Adaptive strategies based on shrub leaf-stem anatomy and their environmental interpretations in the eastern Qaidam Basin.

BACKGROUND: Water stress seriously affects the survival of plants in natural ecosystems. Plant resistance to water stress relies on adaptive strategies, which are mainly based on plant anatomy with following relevant functions: (1) increase in water uptake and storage; (2) reduction of water loss; and (3) mechanical reinforcement of tissues. We measured 15 leaf-stem anatomical traits of five dominant shrub species from 12 community plots in the eastern Qaidam Basin to explore adaptive strategies based on plant leaf-stem anatomy at species and community levels. and their relationship with environmental stresses were tested. RESULTS: Results showed that the combination of leaf-stem anatomical traits formed three types of adaptive strategies with the drought tolerance of leaf and stem taken as two coordinate axes. Three types of water stress were caused by environmental factors in the eastern Qaidam Basin, and the established adaptive strategy triangle could be well explained by these environmental stresses. The interpretation of the strategic triangle was as follows: (1) exploitative plant strategy, in which leaf and stem adopt the hydraulic efficiency strategy and safety strategy, respectively. This strategy is mostly applied to plants in sandy desert (i.e., Nitraria tangutorum, and Artemisia sphaerocephala) which is mainly influenced by drought stress; (2) stable plant strategy, in which both leaf/assimilation branches and stem adopt hydraulic safety strategy. This strategy is mostly applied to plants in salty desert (i.e., Kalidium foliatum and Haloxylon ammodendron) which aridity has little effect on them; and (3) opportunistic plant strategy, in which leaf and stem adopt hydraulic safety strategy and water transport efficiency strategy. This strategy is mostly applied to plants in multiple habitats (i.e., Sympegma regelii) which is mainly affected by coldness stress. CONCLUSION: The proposed adaptive strategy system could provide a basis for elucidating the ecological adaptation mechanism of desert woody plants and the scientific management of natural vegetation in the Qinghai-Tibet Plateau.

Sucrose phosphate synthase 8 is required for the remobilization of carbon reserves in rice stems during grain filling.

Carbon reserve remobilization in stems is closely related to rice grain filling. Sucrose phosphate synthase (SPS) is highly associated with carbon reserve remobilization. In this study, we investigated the expression pattern of SPS genes in various rice tissues, and found that SPS8 is the major SPS isoform in rice stems during the grain-filling stage. We then constructed sps8 mutants using the CRISPR/Cas9 system. The SPS activity of the sps8 mutants was markedly reduced in the stems. In addition, the sps8 mutants exhibited significant starch accumulation in stems. 14C-labelling experiments revealed that the remobilization of non-structural carbohydrates from rice stems to grains was impaired in the sps8 mutants. In the sps8 mutants, grain filling was delayed and yield decreased by 15% due to a reduced percentage of ripened grains. RNA sequencing and quantitative PCR analyses indicated that the genes involved in starch synthesis and degradation were up-regulated in the sps8 mutant stems. In addition, the activity of the enzymes involved in starch synthesis and degradation was increased in the sps8 stems. These results demonstrate that SPS8 is required for carbon reserve remobilization from rice stems to grains, and that its absence may enhance 'futile cycles' of starch synthesis and degradation in rice stems.

The challenge of estimating global termite methane emissions.

Methane is a powerful greenhouse gas, more potent than carbon dioxide, and emitted from a variety of natural sources including wetlands, permafrost, mammalian guts and termites. As increases in global temperatures continue to break records, quantifying the magnitudes of key methane sources has never been more pertinent. Over the last 40 years, the contribution of termites to the global methane budget has been subject to much debate. The most recent estimates of termite emissions range between 9 and 15 Tg CH4 year-1, approximately 4% of emissions from natural sources (excluding wetlands). However, we argue that the current approach for estimating termite contributions to the global methane budget is flawed. Key parameters, namely termite methane emissions from soil, deadwood, living tree stems, epigeal mounds and arboreal nests, are largely ignored in global estimates. This omission occurs because data are lacking and research objectives, crucially, neglect variation in termite ecology. Furthermore, inconsistencies in data collection methods prohibit the pooling of data required to compute global estimates. Here, we summarise the advances made over the last 40 years and illustrate how different aspects of termite ecology can influence the termite contribution to global methane emissions. Additionally, we highlight technological advances that may help researchers investigate termite methane emissions on a larger scale. Finally, we consider dynamic feedback mechanisms of climate warming and land-use change on termite methane emissions. We conclude that ultimately the global contribution of termites to atmospheric methane remains unknown and thus present an alternative framework for estimating their emissions. To significantly improve estimates, we outline outstanding questions to guide future research efforts.

Reverse total shoulder arthroplasty with proximal bone loss: a biomechanical comparison of partially vs. fully cemented humeral stems.

BACKGROUND: The appropriate amount of cementation at the time of reverse total shoulder arthroplasty with significant proximal bone loss or resection is unknown. Extensive cementation of a humeral prosthesis makes eventual revision arthroplasty more challenging, increasing the risk of periprosthetic fracture. We analyzed the degree of subsidence and torque tolerance of humeral components undergoing standard cementation technique vs. our reduced polymethyl methacrylate (PMMA) protocol. Reduced cementation may provide sufficient biomechanical stability to resist physiologically relevant loads, while still permitting a clinically attainable torque for debonding the prosthesis. METHODS: A total of 12 cadaveric humeri (6 matched pairs) underwent resection of 5 cm of bone distal to the greater tuberosity. Each pair of humeri underwent standard humeral arthroplasty preparation followed by either cementation using a 1.5-cm PMMA sphere at a location 3 cm inferior to the porous coating or standard full stem cementation. A 6-degree-of-freedom robot was used to perform all testing. Each humeral sample underwent 200 cycles of abduction, adduction, and forward elevation while being subjected to a physiologic compression force. Next, the samples were fixed in place and subjected to an increasing torque until implant-cement separation or failure occurred. Paired t tests were used to compare mean implant subsidence vs. a predetermined 5-mm threshold, as well as removal torque in matched samples. RESULTS: Fully and partially cemented implants subsided 0.49 mm (95% CI 0.23-0.76 mm) and 1.85 mm (95% CI 0.41-3.29 mm), respectively, which were significantly less than the predetermined 5-mm threshold (P < .001 and P < .01, respectively). Removal torque between fully cemented stems was 45.22 Nm (95% CI 21.86-68.57 Nm), vs. 9.26 Nm (95% CI 2.59-15.93 Nm) for partially cemented samples (P = .021). Every fully cemented humerus fractured during implant removal vs. only 1 in the reduced-cementation group. The mean donor age in our study was 76 years (range, 65-80 years). Only 1 matched pair of humeri belonged to a female donor with comorbid osteoporosis. The fractured humerus in the partially cemented group belonged to that donor. CONCLUSION: Partially and fully cemented humeral prostheses had subsidence that was significantly less than 5 mm. Partially cemented stems required less removal torque for debonding of the component from the cement mantle. In all cases, removal of fully cemented stems resulted in humeral fracture. Reduced cementation of humeral prostheses may provide both sufficient biomechanical stability and ease of future component removal.

Minimum 2-Year Outcomes of a Modern Monoblock Titanium Fluted Tapered Revision Stem for Complex Primary and Revision Total Hip Arthroplasty.

BACKGROUND: Modular titanium fluted tapered (TFT) stems have demonstrated excellent clinical success for femoral revision total hip arthroplasty (THA) surgery. This study reports the short-term outcomes of a novel modern monoblock TFT stem used for revision and complex primary THA with a minimum of 2 years of follow-up. METHODS: We identified 126 patients who received a single monoblock TFT stem: 26 patients for complex THA (failed fracture fixation) and 100 patients for revision THA. The reasons for revision THA included 40 for previous periprosthetic joint infection, 42 for aseptic loosening, 9 for trunnionosis, and 9 for periprosthetic fractures. The Paprosky grading for femoral bone loss at the time of surgery and the measured subsidence of femoral stems at 3-month follow-up were determined. We evaluated the number and indications for reoperations. RESULTS: The mean time from surgery was 3.9 years (range, 2.0 to 6.9). A paired t-test analysis showed significant improvement from preoperative versus postoperative clinical outcome scores (P < .001) for Harris Hip Score (38.76 ± 15.24 versus 83.42 ± 15.38), Western Ontario and McMaster Universities Arthritis Index (45.6 ± 19.0 versus 69.9 ± 21.3), Veterans RAND 12 Item Health Survey Physical component (31.7 ± 8.1 versus 37.8 ± 11.3), and Veterans RAND 12 Item Health Survey Mental component (48.2 ± 12.2 versus 51.6 ± 12.5). The Paprosky grading for femoral bone loss was Grade 1 (3.9%), Grade 2 (35.7%), Grade 3A (47.6%), Grade 3B (11.1%), and Grade 4 (1.6%) cases. There were 18 reoperations (14.7%), with 13 for periprosthetic joint infection (7 treated with implant retention and 6 treated with a 2-stage revision), 4 for instability, and 1 for acetabular aseptic loosening. There were no aseptic failures of the stem. CONCLUSIONS: This novel modern monoblock TFT stem provided reliable femoral fixation and has increasingly supplanted the use of modular TFT stems for complex primary and revision surgery in our institution.

Collared Cementless Femoral Components Reduce the Revision Rates in Primary Total Hip Arthroplasty Using the Direct Anterior Approach: An Australian Orthopaedic Association National Joint Replacement Registry Study.

BACKGROUND: An increased risk of periprosthetic fracture and aseptic loosening is reported when the direct anterior approach (DAA) is used for total hip arthroplasty (THA), especially with cementless implants. We assessed the rate of revision comparing collared and collarless femoral stems when using the DAA for THA. METHODS: We used data from the Australian Orthopaedic Association National Joint Replacement Registry for primary THA for osteoarthritis inserted with the DAA between January 2015 and December 2022. There were 48,567 THAs that used the DAA (26,690 collarless cementless, 10,161 collared cementless, and 11,716 cemented). Cumulative percent revision was calculated for all-cause revision, revision for periprosthetic femoral fractures, and aseptic femoral stem loosening. Cox proportional hazard ratios [HRs] were used to compare the revision of collared and collarless cementless stems. We also compared collared cementless stems and cemented stems. RESULTS: A higher rate of all-cause revision within 3 months of surgery was observed with collarless compared to collared cementless implants (HR: 1.99 [95% confidence interval (CI), 1.56 to 2.54]; P < .001). Similarly, collarless cementless implants were associated with a greater rate of revision for fracture in the first 6 months (HR: 2.90 [95% CI, 1.89 to 4.45]; P < .001) and after 6 months (HR 10.04 [95% CI 1.38 to 73.21]; P = .02), as well as an increased rate of revision for aseptic loosening after 2 years (HR: 5.76 [95% CI, 1.81 to 18.28], P = .003). Collared cementless and cemented stems performed similarly. CONCLUSION: Collared stems were associated with a reduced rate of all-cause revision for cementless THA performed via the DAA. The reduction in risk may be due to protection from periprosthetic femoral fracture and aseptic loosening.

Periprosthetic Fractures: A Rising Tide of Hip Arthroplasty Failure Noted in the American Joint Replacement Registry and the Preventative Role of Cemented Stems.

BACKGROUND: This investigation examined cemented femoral component use in total hip arthroplasty (THA) and its impact on the incidence of periprosthetic fractures (PPFx), a common failure mode in THA. The study leverages data from the American Joint Replacement Registry (AJRR) to assess trends in cemented femoral component usage over time, its association with PPFx rates, and compares the survivorship and 90-day complication rates between cemented and cementless femoral component THAs. METHODS: Primary THAs, captured in the AJRR, in patients aged 65 years and older from 2012 to 2021 were analyzed. Variables considered included age, sex, race, region, teaching status, year, Charlson comorbidity index, and institution bed size. Analysis compared fixation types for THA on all-cause linked revision and PPFx. Logistic regression models analyzed the odds ratios for all-cause linked revision and PPFx for any follow-up time as well as for 90-day revision. The models were adjusted for the listed variables. RESULTS: During the study period, the rate of cement utilization as a percentage of primary THAs performed and reported to the AJRR increased from 4.4 to 8.3%. The rate of THA failure from PPFx increased from 11.4 to 33.3%. When both fixation groups were compared in the univariate analysis, there was a statistically significant difference in all demographic variables (P < .001). To account for this, multivariable logistic regression models were applied. In our models, cemented stems showed a 54.4% (odds ratio: 0.456; 95% confidence interval: 0.347 to 0.599; P < .0001) and 65.8% (odds ratio: 0.342; 95% confidence interval: 0.237 to 0.493; P < .0001) lower risk of PPFx linked and PPFx early linked revision, respectively. CONCLUSIONS: Periprosthetic fractures are becoming a leading failure mode for THAs in the AJRR. Given cemented fixation's relative resistance to this failure mode compared to cementless fixation, we should consider increasing the utilization of this technique.

Aseptic midterm survival rates between different cemented tibial stem designs in hinged total knee arthroplasty: a 6-year evaluation from the German Arthroplasty Registry.

INTRODUCTION: The rate of revision TKA and thus the use of hinged implants (HI) steadily rises. Aseptic loosening lies on the top of the failure patterns. However, no evidence exists until now based on national scale high-caseloads that analyzes the impact of cemented HI stem-design on aseptic survival rates. METHODS: Data on aseptic HI-revisions with full-cemented tibia-stems were conducted from the German Arthroplasty Registry. Cases were divided in primary HI (PHI) and HI used in revision operations (RHI). Endpoint was a new revision following either a PHI or an RHI. The impact of stem conicity (conical vs. cylindrical), diameter (≤ 13 mm vs. > 13 mm), length (≤ 90 mm vs. > 90 mm) and offset on the 6-Year-Cumulative-Aseptic-Revision-Rate (6Y-CARR) was estimated via Kaplan-Meier curve and compared between groups via Log-Rank-Tests. RESULTS: 3953 PHI and 2032 RHI fulfilled inclusion-criteria. Stem conicity had no impact on 6Y-CARR (p = 0.08 and p = 0.8). Diameter > 13 mm hat an impact on PHI (p = 0.05) with lower 6Y-CARR but not on RHI (p = 0.2). Length > 90 mm showed significantly worst 6Y-CARR in PHI (p = 0.0001) but not in RHI (p = 0.3). Offset-stems showed significantly better 6Y-CARR in PHI (p = 0.04), but not in RHI (p = 0.7). CONCLUSION: There was no significant impact of the cemented tibia-stem conicity on 6Y-CARR, neither in PHI nor in RHI. The effect of length, diameter and offset on the 6Y-CARR observed in the PHI, was not detectable in the more complex RHI-cases reflecting its limited clinical relevance by itself in more multifactorial backgrounds. Therefore, results must be interpreted with caution due to considerable system-effects and different utilization-scenarios.

[Quality control method for phenolic acid components in abandoned stems and leaves of Artemisia selengensis based on UPLC fingerprint combined with quantitative analysis of multi-components by single marker (QAMS)].

This study established an ultra-performance liquid chromatography(UPLC) fingerprint of abandoned stems and leaves of Artemisia selengensis and quantitative analysis of multi-components by single marker(QAMS) for five phenolic acid components. Waters Acquity UPLC BEH C_(18) chromatography column(2.1 mm×100 mm, 1.7 µm) was used. The gradient elution was carried out with the mobile phase composed of 0.1% phosphoric acid water and acetonitrile at a flow rate of 0.3 mL·min~(-1) and a column temperature at 30 ℃. The detection wavelength was 330 nm, and the injection volume was 2 µL. Similarity evaluation and cluster analysis were conducted on the fingerprint data, and 15 common components in 13 batches of abandoned stems and leaves of A. selengensis were identified. The relative correction factors of ferulic acid, isochlorogenic acid A, isochlorogenic acid B, and isochlorogenic acid C were calculated using chlorogenic acid as the internal reference. The QAMS for determining five components in the abandoned stems and leaves of A. selengensis was established. At the same time, the content of these five components was determined using the external standard method(ESM), and the results showed that there were no significant differences in their content determined by the QAMS and the ESM. The results indicated that the content of phenolic acid components in the abandoned stems and leaves of A. selengensis from different varieties and different origins had obvious differences. In addition, the content of phenolic acid components in the abandoned stems and leaves of lignified A. selengensis was significantly higher than that of non-lignified A. selengensis. In summary, QAMS established in this study can be quickly, accurately, and economically used to determine the content of five phenolic acid components in abandoned stems and leaves of A. selengensis, laying a foundation for the resource development and utilization of abandoned stems and leaves of A. selengensis.

Molecular phylogeny of Urvillea (Paullinieae, Sapindaceae) and its implications in stem vascular diversity.

BACKGROUND AND AIMS: The tribe Paullinieae has the highest diversity of vascular variants among the seed plants. The developmental diversity is better understood in the species-rich genera Paullinia and Serjania; however, the phylogeny and diversity of vascular variants in the smaller genera of Paullinieae remain understudied. Here we investigate the evolution of development of stem vasculatures in the small genus Urvillea. METHODS: We generate the first molecular phylogeny of Urvillea derived from 11 markers using a maximum likelihood and Bayesian approach. In combination with phylogenetic reconstruction, stochastic character mapping is used to assess evolutionary changes in stem ontogenies, determined from developmental anatomy of stems collected in the field or from herbarium and wood collections. KEY RESULTS: Urvillea is supported as a monophyletic group and sister to Serjania. There are five stem ontogenies in Urvillea, including typical growth and four different vascular variants. Most stem ontogenies initiate with lobed stems in primary growth. Lobed stems in secondary growth are ancestral in Urvillea, but this ontogeny was lost multiple times. A reversal to typical growth occurred in non-climbing species. Phloem wedges, fissured stems, and ectopic cambia each evolved once independently. Phloem wedges is an intermediate developmental stage in the formation of fissured stems, which is characterized by a continuous fragmentation of vascular tissues. Lobed stems may generate constriction zones and lobes may split or not. CONCLUSIONS: Urvillea is the third most diverse genus (after Serjania and Paullinia) with respect to the number of vascular variants within Paullinieae. One ontogeny (fissured stems) is exclusive to the genus. Differential cambial activity and ectopic cambia are the main ontogenetic processes generating stem diversity. The evolutionary history of vascular variants demonstrates the large developmental plasticity of the cambium in such a small genus and further demonstrates that complex anatomies have repeatedly evolved within Paullinieae lianas.

No Difference in Subsidence Between Modern Monoblock and Modular Titanium Fluted Tapered Femoral Stems.

BACKGROUND: Subsidence remains a concern when utilizing tapered fluted titanium (TFT) femoral stems and may lead to leg length discrepancy, impingement, instability, and failure to obtain osseointegration. This study aims to compare stem subsidence across 3 modern TFT stems. Our secondary aim was to investigate the influence of bicortical contact or "scratch fit" on subsidence, as well as the role of intraoperative imaging in maximizing bicortical contact and preventing stem subsidence. METHODS: A retrospective review of 271 hip arthroplasties utilizing modern TFT stems at a single institution was performed. Three stem designs were included in the analysis: 1 monoblock TFT stem (n = 91) and 2 modular TFT stems (n = 90; n = 90). Patient demographics, Paprosky femoral bone loss classification, bicortical contact, utilization of intraoperative imaging, and stem subsidence (comparison of initial postoperative radiograph to the latest follow-up radiograph-minimum 3 months) were recorded. RESULTS: There was no statistically significant difference in overall subsidence (P = .191) or the incidence of subsidence >5 millimeters between stems (P = .126). Subgroup analysis based on femoral bone loss grading showed no difference in subsidence between stems. Increased bicortical contact was associated with reduced subsidence (P = .004). Intraoperative imaging was used in 46.5% (126 of 271) of cases; this was not correlated with bicortical contact (P = .673) or subsidence (P = .521). CONCLUSION: All 3 modern TFT stems were highly successful and associated with low rates of subsidence, regardless of modular or monoblock design. Surgeons should select the stem that they feel is most clinically appropriate.

Minimum 5-Year Clinical Outcomes and Survivorship for a Single Revision Total Knee Arthroplasty System Using Hybrid Fixation and Press-Fit Stems.

BACKGROUND: Hybrid fixation, utilizing diaphyseal press-fit stems and cement fixation in the tibial and femoral metaphyseal areas, has long been a strategy for revision total knee arthroplasty (rTKA). The purpose of this study was to evaluate the clinical outcomes and survivorships of hybrid fixation using a single rTKA revision system with a minimum of 5 years follow-up. METHODS: We reviewed our prospectively collected database to identify 281 patients who underwent rTKA using a single revision system with hybrid fixation and press-fit stems between July 2006 and August 2016. We reviewed the clinical outcome scores, including the Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis index, and Veterans RAND 12 Item Health Survey. We also evaluated the 5 and 10-year survivorships and the indications for reoperations. The cohort had a mean age of 70 years (range, 45.2 to 92.0) and a mean body mass index of 33.4 (range, 17.3 to 55.8). The mean time from rTKA surgery was 11.1 years (range, 5.3 to 15.5). RESULTS: Paired t-test analyses showed significant improvements from preoperative versus postoperative clinical outcome scores (P < .001) for Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis, and Veterans RAND 12 Item Health Survey Physical component. Prosthetic joint infections after index rTKA were the most common failure mode with 29 patients requiring reoperations. Rerevision due to aseptic loosening was uncommon (6 patients) with a cumulative survival rate of 95.2% at 5 years and 94.2% at 10 years. CONCLUSION: The use of this single rTKA system utilizing press fit stems combined with hybrid fixation provided significant improvements in the clinical outcomes and excellent survivorships at 5 and 10 years.

Are Short Stems Associated With Higher Fracture Rates and Early Revision Rates in Primary Total Hip Arthroplasty? A Noninferiority Analysis.

BACKGROUND: This study aimed to determine if "short" femoral stems were noninferior to (at least as good as) standard-length stems in regards to 90-day periprosthetic fracture and 1-year revision rates. METHODS: Using the MARCQI implant registry, a retrospective study of statewide data was carried out on 64,084 total hip arthroplasties (THAs) between 2012 and 2017. We noticed an increase in the use of "short" uncemented femoral hip stems during THA. Chi-square tests were used to test homogeneity of categorical variables. The covariates included in the analyses were identified using modern epidemiological methods. A Type I probability of 0.05 was used as the level of statistical significance. Inverse probability of treatment weighting (IPTW) was used to mitigate confounding variables. RESULTS: One hundred and seven stems were implanted by surgeons in the state of Michigan. They were classified according to the Khanuja Classification System as Type 2A (trapezoidal, double-tapered calcar loading, n = 3,281), Type 3 (calcar loading with lateral flare, n = 1,898), and Type 4 (shortened, tapered, conventional, n = 19,580), and were compared to standard-length, type 5, stems (n = 33,322) in regards to the 2 outcomes (periprosthetic fractures and 1-year revision rates). Overall, 1-year revision and the 90-day fracture rates were 1.3% (791/57,853) and 1.1% (631/57,968), respectively. Noninferiority was established for all short stems at the clinical threshold of an odds ratio (OR) of 1.5 with P-values <0.05 for 90-day fractures. In regards to 1-year revision rates, noninferiority was also established for Type 3 and 4 stems (P < .05). CONCLUSION: The increased use of "short stems" in Michigan did not lead to increased 1-year revision or 90-day fracture rates.

Revealing the Beauty Potential of Grape Stems: Harnessing Phenolic Compounds for Cosmetics.

Grape stems have emerged as a promising natural ingredient in the cosmetics industry due to their abundance of phenolic compounds, known for their antioxidant and anti-inflammatory properties. These compounds have shown great potential in promoting skin health, fighting signs of aging, and shielding against environmental stressors. With high concentrations of resveratrol, flavonoids, and tannins, grape stems have garnered attention from cosmetic scientists. Research has indicated that phenolic compounds extracted from grape stems possess potent antioxidant abilities, effectively combating free radicals that accelerate aging. Moreover, these compounds have demonstrated the capacity to shield the skin from UV damage, boost collagen production, and enhance skin elasticity. Cosmetic formulations incorporating grape stem extracts have displayed promising results in addressing various skin concerns, including reducing wrinkles, fine lines, and age spots, leading to a more youthful appearance. Additionally, grape stem extracts have exhibited anti-inflammatory properties, soothing irritated skin and diminishing redness. Exploring the potential of grape stem phenolic compounds for cosmetics paves the way for sustainable and natural beauty products. By harnessing the beauty benefits of grape stems, the cosmetics industry can provide effective and eco-friendly solutions for consumers seeking natural alternatives. Ongoing research holds the promise of innovative grape stem-based formulations that could revolutionize the cosmetics market, fully unlocking the potential of these extraordinary botanical treasures.

The (Poly)phenolic Profile of Separate Winery By-Products Reveals Potential Antioxidant Synergies.

The by-products of grapes (Vitis vinifera L.) in the winemaking process present a diverse phytochemical profile of (poly)phenols, essentially represented by phenolic acids, flavonoids, and stilbenes, which have health benefits. In winemaking, solid (grape stems and pomace) and semisolid (wine lees) by-products are generated, negatively impacting the sustainability of the agro-food activity and the local environment. Although information on the phytochemical profile of grape stems and pomace has been reported, especially information concerning (poly)phenols, research on wine lees is necessary to take advantage of the compositional traits of this residue. So, in the present work, an updated, in-depth comparison of the (poly)phenolic profiles of these three resulting matrices in the agro-food industry has been carried out to provide new knowledge and interesting data on the action of yeast and lactic acid bacteria (LAB) metabolism in the diversification of phenolic composition; additionally, we extract complementarities for the possible joint application of the three residues. The phytochemical analysis of the extracts was carried out using HPLC-PDA-ESI-MSn. The (poly)phenolic profiles of the residues showed significant discrepancies. The results obtained showed that the greatest diversity of (poly)phenols was found in the stems of the grapes, followed closely by the lees. Through technological insights, it has been suggested that yeasts and LAB, responsible for the fermentation of must, might play a key role in the transformation of phenolic compounds. This would provide new molecules with specific bioavailability and bioactivity features, which might interact with different molecular targets and, consequently, improve the biological potential of these underexploited residues.

Are we getting better at cementing femoral stems in total hip arthroplasty? A 5-year institutional trend.

INTRODUCTION: Femoral stem cementation provides excellent implant longevity with a low periprosthetic fracture rate among patients with compromised bone quality or abnormal anatomy. We radiologically evaluated the quality of the femoral cement mantle in patients undergoing THA to examine whether cementation quality improved with increased institutional experience. METHODS: A retrospective study of 542 primary elective THAs performed using cemented stems from 2016 to 2021 at a high-volume orthopedic specialty center was conducted. Immediate post-operative anterior-posterior (AP) and lateral radiographs were evaluated to assess cement mantle quality based on the Barrack classification. Cement mantles were deemed satisfactory (Barrack A and B) or unsatisfactory (Barrack C and D). Regression was performed to identify predictors of unsatisfactory cementation quality. RESULTS: The annual cemented primary THA volume increased throughout the study period from 14 cases in 2016 to 201 cases in 2021. Overall, the majority of cement mantles were deemed satisfactory; 91.7% on AP radiographs and 91.0% on lateral radiographs. Satisfactory cementation on AP radiograph achievement rates improved during the study period, which coincided with greater annual volume (p < 0.001). No association was found between posterior and direct anterior surgical approaches and satisfactory cementation quality on both AP and lateral radiographs. CONCLUSION: Majority of femoral stems had satisfactory cementation quality. Higher institutional annual cemented THA volume was associated with improved cementation quality. Residency and fellowship training programs should place greater emphasis on the importance of femoral stem cementation for appropriately indicated patients. LEVEL OF EVIDENCE: III, retrospective cohort study.

Impact of stem profile on the revisability and the need for osteotomy in well-fixed cemented revision total knee arthroplasty implants.

INTRODUCTION: While re-revision total knee arthroplasty (ReRTKA) steadily increases, the ease and bone-sparing removal of RTKA implants is gaining more and more in importance. Biomechanical data suggest that cemented conical stems can be removed significantly easier than cylindrical stems. However, no clinical evidence exists supporting this observation. Aim of this study was to compare the revisability and need for osteotomy (OT) between removals of well-fixed cemented conical vs. cylindrical RTKA stems. MATERIALS AND METHODS: 55 removals of well-fixed full-cemented RTKA stems (29 knees) performed between 2016 and 2018 were retrospectively analyzed. Main outcome variables were: bone loss, fractures, osteotomy incidence, surgery duration, early postoperative complications (EPC), hemoglobin drop and blood transfusion. SPSS was used for the statistical analysis. RESULTS: 44.8% were conical, 48.3% cylindrical, and 6.9% combined stem designs. Causes for re-revision were PJI (75.9%), malposition (17.2%) and persistent pain (6.9%). 10 stem removals (18.2%) required an OT (four femoral, six tibial): eight stems (14.5%) had cylindrical and two (3.6%) conical designs (P = 0.041). Fractures were noted solely in removals without OT (11.1% vs. 0%,). There was a tendency to more bone loss in cylindrical stem revisions (53.8% vs. 32%, P = 0.24). A longer overall surgery time was observed in revisions of cylindrical stems (+ 37 min, P = 0.05). There was higher hemoglobin drop and need for blood transfusion in revisions of cylindrical stems or after OT but without reaching statistical significance. The EPC rates were slightly higher in ReRTKA on cylindrical stems (P = 0.28). CONCLUSION: Well-fixed cemented conical stems may be revision friendlier with less demands on OT and shorter overall surgery time than cemented cylindrical stems.

Satisfactory clinical and radiographic outcomes following revision total hip arthroplasty by direct anterior approach using primary femoral stems at 2-8 years of follow-up.

INTRODUCTION: To report clinical and radiographic outcomes of revision total hip arthroplasty (THA) through the direct anterior approach (DAA) using primary stems. MATERIALS AND METHODS: The authors assessed a consecutive series of revision THAs operated by DAA using primary (cemented and uncemented) stems between 1/1/2010 and 30/06/2017. The initial cohort comprised 47 patients (50 hips), aged 65 ± 10 years with BMI of 25 ± 4 kg/m2. Clinical assessment included modified Harris Hip Score (mHHS) and satisfaction with surgery. Radiographic assessment included radiolucent lines > 2 mm, bone remodelling, cortical hypertrophy, pedestal formation, and osteolysis. Linear regression analyses were performed. RESULTS: Of the 50 hips (47 patients) in the initial cohort, intraoperative complications that did not require re-revision occurred in 5 hips. At a follow-up of > 2 years: 5 hips (10%) were lost to follow-up and 3 hips (6%) required stem re-revision, leaving a final cohort of 42 hips (40 patients). Postoperative complications that did not require re-revision occurred in 4 hips (8%). At 4.3 ± 1.6 years, post-revision mHHS was 89 ± 14 (range 47-100) and 38 patients were satisfied or very satisfied with revision surgery. Bone remodelling was observed in 8 hips (16%), cortical hypertrophy in 6 hips (12%), grade I heterotopic ossification in 7 hips (14%), and grade II in 1 hip (2%). There were no cases of radiolucent lines, pedestal formation, or osteolysis. Regression analyses revealed that post-revision mHHS was not associated with any variable. CONCLUSIONS: Revision THA performed through the DAA using primary stems grants satisfactory clinical and radiographic outcomes at a minimum follow-up of two years.

Kombucha fermentation as a modern way of processing vineyard by-products into cosmetic raw materials.

OBJECTIVE: The wine industry generates large quantities of by-products presenting a remarkably valuable composition in phytochemicals. The process that can significantly increase the content of bioactive compounds is fermentation by yeast and other microorganisms. The current study presents, for the first time, an evaluation of the potential of grape stems extract and its ferments using the Scoby consortium, as a cosmetic raw material for improving the skin care properties of facial cosmetics. METHODS: Fermentation of grape stems using Scoby consortium was carried out for 10 and 20 days. Unfermented and fermented extracts were analysed for their antioxidant activity and chemical composition, with a particular emphasis on biologically active substances. Additionally, the influence of the addition of the obtained ferments to the model cosmetic creams on hydration, transepidermal water loss and skin pH were assessed. RESULTS: The obtained results revealed that grape stems extract and its ferments are a rich source of phenolic compounds and show antioxidant activity, with the highest values observed for extracts on the 20th day of fermentation. Furthermore, the addition of the extract, as well as ferment, to the cream has a positive effect on skin hydration and reduces transepidermal water loss. CONCLUSION: These results suggest that grape stem extracts are a prospective source of active compounds that may be valuable ingredients for the cosmetic industry. Unfermented and fermented extracts can be used in moisturizing cosmetic formulations and also to complement the treatment of dry and sensitive skin.

OBJECTIF: L'industrie du vin génère de grandes quantités de sous-produits présentant une composition remarquablement précieuse en matière de phytochimie. Le procédé susceptible d'augmenter significativement la teneur en composés bioactifs est la fermentation par la levure et d'autres micro-organismes. Cette étude présente pour la première fois une évaluation du potentiel de l'extrait de rafle de raisin et de ses ferments réalisés à l'aide du consortium Scoby lors de l'utilisation en matière première pour améliorer les propriétés de soin cutané des cosmétiques du visage. MÉTHODES: La fermentation des rafles de raisin a été réalisée à l'aide du consortium Scoby pendant 10 et 20 jours. L'activité antioxydante et la composition chimique des extraits non fermentés et fermentés a été analysée en mettant l'accent sur les substances biologiquement actives. En outre, l'évaluation a également porté sur l'influence de l'ajout des ferments obtenus aux crèmes cosmétiques types sur l'hydratation, la perte d'eau transépidermique et le pH cutané. RÉSULTATS: Les résultats obtenus ont révélé que l'extrait de rafles et ses ferments représentaient une source riche en composés phénoliques et montraient une activité antioxydante ; les valeurs les plus élevées des extraits étant observées au 20 -ème jour de fermentation. En outre, l'ajout de l'extrait et du ferment à la crème entraîne un effet positif sur l'hydratation de la peau et réduit la perte d'eau transépidermique. CONCLUSION: Ces résultats suggèrent que les extraits de rafles représentent une source prospective de composés actifs et peuvent constituer des principes actifs précieux pour l'industrie cosmétique. Il est possible d'utiliser des extraits non fermentés et fermentés dans les formulations cosmétiques hydratantes et pour compléter le traitement des peaux sèches et sensibles.

Does stem profile have an impact on the failure patterns in revision total knee arthroplasty?

INTRODUCTION: Revision total knee arthroplasty (RTKA) has been increasing continuously. The results of RTKA still remain unsatisfactory. Failure patterns and risk factors in RTKA were thoroughly analyzed, with periprosthetic joint infections (PJI) and aseptic loosening remaining at the forefront of re-revision (ReRTKA) causes. While there is evidence that stem profile impacts the revisability of cemented implants, its association with the modes of RTKA failure is unknown. METHODS: 50 consecutive ReRTKA performed in a single orthopedic center during 2016-2017 were retrospectively analyzed. The cases were stratified according to age, sex, number of preexisting revisions, fixation technique, stem design and causes of re-revision. All explanted implants with conical vs. cylindrical stem profiles were compared. RESULTS: Mean age was 67 ± 11.5, and 54% were females. 72% of the cases had ≥ 3 previous revisions. 88% were full-cemented, 3% hybrid and 9% press-fit stems. 36% of the RTKA had conical, 58% cylindrical and 6% combined stem profiles. 92% of the RTKA components were removed. Removal causes were: PJI (52.2%), aseptic loosening (34.8%), implant malposition (9.8%), painful knee (1.1%) and instability (2.2%). While the overall RTKA failure patterns were equally distributed between conical and cylindrical stems, subgroup analysis of only cemented ReRTKA revealed a higher incidence of aseptic loosening within cylindrical stem profiles (46.7% vs. 25.7%, P = 0.05). CONCLUSION: Stem profile may have an impact on the process of aseptic loosening in cemented non-metaphyseal engaging RTKA, with cylindrical designs tending to worse outcomes than conical designs. Large cohort studies could provide more clarity on current observation.