bluuebunny/crossref_metadata_2025 huggingface dataset:
Insights from Egyptian ticagrelor study in patients who presented with acute coronary syndrome (ETS in ACS)
Authors: Taha Hesham S. , Kandil Hossam , Farag Nabil , Zaki Amr , Mahrous Hossam , Shaker Mirna M.
Published: June 2022

Background

Dual antiplatelet therapy with aspirin and a thienopyridine is used to prevent thrombotic complications of acute coronary syndrome (ACS) and percutaneous coronary interventions (PCI). Ticagrelor is an oral, reversible inhibitor of the adenosine diphosphate receptor P2Y12 with a faster onset and more potent platelet inhibition than clopidogrel. A study was needed to evaluate the efficacy and safety of generic ticagrelor in Egyptian patients.

Results

This multicenter study included 830 patients aged above 40 years and diagnosed with ACS, with or without ST segment elevation during the preceding 6 months. They received generic ticagrelor (Thrombolinta, Global Napi Pharmaceutical Company, Egypt) (180 mg loading dose, 90 mg twice daily thereafter), added to aspirin 75–100 mg daily. The mean age of our study population was 57.5 (8.3) years and 38.3% were females. Hypertension, diabetes mellitus, dyslipidemia and previous coronary revascularization were present in 70.7%, 59.2%, 80.7% and 31% of the patients, respectively, and 42.5% were current smokers. The qualifying event was unstable angina, non-ST segment elevation myocardial infarction and ST segment elevation myocardial infarction in 54%, 21.8% and 24.2% of the patients, respectively. At 6 months, the primary efficacy end point—a composite of cardiovascular death, myocardial infarction and stroke—occurred in 3.4% of patients, while the secondary efficacy endpoint—a composite of the primary efficacy endpoints with the addition of hospitalization for unstable angina and urgent revascularization—occurred in 15.3%. Cardiovascular death occurred in 1.2% of the patients, myocardial infarction in 0.8%, stroke in 1.3%, hospitalization for UA in 8.1% and urgent revascularization in 3.9%. TIMI major bleeding occurred in 1.2% of patients, intracranial hemorrhage in 0.2% and TIMI minor bleeding in 13.3%. No significant difference was found between patients who underwent PCI at baseline and those who were treated conservatively regarding the primary (14 patients in each group, P = 0.931) and secondary (62 vs. 65 patients, P = 0.946) efficacy endpoints.

Conclusions

In patients who had an ACS during the 6 months preceding enrollment, treatment with generic ticagrelor led to a low rate of cardiovascular death, myocardial infarction and stroke with a minor increase in the risk of major bleeding.
New biomarkers for the diagnosis of pleural effusion
Authors: El-Sokkary Raafat T. , Abuelkassem Nermen M. , Seddik Mohamed Ismail , Metwally Ahmed
Published: June 2022

Background

Persistent undiagnosed effusion is present in approximately 15% of all causes of exudative effusion. Pleural effusion caused by immunoglobulin G4 (IgG4) is a new type of pleural effusion. Tumor markers such as Carcinoembryonic antigen (CEA) may play a role in the diagnosis of malignant pleural effusion. This study aimed to evaluate the use of serum Immunoglobulin G4 and carcinoembryonic antigen in diagnosing pleural effusion.

Methods

This observational descriptive cross-sectional study comprised 89 individuals with exudative pleural effusion who visited the Assiut university hospital's chest department. All patients were examined and asked about their medical history. Also, chest X-ray, MSCT chest, transthoracic ultrasonography, pleural fluid analysis and cytology, serum level of carcinoembryonic antigen, and immunoglobulin G4 were performed. In addition, pleural biopsy, bronchoscopy, and thoracoscopy were performed when required.

Results

In comparison to another diagnosis, the level of serum IgG 4 was observed to be substantially greater in individuals with IgG4-associated effusion (725± 225.45). Patients with malignant mesothelioma (70± 16.24) and metastatic adenocarcinoma (93.52± 19.34) had lower levels of IgG4. In contrast, the serum level of CEA was significantly higher in individuals with malignant mesothelioma (79.50± 29.47) and metastatic adenocarcinoma (68.71± 28.98). Patients with para-pneumonic effusion had a minor serum level of CEA (0.36 ± 0.26). At cutoff point > 152 mg/dl serum IgG-4 had 100% sensitivity and 94% specificity in the diagnosis of IgG4 related pleural effusion with an overall accuracy of 95.3% and area under the curve of 0.97. At the cutoff point > 5 ng/ml serum CEA had 77% sensitivity and 100% specificity in diagnosing malignant pleural effusion with an overall accuracy of 91.1% and area under the curve of 0.88.

Conclusion

Serum IgG4 higher than 152 mg/dl has good diagnostic accuracy in cases of undiagnosed pleural effusion. Carcinoembryonic antigen aids in diagnosing malignant pleural effusion with a cutoff point higher than 5 ng/ml in serum.

Trial registration

ClinicalTrials.gov registration ID NCT03260088
Development of a chromatographic lateral flow immunoassay for detection of African swine fever virus antigen in blood
Authors: Madden Daniel W. , Sunwoo Sun-Young , Gaudreault Natasha N. , Trujillo Jessie D. , Morozov Igor , Gallardo Carmina , Richt Juergen A.
Published: June 2022

African swine fever (ASF) is a highly lethal disease of domestic and wild swine caused by African swine fever virus (ASFV). The disease currently circulates in Africa, Europe, Asia and on the island of Hispaniola. The ongoing epizootics in Europe and Asia have produced millions of animal deaths and severe economic losses. No effective vaccine is available for ASF, making rapid and accurate detection of ASFV essential for disease mitigation strategies. Currently available diagnostics for ASFV possess significant limitations related to assay performance, deployability, and/or turn-around time; therefore there is an unmet need for pen-side diagnostic tests with sufficient sensitivity and specificity. A chromatographic lateral flow immunoassay (LFIA) was developed for the detection of ASFV antigen in EDTA-treated whole blood using monoclonal antibodies targeting the viral p30 protein. The assay requires only water to perform and provides results in 25 min, making it well-suited for field use. The LFIA was capable of detecting genotype I and genotype II strains of ASFV in EDTA blood from experimentally infected pigs at varying time-points after infection, though it was unable to detect a genotype X ASFV strain. Diagnostic sensitivity correlated with clinical disease severity, body temperature, and viral DNA levels, and was over 90% in animals showing moderate to severe ASF-related symptoms after challenge with virulent genotype II virus. The LFIA also showed a robust diagnostic specificity of over 98%, which is essential to field testing for a high consequence to foregin animal disease. The LFIA targeting the viral p30 protein can reliably detect ASFV in whole blood from animals showing moderate to severe clinical signs of infection with virulent genotype I and II isolates, making it a promising candidate for use as a field-deployable antigen detection assay. Additional evaluation using field samples and different virus strains is required to further assess the utility of this rapid diagnostic test.
Expert opinion document: “Electrical impedance tomography: applications from the intensive care unit and beyond”
Authors: Rauseo Michela , Spinelli Elena , Sella Nicolò , Slobod Douglas , Spadaro Savino , Longhini Federico , Giarratano Antonino , Gilda Cinnella , Mauri Tommaso , Navalesi Paolo ,   SIAARTI Study Group
Published: June 2022

Mechanical ventilation is a life-saving technology, but it can also inadvertently induce lung injury and increase morbidity and mortality. Currently, there is no easy method of assessing the impact that ventilator settings have on the degree of lung inssflation. Computed tomography (CT), the gold standard for visually monitoring lung function, can provide detailed regional information of the lung. Unfortunately, it necessitates moving critically ill patients to a special diagnostic room and involves exposure to radiation. A technique introduced in the 1980s, electrical impedance tomography (EIT) can non-invasively provide similar monitoring of lung function. However, while CT provides information on the air content, EIT monitors ventilation-related changes of lung volume and changes of end expiratory lung volume (EELV). Over the past several decades, EIT has moved from the research lab to commercially available devices that are used at the bedside. Being complementary to well-established radiological techniques and conventional pulmonary monitoring, EIT can be used to continuously visualize the lung function at the bedside and to instantly assess the effects of therapeutic maneuvers on regional ventilation distribution. EIT provides a means of visualizing the regional distribution of ventilation and changes of lung volume. This ability is particularly useful when therapy changes are intended to achieve a more homogenous gas distribution in mechanically ventilated patients. Besides the unique information provided by EIT, its convenience and safety contribute to the increasing perception expressed by various authors that EIT has the potential to be used as a valuable tool for optimizing PEEP and other ventilator settings, either in the operative room and in the intensive care unit. The effects of various therapeutic interventions and applications on ventilation distribution have already been assessed with the help of EIT, and this document gives an overview of the literature that has been published in this context.
Understanding the impact of the COVID-19 pandemic on psychiatric trainees and what can help
Authors: Anastasis Matthew , Freudenthal Robert , O'Reilly Jo
Published: June 2022

The COVID-19 pandemic has increased rates of psychological distress and burnout in healthcare staff. How can we understand our experiences of the pandemic? We reflect on the experiences of psychiatry trainees in two north London mental health trusts. From a psychoanalytic understanding, states of extreme anxiety can lead to a manic defence and functioning in the paranoid–schizoid position. This position is derived from object relations theory and is characterised by binary thinking, splitting, projection, defensiveness and ‘knee-jerk’ decision-making. This can affect our perceptions, responses to others, relationships and ability to function and, therefore, our clinical practice and well-being. We consider the importance of recognising these processes and of organisational containment and having space to reflect. This supports functioning in the depressive position, a state of mind where we can tolerate anxiety, address difficult realities and develop new ideas. We hope these understandings are helpful to our colleagues in all professions.
Not Telling Patients Their Cancer Diagnosis in Egypt: Is It Associated With Less Anxiety and Depression and Better Quality of Life?
Authors: Alsirafy Samy A. , Abdel-Aziz Hadeer I. , Abdel-Aal Hesham H. , El-Sherief Wessam A. , Farag Dina E.
Published: June 2022

PURPOSE

In many countries, including Egypt, it is still believed that not telling patients their cancer diagnosis is associated with less psychological morbidity. This study was conducted to explore whether not telling Egyptian patients their cancer diagnosis is associated with less anxiety and depression and better quality-of-life (QoL) or not.

METHODS

A cross-sectional observational study was conducted in two Egyptian cancer care facilities and included 292 adult patients with cancer of whom 197 (67%) were aware of their diagnosis and 95 (33%) were unaware. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression and the Functional Assessment of Cancer Therapy-General 7 questionnaire to assess QoL.

RESULTS

Patients unaware of their cancer diagnosis were significantly more likely to be less educated, with no family history of cancer, interviewed within 6 months of cancer diagnosis, diagnosed with a cancer other than breast and colorectal cancer, in a poorer performance status, and with no history of anticancer treatment. There was no significant difference between unaware and aware patients in the scores of HADS-Anxiety (median [interquartile range (IQR)] = 6 [3-11] and 7 [4-11], P = .203), HADS-Depression (median [IQR] = 8 [4-12] and 8 [4-11], P = .64), and Functional Assessment of Cancer Therapy-General 7 (median [IQR] = 16 [12-20] and 16 [11-21], P = .754). In multiple regression analysis with adjustment, diagnosis unawareness did not associate significantly with anxiety, depression, and QoL ( P = .394, .662, and .845, respectively).

CONCLUSION

The results of the current study confirm that not telling adult patients their cancer diagnosis is not associated with less anxiety and depression nor better QoL.
Management of Metastatic Clear Cell Renal Cell Carcinoma: ASCO Guideline
Authors: Rathmell W. Kimryn , Rumble R. Bryan , Van Veldhuizen Peter J. , Al-Ahmadie Hikmat , Emamekhoo Hamid , Hauke Ralph J. , Louie Alexander V. , Milowsky Matthew I. , Molina Ana M. , Rose Tracy L. , Siva Shankar , Zaorsky Nicholas G. , Zhang Tian , Qamar Rubina , Kungel Terry M. , Lewis Bryan , Singer Eric A.
Published: June 2022

PURPOSE

To provide recommendations for the management of patients with metastatic clear cell renal cell carcinoma (ccRCC).

METHODS

An Expert Panel conducted a systematic literature review to obtain evidence to guide treatment recommendations.

RESULTS

The panel considered peer-reviewed reports published in English.

RECOMMENDATIONS

The diagnosis of metastatic ccRCC should be made using tissue biopsy of the primary tumor or a metastatic site with the inclusion of markers and/or stains to support the diagnosis. The International Metastatic RCC Database Consortium risk criteria should be used to inform treatment. Cytoreductive nephrectomy may be offered to select patients with kidney-in-place and favorable- or intermediate-risk disease. For those who have already had a nephrectomy, an initial period of active surveillance may be offered if they are asymptomatic with a low burden of disease. Patients with favorable-risk disease who need systemic therapy may be offered an immune checkpoint inhibitor (ICI) in combination with a vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitor (TKI); patients with intermediate or poor risk should be offered a doublet regimen (no recommendation was provided between ICIs or an ICI in combination with a VEGFR TKI). For select patients, monotherapy with either an ICI or a VEGFR TKI may be offered on the basis of comorbidities. Interleukin-2 remains an option, although selection criteria could not be identified. Recommendations are also provided for second- and subsequent-line therapy as well as the treatment of bone metastases, brain metastases, or the presence of sarcomatoid features. Participation in clinical trials is highly encouraged for patients with metastatic ccRCC. Additional information is available at www.asco.org/genitourinary-cancer-guidelines
PDZK1 Interacting Protein 1 Promotes the Progression of Papillary Thyroid Cancer
Authors: Wang Kun , Liu Shiyang , Tian Yao , Liu Chenguang , Gui Zhengwei , Yu Tianyao , Zhang Lin
Published: June 2022

Background

The incidence of papillary thyroid cancer (PTC) has increased rapidly in recent decades, and tumor progression events are common in PTC. The purpose of our study is to identify the differentially expressed genes (DEGs) correlated with PTC progression and investigate the function of PDZK1IP1 (PDZK1 interacting protein 1) in PTC.

Methods

We first analyzed DEGs associated with PTC progression between paired PTC and normal thyroid tissues in 3 Gene Expression Omnibus data sets (GSE29265, GSE33630, and GSE60542) and The Cancer Genome Atlas (TCGA) database. Data from the TCGA database and our institution were utilized to explore the relationship between PDZK1IP1 expression and clinicopathological characteristics of PTC. The CCK8 cell proliferation assay, clone formation assay, flow cytometry assay, and the xenograft model were used to investigate the function of PDZK1IP1 in PTC.

Results

Thirty-nine DEGs associated with PTC progression were identified, in which only PDZK1IP1 was upregulated in PTC tissue at both messenger RNA and protein levels. In addition, we found that high expression of PDZK1IP1 in the TCGA database was associated with poor progression-free survival, extrathyroidal extension, high stage, tall cell variant, and BRAFV600E mutation of the PTC (P < 0.001). In our collected samples, high expression of PDZK1IP1 was only related to lymph node metastasis (P < 0.05). Overexpression of PDZK1IP1 significantly promoted proliferation and inhibited apoptosis of PTC cells. Knockdown of PDZK1IP1 significantly inhibited proliferation, promoted apoptosis, and prevented xenograft formation of PTC cells.

Conclusion

PDZK1IP1 is an oncogene for tumorigenesis and development of PTC and might be a potential therapeutic target.
Two-Level Pedicle Subtraction Osteotomy in Lateral Position for an Ankylosing Spondylitis Patient With Severe Thoracolumbar Kyphosis and Hip Flexion Contracture: A Case Report
Authors: Ma Shengbiao , Zhou Zhenhai , Yu Honggui , Wu Chunyang , Deng Wenqiang , Cao Kai
Published: June 2022

BACKGROUND AND IMPORTANCE:

Spinal osteotomy and total hip replacement (THR) are the most common surgical interventions for ankylosing spondylitis (AS). It is recommended that patients with AS with severe thoracolumbar kyphotic deformity (TLKD) and flexed hips receive spinal osteotomy before THR to reduce the risk of hip prosthesis dislocation after THR. Standardly, spinal osteotomy is performed in the prone position; however, it is impractical to place patients with AS with kyphosis and closed hips in a prone position. In this report, we present an AS case with severe TLKD and closed hips who underwent spinal osteotomy in a lateral position first, then THR in the second stage.

CLINICAL PRESENTATION:

The patient with AS was a 40-year-old woamn with severe TLKD and a closed hip. Back pain, difficulty walking, and gaze loss are the chief complaints. In consideration of the infeasibility of adopting the prone position, the patient was placed in a lateral position and underwent 2-level pedicle subtraction osteotomy at L1 and L3 with a long instrumentation from T10 to S1 at the first stage. Then, THR was performed at the second stage. The patient achieved pain relief, horizontal gaze, and nearly normal ambulation after spinal deformity correction and THR. After 2-year follow-up, the spinal alignment remains good and hip function was satisfactory.

DISCUSSION:

The sequence of spinal osteotomy and THR performed for AS patients with TLKD and hip flexion contracture remains inconclusive. According to previous studies, patients treated with THR under a sagittal malaligned spine may require revision of the acetabular component to accommodate to the re-orientated acetabula resulting from the subsequent spinal osteotomy and realignment. Thus, we believe it is more reasonable to perform spinal osteotomy first. For osteotomy in lateral position, one of the key points is that the operation table should be tilted away from the surgeon side at a certain angle. Another point is that contralateral cancellous bone should be removed as much as possible when performing osteotomy at the side of vertebral away from the table. The satisfactory outcomes of this case revealed the feasibility of osteotomy in a lateral position for such severe AS with closed hip.

CONCLUSION:

Performing double-level spinal osteotomy in a lateral position first could be an alternative for patients with AS who cannot be placed in the prone position because of the severe deformity of the spine and hips.
FRAUD RISK AND AUDIT QUALITY: THE CASE OF US PUBLIC FIRMS
Authors: Frikha Chaari Hela , Belanès Amel , Lajmi Azhaar
Published: June 2022

The study raises questions about the fraud detection technique and the relevance of audit quality to mitigate fraud. The paper suggests a more comprehensive proxy for fraud risk that relies on the combination of Z-score and Beneish M-score. Basing on Logit, regressions are applied to a sample of 5,613 US-listed public firms. The study reveals that the existence of an internal auditor and independent members within the audit committee would potentially reduce the fraud risk. Hiring a Big external auditor and paying it high fees is also helpful. Findings show that, unlike the firm leverage, both firm profitability and growth opportunities have a negative effect of on fraud risk. Leverage provides a motivation for fraudulent financial reporting. It is important to note that this research underscores the audit’s monitoring role to mitigate fraud. Also, the adopted model helps regulators, bankers, managers and auditors to detect fraud at an early stage. So needed action can be taken at suitable time. Finally, in this study, we focus on financially distressed companies rather than those with financial restatements. We suggest a collective tool to predict fraud risk; which is expected to offer a more reliable proxy for fraud risk than do binary models.
CREATIVE ACCOUNTING AND SHAREHOLDERS WEALTH MAXIMIZATION IN LISTED CONSUMER GOODS COMPANIES IN NIGERIA
Authors: Olalekan Iredele Oluwamayowa , Babatunde Adeyeye Gbadegesin , Babatunde Owoyomi Ebenezer
Published: June 2022

This study examines the effect of creative accounting practices on the shareholders wealth of 90 firm-year observations of ten (10) consumer goods companies listed on the Nigerian Stock Exchange (NSE). Ex post facto research design was adopted usingdataset for the period 2011–2019 which were collated from the annual reports and financial statements of the listed consumer goods companies. Four hypotheses were proposed and tested using pooled panel data regression. Findings revealed that frequentchanges in inventory valuation method and assets valuation methods respectively have significant effect on shareholders wealth, while frequent changes in depreciation methods and liabilities valuation methods do not significantly affect shareholders’ wealth. The study recommends that external auditors should pay attention to discretionary items in the financial statements in order to ensure that the assumptions used by managers are fair. Regulators should also evaluate the adequacy of policies around inventory and assets valuation while financial analysts and shareholders should note the application and consistency of accounting policies on inventory and assets.
Should Doctors Open Online Consultation Services? An Empirical Investigation of Their Impact on Offline Appointments
Authors: Fan Wenjuan , Zhou Qiqi , Qiu Liangfei , Kumar Subodha
Published: June 2022

Online healthcare portals have become prevalent worldwide in recent years. One common form of healthcare portal is the online consultation website, which provides a bridge between patients and doctors and reduces patients’ time and cost when seeking healthcare services. Another form is the healthcare service appointment website, which facilitates offline visits for patients. Though nominally separate, the behaviors of the users (including patients and doctors) on these two types of websites could be related to each other. In particular, how does opening online consultation services impact the offline appointments of doctors? Although this is an important question for healthcare portals, doctors, and policy makers, it has not been rigorously examined in the literature. We examine the overall impact of opening online consultation services on offline appointments and show that the number of offline appointments for doctors increases after opening online consultation services. Given that online consultation is a new but important way to connect patients and doctors, our findings provide useful implications for all the stakeholders—doctors, patients, hospitals, and policy makers—regarding how to integrate online and offline channels in the healthcare context.
Pollen Profile of Geopropolis Samples Collected by Native Bees (Meliponini) in Some South American Countries
Authors: Barth Ortrud Monika
Published: June 2022

A total of 16 geopropolis samples from Brazil, Bolivia and Venezuela were analysed in the present study. Samples were submitted to the standard procedure used to obtain pollen grains and additional structured elements. At least 300 pollen grains per sample were counted; five samples did not reach 300 grains. The pollen types of Brazilian samples displayed Melastomataceae as the predominant pollen; Arecaceae, Cecropia and one as yet unidentified pollen type were established as accessory pollen. The Bolivian samples presented Cecropia and Solanum as the dominant pollen and Eucalyptus, Inga and Rubiaceae as accessory pollen. Venezuelan samples presented Melochia as the dominant pollen type and Cassia, Crotalaria, Didymopanax, Fabaceae, Melastomataceae, Myrcia, Rubiaceae, Tabebuia and one as yet unidentified pollen type as accessory pollen. The study showed a high diversity of vegetation surrounding the collection sites, indicative of the resources available for geopropolis production, and a rare superposition of plant taxa even by the same bee species.
Isolation and Characterization of P450 Gene from the Formosan Subterranean Termite, Coptotermes formosanus (Isoptera: Rhinotermitidae)
Authors: Mo Jianchu , Zhou Yue , Chen Keping , Xu Qinggang
Published: June 2022

A cytochrome P450 gene belonging to family9 was isolated from the midgut transcriptome of the termite Coptotermes formosanus Shiraki, for screening enzymes related to biomass degeneration. Some studies show that insect P450 enzymes have ligninase activities for catalyzing lignin degradation. We employed the RACE method to clone this cytochrome P450 gene, named CYP9AX1 (GenBank accession No.JN969113). To the best of our knowledge, CYP9AX1 is the first member of the CYP9 family cloned from this termite. The full-length CYP9AX1 cDNA was 2242 bp long and included a 1599bp open-reading-frame (ORF), a 61-bp 5’-untranslated region (UTR) and a 592-bp 3’-UTR (excluding the poly-A tail). The CYP9AX1 protein deduced from the ORF contains 532 amino acids with a predicted signal peptide composed of 20 amino acid at its N-terminal and the classic heme-binding domain FXXGXXXCXG (residues 468-477). At position 473, residue Arg (R) changes to Gln (Q), this suggests that CYP9AX1 is a new type of CYP subfamily 9A. The phylogenetic tree showed that C. formosanus has high genetic relationship with Blattella germanica and Diploptera punctata. Quantitative RT-PCR assays demonstrated that CYP9AX1 was expressed most abundantly in malpighian tubules, and slightly lower in the head, foregut, midgut and hindgut. The results suggested that CYP9AX1 may be involved in enzymatic detoxification systems of the delignification process in C. formosanus.
Editorial for WIROC 22 Issue
Authors: Antao Nicholas , Shyam Ashok
Published: June 2022

The 2019 WIROC issue featured the first symposium on surgical site infections, spearheaded by Dr. Gautam Zaveri. Our symposium in the 2022 WIROC issue, the brainchild of Dr. Vishall Kundnani and team, features a special on spine pathology. It has contributions from stalwarts of spinal surgery all over India in the form of case reports, review articles, original articles, imaging and diagnostic tests, meta-analysis, arthroscopy-assisted spinal surgery, and current trends in spinal surgery. It provides insight into the challenges associated with the diagnosis and management of various spinal ailments, which can cause our patients significant distress. Our four guest editorials include heart-warming messages from Dr. S. Gawhale, Bombay Orthopedic Society President, Dr. Kushall Kundnani, Dr. K. Badani, and Dr. Kshitij Chaudhary. We are fortunate that Dr. Bhaskar Anand, winner of Indian Society of Hand Surgery Award for lifetime achievement, has contributed his rich experience in dealing with CLUB hand. We feature a highly informative review article on management of the 1st time shoulder dislocators as well as an inspiring research article on newer concepts in the 1st time patellar dislocators. An original article summarizing the technique of Arthroscopic Latarjet management of shoulder instability is particular enlightening as it simplifies a difficult surgery in a succinct manner. The landscape of joint replacement surgery is ever changing with newer techniques of uncemented knee joint replacement receiving positive reviews in meta-analyses. Therefore, we have also featured an article on cementless knee replacement, which is an eye opener to the progress of science and technology. An article on the severity of violence of irate patient relatives toward doctors is frightening, but thought provoking. It guides the reader on how to take various preventive measures when faced with aggression and violence. The role of ultrasonography of the hip reveals how hip pathologies can be identified in their infancy, especially in the neonatal setting. Finally, a potpourri of articles in trauma of the foot and ankle is both stimulating and informative. I am certain our readers will be enriched by the information discussed in this issue and utilize the knowledge gained to provide the best evidence-based care to their patients.
Ultrasonic Bone Scalpel and Its Role In Spine Surgeries : A Article Review
Authors: Shikalgar TausifAhmed , Patel Priyank , Nene Abhay , Bhaladhare Shubhanshu , Puri Sanjay , Gaddiker Manojkumar
Published: June 2022

The past few decades have seen tremendous improvement in the field of spine surgery. Spine surgery involves a number of procedures from simple laminectomy to deformity correction. This requires high surgical skills and care, which is achieved by a number of instruments, which, in turn, protect surgeons from committing complications. Recent advancements in spine surgery include ultrasonic bone scalpel, which cut bone accurately and precisely. It is a unique surgical device which offers a controlled osteotomy which slices the hard bone while the soft tissues remain largely unaffected. The major benefits of using this modern instrument are the soft-tissue sparing, controlled cutting, reduced bleeding, and thereby increasing the effectiveness. The aim of this article is to summarize its uses in current practice of spine surgeons and to focus on its advantages and complications associated with uses of this device.
Posterolateral approach to the thoracic spine for spinal tuberculosis: A Technical Note and an Analysis of Results
Authors: Zaveri Gautam
Published: June 2022

Surgical pathologies in the thoracic spine are principally located anteriorly within the vertebral body resulting in vertebral body destruction, kyphotic deformity, and anterior or anterolateral compression of the spinal cord. Adequate decompression of the neural elements and vertebral body reconstruction requires access to the anterior spinal column. The posterolateral approach through a posterior midline incision allows circumferential spinal cord decompression, anterior column reconstruction, correction of thoracic kyphosis, and posterior spinal stabilization to be safely performed through a single incision, at a single sitting with excellent outcomes.
MIS-TLIF: Technical note, Learning goals behind case selection during early part of learning curve and clinical outcomes in first 150 cases
Authors: Srikantha Umesh , Perikal Parichay , Hari Akshay , Lokanath Yadhu , Somasundaram Deepak , Subramaniam Nirmala , Varma Ravi Gopal
Published: June 2022

Introduction: Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF) has been shown to offer several advantages over conventional (open) TLIF and is being increasingly employed by young surgeons early in their careers. It is important to know the appropriate technique and the correct cases to be selected in the early phase to achieve good outcomes during the learning curve. A detailed and illustrative technical note along with a guide for case selection at different phases of experience has been presented in this article. Methods: The first consecutive single surgeon series of 150 MIS-TLIF cases done over 4 years between 2012 and 2015 were considered for analysis. Demographic and peri-operative data and previously documented follow-up were collected from case records. Telephonic questionnaire and consultation were done to collect latest status, any procedures/surgeries done elsewhere for issues related to index procedure. Results were stratified as Group 1 – first 25 cases; Group 2 – 26–75 cases; Group 3 – 76–150 cases. Results: The major indication for surgery in group 1 was either Grade 1 spondylolisthesis or lumbar canal stenosis with concomitant axial symptoms. The incidence of relatively complex cases (Grade 2 or 3 listhesis; Revision cases; Multilevel cases) increased with each successive group. As expected, the operative time (calculated for only single-level cases) improved with time. The overall rate of peri-operative complications was higher in group 2 as compared to groups 1 and 3, predominantly due to an increased incidence of intra-operative dural tears in group 2. Symptomatic screw malposition was detected in five screws, all were managed conservatively. The median duration of follow-up for the entire group was 39 months (Range – 1–119 months). Eighty-two (55%) patients had follow-up of more than 1 year while 31 (20.6%) patients had follow-up of more than 7 years. Around 80–85% of patients at each point of follow-up assessment had a successful outcome (McNab 4 and 5). The re-operation rate for index level problems or adjacent segment was 2.6%, only one of which was done at the author’s center. Conclusions: Minimally invasive TLIF is a safe and effective procedure with favorable long-term results and acceptable complication rates. Though technically challenging in initial phases, a good understanding of the technique and principles of minimally invasive spine surgery along with fulfilling helpful pre-requisites and appropriate case selection as mentioned in this article, will help to smoothen the learning curve and avoid unfavorable outcomes in early stages.
Functional Outcome Of Unilateral Biportal Endoscopic Ligamentum Flavum Preserving Discectomy
Authors: Antao Nicholas , Desouza Clevio , Pestonji Malcolm , Pestonji Jehangir , Langaliya Maulik
Published: June 2022

Introduction: Low back pain affects roughly 70–80% of people at some point in their lives. Lumbar disc prolapse is one of the major reasons of low back pain that causes severe morbidity around the world, affecting primarily the working-class young population. We conducted this study to describe the unilateral biportal endoscopic (UBE) discectomy technique for lumbar herniated disc with the aim on how to perform theses procedure safely while also preserving the structures like the facet joints through the posterior interlaminar approach. Materials and Methods: This was a retrospective study conducted between July 2019 and July 2021. The total number of patients included in the study was 41. A total of 54 levels of discectomy were done. The visual analog scale was used to assess back pain and lower leg symptoms, the Oswestry Disability Index was used to assess degrees of disability, and modified Macnab criteria were used to assess overall outcomes of treatment. Results: Following the procedure, there was a significant improvement. The ultimate outcomes were excellent in 24 patients (58.53%), good in 15 (36.58%), fair in 2 (4.8%), and poor in 0 patients, according to the modified Macnab criteria. That is, 95.11% of patients had excellent or good results. Conclusion: The UBE discectomy approach for lumbar disc herniation is a minimally invasive procedure that is both safe and successful. There is no soft-tissue degradation or facet joint destruction.
Clinical outcome of Patella stability after fixation of Osteochondral fracture in Acute Primary Traumatic Patella Dislocation without MPFL Repair or Reconstruction
Authors: Laddha Mukesh , Pancholiya Anshul , Gaura Sahu
Published: June 2022

Introduction: Conservative management is advisable for acute primary traumatic patella dislocation (PTPD). Surgical treatment is reserved for osteochondral fractures (OCF), medial patello femoral ligament (MPFL) avulsion/tear, compound injuries, and any underlying bony abnormalities requiring correction. MPFL repair (at avulsed site) or reconstruction along with underlying bony correction in PTPD is controversial. The purpose of this study is to evaluate patella stability after fixation of OCF in PTPD without performing MPFL repair or reconstruction, even in the presence of any underlying bony abnormalities. Material and Methods: This is a retrospective study of eight patients who had PTPD with OCF along with MPFL injury who presented between 2016 and 2019. Pre-operative X-rays and MRI were done to assess the status of MPFL, identify the presence of OCF and to calculate Insall-Salvati index, Tibial Tuberosity-Trochlear groove distance and Trochlear dysplasia. All patients underwent surgery by open approach and OCF fixation by bioabsorbable pins or suture material. MPFL was neither repaired at avulsed site nor reconstructed and even no bony corrections were done. Results: Average size of OCF fragments is 15*7 mm and all involving medial facet of patella. Lysholm score improved significantly from 32.8 to 94.8 and Kujala score from 49.1 to 96 at the end of 6 months. None of the patient had patella instability till latest follow-up, average follow-up period is 4.5 years (3–6 years). Clinically, apprehension test was negative in all cases with full ROM. Post-operative imaging including X-ray and MRI showed complete healing of the OCF along with complete healing/regeneration of MPFL with same pre-existing bony abnormalities if present preoperatively. Conclusion: This study shows excellent patella stability and full knee function along with complete union of OCF and complete healing/regeneration of MPFL in PTPD even in the presence of underlying bony abnormality. Hence, in PTPD with OCF, there is no need to repair/reconstruct MPFL or to correct underlying bony pathology, only OCF fixation is required.
Uncemented Total Knee Replacement- Rediscovering the Past
Authors: Rao Nandan , Patil Abhishek Shashikant , Bansal Kunal
Published: June 2022

Total knee replacements (TKR) both cemented and uncemented were developed almost simultaneously in the 1980’s. Cemented TKR found favor among the surgeons due to its technical ease and early failure of uncemented TKR due to poor design. In the past two decades; however, interest has been generated in uncemented TKR both because of design improvements which, in turn, has led to better results, especially in young active, obese, and geriatric but active patients where cemented TKR’s have been found to have increased failure rates. Active research is ongoing to refine the designs of uncemented TKR and future holds promise for this re-emerging technique and implant. This review helps to summarize the reasons for increasing interest in uncemented TKR, the newer designs and their results and the future developments expected.
Numerical analysis of beam self-cleaning in multimode fiber amplifiers
Authors: Jima Mesay Addisu , Tonello Alessandro , Niang Alioune , Mansuryan Tigran , Krupa Katarzyna , Modotto Daniele , Cucinotta Annamaria , Couderc Vincent , Wabnitz Stefan
Published: June 2022

Recent experimental results have reported the observation of beam self-cleaning or, more generally, nonlinear beam reshaping in active multimode fibers. In this work, we present a numerical analysis of these processes by considering the ideal case of a diode-pumped signal amplifier made of a graded-index multimode fiber with uniform Yb doping. Simulations confirm that beam cleaning of the signal may take place even in amplifying fibers, in the absence of beam power conservation. Moreover, we show how the local signal intensity maxima, which are periodically generated by the self-imaging process, may influence the population inversion of the doping atoms, and locally saturate the amplifier gain.
Laser triangulation measurement system with Scheimpflug calibration based on the Monte Carlo optimization strategy
Authors: Chen Ruiming , Li Yiming , Xue Gaopeng , Tao Yihao , Li Xinghui
Published: June 2022

We propose a linear laser triangulation measurement system using Scheimpflug calibration based on the Monte Carlo optimization strategy. A Scheimpflug inclination camera calibration model is introduced in the measurement system for improving the image definition in small-range measurements with a large depth-of-field. To address the nonlinear optimization problem between the instrument resolution and measurement range, the Monte Carlo method is adopted to determine the optimal optical parameters (scattering angle, Scheimpflug angle, and focus length) in a practical measurement system. Furthermore, we experimentally constructed the measurement system to demonstrate the measurement precision by measuring a standard step block (measurement range 15 mm). The performance parameters of the maximum measurement error, maximum standard deviation, and linearity are obtained as ±7 μm, 0.225 μm, and 0.046%, respectively. Finally, the proposed measurement system based on the Monte Carlo optimization strategy is promising for high-precision measurements in industrial applications and provides guidance for optimizing the design parameters of ranging measurement sensors.
Pure longitudinal reversible magnetization at the focal spot generated by a bifunctional triplex metalens
Authors: Zhao Kun , Zhang Zhiyu , Du Jing , Liu Liangliang , Lu Yonghua , Wang Pei
Published: June 2022

Bifunctional metalens for generation of pure longitudinal magnetization focal spot with reversible magnetization direction is greatly desired for the miniaturization and integration of all-optical magnetic storage. In this paper, we demonstrate a bifunctional triplex metalens that integrates the functions of an azimuthal polarizer, a helical phase plate, and a focusing lens for all-optical magnetic storage. Constructing the triplex metalens with tetratomic macropixels, the direction of the longitudinal magnetization at the focal spot can be flexibly switched by reversing the handedness of the incident light. Nearly perfect circularly polarized focal spot for left-handed or right-handed incident polarization are experimentally demonstrated, which is well consistent with the numerical simulations. The proposed bifunctional triplex metalens paves the way for the application of metalens in all-optical magnetic storage.
Spectro-temporal behavior of dye-based solid-state random lasers under picosecond pumping regime: part II
Authors: Iparraguirre I. , Azkargorta J. , García-Revilla S. , Fernández J. , Balda R.
Published: June 2022

In a very recent work the spectral and temporal properties of the random laser emission from solid state dye-doped powders have been investigated by the authors in picosecond pumping regime. The emission shows within each pulse, peaks of more intensity than background, and of a spectro-temporal width at the theoretical limit (ΔωΔt≅1), even in conditions well below the threshold. The relationship between the distribution of paths lengths traveled by photons inside the active medium, and the amplification by stimulated emission explains this behavior. The aim of the present work is to propose a simple model that, in addition to explaining these characteristics of the emission, is compatible with the energetic properties of the material. Particularly interesting is the behavior predicted by the model for the emission decay in sub-threshold conditions, as well as its very good fit with the experimental measurements and its comparison with the one found in low dispersive media, that shows the decisive effect of scattering. The set of results is hardly compatible with a mode structure.
Soft X-ray ptychography system using a Wolter mirror for achromatic illumination optics
Authors: Kimura Takashi , Takeo Yoko , Sakurai Kai , Furuya Noboru , Egawa Satoru , Yamaguchi Gota , Matsuzawa Yusuke , Kume Takehiro , Mimura Hidekazu , Shimura Mari , Ohashi Haruhiko , Matsuda Iwao , Harada Yoshihisa
Published: June 2022

A soft X-ray ptychography system using a Wolter mirror for the illumination optics has been developed. By taking advantage of the achromaticity of the optics, the system is capable of seamlessly imaging at half-period resolution of 50 nm with a broad photon-energy range from 250 eV to 2 keV while maintaining the focal position. Imaging a mammalian cell at various wavelengths was demonstrated, and high-resolution visualization of organelle was achieved. Stereo imaging was also performed with a long working distance of 20 mm. In combination with in-situ/operando and tomographic measurements, this system will be a powerful tool for observing biological and material targets with complex features.
Moving-frame imaging of transiting cold atoms for precise long-range transport
Authors: Seo Meungho , Do In Hwan , Lee Hansuek , Yu Dai-Hyuk , Seo Sangwon , Hong Hyun-Gue , Han Jeong Ho , Park Sang Eon , Lee Sang-Bum , Kwon Taeg Yong , Mun Jongchul , Lee Jae Hoon
Published: June 2022

Transporting cold atoms between interconnected vacuum chambers is an important technique for increasing the versatility of cold atom setups, particularly for those that couple atoms to photonic devices. In this report, we introduce a method where we are able to image the atoms at all points during transport via moving optical dipole trap. Cooled 87Rb atoms are transported ∼50 cm into an auxiliary vacuum chamber while being monitored with a moving-frame imaging system for which in-situ characterization of the atom transport is demonstrated. Precise positioning of the atoms near photonic devices is also tested across several tapered fibers showing an axial positioning resolution of ∼450 μm.
64-Pixel Mo80Si20 superconducting nanowire single-photon imager with a saturated internal quantum efficiency at 1.5 µm
Authors: Wang Hui , Zhao Qing-Yuan , Kong Ling-Dong , Chen Shi , Huang Yang-Hui , Hao Hao , Guo Jia-Wei , Pan Dan-Feng , Tu Xue-Cou , Zhang La-Bao , Jia Xiao-Qing , Chen Jian , Kang Lin , Wu Pei-Heng
Published: June 2022

A superconducting nanowire single-photon imager (SNSPI) uses a time-multiplexing method to reduce the readout complexity. However, due to the serial connection, the nanowire should be uniform so that a common bias can set all segments of the nanowire to their maximum detection efficiency, which becomes more challenging as the scalability (i.e., the length of the nanowire) increases. Here, we have developed a 64-pixel SNSPI based on amorphous Mo80Si20 film, which yielded a uniform nanowire and slow transmission line. Adjacent detectors were separated by delay lines, giving an imaging field of 270 µm × 240 µm. Benefiting from the high kinetic inductance of Mo80Si20 films, the delay line gave a phase velocity as low as 4.6 µm/ps. The positions of all pixels can be read out with a negligible electrical cross talk of 0.02% by using cryogenic amplifiers. The timing jitter was 100.8 ps. Saturated internal quantum efficiency was observed at a wavelength of 1550 nm. These results demonstrate that amorphous film is a promising material for achieving SNSPIs with large scalability and high efficiency.