OBJECTIVE: Residual varus after total knee arthroplasty (TKA) can affect functional outcomes, which may worsen in the presence of obesity. However, no studies were found to compare the outcomes of obese patients involving postoperative residual mild varus or neutral. The aim of this study was to compare postoperative complications and prosthesis survival, and functional outcomes for knees of obese patients with neutral or mild varus after TKA.
METHODS: We retrospectively reviewed 188 consecutive obese patients (body mass index ≥30 kg/m2) at our hospital who underwent TKA due to varus knee osteoarthritis from January 2010 to December 2015. The mechanical hip-knee-ankle axis angle was measured in all patients at admission and discharge. Knee functions were retrospectively assessed based on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Knee Society Knee Score (KS-KS), Knee Society Function Score (KS-FS), Forgotten Joint Score (FJS), and range of motion (ROM). Continuous data were compared between knees with neutral or mild varus alignment using analysis of Student\'s t test or variance or the Kruskal-Wallis test as appropriate. For multiple comparisons of outcomes, we used Bonferroni-Dunn method to adjust p-values. Categorical data were compared using the chi-squared test.
RESULTS: Of the 156 knees in 137 obese patients who completed follow-up for a mean of 8.32 ± 1.47 years, 97 knees were corrected from varus to neutral and 54 knees were kept in mild residual varus. Patients with mild varus knees had significantly WOMAC (8.25 ± 8.637 vs. 14.97 ± 14.193, p = 0.009) and better FJS (86.03 ± 15.607 vs. 70.22 ± 30.031, p = 0.002). The two types of knees did not differ significantly in KS-KS, KS-FS, or ROM. Although one patient with a neutral knee had to undergo revision surgery, there was no significant difference between two groups.
CONCLUSIONS: For obese patients with osteoarthritis, preservation of residual varus alignment after TKA can improve functional outcomes without compromising prosthesis survival.

Community dynamics are governed by two opposed processes: species sorting, which produces deterministic dynamics leading to an equilibrium state, and ecological drift, which produces stochastic dynamics. Despite a great deal of theoretical and empirical work aiming to demonstrate the predominance of one or the other of these processes, the importance of drift in structuring communities and maintaining species diversity remains contested. Here, we present the results of a basic community dynamics experiment using floating aquatic plants, designed to measure the relative contributions of species sorting and ecological drift to community change over about a dozen generations. We found that species sorting became overwhelmingly dominant as the experiment progressed, and directed communities toward a stable equilibrium state maintained by negative frequency-dependent selection. The dynamics of any particular species depended on how far its initial frequency was from its equilibrium frequency, however, and consequently the balance of sorting and drift varied among species.

Mine tailings host dynamic biogeochemical processes that can mobilize a range of elements from the host material and release them into the environment through acidic, neutral, or alkaline mine drainage. Here we use a combination of mineralogical, geochemical, and microbiological techniques that provide a better understanding of biogeochemical processes within the surficial layers of neutral cobalt and arsenic-rich tailings material at Cobalt, ON, Canada. Tailings material within 30-cm depth profiles from three tailings sites (sites A, B, and C) were characterized for their mineralogical, chemical and microbial community compositions. The tailings material at all sites contains (sulf)arsenides (safflorite, arsenopyrite), and arsenates (erythrite and annabergite). Site A contained a higher and lower amount of (sulf)arsenides and arsenates than site B, respectively. Contrary to site A and B, site C depicted a distinct zoning with (sulf)arsenides found in the deeper reduced zone, and arsenates occurring in the shallow oxidized zone. Variations in the abundance of Co+As+Sb+Zn (Co#), Fe (Fe#), total S (S#), and average valence of As indicated differences in the mineralogical composition of the tailings material. For example, material with a high Co#, lo Fe# and high average valence of As commonly have a higher proportion of secondary arsenate to primary (sulf)arsenide minerals. Microbial community profiling indicated that the Cobalt tailings are primarily composed of Actinobacteria and Proteobacteria, and known N, S, Fe, methane, and possible As-cycling bacteria. The tailings from sites B and C had a larger abundance of Fe and S-cycling bacteria (e.g., Sulfurifustis and Thiobacillus), which are more abundant at greater depths, whereas the tailings of site A had a higher proportion of potential As-cycling and -resistant genera (e.g., Methylocystis and Sphingomonas). A multi-variate statistical analysis showed that (1) distinct site-specific groupings occur for the Co # vs. Fe #, Co# vs. S#\'s and for the microbial community structure and (2) microbial communities are statistically highly correlated to depth, S#, Fe#, pH and the average valence of As. The variation in As valence correlated well with the abundance of N, S, Fe, and methane-cycling bacteria. The results of this study provide insights into the complex interplay between minerals containing the critical element cobalt, arsenic, and microbial community structure in the Cobalt Mining Camp tailings.

Intrauterine growth restriction (IUGR) is associated with reduced placental amino acid transport (AAT). However, it remains to be established if changes in AAT contribute to restricted fetal growth. We hypothesized that reduced in vivo placental AAT precedes the development of IUGR in baboons with maternal nutrient restriction (MNR). Baboons were fed either a control (ad libitum) or MNR diet (70% of control diet) from gestational day (GD) 30. At GD 140, in vivo transplacental AA transport was measured by infusing nine (13)C- or (2)H-labeled essential amino acids (EAAs) as a bolus into the maternal circulation at cesarean section. A fetal vein-to-maternal artery mole percent excess ratio for each EAA was measured. Microvillous plasma membrane (MVM) system A and system L transport activity were determined. Fetal and placental weights were not significantly different between MNR and control. In vivo, the fetal vein-to-maternal artery mole percent excess ratio was significantly decreased for tryptophan in MNR. MVM system A and system L activity was markedly reduced in MNR. Reduction of in vivo placental amino acid transport precedes fetal growth restriction in the non-human primate, suggesting that reduced placental amino acid transfer may contribute to IUGR.

Rechargeable aqueous zinc-air cells (ZACs) promise an extremely safe and high energy technology. However, they are still significantly limited by sluggish electrochemical kinetics and irreversibility originating from the parasitic reactions of the bifunctional catalysts and electrolytes. Here, we report the preferential in situ building of interfacial structures featuring the edge sites constituted by FeCo single/dual atoms with the integration of Co sites in the nitrogenized graphitic carbon frameworks (FeCo SAs@Co/N-GC) by electronic structure modulation approach. Compared to commercial Pt/C and RuO2, FeCo SAs@Co/N-GC reveals exceptional electrochemical performance, reversible redox kinetics, and durability toward oxygen reduction and evolution reactions under universal pH environments, i.e., alkaline, neutral, and acidic, due to synergistic effect at interfaces and preferred charge/mass transfer. The aqueous (alkaline, nonalkaline, and acidic electrolytes) ZACs constructed with a FeCo SAs@Co/N-GC cathode tolerate stable operations, have significant reversibility, and have the highest energy densities, outperforming those of noble metal counterparts and state-of-the-art ZACs in the ambient atmosphere. Additionally, flexible solid-state ZACs demonstrate excellent mechanical and electrochemical performances with a highest power density of 186 mW cm-2, specific capacity of 817 mAh gZn-1, energy density of 1017 Wh kgZn-1, and cycle life >680 cycles with extremely harsh operating conditions, which illustrates the great potential of triphasic catalyst for green energy storage technologies.

Dysphagia is a less reported but serious adverse outcome post occipitocervical fusion. Any patient suffering from dysphagia and or nasal regurgitation post fusion in flexion should be offered early revision. The right position for occipitocervical fusion is neutral alignment.

BACKGROUND: The SARS-CoV-2 infection has spread at an alarming rate with many places showing multiple peaks in incidence. Present study analyzes a total of 332 SARS-CoV-2 genome sequences from 114 asymptomatic and 218 deceased patients from twenty-one different countries to assess the mutation profile therein in order to establish the correlation between the clinical status and the observed mutations.
METHODS: The mining of mutations was carried out using the GISAID CoVSurver (www.gisaid.org/epiflu-applications/covsurver-mutations-app) with the reference sequence \'hCoV-19/Wuhan/WIV04/2019\' present in NCBI with Accession number NC-045512.2. The impact of the mutations on SARS-CoV-2 proteins mutation was predicted using PredictSNP1(loschmidt.chemi.muni.cz/predictsnp1) which is a meta-server integrating six predictor tools: SIFT, PhD-SNP, PolyPhen-1, PolyPhen-2, MAPP and SNAP. The iStable integrated server (predictor.nchu.edu.tw/iStable) was used to predict shifts in the protein stability due to mutations.
RESULTS: A total of 372 variants were observed in the 332 SARS-CoV-2 sequences with several variants present in multiple patients accounting for a total of 1596 incidences. Asymptomatic and deceased specific mutants constituted 32% and 62% of the repertoire respectively indicating their partial exclusivity. However, the most prevalent mutations were those present in both. Though some parts of the genome are more variable than others but there was clear difference between incidence and prevalence. Non-structural protein 3 (NSP3) with 68 variants had a total of only 105 incidences whereas Spike protein had 346 incidences with just 66 variants. Amongst the Deleterious variants, NSP3 had the highest incidence of 25 followed by NSP2 (16), ORF3a (14) and N (14). Spike protein had just 7 Deleterious variants out of 66.
CONCLUSIONS: Deceased patients have more Deleterious than Neutral variants as compared to the asymptomatic ones. Further, it appears that the Deleterious variants which decrease protein stability are more significant in pathogenicity of SARS-CoV-2.

Pictures with affective content have been widely used in the scientific study of emotions, from two main perspectives: on the one hand, dimensional theories claiming that affective experiences can be described according to a few fundamental dimensions such as valence and arousal, and on the other hand, discrete-category theories proposing the presence of a number of basic and universal emotions. Although it has been demonstrated that these two approaches are not mutually exclusive, the existing standardized affective picture databases have been created from the dimensional perspective, which has led to important gaps for research focused on discrete emotions. The present work introduces MATTER, a new database comprising 540 pictures depicting disgusting, fearful, neutral, erotic, mirthful and incongruent content, which provides normative values (total N = 368, mean = 120.47 ratings/picture) in valence and arousal dimensions, as well as in discrete affective (disgust, fear, erotica and mirth) and cognitive (incongruence and interest) features. A tentative classification into discrete categories is presented, and the physical properties of each picture are reported. Our findings suggest that MATTER constitutes a modern and suitable set of affective images including, for the first time, both mirth- and incongruence-related pictures. Additionally, it will enable the examination of affective and cognitive processes in fear/disgust and humor/incongruence fields.

BACKGROUND: The perception of the affective quality of stimuli with regard to valence and arousal has mostly been studied in laboratory experiments. Population-based research may complement such studies by accessing larger, older, better balanced, and more heterogeneous samples. Several characteristics, among them age, sex, depression, or anxiety, were found to be associated with affective quality perception. Here, we intended to transfer valence and arousal rating methods from experimental to population-based research. Our aim was to assess the feasibility of obtaining and determining the structure of valence and arousal ratings in the setting of the large observational BiDirect Study. Moreover, we explored the roles of age, sex, depression, and anxiety for valence and arousal ratings of words.
METHODS: 704 participants provided valence and arousal ratings for 12 written nouns pre-categorized as unpleasant, neutral, or pleasant. Predictors of valence and arousal ratings (i.e. age, sex, depression, and anxiety) were analyzed for six outcomes that emerge by combining two affective dimensions with three words categories. Data were modeled with multiple linear regression. Relative predictor importance was quantified by model-explained variance decomposition.
RESULTS: Overall, average population-based ratings replicated those found in laboratory settings. The model did not reach statistical significance in the valence dimension. In the arousal dimension, the model explained 5.4% (unpleasant), 4.6% (neutral), and 3.5% (pleasant) of the variance. (Trend) effects of sex on arousal ratings were found in all word categories (unpleasant: increased arousal in women; neutral, pleasant: decreased arousal in women). Effects of age and anxiety (increased arousal) were restricted to the neutral words.
CONCLUSIONS: We report results of valence and arousal ratings of words in the setting of a large, observational, population-based study. Method transfer yielded acceptable data quality. The analyses demonstrated small effects of the selected predictors in the arousal dimension.

This paper analyzes the role of neutral viruses in the phenomenon of local immunodeficiency. We show that, even in the absence of altruistic viruses, neutral viruses can support the existence of persistent viruses and thus local immunodeficiency. However, in all such cases neutral viruses can maintain only bounded (relatively small) concentration of persistent viruses. Moreover, in all such cases the state of local immunodeficiency could only be marginally stable, while it is known that altruistic viruses can maintain stable local immunodeficiency. We also present an absolutely minimal cross-immunoreactivity network where a stable and robust state of local immunodeficiency can be maintained. It is now a challenge to synthetic biology to build such small networks with stable local immunodeficiency. Another important challenge for biology is to understand which types of viruses can play a role of persistent, altruistic and neutral ones and whether a role which a given virus plays depends on the structure (topology) of a given cross-immunoreactivity network.