Nutrient Management for Recirculating Hydroponics

Steady-state nutrient management is essential in hydroponic culture. Determination of an appropriate refill solution is attained using the principle of mass balance. Optimizing the ratio of nutrient elements and refill solution concentrations requires an understanding of the ratio of nutrients in tissue to water, which is measured as water use efficiency (WUE). This ratio is then multiplied by the desired concentration of nutrients in leaf tissue to determine the refill solution composition. Deep-flow hydroponics enables constant monitoring of solution parameters and root health. We have achieved a steady-state nitrogen concentration in solution by using an automated pH control system that adds a solution of 50 mM nitric acid and 200 mM ammonium sulfate. The pH remains stable throughout the life cycle as roots release a similar ratio of protons and hydroxide ions to balance uptake of either ammonium or nitrate. Daily monitoring of electrical conductivity (EC) guides adjustment of the refill solution concentration. A variable WUE and water to nutrient uptake ratio among species necessitates custom refill solutions. In our preliminary studies, wheat (Triticum aestivum) has a moderate WUE (3 g L-1) but ceases substantial nutrient uptake late in the lifecycle and the EC thus increases over time, causing nutrient accumulation in solution. Lettuce (Lactuca sativa) also has a moderate WUE (3 g L-1), and the EC of the solution remains stable. Tomato (Solanum lycopersicum) has a high WUE (6 g L-1), causing reduced EC and nutrient solution depletion. Monitoring solution compositions has allowed us to optimize the refill solution and acid addition concentration among species and lifecycle stages

Salinity Reduces the Forage Quality of Forage Kochia: A Halophytic Chenopodiaceae Shrub

Forage kochia (Bassia prostrata [L.] A.J. Scott) is a perennial, halophytic Chenopodiaceae shrub adapted to semiarid rangelands and steppes. It is noted for its ability to produce edible forage in saline environments, but the effect of salinity on its nutritive value has not been determined. Therefore, this study evaluated the dose-response of increasing salinity on the forage quality of forage kochia and Gardner’s saltbush (Atriplex gardneri [Moq.] D. Dietr., a chenopod forage shrub indigenous to the United States). Individual plants were evaluated in hydroponics for 28 days at 0, 150, 300, and 600 mM NaCl. Salt from accumulated ions, minerals, and forage nutritive value were determined using ground shoot samples. Analysis of forage nutritive value is problematic in plants with high salt concentrations, so neutral detergent fiber (NDF) and in vitro true digestibility (IVTD) were also predicted on an ash-corrected dry matter (DM) basis (NDFcorrected and IVTDcorrected). Forage kochia exhibited a dose-response for salt concentration, IVTDcorrected, and crude protein (CP) as salinity increased. Salt concentrations increased to 19% of DM at 600 mM NaCl, which may reduce voluntary intake by ruminants grazing forage kochia. Results indicated that uncorrected IVTD estimates were inflated as forage kochia IVTDcorrected decreased from 65% to 56% with the major change between 300 and 600 mM NaCl. Crude protein did not differ between two forage kochia cultivars but decreased from 26% to 15% between 0 and 600 mM NaCl, whereas Gardner’s saltbush CP decreased by only five percentage points as salinity increased. Nonetheless, despite the greater CP sensitivity to salinity level, forage kochia salt concentration was less and digestibility and metabolizable energy (ME) were greater than Gardner’s saltbush. Overall, salinity reduced the forage quality of forage kochia, though not as dramatically as for Gardner’s saltbush, thus supporting use of forage kochia to improve the forage base of saline rangelands

Polyethylene thickness is a risk factor for wear necessitating insert exchange

PURPOSE: The aim of this observational study was to investigate the optimal minimal polyethylene (PE) thickness in total knee arthroplasty (TKA) and identify other risk factors associated with revision of the insert due to wear. METHODS: A total of 84 TKA were followed for 11-16 years. All patients received the same prosthesis design (Interax; Howmedica/ Stryker) with halfbearings: separate PE-inserts medially and laterally. Statistical analysis comprised Cox-regression to correct for confounding. RESULTS: Eight knees (9.5%) had been revised due to thinning inserts and an additional patient is scheduled for revision. PE thickness, diagnosis, BMI and weight are risk factors for insert exchange. For each millimetre decrease in PE thickness, the risk of insert exchange increases 3.0 times, which remains after correction for age, gender, weight, diagnosis and femoral-tibial angle. Insert exchange was 4.73 times more likely in OA-patients compared to RA-patients. For every unit increase in BMI and weight the risk for insert exchange increases 1.40 times and 1.14 times, respectively. CONCLUSIONS: In conclusion we therefore advise against the use of thin PE inserts in modular TKA and recommend PE inserts with a minimal 8-mm thickness.Optimising joint reconstruction management in arthritis and bone tumour patient

An Expert Consensus Statement on the Management of Large Chondral and Osteochondral Defects in the Patellofemoral Joint

© The Author(s) 2020. Background: Cartilage lesions of the patellofemoral joint constitute a frequent abnormality. Patellofemoral conditions are challenging to treat because of complex biomechanics and morphology. Purpose: To develop a consensus statement on the functional anatomy, indications, donor graft considerations, surgical treatment, and rehabilitation for the management of large chondral and osteochondral defects in the patellofemoral joint using a modified Delphi technique. Study Design: Consensus statement. Methods: A working group of 4 persons generated a list of statements related to the functional anatomy, indications, donor graft considerations, surgical treatment, and rehabilitation for the management of large chondral and osteochondral defects in the patellofemoral joint to form the basis of an initial survey for rating by a group of experts. The Metrics of Osteochondral Allografts (MOCA) expert group (composed of 28 high-volume cartilage experts) was surveyed on 3 occasions to establish a consensus on the statements. In addition to assessing agreement for each included statement, experts were invited to propose additional statements for inclusion or to suggest modifications of existing statements with each round. Predefined criteria were used to refine statement lists after each survey round. Statements reaching a consensus in round 3 were included within the final consensus document. Results: A total of 28 experts (100% response rate) completed 3 rounds of surveys. After 3 rounds, 36 statements achieved a consensus, with over 75% agreement and less than 20% disagreement. A consensus was reached in 100.00% of the statements relating to functional anatomy of the patellofemoral joint, 88.24% relating to surgical indications, 100.00% relating to surgical technical aspects, and 100.00% relating to rehabilitation, with an overall consensus of 95.5%. Conclusion: This study established a strong expert consensus document relating to the functional anatomy, surgical indications, donor graft considerations for osteochondral allografts, surgical technical aspects, and rehabilitation concepts for the management of large chondral and osteochondral defects in the patellofemoral joint. Further research is required to clinically validate the established consensus statements and better understand the precise indications for surgery as well as which techniques and graft processing/preparation methods should be used based on patient- and lesion-specific factors

Basic Science Considerations in Primary Total Hip Replacement Arthroplasty

Total Hip Replacement is one of the most common operations performed in the developed world today. An increasingly ageing population means that the numbers of people undergoing this operation is set to rise. There are a numerous number of prosthesis on the market and it is often difficult to choose between them. It is therefore necessary to have a good understanding of the basic scientific principles in Total Hip Replacement and the evidence base underpinning them. This paper reviews the relevant anatomical and biomechanical principles in THA. It goes on to elaborate on the structural properties of materials used in modern implants and looks at the evidence base for different types of fixation including cemented and uncemented components. Modern bearing surfaces are discussed in addition to the scientific basis of various surface engineering modifications in THA prostheses. The basic science considerations in component alignment and abductor tension are also discussed. A brief discussion on modular and custom designs of THR is also included. This article reviews basic science concepts and the rationale underpinning the use of the femoral and acetabular component in total hip replacement

The use of mesenchymal stem cells for cartilage repair and regeneration: a systematic review.

BACKGROUND: The management of articular cartilage defects presents many clinical challenges due to its avascular, aneural and alymphatic nature. Bone marrow stimulation techniques, such as microfracture, are the most frequently used method in clinical practice however the resulting mixed fibrocartilage tissue which is inferior to native hyaline cartilage. Other methods have shown promise but are far from perfect. There is an unmet need and growing interest in regenerative medicine and tissue engineering to improve the outcome for patients requiring cartilage repair. Many published reviews on cartilage repair only list human clinical trials, underestimating the wealth of basic sciences and animal studies that are precursors to future research. We therefore set out to perform a systematic review of the literature to assess the translation of stem cell therapy to explore what research had been carried out at each of the stages of translation from bench-top (in vitro), animal (pre-clinical) and human studies (clinical) and assemble an evidence-based cascade for the responsible introduction of stem cell therapy for cartilage defects. This review was conducted in accordance to PRISMA guidelines using CINHAL, MEDLINE, EMBASE, Scopus and Web of Knowledge databases from 1st January 1900 to 30th June 2015. In total, there were 2880 studies identified of which 252 studies were included for analysis (100 articles for in vitro studies, 111 studies for animal studies; and 31 studies for human studies). There was a huge variance in cell source in pre-clinical studies both of terms of animal used, location of harvest (fat, marrow, blood or synovium) and allogeneicity. The use of scaffolds, growth factors, number of cell passages and number of cells used was hugely heterogeneous. SHORT CONCLUSIONS: This review offers a comprehensive assessment of the evidence behind the translation of basic science to the clinical practice of cartilage repair. It has revealed a lack of connectivity between the in vitro, pre-clinical and human data and a patchwork quilt of synergistic evidence. Drivers for progress in this space are largely driven by patient demand, surgeon inquisition and a regulatory framework that is learning at the same pace as new developments take place