bluuebunny/crossref_metadata_2025 huggingface dataset:
Lambrinudi Triple Arthrodesis with Posterior Tibial Tendon Transfer in Adult Fixed Equinus Deformity: Case Report
Authors:   Department of Orthopaedics, Apollo Hospitals, Navi Mumbai, Maharashtra, India., Agrawal Prashant , Mehta Yash ,   Department of Orthopaedics, Apollo Hospitals, Navi Mumbai, Maharashtra, India., Vishwakarma Ranjeet ,   Department of Orthopaedics, Apollo Hospitals, Navi Mumbai, Maharashtra, India., Bedwal Dharm ,   Department of Orthopaedics, Apollo Hospitals, Navi Mumbai, Maharashtra, India., Pande Sameer ,   Department of Orthopaedics, Apollo Hospitals, Navi Mumbai, Maharashtra, India.
Published: June 2024

Introduction: Fixed Equinus deformity is characterized by limited dorsiflexion of ankle joint and restricted passive movement, along with medial and lateral tibiotalar instability, progressive hindfoot varus, and a supination deformity of the forefoot. Degree of equinus deformity is determined by the Tibio-Metatarsal (TM) angle, subtended between the longitudinal axes of Tibia and 1st Metatarsal, in lateral view of foot. Lambrinudi triple arthrodesis involves the surgical fusion of the talonavicular, talocalcaneal, and calcaneocuboid joints to correct fixed foot deformities, to relieve pain from joint, to provide stability to the imbalanced foot, and to create a plantigrade foot. We combined a Lambrinudi type arthrodesis with a transfer of the posterior tibial tendon (PTT) in adult patients to provide dynamic dorsiflexion and pronation. Case Report: The case was of 39-year-old male diagnosed as fixed cavoequinus deformity of right foot and ankle, who was operated with Lambrinudi triple arthrodesis with PTT transfer in January 2019 and followed up to 5 years. Outcome measurements included radiographic and clinical investigations, including the TM Angle, American Orthopaedic Foot and Ankle Society (AOFAS) Score and Ankle range of motion (ROM), which were assessed preoperatively, immediate postoperatively, at 3 months, 6 months, 1 year, and 5 years. Results: The TM angles were 177, 133, 125, and 122, at pre-operative, immediate post-operative, 3 months, 5 years, respectively. Fusion was seen at 1-year follow-up. Improvement in AOFAS Score with values 38, 57, 73, and improvement in Ankle ROM with values 0 (fixed), 10, 15° at pre-operative, 3 months, and 5 years postoperative, respectively. Patient could use ordinary footwear afterward and had no significant subjective pain or pain which affected his daily activities, but patient had post-procedural right lower limb shortening of 1 cm. Conclusion: This combined procedure demonstrated clinical correction of foot deformity and significant improvement in functional outcome in the form of AOFAS score and Ankle ROM. The ability of all patients to use normal shoes and significant reduction in pain scores represent ultimately, the improvement in quality of life. We have corrected muscle imbalance and provided dynamic force for dorsiflexion and pronation of foot in the form of tibialis posterior. Keywords: Fixed equinus deformity, lambrinudi triple arthrodesis, tibialis posterior tendon, tibio-metatarsal angle, American orthopaedic foot and ankle society score.
Primary Total Knee Replacement using Rotating Hinge Implants in Poliomyelitis: A Case Series and Review of the Literature
Authors:   Shalby Ltd., Ahmedabad, Gujarat, India,, Shah Vikram I , Patil Jayesh ,   Department of Joint Replacement and Trauma Surgery, Shalby Hospital, Ahmedabad, Gujarat, India., Shetty Gautam M ,   Shalby Ltd., Ahmedabad, Gujarat, India,, Trivedi Parth ,   Department of Joint Replacement and Trauma Surgery, Shalby Hospital, Ahmedabad, Gujarat, India.
Published: June 2024

Introduction: The results of primary total knee replacement (TKR) using hinge implants performed in the Indian population with post-polio residual paresis (PPRP) are unknown. The purpose of this study was to report the outcome of primary rotating hinge TKR in Indian patients with PPRP at a minimum follow-up of 12 months. Materials and Methods: We retrospectively reviewed the clinical and radiological records of six patients treated with primary rotating hinge TKR. Pre-and post-operative (at final follow-up) knee range of motion (ROM), knee sagittal deformity, knee society score (KSS), and Oxford knee score (OKS) were compared to determine improvement in function. Results: Six rotating hinge TKRs (five female and one male patient) were analyzed for this study. At a mean follow-up of 27 ± 22 months (range, 12–71 months), the mean pre-operative KSS of 50.6 ± 2.5 significantly improved (P < 0.0001) to 72.5 ± 1.6, and the mean pre-operative OKS of 23.6 ± 1.6 significantly improved (P < 0.0001) to 35.3 ± 1.7. The mean pre-operative knee ROM of 94° ± 10° changed to 92° ± 4° (P = 0.64) and the mean pre-operative sagittal deformity of 7° ± 23.5° changed to −3° ± 2.5° (P = 0.32) at final follow-up. None of the knees had any intra- or post-operative complications or showed radiologic evidence of post-operative loosening, subsidence, or periprosthetic radiolucent lines at the final follow-up. Conclusion:Rotating hinge TKR gave excellent clinical and radiological results at a mean follow-up of 27 months in the present study. Despite TKR being a technically challenging procedure in patients with poliomyelitis-affected limbs, a rotating hinge design, along with meticulous surgical technique, can significantly improve function in such patients. Keywords: Poliomyelitis, total knee arthroplasty, hyperextension, rotating hinge, knee, outcome.
https://jocr.co.in/wp/2024/06/10/primary-total-knee-replacement-using-rotating-hinge-implants-in-poliomyelitis-a-case-series-and-review-of-the-literature/
Authors:   Department of Orthopaedics, Melmaruvathur Adhiparasakthi Institute of Medical Sciences, Melmaruvathur, Tamil Nadu, India, Mani A , Joseph P Chacko Paul ,   Department of Orthopaedics, Melmaruvathur Adhiparasakthi Institute of Medical Sciences, Melmaruvathur, Tamil Nadu, India, Choudary Dinesh ,   Department of Orthopaedics, Faculty of Medicine – Sri Lalithambigai Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu, India,, Jeyaraman Naveen ,   Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu, India,, Ramasubramanian Swaminathan ,   Department of Orthopaedics, Government Medical College, Omandurar Government Estate, Chennai, Tamil Nadu, India., Karthik KS ,   Department of Orthopaedics, Faculty of Medicine – Sri Lalithambigai Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu, India,
Published: June 2024

Introduction: Osteoarthritis (OA) is a degenerative joint disease characterized by cartilage degradation, bone remodeling, and pain. Recent evidence suggests that Vitamin D insufficiency, alterations in parathyroid hormone (PTH) levels, and dyslipidemia may play roles in the pathophysiology of OA, affecting calcium homeostasis and bone health. We investigated the association between Vitamin D, PTH levels, lipid profile, and calcium homeostasis in OA patients. Materials and Methods: This case–control study involved 200 participants, divided into OA and control groups, at a tertiary care center from April to May 2023. Serum levels of 25-hydroxyvitamin D, PTH, total cholesterol, HDL, LDL, triglycerides, and calcium were measured. Statistical analysis was conducted to assess correlations between these biomarkers and OA status. Results: OA patients demonstrated significantly lower Vitamin D levels and higher PTH and total cholesterol levels compared to controls. Vitamin D insufficiency was prevalent, with a notable correlation between decreased Vitamin D levels, elevated PTH, and dyslipidemia. These findings suggest a potential metabolic interplay affecting OA progression and symptomatology. Conclusion: The study highlights a significant association between Vitamin D insufficiency, altered PTH levels, and lipid dysregulation in OA patients, underscoring the importance of assessing these parameters in the clinical management of OA. Further research is needed to explore the therapeutic implications of correcting Vitamin D insufficiency and lipid abnormalities in OA. Keywords: Osteoarthritis, Vitamin D, parathyroid hormone, lipid profile, calcium homeostasis, dyslipidemia.
Comparison of Conventional Incision and 10 mm Approach for Volar Locking Plates in Dorsal Displaced Distal Radius Fractures
Authors:   Department of Orthopedics, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan,, Kunishige Ren , Naito Kiyohito ,   Department of Orthopedics, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan, Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan., Obata Hiroyuki ,   Department of Orthopedics, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan,, Kawakita So ,   Department of Orthopedics, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan, Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan., Suzuki Takamaru ,   Department of Orthopedics, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan, Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan., Ishijima Muneaki ,   Department of Orthopedics, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan, Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.
Published: June 2024

Introduction: The aim of this study was to investigate whether surgery with a 10 mm approach for volar locking plate fixation provides equivalent early post-operative outcomes to conventional incision surgery for distal radius fractures. Materials and Methods: The subjects were divided into a conventional incision group (mean age: 59.1 years, 8 males and 23 females) and a 10 mm approach group (mean age: 59.9 years of age, 6 males and 20 females). The wrist range of motion; grip strength; visual analog scale (VAS); quick disabilities of the arm, shoulder, and hand (Q-DASH) score; and modified Mayo score were assessed at 3 months after surgery. In addition, radial inclination, ulnar variance, and volar tilt were evaluated on post-operative radiography. Results: There was no significant difference between the groups in the wrist range of motion, grip strength, VAS, Q-DASH score, modified Mayo wrist score, and three parameters of post-operative radiography. All patients in both groups had no complications during the perioperative period. Conclusion: We found that a 10 mm approach obtained early post-operative outcomes and alignment comparable to conventional incision surgery for patients with dorsal displaced distal radius fractures. Keywords: Distal radius fractures, volar locking plates, conventional incision, 10 mm approach, minimally invasive plate osteosynthesis.
Precise Calibration of Femoral Component Rotation Using the Posterior Condylar Axis as a Reference during Image-free Robot-assisted Total Knee Arthroplasty: A Technical Note
Authors:   Department of Orthopaedic Surgery, Medicover Hospitals, Hyderabad, Telangana, India, Parameswaran Apurve , Reddy Jakkidi N ,   Department of Orthopaedic Surgery, Medicover Hospitals, Hyderabad, Telangana, India, Ponnala Vinay K ,   Department of Orthopaedic Surgery, Medicover Hospitals, Hyderabad, Telangana, India, Apsingi Sunil ,   Department of Orthopaedic Surgery, Medicover Hospitals, Hyderabad, Telangana, India, Eachempati Krishna K ,   Department of Orthopaedic Surgery, Medicover Hospitals, Hyderabad, Telangana, India
Published: June 2024

Introduction: The use of image-free robotic systems for total knee arthroplasty (TKA) is gaining popularity. Although the surgical transepicondylar axis (sTEA) is considered the optimal femoral rotational reference during TKA, it is difficult to define intra-operatively. Conventional and image-free robot-assisted TKA (RA-TKA) therefore rely on the use of Whiteside’s axis (WSA) or the posterior condylar axis (PCA) as surrogate references. The PCA is considered to be associated with less variability than WSA. The authors present a simple technique to permit calibration of femoral component rotation (FCR) using the PCA as a reference for image-free robotic systems that do not permit this option. Technique: The image-free robotic systems used by the authors (Navio and CORI, Smith and Nephew, Memphis, TN, USA) permit calibration of FCR only when the perpendicular to WSA is used as a reference. When the PCA is selected as a reference, a fixed 3° of external rotation is set by the robot. The technique proposed by the authors involves the use of the former setting, followed by internal rotation of the perpendicular to WSA to co-align it with the PCA. The planning menu subsequently permits virtual surgical planning using the PCA as the femoral rotational reference and permits adjustments in rotational positioning of the femoral component while displaying the effect of rotation on bony resection and vice versa in real time. In addition, coaligning the perpendicular to WSA with the anatomic trans-epicondylar axis (aTEA) displays the internal rotation of the PCA with respect to the aTEA. This information can be used for setting rotational boundaries with respect to the PCA while using various alternate alignment strategies, like functional alignment, since the relation between the aTEA and sTEA is less likely to be affected by dyplasia and wear when compared with the PCA or WSA. Conclusion: This simple technique permits optimally calibrated rotational positioning of the femoral component during image-free RA-TKA, using the PCA as a reference. It can be applied for optimizing surgery in knees with altered or outlier anatomy, as well as routinely, especially when alternate alignment strategies are used. Keywords: Femoral component rotation, robot-assisted total knee arthroplasty, posterior condylar axis, trans-epicondylar axis, image-free robotics.
Deep learning-based hyperspectral microscopic imaging for cholangiocarcinoma detection and classification
Authors: Kumar Sikhakolli Sravan , Sahoo Omm Prakash , Mundada Gagan , Aala Suresh , Sudarsa Dorababu , Pandey Om Jee , Chinnadurai Sunil , Matoba Osamu , Muniraj Inbarasan , Deshpande Anuj
Published: June 2024

Cholangiocarcinoma is one of the rarest yet most aggressive cancers that has a low 5-year survival rate (2% - 24%) and thus often requires an accurate and timely diagnosis. Hyperspectral Imaging (HSI) is a recently developed, promising spectroscopic-based non-invasive bioimaging technique that records a spatial image (x, y) together with wide spectral (λ) information. In this work, for the first time we propose to use a three-dimensional (3D)U-Net architecture for Hyperspectral microscopic imaging-based cholangiocarcinoma detection and classification. In addition to this architecture, we opted for a few preprocessing steps to achieve higher classification accuracy (CA) with minimal computational cost. Our results are compared with several standard unsupervised and supervised learning approaches to prove the efficacy of the proposed network and the preprocessing steps. For instance, we compared our results with state-of-the-art architectures, such as the Important-Aware Network (IANet), the Context Pyramid Fusion Network (CPFNet), and the semantic pixel-wise segmentation network (SegNet). We showed that our proposed architecture achieves an increased CA of 1.29% with the standard preprocessing step i.e., flat-field correction, and of 4.29% with our opted preprocessing steps.
Dual channel D-shaped SPR sensor for efficient detection of change in refractive index of analytes
Authors: Nahid Elora , Kaysir Md Rejvi , Islam Md Jahirul , Hossain Sheikh Shahriar , Rahman Mohammad
Published: June 2024

Over the past ten years, significant advancements have been made in the field of D-shaped Surface Plasmon Resonance (SPR)-based optical fiber refractive index (RI) sensors which can be effectively used in chemical, biological, and health monitoring applications. Among single and dual/multi-channel SPR sensors, single-channel SPR sensors require analyte filling, emptying, and cleaning stages which is time-consuming and expensive. This work focuses on the design and performance investigation of a dual-channel D-shaped SPR sensor that can be used for the efficient detection of changes in the RI of analytes between two channels. The finite element method is used for the performance evaluation of the designed sensor, where the RI of the analyte of one channel is kept constant and that of the other channel is varied to observe the effect of change in RI difference from the known value. The proposed sensor can effectively detect the RI of analytes in the range of 1.33–1.40. The maximum wavelength and amplitude sensitivities are found to be 46000 nm/RIU and 6.96 RIU-1, respectively. In addition, it exhibits comparable wavelength and amplitude resolutions of 1.30×10¬-05 RIU and 1.75×10-08 RIU, respectively with asymmetrical RIs in two channels. Besides, the single-channel D-shaped SPR sensor having the same design parameters as the dual channel shows the maximum wavelength and amplitude sensitivities of 44000 nm/RIU and -59.22 RIU-1, with wavelength and amplitude resolutions of 2.27×10-6 RIU and 1.01×10-09 RIU, respectively. Thus, the designed dual-channel D-shaped SPR sensor has the provision for determining the RI differences of analytes, which could be used to check the consistency of RI among different batches of analytes for the same biological sample
Assessment of prevalence and severity of food insecurity among parents/guardians of students in Basrah Province, Southern Iraq
Authors: Abdulhameed Mohanad Faris , AL-Farhan Mohanad Musa , Alhasson Firas Ali , Alsadwi Akhil Mosleem
Published: June 2024

Background and Aim: An individual’s ability to obtain enough nutritious and healthy food to sustain a healthy lifestyle is a crucial indicator of food security. This study estimated food insecurity’s prevalence and levels among parents/guardians of secondary school students in Basrah and describe its consequences. Materials and Methods: The Food Insecurity Experience Scale (FIES) was implemented through a questionnaire survey to evaluate food insecurity. The relationship between financial factors, attitudes, and psychological impacts regarding food accessibility and affordability was studied in detail. The eight food insecurity questions’ responses were measured using the Rasch model approach. Results: Two hundred and fifty-two parents/guardians took part in the survey. The prevalence of food insecurity was estimated as 24% (with a 95% confidence interval of 18.9%–29.8%). Around 50% of the parents/guardians stated that their typical income is middle-income. 28% of respondents reported having sufficient food but not their preferred choices, while 35% paired food shortage with financial instability, 32% could not afford nutritionally balanced meals, and 21% of the parents admitted to cut or skipped their meals to other family members. 21% of parents/guardians were affected by inadequate food supply during the COVID-19 pandemic. The level of food insecurity included that 50% of the respondents exhibited mild food insecurity, 19.4% had moderate food insecurity, and 4.3% were classified as having severe food insecurity. According to the Rasch analysis of the FIES data, the likelihood of experiencing severe food insecurity is linked to consuming unhealthy food, having food run out, and eating unbalanced meals. Conclusion: The study found that financial constraints, food safety concerns, and limited access to nutritious food explain the widespread food insecurity reported. Significant efforts are required to alleviate chronic food shortages in Basrah, including job creation, strengthening agricultural production, and implementing safety-net policies for affected families. Keywords: food accessibility, food insecurity, parents/guardians, Rasch model.
Generation of Spatial Terrain Using the Hermes Editor
Authors:   Zachodniopomorski Uniwersytet Technologiczny w Szczecinie, Tecław Mateusz , Szłapczyński Maciej ,   Autocomp Management Sp. z o.o., Szczecin
Published: June 2024

The article presents the Hermes route editor in the context of automating the process of creating three-dimensional terrain. The classic approach to this issue was described, the problems present in this process were defined, and then areas suitable for automation were proposed. The following sections present the steps necessary to obtain source data from external, publicly available suppliers, as well as tools for processing them in order to generate and process semi finished products (data tiles). The article discusses a number of problems encountered in the process of automatic generation of three dimensional models of buildings and areas, and also proposes and implements working software solutions. Finally, ways of synthesizing the generated and processed data into one coherent terrain model along with infrastructure elements and buildings were discussed.
Automatic Generation of Virtual Railway Infrastructure Elements
Authors:   Autocomp Management Sp. z o.o., Szczecin, Lisiecki Paweł , Szłapczyński Maciej , Chołodowicz Ewelina ,   Szkoła Doktorska w Zachodniopomorskim Uniwersytecie Technologicznym w Szczecinie
Published: June 2024

This article is devoted to the issues of modeling a 3D virtual world for railroad simulators and the problems of creating a map for such a simulator. An algorithm using artificial intelligence methods for detection, classification, and place railway infrastructure objects from video recordings in a 3D virtual world, as well as GPS data has been proposed. The proposed solution, supporting automatic generation of virtual elements of railway infrastructure, is a significant innovation in the field of research.
Using the Digital-Twin Technology in the Mi-17 Mixed Reality Simulator
Authors:   Air Force Institute of Technology, Warsaw, Golański Piotr , Szczekala Marek
Published: June 2024

The article is aimed at the issue of combining the real world with the virtual world in Mixed Reality (MR) simulators. Mixed reality allows for integrating the real world with the virtual world – real objects with computer-generated objects. A person interacting with such a system receives both visual and tactile sensations. To ensure proper interaction with system elements, high reconstruction accuracy of virtual objects in relation to the corresponding real objects is necessary. The article presents the concept of combining the real and virtual world using a combination of VR and digital-twin technology and aims to illustrate how to ensure high accuracy of mapping virtual objects in relation to their real originals on the example of the Mi-17 helicopter simulator made using MR technology.
Wideband AC Voltage Standards
Authors:   Politechnika Śląska, Gliwice, Kubiczek Krzysztof , Kampik Marian , Grzenik Michał , Musioł Krzysztof , Piaskowy Anna
Published: June 2024

This article presents a critical review and comparison of constructions and metrological properties of contemporary wideband standards for AC voltage. It focuses on selected thermal voltage converters (TVCs) used in alternating current-direct current (AC-DC) transfer voltage standards and for the most precise measurements of AC voltages up to approximately 100 MHz. These devices serve as primary AC voltage standards at National Measurement Institutes (NMIs).
The Method of Measuring Human Body Temperature Using a Thermal Imaging Camera
Authors:   Wojskowa Akademia Techniczna, Instytut Optoelektroniki, Warszawa, Sosnowski Tomasz , Kastek Mariusz , Sawicki Krzysztof , Bieszczad Grzegorz , Gogler Sławomir , Piątkowski Tadeusz
Published: June 2024

Measurement and monitoring of human physiological parameters play an important role in many applications such as health care, sports training and prevention of disease spread. Dynamic changes in physiological parameters can reveal not only changes in a patient’s physiological state and function, but also be used to assess a person’s activity status, fitness and fatigue. Body temperature is among the most important human physiological parameters for assessing basic vital functions, apart from heart rate, blood pressure and respiratory rate. In medical practice, various types of measuring instruments are used to measure temperature, such as liquid thermometers, electronic thermometers, non-contact ear thermometers, non-contact forehead thermometers. Liquid and electronic thermometers require the appropriate sensors to be connected to a person, which may be undesirable or impossible as, for example, in newborns or during sports training. Non-contact thermometers operate over short distances and often force a specific position of the person during the measurement. In addition, the above body temperature measurement techniques require direct supervision by medical personnel, which often reduces the effectiveness and efficiency of screening temperature measurement. In screening temperature measurements of a large number of people, especially those on the move, a measuring thermal imaging camera works well. The article presents a method for measuring human body temperature using a thermal imaging camera. The presented method is characterized by high accuracy of temperature measurement, which allows medical use of the obtained measurements. The measurement method has been tested on a test stand and for a selected test sample of people. The measurements and tests carried out confirmed the possibility of obtaining temperature measurement accuracy with an expanded uncertainty of less than 0.05 K with a resolution of less than 0.1 K.
A Method of Measurement of Minimum Resolvable Temperature Difference as a Function of Magnification and Defocusing of a Thermal Camera
Authors:   Wojskowa Akademia Techniczna, Warszawa, Gogler Sławomir , Sawicki Krzysztof , Ligienza Andrzej , Mścichowski Mariusz
Published: June 2024

Temperature measurement of allergic skin reactions requires meeting certain criteria regarding temperature resolution between small areas. The usual criterion of temperature resolution is NETD. However, this metric does not take into account the limitations of the spatial resolution of the optical system or the detector. In this paper, a model is presented that allows for selection of camera parameters based on the required spatial thermal resolution and size of the object being imaged. The method has been implemented and compared to results obtained in commercial software and has been applied to evaluate spatial thermal resolution of a prototype objective designed for the LWIR band.
Local injection therapy with hyaluronic acid preparations: in focus of rheumatologists and orthopedic traumatologists
Authors: Karateev A. E.
Published: June 2024

Hyaluronic acid (HA) is an effective and safe medication for local injection therapy (LIT) widely used in the treatment of osteoarthritis (OA) of large joints. The therapeutic effect of HA is determined both by the replacement of the lubricating function of natural hyaluronate (viscosupplementation), which leads to an improvement in the biomechanical parameters of the joint, and by the biological effects that unfold when interacting with cellular receptors (CD44, RHAMM, etc.), resulting in an anti-inflammatory, anti-nociceptive and anabolic effect of HA. HA therapy has a reliable evidence base. According to a number of clinical studies and meta-analyses, LIT with HA – reduces pain intensity by 28–54 % and improves the function of the affected joint by 9–32 % compared to baseline over a 12-24 week observation period. Repeated administration of HA can delay the need for orthopedic surgery. HA extremely rarely causes serious adverse events and can also be prescribed to patients with concomitant diseases. The use of HA for the treatment of OA is included in Russian and several foreign clinical guidelines (in particular OARSI and ESCEO). A new direction in LIT for OA is therapy with combined (hybrid) HA preparations containing high molecular weight (HMW) and low molecular weight (LMW) fractions. A new HA preparation has appeared in our country, which is a stabilized, highly purified hydrogel containing 80 % HMW HA (molecular weight – 30,000 kDa) with transverse "crosslinking" BDDE (innovative ECHATM technology) and 20 % "uncluttered" linear HA (molecular weight – 1500 kDa). This product is characterized by favorable rheological parameters, which guarantee a long-term improvement in the biomechanics of the affected joint and a rapid onset of biological effects, reduction in pain and inflammation and activation of the synthesis of natural hyaluronate.
Battle of the strategies: diet versus drug therapy for gout
Authors: Zhelyabina O. V. , Eliseev M. S. , Lila A. M.
Published: June 2024

The best results in combating gout are achieved through a combination of diet and drug therapy. Urate-lowering therapy, which includes febuxostat, has been shown to be more effective and convenient than diet when it comes to achieving and maintaining target uric acid (UA) levels in gout patients. Febuxostat, a xanthine oxidase inhibitor, helps to reduce UA levels in the blood by blocking its formation. This helps prevent the deposition of urate crystals in joints and tissues and reduces the frequency and severity of gout attacks. At the same time, a diet of low purine foods may also have some effect on UA levels. Diet can improve the results of drug treatment by reducing the need for medications and minimizing the risk of side effects. However, without adequate drug therapy, diet will not produce the desired results. Therefore, febuxostat remains the preferred urate-lowering treatment option for gout, especially given its proven efficacy in these patients.
Position on the use of anifrolumab in patients with systemic lupus erythematosus with insufficient efficacy of standard therapy in real-life clinical practice. Comments from Russian experts
Authors: Aseeva E. A. , Soloviev S. K. , Reshetnyak T. M. , Lila A. M.
Published: June 2024

Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease characterized by unpredictable exacerbations and outcome. Many SLE patients receiving standard therapy (ST) do not achieve the recommended treatment goal of remission or Lupus Low Disease Activity State (LLDAS). Currently, there is still great dissatisfaction with ST in SLE, especially with long-term treatment with glucocorticoids and immunosuppressants. The recently approved type I interferon receptor antagonist anifrolumab (AFM) may be promising in SLE patients who do not respond adequately to ST. Phase III efficacy studies of AFM have demonstrated higher remission rate and lower LLDAS activity in patients treated with AFM compared to placebo. This publication contains comments from Russian experts on the article by Y. Tanaka “Viewpoint on anifrolumab in patients with systemic lupus erythematosus and a high unmet need in clinical practice”.
Resolution of the Expert Council “New approaches to the treatment of axial spondyloarthritis”
Authors: Lila A. M. , Mazurov V. I. , Nasonov E. L. , Lukyanov S. A. , Dubinina T. V. , Gaidukova I. Z. , Klimenko A. A. , Lapshina S. A. , Lukina G. V. , Korolev M. A. , Dreval R. O. , Pchelnikova P. I. , Shatalova N. V.
Published: June 2024

On 30 May, 2024, an expert meeting was held to update the approaches for the treatment of axial spondyloarthritis (axSpA). A new approach to the treatment of axSpA was considered, which consists of depleting autoreactive TRBV9+ T- lymphocytes by introducing a monoclonal antibody – the drug seniprutug. The value of the drug seniprutug in the treatment of the disease was discussed and key aspects for the incorporation of the drug seniprutug into real-world clinical rheumatological practice were agreed.
Efficacy and safety of levilimab in the treatment of rheumatoid arthritis in real-life clinical practice: first results of the HELIOS observational study
Authors: Lila A. M. , Gaydukova I. Z. , Anoshenkova O. N. , Bannikova I. G. , Vinogradova I. B. , Goldman M. L. , Davidian S. Yu. , Evstigneeva L. P. , Epifanova O. E. , Zemerova E. V. , Zagrebneva A. I. , Ivanova L. V. , Karibova A. K. , Menshikova I. V. , Mironenko O. N. , Mikhailova M. P. , Nikulenkova N. E. , Patrikeeva I. M. , Plaksina T. V. , Savvina G. R. , Samigullina R. R. , Sarantseva L. E. , Usacheva J. V. , Ukhanova O. P. , Fatkhullina G. F. , Chudinov A. L. , Shafieva I. A. , Yakupova S. P.
Published: June 2024

The efficacy and safety of levilimab (LVL) in patients with active rheumatoid arthritis (RA) has been confirmed in controlled clinical trials. This article presents the results of a preliminary analysis of a non-interventional observational study of LVL in RA patients.

   Objective: to evaluate the efficacy and safety of LVL in the treatment of patients with RA in real-world clinical practice.

   Materials and methods. The HELIOS study is a retrospective-prospective, multicenter, non-interventional study of retention rate of LVL therapy and the safety of LVL in patients with RA in real-world clinical practice. Patients received medical care, including LVL, according to routine clinical practice for the treatment of RA and Russian instructions for medical use of the drug. This article presents the results of an analysis of the efficacy and safety of LVL after 12 and 24 weeks of treatment. Efficacy was assessed using the DAS28-CRP/ESR, SDAI, CDAI and patient assessment of pain, fatigue and morning stiffness according to VAS (0–100 mm).

   Results and discussion. 524 patients from 42 medical centers in the Russian Federation were enrolled in the study from June 2022 to November 2023. The majority of patients were female (83.2 %) and the mean age of patients was 53 years. A statistically significant decrease in DAS28-CRP/ESR, SDAI, CDAI, patient assessment of pain, fatigue and morning stiffness (VAS) was observed after 12 and 24 weeks of treatment, regardless of previous treatment with biologics or Jak inhibitors (JAKi). LVL was well tolerated by patients, the most frequently reported adverse events were infections, changes in peripheral blood and laboratory abnormalities characteristic of treatment with IL-6R inhibitors.

   Conclusion. In real-world clinical practice, LVL has been shown to be highly effective and well tolerated in patients with RA when prescribed as the first biologic disease-modifying antirheaumatic drus (bDMARD) and after switching from other bDMARDs or JAKi.
Survival and lethal outcomes in Orenburg population of patients with systemic lupus erythematosus
Authors: Lazareva N. V. , Bugrova O. V. , Artemova N. E. , Nagornova K. A.
Published: June 2024

Currently, the prognosis for systemic lupus erythematosus (SLE) has improved significantly, but the relative risk of death in these patients is stillhigher than in the general population. Thrombotic complications are one of the leading causes of death in SLE.

   Objective: to analyze the survival rate and structure of lethal outcomes in Orenburg population of patients with SLE, including deaths due to thrombotic complications.

   Material and methods. A two-stage study of SLE progression and patient survival was conducted from 2007 to 2022. Clinical signs of the diseasewere analyzed in all patients at baseline (n = 68) and in survivors (n = 50) after 15 years. The median age at the time of enrolment in the study was 35 [29; 45] years, the disease duration – 7.5 [3; 13.5] years. During the second stage, the characteristics of the course of the disease in the survived patients and the causes of death in those who died over 15-year period were determined.

   Results and discussion. The 10-, 15- and 20-year survival rates in Orenburg population of patients with SLE reached 98.5, 95.5 and 86.3%, respectively. During this period, 18 (26.5 %) deaths were registered, the median age of the deceased was 48.5 [39; 57] years, and the duration of the disease was 22 [16; 30] years. The most common causes of death were thrombotic complications (n = 14, 78 %) due to antiphospholipid syndrome, lupus nephritis, and arterial hypertension. Less frequently, infectious complications were the cause of death (n = 4, 22 %). Patients with thrombotic complications had a 20-year survival rate of 80.2% that was significantly lower than in the SLE group without thrombosis.

   Conclusion. The results obtained allow to consider the presence of thrombotic complications in patients with SLE in Orenburg population as an unfavorable prognostic factor.
Osteosarcopenia in women with rheumatoid arthritis: association with nutritional status and physical condition
Authors: Dobrovolskaya O. V. , Feklistov A. Yu. , Demin N. V. , Kozyreva M. V. , Toroptsova N. V.
Published: June 2024

Objective: to evaluate nutritional status, muscle strength, functional status of skeletal muscles and physical activity (PHA) and their relationship with the osteopenic body composition phenotype in women in post menopause with rheumatoid arthritis (RA).

   Material and methods. The case-control study included 134 women in post menopause with RA, 52 of them had osteosarcopenia (OSP) according to densitometry and 82 had no decrease in bone mineral density (BMD) and muscle mass (mean age 62.0 ± 7.2 and 59.6 ± 7.5 years, respectively; p > 0.05). A clinical and laboratory examination as well as tests to assess muscle strength and functional status were performed. The MNA-SF and IPAQ questionnaires were used to determine nutritional status and physical activity.

   Results and discussion. Malnutrition was found in 51.9 % of patients, and low and average levels of PHA were found in 5.8 and 50.0 % of patients with OSP, respectively. Factors associated with OSP were identified: nutritional status according to MNA-SF < 12 points (odds ratio, OR 2.52; 95 % confidence interval, CI 1.10–5.77; p = 0.029), dietary calcium intake < 500 mg/day (OR 3.23; 95 % CI 1.49–7.01; p = 0.003), 25(OH)D level < 30 ng/ml (OR 4.55; 95 % CI 1.86–11.16; p = 0.001), moderate PHA < 1 hour per day (OR 2.67; 95 % CI 1.06–6.75; p = 0.037), walking < 1 hour per day and < 4 hours per week (OR 3.25; 95 % CI 1.26–8.38; p = 0.015 and OR 3.17; 95 % CI 1.19–8.46; p = 0.021, respectively).

   Conclusion. Reduced nutritional status was found in 51.9 % and average or low levels of PHA in 55.8 % of patients with OSP. The risk of OSP development was increased by low nutritional status, inadequate dietary calcium intake, low vitamin D levels, short duration of daily moderate exercise, and inadequate daily and weekly walking time.
Efficacy of low molecular weight hyaluronic acid (500–730 kDa) in post-traumatic pathology of periarticular soft tissues at different sites: data from an open-label pilot clinical study
Authors: Nesterenko V. A. , Makarov M. A. , Karateev A. E. , Bialik E. I. , Bialik V. E. , Bialik A. A.
Published: June 2024

Local injection therapy (LIT) with hyaluronic acid (HA) medications is one of the most promising methods for the treatment of periarticular soft tissue pathology (PASTP) caused by injury or overuse.

   Objective: to evaluate the efficacy and safety of LIT with HA medication with a molecular weight of 500–730 kDa in patients with various post-traumatic PASTP.

   Material and methods. The study included 30 patients with rotator cuff syndrome (RCS), lateral epicondylitis (LE) and plantar fasciitis (PF) after trauma. Inclusion criteria were the presence of moderate/severe pain (≥40 mm on a visual analogue scale (VAS)) over a 3-month period and the absence of effect of LIT with glucocorticoids. All patients were administered HA peritendinously three times (7 days apart) under ultrasound guidance. Treatment results were evaluated after 1 and 3 months based on the dynamics of pain intensity (VAS) and functional indicators using the ASES (American Shoulder and Elbow Surgical Evaluation), MES (Mayo Elbow Score) and FFI (Foot Functional Index) questionnaires.

   Results and discussion. In the general group, there was a statistically significant decrease in pain intensity after 1 and 3 months from a mean of 57.6 ± 14.7 to 37.0 ± 14.8 and 35.0 ± 14.3 mm according to VAS respectively (p < 0.05). In the patient groups with different PASTP, the average assessment of pain intensity and functional impairment at baseline and after 1 and 3 months was: for RCS (n = 11) 59.0 ± 15.1, 39.0 ± 15.7, 36.3 ± 16.2 mm according to VAS and 49.1 ± 14.3, 60.1 ± 13.7, 61.7 ± 3.8 according to ASES, respectively; with LE (n = 10) 54.0 ± 13.4, 35.0 ± 9.7, 34.0 ± 11.7 mm according to VAS and 71.5 ± 11.1, 78.3 ± 9.0, 81.5 ± 8.3 according to MES; with PF (n = 9) 61.0 ± 16.5, 36.6 ± 19.3, 34.4 ± 15.8 mm according to VAS and 47.2 ± 22.8, 39.6 ± 39.7, 39.0 ± 29.9 according to FFI. None of the patients experienced any adverse events during treatment.

   Conclusion. HA medication with a molecular weight of 500–730 kDa showed good efficacy and safety in LIT of PASTP of the shoulder, elbow joint and foot. Further studies are needed to evaluate the possibility of a broad use of the drug for the treatment of PASTP in real clinical practice.
The development of postoperative pain in patients with late-stage knee osteoarthritis is associated with impaired metabolism and transport of fatty acids in blood cells
Authors: Chetina E. B. , Markova G. A. , Glemba K. E. , Makarov M. A.
Published: June 2024

Objective: to evaluate differences in the expression of genes associated with β-oxidation and de novo synthesis of fatty acids (FAs) in the blood of patients with the late stage of knee osteoarthritis (OA) before total knee arthroplasty (TA) depending on the development of postoperative pain (POP) in order to determine the molecular mechanisms responsible for the development of chronic POP.

   Material and methods. Blood of 50 patients with stage III–IV knee OA complaining of constant pain and joint dysfunction was analyzed prior to TA. The control group consisted of 26 healthy individuals. Pain intensity was assessed using a visual analogue scale (VAS) and the BPI questionnaire. In addition, pain, stiffness and physical functioning were assessed using WOMAC index and the presence of neuropathic pain was assessed using the DN4 and PainDETECT questionnaires. The development of POP was assessed 3 and 6 months after TA. Total RNA isolated from blood was used to determine the expression of ACLY, ACC1, MLYCD, FASN and CPT1A genes by real-time quantitative reverse transcriptase-polymerase chain reaction.

   Results and discussion. POP ≥ 30 mm by VAS was detected in 17 patients. Before TA, the expression of most of the analyzed genes was significantly increased compared to controls, while the expression of the FASN gene was comparable in patients with OA and healthy individuals. There were no differences in clinical and functional parameters between the groups of patients with and without POP. Before surgery, patients who subsequently developed POP had significantly higher expression of ACLY and CPT1A genes than patients who were satisfied with the results of TA. At the same time, no differences in the expression of ACC1, MLYCD and FASN were found in the groups analyzed.

   Conclusion. The development of POP is associated with an increased supply of FAs to the mitochondria caused by overexpression of the CPT1A gene, as well as with the accumulation of acetyl-CoA, a product of high expression of the ACLY gene, which can be measured in the blood of OA patients before TA.
Rapid achievement of low disease activity during the use of a type I interferon inhibitor in a patient with torpid systemic lupus erythematosus (case report)
Authors: Baranov A. A. , Aseeva E. A. , Soloviev S. K. , Nikishina N. Yu. , Malygina E. A. , Abissova T. O. , Pimenova Z. Yu. , Reshetnyak T. M. , Makarov S. A. , Lapkina N. A. , Lila A. M.
Published: June 2024

This article describes the experience of using the type I interferon inhibitor anifrolumab (AFM) in a patient with a torpid course of systemic lupus erythematosus. The reason for prescribing AFM was the need for a quick achievement of low disease activity due to a planned hip replacement. Dynamic observational data over a six-month period confirmed that AFM enables a rapid achievement of low disease activity without increasing the dose of glucocorticoids, significantly improve the patient's quality of life and even prepare them for major surgery without exacerbating the underlying process.
Peculiar features of intravenous immunoglobulins application in rheumatic diseases
Authors: Egorova O. N. , Tarasova G. M. , Datsina A. V. , Sazhina E. G.
Published: June 2024

Intravenous immunoglobulins (IVIG) are the most commonly used immunobiological agents produced from donor blood. They were first used in the mid-twentieth century for the treatment of primary immunodeficiencies. Later, they were successfully used to treat a variety of autoimmune, inflammatory and other diseases. There are currently a growing number of basic and clinical studies looking at the mechanism of action and efficacy of different doses of IVIG. At the same time, much remains unclear, contradictory, and some data are mutually exclusive.
Some features of osteogenesis in ankylosing spondylitis and the possibilities of treatment with bisphosphonates
Authors: Datsina A. V. , Erdes S. F.
Published: June 2024

Despite the high efficacy of currently available targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs) and biologic DMARDs (bDMARDs), approximately 40 % of patients with ankylosing spondylitis (AS) fail to achieve treatment goals according to clinical, laboratory and imaging tests. In addition, comorbidities in AS, which require an integrated approach involving different specialists, may limit the use of such therapy. In view of the above, as well as the peculiarities of bone metabolism in AS, new therapeutic approaches for this disease have recently been sought, one of which is the use of bisphosphonates. This article discusses some aspects of bone metabolism and unconventional therapeutic options – the use of bisphosphonates in AS complicated by severe comorbidities, in patients with insufficient efficacy of bDMARDs and/or DMARDs.
Understanding the advances in Sorghum grain quality improvement: An overview
Authors: Dhar Anamika , Meena Kumari B. , Kavithamani D. , Boopathi N. Manikanda , Meenakshi P.
Published: June 2024

Sorghum, a crucial cereal crop with versatile applications, is increasingly recognized for its grain quality attributes. The nutritional and biochemical diversity within sorghum, encompassing elements such as iron (Fe), zinc (Zn), proteins, starch, dietary fibers, and ß-carotene, plays a pivotal role in enhancing the quality across diverse sorghum accessions. Breeding programs offer a promising avenue for further improvement in these traits. Additionally, sorghum features a spectrum of phenolic compounds, including tannins and flavonoids, influencing both pigmentation and potential health benefits. The antioxidative properties of these compounds underscore their critical role in promoting health and mitigating oxidative stress. The significance of sorghum is shaped by genetic factors, environmental conditions, ripening stages, and varietal distinctions, highlighting the complex interplay between grain structure, genetics, and nutritional content.  As the global demand for diverse, nutritionally rich food sources continues to rise, this review provides insights aimed at deepening our understanding of sorghum's potential as a staple crop with substantial nutritional and health-promoting attributes.