Currently, there is no effective vaccine for tackling the ongoing COVID-19 pandemic caused by SARS-CoV-2 with the occurrence of repeat waves of infection frequently stretching hospital resources beyond capacity. Disease countermeasures rely upon preventing person-to-person transmission of SARS-CoV2 so as to protect front-line healthcare workers (HCWs). COVID-19 brings enormous challenges in terms of sustaining the supply chain for single-use-plastic personal and protective equipment (PPE). Post-COVID-19, the changes in medical practice will drive high demand for PPE. Important countermeasures for preventing COVID-19 transmission include mitigating potential high risk aerosol transmission in healthcare setting using medical PPE (such as filtering facepiece respirators (FFRs)) and the appropriate use of face coverings by the general public that carries a lower transmission risk. PPE reuse is a potential short term solution during COVID-19 pandemic where there is increased evidence for effective deployment of reprocessing methods such as vaporized hydrogen peroxide (30 to 35% VH2O2) used alone or combined with ozone, ultraviolet light at 254 nm (2000 mJ/cm²) and moist heat (60 °C at high humidity for 60 min). Barriers to PPE reuse include potentially trust and acceptance by HCWs. Efficacy of face coverings are influenced by the appropriate wearing to cover the nose and mouth, type of material used, number of layers, duration of wearing, and potentially superior use of ties over ear loops. Insertion of a nose clip into cloth coverings may help with maintaining fit. Use of 60 °C for 60 min (such as, use of domestic washing machine and spin dryer) has been advocated for face covering decontamination. Risk of virus infiltration in improvised face coverings is potentially increased by duration of wearing due to humidity, liquid diffusion and virus retention. Future sustained use of PPE will be influenced by the availability of recyclable PPE and by innovative biomedical waste management.

Keywords: COVID-19; Face coverings; PPE; Reuse; Sustainability; Waste management.

Thirty-six steers (12 of each Angus, Charolais, and Brahman) with an initial BW of 318.5 ± 6.7 kg were used in a 130-day study. Two treatments were imposed: un-shaded and shaded (3 m2/animal; 90% solar block shade cloth). On day 1, steers were administered with rumen temperature boluses. Rumen temperatures (T RUM) were obtained at 10 min intervals over the duration of the study to determine differences in T RUM between Bos indicus and Bos taurus cattle. Six feedlot pens (162 m2) were used with six steers (2/breed) per pen with three pens/treatment. Ambient dry bulb temperature (T A; °C), relative humidity (RH; %), wind speed (WS; m/s) and direction, and solar radiation (SR; W/m2) were recorded at 10 min intervals. Rainfall (mm) was collected daily at 0900 h. From these data, black globe temperature (BGT; °C), temperature humidity index (THI), heat load index (HLI), and accumulated heat load (AHL) were calculated. Individual T RUM were converted to an hourly average and then mean hourly T RUM were converted to a mean within hour T RUM across the 130 days. Rumen temperatures were analyzed using an autoregressive repeated measures model. The model analyzed the effect of breed (P < 0.0002), treatment (P = 0.3543), time of day (hour, h; P < 0.0001), breed × treatment (P < 0.3683), breed × h (P < 0.0001), treatment × h (P < 0.0001), breed × treatment × h (P = 0.0029), pen within treatment (P = 0.0195), and animal × breed × treatment within pen (P = 0.1041). Furthermore, there were breed × treatment × hour differences in T RUM (P = 0.0036), indicating that Bos indicus and Bos taurus regulate T RUM differently.

The new coronavirus disease 2019 (COVID-19) has been emerged as a rapidly spreading pandemic. The disease is thought to spread mainly from person-to-person through respiratory droplets produced when an infected person coughs, sneezes, or talks. The pathogen of COVID-19 is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It infects the cells binding to the angiotensin-converting enzyme 2 receptor (ACE2) which is expressed by cells throughout the airways as targets for cellular entry. Although the majority of persons infected with SARS-CoV-2 experience symptoms of mild upper respiratory tract infection, in some people infections of the acinar airways result in severe, potentially fatal pneumonia. However, the induction of COVID-19 pneumonia requires that SARS-CoV-2 reaches the acinar airways. While huge efforts have been made to understand the spread of the disease as well as the pathogenesis following cellular entry, much less attention is paid to how SARS-CoV-2 from the environment reach the receptors of the target cells. The aim of the present study is to characterize the deposition distribution of SARS-CoV-2 in the airways upon exposure to cough-generated droplets and aerosol particles. For this purpose, the Stochastic Lung Deposition Model has been applied. Particle size distribution, breathing parameters supposing normal breathing through the nose, and viral loads were taken from the literature. We found that the probability of direct infection of the acinar airways due to inhalation of particles emitted by a bystander cough is very low. As the number of viruses deposited in the extrathoracic airways is about 7 times higher than in the acinar airways, we concluded that in most cases COVID-19 pneumonia must be preceded by SARS-CoV-2 infection of the upper airways. Our results suggest that without the enhancement of viral load in the upper airways, COVID-19 would be much less dangerous. The period between the onset of initial symptoms and the potential clinical deterioration could provide an opportunity for prevention of pneumonia by blocking or significantly reducing the transport of viruses towards the acinar airways. Therefore, even non-specific treatment forms like disinfection of the throat and nasal and oral mucosa may effectively keep the viral load of the upper airways low enough to avoid or prolong the progression of the disease. In addition, using a tissue or cloth in order to absorb droplets and aerosol particles emitted by own coughs of infected patients before re-inhalation is highly recommended even if they are alone in quarantine.

Air pollution is a major health problem and children are particularly vulnerable to the adverse effects. Facemasks are one form of protection but, to be effective, they need to filter out airborne pollutants, fit the face well and be wearable. In this pilot study, we assess the perceived wearability of three facemasks (Vogmask, TuHao and ReSpimask) marketed in the UK as being designed to protect children against exposure to air pollution. Twenty-four primary school children wore each facemask during a standardised walking and running activity. After each activity, the children were asked to rate facemask wearability in terms of parameters, such as perceived comfort, hotness, breathability and fit. At the end of the trial, the children compared and identified their preferred facemask. The main complaint about the facemasks was the children's faces being too hot. The ReSpimask was most frequently reported as being perceived to be the hardest to breathe through. The TuHao facemask was the only adjustable strap mask assessed but was reported to be difficult to adjust. Facemasks with a nose clip were frequently rated highest for fit (TuHao and Vogmask). The patterned, cloth fabric Vogmask had significantly higher ratings for appearance and perceived fit. The results show children's perceptions of facemasks are highly affected by the facemask's design, hotness and perceived breathability. By making children's facemasks more appealing, breathable, cooler and improving their fit, wearability may be improved.

Keywords: air pollution; children; facemask; wearability.

Introduction: The COVID-19 pandemic has made well-fitting face masks a critical piece of protective equipment for healthcare workers and civilians. While the importance of wearing face masks has been acknowledged, there remains a lack of understanding about the role of good fit in rendering protective equipment useful. In addition, supply chain constraints have caused some organizations to abandon traditional quantitative or/and qualitative fit testing, and instead, have implemented subjective fit checking. Our study seeks to quantitatively evaluate the level of fit offered by various types of masks, and most importantly, assess the accuracy of implementing fit checks by comparing fit check results to quantitative fit testing results.

Methods: Seven participants first evaluated N95 and KN95 respirators by performing a fit check. Participants then underwent quantitative fit testing wearing five N95 respirators, a KN95 respirator, a surgical mask, and fabric masks.

Results: N95 respirators offered higher degrees of protection than the other categories of masks tested; however, it should be noted that most N95 respirators failed to fit the participants adequately. Fit check responses had poor correlation with quantitative fit factor scores. KN95, surgical, and fabric masks achieved low fit factor scores, with little protective difference recorded between respiratory protection options. In addition, small facial differences were observed to have a significant impact on quantitative fit.

Conclusion: Fit is critical to the level of protection offered by respirators. For an N95 respirator to provide the promised protection, it must fit the participant. Performing a fit check via NHS self-assessment guidelines was an unreliable way of determining fit.

Hydrogen production by electrocatalytic water splitting is an efficient and economical technology, however, is severely impeded by the kinetic-sluggish and low value-added anodic oxygen evolution reaction. Here we report the nickel-molybdenum-nitride nanoplates loaded on carbon fiber cloth (Ni-Mo-N/CFC), for the concurrent electrolytic productions of high-purity hydrogen at the cathode and value-added formate at the anode in low-cost alkaline glycerol solutions. Especially, when equipped with Ni-Mo-N/CFC at both anode and cathode, the established electrolyzer requires as low as 1.36 V of cell voltage to achieve 10 mA cm^-2, which is 260 mV lower than that in alkaline aqueous solution. Moreover, high Faraday efficiencies of 99.7% for H₂ evolution and 95.0% for formate production have been obtained. Based on the excellent electrochemical performances of Ni-Mo-N/CFC, electrolytic H₂ and formate productions from the alkaline glycerol solutions are an energy-efficient and promising technology for the renewable and clean energy supply in the future.

Evidence is accumulating that indoor dampness and mold are associated with the development of asthma. The underlying mechanisms remain unknown. New Zealand has high rates of both asthma and indoor mold and is ideally placed to investigate this. We conducted an incident case-control study involving 150 children with new-onset wheeze, aged between 1 and 7 years, each matched to two control children with no history of wheezing. Each participant's home was assessed for moisture damage, condensation, and mold growth by researchers, an independent building assessor and parents. Repeated measures of temperature and humidity were made, and electrostatic dust cloths were used to collect airborne microbes. Cloths were analyzed using qPCR. Children were skin prick tested for aeroallergens to establish atopy. Strong positive associations were found between observations of visible mold and new-onset wheezing in children (adjusted odds ratios ranged between 1.30 and 3.56; P ≤ .05). Visible mold and mold odor were consistently associated with new-onset wheezing in a dose-dependent manner. Measurements of qPCR microbial levels, temperature, and humidity were not associated with new-onset wheezing. The association between mold and new-onset wheeze was not modified by atopic status, suggesting a non-allergic association.

In this work, we present a potentiometric pH sensor on textile substrate for wearable applications. The sensitive (thick film graphite composite) and reference electrodes (Ag/AgCl) are printed on cellulose-polyester blend cloth. An excellent adhesion between printed electrodes allow the textile-based sensor to be washed with a reliable pH response. The developed textile-based pH sensor works on the basis of electrochemical reaction, as observed through the potentiometric, cyclic voltammetry (100 mV/s) and electrochemical impedance spectroscopic (10 mHz to 1 MHz) analysis. The electrochemical double layer formation and the ionic exchanges of the sensitive electrode-pH solution interaction are observed through the electrochemical impedance spectroscopic analysis. Potentiometric analysis reveals that the fabricated textile-based sensor exhibits a sensitivity (slope factor) of 4 mV/pH with a response time of 5 s in the pH range 6⁻9. The presented sensor shows stable response with a potential of 47 ± 2 mV for long time (2000 s) even after it was washed in tap water. These results indicate that the sensor can be used for wearable applications.

Purpose: The study aimed to explore the prevalence and possible risk factors to prevent the face mask related adverse skin reactions during the ongoing COVID-19 after a recommendation of face mask wearing for public use in Thailand.

Results: The prevalence of face mask related adverse skin reactions was 454 cases (54.5%), of which acne was the most frequent (399; 39.9%), followed by rashes on the face (154; 18.4%), and itch symptoms (130; 15.6%). Wearing a surgical mask showed a higher risk of adverse skin reaction compared to a cloth mask, OR (95% CI) = 1.54 (1.16-2.06). A duration of face mask wearing of more than 4 hours/day and the reuse of face masks increased the risk of adverse skin reactions compared to changing the mask every day, adjusted OR(95% CI) = 1.96 (1.29-2.98), and 1.5 (1.11-2.02).

Conclusion: Suggestions were made for wearing a cloth mask in non-health care workers (HCW) to decrease the risk of face mask related adverse skin reactions. This suggestion could potentially help in decreasing the demand of surgical masks which should be reserved for the HCW population during the ongoing COVID-19 pandemic.

Keywords: COVID-19; adverse skin reaction; face mask.

Around the end of XIII century (at the time of young Marco Polo's first trip to China at the court of Khubilai Khan in Khan Baliq) a pocket Bible was delivered by a Franciscan friar to the Mogul Emperor, in the framework of the evangelization program of the Far East. Four centuries later, in 1685, this Bible was rediscovered by the Jesuit Philippe Couplet in the house of a rich Chinese in Nanchin and donated to Cosimo III, Grand Duke of Tuscany. This Bible was recently "unearthed" in the Biblioteca Medicea Laurenziana in Florence, wrapped up in a precious yellow silk cloth, in a rather ruined state. After two years of restoration, the Bible will return to China in 2012 for a celebration of its >700years of life and of its remarkable return trip on the Silk Road. On account of the thinness of the parchment (barely 80μm thickness, the size of each foil being 16.5×11cm) it was widely held that the pages were produced from foetal lambskins. On tiny fragments of the margins of a foil, after several unsuccessful attempts at digesting the vellum, we were able to obtain a tryptic peptide mixture, which, upon mass spectrometry analysis, yielded the identity of 8 unique proteins, belonging to the genus Bos taurus, thus confirming the origin of the vellum from calfskins rather than from foetal lambskins. Our results prove that it is possible to obtain reliable protein extraction and IDs from ancient parchment documents.

A test is described which correlates the stress of stretching surgical gown and drape material with moist bacterial strike-through. By application of this test to a number of woven and nonwoven surgical gown and drape materials, it was found that not all of these materials, either woven or nonwoven, are impermeable to moist contamination for equal periods of time. Nonwoven disposable materials now in use range from those which remain impermeable to moist bacterial permeation through all tests while some remain impermeable for limited periods of time, and others almost immediately permeable to moist bacterial penetration. The same situation holds for woven materials. Under conditions of our test, Quarpel treated Pima tight-woven cotton cloth was impermeable to moist bacterial strike-through, through up to 75 washing and sterilizing cyclings, while ordinary linen and untreated Pima cloth permitted bacterial permeation almost immediately. These results have significance in lengthy wet surgical operations.

A study was conducted to assess the effect of UV(254) on the concentration and viability of PRRSV on surfaces and materials commonly encountered on swine farms. A standard quantity (5 × 10(6)TCID(50), total dose) of a PRRSV modified live vaccine virus was inoculated onto 2 matched sets of surfaces/materials including wood, plastic, latex, rubber, styrofoam, metal, leather, cloth, concrete, cardboard, glass and paper. One set was exposed to UV(254) radiation (treatments) and the other to incandescent light (controls) for a 24h period. During this time, treatments and controls were swabbed at 10 min intervals from 0 to 60 min post-inoculation (PI) and again at 24h PI. The quantity of PRRSV RNA on each item at each sampling time was calculated by RT-PCR and the presence of viable PRRSV in each sample was determined by swine bioassay. A significant reduction (p<0.0001) in the quantity of PRRSV RNA was demonstrated at 24h PI independent of treatment. In addition, a significant reduction (p=0.012) in the number of UV(254)-treated surfaces which harbored viable virus was observed at 60 min (0/12 positive) when compared to control surfaces (5/12 positive). In addition, all UV(254) treated samples collected between 10 and 50 min PI were bioassay negative. These results suggest that UV(254) is an effective means to inactivate PRRSV on commonly encountered farm surfaces and materials and inactivation can be accomplished following 10 min of exposure.

Brown stink bug, Euschistus servus (Say), and green stink bug, Acrosternum hilare (Say) (Hemiptera: Pentatomidae), are major agricultural pests. Although various insecticides are used to control nymphs and adults, little is known about how they affect eggs. Laboratory bioassays and field trials were conducted to determine the efficacy of common field rates of acephate, lamda-cyhalothrin, spinosad, and thiamethoxam on developing E. servus and A. hilare eggs, as well as Telenomus podisi Ashmead (Hymenoptera: Scelionidae) parasitoids developing in E. servus eggs. In laboratory bioassays, egg masses were dipped into insecticide and water solutions and assessed for mortality after 2 wk. In the field trials, egg masses on a cloth section were pinned to leaves in each plot ofa randomized complete block and returned to the laboratory 24 h after exposure to insecticide sprays. Mortality was assessed after 2 wk. In dip bioassays, there was a significant effect of insecticide treatment on A. hilare eggs with all insecticides resulting in greater mortality than the water control. However, no effect of treatment occurred in the field with A. hilare or for E. serous eggs in both the laboratory bioassays and the field trials. In contrast, developing T. podisi parasitoids showed significant mortality when exposed to all insecticide treatments, when dipped or field-treated. Spinosad and lamda-cyhalothrin treatments resulted in 100% mortality of T. podisi, and acephate resulted in greater mortality than thiamethoxam. Our results suggest that there is relatively little efficacy from insecticide sprays on stink bugs developing in eggs but that mortality of egg parasitoids may be significant.

OBJECTIVE

This study assessed the impact of Family Nurture Intervention (FNI) on the quality of maternal caregiving behavior (MCB) while in the neonatal intensive care unit (NICU). FNI is a randomized controlled trial conducted in a high-acuity NICU to facilitate an emotional connection between mothers and their premature infants. FNI begins shortly after birth, continues until discharge, and involves mother/infant calming sessions that include scent cloth exchange, vocal soothing and emotion expression, eye contact, skin-to-skin and clothed holding, and family-based support sessions.

METHODS

Maternal caregiving behavior was coded during a single holding and feeding session (∼30 min) in the NICU before discharge at approximately 36 weeks gestational age (GA). Sixty-five mothers and their premature infants (34 male, 31 female; 26-34 wk GA) were included in these analyses (FNI, n = 35; standard care [SC], n = 30).

RESULTS

Relative to mothers in the SC condition, those in the FNI group showed significantly higher quality MCB, which remained significant when controlling for birth order, twin status, maternal depression, and maternal anxiety.

CONCLUSIONS

This is the first study to demonstrate that in-unit MCB can be enhanced by a hospital-based intervention. FNI provides a new rationale for integrating nurture-based interventions into standard NICU care.

Since 1986, we have cared for 17 patients whose abdomen could not be closed because of bowel edema and loss of abdominal wall compliance. These patients were managed by a technique of visceral packing with the intestines kept in place by a combination of rayon cloth, gauze packs, and retention sutures. This packing was changed in the operating room under general anesthesia until the edema was sufficiently resolved to allow for closure. Two patients died within 24 hours of operation from irreversible shock. The remaining 15 patients had their fascia successfully closed with an average of two additional anesthetics. There was one case of fasciitis associated with the development of an intra-abdominal abscess and one patient died of late sepsis. There was no early postoperative ventilatory compromise or acute oliguric renal failure. Other direct complications have been minor with no enterocutaneous fistulae, dehiscence, or incisional hernia. Visceral packing of posttraumatic abdominal wounds circumvents expected complications of intraperitoneal hypertension and enhances the chance for survival. Its ease and low morbidity also lends itself to a wide variety of other uses.

The objective of these experiments was to quantify the pattern of change in arterial blood pressure (BP) during a discriminative aversive classical conditioning paradigm in rat using a new "high resolution" computer analysis. Sprague-Dawley rats (n = 5) were restrained in a soft, conical cloth pouch and conditioned using a 6 sec. pulsed tone (CS+) followed by a 0.5 sec. tail shock; a steady tone, never followed by shock, served as a CS-. BP peaked at 16.4 +/- 6.5 mm Hg (mean +/- SD) above control at 1.5 +/- 0.1 sec. after onset of CS+. This "first component" ("C1") also occurred during CS- (12.1 +/- 3.8 mm Hg), although the magnitudes of the two were significantly (p < 0.05) different. Another group of rats (n = 8) was treated identically except the tones were 15 seconds long. The conditional BP response consisted of two components. C1 was reminiscent of that seen using the short tone: for CS+ a peak of 13.6 +/- 5.6 mm Hg at 1.5 sec. or, for CS-, of 10.0 +/- 4.3 at 1.3 sec. (p < 0.05). In CS+ trials BP peaked again ("C2," 7.4 +/- 2.5 mm Hg) at 8.3 +/- 1.2 sec. There was no statistically significant C2 for CS- trials, clearly demonstrating discrimination between tones. The unconditional BP response in both groups consisted of two large, closely spaced peaks in BP. Respiration was recorded in 3 additional rats. After shock delivery these subjects often showed a sudden shift between (1) a regular respiratory pattern with moderate chest excursion and (2) apneic episodes interspersed with single, deep breaths. This latter pattern was associated with large, low frequency fluctuations in BP. Continued development of the rat conditioning paradigm is especially warranted because of the ability to record sympathetic nerve activity in intact, awake subjects and the large number of readily available genetic strains, which model human pathological states.

OBJECTIVE

Much of the cost of exposure assessment for studies of residential cohorts is in scheduling and travel time for field staff. One way to reduce costs is to simplify methods such that subjects can sample their own residence. Analysis of settled dust is being widely used for assessment of exposures to allergens, lead and pesticides and can also be used for endotoxins. While vacuum sampling is the most common surface sampling method, wipe sampling has the advantage that it can be readily performed by the resident when convenient and samples can then be mailed to researchers. Thus, we evaluated the feasibility of wipe sampling for endotoxin environmental assessment using electrostatic wipes with or without the use of disposable examination gloves.

METHODS

Multiple lots of six types of commercial wipes and eight types of gloves were extracted and analyzed for endotoxin content using the kinetic chromogenic Limulus amebocyte lysate assay. Wipes were compared across brands, between lots, within lots, between pairs depending on proximity to cardboard packaging, and in wipe tests with or without gloves. Collected dust samples of known concentration were also tested in spiking assays for endotoxin recovery.

RESULTS

The most striking finding was the high variability of endotoxin contamination of both wipes and gloves across brands and between various lots. The content of endotoxin in unused gloves ranged from <1.5 to 5810 endotoxin units (EU). The range for unused wipes was 3.6-87.8 EU. Surfaces of equal loading and area were sampled using three types of cloths that had low initial endotoxin contamination. The cloths were very good at collecting dust and endotoxin could be assayed from aqueous extracts of the wipes. Samples collected using cloths with bare washed hands yielded higher endotoxin loading per mass of collected dust versus samples collected wearing endotoxin-free gloves. This demonstrated additional endotoxin loading from the subject's hand.

CONCLUSIONS

This study shows that wipe sampling while wearing medical gloves can be an effective method for collecting and assessing endotoxin on surfaces, so long as each lot of wipes and gloves have been tested and determined to be low in endotoxin.

Hybrid supercapacitor (HSC), which typically consists of a Li-ion battery electrode and an electric double-layer supercapacitor electrode, has been extensively investigated for large-scale applications such as hybrid electric vehicles, etc. Its application potential for thin-film downsized energy storage systems that always prefer high volumetric energy/power densities, however, has not yet been explored. Herein, as a case study, we develop an entirely binder-free HSC by using multiwalled carbon nanotube (MWCNT) network film as the cathode and Li(4)Ti(5)O(12) (LTO) nanowire array as the anode and study the volumetric energy storage capability. Both the electrode materials are grown directly on carbon cloth current collector, ensuring robust mechanical/electrical contacts and flexibility. Our 3 V HSC device exhibits maximum volumetric energy density of ~4.38 mWh cm(-3), much superior to those of previous supercapacitors based on thin-film electrodes fabricated directly on carbon cloth and even comparable to the commercial thin-film lithium battery. It also has volumetric power densities comparable to that of the commercial 5.5 V/100 mF supercapacitor (can be operated within 3 s) and has excellent cycling stability (~92% retention after 3000 cycles). The concept of utilizing binder-free electrodes to construct HSC for thin-film energy storage may be readily extended to other HSC electrode systems.

The purposes of this study were to examine the impact of chlorhexidine on the transmission of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) on an inpatient oncology unit, compare the cost of 2 chlorhexidine bath delivery methods, and evaluate nursing time and satisfaction to administer the baths. MRSA and VRE transmission rates decreased from those during the previous years. Costs associated with bathing increased, but time to administer the bath decreased with the chlorhexidine cloths, and nursing staff reported satisfaction with their use.

Factors other than ligament graft length (knee ROM, knee swelling, initial knee laxity) may need to be accounted for in interpreting changes in knee laxity during rehabilitation following anterior cruciate ligament reconstruction (ACLR) surgery. Twenty-three patients recovering from ACLR surgery (16 M, 7 F, age mean = 30) were tested at 2 and 6 weeks after ACLR with knee laxity measured using th Knee Signature System arthrometer, passive ROM with a standard goniometer and swelling by measuring knee circumference at the mid-patella level using a cloth measuring tape. Spearman correlation coefficients (in parentheses) were calculated using rankings of the change in the injured minus uninjured knee laxity as the dependent variable and the following independent variables: pre-test injured minus uninjured knee laxity (ranked; -0.457; statistically significant two-tailed P < 0.05); change in injured knee maximum extension relative to the uninjured side (ranked; 0.127); change in injured knee maximum flexion relative to the uninjured side (unranked; -0.073); and change in the injured minus uninjured knee girth (unranked; -0.159). These results indicate that consideration should be given to the patient's knee laxity at the start of intervention when using changes in laxity to guide rehabilitation after ACLR.

A cloth-sandwich construction of a carbon-carbon composite material has been implanted in the femora of a series of rats and the response of the bone to this material compared to the response to titanium. It is shown that the carbon provides for excellent hard tissue biocompatibility. When the composite has a surface texture associated with fibre run out there is a degree of bony attachment, the interfacial shear strength for the composite-bone system being significantly greater than that for the titanium-bone system during the period 4-40 weeks post implantation.