Purpose
Portable ultrasonography (P-US) is increasingly used to diagnose syndesmotic instability. The aim of this study was to evaluate syndesmotic instability by measuring the distal tibiofibular ...clear space (TFCS) in a cadaveric model using P-US with progressive stages of syndesmotic ligamentous transection under external rotation stress.
Methods
Ten fresh lower leg cadaveric specimens amputated above the proximal tibiofibular joint were used. Using P-US, the TFCS was evaluated in the intact stage and after progressive sectioning of the (1) anterior–inferior tibiofibular ligament (AITFL), (2) interosseous ligament (IOL), and (3) posterior–inferior tibiofibular ligament (PITFL). The TFCS was measured in both the unstressed (0 Nm) state and with 4.5, 6.0, 7.5, and 9.0 Nm of external rotation stress using a bone hook placed on the first metatarsal bone at each stage of ligamentous transection stage using both P-US and fluoroscopy.
Results
When assessed with P-US, partial syndesmotic injury encompassing the AITFL and IOL resulted in significant TFCS widening at 4.5 Nm of external rotation torque when compared to intact state with a TFCS-opening of 2.6 ± 2 mm,
p
= 0.01. In contrast, no significant differences in TFCS were detected using fluoroscopy. Only a moderate correlation was found between P-US and fluoroscopy.
Conclusion
P-US is a useful tool in diagnosing syndesmotic instability during external rotation stress examination. TFCS-opening increased as additional ligaments of the syndesmosis were transected, and application of 4.5 Nm torque was sufficient to detect a difference of 2.6 mm after the IOL cut.
Full text
Available for:
EMUNI, FIS, FSPLJ, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
After every other failure mode has been considered, in the end, the high-performance limit of all lasers is set by optical damage. The demands of inertial confinement fusion (ICF) pushed lasers ...designed as ICF drivers into this limit from their very earliest days. The first ICF lasers were small, and their pulses were short. Their goal was to provide as much power to the target as possible. Typically, they faced damage due to high intensity on their optics. As requests for higher laser energy, longer pulse lengths, and better symmetry appeared, new kinds of damage also emerged, some of them anticipated and others unexpected. This paper will discuss the various types of damage to large optics that had to be considered, avoided to the extent possible, or otherwise managed as the National Ignition Facility (NIF) laser was designed, fabricated, and brought into operation. It has been possible for NIF to meet its requirements because of the experience gained in previous ICF systems and because NIF designers have continued to be able to avoid or manage new damage situations as they have appeared.
Full text
Available for:
BFBNIB, GIS, IJS, KISLJ, NUK, PNG, UL, UM, UPUK
•Dynamic ultrasound can reliably evaluate fibular translation in healthy controls.•It affords bilateral comparisons, which becomes critical as the amount of syndesmotic instability approaches greater ...degrees of subtlety.•Patient characteristics did not affect the amount of fibular translation.•Dynamic ultrasound is readily accessible at the point of care, at low cost, and with no ionizing radiation.•The dynamic assessment technique using ultrasound has potential to diagnose subtle syndesmotic instability.
Syndesmotic instability, when subtle, is challenging to diagnose and often requires visualization of the syndesmosis during applied stress. The primary aim was to assess normal distal tibiofibular motion in the sagittal plane using dynamic ultrasound under stress conditions. The secondary aim was to evaluate the reliability of dynamic stress ultrasonography.
Twenty-eight participants without history of ankle injury were included. Sagittal fibular translation was generated by applying a manual force to the fibula from anterior to posterior and from posterior to anterior. Distance between the ultrasound probe and the fibula was taken at two predefined points: 1) no force applied and, 2) during maximum force application. Each participant was scanned twice by two independent examiners, and each scan was analysed by two independent examiners. Three participants were scanned a second time by the same examiner who analysed these films twice to assess for intraobserver agreement. Means of exam 1 versus exam 2 were compared using a mixed linear model. Agreement among observers was calculated using intraclass correlation coefficients (ICC) interpreted as 0.4, poor; 0.4 〈 ICC < 0.59, acceptable; 0.6 < ICC < 0.74, good; ICC 〉 0.74, excellent.
Fifty-six ankles were included in the study, including 16 (57%) males and 12 (42%) females. Average anterior to posterior fibular sagittal translation was 0.89 ± 0.6 mm and posterior to anterior fibular sagittal translation was 0.49 ± 1.1 mm. Anterior to posterior translation means of exam 1 versus exam 2 showed no significant differences, means of 0.81 mm 0.7–0.9 versus 0.77 mm 0.7–1.0, and posterior to anterior means 95% CI of 0.42 mm 0.3–0.5 versus 0.44 mm 0.2–0.6 (p-values 0.416 and 0.758, respectively). Excellent Inter- and intraobserver agreement was found for all measurements taken.
Dynamic ultrasound allows one to effectively and readily evaluate sagittal translation of the distal tibiofibular joint. It is able to afford bilateral comparisons, which becomes critical as the amount of syndesmotic instability approaches greater degrees of subtlety.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
In Bacillus subtilis, the KipI protein is a regulator of the phosphorelay governing the onset of sporulation. KipI binds the relevant sensor histidine kinase, KinA, and inhibits the ...autophosphorylation reaction. Gene homologues of kipI are found almost ubiquitously throughout the bacterial kingdom and are usually located adjacent to, and often fused with, kipA gene homologues. In B. subtilis, the KipA protein inhibits the antikinase activity of KipI thereby permitting sporulation. We have used a combination of biophysical techniques in order to understand the domain structure and shape of the KipI–KipA complex and probe the nature of the interaction. We also have solved the crystal structure of TTHA0988, a Thermus thermophilus protein of unknown function that is homologous to a KipI–KipA fusion. This structure, which is the first to be described for this class of proteins, provides unique insight into the nature of the KipI–KipA complex. The structure confirms that KipI and KipA are proteins with two domains, and the C-terminal domains belong to the cyclophilin family. These cyclophilin domains are positioned in the complex such that their conserved surfaces face each other to form a large “bicyclophilin” cleft. We discuss the sequence conservation and possible roles across species of this near-ubiquitous protein family, which is poorly understood in terms of function.
Display omitted
► KipI and KipA regulate sporulation in Bacillus subtilis. ► TTHA0988 from Thermus thermophilus is homologous to a fusion of KipI and KipA. ► Crystal structure of TTHA0988 reveals a novel domain arrangement. ► TTHA0988 is a good model for the KipI–KipA complex based on small-angle scattering data. ► Cleft between cyclophilin domains is the site of highest sequence conservation.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Evaporation and ablation are fundamental processes which drive laser-material processing performance. In applications where surface shape is important, control of the temperature field and the ...resulting spatially varying material response must be considered. For that purpose, assist gases are useful in, first, lowering treatment temperatures and, second, in changing interfacial and bulk chemistry to limit capillary-driven flow. Additionally, laser-matter coupling is influenced by pulse length as it determines the heat affected zone. Using infrared imaging of CO
2
laser-heated fused silica and surface profile measurements, we derive temperature and time dependent pitting rates along with shapes for a range of gases that include hydrogen, nitrogen, air, and helium. In the range of 1,500–4,500 K, evaporation, flow, and densification are shown to contribute to the pit shape. Analysis reveals a strong and complex dependence of rim formation on heating time and gas chemistry, mostly by lowering treatment temperature. Under dynamic heating, chemicapillarity appears to help in lowering rim height, in spite of the reactants mass transport limitations. Results on this gas-assisted approach suggest the possibility for sub-nanometer “rimless” laser-based machining.
Full text
Available for:
DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Metabolic syndrome is characterized by obesity, hyperglycemia, hypertension, insulin resistance, and dyslipidemia. Metabolic syndrome is associated with osteoarthritis (OA), but it is unclear if the ...association is attributable to increased mechanical loading on joints caused by obesity or other aspects of metabolic syndrome. Here we examined the effects of altered metabolism, obesity, and the gut microbiome on load-induced OA.
Cartilage damage was induced through cyclic compressive loading in four groups of adult male mice: Toll-like receptor-5 deficient (TLR5KO) mice that develop metabolic syndrome due to alterations in the gut microbiome, TLR5KO mice submitted to chronic antibiotics to prevent metabolic syndrome (TLR5KOΔMicrobiota), C57BL/6J mice fed a high fat diet to cause obesity (HFD), and untreated C57BL/6J mice (WT). Loading was applied for 2 weeks (n = 10–11/group) or 6 weeks (n = 10–11/group).
After 2 weeks of loading, cartilage damage (OARSI score) was not different among groups. After 6 weeks of loading, HFD mice had increased load-induced cartilage damage, while TLR5KO mice had cartilage damage comparable to WT mice. TLR5KOΔMicrobiota mice had less cartilage damage than other groups. HFD mice had elevated serum inflammatory markers. Each group had a distinct gut microbiome composition.
Severe obesity increased load-induced cartilage damage, while milder changes in adiposity/metabolic syndrome seen in TLR5KO mice did not. Furthermore, the effects of systemic inflammation/obesity on cartilage damage depend on the duration of mechanical loading. Lastly, reduced cartilage damage in the TLR5KOΔMicrobiota mice suggests that the gut microbiome may influence cartilage pathology.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Cyclic peptide library screening technologies show immense promise for identifying drug leads and chemical probes for challenging targets. However, the structural and functional diversity encoded ...within such libraries is largely undefined. We have systematically profiled the affinity, selectivity, and structural features of library-derived cyclic peptides selected to recognize three closely related targets: the acetyllysine-binding bromodomain proteins BRD2, -3, and -4. We report affinities as low as 100 pM and specificities of up to 10⁶-fold. Crystal structures of 13 peptide–bromodomain complexes reveal remarkable diversity in both structure and binding mode, including both α-helical and β-sheet structures as well as bivalent binding modes. The peptides can also exhibit a high degree of structural preorganization. Our data demonstrate the enormous potential within these libraries to provide diverse binding modes against a single target, which underpins their capacity to yield highly potent and selective ligands.
Full text
Available for:
BFBNIB, NMLJ, NUK, PNG, SAZU, UL, UM, UPUK
Indications for head computed tomography (CT) scans are unclear in patients with nonpenetrating head injury and Glasgow Coma Scale (GCS) scores of 15. We performed a prospective study to determine if ...significant intracranial injury could be excluded in patients with GCS-15 and a normal complete neurological examination. A prospective trial of clinically sober adult patients with GCS = 15 on emergency department (ED) presentation after closed head injury with loss of consciousness or amnesia was conducted from May 1996 through April 1997. All subjects underwent a standardized neurological examination including mental status evaluation, and assessment of motor, sensory, cerebellar and reflex function before CT scan. During the study period, 58 patients met inclusion criteria. Fifty-five patients (95%) had normal CT scans and 23 (42%) had focal neurological abnormalities. Three patients (5%) had CT scan findings of acute intracranial injury, two of whom had normal neurological examinations. One patient had an acute subdural hematoma requiring emergent surgical decompression; the other had both an epidural hematoma and pneumocephalus that did not require surgery. Significant brain injury and need for CT scanning cannot be excluded in patients with minor head injury despite a GCS = 15 and normal complete neurological examination on presentation.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Mixed plastics waste represents an abundant and largely untapped feedstock for the production of valuable products. The chemical diversity and complexity of these materials, however, present major ...barriers to realizing this opportunity. In this work, we show that metal-catalyzed autoxidation depolymerizes comingled polymers into a mixture of oxygenated small molecules that are advantaged substrates for biological conversion. We engineer a robust soil bacterium,
Pseudomonas putida
, to funnel these oxygenated compounds into a single exemplary chemical product, either β-ketoadipate or polyhydroxyalkanoates. This hybrid process establishes a strategy for the selective conversion of mixed plastics waste into useful chemical products.
Funneling mixed waste with microbes
Current plastic recycling methods require sorting by chemical composition, a method that is expensive and results in products that are of lower quality and value than the starting plastic. If plastic waste could instead be converted to valuable chemical intermediates, then economical use of mixed waste as a feedstock might be feasible. Sullivan
et al
. developed a two-stage oxidation and biological funneling approach that can break down and reform mixtures of common consumer plastics (see the Perspective by Yan). The end products can be adjusted by metabolic engineering of the microbes in the second step, which should enable tailored conversion into various platform or specialty chemicals. —MAF
Autoxidation and biological funneling converts mixed plastics to a single product.
PDF
