Relationship Between Hip Capsular Thickness and Instability After Previous Hip Arthroscopic Surgery: A Matched-Cohort Analysis.

Background: Thinner anterior hip capsules are associated with hip laxity, but there is little known about the impact of capsular thickness on the development of instability after primary hip arthroscopic surgery. Purpose: To investigate the relationship between hip capsular thickness as measured on preoperative magnetic resonance imaging (MRI) and the development of hip instability after hip arthroscopic surgery for femoroacetabular impingement. Study Design: Case-control study; Level of evidence, 3. Methods: We reviewed revision hip arthroscopic procedures performed between January 1, 2019, and May 1, 2021, at a single institution. Inclusion criteria were preoperative MRI/magnetic resonance arthrography, completion of the study traction protocol, and asymmetric distraction between the hips of ≥3 mm on examination under anesthesia. A comparison group of patients treated for femoroacetabular impingement with primary hip arthroscopic surgery who did not develop capsular instability were matched 1:1 to the patients with instability. Superolateral hip capsular thickness was measured on MRI before index surgery. Analysis was conducted using independent-samples t tests and multivariable linear regression. Results: A total of 44 patients were included, with 22 patients each in the instability and no-instability groups. The mean capsular thickness was lower in the patients with hip instability than in those without (1.9 ± 0.6 vs 3.4 ± 1.1 mm, respectively; P < .001). Decreased capsular thickness was significantly associated with hips with instability versus no-instability (ß = -1.468 [95% CI, -2.049 to -0.887]; P < .001). Conclusion: Thinner preoperative hip capsules in the region of the iliofemoral ligament were seen in patients who subsequently underwent revision arthroscopic surgery for hip instability compared to patients who underwent primary hip arthroscopic surgery without subsequent revision. Patients at a higher risk for the development of postoperative hip instability had a superolateral hip capsular thickness of <2 mm.

Osteomyelitis with abscess associated with acute closed upper humerus fracture in an adult: A case report.

A 64-year-old female presented with malaise and fever 11 days after a closed, minimally displaced humerus surgical neck fracture. MR imaging revealed an abscess around the fracture, which is a very rare occurrence in adults. Two open debridements and IV antibiotics eradicated the infection. Reverse total shoulder arthroplasty was eventually performed for fracture nonunion.

1,4,5,8-Naphthalene tetracarboxylate dianhydride/g-C3N4 van der Waals heterojunctions exhibit enhanced photochemical H2O2 production and antimicrobial activity.

Organic semiconductors, including graphitic carbon nitride (g-C3N4, CN), represent an important class of materials for the development of novel antimicrobial or biomedical technologies. Of principal interest is the ability of these materials to catalyze the reduction of elemental oxygen to generate reactive oxygen species (ROS), including hydrogen peroxide (H2O2). Here, we describe the fabrication of photoactive van der Waals heterojunctions incorporating 1,4,5,8-naphthalene tetracarboxylic dianhydride (NTCDA) and CN. The composite heterojunction systems were characterized by a combination of physical (TEM, SEM, pXRD), spectroscopic (FT-IR, XPS, DRUV, photoluminescence, TCSPC) and kinetic experiments. Electronic interactions between the two components of the heterojunction increase the rate of photochemical production of H2O2 from elemental oxygen by 410%, relative to samples of pure CN. Mechanistic analysis reveals that interaction of NTCDA with the surface of CN modifies the mechanism of H2O2 formation in the heterojunction photocatalysts. The photochemical production of H2O2 by irradiation of the most active heterojunction composition is sufficient to reduce the viability of E. coli O157:H7, S. aureus and Ps. aeruginosa PAO1 by 99%. Importantly, H2O2 production by the NTCDA/CN heterojunctions suppresses Ps. aeruginosa biofilm formation, even at light exposure doses that had a lesser impact on overall planktonic cell growth.

Development of Photoactive g-C3N4/Poly(vinyl alcohol) Composite Hydrogel Films with Antimicrobial and Antibiofilm Activity.

Free-standing, composite hydrogels containing the visible-light responsive metal-free semiconductor graphitic carbon nitride (g-C3N4) as an integral component have been fabricated by direct casting techniques. At 0.67% g-C3N4 loading, intermolecular interactions between the semiconductor particles and the PVA polymer chains enhance both the mechanical and photophysical properties of the resulting hydrogels. In contrast, much higher g-C3N4 loadings of 3.3 or 6.7% g-C3N4 resulted in growth of the average semiconductor particle size and reduction in interactions between the incorporated photocatalyst and the PVA chains. The increased dimensions of the g-C3N4 semiconductor particles had the effect of compromising the mechanical properties of the composite system and reducing the lifetime of photogenerated charge carriers. However, the close proximity of g-C3N4 particles that is realized at increased semiconductor loading densities improves the absorption cross section of the material, resulting in an overall improvement in the photocatalytic activity of the material. Application of visible radiation caused all of the composite hydrogels to generate hydrogen peroxide (H2O2) at catalytic rates of 0.9-2.5 µM/min, while H2O2 decomposition rates remained similar across the different preparations. In studies to examine antimicrobial performance, irradiation of 6.7% g-C3N4/PVA hydrogel samples with visible radiation (400 ≤ λ ≤ 800 nm) generated sufficient H2O2 to significantly reduce both the viable planktonic cell population and biofilm formation in cultures of Pseudomonas aeruginosa.

PEPFAR's past and future efforts to cut costs, improve efficiency, and increase the impact of global HIV programs.

Amid the global economic crisis, the President's Emergency Plan for AIDS Relief (PEPFAR) and other organizations have been pressed to do more with constrained resources to meet unmet needs in the worldwide HIV/AIDS pandemic. PEPFAR has approached this challenge through the development of an Impact and Efficiency Acceleration Plan, which includes improving the collection and use of economic and financial data, increasing the efficiency of HIV/AIDS program implementation, and collaborating with governments and multilateral organizations to maximize the impact of the resources provided by the United States. For example, by linking financial data with program outputs, PEPFAR was able to help its implementing partners in Mozambique reduce mean unit expenditures for people receiving antiretroviral treatment by 45 percent, from $265 to $145 per person, between 2009 and 2011. This article describes the plan's elements, provides examples of progress and challenges to its implementation, and assesses the prospects for further improvements in efficiency and impact.

Progressive Cenozoic cooling and the demise of Antarctica's last refugium.

The Antarctic Peninsula is considered to be the last region of Antarctica to have been fully glaciated as a result of Cenozoic climatic cooling. As such, it was likely the last refugium for plants and animals that had inhabited the continent since it separated from the Gondwana supercontinent. Drill cores and seismic data acquired during two cruises (SHALDRIL I and II) in the northernmost Peninsula region yield a record that, when combined with existing data, indicates progressive cooling and associated changes in terrestrial vegetation over the course of the past 37 million years. Mountain glaciation began in the latest Eocene (approximately 37-34 Ma), contemporaneous with glaciation elsewhere on the continent and a reduction in atmospheric CO(2) concentrations. This climate cooling was accompanied by a decrease in diversity of the angiosperm-dominated vegetation that inhabited the northern peninsula during the Eocene. A mosaic of southern beech and conifer-dominated woodlands and tundra continued to occupy the region during the Oligocene (approximately 34-23 Ma). By the middle Miocene (approximately 16-11.6 Ma), localized pockets of limited tundra still existed at least until 12.8 Ma. The transition from temperate, alpine glaciation to a dynamic, polythermal ice sheet took place during the middle Miocene. The northernmost Peninsula was overridden by an ice sheet in the early Pliocene (approximately 5.3-3.6 Ma). The long cooling history of the peninsula is consistent with the extended timescales of tectonic evolution of the Antarctic margin, involving the opening of ocean passageways and associated establishment of circumpolar circulation.