Effect of supercooling and freezing on photosynthesis in freezing tolerant leaves of Afroalpine ‘giant rosette’ plants

Summary The effect of supercooling and freezing on the photosynthetic capability of representatives of the permanent frost hardy giant rosette plants Dendrosenecio keniodendron, D. brassica and Lobelia telekii, of the tropical alpine regions was investigated with the non-invasive chlorophyll a fluorescence technique. While supercooling, normal chlorophyll a fluorescence kinetics exhibiting the sequence 0, I, (D), P, S, M, were recorded, however with some retardation of both, the fast and the slow characteristics as compared to those obtained at day-time temperature. As long as the leaves remained unfrozen, the rise of the variable fluorescence F from the level 0 to P was inversely related to a drop of the temperature from about 0°C to-8°C. The increase of F with lower temperature is understood to result from a decrease of the velocity of the quenching reactions while photoreduction of the primary electron acceptor appeared to be unimpeded. The second fluorescence maximum (M), usually interpreted to indicate the commencement of the biochemical reactions of photosynthesis was consistenly to be observed during supercooling. Fluoescence induction kinetics of frozen leaves showed only fast rise to presumably F _max which was not followed by a significant decay for as long as 4 min. The lack of substantial quenching indicates that in the freeze-dehydrated state neither reoxidation of the primary acceptor nor energetization of the thylakoid membrane was accomplished. This effect however was immediately and fully reserved upon thawing of the leaves when the usual fluorescence induction kinetics as well as normal rates of CO₂-uptake were observed. Thus the permanent frost-hardy afroalpine plants do not exhibit any even short-term memory effect of the nocturnal frost on such a delicate process as is photosynthesis.     

中老年肩痛患者疼痛及肩关节功能恢复的影响因素分析

摘要 目的：探究分析中老年肩痛患者疼痛及肩关节功能恢复的影响因素分析。方法：采用便利抽样法,随机抽取2020年9月至2022年9月期间于我院门诊就诊的2010名中老年患者作为调查对象,对患者进行筛查、复查、确诊、随访等。并对所搜集信息进行疼痛及肩关节功能恢复单因素与多因素Logistic回归分析。结果：单因素分析显示,年龄（x²=15.274, P＜0.001）、性别（x²=10.401, P=0.001）、病程（x²=16.410, P＜0.001）和是否进行功能锻炼（x²=6.293, P=0.012）为影响中老年肩痛患者肩关节功能恢复的主要因素;年龄≥70岁（OR=1.292, 95%CI 0.953-1.750）、女性（OR=1.672, 95%CI 1.348-2.074）、病程＞1个月（OR=1.470, 95%CI 1.021-2.116）和未进行功能锻炼（OR=1.844, 95%CI 1.175-2.894）为影响中老年肩痛患者肩关节功能恢复的独立危险因素。结论：年龄≥70岁、女性、病程＞1个月和未进行功能锻炼为影响中老年肩痛患者肩关节功能恢复的独立危险因素,根据上述因素尽早快速甄别高风险患者,及早给予合理有效的康复治疗措施,可显著改善肩痛患者肩关节功能的预后。     

关节镜下同期行冻结肩松解术对肩袖损伤患者的治疗效果评估

目的:评估关节镜下同期行冻结肩松解术对肩袖损伤患者的治疗效果。方法:选择2015年3月到2018年3月在我院诊治的肩袖损伤患者70例进行研究,按随机数表法将其分为观察组(n=36)和对照组(n=34)。对照组采用传统小切口肩袖修复术治疗,观察组采用关节镜下同期行冻结肩松解术进行治疗。比较两组治疗后疗效、手术时间、术中出血量、住院时间、疼痛减轻时间、治疗前后VAS、美国肩肘外科协会评分(ASES)、Contant-Muley评分的变化情况。结果:治疗后,观察组总有效率为94.44%,显著高于对照组(73.53%,P0.05);观察组手术时间、术中出血量、住院时间及疼痛减轻时间均显著低于对照组(P0.05);两组VAS、ASES、Contant-Muley评分较治疗前均显著改善(P0.05),且观察组VAS评分明显低于对照组,ASES及Contant-Muley评分显著高于对照组(P0.05)。结论:关节镜下同期行冻结肩松解术治疗肩袖损伤的临床疗效显著优于传统小切口肩袖修复术治疗,其可显著促进关节功能恢复,并减轻患者痛苦。     

Soft tissue structures resisting anterior instability in a computational glenohumeral joint model

The glenohumeral joint is the most dislocated joint in the body due to the lack of bony constraints and the dependence on soft tissue for stability. The roles that various structures provide to joint function are important for understanding injury treatment and orthopaedic device design purposes. The goal of this study was to develop a computational model of the glenohumeral joint whereby joint behaviour was dictated by articular contact, ligamentous constraints, muscle loading and external perturbations. The bone structure of the computational model consisted of assembled computer tomographic images of the scapula, humerus and clavicle. The soft tissue elements were composed of forces and tension-only springs that represented muscles and ligaments. Validation of this model was achieved by comparing computational predictions to the results of a cadaveric experiment in which the relative contribution of muscles and ligaments to anterior joint stability was examined. The computational model predicted an anterior subluxation force that was similar to the cadaveric experimental results in humeral external rotation. The individual structure results showed the subscapularis to be critical to stabilisation in both neutral and external rotations, the biceps stabilised the joint in neutral but not in external rotation, and the inferior glenohumeral ligament resisted anterior displacement only in external rotation. The model's predictions were similar to the conclusions of the cadaveric experiment and the literature. Knowledge gained from this type of model could assist in further understanding the contribution of soft tissue stabilisers to joint function, pre-operative planning or the design of orthopaedic implants.     

A method to determine whether a musculoskeletal model can resist arbitrary external loadings within a prescribed range

Computational models of the musculoskeletal system are prone to design errors. It is possible to create a model that cannot satisfy equilibrium conditions for a set of external loading conditions. A model is ‘loadable’ if there exists a set of muscle forces that can resist an arbitrary applied force within a prescribed range. In this study, a novel mathematical method is introduced to determine whether models are loadable. In addition, an idealised musculoskeletal model is presented in order to develop the theory behind the mathematical method. The method uses the simplex algorithm to determine feasibility of the linear programming problem and can determine loadability for an arbitrary, continuous range of external forces. The method was applied to a three-dimensional model of the shoulder and correctly determined loadability for a range of externally applied forces.     

Comparison of an EMG-based and a stress-based method to predict shoulder muscle forces

The estimation of muscle forces in musculoskeletal shoulder models is still controversial. Two different methods are widely used to solve the indeterminacy of the system: electromyography (EMG)-based methods and stress-based methods. The goal of this work was to evaluate the influence of these two methods on the prediction of muscle forces, glenohumeral load and joint stability after total shoulder arthroplasty. An EMG-based and a stress-based method were implemented into the same musculoskeletal shoulder model. The model replicated the glenohumeral joint after total shoulder arthroplasty. It contained the scapula, the humerus, the joint prosthesis, the rotator cuff muscles supraspinatus, subscapularis and infraspinatus and the middle, anterior and posterior deltoid muscles. A movement of abduction was simulated in the plane of the scapula. The EMG-based method replicated muscular activity of experimentally measured EMG. The stress-based method minimised a cost function based on muscle stresses. We compared muscle forces, joint reaction force, articular contact pressure and translation of the humeral head. The stress-based method predicted a lower force of the rotator cuff muscles. This was partly counter-balanced by a higher force of the middle part of the deltoid muscle. As a consequence, the stress-based method predicted a lower joint load (16% reduced) and a higher superior–inferior translation of the humeral head (increased by 1.2 mm). The EMG-based method has the advantage of replicating the observed cocontraction of stabilising muscles of the rotator cuff. This method is, however, limited to available EMG measurements. The stress-based method has thus an advantage of flexibility, but may overestimate glenohumeral subluxation.     

Wear analysis in anatomical and reversed shoulder prostheses

This paper describes the development of a computational model to calculate wear rates in total shoulder prostheses, for a 5–150 degrees arm abduction. Anatomical keeled and pegged prosthesis as well as reversed prosthesis were the studied implants. The bone models were built based on computed tomography (CT) images and using a computer aided design-based modelling pipeline. The finite element method was used to solve the contact problem between the surface of the polyethylene (PE) components and the corresponding articular component. The aim of this work was to determine linear and volumetric PE wear, for several radial mismatches, in conditions of pathological (rheumatoid arthritis) and non-pathological bone. Results showed that contact pressures and linear wear developed in anatomical prosthesis were higher than those visualised in reversed prosthesis. However, anatomical prosthesis exhibited a better volumetric wear performance. Moreover, our findings indicated higher values of volumetric wear in higher congruent models and on pathological bone conditions.     

Vascular endothelial growth factor enhances tendon-bone healing by activating Yes-associated protein for angiogenesis induction and rotator cuff reconstruction in rats

Local angiogenesis following rotator cuff reconstruction is crucial for tendon-bone healing. The current research on the mechanism underlying angiogenesis that promotes tendon-bone healing is scarce. This study investigates the mechanism underlying vascular endothelial growth factor (VEGF)-Hippo signaling pathway's involvement in tendon-bone healing following rotator cuff reconstruction. Verteporfin, the inhibitor of the Yes-associated protein (YAP), was used to mechanically test and analyze two groups of tensile-failure loads following rotator cuff reconstruction and to detect collagen and angiogenesis-related marker expressions in the tendon. The interaction mechanism of the VEGF-Hippo signaling pathway was assessed using human umbilical vein endothelial cells (HUVECs). The diameter of the supraspinatus tendon reduced following verteporfin treatment. Mechanical tests revealed that verteporfin significantly reduces the tensile-failure load of the supraspinatus tendon. Verteporfin significantly reduces collagen 1 (Col 1), Col 3, Angiopoietin 2, CD31, Von Willebrand factor, CTGF, and CYR61 expressions. In HUVECs, VEGF activates VEGF receptors and inhibits LATS and YAP phosphorylation. YAP is then transferred to the nucleus to further activate downstream pathways. Therefore, verteporfin can inhibit VEGF-induced YAP pathway activation by inhibiting YAP activity. Angiogenesis in tendon-bone healing following rotator cuff reconstruction requires VEGF-Hippo signaling pathway synergy.     

Improving anterior deltoid activity in a musculoskeletal shoulder model – an analysis of the torque-feasible space at the sternoclavicular joint

Modelling the shoulder's musculature is challenging given its mechanical and geometric complexity. The use of the ideal fibre model to represent a muscle's line of action cannot always faithfully represent the mechanical effect of each muscle, leading to considerable differences between model-estimated and in vivo measured muscle activity. While the musculo–tendon force coordination problem has been extensively analysed in terms of the cost function, only few works have investigated the existence and sensitivity of solutions to fibre topology. The goal of this paper is to present an analysis of the solution set using the concepts of torque-feasible space (TFS) and wrench-feasible space (WFS) from cable-driven robotics. A shoulder model is presented and a simple musculo–tendon force coordination problem is defined. The ideal fibre model for representing muscles is reviewed and the TFS and WFS are defined, leading to the necessary and sufficient conditions for the existence of a solution. The shoulder model's TFS is analysed to explain the lack of anterior deltoid (DLTa) activity. Based on the analysis, a modification of the model's muscle fibre geometry is proposed. The performance with and without the modification is assessed by solving the musculo–tendon force coordination problem for quasi-static abduction in the scapular plane. After the proposed modification, the DLTa reaches 20% of activation.