Detection of incorrect manufacturer labelling of hip components

We describe the case of a 53-year-old man who underwent a left metal-on-metal hip resurfacing in 2015. Component size mismatch (CSM) was suspected because of the patient's immediate post-operative mechanical symptoms and high metal ion levels. Surgical notes indicated the appropriate combinations of implants were used. However, we detected a mismatch using computed tomography. Revision was performed and subsequent measurements of explanted components confirmed the mismatch. To our knowledge, this case is the first report of a CT method being used in a patient to pre-operatively identify CSM

Can custom 3D printed implants successfully reconstruct massive acetabular defects? A 3D-CT assessment

We report on the accuracy, measured with three-dimensional (3D) computed tomography (CT) postoperatively, in positioning custom 3D printed titanium components in patients with large acetabular defects. Twenty patients (13 females and 7 males) received custom-made acetabular implants between 2016 and 2018; the mean age was 66 years (SD = 11.6) and their mean body mass index was 28 (SD = 6.1). The median time to follow up was 25.5 months, range: 12 to 40 months. We describe a comparison method that uses the 3D models of CT-generated preoperative plans and the postoperative CT scans to quantify the discrepancy between planned and achieved component positions. Our primary outcome measures were the 3D-CT-measured difference between planned and achieved a component position in six degrees of freedom: center of rotation (CoR), component rotation, inclination (INC), and version (VER) of the cup. Our secondary outcome measures were: Oxford hip score, walking status, and complication rate. All components (100%) were positioned within 10 mm of planned CoR (in the three planes). Eighteen (95%) components were not rotated by more than 10° compared to the plan. Eleven (58%) components were positioned within 5° of planned cup angle (INC and VER). To date one complication has occurred, a periprosthetic fracture. This is the largest study in which postoperative 3D-CT measurements and clinical outcomes of custom-made acetabular components have been assessed. Accurate pre-op planning and the adoption of custom 3D printed implants show promising results in complex hip revision surgery

Hyperoxia Causes Mitochondrial Fragmentation in Pulmonary Endothelial Cells by Increasing Expression of Pro-Fission Proteins

Objective—We explored mechanisms that alter mitochondrial structure and function in pulmonary endothelial cells (PEC) function after hyperoxia. Approach and Results—Mitochondrial structures of PECs exposed to hyperoxia or normoxia were visualized and mitochondrial fragmentation quantified. Expression of pro-fission or fusion proteins or autophagy-related proteins were assessed by Western blot. Mitochondrial oxidative state was determined using mito-roGFP. Tetramethylrhodamine methyl ester estimated mitochondrial polarization in treatment groups. The role of mitochondrially derived reactive oxygen species in mt-fragmentation was investigated with mito-TEMPOL and mitochondrial DNA (mtDNA) damage studied by using ENDO III (mt-tat-endonuclease III), a protein that repairs mDNA damage. Drp-1 (dynamin-related protein 1) was overexpressed or silenced to test the role of this protein in cell survival or transwell resistance. Hyperoxia increased fragmentation of PEC mitochondria in a time-dependent manner through 48 hours of exposure. Hyperoxic PECs exhibited increased phosphorylation of Drp-1 (serine 616), decreases in Mfn1 (mitofusion protein 1), but increases in OPA-1 (optic atrophy 1). Pro-autophagy proteins p62 (LC3 adapter–binding protein SQSTM1/p62), PINK-1 (PTEN-induced putative kinase 1), and LC3B (microtubule-associated protein 1A/1B-light chain 3) were increased. Returning cells to normoxia for 24 hours reversed the increased mt-fragmentation and changes in expression of pro-fission proteins. Hyperoxia-induced changes in mitochondrial structure or cell survival were mitigated by antioxidants mito-TEMPOL, Drp-1 silencing, or inhibition or protection by the mitochondrial endonuclease ENDO III. Hyperoxia induced oxidation and mitochondrial depolarization and impaired transwell resistance. Decrease in resistance was mitigated by mito-TEMPOL or ENDO III and reproduced by overexpression of Drp-1. Conclusions—Because hyperoxia evoked mt-fragmentation, cell survival and transwell resistance are prevented by ENDO III and mito-TEMPOL and Drp-1 silencing, and these data link hyperoxia-induced mt-DNA damage, Drp-1 expression, mt-fragmentation, and PEC dysfunction

Quasi-fixed point scenario in the modified NMSSM

The simplest extension of the MSSM that does not contradict LEP II experimental bound on the lightest Higgs boson mass at $\tan\beta\sim 1$ is the modified Next-to-Minimal Supersymmetric Standard Model (MNSSM). We investigate the renormalization of Yukawa couplings and soft SUSY breaking terms in this model. The possibility of $b$-quark and $\tau$-lepton Yukawa coupling unification at the Grand Unification scale $M_X$ is studied. The particle spectrum is analysed in the vicinity of the quasi-fixed point where the solutions of renormalization group equations are concentrated at the electroweak scale.Comment: 19 pages, 3 figures, LaTeX2

Infrared quasi-fixed solutions in the NMSSM

The considerable part of the parameter space in the MSSM corresponding to the infrared quasi fixed point scenario is almost excluded by LEP II bounds on the lightest Higgs boson mass. In the NMSSM the mass of the lightest Higgs boson reaches its maximum value in the strong Yukawa coupling limit when Yukawa couplings are essentially larger than gauge ones at the Grand Unification scale. In this limit the solutions of the renormalisation group equations are attracted to the infrared and Hill type effective fixed lines or surfaces in the Yukawa coupling parameter space. They are concentrated in the vicinity of quasi fixed points for $Y_i(0)\to\infty$. However the solutions are attracted to such points rather weakly. For this reason when all $Y_i(0)\sim 1$ the solutions of the renormalisation group equations are gathered near a line in the Hill type effective surface. In the paper the approximate solutions for the NMSSM Yukawa couplings are given. The possibility of $b$--quark and $\tau$--lepton Yukawa coupling unification at the scale $M_{X}$ is also discussed.Comment: 32 pages, 8 figures included, LaTeX 2

Higgs bosons in the simplest SUSY models

Nowadays in the MSSM the moderate values of $\tan\beta$ are almost excluded by LEP II lower bound on the lightest Higgs boson mass. In the Next-to-Minimal Supersymmetric Standard Model the theoretical upper bound on it increases and reaches maximal value in the strong Yukawa coupling limit when all solutions of renormalization group equations are concentrated near the quasi-fixed point. For calculation of Higgs boson spectrum the perturbation theory method can be applied. We investigate the particle spectrum in the framework of the modified NMSSM which leads to the self-consistent solution in the strong Yukawa coupling limit. This model allows one to get $m_h\sim 125$ GeV at values of $\tan\beta\ge 1.9$. In the investigated model the lightest Higgs boson mass does not exceed $130.5\pm 3.5$ GeV. The upper bound on the lightest CP-even Higgs boson mass in more complicated supersymmetric models is also discussed.Comment: 27 pages, 5 figures included, LaTeX 2e. Plenary talk at the Conference of RAS Nuclear Physics Department 2000 in ITEP, Moscow, Russia; to appear in Phys. Atom. Nuc

Particle spectrum in the modified NMSSM in the strong Yukawa coupling limit

A theoretical analysis of solutions of renormalisation group equations in the MSSM corresponding to the quasi-fixed point conditions shows that the mass of the lightest Higgs boson in this case does not exceed $94\pm 5\text{GeV}$. It means that a substantial part of the parameter space of the MSSM is practically excluded by existing experimental data from LEP II. In the NMSSM the upper bound on the lightest Higgs boson mass reaches its maximum in the strong Yukawa coupling regime, when Yukawa constants are considerably larger the gauge ones on the Grand Unification scale. In this paper a particle spectrum in a simple modification of NMSSM which leads to a self-consistent solution in the considered region of the parameter space is studied. This model allows one to get $m_h\sim 125\text{GeV}$ even for comparatively low values of $\tan\beta\ge 1.9$. For an analysis of the Higgs boson spectrum and neutralino spectrum a method for diagonalisation of mass matrices proposed formerly is used. The mass of the lightest Higgs boson in this model does not exceed $130.5\pm 3.5\text{GeV}$.Comment: 34 pages, 5 figures included, LaTeX 2

The stability of present-day Antarctic grounding lines – Part 2: Onset of irreversible retreat of Amundsen Sea glaciers under current climate on centennial timescales cannot be excluded

Observations of ocean-driven grounding-line retreat in the Amundsen Sea Embayment in Antarctica raise the question of an imminent collapse of the West Antarctic Ice Sheet. Here we analyse the committed evolution of Antarctic grounding lines under the present-day climate. To this aim, we first calibrate a sub-shelf melt parameterization, which is derived from an ocean box model, with observed and modelled melt sensitivities to ocean temperature changes, making it suitable for present-day simulations and future sea level projections. Using the new calibration, we run an ensemble of historical simulations from 1850 to 2015 with a state-of-the-art ice sheet model to create model instances of possible present-day ice sheet configurations. Then, we extend the simulations for another 10 000 years to investigate their evolution under constant present-day climate forcing and bathymetry. We test for reversibility of grounding-line movement in the case that large-scale retreat occurs. In the Amundsen Sea Embayment we find irreversible retreat of the Thwaites Glacier for all our parameter combinations and irreversible retreat of the Pine Island Glacier for some admissible parameter combinations. Importantly, an irreversible collapse in the Amundsen Sea Embayment sector is initiated at the earliest between 300 and 500 years in our simulations and is not inevitable yet – as also shown in our companion paper (Part 1, Hill et al., 2023). In other words, the region has not tipped yet. With the assumption of constant present-day climate, the collapse evolves on millennial timescales, with a maximum rate of 0.9 mm a−1 sea-level-equivalent ice volume loss. The contribution to sea level by 2300 is limited to 8 cm with a maximum rate of 0.4 mm a−1 sea-level-equivalent ice volume loss. Furthermore, when allowing ice shelves to regrow to their present geometry, we find that large-scale grounding-line retreat into marine basins upstream of the Filchner–Ronne Ice Shelf and the western Siple Coast is reversible. Other grounding lines remain close to their current positions in all configurations under present-day climate

“Sexual” Population Structure and Genetics of the Malaria Agent P. falciparum

The population genetics and structure of P. falciparum determine the rate at which malaria evolves in response to interventions such as drugs and vaccines. This has been the source of considerable recent controversy, but here we demonstrate the organism to be essentially sexual, in an area of moderately high transmission in the Lower Shire Valley, Malawi. Seven thousand mosquitoes were collected and dissected, and genetic data were obtained on 190 oocysts from 56 infected midguts. The oocysts were genotyped at three microsatellite loci and the MSP1 locus. Selfing rate was estimated as 50% and there was significant genotypic linkage disequilibrium (LD) in the pooled oocysts. A more appropriate analysis searching for genotypic LD in outcrossed oocysts and/or haplotypic LD in the selfed oocysts found no evidence for LD, indicating that the population was effectively sexual. Inbreeding estimates at MSP1 were higher than at the microsatellites, possibly indicative of immune action against MSP1, but the effect was confounded by the probable presence of null mutations. Mating appeared to occur at random in mosquitoes and evidence regarding whether malaria clones in the same host were related (presumably through simultaneous inoculation in the same mosquito bite) was ambiguous. This is the most detailed genetic analysis yet of P. falciparum sexual stages, and shows P. falciparum to be a sexual organism whose genomes are in linkage equilibrium, which acts to slow the emergence of drug resistance and vaccine insensitivity, extending the likely useful therapeutic lifespan of drugs and vaccines