The Hip Spine Relationship—What We Know and What We Don’t: A Narrative Review

Background and Objective: The hip-spine syndrome was first described in 1983. The premise of the report was that the hip and spine are closely related and patients can easily have overlapping conditions and misdiagnoses. Since that time, there has been considerable advancement in our understanding of spinopelvic parameters and how degenerative disc disease can affect the pelvis and subsequently the acetabulum. Our objective is to provide an updated review on the relationship between hip and spine degeneration, how we define the relationship, and what steps should be taken when planning surgical intervention for these patients. Methods: A literature review was conducted via the PubMed database. Articles were screened based on their relevancy, recency, and quality of analysis. Search items included the following MeSH terms: “lumbar spine” with free text items: “hip, arthroplasty, parameters, spinopelvic, sagittal alignment, fusion, total hip arthroplasty, hip-spine syndrome, surgical complications, and dislocation”. Key Content and Findings: Novel spinopelvic parameters such as the combined sagittal index (CSI) may be useful in predicting complications in patients undergoing total hip arthroplasty. A reasonable approach may be to perform hip arthroplasty prior to a multilevel spinal fusion, especially when the fusion includes the pelvis. However, for patients with radiculopathy requiring a simpler one- or two-level spinal fusion, the spine may be safely addressed first to relieve the patient of radiculopathy prior to proceeding with a hip arthroplasty. Conclusions: New interpretations and applications of these parameters may decrease risk, prevent complications, and improve outcomes for patients who experience these associated, and often concurrent, pathologies

In-Hospital Mortality Trends After Surgery for Traumatic Thoracolumbar Injury: A National Inpatient Sample Database Study

INTRODUCTION: Given the increasing incidence of traumatic thoracolumbar injuries in recent years, studies have sought to investigate potential risk factors for outcomes in these patients. RESEARCH QUESTION: The aim of this study was to investigate trends and risk factors for in-hospital mortality after fusion for traumatic thoracolumbar injury. MATERIALS AND METHODS: Patients undergoing thoracolumbar fusion after traumatic injury were queried from the National Inpatient Sample (NIS) from 2012 to 2017. Analysis was performed to identify risk factors for inpatient mortality after surgery. RESULTS: Patients in 2017 were on average older (51.0 vs. 48.5, P = 0.004), had more admitting diagnoses (15.5 vs. 10.7, p \u3c 0.001), were less likely to be White (75.8% vs. 81.2%, p = 0.006), were from a ZIP code with a higher median income quartile (Quartile 1: 31.4% vs. 28.6%, p = 0.011), and were more likely to have Medicare as a primary payer (22.9% vs. 30.1%, p \u3c 0.001). Bivariate analysis of demographics and surgical characteristics demonstrated that patients in the in-hospital mortality group (n = 90) were older (70.2 vs. 49.6, p \u3c 0.001), more likely to be male (74.4% vs. 62.8%, p = 0.031), had a great number of admitted diagnoses (21.3 vs. 12.7, p \u3c 0.001), and were more likely to be insured by Medicare (70.0% vs. 27.0%, p \u3c 0.001). Multivariate regression analysis found age (OR 1.06, p \u3c 0.001) and Black race (OR 3.71, p = 0.007) were independently associated with in-hospital mortality. CONCLUSION: Our study of nationwide, traumatic thoracolumbar fusion procedures from 2012 to 2017 in the NIS database found older, black patients were at increased risk for in-hospital mortality after surgery

A Cross-Study Transcriptional Analysis of Parkinson's Disease

The study of Parkinson's disease (PD), like other complex neurodegenerative disorders, is limited by access to brain tissue from patients with a confirmed diagnosis. Alternatively the study of peripheral tissues may offer some insight into the molecular basis of disease susceptibility and progression, but this approach still relies on brain tissue to benchmark relevant molecular changes against. Several studies have reported whole-genome expression profiling in post-mortem brain but reported concordance between these analyses is lacking. Here we apply a standardised pathway analysis to seven independent case-control studies, and demonstrate increased concordance between data sets. Moreover data convergence increased when the analysis was limited to the five substantia nigra (SN) data sets; this highlighted the down regulation of dopamine receptor signaling and insulin-like growth factor 1 (IGF1) signaling pathways. We also show that case-control comparisons of affected post mortem brain tissue are more likely to reflect terminal cytoarchitectural differences rather than primary pathogenic mechanisms. The implementation of a correction factor for dopaminergic neuronal loss predictably resulted in the loss of significance of the dopamine signaling pathway while axon guidance pathways increased in significance. Interestingly the IGF1 signaling pathway was also over-represented when data from non-SN areas, unaffected or only terminally affected in PD, were considered. Our findings suggest that there is greater concordance in PD whole-genome expression profiling when standardised pathway membership rather than ranked gene list is used for comparison

Software for the frontiers of quantum chemistry:An overview of developments in the Q-Chem 5 package

This article summarizes technical advances contained in the fifth major release of the Q-Chem quantum chemistry program package, covering developments since 2015. A comprehensive library of exchange–correlation functionals, along with a suite of correlated many-body methods, continues to be a hallmark of the Q-Chem software. The many-body methods include novel variants of both coupled-cluster and configuration-interaction approaches along with methods based on the algebraic diagrammatic construction and variational reduced density-matrix methods. Methods highlighted in Q-Chem 5 include a suite of tools for modeling core-level spectroscopy, methods for describing metastable resonances, methods for computing vibronic spectra, the nuclear–electronic orbital method, and several different energy decomposition analysis techniques. High-performance capabilities including multithreaded parallelism and support for calculations on graphics processing units are described. Q-Chem boasts a community of well over 100 active academic developers, and the continuing evolution of the software is supported by an “open teamware” model and an increasingly modular design

Evaluation of a Probabilistic Exposure Model Applied to Carbon Monoxide (pNEM/CO) Using Denver Personal Exposure Monitoring Data

The probabilistic National Ambient Air Quality Standards (NAAQS) Exposure Model applied to carbon monoxide (pNEM/CO) was developed by the U.S. Environmental Protection Agency (EPA) to estimate frequency distributions of population exposure to carbon monoxide (CO) and the resulting carboxyhemoglobin (COHb) levels. To evaluate pNEM/CO, the model was set up to simulate CO exposure data collected during a Denver Personal Exposure Monitoring Study (PEM) conducted during the winter of 1982-1983. This paper compares computer-simulated exposure distributions obtained by pNEM/CO with the observed cumulative relative frequency distributions of population exposure to CO from 779 people in the Denver PEM study

Evidence for an unusual transmembrane configuration of AGG3, a class C Gγ subunit of Arabidopsis

Heterotrimeric G proteins are crucial for the perception of external signals and subsequent signal transduction in animal and plant cells. In both model systems, the complex comprises one Gα, one Gβ, and one Gγ subunit. However, in addition to the canonical Gγ subunits (class A), plants also possess two unusual, plant-specific classes of Gγ subunits (classes B and C) that have not yet been found in animals. These include Gγ subunits lacking the C–terminal CaaX motif (class B), which is important for membrane anchoring of the protein; the presence of such subunits gives rise to a flexible sub-population of Gβ/γ heterodimers that are not necessarily restricted to the plasma membrane. Plants also contain class C Gγ subunits, which are twice the size of canonical Gγ subunits, with a predicted transmembrane domain and a large cysteine-rich extracellular C–terminus. However, neither the presence of the transmembrane domain nor the membrane topology have been unequivocally demonstrated. Here, we provide compelling evidence that AGG3, a class C Gγ subunit of Arabidopsis, contains a functional transmembrane domain, which is sufficient but not essential for plasma membrane localization, and that the cysteine-rich C–terminus is extracellular