Standard Versus Dysplastic Inlay Implant for Patellofemoral Arthroplasty: Surgical Technique and Decision-Making.

Patellofemoral arthroplasty (PFA) has emerged as an alternative bone-preserving surgical option for treating isolated symptomatic patellofemoral osteoarthritis that better replicates the natural knee kinematics compared with total knee arthroplasty. Achieving successful outcomes in PFA relies on meticulous patient selection, proper surgical technique, and appropriate implant choice and placement. Recent advancements in inlay trochlea implants, allowing for customized and anatomic joint line reconstruction with less bone resection, have demonstrated significant improvements in functional outcome scores and pain relief. This Technical Note aims to provide insights into the surgical technique of PFA with inlay implants, highlighting key considerations and potential challenges. It also assists surgeons in making informed decisions regarding the choice between standard and dysplastic inlay implants, while suggesting concurrent procedures to optimize tracking and overall outcomes.

Effects of virtual tour on perioperative pediatric anxiety.

BACKGROUND: There is a high incidence of perioperative anxiety in the pediatric population, with adverse side effects, such as emergency delirium and maladaptive postoperative behaviors. AIMS: The study's objective was to compare the level of preoperative anxiety in children after standard preparation plus a virtual tour of the operating room vs. standard preparation alone. PATIENTS/METHODS: This was a prospective single-center, randomized, controlled, blinded trial with parallel assignment, registered as NCT04043663. Eligible subjects were healthy children (ASA I-II) aged 4-12, scheduled for outpatient surgery. Five visits were conducted during the study, two at the hospital and three over the phone. Variables assessed were child's anxiety through the modified Yale Perioperative Anxiety Scale, demographic data, cooperation with induction through the Induction Compliance Checklist, preoperative parental anxiety through the State-Trait Anxiety Inventory and Anxiety Visual Analog Scale, the postoperative delirium degree through the Pediatric Anesthesia Emergence Delirium Scale, the presence of behavioral changes through the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery, and the overall parental satisfaction. RESULTS: A total of 125 participants were included; 61 (48.8%) of them were randomized to the Virtual Tour Group (VT+) and 64 (51.2%) to the Non-virtual Tour Group (VT-). Yale Preoperative Anxiety Scale results in VT+ vs. VT- were mean 27.26 vs. 32.57, and median 23.4 (CI 95% 23.4-23.4) vs. 23.4 (CI 95% 23.4-33.4), (p = .0086). In the VT+ group, satisfaction was higher for questions one (p = .0213), three (p = <.0001), and four (p = .0130). Throughout the study, we observed a significant reduction in perioperative anxiety in the VT+ group, facilitating anesthetic induction in perfect (p = .018) and moderate compliance (p = .0428). The other variables did not show statistically significant differences. CONCLUSION: Our study confirms previous studies that found virtual tours for perioperative patients may reduce perioperative anxiety and improve satisfaction. We found no impact on longer-term outcomes.

Limiting Dietary Lysine Increases Body Weight Variability by Restricting Growth Potential of the Lightest Growing Pigs.

The goal of this experiment was to determine the implications of dietary standardized ileal digestible lysine (SID Lys:NE) on body weight variability of growing pigs grouped in three initial body weight categories (BWCAT). Animals (N = 1170) were individually weighed and classified in 3 BWCAT (Lp: 32.1 ± 2.8 kg, Mp: 27.5 ± 2.3 kg, and Sp: 23.4 ± 2.9 kg). Afterward, pens were randomly allocated to five dietary SID Lys:NE treatments (3.25 to 4.88 g/Mcal) that were fed over 47 days. Pen coefficient of variation of Sp at day 47 was linearly increased when reducing SID Lys:NE (p < 0.01), from 9.8% to 15.4% between the two extreme dietary levels. The linear effect was different in Sp compared to Lp (p < 0.05) as no effect of SID Lys:NE was reported in the latter BWCAT (p = 0.992). Further analysis showed that this effect was explained by a growth restriction that was more severe the lightest the pigs were at the start of the trial. To summarize, swine body weight variability can be negatively affected when SID Lys requirements are not fulfilled.

Fragment dissolved molecular dynamics: a systematic and efficient method to locate binding sites.

Diverse computational methods to support fragment-based drug discovery (FBDD) are available in the literature. Despite their demonstrated efficacy in supporting FBDD campaigns, they exhibit some drawbacks such as protein denaturation or ligand aggregation that have not yet been clearly overcome in the framework of biomolecular simulations. In the present work, we discuss a systematic semi-automatic novel computational procedure, designed to surpass these difficulties. The method, named fragment dissolved Molecular Dynamics (fdMD), utilizes simulation boxes of solvated small fragments, adding a repulsive Lennard-Jones potential term to avoid aggregation, which can be easily used to solvate the targets of interest. This method has the advantage of solvating the target with a low number of ligands, thus preventing the denaturation of the target, while simultaneously generating a database of ligand-solvated boxes that can be used in further studies. A number of scripts are made available to analyze the results and obtain the descriptors proposed as a means to trustfully discard spurious binding sites. To test our method, four test cases of different complexity have been solvated with ligand boxes and four molecular dynamics runs of 200 ns length have been run for each system, which have been extended up to 1 µs when needed. The reported results point out that the selected number of replicas are enough to identify the correct binding sites irrespective of the initial structure, even in the case of proteins having several close binding sites for the same ligand. We also propose a set of descriptors to analyze the results, among which the average MMGBSA and the average KDEEP energies have emerged as the most robust ones.

The Implications of Nutritional Strategies that Modify Dietary Energy and Lysine for Growth Performance in Two Different Swine Production Systems.

This work aimed to determine the impacts of lowering dietary net energy (NE) density in two swine production systems that produce pigs with different carcass traits. To ensure that dietary lysine was not limiting growth, two studies were conducted in a 2 × 2 factorial arrangement with NE and standardized ileal digestible lysine (SID Lys) as experimental factors. A total of 1248 pigs were used in each study, Pietrain (Exp. 1, males non-castrated) or Duroc (Exp. 2, males castrated) sired. Reducing NE resulted in a greater feed intake; however, this was not sufficient to reach the same NE intake. While in Exp. 1 a 3.2% lower NE intake did not impair average daily gain (ADG; p = 0.220), in Exp. 2 a 4.7% lower NE intake reduced ADG by 1.4% (p = 0.027). Furthermore, this effect on ADG entailed a reduced ham fat thickness (p = 0.004) of the first marketed pigs. Increasing SID Lys only had a positive effect in Exp. 1, but no significant interaction between NE and SID Lys was reported (p ≥ 0.100). Therefore, dietary NE can be reduced without impairing growth performance when pigs can increase feed intake sufficiently, and thus, limit energy deficiencies.

Interrelationships between sex and dietary lysine on growth performance and carcass composition of finishing boars and gilts.

The main goals of this study were to determine whether boars and gilts respond differently to the standardized ileal digestible lysine to net energy ratio (SID Lys:NE) and model the response to optimize growth performance. A total of 780 finishing pigs, 390 boars and 390 gilts [Pietrain NN × (Landrace × Large White)], with an initial individual body weight of 70.4 ± 9.2 for boars and 68.7 ± 8.0 kg for gilts, were used in a 41-d dose-response experiment. Pens (13 pigs per pen) were randomly allocated to a dietary treatment (2.64, 3.05, 3.46, 3.86, 4.27 g SID Lys/Mcal NE) by block and sex, with six replicates per treatment and sex. Two isoenergetic diets (2,460 kcal NE/kg), representing the extreme SID Lys:NE, were formulated and then mixed. Pigs were individually weighed at days 0, 22, and 41, when the experiment finished. The differential effect of SID Lys:NE on growth performance and carcass composition between sexes was analyzed with orthogonal polynomial contrasts to compare the linear and quadratic trends in each sex. In addition, broken-line linear (BLL) models to optimize average daily gain (ADG), including average daily feed intake (ADFI) as a covariate, were fitted when possible. As expected, boars had a greater ADG and feed efficiency (G:F; P < 0.001) than gilts, but there was no evidence of differences in ADFI (P = 0.470). Increasing SID Lys:NE had a greater linear impact on boars ADG (P = 0.087), G:F (P = 0.003), and carcass leanness (P = 0.032). In contrast, gilts showed a greater linear increase in SID Lys intake per kg gain (P < 0.001) and feed cost per kg gain (P = 0.005). The best fitting BLL models showed that boars maximized ADG at 3.63 g SID Lys/Mcal NE [95% confidence interval (CI): (3.32 to 3.94)], although another model with a similar fit, compared with the Bayesian information criterion, reported the optimum at 4.01 g SID Lys/Mcal NE [95% CI: (3.60, 4.42)]. The optimum to maximize ADG for gilts was estimated at 3.10 g SID Lys/Mcal NE [95% CI: (2.74, 3.47)]. Thus, the present study confirmed that boars and gilts have a different linear response to SID Lys:NE, explained by the greater protein deposition potential of boars. Likewise, BLL models indicated that boars require a higher SID Lys:NE to maximize ADG from 70 to 89 kg. These results suggest that split feeding of finishing boars and gilts could be beneficial in terms of both performance and cost return.

Increasing Dietary Lysine Impacts Differently Growth Performance of Growing Pigs Sorted by Body Weight.

An experiment was conducted analyzing whether growing pigs classified in different initial body weight categories (BWCAT) have a different response to increasing standardized ileal digestible lysine to net energy ratio (SID Lys:NE), to assess whether light pigs might benefit from being differentially fed. A total of 1170 pigs in pens of 13 were individually weighed, classified in 3 BWCAT (Lp: 32.1 ± 2.8 kg, Mp: 27.5 ± 2.3 kg, and Sp: 23.4 ± 2.9 kg), and afterwards pens were randomly allocated to 5 dietary SID Lys:NE treatments (3.25 to 4.88 g/Mcal) fed over 47 days. Results reported a greater linear improvement of growth and feed efficiency of Sp compared to Lp when increasing SID Lys:NE. Modelling the response to SID Lys:NE using quadratic polynomial models showed that the levels to reach 98% of maximum growth from day 0-47 were 3.67, 3.88, 4.06 g SID Lys/Mcal NE for Lp, Mp, and Sp, respectively. However, due to the overlapping SID Lys:NE confidence intervals at maximum performance, it was not possible to determine if requirements were different between BWCAT. Summarizing, the results suggested that feeding small pigs greater SID Lys:NE than large pigs can improve their performance and increase the efficiency of the overall production system.

Applicability of an Unmedicated Feeding Program Aimed to Reduce the Use of Antimicrobials in Nursery Piglets: Impact on Performance and Fecal Microbiota.

This study aimed to assess the impact of two different feeding programs, including or not antimicrobials, on gut microbiota development at early ages in commercial pigs. For this, 21-day-old weaned piglets were distributed into 12 pens (6 replicates with 26 pigs each) and fed ad libitum until fattening with: standard commercial formula with antibiotics and zinc oxide (2400 ppm) (AB), and alternative unmedicated feed formula (UN). Subsequently, the animals were moved to the fattening unit (F) receiving a common diet. Pigs were weighed, and feed consumption and diarrhea scores registered. Feces were collected on days 9 (pre-starter), 40 (starter) and 72 (fattening) post-weaning and microbial DNA extracted for 16S rDNA sequencing. Piglets fed UN diets had a worse feed efficiency (p < 0.05) than AB during nursery; however, UN pigs spent less time scouring after weaning (p = 0.098). The structure of fecal community evolved with the age of the animals (p = 0.001), and diet also showed to have a role, particularly in the starter period when UN microbiomes clustered apart from AB, resembling the ecosystems found in the fattening animals. Fibrolytic genera (Fibrobacter, Butyrivibrio, Christellansellaceae) were enriched in UN piglets whereas Lactobacillus characterized AB piglets (adjusted p < 0.05). Overall, this alternative feeding program could anticipate the gut development of piglets despite a lower feed efficiency compared to standard medicalized programs.

Strategies to improve the growth and homogeneity of growing-finishing pigs: feeder space and feeding management.

BACKGROUND: The aim was to test two strategies to improve the growth rate of the slow-growth pigs and to increase the batch's homogeneity at slaughter. In Trial 1 a total of 264 weaned piglets were distributed into 24 pens (11 piglets/pen) according to sex and initial body weight (BW) for the transition period (T; 28 d to 64 d). During the T period, a commercial lidded feeder hopper was used (3.7 pigs/feeder space). When moving to the growing facilities, the 24 pens were maintained and split into two groups of 12 according to sex, feeder type (HD or 5.5 pigs/feeder space and LD or 2.2 pigs/feeder space). In Trial 2 a total of 1067 piglets were used and classified, when leaving the nursery at 63d of age, as Heavy (Hp, n = 524) and Light (Lp, n = 543) pigs. Along the growing period, Hp and half of the Lp pigs were fed with four consecutive feeds, following a standard feeding program (Std). Alternatively, the other half of the Lp pigs were fed according to a budget approach, changing the first three feeds on the basis of an equivalent feed consumption instead of age (Sp). RESULTS: In Trial 1, higher BW (80.2 kg vs. 82.1 kg; P = 0.02), ADG (704 g/d vs. 725 g/d; P = 0.02) and lower number of lesions were observed for pigs raised in the LD treatment, compared to the HD treatment at d 154 (P < 0.05). The CV of the final BW was numerically lower for the LD treatment. In Trial 2, higher BW and ADG and lower CV were observed for the LSp pigs from 83 d until 163 d (P < 0.001) of age compared to LStd. Moreover, an interaction observed for carcass weight at slaughter (P = 0.016) showed that the Sp pigs had a higher carcass weight than did the Std pigs, and the difference increased as the emptying of the barn facility advanced. CONCLUSION: It is concluded that feeder space and feeding management may affect the growth of growing-finishing pigs and body-weight homogeneity at the end of the period.

Potential risk factors related to pig body weight variability from birth to slaughter in commercial conditions.

The aim of this observational study is to identify risk factors associated with body weight (BW) variability in three data sets (DS) in commercial conditions. A total of 1,009 (DS1), 460 (DS2), and 1304 (DS3) male and female crossbreed pigs (Pietrain × [Landrace × Large White]), respectively, were included in each trial. Pigs were periodically weighed until slaughter. Then, variables such as length of gestation, length of lactation, parity, litter size, sex, birth BW, and ADG were considered. Pigs remaining on the farm after two loads to the slaughterhouse were defined as last group of animals sent to slaughterhouse (LGS). Descriptive statistics of variability were calculated, and a risk analysis approach was used to look for the factors related to LGS. A multiple logistic regression was performed to identify all variables that were significant (P < 0.05). The risk ratio (RR), odds ratio (OR), and population attributable risk (PAR) were calculated for all of the significant variables after transforming all of them into binary factors using the 25th percentile as the cut-off point. Results showed that the major part of the variability (as CV) comes from birth (20% to 25%) and increased only a little during lactation and 14-d post weaning. From this point onwards, CV tended to decrease, as pigs got closer to the marketing weight (down 11.5% to 12.7%). Regarding the indicators selected, RR, OR, and PAR presented similar trends in the three DS studied. Therefore, for the variables finally included, these indicators had their minimum values at the start of the cycle and then gradually increased at the end. Those results, based on an epidemiological approach, suggest that the closer to the end of the cycle the greater the probability for a light piglet of being/becoming LGS. It might be explained by the shorter available time to efficiently implement preventive measures aimed to improve the performance of delayed pigs and, thus, reducing variability.Those results, based on an epidemiological approach, make sense as the probability for a light piglet to be a LGS increases the closer to the end of the cycle, due to the short time to implement preventive measures and increase the performance of delayed pigs and reduce variability. The differential PAR associated with both, the nursery and the growing period, was 1.7% and 1.5% for DS1, 5.1% and 3.1% for DS2, and 3.7% and 2.8% for DS3. For the lactation period, the results were 4.3% for DS2 and 4.5% for DS3. Results suggest that the most critical periods, in relation to retardation of growth in swine, are lactation and nursery. Implementing measures that maintain risk factors under or above thresholds, especially in the initial phases of growth, will reduce the percentage of LGS pigs and positively affect the overall homogeneity of the batch.

Determination and occurrence of phthalates, alkylphenols, bisphenol A, PBDEs, PCBs and PAHs in an industrial sewage grid discharging to a Municipal Wastewater Treatment Plant.

Industrial and urban discharges release organic contaminants which might affect the quality of receiving waters if not properly eliminated in Wastewater Treatment Plants (WWTP). This study is aimed to evaluate the source, transport and fate of contaminants of industrial origin in a sewage grid discharging to a WWTP and finally to the sea. The sampling network covered an industrial and urban area and wastewaters, influents and effluents of a WWTP were analyzed using a newly developed multiresidual method to capture a wide range contaminants (phthalates, alkylphenols, bisphenol A, PBDEs, PCBs and PAHs). Alkylphenols and phthalates followed by PAHs were the main compounds detected at levels between 0.01 to 698 microg l(-1) in the sewage pipelines. At the WWTP influent they were detected at concentrations up to 345 microg l(-1). The contaminant load was eliminated in a 64-92% during the primary and secondary treatment of the plant. However, alkylphenols, phthalates bisphenol A and traces of PAHs were discharged with the effluent, producing a total net input of 825 g d(-1) to the sea. The study of wastewaters herein proposed can be used to better predict the loads into WWTP to improve treatment conditions according to specific sewage inputs and to assess the risks associated with the continuous discharge of contaminants to receiving plants.

From residual to useful oil: revalorization of glycerine from the biodiesel synthesis.

The reaction kinetics for the synthesis of glycerol triacetate (triacetin) from glycerol and acetic acid has been studied in the frame of revalorization of residual glycerol in biodiesel production. The reaction has taken place in a stirred reactor at a pressure of 1070 kPa. No external catalyst has been added because the reaction performs better by using as catalyst an excess of acetic acid. Kinetic parameters were obtained at 120 and 160 degrees C and a model of three reactions with monoacetin, diacetin and triacetin formation was proposed with a good agreement with the experimental results. Arrhenius constants were determined for the involved reactions.