bluuebunny/crossref_metadata_2025 huggingface dataset:
INVESTIGATING THE ANTI-CATABOLIC PROPERTIES OF NOTOCHORDAL CELLS IN DISC REGENERATION
Authors: Basatvat S. , Braun T. , Snuggs J. , Williams R. , Templin M. , Tryfonidou M. , Le Maitre C.
Published: July 2023

Low back pain resulting from Interertebral disc (IVD) degeneration is a serious worldwide problem, with poor treatment options available. Notochordal (NC) cells, are a promising therapeutic cell source with anti-catabolic and regenerative effect. However, their behaviour in the harsh degenerate environment is unknown.

Porcine NC cells (pNCs), and Human NP cells from degenerate IVDs were cultured in alginate beads to maintain phenotype. Cells were cultured alone or in combination, or co-stimulated with notochordal cell condition media (NCCM), in media to mimic the healthy and degenerate disc environment, together with controls for up to 1 week. Following culture viability, qPCR and proteomic analysis using Digiwest was performed.

A small increase in pNC cell death was observed in degenerated media compared to standard and healthy media, with a further decrease seen when cultured with IL-1β. Whilst no significant differences were seen in phenotypic marker expression in pNCs cultured in any media at gene level (ACAN, KRT8, KRT18, FOXA2, COL1A1 and Brachyury). Preliminary Digiwest analysis showed increased protein production for Cytokeratin 18, src and phosphorylated PKC but a decrease in fibronectin in degenerated media compared to standard media. Human NP cells cultured with NCCM, showed a decrease in IL-8 production compared to human NP cells alone when cultured in healthy media. However, gene expression analysis (ACAN, VEGF, MMP3 and IL-1β) demonstrated no significant difference between NP only and NP+NCCM groups.

Studying the behaviour of the NCs in in vitro conditions that mimic the in vivo healthy or degenerate niche will help us to better understand their potential for therapeutic approaches. The potential use of NC cell sources for regenerative therapies can then be translated to investigate the potential use of iPSCs differentiated into NC cells as a regenerative cell source.
JOINT REPAIR EVALUATED ON RADIOGRAPHS IS ASSOCIATED WITH PAIN AND SYNOVIAL FLUID MARKER CHANGES AFTER KNEE JOINT DISTRACTION TREATMENT
Authors: Jansen M. , Salzlechner C. , Barnes E. , DiFranco M. , Custers R. , Watt F. , Vincent T. , Lafeber F. , Mastbergen S.
Published: July 2023

Knee joint distraction (KJD) has been associated with clinical and structural improvement and synovial fluid (SF) marker changes. However, structural changes have not yet been shown satisfactorily in regular care, since radiographic acquisition was not fully standardized. AI-based modules have shown great potential to reduce reading time, increase inter-reader agreement and therefore function as a tool for treatment outcome assessment. The objective was to analyse structural changes after KJD in patients using this AI-based measurement method, and relate these changes to clinical outcome and SF markers.

20 knee OA patients (<65 years old) were included in this study. KJD treatment was performed using an external fixation device, providing 5 mm distraction for 6 weeks. SF was aspirated before, during and immediately after treatment. Weight-bearing antero-posterior knee radiographs and WOMAC questionnaires were collected before and ~one year after treatment. Radiographs were analysed with the Knee Osteoarthritis Labelling Assistant (KOALA, IB Lab GmbH, Vienna, Austria), and 10 pre-defined biomarker levels in SF were measured by immunoassay. Radiographic one-year changes were analysed and linear regression was used to calculate associations between changes in standardized joint space width (JSW) and WOMAC, and changes in JSW and SF markers.

After treatment, radiographs showed an improvement in Kellgren-Lawrence grade in 7 of 16 patients that could be evaluated; 3 showed a worsening. Joint space narrowing scores and continuous JSW measures improved especially medially. A greater improvement in JSW was significantly associated with a greater improvement in WOMAC pain (β=0.64;p=0.020). A greater increase in MCP1 (β=0.67;p=0.033) and lower increase in TGFβ1 (β=-0.787;p=0.007) were associated with JSW improvement.

Despite the small number of patients, also in regular care KJD treatment shows joint repair as measured automatically on radiographs, significantly associated with certain SF marker change and even with clinical outcome.
FINITE ELEMENT ANALYSIS OF THE IMPINGING HIP: SUBJECT-SPECIFIC MODELS TO ASSESS THE RISK OF OSTEOARTHRITIC DEGENERATION
Authors: de Angelis N. , Beaule P. , Speirs A.
Published: July 2023

Femoro-acetabular impingement involves a deformity of the hip joint and is associated with hip osteoarthritis. Although 15% of the asymptomatic population exhibits a deformity, it is not clear who will develop symptoms. Current diagnostic imaging measures have either low specificity or low sensitivity and do not consider the dynamic nature of impingement during daily activities. The goal of this study is to determine stresses in the cartilage, subchondral bone and labrum of normal and impinging hips during activities such as walking and sitting down.

Quantitative CT scans were obtained of a healthy Control and a participant with a symptomatic femoral cam deformity (‘Bump’). 3D models of the hip were created from automatic segmentation of CT scans. Cartilage layers were added so the articular surface was the mid-line of the joint. Finite element meshes were generated in each region. Bone elastic modulus was assigned element-by-element, calculated from CT intensity converted to bone mineral density using a calibration phantom. Cartilage was modelled as poroelastic, E=0.467 MPa, v=0.167, and permeability 3×10-16 m4/N s. The pelvis was fixed while rotations and contact forces from Bergmann et al. (2001) were applied to the femur over one load cycle for walking and sitting in a chair. All analyses were performed in FEBio.

High shear stresses were seen near the acetabular cartilage-labrum junction in the Bump model, up to 0.12 MPa for walking and were much higher than in the Control.

Patient-specific modelling can be used to assess contact and tissue stresses during different activities to better understand the risk of degeneration in individuals, especially for activities that involve high hip flexion. The high stresses at the cartilage labrum interface could explain so-called bucket-handle tears of the labrum.
DOES KINEMATICALLY ALIGNED TOTAL KNEE ARTHROPLASTY RESTORE NATIVE JOINT LAXITY BETTER THAN MECHANICAL ALIGNMENT? A CADAVERIC STUDY
Authors: Taylan O. , Shah D. , Dandois F. , Han W. , Neyens T. , Van Overschelde P. , Scheys L.
Published: July 2023

Mechanical alignment (MA) in total knee arthroplasty (TKA), although considered the gold standard, reportedly has up to 25% of patients expressing post-operative dissatisfaction. Biomechanical outcomes following kinematic alignment (KA) in TKA, developed to restore native joint alignment, remain unclear. Without a clear consensus for the optimal alignment strategy during TKA, the purpose of this study was to conduct a paired biomechanical comparison of MA and KA in TKA by experimentally quantifying joint laxity and medial collateral ligament (MCL) strain.

14 bilateral native fresh-frozen cadaveric lower limbs underwent medially-stabilised TKA (GMK Sphere, Medacta, Switzerland) using computed CT-based subject-specific guides, with KA and MA performed on left and right legs, respectively. Each specimen was subjected to sensor-controlled mediolateral laxity tests. A handheld force sensor (Mark-10, USA) was used to generate an abduction-adduction moment of 10Nm at the knee at fixed flexion angles (0°, 30°, 60°, 90°). A digital image correlation system was used to compute the strain on the superficial medial collateral ligament. A six-camera optical motion capture system (Vicon MX+, UK) was used to acquire kinematics using a pre-defined CT-based anatomical coordinate system. A linear mixed model and Tukey's posthoc test were performed to compare native, KA and MA conditions (p<0.05).

Unlike MA, medial joint laxity in KA was similar to the native condition; however, no significant difference was found at any flexion angle (p>0.08). Likewise, KA was comparable with the native condition for lateral joint laxity, except at 30°, and no statistical difference was observed. Although joint laxity in MA seemed lower than the native condition, this difference was significant only for 30° flexion (p=0.01). Both KA and MA exhibited smaller MCL strain at 0° and 30°; however, all conditions were similar at 60° and 90°.

Medial and lateral joint laxity seemed to have been restored better following KA than MA; however, KA did not outperform MA in MCL strain, especially after mid-flexion. Although this study provides only preliminary indications regarding the optimal alignment strategy to restore native kinematics following TKA, further research in postoperative joint biomechanics for load bearing conditions is warranted.
THE DEVELOPMENT OF HYALURONIC ACID/COLLAGEN-BASED HYDROGEL TOWARDS THE NUCLEUS PULPOSUS NICHE IN FACILITATING STEM CELL TRANSPLANTATION TO MODULATE PAIN
Authors: Isa I.L.M. , Fauzi M.B. , Yusoff N.H.M. , Sapri S.R. , Sahruddin N.N. , Damanhuri M.H. , Mokhtar S.A.
Published: July 2023

The extracellular matrix (ECM)-based biomaterials provide a platform to mimic the disc microenvironment in facilitating stem cell transplantation for tissue regeneration. However, little is known about in vitro preconditioning human umbilical cord Wharton Jelly-derived mesenchymal stem cells (MSCs) on 3D hyaluronic acid (HA)/type II collagen (COLII) hydrogel for nucleus pulposus (NP) phenotype and pain modulation.

We developed a tuneable 3D HA/COLII by fabricating HA/COLII hydrogel at 2 mg/ml COLII and various weight ratios of HA:COLII, 1:9 and 4.5:9. The hydrogel was characterized for degradability, stability, and swelling capacity. The viability of hWJ-MSC encapsulated on hydrogel supplemented with TGF-β3 was assessed. The implantation of HA/COLII hydrogel was done in surgically induced disc injury model of pain in the rat tail. The general health status in rats was monitored. The nociceptive behaviour in rats was performed for mechanical allodynia using von Frey test.

The HA/COLII 4.5:9 hydrogel showed higher swelling capacity than weight ratio 1:9, suggesting that a higher amount of HA can absorb a large amount of water. Both HA/COLII 4.5:9 and 1:9 hydrogel formulations had a similar degradation profile, stable to the hydrolytic process. The hWJ-MSC-encapsulated on hydrogel marked higher cell viability with round morphology shape of cells in vitro. The surgically induced disc injury in the rat tail evoked mechanical allodynia, without affecting general health status in rats. The implantation of HA/COLII 1:9 hydrogel was observed to slightly alleviate injury-induced mechanical allodynia.

Fine-tuning HA/COLII-based hydrogel provides the optimal swelling capacity, stability, degradability, and non-cytotoxic, mimicking the 3D NP niche in guiding hWJ-MSCs towards NP phenotype. The HA/COLII hydrogel could be employed as an advanced cell delivery system in facilitating stem cell transplantation for intervertebral disc regeneration targeting pain.
EFFECTIVENESS OF MANAGING ISOLATED AVULSION FRACTURES OF PERONEUS LONGUS TENDON CONSERVATIVELY
Authors: Nand R. , Sunderamoorthy D.
Published: July 2023

An isolated avulsion fracture of the peroneus longus tendon is seldom seen and potentially can go undiagnosed using basic imaging methods during an initial emergency visit. If not managed appropriately it can lead to chronic pain, a reduced range of motions and eventually affect mobility. This article brings to light the effectiveness of managing such injuries conservatively.

A 55 year old postman presented to clinic with pain over the instep of his right foot for 2 months with no history of trauma. Clinically the pain was confined to the right first metatarsophalangeal joint with occasional radiation to the calf. X-ray films did not detect any obvious bony injury. MR imaging revealed an ununited avulsion fracture of the base of the 1st metatarsal. The patient was subsequently injected with a mix of steroid and local anesthetic injections at the painful nonunion site under fluoroscopic guidance.

Post procedure there was no neurovascular deficit. The patient was reviewed at three months and his pain score and functional outcome improved significantly. Moreover following our intervention, the Manchester Oxford Foot Questionnaire reduced from 33 to 0. At the one year follow up he remained asymptomatic and was discharged.

The peroneus longus tendon plays a role in eversion and planter flexion of foot along with providing stabilization to arches of foot. The pattern of injury to this tendon is based on two factors one is the mechanism of insult, if injured, and second is the variation in the insertion pattern of peroneus longus tendon itself.

There is no gold standard treatments by which these injuries can be managed. If conservative management fails we must also consider surgery which involves percutaneous fixation, or excision of the non-healed fracture fragment and arthrodesis

To conclude isolated avulsion fractures of peroneus longus tendon are rare injuries and it is important to raise awareness of this injury and the diagnostic and management challenges faced. In this case conservative management was a success in treating this injury however it is important to take factors such as patient selection, patient autonomy and clinical judgement into account before making the final decision.
IS MESENCHYMAL STROMAL CELL-BASED CELLULAR THERAPY BENEFICIAL IN THE MANAGEMENT OF ROTATOR CUFF TEARS? A META-ANALYSIS OF COMPARATIVE CLINICAL STUDIES
Authors: Muthu S.
Published: July 2023

To analyse the efficacy and safety of cellular therapy utilizing Mesenchymal Stromal Cells (MSCs) in the management of rotator cuff(RC) tears from clinical studies available in the literature.

We conducted independent and duplicate electronic database searches including PubMed, Embase, Web of Science, and Cochrane Library on August 2021 for studies analyzing the efficacy and safety of cellular therapy (CT) utilizing MSCs in the management of RC tears. VAS for pain, ASES Score, DASH Score, Constant Score, radiological assessment of healing and complications and adverse events were the outcomes analyzed. Analysis was performed in R-platform using OpenMeta [Analyst] software.

RESULTS:

6 studies involving 238 patients were included for analysis. We noted a significant reduction in VAS score for pain at 3 months (WMD=-2.234,p<0.001) and 6 months (WMD=-3.078,p<0.001) with the use of CT. Concerning functional outcomes, utilization of CT produced a significant short-term improvement in the ASES score (WMD=17.090,p<0.001) and significant benefit in functional scores such as Constant score (WMD=0.833,p=0.760) at long-term. Moreover, we also observed a significantly improved radiological tendon healing during the long-term follow-up (OR=3.252,p=0.059). We also noted a significant reduction in the retear rate upon utilization of CT in RC tears both at short- (OR=0.079,p=0.032) and long-term (OR=0.434,p=0.027). We did not observe any significant increase in the adverse events as compared with the control group (OR=0.876,p=0.869).

Utilization of CT in RC tear is safe and it significantly reduced pain severity, improved functional outcome, enhanced radiological tendon healing, and mitigated retear rates at short- and long-term follow-up.
SUBJECTIVE FACTORS AFFECTING THE CELLULAR YIELD OF PROGENITOR CELLS IN BONE MARROW ASPIRATION CONCENTRATE OF ILIAC CREST: A RETROSPECTIVE ANALYSIS OF 63 PATIENTS
Authors: Muthu S.
Published: July 2023

We aim to analyze the role of patient-related factors on the yield of progenitor cells in the bone marrow aspiration concentrate (BMAC).

We performed a retrospective analysis of patients who underwent autologous iliac crest-based BMAC therapy between Jan 2021–and June 2021. Patient-related factors such as age, sex, and comorbidities and procedure variables such as aspirate volume were analyzed. The yield of the bone marrow aspiration concentrate was assessed with MNC count and CFU assay from the aspirates.

63 patients with a mean age of 51.33±17.98 years were included in the study. There were 31 males and 32 females in the study population with a mean volume of 67.16±17.312 ml being aspirated from the iliac crest for the preparation of BMAC. The final aspirate had a mean MNC count of 20.16±15.73×10^6 cells which yielded a mean of 11±12 CFUs. We noted significant negative correlation between age and MNC count (r=minus;0.671, p<0.001) and CFUs (r=minus;0.688, p<0.001). We did not find the sex to have any significant role in MNC (p=0.082) count or CFUs formed (p=0.348). The presence of comorbidity significantly reduced the MNC count (p=0.003) and CFUs formed (p=0.005). The aspiration volume significantly negatively correlated with MNC count (r=minus;0.731, p<0.001) and CFUs (r=minus;0.618, p<0.001).

The MNC count and CFUs formed from the BMAC depend on the patient-specific subjective variables such as age, and comorbid conditions present in them. Sex and volume of aspiration do not alter the MNC count or the CFUs formed from BMAC.
BIODEGRADABLE MAGNESIUM COMBINED WITH DISTRACTION OSTEOGENESIS SYNERGISTICALLY STIMULATES BONE TISSUE REGENERATION
Authors: Li Y. , Xu J. , Li G. , Qin L.
Published: July 2023

Critical size bone defects are frequently caused by accidental trauma, oncologic surgery, and infection. Distraction osteogenesis (DO) is a useful technique to promote the repair of critical size bone defects. However, DO is usually a lengthy treatment, therefore accompanied with increased risks of complications such as infections and delayed union.

Herein, we developed an innovative intramedullary biodegradable magnesium (Mg) nail to accelerate bone regeneration in critical size bone defect repair during DO.

We observed that Mg nail induced almost 4-fold increase of new bone formation and over 5-fold of new vessel formation at 2 weeks after distraction. Mg nail upregulated the expression of calcitonin gene-related peptide (CGRP) in the new bone as compared with the DO alone group. We further revealed that blockade of the sensory nerve by overdose capsaicin blunted Mg nail enhanced critical size bone defect repair during the DO process. Moreover, inhibitors/antagonist of CGRP receptor, FAK, and VEGF receptor blocked the Mg nail stimulated vessel and bone formation.

In summary, we revealed, for the first time, a CGRP-FAK-VEGF signaling axis linking sensory nerve and endothelial cells, which may be the main mechanism underlying Mg-enhanced critical size bone defect repair when combined with DO, suggesting a great potential of Mg implants in reducing DO treatment time for clinical applications.
THE IMPACT OF HARM REVIEW SERVICE ON PATIENTS AWAITING ELECTIVE ORTHOPAEDIC FOOT AND ANKLE SURGERY FOR MORE THAN 52 WEEKS
Authors: Virani S. , Asaad O. , Divekar O. , Southgate C. , Dhinsa B.
Published: July 2023

There has been a significant increase in waiting times for elective surgical procedures in orthopaedic surgery as a result of the coronavirus disease 2019 (COVID-19) pandemic. As per the hospital policy, patients awaiting elective surgery for more than 52 weeks were offered a consultant-led harm review.

The aim of this study was to objectively assess the impact of this service on the field of foot and ankle surgery.

The data from harm review clinics at a District General Hospital related to patients waiting to undergo elective foot and ankle procedures in the year 2021 (wait time of more than 52 weeks) were assessed. Clinical data points like change in diagnosis, need for further investigations, and patients being taken off the waiting list were reviewed. The effect of the waiting time on patients’ mental health and their perception of the service was assessed as well.

A total of 72 patients awaiting foot and ankle procedures for more than 52 weeks were assessed as a part of the harm review service. It was noted that 25% of patients found that their symptoms had worsened while 66.1% perceived them to be unchanged. Twelve patients (16.9%) were sent for updated investigations. Twenty-one patients (29.5%) were taken off the waiting lists for various reasons with the most common one being other pressing health concerns; 9% of patients affirmed that the wait for surgery had a significant negative impact on their mental health.

This study concludes that the harm review service is a useful programme as it helps guide changes in the diagnosis and clinical picture. The service is found to be valuable by most patients, and its impact on the service specialities and multiple centres could be further assessed to draw broad conclusions.
CUSTOM-MADE PATIENT-SPECIFIC HIGH TIBIAL OSTEOTOMY IMPLANTS AND SURGICAL GUIDES SIGNIFICANTLY IMPROVE CLINICAL OUTCOMES: FIRST-IN-MAN CASE SERIES
Authors: MacLeod A. , Dal Fabbro G. , Grassi A. , Belvedere C. , Nervuti G. , Casonato A. , Leardini A. , Gil H. , Zaffagnini S.
Published: July 2023

High tibial osteotomy (HTO) is a joint preserving alternative to knee replacement for medial tibiofemoral osteoarthritis in younger, more active patients. The procedure is technically challenging and limited also by ‘one size fits all’ plates which can result in patient discomfort necessitating plate removal.

This clinical trial evaluated A novel custom-made HTO system – TOKA (3D Metal Printing LTD, Bath, UK) for accuracy of osteotomy correction and improvements in clinical outcome scores.

The investigation was a single-arm single-centre prospective clinical trial (IRCCS Istituto Ortopedico Rizzoli; ClinicalTrials.gov NCT04574570), with recruitment of 25 patients (19M/6F; average age: 54.4 years; average BMI: 26.8), all of whom received the TOKA HTO 3D planning and surgery. All patients were predominantly diagnosed with isolated medial knee osteoarthritis and with a varus deformity under 20°. Patients were CT scanned pre- and post-operatively for 3D virtual planning and correctional assessment. All surgeries were performed by the lead clinical investigator – a consultant knee surgeon with a specialist interest in and clinical experience of HTO.

On average, Knee Society Scores (KSS) improved significantly (p<0.001) by 27.6, 31.2 and 37.2 percentage points respectively by 3-, 6- and 12-months post-surgery respectively. Other measures assessed during the study (KOOS, EQ5D) produced similar increases.

Our early experience using custom implants is extremely promising. We believe the reduced profile of the plate, as well as the reduced invasiveness and ease of surgery contributed to faster patient recovery, and improved outcome scores compared to conventional techniques. These clinical outcome results compare very favourably other case-series with published KOOS scores using different devices.
PATIENT SATISFACTION WITH VIDEO AND TELEPHONE CONSULTATIONS: A CONTEMPORANEOUS COMPARISON WITH FACE-TO-FACE CONSULTATIONS DURING THE COVID-19 PANDEMIC
Authors: Cochrane I. , Hussain A. , Kang N. , Chaudhury S.
Published: July 2023

During the COVID-19 pandemic, video/phone consultations (VPC) were increasingly utilised as an alternative to face-to-face (F2F) consultations, to minimise nosocomial viral exposure. We previously demonstrated that VPCs were highly rated by both patients and clinicians. This study compared satisfaction between both clinic modalities in contemporaneously delivered outpatient surveys. We also assessed the feasibility and effects of converting F2F orthopaedic consultations to VPC.

Surveys were posted to patients who attended VPCs and F2F consultations at a large tertiary centre from August to October 2020 inclusive, across 51 specialties. F2F and VPC patients ranked their overall satisfaction with their consultation on a 10-point numerical scale (10=highest satisfaction). Simultaneously, a pilot study was undertaken of outpatient fracture clinics to identify patients suitable for VPCs, with X-rays (if needed) taken and transferred from satellite sites to reduce tertiary centre footfall.

For F2F consultations, 1419 of 4465 surveys (31.8%) were returned with similar rates for VPCs (1332 of 4572, 29.1%). While mean satisfaction ratings were high for both clinic modalities, they were significantly higher for F2F: 9.13 (95% CI 9.05-9.22) for F2F clinics, compared to 8.23 (95% CI 8.11-8.35) for VPCs (p<0.001, t-test). F2F patients were almost four times more likely to state a preference for future F2F appointments compared to VPCs, whereas patients who attended VPCs showed an equal preference for either option (p< 0.001, chi2 test). 53% of 111 fracture clinic patients sampled were identified as suitable for VPCs. 1 patient (1.7%) requested their VPC to be converted to F2F due to poor symptom control.

Our study showed patients reported high satisfaction ratings for both F2F clinics and VPCs, with prior experience of VPCs affecting patients’ future preferences. Only 1.7% of F2F patients converted to VPCs declined their virtual appointment. Our results support future use of VPCs.
INTERLEUKIN-1B (IL-1B)-INHIBITED MENISCUS DEPOSITION IS COUNTERED BY CULTURE UNDER PHYSIOXIA TO A GREATER EXTENT COMPARED WITH CELECOXIB-TREATED MENISCUS CELLS
Authors: Rambacher K. , Gennrich J. , Schewior R. , Lang S. , Pattappa G. , Zihlmann C. , Stiefel N. , Zellner J. , Docheva D. , Angele P.
Published: July 2023

Meniscus tears have been treated using partial meniscectomy to relieve pain in patients, although this leads to the onset of early osteoarthritis (OA). Cell-based therapies can help preserve the meniscus, although the presence of inflammatory cytokines compromises clinical outcomes. Anti-inflammatory drugs (e.g. celecoxib), can help to reduce pain in patients and in vitro studies suggest a beneficial effect on cytokine inhibited matrix content. Previously, we have demonstrated that the inhibitory effects of IL-1β can be countered by culture under low oxygen tension or physioxia. The present study sought to understand whether physioxia, celecoxib or combined application can counter the inhibitory effects IL-1β inhibited meniscus cells.

Human avascular and vascular meniscus cells (n =3) were isolated and expanded under 20% (hyperoxia) or 2% (physioxia) oxygen. Cells were seeded into collagen scaffolds (Geistlich, Wolhusen) and cultured for 28 days either in the presence of 0.1ng/mL IL-1β, 5µg/mL celecoxib or both under their expansion oxygen conditions. Histological (DMMB, collagen I and collagen II immunostaining), GAG content and gene expression analysis was evaluated for the scaffolds.

Under hyperoxia, meniscus cells showed a significant reduction in GAG content in the presence of IL-1β (*p < 0.05). Celecoxib alone did not significantly increase GAG content in IL-1β treated cultures. In contrast, physioxic culture showed a donor dependent increase in GAG content in control, IL-1β and celecoxib treated cultures with corresponding histological staining correlating with these results. Additionally, gene expression showed an upregulation in COL1A1, COL2A1 and ACAN and a downregulation in MMP13 and ADAMTS5 under physioxia for all experimental groups.

Physioxia alone had a stronger effect in countering the inhibitory effects of IL-1β treated meniscus cells than celecoxib under hyperoxia. Preconditioning meniscus cells under physioxia prior to implantation has the potential to improve clinical outcomes for cell-based therapies of the meniscus.
THE RELATIONSHIP OF CERVICAL SPINE FACET TROPISM AND CERVICAL SAGITTAL ALIGNMENT
Authors: Aljuaid M. , Alzahrani S. , Alzahrani A. , Filimban S. , Alghamdi N. , Alswat M.
Published: July 2023

Cervical spine facet tropism (CFT) defined as the facets’ joints angles difference between right and left sides of more than 7 degrees. This study aims to investigate the relationship between cervical sagittal alignment parameters and cervical spine facets’ tropism.

A retrospective cross-sectional study carried out in a tertiary center where cervical spine magnetic resonance imaging (MRI) radiographs of patients in orthopedics/spine clincs were included. They had no history of spine fractures. Images’ reports were reviewed to exclude those with tumors in the c-spine.

A total of 96 patients was included with 63% of them were females. The mean of age was 45.53± 12.82. C2-C7 cobb's angle (CA) and C2-C7 sagittal vertical axis (SVA) means were −2.85±10.68 and 1.51± 0.79, respectively. Facet tropism was found in 98% of the sample in at least one level on either axial or sagittal plane. Axial C 2–3 CFT and sagittal C4-5 were correlated with CA (r=0.246, P 0.043, r= −278, P 0.022), respectively. In addition, C2-C7 sagittal vertical axis (SVA) was moderately correlated with axial c2-3 FT (r= −0.330, P 0.006) Also, several significant correlations were detected in our model Cervical vertebral slopes and CFT at the related level. Nonetheless, high BMI was associated with multi-level and multiplane CFT with higher odd's ratios at the lower levels.

This study shows that CFT at higher levels is correlated with increasing CA and decreasing SVA and at lower levels with decreasing CA. Obesity is a risk factor for CFT.
NOTTINGHAM HIP FRACTURE SCORE: IS IT A USEFUL PREDICTOR OF 30-DAY MORTALITY AFTER HIP FRACTURE SURGERY?
Authors: Gupta P. , Butt S. , Dasari K. , Galhoum A. , Nandhara G.
Published: July 2023

The Nottingham Hip Fracture Score (NHFS) was developed in 2007 as a predictor of 30-day mortality after hip fracture surgery following a neck of femur fracture. The National Hip Fracture Database is the standard used which calculated their own score using national data.

The NHF score for 30-day mortality was calculated for 50 patients presenting with a fractured neck femur injury between January 2020 to March 2020. A score <5 was classified as low risk and >/=5 as high risk. Aim was to assess the accuracy in calculating the Nottingham Hip Fracture Score against the National Hip Fracture Database. To explore whether it should it be routinely included during initial assessment to aid clinical management?

There was an increase in the number of mortalities observed in patients who belonged to the high-risk group (>=5) compared to the low risk group. COVID-19 positive patients had worse outcomes with average 30-day mortality of 6.78 compared to the average of 6.06. GEH NHF score per month showed significant accuracy against the NHFD scores.

The identification of high-risk groups from their NHF score can allow for targeted optimisations and elucidation of risk factors easily gathered at the point of hospitalisation. The NHFS is a valuable tool and useful predictor to stratify the risk of 30-day mortality and 1-year mortality after hip fracture surgery. Inclusion of the score should be considered as mandatory Trust policy for neck of femur fracture patients to aid clinical management and improve patient safety overall.
Kitchens of Dejima: Japanese Cookery and Dutch Sovereignty in Nineteenth-Century Miniatures
Authors: Schlachet Joshua
Published: July 2023

Abstract: Through an object-oriented history of Japanese foodways on the move, this article explores how a miniature kitchen diorama collected by Jan Cock Blomhoff in Nagasaki in the 1820s situated Japan within the Netherlands’ narrative of post-Napoleonic national sovereignty. Blomhoff’s kitchen blended a display of Japanese culinary craftsmanship—its tools, vessels, and utensils procured from Japanese artisans—with classical Dutch dollhouse design that evoked Golden Age domestic prosperity, a microcosm of a properly functioning state. Everyday life objects like Blomhoff’s kitchen became powerful symbols for continuity throughout the Netherlands’ era of national dissolution. Despite limited mobility outside Japan during the early modern period, representation of cooking and domestic life through miniaturized kitchen accouterments produced an insistent presence of Japanese foodways in the European imagination.
Cooled infrared coaxial four-mirror system design with a low F-number
Authors: Zhang Shuqing , Liu Guangsen , Wang Zhile , Xie Jiayi , Ji Lingyun , He Xiaobo , Tang Shanjun
Published: July 2023

A low F-number and 100% cold stop efficiency are beneficial for
improving the performance of optical systems and have a wide range of
applications in various thermal imaging scenarios. The cooled infrared
coaxial four-mirror system can meet these two requirements, improve
system integration, and reduce adjustment costs and difficulties.
However, the secondary obstruction caused by the central hole of the
third mirror will generate potential stray light. A structure model is
proposed in which the primary mirror and the quaternary mirror are
processed on the same mirror blank. In this model, a method is given
to calculate system parameters using the obstruction ratio and
magnification of each mirror. To evaluate the performance of the
method, two design examples with different F-numbers (1.4, 1.0) were
constructed. The influence of initial structural constraints on the
exit pupil position and secondary obstruction was analyzed based on
the design objectives of the examples. The aberrations were optimized
by targeting the spot. In the optimization process, the incident
coordinates and directions of the restricted edge field rays in the
tertiary mirror and the quaternary mirror were limited to achieve
control of the obstruction caused by the holes in the center of the
mirrors. In the results, the RMS spot radius of the two design
examples is smaller than the Airy disk radius, and the axial beam
wavefront deviation RMS values are 0.026λ and 0.024λ, respectively. Moreover, the
obstruction caused by the central holes of the mirrors is controlled
within the given field of view. The results show that the proposed
model and method can be used to design a low F-number cooled infrared
coaxial four-mirror system and have good application prospects.
Influence of spherical aberration on the tightly focusing characteristics of vector vortex beams
Authors: Wang YuQin , Yong KangLe , Chen Dan , Zhang RongZhu
Published: July 2023

For a tightly focusing imaging system, the aberration of the lens will result in a distorted focusing spot and undermine the system performance. In this paper, the expression of the tightly focused light field of Laguerre-Gaussian vector vortex beam (LGVVB) is deduced. Then the intensity distribution, focal shift and spot size that influenced by spherical aberration are calculated in detail. Since the vector vortex beams have multiple degrees of freedom to control the form of the intensity distribution on the focal plane, the effects of aberration on the focal spot are analyzed when some key parameters are changed. The results show the Pancharatnam topological charge is the most influential parameter to change the light distribution on the focal plane. According to the change rule, a scheme is proposed to minimize the effect of aberration by jointly adjusting the parameters of the LGVVB.
Photonics for Harsh Environments: introduction to the special issue
Authors: Bermel Peter , Wu Yiquan , Girard Sylvain , Hu Juejun
Published: July 2023

This is an introduction to the feature issue of Optical Materials Express on the topic of Photonics for Harsh Environments.
Light scattering features induced by residual layers in dielectric dewetted nanoparticles
Authors: Granchi Nicoletta , Fagiani Luca , Barri Chiara , Fedorov Alexey , Abbarchi Marco , Vincenti Maria Antonietta , Intonti Franesca , Bollani Monica
Published: July 2023

All-dielectric, sub-micrometric particles obtained through solid state dewetting of thin SiGe-films have been shown to support Mie resonances together with a high-quality monocrystalline composition and atomically smooth facets. Recently, a precise study on the impact given by the effective complex morphology of a SiGe dewetted nanoparticle to the Mie scattering properties has been provided and carried on through a novel experimental technique called Dark-field Scanning Optical Microscopy. In this work, by means of the same experimental technique and numerical simulations of light scattering, we show how the presence of a pedestal enriched with silicon placed under the SiGe-nanoparticle results in a sharp peak at high energy in the total scattering cross-section. Exploiting a tilted illumination to redirect scattered light, we are able to discriminate the spatial localization of the pedestal-induced resonance. Our results contribute to extending the practical implementations of dewetted Mie resonators in the field of light scattering directionality, sensing applications and show further engineering options beyond the simple isolated-island case.
TCAD-assisted progress on the CISCO platform towards low-bias 200 Gbit/s vertical-pin Ge-on-Si waveguide photodetectors
Authors: Alasio Matteo , Vallone Marco , Tibaldi Alberto , Namnabat Soha , Adams Donald , Gothoskar Prakash , Forghieri Fabrizio , Masini Gianlorenzo , Bertazzi Francesco , Ghione Giovanni , Gioannini Mariangela , Goano Michele
Published: July 2023

We discuss the characterization and numerical simulation of vertical Ge-on-Si waveguide photodetectors (VPIN WPDs) of the Cisco platform for data communications in the O-band (1.31 μm), with the goal of optimizing their frequency response while integrating them into low-power systems.
In a large set of WPDs belonging to 6 different structural variants, at a standard bias voltage of -2 V the best specimens exhibit an intrinsic electro-optic bandwidth of more than 40 GHz, which is reduced to about 10 GHz at zero bias.
A comprehensive 3D multiphysics model, validated through the characterization campaign, provides design guidelines towards intrinsic bandwidths not only wider than 60 GHz at -2 V, directly suitable for application in 200 Gbit/s systems, but also wider than 40 GHz at zero bias, not including the possible recourse to extrinsic parameter engineering.
Non-line-of-sight reconstruction via structure sparsity regularization
Authors: Huang Duolan , Chen Quan , Wei Zhun , CHEN RUI
Published: July 2023

Non-line-of-sight (NLOS) imaging allows for the imaging of obje¬¬cts around a corner, which enables potential applications in various fields such as autonomous driving, robotic vision, medical imaging, security monitoring, etc. However, the quality of reconstruction is challenged by low signal-noise-ratio (SNR) measurements. In this study, we present a regularization method, referred to as structure sparsity (SS) regularization, for denoising in NLOS reconstruction. By exploiting the prior knowledge of structure sparseness, we incorporate nuclear norm penalization into the cost function of directional light-cone transform (DLCT) model for NLOS imaging system. This incorporation effectively integrates the neighborhood information associated with the directional albedo, thereby facilitating the denoising process. Subsequently, the reconstruction is achieved by optimizing a directional albedo model with SS regularization using fast iterative shrinkage-thresholding algorithm. Notably, the robust reconstruction of occluded objects is observed. Through comprehensive evaluations conducted on both synthetic and experimental datasets, we demonstrate that the proposed approach yields high-quality reconstructions, surpassing the state-of-the-art reconstruction algorithms, especially in scenarios involving short exposure and low SNR measurements.
The Ground State Decoherence Effect on an
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.
Impact of malaria diagnostic choice on monitoring of Plasmodium falciparum prevalence estimates in the Democratic Republic of the Congo and relevance to control programs in high-burden countries
Authors: Diallo Alpha Oumar , Banek Kristin , Kashamuka Melchior Mwandagalirwa , Bala Joseph Alexandre Mavungu , Nkalani Marthe , Kihuma Georges , Nseka Tommy Mambulu , Atibu Joseph Losoma , Mahilu Georges Emo , McCormick Lauren , White Samuel J. , Sendor Rachel , Sinai Cyrus , Keeler Corinna , Herman Camelia , Emch Michael , Sompwe Eric , Thwai Kyaw Lay , Dinglasan Rhoel R. , Rogier Eric , Juliano Jonathan J. , Tshefu Antoinette Kitoto , Parr Jonathan B.
Published: July 2023

Malaria programs rely upon a variety of diagnostic assays, including rapid diagnostic tests (RDTs), microscopy, polymerase chain reaction (PCR), and bead-based immunoassays (BBA), to monitor malaria prevalence and support control and elimination efforts. Data comparing these assays are limited, especially from high-burden countries like the Democratic Republic of the Congo (DRC). Using cross-sectional and routine data, we compared diagnostic performance and Plasmodium falciparum prevalence estimates across health areas of varying transmission intensity to illustrate the relevance of assay performance to malaria control programs. Data and samples were collected between March–June 2018 during a cross-sectional household survey across three health areas with low, moderate, and high transmission intensities within Kinshasa Province, DRC. Samples from 1,431 participants were evaluated using RDT, microscopy, PCR, and BBA. P. falciparum parasite prevalence varied between diagnostic methods across all health areas, with the highest prevalence estimates observed in Bu (57.4–72.4% across assays), followed by Kimpoko (32.6–53.2%), and Voix du Peuple (3.1–8.4%). Using latent class analysis to compare these diagnostic methods against an “alloyed gold standard,” the most sensitive diagnostic method was BBA in Bu (high prevalence) and Voix du Peuple (low prevalence), while PCR diagnosis was most sensitive in Kimpoko (moderate prevalence). RDTs were consistently the most specific diagnostic method in all health areas. Among 9.0 million people residing in Kinshasa Province in 2018, the estimated P. falciparum prevalence by microscopy, PCR, and BBA were nearly double that of RDT. Comparison of malaria RDT, microscopy, PCR, and BBA results confirmed differences in sensitivity and specificity that varied by endemicity, with PCR and BBA performing best for detecting any P. falciparum infection. Prevalence estimates varied widely depending on assay type for parasite detection. Inherent differences in assay performance should be carefully considered when using community survey and surveillance data to guide policy decisions.
Perspectives of people living with HIV on barriers to timely ART initiation following referral for antiretroviral therapy: A qualitative study at an urban HIV clinic in Kampala, Uganda
Authors: Kiyingi Micheal , Nankabirwa Joaniter I. , Wiltshire Christine Sekaggya , Nangendo Joan , Kiweewa John M. , Katahoire Anne R. , Semitala Fred C.
Published: July 2023

Early initiation of antiretroviral therapy (ART) after HIV diagnosis prevents HIV transmission, progression of HIV to AIDS and improves quality of life. However, little is known about the barriers to timely ART initiation among patients who test HIV positive in settings different from where they will receive HIV treatment, hence are referred in the routine setting. Therefore, we explored the perspectives of people living with HIV on barriers faced to initiate ART following HIV testing and referral for treatment. In this qualitative study, we purposively sampled and enrolled 17 patients attending the Mulago ISS clinic. We selected patients (≥18 years) who previously were received as referrals for HIV treatment and had delayed ART initiation, as ascertained from their records. We conducted in-depth interviews, which were audio recorded, transcribed and translated. We used Atlas.ti version 9 software for data management. Data analysis followed thematic and framework analysis techniques and we adopted the socio-ecological model to categorize final themes. Key themes were found at organizational level including; negative experiences at the place of HIV diagnosis attributed to inadequate counselling and support, unclear communication of HIV-positive results and ambiguous referral procedures; and, long waiting time when patients reached the HIV clinic. At individual level, the themes identified were; immediate denial with late acceptance of HIV-positive results attributed to severe emotional and psychological distress at receiving results, fear of perceived side effects and long duration on ART. At interpersonal level, we found that anticipated and enacted stigma after HIV diagnosis resulted in non-disclosure, discrimination and lack of social support. We found that challenges at entry (during HIV test) and navigation of the HIV care system in addition to individual and interpersonal factors contributed to delayed ART initiation. Interventions during HIV testing would facilitate early ART initiation among patients referred for HIV care.
Integrated bioinformatics and statistical approach to identify the common molecular mechanisms of obesity that are linked to the development of two psychiatric disorders: Schizophrenia and major depressive disorder
Authors: Islam Md Khairul , Islam Md Rakibul , Rahman Md Habibur , Islam Md Zahidul , Hasan Md Mehedi , Mamun Md Mainul Islam , Moni Mohammad Ali
Published: July 2023

Obesity is a chronic multifactorial disease characterized by the accumulation of body fat and serves as a gateway to a number of metabolic-related diseases. Epidemiologic data indicate that Obesity is acting as a risk factor for neuro-psychiatric disorders such as schizophrenia, major depression disorder and vice versa. However, how obesity may biologically interact with neurodevelopmental or neurological psychiatric conditions influenced by hereditary, environmental, and other factors is entirely unknown. To address this issue, we have developed a pipeline that integrates bioinformatics and statistical approaches such as transcriptomic analysis to identify differentially expressed genes (DEGs) and molecular mechanisms in patients with psychiatric disorders that are also common in obese patients. Biomarker genes expressed in schizophrenia, major depression, and obesity have been used to demonstrate such relationships depending on the previous research studies. The highly expressed genes identify commonly altered signalling pathways, gene ontology pathways, and gene-disease associations across disorders. The proposed method identified 163 significant genes and 134 significant pathways shared between obesity and schizophrenia. Similarly, there are 247 significant genes and 65 significant pathways that are shared by obesity and major depressive disorder. These genes and pathways increase the likelihood that psychiatric disorders and obesity are pathogenic. Thus, this study may help in the development of a restorative approach that will ameliorate the bidirectional relation between obesity and psychiatric disorder. Finally, we also validated our findings using genome-wide association study (GWAS) and whole-genome sequence (WGS) data from SCZ, MDD, and OBE. We confirmed the likely involvement of four significant genes both in transcriptomic and GWAS/WGS data. Moreover, we have performed co-expression cluster analysis of the transcriptomic data and compared it with the results of transcriptomic differential expression analysis and GWAS/WGS.