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Objective Quadriceps weakness is considered the primary determinant of gait function after total knee arthroplasty (TKA). However, many patients have shown a gap in improvement trends between gait function and quadriceps strength in clinical situations. Factors other than quadriceps strength in the recovery of gait function after TKA may be essential factors. Because muscle power is a more influential determinant of gait function than muscle strength, the maximum knee extension velocity without external load may be a critical parameter of gait function in patients with TKA. This study aimed to identify the importance of knee extension velocity in determining the gait function early after TKA by comparing the quadriceps strength. Methods This prospective observational study was conducted in four acute care hospitals. Patients scheduled for unilateral TKA were recruited (n = 186; age, 75.9 ± 6.6 years; 43 males and 143 females). Knee extension velocity was defined as the angular velocity of knee extension without external load as quickly as possible in a seated position. Bilateral knee function (knee extension velocity and quadriceps strength), lateral knee function (pain and range of motion), and gait function (gait speed and Timed Up and Go test (TUG)) were evaluated before and at 2 and 3 weeks after TKA. Results Both bilateral knee extension velocities and bilateral quadriceps strengths were significantly correlated with gait function. The knee extension velocity on the operation side was the strongest predictor of gait function at all time points in multiple regression analysis. Conclusion These findings identified knee extension velocity on the operation side to be a more influential determinant of gait function than impairments in quadriceps strength. Therefore, training that focuses on knee extension velocity may be recommended as part of the rehabilitation program in the early postoperative period following TKA. Trial registration UMIN Clinical Trials Registry (UMIN-CTR) UMIN000020036.

While numerous studies have suggested the involvement of cerebrovascular dysfunction in the pathobiology of blast‐induced traumatic brain injury (bTBI), its exact mechanisms and how they affect the outcome of bTBI are not fully understood. Our previous study showed the occurrence of cortical spreading depolarization (CSD) and subsequent long‐lasting oligemia/hypoxemia in the rat brain exposed to a laser‐induced shock wave (LISW). We hypothesized that this hemodynamic abnormality is associated with shock wave‐induced generation of nitric oxide (NO). In this study, to verify this hypothesis, we used an NO‐sensitive fluorescence probe, diaminofluorescein‐2 diacetate (DAF‐2 DA), for real‐time in vivo imaging of male Sprague–Dawley rats' brain exposed to a mild‐impulse LISW. We observed the most intense fluorescence, indicative of NO production, along the pial arteriolar walls during the period of 10–30 min post‐exposure, parallel with CSD occurrence. This post‐exposure period also coincided with the early phase of hemodynamic abnormalities. While the changes in arteriolar wall fluorescence measured in rats receiving pharmacological NO synthase inhibition by nitro‐L‐arginine methyl ester (L‐NAME) 24 h before exposure showed a temporal profile similar to that of changes observed in LISW‐exposed rats with CSD, their intensity level was considerably lower; this suggests partial involvement of NOS in shock wave‐induced NO production. To the best of our knowledge, this is the first real‐time in vivo imaging of NO in rat brain, confirming the involvement of NO in shock‐wave‐induced hemodynamic impairments. Finally, we have outlined the limitations of this study and our future research directions.

Mixed reality (MR) technology can be applied to various applications such as architecture, advertising, and navigation systems, so the desire to utilize MR in outdoor environments has been increasing. In order to utilize MR, it is necessary to achieve alignment super imposing virtual contents in the desired position. However, because light changes continually in outdoor environments, and the appearance of real objects changes also, in some cases the previous image-based alignment methods do not work well. In this paper, a robust image-based alignment method to be used in outdoor environments is proposed. In the proposed method, the albedo of real objects is estimated using 3D shapes of these objects in advance, and the appearance is reproduced from the albedo and current light environment. The appearance of real objects and reproduced image becomes close, so a robust image-based alignment is achieved.

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