bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic Processes of Self-Organization in Nonstationary Conditions of Friction
Authors: Al-Quraan Tareq M. A. , Ilina Olha , Kulyk Mukola , Mnatsakanov Rudolf , Mikosianchyk Oksana , Melnyk Volodumur
Published: February 2023

Self-organization mechanisms of metastable dissipative structures during friction depending on base and oil functional additives for hypoid gears are considered. Research was conducted on a software-hardware complex with simulation of gears’ operation in rolling with slipping conditions in start-stop mode. Indicators of formation of wear-resistant dissipative structures include the following: improvement of antifriction characteristics, lubricant boundary layers’ formation, contact surfaces’ strengthening, and formation of heterogeneous deformation microrelief with a fine-grained structure. The formation of chemically modified boundary layers on 90% of the contact area of tribo-coupling elements ensures an increase in the wear resistance of leading and lagging surfaces by 2 and 1.4 times, respectively. The sclerometry method was used to establish that the formation of dissipative structures when lubricating tribo-coupling elements with various transmission oils can reduce deformation processes in metal near-surface layers by 23%. Highly viscous flavored lubricant with distillate oil and additive composition ensures wear-resistant dissipative structures with active components, including oxygen, sulfur, and phosphorus.
Outbreak of Fatal Piglet Diarrhea Caused by Chromobacterium haemolyticum in China
Authors: Zhang Leyi , Zhang Pengfei , Xu Ge , Song Kevin Sun , Liang Tairun , Peng Jiawei , Wu Shoutang , Yang Ningjia , Wang Lin , Liu Yanling , Zhang Xinming , Liang Pengshuai , Xu Zheng , Song Changxu
Published: February 2023

Chromobacterium haemolyticum is a fatal Gram-negative bacterium which could infect human beings. Our investigation found severe piglet diarrhea in one farm; the morbidity rate of piglets was 30.65%. Then, we isolated a nonpigmented, β-hemolytic Gram-negative bacillus from the clinical samples of this farm, which was designated GDHYZ30 strain. The 16S rRNA gene sequence indicated it was most closely related to Chromobacterium haemolyticum. Similar clinical symptoms were successfully reproduced in experimental piglets with this isolate, and the isolate was also subjected to whole genome-sequencing. It is worth noting that this Chromobacterium haemolyticum has been isolated from several other pig farms with diarrhea of unknown causes. To our knowledge, this is the first report that discusses Chromobacterium haemolyticum as a new pathogen causing diarrhea and death in piglets and transmitting through water sources, and it provides a reference for the prevention and control of human/animal infections as well as food safety.
Deep Learning Methods for Arabic Autoencoder Speech Recognition System for Electro-Larynx Device
Authors: Mohammed Ameen Zinah J. , Abdulrahman Kadhim Abdulkareem
Published: February 2023

Recent advances in speech recognition have achieved remarkable performance comparable with human transcribers’ abilities. But this significant performance is not the same for all the spoken languages. The Arabic language is one of them. Arabic speech recognition is bounded to the lack of suitable datasets. Artificial intelligence algorithms have shown promising capabilities for Arabic speech recognition. Arabic is the official language of 22 countries, and it has been estimated that 400 million people speak the Arabic language worldwide. Speech disabilities have been one of the expanding problems in the last decades, even in kids. Some devices can be used to generate speech for those people. One of these devices is the Servox Digital Electro-Larynx (EL). In this research, we developed an autoencoder with a combination of long short-term memory (LSTM) and gated recurrent units (GRU) models to recognize recorded signals from Servox Digital EL Electro-Larynx. The proposed framework consisted of three steps: denoising, feature extraction, and Arabic speech recognition. The experimental results show 95.31% accuracy for Arabic speech recognition with the proposed model. In this research, we evaluated different combinations of LSTM and GRU for constructing the best autoencoder. A rigorous evaluation process indicates better performance with the use of GRU in both encoder and decoder structures. The proposed model achieved a 4.69% word error rate (WER). Experimental results confirm that the proposed model can be used for developing a real-time app to recognize common Arabic spoken words.
RBM10 Loss Promotes EGFR-Driven Lung Cancer and Confers Sensitivity to Spliceosome Inhibition
Authors: Bao Yufang , Zhang Sirui , Zhang Xiaoyu , Pan Yunjian , Yan Yueren , Wang Ning , Ren Yunpeng , Zuo Ji , Zong Wei-Xing , Wang Zefeng , Wang Yongbo
Published: February 2023

In lung adenocarcinoma (LUAD), loss-of-function mutations in the splicing factor RBM10 frequently co-occur with oncogenic EGFR mutations. A detailed understanding of the functional consequences and therapeutic impact of RBM10 loss in EGFR-mutant LUAD could help identify more effective treatment strategies. Here, analysis of LUAD data sets indicated that RBM10 mutations are mutually exclusive with mutations in the tumor suppressor gene TP53. In an EGFR-driven LUAD mouse model, lung-specific ablation of either Rbm10 or Trp53 similarly promoted tumor development, leading to overlapping gene expression changes enriched in cancer-related pathways. RBM10 loss induced key RNA splicing changes concordant in mice and LUAD patients. Importantly, RBM10 deficiency conferred high sensitivity to spliceosome inhibition in EGFR-mutated LUAD cells. Combined treatment with spliceosome inhibitor improved the therapeutic efficacy of EGFR tyrosine kinase inhibitor osimertinib and overcame drug resistance, especially in RBM10-deficient LUAD. Together, this study establishes RBM10 as a tumor suppressor akin to p53 and provides a therapeutic strategy of targeting the splicing machinery in EGFR-driven LUAD.

Significance:

Loss of the splicing factor RBM10 is mutually exclusive with p53 mutations, promotes tumorigenesis, and enhances the efficacy of spliceosome inhibition in EGFR-driven lung cancer.
Phase II Study of Palbociclib (PD-0332991) inCCND1,2, or3Amplification: Results from the NCI-MATCH ECOG-ACRIN Trial (EAY131) Subprotocol Z1B
Authors: Clark Amy S. , Hong Fangxin , Finn Richard S. , DeMichele Angela M. , Mitchell Edith P. , Zwiebel James , Arnaldez Fernanda I. , Gray Robert J. , Wang Victoria , McShane Lisa M. , Rubinstein Larry V. , Patton David , Williams P. Mickey , Hamilton Stanley R. , Copur Mehmet S. , Kasbari Samer S. , Thind Ravneet , Conley Barbara A. , Arteaga Carlos L. , O'Dwyer Peter J. , Harris Lyndsay N. , Chen Alice P. , Flaherty Keith T.
Published: February 2023

Purpose:

Cyclin D/CDK4/6 is critical in controlling the G1 to S checkpoint. CCND, the gene encoding cyclin D, is known to be amplified in a variety of solid tumors. Palbociclib is an oral CDK4/6 inhibitor, approved in advanced breast cancer in combination with endocrine therapy. We explored the efficacy of palbociclib in patients with nonbreast solid tumors containing an amplification in CCND1, 2, or 3.

Patients and Methods:

Patients with tumors containing a CCND1, 2, or 3 amplification and expression of the retinoblastoma protein were assigned to subprotocol Z1B and received palbociclib 125 mg once daily for 21 days of a 28-day cycle. Tumor response was assessed every two cycles.

Results:

Forty patients were assigned to subprotocol Z1B; 4 patients had outside assays identifying the CCND1, 2, or 3 amplification and were not confirmed centrally; 3 were ineligible and 2 were not treated (1 untreated patient was also ineligible), leaving 32 evaluable patients for this analysis. There were no partial responses; 12 patients (37.5%) had stable disease as best response. There were seven deaths on study, all during cycle 1 and attributable to disease progression. Median progression-free survival was 1.8 months. The most common toxicities were leukopenia (n = 21, 55%) and neutropenia (n = 19, 50%); neutropenia was the most common grade 3/4 event (n = 12, 32%).

Conclusions:

Palbociclib was not effective at treating nonbreast solid tumors with a CCND1, 2, or 3 amplification in this cohort. These data do not support further investigation of single-agent palbociclib in tumors with CCND1, 2, or 3 amplification.
Precision Oncology: 2022 in Review
Authors: Rosen Ezra , Drilon Alexander , Chakravarty Debyani
Published: February 2023

This article presents a review of the major advances and future implications in precision oncology accomplished in 2022 and centers on three primary pillars: advances in (i) rational drug design, (ii) study design, and (iii) novel biomarkers.
Habitats of House Sparrow Passer domesticus (Linnaeus, 1758) in Rameswaram Island, Tamil Nadu, India
Authors: M. Pandian
Published: February 2023

This paper pertains to the nesting habitats of House Sparrow Passer domesticus with specific reference to population dynamics, nesting-related habits, nests, behaviours and other threats faced by these birds in Rameswaram Island. A total of 2,988 adult House Sparrows and 407 active nests were counted during the study. Of nests counted, 19% (n = 77) were solitary. The highest number of nests observed in a cluster was 9 (2 clusters). 60% of nests (n = 244) were found in concrete buildings, 39% (n = 159) in artificial nest-boxes, and 35% (n = 144) in cavities/crevices within buildings. House Sparrow population exhibited nesting plasticity, and 2% of nests were found constructed on vegetation. A wide variety of locally available materials, such as pieces of synthetic fishing nets, nylon ropes, and polythene papers were used for construction of nests. Sand and water bathing by birds were observed. Accidental fall of eggs and chicks, predation of nests by House Crows Corvus splendens, and unsuccessful attempts to predate adult birds by Black Kite Milvus migrans were observed, as well as opportunistic sightings of Shikra Accipiter badius.
The genera Philanthus Fabricius, 1790 and Philanthinus de Beaumont, 1949 (Hymenoptera: Crabronidae: Philanthinae) in Egypt, with a new record and the description of a new species
Authors: MALASH ALYAA A. , EDMARDASH YUSUF A. , GADALLAH NEVEEN S.
Published: February 2023

The digger wasps of the genera Philanthinus de Beaumont and Philanthus Fabricius (Crabronidae: Philanthinae) of Egypt are reviewed. One species in Philanthinus and 10 in Philanthus are recorded. Philanthus ammochrysus is newly recorded for the country, and a new species, Philanthus pulawskii Malash, Edmardash and Gadallah is described. The following species and subspecies are doubtful records: Philanthus sulphureus F. Smith, P. venustus (Rossi), and P. triangulum obliteratum Pic. A key to the Egyptian species of Philanthus is provided. Illustrations to all important characters of species under study are also provided.
The Station Marine d’Endoume, Marseille: 150 years of natural history
Authors: BOURY-ESNAULT NICOLE , BELLAN GERARD , BELLAN-SANTINI DENISE , BOUDOURESQUE CHARLES-FRANCOIS , CHEVALDONNÉ PIERRE , DIAS ALRICK , FAGET DANIEL , HARMELIN JEAN-GEORGES , HARMELIN-VIVIEN MIREILLE , LEJEUSNE CHRISTOPHE , PEREZ THIERRY , VACELET JEAN , VERLAQUE MARC
Published: February 2023

When marine natural sciences began to be the concern of most European scientists, in the middle of the 19th century, Marseille, in southern France, was no exception. The creation, ca. 150 years ago, of the first Zoology Laboratory of the Faculty of Sciences of Marseille took place in 1868. Under the leadership of Antoine-Fortuné Marion, it soon led to the creation of the Station Marine d’Endoume (SME) in 1889. Marion’s pioneering work survived both world wars and was then taken to another dimension by Jean-Marie Pérès, head of the marine station from 1948 to 1983. This institution is still alive to date. We here inventoried all the taxa described by SME scientists (1870 to 2021) and arranged them in a public database. Three main periods of activity at the SME are described, as well as the focus made through time to different groups of taxa, selected ecosystems, or biogeographic areas. Through many examples, it was possible to document how these naturalistic, taxonomic descriptions contributed to a broader scientific knowledge within this period. Finally, we discussed trends in taxonomic and naturalistic research, based on the SME experience.
Reappraisal of Hawaiian species of Corallianassa Manning, 1987 (Crustacea: Axiidea: Callichiridae)
Authors: POORE GARY C. B. , LONGENECKER KEN , TUDGE CHRISTOPHER C.
Published: February 2023

Four species of the callichirid ghost shrimp genus Corallianassa Manning, 1987 are recognised in Hawaii based on evidence from morphology and the CO1 gene. Corallianassa borradailei (De Man, 1928) is a widespread Indo-West Pacific species now confirmed for Hawaii. Corallianassa lanceolata Edmondson, 1944 is an endemic species similar to C. assimilis (De Man, 1928) from Indonesia and Guam. Corallianassa martensi (Miers, 1884) is also a widespread Indo-West Pacific species. Callianassa (Callichirus) winslowi Edmondson, 1944 (Hawaii), Callianassa (Callichirus) nakasonei Sakai, 1967 (Japan) and Callianassa haswelli Poore & Griffin, 1979 (Australia) are treated as junior subjective synonyms of C. martensi. Callianassa (Callichirus) oahuensis Edmondson, 1944, long treated as a junior synonym of C. borradailei, is revived as a valid species of Corallianassa. The four species differ in the shape and dorsal setae of the telson, the extent of the carina along the upper margin of the major cheliped palm, the attitude of the rostrum, and the shape of the maxilliped 3.
Two new species of the genus Eophileurus Arrow, 1908 (Coleoptera: Scarabaeidae: Dynastinae) from the Philippines and Vietnam, with first description of E. quadratifovealis Yang & Pathomwattananurak, 2022 female
Authors: QIAO-ZHI YANG (GEORGI GESHEV)  , PATHOMWATTANANURAK WUTTIPON , ZHAO MING-ZHI
Published: February 2023

Two new species, Eophileurus varipunctatus Yang, Pathomwattananurak & Zhao, new species from Mindoro and Palawan, the Philippines and Eophileurus vietnamensis Yang, Pathomwattananurak & Zhao, new species from Vietnam are described and illustrated. Eophileurus iwasei Muramoto, 1995 and E. chinensis (Faldermann, 1935) are illustrated and compared to each new species, respectively. The female of E. quadratifovealis Yang & Pathomwattananurak, 2022 is described for the first time.
Pharmacokinetics of cefiderocol during extracorporeal membrane oxygenation: A case report
Authors: Riera Jordi , Domenech Laura , García Sonia , Pau Alba , Sosa Manuel , Domenech Josep , Palmada Clara , Torrella Pau , Sánchez Ariadna , Lamora Anna , Gallart Elisabet , Girón Pilar , Nuvials Xavier , Ferrer Ricard
Published: February 2023

Patients with extracorporeal membrane oxygenation (ECMO) support do frequently receive broad-spectrum antibiotics, due to the high frequency of infection by multidrug resistant microorganisms. The extracorporeal circuit can alter the pharmacokinetics (PK) of administered drugs, and in the case of antibiotics this may lead to treatment failure. Cefiderocol is a new cephalosporin that exhibits excellent in vitro activity against many multidrug-resistant (MDR) microorganisms, but there is no published data about the modifications of its PK in patients with ECMO support. Herein we report the results of a pharmacokinetic investigation of cefiderocol in a critically ill patient receiving extracorporeal respiratory support.
Ethical challenges in caring for healthy older adults: Qualitative perspectives
Authors: Zendehtalab Hamidreza , Vanaki Zohreh , Memarian Robabeh
Published: February 2023

Background

Healthy aging is one of the essential aspects of a health promotion program in the elderly.

Aim

Exploring ethical challenges in healthy elderly care from the perspective of nurses, older adults, and families in the Iranian context.

Research Design

This qualitative study was conducted using a content analysis approach in 4 health centers in northeastern Iran from 2017 to 2019. Semi-structured interviews, observation, review of elderly files, and focus groups were used to collect data.

Ethical considerations

The ethics committee of the university approved this study in Iran. This study adhered to the principles of the Helsinki Declaration. Ethical principles autonomy, confidentiality, and anonymity were considered for the participants. Participants were informed about the purpose of the study and submitted written informed consent regarding their participation.

Findings

The central theme was: An unfair approach to caring for healthy older adults. The three categories were as follows: Forgotten human care, disrespect, and lack of a meaningful and trustworthy relationship. The 14 subcategories highlighted the ethical challenges of healthy aging care in health centers.

Discussion

The findings showed that due to nurses’ unfamiliarity with the concept of healthy aging, older adults are discriminated against in care centers. Creating a standard care program for healthy older adults ensures that ethical principles are followed for these clients.

Conclusion

Various individual and organizational factors lead to an unfair approach to caring for healthy elderly in health centers. The following factors can help improve the care of healthy aging and reduce ethical challenges in this area: Introducing nurses to the concept of healthy old age and its dimensions, creating a community-based approach in health centers, prioritizing health issues over health issues, Involvement of families and older adults in needs assessment-goal setting-implementation and evaluation of health services, and design of home visit programs to provide services to healthy elderly.
Exploring Roles of Stakeholders in Combating Substance Abuse in the DIMAMO Surveillance Site, South Africa
Authors: Muthelo Livhuwani , Mbombi Masenyani Oupa , Mphekgwana Peter , Mabila Linneth Nkateko , Dhau Inos , Tlouyamma Joseph , Nemuramba Rathani , Mashaba Reneilwe Given , Mothapo Katlego , Ntimana Cairo Bruce , Maimela Eric
Published: February 2023

Background:

The increasing prevalence of substance abuse in rural areas of Limpopo Province is a concern for most stakeholders including the families, South Africa Police Service, and social workers. Combating Substance Abuse requires the active roles of various stakeholders in the rural community, due to limited resources for prevention, treatment, and recovery.

Purpose:

To report on the roles of stakeholders in tackling Substance Abuse during the awareness campaign conducted in the deep rural community of Limpopo Province, DIMAMO surveillance area.

Methods:

Qualitative narrative design was adopted to explore the roles of stakeholders in combating Substance Abuse during the awareness campaign conducted in the deep rural community. The population consisted of different stakeholders who play an active role in reducing Substance Abuse. The triangulation method was used for data collection (interviews, observations, and taking field notes during presentations). Purposive sampling was used to select all the available stakeholders who actively combat substance abuse in the communities. Thematic narrative analysis was used to analyze the interviews conducted with and content presented by the stakeholders to generate the themes.

Results:

The prevalence of Substance Abuse among the youth in the Dikgale community is high with a growing trend of Crystal Meth, “nyaope,” and Cannabis(marijuana). The prevalence is worsened by the diverse challenges experienced by the families and stakeholders which impact the strategies targeted to combat Substance Abuse.

Conclusion:

The findings indicated the need for strong collaborations among the stakeholders (including school leadership) to successfully combat Substance Abuse in rural areas. The findings demonstrated a need for a well-capacitated healthcare services with adequate rehabilitation centers and well-trained healthcare providers for combating Substance Abuse to minimize victim stigmatization.
Hospital discharge intervention developed in a dialogical way with families to prepare them to care for children with chronic diseases at home: Mixed methods study
Authors: Nóbrega Vanessa Medeiros da , Viera Claudia Silveira , Lorenzini Elisiane , Neves Eliane Tatsch , Reichert Altamira Pereira da Silva , Vaz Elenice Maria Cecchetti , Collet Neusa
Published: February 2023

A convergent parallel mixed methods design with qualitative data collection embedded in a quasi-experimental study was developed to examine the potential of three modalities of preparation for hospital discharge of the families of children with chronic diseases in terms of uncertainty levels and management of the disease at home. Caregivers of these children were divided into three groups: two experimental groups and one control group. Two scales were applied: one measured family management, and the other evaluated uncertainties in relation to the disease. In addition, an in-depth interview was conducted. Wilcoxon’s test and the integrated response index were used in data analysis to compare performance between the groups. Inductive thematic analysis was employed for the qualitative data. The data were integrated, comparing the groups before and after preparation for hospital discharge. Twenty-five family caregivers completed this study. Data integration showed that the intervention group, in which the families developed planning to prepare for discharge in a dialogical way with professionals, presented better perceptions regarding care management when compared to structured guide and usual care groups. Participation of families in planning for hospital discharge showed a reduction in uncertainties regarding the disease and better care management of children at home.
The Short Graft ACL Reconstruction
Authors: Dave Lee Yee Han
Published: February 2023

The Short Graft Anterior Cruciate Ligament (ACL) reconstruction is increasing in popularity. Surgeons are making use of autograft lengths of between 6-6.5 cm for ACL reconstruction. The grafts of choice are the hamstring and quadriceps tendon autograft. The grafts are prepared with cortical fixation on both the femur and tibia ends for cortical fixation. Short tunnels or sockets are reamed instead of full bone tunnels. This helps with bone preservation and the patients have less postoperative pain; but will require special instrumentation for retrograde drilling.

The benefit of this technique is improved postoperative hamstring strength with the gracilis preserved, as only the semitendinosus tendon is harvested to obtain a quadrupled ACL graft. The outcomes of short graft ACL reconstruction are comparable to established transportal ACL reconstruction techniques. However, there is a learning curve and additional implant costs involved. The familiarity with the surgical technique, understanding of optimal graft fixation and biology are all paramount to success of this surgery.
How to Optimize Return to Sport in ACL Surgery
Authors: Albar Husnul Fuad
Published: February 2023

Anterior cruciate ligament (ACL) rupture is one of the most common sport injuries. The incidence of ACL rupture was estimated to range from 30 to 78 per 100.000 person-years. Several sport contact injuries were reported that highly associated with ACL rupture, such as football (15%) and soccer (5.2%) competition. ACL rupture was also found more common in male than female players.

The anatomy of ACL originates from lateral wall of the intercondylar fossa and inserts to the tibial eminence anteriorly. It comprises of two bundles, such as anteromedial and posterolateral bundle. The femoral attachment arises from resident’s ridge to the posterior articular margin of the lateral femoral condyle. The tibial attachment is closely related to the attachment of the lateral meniscus.

Return to sport (RTS) remains to be the main goal of ACL reconstruction (ACLR). However, RTS criteria remains debatable due to differences outcome measure. RTS was noted 60-80% in different sports following ACL reconstruction surgery. However, there was several factors that may affect the ACLR surgery.

Concomitant ligamentous and meniscus injury may prolong the RTS. Graft choice may also contribute to the process of RTS. Bone-patellar-tendon-bone (BPTB) graft has shown to have early incorporation to the femoral and tibial tunnel due to bone-to-bone healing. Surgical technique also plays role in the early RTS. Single-bundle and double-bundle ACL reconstruction remains debatable in ACLR surgery. However, there was no differences in both surgical techniques in terms of early RTS.
Management for Arthrofibrosis Following ACL Reconstruction
Authors: Sutanto Ronny
Published: February 2023

Introduction:

Arthrofibrosis following ACL reconstruction is a debilitating complication. The incidence range from 2% to as high 35%. This Loss of motion not only cause of anterior knee pain but also inability to return to sports, and persistent weakness. The emergence of intra-articular scar tissue adhesions, or post-traumatic arthrofibrosis, may restrict the patient’s knee motion in the early postoperative period even though many factors may contribute to the development of motion loss. It might be difficult to manage motion loss once it has been diagnosed as a condition. Better understanding of the time of surgery, surgical technique improvement, and rehabilitation protocols showed less incidence of motion loss after ACL reconstruction.

Case Presentation:

A 46-year-old female complains of pain, stiffness, and decreased range of motion following arthroscopy ACL reconstruction of her left knee. Local examination showed diffused firm swelling over the anteromedial aspect of the knee and limitation of motion to mobilize the patella in all directions. Her bad rehabilitation program after surgery caused the main loss of her knee motion and the development of pain. Arthroscopic lysis of adhesions with manipulation under anesthesia was conducted. Following the surgery, graft observation was normal. A cyclops located between the infrapatellar pouch and medial gutter was observed and excised. Passive range of motion was also checked intra-operatively. Immediately after surgery, intensive physiotherapy was begun. The patient was very compliant with the rehabilitation program and the clinic follow-up schedule. Gradually, the patient started to regain her active full extension and flexion.

Result:

The functional outcome score showed improvement at the time of final follow-up, as did the average pain scores.

Conclusion:

Arthrofibrosis is multifactorial etiology. Knee joint ROM is better maximized by arthroscopic debridement and lysis of adhesions following arthrofibrosis after ACLR in conjunction with an intensive post-operative physical therapy plan.
How to Deal with Cartilage Lesions Based on the Size
Authors: Warindra Taufin
Published: February 2023

Cartilage lesions are problematic because hyaline articular cartilage has limited ability to regenerate in response to damage. The size of the lesions is a determining factor in every algorithm of decision-making in terms of treatment. The decision if a cartilage lesion demands surgical treatment is depending on a variety of parameters and should always be reached mutually between physician and patient after thorough education about the risks and benefits of operative and conservative treatment options. Lesion characterization is often accomplished by the interpretation of advanced imaging studies (e.g., radiographs and magnetic resonance imaging [MRI]) and direct arthroscopic examination, which remains the gold standard to assess chondral/osteochondral pathology.

A wide range of options for cartilage lesions is practised nowadays, ranging from conservative measures to simple arthroscopic interventions, marrow tapping techniques, osteochondral auto/allografting, cell-based techniques, growth factors, and emerging gene therapy techniques. Once a cartilage lesion is identified, multiple variables must be evaluated when determining treatment options. The patient’s clinical symptoms must correlate to physical examination and imaging findings to determine if the cartilage injury is the source of the patient’s pain. In this presentation, I tried to summarize how to deal with cartilage lesions based on their size.
The Biologic Approach for Managing Cartilage Injury: Where are We Now™
Authors: Evan
Published: February 2023

Articular cartilage or Hyaline cartilage consists of 95% type 2 collagen, water, proteoglycans and chondrocytes. Cartilage functions to decrease friction, distribute loads, resists shear/compression, and also as a shock-absorbing cushion. It has the characteristics of alymphatic, avascular, aneural, anisotropic, biphasic and viscoelastic. Cartilage can be damaged by direct trauma, loss of underlying bone structure, a genetic defect in the normal structure and chemical/enzymatic threats. Articular cartilage injuries are commonly caused by sports and recreational activities. Articular cartilage damage has inherent limited healing potential; hence it remains a challenging problem for orthopedic surgeons.

There are three eras of cartilage repair technique: the pre-Autologous Chondrocyte Transplantation Era or Autologous Chondrocytes Implantation (ACI), Matrix – Assisted Chondrocytes Implantation (MACI) era and Regenerative Medicine era.

In 1743 Hunter stated, “Cartilage injury is a troublesome thing and once injured is seldom repaired“. Nowadays, there are a lot of modalities for cartilage repair such as microfracture, mosaicplasty, ACI, MACI, platelet-rich plasma, bone marrow aspirate concentrate, orthokine or interleukin receptor antagonist and Matrix metalloproteinases (MMPs) inhibitor.
Management of Chronic Patellar Tendon Rupture Left Knee Joint with Primary Repair Using Fiber Wire and Endo Button As A Cost-Effective and Simple Anatomical Reconstruction Without Grafts: A Case Report
Authors: Suria Vincentius Handy , Riansyah Wahyu
Published: February 2023

Patellar tendon ruptures mostly occur in persons under 40 years of age, typically during sports activities. Neglected ruptures of the patellar tendon, defined as ruptures presenting after six weeks, are often difficult to repair, and different techniques have been described for reconstruction of this uncommon problem including the use of auto-grafts, allografts, and synthetic materials. We hereby describe a cost-effective and simple anatomical reconstruction without the requirement for grafts for chronic patellar tendon injuries. This is a retrospective study of a 29-year-old man who came to the orthopaedic clinic with the chief complaint of pain in the left knee. Pain has been felt since 2 years ago after the patient falls when were playing football. After the incident, the patient was taken to alternative therapy, but still felt the pain and difficulty moving the left knee. From the physical examination, the patient presented elevation of left patella height, localized tenderness, palpable gap below the inferior pole of the patella, and limited range of movement on the left knee. There was also a straight leg raise provocative test positive. The x-ray results were obtained patella alta with Insall-Salvatti Index was 1.6. An MRI examination was also performed, showing patella contusion and marrow edema, suspicious of soft tissue rupture, with intact ACL/PCL. The patient was diagnosed with chronic patellar tendon rupture of the left knee. At the time of surgery, it was found that the patellar tendon ruptured with remnants still on the distal part, and the cartilage was still in good condition. The next step is to perform a primary repair of the patellar tendon using fiber wire and endo button at the tibial part. Postoperative rehabilitation was carried out by starting limited ROM exercise of the left knee on day 4. Six weeks after surgery, there was an improvement in left knee ROM and improvement in walking ability. In this case, primary repair of patellar tendon using fiber wire and endo button provides good results and can be used as a costeffective and simple anatomical reconstruction without the requirement for grafts.
Arthroscopic Fixation of Posterior Cruciate Ligament Avulsion Fracture with Combined Suture Tape and Internal Bracing by Suture-bridge Technique
Authors: Chernchujit Bancha , Situmeang Adrian
Published: February 2023

Background:

Tibial-sided avulsion fracture of the posterior cruciate ligament (PCL) almost always require surgical intervention. Multiple techniques of reduction and fixation have been described in the literature from open/mini-open conventional screw fixation to the all-arthroscopic fixation techniques. Recent evidence shows that the all-arthroscopic fixation techniques had higher subjective and objective knee outcome scores with the advantage of addressing concomitant intra-articular injuries such as osteochondral injuries or meniscal problems.

Objectives:

We propose an arthroscopic fixation technique using suture tapes placed in a suture-bridge technique and combined it with internal bracing to fix tibial-sided avulsion fracture of the PCL.

Surgical Technique:

After routine diagnostic knee arthroscopy in supine position via standard anterolateral and anteromedial portal, two standard posteromedial and posterolateral portal was created. A standard PCL aiming guide was used to create the tibial tunnel. PCL was secured using two single-looped suture tapes around it with both limbs brought to the posterior compartment through either side of the PCL (medial and lateral). Internal bracing was done with suture tape secured to the femoral side using fixed suspensory device and brought to the posterior compartment through the lateral side of the PCL. All tapes are then passed through the tibial tunnel in a suture-bridge manner and fixed to a button in 30° flexion while reduction quality was constantly checked under direct visualization.

Results:

The suture bridge configuration provides direct bone-to-bone healing and secure enough fixation for early range of motion and power exercises. All-arthroscopic approach avoids posterior element related complications such as fragment comminution and neurovascular injuries.

Conclusions:

This technique can be considered as a safe and effective method for fixation of tibial-sided PCL avulsion fracture, which allows active mobilization with lowered risk of complications.
Neglected Patellar Tendon Rupture Augmentation Using Fibertape Augmentation: A Case Report
Authors: Yurianto Herbert , Utoyo Ghuna Arioharjo
Published: February 2023

Introduction:

Rupture of the patellar tendon is an uncommon problem caused by athletic activities. Delayed treatment would result in suboptimal outcomes such as quadriceps contracture, residual quadriceps weakness, and loss of knee flexion.

Case presentation:

18 years old female patient with a seven-month-old injury twisting her knee comes with pain and instability and positive anterior drawer test and Lachman test. The radiology findings showed total rupture of the anterior cruciate ligament (ACL) and partial tear of the patellar tendon on the MRI right knee. We perform a direct end-to-end approximation of the patellar tendon with augmentation through the transosseous site in the patella proximally and tibial tubercle distally without using a graft with a good outcome.

Discussion:

This is the first reported case where a patellar tendon reconstruction is done without implants, synthetic augmentation or graft. Based on this outcome, the use of this technique could be promising for patellar tendon augmentation without graft. This might be an alternative to the less expensive method of repairing a chronic patellar tendon rupture.

Conclusion:

The use of fibertape augmentation provides a practical solution for treating a neglected patellar tendon rupture with concurrent ligament injury needing graft repair. We believe that this technique is easily reproducible and warrants further investigation.
The applicability research of the diagnostic criteria for 10.2 Heamodialysis-related headache in the international classification of headache disorders-3rd edition
Authors: Yang Ying , Meng Fanchao , Zhu Hanyu , Zhang Lei , Lu Guangshuang , Xiao Shaobo , He Jiaji , Yu Shengyuan , Liu Ruozhuo
Published: February 2023

Background

Headache during hemodialysis (HDH) is prevalent but not negligible. Despite the high prevalence of dialysis headaches, they have rarely been studied. Therefore, this study aimed to evaluate the prevalence, risk factors, and clinical characteristics of HDH and reappraise the HDH diagnostic criteria in the International Classification of Headache Disorders 3 (ICHD-3).

Methods

One hundred and fifty-four patients completed this randomized cross-sectional study. Consecutive patients who underwent haemodialysis were assessed using a semi-structured questionnaire. The patients were administered face-to-face questionnaires while undergoing dialysis.

Results

This study included 154 patients. Before commencing dialysis, 3.24% (5/154) of the patients had migraine without aura, 1.29% (2/154) had menstrual-related migraine, 0.6% (1/154) had tension-type headaches, and 0.6% (1/154) had an unclassifiable headache. One case (0.6%) of headache resolved after dialysis treatment. HDH was diagnosed in 9.09% (14/154) of the patients. Headache after haemodialysis (HAH) was reported in 6.49% (10/154) of patients. The most prevalent features of HDH were frontal or temporal location, bilateral headaches, dull and throbbing nature, and moderate severity. HDH started at a mean of 2.33 ± 0.79 h after dialysis commenced. The average headache duration was 6.56 ± 1.57 h (median = 3.0 h), with 66.67% of the patients reporting a duration of ≤4 h. HDH was more prevalent in females than males (P = 0.01, P < 0.05). Female sex was a risk factor for HDH (P = 0.01，P < 0.05).

Conclusions

The diagnostic criteria for 10.2 HDH in ICHD-3 may miss several HAH. Therefore, ICHD-3 should be revised according to the literature and further studies.
The prognostic utility of preoperative neutrophil-to-lymphocyte ratio (NLR) in patients with colorectal liver metastasis: a systematic review and meta-analysis
Authors: Li Yanqing , Xu Tianxiang , Wang Xin , Jia Xiangdong , Ren Meng , Wang Xiaoxia
Published: February 2023

The neutrophil-to-lymphocyte ratio is used to reflect body's inflammatory status with prognostic value in different cancers. We aimed to investigate the influence of preoperative NLR in the prognosis of CRLM patients receiving surgery using meta-analysis. Data in Cochrane Library, PubMed, Embase, and Web of Science databases created before October 2022 were recruited. Meta-analysis was carried out with RevMan 5.3 and Stata16 software, and the primary outcome indicators included overall survival (OS), and secondary outcome indicators included disease-free survival (DFS) and relapse-free survival (RFS). The pooled risk ratio (HR) and 95% confidence interval (CI) for each outcome indicator were determined using random-effects models or fixed-effects models. The pooled odds ratio (OR) and corresponding 95% confidence intervals (CI) for NLR and clinicopathological characteristics were determined with a fixed-effects model. 18 papers published between 2008 and 2022 (3184 patients in total) were included. The pooled analysis found that high preoperative NLR was correlated with poor OS (multivariate HR = 1.83, 95% CI = 1.61–2.08, p < 0.01), DFS (multivariate HR = 1.78, 95% CI = 1.16–2.71, p < 0.01) and RFS (multivariate HR = 1.46, 95% CI = 1.15–1.85, p < 0.01), but NLR was not related to clinicopathological features of CRLM patients correlation. In conclusion, NLR is an independent risk factor for poor prognosis in patients with CRLM. More large-scale clinical researches are required in the future to demonstrate the inclusion of preoperative NLR as a prognostic indicator for CRLM patients to guide postoperative adjuvant chemotherapy.
Wangbi granule as a combination therapy to achieve clinical deep remission in rheumatoid arthritis: protocol for a multicenter, triple-blind, randomised, placebo-controlled trial
Authors: Wang Jinping , Wang Zihan , Lan Tianyi , Zhang Liubo , Li Zhenbin , Wang Xinchang , Zou Qinghua , Wang Yuan , Li Yanqi , Luo Ruili , Zhang Nan , Xu Yuan , Li Mengtao , Tao Qingwen
Published: February 2023

Introduction

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that may lead to bone erosion and disability. Although there are many biological therapies in RA treatment nowadays, such as etanercept and tofacitinib, there are still a considerable number of patients who cannot achieve clinical deep remission, which makes patients feel pain and stiffness of joints. As a traditional Chinese medicine preparation, Wangbi granule showed a synergistic role with methotrexate in the treatment of RA patients with “kidney deficiency and dampness” or “stasis blocking channels”. Therefore, it is a promising therapeutic strategy for the clinical deep remission of RA. In this study, Wangbi granule will be used as the test drug. The investigators conduct this study to evaluate the efficacy and safety of Wangbi granule in the treatment of patients who have not achieved deep remission despite the use of methotrexate and tofacitinib.

Methods and analysis

Two parallel randomized, triple-blind, placebo-controlled trials will be conducted. In six study centers, 340 eligible RA patients will be recruited and randomly allocated to either the intervention group or the control group (in a 1:1 ratio). They will receive Wangbi granule or Wangbi placebo 12.0 g each time, three times a day for 12 weeks. The primary outcome is the disease activity score derivative for 28 joints (DAS28). Secondary outcomes are patient-reported outcomes, American College of Rheumatology 50% response criteria (ACR50), fatigue scale-14 (FS-14), visual analogue scale for pain (VAS), health assessment questionnaire disability index (HAQ-DI) and biomarkers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).

Expected outcomes

The success of this study will provide strong evidence to confirm the efficacy and safety of Wangbi granule in the treatment of RA.

Trial registration The trial has been registered in the ClinicalTrials Registry (NCT05540938, Date: 09/15/2022, https://clinicaltrials.gov/ct2/show/NCT05540938)
No indication for SARS-CoV-2 transmission to pet ferrets, in five cities in Poland, 2021 - antibody testing among ferrets living with owners infected with SARS-CoV-2 or free of infection
Authors: Kaczorek-Łukowska Edyta , Wernike Kerstin , Beer Martin , Blank Alicja , Małaczewska Joanna , Blank Mirosława , Jałonicka Anna , Siwicki Andrzej Krzysztof
Published: February 2023

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in China by the end of 2019 and was responsible for a pandemic in the human population that resulted in millions of deaths worldwide. Since the beginning of the pandemic, the role of animals as spill-over or reservoir hosts was discussed. In addition to cats and dogs, ferrets are becoming increasingly popular as companion animals. Under experimental conditions, ferrets are susceptible to SARS-CoV-2 and it appears that they can also be infected through contact with a SARS-CoV-2 positive owner. However, there is still little information available regarding these natural infections. Here, we serologically tested samples collected from pet ferrets (n = 45) from Poland between June and September 2021. Of the ferrets that were included in the study, 29% (13/45) had contact with owners with confirmed SARS-CoV-2 infections. Nevertheless, SARS-CoV-2-specific antibodies could not be detected in any of the animals, independent of the infection status of the owner. The obtained results suggest that ferrets cannot be readily infected with SARS-CoV-2 under natural conditions, even after prolonged contact with infected humans. However, due to the rapid mutation rate of this virus, it is important to include ferrets in future monitoring studies.
Exosome-mediated crosstalk between epithelial cells amplifies the cell injury cascade in CaOx stone formation
Authors: Yang Yuanyuan , Hong Senyuan , Wang Qing , Wang Shaogang , Xun Yang
Published: February 2023

Background

Calcium oxalate (CaOx) stone disease is found worldwide. To explore the role of exosomes as a mediator of intercellular crosstalk during CaOx stone formation, we conducted this study, which may provide a new insight into the treatment and prevention of CaOx stones.

Methods

Exosomes derived from HK2 cells with (EXO(S)) or without (EXO(C))CaOx crystal stimulation were cocultured with normal tubular epithelial cells and subcapsularly injected into rat kidneys. Then, oxidative stress levels, the MAPK signalling pathway and osteogenic changes were detected via qPCR, Western blotting, immunofluorescence and immunohistochemical staining. In vivo fluorescence imaging and exosome internalization assays showed the absorption and utilization of exosomes.

Results

EXO(S) increased the reactive oxygen species (ROS) level and activated the expression of BMP2, OPN and OCN via the MAPK/P-38 pathway both in vivo and in vitro. In vivo experiments showed that preinjection of EXO(S) aggravated, while preinjection of EXO(C) ameliorated, these effects. Crystal depositions were significantly increased in SD rats injected with GAM when they were preinjected with EXO(S), and these effects could be reversed after preinjection with EXO(C).

Conclusion

Our study revealed that exosome-mediated intercellular crosstalk could accelerate the formation of CaOx stones by promoting oxidative stress and the osteogenic cascade in normal tubular epithelial cells.

Graphical Abstract

HK2 cells stimulated with CaOx crystals released more exosomal miR-223-3p and S100A8 comparing with normal HK2 cells. These exosomes derived from HK2 cells stimulated with CaOx (EXO(S)) could amplify the oxidative stress and osteogenic changes via MAPK/P-38 pathway, which finally led to the formation of Randall’s plaque.