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Objectives: The excessive adduction of ventricular folds has been observed in patients with dysphonia and professional singers. Whether these changes in the ventricular folds are the cause or just a result of disease progression remains unclear, and their potential pathological and physiological implications are yet to be determined. This study aimed to examine the impact of different degrees of ventricular adduction on acoustics, aerodynamics, and vocal fold vibration. Methods: The excised models of mild and severe ventricular adduction were established. We recorded the vibration pattern of vocal folds and ventricular folds and measured acoustic metrics, including fundamental frequency (F0), Jitter, Shimmer, harmonic‐to‐noise ratio (HNR), and sound pressure level (SPL). Furthermore, we evaluated the aerodynamics index through phonation threshold pressure (PTP), phonation instability pressure (PIP), mean flow rate (MFR), phonation threshold flow (PTF), and phonation instability flow (PIF). Results: Irregular vibrations of the ventricular fold were observed during ventricular adduction. Notably, mild and severe ventricular adduction conditions showed a significant increase in PTP, Shimmer, and Jitter, whereas MFR, PIF, and HNR decreased compared with the control condition. Conclusions: Ventricular adduction leads to the deterioration of acoustic and aerodynamic parameters. The aperiodic and irregular vibration of the ventricular folds may be responsible for this phenomenon, although further experiments are warranted. Understanding the functioning of ventricular folds can be beneficial in directing the treatment of muscle tension dysphonia and improving voice training techniques. Level of evidence: level 4. [ABSTRACT FROM AUTHOR]

A novel fixation system for a hand‐held dynamometer (HHD) was designed to enable isometric muscle measurements on various muscle groups of strong, healthy individuals in a field setting. The objective of this study was to evaluate the intra‐ and interrater reliability of the system and determine its suitability for use by multiple researchers within large‐scale data collections during field activities. Four researchers tested eight healthy subjects, who each completed eight different maximal isometric muscle strength assessments using the HHD fixation system. Intraclass correlation coefficients (ICC) results were evaluated with a 95% confidence interval. ICC results for interrater reliability demonstrated excellent agreement of all eight measurements tested. ICC results for intrarater reliability demonstrated excellent agreement for six out of eight measurements. This system provides a new opportunity for several different high‐quality maximal muscle strength measurements to be collected by multiple data collectors on large numbers of strong, healthy individuals in a field setting. Highlights: This system is a reliable testing procedure that provides a new opportunity for several different high‐quality maximal muscle strength measurements.The system allows for laboratory quality data to be collected in the field by multiple data collectors on large numbers of strong, healthy individuals. [ABSTRACT FROM AUTHOR]

Glycans, carbohydrates, and glycoconjugates are involved in many crucial biological processes, such as disease development, immune responses, and cell–cell recognition. Glycans and carbohydrates are known for the large number of isomeric features associated with their structures, making analysis challenging compared with other biomolecules. Mass spectrometry has become the primary method of structural characterization for carbohydrates, glycans, and glycoconjugates. Metal adduction is especially important for the mass spectrometric analysis of carbohydrates and glycans. Metal‐ion adduction to carbohydrates and glycoconjugates affects ion formation and the three‐dimensional, gas‐phase structures. Herein, we discuss how metal‐ion adduction impacts ionization, ion mobility, ion activation and dissociation, and hydrogen/deuterium exchange for carbohydrates and glycoconjugates. We also compare the use of different metals for these various techniques and highlight the value in using metals as charge carriers for these analyses. Finally, we provide recommendations for selecting a metal for analysis of carbohydrate adducts and describe areas for continued research. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) pain management options are currently limited. Fasinumab, an anti‐nerve growth factor monoclonal antibody, has been investigated in healthy volunteers and patients with OA‐related pain, among other conditions. Data from 12 Phase I‐III clinical trials of 92 healthy volunteers and 7430 patients with OA were used to develop a population pharmacokinetic model to characterize fasinumab concentration‐time profiles and assess the covariates' effect on fasinumab pharmacokinetic parameters. Participants received single or repeated fasinumab doses intravenously (IV)/subcutaneously (SC), based on body weight (0.03‐1 mg/kg IV or 0.1‐0.3 mg/kg SC)/fixed dose (9‐12 mg IV or 1‐12 mg SC). Fasinumab concentration‐time data following IV and SC administration in healthy volunteers and patients with OA‐related pain were adequately described by a 2‐compartment model. Bioavailability increased with higher doses; estimated at 55.1% with 1 mg SC dose, increasing in a greater‐than‐proportional manner above this. Body weight had the largest predicted impact on fasinumab steady‐state exposures, participants at the 5th and 95th percentiles had a 43%‐45% higher/22%‐23% lower exposure versus reference, respectively. Other covariates had small but clinically irrelevant impacts. [ABSTRACT FROM AUTHOR]

Gait analysis offers vital insights into human movement, aiding in the diagnosis, treatment, and rehabilitation of various conditions. Analyzing gait in corridors, rather than in lab, provides unique advantages for a more comprehensive understanding of human locomotion. However, limited dedicated technologies constrain gait data analysis in this context. In this study, a markerless gait analysis system using an Azure Kinect sensor mounted on a mobile robot is proposed and validated as a potential solution for gait analysis in corridors. Ten healthy participants (4 males and 6 females) underwent two tests. The first test (5 trials per participant) took place in the laboratory. Here, Azure Kinect performance was validated against a Vicon system, assessing eight gait signals and 22 gait parameters. The second test (2 trials per participant) was performed in the corridors over a 32‐m walking distance to compare this gait pattern with the one developed within the laboratory. The intrasession Intraclass Correlation Coefficient (ICC) reliability for in‐lab experiments was assessed by calculating the ICC between gait cycles captured in each session per participant. Notably, knee flexion/extension (ICC‐0.95), hip flexion/extension (ICC‐0.96), pelvis rotation (ICC‐0.88), and interankle distance (ICC‐0.98) demonstrated excellent reliability with high confidence. Similarly, hip adduction/abduction showed good reliability (ICC‐0.79), while trunk rotation exhibited moderate reliability (ICC‐0.72). In contrast, both trunk tilt (ICC‐0.24) and pelvis tilt (ICC‐0.41) consistently displayed lower reliability. This was observed for both the Vicon and the Azure systems, highlighting the intricate nature of capturing precise data for these specific signals in both systems. Validity outcomes indicated comparable error rates to literature standards (12.68° $12.68^\circ $ knee flexion/extension, 5.54° $5.54^\circ $ hip flexion/extension, and 3.45° $3.45^\circ $ hip adduction/abduction), with 11 parameters having no significant differences from Vicon. Comparison of in‐lab and in‐corridor experiments show that individuals exhibit significantly longer stride time (1.10 s vs. 1.05 s), lower pelvis tilt (6.83° $6.83^\circ $ vs. 9.39° $9.39^\circ $), and lower minimum pelvis rotation (−5.82° $-5.82^\circ $ vs. −14.61° $-14.61^\circ $) when walking in the laboratory. This study demonstrates promising outcomes in outdoor gait analysis with a robot‐mounted camera, revealing significant distinctions from controlled laboratory evaluations [ABSTRACT FROM AUTHOR]

The hip joint is subjected to different loads, leading to hip stem failure from the crack nucleation to the final implant failure. The main objective of the present work is to assess hip stem damage due to pelvic positioning and femur movement. The three‐dimensional finite element analysis (3D FEA) was created to simulate the artificial hip joint subjected to static or cyclic loading. The fatigue crack growth rate in the hip stem was investigated based on the extended finite element method (XFEM) with the cycle fatigue approach. The femoral stem loosening during adduction and abduction movements, which may have occurred, was considered. The numerical results showed that the von Mises stress value increases as the loosening distance increases, which appears with the decrease of the cup positioning angle. Furthermore, the pelvic positioning does not affect the crack initiation site, while the loosening and femur movement affect the crack initiation site. On the other hand, the fatigue crack growth rate was affected by pelvic positioning, loosening, and femur movement. Highlights: The femur movement and loosening affect the crack initiation and FCGR.The loosening greatly affects the lifetime of the artificial hip joint.The pelvis movement affects the crack growth rate, not its initiation. [ABSTRACT FROM AUTHOR]

Prolonged sensory deprivation has repeatedly been linked to cortical reorganization. We recently demonstrated that individuals with congenital anosmia (CA, complete olfactory deprivation since birth) have seemingly normal morphology in piriform (olfactory) cortex despite profound morphological deviations in the orbitofrontal cortex (OFC), a finding contradictory to both the known effects of blindness on visual cortex and to the sparse literature on brain morphology in anosmia. To establish whether these unexpected findings reflect the true brain morphology in CA, we first performed a direct replication of our previous study to determine if lack of results was due to a deviant control group, a confound in cross sectional studies. Individuals with CA (n = 30) were compared to age and sex matched controls (n = 30) using voxel‐ and surface‐based morphometry. The replication results were near identical to the original study: bilateral clusters of group differences in the OFC, including CA atrophy around the olfactory sulci and volume increases in the medial orbital gyri. Importantly, no group differences in piriform cortex were detected. Subsequently, to assess any subtle patterns of group differences not detectable by our mass‐univariate analysis, we explored the data from a multivariate perspective. Combining the newly collected data with data from the replicated study (CA = 49, control = 49), we performed support vector machine classification based on gray matter volume. In line with the mass‐univariate analyses, the multivariate analysis could accurately differentiate between the groups in bilateral OFC, whereas the classification accuracy in piriform cortex was at chance level. Our results suggest that despite lifelong olfactory deprivation, piriform (olfactory) cortex is morphologically unaltered and the morphological deviations in CA are confined to the OFC. [ABSTRACT FROM AUTHOR]

Background: Lateral wedge insoles (both standalone and those incorporating individualized arch support) have been frequently studied for the effects on knee joint loading and pain in people with knee osteoarthritis. It has been shown that many people who use these insoles do not obtain the intended biomechanical effect, and thus may not experience a clinical benefit. The ability to identify biomechanical responders to lateral wedge insoles before research or clinical intervention is an important objective for efficient resource use and optimizing patient outcomes. The purpose of our exploratory, hypothesis-generating study was to provide an initial assessment of variables that are associated with the biomechanical response to lateral wedge insoles in people with knee osteoarthritis. Methods: We collected a number of demographic (age, sex, body mass index, foot posture), clinical (knee pain, foot pain, radiographic disease severity), and walking-related (speed, knee alignment, frontal plane subtalar movement, and foot rotation) outcomes from 53 individuals with painful, radiographically-confirmed knee osteoarthritis. The walking-related outcomes were obtained using equipment both from the research laboratory and the clinical setting. We used logistic regression to generate predictive models to determine candidate variables associated with a reduction in the knee adduction moment during walking – a surrogate for tibiofemoral load distribution, and a known biomechanical risk factor for osteoarthritis progression – with the use of standalone and arch-supported lateral wedge insoles. Three different response thresholds (2%, 6%, and 10% reductions in the knee adduction moment) were used. Results: In general, biomechanical responders were those who walked faster, were female, had less varus alignment, and had less severe radiographic severity. Findings were similar between the standalone and arch-supported lateral wedge insoles, as well as between models using the laboratory-derived or clinically-available measures of walking performance. Conclusions: Our hypothesis-generating study provides valuable information that will inform future research into the efficient and effective use of lateral wedge insoles in the conservative management of knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Purpose: Tibiofemoral Varus Malalignment (TFRV) contributes to overuse injuries by altering lower limb biomechanics. Both Posterior X Taping (PXT) and Real Time Feedback (RTF), have each been recommended for subjects with TFRV as they are thought to enhance control of excessive tibiofemoral rotations. This paper evaluates this claim. Methods: A total of recreational male 24 athletes with TFRV participated in the current study. Kinematic and electromyography variables of lower extremity were synchronously ​recorded on five consecutive repetitions of the single-legged-squat (SLS) and forward-step-down) FSD) tasks before and after applications of PXT and RTF. Results: The subjects at post-intervention in RTF group exhibited decreased hip adduction during FSD, and decreased hip adduction and internal rotation during eccentric and concentric phases of the SLS; Additionally, we observed increased gluteus medius activity during eccentric phase of the SLS and FSD tasks. In contrast, subjects at the post-intervention in PXT group exhibited decreased tibiofemoral external rotation and increased ankle external rotation during all the phases of both SLS and FSD tasks. Conclusion: These results suggest that the PXT and RTF interventions are recommended to immediately improve the functional defects of the subjects with TFRV during SLS and FSD tasks. [ABSTRACT FROM AUTHOR]

Background: and Purpose: Hereditary spastic paraplegias (HSP) are a group of clinically diverse genetic disorders that share the neurologic symptom of difficulty in walking due to progressive serious muscle weakness and spasticity in the legs. This study describes a physiotherapy program for improving the functional ability of a child diagnosed with complicated HSP and reports the treatment results. Methods: A 10‐year‐old boy with complicated HSP received a physiotherapy intervention that included strengthening of the leg muscles and treadmill training for 1 h per session, three to four times a week for 6 weeks. Outcome measures included sit‐to‐stand, 10‐m walk, 1‐min walk tests, and gross motor function measures (dimensions D and E). Results: After the intervention, the sit‐to‐stand, 1‐min walk, and 10‐m walk test scores improved by 6.75 times, 2.57 m, and 0.05 m/s, respectively. Furthermore, the gross motor function measure dimensions D and E scores improved by 8% (46%–54%) and 5% (22%–27%), respectively. The gains in each parameter were maintained at the 3‐ and 6‐month and 1‐year follow‐ups. Conclusion: These results suggest that structured physiotherapy programs can benefit the functional rehabilitation of children with complicated HSP. [ABSTRACT FROM AUTHOR]

Aim: To determine the movement features governing expert assessment of gait dystonia severity in individuals with cerebral palsy (CP). Method: In this prospective cohort study, three movement disorder neurologists graded lower extremity dystonia severity in gait videos of individuals with CP using a 10‐point Likert‐like scale. Using conventional content analysis, we determined the features experts cited when grading dystonia severity. Then, using open‐source pose estimation techniques, we determined gait variable analogs of these expert‐cited features correlating with their assessments of dystonia severity. Results: Experts assessed videos from 116 participants (46 with dystonia aged 15 years [SD 3] and 70 without dystonia aged 15 years [SD 2], both groups ranging 10–20 years old and 50% male). Variable limb adduction was most commonly cited by experts when identifying dystonia, comprising 60% of expert statements. Effect on gait (regularity, stability, trajectory, speed) and dystonia amplitude were common features experts used to determine dystonia severity, comprising 19% and 13% of statements respectively. Gait variables assessing adduction variability and amplitude (inter‐ankle distance variance and foot adduction amplitude) were significantly correlated with expert assessment of dystonia severity (multiple linear regression, p < 0.001). Interpretation: Adduction variability and amplitude are quantifiable gait features that correlate with expert‐determined gait dystonia severity in individuals with CP. Consideration of these features could help optimize and standardize the clinical assessment of gait dystonia severity in individuals with CP. [ABSTRACT FROM AUTHOR]

Objective: In this Mendelian randomization (MR) study, the objective was to investigate the causal effect of metabolically different adiposity subtypes on osteoarthritis. Methods: We performed 2‐sample MR using summary‐level data for osteoarthritis (10,083 cases and 40,425 controls) from a genome‐wide association using the UK Biobank, and for site‐specific osteoarthritis from the Arthritis Research UK Osteoarthritis Genetics consortium. We used 3 classes of genetic instruments, which all increase body mass index but are associated with different metabolic profiles (unfavorable, neutral, and favorable). Primary analysis was performed using inverse variance weight (IVW), with additional sensitivity analysis from different MR methods. We further applied a nonlinear MR using UK Biobank data to understand the nature of the adiposity–osteoarthritis relationship. Results: Greater metabolically unfavorable and metabolically neutral adiposity were associated with higher odds of osteoarthritis (IVW odds ratio [OR] 1.56 [95% confidence interval (95% CI) 1.31, 1.85] and OR 1.60 [95% CI 1.15, 2.23], respectively). The estimate for the association between metabolically favorable adiposity and osteoarthritis was similar, although with notable imprecision (OR 1.55 [95% CI 0.70, 3.41]). Using site‐specific osteoarthritis, metabolically unfavorable, neutral, and favorable adiposity were all associated with higher odds of knee osteoarthritis (OR 1.44 [95% CI 1.04, 1.98], OR 2.28 [95% CI 1.04, 4.99], and OR 6.80 [95% CI 2.08, 22.19], respectively). We found generally consistent estimates with a wider confidence interval crossing the null from other MR methods. The nonlinear MR analyses suggested a nonlinear relationship between metabolically unfavorable adiposity and osteoarthritis (Pnonlinear = 0.003). Conclusion: Metabolic abnormalities did not explain the association between greater adiposity and the risk of osteoarthritis, which might suggest that the association is largely due to a mechanical effect on the joints. [ABSTRACT FROM AUTHOR]

Torsional profiles of the lower limbs, such as femoral anteversion, can dictate gait and mobility, joint biomechanics and pain, and functional impairment. It currently remains unclear how the interactions between femoral anteversion, kinematics, and muscle activity patterns contribute to joint biomechanics and thus conditions such as knee pain. This study presents a computational modeling approach to investigating the interactions between femoral anteversion, muscle forces, and knee joint loads. We employed an optimal control approach to produce actuator and muscle‐driven simulations of the stance phase of gait for femoral anteversion angles ranging from −8° (retroversion) to 52° (anteversion) with a typically developing baseline of 12° of anteversion and implemented a Monte Carlo analysis for variations in lower limb muscle forces. While total patellofemoral joint load decreased with increasing femoral anteversion, patellofemoral joint load alignment worsened, and knee abduction/adduction magnitude increased with both positive and negative changes in femoral anteversion (p < 0.001). The rectus femoris muscle was found to greatly influence patellofemoral joint loads across all femoral anteversion alignments (R > 0.8, p < 0.001), and the medial gastrocnemius was found to greatly influence knee abduction/adduction moments for the extreme version cases (R > 0.74, p < 0.001). Along with the vastus lateralis, which decreased with increasing femoral anteversion (R = 0.89, p < 0.001), these muscles are prime candidates for future experimental and clinical efforts to address joint pain in individuals with extreme femoral version. These findings, along with future modeling efforts, could help clinicians better design treatment strategies for knee joint pain in populations with extreme femoral anteversion or retroversion. [ABSTRACT FROM AUTHOR]

Objective: The outcome of congenital clubfoot treatment is still challenging if the feet deformities are not completely corrected. Here we explore a minimal invasive procedure with an eight‐plate implant to correct the residual forefoot adduction deformity after treatment of neglected or relapsed clubfoot. Methods: We retrospectively reviewed patients with residual forefoot adduction deformity after clubfoot treatment between January 2013 and June 2016. The patients underwent temporary epiphysiodesis of the lateral column of the mid‐foot, which in detail, an eight‐plate was placed on each side of the calcaneocuboid joint. The foot deformities were recorded according to the weight‐bearing radiographic measurements including talo‐first metatarsal angle, calcaneo‐fifth metatarsal angle and medial‐to‐lateral column length. Results: A total of 13 patients (20 feet) with an average age of 7.8 years old were located with an average duration of 40.8 months follow‐up (range, 28 to 54 months). The average talo‐first metatarsal angle improved from 28.3° (range, 19° to 47°) preoperatively to 8.3° (range, 3° to 18°) and the calcaneo‐fifth metatarsal angle improved from 29.1° (range, 19° to 40°) preoperatively to 8.4° (range, 0° to 21°) at final follow‐up. The mean ratio of the medial‐to‐lateral column length improved from 1.14 ± 0.06 to 1.55 ± 0.09 with statistical significance (t = 3.566; P < 0.001). Conclusions: Eight‐plate epiphysiodesis is an easy and effective method for the correction of residual forefoot adduction deformity after clubfoot treatment in growing children without the need of osteotomy. [ABSTRACT FROM AUTHOR]

This article discusses the determinants of gait dystonia severity in individuals with cerebral palsy (CP). Dystonia, a movement condition, is often under-diagnosed in people with CP, particularly in the legs. The study found that only 13% of people with CP and leg dystonia had their condition diagnosed during a CP clinic visit. Expert clinicians identified leg adduction variability and amplitude as the key features used to diagnose and determine the severity of dystonia. The article suggests that recognizing these features can aid clinicians and individuals with CP in diagnosing dystonia more effectively. [Extracted from the article]

Nine months after anterior cruciate ligament (ACL) reconstruction, athletes who undergo surgery using a bone‐patellar‐tendon‐bone (BPTB) autograft demonstrate higher loading asymmetries during vertical jumping than those with a hamstring tendon (HT) autograft. These asymmetries may transfer into sporting movements with a greater ACL injury risk. The aim of this study was to compare between‐limb asymmetries in knee mechanics and task performance during an unplanned 90° change‐of‐direction (CoD) task in male field sport athletes reconstructed with BPTB or HT autografts. Seventy‐eight male multidirectional field sport athletes with either a BPTB (n = 39) or HT (n = 39) autograft completed maximal unplanned CoD trials in a three‐dimensional motion capture laboratory at approximately 9 months post‐surgery. A mixed‐model 2x2 ANOVA (autograft type x limb) was used to compare variables related to ACL injury risk (e.g., internal knee moments) and performance (e.g., completion time) between autografts and limbs. Statistical parametric mapping was used for a waveform comparison throughout stance, supplemented with a discrete point analyses of peak knee moments and performance variables. Interaction effects were found at the knee joint, with BPTB demonstrating greater asymmetries than HT in knee extension moment (p < 0.001); resultant ground reaction force (p < 0.001); peak knee external rotation moment (p = 0.04); and knee adduction (p = 0.05), medial rotation (p < 0.001), and flexion (p < 0.001) angles. No differences were found between autografts for any performance variable. BPTB demonstrated greater lower‐limb biomechanical asymmetries than HT during CoD, which may influence knee loading and longer‐term outcomes and should thus be targeted during rehabilitation prior to return to play. [ABSTRACT FROM AUTHOR]

Purpose: Several cytokines and growth factors start and progress the destruction process of joint hyaline cartilage and fibrosis formation. Captopril is classified as an Angiotensin-converting enzyme inhibitor in which several studies revealed that captopril significantly decreases fibrosis formation in some organs like the liver, heart, and kidney. This study aimed to evaluate the use of captopril in reducing the possibility of arthrofibrosis and osteoarthritis in an animal model. Method: In this in-vivo animal model study, the anterior cruciate ligament of 24 rabbits was transected to induce osteoarthritis and arthrofibrosis. The control group contained 11 rabbits and the second group consisted of 13 rabbits. The second group was treated with 10 mg/ kilogram/day captopril through a nasogastric tube. The control group was treated with normal saline in the same way. Cartilage damage and osteoarthritis were evaluated by Osteoarthritis Research Society International (OARSI) scoring system. After 30 days, animals were sacrificed, and arthrofibrosis and cartilage damage were evaluated microscopically and macroscopically. Results: According to macroscopic and microscopic evaluation, captopril dramatically reduced arthrofibrosis formation based on visual scoring and the Masson trichrome staining system. Cartilage damage was lower in the intervention group compared to the control group. Conclusions: Captopril is an angiotensin-converting enzyme inhibitor that demonstrated to significantly decreases the possibility of arthrofibrosis. Although the beneficial preventive effect of captopril on osteoarthritis was not proved statistically, better results may be obtained if the route of administration or drug dosage is changed. [ABSTRACT FROM AUTHOR]

In seasonal environments subject to climate change, organisms typically show phenological changes. As these changes are usually stronger in organisms at lower trophic levels than those at higher trophic levels, mismatches between consumers and their prey may occur during the consumers' reproduction period. While in some species a trophic mismatch induces reductions in offspring growth, this is not always the case. This variation may be caused by the relative strength of the mismatch, or by mitigating factors like increased temperature‐reducing energetic costs. We investigated the response of chick growth rate to arthropod abundance and temperature for six populations of ecologically similar shorebirds breeding in the Arctic and sub‐Arctic (four subspecies of Red Knot Calidris canutus, Great Knot C. tenuirostris and Surfbird C. virgata). In general, chicks experienced growth benefits (measured as a condition index) when hatching before the seasonal peak in arthropod abundance, and growth reductions when hatching after the peak. The moment in the season at which growth reductions occurred varied between populations, likely depending on whether food was limiting growth before or after the peak. Higher temperatures led to faster growth on average, but could only compensate for increasing trophic mismatch for the population experiencing the coldest conditions. We did not find changes in the timing of peaks in arthropod availability across the study years, possibly because our series of observations was relatively short; timing of hatching displayed no change over the years either. Our results suggest that a trend in trophic mismatches may not yet be evident; however, we show Arctic‐breeding shorebirds to be vulnerable to this phenomenon and vulnerability to depend on seasonal prey dynamics. [ABSTRACT FROM AUTHOR]

Purpose: Dynamic radiostereometric analysis (dRSA) enables precise non-invasive three-dimensional motion-tracking of bones for assessment of joint kinematics. Hereby, the biomechanical effects of arthroscopic osteochondroplasty of the hip (ACH) can be evaluated in patients with femoroacetabular impingement (FAI). The aim was to investigate the pre- and postoperative range of motion (ROM) and the CT bone volume removed (BV) after ACH. We hypothesize increase in ROM 1 year after surgery. Methods: Thirteen patients (6 female) with symptomatic FAI were included prospectively. The patient's hips were CT-scanned and CT-bone models were created. Preoperative dRSA recordings were acquired during passive flexion to 90°, adduction, and internal rotation (FADIR). ACH was performed, CT and dRSA were repeated 3 months and 1 year postoperatively. Hip joint kinematics before, and 3 months and 1 year after ACH were compared pairwise. The bone volume removal was quantified and compared to change in ROM. Results: Mean hip internal rotation, adduction and flexion were all unchanged after ACH at 1-year follow-up (p > 0.84). HAGOS scores revealed improvement of quality of life (QOL) from 32 to 60 (p = 0.02). The BV was between 406 and 1783 mm3 and did not correlate to post-operative ROM. Conclusions: ACH surgery in FAI patients had no impact of ROM at 1-year follow-up. QOL improved significantly. This indicates that the positive clinical effects reported after ACH might be a result of reduced labral stress and cartilage pressure during end-range motion rather than increased ROM. Level of evidence: Therapeutic prospective cohort study, level II. [ABSTRACT FROM AUTHOR]

Quantifying asymmetries between dominant and non‐dominant limbs is a common research objective aimed at identifying systematic differences between limbs and establishing normative ranges of asymmetry. Multiple methods for classifying limb dominance exist, and it is unclear how different methods relate to directional asymmetries during change of direction (CoD). This study aimed to determine whether different methods of classifying limb dominance, including a novel CoD task‐specific method, identified significant inter‐limb asymmetries during a 90° CoD task. Fifty participants completed a testing battery consisting of jumping, hopping, CoD, and isokinetic dynamometry. Limb dominance was classified for each participant according to preferred kicking limb, vertical jump height, horizontal hop distance, initial force plate contact during landing, max isokinetic knee extensor strength, and turning velocity. Asymmetries in whole‐body and joint‐level mechanics were defined using each method. No method for classifying limb dominance was associated with consistent inter‐limb biomechanical asymmetries during CoD, and no method was related to any other method. The magnitude of asymmetry relative to the magnitude of absolute asymmetry present within the cohort suggests that using these tasks to classify the dominant limb in this CoD is akin to assigning dominance to a randomly selected limb. Previous observations of group symmetry during CoD may be statistical artifacts as opposed to a true indication of normative movement. Until an appropriate means of classifying limbs during CoD is established, quantifying normative asymmetry based on limb dominance should be done with caution. [ABSTRACT FROM AUTHOR]

Objective: To investigate effects of foot progression angle (FPA) modification on the first and second peaks of external knee adduction moment (EKAM) and knee adduction angular impulse (KAAI) in individuals with and without medial knee osteoarthritis (OA) during level walking. Methods: PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and SPORTDiscus were searched from inception to February 2020 by 2 independent reviewers. Included studies compared FPA modification (toe‐in or toe‐out gait) interventions to lower EKAM and/or KAAI with natural walking. Studies were required to report the first or second peaks of EKAM or KAAI. Results: Sixteen studies were included, and >85% of included patients were graded with Kellgren/Lawrence grade II–IV knee OA. Toe‐in gait reduced the first EKAM peak (standardized mean difference [SMD] –0.75 [95% confidence interval (95% CI) –1.05, –0.45]) and KAAI (SMD –0.46 [95% CI –0.86, –0.07]), while toe‐out gait reduced the second EKAM peak (SMD –1.04 [95% CI –1.34, –0.75]) in healthy individuals. For patients with knee OA, toe‐out gait reduced the second EKAM peak (SMD –0.53 [95% CI –0.75, –0.31]) and KAAI (SMD –0.26 [95% CI –0.49, –0.03]), while toe‐in gait did not affect both EKAM peaks and KAAI. Conclusion: Discrepancy in biomechanical effects of FPA modification was demonstrated between individuals with and without medial knee OA. Compared with natural walking, both toe‐in and toe‐out gait may be more effective in lowering EKAM and KAAI in healthy individuals. Toe‐out gait may reduce EKAM and KAAI in patients with mild‐to‐severe knee OA. There is insufficient data from patients with early‐stage knee OA, indicating that future research is required. [ABSTRACT FROM AUTHOR]

Intra‐articular injection of mesenchymal stem cells has shown benefit for the treatment of osteoarthritis (OA). However, mesenchymal stem/stromal cells at the origin of these clinical results are heterogenous cell populations with limited cellular characterization. Here, two transgenic reporter mice were used to examine the differential effects of two precisely defined perivascular cell populations (Pdgfrα+ and Pdgfrβ+ cells) from white adipose tissue for alleviation of OA. Perivascular mesenchymal cells were isolated from transgenic Pdgfrα‐and Pdgfrβ‐CreERT2 reporter animals and delivered as a one‐time intra‐articular dose to C57BL/6J mice after destabilization of the medial meniscus (DMM). Both Pdgfrα+ and Pdgfrβ+ cell preparations improved metrics of cartilage degradation and reduced markers of chondrocyte hypertrophy. While some similarities in cell distribution were identified within the synovial and perivascular spaces, injected Pdgfrα+ cells remained in the superficial layers of articular cartilage, while Pdgfrβ+ cells were more widely dispersed. Pdgfrβ+ cell therapy prevented subchondral sclerosis induced by DMM, while Pdgfrα+ cell therapy had no effect. In summary, while both cell therapies showed beneficial effects in the DMM model, important differences in cell incorporation, persistence, and subchondral sclerosis were identified. [ABSTRACT FROM AUTHOR]

Background: Lateral wedge insoles (LWI), standalone or with medial arch support (supported-LWI), have been thoroughly investigated for their effects on modifying gait biomechanics for people with knee osteoarthritis. However, plantar pressure distribution between these insole types has not been investigated and could provide insight towards insole prescription with concomitant foot symptoms taken into consideration. Methods: In a sample of healthy individuals (n = 40), in-shoe plantar pressure was measured during walking with LWI, with or without medial arch support (variable- and uniform-stiffness designs), and a flat control insole condition. Pressure data from the plantar surface of the foot were divided into seven regions: medial/lateral rearfoot, midfoot, medial/central/lateral forefoot, hallux. Plantar pressure outcomes assessed were the medial-lateral pressure index (MLPI) for the whole foot, and the peak pressure, pressure-time integral (PTI), and contact area in each plantar region. Comfort in each insole condition was rated as a change relative to the flat control insole condition. Repeated-measures analyses of variance were calculated to compare the plantar pressure outcomes between insole conditions. Results: Regionally, medial rearfoot and forefoot pressure were reduced by all wedged insoles, with the variable-stiffness supported-wedge showing greater reductions than the standalone wedge. Lateral rearfoot and forefoot pressure were reduced by both supported-LWI, but unchanged by the standalone wedge. In the midfoot, the standalone wedge maintained pressure but reduced regional contact area, while both supported-LWI increased midfoot pressure and contact area. All LWI increased the MLPI, indicating a lateral shift in plantar pressure distribution throughout the weightbearing phase of gait. Comfort ratings were not significantly different between insole conditions. Conclusions: Regional differences in plantar pressure may help determine an appropriate lateral wedge insole variation to avoid exacerbation of concomitant foot symptoms by minimizing pressure in symptomatic regions. Lateral shifts in plantar pressure distribution were observed in all laterally wedged conditions, including one supported-LWI that was previously shown to be biomechanically ineffective for modifying knee joint load distribution. Thus, shifts in foot centre of pressure may not be a primary mechanism by which LWI can modify knee joint load distribution for people with knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Epigenetic factors, such as DNA methylation, play an influential role in the development of the degenerative joint disease osteoarthritis (OA). These molecular mechanisms have been heavily studied in humans, and although OA affects several other animals in addition to humans, few efforts have taken an evolutionary perspective. This study explores the evolution of OA epigenetics by assessing the relationship between DNA methylation variation and knee OA development in baboons (Papio spp.) and by comparing these findings to human OA epigenetic associations. Genome‐wide DNA methylation patterns were identified in bone and cartilage of the right distal femora from 56 pedigreed, adult baboons (28 with and 28 without knee OA) using the Illumina Infinium MethylationEPIC BeadChip. Several significantly differentially methylated positions (DMPs) and regions were found between tissue types. Substantial OA‐related differential methylation was also identified in cartilage, but not in bone, suggesting that cartilage epigenetics may be more influential in OA than bone epigenetics. Additionally, some genes containing OA‐related DMPs overlap with and display methylation patterns similar to those previously identified in human OA, revealing a mixture of evolutionarily conserved and divergent OA‐related methylation patterns in primates. Overall, these findings reinforce the current etiological perspectives of OA and enhance our evolutionary understanding of epigenetic mechanisms associated with OA. This study further establishes baboons as a valuable nonhuman primate model of OA, and continued investigations in baboons will help to disentangle the molecular mechanisms contributing to OA and their evolutionary histories. [ABSTRACT FROM AUTHOR]

Aim: Previous studies have provided evidence linking the DPEP1 gene to the risk of osteoarthritis (OA) in Europeans. In this study, we aimed to examine the relationship between DPEP1 gene and the susceptibility and clinical severity of OA in a Chinese Han population. Methods: This study comprised two independent samples. For the discovery stage, 1022 patients with knee OA and 1864 controls were recruited. Fourteen tag single nucleotide polymorphisms (SNPs) covering the DPEP1 gene were selected and genotyped. Associated SNPs in the discovery data set were subsequently genotyped in the replication data set consisting of 826 hip OA cases and 1662 controls. Both genotypic and allelic genetic associations were tested. The relationship of significant SNPs to the expression of DPEP1 and its neighboring genes was examined using the GTEx database. Results: A nonsynonymous SNP, rs1126464, was determined to be associated with the disease status of OA in both the discovery and replication stages (odds ratio [OR] 0.75, 95% confidence interval [95% CI] 0.68‐0.82, P = 7.16 × 10−11). This SNP was further characterized as being significantly related to a higher Kellgren‐Lawrence grade in OA patients (OR 0.64, 95% CI 0.55‐0.74, P = 2.53 × 10−9). According to the GTEx data, SNP rs1126464 was significantly related to the gene expression of 15 genes in multiple types of human tissues. Conclusion: We reported a common DNA variant in the DPEP1 gene that contributes to the risk of OA, providing additional evidence that the DPEP1 gene plays a significant role in the pathological mechanisms of OA. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) is a common cause of disability, especially among the elderly. With an ageing and increasingly obese population, OA will become more prevalent. Obesity and metabolic syndrome are risk factors for OA and have been implicated in its pathogenesis. The gut microbiome may shed light on this possible common pathogenesis. Recent animal and human studies have gained important insights into the relationship between OA, obesity, and the gut microbiome. Animal studies have demonstrated links between obesity and increased severity of OA and altered gut microbial DNA profile. Use of prebiotics and probiotics in animal trials provides proof‐of‐concept that interventional options to the gut microbiome can modulate the progression of OA favorably. Current evidence in human studies is limited. Shifts in gut microbial profile and reduced gut microbial diversity have been associated with people with OA, as well as blood and synovial fluid lipopolysaccharide endotoxemia. Linkages between microbiome dysbiosis and host responses may help in the understanding of OA pathogenesis and the discovery of therapeutic targets. This narrative review provides a summary of up‐to‐date animal and human studies on the gut microbiome and its link with OA. [ABSTRACT FROM AUTHOR]

The pectoralis major fiber regions contribute uniquely to the mobility and the stability of the shoulder complex. It is unknown how age and sex influence the stiffness of these regions during volitional contractions, but this knowledge is critical to inform clinical interventions targeting the pectoralis major. The aim of the present study was to determine if the activation‐dependent stiffness of the pectoralis major fiber regions differs between the sexes and if it is altered with age. Ultrasound shear wave elastography was used to acquire shear wave velocity from the clavicular and the sternocostal fiber regions of 48 healthy participants, including 24 younger (12 males, 12 females, mean ± SD age 25 ± 4.1 years) and 24 older adults (12 males, 12 females, 55 ± 3.6 years). Participants performed vertical adduction and horizontal flexion torques in neutral and 90° externally rotated shoulder positions, and one of the two shoulder abduction positions (60° and 90°) at varying torque magnitudes (passive, 15% and 30% of maximal voluntary contraction). Separate linear mixed‐effects models were run for each fiber region and shoulder position to determine if the activation‐dependent stiffness differed between the sexes and was altered in older adults. Age‐related alterations in stiffness during volitional contractions were observed in both fiber regions and were dependent on the task. Alterations in activation‐dependent stiffness due to age were more pronounced in females than males. Additionally, females had greater stiffness than males during volitional contractions in both fiber regions. The present findings provide the first line of evidence that the activation‐dependent stiffness of the pectoralis major fiber regions is influenced by sex and changes with age. [ABSTRACT FROM AUTHOR]

Purpose: Despite practised for decades, the planning of osteotomy around the knee, commonly using the Mikulicz-Line, is only empirically based, clinical outcome inconsistent and the target angle still controversial. A better target than the angle of frontal-plane static leg alignment might be the external frontal-plane lever arm (EFL) of the knee adduction moment. Hypothetically assessable from frontal-plane-radiograph skeleton dimensions, it might depend on the leg-alignment angle, the hip-centre-to-hip-centre distance, the femur- and tibia-length. Methods: The target EFL to achieve a medial compartment force ratio of 50% during level-walking was identified by relating in-vivo-measurement data of knee-internal loads from nine subjects with instrumented prostheses to the same subjects' EFLs computed from frontal-plane skeleton dimensions. Adduction moments derived from these calculated EFLs were compared to the subjects' adduction moments measured during gait analysis. Results: Highly significant relationships (0.88 ≤ R2 ≤ 0.90) were found for both the peak adduction moment measured during gait analysis and the medial compartment force ratio measured in vivo to EFL calculated from frontal-plane skeleton dimensions. Both correlations exceed the respective correlations with the leg alignment angle, EFL even predicts the adduction moment's first peak. The guideline EFL for planning osteotomy was identified to 0.349 times the epicondyle distance, hence deducing formulas for individualized target angles and Mikulicz-Line positions based on full-leg radiograph skeleton dimensions. Applied to realistic skeleton geometries, widespread results explain the inconsistency regarding correction recommendations, whereas results for average geometries exactly meet the most-consented "Fujisawa-Point". Conclusion: Osteotomy outcome might be improved by planning re-alignment based on the provided formulas exploiting full-leg-radiograph skeleton dimensions. [ABSTRACT FROM AUTHOR]

Mass spectrometry (MS) promises small‐metabolite profiling as a tool of the future and calls for the comprehensive understanding of key procedures to enhance its capability. Herein, we studied cation adduction and fragmentation of small metabolites by a combination of theoretical and experimental approaches, via nanoparticle‐assisted laser desorption/ionization (LDI)‐MS and MS/MS. We calculated the energies of adduction conformers and atomic bond orders to establish the rules of cation–metabolite affinity and multiple cation adductions in charge transfer. Further, we demonstrated the reaction paths of adducted ions and mapped the potential energy surfaces to characterize the loss of given groups during fragmentation. Finally, we successfully controlled metabolite fragmentation by selected and multiple adductions to enhance the atomic/fragment coverage as defined for metabolite identification toward profiling. Considering the success of MS in the analysis of large biomolecules, our work may have an impact and guide to advanced analysis of small metabolites. [ABSTRACT FROM AUTHOR]

Summary: A 3‐year‐old Warmblood gelding was evaluated for intermittent respiratory distress and an inspiratory noise. These signs were mainly observed at exercise but sometimes occurred at rest as well. At the age of 2 months, a severe episode of respiratory distress had necessitated a temporary tracheotomy, which had then healed uneventfully. Examination of the patient and resting endoscopy revealed no structural laryngeal alterations. Exercise endoscopy revealed episodes of active bilateral laryngeal adduction during inspiration. Spirometrically, a corresponding impairment of inspiratory airflow was identified. These abnormalities were most pronounced at the trot but they occurred at magnitudes of inspiratory airflow lower than those inducing dynamic arytenoid collapse in horses with recurrent laryngeal neuropathy. Therefore, the diagnosis of a laryngeal dyskinesia characterised by an active bilateral arytenoid adduction during inspiration was made. No specific treatment was implemented. Three years later, the owner reported that the condition was markedly improved and the horse was used for pleasure riding. [ABSTRACT FROM AUTHOR]

Introduction: Knee osteoarthritis (OA) is characterized by pain and functional deficits. Common conservative strategies include medications, physical therapy, and intra‐articular injections. Recently, treatment using autologous cell injections has increased. Objective: To characterize the cellular content of bone marrow aspirate (BMA) and to evaluate the effect of intra‐articular autologous BMA injections in patients with mild knee OA. Design: Prospective pilot observational study. Setting: Academic institution. Patients: Eleven patients with unilateral or bilateral mild knee OA (15 knees) were included in the cellular analysis. Ten patients (13 knees) were included in the overall (cellular and clinical) analysis. Interventions: BMA was aspirated from patients' iliac crests and then injected intra‐articularly under fluoroscopic and/or ultrasound guidance. BMA samples were analyzed using flow cytometry, colony forming unit (CFU) assays, and enzyme‐linked immunosorbent assays. Questionnaires assessing pain and function were administered preinjection and at 1, 3, 6, and 12 months postinjection. Side effects and satisfaction were assessed. Main Outcome Measures: Total nucleated cell (TNC) concentration, mesenchymal stem cell (MSC) concentration, CFU count, and interleukin‐1 receptor antagonist (IL‐1Ra) concentration. Results: BMA sample analyses revealed wide ranges in TNC concentration (173300‐4 491 050 cells/mL), MSC concentration (0‐500 cells/mL), CFUs (0‐19), and IL‐1Ra concentration (2806‐29 394 pg/mL). Improvements in Knee Injury and Osteoarthritis Outcomes Score for Joint Replacement were observed throughout the 12‐month follow‐up period (F[4,12] = 12.29, P <.001). Additionally, current, usual, best, and worst numerical rating scale pain scores significantly decreased over time (P <.001). Patient satisfaction was high (range: 8.1 ± 2.1‐8.8 ± 1.9), and side effects were uncommon. Conclusions: The cellular content of BMA samples varied widely between patients and was lower than the anticipated yield reported by the device's manufacturer. However, intra‐articular BMA injections for knee OA in a small pilot cohort appeared to be safe with potential therapeutic value. Larger, prospective, double‐blinded studies are warranted. [ABSTRACT FROM AUTHOR]

This study aimed to determine if changes in knee adduction moment (KAM) after 6 months of variable‐stiffness shoe wear are associated with changes in symptoms or serum levels of cartilage oligomeric matrix protein (COMP) following a mechanical stimulus in subjects with medial knee osteoarthritis (OA). Twenty‐five subjects were enrolled in the study and assigned a variable‐stiffness shoe, and 19 subjects completed the 6‐month follow‐up. At baseline and follow‐up subjects underwent gait analysis in control and variable‐stiffness shoes, completed Western Ontario and McMaster Universities (WOMAC) questionnaires, and serum COMP concentrations were measured immediately before, 3.5 and 5.5 hours after a 30‐minute walking activity. Relationships between changes in KAM (first peak and impulse) and changes in (a) COMP levels in response to the 30‐minute walking activity and (b) WOMAC scores from baseline to 6‐month follow‐up were assessed by Pearson correlation coefficients. Changes in first peak KAM were associated with changes in COMP levels 5.5 hours postactivity from baseline to follow‐up (R =.564, P =.045). Subjects with greater reductions in KAM had larger decreases in COMP (expressed as a percent of preactivity levels) at follow‐up. Subjects with greater reductions in KAM impulse had significantly greater improvements in WOMAC Pain (R = −.56, P =.015) and Function (R = −.52, P =.028) scores at follow‐up. The study results demonstrated the magnitude of reduction in the KAM wearing a variable‐stiffness shoe is associated with decreases in mechanically stimulated COMP levels and pain/function. This work suggests that interactions between COMP and joint loading during walking should be further investigated in future studies of treatment outcomes in OA. [ABSTRACT FROM AUTHOR]

Activating transcription factor 4 (ATF4) is critical for chondrocyte proliferation and bone formation. Exosomes are considered as promising gene‐delivery vehicles for the treatment of osteoarthritis (OA). This study utilized the serum‐derived exosomes from OA mice as the gene‐delivery vehicles for ATF4 gene therapy and explored their therapeutic effects on OA. Meniscus injury‐induced OA model was established by the excision of anterior part of medial meniscus in the right knee of C57BL/6J mice. Exosomes were isolated from serum samples of sham and OA mice, and were referred to as sham‐Exo and OA‐Exo, respectively. ATF4‐overexpressing OA‐Exo (ATF4‐OA‐Exo) was developed by introducing ATF4 mRNA into OA‐Exo via electroporation. Four weeks after surgery, OA mice received intra‐articular injections of sham‐Exo, OA‐Exo, and ATF4‐OA‐Exo, respectively. The results showed that intra‐articular injection of ATF4‐OA‐Exo alleviated articular cartilage degeneration or damage and inflammatory response of OA mice. Autophagy was weakened in knee joint cartilage of OA mice, which was partially restored by intra‐articular injection of ATF4‐OA‐Exo. Further in vitro assays revealed that ATF4‐OA‐Exo promoted chondrocyte autophagy and inhibited chondrocyte apoptosis in the TNF‐α‐ or tunicamycin‐treated chondrocytes. Together, ATF4‐modified serum exosomes derived from OA mice protect cartilage and alleviate OA progression by inducing autophagy. [ABSTRACT FROM AUTHOR]

During osteoarthritis, chondrocytes change their spatial arrangement from single to double strings, then to small and big clusters. This change in pattern has recently been established as an image‐based biomarker for osteoarthritis. The pericellular matrix (PCM) appears to degrade together alongside cellular reorganization. The aim of this study was to characterize this PCM‐degradation based on different cellular patterns. We additionally wanted to identify the earliest time point of PCM‐breakdown in this physiopathological model. To this end, cartilage samples were selected according to their predominant cellular pattern. Qualitative analysis of PCM degradation was performed immunohistochemically by analysing five main PCM components: collagen type VI, perlecan, collagen type III, biglycan, and fibrillin‐1 (n = 6 patients). Their protein content was quantified by enzyme‐linked immunosorbent assay (127 patients). Accompanying spatial cellular rearrangement, the PCM is progressively destroyed, with a pericellular signal loss in fluorescence microscopy for collagen type VI, perlecan, and biglycan. This loss in protein signal is accompanied by a reduction in total protein content from single strings to big clusters (P <.001 for collagen type VI, P =.003 for perlecan, and P <.001 for biglycan). As a result of an increase in the number of cells from single strings to big clusters, the amount of protein available per cell also decreases for collagen type III and fibrillin‐1, where total protein levels remain constant. Biochemical changes of the PCM and cellular rearrangement are thus highly interconnected hallmarks of osteoarthritis. Interestingly, the earliest point in time for a relevant PCM impairment appears to be at the transition to small clusters. [ABSTRACT FROM AUTHOR]

Aim: Osteoarthritis (OA) is a chronic degenerative joint disease. Early studies have indicated that genetic and environmental factors contribute to the risk of OA. However, the etiology of OA remains unknown. Our study aimed to evaluate the association of DNMT3B gene with the risk of hip OA in Han Chinese individuals. Methods: A total of 2070 subjects were recruited into the study, including 658 patients with hip OA and 1412 healthy controls. Twelve tag single nucleotide polymorphisms (SNPs) were selected and genotyped in our samples. Genetic associations between DNMT3B gene and the risk of hip OA were examined at both the single marker and haplotype levels. Cis‐expression quantitative trait loci signals that achieve genome‐wide significance of targeted SNPs from multiple types of human tissues were extracted from the GTEx database. Results: Significant signals were identified for SNP rs2424905 in 4 genetic models. The T allele was significantly associated with an increased risk of hip OA (odds ratio = 1.53; 95% CI = 1.28‐1.83). The T allele was also significantly associated with higher Kellgren–Lawrence grade in the patients with hip OA (χ2 = 32.70, P = 1.37 × 10−6). Moreover, SNP rs2424905 was significantly associated with the gene expression level of multiple genes, including DNMT3B, C20orf203, COMMD7, EFCAB8, MAPRE1, and RP5‐1085F17.3, from several types of human tissues. Conclusion: Our results indicated that rs2424905 of DNMT3B gene contributed to the risk of hip OA and its clinical severity in a Han Chinese population. These findings suggested that rs2424905 of DNMT3B could be a promising genetic marker to assess susceptibility to hip OA in Han Chinese populations. [ABSTRACT FROM AUTHOR]

Aim: The prevalence of hip and knee osteoarthritis (OA) varies by ethnicity, suggesting genetic heterogeneity in populations and predilection sites. Given the unknown mechanism of IL17F gene in the etiology of OA, it is necessary to examine the potential shared susceptibility of IL17F gene between knee OA and hip OA (HOA). This study aimed to evaluate the association of the IL17F gene and susceptibility to HOA in a Han Chinese population. Methods: A total of 2650 study subjects, comprising 796 HOA patients and 1854 controls, were recruited into the present study. Seven tag single nucleotide polymorphisms (SNPs) were selected for genotyping. Single marker‐based genetic association analyses were conducted at both the genotypic and allelic levels. χ2 statistics were calculated for statistical testing, and odds ratios were obtained to estimate the effects of genotypes and alleles for each SNP. Results: The SNP rs763780 was identified to be significantly associated with the risk of HOA at both genotypic (χ2 = 12.45, P =.002) and allelic levels (χ2 = 11.83, P =.0006). A linkage disequilibrium (LD) block comprised of 3 SNPs (rs12201582‐rs12203736‐rs722323) was also significantly associated with the risk of HOA. In addition, rs2294835 was identified to be associated with HOA severity (χ2 = 12.10, P =.02). Conclusion: Our results showed that IL17F gene contributed to the risk of HOA in a Han Chinese population, which would help to elucidate the pathogenesis of OA and facilitate the development of novel medicines and treatments for OA. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate changes in coordination variability (CV) over the course of a prolonged treadmill run and the influence of stability and neutral footwear on CV. Fourteen male habitually rearfoot runners completed two 42 min prolonged running sessions while three-dimensional kinematics and kinetics were recorded. During the first 21 min, participants ran in a neutral shoe (baseline run), then changed into either another neutral shoe of the same construction but another colour or a stability shoe and ran a further 21 min (intervention run). A modified vector coding technique was used to compute thigh-leg, leg-rearfoot and rearfoot-forefoot segment CV. Following the baseline run, thigh flexion/extension-leg flexion/extension, rearfoot inversion/eversion-forefoot plantar flexion/dorsiflexion and rearfoot inversion/eversion-forefoot adduction/abduction CV increased (p <.05). During the intervention run, CV was higher in the neutral shoe compared with the stability shoe for thigh flexion/extension-leg flexion/extension and leg flexion/extension-rearfoot inversion/eversion couplings (p <.05). Lower extremity CV increased or was maintained during a prolonged treadmill run in healthy male rearfoot runners, likely to distribute stresses among the tissues as muscles begin to fatigue. CV increased to a greater extent in neutral compared with stability footwear which may be a result of: (1) the stability shoe acting as a perturbation to the runner and their response is to regulate CV, or; (2) stability footwear provides greater support and consequently, runners do not need to explore additional degrees of freedom to reduce stresses applied to the tissues throughout a prolonged run. [ABSTRACT FROM AUTHOR]

While there is emerging data on how duration of symptoms prior to surgery relates to outcomes of patients undergoing arthroscopic partial meniscectomy, little is known about how duration of symptoms relates to the biology of the knee in these patients. The purpose of this study was to test the hypothesis that duration of symptoms prior to arthroscopic partial meniscectomy is associated with expression of osteoarthritis (OA)‐related genes in the meniscus. We collected resected meniscus from patients (N = 76) undergoing clinically indicated arthroscopic partial meniscectomy from knees without advanced degenerative changes. RNA from 64 patients was analyzed for 28 candidate OA transcripts by real‐time polymerase chain reaction (PCR). RNA was also probed for identification of novel genes by RNA microarray in 12 patients followed by validation of selected candidates by real‐time PCR. The association of gene expression with duration of symptoms prior to surgery was tested. Additional screening was performed with known OA genetic risk alleles assembled from published literature and with gene transcripts differentially expressed between non‐OA and OA cartilage and menisci. Our data revealed that duration of symptoms did not predict expression of OA genes in the meniscus, other than limited association with CXCL3, BMP2, and HLA‐DQA1. Microarray identified new genes and pathways with unknown role(s) in meniscus injury and OA and validation of a subset of genes by real‐time PCR showed expression pattern highly concordant with the microarray data. While duration of symptoms prior to arthroscopic partial meniscectomy does not significantly alter the expression of OA related genes, the association with novel genes and pathways deserves further investigation. [ABSTRACT FROM AUTHOR]

Bicycle saddle height configurations have been shown to affect knee joint biomechanics. Research suggests that an excessively low saddle height may lead to Patellofemoral Pain Syndrome, which is thought to be caused by the knee adduction moment during cycling. However, how saddle heights affect frontal plane knee biomechanics was not clear. We aimed to compare different saddle heights on frontal plane knee biomechanics during cycling. Twenty healthy young recreational cyclists (23.4 ± 0.5 years) performed 3 min of cycling at four different saddle heights (Medium [25° knee flexion angle], Preferred [a height chosen by cyclists], Low [Preferred + 15°], High [Preferred - 15°] measured at the bottom-dead-center). Cycling workload and cadence were set at 60 w and 60 RPM, respectively, since our project was focused on rehabilitation. A motion analysis system and a custom instrumented pedal were used to collect three-dimensional kinematics d (200 Hz) and pedal reaction force (1000 Hz). Results showed that, compared with other saddle heights, Low saddle height produced greater adduction knee moments (11.9 ± 1.9 Nm, P < 0.05), a longer duration (0.15 ± 0.01 s, P < 0.05), larger knee flexion (58.5 ± 2.6°, P < 0.05) and larger abduction angles (−4.5 ± 0.8°, P < 0.05). We showed that Low saddle height resulted in increased knee adduction moments with longer duration. In contrast, High saddle height reduced both knee moments and time duration. The results suggest that increased saddle heights may provide a safe and efficient cycling strategy for healthy young recreational cyclists. [ABSTRACT FROM AUTHOR]

Rationale: Cationic adduction causes poor sensitivity and increases spectral complexity during mass spectral analysis of oligonucleotides and alkylamines are used to reduce this adduction. It is unclear the effect of the physiochemical properties of the alkylamines on the reduction of the cationic adduction. Methods: All samples were directly infused into a Synapt G2 HDMS quadrupole time‐of‐flight (TOF) hybrid mass spectrometer in negative ion electrospray ionization mode through the native built‐in fluidics system. The infusion flow rate was set to 50 μL/min. The TOFMS tuning parameters were as follows: capillary voltage −2.0 kV, cone voltage 25 V, extraction cone voltage 2 V, source temperature 125°C, desolvation temperature 450°C, cone gas flow rate 0 L/h, and desolvation gas (nitrogen) flow rate 1000 L/h. Results: A quantitative model was created to predict the optimized alkylamine for MS analysis, while a qualitative model was generated to explain the most important physiochemical properties: proton affinity (13.83%), gas‐phase basicity (11.79%), pKa (11.47%), boiling point (10.73%), MW (10.3%), Henry's Law Constant (9.56%), and partition coefficient (logP) (9.44%). The quantitative model was applied to RNA (microRNA) and a phosphorothioate and predicts the trend of cationic adduction. Conclusions: Two models are described to understand the physiochemical properties that contribute to the adduction and to provide users a quick mathematical tool to predict the best choice of alkylamine to lower cationic adduction and decrease spectral complexity while enhancing sensitivity. [ABSTRACT FROM AUTHOR]

Background: Suprascapular nerve (SSN) block is a useful tool for pain control of different chronic shoulder pain syndromes. If the short‐term effect of nerve block using local anesthetics is not sufficient, pulsed radiofrequency (PRF) neuromodulation of the SSN may provide long‐term pain relief. Aim of Investigation: The aim of this study was to determine the effectiveness of ultrasonography‐guided PRF of the SSN for management of chronic shoulder pain. Subjects and Method: Thirty patients with chronic shoulder pain underwent diagnostic ultrasonography‐guided SSN block. After confirmation of positive results (>50% pain relief) via diagnostic testing, PRF of the SSN was performed in 27 patients, followed by application of dexamethasone; however, 2 patients had negative results with diagnostic block and 1 patient dropped out after positive results with diagnostic block. Pain was recorded using the VAS, and active range of motion of the affected shoulder was measured by goniometry (flexion, extension, adduction, abduction, external rotation, internal rotation). Assessments were done on day 0 and after 4, 8, 12, and 24 weeks. Statistical Test: One‐way analysis of variance testing. Results: The VAS score decreased significantly (P < 0.05) immediately after injection, and pain reduction was sustained for up to 24 weeks. Active range of motion in all directions also increased significantly (P < 0.5) after the procedure. Conclusion: PRF of the SSN under ultrasonography guidance is a safe and effective treatment modality for management of chronic shoulder pain. The effect of a combination of PRF and a short‐acting corticosteroid lasts up to 24 weeks, thereby assisting patients in undergoing relatively painless physiotherapy. [ABSTRACT FROM AUTHOR]

Aim: This meta‐analysis was conducted with the aim of collecting and synthesizing the existing evidence on the association of interleukin‐17A (IL‐17A)‐197G/A and IL‐17F‐7488T/C gene polymorphisms and osteoarthritis (OA) susceptibility. Methods: Six electronic databases including PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, and Wanfang were systematically searched for potentially relevant studies previous to June 2019. The strengths of association were estimated by summary odds ratios (ORs) and 95% confidence intervals (95%CIs) in a model‐free approach. Heterogeneity test and sensitivity analysis were also conducted to guarantee the reliability of this study. Results: Six eligible case‐control studies comprising 1989 OA patients and 2116 healthy controls were obtained for the meta‐analysis. Dominant model was confirmed to be the optimal genetic model (MM + Mm vs mm). The pooled estimate supported that IL‐17A‐197G/A and IL‐17F‐7488T/C polymorphisms were significantly associated with OA susceptibility in the overall population (IL‐17A‐197G/A: GG + GA vs AA, OR = 0.69, 95%CI 0.57‐0.80; P <.001; IL‐17F‐7488T/C, TT + TC vs CC, OR = 0.46, 95%CI 0.29‐0.71, P <.001). However, subgroup analyses suggested the association only existed in Asians and knee OA. Conclusion: The findings of the present study indicate that IL‐17A‐197G/A and IL‐17F‐7488T/C polymorphisms are positively associated to reduced risk of knee OA, especially in Asian populations. [ABSTRACT FROM AUTHOR]

In order to prevent further damage to an already damaged larynx, the "all muscles preserved" method (AMPM) in arytenoid adduction was developed, which preserves extrinsic laryngeal muscles, pharyngeal constrictor muscles, the external branch of the superior laryngeal nerve and the cricothyroid muscles. B, As arytenoid adduction is usually combined with type I thyroplasty, incision is made along the line connecting the lower one-third of the midline of the thyroid cartilage and the arytenoid cartilage gl Various surgical techniques involving arytenoid cartilage have been described since the report by Isshiki et al[7] When arytenoid adduction surgery was originally developed, anatomical examination was used to identify the location of the arytenoid cartilage. [Extracted from the article]

We studied the genetic epidemiology of primary large‐joint (hip and knee) osteoarthritis (OA), in order to find disease risk factors by a candidate‐gene approach. We used case–control study in the Croatian Caucasian population. We genotyped 500 OA patients (260 hip, 240 knee; both with total joint replacements) and 597 healthy individuals for single‐nucleotide polymorphisms (SNPs) in interleukin 17A (IL17A) (rs2275913) and IL17F (rs763780 and rs1889570) genes. On the basis of our population and allelic and genotypic frequencies haplotypes were predicted by PHASE software and compared between patients and controls. The three‐SNP haplotype (rs2275913–rs763780–rs1889570) G–C–A confers predisposition to hip (p < 0.005) but not knee OA. The three‐SNP haplotype having opposed nucleotides A–T–G was found significantly associated with 2.6 times higher risk for developing knee (p < 0.02) but not hip OA. The haplotype G–T (IL17A–IL17F; rs2275913–rs763780) is associated with protection to the disease in hip OA (p < 0.01). Our analyses show that two disparate haplotypes within the IL17A‐F gene locus are associated with higher risk to developing hip and knee OA in the Croatian population. The data might suggest a difference in the etiology of hip OA from that of the knee OA, perhaps due to an unknown dissimilarity in vulnerability of these joints to the actions of IL17. Alternatively, other differences in genetic factors like the long non‐protein coding region LINCMD1 and/or microRNA species like miR133b and miR206 found in the vicinity of the IL17 locus might be involved in the observed risk. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1972–1978, 2019 [ABSTRACT FROM AUTHOR]

Groin injuries represent a considerable problem in male football, accounting for 4%‐19% of all time‐loss injuries. The Adductor Strengthening Programme is the first groin‐specific prevention program shown to reduce the risk of groin problems. We aimed to use the RE‐AIM framework to examine the players' experiences with the implementation of the program and player attitude toward groin injury prevention in football. Of the 632 players involved in the trial examining the effect of the Adductor Strengthening Programme, 501 agreed to participate in a survey at the end of the season. Most players thought that footballers are at moderate to high risk for groin injuries (87%) and that there is a need for preventive measures (96%). They also believed that a preventive program with strengthening exercises would reduce the risk of groin injuries (91%). Majority of the players reported using <5 minutes to complete the program (73%), and only 11% wanted additional exercises. However, only 46% reported to have performed the program as recommended, and an even smaller proportion (31%) planned to continue using it as recommended the next season. Our results suggest that footballers believe that prevention of groin injuries is needed. Attitude toward implementation of the Adductor Strengthening Programme was positive, and the single‐exercise approach was considered an important facilitator. However, in future dissemination of the program, the players' reluctance to maintain the exercise protocol may be a potential barrier to implementation that should be addressed. [ABSTRACT FROM AUTHOR]

Athletes exposed to rapid maneuvers need a high level of dynamic knee stability and robustness, while also controlling whole body movement, to decrease the risk of non‐contact knee injury. The effects of high‐level athletic training on such measures of movement control have not, however, been thoroughly evaluated. This study investigated whether elite athletes (who regularly perform knee‐specific neuromuscular training) show greater dynamic knee robustness and/or different movement strategies than non‐athletic controls, in relation to overall knee function. Thirty‐nine women (19 athletes, 20 controls) performed standardized rebound side hops (SRSH) while a motion capture system synchronized with two force plates registered three‐dimensional trunk, hip, and knee joint angles and moments. Dynamic knee robustness was evaluated using finite helical axis (FHA) inclination angles extracted from knee rotation intervals of 10°, analyzed with independent t tests. Angle and moment curves were analyzed with inferential methods for functional data. Athletes had superior knee function (less laxity, greater hop performances, and strength) but presented similar FHA inclination angles to controls. Movement strategies during the landing phase differed; athletes presented larger (a) hip flexion angles (during 9%‐29% of the phase), (b) hip adduction moments (59%‐99%), (c) hip internal rotation moments (83%‐89%), and (d) knee flexion moments (79%‐93%). Thus, elite athletes may have a greater ability than non‐athletes to keep the knee robust while performing SRSH more efficiently through increased engagement of the hip. However, dynamic knee robustness associated with lower FHA inclination angles still show room for improvement, thus possibly decreasing knee injury risk. [ABSTRACT FROM AUTHOR]

The biological functions of modified aminophospholipids (APL) have become a topic of interest during the last two decades, and distinct roles have been found for these biomolecules in both physiological and pathological contexts. Modifications of APL include oxidation, glycation, and adduction to electrophilic aldehydes, altogether contributing to a high structural variability of modified APL. An outstanding technique used in this challenging field is mass spectrometry (MS). MS has been widely used to unveil modified APL of biological interest, mainly when associated with soft ionization methods (electrospray and matrix‐assisted laser desorption ionization) and coupled with separation techniques as liquid chromatography. This review summarizes the biological roles and the chemical mechanisms underlying APL modifications, and comprehensively reviews the current MS‐based knowledge that has been gathered until now for their analysis. The interpretation of the MS data obtained by in vitro‐identification studies is explained in detail. The perspective of an analytical detection of modified APL in clinical samples is explored, highlighting the fundamental role of MS in unveiling APL modifications and their relevance in pathophysiology. [ABSTRACT FROM AUTHOR]

Objective: Lateral wedge shoe insoles decrease medial knee loading, but trials have shown no effect on pain in medial knee osteoarthritis (OA). However, loading effects of insoles are inconsistent, and they can increase patellofemoral loading. We undertook this study to investigate the hypothesis that insoles would reduce pain in preselected patients. Methods: Among patients with painful medial knee OA, we excluded those with patellofemoral OA and those with a pain rating of <4 of a possible 10. We further excluded participants who, in a gait analysis using lateral wedges, did not show at least a 2% reduction in knee adduction moment (KAM), compared to wearing their shoes and a neutral insole. We then randomized subjects to lateral wedge versus neutral insole for 8‐week periods, separated by an 8‐week washout. The primary outcome measure was knee pain (0–10 scale) during the past week, and secondary outcome measures included activity pain and pain rated in the Knee Injury and Osteoarthritis Outcome Score questionnaire. We carried out mixed model analyses adjusted for baseline pain. Results: Of 83 participants, 21 (25.3%) were excluded from analysis because of insufficient reduction in KAM. In the 62 patients included in analysis, the mean ± SD age was 64.2 ± 9.1 years, and 37.1% were women. Lateral wedge insoles produced a greater reduction in knee pain than neutral insoles (mean difference of 0.7 on 0–10 scale [95% confidence interval 0.1, 1.2]) (P = 0.02). Findings for secondary outcome measures were mixed. Conclusion: In participants prescreened to eliminate those with patellofemoral OA and biomechanical nonresponders, lateral wedge insoles reduced knee pain, but the effect of treatment was small and is likely of clinical significance in only a minority of patients. Targeting patients may identify those who respond to this treatment. [ABSTRACT FROM AUTHOR]

Aim: In anatomic studies of the embryo, it has been established that during the development of the lower limb, several changes in foot position can be observed defined as a temporary 'physiological clubfoot'. The aim of this study was to develop and test a measurement tool for objective documentation of the first trimester foot position in vivo and made an attempt to create a chart for first trimester foot position. Methods: We developed a virtual orthopedic protractor for measuring foot positioning using three‐dimensional virtual reality visualization. Three‐dimensional ultrasound volumes of 112 pregnancies of women examined during the first trimester were studied in a BARCO I‐Space. The frontal angle (plantar flexion) and the lateral angle (adduction) between the leg and foot were measured from 8 until 13 weeks gestational age. Results: We observed that the frontal angle steadily decreases, whereas the lateral angle first increases, resulting in transient physiological clubfeet position at 10‐ to 11‐week gestation, followed by a decrease to a normal foot position. Conclusion: A transient clubfoot position is present during the normal development of the lower limbs, and it has been measured in vivo for the first time. This study emphasizes that a diagnosis of congenital clubfoot should not be made in the first trimester of pregnancy. [ABSTRACT FROM AUTHOR]

GLO:81V/01dec22:jpc15886-fig-0001.jpg PHOTO (COLOR): 1 Left axillary tumefaction with 180° abduction arm. gl GLO:81V/01dec22:jpc15886-fig-0002.jpg PHOTO (COLOR): 2 Left axillary tumefaction with 90° abduction arm. gl GLO:81V/01dec22:jpc15886-fig-0003.jpg PHOTO (COLOR): 3 Left axillary tumefaction with adduction arm. gl What diagnosis should you consider? A 9-year-old female, previously healthy, Tanner II, clinically asymptomatic, had a soft left axillary tumefaction with intermittent local pain, measuring up to 2 cm in diameter with ill-defined limits and non-adherent to adjacent planes (Figs 1-3). [Extracted from the article]