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Abstract:. We previously conducted a single-arm, prospective study in which 31 patients (mean age [and standard deviation], 42.5 ± 11.3 years) with cartilage lesions were treated with use of the BioPoly Partial Resurfacing Knee Implant. Treatment outcomes were compared with those reported for the standard of care, microfracture. We found that the mean KOOS (Knee injury and Osteoarthritis Outcome Score) Quality of Life score at 5 years in the BioPoly cohort was noninferior to (p = 0.004), and indeed greater than (p = 0.021), that in the microfracture cohort. The BioPoly cohort demonstrated improvement in the mean scores for all KOOS domains at every postoperative time point (p < 0.025). The mean score for the visual analog scale (VAS) for pain significantly improved (p < 0.025) at all time points up to 4 years and trended toward significant improvement at 5 years (p = 0.027). This study indicated that the BioPoly implant was safe, provided significant improvement starting at 6 months and continuing to 5 years, and provided greater improvement than microfracture for some outcome measures. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Abstract Introduction Custom acetabular components have become an established method of treating massive acetabular bone defects in hip arthroplasty. Complication rates, however, remain high and migration of the cup is still reported. Ischial screw fixation (IF) has been demonstrated to improve mechanical stability for non-custom, revision arthroplasty cup fixation. We hypothesize that ischial fixation through the flange of a custom acetabular component aids in anti-rotational stability and prevention of cup migration. Methods Electronic patient records were used to identify a consecutive series of 49 custom implants in 46 patients from 2016 to 2022 in a unit specializing in complex joint reconstruction. IF was defined as a minimum of one screw inserted into the ischium passing through a hole in a flange on the custom cup. The mean follow-up time was 30 months. IF was used in 36 cups. There was no IF in 13 cups. No difference was found between groups in age (68.9 vs. 66.3, P = 0.48), BMI (32.3 vs. 28.2, P = 0.11) or number of consecutively implanted cups (3.2 vs. 3.6, P = 0.43). Aseptic loosening with massive bone loss was the primary indication for revision. There existed no difference in Paprosky grade between the groups (P = 0.1). 14.2% of hips underwent revision and 22.4% had at least one dislocation event. Results No ischial fixation was associated with a higher risk of cup migration (6/13 vs. 2/36, X 2 = 11.5, P = 0.0007). Cup migration was associated with an increased risk for all cause revision (4/8 vs. 3/38, X 2 = 9.96, P = 0.0016, but not with dislocation (3/8 vs. 8/41, X 2 = 1.2, P = 0.26). Conclusion The results suggest that failure to achieve adequate ischial fixation, with screws passing through the flange of the custom component into the ischium, increases the risk of cup migration, which, in turn, is a risk factor for revision.

Background. Patients with field cancerization will develop numerous superficial non-melanoma skin cancers (NMSCs). Treating patients with field cancerization can be challenging and burdensome due to the numerous non-melanoma skin cancers (NMSCs) they develop and the frequent dermatology visits required for biopsy and treatment. Objective. The success rate of diagnosing and treating lesions suspicious for NMSCs on the same day is measured, immediately after biopsy. Methods. We retrospectively reviewed records of patients with same day lesion diagnosis and curettage treatment to determine diagnostic accuracy, treatment failure, and number needed to treat to reduce a follow-up treatment. Results. A total of 237 lesions underwent same day biopsy and treatment, of which the majority were NMSC (66%) or actinic keratosis (23%). Patients had at least 3 months and a median of 17 months follow-up. A total of 20 lesions either recurred or were deemed to require additional treatment. The number needed to treat (NNT) to prevent one follow-up treatment was 1.3. Limitations: sample size limited ability to determine risk factors for treatment failure. Conclusion. Simultaneous diagnosis and treatment of superficial NMSCs is a successful way of improving efficiency and patient satisfaction.

A spectrum of anatomic variants of the conventional single patellar tendon have been described however a double patellar tendon is a highly rare finding, which has only been described once before where a cross-over tendon morphology was illustrated. We report the case of a 46-year-old man with a 3 month history of left knee pain who was found to have an incidental double patellar tendon without cross-over, with one deep bundle demonstrating a more conventional patellar tendon course, paralleled by a second anatomically-distinct superficial bundle of differing morphology coursing anterolateral to the deep conventional bundle, explicitly connecting patella to tibial tuberosity. A comprehensive understanding of the anatomic variations of the patellar tendon is essential for both radiologist and clinician to deliver safe clinical practice. We present a rare case of an uncrossed-doubled patellar tendon, which to our knowledge, has never been reported. Keywords: Anatomic variant, Cross-over, Doubled patellar tendon, Knee, MRI

Background:. Current treatments for focal chondral and osteochondral lesions of the femoral condyle have been associated with variable outcomes. We conducted a clinical trial of the BioPoly RS Partial Resurfacing Knee Implant to address this unmet need. Methods:. We performed a single-arm, prospective study in which 33 patients with focal cartilage lesions affecting the femoral condyle were managed with the BioPoly RS Partial Resurfacing Knee Implant. Knee injury and Osteoarthritis Outcome Score (KOOS) scores, a visual analog scale (VAS) for pain, the Short Form-36 (SF-36) physical component score , and the Tegner activity score were used to assess outcomes preoperatively and at 6 months, 1 year, and 2 years postoperatively. The KOOS outcomes at 2 years were compared with historical outcomes following microfracture treatment. Results:. We found significant and clinically meaningful improvements in the KOOS scores, VAS pain score, and SF-36 physical component score (p < 0.025) when the values at all 3 postoperative time points were compared with the preoperative scores, and we also found significant improvements when the Tegner activity score at 2 years was compared with the preoperative score (p < 0.025). More than half of the cohort of patients had had a previous failure of cartilage-repair procedures. No significant differences were detected between younger patients (≤40 years) and older patients (>40 years). When compared with historical microfracture data, the BioPoly RS Implant demonstrated significantly superior KOOS scores for quality of life and sports. Conclusions:. The present study indicated that the BioPoly RS Partial Resurfacing Knee Implant is safe, that it resulted in significantly improved knee function by 6 months, and that this improvement was sustained for 2 years regardless of patient age. The BioPoly RS Knee Implant allows return to a higher level of sporting activity than microfracture. Additional long-term follow-up is needed to determine the long-term effects of the device. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Introduction. Metal-on-metal (MoM) hip resurfacings have been associated with a variety of complications resulting from adverse reaction to metal debris. Pseudotumors have rarely been reported to cause deep venous thrombosis (DVT). Study Design. A case report and a review of the literature. Case Presentation. A 75-year-old female who had left metal-on-metal hip resurfacing 6 years ago presented with left groin pain associated with unilateral lower limb edema and swelling. By duplex and MRI studies, our patient had an extensive soft tissue necrosis associated with a large pelvic mass causing extensive DVT of the lower limb secondary to mechanical compression of the left iliac vein. Results. Our case was initially treated for DVT followed by dual surgical approach. The pseudotumor was excised through a separate iliofemoral approach and revision of the hip implant was undertaken through a posterior approach in the same setting. An inferior vena cava (IVC) filter was inserted to minimise the perioperative risks of handling the iliac veins. Conclusion. A combined approach with vascular surgeons is required. Combined resection of the pseudotumor and revision of the metal bearing surfaces is essential, in order to achieve a good surgical outcome in this rare complication.

Patellar instability is a common finding in patients with below-knee amputation and yet management options are not commonly described in the literature. We describe the first reported case of a medial patellofemoral ligament reconstruction using allograft in a patient with a below-knee amputation. Clinical outcome at two-year follow-up remains very good.

The recent Commonwealth Games opening ceremony aimed to showcase the places and people of India to the world. The image it sought to project (of a united yet diverse place, where the past and the present sat comfortably together) was at odds with the image that Western-based media companies had projected in the weeks building up to the games. This latter vision was of India as a chaotic and wild place, where hygiene was questionable and planning imprecise. This is no surprise, for these elements of the modern Indian landscape often attract the Western gaze. This summer a group of academics came together at the annual meeting of European social anthropologists in an attempt to somewhat rectify the selective nature of this gaze through a presentation of different reflections on (and of ) landscapes of contemporary India. The group, which consisted of both Indian and Western academics, gathered together for two panels, connected by the workshop title ‘Indiascapes: reflections of contemporary India’.1 It was part of a larger academic conference, the 11th biennial conference of the European Association of Social Anthropologists (EASA), which attracted over 1,100 academics. Most participants came from Europe but there were also delegates from Asia, Africa, Latin America and North America. The theme of the conference was ‘Crisis and Imagination’ and Professor Talal Asad gave the keynote speech. The conference was hosted by the National University of Ireland, Maynooth; the organising team included the local department of anthropology, EASA and NomadIT (a professional event organising team).

Methanogenic and methanotrophic microbes together determine the net methane flux from rice fields. Despite much research on them as separate communities, there has been little study of combined community patterns, and how these vary between the rhizoplane (root surface), rhizosphere (soil surrounding the root) and bulk soil around rice plants, especially at larger spatial scale. We collected samples from 32 geographically scattered rice fields in east central China, amplicon targeting the mcrA gene for methanogenesis and pmoA gene for methanotrophy by using high‐throughput sequencing. Distinct communities of both methanogens and methanotrophs occurred in each of the three compartments, and predominantly positive links were found between methanogens and methanotrophs in all compartments indicating cross‐feeding or consortia relationships. Methanogens were acting as the network hub in the bulk soil, and methanotrophs in rhizoplane. Network complexity and stability was greater in the rhizosphere than rhizoplane and bulk soil, with no network hubs detected, suggesting the strongest effect of homeostatic influence by plant occurred in the rhizosphere. The proportion of determinism (homogeneous selection) and distance–decay relation (DDR) in rhizoplane was consistently lower than that in the rhizosphere for both communities, indicating weaker phylogenetic clustering in rice root surface. Our results have provided a better understanding of CH4 oxidation and emission in rice paddy fields and future agriculture management could take into consideration of the subtle variation among different soil compartments and interactions within methanogenic and methanotrophic communities. [ABSTRACT FROM AUTHOR]

The rice rhizosphere microbiota is crucial for crop yields and nutrient use efficiency. However, little is known about how co‐occurrence patterns, keystone taxa and functional gene assemblages relate to soil pH in the rice rhizosphere soils. Using shotgun metagenome analysis, the rice rhizosphere microbiome was investigated across 28 rice fields in east‐central China. At higher pH sites, the taxonomic co‐occurrence network of rhizosphere soils was more complex and compact, as defined by higher average degree, graph density and complexity. Network stability was greatest at medium pH (6.5 < pH < 7.5), followed by high pH (7.5 < pH). Keystone taxa were more abundant at higher pH and correlated significantly with key ecosystem functions. Overall functional genes involved in C, N, P and S cycling were at a higher relative abundance in higher pH rhizosphere soils, excepting C degradation genes (e.g. key genes involved in starch, cellulose, chitin and lignin degradation). Our results suggest that the rice rhizosphere soil microbial network is more complex and stable at higher pH, possibly indicating increased efficiency of nutrient cycling. These observations may indicate routes towards more efficient soil management and understanding of the potential effects of soil acidification on the rice rhizosphere system. [ABSTRACT FROM AUTHOR]

This case series reports familial cases of nodular oncocytic hyperplasia (NOH) diagnosed in a mother and her son, 15 years apart. A 39-year-old man presented in 2003 with a lump below his left ear. Magnetic resonance imaging (MRI) performed showed multifocal parotid nodules and a diagnosis of NOH was histopathologically confirmed following left total parotidectomy. Two years later, he represented with similar symptoms on the right side. NOH was diagnosed following excision of his right parotid gland. In 2018, his 73-year-old mother presented with left ear pain and a lump below her left ear. An MRI scan showed multiple lesions within both parotid glands and bilateral NOH was once again diagnosed following a left superficial parotidectomy and right total parotidectomy. We believe that this is the first reported case of bilateral familial NOH. [ABSTRACT FROM AUTHOR]

A chemical synthetic approach for the preparation of valine is presented by incorporating 13CHD2 isotopomers. The benefits of this approach in 13C side-chain relaxation measurements on the mouse major urinary protein selectively enriched with valine are illustrated.

A number of NMR studies were conducted to determine the structure of G protein-coupled receptors (GPCRs) based on rhodospin, which responds to photons and not chemical ligands. The resulting bicelles provide a fully hydrated bilayer environment that both immobilizes and aligns the proteins for solid-state NMR experiments.

The implementation of [13Cα,13C′,15N,2Hα] labelled amino acids into proteins allows the acquisition of high resolution triple resonance experiments. We present for the first time resonance assignments facilitated by this new labelling strategy. The absence of 1JCα,Cβ couplings enables us to measure 1JCα,C′ scalar and 1DCα,C′ residual dipolar coupling constants using modified HNCA experiments which do not suffer from sensitivity losses characteristic for 13C constant time experiments. [ABSTRACT FROM AUTHOR]

Elevational trends in the ecology of macroorganisms have been studied extensively; by contrast very little is known of such trends in microbial diversity. Previous studies on soil bacteria have found either a diversity decline, a 'peak' in mid altitudes, or no trend with increasing elevation. Here we studied bacterial diversity and community composition in relation to elevation on Mt. Halla, Jeju Island, South Korea, a massive shield volcano. Samples were taken along two transects, from 100 m.a.s.l. to the summit at 1950 m.a.s.l., at elevational intervals of 200 m. PCR-amplified soil DNA for the bacterial 16S rRNA gene targeting V1 to V3 region was 454-pyrosequenced, and taxonomically classified against EzTaxon-e database. Elevation was the best predictor of variation in bacterial community composition along the two transects, even when considering other soil parameters. Elevation was itself highly correlated with mean annual temperature (MAT) and mean annual precipitation (MAP), suggesting that soil bacterial community composition on Mt. Halla is more strongly affected by climate than by geochemical or soil textural factors. The two transects showed certain consistent differences in bacterial phyla composition, with one transect having significantly higher abundance of Planctomycetes and Gemmatimonadetes than the other. Certain other phyla (e.g. Acidobacteria) also showed striking trends in abundance with elevation, but the trends differed between the two transects. Bacterial diversity and richness were also most strongly correlated with elevation, MAT and MAP, although soil pH explained a part of the variation. Moreover, vegetation cover type, irrespective of elevation, had an effect on soil bacterial diversity and richness. We found a 'dip' in diversity at lower mid elevations (700-1300 m) in both transects; a trend which has not been found before. Our results, when compared with other studies, emphasize that no simple rule can be applied to mountain systems in general, but that climate itself is a major influence on community composition. [ABSTRACT FROM AUTHOR]

Abstract: Initial steps in the development of a suite of triple-resonance 1H/13C/15N solid-state NMR experiments applicable to aligned samples of 13C and 15N labeled proteins are described. The experiments take advantage of the opportunities for 13C detection without the need for homonuclear 13C/13C decoupling presented by samples with two different patterns of isotopic labeling. In one type of sample, the proteins are ∼20% randomly labeled with 13C in all backbone and side chain carbon sites and ∼100% uniformly 15N labeled in all nitrogen sites; in the second type of sample, the peptides and proteins are 13C labeled at only the α-carbon and 15N labeled at the amide nitrogen of a few residues. The requirement for homonuclear 13C/13C decoupling while detecting 13C signals is avoided in the first case because of the low probability of any two 13C nuclei being bonded to each other; in the second case, the labeled 13Cα sites are separated by at least three bonds in the polypeptide chain. The experiments enable the measurement of the 13C chemical shift and 1H–13C and 15N–13C heteronuclear dipolar coupling frequencies associated with the 13Cα and 13C′ backbone sites, which provide orientation constraints complementary to those derived from the 15N labeled amide backbone sites. 13C/13C spin-exchange experiments identify proximate carbon sites. The ability to measure 13C–15N dipolar coupling frequencies and correlate 13C and 15N resonances provides a mechanism for making backbone resonance assignments. Three-dimensional combinations of these experiments ensure that the resolution, assignment, and measurement of orientationally dependent frequencies can be extended to larger proteins. Moreover, measurements of the 13C chemical shift and 1H–13C heteronuclear dipolar coupling frequencies for nearly all side chain sites enable the complete three-dimensional structures of proteins to be determined with this approach. [Copyright &y& Elsevier]

The article discusses the creation of a media for nuclear magnetic resonance (NMR) spectroscopy of G protein-coupled receptors (GPCR) expressed in bacteria as fusion proteins. In the process, GPCR is purified, restructured in Dimyristoylphosphatidylcholine phospholipid vesicles, and added with short chain phospholipids to form bicelles. The bicelles in turn offers an environment for protein to immobilize and align. The protein structure is then mapped directly onto the spectra through NMR.

This case series reports familial cases of nodular oncocytic hyperplasia (NOH) diagnosed in a mother and her son, 15 years apart. A 39-year-old man presented in 2003 with a lump below his left ear. Magnetic resonance imaging (MRI) performed showed multifocal parotid nodules and a diagnosis of NOH was histopathologically confirmed following left total parotidectomy. Two years later, he represented with similar symptoms on the right side. NOH was diagnosed following excision of his right parotid gland. In 2018, his 73-year-old mother presented with left ear pain and a lump below her left ear. An MRI scan showed multiple lesions within both parotid glands and bilateral NOH was once again diagnosed following a left superficial parotidectomy and right total parotidectomy. We believe that this is the first reported case of bilateral familial NOH., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)