The aim of this study was to determine if the dietary benefits of bioflavonoids are linked to the inhibition of ATP synthase. We studied the inhibitory effect of seventeen bioflavonoid compounds on purified F1 or membrane bound F1FO E. coli ATP synthase. We found that the extent of inhibition by bioflavonoid compounds was variable. Morin, silymarin, baicalein, silibinin, rimantadin, amantidin, or, epicatechin resulted in complete inhibition. The most potent inhibitors on molar scale were morin (IC50 ~0.07mM) > silymarin (IC50 ~0.11mM) > baicalein (IC50~0.29mM) > silibinin (IC50 ~0.34mM) > rimantadine (IC50 ~2.0mM) > amantidin (IC50 ~2.5mM) > epicatechin (IC50 ~4.0mM). Inhibition by hesperidin, chrysin, kaempferol, diosmin, apigenin, genistein, or rutin was partial in the range of 40–60% and inhibition by galangin, daidzein, or luteolin was insignificant. The main skeleton, size, shape, geometry, and position of functional groups on inhibitors played important role in the effective inhibition of ATP synthase. In all cases inhibition was found fully reversible and identical in both F1Fo membrane preparations isolated purified F1. ATPase and growth assays suggested that the bioflavonoids compounds used in this study inhibited F1-ATPase as well as ATP synthesis nearly equally, which signifies a link between the beneficial effects of dietary bioflavonoids and their inhibitory action on ATP synthase.

Introduction:Multiple cadaver and radiographic analyses have been performed to define the surgical anatomy of the sacrum and pelvis. We provide a comprehensive review of this information, creating an accurate anatomic guide for practice and research.Methods:A systematic review was performed to identify publications citing sacral or iliac morphometric parameters based on cadaver or radiographic anatomy.Results:A total of 780 abstracts were evaluated. Fifty-six articles were included for final review and grouped into four sections: (1) bone density, (2) bony corridors, (3) screw length and trajectory, and (4) neurovascular and alimentary anatomy.Conclusion:A systematic analysis of the radiographic and gross anatomic features of the sacrum has yet to be published. This review includes details on the spatial arrangement of the S1 and S2 pedicle screws, sacroiliac screws, iliac screws, S2 alar iliac screws, and pelvic neurovascular anatomy. The study can be referenced by clinicians for sacral dissection, implant application, and ongoing advances in orthopaedic research.Study Design:Systematic reviewLevel of Evidence:Level IV

Osteoporosis screening, diagnosis, and treatment have gained much attention in the health care community over the past 2 decades. During this time, creation of multispecialty awareness programs (eg, “Own the Bone,” American Orthopedic Association; “Capture the Fracture,” International Osteoporosis Foundation) and improvements in diagnostic protocols have been evident. Significant advances in technology have elucidated elements of genetic predisposition for decreased bone mineral density in the aging population. Additionally, several novel drug therapies have entered the market and provide more options for primary care and osteoporosis specialists to medically manage patients at risk for fragility fractures. Despite this, adherence to osteoporosis screening and treatment protocols has been surprisingly low by health care practitioners, including orthopedic surgeons. Continued awareness and education of this skeletal disorder is crucial to effectively care for our aging population. [ Orthopedics . 2023;46(1):e20–e26.]

Intraoperative navigation for spinal procedures has continued to gain popularity. Numerous platforms are currently on the market and offer a spectrum of features. Preoperative considerations when utilizing this technology begin with understanding the fundamental concepts and methods of navigation.Several key factors including patient positioning, reference array placement, and sequence of instrumentation can help improve intraoperative navigation workflow when planned appropriately. The authors review current literature to help guide surgeon decision making when utilizing navigation. Additionally, tips and techniques for use of navigation are detailed to help avoid common surgeon pitfalls. In general, navigation platforms are classified based on image acquisition and degree of surgeon motion restriction during instrumentation. Imageless platforms often require preoperative images to be uploaded into the navigation system. Image-based systems rely on intraoperative imaging to ensure accuracy of its referencing software.The system then creates a three-dimensional model that allows for visualization of the navigated instrument within the surgical field. Active and passive navigation describe the degree of surgeon free-motion restriction when utilizing navigated instruments. Active navigation platforms, such as most robotic systems, prevent the deviation of the surgeon's instrument from a predetermined trajectory. Passive navigation does not restrict surgeon motion and the projected trajectory of the instrumented can be displayed on a three-dimensional model.