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Category: Hindfoot; Arthroscopy; Sports; Trauma Introduction/Purpose: Flatfoot deformities are chronic debilitations that involve multiple ligament complexes that stabilize the hindfoot. No study has clearly evaluated the efficacy of utilizing the spring ligament internal-brace fibertape device as an adjunct through clinical and radiographic measures. The purpose of this study is to explore the diagnostic efficacy of 3T MRI to evaluate the spring ligament, and to compare operative failures, complications, and radiographic outcomes of patients who underwent procedures for posterior tibial tendon dysfunction (PTTD) that employed the internal-brace fibertape (IB) and those that did not in the non-internal-brace (NIB) group. Methods: Following IRB approval, patients that underwent flatfoot reconstruction by four surgeons at a single institution between 2015 and 2018 were queried from an institutional radiology database. A total of 44 cases were identified with procedures that utilized the IB, and those that underwent MRI preoperatively had spring ligament integrity compared to intraoperative findings. These 44 cases that utilized the IB were subsequently match paired 1:2 with an NIB group. Data was collected retrospectively for both clinical and radiographic outcomes. Clinical outcomes included failures leading to reoperation, complications, and additional procedures. Radiographic parameters involved pre- and post-operative comparisons. Inadvertent reoperations that implicated malunion or the need for a triple arthrodesis within 13 months of the initial procedure were compared. Patient complications were compared. Statistical analysis was performed to evaluate the relationship between the clinical outcomes of these patients and use of the IB as an additional source of stabilization. Results: A total of 132 cases were analyzed with 44 that employed the IB and 88 NIB. The average ages for each group were 46.7 and 46.5 years for the IB and NIB group respectively. Of the 44 IB patients, 0 out of the 10 (0.0%) who had received a preoperative MRI were correctly identified as having an attenuated or frankly torn spring ligament as determined intraoperatively. There were significant differences in failure rates between groups with 0.0% of IB procedures and 4.5% of NIB procedures resulting in failure (p=0.022). There were no significant differences among complications between groups. There were significant improvements between all pre- and post-operative radiographic measurements within each group. However, the improvements were not found to be significant between groups. Conclusion: The results of this systematic retrospective chart review demonstrate that the spring ligament internal-brace device may serve as an effective adjunct in PTTD procedures and suggest considering it when planning irrespective of preoperative MRI findings. The data suggest that failure rates may be reduced without increasing complications. Both methods of fixation can provide significant improvements in reconstructing the arch. However, the internal-brace may reduce the prevalence of post- operative malunion or the need for a triple arthrodesis.

Quantum key distribution (QKD) enables the transmission of information that is secure against general attacks by eavesdroppers. The use of on-demand quantum light sources in QKD protocols is expected to help improve security and maximum tolerable loss. Semiconductor quantum dots (QDs) are a promising building block for quantum communication applications because of the deterministic emission of single photons with high brightness and low multiphoton contribution. Here we report on the first intercity QKD experiment using a bright deterministic single photon source. A BB84 protocol based on polarisation encoding is realised using the high-rate single photons in the telecommunication C-band emitted from a semiconductor QD embedded in a circular Bragg grating structure. Utilising the 79 km long link with 25.49 dB loss (equivalent to 130 km for the direct-connected optical fibre) between the German cities of Hannover and Braunschweig, a record-high secret key bits per pulse of 4.8 × 10 -5 with an average quantum bit error ratio of ~ 0.65% are demonstrated. An asymptotic maximum tolerable loss of 28.11 dB is found, corresponding to a length of 144 km of standard telecommunication fibre. Deterministic semiconductor sources therefore challenge state-of-the-art QKD protocols and have the potential to excel in measurement device independent protocols and quantum repeater applications., (© 2024. The Author(s).)

Background: Fear of pain and movement is an important factor in the development of hypervigilance and avoidance behaviours., Objective: We examined the effectiveness of exercise training on improving fear-avoidance beliefs., Methods: A systematic review (data sources: MEDLINE, CINAHL, SPORTDiscus, EMBASE, CENTRAL) and metaanalysis of randomised controlled/clinical trials of exercise training in adults versus relevant nonexercise comparators that quantified fear-avoidance was conducted., Results: After screening 4603 identified records, 17 (2014 participants) and 13 (1152 participants) studies were eligible for qualitative and quantitative synthesis, respectively. Pairwise meta-analysis showed exercise training was more effective than all non-exercise comparators (standardised mean difference (SMD) [95% CI] - 0.378 [- 0.623, - 0.133], P = 0.002, Grading of Recommendations Assessment, Development and Evaluation [GRADE]: very low) for reducing fear-avoidance. Exercise training was more effective than true control for reducing fear avoidance (- 0.407 [- 0.750, - 0.065], P = 0.020, GRADE: very low), however it was not more effective than other interventions (- 0.243 [- 0.614, 0.128], P = 0.199, GRADE: very low). In people with low back pain, exercise training was more effective than non-exercise comparator groups for reducing fear-avoidance (- 0.530 [- 0.755, - 0.304], P < 0.001, GRADE: very low). For individuals with neck pain, exercise training was not more effective than non-exercise comparator groups for reducing fear-avoidance (0.061 [- 0.360, 0.482], P = 0.777, GRADE: very low)., Conclusion: There is very low to low-quality evidence that exercise training is effective for reducing fear-avoidance, including in people with low back pain. Exercise training may be more effective than no intervention for reducing fear avoidance, but there is very low-quality evidence that non-exercise interventions are as effective as exercise for fear avoidance. Few studies with low risk of bias is a limitation., Trail Registration: PROSPERO Registration Number: CRD42019139678.

Haemosporidians and trypanosomes of the northern goshawk (Accipiter gentilis) population in the Czech Republic were studied by morphological and molecular methods. Despite the wide distribution of these medium-large birds of prey, virtually nothing is known about their blood parasites. During a 5-year period, altogether 88 nestlings and 15 adults were screened for haemosporidians and trypanosomes by microscopic examination of blood smears and by nested PCR. Both methods revealed consistently higher prevalence of blood protists in adults, Leucocytozoon (80.0 % in adults vs. 13.6 % in nestlings), Haemoproteus (60.0 vs. 2.3 %), Plasmodium (6.7 vs. 0 %), and Trypanosoma (60.0 vs. 2.3 %). Altogether, five haemosporidian lineages were detected by cytochrome b sequencing. Two broadly distributed and host nonspecific lineages, Plasmodium (TURDUS1) and Leucocytozoon (BT2), were detected only sporadically, while three newly described northern goshawk host-specific Leucocytozoon lineages (ACGE01-03) represent the absolute majority of the haemosporidians identified by molecular methods. Our findings support evidences that in falconiform birds the Leucocytozoon toddi group is formed by several host-specific clusters, with Leucocytozoon buteonis in buzzards and Leucocytozoon mathisi in hawks. Between-year comparisons revealed that the infection status of adults remained predominantly unchanged and individuals stayed uninfected or possessed the same parasite lineages; however, two gains and one loss of blood parasite taxa were also recorded.

In altricial birds, energy supply during growth is a major predictor of the physical condition and survival prospects of fledglings. A number of experimental studies have shown that nestling body mass and wing length can vary with particular extrinsic factors, but between-year observational data on this topic are scarce. Based on a seven-year observational study in a central European Tengmalm's owl population we examine the effect of year, brood size, hatching order, and sex on nestling body mass and wing length, as well as the effect of prey abundance on parameters of growth curve. We found that nestling body mass varied among years, and parameters of growth curve, i.e. growth rate and inflection point in particular, increased with increasing abundance of the owl's main prey (Apodemus mice, Microtus voles), and pooled prey abundance (Apodemus mice, Microtus voles, and Sorex shrews). Furthermore, nestling body mass varied with hatching order and between sexes being larger for females and for the first-hatched brood mates. Brood size had no effect on nestling body mass. Simultaneously, we found no effect of year, brood size, hatching order, or sex on the wing length of nestlings. Our findings suggest that in this temperate owl population, nestling body mass is more sensitive to prey abundance than is wing length. The latter is probably more limited by the physiology of the species.

The music habits of 569 pre-teens and teenagers, between 10 and 17 years of age, were examined and exposure to music from portable music players was compared to that in discotheques. Using a questionnaire we determined the length of time spent listening to portable music players and the frequency of disco visits. The individual level of the music heard through portable music players was measured as a free-field corrected short term mean level. The total music exposure (related to 40 hours per week) was calculated from the data and different assumed disco sound levels. We estimated the risk of ear damage according to ISO 1999 standards on the basis of the total music exposure, whereby the mean disco level was varied as a parameter in the range of 95 to 110 dB(A). Taking only the portable music players into account, one can expect that even after 5 years of music, approximately 5% of the total group would have a hearing loss of 20 dB. This percentage clearly rises when additional exposure is given in discotheques having music levels above 100 dB(A). We suggest therefore that for safety reasons the following sound levels should be observed: 90 dB(A) for portable music players and 95 dB(A) for discos. Through adherence to these levels we would expect that 1% of the young people in our study would have a hearing loss > 10 dB, whereas momentary exposure would result in a hearing loss > 10 dB of 10-20%. Therefore we believe that sound level limitations should be enacted immediately for portable music players and in discotheques.

Sound levels of music played from mini-cassette players via headphones were measured in a nonrepresentative group of 681 pupils whose ages were between 10 to 19 years. Each pupil completed a questionnaire giving the total time spent listening to music each day. The pupils set the music levels (free field corrected short time Leq) between 60 dB(A) and 110 dB(A). In the age group from 12-16 years, 10% chose 110 dB(A). Nearly 50% of the total group usually listened to music less than one hour per day, and just less than 10% listened for four or more hours. The energy equivalent of continuous sound pressure level for an exposure time of 8 h per day was for 55% Leq 8 h < 66 dB(A) and for 7% Leq 8 h > 95 dB(A) while 4% had an Leq 8 h > 105 dB(A). Estimation of the expected hearing losses (HL) were based on ISO 1999: about 10% of the total group were predicted to have a HL > 10 dB at 4 kHz after 5 years. After listening to sound in this manner 0.3% were expected to develop hearing losses at age 25 years that would be severe enough to substantially impair speech intelligibility.