Effect of femoral head size, subject weight and activity level on acetabular cement mantle stress following total hip arthroplasty

In cases where cemented components are used in total hip arthroplasty, damage or disruption of the cement mantle can lead to aseptic loosening and joint failure. Currently, the relationship between subject activity level, obesity and prosthetic femoral head size and the risk of aseptic loosening of the acetabular component in cemented THA is not well understood. This study aims to provide an insight into this. Finite element models, validated with experimental data, were developed to investigate stresses in the acetabular cement mantle and pelvic bone resulting from the use of three prosthetic femoral head sizes, during a variety of daily activities and one high impact activity (stumbling) for a range of subject body weights. We found that stresses in the superior quadrants of the cortical bone‐cement interface increased with prosthetic head size, patient weight and activity level. In stumbling, average von Mises stresses (22.4 MPa) exceeded the bone cement yield strength for an obese subject (143 kg) indicating that the cement mantle would fail. Our results support the view that obesity and activity level are potential risk factors for aseptic loosening of the acetabular component and provide insight into the increased risk of joint failure associated with larger prosthetic femoral heads

Impact on adolescent mental health of replacing screen-use with exercise: A prospective cohort study

BACKGROUND: Screen-based device use could increase the risk of adolescent depression. Distinct modalities of screen-use may have differential effects on mental health. We used compositional data analysis to examine how theoretically replacing different screen-uses with exercise might influence future adolescent emotional distress. METHODS: In 4,599 adolescents (55% female) from a nationally-representative, prospective cohort, we used time-use diary data at age 14 to estimate daily screen use (television, social media, video game, general computer use) and exercise (team sport and individual exercise). The outcome was emotional distress at age 17, assessed using the emotional symptoms subscale of the Strengths and Difficulties Questionnaire. RESULTS: Theoretically replacing 60 minutes of total screen time with exercise at age 14 was associated with a 0.05 (95%CI -0.08, -0.02) score reduction on the emotional symptoms' subscale at 17 in fully-adjusted models. Replacing 60 minutes of television or social media use with team sports was associated with a reduction of 0.17 (95%CI, -0.31, -0.04) and 0.15 (95%CI, -0.29, -0.01) in emotional symptom scores, respectively. We found no change in emotional symptom scores when replacing video game or general computer use with team sport, or when replacing any screen time with individual exercise. LIMITATIONS: No direct measure of depressive symptoms at follow-up. CONCLUSIONS: Replacing any screen time with exercise could reduce emotional distress, but the largest effect sizes were associated with replacing time in television watching and social media with team sports. Recommendations to limit screen-use in adolescents may require a nuanced approach for protecting mental health

Neonatal pyruvate dehydrogenase deficiency due to a R302H mutation in the PDHA1 gene: MRI findings

Pyruvate dehydrogenase (PDH) deficiency is one of the most common causes of congenital lactic acidosis. Correlations between the genetic defect and neuroimaging findings are lacking. We present conventional and diffusion-weighted MRI findings in a 7-day-old male neonate with PDH deficiency due to a mosaicism for the R302H mutation in the PDHA1 gene. Corpus callosum dysgenesis, widespread increased diffusion in the white matter, and bilateral subependymal cysts were the main features. Although confirmation of PDH deficiency depends on specialized biochemical analyses, neonatal MRI plays a role in evaluating the pattern and extent of brain damage, and potentially in early diagnosis and clinical decision making

Histidine kinase two-component response regulators Ssk1, Skn7 and Rim15 differentially control growth, developmental and volatile organic compounds emissions as stress responses in Trichoderma atroviride

The Skn7, Ssk1 and Rim15 proteins are response regulators involved in osmotic, oxidative and nutritional stress in fungi. In order to verify the involvement of these genes in Trichoderma atroviride IMI206040’s growth, conidiation, direct antagonism against plant pathogens (Rhizoctonia solani and Sclerotinia sclerotiorum), production of volatile organic compounds (VOCs) with fungistatic effect, and interaction with plants (growth promotion), single mutants were generated, and the phenotypic patterns were analysed in comparison to the wild-type (wt) strain. The mutants were submitted to osmotic, oxidative, membrane and cell wall stress conditions in vitro. The Δskn7 and Δrim15 mutants did not show either significant differences at morphological level, or marked decreases in mycelial growth and conidiation in relation to wt, whereas Δssk1 had altered phenotypes in most conditions tested. The plant-growth promotion of Arabidopsis thaliana seedlings induced by VOCs was not quantitatively modified by any of the mutants in relation to the wt strain, although possible differences in secondary root hairs was noticed for Δrim15. The fungistatic activity was significantly altered for Δssk1 and Δrim15. Overall, the Δssk1 strain showed remarkable morphological differences, with decrease in mycelial growth and conidiation, being also affected in the antagonistic capacity against plant pathogens. The impacts demonstrated by the deletion of ssk1 suggest this gene has a relevant participation in the signalling response to different stresses in T. atroviride and in the interactive metabolism with phytopathogens and plants. On the other hand, unlike other fungal models, Skn7 did not appear to have a critical participation in the above-mentioned processes; Rim15 seemed to confirm its involvement in modulating cellular responses to nutritional status, although with a possible cross-talk with other cellular processes. Our results suggest that Ssk1 likely plays a key regulatory role, not only in basic metabolisms of T. atroviride, but also in biocontrol-related characteristics