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Aims: The aims of this study were to: 1) report on a cohort of skeletally mature patients with native hip and knee septic arthritis over a 14-year period; 2) to determine the rate of joint failure in patients who had experienced an episode of hip or knee septic arthritis; and 3) to assess the outcome following septic arthritis relative to the infecting organism, whether those patients infected by Staphylococcus aureus would be more likely to have adverse outcomes than those infected by other organisms. Methods: All microbiological samples from joint aspirations between March 2000 and December 2014 at our institution were reviewed in order to identify cases of culture-proven septic arthritis. Cases in children (aged < 16 years) and prosthetic joints were excluded. Data were abstracted on age at diagnosis, sex, joint affected (hip or knee), type of organisms isolated, cause of septic arthritis, comorbidities within the Charlson Comorbidity Index (CCI), details of treatment, and outcome. Results: A total of 142 patients were confirmed to have had an episode of septic arthritis in a native hip (n = 17) or knee joint (n = 125). S. aureus accounted for 57.7% of all hip and knee joint infections. There were 13 inpatient deaths attributed to septic arthritis. The median age of the patients who died was 77.5 (46.9 to 92.2) and their median age-adjusted CCI was 8 (6 to 12). A failure of the joint occurred in 26 knees (21%) and nine hips (53%). Of the knee joints infected by S. aureus (n = 71), 23 knees (32%) went into failure of joint, whereas of those infected by other organisms (n = 54), only three knees (6%) failed. Conclusion: Based on our study findings, hip and knee septic arthritis long-term outcomes were substantially worse than their immediate outcome suggested. Failure of knee joint is 6.1 times more likely to occur in those infected with S. aureus. Cite this article: Bone Jt Open 2024;5(9):785–792.

AimsStaphylococcus aureus is a major cause of septic arthritis, and in vitro studies suggest α haemolysin (Hla) is responsible for chondrocyte death. We used an in vivo murine joint model to compare inoculation with wild type S. aureus 8325-4 with a Hla-deficient strain DU1090 on chondrocyte viability, tissue histology, and joint biomechanics. The aim was to compare the actions of S. aureus Hla alone with those of the animal’s immune response to infection.MethodsAdult male C57Bl/6 mice (n = 75) were randomized into three groups to receive 1.0 to 1.4 × 107 colony-forming units (CFUs)/ml of 8325-4, DU1090, or saline into the right stifle joint. Chondrocyte death was assessed by confocal microscopy. Histological changes to inoculated joints were graded for inflammatory responses along with gait, weight changes, and limb swelling.ResultsChondrocyte death was greater with 8325-4 (96.2% (SD 5.5%); p < 0.001) than DU1090 (28.9% (SD 16.0%); p = 0.009) and both were higher than controls (3.8% (SD 1.2%)). Histology revealed cartilage/bone damage with 8325-4 or DU1090 compared to controls (p = 0.010). Both infected groups lost weight (p = 0.006 for both) and experienced limb swelling (p = 0.043 and p = 0.018, respectively). Joints inoculated with bacteria showed significant alterations in gait cycle with a decreased stance phase, increased swing phase, and a corresponding decrease in swing speed.ConclusionMurine joints inoculated with Hla-producing 8325-4 experienced significantly more chondrocyte death than those with DU1090, which lack the toxin. This was despite similar immune responses, indicating that Hla was the major cause of chondrocyte death. Hla-deficient DU1090 also elevated chondrocyte death compared to controls, suggesting a smaller additional deleterious role of the immune system on cartilage.Cite this article: Bone Joint Res 2022;11(9):669–678.

Abstract Pain catastrophizing is an exaggerated focus on pain sensations. It may be an independent factor influencing pain and functional outcomes of knee arthroplasty. We aimed to evaluate the association between pre-operative pain catastrophizing with pain and function outcomes up to one year after knee arthroplasty. We used data from a cohort study of patients undergoing primary knee arthroplasty (either total or unicompartmental arthroplasty) for knee osteoarthritis. Pain catastrophizing was assessed pre-operatively using the Pain Catastrophizing scale (PCS). Other baseline variables included demographics, body mass index, radiographic severity, anxiety, depression, and knee pain and function assessed using the Western Ontario and McMaster University Index (WOMAC). Patients completed the WOMAC at 6- and 12-months after arthroplasty. WOMAC pain and function scores were converted to interval scale and the association of PCS and changes of WOMAC pain and function were evaluated in generalized linear regression models with adjustment with confounding variables. Of the 1136 patients who underwent arthroplasty (70% female, 84% Chinese, 92% total knee arthroplasty), 1102 and 1089 provided data at 6- and 12-months post-operatively. Mean (± SD) age of patients was 65.9 (± 7.0) years. PCS was associated with a change in WOMAC pain at both 6-months and 12-months (β = − 0.04, 95% confidence interval: − 0.06, − 0.02; P

Neurodegenerative diseases are often associated with the accumulation of oxidative stress and neuroinflammation. Edible bird’s nest (EBN) is a glycoprotein (sialylated mucin glycopeptides) found to be beneficial against neurodegenerative diseases. Antioxidative, anti-inflammatory, and anti-apoptotic properties of EBN in preserving neuronal cells were widely researched using in vitro and in vivo models. Functional effects of EBN are often linked to its great number of antioxidants and anti-inflammatory glycopeptides. Bioactive compounds in EBN, especially sialic acid, add value to neurotrophic potential of EBN and contribute to neuronal repair and protection. Various studies reporting the neuroprotective effects of EBN, their molecular mechanisms, and neuroactive composition were gathered in this review to provide better insights on the neuroprotective effects of EBN.

The swiftlet’s nest is an edible bird’s nest (EBN) produced from dried gelatinized saliva secreted by swiftlets during the breeding season. It is widely used in industries for its high nutritional values and health benefits. However, the utilization of ESN is restricted due to its physicochemical properties, such as insolubility. The recently invented bioactive ESN hydrolyzate is reported to improve the ESN’s solubility, functional and nutritional properties to broaden its application. This study has produced bioactive ESN hydrolyzates with different hydrolysis periods to investigate the optimum conditions to achieve maximized degree of hydrolysis (DH) and to compare the physicochemical differences. The result revealed that optimum ESN hydrolysis was at 90 minutes, in which the DH and enhanced solubility (three folds) indicated a complete breakdown of glycoprotein into bioactive glycopeptide. This result is in line with the physicochemical analyses result. The hydrolysis has significantly decreased (p ≤ .05) the ESN protein content, while the levels for peptide, glycopeptide, polysaccharides, and sialic acid showed the opposite. Interestingly, the amino acid from raw ESN and hydrolyzates in all incubation periods showed no significant difference (p ≤ .05). This result suggests that the ESN biological properties remained unchanged with alcalase hydrolysis. Therefore, the findings in this study confirm the feasibility of bioactive ESN hydrolyzate as a versatile product suitable for various industries in utilizing ESN in whole instead of as extracts.

This study was conducted to recover edible bird’s nest (EBN) hydrolysates from different grades of EBN, including the industrial by-products, using enzymatic treatment. The nutrient, physicochemical properties and antioxidant activities of the recovered hydrolysates at different hydrolysis times were evaluated. Results showed that the recovery yield of enzymatic hydrolysis was above 89 % for all grades of EBN and the degree of hydrolysis increased over time. Nitrite content (0.321–0.433 mg/L) was below the permissible tolerance level for all samples. Interestingly, the antioxidant activities (DPPH and ABTS scavenging activities and ferric reducing antioxidant powder (FRAP) activity) were significantly higher (P ≤ 0.05) in hydrolysates recovered from EBN by-products (EBNhC and EBNhD) as compared to the high grade EBN hydrolysates (EBNhA and EBNhB). The in-vitro probiotic activity of EBN and its hydrolysates were examined using the probiotic bacterium Lactobacillus plantarum. Evidently, EBN by-products hydrolysate (EBNhD) recorded the highest number of L. plantarum (1.1 × 1011 CFU/mL), indicating that low grade EBN has the potential as prebiotic material that promotes probiotic activity. This study demonstrated the concept of using EBN by-products hydrolysates for various applications, such as functional ingredients with enhanced bioactivities, to improve its economic value.

Introduction: Glenohumeral septic arthritis is most caused by hematogenous seeding of the joint by S. Aureus, and also as a result of previous surgery or intra-articular injection. Although rare, septic arthritis of the glenohumeral joint has poor prognosis. In patients who survive the infection, the potential to cause rapid and catastrophic damage to articular cartilage, frequently causes lifelong morbidity. Methods: Four consecutive patients (five shoulders) treated at our institution between December 2019 to September 2020 were identified for the study. Medical records were reviewed, and basic demographics of the patient series included age, sex, race, BMI were collected. Information such as comorbidities, inciting injuries, history of presentation, examination findings, biochemical results, radiological findings, aspiration results and cultures, intra-operative findings, as well as blood cultures were extracted. Results: Four patients (age range of 65–83 years old) underwent a single arthroscopic washout of the glenohumeral joint. All four patients (3 female, 1 male) presented with acute swollen should joint/s with raised inflammatory markers (ESR, CRP and WBC). Staph Aureus was identified in 50% (n ​= ​2) of the cases with Mycobacterium Kansasii and Group B Streptococcus isolated in the other 2 patients. Half of the cases (n ​= ​2) were deemed to be caused by direct spread of pathogens whereas the other half of the cases (n ​= ​2) were deemed to be due to hematogenous spread. All patients exhibit resolution of clinical infection following the treatment. MRI were done for all patients which aided in the diagnosis of a septic shoulder joint. Conclusion: Our case series shown that single arthroscopic washout and debridement provides acceptable to good short-term outcomes for septic arthritis of the glenohumeral joint. In this case series, the authors have found MRI to be a useful radiographic aid to diagnosis. Level of evidence: Case series.

The angiotensin-I converting enzyme (ACE) plays a pivotal role in hypertension, and while ACE inhibitors are conventional in hypertension management, synthetic medications often carry undesirable side effects. This has spurred interest in alternative ACE inhibitors derived from natural sources, such as edible insects. The silkworm, recognized for its bioactive peptides with potent ACE-inhibitory properties, has emerged as a promising candidate. This study aims to evaluate the acute toxicity and assess the antihypertensive efficacy of crude mature silkworm hydrolysate powder (MSHP) obtained from mature Thai silkworms. Utilizing the commercial protease Alcalase®2.4L, MSHP was administered at various doses, including 50, 100, and 200 mg kg−1, to hypertensive rats. The investigation spans a 14-day period to observe any potential acute toxic effects. Results indicate that MSHP exhibits LD50 values equal to or exceeding 2000 mg kg−1, signifying a low level of acute toxicity. Furthermore, the effective dose for blood pressure reduction in hypertensive rats surpasses 100 mg kg−1 of rat body weight. These findings suggest that MSHP derived from Thai mature silkworms holds promise as a natural antihypertensive food source. The implications of this research extend to the development of functional foods, functional ingredients, and dietary supplements aimed at managing hypertension.

Abstract With one‐third of patients having osteoarthritis predominantly in one compartment of the knee, unicompartmental knee spacers have been introduced as a less invasive alternative to total knee replacement. However, patients with the knee spacer implanted were seen to have persistent pain, resulting in high revision rates. A static finite element model of the knee and its interaction with a knee spacer implant at full extension and 90° flexion was used to investigate the tibio‐femoral contact mechanics of the knee joint after a knee spacer surgery. Three different knee spacer designs (contoured, flat and C‐shaped) were modelled and prescribed with cobalt‐chrome, ultra‐high molecular polyethylene and polyurethane material properties. The results suggested that a softer spacer is generally preferred as this helps in the conformity of knee spacer to the condyle, effectively distributing the load subjected to the implant. Flat spacers that result in high stresses resulting from lower contact areas should be avoided.

Introduction The influence of prior high tibial osteotomy (HTO) on total knee arthroplasty (TKA) functional outcomes remains widely debated. Alignment of failed HTO can pose technical challenges with subsequent TKA. The primary aim of this study was to evaluate the influence of HTO alignment on the clinical outcomes of subsequent TKA. The secondary aim was to compare the time to TKA for each HTO alignment type. Methods Patients who underwent TKA post lateral closing-wedge HTO for symptomatic medial compartment osteoarthritis between 2001 and 2014 were prospectively followed up for 2 years. A total of 159 patients were assigned to three groups based on their pre-TKA femora tibia angles using long lower limb radiographs: varus alignment (VrA) ≤ 3 o valgus, neutral alignment (NA) 3-9 o valgus alignment, valgus alignment (VlA) ≥ 9 o valgus. Functional outcomes were quantified using Knee Society Function Score and Knee Scores (KSFS and KSKS respectively), modified Oxford Knee Score (OKS), Short Form 36 Physical Component Score (SF-36 PCS), and SF-36 Mental Component Score (SF-36 MCS). Pre-operative and post-operative knee range of motion were also measured. Results Mean pre-TKA KSKS in VrA patients (35 ± 18) was significantly lower than both NA (51 ± 19) and VlA (40 ± 21) patients ( p < .05). Otherwise, there was no significant difference in functional outcome scores (KSFS, KSKS, OKS, SF-36 PCS and SF-36 MCS) or range of motion at 6 months and 2 years post-TKA. The mean duration from HTO to TKA was 12 ± 7 years with no significant differences between VrA, NA, and VlA HTO to TKA (13 ± 7 years, 13 ± 6 years and12 ± 8 years respectively, p > .05). Conclusion HTO alignment did not influence time to subsequent TKA. HTO alignment did not influence early outcomes as well as radiological outcomes of subsequent TKA. Level of evidence III

Abstract Background Patient satisfaction is a unique and important measure of success after total hip arthroplasty (THA). Our study aimed to evaluate the use of machine learning (ML) algorithms to predict patient satisfaction after THA. Methods Prospectively collected data of 1508 primary THAs performed between 2006 and 2018 were extracted from our joint replacement registry and split into training (80%) and test (20%) sets. Supervised ML algorithms (Random Forest, Extreme Gradient Boosting, Support Vector Machines, Logistic LASSO) were developed with the training set, using patient demographics, comorbidities and preoperative patient reported outcome measures (PROMs) (Short Form-36 [SF-36], physical component summary [PCS] and mental component summary [MCS], Western Ontario and McMaster’s Universities Osteoarthritis Index [WOMAC] and Oxford Hip Score [OHS]) to predict patient satisfaction at 2 years postoperatively. Predictive performance was evaluated using the independent test set. Results Preoperative models demonstrated fair discriminative ability in predicting patient satisfaction, with the LASSO model achieving a maximum AUC of 0.76. Permutation importance revealed that the most important predictors of dissatisfaction were (1) patient’s age, (2) preoperative WOMAC, (3) number of comorbidities, (4) preoperative MCS, (5) previous lumbar spine surgery, and (6) low BMI (

Abstract Lactic acid has become one of the most important chemical substances used in various sectors. Its global market demand has significantly increased in recent years, with a CAGR of 18.7% from 2019 to 2025. Fermentation has been considered the preferred method for producing high-purity lactic acid in the industry over chemical synthesis. However, the recovery and separation of lactic acid from microbial fermentation media are relatively complicated and expensive, especially in the process relating to second-generation (2G) lactic acid recovery. This article reviews the development and progress related to lactic acid separation and recovery from fermentation broth. Various aspects are discussed thoroughly, such as the mechanism of lactic acid production through fermentation, the crucial factors that influence the fermentation process, and the separation and recovery process of conventional and advanced lactic acid separation methods. This review's highlight is the recovery of lactic acid by adsorption technique using ion-exchange resins with a brief focus on the potential of in-site separation strategies alongside the important factors that influenced the lactic acid recovery process by ion exchange. Apart from that, other lactic acid separation techniques, such as chemical neutralization, liquid–liquid extraction, membrane separation, and distillation, are also thoroughly reviewed.

As the High Flux Advanced Neutron Application Reactor (HANARO) has been recently required to support new R&D relevant to future nuclear systems requiring a much higher neutron fluence, the development of irradiation capsule technology for long-term irradiation testing was performed in three steps (3, 5, 10 dpa). At first, several design improvements of a standard capsule were suggested based on a failure analysis of the capsule and successfully applied for irradiation testing at HANARO at up to eight reactor operation cycles equivalent to 3 dpa. Based on a schematic stress analysis of the vulnerable parts of the previous capsule, an optimized design of the capsule was made for 5 dpa irradiation. The newly designed capsule was safely out-pile tested up to 450 days, which was equivalent to 5 dpa irradiation in the reactor. The test results were submitted to the Reactor Safety Review Committee of HANARO and irradiation testing for 5 dpa was approved. The capsule was also successfully out-pile tested to evaluate the possibility of irradiation testing for 10 dpa. For a higher neutron fluence exceeding 10 dpa, new capsule technologies, including a new capsule that has a different bottom design and neutron flux boosting capsule, were also suggested.

Abstract Xanthorrhizol (XNT), is a bioactive compound found in Curcuma xanthorrhiza Roxb. This study aimed to determine the potential targets of the XNT via computational target fishing method. This compound obeyed Lipinski’s and Veber’s rules where it has a molecular weight (MW) of 218.37 gmol-1, TPSA of 20.23, rotatable bonds (RBN) of 4, hydrogen acceptor and donor ability is 1 respectively. Besides, it also has half-life (HL) values 3.5 h, drug-likeness (DL) value of 0.07, oral bioavailability (OB) of 32.10, and blood–brain barrier permeability (BBB) value of 1.64 indicating its potential as therapeutic drug. Further, 20 potential targets were screened out through PharmMapper and DRAR-CPI servers. Co-expression results derived from GeneMANIA revealed that these targets made connection with a total of 40 genes and have 744 different links. Four genes which were RXRA, RBP4, HSD11B1 and AKR1C1 showed remarkable co-expression and predominantly involved in steroid metabolic process. Furthermore, among these 20 genes, 13 highly expressed genes associated with xenobiotics by cytochrome P450, chemical carcinogenesis and steroid metabolic pathways were identified through gene ontology (GO) and KEGG pathway analysis. In conclusion, XNT is targeting multiple proteins and pathways which may be exploited to shape a network that exerts systematic pharmacological effects.

Background Posterior stabilized (PS) total knee arthroplasty (TKA) is advocated in severe varus osteoarthritic (OA) knees as the posterior cruciate ligament posed challenges in gap balancing. However, there is scarcity in the literature to illustrate the superiority of PS TKA over cruciate retaining (CR) TKA. Our study aims to compare the outcomes between CR and PS TKAs in patients with severe varus OA knees. Methods: A retrospective review was conducted on patients who underwent primary TKA for OA knee from 2003 to 2013. Patients with OA knees of varus tibiofemoral angle ≥15 were matched into two groups (Group CR and PS) according to age, gender, and body mass index and compared in terms of clinical (tibiofemoral alignment, range of motion, and revision rate) and functional outcome (Knee Society Scoring, Oxford Knee Score, Short Form-36 Health Survey). Results: Both Group CR ( n = 56) and PS ( n = 56) had similar pre-operative scores. Both groups achieved correction of tibiofemoral alignment from median pre-operative varus of 17.6/17.0 (CR/PS) ( p = .279) to median post-operative valgus of 4.9/4.0 (CR/PS) ( p = .408). Over 24 months, both groups were comparable in achieving significant improvement in clinical and functional outcomes. No case of revision surgery was reported (median follow-up months; CR: 65, PS: 74, p = .549). Conclusion: Both CR and PS TKAs perform similarly well in severe varus OA knee up to 2 years post-operation. Further studies are warranted to assess the long-term outcome between the two implant designs.

Objective: The objective of this study was to characterize the structure, physicochemical and toxicity properties of Dioscorea Pentaphylla tuber’s starch. Methods: Starch was extracted from Dioscorea Pentaphylla tuber’s and analyzed to determine their properties such as pH, water binding capacity, solubility, swelling power, chemical composition, thermal properties, degree of crystallinity, morphology and toxicity. Results: Results showed that more than half of Dioscorea pentaphylla starch consist of amylose (64.10 ± 1.15%). It has gelatinization temperature started at 76.90 ± 0.08 °C. This C-Type starch has a degree of crystallinity around 32.90 ± 2.59%. The SEM image showed that Dioscorea pentaphylla has oval-shaped particles with sizes ranging from 42 to 55 µm. The toxicity test demonstrated that the starch was safe and can be classified as non-toxic. Conclusion: The physicochemical and toxicology properties of Dioscorea Pentaphylla starch recorded in this study indicate that this starch is applicable as biopolymer source for food and non-food purposes.

Background: Unicompartmental knee arthroplasty (UKA) has gained popularity in recent years in view of its minimally invasive nature and proven benefits over the traditional total knee arthroplasty (TKA) in terms of superior knee range of motion and kinametics, faster recovery, lower blood loss, shorter hospital stay and ease of revision with the preservation of bone stock.With the increasing incidence of diabetes mellitus (DM) worldwide and an increased risk of deep infection, wound complications and early failure previously shown in diabetic patients undergoing TKA, it is prudent that we establish the impact of DM on the outcomes and complications of UKA given that there is little on the topic in the current literature.This is especially significant in Asia as Asia is home to more than 60% of the world's population of diabetic patients with estimates of more than 200 million people having the condition. Type 2 DM in particular, is an increasing epidemic with projections to increase by more than 150% between year 2000 and 2035.The purpose of this study is to evaluate the impact of diabetes mellitus on the outcomes and satisfaction of UKA at 2 years postoperatively. We hypothesize that diabetes mellitus does not affect the outcomes and satisfaction following UKA in Asians at 2 years postoperatively. Methods: We conducted a retrospective review of prospectively collected registry data of 1075 UKAs performed in a multiethnic Asian population between 2006 and 2013 at our institution. Outcomes assessed included flexion range, Knee Society Score (KSS), Oxford Knee Score (OKS), Short-Form 36 (SF-36) and satisfaction scores.All patients with DM were identified and matched with patients without DM for age, gender and body mass index. Outcomes, satisfaction, complication and revision rates were then compared between the two groups up to 2 years postoperatively. Preoperative HbA1c was used to assess the patients’ blood glucose control in the DM group. Results: A total of 104 patients (9.7%) had DM, close to the national prevalence (11.3%). At 2 years postoperatively, DM patients had better improvement in their SF-36 Mental Component Score (MCS) (p = 0.015) despite poorer preoperative scores (DM group = 70 ± 23, non-DM group = 77 ± 17, p = 0.013), and were in 1° more varus (p = 0.005) when compared to patients without DM.There was no significant difference in the proportion of patients achieving the minimal clinically important difference for knee-specific outcomes (DM:90%, non-DM:96%) or the satisfaction rates between the groups (DM:92%, non-DM:94%). Complication rates were similar (DM:5.8%, non-DM:4.8%). There were no venous thromboembolic events, deaths or revisions during the follow-up period in both groups. The mean preoperative HbA1c in our DM group was 6.6%. Conclusion: In this matched-pair study of diabetic versus non-diabetic patients undergoing surgery for UKA, DM does not have a clinically significant negative impact on the outcomes and satisfaction following UKA in patients with well-controlled disease. Keywords: Unicompartmental knee arthroplasty, UKA, Diabetes mellitus, Outcomes, Satisfaction

Fucoxanthin is an algae-specific xanthophyll of aquatic carotenoid. It is prevalent in brown seaweed because it functions as a light-harvesting complex for algal photosynthesis and photoprotection. Its exceptional chemical structure exhibits numerous biological activities that benefit human health. Due to these valuable properties, fucoxanthin’s potential as a potent source for functional food, feed, and medicine is being explored extensively today. This article has thoroughly reviewed the availability and biosynthesis of fucoxanthin in the brown seaweed, as well as the mechanism behind it. We included the literature findings concerning the beneficial bioactivities of fucoxanthin such as antioxidant, anti-inflammatory, anti-obesity, antidiabetic, anticancer, and other potential activities. Last, an additional view on its potential as a functional food ingredient has been discussed to facilitate a broader application of fucoxanthin as a promising bioactive compound.

Background: Metaphyseal sleeves have been used as metaphyseal filling implants to address bone loss during revision total knee replacements (TKRs). This study aims to compare the 2-year clinical and radiological outcomes of constraint implant with bone defect and constraint implant without or minimal bone defect in revisions TKR with preoperative coronal plane instability. Materials and Methods: Seventeen cases of constraint implants with metaphyseal sleeve matched paired with 34 cases of constrained condylar knee (CCK) prosthesis. Age, gender, body mass index and aetiology for revision surgery were recorded. Clinical outcome measures included Knee Society Knee Score (KSKS), Knee Society Function Score (KSFS), Oxford Knee Score (OKS), physical component summary (PCS) and mental component summary (MCS). Radiological outcome measures included joint line changes, hip–knee–ankle angle (HKA), coronal femoral angle (CFA) and coronal tibial angle (CTA). Result: Patients in sleeve group showed significant improvement in KSKS, KSFS and OKS (38 ± 7, 35 ± 6 and 20 ± 2 points, respectively, p < 0.001), while they were 19 ± 3 and 6 ± 2 points for PCS and MCS, respectively ( p < 0.001 and p = 0.021). These postoperative scores after surgery were similar between the two groups at 6 months and 2 years. The sleeve provides comparable result in joint line restoration; the postoperative HKA, CFA and CTA were all comparable between the two groups. Conclusion: Metaphyseal sleeve with constraint implant is a viable option for revision TKR with preoperative coronal plane instability and significant bone defect. It is able to achieve similar clinical outcomes and joint line restoration compared to CCK prosthesis at 2-year follow-up.

Purpose: Concerning the ongoing debate on the effects of continuing aspirin therapy on blood loss in knee arthroplasty, we conducted a retrospective investigation to test the hypothesis that continuation of aspirin prior total knee arthroplasty (TKA) will not cause more blood loss. Methods: From a database of patients who underwent unilateral TKA between 2011 and 2016, we identified two groups: the aspirin group (patients continued aspirin during perioperative period) and the nonaspirin group (patients had no current or recent history of aspirin usage). We extracted and compared patient demographic information, comorbidity index, baseline serum hemoglobin (Hb), and creatinine level between the two groups. We also compared our primary outcomes, including the total blood loss, transfusion requirement, and length of hospitalization between the two groups. A multivariate logistic regression for analyzing the risk factors of requiring transfusion was performed. Results: We found that apart from preoperative serum creatinine level, there was no difference in the baseline Hb level, perioperative change in Hb, total blood loss, or length of hospitalization between the two groups. The percentage of transfusion utilization was also comparable between the two groups. Our regression analysis shows that the risk of requiring transfusion after TKA is not significantly associated with patients taking aspirin therapy before operation. Conclusion: Patients who underwent TKA with continuation of low-dose aspirin did not result in more blood loss. Current blood loss management has provided sufficient reduction of blood loss to accommodate aspirin therapy perioperatively. We suggest that it is safe to continue aspirin prior to TKA.

Bacterial outer membrane vesicles (OMVs) contain immunogens but no study has yet examined their potential in treating cancer. Here, the authors demonstrate that OMVs can suppress established tumours and prevent tumour metastasis by an interferon-γ mediated antitumor response.

Introduction: Hip fractures are a cause of significant morbidity. While rare, ipsilateral hip fractures within 12 months after total knee arthroplasty (TKA) can negatively affect the functional outcome and the quality of life for patients who have had TKA. This aim of this study is to investigate (1) the incidence of hip fracture within 12 months after TKA and (2) the influence of hip fracture after TKA on functional outcome and quality of life in patients. Methods: Between March 1999 and February 2012, 25 patients who sustained an ipsilateral hip fracture within 12 months after TKA were included in this study. A propensity score matching algorithm was used to select a 1:3 control group without hip fracture. All patients were assessed using the Oxford Knee Score (OKS), Knee Society Function Score (KSFS), Knee Society Knee Score (KSKS), Physical Component Score (PCS) and Mental Component Score (MCS) of SF-36®. Results: The incidence of hip fracture was 0.16% among male patients and 0.20% for female patients. At 24 months after TKA, the OKS was 36 ± 7 in the hip fracture group versus 41 ± 5 in the control group ( p = 0.003). The KSFS was 50 ± 24 in the hip fracture group versus 68 ± 21 in the control group ( p = 0.001), while the KSKS was 83 ± 12 and 87 ± 8, respectively ( p = 0.166). The PCS was 37 ± 12 in the hip fracture group versus 47 ± 11 in the control group ( p < 0.001), while the MCS was 55 ± 10 and 54 ± 11, respectively ( p = 0.664). Conclusion: Although hip fracture during the rehabilitation period after TKA is uncommon, these patients have poorer functional outcome and quality of life. We recommend additional caution against hip fracture after TKA.

Carcinogenicity and aging are characterized by a set of complex endpoints, which appear as a series of molecular events. Many of these events can be modified by caloric intake. Since most of these processes determine an organism's ability to cope with various environmental stressors, it is not surprising that a relationship (in the presence of a constant nutrient density) exists between caloric intake and time-to-tumor and/or life span. Our studies have clearly shown that generally, the greater the caloric intake, the greater the body weight, the higher the incidence of spontaneous tumor occurrence, the greater the susceptibility to chemical carcinogens, and the shorter the life span. It is also recognized that variables other than body weight influence the life span and carcinogenesis. We have focused our attention on the questions of how and to what extent caloric intake modifies those homeostatic processes believed to be critical in determining the ability of an organism to cope with endogenous and exogenous stresses such as chemical, physical, and biological carcinogens. [ABSTRACT FROM PUBLISHER]

The mulberry silkworm (Bombyx mori L.) is a common edible insect in many countries. However, the impact of thermal processing, especially regarding Thai silkworm powder, is poorly known. We, therefore, determined the optimum time for treatment in hot water and subsequent drying temperatures in the production of silkworm powder. The silkworms exposed to 90 °C water for 0, 5, 10, 15, and 20 min showed values of Total Phenolic Compounds (TPCs), 2,2-Diphenyl-1-picrylhydrazyl free radical scavenging (DPPH) assay, 2,2′-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid (ABTS) assay, and Ferric Reducing Antioxidant Power (FRAP) assay that were significantly (p < 0.05) higher at the 5 min exposure time compared with the other times. The reduction of microorganisms based on log CFU/g counts was ≥3 log CFU/g (99%) at the 5 min treatment. To determine the optimum drying temperature, the silkworms exposed to 90 °C water for 5 min were subjected to a hot-air dryer at 80, 100, 120, and 140 °C. The TPC value was the highest (p < 0.05) at 80 °C. The silkworm powder possessed significantly (p < 0.05) higher DPPH, ABTS radical scavenging ability, and ferric ion reducing capability (FRAP assay) at 80 °C compared with other drying temperatures. This study indicates that shorter exposure times to hot water and a low drying temperature preserve the antioxidant activities. High antioxidant activities (in addition to its known protein and fat content) suggest that silkworms and silkworm powder can make a valuable contribution to human health.

Presents a study which focuses on a kinematic algorithm for the control of mechanisms. Advantages of this algorithm over the damped least-squares method; Derivation of the algorithm; Capabilities of the algorithm; Discussion on the study and conclusions drawn.

Changes in the soluble protein pattern of leaves of eight lines of barley, carrying different resistance genes to mildew, were analysed by SDS-polyacrylamide gel electrophoresis and isoelectric focusing. Apparently new host proteins were induced by Erysiphe graminis f. sp. bordei in the incompatible reaction which were not present in the immune or susceptible response. These proteins are of low molecular weight, 13,500-27,500 d, and have either very low or very high isoelectric points. Thus, they resemble the pathogenesis-related proteins found in many dicotyledonous species. [ABSTRACT FROM AUTHOR]

Obesity is a known major contributing risk factor for knee osteoarthritis (OA). It is also believed that obese unicompartmental knee arthroplasty (UKA) patients tend to have poorer outcome and possible early failure. The purpose of this study is to investigate the early outcome of obese UKA patients in a single institution. Patients who underwent fixed bearing medial UKA in between year 2005 and 2010 were included in this study. They were divided into four groups based on Body Mass Index (BMI): 25 kg/m 2 (Control); 25–29.9 kg/m 2 (Overweight); 30–34.9 kg/m 2 (Obese); >35 kg/m 2 (Severely Obese). Functional outcome was assessed using Knee Society Score (KSS), Oxford Knee Score (OKS) and Short-form 36 (SF-36). One-way ANOVA with Bonferroni post-hoc test was used to compare the four groups for quantitative variables. There were 673 patients in this study, no significant difference between the four BMI groups for gender and side of operated knee ( p > 0.05). The functional outcome of all four groups at 2 years were comparable (all p > 0.05). At a mean follow up of 5.4 (range 2.5, 8.5) years, 9 revision surgeries (1.3%) were identified. The mean duration from initial surgery to revision surgery was 49 months (Range 6, 90). Patients’ pre-operative BMI did not influence the early outcome of UKA patients. However, patients with higher BMI had relatively lower functional score prior to the surgery and tended to be younger. This did not translate to early failure and the functional improvement was similar among all four groups.

This study aims to evaluate the 2-year post-operative clinical outcomes of patients undergoing total knee arthroplasty (TKA) with computer-assisted surgery (CAS) using the pinless BrainLAB ® VectorVision ® Knee 2.5 Navigation System versus standard CAS. A retrospective case–control study of 200 patients who underwent TKA with CAS from 2008 to 2012 was conducted. Patients in the pinless arm underwent a shorter duration of surgery compared to the standard CAS arm with 72 ± 13 min and 83 ± 11 min, respectively ( p < 0.001), with improvement in Oxford Knee Score from 34 ± 8 to 18 ± 5 and 34 ± 9 to 18 ± 5, respectively, without statistically significant differences in clinical outcomes at 2 years.

Presents a study which determined the effects of phosphorylated heat shock protein 20 (HSP20) on the actin cytoskeleton. Effect of HSP20 phosphopeptide on focal adhesion protein localization and on focal adhesion disassembly; Role of HSP20 phosphopeptide in cofilin dephosphorylation.

Purpose. To compare the outcome after simultaneous bilateral total knee arthroplasty (TKA) with or without an intra-articular tranexamic acid (TXA) wash in terms of blood loss, haemoglobin change, and transfusion requirement. Methods. 35 women and 10 men (mean age, 67.5 years) who underwent primary simultaneous bilateral TKA by a single senior surgeon were compared with 45 matched controls. In the TXA group, 1500 mg of TXA diluted in 100 ml of 0.9% sodium chloride was administered as a wash after cementing of implant and before closure of the retinaculum. At least 5 minutes of contact time was allowed before wound closure and tourniquet deflation. No drain was used. Results. No patients had thromboembolic complication. Compared with controls, the TXA group had lower perioperative blood loss (920 vs. 657 ml, p=0.001), total blood loss (997 vs. 679 ml, p

Purpose. To compare the outcome of 145 women who underwent conventional total knee arthroplasty (TKA) with 77 women who underwent gender-specific TKA. Methods. Records of 222 women who underwent primary TKA using a conventional (n=145) or gender-specific (n=77) size E or F prosthesis for end-stage osteoarthritis were reviewed. The gender-specific prosthesis has a narrower mediolateral dimension. Patients were assessed for flexion, Oxford Knee Score, Knee Society function and knee scores, and Short Form–36 Health Survey preoperatively and postoperatively (at 6 months and 2 years). Results. The 2 groups were comparable in terms of age (67.8 vs. 68.1 years, p=0.789), body mass index (28.6 vs. 27.8 kg/m 2 , p=0.189), and preoperative scores. 12 women with conventional TKA and 4 women with gender-specific TKA were lost to follow-up. Compared with women with conventional TKA, women with gender-specific TKA had better flexion at 6 months (116° vs. 121.9°, p=0.007) and 2 years (118.7° vs. 124.6°, p=0.006), better bodily pain score at 2 years (65.1 vs. 72.4, p=0.049), and greater improvement in bodily pain score from baseline to 2 years (30 vs. 38.5, p=0.034). Conclusion. Gender-specific TKA enables better knee flexion and less bodily pain in women who have a high propensity to develop mediolateral overhang of the femoral component.