Background: The lectin from Cratylia argentea (CFL) is able to modulate the immune system response and is thus a potential phytotherapeutic substance.

Hypothesis/purpose: In this study, we investigated the role of CFL on control of bacterial infection caused by Listeria monocytogenes, the causative agent of human listeriosis.

Study design: Swiss mice were infected with L. monocytogenes and then treated with CFL.

Methods: Adult Swiss mice weighing with 30-40 g were infected intraperitoneally with a bacterial suspension (0.2 ml; 1 × 10⁷ CFU/ml). After 30 min, the mice were treated with CFL intravenously at concentrations of 0.1 or 10 mg/kg. Control mice received phosphate-buffered saline (PBS). The animals were euthanized 24 h after infection.

Results: We observed that i.v. administration of CFL to Swiss mice did not cause acute toxicity, and reduced the leukocyte counts in the bloodstream 24 h after infection with virulent L. monocytogenes. There was a reduction in the bacterial burden within peritoneal macrophages after infection in CFL-treated mice. Accordingly, the bacterial counts in the bloodstream, spleen and liver also decreased in comparison with the PBS group. Histological damage in the spleen and liver was lower in mice that received CFL treatment. In vitro antimicrobial assays demonstrated that CFL does not inhibit the growth of L. monocytogenes. The mRNA expression of the anti-inflammatory cytokine IL-10 was enhanced with CFL treatment after infection.

Conclusion: The lectin from C. argentea (CFL) has immunomodulatory and anti-infective properties of pharmacological interest for control of infectious diseases.

Keywords: Bacterial sepsis; Immunotherapeutic; Inflammation; Plant proteins.

Study Design: A quasi-experimental Background: The talar tilt test and the anterior drawer test are clinically used to evaluate the length of the anterotalofibular (ATFL) and calcaneofibular (CFL) ligaments. Based on the current literature, there is no clear diagnostic utility or preference for either test. This study investigated ligament lengthening during these special tests and compared the talar tilt test to the long axis distraction test for the CFL length. Methods: A convenience sample of 47 healthy subjects were recruited for this study. Musculoskeletal ultrasound imaging (MSK US) was used to measure the length of the ATFL and CFL during the talar tilt and anterior drawer tests. Additionally, CFL lengthening during the talar tilt was compared to the long axis distraction test. Outcomes: A significant difference was found (p < .001) in ATFL length between the talar tilt and anterior drawer test. This indicates that the talar tilt test is preferred to maximally lengthen the ATFL. There was a significant difference in CFL length (p < .001) between the talar tilt test and the long axis distraction test. Discussion: The results of this study identified that the talar tilt test resulted in more ATFL lengthening than the anterior drawer test and thus is the preferred test to assess ligament length. Additionally, both the long axis distraction test and the talar tilt test cause lengthening of the CFL. Therefore, the long axis distraction test can be used as a differentiation test to determine if either the ATFL or the CFL is the structure with increased laxity.

Keywords: Talar tilt test; anterior drawer test; anterotalofibular ligament; calcaneofibular ligament; musculoskeletal ultrasound imaging.

In the Nile Delta, a complex network of canals collects drainage water from surface-irrigated fields, but also municipal wastewater. The goal of this work was to assess the technical, environmental and financial feasibility of the upgrade of a drainage canal (DC) into either an in-stream constructed wetland (ICW) or a canalized facultative lagoon (CFL), in order to produce a water re-usable in agriculture according to the Egyptian law. The model-based design of the proposed technologies was derived from field experimental data for the ICW and laboratory data for the CFL. Both technologies, integrated by a sedimentation pond and a disinfection canal, led to the attainment of the water quality standards imposed by Egyptian Law 92/2013 for the reuse of drainage water. The life cycle assessment indicated that the upgrade of an existing DC to either an ICW or a CFL results in an extremely small environmental burden, ≤ 0.3% of that of a traditional activated sludge process. The cost/benefit analysis (CBA) was based on the assumptions that (i) farmers currently irrigate a non-food crop (cotton) with the low-quality drainage water present in the DC, and (ii) thanks to the upgrade to a ICW or CFL, farmers will irrigate a food crop characterized by a higher market price (rice). The CBA indicated that the DC upgrade to an ICW represents an attractive investment, as it leads to a financial rate of return > 10% over a wide range of cotton market prices. Conversely, the upgrade to a CFL is less attractive due to high investment costs. In conclusion, the upgrade of DCs to ICWs appears a promising option for the treatment of drainage canal water in the Nile Delta, thanks to the high pollutant removal performances, low cost and negligible environmental burden. This article is protected by copyright. All rights reserved.

Stellera chamaejasme L. is a traditional Chinese medicine with a long history to treat stubborn skin ulcer, and it also has antiviral and antitumor effects. Neochamaejasmine B (NCB), Neochamaejasmine A (NCA) and Chamaechromone (CMC) are the major components in dried roots of Stellera chamaejasme L.. Our studies suggested that NCB, NCA and CMC are inhibitors of Organic anion transporter 1 (OAT1). OAT1 is encoded by solute carrier family 22 member 6 gene (SLC22A6) in humans and plays a critical role in the organic anion drug uptake and excretion in the kidney. Lamivudine is the typical substrate of OAT1 and is frequently used in combination with other antiviral drugs in clinical antiviral treatments. The aim of this study is to investigate the interaction and its mechanism between these bi-flavone components in Stellera chamaejasme L. and lamivudine via OAT1 both in vitro and in vivo. In vitro, the uptake studies in Madin-Darby canine kidney (MDCK) cells overexpressing OAT1 suggested that NCB inhibited the uptake of 6-CFL and lamivudine.Similar results were obtained for NCA and CMC. NCB was a noncompetitive and competitive inhibitor interaction with OAT1. IC₅₀ values of NCB, NCA and CMC for inhibiting OAT1-mediated lamivudine transport were 2.46, 8.35 and 0.61 μmol·L^-1, respectively. In vivo, the pharmacokinetic results of lamivudine in rats showed that the mean area under the plasma concentration-time curve (AUC_0-∞) and maximal plasma concentration (C_max) of lamivudine after co-administration is increased 2.94-fold and 1.87-fold, respectively, compared to lamivudine administration alone. The results of interactions between lamivudine and these bi-flavone components in Stellera chamaejasme L. extracts via OAT1 in vivo are consistent with studies in vitro. The inhibition of OAT1-mediated uptake of lamivudine by NCB, NCA and CMC is the possible mechanism for Stellera chamaejasme L. extracts improving the oral bioavailability of lamivudine in rats.

Novel hierarchical chrysanthemum-flower-like carbon nanomaterials (CFL-CNMs) were synthesized by thermal chemical vapor deposition based on acetylene decomposition. A scanning electron microscope and a transmission electron microscope were employed to observe the morphology and structure of the unconventional nanostructures. It is found that the CFL-CNMs look like a blooming chrysanthemum with a stem rather than a spherical flower. The carbon flower has an average diameter of 5 μm, an average stem diameter of 150 nm, branch diameters ranging from 20 to 70 nm, and branch lengths ranging from 0.5 to 3 μm. The morphologies of the CFL-CNMs are unlike any of those previously reported. Fishbone-like carbon nanofibers with a spindle-shaped catalyst locating at the tip can also be found. Furthermore, the catalyst split was proposed to elucidate the formation mechanism of CFL-CNMs. A large and glomerate catalyst particle at the tip of the carbon nanofiber splits into smaller catalyst particles which are catalytic-active points for branch formation, resulting in the formation of CFL-CNMs.

In summary, operations in the FCRC pilot plant have included training an operating staff, operability trials, equipment modification and repair, and supplementation of the original equipment to gain greater versatility. In addition to effort spent on proving and improving the capacity of the pilot plant, development studies and production operations involving translation of laboratory operations to pilot level or volume have included: 1. Development of a production process for interferon as described above. As a by-product of the interferon program, samples of cell culture have been studied in the Basic Research Division of FCRC for the production of lymphokines. 2. Production of starting materials (cell paste) for carboxypeptidase G1, using three different organisms, and production of refined material from the FCRC 252 organism as described herein. 3. Production of large quantities of crude phenylalanine ammonia lyase in the form of cell paste for Prof. Creed Abell at the University of Texas, Medical Branch, at Galveston,. 4. Production of a crude staphylococcal nuclease for the program of Dr. David Sachs, National Cancer Institute, Bethesda, Maryland. 5. Developmental studies and limited production of a crude cysteine desulfhydrase according to the protocols of Dr. J. Uren, Sidney Farber Cancer Center, Boston, Massachusetts. 6. Preliminary production studies on the agent produced by Culture FCRC 14, discovered in the CFL search program. 7. Developmental fermentation studies on the antitumor antibiotic, piperazinedione 593A [6], in preparation for production of quantities of this antibiotic to support clinical studies under the auspices of the National Cancer Institute.

This work focused on characterizing hydrophilic fractions of Clematis flammula (CFl). The data here clearly demonstrated that hydrolate fractions act as a free radical scavengers and inhibited proliferation of different cell lines in a time- and concentration-dependent manner, transwell, and with a significant cytotoxic effect. Treating cells with CFl had the effect of suppressing cell growth attenuated by ROS generation in colonic carcinoma. Moreover, CFl in HCT116 cells suppressed survival, proliferation, invasion, angiogenesis and metastasis in vitro by inhibiting gene expression. Following CFl treatment, caspases and PARP cleavage were detected. The up- and down-regulated genes obtained from the WBA of the effect of CFl showed that several biological processes were associated with apoptosis and induction of G1 cell cycle arrest. CFl synergizes the effect of TRAIL by down-regulating the expression of cell survival proteins involved in apoptosis compared to cells treated with CFl or TRAIL alone. Our findings showed that CFl sensitizes apoptosis in TRAIL-resistant cells by activating MAPKs, SP1, and CHOP, that induced DR5 expression. Overall, our data showed that CFl is a promising antitumor agent through kinases and transcription factor induction, both of which are required to activate TRAIL receptors. Colon inflammation induced by LPS was inhibited by CFl hydrolate.

Coelomic fluid of Lumbricus rubellus (CFL) has attracted interest due to its pharmacological properties, including antitumor effect. Furthermore, it is necessary to evaluate the response to treatment with new cancer therapeutic agents. This study aims to investigate whether the combination of CFL and 5-fluorouracil could reduce FAK protein level and iCa²⁺ and enhance p21 level. Furthermore, it is necessary to evaluate the response to treatment with new cancer therapeutic agents. After 24 hours of treatment, it was necessary to assess the percentage of apoptosis, FAK, and p21 protein expression by flow cytometry. iCa²⁺ concentration was measured using immunofluorescence. The combination therapy of CFL with 5-fluorouracil potently suppressed six treatment groups were included in this study. HT-29 cell lines were cultured and divided into six groups: group 1 was treated with vehicle (negative control), groups 2-5 were treated with 5-fluorouracil, groups 3-5 were treated with either CFL 5, 10, or 20 µg/ml immediately after 5-fluorouracil, and group 6 was treated with CFL 20 µg/ml, the progression of colorectal cancer. Combination of CFL and 5-fluorouracil significantly decreased FAK expression (p<0.05), iCa²⁺ (p<0.05), and increased p21 expression (p<0.05) in HT-29 cells. Our results suggest that CFL has an anticancer potential in colorectal cancer when combined with 5-fluorouracil.

Background: Anatomic lateral ankle ligament reconstruction has been proposed for patients with chronic ankle instability. A reliable approach is a reconstruction technique using an allograft and 2 fibular tunnels. A recently introduced approach that entails 1-fibular tunnel reconstruction might reduce the risk of intraoperative complications and ultimately improve patient outcome.

Hypothesis: We hypothesized that both reconstruction techniques show similar ankle stability (joint laxity and stiffness) and are similar to the intact joint condition.

Study design: Controlled laboratory study.

Methods: A total of 10 Thiel-conserved cadaveric ankles were divided into 2 groups and tested in 3 stages-intact, transected, and reconstructed lateral ankle ligaments-using either the 1- or the 2-fibular tunnel technique. To quantify stability in each stage, anterior drawer and talar tilt tests were performed in 0°, 10°, and 20° of plantarflexion (anterior drawer test) or dorsiflexion (talar tilt test). Bone displacements were measured using motion capture, from which laxity and stiffness were calculated together with applied forces. Finally, reconstructed ligaments were tested to failure in neutral position with a maximal applicable torque in inversion. A mixed linear model was used to describe and compare the outcomes.

Results: When ankle stability of intact and reconstructed ligaments was compared, no significant difference was found between reconstruction techniques for any flexion angle. Also, no significant difference was found when the maximal applicable torque of the 1-tunnel technique (9.1 ± 4.4 N·m) was compared with the 2-tunnel technique (8.9 ± 4.8 N·m).

Conclusion: Lateral ankle ligament reconstruction with an allograft using 1 fibular tunnel demonstrated similar biomechanical stability to the 2-tunnel approach.

Clinical relevance: Demonstrating similar stability in a cadaveric study and given the potential to reduce intraoperative complications, the 1-fibular tunnel approach should be considered a viable option for the surgical therapy of chronic ankle instability. Clinical randomized prospective trials are needed to determine the clinical outcome of the 1-tunnel approach.

Keywords: anatomic lateral ankle reconstruction; ankle stability; anterior talofibular ligament (ATFL); biomechanical investigation; calcaneofibular ligament (CFL); chronic ankle instability.

Primary lateral ankle ligament reconstruction has a high success rate, but failures may lead to recurrent instability. In patients with recurrent lateral ankle instability, it is important to determine the mode of failure. Underlying cavovarus deformity and joint hypermobility must be identified and addressed at the time of revision surgical stabilization. The modified Brostrom-Gould procedure is typically performed for primary lateral ankle ligament reconstruction, but it may be used in revision stabilization procedures utilizing suture-tape augmentation. Revision lateral ankle stabilization surgery can also be addressed with anatomic allograft reconstruction of the ATFL and CFL, and is the authors'preferred technique.

Keywords: Ankle instability; Failed surgical stabilization; Lateral ankle ligaments; Revision ankle stabilization; Surgical treatment.

Objectives: To review the literature, identify and describe commonly used special tests for diagnosing injury to the ligaments of the ankle complex, present the distinguishing characteristics and limitations of each test, and discuss the current evidence for the clinical use of each test.

Data sources: Multiple PubMed (1920-2018) and CINAHL (1920-2018) searches were conducted and various musculoskeletal examination textbooks were reviewed to examine common orthopedic tests used to assess the ankle. The articles were reviewed for additional references and the search continued until the original description was found when possible.

Study selection: All articles discussing the performance of the test or its validity (ie, sensitivity and specificity) were reviewed and summarized.

Data extraction: Articles were reviewed for additional references and the search continued until the original description was found when possible.

Data synthesis: The literature was reviewed, commonly used special tests for diagnosing ankle injuries were identified and described, distinguishing characteristics and limitations of each test were presented, and the current evidence for the clinical use of each test was discussed.

Conclusions: A complete physical examination is critical in the diagnosis of ankle injuries. The combination of available information such as mechanism of injury, all signs and symptoms, and changes in gait, is key to a conclusive and correct diagnosis. Clinicians should be aware of the severely limited evidence supporting the use of many commonly used special tests. Applying evidence from the literature will improve diagnostic accuracy. Further research is needed to understand the performance ability of special tests, both individually and when grouped as part of a test battery.

Keywords: ADL, anterior deltoid ligament; ATFL, anterior talofibular ligament; CFL, calcaneofibular ligament; Ligaments; PCNL, plantar calcaneonavicular ligament; Rehabilitation; Sensitivity and specificity; Sprains.

Background: An injured calcaneofibular ligament (CFL) is a major cause of ankle instability (AI). Previous research has demonstrated that the thickness of the calcaneofibular ligament (CFLT) is correlated with higher-grade sprains and ankle instability. However, inflammatory hypertrophy is distinct from ligament thickness; accordingly, we considered that the calcaneofibular ligament cross-sectional area (CFLCSA) as a potential morphological parameter to analyze inflammatory CFL. We hypothesized that the CFLCSA was a key morphologic parameter in AI diagnosis.

Methods: We gathered the CFL data of 26 AI patients and 25 control subjects who had undergone ankle magnetic resonance imaging (A-MRI), and it had revealed no evidence of AI. Ankle level T1-weighted coronal A-MRI images were acquired. Using our image analysis program (INFINITT PACS), we analyzed the CFLT and CFLCSA at the CFL on the A-MRI. The CFLCSA was measured as the whole ligament cross-sectional area of the CFL that was most hypertrophied in the transverse A-MR images. The CFLT was measured at the thickest level of CFL.

Results: The mean CFLT was 3.49±0.82 mm in the control group, and 4.82±0.76 mm in the AI group. The mean CFLCSA was 33.31±7.02 mm² in the control group, and 65.33±20.91 mm² in the AI group. The AI patients had significantly greater CFLT (P<0.001) and CFLCSA (P<0.001) than the control group participants. A receiver operating characteristic (ROC) curve analysis in the evaluation of the diagnostic tests showed that the optimal cut-off score of the CFLT was 4.06 mm, with 76.9% sensitivity, 76.0% specificity, and an area under the curve (AUC) of 0.89 (95% CI, 0.79-0.99). The optimal cut-off threshold of the CFLCSA was 43.85 mm², with 92.3% sensitivity, 92.0% specificity, and AUC of 0.94 (95% CI, 0.86-1.00).

Conclusions: Even though the CFLT and CFLCSA were both significantly associated with AI, the CFLCSA was a more sensitive diagnostic test.

Keywords: Ankle instability (AI); calcaneofibular ligament (CFL); cross-sectional area; thickness.

Background: The lateral ankle ligament complex is the most frequently injured ligament secondary to strong ankle inversion movement during lateral ankle sprains (LAS). Among these injuries, anterior talofibular ligament (ATFL) injury is the most frequent condition (present in 66-85% of such injuries). The purpose of this research was to use magnetic resonance imaging (MRI) to determine the association between ankle tendon, ligament, and joint conditions and ATFL injuries.

Methods: A case-control MRI study was carried out to compare the presence of ankle muscle, tendon, ligament, and joint conditions in patients with injured ATFLs (case group; n=25) and non-injured ATFLs (control group; n=25).

Results: Achilles tendinopathy was present in 1/25 (4%) patients with injured ATFLs and 7/25 (28%) non-injured ATFL subjects (P=0.048). Injured calcaneofibular ligaments (CFLs) were present in 19/25 (76%) patients with injured ATFLs and 1/25 (4%) non-injured ATFL subjects (P<0.001). Finally, injured tibiotalar joints were present in 16/25 (64%) patients with injured ATFLs and 5/25 (20%) non-injured ATFL subjects (P=0.002). Other musculoskeletal structure injuries occurred at similar rates between patients with injured ATFLs and those with non-injured ATLFs (P≥0.05).

Conclusions: Patients with ATFL injuries showed a greater presence of CFL and tibiotalar joint injuries than subjects with non-injured ATFLs.

Keywords: Ankle injuries; magnetic resonance imaging (MRI); musculoskeletal diseases; sprains and strains.

In this work, we demonstrate the high-throughput fabrication of 3D microparticles using a scanning two-photon continuous flow lithography (STP-CFL) technique in which microparticles are shaped by scanning the laser beam at the interface of laminar co-flows. The results demonstrate the ability of STP-CFL to manufacture high-resolution complex geometries of cell carriers that possess distinct regions with different functionalities. A new approach is presented for printing out-of-plane features on the microparticles. The approach eliminates the use of axial scanning stages, which are not favorable since they induce fluctuations in the flowing polymer media and their scanning speed is slower than the speed of galvanometer mirror scanners.

With the prestressed carbon fiber reinforced polymer (CFRP) strengthening technique widely used in reinforced concrete (RC) structures, it is more and more important to study the fatigue performance of RC structures. Since the fracture of a tensile steel bar at the main cracked section is the leading reason for the failure of RC beams reinforced by prestressed CFRP, a fatigue life prediction model of RC beams reinforced by prestressed CFRP was developed based on an accumulative damage model. Moreover, gradual degradation of the performance of the concrete was considered in the fatigue life prediction model. An experimental study was also conducted to research the fatigue behavior of RC beams reinforced by prestressed or non-prestressed carbon fiber laminate (CFL). During the tests, fatigue crack patterns were captured using a digital image correlation (DIC) technique, and the fatigue lives of a total of 30 beams were recorded. The results showed that the predicted main crack propagation curves and the fatigue lives were close to the experimental data. This study also exhibited that the prestressed CFRP could reduce the stress of main steel bars in RC beams and effectively improve the fatigue performance of the RC beams.

The study describes an attributional life cycle assessment carried out according to the ISO standards and focused on an Italian multifamily residential building. The aim was developing an exhaustive and reliable inventory of high-quality primary data, comparing the environmental impacts along the three stages of the building life cycle. The pre-use phase takes into account the production of all the construction materials, transportation, and on-site assembling. The use phase quantifies the resource consumptions for 50 years of the building utilization and ordinary maintenance. The end-of-life phase includes the building demolition and the management of generated wastes. The results quantify how the design criteria affect the environmental performances of the residential building along its life cycle. The role of the pre-use phase appears remarkable for global warming potential (GWP), due to the huge impacts of steel and concrete production processes. The use phase gives the largest contributions, which reach 77% and 84% of the total, for the categories of global warming and non-renewable energy. The end-of-life phase provides limited avoided impacts. A comparative analysis quantifies the improvements achievable with an alternative type of partitions and external walls. Acronyms: AC: air conditioning; C&DW: construction and demolition waste; CFL: compact fluorescent lamp; DHW: domestic hot water; EC: European Commission; EU: European Union; GDP: gross domestic product; GHG: greenhouse gases; GWP: global warming potential; LCA: life cycle assessment; LCI: life cycle inventory; LCIA: life cycle impact assessment; MFA: material flow analysis; NREP: non-renewable energy potential; RINP: respiratory inorganics potential; WFD: Waste Framework Directive.

A plasma stratum (cell free layer or CFL) generated by flowing blood interposed between the red blood cell (RBC) core and the endothelium affects generation, consumption, and transport of nitric oxide (NO) in the microcirculation. CFL width is a principal factor modulating NO diffusion and vessel wall shears stress development, thus significantly affecting NO bioavailability. Since the CFL is bounded by the surface formed by the chaotically moving RBCs and the stationary but spatially non-uniform endothelial surface, its width fluctuates randomly in time and space. We analyze how these stochastic fluctuations affect NO transport in the CFL and NO bioavailability. We show that effects due to random boundaries do not average to zero and lead to an increase of NO bioavailability. Since endothelial production of NO is significantly enhanced by temporal variability of wall shear stress, we posit that stochastic shear stress stimulation of the endothelium yields the baseline continual production of NO by the endothelium. The proposed stochastic formulation captures the natural continuous and microscopic variability, whose amplitude is measurable and is of the scale of cellular dimensions. It provides a realistic model of NO generation and regulation.

Electricity consumption of compact fluorescent lamps (CFLs) is low, making them a useful tool for minimizing the rapidly increasing demand of electrical energy in India. The present study aims to project the likely electricity conservation in a scenario of complete replacement of existing Fluorescent Tubes (FTs) by CFLs at CSIR-NEERI (National Environmental Engineering Research Institute) visa vis the financial repercussions and indirect reduction in emissions of greenhouse gases, e.g. CO2, N2O, CH4 and other air pollutants, e.g. SO2, NO, suspended particulate matter (SPM), black carbon (BC) and mercury (Hg) from coal fired thermal power plants. The calculations show that the Institute could save around 122850 kWh of electricity per annum, thereby saving approximately INR 859950/(USD 18453.86) towards electricity cost per annum and would be able to minimize 44579.08 kg of CO2-C equivalent (over 100 year time horizon), 909 kg SO2, 982.8 kg NO, 9.8 kg of BC, 368.5 kg SPM, 18.4 kg PM10 and 0.0024 kg Hg emissions per annum from a coal fired thermal power plant by conserving electricity at the institute level.

It is pivotal that endothelium-dependent Nitric Oxide (NO) consumed by hemoglobin (Hb) inside red blood cells (RBCs) membrane, regulates the vascular tone. The whole processes of NO transport in vessel containing flowing RBCs is still not clear, such as NO production in endothelium, diffusion in plasma and consumption inside RBCs. In this work, the motion of RBCs in a microvessel is investigated by using immersed boundary lattice Boltzmann method (IB-LBM) first and the deformability of RBCs is expressed by using spring network model which is based on the minimum energy principle. Furthermore, the interaction between RBCs is considered. Based on the wall shear stress (WSS), NO production rate originated from endothelium was obtained by using a hyperbolic model. NO distribution inside the microvessel with multiple RBCs was computed by using immersed boundary finite difference method (IB-FDM). The result shows that a large (small) WSS exists at locations with a relatively wide(narrow) gap between the wall and cell. In terms of mass transfer, an increase of RBC membrane permeability leads to a decrease of NO concentration in the vessel and the surrounding endothelium significantly. In addition, with the increasing of hematocrit (Hct) value, NO concentration distribution in the whole vessel decreases both in the lumen and vascular wall. Finally, the thickness of RBCs-depleted layer gradually decreases with the weakened deformability of RBCs membrane, and the change degree of cell free layer (CFL) thickness decreases as the bending stiffness is relatively higher. Thus, when bending stiffness is higher, the NO concentration in vascular wall is reduced resulting from the thinner CFL.

The majority of states in the USA, including Wisconsin, have been affected by elevated air, soil and waterborne mercury levels. Health risks associated with mercury increase from the consumption of larger fish species, such as Walleye or Pike, which bio-accumulate mercury in muscle tissue. Federal legislation with the 2011 Mercury and Air Toxics Standards and the Wisconsin legislation on mercury, 2009 Wisconsin Act 44, continue to aim at lowering allowable levels of mercury emissions. Meanwhile, mercury-containing compact fluorescent lights (CFL) sales continue to grow as businesses and consumers move away from energy intensive incandescent light bulbs. An exchange in pollution media is occurring as airborne mercury emissions from coal-burning power plants, the largest anthropogenic source of mercury, are being reduced by lower energy demand and standards, while more universal solid waste containing mercury is generated each time a CFL is disposed. The treatment of CFLs as a 'universal waste' by the Environmental Protection Agency (EPA) led to the banning of non-household fluorescent bulbs from most municipal solid waste. Although the EPA encourages recycling of bulbs, industry currently recycles fluorescent lamps and CFLs at a rate of only 29%. Monitoring programs at the federal and state level have had only marginal success with industrial and business CFL recycling. The consumer recycling rate is even lower at only 2%. A projected increase in residential CFL use in Wisconsin owing to the ramifications of the Energy Independence and Security Act of 2007 will lead to elevated atmospheric mercury and landfill deposition in Wisconsin.

The handling of blood in vitro is demanding because of ethical, economical and safety issues. Although several Newtonian and non-Newtonian blood analogues are found in the literature, few studies have used particles to mimic red blood cells (RBCs) and built an analogue with similar rheological properties of blood. This work reports the development of a blood analogue suspension composed of polydimethylsiloxane (PDMS) microparticles with an average diameter of ∼7 μm. High throughput production of PDMS particles is possible using a multi-stage membrane emulsification process; up to ∼6 mL of microparticles are manufactured in 3 hours. PDMS particles at a concentration of around 21% (w/w) at 20 °C present steady, oscillatory and extensional rheologies very similar to those of blood under physiological conditions (37 °C and ∼41% hematocrit), making them a good candidate whole blood analogue. Also, flow studies were performed in microchannels with contraction to study the cell-free layer (CFL) formation and particle deformation, achieving good qualitative results. Using the procedure developed, it is possible to obtain blood analogue fluids with a shelf life of at least 6 months.

The epidemiology of cutaneous malignant melanoma (CMM) has a number of facets that do not fit with sunlight and ultraviolet light as the primary etiologic agents. Indoor workers have higher incidence and mortality rates of CMM than outdoor workers; CMM occurs in body locations never exposed to sunlight; CMM incidence is increasing in spite of use of UV blocking agents and small changes in solar radiation. Installation of two new fluorescent lights in the milking parlor holding area of a Minnesota dairy farm in 2015 caused an immediate drop in milk production. This lead to measurement of body amperage in humans exposed to modern non-incandescent lighting. People exposed to old and new fluorescent lights, light emitting diodes (LED) and compact fluorescent lights (CFL) had body amperage levels above those considered carcinogenic. We hypothesize that modern electric lighting is a significant health hazard, a carcinogen, and is causing increasing CMM incidence in indoor office workers and tanning bed users. These lights generate dirty electricity (high frequency voltage transients), radio frequency (RF) radiation, and increase body amperage, all of which have been shown to be carcinogenic. This could explain the failure of ultraviolet blockers to stem the malignant melanoma pandemic. Tanning beds and non-incandescent lighting could be made safe by incorporating a grounded Faraday cage which allows passage of ultraviolet and visible light frequencies and blocks other frequencies. Modern electric lighting should be fabricated to be electrically clean.

Background: Acute ankle sprains are common injuries. The anterior talofibular (ATFL) and calcaneofibular ligaments (CFL) are the most injured lateral structures. However, controversy exists on the optimal surgical treatment when the injury is both acute and severe or becomes chronic and unstable. Studies have evaluated the biomechanics of these ligaments, but no studies have robotically evaluated injury effects and surgical treatment of ATFL or ATFL and CFL injuries.

Purpose: To quantitatively evaluate biomechanical effects of ATFL and CFL lesions, ATFL repair, ATFL and CFL repair, and augmentation of ATFL on ankle stability.

Study design: Controlled laboratory study.

Methods: Ten nonpaired cadaveric ankles were tested using a 6 degrees of freedom robot. Each ankle underwent testing in the following states sequentially: (1) intact, (2) ATFL cut, (3) CFL cut, (4) ATFL repair + CFL cut, (5) ATFL repair + CFL repair, and (6) ATFL repair with augmentation with suture tape + CFL repair. Testing included 88 N anterior drawer and 5 N·m varus talar tilt tests at 0° and 30° of plantarflexion, and 88 N Cotton test at 0° of plantarflexion.

Results: After all surgical treatments ankles still had increased laxity compared with intact state testing, except after augmented ATFL repair + CFL repair in anterior drawer testing at 30° of plantarflexion (P = .393). Sectioning the CFL caused a significant increase in talar tilt compared with the ATFL cut state at 0° (P < .001) and 30° of plantarflexion (P < .001), but no increase in anterior drawer or Cotton tests.

Conclusion: Complete native stability may not be attainable at time zero repair with the tested treatments. The option that best returned stability in anterior translation was augmented ATFL repair with nonaugmented CFL repair. The importance of the CFL as a primary ligamentous stabilizer for talar tilt was confirmed.

Clinical relevance: Evaluating lateral ankle stability and treatment with a 6 degrees of freedom robot should help delineate optimal treatment options. Findings in this study show that none of the repair methods at time zero restored kinematics to the intact state. Of the tested states, the augmented ATFL repair with CFL repair was the best option for controlling anterior translation at time zero. The importance of addressing the CFL to correct talar tilt instability was suggested as was the importance of a period of immobilization before beginning protected rehabilitation. The benefit of ATFL repair augmentation with suture tape is in limiting the postoperative motion in an anterior drawer motion to just 0.5 to 1 mm, but there was no significant improvement to talar tilt even with CFL repair, suggesting that further consideration should be given to CFL augmentation in future studies.

Keywords: ankle; anterior talofibular ligament; biomechanics; calcaneofibular ligament; lateral ankle instability.

Background Ankle sprains are common injuries that may recur as chronic conditions. We aim to describe a treatment algorithm for chronic lateral ankle instability based on the arthroscopic findings of the calcaneofibular ligament (CFL). Methods We assessed 67 highly active patients with chronic lateral ankle instability. They were recreational athletes or active military personnel. After clinical examination, they were all investigated further with MRI scans and stress views. Diagnostic arthroscopy followed, where the integrity of the CFL was assessed. Patients with an intact CFL were placed in group A while those with CFL tears in group B. Concomitant intra-articular pathologies, if present, were treated arthroscopically. CFL tears mandated that modified Broström-Gould reconstruction would follow. The American Orthopaedic Foot and Ankle Society (AOFAS) and Tegner scores were noted post-injury and during the 24-month follow-up. Results A total of 37 patients were put in group A and 30 in group B. The posterior talofibular ligament was intact in both groups. Synovitis and scar tissue were more common in group A (p = 0.01) compared to group B. Overall, no postoperative ankle instability or relapsing ankle sprain was documented. Both groups demonstrated significant improvement in their Tegner (p = 0.009) and AOFAS scores (p = 0.001) during their 24 months follow-up. Inter-rater reliability for CFL tears was moderate on clinical examination (k = 0.514) and fair on MRI, in conjunction with ankle arthroscopy (k = 0.357). Conclusion Our proposed algorithm offered a reliable pathway for accurate evaluation and successful treatment of chronic lateral ankle instability in high-demand groups.

Keywords: arthroscopy; athlete; brostrom-gould; calcaneofibular ligament; chronic ankle instability.