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Robocasting is an extrusion-based additive manufacturing (AM) technique, highly explored in the fabrication of porous structures or thin-walled ceramics. Comparing to other slurry-based AM technologies, robocasting presents a high potential to produce dense bulk ceramics, thanks to the low organic binder contents and high solids loading used in the feedstock. Despite these benefits, the robocasting fabrication of ceramics with similar mechanical performance as those produced by traditional methods remains a challenge. The goal of this work is to fine-tune the robocasting printing process of dense alumina ceramics by evaluating the influence of in-fill filaments orientation and the medium where the deposition process occurs (air or paraffin bath), on defects and mechanical performance of the sintered parts. Relative density, shrinkage, three-point flexural strength, Young's modulus and hardness were analysed. The specimens with the highest performance were sintered at 1550 °C or 1600 °C temperatures for 2 h holding time and the results were compared with slip casting (SC) samples sintered in the same conditions. Alumina robocasting samples, printed longitudinally in air with controlled humidity and sintered at 1600 °C, exhibited relative density ≈99% with flexural strength (≈350 MPa), Young's modulus (≈366 GPa) and hardness (≈17 GPa) values comparable to those obtained for SC samples. Numerical modelling and simulation were used to analyse the experimental values and the anisotropic behaviour of the printed specimens. Experimental Young's modulus results were compared with the Voigt-Reuss bound and the Hashin-Shtrikman upper-bound, as well as the analytical predictions of a Mooney-type exponential relation.

Aims COVID-19 has compounded a growing waiting list problem, with over 4.5 million patients now waiting for planned elective care in the UK. Views of patients on waiting lists are rarely considered in prioritization. Our primary aim was to understand how to support patients on waiting lists by hearing their experiences, concerns, and expectations. The secondary aim was to capture objective change in disability and coping mechanisms. Methods A minimum representative sample of 824 patients was required for quantitative analysis to provide a 3% margin of error. Sampling was stratified by body region (upper/lower limb, spine) and duration on the waiting list. Questionnaires were sent to a random sample of elective orthopaedic waiting list patients with their planned intervention paused due to COVID-19. Analyzed parameters included baseline health, change in physical/mental health status, challenges and coping strategies, preferences/concerns regarding treatment, and objective quality of life (EuroQol five-dimension questionnaire (EQ-5D), Generalized Anxiety Disorder 2-item scale (GAD-2)). Qualitative analysis was performed via the Normalization Process Theory. Results A total of 888 patients responded. Better health, pain, and mood scores were reported by upper limb patients. The longest waiters reported better health but poorer mood and anxiety scores. Overall, 82% had tried self-help measures to ease symptoms; 94% wished to proceed with their intervention; and 21% were prepared to tolerate deferral. Qualitative analysis highlighted the overall patient mood to be represented by the terms ‘understandable’, ‘frustrated’, ‘pain’, ‘disappointed’, and ‘not happy/depressed’. COVID-19-mandated health and safety measures and technology solutions were felt to be implemented well. However, patients struggled with access to doctors and pain management, quality of life (physical and psychosocial) deterioration, and delay updates. Conclusion This is the largest study to hear the views of this ‘hidden’ cohort. Our findings are widely relevant to ensure provision of better ongoing support and communication, mostly within the constraints of current resources. In response, we developed a reproducible local action plan to address highlighted issues. Cite this article: Bone Jt Open 2021;2(8):583–593.

Antimicrobial nonwovens for single use applications (e.g., diapers, sanitary napkins, medical gauze, etc.) are of utmost importance as the first line of defense against bacterial infections. However, the utilization of petrochemical nondegradable polymers in such nonwovens creates sustainability-related issues. Here, sustainable poly(hydroxybutyrate) (PHB) and e-poly-l-lysine (e-PLL) submicro- and microfiber-based antimicrobial nonwovens produced by a novel industrially scalable process, solution blowing, have been proposed. In such nonwovens, e-PLL acts as an active material. In particular, it was found that most of e-PLL is released within the first hour of deployment, as is desirable for the applications of interest. The submicro- and microfiber mat was tested against C. albicans and E. coli, and it was found that e-PLL-releasing microfibers result in a significant reduction of bacterial colonies. It was also found that e-PLL-releasing antimicrobial submicro- and microfiber nonwovens are safe for human cells in fibroblast culture. Mechanical characterization of these nonwovens revealed that, even though they are felt as soft and malleable, they possess sufficient strength, which is desirable in the end-user applications.

Scaphoid non-union causes osteoarthritis but factors associated are poorly understood. We investigated the rate of osteoarthritis after scaphoid fracture non-union, and if duration and fracture location influenced arthritis and its severity.This retrospective cross-sectional observational study of 278 consecutive cases with scaphoid fracture non-union retrieved data on demographics, non-union duration, fracture location, dorsal intercalated segment instability (DISI), severity and distribution of wrist arthritis. Patient Evaluation Measure (PEM) and Quality of Life assessed impact on patients. Regression models investigated prediction of osteoarthritis by different variables. Time-to-event analysis investigated osteoarthritis evolution. Missing (MAR) data for the PEM and QoL was imputed and analysed.278 patients, 246 males, aged 27.9 years (range 11 to 78 years), with a scaphoid fracture non-union confirmed on computed tomography (CT) scans (243) and plain radiographs (35) were reviewed. The interval between injury and imaging was 3.3 years (SD 5.9 years; range 0.1-45). The fracture was proximal to the ridge in 162, distal to the ridge in 83 and in the proximal 20% in 33. DISI (RLA ≥ 10°) occurred in 93.5% (260/278). Osteoarthritis was identified in 62.2% (173/278), and we classified a SNAC pattern in 93.6% (162/173). Of these, 100 (61.7%) had SNAC 1, 22 (13.6%) SNAC 2, 17 (10.5%) SNAC 3, and 23 (14.2%) SNAC 4. The mean duration in years for SNAC 1, 2, 3 and 4 were 2.5, 6.0, 8.2, and 11.3 years respectively. In fractures proximal to the ridge, 50% had arthritis in 2.2 years. Whereas in proximal pole, and distal to the ridge, 50% developed in 3.8 and 6.6 years, respectively. The PEM score was 42.8% (SD 18.9%) in those without arthritis and 48.8% (SD 21.5%) in those with arthritis. The mean QoL was 0.838 in patients without SNAC and 0.792 with SNAC.Scaphoid fracture non-union caused early carpal collapse, majority had osteoarthritis usually observed within a year following injury and occurred earliest in proximal waist fractures. Distribution of osteoarthritis (SNAC stage) may not always follow a distinctive pattern, as previously described.

Aims There has been an increasing use of early operative fixation for scaphoid fractures, despite uncertain evidence. We conducted a meta-analysis to evaluate up-to-date evidence from randomized controlled trials (RCTs), comparing the effectiveness of the operative and nonoperative treatment of undisplaced and minimally displaced (≤ 2 mm displacement) scaphoid fractures. Methods A systematic review of seven databases was performed from the dates of their inception until the end of March 2021 to identify eligible RCTs. Reference lists of the included studies were screened. No language restrictions were applied. The primary outcome was the patient-reported outcome measure of wrist function at 12 months after injury. A meta-analysis was performed for function, pain, range of motion, grip strength, and union. Complications were reported narratively. Results Seven RCTs were included. There was no significant difference in function between the groups at 12 months (Hedges’ g 0.15 (95% confidence interval -0.02 to 0.32); p = 0.082). The complication rate was higher in the operative group and involved more serious complications. Conclusion We found no difference in functional outcome at 12 months for fractures of the waist of the scaphoid with ≤ 2 mm displacement treated operatively or nonoperatively. The complication rate was higher with operative treatment. Cite this article: Bone Joint J 2022;104-B(8):953–962.

In this study we investigated the in vivo Hepatoprotective activity of ethanolic extract of Garuga pinnata (EEGP) leaves in Carbon tetrachloride (CCl4) induced hepatotoxicity using wistar rats of either sex as model. Hepatotoxicity was induced by the administration of CCl4 intraperitoneally (0.125ml CCl4 in liquid paraffin (1:1) per 100g body weight). Garuga pinnata leaves extract at different dose levels (200 and 400mg/kg, p.o.) showed the dose dependant hepatoprotective effect and was compared with well known standard hepatoprotective Silymarain (100mg/kg). When groups were treated with CCl4, significant increase in serum biochemical parameters such as Serum Glutamate Oxaloacetate Transaminase (SGOT), Serum Glutamate Pyruvate Transaminase (SGPT), Alkaline phosphate (ALP), Acid Phosphate (ACP), Creatinine and alteration of tissue biochemical parameters such as reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), lipid peroxidation (LPO), and the total proteins were observed. The histopathological examination of the CCl4 treated groups showed sinusoidal congestion, centrilobular necrosis, marked vacuolations and congestion. However, pretreatment with extract of leaves of Garuga pinnata significantly reduced the increased serum levels of biochemical parameters and restored antioxidant defense enzymes level to its normal. Moreover, histopathology of leaves extract treated groups showed normal architecture with minimal sinusoidal congestion. Taken together, our study concludes that EEGP to be a more potential agent for caring liver from CCl4 induced damage.

Background There is currently no consensus for the optimum configuration and number of Kirschner wires (K-wires) to use for the stabilization of dorsally displaced distal radius fractures. In this biomechanical study, we compared the load to failure and stiffness of four common K-wire configurations to identify the strongest construct for use in extra-articular dorsally displaced distal radius fractures. Case Description We created a standard distal radius fracture model in turkey tarsometatarsi which was stabilized using two or three K-wires (1.6 mm) in four different configurations. Following a power calculation, 10 fracture models of each configuration underwent testing in cantilever bending and axial compression. Literature Review Recent randomized trials have shown no evidence that volar locking plates are superior to K-wires for the treatment of dorsally displaced distal radius fractures. This has led to an increase in the popularity of much cheaper K-wires. Several different K-wire techniques have been described but there is no strong evidence to determine which is the optimal configuration and number of wires. Clinical Relevance The three-wire interfragmentary configuration was stiffer than the three-wire Kapandji in axial compression and cantilever bending. There was no difference in load to failure in cantilever bending or axial compression. The three-wire interfragmentary technique is the stiffest configuration of K-wires for dorsally displaced distal radius fractures. The two-wire Kapandji technique was significantly weaker than the other configurations, especially in cantilever bending. Conclusion The authors recommend to always use three wires for percutaneous pinning and never to use two intrafocal wires alone.

Este artigo tem como objetivo realizar revisão de literatura sobre a evolução da criação dos veículos elétricos e híbridos. Para tanto, foram realizadas buscas no site https://www.sciencedirect.com/ utilizando as palavras-chave: “Veículos Elétricos; Veículos Híbridos; História dos Veículos Elétricos; Perspectivas para o Brasil”. Os resultados obtidos foram que a substituição da frota dos veículos a combustão interna por elétricos e híbridos no mundo, e especialmente no Brasil, é uma alternativa para reduzir impactos ambientais, manter a sustentabilidade do setor automobilístico, colaborar para manter a segurança energética dos países, e é vantajosa a longo prazo devido aos menores custos de condução.

Os parâmetros utilizados no processo de soldagem são fatores determinantes para obtenção de soldas com qualidade, sendo assim, o presente trabalho teve como objetivo a determinação de parâmetros otimizados para o processo de RSW (resistance spot welding) com duas e três chapas, utilizadas em uma indústria automobilística. Baseando-se nos três principais parâmetros da soldagem a ponto, corrente, força e tempo, o estudo foi dividido em 3 etapas, para cada mix de chapas, realizando a análise individual da influência de cada um dos parâmetros. Através de ensaios de tração foram obtidos valores de forçamáxima e diâmetro médio das lentilhas, sendo determinados parâmetros otimizados para o processo de soldagem, tendo os valores para a soldagem de duas chapas corrente de 8,0kA, pressão de 2,5kN e tempo de 250ms, e para três chapas corrente de 8,5kA, pressão de 3kN e tempo de 250ms.

A energia elétrica vem se tornando a cada dia mais indispensável para sobrevivência humana, pois vivemos uma sociedade dependente das tecnologias e que buscam melhorias constantes. Dessa forma, a busca por maior produção de energia limpa e sustentável ao meio ambiente cresce de uma maneira agressiva, partindo desse princípio a energia eólica (força do vento), energia solar (irradiação solar) apresenta uma proposta de energia alternativa, contribuindo assim para preservação do meio ambiente. Este trabalho teve como objetivos encontrar as condições ideias, por meio de estudos da melhor posição dos módulos de produção em uma residência familiar do município de Vianópolis-Goiás. A metodologia utilizada foi realizar medições das produções em intervalos de uma hora (07h às 18h), entre os dias 16/09/2019 a 20/09/2019, alterando o ângulo de inclinação de fixação dos módulos. Os dados foramtratados es tatisticamente com o auxílio de software para demonstrar os resultados graficamente. Os painéis analisados foram de material policristalino da empresa Byd Company Limited com potência máxima 330W. Após a análise estatística dos dados, foi evidenciado que os resultados que apresentaram melhores posicionamento foram das placas no sentido norte, com inclinação 16° sendo também observado que a maior produção foi correspondida entre o período compreendido entre 11h às 13h.

Com a crescente concorrência no mercado consumidor, as empresas necessitam produzir mais, com menor custo e com melhor qualidade. Este artigo objetiva o estudo à implantação do OEE (Overall Equipment Effectiveness), sendo uma ferramenta de gestão, mensurando a eficiência do processo produtivo em uma indústria farmacêutica de Anápolis-GO. Para tanto, instalou-se um sistema de supervisório permitindo obter dados de produção disponíveis em tempo real, realizando cálculos de OEE, expondo em telas gráficas percentuais de disponibilidade, performance, qualidade, produtividade. Com a implantação do OEE, originou-se uma nova visão do acompanhamento de produção, possibilitando tomadas de decisões mais rápidas e eficientes.

O setor de produção de alumínio primário, no Brasil, apresenta um grande valor econômico. O objetivo deste foi desenvolver uma revisão bibliográfica sistemática, para relatar a viabilidade na utilização dos processos de moagem de alta energia e metalurgia do pó como uma alternativa de reciclagem de alumínio e suas ligas. Limitaram-se se as buscas em 20 anos, nas bases Science Direct e Web of Science, e por meio da ferramenta StArt foi dividido em 3 filtros. Determinou‑se a importância dos processos estudados em produzir materiais secundários com propriedades semelhantes às dos primários, tornando-se cadeias produtivas, econômicas e sustentáveis.

The extracts and the compounds isolated from Phyllanthus amarus Schumm and Thonn (Family: Euphorbiaceae) have shown a wide spectrum of pharmacological activities including antiviral, antibacterial, antiplasmodial, antimalarial, antimicrobial, anticancer, antidiabetic, hypolipidemic, antioxidant, hepatoprotective, nephroprotective and diurectic properties. Background: This investigation was aimed at exploring the anxiolytic potential of Phyllanthus amarus standardized extracts and predict probable role of marker phyto constitutents. Objective and Methods: Three standardized extracts of Phyllanthus amarus plant viz. standardized aqueous extract of Phyllanthus amarus whole plant (PAAE), standardized methanolic extract of P. amarus leaf (PAME) and the standardized hydro-methanolic extract of P. amarus leaf (PAHME) were tested in the classical animal models of anxiety: Elevated plus-maze model and Light & Dark Exploration test. Results: The lower doses of the tannin rich extract (PAHME) of the P. amarus possess significant anxiolytic activity compared to lignin rich (PAME) and aqueous extracts (PAAE), while at a higher dose (400mg/kg) the results of all three extracts appears to be potentially sedative. While the molecular docking studies support these probable anxiolytic, the sedative effects of the Phyllanthus amarus extracts could be due to the interaction of tannins and lignans with the GABAbenzodiazepine receptor complex. Conclusion: The results of the present study indicate that the tannin-rich extract of the P. amarus may have potential clinical applications in the management of anxiety. It can be further studied for optimum dosage to be used as a future of anti-anxiety drug development or as a standardized Phytomedicine.

INTRODUCTION Corneal crosslinking (CXL) has revolutionized the treatment of keratoconus during the past decade. In the present study, the morphological changes in the corneal collagen fibrils (CFs) following crosslinking treatment are described. MATERIALS AND METHODS Ten pairs of porcine and rabbit corneas were retrieved. In each pair, one cornea was the control and the other underwent CXL treatment. The central corneal thickness (CCT) was measured before and after CXL treatment. Each treated and control cornea was examined with light microscopy and by transmission electron microscopy. RESULTS (a) The mean CCT was significantly reduced following treatment. (b) CFs were more closely packed in the anterior region and loosely packed in the posterior region. (c) CF diameter increased significantly in the anterior and intermediate regions but declined gradually towards the deeper regions. (d) There was a statistically significant decrease in the interfibrillar distance over the different regions of the cornea, except for the posterior region in porcine corneas, where there was no change. (e) The distance between adjacent collagen lamellae was significantly decreased in all regions of treated rabbit corneas. There was no change in porcine corneas. CONCLUSION CXL treatment resulted in increased the CF diameter and decreased interfibrillar distance in the anterior and intermediate regions, while its effects on the posterior region differed among species. The effect on interlamellar distance was more prominent in the rabbit model than the porcine model. CXL treatment stiffened the corneas by increasing CF diameter and decreasing interfibrillar distance in both rabbit and pig corneas.

Objectives The present study aimed to evaluate the nootropic activity of Limonia acidissima in rats. Materials and methods Methanolic extract of Limonia acidissima was used to evaluate nootropic activity, piracetam (200 mg/kg, i.p.) was used as a standard, and scopolamine (1 mg/kg, i.p.) was used to induce amnesia. The effect of drugs on learning and memory in rats was evaluated by using the Y-maze task and elevated plus maze on scopolamine-induced amnesia models. Locomotor activity was performed using an actophotometer. Also, levels of acetylcholinestrease, including histopathological examination of rat brains, were assessed. Results Methanolic extract of Limonia acidissima showed increased alteration of the behavior response and percentage spontaneous alteration with the Y-maze task. In the elevated plus maze scopolamine-induced amnesia model, methanolic extract of Limonia acidissima showed a decrease in transfer latency, which is indicative of cognition improvement. Methanolic extract increased locomotor activity in rats and decreased the levels of acetylcholinestrease enzyme significantly. A histopathological study with both low and high doses of extract showed effective regenerative scores as compared to normal control, negative control and standard treatment. Conclusion The results suggested that the administration of methanolic extract of Limonia acidissima enhances learning and memory in different experimental models. The histopathological study revealed the neuroprotective property of the extract. The study indicates that the extract may be used in the treatment of Alzheimer's disease.

This essay explores interreligious education at the Toronto School of Theology (TST) through a survey of some recent programs and curricular offerings, ecclesial commitments, sociological trends, and developments in scholarship. These contextual realities continue to shape theological education at TST especially as they relate to cultural texturality and post-coloniality. The article demonstrates that interreligious engagement, as much as it has been part of the history of TST, remains a significant feature today, with creative promise for the future.

Rabbit and porcine corneas have been used in scientific research due to their structural similarity to the human cornea. Currently, there are no studies that have compared corneal collagen fibrillar diameter, interfibrillar distance and interlamellar distance between human and animal models. Ten pairs of porcine, rabbit, and human corneas were used. These were analysed using light and Transmission Electron microscopy. The collagen fibrillar diameter, interfibrillar distance and interlamellar distance were statistically compared between porcine, rabbit and human corneas. The human, porcine and rabbit; mean collagen fibrillar diameters were: 24.52 ± 2.09 nm; 32.87 ± 0.87 nm; and 33.67 ± 1.97 nm. The mean interfibrillar distances were: 46.10 ± 2.44 nm; 53.33 ± 2.24 nm; and 52.87 ± 2.73 nm, respectively. The collagen fibrillar diameter and interfibrillar distance of porcine and rabbit corneas were significantly different (p

Background:: Phyllanthus fraternus Webster Linn (family, Euphorbiaceae) is used as a traditional medication for the treatment of various disorders and has therapeutic implications. Objective:: This study intends to investigate the anxiolytic potential of Phyllanthus fraternus standardized extract and prediction of the probable role of its marker phytoconstituents. Methods:: We tested the standardized hydro-ethanolic extract of Phyllanthus fraternus (whole plant) for the Elevated plus-maze model (EPM) and Light & Dark Exploration test as classical models for anxiety. Phyto-chemical HPTLC fingerprint analysis was performed for the detection of two classes of compounds lignans and tannins. HPTLC analysis of the standardized extract was performed using phyllanthin hypophyllanthin and corilagin as marker compounds. Additionally, GABA receptor antagonism was studied in other sets of experiments to assess the involvement of this receptor in the anxiolytic- like effects produced by Phyllanthus fraternus. Results:: The lower doses of the lignan and tannin-rich extract of the Phyllanthus fraternus possess significant anxiolytic-like activity compared to the standard diazepam. Additionally, the results of the present study suggested that high doses (400mg/kg) of Phyllanthus fraternus have exerted some sedative- like effects. Phytochemical screening and HPTLC fingerprint analysis indicate the presence of lignans and tannins, whereas HPLC analysis of the standardized extract revealed the presence of marker lignan (Hypophyllanthin) and Tannin (Corilagin). The anxiolytic-like effect of Phyllanthus fraternus observed in the mice models were blocked by Flumazenil indicating the involvement of GABAA receptors in the modulation of this effect. Our molecular docking studies also supported probable anxiolytic and sedative effects. Conclusion:: To summarize, results support the use of Phyllanthus fraternus in the anxiety-like symptoms/ disease condition and suggest its anxiolytic-like effect governed by the GABA-A receptors.

Aim: The aim of the current research work was to isolate, characterize and evaluate the hepatoprotective activity of Garuga pinnata leaves in both acute and chronic hepatic disorder.Materials and m...

Eye drops are considered standard practice for the delivery of ocular drugs. However, low patient compliance and low drug levels compromise its effectiveness. Our group developed a ketorolac-loaded ocular coil for sustained drug delivery up to 28 days. The aim of this study was to gain insight into the pharmacokinetics and efficacy of the ocular coil. The pharmacokinetics of the ketorolac-loaded ocular coil versus eye drops were tested in New Zealand White rabbits by repetitive sampling for 28 days. Efficacy of the ocular coil was also tested in New Zealand White rabbits. Ocular inflammation was induced where after the ocular coil was inserted, or eye drops, or no treatment was provided. The total protein concentration and cytokine levels were measured in tears, aqueous humor, and plasma at 4 h, 8 h, 24 h, 4 d, 7 d, 14 d, 21 d, and 28 d. Four h after inserting the ocular coil in the eye, ketorolac levels in aqueous humor and plasma were higher in the ocular coil group than in the eye drop group. Ketorolac released from the ocular coil could be detected up to 28 d in tears, up to 4 d in aqueous humor and up to 24 h in plasma. After inducing inflammation, both the ocular coil and eye drops were able to suppress prostaglandin E2, TNFα and IL-6 levels in aqueous humor and plasma as compared to the group that received no treatment. To conclude, the ocular coil facilitated a sustained release of the drug and showed similar therapeutic benefit in suppressing post-operative inflammation as eye drops.

Study question Does verteporfin, an inhibitor of Hippo signaling pathway, influence mechanisms involved in chemotherapy-induced follicle activation and survival in vitro? Summary answer Verteporfin acts directly on cell growth and indirectly on phosphatidylinositol-3-kinase (PI3K) signaling pathway, but does not prevent chemotherapy-induced follicle activation, although moderates 4-hydroperoxycylophosphamide (4HC) gonadotoxicity. What is known already Cryopreservation of ovarian tissue is an experimental technique aimed at prepubertal patients in need of chemotherapy. To optimize this method, in vitro culture of cryopreserved tissue is being investigated. However, this process leads to a massive loss of primordial follicles due to their spontaneous activation. Inhibition of PI3K pathway, the major signaling pathway involved in follicle activation, is moderately efficient to prevent chemotherapy-induced follicle activation. Recently, the effect of Hippo pathway disruption due to sectioning on follicle activation has been described, suggesting that verteporfin can inhibit Hippo pathway-induced follicle activation. Study design, size, duration Ovaries collected from post-natal day 3 and/or 4 (PND3/4) mice were used for this study. Whole and cut ovaries were cultured in vitro for 3 hours to validate the effect of verteporfin on Hippo pathway disruption. Whole ovaries were cultured in vitro for 24 and 48 hours to assess the impact of verteporfin and/or chemotherapy (4HC, 10 µM) exposure on primordial follicle activation and survival. At least 3 ovaries were used for each condition. Participants/materials, setting, methods The inhibitory and toxic effects of verteporfin on whole and cut ovaries were investigated by analysing the expression of genes involved in Hippo and PI3K pathways, as well as in apoptosis (RT-qPCR). The effect of co-treatment with verteporfin and 4HC on follicle activation and survival was assessed by histological analysis (immunohistochemistry and TUNEL staining), gene expression (RT-qPCR) and protein analysis (immunostaining and Western Blot) to investigate signaling pathways, cell proliferation and apoptosis. Main results and the role of chance The inhibitory effect of verteporfin on Hippo pathway disruption induced by sectioning was achieved on ovaries exposed to 3 µM of verteporfin despite slightly increasing apoptosis at 3 hours of culture. Verteporfin was able to slightly prevent the effect of chemotherapy on Hippo pathway, but its impact was limited by the time of culture. Surprisingly, verteporfin also acted indirectly on PI3K pathway by significantly decreasing the level of downstream phosphorylated proteins. However, in presence of chemotherapy, verteporfin was not sufficient to prevent the effect of 4HC on this pathway. Alone, verteporfin also significantly decreased granulosa cells proliferation, depending on the time of culture: although reducing cell growth at 24 hours of culture, this effect was not observed after 48 hours of in vitro culture. The inhibitor was not able to prevent apoptosis induced by 4HC at 24 hours of culture. However, at 48 hours of culture, the decrease in the number of positive TUNEL follicles in the co-treatment condition compared to ovaries treated with chemotherapy alone suggested a potential positive effect of verteporfin to prevent chemotherapy-induced gonadotoxicity. Limitations, reasons for caution The main limitation of this study is the experimental model used. Although mouse is a strong and reliable model, it lacks certain characteristics specific to human. Investigating other timepoints of culture and exposition, as well as different doses of verteporfin, might benefit the study. Wider implications of the findings Our study supports Hippo and PI3K pathways interaction during in vitro follicle activation. Despite verteporfin does not appear to be an inhibitor of interest, testing another Hippo inhibitor or combining Hippo and PI3K pathways inhibitors could be investigated to control follicle activation during in vitro culture of ovarian tissue. Trial registration number Not applicable

The salinity of irrigation water and soil create considerable challenges in agriculture, as they harm the physiological processes and growth of plants. The exogenous application of antioxidant compounds, such as salicylic acid, can reduce the damage caused by salt stress. Thus, this study aimed to evaluate the attenuation of salt stress induced by salicylic acid in Ocimum basilicum “Cinnamon”. The experiment was performed in randomized blocks with five irrigation water salinity levels (0.5, 1.3, 3.25, 5.2 and 6.0 dS m-1) and five salicylic acid concentrations (0, 0.29, 1.0, 1.71 and 2.0 mM), with five repetitions and two plants per plot. Growth, gas exchange, and chlorophyll indices and fluorescence were evaluated 30 days after the salt treatment was applied. An increase in the salinity of irrigation water decreased the plant height, stem diameter, number of leaves, stomatal conductance, instantaneous water use efficiency, and initial fluorescence of basil “Cinnamon”. Salicylic acid was revealed to attenuate the harmful effects of irrigation water salinity on gas exchange, total chlorophyll, and initial and maximum fluorescence of basil plants. RESUMO A salinidade da água de irrigação e do solo é um dos grandes desafios da agricultura, pois prejudica os processos fisiológicos e o crescimento das plantas. A aplicação exógena de compostos antioxidantes, como o ácido salicílico, pode reduzir os danos causados pelo estresse salino nas plantas. Assim, o presente estudo teve como objetivo avaliar a ação atenuante do ácido salicílico sobre o estresse salino em Ocimum basilicum cv. Cinnamon. O experimento foi conduzido em blocos casualizados com cinco níveis de salinidade da água de irrigação (0,5; 1,3; 3,25; 5,2 e 6,0 dS m-1) e cinco concentrações de ácido salicílico (0; 0,29; 1,0; 1,71 e 2,0 mM), com cinco repetições e duas plantas por parcela. O crescimento, as trocas gasosas, os índices de clorofila e a fluorescência da clorofila foram avaliados 30 dias após a aplicação do estresse salino. O aumento da salinidade da água de irrigação diminui a altura da planta, diâmetro do caule, número de folhas, condutância estomática, eficiência instantânea do uso da água e fluorescência inicial do manjericão cv. Cinnamon. A aplicação de ácido salicílico atenua os efeitos nocivos da salinidade da água de irrigação nas trocas gasosas, clorofila total e fluorescência inicial e máxima de plantas de manjericão.

Background: Unconstrained pyrocarbon and metal-on-polyethylene (MoP) proximal interphalangeal (PIP) joint arthroplasty is an increasingly popular alternative to silicone implants and arthrodesis. This systematic review appraises their outcomes. Methods: Thirty studies comprising 1,324 joints (813 pyrocarbon, 511 MoP) were included. Mean patient age was 59 years (38–78) and mean follow-up period was 54 months (12–118). Results: There were mean improvements of 4.5 points (2–6.9) in pain visual analogue score, 10.5° (−26 to 58) in range of motion (ROM), 3.1 kg (−4 to 7) in grip strength, 0.6 kg (−1.5 to 2) in pinch strength and 18 points (−3 to 29) in the disabilities of the arm, shoulder and hand score, with no significant differences between implant types. ROM gains deteriorated over time. Clinical complications were frequent (23%) and significantly more common with pyrocarbon, as were radiographic complications. However, most were mild-moderate and did not necessarily correlate with negative outcomes or dissatisfaction. Overall re-operation rate was 21%, and revision rate 11%, both more frequent with pyrocarbon. Most revisions were within 24 months, beyond which survival was maintained up to 10 years. Conclusions: Unconstrained PIP joint arthroplasty is effective in improving pain scores, active ROM, grip/pinch strength and patient-reported outcome measures, particularly in patients with osteoarthritis. Results are generally maintained at least to the medium term, although gains diminish in the longer term. Complication and early revision rates are high, particularly with pyrocarbon implants. Most patients express positive attitudes to arthroplasty, with significant improvements in patient-reported outcome measures for both pyrocarbon and MoP implants. Patients with post-traumatic and inflammatory arthropathy are generally less satisfied. There is currently insufficient data to recommend one implant type over another, although the early-to-medium term results of MoP implants are promising. Prospective surveillance via small joint registries is recommended. Level of Evidence: Level III (Therapeutic)

The risks of venous thromboembolism (VTE) following total hip and knee arthroplasty have been widely published. Our aim was to investigate the recorded incidence of VTE events at the time of elective and trauma hand surgery. The UK National Hospital Episode Statistics (HES) data linking VTE events with hand surgery for the financial years 2010-2012 were analysed. The local VTE rates following hand surgical procedures were also analysed. Finally, a cost assessment of VTE thromboprophylaxis was performed according to the British Society for Surgery of the Hand (BSSH) guidelines. 334,211 hand surgical procedures were performed throughout England of which there were 13 DVT and 27 PE events. These events were seen in patients with pre-existing comorbidities. The annual incidence of VTE is 0.006% at most in hand surgical patients in England. The cost of implementing mechanical VTE thromboprophylaxis to all patients having hand surgery would amount to £6,336,641 over 2 years. The cost of treatment for all VTE events would amount to £20,418. VTE prophylaxis is probably not necessary in patients undergoing isolated elective or trauma hand surgical procedures.

BackgroundScaphoid fractures account for 90% of carpal fractures and occur predominantly in young men. Immediate surgical fixation of this fracture has increased.ObjectiveTo compare the clinical effectiveness and cost-effectiveness of surgical fixation with cast treatment and early fixation in adults with scaphoid waist fractures that fail to unite.DesignMulticentre, pragmatic, open-label, parallel two-arm randomised controlled trial with an economic evaluation and a nested qualitative study.SettingOrthopaedic departments of 31 hospitals in England and Wales recruited from July 2013, with final follow-up in September 2017.ParticipantsAdults (aged ≥ 16 years) presenting within 2 weeks of injury with a clear, bicortical fracture of the scaphoid waist on plain radiographs.InterventionsEarly surgical fixation using Conformité Européenne-marked headless compression screws. Below-elbow cast immobilisation for 6–10 weeks and urgent fixation of confirmed non-union.Main outcome measuresThe primary outcome and end point was the Patient-Rated Wrist Evaluation total score at 52 weeks, with a clinically relevant difference of 6 points. Secondary outcomes included Patient-Rated Wrist Evaluation pain and function subscales, Short Form questionnaire 12-items, bone union, range of movement, grip strength, complications and return to work.ResultsThe mean age of 439 participants was 33 years; 363 participants were male (83%) and 269 participants had an undisplaced fracture (61%). The primary analysis was on 408 participants with valid Patient-Rated Wrist Evaluation outcome data for at least one post-randomisation time point (surgery,n = 203 of 219; cast,n = 205 of 220). There was no clinically relevant difference in the Patient-Rated Wrist Evaluation total score at 52 weeks: the mean score in the cast group was 14.0 (95% confidence interval 11.3 to 16.6) and in the surgery group was 11.9 (95% confidence interval 9.2 to 14.5), with an adjusted mean difference of –2.1 in favour of surgery (95% confidence interval –5.8 to 1.6;p = 0.27). The non-union rate was low (surgery group,n = 1; cast group,n = 4). Eight participants in the surgery group had a total of 11 reoperations and one participant in the cast group required a reoperation for non-union. The base-case economic analysis at 52 weeks found that surgery cost £1295 per patient more (95% confidence interval £1084 to £1504) than cast treatment. The base-case analysis of a lifetime-extrapolated model confirmed that the cast treatment pathway was more cost-effective. The nested qualitative study identified patients’ desire to have a ‘sense of recovering’, which surgeons should address at the outset.LimitationThere were 17 participants who had initial cast treatment and surgery for confirmed non-union, which in 14 cases was within 6 months from randomisation and in three cases was after 6 months. Three of the four participants in the cast group who had a non-union at 52 weeks were not offered surgery.ConclusionsAdult patients with an undisplaced or minimally displaced scaphoid waist fracture should have cast immobilisation and suspected non-unions immediately confirmed and urgently fixed. Patients should be followed up at 5 years to investigate the effect of partial union, degenerative arthritis, malunion and screw problems on their quality of life.Trial registrationCurrent Controlled Trials ISRCTN67901257.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 24, No. 52. See the NIHR Journals Library website for further project information.

Keratin constitutes the major component of the feather, hair, hooves, horns, and wool represents a group of biological material having high cysteine content (7–13%) as compared to other structural proteins. Keratin -based biomaterials have been investigated extensively over the past few decades due to their intrinsic biological properties and excellent biocompatibility. Unlike other natural polymers such as starch, collagen, chitosan, the complex three-dimensional structure of keratin requires the use of harsh chemical conditions for their dissolution and extraction. The most commonly used methods for keratin extraction are oxidation, reduction, steam explosion, microbial method, microwave irradiation and use of ionic liquids. Keratin -based materials have been used extensively for various biomedical applications such as drug delivery, wound healing, tissue engineering. This review covers the structure, properties, history of keratin research, methods of extraction and some recent advancements related to the use of keratin derived biomaterials in the form of a 3-D scaffold, films, fibers, and hydrogels., Graphical abstract Image 1, Highlights • Keratin a versatile material having unique structural moiety. • Keratin sources and methods of extraction. • Keratin-based materials for biomedical applications. • 3-D scaffold, films, fibers, and hydrogels.