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Background: Endometriosis is an enigma. Extrapelvic endometriosis is even more challenging, as theories of origin are difficult to explain. Very few cases of skeletal endometriosis have been reported in the literature., Method: We managed a case of 39-year-old nulliparous woman, who presented to the department of plastic surgery with complaints of a painful nodule measuring about 2 cm, in left upper arm since past 8 years. She had history of myomectomy 8 years back, while she was undergoing treatment for primary infertility. Differential diagnosis of extrapelvic endometriosis was made based on clinical history of cyclical pain and swelling, and she was referred to gynecology for hormonal treatment. MRI and FNAC were inconclusive. She underwent excision biopsy of the lesion., Result: Histopathology confirmed intramuscular endometriosis of left deltoid with positive margins. Postoperatively, she was started on dienogest 2 mg once daily and LNG IUS was inserted. Both were withdrawn a year later, due to side effects. It has been more than 6 months since removal of LNG IUS, and currently she is asymptomatic., Conclusion: To the best of our knowledge, this is the third case of deltoid endometriosis reported till date., Competing Interests: Conflict of interestAll authors declare that they have no conflict of interest., (© Federation of Obstetric & Gynecological Societies of India 2019.)

The clinical course of a 40-year-old female patient, who presented with acute febrile illness due to scrub typhus fever became complicated by seizures and posterior reversible encephalopathy syndrome (PRES), leading to a fatal outcome. She had normal blood pressure at admission; however, she later developed hypotension and shock. PRES is a syndrome of vasogenic cerebral oedema and accompanying neurological deficits resulting from the breakdown of blood-brain barrier due to high blood pressure or radical blood pressure changes. PRES is a clinico-radiographic diagnosis of heterogeneous aetiologies and is rare in the context of infections. Although there are many neurological manifestations in scrub typhus, to the best of our knowledge, PRES has never been reported., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

A 19-year-old girl presented with fever, headache, vomiting and drowsiness. She had grade 1 papilloedema and neck rigidity but no focal deficits or seizures. Cerebrospinal fluid analysis revealed lymphocytic pleocytosis, slightly elevated protein and normal glucose. MRI of the brain showed a hyperintense lesion in left ganglio-capsular region on the fluid attenuation inversion recovery sequence with perilesional oedema and mild midline shift. Haemorrhage was seen in the region on susceptibility weighted imaging . The patient was thoroughly investigated for known causes of meningoencephalitis, but the diagnosis of scrub typhus was delayed till the 10th day of illness. She was treated with doxycycline for 2 weeks and had marked improvement, both clinically and radiologically. Literature review has revealed that although meningoencephalitis in scrub typhus is not uncommon, such atypical lesions on brain MRI are a rarity. Serial imaging was performed to document the disease progression and resolution on treatment., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Arable weeds are key organisms for biodiversity maintenance and ecosystem service provision in agroecosystems. Disentangling the drivers of weed diversity is critical to counteract the global decline of farmland biodiversity. Even if distinct scale-dependent processes were alternatively proposed, no general framework unifying the multi-scale drivers of weed dynamics has yet emerged. Here, we investigate the joint effects of field- and landscape-scale processes on weed assemblages in 444 arable fields. First, field margins sheltered greater weed diversity than field core, evidencing their role as biodiversity refugia. Second, community similarity between field core and margin decreased with the distance to margin, highlighting a major role of local dispersal. Third, weed diversity at field margins increased with organic field cover in the landscape, pointing out massive regional dispersal. Fourth, while both local and landscape dispersal explained up to 41% of field core weed diversity, crop type strongly modulated their strength, depicting an intense filtering effect by agricultural management. This study sheds new light on the complex multi-scale interactions shaping weed diversity, field margins playing a key role by strengthening regional dispersal and sustaining local dispersal. Land-sharing strategies improving habitat heterogeneity both locally and regionally should largely promote agroecosystem multifunctionality and sustainability.

: The definition of "arable weeds" remains contentious. Although much attention has been devoted to specialized, segetal weeds, many taxa found in arable fields also commonly occur in other habitats. The extent to which adjacent habitats are favorable to the weed flora and act as potential sources of colonizers in arable fields remains unclear. In addition, weeds form assemblages with large spatiotemporal variability, so that many taxa in weed flora are rarely observed in plot-based surveys. We thus addressed the following questions: How often do weeds occur in other habitats than arable fields? How does including field edges extend the taxonomic and ecological diversity of weeds? How does the weed flora vary across surveys at different spatial and temporal scales? We built a comprehensive dataset of weed taxa in France by compiling weed flora, lists of specialized segetal weeds, and plot-based surveys in agricultural fields, with different spatial and temporal coverages. We informed life forms, biogeographical origins and conservation status of these weeds. We also defined a broader dataset of plants occupying open habitats in France and assessed habitat specialization of weeds and of other plant species absent from arable fields. Our results show that many arable weeds are frequently recorded in both arable fields and non-cultivated open habitats and are, on average, more generalist than species absent from arable fields. Surveys encompassing field edges included species also occurring in mesic grasslands and nitrophilous fringes, suggesting spill-over from surrounding habitats. A total of 71.5% of the French weed flora was not captured in plot-based surveys at regional and national scales, and many rare and declining taxa were of Mediterranean origin. This result underlines the importance of implementing conservation measures for specialist plant species that are particularly reliant on arable fields as a habitat, while also pointing out biotic homogenization of agricultural landscapes as a factor in the declining plant diversity of farmed landscapes. Our dataset provides a reference species pool for France, with associated ecological and biogeographical information ., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Introduction Hyperemesis gravidarum (HG) is said to occur when early pregnancy is complicated by excessive vomiting that leads to electrolyte imbalance, ketosis or loss of more than 5% of the bodyweight. It can be accompanied by deranged liver function tests (LFT), and most patients recover uneventfully with no fetal harm. Methods A retrospective study was conducted by evaluating records of 135 patients who were admitted or underwent day care for HG at our center over a period of 30 months. After excluding patients who were not investigated and those with another pre-existing or newly diagnosed liver disease, 63 patients were enrolled in the study. Their LFT were analyzed with the software Graphpad Prism version 8.4 (GraphPad Software, San Diego, California). The values were expressed as mean ± standard deviation and statistical analysis was done using unpaired t test and simple linear regression. Results The mean age of the study population was 26.59 ± 5.15 years and the mean period of gestation was 13.27 ± 2.48 weeks. 60.3% (38/63) of the patients had some form of abnormality on the LFT. The mean total serum bilirubin (TSB) was 1.56 ± 0.84 mg/dL, mean aspartate transaminase (AST) was 46.63 ± 30.89 U/L and mean alanine transaminase (ALT) was 51.35 ± 42.86 U/L. ALT was higher than AST with statistical significance (p<0.0001). There was no statistically significant difference in the LFT of primigravida and multigravida women. The study population included three diabetic and two hypertensive women, and two women had multiple pregnancy. All the patients were treated with anti-emetics. One patient required corticosteroid administration, and none required termination of pregnancy. Conclusion Mild liver dysfunction in HG can occur in over 50% of the patients. When diagnosis is not in doubt, no further intervention is required with regard to the LFT., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Gaba et al.)

Microbial communities are continuously exposed to the arrival of alien species. In complex environments such as soil, the success of invasion depends on the characteristics of the habitat, especially the diversity and structure of the residing bacterial communities. While most data available on microbial invasion relies on experiments run under constant conditions, the fate of invading species when the habitat faces disturbances has not yet been addressed. Here, we designed experiments to assess the consequences of habitat disturbance on the success of ongoing microbial invasion. We investigated (i) if disturbance-induced alterations in resident microbial communities could mitigate or facilitate invasion of Listeria monocytogenes , (ii) if disturbance itself could either improve or reduce the invader's fitness and (iii) if the invading species alters the structure of indigenous microbial communities. Our data show that environmental disturbances affect invasion patterns of L. monocytogenes in soils. Intriguingly, successful invasion was recorded in a regimen of disturbances that triggered small changes in microbial community structure while maintaining high bacterial diversity. On the opposite, dramatic decline of the invader was recorded when disturbance resulted in emergence of specific communities albeit concomitant with a diversity loss. This suggests that community composition is more important than its diversity when it comes to prevent the establishment of an invading species. Finally, shifts in bacterial communities during the disturbance event were strengthened by the presence of the invader indicating a major impact of invasion on microbial diversity when the habitat faces disturbance., (Copyright © 2020 Spor, Camargo, Bru, Gaba, Garmyn, Gal and Piveteau.)

Introduction Scrub typhus is a resurging zoonotic infection prevalent in South Asia with many recent outbreaks in India. It can mimic other tropical infections and the disease spectrum ranges from subclinical illness to life-threatening disease with multiorgan dysfunction. This study was conducted to study the pattern of hepatic and renal injury. Methods A retrospective study was done on 176 patients diagnosed by detecting IgM antibodies using an enzyme-linked immunosorbent assay (ELISA) over a period of three years at a tertiary center in Chandigarh, India. They were treated with doxycycline (azithromycin if pregnant) and supportive therapies. The patterns of hepatic and renal functions, along with the need of renal replacement therapy, were recorded and evaluated. The values were expressed as mean ± SD, and p values were calculated to establish statistical significance. Results Most of the cases were from the state of Haryana (37.5%), followed by Punjab (33.5%), Himachal Pradesh (13.6%), Uttar Pradesh (10.2%) and Chandigarh (5%). 30% of the study population was engaged in agriculture. The mean age was 32.3 ± 13.5 years with range of 13-65 years. A peak in the incidence was observed during monsoon months. Approximately 13% of the patients died. Urea, creatinine, bilirubin and aspartate transaminase were found to be higher in mortality group with statistical significance (p < 0.05). Alanine transaminase was higher and albumin was lower in the mortality group but without statistical significance. 27.8% had acute kidney injury, 90.9% had liver dysfunction and one patient had acute liver failure. All the pregnant patients had fetal loss. Conclusion Renal and liver dysfunctions are common in scrub typhus, and their occurrence adversely affects the outcome., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Gaba et al.)

MicroRNAs are ~22 nucleotide long non-coding RNAs that regulate gene expression at posttranscriptional level. Genome-wide analysis was performed to identify polycistronic miRNAs from wheat. Total 89 polycistronic miRNAs were identified in bread wheat which were distributed on three component sub-genomes (A = 26, B = 33 and D = 30). Except some, most of the identified polycistronic miRNAs were also present in other cultivated and wild wheat species. Expression of 11 identified polycistronic miRNAs could be validated using previously assembled transcriptomes, RNA-seq/s-RNA seq data of cultivated and wild wheats and RT-PCR. Polycistronic miRNAs orthologs were also localized on rice and Brachypodium genomes. As a case study, we also analyzed molecular evolution of miR395 family polycistrons in wheat. Both tandem and segmental duplications contributed to expansion of miR395 family polycistrons. Our findings provide a comprehensive view on wheat polycitronic miRNAs that will enable their in-depth functional analysis in the future., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Introduction: Morphometric variations of the anterior column of the acetabulum have been described in the literature for its complex structure, which can influence the safe containment of intramedullary screw for fixation of its fractures. The purpose of this CT-based study is to present a preliminary report on the morphometric variations and safety of intramedullary screw fixation of the anterior column of the acetabulum in the Indian population., Methods: CT-based data from 102 uninjured pelves were retrospectively analyzed in iPlanⓇ BrainLab AG, Feldkirchen, Germany. Narrowest zones around acetabulum and superior pubic ramus were measured. We calculated the axis of the anterior column of the acetabulum by joining the centres of these narrowest zones. Standard screws trajectories were directed along this axis. Screw length up to the first cortical perforation, the distance of the exit point from the pubic symphysis, and the length of the anterior column up to the pubic tubercle were measured., Results: The osseous corridor of the anterior column of acetabulum had variable cross-section along its length with two constriction zones, first in the acetabular region and second in the superior pubic ramus. Only 54% of our cases allowed safe applicability of 6.5-mm-diameter screw trajectories with safety margin of 2 mm on either side of the screw. Significant morphometric and screw applicability-related differences were observed among male and female cases with males having a wider osseous corridor in general. Elimination of safety margin results in a significant increase in the screw applicability., Conclusion: The osseous corridor of the anterior column varies in its dimensions from individual to individual. Standard screws of 6.5-mm and 7.3-mm diameters may not be safe for intramedullary screw fixation in every patient and carry a risk of cortical violation when a 2 mm of width around the screw is considered as a safety margin. However, with a precise screw placement within the extents of the cortices of the anterior column, 6.5-mm screws can be applied in most of the female cases and 7.3-mm screws can be applied in most of the male cases for anterior column fixation.

Efficient management of agricultural management should consider multiple services and stakeholders. Yet, it remains unclear how to guarantee ecosystem services for multiple stakeholders' demands, especially considering the observed biodiversity decline following reductions in semi-natural habitat (SNH), and global change. Here, we use an ecosystem service model of intensively-managed agricultural landscapes to derive the best landscape compositions for different stakeholders' demands, and how they vary with stochasticity and the degree of pollination dependence of crops. We analyse three groups of stakeholders assumed to value different ecosystem services most - individual farmers (crop yield per area), agricultural unions (landscape production) and conservationists (biodiversity). Additionally, we consider a social average scenario that aims at maximizing multifunctionality. Trade-offs among stakeholders' demands strongly depend on the degree of pollination dependence of crops, the strength of environmental and demographic stochasticity, and the relative amount of an ecosystem service demanded by each stakeholder. Intermediate amounts of SNH deliver relatively high levels of the three services (social average). Our analysis further suggests that the current levels of SNH protection lie below these intermediate amounts of SNH in intensively-managed agricultural landscapes. Given the worldwide trends in agriculture and global change, current policies should start to consider factors such as crop type and stochasticity, as they can strongly influence best landscape compositions for different stakeholders. Our results suggest ways of managing landscapes to reconcile several actors' demands and ensure for biodiversity conservation and food production., Competing Interests: Declaration of Competing Interest None.

Introduction: This study was carried out to compare the efficacy of silver nanoparticle gel (SG), nanosilver foam (SF) and collagen (C) dressings in partial thickness burn wounds., Methods: This was a single-center, prospective cohort study carried out over a period of 1 year on patients with 15-40% partial thickness thermal burns ≤48 h. Each patient received all three dressings (silver-nanoparticle gel, nanosilver foam, collagen) simultaneously at 3 randomly selected areas which were comparable in terms of burn depth and surface area. Efficacy of the dressings was assessed in terms of healing rates, time taken and ease of application, pain at dressing change, cost, wound-swab culture and scar quality (at 3 months)., Results: A total of 20 patients were included. In SF group, number of patients with 60%-80% re-epithelialization on day10 (SG: 10/20; C: 10/20; SF: 16/20; p = 0.042) and complete healing on day14 (SF: 11/20, C: 6/20, SG: 4/20; p = 0.032) was significantly higher. The time for dressing change was similar at admission (p = 0.918) and day 10 (p = 0.163), although majority of the patients in SF group needed less than 10 min. The time taken (<10 min) was significantly lower in SF group by 14th day (SF: 18/20 C: 6/20 SG: 6/20; p < 0.001). The ease of application rated by clinicians as "extremely easy" was significantly better in SF group (SG: 78%, C: 80%, SF: 95%; p = 0.011). There was a significantly faster decrease in pain scores in SF group by 5th day (VAS score SF: 6, C: 8; SG: 8; p = 0.038), however, pain scores were comparable at 2 weeks. The scar quality (p = 0.82), cost (p = 0.09) and infection rates (SG: 7/20; C: 4/20; SF: 3/20; p = 0.05) were comparable. The need for skin-graft cover was lower in SF group (SG: 5/20; C: 3/20; SF: 1/20)., Conclusion: Nanosilver-foam dressings were found to be more efficacious for re-epithelialization, healing, ease of application, tolerance when compared to silver nanoparticle gel and collagen dressings in partial-thickness burns. All were found to be safe., (Copyright © 2019 Elsevier Ltd and ISBI. All rights reserved.)

Nature-based agriculture that reduces dependency on chemical inputs requires using ecological principles for sustainable agro-ecosystems, aiming to balance ecology, economics and social justice. There is growing evidence that pollinator-dependent crops with high insect, particularly bee, pollination service can give higher yields. However, the interacting effects between insect pollination and agricultural inputs on crop yields and farm economics remain to be established to reconcile food production with biodiversity conservation. We quantified individual and combined effects of pesticides, insect pollination and soil quality on oilseed rape ( Brassica napus L.) yield and gross margin, using a total of 294 farmers' fields surveyed between 2013 and 2016. We show that yield and gross margins are greater (15-40%) in fields with higher pollinator abundance than in fields with reduced pollinator abundance. This effect is, however, strongly reduced by pesticide use. Greater yields may be achieved by either increasing agrochemicals or increasing bee abundance, but crop economic returns were only increased by the latter, because pesticides did not increase yields while their costs reduced gross margins.

To determine effects of reconstruction in advanced oral cavity cancers in achieving a quality of life (QOL), which can help patients to cope with their routine day to day activity. A Cross sectional analysis involving 32 patients of stage III and IV oral cavity cancers already operated in the department of otolaryngology and head and neck surgery was carried out. All these patients had resection of their tumors along with reconstruction. Patients who consented for QOL assessment and follow up through personal visit and telephonic interviews were included in the study. Voice related quality of life; Swallowing related QOL; overall Quality of life (WHO QOL BREF II) and disability assessment scale (WHO DAS II) were used for assessing the various QOL parameters during post-operative period. Patients with stage T3 tumors had better QOL compared to patients with T4 stage tumors. Patients who had reconstruction with free flaps had better QOL compared to those with Pectoralis Major myocutaneous (PMMC) flaps or those reconstructed with combinations of flaps involving delto-pectoral flaps or local flaps along with a free flap or PMMC. Patients with lower stage tumors have better QOL even after reconstruction. If available, free flaps should be preferred over local flaps. Delto-pectoral flaps should be a less preferred option in terms of QOL. Every patient should be counseled accordingly while any reconstruction plan is included in the management of cancers of oral cavity., Competing Interests: Conflicts of interestNone., (© Association of Otolaryngologists of India 2018.)

Background: The role of virtual surgical planning and three-dimensional printing in improving the accuracy, precision, functional and aesthetic outcomes have been demonstrated in the literature; however, there is a dearth of studies evaluating these parameters., Objective: This study was carried out at a tertiary care center in North India to assess the accuracy of virtual surgical planning in mandibular reconstruction., Method: All the included patients were preoperatively assessed with a contrast enhanced computed tomography (CECT) of head and neck. Based on the dimensions a patient-specific fibula cutting guide was fabricated by three-dimensional printing. All patients were evaluated with a postoperative CECT at 6 months of follow-up. The precision outcomes were measured by comparing surgical results with the images of the preoperative virtual planning based on several measurements on the reconstructed mandible such as anteroposterior measurement, transverse measurement, height of the mandible, angle of the mandible, and lateral tilt.The secondary outcomes analyzed were the mean total operative time, mean ischemia time, and morbidity parameters., Result: Twelve consecutive patients (6 male, 6 female) with mean age of 33.1 ± 11 years who underwent free fibula graft mandibular reconstruction were included in the study. The mean difference in the anteroposterior, transverse, and height dimensions were 0.87 ± 0.43 mm (P = 0.24), 2.43 ± 3.72 mm (P = 0.64), and 1.08 ± 0.67 (P = 0.88), respectively. The difference in the angles of the reconstructed mandible was 2.37 ± 3.92 degrees (P = 0.51) and of lateral tilt was 1.57 ± 1.5 degrees (P = 0.54). The mean total operative time was 639 ± 27.2 minutes and mean ischemia time was 88.4 ± 8.6 minutes., Conclusion: All the patients had satisfactory aesthetic results and good oral function at 6 months postoperative period.

Modern agriculture needs a paradigm shift to make the world's food production sustainable while mitigating social and environmental externalities. Although various policies to limit the use of agrochemicals have recently been implemented in the European Union, the use of both herbicides and fertilizers has remained fairly constant. Farmers are assumed to behave optimally, producing the best they can, given the agronomic constraints of their fields. Based on this assumption, reducing agrochemicals should inevitably have negative effects on food production, or reduce farmers' incomes. Coupling empirical analysis based on field surveys and experimental trials where weed management and nitrogen input were manipulated in the same production fields and under real farming conditions, we demonstrate that high use of N fertiliser or intense weed control slightly increase yields, but that this increase is not enough to offset the additional costs incurred by their use. Our experimental design allowed inputs to be varied in a two-factor design, along a gradient spanning from organic to highly intensive farming, while holding all other conditions constant and thus avoiding confounding effects. Quantification of crop yields and gross margins from winter cereal farming showed that reducing dependence on weed management may not hamper cereal production in this system, and is economically profitable at the field level on the short term. Our study thus contributes to addressing a key gap in our economic knowledge, and gives hope for implementing win-win strategies for farmers and the environment.

Background: Traumatic amputations are very prevalent in today's world. Successful rehabilitation of an amputee largely depends on how well he/she adapt to prosthesis. However, because of poor scar characteristics, these patients often complain of pain while using prosthesis. Autologous fat graft is being vastly used all over the world to improve the scar of various etiologies. However, it has been associated with unpredictable resorption rate., Objectives: We report the results of the study which was done to assess the consequences of fat grafting over scars and to see its effects on pain management in amputated stump and compare the autologous fat graft with stromal vascular filtrate (SVF)-enriched fat graft for scar remodeling and pain modulation on amputation stumps., Materials and Methods: A prospective randomized trial was conducted from July 2014 to December 2015. A group of ten patients, who were unable to wear prosthesis due to painful amputation stump, incorporated in the study and randomly distributed in two groups. Group A of five patients (case group) was treated with autologous fat graft enriched with SVF while Group B (control group) of remaining five patients was treated with fat graft alone. The results were assessed at baseline, at 1 month, and at 6 months postoperatively using patient and observer scar assessment scale (POSAS) score. Magnetic resonance imaging (MRI) was done to compare fat content preoperatively and 6 months postoperatively., Results: All ten patients reported improvement in scar characteristics, most notably in pain in both scales of POSAS score. The improvement was comparable in both groups. However, the fat content in case group was significantly more in comparison to control group when assessed 6 months postoperatively using MRI scan., Conclusion: Autologous fat grafting is a viable and minimally invasive solution for painful amputation stump. Enrichment of fat graft with SVF can enhance its viability over long term. This study was done as a pilot project. Hence, further long term studies with large sample size are needed to ascertain the benefits observed in this study., Competing Interests: There are no conflicts of interest.

Changes in land use generate trade-offs in the delivery of ecosystem services in agricultural landscapes. However, we know little about how the stability of ecosystem services responds to landscape composition, and what ecological mechanisms underlie these trade-offs. Here, we develop a model to investigate the dynamics of three ecosystem services in intensively managed agroecosystems, i.e., pollination-independent crop yield, crop pollination, and biodiversity. Our model reveals trade-offs and synergies imposed by landscape composition that affect not only the magnitude but also the stability of ecosystem service delivery. Trade-offs involving crop pollination are strongly affected by the degree to which crops depend on pollination and by their relative requirement for pollinator densities. We show conditions for crop production to increase with biodiversity and decreasing crop area, reconciling farmers' profitability and biodiversity conservation. Our results further suggest that, for pollination-dependent crops, management strategies that focus on maximizing yield will often overlook its stability. Given that agriculture has become more pollination-dependent over time, it is essential to understand the mechanisms driving these trade-offs to ensure food security., (© 2019 by the Ecological Society of America.)

Oxford unicompartmental knee replacement (OUKR) has shown excellent long-term clinical outcomes as well as implant survival when used for correct indications with optimal surgical technique. Anteromedial osteoarthritis is highly prevalent in Indian patients, and OUKR is the ideal treatment option in such cases. Uncertainty prevails about the best method to determine femoral component size in OUKR. Preoperative templating has been shown to be inaccurate, while height- and gender-based guidelines based on European population might not apply to the Indian patients. Microplasty instrumentation introduced in 2012 introduced the sizing spoon, which has the dual function of femoral component sizing and determining the level of tibia cut. We aimed to check the accuracy of sizing spoon and also to determine whether the present guidelines are appropriate for use in the Indian patients. A total of 130 consecutive Oxford mobile bearing medial cemented UKR performed using the Microplasty instrumentation were included. The ideal femoral component size for each knee was recorded by looking for overhang and underhang in post-operative lateral knee radiograph. The accuracy of previous guidelines was determined by applying them to our study population. Previously published guidelines (which were based on Western population) proved to be accurate in only 37% of cases. Hence, based on the demographics of our study population, we formulated modified height- and gender-based guidelines, which would better suit the Indian population. Accuracy of modified guidelines was estimated to be 74%. The overall accuracy of sizing spoon (75%), when used as an intraoperative guide, was similar to that of modified guidelines. Existing guidelines for femoral component sizing do not work in Indian patients. Modified guidelines and use of intraoperative spoon should be used to choose the optimal implant size while performing OUKR in Indian patients., Competing Interests: One of the authors (H.P.) is a paid consultant with Zimmer-Biomet, receives Institutional support from Depuy and Zimmer-Biomet, and is involved in medico-legal work with Kennedy's Law., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Objectives: Nonsurgical management of unstable pelvic ring injuries is associated with poor outcomes. Posterior pelvic ring injuries include sacroiliac joint disruption and sacral fractures or a combination of the two. Morbidity is high in non-operatively managed patients. Screw fixation is being increasingly used to manage unstable posterior pelvic injuries. Limitations include a steep learning curve and potential for neurovascular injury. This is the first study in Indian population to describe the safe corridor for screw placement and check the feasibility of screw in both upper and lower sacral segments., Methods: This study involved retrospective analysis of 105 pelvic CT scans of patients admitted to the emergency department of a Level 1 trauma centre. Vertical height at the level of constriction (vestibule) of S1 and S2 was measured in coronal sections and anteroposterior width of constrictions was measured in axial sections. We created a trajectory for 7.3 mm cylinder keeping additional 2 mm free bony corridor around it and confirmed that bony limits were not breached in axial, coronal and sagittal sections. Whenever there was breach in bony limit we checked applicability of 6.5 mm screw., Results: The vertical height and anteroposterior width of vestibule/constriction of S1 was significantly higher in males, whereas S2 vestibule height and width were similar in males and females. Both male and female pelves were amenable to S1 Trans-sacral and S1 Iliosacral screw fixation with a 7.3 mm screw when a safe corridor of 2 mm was kept on all sides. However, when S2 segment was analysed, only 42.9% of male pelves and 25.7% of female pelves were amenable to insertion of trans-sacral 7.3 mm screw., Conclusion: An individualized approach is necessary and each patient's CT must be carefully studied before embarking on sacroiliac screw fixation in Indian population.

Premise of the Study: Despite long-term research efforts, a comprehensive perspective on the ecological and functional properties determining plant weediness is still lacking. We investigated here key functional attributes of arable weeds compared to non-weed plants, at large spatial scale., Methods: We used an intensive survey of plant communities in cultivated and non-cultivated habitats to define a pool of plants occurring in arable fields (weeds) and one of plants occurring only in open non-arable habitats (non-weeds) in France. We compared the two pools based on nine functional traits and three functional spaces (LHS, reproductive and resource requirement hypervolumes). Within the weed pool, we quantified the trait variation of weeds along a continuum of specialization to arable fields., Key Results: Weeds were mostly therophytes and had higher specific leaf area, earlier and longer flowering, and higher affinity for nutrient-rich, sunny and dry environments compared to non-weeds, although functional spaces of weeds and non-weeds largely overlapped. When fidelity to arable fields increased, the spectrum of weed ecological strategies decreased as did the overlap with non-weeds, especially for the resource requirement hypervolume., Conclusions: Arable weeds constitute a delimited pool defined by a trait syndrome providing tolerance to the ecological filters of arable fields (notably, regular soil disturbances and fertilization). The identification of such a syndrome is of great interest to predict the weedy potential of newly established alien plants. An important reservoir of plants may also become weeds after changes in agricultural practices, considering the large overlap between weeds and non-weeds., (© 2019 Botanical Society of America.)

As a matter of policy, minimizing human health and environmental risks associated with pesticide use is a major challenge but necessary for improving agricultural sustainability. Efficient and effective policies that encourage the use of less risky pesticides, such as pesticide taxes, necessitate a precise and realistic quantification of potential adverse effects. Various indicators are currently utilized in policies and they focus mainly on a purely quantitative dimension of the pesticides used, which can lead potentially to unfavorable outcomes of pesticide policies. A unique dataset applied to pesticide use by Swiss farmers in winter wheat and potato production, demonstrates that on average the two most important quantitative indicators show a significant correlation with pesticide risks as expressed by the Danish Load Indicator. However, they have almost no explanatory power for extreme risks (e.g. most intensive use patterns for pesticides with unfavorable toxicity profiles). Results remain stable over a range of aggregation levels, from application- to farm-level indicators of pesticide use. These findings render the commonly used, quantitative indicators ineffective to reduce potential environmental and human health risks of pesticides and, in the worst case, lead to misinformed market-based pesticide policies consequential to National Action Plans., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Objectives: The management of high energy tibial plateau fractures is a surgical challenge. Recently described Luo's classification is based on CT scans and is more objective with a better inter-observer agreement as compare to Schatzker and AO/OTA classifications. We describe the functional results of a series of 53 cases classified and managed according to the Luo's column concept., Methods: A retrospective review of 53 high energy tibial plateau fractures, operated between January 2012 and March 2015 at a Level I trauma center, was performed. CT scans were used to classify these injuries based on the number of columns involved. Plating configuration and surgical approach were chosen based on the number of independent articular fragments on axial sections at the level of fibular head., Results: 1 one-column, 51 two-column and 1 three-column fractures were studied. Triple plating was done in 5 patients. Mean follow-up was 2.7 years and mean Insall Knee score was 95.42. Four patients had varus malalignment and 1 had joint depression in the post-operative period. These were due to imperfect reduction during the surgery itself, and no case of late collapse was detected., Conclusion: Utilizing Luo's classification for treating these complex injuries will assist in better understanding of fracture pattern and hence help in achieving a better functional outcome. Each fractured column needs to be independently addressed.

RECOTOX is a cross-cutting initiative promoting an integrated research to respond to the challenges of monitoring, understanding, and mitigating environmental and health impacts of pesticides in agroecosystems. The added value of RECOTOX is to develop a common culture around spatial ecotoxicology including the whole chain of pressure-exposure-impact, while strengthening an integrated network of in natura specifically equipped sites. In particular, it promotes transversal approaches at relevant socioecological system scales, to capitalize knowledge, expertise, and ongoing research in ecotoxicology and, to a lesser extent, environmental toxicology. Thus, it will open existing research infrastructures in environmental sciences to research programs in ecotoxicology of pesticides.

Background: Salinity severely limits wheat production in many parts of the world. Development of salt tolerant varieties represents the most practical option for enhancing wheat production from these areas. Application of marker assisted selection may assist in fast tracking development of salt tolerant wheat varieties. However, SSR markers available in the public domain are not specifically targeted to functional regions of wheat genome, therefore large numbers of these need to be analysed for identification of markers associated with traits of interest. With the availability of a fully annotated wheat genome assembly, it is possible to develop SSR markers specifically targeted to genic regions. We performed extensive analysis to identify candidate gene based SSRs and assessed their utility in characterizing molecular diversity in a panel of wheat genotypes., Results: Our analysis revealed, 161 SSR motifs in 94 salt tolerance candidate genes of wheat. These SSR motifs were nearly equally distributed on the three wheat sub-genomes; 29.8% in A, 35.7% in B and 34.4% in D sub-genome. The maximum number of SSR motifs was present in exons (31.1%) followed by promoters (29.8%), 5'UTRs (21.1%), introns (14.3%) and 3'UTRs (3.7%). Out of the 65 candidate gene based SSR markers selected for validation, 30 were found polymorphic based on initial screening and employed for characterizing genetic diversity in a panel of wheat genotypes including salt tolerant and susceptible lines. These markers generated an average of 2.83 alleles/locus. Phylogenetic analysis revealed four clusters. Salt susceptible genotypes were mainly represented in clusters I and III, whereas high and moderate salt tolerant genotypes were distributed in the remaining two clusters. Population structure analysis revealed two sub-populations, sub-population 1 contained the majority of salt tolerant whereas sub-population 2 contained majority of susceptible genotypes. Moreover, we observed reasonably higher transferability of SSR markers to related wheat species., Conclusion: We have developed salt responsive gene based SSRs in wheat for the first time. These were highly useful in unravelling functional diversity among wheat genotypes with varying responses to salt stress. The identified gene based SSR markers will be valuable genomic resources for genetic/association mapping of salinity tolerance in wheat.

Background: Proprioception is a specialized sensory modality encompassing the movement of the joint and its position in space. Reconstruction of the anterior cruciate ligament (ACL) does not always yield expected outcome, suggesting that successful reconstruction depends on not only the ultimate strength of the graft but also recovery of proprioception. Treatment delay is a significant concern in developing countries, e.g., in Asia. Thus, presence of mechanoreceptors is one of the factors having paramount importance for successful outcome. We conducted this study to identify mechanoreceptors via immunohistochemical staining and correlate their presence with duration of injury., Materials and Methods: A total of 38 injured native ACL stumps were harvested from patients undergoing ACL reconstruction and stained with neurofilament protein stain to detect functional mechanoreceptors., Results: Of the specimens, 44.7% stained positive for monoclonal antibody. No association was found between duration of injury and presence of mechanoreceptors (p = 0.897). No correlation was seen between age and side., Conclusions: No correlation was found between duration of injury and presence of viable mechanoreceptors, hence it is beneficial to preserve the native ACL stump irrespective of the time interval between injury and surgery., Level of Evidence: III.

Background: Oxford medial unicompartmental knee replacement (UKR) is indicated in patients with anteromedial osteoarthritis (AMOA) of the knee. Microplasty (MP) instrumentation was introduced in 2012 as an improvement over phase 3 instrumentation. Advantages of this instrumentation include conservative tibial cut, decreased tibial re-cut rate and improved component alignment. We report the results of UKR with the new instrumentation in a consecutive series with a minimum follow-up of 2 years., Methods: A prospective study of 115 cemented medial Oxford UKRs implanted in 89 patients was done. Post-operative alignment of the tibial and femoral components was analysed. Patient reported outcome measures were recorded using Oxford Knee Score (OKS) and the American Knee Society Score (KSS). Tegner Activity Scale (TAS) was used to record the activity level., Results: 115 consecutive medial Oxford UKRs were studied. All patients were followed up annually in this prospective ethically approved study. The mean follow-up was 36 months and the minimum follow-up was 25 months. No patient died and none were lost to follow-up. At the final follow-up, the average OKS of the cohort was 39.5 (SD: 5.7). 91.2 % of the patients had good or excellent OKS with only 3.5 % reporting poor OKS. The overall limb alignment was 4.8 0 varus (0 - 14 0 varus). Tibia was recut in 5.2 % of cases. Median bearing size was 3 (range: 3 to 6). There was one case of bearing dislocation and one case of aseptic tibial loosening., Conclusion: This is the first study to report results of MP instrumentation at a minimum follow-up of 2 years. Our study indicates that the new instrumentation results in reliable and accurate implantation of femoral and tibial components in majority of the cases, with a decrease in number of alignment outliers, and also a reduced rate of bearing dislocation.

Agriculture is currently facing unprecedented challenges: ensuring food, fiber and energy production in the face of global change, maintaining the economic performance of farmers and preserving natural resources such as biodiversity and associated key ecosystem services for sustainable agriculture. Addressing these challenges requires innovative landscape scale farming systems that account for changing economic and environmental targets. These novel agricultural systems need to be recognized, accepted and promoted by all stakeholders, including local residents, and supported by public policies. Agroecosystems should be considered as socio-ecological systems and alternative farming systems should be based on ecological principles while taking societal needs into account. This requires an in-depth knowledge of the multiple interactions between sociological and ecological dynamics. Long Term Socio-Ecological Research platforms (LTSER) are ideal for acquiring this knowledge as they (i) are not constrained by traditional disciplinary boundaries, (ii) operate at a large spatial scale involving all stakeholders, and (iii) use systemic approaches to investigate biodiversity and ecosystem services. This study presents the socio-ecological research strategy from the LTSER "Zone Atelier Plaine & Val de Sèvre" (ZA PVS), a large study area where data has been sampled since 1994. Its global aim is to identify effective solutions for agricultural development and the conservation of biodiversity in farmlands. Three main objectives are targeted by the ZAPVS. The first objective is intensive monitoring of landscape features, the main taxa present and agricultural practices. The second objective is the experimental investigation, in real fields with local farmers, of important ecosystem functions and services, in relation to pesticide use, crop production and farming socio-economic value. The third aim is to involve stakeholders through participatory research, citizen science and the dissemination of scientific results. This paper underlines the relevance of LTSERs for addressing agricultural challenges, while acknowledging that there are some yet unsolved key challenges., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Understanding the response of biodiversity to management, land use and climate change is a major challenge in farmland to halt the decline of biodiversity. Farmlands shelter a wide variety of taxa, which vary in their life cycle and habitat niches. Consequently, monitoring biodiversity from sessile annual plants to migratory birds requires dedicated protocols. In this article, we describe the protocols applied in a long-term research platform, the LTSER Zone Atelier "Plaine & Val de Sèvre" (for a full description see Bretagnolle et al. (2018) [1]). We present the data in the form of the description of monitoring protocols, which has evolved through time for arable weeds, grassland plants, ground beetles, spiders, grasshoppers, wild bees, hoverflies, butterflies, small mammals, and farmland birds (passerines, owls and various flagship species).

A spectrophotometric method based on diazotization of aniline with triclosan has been developed for the determination of triclosan in water samples. The diazotization process involves two steps: (1) reaction of aniline with sodium nitrite in an acidic medium to form diazonium ion and (2) reaction of diazonium ion with triclosan to form a yellowish-orange azo compound in an alkaline medium. The resulting yellowish-orange product has a maximum absorption at 352 nm which allows the determination of triclosan in aqueous solution in the linear concentration range of 0.1-3.0 μM with R 2 = 0.998. The concentration of hydrochloric acid, sodium nitrite, and aniline was optimized for diazotization reaction to achieve good spectrophotometric determination of triclosan. The optimization of experimental conditions for spectrophotometric determination of triclosan in terms of concentration of sodium nitrite, hydrogen chloride and aniline was also carried out by using Box-Behnken design of response surface methodology and results obtained were in agreement with the experimentally optimized values. The proposed method was then successfully applied for analyses of triclosan content in water samples.

Introduction: There is a lack of in vivo studies comparing the functional outcome and knee stability after anterior cruciate ligament reconstruction (ACLR) using fixed loop (EndoButton (EB) CL) and adjustable loop (TightRope (TR) RT) devices for femoral fixation of soft tissue grafts., Materials and Methods: Functional outcomes were assessed in terms of the International Knee Documentation Committee (IKDC) and Lysholm scores, knee stability by anteroposterior laxity and side-to-side difference (SSD) using KT-1000 arthrometer. The evaluation was performed preoperatively and post-operatively at 6 months and 2 years., Results: Both groups were matched in terms of demographic, preoperative, intraoperative and post-operative covariates. EB ( n = 52) appeared to have better IKDC and Lysholm scores at 6 months post-operative when compared to TR ( n = 50). However, at a final follow-up of 2 years, the results were similar. The anterior tibial translation and SSD were statistically insignificant between the two groups at 6 months and 2 years., Conclusion: ACLR using EB or TR for femoral fixation gives substantially equivalent functional results and knee stability at mid-term follow-up.

Acute bacterial suppurative thyroiditis is an infrequent but life-threatening medical emergency. It needs to be considered in a patient with painful thyroid enlargement. Therapy consists of appropriate antibiotics and drainage of abscess. The disease may prove fatal if diagnosis and treatment are delayed.

Background: A small proportion of patients with mobile unicompartmental knee arthroplasty (UKA) report poor functional outcomes in spite of optimal component alignment on postoperative radiographs. The purpose of this study is to assess whether there is a correlation between functional outcome and knee kinematics., Methods: From a cohort of consecutive cases of 150 Oxford medial UKA, patients with fair/poor functional outcome at 1-year postsurgery (Oxford Knee Score [OKS] < 34, n = 15) were identified and matched for age, gender, preoperative clinical scores, and follow-up period with a cohort of patients with good/excellent outcome (OKS ≥ 34, n = 15). In vivo kinematic assessment was performed using step-up and deep knee bend exercises under fluoroscopic imaging. The fluoroscopic videos were analyzed using MATLAB software to measure the variation in time taken to complete the exercises, patellar tendon angle, and bearing position with knee flexion angle., Results: Mean OKS in the fair/poor group was 29.9 and the mean OKS in the good/excellent group was 41.1. The tibial slope, time taken to complete the exercises, and patellar tendon angle trend over the flexion range were similar in both the groups; however, bearing position and the extent of bearing excursion differed significantly. The total bearing excursion in the OKS < 34 group was significantly smaller than the OKS ≥ 34 group (35%). Furthermore, on average, the bearing was positioned 1.7 mm more posterior on the tibia in the OKS < 34 group., Conclusion: This study provides evidence that abnormal knee kinematics, in particular bearing excursion and positioning, are associated with worse functional outcomes after mobile UKA., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Competing Interests: There are no conflicts of interest.

Objective: The aim of this study was to evaluate the role of tendon transfers and universal cuff in restoring hand function in tetraplegic patients., Methods: Twenty-one upper limbs on 12 tetraplegic patients (9 males and 3 females); mean age: 42.2 years (range 22-58 years) with a spinal cord injury at or distal to C6, were included in this study. Key pinch was restored using Brachioradialis to Flexor Pollicis Longus transfer and hook using Pronator Teres to Flexor Digitorum Profundus transfer. The gains achieved were measured objectively at six months and at final follow up, the average follow up being 26 months. The functional outcome was assessed using the Modified Lamb and Chan score., Results: Average value was 1.67 kg for key pinch and 2.58 kg for hook grip at final follow up. The Modified Lamb and Chan score revealed good to fair outcome in 75% of patients. Complications resulted from stretching of transfer and mal-tensioning and were salvaged by the use of a 'Universal Cuff'., Conclusion: Surgery should be routinely offered to tetraplegic patients with deficient hand function in whom no recovery is expected after six months following spinal cord injury. Universal Cuff is a good salvage method for patients who refuse re-surgery., Level of Evidence: Level IV, Therapeutic study., (Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.)