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If you have a cut or puncture, even a small one, on the joint, it is possible for bacteria to enter the bursa and cause a bacterial infection that leads to bursitis

the inability of tertiary amides to donate hydrogen bonds to water (they can only be H-bond acceptors)

In conclusion, the current study revealed that arogenate-specific TyrA a enzymes evolved in some bacterial lineages, through the acquisition of an acidic residue at the 222 position, which later gave rise to the TyrAs of algae and land plants likely through a novel HGT event

2013, Humana Press

It's also NSF Certified for Sport, which most nootropics aren't