An anthropometric evaluation of the scapula, with emphasis on the coracoid process and glenoid fossa in a South African population

The exact dimensions of the scapula, including the coracoid process and glenoid fossa, are fundamental in the patho-mechanics of the glenohumeral joint (GHJ); as these structures act as initiators of shoulder movement. The aim of the study was to evaluate the anthropometric parameters of the GHJ, with emphasis on the coracoid process and glenoid fossa. The morphometric (Linear Tools 2012, 0-150mm, LIN 86500963) and morphological parameters of a total of one hundred and sixty-four (n = 164) dry bone scapulae [Right (R): 80; Left (L): 84, Male (M): 68; Female (F): 96] were recorded. Results: (i) Shape of glenoid fossa: Type 1: (R) 16.5%, (L) 11.0%; Male (M) 20.1%, Female (F) 7.3%; Type 2: (R) 14.0%, (L) 15.2%; (M) 18.3%, (F) 11.0%; Type 3: (R) 18.3%, (L) 25.0%; (M) 27.4%, (F) 15.9%. (ii) Notch type: Type 1: (R) 1.7%, (L) 7.3%; (M) 6.7%, (F) 2.4%; Type 2: (R) 47.0%, (L) 43.9%; (M) 59.2%, (F) 31.7%. (iii) Vertical diameter of glenoid fossa (VD) (mm): (R) 35.2 ± 3.1, (L) 34.9 ± 3.0; (M) 35.3 ± 3.2, (F) 34.6 ± 2.8. (iv) Horizontal diameter 1 (HD1) of glenoid fossa (mm): (R) 18.4 ± 3.3, (L) 17.5 ± 2.9; (M) 18.2 ± 3.3, (F) 17.4 ± 2.6. (v) Horizontal diameter 2 (HD2) of glenoid fossa (mm): (R) 24.5 ± 2.9, (L) 23.6 ± 2.6; (M) 24.2 ± 2.7, (F) 23.7 ± 2.8. (vi) Length of coracoid process (CL) (mm): (R) 41.7 ± 4.7, (L) 41.5 ± 4.9; (M) 42.1 ± 4.7, (F) 40.7 ± 4.8. (vii) Width of coracoid process (CW) (mm): (R) 13.3 ± 1.9, (L) 14.2 ± 11.9; (M) 13.1 ± 1.9, (F) 15.1 ± 14.5. (viii) Coracoglenoid distance (CGD) (mm): (R) 27.4 ± 8.3, (L) 28.2 ± 3.5; (M) 28.2 ± 7.4, (F) 27.0 ± 3.4. In the present study, Type 3 (oval) was observed to be the predominant glenoid fossa shape with a higher incidence in male individuals and on the right side. Although only notch Types 1 (without a notch) and 2 (with one notch) were observed in this study, Type 2 (one notch) was the most prevalent, presenting with a significant p-value (p = 0.019), suggesting that notch Type 1 (without a notch) and 2 (with one notch) are common findings in the right and left side of individuals. The findings observed in this study may provide knowledge regarding the role of the coracoid parameters in etiology of subcoracoid impingement while knowledge on the glenoid fossa parameters and variations are essential for evaluation in shoulder arthroplasty for glenoid fractures and anterior dislocations, and for glenoid prosthesis designs for the South African population.

Integral measurement of spectrum-averaged cross sections of a few threshold reactions induced by fast neutrons of a TRIGA reactor: comparison with integrated data from excitation functions given in various data libraries

Integral cross sections of the reactions 24Mg(n,p)24Na, 27Al(n,p)27Mg, 27Al(n,α)24Na, 58Ni(n,d + np)57Co and 60Ni(n,p)60Co were measured for the first time using the fast neutron spectrum of a TRIGA reactor extending from 0.5 to 20 MeV. The values obtained in this work were comparable with the recommended values for a pure 235U prompt fission spectrum. The measured integral value was utilized for integral test of excitation function of each reaction given in some data libraries, namely ENDF/B-VIII.0, TENDL-2017, IRDFF-1.05 and ROSFOND-2010. The integral measurements are generally consistent with the integrated values within 5 %, except for a few cases, e. g. the reaction 60Ni(n,p)60Co, where the data libraries appear to need improvement.

Green Synthesis of Cr3+ Doped CaIn₂O₄-Carbon Hybrid Nanostructure and Its Light Absorption and Emission Properties

In this research article, we have used a novel route for synthesis of a greenish phosphor C-CaIn₂O₄ doped with Cr³⁺ ions using green plant (aloe vera gel) and measured its light absorption and emission properties. Our main aim was to enhance the light absorption and emission properties of undoped C-CaIn₂O₄ in order to widen its applications. The introduction of CrO₃ ions can produce Cr ion defects that favor charge balance in Cr³⁺:C-CaIn₂O₄ to facilitate its photoluminescence. The effect of doping in core-shell nanostructure can effectively transfer energy from charge-transfer absorption band of optical host material to characteristic transition of Cr³⁺ ions, utilizing more energy from host absorption for the photoluminescence of Cr³⁺ ions. As-prepared Cr³⁺:C-CaIn₂O₄ exhibits two bands at 270 nm and 370 nm, which are shifted to at 265 and 370 nm when it is annealed at higher dosage of Cr³⁺ ions. These are the ligand-to-metal O^2- to Cr³⁺ charge transfer bands. The light-emission is studied in analyzing migration, transfer and recombination processes of light-induced e^--h⁺ pairs. The results are described in correlation to a Cr³⁺:C-CaIn₂O₄ core-shell nanostructure.

Erosion-Corrosion of 30°, 60°, and 90° Carbon Steel Elbows in a Multiphase Flow Containing Sand Particles

Erosion-corrosion in flow changing devices as a result of sand transportation is a serious concern in the hydrocarbon and mineral processing industry. In this work, the flow accelerated erosion-corrosion mechanism of 90°, 60°, and 30° long radius horizontal-horizontal (H-H) carbon steel elbows with an inner diameter of 50.8 mm were investigated in an experimental closed-flow loop. For these geometrical configurations, erosion-corrosion was elucidated for erosive slug flow regimes and the extent of material degradation is reported in detail. Qualitative techniques such as multilayer paint modeling and microscopic surface imaging were used to scrutinize the flow accelerated erosion-corrosion mechanism. The 3D roughness characterization of the surface indicates that maximum roughness appears in downstream adjacent to the outlet of the 90° elbow. Microscopic surface imaging of eroded elbow surfaces disseminates the presence of corrosion pits on the exit regions of the 90° and 60° elbows, but erosion scars were formed on the entry regions of the 30° elbow. Surface characterization and mass loss results indicated that changing the elbow geometrical configuration from a small angle to wide angle significantly changed the mechanical wear mechanism of the tested elbows. Moreover, the maximum erosive location was identified at the top of the horizontally-oriented elbow for slug flow.

Synthesis, Characterization and Evaluation of Cytotoxic Activities of Novel Aziridinyl Phosphonic Acid Derivatives

New aziridine 2-phosphonic acids were prepared by monohydrolysis of the aziridine 2-phosphonates that were obtained by the modified Gabriel-Cromwell reaction of vinyl phosphonate or α-tosylvinyl phosphonate with a primary amine or a chiral amine. The cellular cytotoxicity of these compounds was tested against the HCT-116 colorectal cancer cell lines and the CCD-18Co normal colon fibroblast lines using the MTT assay. Three of the synthesized phosphonic acid derivatives 2e (ethyl hydrogen {(2S)-1-[(1S)-1-(naphthalen-2-yl)ethyl]aziridin-2-yl}phosphonate), 2h (ethyl hydrogen (1-benzylaziridin-2-yl)phosphonate), and 2i (ethyl hydrogen (1-cyclohexylaziridin-2-yl)phosphonate) showed higher cytotoxicity than the reference cancer treatment agent etoposide. Cell death was through a robust induction of apoptosis even more effectively than etoposide, a well-known apoptosis inducing agent.

Long head of biceps brachii tendon and transverse humeral ligament morphometry and their associated pathology

BACKGROUND

As a dynamic stabiliser and flexor of the glenohumeral joint, the long head of the biceps brachii tendon (LHBBT) is further stabilised by the retinacular activities of the transverse humeral ligament (THL).

MATERIALS AND METHODS

The LHBBT and THL which were obtained from a total of 40 cadaveric upper limb specimens (n = 80; females: 36, males: 44; right: 40, left: 40), were bilaterally dissected and subjected to morphometric evaluation.

RESULTS

The results are in millimetres. LHBBT length: 81.99 ± 21.28 right, 79.73 ± 17.27 left; 79.82 ± 19.66 male, 82.14 ± 19.03 female; LHBBT width: 4.28 ± 1.31 right, 4.67 ± 1.43 left; 4.35 ± 1.17 male, 4.63 ± 1.60 female; THL length: 20.91 ± 5.24 right, 21.19 ± 6.63 left; 21.52 ± 5.71 male, 20.48 ± 5.92 female; THL width: 16.65 ± 6.92 right, 16.63 ± 7.49 left; 16.83 ± 6.65 male, 16.40 ± 7.84 female. With larger LHBBT length observed on the right side and larger LHBBT width observed on the left side; both parameters appeared to be distinctly longer in female individuals. On the contrary, the THL length and width were evidently greater in male individuals, with larger lengths and widths present on the left and right sides respectively.

CONCLUSIONS

These findings may contribute to South African literature and to clinical knowledge as these parameters are important in the successful outcomes of tenotomy, tenodesis and shoulder-related procedures.

Skeletal muscle hypertrophy and attenuation of cardio-metabolic risk factors (SHARC) using functional electrical stimulation-lower extremity cycling in persons with spinal cord injury: study protocol for a randomized clinical trial

Background

Persons with spinal cord injury (SCI) are at heightened risks of developing unfavorable cardiometabolic consequences due to physical inactivity. Functional electrical stimulation (FES) and surface neuromuscular electrical stimulation (NMES)-resistance training (RT) have emerged as effective rehabilitation methods that can exercise muscles below the level of injury and attenuate cardio-metabolic risk factors. Our aims are to determine the impact of 12 weeks of NMES + 12 weeks of FES-lower extremity cycling (LEC) compared to 12 weeks of passive movement + 12 weeks of FES-LEC on: (1) oxygen uptake (VO₂), insulin sensitivity, and glucose disposal in adults with SCI; (2) skeletal muscle size, intramuscular fat (IMF), and visceral adipose tissue (VAT); and (3) protein expression of energy metabolism, protein molecules involved in insulin signaling, muscle hypertrophy, and oxygen uptake and electron transport chain (ETC) activities.

Methods/Design

Forty-eight persons aged 18–65 years with chronic (> 1 year) SCI/D (AIS A-C) at the C5-L2 levels, equally sub-grouped by cervical or sub-cervical injury levels and time since injury, will be randomized into either the NMES + FES group or Passive + FES (control group). The NMES + FES group will undergo 12 weeks of evoked RT using twice-weekly NMES and ankle weights followed by twice-weekly progressive FES-LEC for an additional 12 weeks. The control group will undergo 12 weeks of passive movement followed by 12 weeks of progressive FES-LEC. Measurements will be performed at baseline (B; week 0), post-intervention 1 (P1; week 13), and post-intervention 2 (P2; week 25), and will include: VO₂ measurements, insulin sensitivity, and glucose effectiveness using intravenous glucose tolerance test; magnetic resonance imaging to measure muscle, IMF, and VAT areas; muscle biopsy to measure protein expression and intracellular signaling; and mitochondrial ETC function.

Discussion

Training through NMES + RT may evoke muscle hypertrophy and positively impact oxygen uptake, insulin sensitivity, and glucose effectiveness. This may result in beneficial outcomes on metabolic activity, body composition profile, mitochondrial ETC, and intracellular signaling related to insulin action and muscle hypertrophy. In the future, NMES-RT may be added to FES-LEC to improve the workloads achieved in the rehabilitation of persons with SCI and further decrease muscle wasting and cardio-metabolic risks.

Trial registration

ClinicalTrials.gov, NCT02660073. Registered on 21 Jan 2016.

Water-dispersible glycosylated poly(2,5'-thienylene)porphyrin-based nanoparticles for antibacterial photodynamic therapy

Here we report the preparation of water-dispersible glycosylated poly(2,5'-thienylene)porphyrin based nanoparticles by a nanoprecipitation method and demonstrate the application of these nanoparticles in antibacterial photodynamic therapy. The diameter of the nanoparticles is in the range of 50-80 nm and the resulting nanoparticles are stable in water without precipitation at least for a month. They have high singlet oxygen efficiency and display light-triggered biocidal activity against both Gram negative bacteria (Escherichia coli, E. coli) and Gram positive bacteria (Bacillus subtilis, B. subtilis). Upon white light irradiation for 10 min with a flux of 22 mW cm-2 of the E. coli suspension incubated with NPs (18 μg mL-1), a killing efficiency of 99% is achieved, whereas in the dark the effect is recorded as only around 8%.

Zinc Gluconate-Loaded Chitosan Nanoparticles Reduce Severity of Collagen-Induced Arthritis in Wistar Rats

Rheumatoid arthritis (RA) is the most prevalent autoimmune disease affecting about 1% world population. Zinc (Zn) is necessary for the maintenance of bone homeostasis and the level of Zn was reported to be decreased in RA patients and collagen-induced arthritic rats. Effective delivery of Zn has been reported using zinc gluconate but oral absorption of Zn from zinc gluconate (ZG) is very low in humans. Zn supplementation reduces disease severity in patients suffering from chronic, refractory RA and exerts mild and transient side effects. The aim of this study was to synthesize and characterize zinc gluconate-loaded chitosan nanoparticles (ZG-Chit NPs) and to evaluate and compare therapeutic efficacy of ZG-Chit NPs and zinc gluconate against collagen-induced RA in Wistar rats. The nanoparticles were formulated by ionic gelation method and the hydrodynamic diameter was 106.5 ± 79.55 nm as measured using DLS. The particle size, shape, and surface morphology was further confirmed by transmission electron microscopy, scanning electron microscopy, and atomic force microscopy. These nanoparticles showed good cytocompatibility against foreskin fibroblasts (BJ) and L929 cells. Arthritic rats were treated with ZG (20 mg/kg body weight, intraperitoneally) and equivalent doses of ZG-Chit NPs. The treatment of both ZG and ZG-Chit NPs reduced the severity of arthritis as evidenced by reduced joint swelling, erythema, and edema but ZG-Chit NPs exhibited superior efficacy. Furthermore, it was found that ZG and ZG-Chit NPs attenuate biomarkers of inflammation (C-reactive protein, myeloperoxidase, nitric oxide, TNF-α, and IL-1β) and oxidative stress (articular elastase, lipid peroxidation, catalase, glutathione, and superoxide dismutase). The results of the histopathology further confirmed that ZG-Chit NPs markedly suppressed infiltration of inflammatory cells as compared to ZG at the ankle joint tissue. Immunohistochemical analysis also revealed that treatment with ZG-Chit NPs resulted in reduced pro-inflammatory marker (TNF-α, IL-6, and iNOS) expression and enhanced SOD1 expression. Overall, this study suggests that ZG and ZG-Chit NPs suppressed the severity of arthritis plausibly mediated by attenuation of inflammation and oxidative stress and more importantly ZG-Chit NPs exhibited superior efficacy as compared to ZG.

Predicting seizures in pregnant women with epilepsy: Development and external validation of a prognostic model

BACKGROUND

Seizures are the main cause of maternal death in women with epilepsy, but there are no tools for predicting seizures in pregnancy. We set out to develop and validate a prognostic model, using information collected during the antenatal booking visit, to predict seizure risk at any time in pregnancy and until 6 weeks postpartum in women with epilepsy on antiepileptic drugs.

METHODS AND FINDINGS

We used datasets of a prospective cohort study (EMPiRE) of 527 pregnant women with epilepsy on medication recruited from 50 hospitals in the UK (4 November 2011-17 August 2014). The model development cohort comprised 399 women whose antiepileptic drug doses were adjusted based on clinical features only; the validation cohort comprised 128 women whose drug dose adjustments were informed by serum drug levels. The outcome was epileptic (non-eclamptic) seizure captured using diary records. We fitted the model using LASSO (least absolute shrinkage and selection operator) regression, and reported the performance using C-statistic (scale 0-1, values > 0.5 show discrimination) and calibration slope (scale 0-1, values near 1 show accuracy) with 95% confidence intervals (CIs). We determined the net benefit (a weighted sum of true positive and false positive classifications) of using the model, with various probability thresholds, to aid clinicians in making individualised decisions regarding, for example, referral to tertiary care, frequency and intensity of monitoring, and changes in antiepileptic medication. Seizures occurred in 183 women (46%, 183/399) in the model development cohort and in 57 women (45%, 57/128) in the validation cohort. The model included age at first seizure, baseline seizure classification, history of mental health disorder or learning difficulty, occurrence of tonic-clonic and non-tonic-clonic seizures in the 3 months before pregnancy, previous admission to hospital for seizures during pregnancy, and baseline dose of lamotrigine and levetiracetam. The C-statistic was 0.79 (95% CI 0.75, 0.84). On external validation, the model showed good performance (C-statistic 0.76, 95% CI 0.66, 0.85; calibration slope 0.93, 95% CI 0.44, 1.41) but with imprecise estimates. The EMPiRE model showed the highest net proportional benefit for predicted probability thresholds between 12% and 99%. Limitations of this study include the varied gestational ages of women at recruitment, retrospective patient recall of seizure history, potential variations in seizure classification, the small number of events in the validation cohort, and the clinical utility restricted to decision-making thresholds above 12%. The model findings may not be generalisable to low- and middle-income countries, or when information on all predictors is not available.

CONCLUSIONS

The EMPiRE model showed good performance in predicting the risk of seizures in pregnant women with epilepsy who are prescribed antiepileptic drugs. Integration of the tool within the antenatal booking visit, deployed as a simple nomogram, can help to optimise care in women with epilepsy.

P52 Prescription of patient’s regular medications on admission to neurosurgical unit

Objectives

Timely and correct prescription of patients’ regular medications on admission to neurosurgical unit is noticed not to be fully compliant with set standards. This audit aims to review the practice of medication prescription by junior doctors during patient admission to a national neurosurgical unit, and to identify areas of improvement for prompt and accurate prescription.

Design

Prospective clinical audit.

Subjects

130 patients admitted to the neurosurgical unit in 2 weeks.

Methods

Prescription of patient’s regular medications on admission was audited. The prescription practice was compared against the set standards, and between different settings (in-hour vs. out-of-hour, emergency vs. elective, experienced vs. new SHOs).

Results

18% of patients had no regular medications prescribed by clerking doctors, the majority of which were elective admissions during in-hour clerking and performed by experienced SHOs. Of the patients who had their regular medications prescribed on admission, 29% were prescribed inaccurately, and 16% in wrong doses. Total percentage of missed and error prescription was 46%, in which only 18% were corrected within 24 hours and 21% corrected up to 48 hours after admission.

Conclusions

Areas of improvement identified: prescription practice of experienced SHOs during elective admissions, medication and dose check on prescription in both elective and emergency settings, medication reconciliation within 24 hours and thereafter. Changes (e.g. an alert system) are being implemented and re-audit is in plan.

Aptamer based nanobiosensors: Promising healthcare devices

Nanobiosensors based on aptamer are extensively being studied as potent analytical tools in clinical analysis. These biosensors provide high sensitivity, fast response, specificity and desired portability in addition to simplicity and decreased cost compared to conventional methods. The purpose of this manuscript is to provide readers with an overview of current advances about electrochemical, electrochemiluminescent and photoelectrochemical aptasensors from the sea of available literature. These are mainly used for determination of protein-based biomarkers, especially for cancer diagnosis. Here in we have given special emphasis on nanosize-based aptasensors which have been reported to show considerable improvement in the analytical performance.