Optimizing Corn Tar Spot Measurement: A Deep Learning Approach Using Red-Green-Blue Imaging and Stromata Contour Detection Algorithm for Leaf-Level Disease Severity Analysis.

Visual detection of stromata (brown-black, elevated fungal fruiting bodies) is a primary method for quantifying tar spot early in the season, as these structures are definitive signs of the disease and essential for effective disease monitoring and management. Here, we present Stromata Contour Detection Algorithm version 2 (SCDA v2), which addresses the limitations of the previously developed SCDA version 1 (SCDA v1) without the need for empirical search of the optimal Decision Making Input Parameters (DMIPs), while achieving higher and consistent accuracy in tar spot stromata detection. SCDA v2 operates in two components: (i) SCDA v1 producing tar-spot-like region proposals for a given input corn leaf Red-Green-Blue (RGB) image, and (ii) a pre-trained Convolutional Neural Network (CNN) classifier identifying true tar spot stromata from the region proposals. To demonstrate the enhanced performance of the SCDA v2, we utilized datasets of RGB images of corn leaves from field (low, middle, and upper canopies) and glasshouse conditions under variable environments, exhibiting different tar spot severities at various corn developmental stages. Various accuracy analyses (F1-score, linear regression, and Lin's concordance correlation), showed that SCDA v2 had a greater agreement with the reference data (human visual annotation) than SCDA v1. SCDA v2 achievd 73.7% mean Dice values (overall accuracy), compared to 30.8% for SCDA v1. The enhanced F1-score primarily resulted from eliminating overestimation cases using the CNN classifier. Our findings indicate the promising potential of SCDA v2 for glasshouse and field-scale applications, including tar spot phenotyping and surveillance projects.

Pectoralis major tendon rupture repairs using intramedullary suture anchors shows high patient-reported outcomes in military service members.

BACKGROUND: In the general population, pectoralis major tendon ruptures are uncommon; however, it is a common injury in the military population. The military service members have greater physical demands than the general population. The purpose of this study is to critically assess the postoperative outcomes of pectoralis major tendon ruptures in military service members following a repair using intramedullary suture anchors. METHODS: A retrospective chart review was performed between 2014 and 2022, identifying patients who underwent a pectoralis major rupture repair performed by the senior surgeon using intramedullary suture anchors. Records were reviewed for age, gender, mechanism of injury, chronicity, visual analog scale, and Single Assessment Numeric Evaluation (SANE) scores. Patients who had less than 1 year of follow-up were excluded from the study. During the study period, 18 patients underwent surgical repair of their torn pectoralis major, and 15 patients were followed up >1 year postoperatively. Twelve of these 15 patients (80%) were successfully contacted, and patient-reported outcomes were collected. RESULTS: A total of 12 patients (12 male, 0 female) with a mean age of 34.5 years were identified. Average time from injury to surgery was 471.4 days. Average duration of follow-up was 3.7 years. There was a decrease in the preoperative average single repetition maximum (1RM) barbell bench press of 125.7 kg (277 lbs) to a postoperative average 1RM bench press of 101.8 kg (225 lbs) (P = .03). Mean change in average 1RM barbell bench press is a 19.04% decrease postoperatively. Postoperative SANE score was 80.8 and an American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form score of 86.9. Seven patients (58.3%) stated they were afraid to bench press at their previous weight because of fear of reinjury. None of the patients were medically discharged from the military owing to limitations from their repaired shoulder. Ten patients (83%) reported they were extremely satisfied with their shoulder function postoperatively. CONCLUSION: Repair of the pectoralis major tendon ruptures using intramedullary suture anchors has high rates of return to duty, patient satisfaction, and patient-reported outcomes. More than half of the patients reported they were afraid to bench press at their preinjury weight because of concerns of reinjury; the decrease in postoperative strength may be a result of the patients' fear of reinjury rather than physiologic limitations.

Perioperative intravenous dexamethasone use is not associated with periprosthetic joint infection or wound healing complications following shoulder arthroplasty.

BACKGROUND: Perioperative intravenous (IV) dexamethasone is commonly used in lower extremity total joint arthroplasty to manage postoperative pain and nausea/vomiting, and recent studies have demonstrated that its use may lower rates of acute postoperative medical complications. However, there is limited information regarding the safety and efficacy of IV dexamethasone in patients undergoing total shoulder arthroplasty (TSA). Additionally, there is concern surrounding corticosteroid use prior to surgery as preoperative corticosteroid injections have been associated with adverse outcomes after TSA, including periprosthetic joint infection (PJI) and revision surgery. Thus, the purpose of this study was to evaluate the effect of perioperative IV dexamethasone on 90-day rates of PJI, wound complications, and medical complications after TSA. METHODS: The Premiere national hospital database was used to identify adult patients undergoing elective TSA between 2016 and 2020; patients were excluded if they were under 18 years old, were undergoing revision TSA, or had a prior proximal humerus open reduction internal fixation procedure. Patients who did and did not receive perioperative IV dexamethasone were then compared in both univariate and multivariate analyses. A Bonferroni correction was utilized to adjust for multiple comparisons. The primary end point was risk of acute infectious complications within 90 days of surgery, including PJI and wound infection/dehiscence. Secondary end points included acute pulmonary, renal, and thromboembolic complications. RESULTS: A total of 135,333 patients underwent TSA during the study period; 61.2% underwent reverse total shoulder arthroplasty, 33.8% underwent anatomic total shoulder arthroplasty, and 5.0% underwent hemiarthroplasty. From 2016 to 2020, perioperative IV dexamethasone use increased by 135%. Multivariate analysis revealed that patients who received perioperative IV dexamethasone did not have increased odds of PJI, superficial wound infection, or wound dehiscence (P = .15-.47) but did have decreased odds of sepsis (odds ratio [OR] 0.67, 95% confidence interval [CI] 0.55-0.81) and other medical complications such as urinary tract infection and acute kidney injury. Additionally, there was a trend towards decreased 90-day hospital readmission (OR 0.88, 95% CI 0.81-0.96, P = .003). CONCLUSIONS: Perioperative IV dexamethasone was not associated with increased risk of acute infectious and wound healing complications. Moreover, patients who received perioperative IV dexamethasone had decreased odds of medical complications and trended toward lower rates of 90-day hospital readmission. The results of this study support the safety of perioperative IV dexamethasone use in patients undergoing elective TSA.

Recommendations for the Development of Psychological Smartphone Applications in the Context of Bariatric Surgery: Focus Groups with Professionals and Patients.

To explore the experiences and preferences of patients and healthcare professionals regarding the development of an app to provide psychological intervention to improve emotion regulation in the context of bariatric surgery (BS). Sixteen people (6 patients who underwent BS and 10 professionals) participated in two separate focus group sessions. We performed a content analysis of transcribed focus group discussions to extract and organize categories, subcategories and areas. Both sets of stakeholders provided information about how to develop and implement an app. According to participants' comment, content should include information (i.e., nutrition, exercise) and emotional regulation skills. Patients and professionals mentioned that the app should include visual information, continuous emotional assessments and peer contact. It was also mentioned that the app should be used before and after BS and its contents should be developed by a multidisciplinary team (i.e., collaboration of endocrinologist, nutritionists and psychologists). Participants in both focus groups considered technology to be useful in the context of BS, especially as part of blended interventions (combining face-to-face and online sessions). Patients and professionals seem to be receptive towards the use of technology in a BS context. Specific recommendations are identified for designing and implementing app solutions for BS. More efforts should be made in the future to develop and implement evidence-based apps according to patients and professionals' needs.

QTL Pyramiding Provides Marginal Improvement in 2NvS-Based Wheat Blast Resistance.

Wheat blast, caused by the fungus Magnaporthe oryzae Triticum pathotype (MoT), is a devastating disease affecting South America, Bangladesh, and Zambia. Resistance to wheat blast has strongly relied on the 2NvS translocation; however, newer MoT isolates have increased aggressiveness, threatening the 2NvS translocation's effectiveness and durability. To identify genomic regions associated with wheat blast resistance, we performed a quantitative trait loci (QTL) mapping study using 187 double-haploid (DH) lines from a cross between the Brazilian wheat cultivars 'TBIO Alvorada' and 'TBIO Sossego', which are moderately resistant and susceptible to blast, respectively. The DH population was evaluated in a greenhouse in Brazil and Bolivia, and field conditions in Bolivia. Contrasting models best explained the relationship between traits evaluated according to differences in disease levels and the presence of the 2NvS. A large effect-locus, derived from 'TBIO Sossego', was identified on chromosome 2AS, which was confirmed to be 2NvS translocation and explained 33.5 to 82.4% of the phenotypic variance. Additional significant loci were identified on 5AL, 1DS, 4DS, 5DL, and 6DL chromosome arms with phenotypic variance <6%, but they were not consistent across trait-environment combinations. QTL pyramiding analyses showed that some specific loci had an additive effect when combined with the 2NvS, suggesting that stacking multiple loci may be an effective strategy to help manage wheat blast. The markers associated with the 2NvS can be used as dominant diagnostic markers for this alien translocation. Additional characterization of these loci using a broader set of MoT isolates is critical to validate their effectiveness against current MoT populations.

Surgical treatment of shoulder instability in active-duty service members with subcritical glenoid bone loss: Bankart vs. Latarjet.

INTRODUCTION: Subcritical bone loss has been identified as a risk factor for potentially inferior outcomes following typical arthroscopic soft tissue repair. One alternative that has been presented as an option for patients with bone loss is the Latarjet, an ipsilateral coracoid transfer to the anteroinferior glenoid. The purpose of this study is to compare the outcomes between the arthroscopic Bankart repair and the open Latarjet for the treatment of anterior shoulder instability in patients with subcritical bone loss. We hypothesize that the open Latarjet will provide higher patient-reported outcome measure scores and lower rates of dislocation. METHODS: A retrospective cohort comparison of patients with anterior glenohumeral instability procedures was performed. Inclusion criteria included symptomatic anterior shoulder instability, subcritical glenoid bone loss (13.5%-24%), surgical treatment with arthroscopic Bankart repair or open Latarjet, and minimum follow-up of 2 years. Outcomes included recurrent instability (defined as postoperative dislocation or subjective subluxation), permanent physical restrictions, Western Ontario Shoulder Index (WOSI), and Single Assessment Numeric Evaluation (SANE) scores. RESULTS: Forty-seven patients were included, 25 of whom underwent an arthroscopic Bankart repair and 23 patients an open Latarjet. The average bone loss was 17.8% and 19.3%, respectively. Overall, 8 patients experienced recurrent instability, 6 in the arthroscopic Bankart group and 2 in the open Latarjet group (P = .162). The average postoperative SANE score for arthroscopic Bankart group was 48% and for the open Latarjet group, 84% (P < .001). The average postoperative WOSI score for the arthroscopic Bankart group was 53.6% and for the open Latarjet group, 67.9% (P = .069). There were significantly more patients placed on permanent physical restrictions in the arthroscopic Bankart repair group (16) compared with open Latarjet (3) (P < .001). CONCLUSION: In patients with subcritical glenoid bone loss (defined as 13.5%-24%), patients treated with an open Latarjet have insignificantly higher SANE and WOSI scores and lower permanent physical restrictions than patients treated with an arthroscopic Bankart repair. We found no statistically significant difference in recurrent instability rates between the open Latarjet and arthroscopic Bankart repair (P = .162).

Temporal changes in the accessory protein mutations of SARS-CoV-2 variants and their predicted structural and functional effects.

Emerging variants enable the continuous spread of SARS-CoV-2 in humans. The factors contributing to behavioral differences in variants remain elusive despite associations with several Spike protein mutations. Exploring accessory proteins may provide a wider understanding of these differences since these proteins may affect viral processes that occur beyond infection. Various bioinformatics tools were utilized to identify significant accessory protein mutations and determine their structural and functional effects over time. The ViruClust web application was used to retrieve accessory protein amino acid sequences and determine mutation frequencies in these sequences across time. The structural and functional effects of the mutations were determined using Missense3D and PROVEAN, respectively. The accessory and Spike protein mutations were compared using mutation densities. Q57H and T151I of ORF3a; T21I and W27L of ORF6; G38V, V82A, and T120I of ORF7a; S31P and T40I of ORF7b; and R52I, C61F, and I121L of ORF8 were highly frequent in most variants of concern and were within known functional domains. Thus, these are good candidates for further experimental evaluation. Among the accessory proteins, ORF6 and ORF8 were highlighted because of their strong and weak correlation with Spike protein mutations, respectively.

Effect of Fucoidan on the Mitochondrial Membrane Potential (ΔΨm) of Leukocytes from Patients with Active COVID-19 and Subjects That Recovered from SARS-CoV-2 Infection.

Fucoidan is a polysaccharide obtained from marine brown algae, with anti-inflammatory, anti-viral, and immune-enhancing properties, thus, fucoidan may be used as an alternative treatment (complementary to prescribed medical therapy) for COVID-19 recovery. This work aimed to determine the ex-vivo effects of treatment with fucoidan (20 µg/mL) on mitochondrial membrane potential (ΔΨm, using a cationic cyanine dye, 3,3'-dihexyloxacarbocyanine iodide (DiOC6(3)) on human peripheral blood mononuclear cells (HPBMC) isolated from healthy control (HC) subjects, COVID-19 patients (C-19), and subjects that recently recovered from COVID-19 (R1, 40 ± 13 days after infection). In addition, ex-vivo treatment with fucoidan (20 and 50 µg/mL) was evaluated on ΔΨm loss induced by carbonyl cyanide 3-chlorophenylhydrazone (CCCP, 150 µM) in HPBMC isolated from healthy subjects (H) and recovered subjects at 11 months post-COVID-19 (R2, 335 ± 20 days after infection). Data indicate that SARS-CoV-2 infection induces HPBMC loss of ΔΨm, even 11 months after infection, however, fucoidan promotes recovery of ΔΨm in PBMCs from COVID-19 recovered subjects. Therefore, fucoidan may be a potential treatment to diminish long-term sequelae from COVID-19, using mitochondria as a therapeutic target for the recovery of cellular homeostasis.

Surgical treatment of anterior shoulder instability with glenoid bone loss with the Latarjet procedure in active-duty military service members.

INTRODUCTION: The arthroscopic Bankart repair in the setting of glenoid bone loss has high rates of failure. In patients with anterior glenoid bone loss, the Latarjet provides glenohumeral stability through restoration of the glenoid bone, the conjoint tendon acting as a sling on the subscapularis, and anterior capsulolabral repair. Active-duty military personnel are at high risk for glenohumeral instability and have been equated to the contact athlete; most are young, male, and engage in contact sports. The purpose of this study is to assess the return to full-duty rates in active-duty military personnel following the Latarjet for anterior glenohumeral instability with glenoid bone loss. METHODS: A retrospective review of all glenohumeral instability procedures were reviewed at a tertiary training hospital from June 2014 to June 2019. The patient population consisted of active-duty military personnel with glenoid bone loss and anterior glenohumeral instability, who were treated with a Latarjet. The primary outcome was return to full-duty status. RESULTS: There were 50 patients identified for the study. Four patients were lost to follow-up, leaving 46 of 50 patients (92.0%) eligible for this study. The average age at the time of the index procedure was 23.1 years. The average percentage bone loss was 18.4%. Forty-one patients (89.1%) were able to return to full-duty status. Four patients (8.7%) sustained a recurrent dislocation following the Latarjet; all 4 dislocations occurred during a combat deployment. Four patients (8.7%) reported episodes of subluxation without dislocation. Forty-one patients (89.1%) reported that their shoulders felt stable, and we found an average return to full duty at 5.3 months CONCLUSION: In our active-duty military cohort, we found an 8.7% rate of recurrent instability after a Latarjet procedure, and 41 patients (89.1%) were able to return to full-duty status. In conclusion, the Latarjet procedure in the active-duty military population with anterior glenoid bone loss resulted in a high rate of return to duty, excellent functional outcomes, low rate of recurrent instability, and a low overall complication rate.

Evaluating the Influence of Gravity on Shoulder Strength Measures Assessed via Handheld Dynamometry.

CONTEXT: Handheld dynamometry is a feasible, reliable, and cost-effective method for assessing shoulder strength. One limitation to this tool is the lack of standardized testing protocols and specified shoulder strength test positions. Although it is recommended that strength tests be performed in a gravity-eliminated position, this may not always be a feasible or practical testing protocol. There is limited research on the influence of gravity on strength measures; to our knowledge, no study has compared handheld dynamometry shoulder strength assessments based on body position and gravity. Therefore, the purpose of this study was to compare shoulder flexion, extension, and abduction strength assessed via handheld dynamometry between a gravity-eliminated and a gravity-influenced test position. DESIGN: This study was a comparison of shoulder strength based on test position. The test position was the independent variable, and the dependent variables were shoulder flexion, extension, and abduction strength. METHODS: Supine (gravity-eliminated) and seated (gravity-influenced) strength measures were assessed in 20 healthy adults (19.4 [1.2] y) on the dominant arm. Paired t tests were used to determine differences between body positions for each test. Significance was accepted at P ≤ .05. RESULTS: There were no differences between supine and seated flexion and extension measures. Absolute supine shoulder abduction scores (152.5 [58.4] N) were significantly higher than seated scores (139.9 [55.6] N). CONCLUSIONS: Findings show that gravity should be considered when using handheld dynamometry scores as indicators of abductor shoulder strength and function.

Comparing the Temporal Development of Wheat Spike Blast Epidemics in a Region of Bolivia Where the Disease Is Endemic.

Epidemics of wheat blast, caused the Triticum pathotype of Magnaporthe oryzae, were studied in the Santa Cruz del la Sierra region of Bolivia to quantify and compare the temporal dynamics of the disease under different growing conditions. Six plots of a susceptible wheat cultivar were planted at Cuatro Cañadas (CC), Okinawa 1 (OK1), and Okinawa 2 (OK2) in 2015. Spike blast incidence (INC) and severity (SEV) and leaf blast severity (LEAF) were quantified in each plot at regular intervals on a 10 × 10 grid (n = 100 clusters of spikes), beginning at head emergence (Feekes growth stage 10.5), for a total of nine assessments at CC, six at OK1, and six at OK2. Spike blast increased over time for 20 to 30 days before approaching a mean INC of 100% and a mean SEV of 60 to 75%. The logistic model was the most appropriate for describing the temporal dynamics of spike blast. The highest absolute rates of disease increase occurred earliest at OK1 and latest at OK2, and in all cases it coincided with major rain events. Estimated y0 values (initial blast intensity) were significantly (P < 0.05) higher at OK1 than at CC or OK2, whereas rL values (the logistic rate parameter) were significantly higher at OK2 than at CC or OK1. It took about 10 fewer days for SEV to reach 10, 15, or 20% at OK1 compared with OK2 and CC. Based on survival analyses, the survivor functions for time to 10, 15 and 20% SEV (ts) were significantly different between OK1 and the other locations, with the probabilities of SEV reaching the thresholds being highest at OK1. LEAF at 21 days after Feekes 10.5 had a significant effect on ts at OK1. For every 5% increase in LEAF, the chance of SEV reaching the thresholds by day 21 increased by 30 to 55%.

Novel Sources of Wheat Head Blast Resistance in Modern Breeding Lines and Wheat Wild Relatives.

Wheat head blast (WHB), caused by the fungus Magnaporthe oryzae pathotype triticum, is a devastating disease affecting South America and South Asia. Despite 30 years of intensive effort, the 2NVS translocation from Aegilops ventricosa contains the only useful source of resistance to WHB effective against M. oryzae triticum isolates. The objective of this study was to identify non-2NVS sources of resistance to WHB among elite cultivars, breeding lines, landraces, and wild-relative accessions. Over 780 accessions were evaluated under field and greenhouse conditions in Bolivia, greenhouse conditions in Brazil, and at two biosafety level-3 laboratories in the United States. The M. oryzae triticum isolates B-71 (2012), 008 (2015), and 16MoT001 (2016) were used for controlled experiments, while isolate 008 was used for field experiments. Resistant and susceptible checks were included in all experiments. Under field conditions, susceptible spreaders were inoculated at the tillering stage to guarantee sufficient inoculum. Disease incidence and severity were evaluated as the average rating for each 1-m-row plot. Under controlled conditions, heads were inoculated after full emergence and individually rated for percentage of diseased spikelets. The diagnostic marker Ventriup-LN2 was used to test for the presence of the 2NVS translocation. Four non-2NVS spring wheat International Maize and Wheat Improvement Center breeding lines (CM22, CM49, CM52, and CM61) and four wheat wild-relatives (A. tauschii TA10142, TA1624, TA1667, and TA10140) were identified as resistant (<5% of severity) or moderately resistant (5 to <25% severity) to WHB. Experiments conducted at the seedling stage showed little correlation with disease severity at the head stage. M. oryzae triticum isolate 16MoT001 was significantly more aggressive against 2NVS-based varieties. The low frequency of WHB resistance and the increase in aggressiveness of newer M. oryzae triticum isolates highlight the threat that the disease poses to wheat production worldwide and the urgent need to identify and characterize new resistance genes that can be used in breeding for durably resistant varieties.

A Sport-specific Analysis of the Epidemiology of Hip Injuries in National Collegiate Athletic Association Athletes From 2009 to 2014.

PURPOSE: To describe the injury rates, mechanisms, time loss, and rates of surgery for hip/groin injuries in National Collegiate Athletic Association (NCAA) athletes across 25 collegiate sports during the 2009/10 to 2013/14 academic years. METHODS: Data from the 2009/10 to 2013/14 academic years were obtained from the NCAA Injury Surveillance Program (ISP). Rates of hip/groin injuries, mechanism of injury, time lost from competition, and surgical treatment were calculated. Differences between sex-comparable sports were quantified using rate ratios and injury proportion ratios. A sport-specific biomechanical classification system, which included cutting, impingement, overhead/asymmetric, endurance, and flexibility sports, was applied for subgroup analysis. RESULTS: In total, 1,984 hip injuries were reported in 25 NCAA sports, including 9 male and female sports, 3 male-only sports, and 4 female-only sports between the years 2009/10 and 2013/14, resulting in an overall hip injury rate of 53.1/100,000 athletic exposures (AEs). In sex-comparable sports, (basketball, cross-country, lacrosse, ice hockey, indoor track, outdoor track, soccer, swimming, and tennis), men were more commonly affected than women (59.53 vs 42.27 per 100,000 AEs respectively; rate ratio, 1.41; 95% confidence interval, 1.28-1.55). Subgroup analysis demonstrated that the highest rate of hip injuries per 100,000 AEs occurred in impingement sports (96.9). Endurance sports had the highest proportion of injured athletes with time lost >14 days (9.5%). For impingement-type sports, the most common mechanism of injury was no apparent contact (48.2%). The rate of athletes undergoing surgery per 100,000 AEs was highest in impingement-type sports (2.0). CONCLUSIONS: We have identified that impingement-type sports are most frequently associated with hip injuries. Additionally, this study demonstrates that hip injuries sustained in athletes who played impingement-type sports had a significantly higher rate of surgical intervention than other sport classifications. LEVEL OF EVIDENCE: Level III, prognostic study.

Climate Suitability for Magnaporthe oryzae Triticum Pathotype in the United States.

Wheat blast, caused by the Triticum pathotype of Magnaporthe oryzae, is an emerging disease considered to be a limiting factor to wheat production in various countries. Given the importance of wheat blast as a high-consequence plant disease, weather-based infection models were used to estimate the probabilities of M. oryzae Triticum establishment and wheat blast outbreaks in the United States. The models identified significant disease risk in some areas. With the threshold levels used, the models predicted that the climate was adequate for maintaining M. oryzae Triticum populations in 40% of winter wheat production areas of the United States. Disease outbreak threshold levels were only reached in 25% of the country. In Louisiana, Mississippi, and Florida, the probability of years suitable for outbreaks was greater than 70%. The models generated in this study should provide the foundation for more advanced models in the future, and the results reported could be used to prioritize research efforts regarding the biology of M. oryzae Triticum and the epidemiology of the wheat blast disease.

Acanthocephalan Parasites (Acanthogyrus sp.) of Nile Tilapia (Oreochromis niloticus) as Biosink of Lead (Pb) Contamination in a Philippine Freshwater Lake.

The potential use of acanthocephalans as bioindicators of Lead (Pb) pollution in Sampaloc Lake, Laguna, Philippines was investigated. Nile tilapias (Oreochromis niloticus) were collected and Pb concentrations were determined in fish tissues and in their acanthocephalan parasites, Acanthogyrus sp. Significantly higher levels of Pb were detected in the parasites relative to the fish host tissues (p = 0.001). Bioaccumulation capacity of the parasites against fish tissues were 102, 119, and 147 times higher than the fish intestine, liver, and muscles, respectively. Pb sensitivity of the parasites was quantified by exact logistic analysis showing higher odds of Pb detection ranging from 18 to 45 folds (p = 0.001-0.009). Interestingly, infected fish showed significantly lower Pb concentration in their tissues compared to uninfected fish (p = 0.001), suggesting parasites were able to sequester Pb and served as active biosinks. The Pb levels in the parasites were also hundred folds higher (988 times) relative to the ambient waters, indicating a potential role of fish parasites as metal biosinks in aquatic ecosystems.

Fresh Osteochondral Allograft Transplantation of the Capitellum for the Treatment of Osteochondritis Dissecans.

BACKGROUND: Osteochondritis dissecans (OCD) of the humeral capitellum is a rare and challenging condition to treat. Several surgical options exist, but in the last few years, the pendulum has swung from debridement and microfracture to restoration of the articular surface. Osteochondral autografts from the rib and knee have been described, but donor-site morbidity is a concern. PURPOSE: To expand the results of fresh osteochondral allograft transplantation (FOCAT) in a previously published report with inclusion of additional patients and a longer follow-up period. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: After institutional review board approval, the charts of patients who underwent FOCAT for OCD of the capitellum between 2006 and 2022 by a single surgeon were reviewed. The majority of cases (94%) had unstable lesions (Minami grades 2 and 3). A trial of nonoperative treatment had failed in all. All patients underwent diagnostic arthroscopy, followed by a mini-open, ligament-sparing approach with grafting using commercially available guides and instruments. RESULTS: A total of 35 patients were identified, of whom 25 were male. The mean age was 16 ± 3.9 years (range, 11-32 years). There were 24 baseball players (19 pitchers and 5 position players), 5 gymnasts, 3 cheerleaders/tumblers, 1 tennis player, 1 student (who did not participate in athletics), and 1 patient with avascular necrosis from chemotherapy. Eighteen patients had a mean flexion contracture of 14.1°± 11.9°. A single osteochondral allograft plug was used in 23 patients (mean diameter, 11.3 ± 2.8 mm), and 12 patients required 2 plugs (Mastercard technique). The mean follow-up was 92.6 ± 54.5 months (range, 24-204 months). There was significant improvement in Oxford (from 25.5 ± 4.9 to 46.7 ± 3.5; P < .00001) and visual analog scale for pain (from 7.5 ± 2 to 0.3 ± 1.0; P < .0001) scores. The mean Single Assessment Numeric Evaluation score at the time of follow-up was 90.6 ± 10.8 (range, 60-100). In overhead athletes, there was significant improvement in the Kerlan-Jobe Orthopaedic Clinic score (from 40.8 ± 11.8 to 90.6 ± 10.8; P < .00001). A postoperative magnetic resonance imaging scan was obtained in 16 (46%) patients at a mean of 32.6 months. In all cases, the graft was incorporated. All overhead athletes were able to return to their sport and perform at the same level or higher for >2 years. Two elbows required a subsequent arthroscopy for loose-body removal; otherwise, there were no other complications. CONCLUSION: FOCAT is an excellent option for treating OCD lesions of the humeral capitellum. Excellent outcomes and high return-to-sport rates were observed, with midterm follow-up showing no graft failures. FOCAT eliminates donor-site morbidity.

Identification of Gα12-vs-Gα13-coupling determinants and development of a Gα12/13-coupled designer GPCR.

G-protein-coupled receptors (GPCRs) transduce diverse signals into the cell by coupling to one or several Gα subtypes. Of the 16 Gα subtypes in human cells, Gα12 and Gα13 belong to the G12 subfamily and are reported to be functionally different. Notably, certain GPCRs display selective coupling to either Gα12 or Gα13, highlighting their significance in various cellular contexts. However, the structural basis underlying this selectivity remains unclear. Here, using a Gα12-coupled designer receptor exclusively activated by designer drugs (DREADD; G12D) as a model system, we identified residues in the α5 helix and the receptor that collaboratively determine Gα12-vs-Gα13 selectivity. Residue-swapping experiments showed that G12D distinguishes differences between Gα12 and Gα13 in the positions G.H5.09 and G.H5.23 in the α5 helix. Molecular dynamics simulations observed that I378G.H5.23 in Gα12 interacts with N1032.39, S1693.53 and Y17634.53 in G12D, while H364G.H5.09 in Gα12 interact with Q2645.71 in G12D. Screening of mutations at these positions in G12D identified G12D mutants that enhanced coupling with Gα12 and to an even greater extent with Gα13. Combined mutations, most notably the dual Y17634.53H and Q2645.71R mutant, further enhanced Gα12/13 coupling, thereby serving as a potential Gα12/13-DREADD. Such novel Gα12/13-DREADD may be useful in future efforts to develop drugs that target Gα12/13 signaling as well as to identify their therapeutic indications.

The Literature that Commercial Insurance Payers Use to Substantiate Knee Osteochondral Allograft Policies Are of a Low Level of Evidence.

OBJECTIVE: The purpose of this study is to analyze how the largest insurance companies support their medical necessity policies regarding osteochondral allograft transplantation (OCA) and to determine whether the literature they cite in their policies is of a high level of evidence (LOE). DESIGN: The 10 largest national health insurance companies were identified. Each payer was contacted via phone or email to obtain their coverage policy regarding OCA. For each policy, the medical necessity criteria were recorded, and all cited references were screened. For all references applicable to OCA, the LOE was recorded, and each reference was screened to determine whether they mentioned the specific criteria reported in the policies. RESULTS: The medical policies for 6 of the 10 national health insurance companies were identified. These 6 policies cited a collective total of 102 applicable references. Most of these studies were an LOE of IV (n = 58, 56.9%) and an LOE of V (n = 18, 17.6%). There were similarities amongst the medical necessity criteria between different commercial payers; however, most criteria were poorly supported by the cited literature. CONCLUSIONS: Our results demonstrate that commercial insurance companies utilize studies that are of a low LOE when justifying their medical necessity criteria. Moreover, these cited studies infrequently support or mention the commercial payers' criteria. Future studies should continue to explore how well-supported insurance policies are with the goal of potentially increasing access and authorization for well-supported treatment modalities.

Exploring the secrets of virus entry: the first respiratory syncytial virus carrying beta lactamase.

Background: Respiratory Syncytial Virus (RSV) presents a significant health threat, especially to young children. In-depth understanding of RSV entry mechanisms is essential for effective antiviral development. This study introduces an innovative RSV variant, featuring the fusion of the beta-lactamase (BlaM) enzyme with the RSV-P phosphoprotein, providing a versatile tool for dissecting viral entry dynamics. Methods: Using the AlphaFold2 algorithm, we modeled the tertiary structure of the P-BlaM chimera, revealing structural similarities with both RSV-P and BlaM. Functional assessments, utilizing flow cytometry, quantified beta-lactamase activity and GFP expression in infected bronchial epithelial cells. Western blot analysis confirmed the integrity of P-BlaM within virions. Results: The modeled P-BlaM chimera exhibited structural parallels with RSV-P and BlaM. Functional assays demonstrated robust beta-lactamase activity in recombinant virions, confirming successful P-BlaM incorporation as a structural protein. Quercetin, known for its antiviral properties, impeded viral entry by affecting virion fusion. Additionally, Ulixertinib, an ERK-1/2 inhibitor, significantly curtailed viral entry, implicating ERK-1/2 pathway signaling. Conclusions: Our engineered RSV-P-BlaM chimera emerges as a valuable tool, illuminating RSV entry mechanisms. Structural and functional analyses unveil potential therapeutic targets. Quercetin and Ulixertinib, identified as distinct stage inhibitors, show promise for targeted antiviral strategies. Time-of-addition assays pinpoint quercetin's specific interference stage, advancing our comprehension of RSV entry and guiding future antiviral developments.

Synthesis, Photophysical Properties, Theoretical Studies, and Living Cancer Cell Imaging Applications of New 7-(Diethylamino)quinolone Chalcones.

In this article, three unsymmetrical 7-(diethylamino)quinolone chalcones with D-π-A-D and D-π-A-π-D type push-pull molecular arrangements were synthesized via a Claisen-Schmidt reaction. Using 7-(diethylamino)quinolone and vanillin as electron donor (D) moieties, these were linked together through the α,ß-unsaturated carbonyl system acting as a linker and an electron acceptor (A). The photophysical properties were studied, revealing significant Stokes shifts and strong solvatofluorochromism caused by the ICT and TICT behavior produced by the push-pull effect. Moreover, quenching caused by the population of the TICT state in THF-H2O mixtures was observed, and the emission in the solid state evidenced a red shift compared to the emission in solution. These findings were corroborated by density functional theory (DFT) calculations employing the wb97xd/6-311G(d,p) method. The cytotoxic activity of the synthesized compounds was assessed on BHK-21, PC3, and LNCaP cell lines, revealing moderate activity across all compounds. Notably, compound 5b exhibited the highest activity against LNCaP cells, with an LC50 value of 10.89 µM. Furthermore, the compounds were evaluated for their potential as imaging agents in living prostate cells. The results demonstrated their favorable cell permeability and strong emission at 488 nm, positioning them as promising candidates for cancer cell imaging applications.