bluuebunny/crossref_metadata_2025 huggingface dataset:
COMPARISON BETWEEN INTRA-ARTICULAR AND INTRAVENOUS TRANEXAMIC ACID APPLICATION IN PRIMARY UNILATERAL KNEE JOINT ARTHROPLASTY
Authors: Akhtar R.R.
Published: July 2023

To compare the efficacy of intra-articular and intravenous modes of administration of tranexamic acid in primary total knee arthroplasty in terms of blood loss and fall in haemoglobin level.

Study Design: Randomized controlled trial.

Duration of Study: Six months, from May 2019 to Nov 2019.

Seventy-eight patients were included in the study. All patients undergoing unilateral primary total knee replacement were included in the study. Exclusion criteria were patients with hepatitis B and C, history of previous knee replacement, bilateral total knee replacement, allergy to TXA, Hb less than 11g/dl in males and less than 10g/dl in females, renal dysfunction, use of anticoagulants for 7 days prior to surgery and history of thromboembolic diseases. Patients were randomly divided into group A and B. Group A patients undergoing unilateral primary total knee replacement (TKR) were given intravenous tranexamic acid (TXA) while group B were infiltrated with intra-articular TXA. Volume of drain output, fall in haemoglobin (Hb) level and need for blood transfusion were measured immediately after surgery and at 12 and 24 hours post operatively in both groups.

The study included 35 (44.87%) male and 43 (55.13%) female patients. Mean age of patients was 61 ± 6.59 years. The mean drain output calculated immediately after surgery in group A was 45.38 ± 20.75 ml compared with 47.95 ± 23.86 ml in group B (p=0.73). At 24 hours post operatively, mean drain output was 263.21 ± 38.50 ml in intravenous group versus 243.59 ± 70.73 ml in intra-articular group (p=0.46). Regarding fall in Hb level, both groups showed no significant difference (p>0.05). About 12.82% (n=5) patients in group A compared to 10.26% (n=4) patients required blood transfusion post operatively (p=0.72).

Intra-articular and intravenous TXA are equally effective in patients undergoing primary total knee arthroplasty in reducing post-operative blood loss.
RISK FACTORS OF INFECTION IN TOTAL KNEE ARTHROPLASTY
Authors: Akhtar R.R.
Published: July 2023

To determine risk factors of infection in total knee arthroplasty

This descriptive study was conducted in the Department of Orthopedics for a duration of three years from January 2016 to January 2019. All patients undergoing primary total knee replacement were included in the study. Exclusion criteria were all patients operated in another hospital and revision total knee replacement. All patients were followed up at 2, 4, 8, 12 and 24 weeks post-operatively. Signs of inflammation and inflammatory markers such as total leukocyte count (TLC), C-reactive protein (CRP) and ESR were measured. Risk factors like age, body mass index (BMI), ASA, co-morbid conditions were also noted.

A total of 78 patients underwent primary unilateral Total Knee Replacement (TKR) during the study period. Of these, 30 (34.09%) were male and 48 (61.54%) female patients. Mean age of patients was 68.32 ± 8.54 years. Average BMI 25.89 Kg/m2 .Osteoarthritis was the pre-dominant cause of total knee replacement (94.87%). Among co-morbid factors 33.33% were diabetic, 28.20% having ischemic heart disease and 12.82% with chronic lung disease. Upon anaesthesia fitness pre-operatively, 91.02% patients had an American society of anaesthesiologist score (ASA) between 0–2 while 07 (8.97%) between 3- 5. Average duration of surgery was 85.62± 4.11 minutes. 6.41% cases got infected. In majority of the infected cases (60%), Staphylococcus aureus was the infective organism. Diabetes Mellitus (p=0.01) and Obesity (p=0.02) had a significant relation to post-operative infection.

Pre-operative risk evaluation and prevention strategies along with early recognition of infection and control can greatly reduce the risk of joint infection post-TKR which will not only improve the mobility of patient but also its morbidity and mortality as well.

Key Words:

C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), Staphylococcus aureus, Total Knee Arthroplasty (TKA)
DOES THE HISTOLOGICAL PRESENCE OF A NIDUS CORRELATE WITH IMPROVED OUTCOMES IN OSTEOID OSTEOMA TREATED WITH PERCUTANEOUS RADIOFREQUENCY ABLATION (RFA)?
Authors: Adlan A. , AlAqeel M. , Evans S. , Davies M. , Sumathi V. , Botchu R.
Published: July 2023

The primary aim of this study was to compare the clinical outcomes of osteoid osteoma (OO) between the group of patients with the presence of nidus on biopsy samples from radiofrequency ablation (RFA) with those without nidus. Secondly, we aimed to examine other factors that may affect the outcomes of OO reflecting our experience as a tertiary orthopaedic oncology centre.

We retrospectively reviewed 88 consecutive patients diagnosed with OO treated with RFA between November 2005 and March 2015, consisting of 63 males (72%) and 25 females (28%). Sixty-six patients (75%) had nidus present in their biopsy samples. Patients’ mean age was 17.6 years (4-53). Median duration of follow-up was 12.5 months (6-20.8). Lesions were located in the appendicular skeleton in seventy-nine patients (90%) while nine patients (10%) had an OO in the axial skeleton. Outcomes assessed were based on patients’ pain alleviation (partial, complete, or no pain improvement) and the need for further interventions.

Pain improvement in the patient group with nidus in histology sample was significantly better than the group without nidus (OR 7.4, CI 1.35-41.4, p=0.021). The patient group with nidus on biopsy demonstrated less likelihood of having a repeat procedure compared to the group without nidus (OR 0.092, CI 0.016-0.542, p=0.008). Our study showed significantly better outcomes in pain improvement in appendicular lesions compared to the axially located lesions (p = 0.005). Patients with spinal lesions tend to have relatively poor pain relief than those with appendicular or pelvic lesions (p=0.007).

Patients with nidus on histology had better pain alleviation compared to patients without nidus. The histological presence of nidus significantly reduces the chance of repeat interventions. The pain alleviation of OO following RFA is better in patients with appendicular lesions than spinal or axially located lesions.
INFLUENCE OF DILATION ON THE STABILITY OF OSTEOCHONDRAL AUTOGRAFTS IMPLANTED IN CADAVERIC HUMAN FEMURS
Authors: McCall B. , Cowie R. , Jennings L.
Published: July 2023

The clinical success of osteochondral autografts is heavily reliant on their mechanical stability, as grafts which protrude above or subside below the native cartilage can have a negative effect on the tribological properties of the joint [1]. Furthermore, high insertion forces have previously been shown to reduce chondrocyte viability [2]. Commercial grafting kits may include a dilation tool to increase the diameter of the recipient site prior to insertion. The aim of this study was to evaluate the influence of dilation on the primary stability of autografts.

Six human cadaveric femurs were studied. For each femur, four 8.5 × 8mm autografts were harvested from the trochlear groove and implanted into the femoral condyles using a Smith & Nephew Osteochondral grafting kit. Two grafts were implanted into dilated recipient sites (n=12) and two were implanted with no dilation (n=12). Insertion force was measured by partially inserting the graft and applying a load at a rate of 1 mm/min, until the graft was flush with the surrounding cartilage. Push-in force was measured by applying the same load, until the graft had subsided 4mm below congruency. Significance was taken as (p<0.05).

Average maximum insertion force of dilated grafts was significantly lower (p<0.001) than their non-dilated equivalent [28.2N & 176.7N respectively]. There was no significant difference between average maximum push-in force between the dilated and non-dilated groups [1062.8N & 1204.2N respectively].

This study demonstrated that significantly less force is required to insert dilated autografts, potentially minimising loss of chondrocyte viability. However, once inserted, the force required to displace the grafts below congruency remained similar, indicating a similar degree of graft stability between both groups.
TREATMENT OF VERY LARGE TRAUMATIC BONE DEFECTS WITH A BIODEGRADABLE POLYCAPROLACTONE-TRICALCIUM PHOSPHATE 3D-PRINTED SCAFFOLD: A REVIEW OF THREE CLINICAL CASES
Authors: Lodewijks L. , Blokhuis T. , Poeze M.
Published: July 2023

The need for an artificial scaffold in very large bone defects is clear, not only to limit the risk of graft harvesting, but also to improve clinical success. The use of custom osteoconductive scaffolds made from biodegradable polyester and ceramics can be a valuable patient friendly option, especially in case of a concomitant infection.

Multiple types of scaffolds for the Masquelet procedure (MP) are available, however these frequently demonstrate central graft involution when defects exceed a certain size and the complication rates remains high. This paper describes three infected tibial defect nonunions with a segmental defect over ten centimeters long treated with a customized 3D printed polycaprolactone-tricalcium phosphate (PCL-TCP) cage in combination with biological adjuncts.

Three male patients, between the age of 37 and 47, were treated for an infected tibial defect nonunion after sustaining Gustilo grade 3 open fractures. All had a segmental midshaft bone defect of more than ten centimeters (range 11–15cm). First stage MPs consisted of extensive debridement, external fixation and placement of anterior lateral thigh flaps (ALT). Positive cultures were obtained from all patients during this first stage, that were treated with specific systemic antibiotics during 12 weeks. The second stage MP was carried out at least two months after the first stage. CT scans were obtained after the first stage to manufacture defect-specific cages. In the final procedure a custom 3D printed PCL-TCP cage (Osteopore, Singapore) was placed in the defect in combination with biological adjuncts (BMAC, RIA derived autograft, iFactor and BioActive Glass). Bridging of the defect, assessed at six months by CT, was achieved in all cases. SPECT-scans 6 months post-operatively demonstrated active bone regeneration, also involving the central part of the scaffold. All three patients regained function and reported less pain with full weight-bearing.

This case report shows that 3D printed PCL-TCP cages in combination with biological adjuncts is a novel addition to the surgical treatment of very large bone defects in (infected) posttraumatic nonunion of the tibia. This combination could overcome some of the current drawbacks in this challenging indication.
MODELLING OSTEOCHONDRAL GRAFT BEHAVIOUR IN TIBIOFEMORAL JOINTS
Authors: Day G. , Jones A. , Mengoni M. , Wilcox R.
Published: July 2023

Autologous osteochondral grafting has demonstrated positive outcomes for treating articular cartilage defects by replacing the damaged region with a cylindrical graft consisting of bone with a layer of cartilage, taken from a non-loadbearing region of the knee. Despite positive clinical use, factors that cause graft subsidence or poor integration are relatively unknown. The aim of this study was to develop finite element (FE) models of osteochondral grafts within a tibiofemoral joint and to investigate parameters affecting osteochondral graft stability.

Initial experimental tests on cadaveric femurs were performed to calibrate the bone properties and graft-bone frictional forces for use in corresponding FE models, generated from µCT scan data. The effects of cartilage defects and osteochondral graft repair were measured by examining contact pressure changes using in vitro tests on a single cadaveric human tibiofemoral joint. Six defects were created in the femoral condyles which were subsequently treated with osteochondral autografts or metal pins. Matching µCT scan-based FE models were created, and the contact patches were compared. Sensitivity to graft bone properties was investigated.

The bone material properties and graft-bone frictional forces were successfully calibrated from the initial tests with good resulting levels of agreement (CCC=0.87). The tibiofemoral joint experiment provided a range of cases to model. These cases were well captured experimentally and represented accurately in the FE models. Graft properties relative to host bone had large effects on immediate graft stability despite limited changes to resultant cartilage contact pressure.

Model confidence was built through extensive validation and sensitivity testing, and demonstrated that specimen-specific properties were required to accurately represent graft behaviour. The results indicate that graft bone properties affect the immediate stability, which is important for the selection of allografts and design of future synthetic grafts.

Acknowledgements

Supported by the EPSRC-EP/P001076.
BONE TISSUE INTERACTION WITH 3D-PRINTED TITANIUM IMPLANTS IN A BIOREACTOR TESTING MACHINE: A PRECLINICAL ASSESSMENT METHODOLOGY FOR NEW IMPLANT DESIGNS
Authors: Theodoridis K. , Hall T. , Munford M. , Van Arkel R.
Published: July 2023

The success of cementless orthopaedic implants relies on bony ingrowth and active bone remodelling. Much research effort is invested to develop implants with controllable surface roughness and internal porous architectures that encourage these biological processes. Evaluation of these implants requires long-term and costly animal studies, which do not always yield the desired outcome requiring iteration. The aim of our study is to develop a cost-effective method to prescreen design parameters prior to animal trials to streamline implant development and reduce live animal testing burden.

Ex vivo porcine cancellous bone cylinders (n=6, Ø20×12mm) were extracted from porcine knee joints with a computer-numerically-controlled milling machine under sterile conditions within 4 hours of animal sacrifice. The bone discs were implanted with Ø6×12mm additive manufactured porous titanium implants and were then cultured for 21days. Half underwent static culture in medium (DMEM, 10% FBS, 1% antibiotics) at 37°C and 5% CO2. The rest were cultured in novel high-throughput stacked configuration in a bioreactor that simulated physiological conditions after surgery: the fluid flow and cyclic compression force were set at 10ml/min and 10–150 N (1Hz,5000 cycles/day) respectively. Stains were administered at days 7 and 14. Samples were evaluated with widefield microscopy, scanning electron microscopy (SEM) and with histology.

More bone remodelling was observed on the samples cultured within the bioreactor: widefield imaging showed more remodelling at the boundaries between the implant-bone interface, while SEM revealed immature bone tissue integration within the pores of the implant. Histological analysis confirmed these results, with many more trabecular struts with new osteoid formation on the samples cultured dynamically compared to static ones.

Ex vivo bone can be used to analyse new implant technologies with lower cost and ethical impact than animal trial. Physiological conditions (load and fluid flow) promoted bone ingrowth and remodelling.
THE EFFECT OF CHRONOLOGICAL AGE ON THE IN VITRO PROPERTIES OF BONE FRAGMENT-DERIVED MESENCHYMAL STROMAL CELLS
Authors: Vogt A. , Darlington I. , Birch M. , Brookes R. , McCaskie A. , Khan W.
Published: July 2023

Osteoarthritis is a common articular cartilage disorder and causes a significant global disease burden. Articular cartilage has a limited capacity of repair and there is increasing interest in the use of cell-based therapies to facilitate repair including the use of Mesenchymal Stromal Cells (MSCs). There is some evidence in the literature that suggests that advancing age is associated with declining MSC function, including reduced proliferation and differentiation potential, and greater cellular apoptosis. In our study, we first performed a systematic review of the literature to determine the effects of chronological age on the in vitro properties of MSCs, and then performed a laboratory study to investigate these properties.

We initially conducted a PRISMA systematic review of the literature to review the evidence base for the effects of chronological age on the in vitro properties of MSCs including cell numbers, expansion, cell surface characterization and differentiation potential. This was followed by laboratory based experiments to assess these properties. Tissue from patients undergoing total knee replacement surgery was used to isolate MSCs from the bone fragments using a method developed in our laboratory. The growth kinetics was determined by calculating the population doublings per day. Following expansion in culture, MSCs at P2 were characterised for a panel of cell surface markers using flow cytometry. The cells were positive for CD73, CD90 and CD105, and negative for CD34 and CD45. The differentiation potential of the MSCs was assessed through tri-lineage differentiation assays. Clear differences between the younger and older patients were indicated.

Chronological age-related changes in MSC function have important implications on the use of these cells in clinical applications for an ageing population. The results from this study will be used to plan further work looking at the effects of chronological age on cellular senescence and identify pathways that could be targeted to potentially reverse any age-related changes.
DEVELOPMENT OF AN ANTIMICROBIAL LIPID COATING TO PREVENT INFECTIONS IN UNCEMENTED JOINT REPLACEMENTS
Authors: Azizova L. , Morgan D. , Rowlands J. , Brousseau E. , Kulik T. , Palianytsia B. , Mansell J. , Birchall J. , Wilkinson T. , Sloan A. , Ayre W.
Published: July 2023

Preventing infections in joint replacements is a major ongoing challenge, with limited effective clinical technologies currently available for uncemented knee and hip prostheses. This research aims to develop a coating for titanium implants, consisting of a supported lipid bilayer (SLB) encapsulating an antimicrobial agent. The SLB will be robustly tethered to the titanium using self-assembled monolayers (SAMs) of octadecylphosphonic acid (ODPA). The chosen antimicrobial is Novobiocin, a coumarin-derived antibiotic known to be effective against resistant strains of Staphylococcus aureus.

ODPA SAMs were deposited on TiO2-coated quartz crystal microbalance (QCM) sensors using two environmentally friendly non-polar solvents (anisole and cyclopentyl methyl ether, CPME), two concentrations of ODPA (0.5mM and 1mM) and two processing temperatures (21°C and 60°C). QCM, water contact angle measurements, X-ray photoelectron spectroscopy (XPS), atomic force microscopy (AFM) and temperature-programmed desorption mass spectrometry (TPD-MS) were used to characterise the ODPA SAM. A SLB with encapsulated Novobiocin was subsequently developed on the surface of the ODPA SAM using fluorescent lipids and a solvent assisted method. The prototype implant surface was tested for antimicrobial activity against S. aureus.

A well-ordered, uniform ODPA SAM was rapidly formed using 0.5 mM ODPA in CPME at 21°C during 10 min, as confirmed by high Sauerbrey mass (≍285-290 ng/cm2), high atomic percentage phosphorus (detected using XPS) and high water contact angles (117.6±2.5°). QCM measurements combined with fluorescence microscopy provided evidence of complete planar lipid bilayer formation on the titanium surface using a solvent assisted method. Incorporation of Novobiocin into the SLB resulted in reduced attachment and viability of S. aureus.

Key parameters were established for the rapid, robust and uniform formation of an ODPA SAM on titanium (solvent, temperature and concentration). This allowed the successful formation of an antimicrobial SLB, which demonstrated potential for reducing attachment and viability of pathogens associated with joint replacement infections.
THE IMPACT OF ACETABULAR INCLINATION ON ACETABULAR AND FEMORAL HEAD RADII
Authors: Aljuaid M. , Alzahrani S. , Bazaid Z. , Zamil H.
Published: July 2023

Acetabular morphology and orientation differs from ethnic group to another. Thus, investigating the normal range of the parameters that are used to assess both was a matter of essence. Nevertheless, the main aim of this study was clarification the relationship between acetabular inclination (AI) and acetabular and femoral head arcs’ radii (AAR and FHAR).

A cross-sectional retrospective study that had been done in a tertiary center where Computed tomography abdomen scouts’ radiographs of non-orthopedics patients were included. They had no history of pelvic or hips’ related symptoms or fractures in femur or pelvis.

A total of 84 patients was included with 52% of them were females. The mean of age was 30.38± 5.48. Also, Means of AI were 38.02±3.89 and 40.15±4.40 (P 0.02, significant gender difference) for males and females, respectively. Nonetheless, Head neck shaft angle (HNSA) means were 129.90±5.55 and 130.72±6.62 for males and females, respectively. However, AAR and FHAR means for males and females were 21.3±3.1mm, 19.9±3.1mm, P 0.04 and 19.7±3.1mm, 18.1±2.7mm, P 0.019, respectively. In addition, negative significant correlations were detected between AI against AAR, FHAR, HNSA and body mass index (BMI) (r 0.529, P ≤0.0001, r 0.445, P ≤0.0001, r 0.238, P 0.029, r 0.329, P ≤0.007, respectively). On the other hand, high BMI was associated with AAR and FHAR (r 0.577, P 0.0001 and r 0.266, p 0.031, respectively).

This study shows that high AI is correlated with lower AAR, FHAR. Each ethnic group has its own normal values that must be studied to tailor the path for future implications in clinical setting.
ROOT CAUSE ANALYSIS: INCREASED POSTOPERATIVE HIP HEMIARTHROPLASTY WOUND INFECTIONS DURING COVID-19 PANDEMIC
Authors: Gupta P. , Butt S. , Galhoum A. , Dasari K.
Published: July 2023

Between 2016–2019, 4 patients developed hip infections post-hemiarthroplasty. However, between 2020–2021 (Covid-19 pandemic period), 6 patients developed hip infections following hip hemiarthroplasty.

The purpose of the investigation is to establish the root causes and key learning from the incident and use the information contained within this report to reduce the likelihood of a similar incident in the future. 65 patients presented with a neck of femur fracture during Covid-19 pandemic period between 2020–2021, 26 had hip hemiarthroplasty of which 6 developed hip infections. Medical records, anaesthetic charts and post-hip infections guidelines from RCS and NICE were utilised.

Proteus, Enterococci and Strep. epidermis were identified as the main organisms present causing the hip infection. The average number of ward moves was 4 with 90% of patients developing COVID-19 during their hospital stay. The chance of post-operative wound infection were multifactorial. Having had 5 of 6 patients growing enterococci may suggest contamination of wound either due to potential suboptimal hygiene measures, inadequate wound management /dressing, potential environmental contamination if the organisms (Vancomycin resistant enterococci) are found to be of same types and potential hospital acquired infection due to inadequate infection control measures or suboptimal hand hygiene practices. 3 of the 5 patients grew Proteus, which points towards suboptimal hygiene practices by patients or poor infection control practices by staff.

Lack of maintenance of sterility in post op wound dressings alongside inexperience of the handling of post-operative wound in non-surgical wards; multiple ward transfers exceeding the recommended number according to trust guidelines especially due to pandemic isolation measures and COVID-19 infection itself had resulted in an increased rate of hip infections during the COVID-19 pandemic. Multidisciplinary team education and planned categorisation and isolation strategy is essential to minimise the rate of further hip infections during the pandemic period in future.
IMPLEMENTATION OF AN ANKLE FRACTURE FIXATION PATHWAY TO REDUCE HOSPITAL BED OCCUPANCY
Authors: Gupta P. , Galhoum A. , Aksar M. , Nandhara G.
Published: July 2023

Ankle fractures are among the most common types of fractures. If surgery is not performed within 12 to 24 hours, ankle swelling is likely to develop and delay the operative fixation. This leads to patients staying longer in the ward waiting and increased hospital occupancy. This prolonged stay has significant financial implication as well as it is frustrating for both patients and health care professionals.

The aim was to formulate a pathway for the ankle fracture patients coming to the emergency department, outpatients and planned for operative intervention. To identify whether pre-operative hospital admissions of stable ankle fracture patients are reduced with the implementation of the pathway. We formulated an ankle fracture fixation pathway, which was approved for use in December 2020. A retrospective analysis of 6 months hospital admissions of ankle fracture patients in the period between January to June 2020. The duration from admission to the actual surgery was collected to review if some admissions could have been avoided and patients brought directly on the surgery day.

A total of 23 patients were included. Mean age was 60.5 years and SD was 17years. 94% of patients were females. 10 patients were appropriately discharged.7 Patients were appropriately admitted. 6 Patients were unnecessarily admitted. These 6 patients were admitted on presentation to ED. Retrospective analysis of this audit showed that this cohort of patients met the safe discharge criteria and could have been discharged. Duration of unnecessary stay ranged from 1 to 11 days (21 days in total). Total saving could have been £6300.

Standards were met in 74% of cases. Preoperative hospital admission could be reduced with the proposed pathway. It is a valuable tool to be used and should be implemented to reduce unnecessary hospital admissions.
Moving plane method for varifolds and applications
Authors: Haslhofer Robert , Hershkovits Or , White Brian
Published: July 2023

abstract: In this paper, we introduce a version of the moving plane method that applies to potentially quite singular hypersurfaces, generalizing the classical moving plane method for smooth hypersurfaces. Loosely speaking, our version for varifolds shows that smoothness and symmetry at infinity (respectively at the boundary) can be promoted to smoothness and symmetry in the interior. The key feature, in contrast with the classical formulation of the moving plane principle, is that smoothness is a conclusion rather than an assumption. We implement our moving plane method in the setting of compactly supported varifolds with smooth boundary and in the setting of varifolds without boundary. A key ingredient is a Hopf lemma for stationary varifolds and varifolds of constant mean curvature. Our Hopf lemma provides a new tool to establish smoothness of varifolds, and works in arbitrary dimensions and without any stability assumptions. As applications of our new moving plane method, we prove varifold uniqueness results for the catenoid, spherical caps, and Delaunay surfaces that are inspired by classical uniqueness results by Schoen, Alexandrov, Meeks and Korevaar-Kusner-Solomon. We also prove a varifold version of Alexandrov's Theorem for compactly supported varifolds of constant mean curvature in hyperbolic space.
James Silk Buckingham (1786–1855) and the Politics of Travel in the Holy Land
Authors: Sakhnini Mohammad
Published: July 2023

Abstract: This essay examines the cultural and political framing of Palestine in the work of the liberal English writer, journalist, and politician, James Silk Buckingham. In his Travels in Palestine (1821), Buckingham posits Palestine as an imaginative space where a liberal Briton develops critiques of Biblical literalism and religious pietism, encouraged by an emerging landscape in nineteenth-century Britain that accommodated vigorous radical and dissenting voices. At the turn of the nineteenth century, as this essay shows, debates in Britain about political radicalism and religious orthodoxy shaped the perception of Palestine and its population in the popular genre of travel writing.
Feeding Mothers, Making Citizens: Japanese Maternity Clinic Meals as Treatment, Care, and Identity
Authors: Runestad Pamela L.
Published: July 2023

Abstract: Postpartum Japanese mothers and neonates typically spend 5-6 days in a hospital or clinic. Therefore, institution-prepared meals are an important part of the immediate postpartum experience. Drawing from ethnographic research conducted at a 17-bed maternity clinic in central Japan, I discuss how 1) nutrients are calculated to ensure adherence to national nutrition guidelines, and meals are individualized to fit specific patients, 2) staff incorporate local ingredients and specialties that support local identity, and 3) non-Japanese foods are used both as entertainment and vehicles through which Japanese mothers consume regional, national, and non-Japanese cultures. With attention to the emic terms tanoshimi , shigoto , and ikigai , I demonstrate that meals here go beyond prescription and care: they are sites of the production and consumption of regional, national, and global citizenship ideals and constitute what Takeda calls “biopolitical governing” (2008).
Tunable Integrated 118 Million Q Reference Cavity for 780 nm Laser Stabilization and Rubidium Spectroscopy
Authors: Isichenko Andrei , Chauhan Nitesh , Wang Jiawei , Harrington Mark W. , Liu Kaikai , Blumenthal Daniel J.
Published: July 2023

We stabilize a 780 nm semiconductor laser to a thermally tuned 118 million Q silicon nitride photonic resonator. The stabilized laser is swept by 400 MHz and probes rubidium transitions at a 500 Hz rate.
Design of 100-μm-cladding weakly coupled 4-core multi-core fiber with 160-μm-coating
Authors: kajikawa shota , Takenaga Katsuhiro , Oda Takuya , Ichii Kentaro
Published: July 2023

Weakly coupled 4-core multi-core fiber (4c-MCF) with 125-μm cladding have been in standardization efforts. Compared with standard single-core fiber with 250-μm-coating, the 4c-MCF has a 4~6.25 times higher core density. In this study, we propose the possibility of a small cladding weakly coupled 4c-MCF, that can achieve approximately 10 times the core density. The feasibility of a 100-μm-cladding / 160-μm-coating 4c-MCF in 1.31-μm-wavelength was confirmed through simulations. The effective trench volume that can suppress confinement loss and XT were estimated, and confirmed that the propagation loss is similar to that of conventional 4c-MCF.
The Ground State Decoherence Effect on an1
Amplification of a Phase Sensitive Δ System
Authors: Pramoth Beena , JAYARAMAN AYYAPPAN , N SURESH BABU
Published: July 2023

The atomic decoherence effect (DE) on electromagnetically induced transparency(EIT) is studied in the phase-sensitive ∆ system. The DE forces the susceptibility of the medium into negative or positive depending upon the resultant phase and the microwave field strength. In general, the phase-sensitive amplification (PSA) on the probe resonance laser field is induced by the microwave field. The DE plays a major role in tuning the PSA in such a medium. Moreover, we show that the control of the ground state decoherence in a phase-sensitive ∆ system leads to the gain in
the output of the probe field. The DE is of great interest in the field of quantum information science, and quantum optics.
The impact of climate change on endangered plants and lichen
Authors: Wrobleski Amy , Ernst Sydney , Weber Theodore , Delach Aimee
Published: July 2023

The Endangered Species Act (ESA) was a landmark protection for rare organisms in the United States. Although the ESA is known for its protection of wildlife, a majority of listed species are actually plants and lichen. Climate change will impact species populations globally. Already-rare species, like those listed in the ESA, are at an even higher risk due to climate change. Despite this, the risk climate change poses to endangered plants has not been systematically evaluated in over a decade. To address this gap, we modified previously existing qualitative assessment toolkits used to examine the threat of climate change in federal documentation on listed wildlife. These modified toolkits were then applied to the 771 ESA listed plants. First, we evaluated how sensitive ESA listed plants and lichens were to climate change based on nine quantitative sensitivity factors. Then, we evaluated if climate change was recognized as a threat for a species, and if actions were being taken to address the threats of climate change. We found that all ESA listed plant and lichen species are at least slightly (score of 1) sensitive to climate change, and therefore all listed plants and lichens are threatened by climate change. While a majority of ESA listing and recovery documents recognized climate change as a threat, very few had actions being taken in their recovery plans to address climate change directly. While acknowledging the threat that climate change poses to rare plants is an important first step, direct action will need to be taken to ensure the recovery of many of these species.
Organization and replicon interactions within the highly segmented genome of Borrelia burgdorferi
Authors: Ren Zhongqing , Takacs Constantin N. , Brandão Hugo B. , Jacobs-Wagner Christine , Wang Xindan
Published: July 2023

Borrelia burgdorferi, a causative agent of Lyme disease, contains the most segmented bacterial genome known to date, with one linear chromosome and over twenty plasmids. How this unusually complex genome is organized, and whether and how the different replicons interact are unclear. We recently demonstrated thatB.burgdorferiis polyploid and that the copies of the chromosome and plasmids are regularly spaced in each cell, which is critical for faithful segregation of the genome to daughter cells. Regular spacing of the chromosome is controlled by two separate partitioning systems that involve the protein pairs ParA/ParZ and ParB/Smc. Here, using chromosome conformation capture (Hi-C), we characterized the organization of theB.burgdorferigenome and the interactions between the replicons. We uncovered that although the linear chromosome lacks contacts between the two replication arms, the two telomeres are in frequent contact. Moreover, several plasmids specifically interact with the chromosomeoriCregion, and a subset of plasmids interact with each other more than with others. We found that Smc and the Smc-like MksB protein mediate long-range interactions on the chromosome, but they minimally affect plasmid-chromosome or plasmid-plasmid interactions. Finally, we found that disruption of the two partition systems leads to chromosome restructuring, correlating with the mis-positioning of chromosomeoriC. Altogether, this study revealed the conformation of a complex genome and analyzed the contribution of the partition systems and SMC family proteins to this organization. This work expands the understanding of the organization and maintenance of multipartite bacterial genomes.
Epidemiological and clinical aspects of sporotrichosis in patients seen at a reference hospital in Madagascar
Authors: Sendrasoa Fandresena Arilala , Ratovonjanahary Volatantely Tobiniaina , Ranaivo Irina Mamisoa , Rasamoelina Tahinamandranto , Rakotoarisaona Mendrika Fifaliana , Andrianarison Malalaniaina , Ramarozatovo Lala Soavina , Rabenja Fahafahantsoa Rapelanoro
Published: July 2023

Introduction

Sporotrichosis is a subacute to chronic fungal infection of skin and subcutaneous tissues, caused by dimorphic fungi belonging to the genus Sporothrix, commonly seen in tropical and subtropical regions like Madagascar. This study describes the epidemiological, clinical, and the treatment outcomes with itraconazole for sporotrichosis.

Methods

A descriptive retrospective study on patients suffering from sporotrichosis, from March 2013 to January 2019, was conducted, in the reference center for endemic mycoses. Patients with sporotrichosis who received itraconazole for at least 3 months were included in the study. Patients received itraconazole 200 mg daily for 3 to 6 months. Therapeutic responses were evaluated at months 3 and 6 after treatment. Outcomes were classified as minor response, major response, cure, and failure.

Results

Forty-three cases of sporotrichosis were included. The median age of patients was 40 years. Most of them (62.8%) were rural workers. Men were more frequently infected (72%). At the end of 6th month of treatment, 20 patients (46.5%) were cured and a major response to itraconazole was observed in 8 patients (18.6%). The cure rate was higher in 12 patients (27.9%) who had disease durations of less than to one year than in those who had more time of disease (18.6%) (p = 0.01). Thirteen patients (30.2%) were lost to follow up. The rate of lost to follow-up was also higher (39.5%) in patients who had sporotrichosis of less than to one year than in those who had more time of disease.

Conclusion

The cure rate found in this study was inferior to that reported in the literature. However, it was higher in patients with early symptomatology.
Inequality in electricity consumption and economic growth: Evidence from a small area estimation study
Authors: Nguyen Cuong Viet , Nguyen Khuong Duc , Tran Tuyen Quang
Published: July 2023

Our study uses a small area estimation method to estimate the average and inequality of per capita kWh consumption for small areas in Vietnam. It shows evidence of a large spatial heterogeneity in the electric power consumption between districts and provinces in Vietnam. Households in the mountains and highlands consumed remarkably less electricity than those in the delta and coastal areas. Notably, we find a U-shaped relationship between the inequality of electricity consumption and economic levels in Vietnam. In poor districts and provinces, there is very high inequality in electricity consumption. Inequality is lower in middle-income districts and provinces.
Assessment of the transmission blocking activity of antimalarial compounds by membrane feeding assays using natural Plasmodium falciparum gametocyte isolates from West-Africa
Authors: B. Henry Noëlie , Soulama Issiaka , S. Sermé Samuel , Bolscher Judith M. , T. G. Huijs Tonnie , S. Coulibaly Aboubacar , Sombié Salif , Ouédraogo Nicolas , Diarra Amidou , Zongo Soumanaba , Guelbéogo Wamdaogo M. , Nébié Issa , Sirima Sodiomon B. , Tiono Alfred B. , Pietro Alano , Collins Katharine A. , Dechering Koen J. , Bousema Teun
Published: July 2023

Antimalarial drugs that can block the transmission of Plasmodium gametocytes to mosquito vectors would be highly beneficial for malaria elimination efforts. Identifying transmission-blocking drugs currently relies on evaluation of their activity against gametocyte-producing laboratory parasite strains and would benefit from a testing pipeline with genetically diverse field isolates. The aims of this study were to develop a pipeline to test drugs against P. falciparum gametocyte field isolates and to evaluate the transmission-blocking activity of a set of novel compounds. Two assays were designed so they could identify both the overall transmission-blocking activity of a number of marketed and experimental drugs by direct membrane feeding assays (DMFA), and then also discriminate between those that are active against the gametocytes (gametocyte killing or sterilizing) or those that block development in the mosquito (sporontocidal). These DMFA assays used venous blood samples from naturally infected Plasmodium falciparum gametocyte carriers and locally reared Anopheles gambiae s.s. mosquitoes. Overall transmission-blocking activity was assessed following a 24 hour incubation of compound with gametocyte infected blood (TB-DMFA). Sporontocidal activity was evaluated following addition of compound directly prior to feeding, without incubation (SPORO-DMFA); Gametocyte viability was retained during 24-hour incubation at 37°C when gametocyte infected red blood cells were reconstituted in RPMI/serum. Methylene-blue, MMV693183, DDD107498, atovaquone and P218 showed potent transmission-blocking activity in the TB-DMFA, and both atovaquone and the novel antifolate P218 were potent inhibitors of sporogonic development in the SPORO-DMA. This work establishes a pipeline for the integral use of field isolates to assess the transmission-blocking capacity of antimalarial drugs to block transmission that should be validated in future studies.
Culicoides jiangchengensis, a new species of the subgenus Sinocoides (Diptera, Ceratopogonidae) based on integrative taxonomy from China
Authors: He Yuwen , Meng Jinxin , Li Nan , Li Zhao , Yu Taoying , Zhang Laxi , Wang Dongmei , Liu Guoping , Wang Jinglin
Published: July 2023

Biting midges of the genus Culicoides are important in both medicine and veterinary medicine because their blood-feeding regime enable them to transmit a variety of pathogens. In this study, the morphological characteristics of the new species of Culicoides (Sinocoides) jiangchengensis Wang et Liu sp. nov are described and compared with the other species of female Culicoides in the subgenus Sinocoides. Three morphological characteristics of C. jiangchengensis, such as without sensory pit in 3rd palpus segment, sensilla coeloconica on flagellomeres 1,9–13, and m1 and m2 cell of the wings with pale spots, were different from the other nine species of culicoides in subgenus Sinocoides. Genetically, C. jiangchengensis are most closely related to C. malipoensis, but they were located in different branches and the minimum interspecific distance between them was 12.6%. In addition, a checklist of 10 species in the subgenus Sinocoides Chu, 1983 (Diptera: Ceratopogonidae: Culicoides) in China, including the new species C. jiangchengensis Wang et Liu sp. nov., is provided, and an updated key to species of the subgenus Sinocoides Chu, 1983 was presented.
CT radiomics for differentiating fat poor angiomyolipoma from clear cell renal cell carcinoma: Systematic review and meta-analysis
Authors: Dehghani Firouzabadi Fatemeh , Gopal Nikhil , Hasani Amir , Homayounieh Fatemeh , Li Xiaobai , Jones Elizabeth C. , Yazdian Anari Pouria , Turkbey Evrim , Malayeri Ashkan A.
Published: July 2023

Purpose

Differentiation of fat-poor angiomyolipoma (fp-AMLs) from renal cell carcinoma (RCC) is often not possible from just visual interpretation of conventional cross-sectional imaging, typically requiring biopsy or surgery for diagnostic confirmation. However, radiomics has the potential to characterize renal masses without the need for invasive procedures. Here, we conducted a systematic review on the accuracy of CT radiomics in distinguishing fp-AMLs from RCCs.

Methods

We conducted a search using PubMed/MEDLINE, Google Scholar, Cochrane Library, Embase, and Web of Science for studies published from January 2011–2022 that utilized CT radiomics to discriminate between fp-AMLs and RCCs. A random-effects model was applied for the meta-analysis according to the heterogeneity level. Furthermore, subgroup analyses (group 1: RCCs vs. fp-AML, and group 2: ccRCC vs. fp-AML), and quality assessment were also conducted to explore the possible effect of interstudy differences. To evaluate CT radiomics performance, the pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were assessed. This study is registered with PROSPERO (CRD42022311034).

Results

Our literature search identified 10 studies with 1456 lesions in 1437 patients. Pooled sensitivity was 0.779 [95% CI: 0.562–0.907] and 0.817 [95% CI: 0.663–0.910] for groups 1 and 2, respectively. Pooled specificity was 0.933 [95% CI: 0.814–0.978]and 0.926 [95% CI: 0.854–0.964] for groups 1 and 2, respectively. Also, our findings showed higher sensitivity and specificity of 0.858 [95% CI: 0.742–0.927] and 0.886 [95% CI: 0.819–0.930] for detecting ccRCC from fp-AML in the unenhanced phase of CT scan as compared to the corticomedullary and nephrogenic phases of CT scan.

Conclusion

This study suggested that radiomic features derived from CT has high sensitivity and specificity in differentiating RCCs vs. fp-AML, particularly in detecting ccRCCs vs. fp-AML. Also, an unenhanced CT scan showed the highest specificity and sensitivity as compared to contrast CT scan phases. Differentiating between fp-AML and RCC often is not possible without biopsy or surgery; radiomics has the potential to obviate these invasive procedures due to its high diagnostic accuracy.
School closures significantly reduced arrests of black and latinx urban youth
Authors: Simes Jessica T. , Cowger Tori L. , Jahn Jaquelyn L.
Published: July 2023

Background & methods

Youth of color are surveilled and arrested by police at higher rates than their White peers, contributing to racial inequities across the life course and in population health. Previous research points to schools as an increasingly relevant site for youth criminalization, but existing studies emphasize within-school mechanisms, with limited analysis of policing in surrounding school areas. To fill this gap, we study changes in police arrests of youth after initial COVID-19 school closures in 2020 across four US cities overall and in relation to public school locations. We analyze geocoded arrest records and use interrupted time series negative binomial regression models with city and month fixed effects to estimate change in weekly arrest rates among White, Black, and Latinx youth. We estimate arrest densities within school areas before and after school closures using spatial buffers of 300 feet.

Results

In the immediate weeks and months following COVID-19 pandemic school closures, youth arrest rates fell dramatically and with lasting impacts compared to other age groups. During the period of remote learning, weekly youth arrest rates declined by 54.0% compared to youth arrests rates in 2019, adjusting for city and seasonality (Incident Rate Ratio 0.46, 95% CI: 0.41, 0.52). We estimate Black youth weekly arrests fell from 43.6 to 16.8 per 100,000, vs. 4.6 to 2.2 per 100,000 among White youth. However, Black youth arrest rates during the remote learning period were still nearly 5 times that of White youth pre-pandemic. We also find that youth arrest rates declined during two school closure periods: at the start of the pandemic in 2020 and during Summer 2019. A spatial analysis shows Black and Latinx youth arrest densities in the surrounding 300 feet of K-12 schools were at least 15 and 8.5 times that of White youth, respectively, in both pre- and remote-learning periods.

Conclusions

Black and Latinx youth face a higher likelihood of being arrested near a school than do White youth and older age groups, and racial inequities in arrests remains after school closures. Our findings show school closures significantly reduced arrests of urban youth of color, and policies addressing youth criminalization and structural racism should consider the joint spatial context of schools and policing. Although school closures may have resulted in learning loss and harms to youth wellbeing, closures interrupted comparatively high levels of arrest for Black and Latinx youth.