Understanding the bio-crystallization: An insight to therapeutic relevance

In the realm of biomedical engineering and materials science, the synthesis of biomaterials plays a pivotal role in advancing therapeutic strategies for regeneration of tissues. The deliberate control of crystallization processes in biomaterial synthesis has emerged as a key avenue for tailoring the properties of these materials, enabling the design of innovative solutions for a wide array of medical applications. This review delves into the interplay between controlled crystallization and biomaterial synthesis, exploring its multifaceted applications in the therapeutic domains. The investigation encompasses a wide spectrum of matrices, ranging from small molecules to large biomolecules, highlighting their unique contributions in modulating crystallization processes. Furthermore, the review critically assesses the analytical techniques and methodologies employed to probe and characterize the depths of crystallization dynamics. Advanced imaging, spectroscopic, and computational tools are discussed in the context of unraveling the intricate mechanisms governing nucleation and crystallization processes within the organic matrix. Finally we delve in the applications of such advance material in therapeutics of hard and soft tissues.

Estimating the minimal clinically important difference of shoulder functional scores after arthroscopic rotator cuff repair: a prospective study

INTRODUCTION

The minimal clinically important difference (MCID) is a valuable tool for patient-based outcome analysis, for which limited data is available in the literature, especially after arthroscopic rotator cuff repair (ARCR). Although several studies have reported MCID after ARCR, few have studied the impact of various clinical factors such as Diabetes, pseudoparalysis, type of cuff repair, and retear over MCID. This study attempts to determine the MCID in shoulder functional scores after ARCR and the impact of various factors on MCID.

METHODS

144 patients undergoing ARCR were prospectively evaluated at six and 12 months by ASES and UCLA scores. MCID for American Shoulder and Elbow Surgeons (ASES) and the University of California and Los Angeles (UCLA) scores were calculated using an anchor-based and distribution-based approach. MCID was also calculated for diabetic and non-diabetic patients, smokers vs. non-smokers, presence or absence of pseudoparalysis, type of cuff repair (single row vs. suture bridge), and presence of retears. Uni- and multivariate analysis was performed to identify factors affecting the MCID of both scores.

RESULTS

Mean MCID for ASES score was 13.3 and 16.6 using an anchor-based and distribution-based approach, respectively. For the UCLA score, the mean MCID was 10.0 and 12.6 by anchor-based and 12.6 by distribution-based approach, respectively. Patients with higher pre-operative ASES scores demonstrated lower MCID values. No significant difference was observed in MCID scores of diabetic vs. non-diabetic patients, smoker vs. non-smoker, patients with or without pseudoparalysis, and type of cuff repair. The age, gender, and presence of retear did not affect MCID values.

CONCLUSION

This study establishes the MCID values of ASES and UCLA scores for rotator cuff repair by anchor and distribution methods. No patient or surgical factors appear to affect the MCID except pre-operative ASES scores.

STUDY DESIGN

Prospective cohort, Level II.

Ozone-induced oxidative stress alleviation by biogenic silver nanoparticles and ethylenediurea in mung bean (Vigna radiata L.) under high ambient ozone

Ground-level ozone (O3) is the most phytotoxic secondary air pollutant in the atmosphere, severely affecting crop yields worldwide. The role of nanoparticles (NP) in the alleviation of ozone-induced yield losses in crops is not known. Therefore, in the present study, we investigated the effects of biogenicB-AgNPs on the mitigation of ozone-induced phytotoxicity in mung bean and compared its results with ethylenediurea (EDU) for the first time. Two mung bean cultivars (Vigna radiata L., Cv. SML-668 and PDM-139) were foliar sprayed with weekly applications of B-AgNPs (0 = control, 10 and 25 ppm) and EDU (0 = control, 200 and 300 ppm) until maturation phase. Morphological, physiological, enzymatic, and non-enzymatic antioxidant data were collected 30 and 60 days after germination (DAG). The mean O3 and AOT40 values (8 h day-1) during the cultivation period were approximately 52 ppb and 4.4 ppm.h, respectively. More biomass was accumulated at the vegetative phase due to the impact of B-AgNPs and EDU, and more photosynthates were transported to the reproductive phase, increasing yield. We observed that the 10 ppm B-AgNPs treatment had a more noticeable impact on yield parameters and lower Ag accumulation in seeds for both cultivars. Specifically, SML-668 cultivar treated with 10 ppm B-AgNPs (SN1) showed greater increases in seed weight plant-1 (124.97%), hundred seed weight (33.45%), and harvest index (37.53%) in comparison to control. Our findings suggest that B-AgNPs can enhance growth, biomass, yield, and seed quality, and can improve mung bean ozone tolerance. Therefore, B-AgNPs may be a promising protectant for mung bean.

Tunable optical bistability of two-dimensional tilted Dirac system

We study the phenomenon of controlling the light by light known as the optical bistability for the two-dimensional tilted Dirac system. Using the Boltzmann approach under relaxation time approximation, we find that the optical bistability can be controlled by the nonlinear response of the system. For the prototype, we consider an inversion symmetry broken system. We find that the optical bistability associated with the nonlinear response is tunable with the strength of the tilt, gap and chemical potential. The resulting features suggest the inputs for the development of future-generation optical devices.

Does glenoid version affect the post-operative clinical outcome after repair of posterior labral tear: A retrospective study

Introduction

Posterior shoulder instability and consequent labral tear have been predominantly associated with retroversion of the bony glenoid and chondrolabral version. However, literature concerning the degree of glenoid and chondrolabral version and clinical outcomes following labral repair is scarce.

Methods

A retrospective cohort study was undertaken among patients with posterior shoulder instability who had undergone arthroscopic isolated posterior labral repair. The MRI was used to assess the bony and labral variations of the glenoid using the Friedman method and further categorized as either anteverted or retroverted glenoid. American Shoulder and Elbow Surgeons (ASES), Oxford Shoulder Score (OSS), and Single Assessment Numeric Evaluation (SANE) scores were used to evaluate pre- and postoperative clinical outcomes at a minimum follow-up of one year.

Results

33 shoulder MRIs performed at our institution were available for radiographic analysis. Among the 33 shoulders that underwent posterior shoulder capsulolabral repair, 23 were available for clinical follow-up for at least one year (range, 12-108 months). The mean (±SD) labral version and bony version were -3.98 (±5.68) and -2.83 (±5.20), respectively. The mean (±SD) postoperative ASES, Oxford score, and SANE scores for all participants were 84.04 (±14.14), 43.38 (±3.81), and 78.57 (±17.40), respectively. However, the difference in clinical outcomes in patients with anteverted or retroverted glenoid versions was not statistically significant.

Conclusion

Our study concludes a strong correlation between posterior glenohumeral instability and higher degree of glenoid retroversion. Nevertheless, variations in the glenoid version appear to have no significant impact on clinical outcomes.

Level of study

Level IV, retrospective cohort.

Hydrogen sulfide (H2S) metabolism: Unraveling cellular regulation, disease implications, and therapeutic prospects for precision medicine

Hydrogen sulfide (H2S), traditionally recognized as a noxious gas with a pungent odor, has emerged as a fascinating metabolite originating from proteinaceous foods. This review provides a comprehensive examination of H2S regulatory metabolism in cell. Dysregulation of cellular processes plays a pivotal role in the pathogenesis of numerous diseases. Recent development explores the chemistry of biosynthesis and degradation of H2S in cells. The consequences of dysregulation causing diseases and the emerging role of hydrogen sulfide (H2S) modulation as a promising therapeutic platform has not been explored much. These disturbances can manifest as oxidative stress, inflammation, and aberrant cellular signaling pathways, contributing to the development and progression of diseases such as cancer, cardiovascular disorders, neurodegenerative diseases, and diabetes. Hydrogen sulfide has gained recognition as a key player in cellular regulation. H2S is involved in numerous physiological processes, including vasodilation, inflammation control, and cytoprotection. Recent advances in research have focused on modulating H2S levels to restore cellular balance and mitigate disease progression. This approach involves both exogenous H2S donors and inhibitors of H2S -producing enzymes. By harnessing the versatile properties of H2S, researchers and clinicians may develop innovative therapies that address the root causes of dysregulation-induced diseases. As our understanding of H2S biology deepens, the potential for precision medicine approaches tailored to specific diseases becomes increasingly exciting, holding the promise of improved patient outcomes and a new era in therapeutics.

Reconstruction Considerations Following Complete Excision of Mucoid-Degenerated Anterior Cruciate Ligament: A Retrospective Study

INTRODUCTION

Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is an unusual cause of knee pain and restricted movement, predominantly affecting the middle-aged population. Arthroscopic partial or total debridement of the mucoid ACL is the surgical treatment of choice. However, little is discussed in the literature regarding subsequent knee instability and functional outcomes following complete ACL excision.

METHODS

A retrospective study was conducted on patients who underwent arthroscopic total ACL excision for mucoid ACL. Pre- and post-operatively, the Tegner-Lysholm score, the International Knee Documentation Committee (IKDC) Subjective Knee Form, and subjective functional instability were used to grade the clinical outcomes.

RESULTS

Ten out of the 13 patients who underwent complete ACL excision were available for evaluation. All patients presented with knee pain on deep flexion or extension with a painfully limited range of motion. Post-operatively, all patients were relieved of their original pain and dysfunction. The mean post-operative IKDC and Tegner-Lysholm scores were 74.96 and 83.6, respectively. All patients had a Lachman test positive, while only two had a grade 1 pivot shift test positive. Two patients had occasional functional instability only after strenuous exercises. None of the patients underwent subsequent ACL reconstruction.

CONCLUSION

All patients reported improved functional outcomes. Only two out of 10 reported occasional instability during strenuous activity. Therefore, complete debridement of mucoid ACL in sedentary patients is safe and efficacious. However, active young patients may experience instability and require ACL reconstruction if it hinders their daily activities.

Prevalence of prediabetes in patients with idiopathic frozen shoulder: a prospective study

Background

The association between diabetes and frozen shoulder is well established. However, the data regarding prediabetes and primary frozen shoulder (PFS) are still lacking.

Methods

In a prospective study, 158 patients with PFS were included. The prediabetes status was ascertained by estimating serum hemoglobin A1c (HbA1c) levels in patients with PFS. According to the level of HbA1c, patients were classified into normoglycemic, prediabetic, and diabetic. In addition, random blood sugar (RBS) was also performed.

Results

Out of 158 participants, 84 (53.2%) were male and 74 (46.8%) were female. Nine patients had bilateral shoulder involvement, and all were diabetics; 47.5% (n = 75) of the patients were in the age group of 51-60 years, 16.5% (n = 26) of the participants were normoglycemic, 37.3% (n = 59) were prediabetics, and 46.2% (n = 73) were diabetics. The difference in mean HbA1c values between the 3 groups was statistically significant (P < .001). However, there was no statistical difference in various age groups (P = .86) or gender (P = .68) between normoglycemics, prediabetics, and diabetics. The difference in mean RBS values between diabetic-nondiabetic and diabetic-prediabetic groups were statistically significant (P < .001), whereas no significant difference was detected between nondiabetic and prediabetic (P = .355).

Conclusion

The prevalence of prediabetes is 37.5% in patients with PFS. Single-point HbA1c estimation is an acceptable tool to detect prediabetes, whereas RBS estimation should not be used to detect prediabetes.

Quality by design-based development and optimization of fourth-generation ternary solid dispersion of standardized Piper longum extract for melanoma therapy

The study aimed to enhance the solubility, dissolution, and oral bioavailability of standardized Piper longum fruits ethanolic extract (PLFEE) via fourth-generation ternary solid dispersion (SD) for melanoma therapy. With the use of solvent evaporation method, the standardized PLFEE was formulated into SD, optimized using Box-Wilson's central composite design (CCD), and evaluated for pharmaceutical performance and in vivo anticancer activity against melanoma (B16F10)-bearing C57BL/6 mice. The optimized SD showed good accelerated stability, high yield, drug content, and content uniformity for bioactive marker piperine (PIP). The X-ray diffraction (XRD), differential scanning calorimetry (DSC), polarized light microscopy (PLM), and selected area electron diffraction (SAED) analysis revealed its amorphous nature. The attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR) and high-performance thin layer chromatography (HPTLC) revealed the compatibility of excipients with the PLFEE. The contact angle measurement and in vitro dissolution study revealed excellent wetting of SD and improved dissolution profile as compared to the plain PLFEE. The in vivo oral bioavailability of SD reflected a significant (p < 0.05) improvement in bioavailability (Frel = 188.765%) as compared to plain extract. The in vivo tumor regression study revealed the improved therapeutic activity of SD as compared to plain PLFEE. Further, the SD also improved the anticancer activity of dacarbazine (DTIC) as an adjuvant therapy. The overall result revealed the potential of developed SD for melanoma therapy either alone or as an adjuvant therapy with DTIC.

Variants in exon 2 of MED12 gene causes uterine leiomyoma's through over-expression of MMP-9 of ECM pathway

AIMS

To study the impact of Mediator complex subunit 12 (MED12) gene variants on the encoded protein's function and pathogenic relevance for genesis of uterine leiomyoma's (ULs).

METHODS

Mutational analysis in exon-2 of MED12 gene was performed by PCR amplification and DNA sequencing in 89 clinically diagnosed ULs tissues. Pathogenicity prediction of variation was performed by computational analysis. The functional effects of missense variation were done by quantity RT-PCR and western blot analysis.

RESULT(S)

Out of 89 samples, 40 (44.94%) had missense variation in 14 different CDS position of exon-2 of MED12 gene. Out of 40 missense variation, codon 44 had 25 (62.5%) looking as a hotspot region for mutation for ULs, because CDS position c130 and c131present at codon 44 that have necleotide change G>A, T, C at c130 and c131 have necleotide change G>A and C. We also find somenovel somatic mutations oncodon 36 (T > C), 38 (G>T) of exon-2 and 88 (G>C) of intron-2. No mutations were detected in uterine myometrium samples. Our computational analysis suggests that change in Med12c .131 G>A leads to single substitution of amino acid [Glycine (G) to Aspartate (D)] which has a pathogenic and lethal impact and may cause instability of MED12 protein. Further, analysis of extracellular matrix (ECM) component (MMP-2 & 9, COL4A2 and α-SMA) mRNA and protein expression levels in the set of ULs having MED12 mutation showed significantly higher expression of MMP-9 and α-SMA.

CONCLUSION(S)

The findings of present study suggest that missense variation in codon 44 of MED12 gene lead to the genesis of leiomyoma's through over-expression of MMP-9 of ECM pathway which could be therapeutically targeted for non-surgical management of ULs.

Emerging Roles of SPT5 in Transcription

Suppressor of Ty homolog-5 (SPT5) discovered in the yeast mutant screens as a suppressor of mutation caused by the insertion of the Transposons of yeast (Ty) element along with SPT4, with which it forms a holoenzyme complex known as DRB sensitivity-inducing factor (DSIF) and plays an essential role in the regulation of transcription. SPT5 is a highly conserved protein across all three domains of life and performs critical functions in transcription, starting from promoter-proximal pausing to termination. We also highlight the emerging role of SPT5 in other non-canonical functions, such as the regulation of post-translational modifications (PTM) and the transcriptional regulation of non-coding genes. Also, in brief, we highlight the clinical implications of SPT5 dysregulation.

Atypical mycobacterium infection following anterior cruciate ligament reconstruction

A man in his 20s presented with instability of the right knee following an incident of fall from a height. He was clinicoradiologically diagnosed to have an anterior cruciate ligament (ACL) tear for which he underwent ACL reconstruction. Postoperatively, he was started on an accelerated ACL rehabilitation protocol. Six weeks postoperatively, he developed features of subclinical septic arthritis for which he underwent arthroscopic debridement. Intraoperative samples cultured Mycobacterium abscessus complex on MGIT 960 system. The patient subsequently had to undergo another debridement after 1 month as there were clinical signs of persisting infection. The graft was intact even on the second debridement and after removing the implants. This case reports a rare complication of ACL reconstruction with infection by atypical mycobacterium and the clinical outcome. It also emphasises that prompt surgical intervention can save the graft.

Preoperative factors affecting the quality of life after arthroscopic rotator cuff repair: a prospective study

Background

Rotator cuff tears are well known to cause significant pain and disability, having a marked impact on an individual's quality of life. This prospective study aimed to analyze the various patient factors and their impact on health-related quality of life (HrQoL) post arthroscopic rotator cuff repair (RCR).

Material and Methods

We prospectively analyzed 95 patients at one year and 81 patients at two years, with complete rotator cuff tear, who underwent arthroscopic repair of the same. The 36-Item Short Form Survey (physical and mental component score), visual analog scale (pain, function), and QuickDASH questionnaires were administered to all the patients preoperatively and at one- and two-year follow-ups. Relationships between various patient factors (age, gender, side, duration of symptoms, pseudoparalysis, diabetes mellitus [DM], type, and size of tear) and outcome measures were analyzed.

Results

All outcome parameters showed significant improvement at one- and two-year follow-ups. Patient factors, such as gender, tear type (traumatic vs degenerative), and DM, affected all outcome parameters and were significant even in the regression analysis model at a 2-year follow-up. Factors such as age and symptoms duration were significant only at 1-year follow-up, with older age and patients with symptoms > 6 weeks showing more disability. Side (dominant or nondominant), tear size, and pseudoparalysis do not affect outcomes.

Conclusions

This study showed that arthroscopic RCR significantly improved HrQoL post arthroscopic RCRs. Factors independently affecting HrQoL were noted as gender, tear type, and DM. On the other hand, age, side involved, duration of symptoms, pseudoparalysis, and tear size had no independent effect on HrQoL at a two-year follow-up.

Unilateral Syndactyly, Hemihypertrophy, and Hyperpigmentation with Mosaic 2q35 Deletion

Pigmentary mosaicism (PM) is a clinical condition of dyspigmentation with chromosomal abnormality. PM presents with both cutaneous and extracutaneous manifestation. Hypomelanosis of Ito and linear and whorled nevoid hypermelanosis are syndromic disorders in which PM is one of the manifestations. We present a case of a 1-year-old child with a unique constellation of symptoms of unilateral syndactyly, hemihypertrophy, and skin hyperpigmentation. Karyotype from peripheral blood was normal. We found genetic aberration (mosaic 2q35 deletion) in the present case from fibroblast cultured from the affected area. This unique constellation of symptoms was previously reported once but genetic study was not done from the affected tissue. This case highlights the need of considering fibroblast culture-based genetic study rather than doing simple karyotype from peripheral blood. Genetic study also established the molecular basis of symptoms in the above case.

Existence of nodal-arc and its evolution into Weyl-nodes in the presence of spin-orbit coupling in TaAs & TaP

In this work, we report the existence ofnodal-arc, which acts as the building block of all the nodal-rings in TaAs & TaP. Thisnodal-arcis found to be capable of generating all the nodal-rings in these materials upon the application of space-group symmetry operations including time-reversal symmetry. The arcs are obtained to be dispersive with the energy spread of ∼109 (∼204) meV in TaAs (TaP). Also, the orbitals leading to bands-inversion and thus the formation ofnodal-arcsare found to be Ta-5d& As-4p(P-3p) in TaAs (TaP). The area of nodal-rings is found to be highly sensitive to the change in hybridization-strength, where the increase in hybridization-strength leads to the decrease in the area of nodal-rings. In the presence of spin-orbit coupling (SOC), all the points on these arcs get gaped-up and two pairs of Weyl-nodes are found to evolve from them. Out of the two pair, one is found to be situated close to the joining point of the two arcs forming a ring. This causes the evolution of each nodal-ring into three pairs of Weyl-nodes. The coordinates of these Weyl-nodes are found to be robust to the increase in SOC-strength from ∼ 0.7-3.5 eV. All the results are obtained at thefirst-principlelevel. This work provides a clear picture of the existence of nodal-arc due to accidental degeneracy and its evolution into Weyl-nodes under the effect of SOC.

Efficacy and Safety of Stempeucel in Osteoarthritis of the Knee: A Phase 3 Randomized, Double-Blind, Multicenter, Placebo-Controlled Study

BACKGROUND

Osteoarthritis is a chronic, progressive, and degenerative condition with limited therapy options. Recently, biologic therapies have been an evolving option for the management of osteoarthritis.

PURPOSE

To assess whether allogenic mesenchymal stromal cells (MSCs) have the potential to improve functional parameters and induce cartilage regeneration in patients with osteoarthritis.

STUDY DESIGN

Randomized controlled trial; Level of evidence, 1.

METHODS

A total of 146 patients with grade 2 and 3 osteoarthritis were randomized to either an MSC group or placebo group with a ratio of 1:1. There were 73 patients per group who received either a single intra-articular injection of bone marrow-derived MSCs (BMMSCs; 25 million cells) or placebo, followed by 20 mg per 2 mL of hyaluronic acid under ultrasound guidance. The primary endpoint was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score. The secondary endpoints were WOMAC subscores for pain, stiffness, and physical function; the visual analog scale score for pain; and magnetic resonance imaging findings using T2 mapping and cartilage volume.

RESULTS

Overall, 65 patients from the BMMSC group and 68 patients from the placebo group completed 12-month follow-up. The BMMSC group showed significant improvements in the WOMAC total score compared with the placebo group at 6 and 12 months (percentage change: -23.64% [95% CI, -32.88 to -14.40] at 6 months and -45.60% [95% CI, -55.97 to -35.23] at 12 months P < .001; percentage change, -44.3%). BMMSCs significantly improved WOMAC pain, stiffness, and physical function subscores as well as visual analog scale scores at 6 and 12 months (P < .001). T2 mapping showed that there was no worsening of deep cartilage in the medial femorotibial compartment of the knee in the BMMSC group at 12-month follow-up, whereas in the placebo group, there was significant and gradual worsening of cartilage (P < .001). Cartilage volume did not change significantly in the BMMSC group. There were 5 adverse events that were possibly/probably related to the study drug and consisted of injection-site swelling and pain, which improved within a few days.

CONCLUSION

In this small randomized trial, BMMSCs proved to be safe and effective for the treatment of grade 2 and 3 osteoarthritis. The intervention was simple and easy to administer, provided sustained relief of pain and stiffness, improved physical function, and prevented worsening of cartilage quality for ≥12 months.

REGISTRATION

CTRI/2018/09/015785 (National Institutes of Health and Clinical Trials Registry-India).

Bioengineered dual fluorescent carbon nano dots from Indian long pepper leaves for multifaceted environmental and health utilities

In this article, we present the synthesis of Piper longum leaves-derived ethanolic carbon dots (PLECDs) using the most simplistic environmentally friendly solvothermal carbonization method. The PLECDs fluoresced pink color with maximum emission at 670 nm at 397 nm excitation. Additionally, the dried PLECDs dissolved in water showed green fluorescence with higher emission at 452 nm at 370 nm excitation. The UV spectra showed peaks in the UV region (271.25 nm and 320.79 nm) and a noticeable tail in the visible region, signifying the efficient synthesis of nano-sized carbon particles and the Mie scattering effect. Various functional groups (-OH, -N-H, -C-H, -C = C, -C-N, and -C-O) were identified using Fourier transform infrared spectroscopy (FTIR). Its nanocrystalline property was revealed by the sharp peaks in the X-ray diffraction (XRD). High-resolution transmission electron microscopy (HRTEM) photomicrograph displayed a roughly spherical structure with a mean size of 2.835 nm. The energy dispersive X-ray (EDAX) and X-ray photoelectron spectroscopy (XPS) revealed the elemental abundance of C, O, and N. The high-performance thin-layer chromatography (HPTLC) fingerprint of PLECDs showed an altered pattern than its precursor (Piper longum leaves ethanolic extract or PLLEE). The PLECDs sensed Cu²⁺ selectively with a limit of detection (LOD) and limit of quantification (LOQ) of 0.063 μM and 0.193 μM, respectively. It showed excellent cytotoxicity toward MDA-MB-231 (human breast cancer), SiHa (human cervical carcinoma), and B16F10 (murine melanoma) cell lines with excellent in vitro bioimaging outcomes. It also has free radical scavenging activity. The PLECDs also showed outstanding bacterial biocompatibility, pH-dependent fluorescence stability, photostability, physicochemical stability, and thermal stability.

Response of tropical trees to elevated Ozone: a Free Air Ozone Enrichment study

Tropospheric ozone (O₃) has become one of the main urban air pollutants. In the present study, we assessed impact of ambient and future ground-level O₃ on nine commonly growing urban tree species under Free Air Ozone Enrichment (FAOE) condition. During the study period, mean ambient and elevated ozone (EO₃) concentrations were 48.59 and 69.62 ppb, respectively. Under EO₃ treatment, stomatal density (SD) significantly decreased and guard cell length (GCL) increased in Azadirachta indica, Bougainvillea spectabilis, Plumeria rubra, Saraca asoca and Tabernaemontana divaricata, while SD increased and GCL decreased in Ficus benghalensis and Terminalia arjuna. Proline levels increased in all the nine plant species under EO₃ condition. EO₃ significantly reduced photosynthetic rate, stomatal conductance (gs), and transpiration rates (E). Only A. indica and N. indicum showed higher gs and E under EO₃ treatment. Water use efficiency (WUE) significantly increased in F. benghalensis and decreased in A. indica and T. divaricata. Air Pollution Tolerance Index (APTI) significantly increased in Ficus religiosa and S. asoca whereas it decreased in B. spectabilis and A. indica. Of all the plant species B. spectabilis and A. indica were the most sensitive to EO₃ (high g_s and less ascorbic acid content) while S. asoca and F. religiosa were the most tolerant (lowg_s and more ascorbic acid content). The sensitivity of urban tree species to EO₃ is a cause of concern and should be considered for future urban forestry programmes. Our study should guide more such studies to identify tolerant trees for urban air pollution abatement.

Size Effect of Nanoceria Blended with CIME Biodiesel on Engine Characteristics

Diesel fuel blends with biodiesels are expected to mitigate the rising price and demand of conventional fuels. Biodiesel fuel blends are also known to reduce engine emissions. Biodiesel is produced from various sources, one of which is Calophyllum Inophyllum methyl ester biodiesel (CIMEBD). Even though it serves to mitigate the energy crisis and has a low overall carbon footprint, CIMEBD has certain negative issues relating to engine performance and emission characteristics. Nanoparticle (NP) addition is known to enhance the engine performance characteristics of next generation biofuels. CeO₂ (cerium oxide or ceria) NPs of varying size are used in this study along with 25:75 biodiesel-diesel (BD) blend and a fixed NP concentration of 90 ppm. Ceria NP-doped fuel is shown to have better engine performance compared to diesel and BD blend for all load conditions. Improvements in brake thermal efficiency (BTE) and brake-specific fuel consumption (BSFC) values equal to +30% and -46%, respectively, are observed from experiments for ceria NP-doped biodiesel, compared to diesel-biodiesel (BD) blend. Ceria NPs in the 20 to 40 nm range have optimum engine performance characteristics. Compared to BD blends, NP-doped biodiesel shows improvements in NOx, CO, CO₂, UHC, and soot parameters up to -35%, -60%, -35%, -38%, and -40%, respectively. Likewise, the optimum size of ceria NPs is in the range 20-40 nm for better emission characteristics.

Bioclimatic modeling and FACE study forecast a bleak future for wheat production in India

Since the impact of future climate change on wheat productivity is inconsistent, we studied geographic distribution and yield of wheat using two global General Circulation Models (GCMs) and Free Air CO_2/O₃ Enrichment (FACE) experiments. The GCMs (IPSL-CM5A-LR and NIMR-HADGEM2-AO) with four Representative Concentration Pathways (RCPs) and 19 bioclimatic variables were used for distribution/ecological niche modeling (ENM). Currently cultivated eight wheat cultivars were exposed to individual treatment of (i) ambient CO₂, temperature, and ozone (ACO + AO + AT) representing the present climate scenario, and (ii) elevated CO₂ (550 ppm) (ECO), (iii) elevated temperature (+ 2 °C) (ET), (iv) elevated O₃ (ambient + 20 ppb) (EO), (v) elevated CO₂ + elevated O₃ (ECO + EO), and (vi) elevated CO₂ + elevated temperature + elevated O₃ (ECO + EO + ET) under FACE facility simulating the future climate change scenarios in 2050. The niche models predicted a reduction in climatically suitable areas for wheat, and identified "maximum temperature" as the most influencing factor for area reduction. The elevated CO₂, O₃, and temperature individually and in combinations had differential impacts on the yield of wheat cultivars. Only two cultivars, viz., DBW 184 and DBW 187 did not exhibit yield decline suggesting their suitability in the future climate change scenario. Since the performance of six out of eight cultivars significantly declined under simulated FACE experiment, and ENM predicted reduction in wheat cultivation area under RCP 8.5 in 2050, it was concluded that future of wheat cultivation in India is bleak. The study further indicates that coupling of bioclimatic modeling and FACE experiment can effectively predict the impact of climate change on different crops.

Trends in Practice Among Shoulder Specialists in the Management of Frozen Shoulder: A Consensus Survey

Background:

The management of frozen shoulder (FS) differs depending on experience level and variation between scientific guidelines and actual practice.

Purpose:

To determine the current trends and practices in the management of FS among shoulder specialists and compare them with senior shoulder specialists.

Study Design:

Consensus statement.

Methods:

A team of 15 senior shoulder specialists (faculty group) prepared a questionnaire comprising 26 questions regarding the definition, terminology, clinical signs, investigations, management, and prognosis of FS. The questionnaire was mailed to all the registered shoulder specialists of Shoulder and Elbow Society, India (SESI) (specialist group; n = 230), as well as to the faculty group (n = 15). The responses of the 2 groups were compared, and levels of consensus were determined: strong (>75%), broad (60%-74.9%), inconclusive (40%-59.9%), or disagreement (<40%).

Result:

Overall, 142 of the 230 participants in the specialist group and all 15 participants in the faculty group responded to the survey. Both groups strongly agreed that plain radiographs are required to rule out a secondary cause of FS, routine magnetic resonance imaging is not indicated to confirm FS, nonsteroidal anti-inflammatory drugs should be administered at bedtime, steroid injection (triamcinolone or methylprednisolone) is the next best option if analgesics fail to provide pain relief, passive physical therapy should be avoided in the freezing phase, <10% of patients would require any surgical intervention, and patients with diabetes and thyroid dysfunction tend to fare poorly. There was broad agreement that routine thyroid dysfunction screening is unnecessary for women, a single 40-mg steroid injection via intra-articular route is preferred, and arthroscopic capsular release (ACR) results in a better outcome than manipulation under anesthesia (MUA). Agreement was inconclusive regarding the use of combined random blood sugar (RBS) and glycosylated hemoglobin versus lone RBS to screen for diabetes in patients with FS, preference of ACR versus MUA to treat resistant FS, and the timing of surgical intervention. There was disagreement over the most appropriate term for FS, the preferred physical therapy modality for pain relief, the most important movement restriction for early diagnosis of FS, and complications seen after MUA.

Conclusion:

This survey summarized the trend in prevalent practices regarding FS among the shoulder specialists and senior shoulder surgeons of SESI.

Piezosurgery Versus Conventional Method Alveoloplasty: A Comparative Study

Purpose

The conventional alveoloplasty approach which uses manual equipment results in more resorption of the underlying alveolar ridge that makes denture prosthesis unstable. The goal of this study was to compare results of piezosurgery alveoloplasty to those of conventional alveoloplasty.

Materials and Methods

This was an in-vivo comparative study consisting of ten edentulous individuals who needed alveoloplasty due to bilateral bony projection. On one side, a conventional alveoloplasty was performed with a bone rongeur and bone file, whereas the contralateral side was treated with a piezosurgery unit. The clinical parameters were analyzed using SPSS version 21 software including operating time, postoperative pain evaluation on day 3 and a healing on day 7.

Results

There was a statistically significant difference between the two groups in terms of outcome variables such as operating time, pain and healing. The Conventional group has a lower mean of operating time, a higher mean rank of VAS and a lower mean rank of healing index compared to the piezosurgery group.

Conclusion

Piezosurgery alveoloplasty not only lowers postoperative patient discomfort but also preserves alveolar bone integrity by not disrupting soft and hard tissue architecture thus allowing faster tissue healing and easier prosthesis replacement in the future.

Trends in Primary Anatomical Single-Bundle Anterior Cruciate Ligament Reconstruction Practice in Adult Patients Prevalent Among Arthroscopy Surgeons of Six Southern States of India

BACKGROUND

Although guidelines from multiple scientific studies decide the general trend in ACLR practice, there is often a variation between scientific guidelines and actual practice.

METHODS

A 17-member committee comprised of sports surgeons with experience of a minimum of 10 years of arthroscopy surgery finalized a survey questionnaire consisting of concepts in ACL tear management and perioperative trends, intraoperative and post-operative practices regarding single-bundle anatomic ACLR. The survey questionnaire was mailed to 584 registered sports surgeons in six states of south India. A single, non-modifiable response was collected from each member and analyzed.

RESULTS

324 responses were received out of 584 members. A strong consensus was present regarding Hamstring tendons preference for ACLR, graft diameter ≥ 7.5 mm, viewing femoral footprint through the anterolateral portal, drilling femoral tunnel from anteromedial portal guided by ridges and remnants of femoral footprint using a freehand technique, suspensory devices to fix the graft in femur and interference screw in the tibia and post-operative bracing. A broad consensus was achieved in using a brace to minimize symptoms of instability of an ACL tear and antibiotic soaking of graft. There was no consensus regarding the timing of ACLR, preferred graft in athletes, pre-tensioning, extra-articular procedure, and return to sports. There was disagreement over hybrid tibial fixation and suture tapes to augment graft.

CONCLUSION

Diverse practices continue to prevail in the management of ACL injuries. However, some of the consensuses reached in this survey match global practices. Contrasting or inconclusive practices should be explored for potential future research.

First Leptophobic Dark Matter Search from the Coherent-CAPTAIN-Mills Liquid Argon Detector

We report the first results of a search for leptophobic dark matter (DM) from the Coherent-CAPTAIN-Mills (CCM) liquid argon (LAr) detector. An engineering run with 120 photomultiplier tubes (PMTs) and 17.9×10^{20} protons on target (POT) was performed in fall 2019 to study the characteristics of the CCM detector. The operation of this 10-ton detector was strictly light based with a threshold of 50 keV and used coherent elastic scattering off argon nuclei to detect DM. Despite only 1.5 months of accumulated luminosity, contaminated LAr, and nonoptimized shielding, CCM's first engineering run has already achieved sensitivity to previously unexplored parameter space of light dark matter models with a baryonic vector portal. With an expected background of 115 005 events, we observe 115 005+16.5 events which is compatible with background expectations. For a benchmark mediator-to-DM mass ratio of m_{V_{B}}/m_{χ}=2.1, DM masses within the range 9  MeV≲m_{χ}≲50  MeV are excluded at 90% C. L. in the leptophobic model after applying the Feldman-Cousins test statistic. CCM's upgraded run with 200 PMTs, filtered LAr, improved shielding, and 10 times more POT will be able to exclude the remaining thermal relic density parameter space of this model, as well as probe new parameter space of other leptophobic DM models.

COVID-19, information management by local governments, and food consumption

Federal and state governments in developing countries have tasked local governments with managing COVID-19 on the ground. The bottom-up approach is critical to ensuring household food security, especially in rural areas. We have utilized data from a panel of Indian households that participated in two rounds of a livelihoods survey. While the first round was fielded before COVID-19, the second round was conducted telephonically after the COVID-19-lockdown. We developed an Information Management Response Index (IMRI) to measure the strength of local governments' information management initiatives. The difference-in-difference estimates show that local governments could partially mitigate the pandemic's adverse effects on (a) level and distribution (adult-equivalent per-capita) of food and nutrition expenditure and (b) household vulnerability to food and nutrition poverty. For landless households, IMRI led to statistically significant and additional welfare effects. Three channels explain our empirical findings: (a) maintenance of essential commodities through fair-price shops, (b) access to paid employment and cash (income effect), and (c) disease management (substitution effect). The estimates have been adjusted for sample attrition and multiple-hypothesis correction. We conducted robustness checks with respect to index construction, instrumental variable estimation, and sub-group analysis.

Comparative transcriptomic analysis and antioxidant defense mechanisms in clusterbean (Cyamopsis tetragonoloba (L.) Taub.) genotypes with contrasting drought tolerance

To understand drought tolerance mechanism(s) in clusterbean (Cyamopsis tetragonoloba), we conducted physiological, biochemical, and de novo comparative transcriptome analysis of drought-tolerant (RGC-1002) and drought-sensitive (RGC-1066) genotypes subjected to 30 days of drought stress. Relative water content (RWC) was maintained in tolerant genotype but was reduced in sensitive genotype. Leaf pigment concentrations were higher in tolerant genotype. Net photosynthesis was significantly decreased in sensitive genotype but insignificant reduction was found in tolerant genotype. Enzymatic antioxidant (GR, APX, DHAR) activities were enhanced in tolerant genotype, while there were insignificant changes in these enzymes in sensitive genotype. The ratios of antioxidant molecules (ASC/DHA and GSH/GSSG) were higher in tolerant genotype as compared to sensitive genotype. In sensitive genotype, 6625 differentially expressed genes (DEGs) were upregulated and 5365 genes were downregulated. In tolerant genotype, 5206 genes were upregulated and 2793 genes were downregulated. In tolerant genotype, transketolase family protein, phosphoenolpyruvate carboxylase 3, temperature-induced lipocalin, and cytochrome oxidase were highly upregulated. Moreover, according to Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, the drought tolerance may be attributed to upregulated starch and sucrose metabolism-related genes in tolerant genotype. Finally, quantitative real-time PCR confirmed the reproducibility of the RNA-seq data.

Measurement of the Nucleon F_{2}^{n}/F_{2}^{p} Structure Function Ratio by the Jefferson Lab MARATHON Tritium/Helium-3 Deep Inelastic Scattering Experiment

The ratio of the nucleon F_{2} structure functions, F_{2}^{n}/F_{2}^{p}, is determined by the MARATHON experiment from measurements of deep inelastic scattering of electrons from ^{3}H and ^{3}He nuclei. The experiment was performed in the Hall A Facility of Jefferson Lab using two high-resolution spectrometers for electron detection, and a cryogenic target system which included a low-activity tritium cell. The data analysis used a novel technique exploiting the mirror symmetry of the two nuclei, which essentially eliminates many theoretical uncertainties in the extraction of the ratio. The results, which cover the Bjorken scaling variable range 0.19<x<0.83, represent a significant improvement compared to previous SLAC and Jefferson Lab measurements for the ratio. They are compared to recent theoretical calculations and empirical determinations of the F_{2}^{n}/F_{2}^{p} ratio.

Clinical and radiological outcome of acute high-grade acromioclavicular joint dislocation: A retrospective cohort study on Hook plate versus arthroscopic assisted single coracoclavicular tunnel with DogBone™ button dual FiberTape® construct

Purpose

Hook plate (HP) is a popular implant of choice in the management of highgrade acute acromioclavicular joint (ACJ) dislocations. Recently, suspensory loop systems have drawn significant interest with comparable results and additionally does not warrant implant removal. However, no studies have compared the outcomes of HP vis-a-vis Dog Bone TM Button with dual FiberTape® (DB).

Methods

38 patients who underwent HP or Arthroscopic assisted single tunnel DB fixation to stabilize high-grade ACJ dislocations were retrospectively included in study for clinically and radiological evaluation at a minimum follow up of one year. American Shoulder and Elbow Society and Constant Murley scores were used for clinical assessment. The radiological evaluation was done by assessing quality of reduction, measuring coracoclavicular distance (CCD), and extent of subacromial erosion.

Results

For final follow up evaluation, both HP and DB group had 16 patients each. The mean follow-up was 55.38 ± 10.9 and 32.88 ± 14.0 months in HP and DB group, respectively. No significant difference in mean ASES (p=0.71) and CM score (p=0.62) was found between the two groups. The DB group revealed higher CCD at the final follow-up compared to the HP group (p=0.01). Although statistically insignificant, there were more subluxations and dislocations in the DB group (37.5%) compared to the HP group (25%). The subacromial erosion was noted in all cases of the HP group at time of implant removal.

Conclusion

Both groups revealed satisfactory functional and radiological outcome. However, the DB group showed a higher tendency of loss of reduction.

Current concepts on management of medial and posteromedial knee injuries

Traditionally, while managing ligament injuries around the knee, medial side injuries are frequently overlooked or considered 'benign' with very little influence on overall knee stability outcomes. However, much has changed in the recent past, and like the lateral side of the knee, it is gaining considerable attention. It is now well known that the Medial collateral ligament and Posteromedial corner are fundamentally two distinct structures that differ in anatomy and biomechanics. When it comes to decision making between conservative versus operative approach for medial side injuries, treating orthopaedic surgeons are subjected to walking on a thin line trying to balance between potential residual laxity and joint stiffness. This review will delve into some of the recent works focusing on the medial side injuries and discuss the evolving concepts.

The promising role of autologous and allogeneic mesenchymal stromal cells in managing knee osteoarthritis. What is beyond Mesenchymal stromal cells?

Mesenchymal stromal cells (MSCs) express a wide range of properties anticipated to be beneficial for treating genetic, mechanical, and age-related degeneration in diseases such as osteoarthritis (OA). Although contemporary conservative management of OA is successful in many patients with mild-moderate OA, it often fails to improve symptoms in many patients who are not a candidate for any surgical management. Further, existing conservative treatment strategies do not prevent the progression of the disease and therefore fail to provide a long-term pain-free life. On the other hand, tremendous progress has been taking place in the exciting field of regenerative medicine involving MSCs (autologous and allogeneic), with promising translation taking place from basic science to the bedside. In this review, we comprehensively discuss the potential role of MSCs in treating OA, both autologous and off-the-shelf, allogeneic stem cells. Further, newer therapies are in the offing to treat OA, such as exosomes and growth factors.

Membrane linked RNA glycosylation as new trend to envision epi-transcriptome epoch

RNAs play several prominent roles in the cellular environment ranging from structural, messengers, translators, and effector molecules. RNA molecules while performing these roles are associated with several chemical modifications occurring post-transcriptionally, responsible for these supporting vital functions. The recent documentation of surface RNA modification with sialic acid residues has sparked advancement to the framework of RNA modifications. Glycan modification of surface RNA which was previously known to modify only proteins and lipids has opened new vistas to explore how these surface RNA modifications affect the cellular responses and phenotype. This paradigm shift in RNA biology with a vision of "glycans being all over the cells" has posed the field with a repertoire of questions and has given headway to the RNA world hypothesis. The review provides a comprehensive overview of glycoRNA discovery with a conceptual understanding of its previous underlying discoveries and their biological consequences with possible insights into the dynamic influence of this modification on their molecular versatility deciding cancer-immunology fate with potential implications of these glycosylation in cellular interaction, signaling, immune regulation, cancer evasion and proliferation.

A randomized comparison between interscalene block and dexmedetomidine for arthroscopic shoulder surgery

Introduction: Management of intraoperative hemodynamics and postoperative analgesia during arthroscopic shoulder surgeries remains a challenge. Although interscalene brachial plexus block (ISB) is considered ideal for shoulder anesthesia it requires skill and proficiency unlike intravenous (IV) dexmedetomidine. Objective: This randomized trial was performed to observe the efficacy of dexmedetomidine infusion which is less invasive and demands lesser skills than plexus block. Methodology: All patients scheduled for elective arthroscopic shoulder surgery under general anesthesia were assigned either to group DEX, which received an IV dexmedetomidine bolus of 0.5 mcg/kg over 20 minutes, followed by an infusion of 0.5 mcg/kg/hour that was stopped 30 minutes before surgery the end of surgery or to group BLOCK which received ultrasound guided ISB with 20ml of 0.25% bupivacaine. The primary outcome assessed was intraoperative hemodynamics; the secondary outcomes were immediate postoperative pain, operating condition as assessed by the surgeon, recovery time, and patient satisfaction after 24 hours. Blinded investigator and composite scores were used for the assessment. Results: Both groups displayed equivalent scores for intraoperative hemodynamics whereas ISB resulted in a better post-operative analgesia (p < 0.001). Surgeon’s opinion and recovery time were comparable. Overall, the patients had a satisfactory experience with both techniques, according to the quality assessment. Conclusion: IV dexmedetomidine infusion is an effective alternative to ISB for reconstructive shoulder surgeries under general anesthesia.

Evaluating impacts of biogenic silver nanoparticles and ethylenediurea on wheat (Triticum aestivum L.) against ozone-induced damages

Tropospheric ozone (O₃) is a phytotoxic pollutant that leads to a reduction in crop yield. Nanotechnology offers promising solutions to stem such yield losses against abiotic stresses. Silver nanoparticles are major nanomaterials used in consumer products however, their impact on crops under abiotic stress is limited. In this study, we evaluated the anti-ozonant efficacy of biogenic silver nanoparticles (B-AgNPs) and compared them with a model anti-ozonant ethylenediurea (EDU) against ozone phyto-toxicity. Growth, physiology, antioxidant defense, and yield parameters in two wheat cultivars (HD-2967 & DBW-17), treated with B-AgNPs (25 mg/L and 50 mg/L) and EDU (150 mg/L and 300 mg/L), were studied at both vegetative and reproductive stages. During the experimental period, the average ambient ozone concentration and accumulated dose of ozone over a threshold of 40 ppb (AOT40) (8 h day^-1) were found to be 60 ppb and 6 ppm h, respectively, which were sufficient to cause ozone-induced phyto-toxicity in wheat. Growth and yield for B-AgNPs as well as EDU-treated plants were significantly higher in both the tested cultivars over control ones. However, 25 mg/L B-AgNPs treatment showed a more pronounced effect in terms of yield attributes and its lower accumulation in grains for both cultivars. DBW-17 cultivar responded better with B-AgNPs and EDU treatments as compared to HD-2967. Meanwhile, foliar exposure of B-AgNPs (dose; 25 mg/L) significantly enhanced grain weight plant^-1, thousand-grain weight, and harvest index by 54.22 %, 29.46 %, and 14.21 %, respectively in DBW-17, when compared to control. B-AgNPs could enhance ozone tolerance in wheat by increasing biochemical and physiological responses. It is concluded that B-AgNPs at optimum concentrations were as effective as EDU, hence could be a promising ozone protectant for wheat.

Tinospora cordifolia Leaves Derived Carbon dots for Cancer Cell Bioimaging, Free radical Scavenging, and Fe3+ Sensing Applications

Herein, we report the fabrication of Tinospora cordifolia leaves-derived carbon dots (TCLCDs) from aqueous extract of leaves as carbon source via simple, environmentally friendly, hydrothermal carbonization (HTC) technique. The synthesized TCLCDs were characterized for their physicochemical properties and further explored for in-vitro cancer cell bioimaging, radical scavenging, and metal ion sensing. The synthesized TCLCDs showed excitation-dependent emission property with maximum emission at 435 nm under the excitation of 350 nm. The High-Resolution Transmission Electron Microscopy (HRTEM) results revealed a roughly spherical shape with an average diameter of 5.47 nm. The diffused ring pattern of Selected Area Electron Diffraction (SAED) and halo diffraction pattern of X-ray diffraction (XRD) disclosed their amorphous nature. The Energy Dispersive X-ray (EDX) showed the existence of C, N, and O. The Fourier-transform infrared spectroscopy (FTIR) revealed the presence of -OH, -NH, -CN, and -CH groups. The TCLCDs showed excellent cellular biocompatibility with dose-dependent bioimaging results in melanoma (B16F10) and cervical cancer (SiHa) cell lines. Also, they exhibited excellent scavenging of free radicals with an IC₅₀ value of 0.524 mg/mL & selective Fe³⁺ ion sensing with a detection limit of 0.414 µM. Further, they exerted excellent bacterial biocompatibility, photostability, and thermal stability. The overall results reflected their potential for in-vitro cancer cell bioimaging, free radical scavenging, and selective Fe³⁺ ion sensing.

Detection and removal of poly and perfluoroalkyl polluting substances for sustainable environment

PFAs (poly and perfluoroalkyl compounds) are hazardous and bioaccumulative chemicals that do not readily biodegrade or neutralize under normal environmental conditions. They have various industrial, commercial, domestic and defence applications. According to the Organization for Economic Co-operation and Development, there are around 4700 PFAs registered to date. They are present in every stream of life, and they are often emerging and are even difficult to be detected by the standard chemical methods. This review aims to focus on the sources of various PFAs and the toxicities they impose on the environment and especially on humankind. Drinking water, food packaging, industrial areas and commercial household products are the primary PFAs sources. Some of the well-known treatment methods for remediation of PFAs presented in the literature are activated carbon, filtration, reverse osmosis, nano filtration, oxidation processes etc. The crucial stage of handling the PFAs occurs in determining and analysing the type of PFA and its remedy. This paper provides a state-of-the-art review of determination & tools, and techniques for remediation of PFAs in the environment. Improving new treatment methodologies that are economical and sustainable are essential for excluding the PFAs from the environment.

Heterotopic Ossification after Open Anchor Fixation of the Posterior Cruciate Ligament Avulsion in a Multiligament Injury of the Knee: A Case Report

Introduction:

Heterotopic ossifications (HO) are a well-recognized but infrequently encountered condition. In the lower limb, the literature commonly reports the formation of HO around the hip after surgeries. However, HO is uncommon around the knee and a rare complication after open fixation of posterior cruciate ligament (PCL) avulsion fracture.

Case Report:

Here, we describe a case of HO in a 42-year-old patient with multiligament injury, including PCL and arcuate ligament avulsion, partial ACL tear, and medial meniscus root tear with suspected vascular compromise. He underwent open reduction and internal fixation of PCL avulsion fracture and medial meniscus root repair after the injury. At a 6-week follow-up, a plain radiograph revealed posterior capsule HO which kept increasing over successive follow-ups compromising his knee function. The patient was not willing for any mode of intervention for the same at any given time.

Conclusion:

HO after open PCL avulsion fixation is an uncommon entity. This article sheds light on how open fixation of PCL bony avulsion in a multiligament injured knee could result in a HO.

Pharmacophore based drug design and synthesis of oxindole bearing hybrid as anticancer agents

Dual TK inhibitors have shown significant clinical effects against many tumors, but with unmanageable side effects. Design approach and selectivity of these inhibitors plays substantial role in their potency and side-effects. Understanding the homology of binding sites in targeted receptors, and involvement of signaling proteins after the inhibition might help in producing less toxic but effective inhibitors. Herein, we designed benzylideneindolon-2-one derivatives based on homology modeling in binding sites of VEGFR-2 and EGFR receptors as dual- inhibitor potent anticancer compounds with high selectivity. The benzylideneindolon-2-one derivatives were found to possess conformational switch in form of oxindole, substituted at 2-benzimidazole. Within synthesized compounds, 5b was found most active in in-vitro enzyme inhibition assay against VEGFR-2 and EGFR with highest IC₅₀ value of 6.81 ± 2.55 and 13.04 ± 4.07 nM, respectively. Interestingly, cytotoxicity studies revealed selective toxicity of compound 5b against proliferation of A-431 cell lines (over expressed VEGFR-2 and EGFR) with GI₅₀ value of 0.9 ± 0.66 µM. However, the compounds showed mild to moderate activity in all other cancer cell line in the range of 0.2-100 μM. Further mode of action studies by flow cytometry and western blot on A-431 indicated that they work via apoptosis at S- phase following Bcl/Bax pathway, and cell migration via MMP9. 5b not only suppressed tumor growth but also improved vandetanib associated with weight loss toxicity. Moreover, 5b was found safer than sunitinib and erlotinib with LD₅₀ of 500 mg/kg body weight. These results propose 5b as potential anti-tumor drug with safer profile of conventional inhibitors of VEGFR-2 and EGFR for solid tumors.

Carbon dots from an immunomodulatory plant for cancer cell imaging, free radical scavenging and metal sensing applications

Aim: This work aimed to develop Tinospora cordifolia stem-derived carbon dots (TCSCD) for cancer cell imaging, free radical scavenging and metal sensing applications. Method: The TCSCDs were synthesized by a simple, one-step, and ecofriendly hydrothermal carbonization method and characterized for their optical properties, morphology, hydrodynamic size, surface functionality, crystallinity, stability, bacterial biocompatibility, in vitro cellular imaging, free radical scavenging and metal sensing ability. Results: The TCSCDs exhibited excellent biocompatibility with dose-dependent bioimaging results in melanoma (B16F10) and cervical cancer (SiHa) cell lines. They exerted good free radical scavenging, Fe³⁺ sensing, bacterial biocompatibility, photostability, colloidal dispersion stability and thermal stability. Conclusion: The results reflect the potential of TCSCDs for biomedical and pharmaceutical applications.

Anab initiostudy of topological and transport properties of YAuPb

In the last few decades, the study of topological materials has been carried out on an extensive scale. Half-Heusler alloys are well known for their topological behaviours. In this work, we present a detailed study of topological properties of a ternary half-Heusler alloy, YAuPb, using the tight-binding approach. We have calculated some important topological properties which includes-finding nodes and their chiralities, Berry curvature (Ω) and the surface-states. Five pairs of characteristic nodes with equal and opposite chiralities are obtained. Based on the study of these properties, we categorise the material as non-trivial topological semimetal. Besides the topological behaviours, we present a comparative study of temperature dependent transport properties corresponding to the chemical potential (μ) of the Fermi level and the node points. The temperature range chosen for the study is 50-300 K. The results obtained from the calculations of electrical conductivity per unit relaxation time (σ/τ) and the electronic part of thermal conductivity per unit relaxation time (κ₀) indicates the conducting nature of the material to both the heat and electricity. At the Fermi level, the value of Seebeck coefficient (S) is found to be ∼-9.07(-35.95) μV K^-1at 50(300) K. The negative value ofSindicates the n-type behaviour of the compound. The calculated value of electronic specific heat (Pauli magnetic susceptibility) corresponding to Fermi level is ∼0.03(0.18) × 10^-2 J mol^-1 K^-1(∼1.21(1.14) × 10^-10 m³ mol^-1) at 50(300) K. This work suggests that YAuPb is a promising candidate of non-trivial topological semimetals which can be employed in transmission of heat and electricity, and as n-type material within the temperature range of 50-300 K.

Effects of ethylenediurea (EDU) on apoplast and chloroplast proteome in two wheat varieties under high ambient ozone: an approach to investigate EDU's mode of action

Rising tropospheric ozone (O₃) is a serious threat to plants and animals in the present climate change scenario. High tropospheric O₃ has the capability to disrupt cellular organelles leading to impaired photosynthesis and significant yield reduction. Apoplast and chloroplast are two important cellular components in a plant system. Their proteomic response with ethylenediurea (EDU) treatment under tropospheric O₃ has not been explored till date. EDU (an organic compound) protects plants exclusively against harmful O₃ effects through activation of antioxidant defense mechanism. The present study investigated the mode of action of EDU (hereafter MAE) by identifying proteins involved in apoplast and chloroplast pathways. Two wheat varieties viz. Kundan and PBW 343 (hereafter K and P respectively) and three EDU treatments (0= control, 200, and 300 ppm) have been used for the study. In apoplast isolates, proteins such as superoxide dismutase (SOD), amino methyltransferase, catalase, and Germin-like protein have shown active role by maintaining antioxidant defense system under EDU treatment. Differential expression of these proteins leads to enhanced antioxidative defense mechanisms inside and outside the cell. Chloroplast proteins such as Rubisco, Ferredoxin NADP- reductase (FNR), fructose,1-6 bis phosphatase (FBPase), ATP synthase, vacuolar proton ATPase, and chaperonin have regulated their abundance to minimize ozone stress under EDU treatment. After analyzing apoplast and chloroplast protein abundance, we have drawn a schematic representation of the MAE working mechanism. The present study showed that plants can be capable of O₃ tolerance, which could be improved by optimizing the apoplast ROS pool under EDU treatment.

Cosmic Ray Background Removal With Deep Neural Networks in SBND

In liquid argon time projection chambers exposed to neutrino beams and running on or near surface levels, cosmic muons, and other cosmic particles are incident on the detectors while a single neutrino-induced event is being recorded. In practice, this means that data from surface liquid argon time projection chambers will be dominated by cosmic particles, both as a source of event triggers and as the majority of the particle count in true neutrino-triggered events. In this work, we demonstrate a novel application of deep learning techniques to remove these background particles by applying deep learning on full detector images from the SBND detector, the near detector in the Fermilab Short-Baseline Neutrino Program. We use this technique to identify, on a pixel-by-pixel level, whether recorded activity originated from cosmic particles or neutrino interactions.

Impact of chronic elevated ozone exposure on photosynthetic traits and anti-oxidative defense responses of Leucaena leucocephala (Lam.) de wit tree under field conditions

In this study, the impact of long term exposure of elevated ozone (+20 ppb above ambient) on photosynthetic traits and anti-oxidative defense system of Leucaena leucocephala, a tree of great economic importance, was studied in a Free Air Ozone Concentration Enrichment (O₃-FACE) facility at different time intervals (6, 12, 18, and 24 months). Results showed that net photosynthesis, photosynthetic pigments and lipid peroxidation were significantly reduced after 6, 12 and 24 months of exposure to elevated ozone (eO₃) whereas stomatal conductance and transpiration rate were significantly decreased after 12 months of exposure to eO₃. Antioxidant enzymatic activities (catalase, ascorbate peroxidase and glutathione reductase) were significantly increased after 12 months of exposure to eO_3. Ascorbate was increased significantly after 6 and 12 months of exposure to eO₃ while reduced glutathione content declined significantly after 6 and 24 months of exposure to eO₃. The study showed that there were several negative long lasting physiological and biochemical responses in Leucaena. The results provide evidence that Leucaena exhibited greater sensitivity to O₃ during initial exposure (up to 12 months) but showed moderate tolerance by the end of the 2nd year.

Ormeloxifene in acute heavy menstrual bleeding in menopausal transition

Background: Ormeloxifene, a selective estrogen receptor modulator, is a safer, cost effective and convenient dosing medical therapy in heavy menstrual bleeding of acute abnormal uterine bleeding. Aims and Objective: The study aimed to find the effectiveness of Ormeloxifene as 1st line therapy for heavy menstrual bleeding in menopausal transition women to prevent unnecessary hysterectomies and improve quality of life. Materials and Methods: This descriptive study was conducted at Lumbini Medical College for a period of one year. Sixty-five cases of acute Abnormal Uterine Bleeding with heavy menstruation during menopausal transition period were provided with Ormeloxifene therapy of 60 milligrams dose two times per week after evaluating pre treatment hemoglobin percentage, Pictorial Blood Loss Assessment Chart (PBAC) score and endometrial thickness. The dose of the drug was reduced to 60 mg weekly after 3rd month if subjective improvement was documented and continued for further 3 months. Results: There was a statistically significant reduction in mean PBAC score, mean endometrial thickness and rise in hemoglobin level. Eighty percentages of women had marked subjective improvement of symptoms, 87.7% women had reduction of blood clots, 15. 8% women had relief from dysmenorrheal pain and 50.8% women had regularization of menstrual pattern after 6 months. Amenorrhea (25.3%) was the most common side effect reported in 6 months therapy. Conclusion: Ormeloxifene is an effective 1st line medical therapy in acute heavy menstrual bleeding in menopausal transition women.

Five Year Follow up of Retrospective Cohort Comparing Structural and Functional Outcome of Arthroscopic Single-row ersus Double-row Suture Bridge Repair of Large Posterosuperior Rotator Cuff Tear in Patients Less than or Equal to 70 Years

BACKGROUND

High re-tear rates after repairing large-sized posterosuperior rotator cuff tears remain a significant concern which may affect the clinical outcome. The most optimal type of repair (single versus double-row suture bridge) suited for large size tear remains debatable.

METHODS

In a retrospective cohort study with a minimum of five years follow up, the structural and functional outcome of 103 patients with large size cuff tear repaired with single row (SR) or double row suture bridge (DRSB) were evaluated. The structural outcome was assessed with ultrasonography whereas functional outcome was evaluated with Constant Murley (CM) and American shoulder elbow score (ASES).

RESULTS

There were 55 patients in the SR group and 48 patients in the DRSB group with a mean follow-up of 74.2 months (range, 60-96 months). While comparing the structural integrity in two groups, we found significantly lower re-tear rates in the DRSB group as compared to the SR group (10.4% vs. 32.7%; P=0.006). Also, there were more focal defects in the SR group (25.4%) than the DRSB group (8.3%). Overall, there was no significant difference in CM and ASES scores when the SR group was compared to DRSB. However, subgroup analysis between those with intact and retorn tendon revealed significant difference (P=0.0001) in the clinical scores.

CONCLUSION

At a minimum of five years follow-up, the DRSB repair of large posterosuperior cuff tear resulted in superior structural healing over SR repair. Nevertheless, overall there was no significant functional difference between both the techniques. However, the functional outcome of the healed tendon subgroup was superior to retear tendon subgroup.