Stem Size Research Articles

Radiologic Results of Three-Dimensional Templating for Total Shoulder Arthroplasty.

BackgroundThe purpose of this study was to evaluate the radiologic results of total shoulder arthroplasty using computerized three-dimensional (3D) templating in preoperative planning.MethodsTen patients who underwent total shoulder arthroplasty using 3D templating preoperatively were enrolled in this study. A specialized computer program was used to reconstruct the 3D images of the shoulder from the computed tomographic images. The 3D images of various sizes of prostheses were used as the template in surgical planning of the shoulder arthroplasty. The size of the glenoid, humeral head, and stem measured in 3D templating were compared with those used in actual operation. Anatomical parameters, such as humeral head size, radius of curvature, and greater tuberosity to humeral head distance of the replaced shoulder, were measured and compared with those of the contralateral normal shoulder.ResultsThe agreement rates between the glenoid size, head size, head thickness, and stem size estimated preoperatively by 3D templating and those measured in operation were 100%, 100%, 100%, and 80%, respectively. The difference in humeral head size, radius of curvature, and greater tuberosity to humeral head distance between the replaced shoulder and contralateral shoulder was 1.31 mm, 0.87 mm, and 1.17 mm, respectively.ConclusionsIn total shoulder arthroplasty, 3D templating seems to enable accurate prediction of sizes of the prostheses to be inserted and thus replication of normal anatomy.

Sawlog quality and tree dimensions of Scots pine 34 years after artificial moose browsing damage

Moose ( L.) browsing causes severe damage in Scots pine ( L.) seedling stands. The effects of this damage on the quality of sawlogs were studied in a long-term controlled experiment. This article reports the stem size and external quality characteristics of Scots pine stems 34 years after artificial moose browsing damage. Damaging the trees by clipping the main stem at the seedling stage reduced the diameter, height, and tree volume of the trees at the end of the experiment. The tree growth reduction was dependent on the severity of clipping. The differences between the damaged and the control trees were more obvious in diameter than in height at the time of final felling. Stem form defects and vertical branches were the most typical externally detectable defects caused by clipping. Defects in the butt logs were detected in 71–89% of the damaged trees, depending on the clipping treatment severity. The stronger the clipping treatment, the more likely the stem form was defected and the more commonly were vertical branches and crooks detected in the stems. The results indicate that both tree dimensions and stem quality suffer from moose browsing. The findings of this controlled experiment more likely underestimate than overestimate the damage in comparison to real moose browsing. Further analyses are required to assess the effects of browsing damage on the internal quality of sawlogs and subsequent economic outcomes.Alces alcesPinus sylvestris

Migration analysis of a metaphyseal-anchored short femoral stem in cementless THA and factors affecting the stem subsidence

BackgroundEarly femoral stem subsidence following a cementless THA is correlated with aseptic loosening of the femoral component. The short femoral stems allow bone sparing and implantation through a minimally invasive approach; however, due to their metaphyseal anchoring, they might demonstrate different subsidence pattern than the conventional stems.MethodsIn this prospective single-center study, a total of 68 consecutive patients with an average age of 63 years, and a minimum follow-up of 5 years following a cementless THA with a metaphyseal-anchored short femoral stem were included. The femoral stem subsidence was evaluated using “Ein Bild Roentgen Analyse” (EBRA).ResultsAverage stem migration was 0.96 +/− 0.76 mm at 3 months, 1.71 +/− 1.26 mm at 24 months, and 2.04+/− 1.42 mm at last follow-up 60 months postoperative. The only factor that affected migration was a stem size of 6 or more (r2 = 5.74; p = 0.039). Subdivision analysis revealed, that only in females migration appeared to be affected by stem size irrespective of weight but not in men (female stem size of 6 or more vs. less (Difference = − 1.48 mm, R2 = 37.5; p = 0.001). Migration did not have an impact on clinical outcome measures.ConclusionsThe examined metaphyseal-anchored short femoral stem showed the highest subsidence within the first 3 months postoperative, the implant began to stabilize at about 24 months but continued to slowly migrate with average total subsidence of 2.04 mm at 5 years following the THA. The amount of stem subsidence was not associated with worse clinical outcomes such as HHS, patient satisfaction, or pain.

Prescribed fire effects on oak woodland advance regeneration at the prairie–forest border in Kansas, USA

Understanding the effects of fire on advance regeneration of oak (Quercus L.) species and their competitors is an important step in determining the role of prescribed fire in regenerating and restoring upland oak ecosystems. Our study aimed to understand how dormant-season prescribed fire affects advance regeneration of chinkapin oak (Quercus muehlenbergii Engelm.), black oak (Quercus velutina Lam.), and their major competitors at sites targeted for woodland restoration and management. We analyzed relationships between stem size and survival probability; determined the effect of fire temperature on survival probability; and compared how mortality, sprouting, and survival differed among species. For chinkapin oak, black oak, and bitternut hickory (Carya cordiformis (Wangenh.) K. Koch), mortality was low and rate of sprouting was high after shoot dieback. Initial basal diameter was significantly related to survival probability after one fire for all species except chinkapin oak and black oak. Height was a significant predictor of survival probability for all species except chinkapin oak. Although sugar maple (Acer saccharum Marsh.) also responded to fire by sprouting, it did so at a much lower rate than oaks and hickory (20% versus 43%–68%). These data reveal that heavily invaded, fire-suppressed woodlands on the prairie–forest border region may not experience major structural and compositional shifts without repeated burning or mechanical treatments.

MORPHOLOGY AND PRODUCTION OF WEST INDIAN CHERRY IRRIGATED WITH SALINE WATERS UNDER COMBINATIONS OF NITROGEN-POTASSIUM FERTILIZATION

ABSTRACT Fertilization management is one of the technologies studied to reduce nutritional imbalance in plants submitted to saline stress. In this context, we analyzed the effect of the combination of nitrogen and potassium fertilization on the morphology and production of West Indian cherry irrigated with saline waters in the first year of cultivation. The experiment was carried out in the CCTA/UFCG, in 60-L lysimeters installed in the field, in a randomized block design and 5 x 4 factorial scheme, referring to five levels of irrigation water salinity (ECw), i.e., 0.3, 1.3, 2.3, 3.3, and 4.3 dS m-1, and four combinations (C) of nitrogen-potassium fertilization, i.e., C1 = 70% N + 50% K2O; C2 = 100% N + 75% K2O; C3 = 130% N + 100% K2O, and C4 = 160% N + 125% K2O of the recommended dose for West Indian cherry, with three replicates and one plant per plot consisting of a lysimeter. The cv. ‘Flor Branca’, grafted on cv. Junco, was studied. The combination of fertilization with 70% N + 50% K2O promoted higher morphology and production values and mitigated the effect of salinity on fruit diameter up to an ECw of 1.3 dS m-1. Nitrogen-potassium fertilization in the combination of 130% N + 100% K2O impaired plant morphology and production. The ECw above 0.3 dS m-1 decreased the stem diameter, size, and average weight of fruits of West Indian cherry in the first year of cultivation.

Disturbance and the elevation ranges of woody plant species in the mountains of Costa Rica.

AimTo understand how disturbance—here defined as a transient reduction in competition—can shape plant distributions along elevation gradients. Theory suggests that disturbance may increase elevation ranges, especially at the lower range limits, through reduced competitive exclusion. Nevertheless, to date this relationship remains unclear.LocationMountains of Costa Rica.MethodsWe compared the elevation range of woody stems over 10 cm dbh (“trees”) observed in plots along two transects spanning a range of elevations in secondary (regrowth) and old‐growth forest (409 and 249 species, respectively). We also estimated these elevation ranges using nationwide data. In addition, we examined the influence of stem size and plot scale basal area (as a measure of competition) on species elevation range limits in the two gradients.ResultsIn general, tree species ranges increased with elevation. Species in the secondary forest had broader elevation ranges (100–318 m broader than species in the old‐growth forest; Wilcoxon: p‐value <.001). Also, in the secondary transect, individuals with greater diameters had broader elevation ranges than those observed as smaller trees (137 m broader; Kruskal–Wallis: p‐value = .03). The lower range limit of species occurred more frequently in plots with lower (vs. higher) basal area than expected by chance in both forest types. We also observed higher elevation upper limits in old growth, but not in secondary forests, with lower (vs. higher) basal area.Main conclusionDisturbance relaxes the constraints imposed by competition and extends effective elevation ranges of species, particularly those in secondary forest, to warmer and cooler climates (minimum increase equivalent to about 0.6–1.4°C). Thus, suitable disturbance may assist species persistence under climate change. We believe this is the first study indicating a consistent relation between disturbance and woody plant species distributions along elevation gradients.

An advanced species of the fern Botryopteris Renault from the Permian of southwestern China

We describe a new species of the Paleozoic fern genus Botryopteris in volcanic tuffs from the Lopingian (upper Permian) aged Junlian Formation in SW China's Sichuan Province. The species has a large stem and stele compared to those of some other species of the genus. Xylem strands of the leaf trace and rachis are “ω”-shaped in cross section and comprise two long lateral arms and a single, shorter median arm. Parenchyma is distributed among the stem metaxylem tracheids and is more common in the central region of the stele that comprises a parenchymatized protostele. Several mesarch protoxylem strands, decurrent from leaf traces, are visible in each cross section of the protostele. Root traces originate from the lateral side of the leaf trace within the stem cortex. The stem surface is covered by thick, multiseriate, multicellular trichomes. Botryopteris multifolia sp. nov. represents the stratigraphically youngest known species of the genus and has a combination of derived evolutionary characteristics including its large stem size, parenchymatized protostele, elaborate trichome structure, roots originating from leaf traces, and the construction of xylem strand of the leaf trace and rachis with distinctive pinna trace formation and emission. It is more similar in leaf anatomy to the Gondwanan species B. nollii from the Permian of Brazil and less like late Pennsylvanian botryopterids from Euramerica. Finally, we consider the evolutionary implications of features shared between Permian members of the botryopterids and catenalean-type plants including members of the Osmundales stem group family Guaireaceae (Shuichengella, Zhongmingella, Tiania) and the enigmatic early ferns Rastropteris and Catenopteris.

The Effect of Size for a Hydroxyapatite-Coated Cementless Implant on Component Revision in Total Hip Arthroplasty: An Analysis of 41,265 Stems

BackgroundThe cementless Corail is one of the most commonly used stems in total hip arthroplasty (THA). The aim of this study was to investigate whether there was a difference in revision rate for smaller stems. MethodsAll primary THA procedures recorded by the Australian Joint Replacement Registry from September 1999 to December 2017 performed for osteoarthritis using the Corail stem, a cementless acetabular cup, modern bearing surfaces (ceramic/ceramic, ceramic/cross-linked polyethylene, and metal/cross-linked polyethylene), and 28 mm, 32 mm, and 36 mm head sizes were included. The primary outcome measure was femoral component revision. Data were analyzed and adjusted for age, gender, and head size. Further analysis investigated the effects of surgical approach. ResultsThere was 41,265 primary THAs recorded. The cumulative percent revision (CPR) at 13 years was 7.7% (5.5, 10.7) for stem sizes 8 and 9 and 3.0% (2.4, 3.8) for sizes 10-20 (P < .001). When adjusted for age and gender, the sizes 8 and 9 collared (hazard ratio [HR]: 6.22 [3.84-10.06], P < .001) and collarless (HR: 3.28 [2.41-4.45], P < .001) had a higher CPR than the collared and collarless size 10-20. The size 8 and 9 stems performed with an anterior approach had the highest CPR (HR: 14.44 [6.21-33.56], P < .001). The main reason for revision of size 8 and 9 femoral stems was loosening (65.2%, compared to 31.5% for 10-20 femoral stems). ConclusionsSmaller Corail stems have 4 times the rate of revision compared with the larger femoral sizes with loosening being the most common diagnosis. This is most evident when using an anterior approach.

Mach reflection in steady supersonic flow considering wedge boundary-layer correction

Mach reflection in steady supersonic flow is an important phenomenon having received extensive studies, among which simplified theoretical models to predict the size of Mach stem and other flow structure are of particular interest. Past efforts for such models were based on inviscid assumption while in real cases the flow is viscous. Here in this paper we consider the influence of wedge boundary layer on the Mach stem height. This is done by including a simplified boundary layer model into a recently published inviscid model. In this viscous model, the wedge angle and the trailing edge height, which control the Mach stem height, are replaced by their equivalent ones accounting for the displacement effect of the wedge boundary layer, with the boundary layer assumed to be laminar or fully turbulent. This viscous model is shown to compare well with numerical results by computational fluid dynamics and gives a Mach stem height as function of the Reynolds number and Mach number. It is shown that due to the viscous effect, the Mach stem height is increased, through increasing the effective wedge angle.

Effects Of Thinning In a Water-Limited Holm Oak Forest

ABSTRACTA natural holm oak forest was selectively thinned to test thinning as a tool to reduce tree mortality, increase productivity, and reverse the recent regression of the dominant species (Quercus ilex) induced by climate change. Thinning increased aboveground productivity and reduced stem mortality in this Mediterranean forest during four years just after thinning, contributing to the maintenance of forest functioning under changing climatic conditions. Q. ilex was the only species positively affected by the thinning: stem growth increased for all stem sizes, and mortality was significantly lower in thinned plots. On the contrary, mortality rates of Phillyrea latifolia and Arbutus unedo were not significantly lower. Stem growth increased for P. latifolia only in the smallest stem-size class. Our results highlight the suitability of selective thinning for improving the forest productivity and ensuring the conservation of Mediterranean coppices. Other benefits of selective thinning, such as a decrease in the risk of fire dispersion and an increase in the water supply for human populations, are also discussed.

Experimental migration upward in elevation is associated with strong selection on life history traits.

One of the strongest biological impacts of climate change has been the movement of species poleward and upward in elevation. Yet, what is not clear is the extent to which the spatial distribution of locally adapted lineages and ecologically important traits may also shift with continued climate change. Here, we take advantage of a transplant experiment mimicking up‐slope seed dispersal for a suite of ecologically diverse populations of yellow monkeyflower (Mimulus guttatus sensu lato) into a high‐elevation common garden during an extreme drought period in the Sierra Nevada mountains, California, USA. We use a demographic approach to quantify fitness and test for selection on life history traits in local versus lower‐elevation populations and in normal versus drought years to test the potential for up‐slope migration and phenotypic selection to alter the distribution of key life history traits in montane environments. We find that lower‐elevation populations tend to outperform local populations, confirming the potential for up‐slope migration. Although selection generally favored some local montane traits, including larger flowers and larger stem size at flowering, drought conditions tended to select for earlier flowering typical of lower‐elevation genotypes. Taken together, this suggests that monkeyflower lineages moving upward in elevation could experience selection for novel trait combinations, particularly under warmer and drier conditions that are predicted to occur with continued climate change.

Intra-annual stem size variations converge across marginal populations of European beech

Key messageThe intra-annual variability in stem size of marginal beech population from south-eastern distribution range of beech in Poland is higher within than between populations.One of the key issues of the distribution of tree species is their ability to track environmental changes. European beech (Fagus sylvatica L.) is a species highly sensitive to extreme climatic events, because of its high phenotypic plasticity. In this study, we aim to determine the variability in stem size between and within marginal beech populations. Marginal populations of beech growing under uniform environmental conditions of provenance trial offer unique opportunity to detect adaptive differentiations driven by natural selection. In this work, we studied stem size variation recorded by automatic band dendrometers in four beech marginal populations growing in a common garden in the south-eastern distribution range of beech in Poland over the period 2016–2018. Strong climatic effects and weak provenance differences in seasonal stem size variation were observed. The provenances exhibited similar climate-related seasonal stem circumference variation. A high within-provenance variation was confirmed. Temperature of spring as well as temperature and precipitation of autumn were detected as key climatic parameters mostly for onset and end of stem size variation. Maximum stem size was mostly affected by the later end of its variation, which positively affected its duration. Climatic distance between beech provenances and provenance trial had a negligible effect on the variability in seasonal stem size variation between provenances. The evidence of weak inter-provenance and high intra-provenance variation in stem size changes observed in the south-eastern distribution range indicates that an individual-based approach could be a suitable strategy, when selecting for phenotypic plasticity.

Occult periprosthetic femoral fractures occur frequently during a long, trapezoidal, double-tapered cementless femoral stem fixation in primary THA

The present study aimed to investigate the prevalence and clinical consequences of occult intra-operative periprosthetic femoral fractures in total hip arthroplasty (THA). Between 2012 and 2017, a total of 113 primary THAs were enrolled. The mean age of the patients was 66.4 ± 7.6 years. We assessed occult intra-operative periprosthetic femoral fractures with the use of computed tomography (CT) and risk factors, including age, sex, body mass index, diagnosis, stem size, and radiographic parameters of proximal femoral geometry were analyzed. We also assessed the differences in thigh pain and stem subsidence and alignment between the patients with and without occult periprosthetic femoral fracture. Occult intra-operative periprosthetic femoral fractures were found in 13 of 113 hips (11.5%). In 9/13 (69.2%) of occult fractures, fracture lines were started from the region below the tip of the lesser trochanter. Six periprosthetic femoral fractures (5.3%) were found during the operation. Out of the five hips that had detected femoral fractures around the lesser trochanter intra-operatively, four hips (80%) showed concurrent occult fractures on different levels. The female sex (P = .01) and canal filling ratio at 7 cm below the tip of the lesser trochanter (P = .01) were significantly different between the patients with and without occult periprosthetic femoral fracture. The sex was significantly associated with an increased risk in predicting an occult intra-operative periprosthetic femoral fracture (odds ratio of male, 0.25 compared with the female; 95% CI, 0.08–0.85; p = .02). There was a significant difference in the incidence of thigh pain between occult fracture group and non-occult fracture group (P < .05). There were no significant differences in stem subsidence and alignment between the patients with and without occult periprosthetic femoral fracture. All 13 cases of occult intra-operative periprosthetic femoral fractures were healed at the final follow-up. Occult periprosthetic femoral fractures are common during a long, trapezoidal, double-tapered cementless femoral stem fixation in primary THA, that CT scans are helpful to identify them, and that these fractures do not adversely affect the implant’s survival if a rigid fixation of the implants has been achieved.

Structural development following stand-replacing disturbance in a boreal mixedwood forest

Knowledge of forest stand successional pathways, and responses to disturbances, is crucial for improved sustainable management of the resource. Forest structure, one attribute of which is the size and height distribution of trees in a stand (known as the stem size distribution; SSD), is highly sensitive to changes in stand dynamics. However, monitoring changes in SSD can be difficult and costly, especially across large spatial extents and by different disturbance types and species groups. As a result, forest managers increasingly utilise three-dimensional remote sensing such as airborne laser scanning (ALS) as a means of modeling forest structure in a cost-effective and spatially consistent manner. In this study, approximately 7000 ALS-derived SSDs representing a chronosequence of over 50 years of forest disturbance in Alberta, Canada were used to evaluate differences in structural development by species groups and disturbance types. Stands were clustered into three structural development phases based on ALS-derived SSDs. Results showed no difference in SSDs for early development phases, but significantly higher proportions of trees in medium-sized diameter classes (up to 25 cm diameter at breast height) in previously burned stands than in previously harvested stands. For each structural development phase, in both burned and harvested stands, there was no significant difference in modeled SSD among species groups. No difference in SSD for each phase was also seen when comparing previously burned to harvested stands for mixed species and white spruce stands. However, aspen and pine-dominated stands had significantly higher proportions of larger trees in burned stands than harvested stands in the second and third phase of structural development. Results from this study provide valuable insights to the current state of the forest, as well as an improved understanding of the general patterns of structural development following disturbance.

Group divisible 3‐designs with block size four and group type 1ns1

AbstractIn this article, we mainly consider the existence problem of a group divisible design GDD of type . We present two recursive constructions for this configuration using candelabra systems and construct explicitly a few small examples admitting given automorphism groups. As an application, several new infinite classes of GDDs of type are produced. Meanwhile a few new infinite families on candelabra quadruple systems with group sizes being odd and stem size greater than one are also obtained.

Sensitivity Study for the Key Parameters in Heterospheroid Preparation with Insulin-Secreting β-Cells and Mesenchymal Stem Cells.

The outcome of islet transplantation in clinics has been determined by the success of tissue engraftment. The strong immune attack that occurs upon transplantation of β-cells plays a central role as this attack results in the failure of transplanted tissue. To improve tissue engraftment, deleterious effects of immune reactions should be minimized for β-cell function and survival. Here, we report a systematic analysis of the effect of insulin-secreting β-cell (MIN6) and mesenchymal stem cell (MSC) number and size on the function of β-cells and present immune protection potential of heterospheroid structures through MSCs and synthetic scaffolds. We prepared 3D heterospheroids with MSCs and MIN6 cells through a hanging-drop approach. To precisely estimate the influence of critical parameters on heterospheroid size and insulin secretion function of β-cells, we prepared heterospheroids using two independent input variables: (i) initial cell number in each droplet and (ii) MIN6:MSC ratio. We studied the influence of initial cell numbers of 200 and 500, and six different MIN6:MSC ratios (1:0, 0:1, 1:1, 2:1, 5:1, and 10:1) for the preparation of heterospheroids through the hanging drop. Next, we used PEG hydrogels as a semipermeable physical barrier to improve immune protection from cytokines. Through encapsulation of our heterospheroids within PEG hydrogel, we were able to observe sustained β-cell survival and insulin secretion despite exposure of heterospheroids with proinflammatory cytokines. Insulin secretion was further promoted with glucagon like peptide-1 (GLP-1) incorporation within PEG hydrogel structure. This study is significant to demonstrate the synergistic effects of MIN6-MSC and scaffold-MIN6 interactions and to improve therapeutic efficacy of islet transplantation. Overall, this study comprehensively presents the optimum conditions for the preparation of MIN6-MSC spheroids, utilizes MSCs and GLP-1 functional PEG hydrogels as a scaffold to retain insulin secretion function and further demonstrates protection of heterospheroids exposed to proinflammatory cytokines.

Performance Analysis of Log Extraction by a Small Shovel Operation in Steep Forests of South Korea

In South Korea, logs for low-value products, such as pulpwood and fuelwood, are primarily extracted from harvest sites and transported to roadside or landing areas using small shovels. Previous studies on log extraction, however, have focused on cable yarding operations with the goal of improving productivity on steep slopes and inaccessible sites, leaving small-shovel operations relatively unexamined. Therefore, the main objectives were to determine small-shovel extraction productivity and costs and to evaluate the impact of related variables on productivity. In addition, we developed a model to estimate productivity under various site conditions. The study took place in 30 case study areas; each area has trees with stems at a diameter at breast height ranging from 18 to 32 cm and a steep slope (greater than 15%). The areas ranged from 241 to 1129 trees per hectare, with conifer, deciduous, and mixed stands. Small-shovel drives ranged from 36 to 72 m per extraction cycle from stump to landing. The results indicated that the mean extraction productivity of small-shovel operations ranged between 2.44 to 9.85 m3 per scheduled machine hour (including all delays). At the forest level, the estimated average stump-to-forest road log production costs were US $4.37 to 17.66/m3. Small-shovel productivity was significantly correlated with stem size (diameter at breast height and tree volume) and total travelled distance (TTD). However, a Pearson’s correlation analysis indicated that stand density and slope did not have a significant effect on productivity. Our findings provide insights into how stem size and TTD influence small shovel performance and the predictive ability of productivity. Further, this information may be a valuable asset to forest planners and managers.

Trace element partitioning in a poplar phytoextraction stand in relation to stem size

At an Italian field test site the efficiency of phytoextraction of toxic trace elements (TEs) from the soil is determined by uptake capacity, bioavailability of TEs in the soil and biomass yield of the plants involved. Altering the quantity and type of biomass produced, especially among fast-growing trees, may be one method of increasing phytoextraction efficiency. In poplar bark and wood show different TE concentration. Poplar also shows changing proportions of bark and wood with increasing diameter at breast height (DBH). Though it is often thought that the amount of TE accumulated in the biomass increases with the size of the plant, in the current study we show that this is only partially true. In fact while Zn is highly accumulated by the largest (60 mm DBH) poplar plants, Cd, Cu, and Ni were more concentrated in slightly smaller plants (50 mm DBH), and Pb in even smaller (40 mm DBH). These findings could open new strategies for managing a poplar phytoextraction stand in terms of coppicing techniques and planting cycles in order to address specific targeted TEs and enhance the overall performance of this green technology.

DNA duplex recognition activates Exo1 nuclease activity

Exonuclease 1 (Exo1) is an evolutionarily conserved eukaryotic nuclease that plays a multifaceted role in maintaining genome stability. The biochemical attributes of Exo1 have been extensively characterized via conventional assays. However, the key step governing its activation remains elusive. Extending the previous finding that Exo1 can digest a randomly selected single-stranded DNA (ssDNA) but not a poly(dT) oligonucleotide and using purified recombinant Exo1 and nuclease and electrophoretic mobility shift assays, here we determined that DNA hairpins with a stem size of 4 bp or longer are able to activate Exo1-mediated digestion of ssDNA. We further provide evidence suggesting that Exo1 uses an evolutionarily conserved residue, Lys185 This residue interacted with the phosphate group bridging the third and fourth nucleotide on the digestion strand of the substrate DNA for duplex recognition, critical for Exo1 activation on not only ssDNA but also dsDNA. Additionally, the defect of an exo1-K185A mutant in duplex digestion was partially rescued by longer overhanging DNA. However, we noted that the enhanced Exo1 nuclease activity by longer overhanging DNA is largely eliminated by replication protein A (RPA), likely because of the previously reported RPA activity that strips Exo1 off the ssDNA. We conclude that duplex DNA contact by Exo1 is a general mechanism that controls its activation and that this mechanism is particularly important for digestion of duplex DNA whose nascent ssDNA is bound by RPA.

Undersizing the Exeter stem in hip hemiarthroplasty increases the risk of periprosthetic fracture

Whether under- or oversizing of the femoral component of cemented hip hemiarthroplasties impacts the risk of periprosthetic fractures (PPF) has only been examined experimentally. This study was carried out to add more knowledge about the risks of PPF in cemented polished tapered hemiarthroplasties. 20 patients with PPF following hip hemiarthroplasty with cemented Exeter V40 stems were compared to 50 controls who never suffered PPF having received the same type of Exeter hemiprosthesis for the same indication. The difference between stem size and post-hoc radiographic ideal templated size was investigated as a predictor of PPF. Cases had a median size difference to post-hoc templating of -2, while controls had a median size difference of -1 (p = 0.09). An ROC curve constructed to find an optimal cutoff point in size difference between cases and controls arrived at an area under curve of 63%, with -1.5 as the cutoff. Patients with size differences exceeding -1.5 had a statistically significant increased PPF risk (odds ratio = 3.8, 95% confidence interval, 1.1-13.3, p < 0.05). This group covered 55% of all cases. An implanted femoral component that is 2 or more sizes smaller than the template that is shown to be appropriate will increase the risk of PPF in Exeter hip hemiarthroplasties.