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Polyomavirus infections are common and relatively benign in the general human population but can become pathogenic in immunosuppressed patients. Because most treatments for polyomavirus-associated diseases nonspecifically target DNA replication, existing treatments for polyomavirus infection possess undesirable side effects. However, all polyomaviruses express Large Tumor Antigen (T Ag), which is unique to this virus family and may serve as a therapeutic target. Previous screening of pyrimidinone–peptoid hybrid compounds identified MAL2-11B and a MAL2-11B tetrazole derivative as inhibitors of viral replication and T Ag ATPase activity (IC 50 of ∼20–50 μM). To improve upon this scaffold and to develop a structure–activity relationship for this new class of antiviral agents, several iterative series of MAL2-11B derivatives were synthesized. The replacement of a flexible methylene chain linker with a benzyl group or, alternatively, the addition of an ortho -methyl substituent on the biphenyl side chain in MAL2-11B yielded an IC 50 of ∼50 μM, which retained antiviral activity. After combining both structural motifs, a new lead compound was identified that inhibited T Ag ATPase activity with an IC 50 of ∼5 μM. We suggest that the knowledge gained from the structure–activity relationship and a further refinement cycle of the MAL2-11B scaffold will provide a specific, novel therapeutic treatment option for polyomavirus infections and their associated diseases. [ABSTRACT FROM AUTHOR]

Patella cubiti is a rare elbow anomaly in which either the entire olecranon or a part of it remains separate from the proximal ulna. Pain and stiffness are the usual presenting symptoms while some patients are diagnosed incidentally following a minor trauma. Our case report is of a 24-year-old male wrestler with bilateral patella cubiti which was painful on right side and asymptomatic on the left. We also mention an additional cause of pain in patella cubiti-intra-articular loose bodies. These loose bodies were removed surgically and the patient remained asymptomatic at 6-months follow-up. Presence of growth disturbance in the secondary epiphyseal centre of first lumbar vertebra supports the 'developmental theory' of origin of patella cubiti. A compilation of data available in the literature on patella cubiti has been included. [ABSTRACT FROM AUTHOR]

Abstract: New polyomaviruses are continually being identified, and it is likely that links between this virus family and disease will continue to emerge. Unfortunately, a specific treatment for polyomavirus-associated disease is lacking. Because polyomaviruses express large Tumor Antigen, TAg, we hypothesized that small molecule inhibitors of the essential ATPase activity of TAg would inhibit viral replication. Using a new screening platform, we identified inhibitors of TAg’s ATPase activity. Lead compounds were moved into a secondary assay, and ultimately two FDA approved compounds, bithionol and hexachlorophene, were identified as the most potent TAg inhibitors known to date. Both compounds inhibited Simian Virus 40 replication as assessed by plaque assay and quantitative PCR. Moreover, these compounds inhibited BK virus, which causes BKV Associated Nephropathy. In neither case was host cell viability compromised at these concentrations. Our data indicate that directed screening for TAg inhibitors is a viable method to identify polyomavirus inhibitors, and that bithionol and hexachlorophene represent lead compounds that may be further modified and/or ultimately used to combat diseases associated with polyomavirus infection. [Copyright &y& Elsevier]

Purpose: Direct anterior approach (DAA) has recently become popular in total hip arthroplasty (THA). However, irrespective of the surgical approach used, component malposition is an important factor affecting function and complications after THA. This study aims to compare component positioning on the femoral and acetabular side between DAA and posterior approach (PA) to the hip joint. We hypothesized that the two approaches are similar in terms of component positioning. Methods: We prospectively studied 50 patients, matched according to age, sex, and body mass index, undergoing THA, divided non-randomly into 2 groups. Group 1 comprised 25 patients (35 hips) undergoing THA using DAA and group 2 comprised 25 patients (25 hips) undergoing THA using PA. Ten patients from group 1 had simultaneous bilateral THA. Radiological parameters studied were acetabular inclination (AI), coronal femoral stem alignment (CFA), leg length difference (LLD), acetabular cup version (AV), and femoral stem version (FV). Results: There was no significant difference in AI, CFA, LLD, AV, and FV between the two groups. Excellent to good inter and intra-observer reliability expressed in terms of intraclass correlation coefficient (ICC) was noted for all the radiographic measurements. Conclusion: Both DAA and PA for THA achieve comparable radiological component positioning. DAA may not provide any advantage over PA in terms of positioning of the prosthesis. Level of Evidence: Level II, non-randomized comparative study. [ABSTRACT FROM AUTHOR]

Over seventy years ago, Niels Bohr described how the charge state of an atomic ion moving through a solid changes dynamically as a result of electron capture and loss processes, eventually resulting in an equilibrium charge state. Although obvious, this process has so far eluded direct experimental observation. By peeling a solid, such as graphite, layer by layer, and studying the transmission of highly charged ions through single-, bi- and trilayer graphene, we can now observe dynamical changes in ion charge states with monolayer precision. In addition we present a first-principles approach based on the virtual photon model for interparticle energy transfer to corroborate our findings. Our model that uses a Gaussian shaped dynamic polarisability rather than a spatial delta function is a major step in providing a self-consistent description for interparticle de-excitation processes at the limit of small separations. Ion-solid interactions are governed by a range of complex processes the direct experimental observation of which pose their own set of challenges. Here, the authors present a joint experimental and first-principles approach to study and describe the underlying mechanism of electron capture for an ion travelling through layers of graphene with monolayer precision. [ABSTRACT FROM AUTHOR]

Background: Posterolateral decompression and debridement in patients with TB spine led to defect in the anterior column which makes the spinal column unstable, thus making anterior column reconstruction an important step in surgical management.Objective: Through the study, authors sought to answer the following questions: 1) What are the differences in clinical outcomes between patients with TB spine undergoing anterior column reconstruction using titanium mesh cage versus PEEK cage? 2) What are the differences in radiological outcomes between these two groups of patients?Methods: This is a retrospective comparative study including patients with TB spine undergoing surgical management. The included subjects were divided into groups A and B depending on the implantation of PEEK or titanium mesh cage respectively for anterior column reconstruction. Outcome criteria analyzed included clinical criteria like VAS and ODI scores, radiological criteria like kyphosis correction, loss of kyphosis at follow-up, cage subsidence, and bony fusion on a 2D CT scan.Results: The study population included 14 patients in Group A and 15 patients in Group B. Improvement in VAS and ODI scores was comparable between groups. There was no significant difference in radiological outcome measures between the two groups, however, two patients from group B showed implant-related complications needing revision. All patients showed good bony fusion at the final follow-up.Conclusion: PEEK and titanium cages have comparable clinico-radiological outcomes for anterior column reconstruction in patients with active TB spine. Its advantages for being radiolucent and its ease of use may make it a choice of implant. [ABSTRACT FROM AUTHOR]

The use of potassium (K) metal anodes could result in highperformance K-ion batteries that offer a sustainable and low-cost alternative to lithium (Li)-ion technology. However, formation of dendrites on such K-metal surfaces is inevitable, which prevents their utilization. Here, we report that K dendrites can be healed in situ in a K-metal battery. The healing is triggered by currentcontrolled, self-heating at the electrolyte/dendrite interface, which causes migration of surface atoms away from the dendrite tips, thereby smoothening the dendritic surface. We discover that this process is strikingly more efficient for K as compared to Limetal.We show that the reason for this is the far greater mobility of surface atoms in K relative to Li metal, which enables dendrite healing to take place at an order-of-magnitude lower current density. We demonstrate that the K-metal anode can be coupled with a potassium cobalt oxide cathode to achieve dendrite healing in a practical full-cell device. [ABSTRACT FROM AUTHOR]

This paper presents secure transmission in orthogonal space time block codes (OSTBC) in the presence of channel estimation error over multiple input multiple output (MIMO) wiretap channels. In this paper, we evaluate probability of non-zero secrecy capacity (PNZSC) and secrecy outage probability (SOP) for OSTBC system over Rayleigh fading channels considering the impact of channel estimation error (CEE). The numerical result demonstrates that the system is generic and valid for any transceiving and eavesdropper antennas. [ABSTRACT FROM AUTHOR]

In the current paper, we propose an approach for the design and implementation of crime detection and criminal identification for Indian cities using data mining techniques. Our approach is divided into six modules, namely-data extraction (DE), data preprocessing (DP), clustering, Google map representation, classification and WEKA implementation. First module, DE extracts the unstructured crime dataset from various crime Web sources, during the period of 2000-2012. Second module, DP cleans, integrates and reduces the extracted crime data into structured 5,038 crime instances. We represent these instances using 35 predefined crime attributes. Safeguard measures are taken for the crime database accessibility. Rest four modules are useful for crime detection, criminal identification and prediction, and crime verification, respectively. Crime detection is analyzed using k-means clustering, which iteratively generates two crime clusters that are based on similar crime attributes. Google map improves visualization to k-means. Criminal identification and prediction is analyzed using KNN classification. Crime verification of our results is done using WEKA. WEKA verifies an accuracy of 93.62 and 93.99 % in the formation of two crime clusters using selected crime attributes. Our approach contributes in the betterment of the society by helping the investigating agencies in crime detection and criminals' identification, and thus reducing the crime rates. [ABSTRACT FROM AUTHOR]

• We unravelled the impact of ligand composition on photocatalytic hydrogen evolution over Ti-based MOFs. • MIL-125-Ti outperforms NH2-containing counterparts by up to 38 times in methanol • Photoluminescence spectroscopy shows effective hole scavenging by methanol in MIL-125-Ti. • Triethanolamine leads to corrosion of the MOFs within the first few hours through partial ligand exchange. • We propose three mechanisms for photocatalytic hydrogen evolution for both single-ligand and mixed-ligand MOFs. We synthesized a series of isostructural MIL-125-Ti with various terephthalic: amino-terephthalic acid ratios and evaluated their photostability and performance for photocatalytic hydrogen evolution in aqueous solutions with different hole scavengers. We demonstrate that the commonly used triethanolamine corroded the MOFs under photocatalytic conditions, in contrast to methanol. The combination of MIL-125-Ti and methanol outperformed the photocatalytic activity of NH 2 -MIL-125-Ti by 45 times under broad UV irradiation. Photoluminescence spectroscopy under simulated photocatalytic conditions and in solid-state as well as time-resolved emission studies reveal that the holes residing in the metal-oxo cluster can be effectively scavenged by methanol, leading to high HER activity, while the holes residing in the NH 2 -groups in the ligand favour charge recombination and are thus detrimental to the photocatalytic performance. The mixed-ligand MOFs follow a dual-excitation pathway, introducing new states and transitions. These results are expected to advance our understanding of MOF-based photocatalysis. [ABSTRACT FROM AUTHOR]

Protrusio acetabuli, or abnormal protrusion of the femoral head into the acetabulum, requires performance of a total hip arthroplasty (THA) for which various reconstruction techniques and outcomes have been described. The aim of this systematic review is to provide a comprehensive analysis of the current evidence, evaluate treatment efficacy, compare surgical techniques, and identify topics for future research along with improving evidence-based decision-making, improving patient outcomes in the management of this condition. A thorough systematic review of the PubMed, Embase, Cochrane Library databases, and Scopus library was conducted, and articles describing techniques of THA for treatment of protrusion acetabuli were extracted. The initial search generated 751 results. After exclusion, 18 articles were included. Of these, eight were prospective studies and 10 were retrospective. Surgery was performed on 783 hips with a mean age of 60 years; 80% of females who mostly had inflammatory arthritis were followed up for 8.86 years (range, 2-15.4 years). Good outcomes have been achieved with THA using uncemented cups with bone graft; however, no conclusion could be drawn with regard to the femoral side. It can be concluded that the concept of restoration of the anatomical hip center of rotation is paramount for good outcome and better survival of the implant is important when using uncemented cups with a bone graft. In addition, screw augmentation for fixation is not recommended unless absolutely necessary. The most common complications were aseptic loosening and heterotopic ossification. While the former required revision, conservative management was administered for the latter.

Assessing students' online learning is a vital constituent of the effective teaching-learning process in a virtual mode. This study addressed teachers' preparedness, challenges and effective practices for students' assessment in online learning during the COVID-19 pandemic. Online assessment at times of uncertainty has become arduous for university teachers as it is not in practice in Indian higher educational institutions (HEIs). This research reports a study of the Adamas University, teachers drawn-out through semi-structured interviews of individual teachers. The researchers employed a case study research method to attain the objectives of the study using thematic analysis for the qualitative data. Thirty-one faculty members were selected as a sample of the study. The study findings indicated that the University teachers used multiple online assessment techniques, some common, some extremely unique, viz. blogs and peer tutorial videos. The preparedness or readiness varied considerably as some were instead sceptical, whereas some were amusingly non-challant. The study found that teachers faced many problems while assessing students' performance during online classes, which were not just tech-based, but also due to their distressed state of mind., Competing Interests: The authors report no conflicts of interest. The authors alone are responsible for the writing and content of this article. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

In this work, we have generated novel Fc-comprising NK cell engagers (NKCEs) that bridge human NKp30 on NK cells to human epidermal growth factor receptor (EGFR) on tumor cells. Camelid-derived VHH single-domain Abs specific for human NKp30 and a humanized Fab derived from the EGFR-specific therapeutic Ab cetuximab were used as binding arms. By combining camelid immunization with yeast surface display, we were able to isolate a diverse panel of NKp30-specific VHHs against different epitopes on NKp30. Intriguingly, NKCEs built with VHHs that compete for binding to NKp30 with B7-H6, the natural ligand of NKp30, were significantly more potent in eliciting tumor cell lysis of EGFR-positive tumor cells than NKCEs harboring VHHs that target different epitopes on NKp30 from B7-H6. We demonstrate that the NKCEs can be further improved with respect to killing capabilities by concomitant engagement of FcγRIIIa and that soluble B7-H6 does not impede cytolytic capacities of all scrutinized NKCEs at significantly higher B7-H6 concentrations than observed in cancer patients. Moreover, we show that physiological processes requiring interactions between membrane-bound B7-H6 and NKp30 on NK cells are unaffected by noncompeting NKCEs still eliciting tumor cell killing at low picomolar concentrations. Ultimately, the NKCEs generated in this study were significantly more potent in eliciting NK cell-mediated tumor cell lysis than cetuximab and elicited a robust release of proinflammatory cytokines, both features which might be beneficial for antitumor therapy., (Copyright © 2022 by The American Association of Immunologists, Inc.)

Purpose: The direct anterior approach (DAA) for total hip replacement (THR) is relatively new. It has been proved superior to other techniques concerning early functional outcomes, stability, and earlier recovery. But DAA-THR has a steeper surgical learning curve and, in its original description, needs special operating room equipment. This study aims to present clinical, functional, and radiological outcomes of DAA compared to the posterior approach (PA), performed using a routine operating table and instrumentation sets., Methods: Eighty patients undergoing THR were non-randomly allocated prospectively into Group 1 DAA and Group 2 PA. Visual analog scale (VAS) for pain was recorded preoperatively and at 6, 12, 24, 48, and 72 h after the surgery and at 1st and 2nd year postoperatively. Both groups' functional outcomes were evaluated pre-and postoperatively at 1st and 2nd-year follow-up with Harris hip score (HHS) and SF-12. Perioperative parameters like blood loss, length of hospital stay, duration of surgery, postoperative complications, and radiological prosthesis positioning were also compared between the two groups., Results: All patients were comparable according to their baseline demographic characteristics. DAA was found to have significantly better early HHS at one year (p = 0.001) and VAS for hip pain (p < 0.05) at 12, 24, 48, and 72 hrs postoperative period only. Clinical outcomes were comparable at the final follow-up of 2 years. Perioperative variables were also similar except the incision length, length of stay in the hospital, and average time to weight bear without walking aids which were statistically better in DAA than PA group. There was no difference in radiological prosthesis positioning. Postoperative complication rates were also comparable in the two groups., Conclusion: Though technically demanding, DAA provides better early functional outcomes with comparable radiological outcomes and complication rates than the PA. Level of evidence: Non-randomized comparative trial, Level II., Competing Interests: The authors declare they have no conflicts of interest., (© 2022.)

Background: Various modalities of treatment have been used for the management of metacarpal and phalangeal fractures which include K-wire fixation, mini plates, lag screws fixation, intramedullary screw fixation and external fixator application. The aim of this study was to analyse complications and patient-related functional outcomes after antegrade or retrograde crossed intramedullary K-wire fixation of metacarpal and proximal phalangeal fractures., Methods: Thirty-one patients (36-fractures, 16-metacarpals, 20-proximal phalanx) meeting the study criteria were included in this prospective study. Fixation of the fractures was done by use of crossed intramedullary K-wire using the principles of 3-point fixation., Results: The mean preoperative angulation of the fractures noted in this study was 35.8° which was significantly reduced at final follow-up. Union was noted at a mean period of 4.2 ± 6.8 weeks. The mean range of motion at the metacarpophalangeal and proximal interphalangeal joint was 96.4% and 86.3%, respectively as compared to the opposite hand. Stiffness ( n = 3, 14.2%) and persistent pain ( n = 2, 9.5%) at the joints were the most common complications noted in this study., Conclusion: Crossed percutaneous intramedullary fixation of small bone fractures of the hand is a versatile method with advantages such as cost-effectiveness and lesser operative time when compared to other modalities of fixation. Earlier range of motion (ROM) exercises can be started due to preservation of gliding planes, no surgical wound along with good fracture stability and minimal hardware impingement., How to Cite This Article: Ahmad S, Gupta T, Ansari S, et al . Intramedullary Crossed K-wire Fixation for the Hand Fractures is a Useful Treatment Modality: A Prospective Observational Study. Strategies Trauma Limb Reconstr 2022;17(2):74-80., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2022; The Author(s).)

Metal-organic frameworks (MOFs) are commended as photocatalysts for H 2 evolution and CO 2 reduction as they combine light-harvesting and catalytic functions with excellent reactant adsorption capabilities. For dynamic processes in liquid phase, the accessibility of active sites becomes a critical parameter as reactant diffusion is limited by the inherently small micropores. Our strategy is to introduce additional mesopores by selectively removing one ligand in mixed-ligand MOFs via thermolysis. Here we report photoactive MOFs of the MIL-125-Ti family with two distinct mesopore architectures resembling either large cavities or branching fractures. The ligand removal is highly selective and follows a 2-step process tunable by temperature and time. The introduction of mesopores and the associated formation of new active sites have improved the HER rates of the MOFs by up to 500%. We envision that this strategy will allow the purposeful engineering of hierarchical MOFs and advance their applicability in environmental and energy technologies., (© 2022. The Author(s).)

Direct-write additive manufacturing of graphene and carbon nanotube (CNT) patterns by aerosol jet printing (AJP) is promising for the creation of thermal and electrical interconnects in (opto)electronics. In realistic application scenarios, this however often requires deposition of graphene and CNT patterns on rugged substrates such as, for example, roughly machined and surface-oxidized metal block heat sinks. Most AJP of graphene/CNT patterns has thus far however concentrated on flat wafer- or foil-type substrates. Here, we demonstrate AJP of graphene and single walled CNT (SWCNT) patterns on realistically rugged plasma-electrolytic-oxidized (PEO) Al blocks, which are promising heat sink materials. We show that AJP on the rugged substrates offers line resolution of down to ∼40 μm width for single AJP passes, however, at the cost of noncomplete substrate coverage including noncovered μm-sized pores in the PEO Al blocks. With multiple AJP passes, full coverage including coverage of the pores is, however, readily achieved. Comparing archetypical aqueous and organic graphene and SWCNT inks, we show that the choice of the ink system drastically influences the nanocarbon AJP parameter window, deposit microstructure including crystalline quality, compactness of deposit, and inter/intrapass layer adhesion for multiple passes. Simple electrical characterization indicates aqueous graphene inks as the most promising choice for AJP-deposited electrical interconnect applications. Our parameter space screening thereby forms a framework for rational process development for graphene and SWCNT AJP on application-relevant, rugged substrates., Competing Interests: The authors declare no competing financial interest., (© 2021 The Authors. Published by American Chemical Society.)

Ground improvement will be critically important in the present and future geotechnical practice for designing the structures in weak soil. This paper presents a review of the recent development in ground improvement techniques, especially chemical stabilisers. Various available chemical stabilisers are identified and compared with other available methods. Though the use of chemicals provides an excellent alternative to the traditional methods, they still lack proper understanding regarding their use, handling, application, and long-term effect on the environment. Various chemical stabilisers and their applicability conditions are summarised in the present paper. Insight of biochemical, electrochemical, inorganic, and organic stabilisers is presented with future scope of these methods along with the potential areas where a lot of efforts is needed to industrialise these methods are also discussed briefly. A need for developing a more environmentally friendly and safe method was felt while reviewing these methods. Lack of a large amount of data is a major concern for lesser use of these methods industrially. A lot of laboratory and field experiments should be conducted in different conditions to ensure safe results from chemical stabilisers., Competing Interests: The authors declare no conflict of interest., (© 2021 The Authors. Published by Elsevier Ltd.)

Lead iodide (PbI 2 ) as a layered material has emerged as an excellent candidate for optoelectronics in the visible and ultraviolet regime. Micrometer-sized flakes synthesized by mechanical exfoliation from bulk crystals or by physical vapor deposition have shown a plethora of applications from low-threshold lasing at room temperature to high-performance photodetectors with large responsivity and faster response. However, large-area centimeter-sized growth of epitaxial thin films of PbI 2 with well-controlled orientation has been challenging. Additionally, the nature of grain boundaries in epitaxial thin films of PbI 2 remains elusive. Here, we use mica as a model substrate to unravel the growth mechanism of large-area epitaxial PbI 2 thin films. The partial growth leading to uncoalesced domains reveals the existence of inversion domain boundaries in epitaxial PbI 2 thin films on mica. Combining the experimental results with first-principles calculations, we also develop an understanding of the thermodynamic and kinetic factors that govern the growth mechanism, which paves the way for the synthesis of high-quality large-area PbI 2 on other substrates and heterostructures of PbI 2 on single-crystalline graphene. The ability to reproducibly synthesize high-quality large-area thin films with precise control over orientation and tunable optical properties could open up unique and hitherto unavailable opportunities for the use of PbI 2 and its heterostructures in optoelectronics, twistronics, substrate engineering, and strain engineering.

Background: Hemivertebrectomy is widely used definitive correction surgery in congenital scoliosis due to hemivertebrae. It may be done either as combined anterior and posterior approach or a single-stage posterior approach only. The purpose of this meta-analysis was to compare two techniques with regards to blood loss, operative time, deformity correction and complications., Methods: The systematic review and meta-analysis were conducted according to PRISMA guidelines among peer-reviewed journals published in English between June 2000 and June 2020. Quality appraisal of all selected articles was done and data extracted., Results: After thorough literature search and excluding, 37 studies were included for review. The commonest location of the hemivertebrae was thoracolumbar spine (51.3%), thoracic (26.2%), lumbar/lumbosacral (21.6%) followed by cervical (0.7%). Pooled data showed a significant difference (p < 0.05) in mean operative time with posterior only approach (227 min, 95% CI 205-250) as compared to Combined Anterior Posterior Approach (CAPA) (316 min 95% CI 291-341). Significant difference (p < 0.05) in mean blood loss was observed in posterior only approach (522 ml, 95% CI 434-611) as compared to CAPA (888 ml, 95% CI 663-1113). No significant difference was noted in mean correction in either of the approaches and overall pooled mean correction rate was 66%, 95% CI 61-72., Conclusion: This review and meta-analysis of two surgical techniques of hemivertebrectomy, shows that operative time and blood loss is significantly lower in posterior only approach with no difference in correction rate as compared to CAPA. There was significant correlation between age at surgery and need for revision surgeries., Level of Evidence: IV., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: Tranexamic acid (TXA) has shown to reduce perioperative blood loss after bilateral total knee arthroplasty (TKA). But dosage and schedule of administration are not clear in literature. This study was aimed to compare prospectively blood loss and transfusion requirement in bilateral TKA with 3-dose regimen versus a single intra-operative dose of intravenous TXA., Methods: This prospective non-randomised controlled trial included 25 patients undergoing bilateral simultaneous TKA who received three doses of 1 g intravenous TXA (group 1). First dose was given prior to deflation of the tourniquet, followed by two more doses 6 h apart. The control group included 25 matched patients (group 2) receiving a single dose of 1 g intravenous TXA just prior to deflation of the tourniquet., Results: Mean drop in haemoglobin was less in group 1 as compared to group 2, but this difference was not statistically significant (2.51 vs 2.93 g/dL, p  = 0.210). Similarly mean drop in haematocrit was more in group 2 as compared to group 1, though it was not statistically significant (9.34 vs. 9.18, p  = 0.868). The need for blood transfusions was more in group 2 compared to group 1, but this difference was not statistically significant ( p  = 0.601). Higher frequency of ecchymosis around the surgical site was noted in group 2 as compared to group 1, for which prophylactic low-molecular-weight heparin had to be stopped post-operatively, but this difference was not statistically significant ( p  = 0.065)., Conclusion: The study has failed to show any significant beneficial effect of three doses of TXA in TKA as compared to a single dose. Though a trend towards reduction in mean haemoglobin drop and decreased need for stopping LMWH in post-operative period was seen, the results were not statistically significant., Level of Evidence: II, prospective non-randomised controlled trial., Competing Interests: Conflict of interestThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.Ethical standard statementThe institutional ethics committee approved the study. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. The study was conducted in All India Institute of Medical Sciences, Rishikesh, India., (© Indian Orthopaedics Association 2020.)

The whole educational system from elementary to tertiary level has been collapsed during the lockdown period of the novel coronavirus disease 2019 (COVID-19) not only in India but across the globe. This study is a portrayal of online teaching-learning modes adopted by the Mizoram University for the teaching-learning process and subsequent semester examinations. It looks forward to an intellectually enriched opportunity for further future academic decision-making during any adversity. The intended purpose of this paper seeks to address the required essentialities of online teaching-learning in education amid the COVID-19 pandemic and how can existing resources of educational institutions effectively transform formal education into online education with the help of virtual classes and other pivotal online tools in this continually shifting educational landscape. The paper employs both quantitative and qualitative approach to study the perceptions of teachers and students on online teaching-learning modes and also highlighted the implementation process of online teaching-learning modes. The value of this paper is to draw a holistic picture of ongoing online teaching-learning activities during the lockdown period including establishing the linkage between change management process and online teaching-learning process in education system amid the COVID-19 outbreak so as to overcome the persisting academic disturbance and consequently ensure the resumption of educational activities and discourses as a normal course of procedure in the education system., Competing Interests: The authors declare that they have no competing interests., (© 2020 The Author(s). Published by Elsevier Ltd.)

Controlling postoperative pain after total hip replacement is important and controversy remains regarding different regimens. By reviewing 18 studies, we attempt to find whether local infiltration analgesia after total hip replacement has any effect on postoperative pain, length of hospital stay and opioid consumption. We conclude that local infiltration analgesia is an effective method for decreasing postoperative pain.