Self-reported Mental Disorders Negatively Influence Surgical Outcomes After Arthroscopic Treatment of Femoroacetabular Impingement.

Background:Femoroacetabular impingement (FAI) is responsible for hip pain and dysfunction, and surgical outcomes depend on multiple factors. The presence of mental disorders negatively influences outcomes of multiple orthopaedic conditions, although the impact on FAI surgery is unclear. Hypothesis:The authors hypothesized that a preoperative self-reported history of mental disorders would negatively influence patient-reported outcome measures after FAI surgery. Study Design:Cohort study; Level of evidence, 3. Methods:A matched-cohort study was performed by reviewing a prospectively collected database of cases of arthroscopic management of FAI with a single surgeon over a 2-year period. Demographics and radiographic parameters were recorded for all patients. Patients completed the Hip Outcome Score-Activity of Daily Living Subscale (HOS-ADL), Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), and modified Harris Hip Score (mHHS) prior to surgery and 2 years after surgery. Unpaired and paired t tests were used to compare results between and within cohorts at baseline and follow-up. Statistical significance was defined as P < .05. Results:The cohort included 301 patients, with 75 and 226 patients reporting and not reporting a history of mental disorders, respectively. Before treatment, all patient-reported outcome measures were significantly lower among patients reporting a history of mental disorders (P < .01 for HOS-ADL, HOS-SSS, and mHHS). Patients in both groups demonstrated significant improvements (P < .0001) in HOS-ADL, HOS-SSS, and mHHS when preoperative outcome measures were compared with follow-up. Patients with reported mental disorders had significantly lower scores after surgery as compared with patients without mental disorders (P < .0001 for HOS-ADL, HOS-SSS, and mHHS). Conclusion:The presence of a reported mental disorder is associated with lower patient-reported outcomes before and after surgical management of FAI. Statistically significant and clinically relevant improvements were observed for patients who reported mental disorders. The magnitude of these improvements was not as large as that for an age- and sex-matched control group without a self-reported mental disorder

Understanding the pincer - The importance of reference plane orientation on acetabular rim evaluation

Objectives: Femoroacetabular impingement (FAI) is a common cause of young adult hip pain. FAI can result from an acetabular-sided bony lesion, or “pincer” lesion. A pincer lesion is defined as an area of linear contact between the acetabular rim and the femoral head-neck junction due to general or focal acetabular overcoverage. Three dimensional (3D) analysis of the acetabular rim morphology is essential to understand etiology and aciculate diagnosis of the of the pincer type FAI. A few studies have measured 3D geometry of the acetabular rim; in which the acetabular rim is described as a deviation from a reference plane. Therefore, the definition of the reference plane is critical to determine the acetabular rim geometry. The purpose of this study was to use 3D Computed Tomography (CT) modeling to evaluate the impact of varied acetabular orientation reference planes on the interpretation of acetabular rim abnormalities, with the goal to determine the ideal reference plane for future study use. Methods: 3D CT modeling was performed on five hip joints of patients who underwent hip arthroscopy with acetabular trimming for a presumed pincer lesion. These models were exported into point-cloud models. An acetabular 3D model was automatically created within 10 mm from the femoral head surface (Fig. 1A,B). The acetabular articular surface and rim were separated with a threshold of 5 mm, which provided an acetabular rim model with a band width of 5 mm (Fig. 1C). A local coordinate system was defined with the acetabular notch midpoint being 6 o’clock. A best-fit plane of the acetabular rim was determined by the least square method using two different acetabular rim models: 1) a model excluding the acetabular notch (plane A) and 2) a model excluding the acetabular notch and superior region from 10:30 to 3:00 (3:00 being anterior) (plane B). The acetabular rim model was transformed into a cylindrical coordinate system with an axis determined by a normal vector of the plane. The final acetabular rim model consisting of 120 points with 3° increments was created by searching the outermost points of the rim. The acetabular center was determined using best-fit sphere of the articular surface model. A reference plane including the center point was determined with orientations determined by normal vectors of the acetabular rim planes (Fig. 1C, yellow line). The 3D geometry of the rim was described by subtended angles from the normal vector of the reference plane. Results: Three distinct peaks were noted at anteroinferior (AI), anterosuperior (AP) and posteroinferior (PI) regions (Fig. 2 A,B). While the AI and PI peaks measured with the plane A were higher than that measured with plane B, the AP peak measured with plane A was lower than that measured with plane B (Fig. 2C). The angle between the normal vectors of plane A and B was 13.7±3.5°. Conclusion: The findings demonstrate that the orientation of the reference plane is critical to the 3D measurement of the acetabular rim. Since bony prominence in the anterosuperior region has been considered as the pathogenesis of the impingement, the reference plane including this region may cause underestimation of the bony lesion. An appropriate determination of the reference plane is crucial for evaluation of the bony lesion in the pincer FAI patient. © The Author(s) 2013

Prevalence of Cam Morphology in Females with Femoroacetabular Impingement

Cam and pincer are two common morphologies responsible for femoroacetabular impingement. Previous literature has reported that cam deformity is predominantly a male morphology, while being significantly less common in females. The purpose of this study was to determine the prevalence of cam morphology in female subjects diagnosed with symptomatic FAI. All females presenting to the senior author’s clinic diagnosed with symptomatic FAI between December 2006 and Cam and pincer are two common morphologies responsible for femoroacetabular impingement. Previous literature has reported that cam deformity is predominantly a male morphology, while being significantly less common in females. Cam morphology is commonly assessed with the alpha angle, measured on radiographs. The purpose of this study was to determine the prevalence of cam morphology utilizing the alpha angle in female subjects diagnosed with symptomatic FAI. All females presenting to the senior author’s clinic diagnosed with symptomatic FAI between December 2006 and January 2013 were retrospectively reviewed. Alpha (α) angles were measured on AP (anteroposterior) and lateral (Dunn 90°, cross-table lateral, and/or frog-leg lateral) plain radiographs by two blinded physicians, and the largest measured angle was used. Using Gosvig et al.’s classification, alpha angle was characterized as (pathologic > 57°), borderline (51-56°), subtle (46-50°), very subtle (43-45°), or normal (≤42°). Three hundred and ninety-one patients (438 hips) were analyzed (age 36.2 ± 12.3 years). Among the hips included, 35.6% were normal, 14.6% pathologic, 15.1% borderline, 14.6% subtle, and 20.1% very subtle. There was no correlation between alpha angle and patient age (R = 0.17) or body mass index (BMI) (R = 0.05). The intraclass correlation coefficient (ICC) for α-angle measurements was 0.84. Sixty-four percent of females in this cohort had an alpha angle > 42°. Subtle cam deformity plays a significant role in the pathoanatomy of female patients with symptomatic FAI. As the majority of revision hip arthroscopies are performed due to incomplete cam correction, hip arthroscopists need to be cognizant of and potentially surgically address these subtle lesions

A Large-Scale Synthesis and Characterization of Quaternary CuIn\u3csub\u3e\u3cem\u3ex\u3c/em\u3e\u3c/sub\u3eGa\u3csub\u3e1−\u3cem\u3ex\u3c/em\u3e\u3c/sub\u3eS\u3csub\u3e2\u3c/sub\u3e Chalcopyrite Nanoparticles via Microwave Batch Reactions

Various quaternary CuInxGa1−xS2 (0 ≤ x ≤ 1) chalcopyrite nanoparticles have been prepared from molecular single-source precursors via microwave decomposition. We were able to control the nanoparticle size, phase, stoichiometry, and solubility. Depending on the choice of surface modifiers used, we were able to tune the solubility of the resulting nanoparticles. This method has been used to generate up to 5 g of nanoparticles and up to 150 g from multiple batch reactions with excellent reproducibility. Data from UV-Vis, photoluminescence, X-ray diffraction, TEM, DSC/TGA-MS, and ICP-OES analyses have shown high reproducibility in nanoparticle size, composition, and bandgap

A Large-scale Synthesis and Characterization of Quaternary CuInₓGa₁₋ₓS₂ Chalcopyrite Nanoparticles via Microwave Batch Reactions

Various quaternary CuInxGa1-xS2 (0≤x≤1) chalcopyrite nanoparticles have been prepared from molecular single-source precursors via microwave decomposition. We were able to control the nanoparticle size, phase, stoichiometry, and solubility. Depending on the choice of surface modifiers used, we were able to tune the solubility of the resulting nanoparticles. This method has been used to generate up to 5g of nanoparticles and up to 150g from multiple batch reactions with excellent reproducibility. Data from UV-Vis, photoluminescence, X-ray diffraction, TEM, DSC/TGA-MS, and ICP-OES analyses have shown high reproducibility in nanoparticle size, composition, and bandgap

The Relationship of Visceral Adipose Tissue with Markers of Energy Homeostasis Following Weight-Loss

Excess levels of adipose tissue, in particular visceral adipose tissue (VAT), is closely associated with the metabolic syndrome and dysregulation of energy homeostasis. It is hypothesized that leptin resistance results in overconsumption of calories and reduced satiety. Recently, brain derived neurotrophic factor (BDNF), beyond functioning in learning and memory, is shown to play a role in energy homeostasis via its positive satiety effects on the hypothalamus. However, it remains to be elucidated how changes in visceral adipose tissue are associated with changes in circulating leptin and BDNF after weight-loss. PURPOSE: To identify changes in adiposity and circulating leptin and BDNF following a 3-month weight-loss program. METHODS: Sixty-five obese (mean±SEM; age=47.9±1.1 years; BMI=34.5±0.8 kg/m2;), men and women completed a 3-month weight-loss program that consisted of a reduced energy intake of 1200-1500 kcals/day using a high-volume low-calorie diet combined with a progressive walking program to target 300 min/wk. Fasted (12 hr) blood samples were collected at baseline and post-weight-loss (3 months) and assayed for concentrations of glucose, insulin, BDNF, and leptin. Using DXA, total VAT and subcutaneous (SubQ) adipose tissue mass were measured at baseline and post-weight-loss (3 months). To identify significant changes over time, ANOVA with repeated measures was performed with significance set at p\u3c0.05. RESULTS: Following the 3-month weight-loss program, both BMI and HOMA-IR were significantly reduced 9.3% and 49%, respectively. The reduction in BMI and HOMA-IR were matched by a significant reduction in both VAT (-658 g; -33%, p\u3c0.001) and SubQ (-367 g; -17%, p\u3c0.001). Interestingly, leptin was reduced and BDNF was increased by 43% (p\u3c0.001) and 42% (p=0.011), respectively. Linear regression revealed that changes in VAT were associated with changes in leptin (b=0.298, p=0.026), but not with BDNF (b=0.027, p=0.896). CONCLUSION: This study shows that the reduction in VAT, by caloric restriction and physical activity, was associated with the reduction in circulating leptin concentrations, but not with changes in BDNF. Changes in leptin and BDNF may be in part responsible for the normalization of the energy homeostasis observed after weight-loss; however, changes in BDNF may be independent of VAT

The Effect of Gender on Circulating Adipokines during Weight Loss and Weight Maintenance

During obesity, the altered release of adipokines, leptin and adiponectin, have been strongly associated with development of the metabolic syndrome. Treatment with weight loss has been shown to increase adiponectin, in particular high molecular weight (HMW) adiponectin, and reduce circulating leptin levels indicating an increased leptin sensitizing effect. Interestingly, a gender dichotomy has been identified with women generally possessing higher plasma concentrations of both adipokines. Weight loss effects have been well established; however, it remains to be determined how the gender differences in adiponectin and leptin will affect these adipokines during prolonged weight maintenance. PURPOSE: To identify gender differences in adiponectin and leptin concentrations following a 6-month weight loss and weight maintenance program. METHODS: Sixty-five obese (mean±SEM; age=47.9±1.1 years; BMI=34.3±0.7 kg/m2;) adults (M=20, F=45) completed a 3-month weight loss program that consisted of a reduced energy intake of 1200-1500 kcals/day using a high-volume low-calorie diet combined with a progressive walking program to target 300 min/wk. During the 3-month weight maintenance program, participants consumed sufficient calories to maintain weight loss with continued walking to target 300 min/wk. Fasted (12 hr) blood samples were collected at baseline, post- weight loss (3 months), and weight maintenance (6 months) and assayed for glucose, insulin, total and HMW adiponectin, and leptin. To identify significant changes over time and between gender, a repeated measures (time x gender) ANOVA was performed with significance set at P\u3c0.05. Results: At baseline, no significant difference in BMI or HOMA-IR were observed between genders. Following 3 months of weight loss, BMI was significantly reduced 9.9% and 8.5% in men and women, respectively, and BMI remained unchanged through the weight maintenance program. Interestingly, only men demonstrated a significant reduction in HOMA-IR following weight loss. Following weight maintenance in women, HOMA-IR increased slightly such that it was not significantly different than the baseline or weight loss time points. At baseline, women had significantly higher circulating levels of total and HMW adiponectin, and leptin. No significant changes in total or HMW adiponectin were observed over time for either gender. Following weight-loss, leptin concentrations were reduced 49.6% and 39.2% in men and women, respectively. Interestingly, only women demonstrated a transient reduction in leptin through the weight maintenance program. Conclusions: At baseline, we identified the presence of a clear gender dichotomy for total and HMW adiponectin, and leptin concentrations. Despite these significant differences in circulating adipokines at baseline, both men and women responded similarly to a 6-month weight loss and weight maintenance program

Resilient Soils for Resilient Farms: An Integrative Approach to Assess, Promote and Value Soil Health for Small- and Medium-Size Farms

Our team was a collaborative group of academic, extension and doctoral student researchers who met internally and conducted an IRB-approved survey that engaged with myriad stakeholders. The result was a clear trifecta on relative timing of soil health initiatives: 1) Stakeholders (91%) embrace soil health and believe soil health should be the top priority for UVM research and outreach. 2) Existing policy demands farmers assess elements of soil health every two years for nutrient management plans. 3) Only a subset of desired metrics is available at commercial laboratories, most soil analyses are sent out of state to Maine or New York, and most data are privately held instead of deposited into public databases. Together, these three findings indicate that soil health be a central focus of UVM\u27s ARS program. Yet, due to attrition, there are no longer any UVM faculty dedicated to updating the 30-year-old soil recommendations upon which regulations rely. There is opportunity for university-government-community partnerships and expanded employment opportunities in Vermont if collaborative resources were assigned to soil health

ArgoNeuT and the Neutrino-Argon Charged Current Quasi-Elastic Cross Section

ArgoNeuT, a Liquid Argon Time Projection Chamber in the NuMI beamline at Fermilab, has recently collected thousands of neutrino and anti-neutrino events between 0.1 and 10 GeV. The experiment will, among other things, measure the cross section of the neutrino and anti-neutrino Charged Current Quasi-Elastic interaction and analyze the vertex activity associated with such events. These topics are discussed along with ArgoNeuT's automated reconstruction software, currently capable of fully reconstructing the muon and finding the event vertex in neutrino interactions.Comment: 6 pages, 4 figures, presented at the International Nuclear Physics Conference, Vancouver, Canada, July 4-9, 2010, to be published in Journal of Physics: Conference Series (JPCS