex interactions between pain and perceptions of the painful body part in musculoskeletal disorders, and disruption of various body representations in people with chronic pain. OBJECTIVES: The purpose of this study was to investigate how frequently people with knee osteoarthritis (OA) complain of swelling without objective evidence of swelling, and describe the clinical characteristics of this population. METHODS: Forty-six people with knee OA (68.1 ± 8.8 years) participated in this cross-sectional study. Subjective and objective swelling was evaluated by knee-specific body perception questionnaire and ultrasonography, respectively. Pain intensity, disability, pain-related beliefs, 2-point discrimination threshold, and quadriceps muscle strength were also evaluated. RESULTS: Approximately 1/3 of participants (n = 15) had subjective feelings of knee swelling in the absence of objective swelling (S only). Fifteen participants had both subjective and objective knee swelling (S + O group) and 16 had neither subjective nor objective knee swelling (No S/O group). Participants in the S only group had similar pain or disability as those in the S + O group but had more severe pain or disability than those with in the No S/O group. Those in the S only group also had larger 2-point discrimination distance threshold at the medial knee (impaired tactile acuity) than those in the S + O group and had more dysfunctional pain catastrophizing and pain-related self-efficacy than both other groups. CONCLUSION: Our results suggest that about 30% of people with knee OA perceive swelling of the knee in the absence of any objective swelling and that this is accompanied by severe pain and functional disability. Considering altered body image of the knee may reveal relevant treatment-based subgroups in people with knee OA.

Associations between dietary consumption and sleep quality in young Japanese males.

PURPOSE: Poor sleep quality has been reported to be a risk factor for cardiovascular disease, diabetes, and metabolic syndrome, as well as mental disorders including depression and anxiety. However, few studies have investigated the association between sleep quality and diet in young males. We aimed to assess this association, adjusting for psychological factors. METHODS: In this study, a total of 124 male Japanese students were analyzed. Sleep quality, diet, and psychological symptoms were assessed using self-reported questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), brief-type self-administered diet history questionnaire (BDHQ), 12-item General Health Questionnaire (GHQ12), and State-Trait Anxiety Inventory (STAI) A-Trait scale. RESULTS: Among participants, 40% exhibited a PSQI total score ≥ 6, indicating poor sleep quality. Poor sleep quality was associated with poor mental health status and higher levels of anxiety. After adjusting for covariates including these psychological factors, poor sleep quality was significantly associated with low intakes of fat, beta-carotene, retinol, alpha-tocopherol, vitamin K, vitamin B1, daidzein, genistein, and iron. Poor sleep quality was also associated with low intake of pulses, fat and oil, as well as high intakes of sugar-sweetened beverages. CONCLUSIONS: Our findings demonstrated that sleep quality among young Japanese males was associated with specific dietary features, independently of psychological status, which may help to elucidate the mechanisms underlying the link between sleep and sleep-related diseases.

Scalable wavelength-selective solar absorber based on refractory TiN nanostructures.

Scalable wavelength-selective solar absorbers with both high selectivity and thermostability are desired for efficient utilization of solar thermal energy. In this study, we present a refractory titanium nitride (TiN) moth-eye-like nanostructure, fabricated via oblique deposition, that provides high solar-light absorptivity (0.9) and low emissivity (0.17) at 100 °C under atmospheric conditions. The strong visible-light absorption of the structure is complemented by a Fabry-Pérot resonance that broadens the strong absorption band into the near-infrared light region for certain structure dimensions. In addition, TiN is a promising material, due to its refractory nature, having a very high melting point of 2930 °C. The oblique deposition method used to obtain the nano-structured TiN does not require the use of lithographic techniques or expensive nano-templates, thus it is suitable for large-scale fabrication. The nanostructure and its fabrication method have significant potential for practical applications requiring efficient use of solar-light energy.

Highly anisotropic titanium nitride nanowire arrays for low-loss hyperbolic metamaterials fabricated via dynamic oblique deposition.

Hyperbolic metamaterials (HMMs) with highly anisotropic metal nanowires exhibit unique optical properties arising from their extraordinary optical anisotropy. Although metal nanowires are often fabricated by embedding noble metals such as silver in an anodic alumina membrane dielectric host, the low melting point of noble metals limits their utilization in high-temperature applications, and there are fabrication issues such as overfilling or discontinuous islands within the host pores. Thus, metal nanowires with a high melting point for HMMs and alternative fabrication techniques are desired. In this study, we fabricated a highly anisotropic nanowire array (NWA) using titanium nitride, which has a high melting point, via dynamic oblique deposition of titanium and subsequent thermal treatment in ammonia. Spectra of ellipsometric parameters were well-fitted by a Fresnel reflection theoretical model considering the optical anisotropy, in which the effective permittivity was described using effective medium theory and the Drude-Lorentz model. The out-of-plane component of the effective permittivity was negative at λ > 850 nm, whereas the in-plane component was positive, indicating that the fabricated NWA behaves as a HMM. The figure of merit in the near-infrared range was higher than that of conventional multilayer TiN HMMs. The NWA presented here is a promising candidate for HMMs in high-temperature applications due to the high melting point of titanium nitride.

Dynamic Modulation of Radiative Heat Transfer beyond the Blackbody Limit.

Dynamic control of electromagnetic heat transfer without changing mechanical configuration opens possibilities in intelligent thermal management in nanoscale systems. We confirmed by experiment that the radiative heat transfer is dynamically modulated beyond the blackbody limit. The near-field electromagnetic heat exchange mediated by phonon-polariton is controlled by the metal-insulator transition of tungsten-doped vanadium dioxide. The functionalized heat flux is transferred over an area of 1.6 cm2 across a 370 nm gap, which is maintained by the microfabricated spacers and applied pressure. The uniformity of the gap is validated by optical interferometry, and the measured heat transfer is well modeled as the sum of the radiative and the parasitic conductive components. The presented methodology to form a nanometric gap with functional heat flux paves the way to the smart thermal management in various scenes ranging from highly integrated systems to macroscopic apparatus.

Overestimation of femoral tunnel length during anterior cruciate ligament reconstruction using the retrograde outside-in drilling technique.

PURPOSE: When the femoral tunnel socket is reamed in an oblique direction from the wall of inter-condylar notch in anterior cruciate ligament (ACL) reconstruction, the tunnel length can be shorter at the periphery than at the centre. Because surgeons can manipulate the direction of tunnel in the outside-in femoral tunnel drilling technique, this length mismatch would vary depending on the direction of the tunnel. The purpose of this study was to investigate this length mismatch when reamed in various directions. METHODS: In total of thirteen points were defined as femoral drilling entry points on concentric lines with 0, 1, 2, and 3 cm radius from the lateral epicondyle of a three-dimensional bone model from 40 subjects. Femoral tunnel drilling was simulated on the models by connecting the centre of the ACL footprint with each defined point on the lateral femoral surface. The mismatch length was measured between the centre and the shortest peripheral side of the tunnel socket. RESULTS: When the distance between the drilling entry point on the lateral femoral surface and the lateral epicondyle was increased to anterior proximal direction, there was a significant increase in the mismatch length. The mismatch length became more than 2 mm when the entry point was located more than 2 cm away from the lateral epicondyle. CONCLUSIONS: When the drilling entry point is set far away from the lateral epicondyle, a significant increase was observed in tunnel length mismatch between the centre of the tunnel and its shortest peripheral side. Because the tunnel length is measured with a guide pin introduced at the centre of the tunnel before reaming in retrograde outside-in technique, this length mismatch could cause an overestimation of the tunnel length. Surgeons should recognise this mismatch when preparing the length of graft and socket to optimise the graft insertion length into the socket.

Accuracy of Proximal Tibial Bone Cut Using Anterior Border of Tibia as Bony Landmark in Total Knee Arthroplasty.

The purpose of our study was to evaluate the accuracy of the tibial bone cut in total knee arthroplasty using the anterior tibial border as a guide compared to using bony and soft tissue landmarks of the ankle joint. The extramedullary alignment guide was set parallel to a line connecting the proximal and distal one-thirds of the anterior border of the tibia while the rotational direction of the distal end of the guide was adjusted to the anteroposterior axis of the proximal tibia. Significant differences were detected in the ideal coronal tibial component angles with improvements from 87.2% to 95.9%. The anterior tibial border was a reliable landmark in total knee arthroplasty in clinical practice, as shown by our previous computer simulation.

Improved design decreases wear in total knee arthroplasty with varus malalignment.

PURPOSE: Controversy still exists whether coronal malalignment would influence the long-term survival of total knee arthroplasty (TKA). The hypothesis was that an improved design of the articular surface of modern TKA would prevent the increase in contact stresses and thus decrease the wear even when the implant was placed in a varus position. Two different designs of TKA were compared biomechanically and clinically. METHODS: The patients whose prosthesis was initially placed in a varus alignment by the postoperative long-leg radiographs were selected. Seventeen knees using the NexGen LPS and 16 knees using the MG I were examined. Changes in postoperative alignment and the thickness of the polyethylene insert in a follow-up period of approximately 7 years were evaluated. Additionally, an in vitro biomechanical testing was conducted to measure the contact stresses and the contact area at the tibiofemoral joint of the NexGen LPS and the MG I components mounted on a servohydraulic testing device. RESULTS: Although the long-leg alignment did not change in NexGen LPS, the varus alignment significantly progressed in MG I. The thickness of polyethylene insert in MG I decreased a significantly greater amount compared with that in NexGen LPS. Biomechanical test showed that the NexGen LPS had a larger contact area and lower mean and peak contact stresses than the MG I significantly. CONCLUSION: These results suggest that comprehensive factors of modern prosthesis including improved implant designs could improve the durability of polyethylene insert and decrease implant failures due to component malalignment.

High incidence of lipid deposition in the liver of rats fed a diet supplemented with branched-chain amino acids under vitamin B6 deficiency.

Male Wistar rats were fed four diets composed of purified 20% vitamin-free casein diet with (+) or without (-) vitamin B(6) (7.0 mg of pyridoxine HCl/kg of diet) and with (+) or without (-) branched-chain amino acids (BCAAs) of valine, leucine, and isoleucine (4.75%): B(6)(+)BCAA(-); B(6)(+)BCAA(+); B(6)(-)BCAA(-); and B(6)(-)BCAA(+) for 21 d. Among rats fed the B(6)(-)BCAA(+) diet, about a half showed lipid deposition in the liver. On the other hand, serum triacylglycerol levels in the B(6)(-)BCAA(+) group tended to be decreased. Hepatic triacylglycerol and cholesterol levels tended to increase in the B(6)(-)BCAA(+) group compared with the other three groups. Serum apolipoprotein B and apolipoprotein E (apo E) levels in the B(6)(-)BCAA(+) group were the lowest among the three groups. In contrast, hepatic apo E levels in the B(6)(-)BCAA(+) group were the highest among the three groups. High-performance liquid chromatography of pooled serum of rats with lipid deposits revealed that triacylglycerol and cholesterol levels in very low-density lipoprotein (VLDL) were decreased compared with other diet groups. These results strongly suggest that one of the mechanisms of lipid deposition in rats fed a B(6)(-)BCAA(+) diet is due to impaired secretion of VLDL.

Antioxidative capacity of extracts and constituents in Cornus capitata adventitious roots.

Radical scavenging activities of extracts and constituents in Cornus capitata adventitious root cultures were evaluated by using 1,1-diphenyl-2-pycrylhydrazyl (DPPH) and superoxide anion radicals. Inhibitory activity against peroxidation of linoleic acid was assayed by using the thiobarbituric acid (TBA) method. Ethyl acetate and aqueous fractions were prepared from adventitious roots cultured in Murashige-Skoog liquid medium with 0.1 microM Cu(2+) (0.1CuMS) or 10 microM Cu(2+) (10CuMS). The highest scavenging activities on DPPH and superoxide anion radicals were observed in the ethyl acetate fraction from 0.1CuMS. In the inhibitory activity against linoleic acid oxidation, the ethyl acetate fraction from 10CuMS was highest among the fractions tested. The ethyl acetate fraction of adventitious roots cultured in 0.1CuMS contained mainly galloylglucoses (1,2,3,6-tetragalloylglucose and 1,2,3,4,6-pentagalloylglucose). The ethyl acetate fraction of adventitious roots cultured in 10CuMS contained mainly ellagic acid derivatives [3,3'-di-O-methylellagic acid 4-(5"-acetyl)-alpha-L-arabinofuranoside and stenophyllin H1]. Aqueous fractions prepared from both media contained iridoid glycosides (dihydrocornin and cornin). Tetra- and pentagalloylglucoses showed strong inhibitory activities (61.9 and 85.2%, respectively) against linoleic acid oxidation relative to those of butylated hydroxytoluene (BHT) (91.1%) or alpha-tocopherol (49.5%) at 50 microM concentration. Although both ellagic acid derivatives had weak activities (<50%) on DPPH and superoxide anion radical scavenging, 3,3'-di-O-methylellagic acid 4-(5"-acetyl)-alpha-L-arabinofuranoside was stronger (74.7%) than alpha-tocopherol (49.5%) in inhibiting linoleic acid oxidation at 50 microM concentration. Iridoid glycosides exhibited little activity against DPPH and superoxide anion radicals or against oxidation of linoleic acid.

A novel method for faster formation of rat liver cell spheroids.

Hepatocyte spheroids are expected to be the main component of the artificial liver bioreactor for their higher function. The preparation of hepatocyte spheroids, however, can require as many as 24 to 96 h. To reduce this time, we investigated a method employing a new technique of rat hepatocyte preparation and a dynamic culture. The modified Seglen's method for standard hepatocyte isolation was altered by elimination of ethyleneglycol bis(aminoethylether) tetraacetate from the first perfusate and calcium from the second perfusate. Isolated hepatocytes were cultured in a spinner flask by spinning at 120 rpm. The modified Seglen's method was used as a control. Cells obtained by the new method were more cohesive and formed a higher proportion of cell aggregates than control cells. In the spinning culture, hepatocytes had a tendency to aggregate and 80% of cells formed spheroids within 6 h of culturing. The mean size of spheroids was 68.5 +/- 18.5 microm. Confocal laser scanning microscopy revealed that individual spheroids contained approximately 30% of nonparenchymal cells over their surface. Using the new hepatocyte preparation method followed by a spinning culture, we were able to produce hepatocyte spheroids in as few as 6 h.