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We have developed a new type of simple lattice Boltzmann (LB) model for the compressible Euler equations based on the collisionless kinetic-equation approach proposed by Sone. The model uses the collisionless kinetic equation in the streaming process, and modifies the distribution function to its Chapman-Enskog type at each time step. Compared with the current LB models which solve the kinetic equation of the BGK type, the proposed model is superior in the following two points: (i) Inviscid flows can be computed stably while there is no such model in the current LBM; (ii) The velocity distribution function does not need to be memorized in computation. We calculate various inviscid compressible flows described by the compressible Euler equations using our new one-, two-, and three-dimensional models. Numerical results show the capability of our scheme to simulate high-speed supersonic flows with shock waves.

Background Limitations of shoulder range of motion (ROM) have been reported to be at high risk for shoulder disorders in baseball players. In this study, we assessed posterior shoulder muscle stiffness using shear wave elastography in baseball players with and without posterior shoulder tightness. Materials and methods In total, 21 college baseball players volunteered to participate in this study. Passive ROMs for shoulder abduction and horizontal adduction were measured using a goniometer. Subsequently, we divided all participants into 2 groups based on the differences between bilateral shoulder ROMs: STIFF+ and STIFF− groups. Thickness and elasticity of the posterior and inferior shoulder muscles were assessed using ultrasound. Results Shoulder abduction ROM on the throwing side was 114.5° ± 5.3° and 131.3° ± 5.7° in the STIFF+ and STIFF− groups, respectively, which was significantly different between the 2 groups (P = .023). Horizontal adduction ROM on the throwing side was 96.6° ± 4.9° and 110.9° ± 4.8° in the STIFF+ and STIFF− groups, respectively, which was also significantly different between the 2 groups (P = .014). The elasticity of infraspinatus and lower trapezius in the STIFF+ group was significantly greater than that in the STIFF− group (P = .018 and .033, respectively). Discussion In this study, we found that the elasticity of infraspinatus and lower trapezius in stiff shoulders was significantly greater than that in nonstiff shoulders, which indicated that the infraspinatus and lower trapezius could be the key muscles in posterior shoulder tightness.

Aims The purpose of this study was to evaluate the in vitro effects of apocynin, an inhibitor of nicotinamide adenine dinucleotide phosphate oxidase (NOX) and a downregulator of intracellular reactive oxygen species (ROS), on high glucose-induced oxidative stress on tenocytes. Methods Tenocytes from normal Sprague-Dawley rats were cultured in both control and high-glucose conditions. Apocynin was added at cell seeding, dividing the tenocytes into four groups: the control group; regular glucose with apocynin (RG apo+); high glucose with apocynin (HG apo+); and high glucose without apocynin (HG apo–). Reactive oxygen species production, cell proliferation, apoptosis and messenger RNA (mRNA) expression of NOX1 and 4, and interleukin-6 (IL-6) were determined in vitro. Results Expression of NOX1, NOX4, and IL-6 mRNA in the HG groups was significantly higher compared with that in the RG groups, and NOX1, NOX4, and IL-6 mRNA expression in the HG apo+ group was significantly lower compared with that in the HG apo– group. Cell proliferation in the RG apo+ group was significantly higher than in the control group and was also significantly higher in the HG apo+ group than in the HG apo– group. Both the ROS accumulation and the amounts of apoptotic cells in the HG groups were greater than those in the RG groups and were significantly less in the HG apo+ group than in the HG apo– group. Conclusion Apocynin reduced ROS production and cell death via NOX inhibition in high-glucose conditions. Apocynin is therefore a potential prodrug in the treatment of diabetic tendinopathy. Cite this article: Bone Joint Res 2020;9(1):23–28.

Introduction Excellent outcomes of arthroscopic rotator cuff repair for small and medium tears have been recently reported. However, re-tears after surgery have been a common complication after surgical repair of large and massive rotator cuff tears and often occur in early postoperative phase. It was previously reported that basic fibroblast growth factor and platelet-rich plasma enhanced rotator cuff tear healing. We hypothesized that this combined therapy could enhance rotator cuff healing after rotator cuff repair in a rat model. This study aimed to evaluate the efficacy of combined therapy of platelet-rich plasma and basic fibroblast growth factor with gelatin-hydrogel sheet. Methods To create a rotator cuff defect, the infraspinatus tendon of Sprague Dawley rat was resected from the greater tuberosity. The infraspinatus tendons were repaired and covered with gelatin-hydrogel sheet impregnated with PBS (control group), basic fibroblast growth factor (bFGF group), platelet-rich plasma (PRP group), or both basic fibroblast growth factor and platelet-rich plasma (combined group). Histological examinations were conducted using hematoxylin and eosin, safranin O, and immunofluorescence staining, such as Isolectin B4, type II collagen at 2 weeks postoperatively. For mechanical analysis, ultimate failure load of the tendon-humeral head complex was evaluated at 6 weeks postoperatively. Results In the hematoxylin and eosin staining, the tendon maturing score of the combined group was higher than that of the control group at postoperative 2 weeks. In the safranin O staining, stronger proteoglycan staining was observed in the combined group compared with the other groups at postoperative 2 weeks. Vascular staining with isolectin B4 in 3 treatment groups was significantly higher than that in the control group. Type II collagen expression in the combined group was significantly higher than those in the other groups. The ultimate failure load of the combined group was significantly higher than that of the control group. Conclusion Combined therapy of basic fibroblast growth factor and platelet-rich plasma promoted angiogenesis, tendon maturing and fibrocartilage regeneration at the enthesis, which could enhance the mechanical strength. It was suggested that combined basic fibroblast growth factor and platelet-rich plasma might enhance both tendon and bone–tendon junction healing, and basic fibroblast growth factor and platelet-rich plasma might be synergistic.

Background Ischemia-reperfusion (I/R) injury is a major contributor to skin flap necrosis, which is a serious complication of reconstructive surgery. The purpose of this study was to evaluate the protective effect of treatment with febuxostat, a selective xanthine oxidase inhibitor, on I/R injury in the skin flap of an animal (rat) model. Methods Superficial epigastric flaps were raised in Sprague-Dawley rats and subjected to ischemia for 3 h. Febuxostat at a dose of 10 mg/kg/day was administered to rats in drinking water from 1 week before the surgery (Feb group). Control animals received no drugs (Con group). The mean ratio of flap survival and contraction was evaluated and compared between animals with and without administration of febuxostat on day 5 after the surgery. In addition, infiltration by polymorphonuclear leukocytes and muscles of the panniculus carnosus in the flap were histologically evaluated using hematoxylin-eosin staining. Furthermore, xanthine oxidase activity, ATP levels, superoxide dismutase activity, and expression of 8-hydroxy-2′-deoxyguanosine (8-OHdG), tumor necrosis factor-α, and interleukin-1β were quantitatively assessed in the skin flap 24 h after the surgery. Results In the Feb group, the survival and contraction rates at the 5 d timepoint post-surgery were significantly higher and lower than those in the Con group, respectively. Histological analysis showed significant reduction in polymorphonuclear leukocyte infiltration and muscle injury scores due to I/R injury in the Feb group. The expression of 8-OHdG was also significantly inhibited in animals administered febuxostat. Biochemical analysis showed a significant reduction in xanthine oxidase activity and significant increases in ATP levels and superoxide dismutase activity in the Feb group. Furthermore, the expression of interleukin-1β was significantly lower in the Feb group than in the Con group. Conclusion Febuxostat, which is clinically used for the treatment of hyperuricemia, was effective against necrosis of the skin flap via inhibition of oxidative stress and inflammation caused by I/R injury.

We have developed a fundamentally new type of simple lattice Boltzmann (LB) model for the compressible Navier‐Stokes equations based on the kinetic system proposed by Sone. The model uses the kinetic equation of free‐molecular type in the streaming process and modifies the distribution function to its Chapman‐Enskog type at each time step. Compared with the current LB models, the proposed model is superior in the following two points: (i) there are no inherent errors associated with the Knudsen number; (ii) any flow parameters, including three transport coefficients, can be chosen freely according to our convenience. Numerical tests and error estimates confirm the above statements.

Background Most rotator cuff tears are the result of age-related degenerative changes, but the mechanisms underlying these changes have not been reported. Recently, advanced glycation end products (AGEs) have been regarded as an important factor in senescence. Therefore, we hypothesized that AGEs would have detrimental effects on rotator cuff–derived cells. In this study, we investigated the influence of AGEs on rotator cuff–derived cells in vitro and ex vivo. Methods Rotator cuff–derived cells were obtained from human supraspinatus tendons. The cells were cultured in the following media: (1) regular medium with 500 μg/mL AGEs (High-AGEs), (2) regular medium with 100 μg/mL AGEs (Low-AGEs), and (3) regular medium alone (Control). Cell viability, secretion of vascular endothelial growth factor, and the expressions of hypoxia-inducible factor-1α, reactive oxygen species, and apoptosis were assessed after cultivation. An ex vivo tissue culture with AGEs was also performed to measure the tensile strength. Results Cell viability in the High-AGEs group was significantly suppressed relative to that in the Controls. The amount of vascular endothelial growth factor secretion was significantly greater in the High- and Low-AGEs groups than in the Controls. Immunofluorescence stain demonstrated enhancement of hypoxia-inducible factor-1α and reactive oxygen species expressions and cell apoptosis in the High- and Low-AGEs groups relative to that in the Controls. In ex vivo mechanical testing, tensile strength was significantly higher in the Control group than in the AGEs groups. Discussion These results indicated that AGEs caused age-related degenerative rotator cuff changes. The reduction of AGEs might prevent rotator cuff senescence-related degeneration.

Introduction: Musculocutaneous nerve lesion in a throwing athlete is a rare condition. We report the case of a professional baseball pitcher with an isolated musculocutaneous nerve lesion that occurred during a pitching motion. Case Presentation: The patient had radiating pain in the upper arm and weakness of elbow flexion. Physical examination revealed flaccid paralysis of the biceps brachii muscle and paresthesia in the right lateral forearm. Musculocutaneous nerve injury was suspected. Because some signs of recovery were observed within a few days, the patient received non-operative management. Nerve conduction studies at 2 weeks after the injury showed low-amplitude compound muscle action potential of the right biceps brachii muscle by stimulation of the musculocutaneous nerve. Needle electromyography showed markedly reduced motor unit potential recruitment in the biceps brachii muscle. He was diagnosed as having isolated musculocutaneous nerve injury. At 2 months after the injury, the muscle contraction and strength of the biceps brachii muscle improved. At 7 months after the injury, muscle weakness was fully recovered. His pitching ability returned to that of a competitive player. Conclusion: Because the neuroparalysis was incomplete and began to recover within a few days, we considered the pathology of this injury to be incomplete axonotmesis, which was successfully treated conservatively. Keywords: Isolated musculocutaneous nerve injury, baseball pitcher, axonotmesis.

The mean flow induced by a three-dimensional propagating internal gravity wave beam in a uniformly stratified fluid is studied experimentally and theoretically. Previous related work concentrated on the early stage of mean-flow generation, dominated by the phenomenon of streaming – a horizontal mean flow that grows linearly in time – due to resonant production of mean potential vorticity in the vicinity of the beam. The focus here, by contrast, is on the long-time mean-flow evolution. Experimental observations in a stratified fluid tank for times up to is the beam period, reveal that the induced mean flow undergoes three distinct stages: (i) resonant growth of streaming in the beam vicinity; (ii) saturation of streaming and onset of horizontal advection; and (iii) establishment of a quasi-steady state where the mean flow is highly elongated and stretches in the along-tank horizontal direction. To capture (i)–(iii), the theoretical model of Fan et al. (J. Fluid Mech., vol. 838, 2018, R1) is extended by accounting for the effects of horizontal advection and viscous diffusion of mean potential vorticity. The predictions of the proposed model, over the entire mean-flow evolution, are in excellent agreement with the experimental observations as well as numerical simulations based on the full Navier–Stokes equations.

We report the case of a 37-year-old male with autism spectrum disorder who was hospitalized for chronic elbow dislocation. He had suffered a posterior elbow dislocation 5 months ago. His elbow dislocation was easily reduced, but the reduction position could not be maintained. Severe varus and valgus instabilities were observed in his right elbow. He was diagnosed with chronic elbow dislocation due to bilateral collateral ligament dysfunction and was surgically treated. Bilateral ligament reconstruction using the bilateral palmaris longus (PL) tendon combined with a temporary ulnohumeral joint fixation was performed. Cast immobilization was applied for 6 weeks. One year after surgery, his range of motion was −15° in extension, 140° in flexion, 80° in pronation, and 90° in supination. He did not face any problems in daily activities.

Background Nicotinamide adenine dinucleotide (NAD+) plays an important role in energy metabolism, mitochondrial function, aging, and cell death. Nicotinamide mononucleotide (NMN) is one of the key precursors of NAD+. The purpose of this study is to evaluate the oxidative stress effects of NMN on rat tenocytes in-vitro.Methods Tenocytes from normal Sprague–Dawley rats were cultured in regular glucose (RG) and high-glucose (HG) conditions with or without NMN, and were divided into four groups: RG NMN−, RG NMN+, HG NMN−, and HG NMN+. Cell viability, reactive oxygen species (ROS) production, apoptosis, and messenger RNA (mRNA) expressions of NADPH oxidase (NOX) 1, NOX4, interleukin (IL)-6, SIRT1, and SIRT6, were determined in-vitro.Results The NMN groups led to significantly higher cell viabilities compared with the other groups. The mRNA expressions of NOX1, NOX4, and IL6, in the HG NMN+ group were significantly lower compared with those of the HG NMN− group. Conversely, the corresponding expressions of the SIRT1 and SIRT6 levels in the HG NMN+ group were significantly higher compared with those of the HG NMN−group. Both the accumulation of ROS and apoptosis in the HG NMN− group were significantly higher compared with those in the RG NMN− group at 48 h.Conclusion The expression levels of NOX1, NOX4, IL6, and ROS were significantly reduced by NMN. These results suggest that NMN could effectively reduce the oxidative stress by activating SIRT1 and SIRT6, and by inhibiting the activity of NOX and apoptosis in the tenocytes.

BACKGROUND: Common peroneal nerve (CPN) injury following a knee dislocation is a serious problem, and an optimal treatment is yet to be established. We report a case of complete CPN palsy following a knee dislocation treated with sural nerve grafting. CASE: A 19-year-old man suffered a knee injury during a hurdle race. Diagnosis in a previous hospital revealed a complex ligament injury with CPN palsy. Ten weeks following injury, he was admitted to our institution because of a lack of neurological improvement. Considering the grade 0 results obtained in the manual muscle test (MMT) of tibialis anterior (TA) and extensor hallucis longus (EHL), the patient was diagnosed with complete neurotmesis of CPN, and surgery was performed. Operative findings revealed CPN discontinuity and an extended nerve defect length of 15 cm; therefore, sural nerve grafting was performed to repair the CPN injury. One year postoperatively, a grade 1 result from MMT of TA and EHL indicated a gradual neurological recovery. Three years postoperatively, MMT of TA and EHL showed significant improvement to grade 4+ and grade 4, respectively, and he could walk and jog without a knee brace. DISCUSSION: Nerve graft length of >6 cm has shown limited success, and their efficacy for the treatment of CPN palsy following knee dislocations is controversial. However, young patients with complete CPN lesion are more likely to recover regardless of the length of nerve injury. Therefore, in such cases, nerve grafting can be considered as one of the treatments for complete CPN lesion following knee dislocations.

Olecranon apophyseal nonunion is an elbow injury from overuse that affects adolescent athletes such as baseball pitchers who participate in overhead throwing sports. However, such injury is rare in collision sports. Here, we report two patients with this condition who are Judo athletes. The purpose of this report was to describe three elbows with olecranon apophyseal nonunion in two adolescent patients participating in Judo. This is a case series; the level of evidence is 4. Two 15-year-old patients were evaluated. One suffered from unilateral and the other from bilateral chronic posterior elbow pain. They were diagnosed with olecranon apophyseal nonunion, which was treated using internal fixation and bone grafting. Radiographic evidence of the apophyseal union was observed four months postsurgery. Two elbows were treated with tension band wiring, then they underwent hardware removal six months postsurgery. Both patients returned to their previous levels of activities six months postsurgery. Internal fixation using autologous bone grafting was a useful treatment for these Judo athletes with olecranon apophyseal nonunion.

Objectives The aim of this study was to investigate the effect of hyperglycaemia on oxidative stress markers and inflammatory and matrix gene expression within tendons of normal and diabetic rats and to give insights into the processes involved in tendinopathy. Methods Using tenocytes from normal Sprague-Dawley rats, cultured both in control and high glucose conditions, reactive oxygen species (ROS) production, cell proliferation, messenger RNA (mRNA) expression of NADPH oxidase (NOX) 1 and 4, interleukin-6 (IL-6), matrix metalloproteinase (MMP)-2, tissue inhibitors of matrix metalloproteinase (TIMP)-1 and -2 and type I and III collagens were determined after 48 and 72 hours in vitro. In an in vivo study, using diabetic rats and controls, NOX1 and 4 expressions in Achilles tendon were also determined. Results In tenocyte cultures grown under high glucose conditions, gene expressions of NOX1, MMP-2, TIMP-1 and -2 after 48 and 72 hours, NOX4 after 48 hours and IL-6, type III collagen and TIMP-2 after 72 hours were significantly higher than those in control cultures grown under control glucose conditions. Type I collagen expression was significantly lower after 72 hours. ROS accumulation was significantly higher after 48 hours, and cell proliferation after 48 and 72 hours was significantly lower in high glucose than in control glucose conditions. In the diabetic rat model, NOX1 expression within the Achilles tendon was also significantly increased. Conclusion This study suggests that high glucose conditions upregulate the expression of mRNA for NOX1 and IL-6 and the production of ROS. Moreover, high glucose conditions induce an abnormal tendon matrix expression pattern of type I collagen and a decrease in the proliferation of rat tenocytes. Cite this article: Y. Ueda, A. Inui, Y. Mifune, R. Sakata, T. Muto, Y. Harada, F. Takase, T. Kataoka, T. Kokubu, R. Kuroda. The effects of high glucose condition on rat tenocytes in vitro and rat Achilles tendon in vivo. Bone Joint Res 2018;7:362–372. DOI: 10.1302/2046-3758.75.BJR-2017-0126.R2

Background: Improvements in ultrasound diagnostic equipment and techniques can enable muscle stiffness to be measured quantitatively as muscle elasticity using ultrasound shear wave elastography (USWE), where high muscle elasticity values represent muscle stiffness. Purpose: To use USWE to analyze the sequential changes in muscle elasticity in the posterior shoulder before and after pitching. Study Design: Descriptive laboratory study. Methods: The authors evaluated 14 baseball players who had played in high school or college at an intermediate level. The elasticity of the supraspinatus, infraspinatus (ISP), middle trapezius, lower trapezius (LT), rhomboideus, and serratus anterior muscles of the throwing shoulder was measured using USWE at 3 time points: before, immediately after, and 24 hours after a throwing session of 100 pitches. The authors analyzed the sequential changes in the mean elasticity values of the respective muscles at the 3 time points. Results: The mean elasticity values before, immediately after, and 24 hours after throwing were as follows: supraspinatus: 32.9, 53.4, 43.8 kPa; ISP: 22.7, 44.8, 43.7 kPa; middle trapezius: 45.1, 70.3, 59.9 kPa; LT: 32.8, 45.5, 46.5 kPa; rhomboideus: 29.1, 47.5, 38.8 kPa; and serratus anterior: 19.2, 36.9, 26.5 kPa, respectively. The mean elasticity values for all tested muscles were significantly higher immediately after throwing compared with before throwing ( P ≤ .0086 for all), and elasticity values in the ISP and LT remained significantly higher 24 hours after throwing compared with before throwing ( P ≤ .019 for both). Conclusion: The study results indicated that pitching significantly increased ISP and LT muscle elasticity even after 24 hours.

The generation of internal gravity waves by a vertically oscillating cylinder that is tilted to the horizontal in a stratified Boussinesq fluid of constant buoyancy frequency, $N$, is investigated. This variant of the widely studied horizontal configuration – where a cylinder aligned with a plane of constant gravitational potential induces four wave beams that emanate from the cylinder, forming a cross pattern known as the ‘St. Andrew’s Cross’ – brings out certain unique features of radiated internal waves from a line source tilted to the horizontal. Specifically, simple kinematic considerations reveal that for a cylinder inclined by a given angle $\unicode[STIX]{x1D719}$ to the horizontal, there is a cutoff frequency, $N\sin \unicode[STIX]{x1D719}$, below which there is no longer a radiated wave field. Furthermore, three-dimensional effects due to the finite length of the cylinder, which are minor in the horizontal configuration, become a significant factor and eventually dominate the wave field as the cutoff frequency is approached; these results are confirmed by supporting laboratory experiments. The kinematic analysis, moreover, suggests a resonance phenomenon near the cutoff frequency as the group-velocity component perpendicular to the cylinder direction vanishes at cutoff; as a result, energy cannot be easily radiated away from the source, and nonlinear and viscous effects are likely to come into play. This scenario is examined by adapting the model for three-dimensional wave beams developed in Kataoka & Akylas (J. Fluid Mech., vol. 769, 2015, pp. 621–634) to the near-resonant wave field due to a tilted line source of large but finite length. According to this model, the combination of three-dimensional, nonlinear and viscous effects near cutoff triggers transfer of energy, through the action of Reynolds stresses, to a circulating horizontal mean flow. Experimental evidence of such an induced mean flow near cutoff is also presented.

To achieve biological regeneration of tendon-bone junctions, cell sheets of human rotator-cuff derived cells were used in a rat rotator cuff injury model. Human rotator-cuff derived cells were isolated, and cell sheets were made using temperature-responsive culture plates. Infraspinatus tendons in immunodeficient rats were resected bilaterally at the enthesis. In right shoulders, infraspinatus tendons were repaired by the transosseous method and covered with the cell sheet (sheet group), whereas the left infraspinatus tendons were repaired in the same way without the cell sheet (control group). Histological examinations (safranin-O and fast green staining, isolectin B4, type II collagen, and human-specific CD31) and mRNA expression (vascular endothelial growth factor; VEGF, type II collagen; Col2, and tenomodulin; TeM) were analyzed 4 weeks after surgery. Biomechanical tests were performed at 8 weeks. In the sheet group, proteoglycan at the enthesis with more type II collagen and isolectin B4 positive cells were seen compared with in the control group. Human specific CD31-positive cells were detected only in the sheet group. VEGF and Col2 gene expressions were higher and TeM gene expression was lower in the sheet group than in the control group. In mechanical testing, the sheet group showed a significantly higher ultimate failure load than the control group at 8 weeks. Our results indicated that the rotator-cuff derived cell sheet could promote cartilage regeneration and angiogenesis at the enthesis, with superior mechanical strength compared with the control. Treatment for rotator cuff injury using cell sheets could be a promising strategy for enthesis of tendon tissue engineering. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:289-296, 2017.

Background Fascia lata augmentation of massive rotator cuff tears has shown good clinical results. However, its biological effect during the early healing process is not clearly understood. The purpose of the study was to evaluate the biological efficacy of fascia lata augmentation during the early healing process of rotator cuff tears using a rabbit rotator cuff defect model. Methods The infraspinatus tendon was resected from the greater tuberosity of a rabbit to create a rotator cuff tear. The tendon edge was directly sutured to the humeral head. The rotator cuff repaired site was augmented with a fascia lata autograft (augmentation group, group A). The rotator cuff defect in the contralateral shoulder was repaired without augmentation (reattachment group, group R). A group with intact rotator cuff was set as the control group. Histological examinations and mechanical analysis were conducted 4 and 8 weeks postoperatively. Results In the HE staining, the tendon maturing score of group A was higher than that of group R at 4 weeks postoperatively. In the safranin O staining, proteoglycan staining at the repaired enthesis in group A at 4 weeks postoperatively was stronger than that in group R. Picrosirius red staining showed that type III and type I collagen in group A was more strongly expressed than that in group R at 4 weeks postoperatively. The ultimate failure load of the infraspinatus tendon–humeral head complex in group A was statistically higher than that in group R at 4 weeks postoperatively. The ultimate failure load of group A was similar to that of the control group. Conclusion The biological and mechanical contribution of fascia lata augmentation for massive rotator cuff tears was analyzed in this study. Type III collagen was reported to be expressed during the tendon healing process. Although the biological action similar to natural ligament healing occurred around the fascia lata grafts, type III collagen was gradually replaced by type I collagen as the tissue matured. Our results suggest that fascia lata augmentation could stimulate biological healing and provide initial fixation strength of the repaired rotator cuff.

Background Advanced glycation end products are associated with aging, hyperglycemia, and oxidative stress. Accumulation of advanced glycation end products can cause various pathological conditions; however, the association of Dupuytren’s disease with advanced glycation end products has not been demonstrated yet. The aim of this study is to investigate the association of Dupuytren’s disease with advanced glycation end products. Methods Normal palmar fascia from five patients with carpal tunnel syndrome (control group) and Dupuytren’s cords from five patients (Dupuytren’s disease group) were harvested. The tissues were stained using an anti-advanced glycation end products antibody, anti-receptor for advanced glycation end products antibody, and an anti-reactive oxygen species modulator 1 antibody. The expression of nicotinamide adenine dinucleotide phosphate oxidase-1 and nicotinamide adenine dinucleotide phosphate oxidase-4 genes was also assessed using real-time PCR. For in vitro analysis, the cells harvested from the control and Dupuytren’s disease groups were used. After 3 days of exposure to four types of media (control group, control + advanced glycation end products group, Dupuytren’s disease group, Dupuytren’s disease + advanced glycation end products group), superoxide detection reagent was detected using a total reactive oxygen species/superoxide detection kit. Results Immunostaining of the palmar fasciae of the Dupuytren’s disease group showed higher expressions of advanced glycation end products and receptor for advanced glycation end products than that in the control group. The expression of nicotinamide adenine dinucleotide phosphate oxidase oxidase-1 and nicotinamide adenine dinucleotide phosphate oxidase-4 as well as reactive oxygen species modulator 1, an oxidatively damaged protein, was also higher in the Dupuytren’s disease group than in the control group. In an in vitro cell culture, the addition of advanced glycation end products to the Dupuytren’s disease-derived cells produced more superoxide free radicals. Conclusions These data suggest that the advanced glycation end products receptor for advanced glycation end products interaction produced free radicals via nicotinamide adenine dinucleotide phosphate oxidase activation in Dupuytren’s disease patients. Further studies are required to confirm these results.

The coupled nonlinear interaction of three-dimensional gravity–inertia internal wavepackets, in the form of beams with nearly monochromatic profile, with their induced mean flow is discussed. Unlike general three-dimensional wavepackets, such modulated nearly monochromatic beams are not susceptible to modulation instability from their inviscid, purely modulation-induced mean flow. However, streaming – the induced mean flow associated with the production of mean potential vorticity via the combined action of dissipation and nonlinearity – can cause cross-beam bending, transverse broadening and increased along-beam decay of the beam profile, in qualitative agreement with earlier laboratory experiments. For wavepackets with general three-dimensional modulations, by contrast, streaming does arise, but plays a less prominent role in the interaction dynamics.

The three-dimensional propagation of internal gravity wave beams in a uniformly stratified Boussinesq fluid is discussed, assuming that variations in the along-beam and transverse directions are of long length scale relative to the beam width. This situation applies, for instance, to the far-field behaviour of a wave beam generated by a horizontal line source with weak transverse dependence. In contrast to the two-dimensional case of purely along-beam variations, where nonlinear effects are minor even for beams of finite amplitude, three-dimensional nonlinear interactions trigger the transfer of energy to a circulating horizontal time-mean flow. This resonant beam–mean-flow coupling is analysed, and a system of two evolution equations is derived for the propagation of a small-amplitude beam along with the induced mean flow. This model explains the salient features of the experimental observations of Bordes et al. (Phys. Fluids, vol. 24, 2012, 086602).

This paper presents power management and low power techniques of our heterogeneous quad/octa-core mobile application processor (AP). This AP has a combination of high-performance 2 GHz cores and energy-efficient 1 GHz cores. The maximum performance in the octa-core configuration is 35,600 DMIPS. The key design highlights are as follows. 1) Using a dedicated PLL and H-tree clock in the high-performance CPU achieves both 2 GHz operation and reduced dynamic power. 2) A low-leakage SRAM in a 28 nm HPM process is used and the leakage current of the peripheral circuits of the SRAM macro is optimized via multiple threshold voltages (Vt) and gate lengths (Lg), resulting in 24% leakage reduction of L1 cache. 3) The effects of process and voltage variations are accurately corrected by an on-chip process sensor and direct sensing of the voltage in the power mesh of the chip. 20% dynamic power reduction, 29% leakage power reduction and 40 mV improvement of minimum operation voltage are achieved. 4) An enhanced CPU clock control mechanism is employed, which uses an on-chip delay sensor to reduce AC voltage drop. 5) The heterogeneous CPU architecture maintains high performance even during thermal throttling.