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Coffee leaf rust (CLR) epidemics on Coffea arabica have led to severe socio-economic crises in Latin America starting in 2008. Until now, the scattered nature of scientific and empirical knowledge of the highly complex CLR-coffee pathosystem has been an obstacle to the development of CLR forecasting models. To help prevent new severe epidemics, we built ExpeRoya, a qualitative model, based on a review of the scientific literature and expert opinion, to forecast the risk of a monthly increase in the incidence of CLR at plot and landscape levels. We adopted the IPSIM (Injury Profile SIMulator) framework, a qualitative and aggregative modeling approach that describes the effects of the cropping system and the plot environment on injuries, thereby making it possible to incorporate scattered knowledge on the system and all its complexity in a simplified way. Involving experts makes this approach powerful and robust because it builds on empirical knowledge based on a very large number of field observations. We argue that broad expert knowledge provides more accurate information on the manifold interactions in the system than existing quantitative models can. The structure of ExpeRoya was discussed with coffee sector experts in 19 workshops and validated in an online survey with 17 CLR experts. ExpeRoya successfully integrates in a simple way 229 multiple interactions that exist within the CLR-coffee pathosystem based on only 12 input variables easily acquired in the field: one incidence monitoring variable; two meteorological variables (temperature and rainfall), four crop management variables (management of shade cover, fungicide application, nutrition and pruning of coffee trees) and five coffee tree characteristics (dates of flowering, beginning and end of harvest, fruit load and cultivar genetic resistance). Coffee institutes in Honduras and Nicaragua now use ExpeRoya, hosted by the platform Pergamino (https://www.redpergamino.net/app-experoya), to assist them in preparing their monthly CLR warning bulletins for growers. ExpeRoya is an improved forecasting model of CLR by fully incorporating the main biophysical factors affecting CLR at the plot and landscape levels. ExpeRoya is both a framework and a proof of concept that improves both forecasting and the comprehensive modeling of CLR. ExpeRoya is a powerful yet user-friendly model designed for all actors of the coffee sector, particularly smallholder farmers and extension agents. ExpeRoya is adaptable: users can modify the model according to advances in knowledge and/or their own expertise of the system. ExpeRoya can help prevent future socio-economic crises. [Display omitted] • Scattered knowledge on the multifactorial coffee leaf rust (CLR)-coffee pathosystem has hampered CLR forecasting models. • ExpeRoya model computes interactions between disease, host, cropping practices and weather to forecast the risk of CLR rise. • ExpeRoya integrates in a simple way 229 multiple relationships to forecast the risk of CLR at plot and landscape levels. • Coffee institutes from Latin America use ExpeRoya to prepare their monthly CLR warning bulletins for producers. • ExpeRoya is adaptable and user-friendly; it can help prevent future socio-economic crises of the coffee sector. [ABSTRACT FROM AUTHOR]

In this perspective, we draw on recent scientific research on the coffee leaf rust (CLR) epidemic that severely impacted several countries across Latin America and the Caribbean over the last decade, to explore how the socioeconomic impacts from COVID-19 could lead to the reemergence of another rust epidemic. We describe how past CLR outbreaks have been linked to reduced crop care and investment in coffee farms, as evidenced in the years following the 2008 global financial crisis. We discuss relationships between CLR incidence, farmer-scale agricultural practices, and economic signals transferred through global and local effects. We contextualize how current COVID-19 impacts on labor, unemployment, stay-at-home orders, and international border policies could affect farmer investments in coffee plants and in turn create conditions favorable for future shocks. We conclude by arguing that COVID-19's socioeconomic disruptions are likely to drive the coffee industry into another severe production crisis. While this argument illustrates the vulnerabilities that come from a globalized coffee system, it also highlights the necessity of ensuring the well-being of all. By increasing investments in coffee institutions and paying smallholders more, we can create a fairer and healthier system that is more resilient to future socialecological shocks. [ABSTRACT FROM AUTHOR]

Internal fixation with volar locking plates has revolutionized the treatment of distal radius fractures. Manufacturers have introduced plate designs that closely follow the anatomy of the distal radius. However, use of volar plates has also led to the emergence of new types of complications. While the use of monoaxial or polyaxial locking screws and of minimally invasive techniques (arthroscopy, preservation of pronator quadratus) increases the cost of the surgical procedure, it results in a tangible benefit for patients, allowing them to move their wrist almost immediately after surgery and to quickly regain their autonomy. We reviewed the literature to analyze the level of proof. [ABSTRACT FROM AUTHOR]

Introduction: Management of infection on internal fixation hardware is particularly complex. The main aim of the present study was to assess bone consolidation rates under septic conditions in patients treated for bone and joint infection (BJI) with hardware retention. Secondary objectives were to determine a time limit beyond which it is unreasonable to retain hardware, and to assess risk factors for non-consolidation and functional results. The study hypothesis was that bone consolidation is possible under septic conditions without hardware exchange., Material and Method: A single-center retrospective observational study was conducted on 69 patients for the period January 1, 2009 to December 31, 2019. We included all patients aged over 15 years with infection after internal fixation or fusion whose files had been discussed in the multidisciplinary team meeting during the study period. Bone healing was screened for on X-ray or CT. Study data comprised type of fracture, smoking status, time to treatment for open fracture, initial surgery time, type of hardware, interval between fixation and revision, and type of irrigation. Functional results were assessed at follow-up: walking, pain, return to work and SF12 and QuickDASH scores., Results: The bone healing rate was 73.5% (50/68 patients) at a mean 24 weeks (range, 6-68 weeks). Time to revision did not significantly impact consolidation: 60% for 2 weeks (6/10 cases), 80% for 2-10 weeks (35/40 cases), and 64% for >10 weeks (9/14 cases) (p = 0.28). Smoking, longer initial surgery time and Gustilo type IIIb or IIIc were significant risks factors for non-consolidation., Discussion: Bone consolidation under septic conditions with hardware retention adhering to an established medical and surgical protocol was reliable and straightforward, without extra morbidity. These findings are encouraging, and in line with the literature. We were unable to determine a time limit beyond which hardware prevented healing., Level of Evidence: IV; descriptive epidemiological study., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Introduction: During infected total hip arthroplasty revisions (THAR), the need for systematic antibiotic cementation remains undefined., Hypothesis: Implantation of a primary cementless stem as first-line implant in 1-stage septic THAR provides results as good as those from a stem cemented with antibiotics in terms of infection resolution., Materials and Methods: We retrospectively examined 35 patients operated on for septic THAR with Avenir® cementless stem placement - between 2008 and 2018 at Besançon University Hospital - with a minimum follow-up of 2 years to define healing in the absence of infectious recurrence. Clinical outcomes were assessed using the Harris, Oxford, and Merle D'Aubigné scores. Osseointegration was analyzed by the Engh radiographic score., Results: The median follow-up was 5±2.6 years (2-11). The infection was cured in 32 of 35 (91.4%) patients. The median scores of the following were: Harris 77/100, Oxford 47.5/60 and Merle d'Aubigné 15/18. Of 32 femoral stems, 31 (96.8%) had radiographically stable osseointegration. Age greater than 80 years was a risk factor for failure to cure the infection during septic THAR., Discussion: A primary cementless stem as first-line implant plays a role in 1-stage septic THAR. It confers good results in terms of infection resolution and stem integration in the setting of loss of femoral bone substances rated Paprosky 1., Level of Evidence: IV; retrospective case series., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Purpose: To describe the number of prosthetic joint infections (PJIs) with late documentation and to identify associated factors. Methods: Bacterial PJIs with surgical management between November 2015 and November 2019 in a French center were analyzed. Results of short (72 h) and late culture (at 14 days) were analyzed. Results: A total of 160 PJIs were reported with 215 bacteria. Twenty-nine patients had late documentation (18.1%). The bacteria most involved were coagulase-negative staphylococci and Cutibacterium spp. (60%). In multivariate analysis, late chronic PJI (odds ratio = 2.47) and antibiotic therapy before surgery (odds ratio = 3.13) were associated with late-documented infection. Conclusion: A better knowledge of the factors associated with late-documented infections is essential in order to simplify antibiotic treatment at the appropriate time.

Introduction: Traumatic injuries to the distal quarter of the leg present a significant risk of skin necrosis and exposure of the underlying fracture site or the osteosynthesis material that often result in bone and joint infection. In the case of small or medium-sized bone exposure, local muscles may be one of the best options for lower extremity coverage. We describe our experience using the extensor digitorum brevis muscle flap in a context of posttraumatic bone and joint infection in fourteen patients. Our main objective was to assess the outcomes and the donor-site morbidity of the extensor digitorum brevis muscle flap., Materials and Methods: A single-center retrospective study in a French reference center for bone and joint infection from 2014 to 2018 reviewed cases of traumatic injuries with skin complications and bone and joint infection that required an extensor digitorum brevis muscle flap coverage. Fourteen patients were evaluated for early and late complications, 11 men and three women with a mean age of 51.4±17.72 (19-71) years. Seven of these were open fractures and nine cases were pilon fractures. Donor-site morbidity was assessed in nine patients., Results: Early flap complications included two cases (14.2%) of hematoma, one case (7.1%) of partial necrosis and four cases (28.5%) of donor-site dehiscence. Late complications caused by persistent infection were found in two patients (14.2%), with one case (7.1%) of chronic osteoarthritis and one case (7.1%) of septic pseudarthrosis. From a functional and cosmetic point of view, eight patients (89%) were satisfied, to very satisfied., Conclusion: Experience and a multidisciplinary approach are keys in providing an optimal treatment strategy for complex cases of bone and joint infection. The extensor digitorum brevis muscle is a reliable flap for small defects with underlying infection. Being made up of muscle tissue, this flap offers good resistance to infection and enables satisfactory distribution of antibiotics., Level of Evidence: IV., (Copyright © 2021. Published by Elsevier Masson SAS.)