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Endometriosis is a common gynaecological condition, with a long diagnostic delay. Surgery is required to confirm a diagnosis, highlighting the need for a non‐invasive biomarker. Extracellular vesicles (EVs) may have a role in endometriosis pathogenesis, yet there is limited EV biomarker literature available. This study aimed to investigate the feasibility of isolating cervico‐vaginal fluid EVs sampled using cervical brushes and vaginal swabs and to compare these methods. After providing informed consent, patients undergoing surgery for suspected endometriosis had cervical brush and vaginal swab samples collected under general anaesthetic. Isolated EVs were characterised through negative stain transmission electron microscopy (TEM), Western blotting (TSG101, CD63, Calnexin, ApoB, Albumin), tunable resistive pulse sensing (TRPS), microBCA assays and RT‐qPCR of miRNAs. PCR was performed on samples prior to EV isolation to assess bacteria present in samples. Cervical brush and vaginal swab EVs were intact vesicles with limited co‐isolated contaminants. Cervical brushes had higher concentrations of particles compared to match vaginal swabs, although both samples had low concentrations. Protein and miRNA yield were similar between matched samples. PCR demonstrated only a small amount DNA within samples was bacterial (>0.5%). Cervico‐vaginal fluids EVs were successfully isolated from cervical brushes and vaginal swabs, demonstrating a new method of sampling reproductive EVs. EV yield from both sample types was low. Similar protein and miRNA levels suggest either sampling method may be suitable for biomarker studies. [ABSTRACT FROM AUTHOR]

Simple Summary: Wildlife rescue centers frequently admit animals with injuries and bone fractures. Open fractures are common in birds due to their anatomy, and this can lead to complications like osteomyelitis, which implies a serious bone infection and often necrosis, or death of the affected bone tissue. Antibiotic therapy is crucial, but the rise in antimicrobial-resistant isolates in wildlife raises concerns about treatment efficacy. A study focused on isolating, identifying, and assessing antimicrobial resistance in bacteria from wounds and fractures in wild birds. Among 36 isolates, Staphylococcus spp. dominated (63.8%), with 82.6% exhibiting antimicrobial resistance, particularly to clindamycin, an antimicrobial key in the treatment of infected bone fractures. This escalating resistance poses a dual threat to wildlife—therapeutic failure and the spread of resistant bacteria in ecosystems. Injuries and bone fractures are the most frequent causes of admission at wildlife rescue centers. Wild birds are more susceptible to open fractures due to their anatomical structure, which can lead to osteomyelitis and necrosis. Antibiotic therapy in these cases is indispensable, but the increase of antimicrobial-resistant isolates in wildlife has become a significant concern in recent years. In this context, the likelihood of antibiotic failure and death of animals with infectious issues is high. This study aimed to isolate, identify, and assess the antimicrobial resistance pattern of bacteria in wounds and open fractures in wild birds. To this end, injured birds admitted to a wildlife rescue center were sampled, and bacterial isolation and identification were performed. Then, antimicrobial susceptibility testing was assessed according to the disk diffusion method. In total, 36 isolates were obtained from 26 different birds. The genera detected were Staphylococcus spp. (63.8%), Escherichia (13.9%), Bacillus (11.1%), Streptococcus (8.3%), and Micrococcus (2.8%). Among Staphylococcus isolates, S. lentus and S. aureus were the most frequent species. Antimicrobial resistance was detected in 82.6% of the isolates, among which clindamycin resistance stood out, and 31.6% of resistant isolates were considered multidrug-resistant. Results from this study highlight the escalating scope of antimicrobial resistance in wildlife. This level of resistance poses a dual concern for wildlife: firstly, the risk of therapeutic failure in species of significant environmental value, and, secondly, the circulation of resistant bacteria in ecosystems. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate detection rates and risk factors for unsuspected proof of bacteria, as well as clinical and radiologic outcomes following femoral shaft nonunion without clinical signs of infection treated by a single-stage surgical revision procedure including reamed intramedullary exchange nailing. Methods: A retrospective cohort study was performed in a European level I trauma center between January 2015 and December 2022. Fifty-eight patients were included who underwent reamed intramedullary exchange nailing as a single-step procedure for surgical revision of posttraumatic diaphyseal femoral nonunion without any indications of infection in medical history and without clinical signs of local infection. Clinical details of the patients were analyzed and functional and radiologic long-term outcomes were determined. Results: In all patients, with and without proof of bacteria osseous, healing could be observed. The physical component summary of the SF-12 demonstrated significantly better results at least one year after the final surgical revision in case of a negative bacterial culture during exchange nailing. Conclusions: Clinical long-term outcomes demonstrated a trend towards better results following femoral shaft nonunion revision if there was no evidence for the presence of low-grade infected nonunion. In this case, a single-stage surgical procedure may be recommended. [ABSTRACT FROM AUTHOR]

Purpose: There is a paucity of literature on infections in civilian gunshot associated with long bone fractures with the reported rates ranging from 0–15.7%.This study aimed to investigate the rates of infection associated with long bone fractures caused by civilian gunshots. The specific objectives were to determine if certain extremities were at a higher risk for infection and to identify the types of bacteria present in these infections by analyzing culture isolates. Methods: We conducted a retrospective review of consecutive patients aged 18–64 who sustained gunshot-associated long bone fractures at an urban Level I trauma centre from 2010 to 2017. Patient selection was based done through a institutional trauma centre database using international classification of diseases (ICD) 9 and 10 codes. We included patients who underwent surgical treatment, specifically fracture fixation, at our institution and excluded patients with fractures involving the pelvis, spine, foot, and hand. A total of 384 gunshot-associated long bone fractures in 347 patients were identified for analysis. Relevant patient-, injury-, and treatment-related variables were extracted from clinical records and radiographic reviews. Outcomes of interest included bony union, repeat operative procedures, and the development of deep infection. Results: 347 patients with 384 long bone fractures were included. 32 fractures in 32 patients developed an infection for an incidence of 9.3% of patients and 8.3% of fractures. Gram-positive bacteria were present in 23/32 (72.0%) culture isolates, gram-negative bacteria in 10/32 (31.3%) culture isolates, and six infections were polymicrobial. Staphylococcus 16/32 (50.0%) and Enterobacter 6/32 (18.8%) species were the most common isolates. Of the Staphylococcus species, 5/16 (31.3%) were MRSA. Lower extremity fractures had a greater risk for infection compared to the upper extremity (11.7% vs 3.7% p < 0.01) and fractures that developed an infection had a larger average zone of comminution (63.9 mm vs 48.5 mm p < 0.05). Conclusion: This study investigated the rates of infection associated with long bone fractures caused by civilian gunshots. The overall infection rate observed in our series aligns with existing literature. Gram-positive bacteria were the predominant isolates, with a notable incidence of MRSA in our patient population, highlighting the need for considering empiric coverage. Additionally, gram-negative organisms were found in a significant proportion of infections, and a notable percentage of infections were polymicrobial. Our findings emphasize the importance of carefully assessing highly comminuted lower extremity fractures and implementing appropriate antibiotic coverage and operative debridement for patients with gunshot-related long bone fractures. While current prophylaxis algorithms for open fractures lack specific inclusion of gunshot wounds, we propose incorporating these injuries to reduce the incidence of infections associated with such fractures. [ABSTRACT FROM AUTHOR]

The Bacillus and Paenibacillus genera are diverse soil-related bacterial pathogens. In this case report, we describe, to our knowledge, the first report of septic arthritis in a native hip joint in an immunocompetent adult patient caused by Bacillus pumilus and Paenibacillus barengoltzii. We describe the case of a 39-year-old Caucasian male patient who sought medical advice for chronic pain on the mobilization of the right hip, decreased range of motion, and physical asthenia. The patient underwent a surgical intervention (core decompression) for a right osteonecrosis of the femoral head, with a slightly favorable postoperative evolution after surgery for one month. Surgical treatment was planned on the basis of clinical and paraclinical investigations and the joint damage. The hip was explored using an anterior approach under spinal anesthesia and standard antibiotic prophylaxis. After resection of the femoral head, meticulous debridement of all inflammatory tissues was performed, and a preformed temporary spacer was inserted into the femoral canal. Bacteriological laboratory studies identified Bacillus pumilus and Paenibacillus barengoltzii via matrix-assisted laser desorption–ionization time-of-flight mass spectrometry analysis. The patient initially received nine days of empirical therapy with intravenous antibiotics (linezolid and meropenem). After the bacterial strains were identified, the patient received organism-specific antibiotic therapy with the same antibiotics and dose for eight days until discharge. After discharge, the patient was referred to another hospital, where he continued treatment with linezolid for seven weeks and, after that, four weeks of oral therapy with cotrimoxazole and rifampicin. During this period, no severe or potentially life-threatening adverse events were recorded during long-term treatment with linezolid or with the two oral antibiotics. In conclusion, our findings suggest that long-term treatment with linezolid may be a viable option for the management of bone and joint infections caused by Bacillus pumilus and Paenibacillus barengoltzii. [ABSTRACT FROM AUTHOR]

The bulk density of grains from a celestial body is a fundamental property related to its composition and structure, contributing to the understanding of its evolutionary history. In this study, we provide the bulk density of 637 grains returned from the C-type near-Earth asteroid 162173 Ryugu. This is the largest number of grains to date for the curation activity, corresponding to 38 wt.% of the total returned samples (approximately 5.4 g). Although several densities of the Ryugu grains were reported, the volume estimation of some samples showed uncertainties. Therefore, we applied a new volume estimation model calibrated by X-ray micro-computed tomography (XCT) to the Ryugu grains to more accurately estimate their bulk density. The obtained average bulk density of 637 Ryugu grains was 1.79 ± 0.31 g/cm3 (1σ variation) for weights of 0.5‒100 mg (sub-mm ‒to 10 mm) irrespective of their 3D shapes characterized by three axial length ratios, considered to be a representative of the returned samples. The bulk density distributions of the grains in Chambers A and C were statistically distinguishable, with mean values of 1.81 ± 0.30 and 1.76 ± 0.33 g/cm3 (1σ variations), respectively. Despite the small difference, bulk density may have differed by sampling site. The obtained average bulk density value of A + C samples was almost the same as that of 16 Ryugu grains estimated based on CT scanned data, and was consistent with the densities of CI chondrites (1.57–1.91 g/cm3). The axial ratios of the grains in Chambers A and C were similar and those of the 724 returned samples and the flying particles ejected during the sampling operations were also similar, suggesting that relatively small Ryugu materials (mm‒cm in size) are similar in shape. The minor difference between the Rygu grains and flying particles could be attributed to events such as scraping during sampling operations and transportation. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the rate of bacterial contamination of semitendinosus (ST) tendons during graft harvest in anterior cruciate ligament reconstruction (ACLR), in order to precisely specify the underlying pathogens and obtain data on their susceptibility to potential antibiotics. Methods: In a prospective study, a total of 59 consecutive patients undergoing primary ACLR were recruited from one centre. No patient had history of previous surgery to the knee or showed clinical signs of infection. Four tissue samples of harvested ST tendons for anterior cruciate ligament (ACL) autografts (case group; ST) were examined for evidence of bacterial colonisation and compared to four tissue samples of the native ACL as negative controls (control group; ACL). Three of the respective samples were subjected to cultural microbiological examination and one to 16S rRNA-PCR. Antibiotic susceptibility testing was performed for each pathogen that was identified. Results: A total of 342 samples were analysed by culture. Significantly more patients showed a positive culture of the ST (33.9%; n = 20/59) compared to 3.4% of patients (n = 2/59) with positive culturing of the ACL (p < 0.0001). Including 16S rRNA-PCR, in a total of 42.4% (25/59) of patients, bacteria were detected in at least one ST sample either by PCR and/or culture. All species found (n = 33) belong to the typical skin flora with Staphylococcus epidermidis (39.4%; n = 13/33) being the most common species, followed by Staphylococcus capitis (24.2%; n = 8/33). All tested isolates (n = 29) were susceptible to vancomycin (29/29, 100%), 69% (n = 20/29) to oxacillin and 65.5% (n = 19/29) to clindamycin. Conclusion: ST autografts for ACLR were commonly contaminated with skin commensal bacteria during harvest. One-third of the isolates showed resistance to typical perioperative intravenous antibiotics, whereas all isolates were sensitive to vancomycin. Therefore, routine prophylactic decontamination of all hamstring autografts before implantation should be recommended, preferably with topical vancomycin. Level of evidence: Level III. [ABSTRACT FROM AUTHOR]

The qualitative evaluation of harvested raw logs and sawlogs is mainly based on the quantitative and qualitative evaluation of the visible macroscopic features of the wood. Modern methods allow for the analysis of whole logs by means of computed tomography. These devices can analyze the internal qualitative features of wood that are not visible on the external structures of the logs. The aim of this work was to evaluate the detection accuracy of a CT-scanning device intended for scanning logs on the internal qualitative features of wood using model trunks. Two logs of beech and oak with a length of 4 m were selected for the analysis, based on availability. Qualitative features were identified through computed tomography scanning, visually identified on cut sections, and then manually measured in accordance with applicable legislation. Relatively good agreement was demonstrated for the detected features in terms of identifying their location (dimension in millimeters from the end of the log). For this parameter, the average differences were 0.90% on the beech log and only 1.21% on the oak log. Relatively high accuracy was shown via CT detection of qualitative features in the beech section (with average differences in dimensions of only 3.5%). In the case of the oak log, the dimensions of the quality features were significantly overestimated. These results indicate that CT scanning technology may have a problem with some hardwood species. It was primarily developed for coniferous tree species, and software algorithms are, therefore, not yet fully adapted to the precise detection of the dimensions of individual quality features. Despite the detected differences, it was confirmed that the CT technology of scanning harvested wood can have a fundamental impact on optimization procedures in the recovery and processing of wood. Renting a scanning line for a certain capacity of wood volume appears to be a deployment option for forestry operations and smaller wood processing operations. Thus, this technology can become an important factor in improving the economic evaluation of the final production of wood. [ABSTRACT FROM AUTHOR]

(1) Background: Recently, Escherichia coli-derived recombinant human bone morphogenetic protein-2 (E. coli-derived rhBMP-2) has been increasingly applied to different types of spinal surgeries and reported to achieve successful fusion. This pilot study aimed to evaluate the clinical efficacy and safety of rhBMP-2 in patients undergoing posterior instrumented fusions for unstable spinal fractures. (2) Methods: This study included ten consecutive patients undergoing spinal surgery using E. coli-derived rhBMP-2 with more than one year of follow-up. Radiologic outcomes were compared, including the average fracture healing period, local kyphosis correction, and clinical outcomes between preoperative and the last follow-up. (3) Results: The average time of radiographic union was 99.9 ± 45.4 (62–192) days, with an average use of 5.2 ± 3.9 months of anabolic agents. Radiologic parameters such as anterior vertebral height and vertebral wedge angle were significantly corrected postoperatively and at the last follow-up. Clinical outcomes other than leg pain were significantly improved after the surgery. In addition, four patients with preoperative neurologic deficits showed improved neurologic status. (4) Conclusions: Combined with the anabolic agents, applying E. coli-derived rhBMP-2 to the fractured vertebral body could be an effective surgical treatment for unstable spinal fractures. Further trials are needed to validate this result. [ABSTRACT FROM AUTHOR]

Marine algae are one of the most important sources of high‐value compounds such as polar lipids, omega‐3 fatty acids, photosynthetic pigments, or secondary metabolites with interesting features for different niche markets. Acetabularia acetabulum is a macroscopic green single‐celled alga, with a single nucleus hosted in the rhizoid. This alga is one of the most studied dasycladalean species and represents an important model system in cell biology studies. However, its lipidome and pigment profile have been overlooked. Total lipid extracts were analyzed using hydrophilic interaction liquid chromatography‐high resolution mass spectrometry (HILIC‐HRMS), tandem mass spectrometry (MS/MS), and high‐performance liquid chromatography (HPLC). The antioxidant capacity of lipid extracts was tested using DPPH and ABTS assays. Lipidomics identified 16 polar lipid classes, corresponding to glycolipids, betaine lipids, phospholipids, and sphingolipids, with a total of 191 lipid species, some of them recognized by their bioactivities. The most abundant polar lipids were glycolipids. Lipid classes less studied in algae were identified, such as diacylglyceryl‐carboxyhydroxymethylcholine (DGCC) or hexosylceramide (HexCer). The pigment profile of A. acetabulum comprised carotenoids (17.19%), namely cis‐neoxanthin, violaxanthin, lutein and β,β‐carotene, and chlorophylls a and b (82.81%). A. acetabulum lipid extracts showed high antioxidant activity promoting a 50% inhibition (IC50) with concentrations of 57.91 ± 1.20 μg · mL−1 (438.18 ± 8.95 μmol Trolox · g−1 lipid) in DPPH and 20.55 ± 0.60 μg · mL−1 in ABTS assays (918.56 ± 27.55 μmol Trolox · g−1 lipid). This study demonstrates the potential of A. acetabulum as a source of natural bioactive molecules and antioxidant compounds. [ABSTRACT FROM AUTHOR]

Premise: Imaging technologies that capture three‐dimensional (3D) variation in floral morphology at micro‐ and nano‐resolutions are increasingly accessible. In herkogamous flowers, such as those of Theobroma cacao, structural barriers between anthers and stigmas represent bottlenecks that restrict pollinator size and access to reproductive organs. To study the unresolved pollination biology of cacao, we present a novel application of micro‐computed tomography (micro‐CT) using floral dimensions to quantify pollinator functional size limits. Methods: We generated micro‐CT data sets from field‐collected flowers and museum specimens of potential pollinators. To compare floral variation, we used 3D Slicer to place landmarks on the surface models and performed a geometric morphometric (GMM) analysis using geomorph R. We identified the petal side door (an opening between the petal hoods and filament) as the main bottleneck for pollinator access. We compared its mean dimensions with proposed pollinators to identify viable candidates. Results: We identified three levels of likelihood for putative pollinators based on the number of morphological (body) dimensions that fit through the petal side door. We also found floral reward microstructures whose presence and location were previously unclear. Discussion: Using micro‐CT and GMM to study the 3D pollination biology of cacao provides new evidence for predicting unknown pollinators. Incorporating geometry and floral rewards will strengthen plant–pollinator trait matching models for cacao and other species. [ABSTRACT FROM AUTHOR]

Probiotic supplements have been shown to improve bone health in animal models, although it remains uncertain whether these beneficial effects extend to humans. we undertook a systematic review of the literature to determine the effects of probiotic interventions on skeletal outcomes in postmenopausal women. MeDLiNe, eMBASe, CeNTRAL, and the Cochrane Database of Systematic Reviews were searched from inception to October 2020 for controlled trials comparing the effects of probiotic-containing supplements with placebo on bone mineral density (BMD) or bone turnover markers. Risk of bias was assessed using the Cochrane Risk of Bias 2 Tool. Of 338 records identified, six randomized, placebo-controlled trials (n = 632) were eligible for inclusion. All studies assessed postmenopausal women for durations of 6-12 months; three were considered to be at high risk of bias. Four studies examined Lactobacillus-containing probiotics, one assessed a proprietary blend of lactic acid bacteria, and one evaluated Bacillus subtilis. effects of probiotic interventions on BMD were inconsistent, with the majority of studies demonstrating no benefit at the spine or hip. Probiotic effects on bone turnover markers were similarly heterogeneous. High quality studies are needed to determine whether probiotic interventions have a role in maintaining bone health in humans. [ABSTRACT FROM AUTHOR]

Permoridium fresenaci gen. et sp. nov., the oldest putative representative of the bug suborder Coleorrhyncha, is described from the lower Permian of Germany, in the new family Permoridiidae. The main autapomorphies of the new taxon are the separation of M+CuA from R at extreme wing base and the veins CuP and PCu strongly appressed. Its position in the Hemiptera is discussed. Its attribution to the modern Coleorrhyncha is supported by the putative synapomorphies 'a very long and well-defined ScP, ending into RA', 'ScP appressed R +M+CuA at extreme wing base' and 'a strong ScA, distant from costal vein and with a short anterior branch at its extreme base, ending into C, plus posterior branches'. The relationships of the extinct families Hoploridiidae, Karabasiidae and Progonocimicidae with the extant Coleorrhyncha are discussed. urn:lsid:zoobank.org:pub:6B3A89FF-6265-4F50-A73E-11D791488909 [ABSTRACT FROM AUTHOR]

The incidence of periprosthetic joint infections (PJIs) is ~2% of total procedures and it is expected to rise due to an ageing population. Despite the large burden PJI has on both the individual and society, the immune response to the most commonly isolated pathogens, i.e., Staphylococcus aureus and Staphylococcus epidermidis, remains incompletely understood. In this work, we integrate the analysis of synovial fluids from patients undergoing hip and knee replacement surgery with in-vitro experimental data obtained using a newly developed platform, mimicking the environment of periprosthetic implants. We found that the presence of an implant, even in patients undergoing aseptic revisions, is sufficient to induce an immune response, which is significantly different between septic and aseptic revisions. This difference is confirmed by the presence of pro- and anti-inflammatory cytokines in synovial fluids. Moreover, we discovered that the immune response is also dependent on the type of bacteria and the topography of the implant surface. While S. epidermidis seems to be able to hide better from the attack of the immune system when cultured on rough surfaces (indicative of uncemented prostheses), S. aureus reacts differently depending on the contact surface it is exposed to. The experiments we performed in-vitro also showed a higher biofilm formation on rough surfaces compared to flat ones for both species, suggesting that the topography of the implant could influence both biofilm formation and the consequent immune response. [ABSTRACT FROM AUTHOR]

Background : The purpose of this randomized trial is to evaluate the early removal of postoperative drains after robot-assisted minimally invasive oesophagectomy (RAMIE). Evidence is lacking about feasibility, associated pain, recovery, and morbidity. Methods/design: This is a randomized controlled multicentric trial involving 72 patients undergoing RAMIE. Patients will be allocated into two groups. The "intervention" group consists of 36 patients. In this group, abdominal and chest drains are removed 3 h after the end of surgery in the absence of contraindications. The control group consists of 36 patients with conventional chest drain management. These drains are removed during the further postoperative course according to a standard algorithm. The primary objective is to investigate whether postoperative pain measured by NRS on the second postoperative day can be significantly reduced in the intervention group. Secondary endpoints are the intensity of pain during the first week, analgesic use, number of postoperative chest X-ray and CT scans, interventions, postoperative mobilization (steps per day as measured with an activity tracker), postoperative morbidity and mortality. Discussion: Until now, there have been no trials investigating different intraoperative chest drain strategies in patients undergoing RAMIE for oesophageal cancer with regard to perioperative complications until discharge. Minimally invasive approaches combined with enhanced recovery after surgery (ERAS) protocols lower morbidity but still include the insertion of chest drains. Reduction and early removal have been proposed after pulmonary surgery but not after RAMIE. The study concept is based on our own experience and the promising current results of the RAMIE procedure. Therefore, the presented randomized controlled trial will provide statistical evidence of the effectiveness and feasibility of the "drainless" RAMIE. Trial registration: ClinicalTrials.gov NCT05553795. Registered on 23 September 2022. [ABSTRACT FROM AUTHOR]

Bacterial contamination of soft tissue in open fractures leads to high infection rates. Pathogens and their resistance against therapeutic agents change with time and vary in different regions. The purpose of this study was to characterize the bacterial spectrum present in open fractures and analyze the bacterial resistance to antibiotic agents based on five trauma centers in East China. A retrospective multicenter cohort study was conducted in six major trauma centers in East China from January 2015 to December 2017. Patients who sustained open fractures of the lower extremities were included. The data collected included the mechanism of injury, the Gustilo-Anderson classification, the isolated pathogens and their resistance against therapeutic agents, as well as the prophylactic antibiotics administered. In total, 1348 patients were included in our study, all of whom received antibiotic prophylaxis (cefotiam or cefuroxime) during the first debridement at the emergency room. Wound cultures were taken in 1187 patients (85.8%); the results showed that the positive rate of open fracture was 54.8% (651/1187), and 59% of the bacterial detections occurred in grade III fractures. Most pathogens (72.7%) were sensitive to prophylactic antibiotics, according to the EAST guideline. Quinolones and cotrimoxazole showed the lowest rates of resistance. The updated EAST guidelines for antibiotic prophylaxis in open fracture (2011) have been proven to be adequate for a large portion of patients, and we would like to suggest additional Gram-negative coverage for patients with grade II open fractures based on the results obtained in this setting in East China. [ABSTRACT FROM AUTHOR]

Purpose: A reliable locoregional recurrence (LRR) prediction model is important for the personalized management of head and neck cancers (HNC) patients who received radiotherapy. This work aims to develop a delta-radiomics feature based multi-classifier, multi-objective, and multi-modality (Delta-mCOM) model for post-treatment HNC LRR prediction. Furthermore, we aim to adopt a learning with rejection option (LRO) strategy to boost the reliability of Delta-mCOM model by rejecting prediction for samples with high prediction uncertainties. Methods: In this retrospective study, we collected PET/CT image and clinical data from 224 HNC patients who received radiotherapy (RT) at our institution. We calculated the differences between radiomics features extracted from PET/CT images acquired before and after radiotherapy and used them in conjunction with pre-treatment radiomics features as the input features. Using clinical parameters, PET radiomics features, and CT radiomics features, we built and optimized three separate single-modality models. We used multiple classifiers for model construction and employed sensitivity and specificity simultaneously as the training objectives for each of them. Then, for testing samples, we fused the output probabilities from all these single-modality models to obtain the final output probabilities of the Delta-mCOM model. In the LRO strategy, we estimated the epistemic and aleatoric uncertainties when predicting with a trained Delta-mCOM model and identified patients associated with prediction of higher reliability (low uncertainty estimates). The epistemic and aleatoric uncertainties were estimated using an AutoEncoder-style anomaly detection model and test-time augmentation (TTA) with predictions made from the Deltam COM model, respectively. Predictions with higher epistemic uncertainty or higher aleatoric uncertainty than given thresholds were deemed unreliable, and they were rejected before providing a final prediction. In this study, different thresholds corresponding to different low-reliability prediction rejection ratios were applied. Their values are based on the estimated epistemic and aleatoric uncertainties distribution of the validation data. Results: The Delta-mCOM model performed significantly better than the single modality models, whether trained with pre-, post-treatment radiomics features or concatenated BaseLine and Delta-Radiomics Features (BL-DRFs). It was numerically superior to the PET and CT fused BL-DRF model (non statistically significant). Using the LRO strategy for the Delta-mCOM model, most of the evaluation metrics improved as the rejection ratio increased from 0% to around 25%. Utilizing both epistemic and aleatoric uncertainty for rejection yielded nonstatistically significant improved metrics compared to each alone at approximately a 25% rejection ratio. Metrics were significantly better than the no-rejection method when the reject ratio was higher than 50%. Conclusions: The inclusion of the delta-radiomics feature improved the accuracy of HNC LRR prediction, and the proposed Delta-mCOM model can give more reliable predictions by rejecting predictions for samples of high uncertainty using the LRO strategy [ABSTRACT FROM AUTHOR]

Background: Prosthetic joint infection (PJI) is a serious complication after joint replacement surgery and it is associated with risk of mortality and morbidity along with high direct costs. Methods: The Clinical Practice Research Datalink (CPRD) data were utilized to quantify PJI incidence after hip or knee replacement up to 5 years after implant and a variety of risk factors related to patient characteristics, medical and treatment history along with characteristics of the original surgery were analyzed through Cox proportional hazard. Results: 221,826 patients (individual joints 283,789) met all the inclusion and exclusion criteria of the study; during the study follow-up period (5 years), 707 and 695 PJIs were diagnosed in hip and knee, respectively. Patients undergoing joint replacement surgery during an unscheduled hospitalization had greater risk of PJI than patients whose surgery was elective; similarly, the risk of developing PJI after a secondary hip or knee replacement was about 4 times greater than after primary arthroplasty when adjusted for all other variables considered. A previous diagnosis of PJI, even in a different joint, increased the risk of a further PJI. Distribution of average LoS per each hospitalization caused by PJI exhibited a right skewed profile with median duration [IQR] duration of 16 days [8–32] and 13 days [7.25–32] for hip and knee, respectively. PJIs causative micro-organisms were dependent on the time between initial surgery and infection offset; early PJI were more likely to be multispecies than later (years after surgery); the identification of Gram- pathogens decreased with increasing post-surgery follow-up. Conclusions: This study offers a contemporary assessment of the budgetary and capacity (number and duration of hospitalizations along with the number of Accident and Emergency (A&E) visits) posed by PJIs in UK for the national healthcare system (NHS). The results to provide risk management and planning tools to health providers and policy makers in order to fully assess technologies aimed at controlling and preventing PJI. The findings add to the existing evidence-based knowledge surrounding the epidemiology and burden of PJI by quantifying patterns of PJI in patients with a relatively broad set of prevalent comorbidities. [ABSTRACT FROM AUTHOR]

Background: As one of the largest drupes in the world, the coconut has a special multilayered structure and a seed development process that is not yet fully understood. On the one hand, the special structure of the coconut pericarp prevents the development of external damage to the coconut fruit, and on the other hand, the thickness of the coconut shell makes it difficult to observe the development of bacteria inside it. In addition, coconut takes about 1 year to progress from pollination to maturity. During the long development process, coconut development is vulnerable to natural disasters, cold waves, typhoons, etc. Therefore, nondestructive observation of the internal development process remains a highly important and challenging task. In this study, We proposed an intelligent system for building a three-dimensional (3D) quantitative imaging model of coconut fruit using Computed Tomography (CT) images. Cross-sectional images of coconut fruit were obtained by spiral CT scanning. Then a point cloud model was built by extracting 3D coordinate data and RGB values. The point cloud model was denoised using the cluster denoising method. Finally, a 3D quantitative model of a coconut fruit was established. Results: The innovations of this work are as follows. 1) Using CT scans, we obtained a total of 37,950 non-destructive internal growth change maps of various types of coconuts to establish a coconut data set called "CCID", which provides powerful graphical data support for coconut research. 2) Based on this data set, we built a coconut intelligence system. By inputting a batch of coconut images into a 3D point cloud map, the internal structure information can be ascertained, the entire contour can be drawn and rendered according to need, and the long diameter, short diameter and volume of the required structure can be obtained. We maintained quantitative observation on a batch of local Hainan coconuts for more than 3 months. With 40 coconuts as test cases, the high accuracy of the model generated by the system is proven. The system has a good application value and broad popularization prospects in the cultivation and optimization of coconut fruit. Conclusion: The evaluation results show that the 3D quantitative imaging model has high accuracy in capturing the internal development process of coconut fruits. The system can effectively assist growers in internal developmental observations and in structural data acquisition from coconut, thus providing decision-making support for improving the cultivation conditions of coconuts. [ABSTRACT FROM AUTHOR]

Premise of research. Eocene sediments of Colorado, Utah, and Wyoming contain fossil leaves and infructescences that appear to represent Tetramelaceae (Cucurbitales). Today, this family consists of two genera (Tetrameles and Octomeles) of towering rain forest trees native to India, Southeast Asia, and Australia. Methodology. We examined the fruit, seed, and leaf morphology of extant Tetramelaceae as a basis for recognizing fossil representatives. Fossils were studied from localities in the Parachute Creek Member of the Green River Formation in Utah and Colorado and in the Bridger and Aycross Formations of western Wyoming. Extant and extinct material was studied by light microscopy and micro–computed tomography (micro-CT) scanning. Pivotal results. Infructescences of Parvaspicula lepidioidea (Cockerell) comb. nov. conform to Tetramelaceae in their spicate arrangement of helically arranged, capsular, ribbed fruits with inferior ovaries and parietal placentation. Each fruit typically has four styles and dehisces apically between the styles, reminiscent of extant Tetrameles , but they share an apical disk and the bulbous stigmas of extant Octomeles. Leaves of Punctaphyllum glandulosum (Brown) comb. nov. conform to Tetramelaceae in their long petioles, basal marginal and intramarginal veins, and regularly spaced circular laminar glands. These glands are small and cover the laminae or are larger and concentrated in a single file row along the lamina margin. Punctaphyllum glandulosum varies in its base shape, lobe number, and margin type, matching the variation seen in extant Octomeles leaves. Conclusions. The repeated co-occurrence of Parvaspicula and Punctaphyllum and the morphological similarities of both of these organs with extant Tetramelaceae lead us to infer that they represent parts of the same extinct plant. These records serve as the first documented leaf and infructescence fossils of Tetramelaceae and suggest that the family once lived in North America, indicating broader biogeographic distribution than previously recognized. [ABSTRACT FROM AUTHOR]

Background: Existing state-of-the-art "safe zone" prediction methods are statistics-based methods, image-matching techniques, and machine learning methods. Yet, those methods bring a tension between accuracy and interpretability. Purpose: To explore the model explanations and estimator consensus for "safe zone" prediction. Material and Methods: We collected the pelvic datasets from Orthopaedic Hospital, and a novel acetabular cup detection method is proposed for automatic ROI segmentation. Hybrid priors comprising both specific priors from data and general priors from experts are constructed. Specifically, specific priors are constructed based on the fine-tuned ResNet-101 convolutional neural networks (CNN) model, and general priors are constructed based on expert knowledge. Our method considers the model explanations and dynamic consensus through appending a SHapley Additive exPlanations (SHAP) module and a dynamic estimator stacking. Results: The proposed method achieves an accuracy of 99.40% and an area under the curve of 0.9998. Experimental results show that our model achieves superior results to the state-of-the-art conventional ensemble classifiers and deep CNN models. Conclusion: This new screening model provides a new option for the "safe zone" prediction of acetabular cup. [ABSTRACT FROM AUTHOR]

Background: The outcome measure of neonatal hip screening is usually the radiographic acetabular index. Objective: To assess the feasibility of magnetic resonance imaging (MRI) without sedation and compare the utility of outcome parameters measured from MRI images. Materials and methods: The invitation for MRI scanning at 5 years of age was incorporated into follow-up for babies who had more than one ultrasound examination during treatment or surveillance. Results: Diagnostic images were obtained in 132 of 134 children. The mean osseous acetabular index (standard deviation [SD]) was 16.6 (3.3) degrees for the right hip and 17.8 (3.2) for the left; the values for the cartilaginous acetabular index were 3.1 (3) and 3.4 (3.2). The mean downslope of a tangent to the lateral bony acetabular roof was 10.4 (4.5) and 9.0 (4.3) with respect to Hilgenreiner's line and that of a line drawn through the apex to the margin of the acetabulum was 3.7 (4.6) and 3.9 (4.7). Intra- and interobserver variation was greater for measures specific to the lateral acetabular roof than for ossific and cartilaginous indices. There was significant negative correlation between the downslope of the tangent to the lateral roof index and the age at onset of treatment on both sides, but no significant correlation for ossific or cartilaginous acetabular indices or apex-marginal index. Conclusion: MRI without sedation at 5 years of age is feasible as an outcome measure for hip screening programmes. Parameters specific to the lateral acetabulum may better reflect acetabular sufficiency, despite having greater observer variation than cartilaginous and ossific acetabular indices. [ABSTRACT FROM AUTHOR]

Introduction: Computed tomography (CT) is a non-invasive examination tool that is widely used in medicine. In this study, we explored its value in visualizing and quantifying coconut. Materials and methods: Twelve coconuts were scanned using CT for three months. Axial CT images of the coconuts were obtained using a dual-source CT scanner. In postprocessing process, various three-dimensional models were created by volume rendering (VR), and the plane sections of different angles were obtained through multiplanar reformation (MPR). The morphological parameters and the CT values of the exocarp, mesocarp, endocarp, embryo, bud, solid endosperm, liquid endosperm, and coconut apple were measured. The analysis of variances was used for temporal repeated measures and linear and non-linear regressions were used to analyze the relationship between the data. Results: The MPR images and VR models provide excellent visualization of the different structures of the coconut. The statistical results showed that the weight of coconut and liquid endosperm volume decreased significantly during the three months, while the CT value of coconut apple decreased slightly. We observed a complete germination of a coconut, its data showed a significant negative correlation between the CT value of the bud and the liquid endosperm volume (y = −2.6955x + 244.91; R2 = 0.9859), and a strong positive correlation between the height and CT value of the bud (y = 1.9576 ln(x) −2.1655; R2 = 0.9691). Conclusion: CT technology can be used for visualization and quantitative analysis of the internal structure of the coconut, and some morphological changes and composition changes of the coconut during the germination process were observed during the three-month experiment. Therefore, CT is a potential tool for analyzing coconuts. [ABSTRACT FROM AUTHOR]

Background: The sustainability of bioenergy is strongly affected by direct field‐derived greenhouse gas (GHG) emissions and indirect emissions form land‐use change. Marginal land in low mountain ranges is suitable for feedstock production due to small impact on indirect land‐use change. However, these sites are vulnerable to high N2O emissions because of their fine soil texture and hydrology. Aims: The perennial cup plant (Silphium perfoliatum L.) might outperform silage maize (Zea mays L.) on cold, wet low mountain ranges sites regarding yield and ecosystem services. The aim of this study was to assess whether the cultivation of cup plant also provides GHG mitigation potential compared to the cultivation of maize. Methods: A t‐year field experiment was conducted in a low mountain range region in western Germany to compare area and yield‐scaled GHG emissions from cup plant and maize fields. GHG emissions were quantified using the closed chamber method. Results: Cup plant fields emitted an average of 3.6 ± 4.3 kg N2O‐N ha–1 year–1 (–85%) less than maize fields. This corresponded to 74.0 ± 94.1 g CO2‐eq kWh–1 (–78%) less emissions per produced electrical power. However, cup plant had a significantly lower productivity per hectare (–34%) and per unit of applied nitrogen (–32%) than maize. Conclusion: Cup plant as a feedstock reduces direct field‐derived GHG emissions compared to maize but, due to lower yields cup plant, likely increases emissions associated with land‐use changes. Therefore, the increased sustainability of bioenergy from biogas by replacing maize with cup plant is heavily dependent on the performance of maize at these sites and on the ecosystem services of cup plant in addition to GHG savings. [ABSTRACT FROM AUTHOR]

Simple Summary: Surgical treatment of sea turtle flipper fractures and the bones' subsequent repair process are not well documented in the scientific literature. This is the first case report describing the repair process of a multiple humeral flipper fracture in a sea turtle, after surgical stabilization, through periodic radiographic follow-up from 0 to 24 months. Due to the accidental death of the turtle 3 months after its release, it was possible to describe the progress of the fracture-healing process by histomorphometric analysis and to histologically compare the structure of the newly formed bone with the normal bone structure of these animals. Based on our findings in this case study, we may be able to obtain a better understanding of how repair tissue in marine turtles works, as well as helping with decisions regarding surgery. This study describes the surgical treatment of multiple humeral fractures in a Caretta caretta sea turtle referred by the 'Centro Faunistico del Parco Regionale Bosco e Paludi di Rauccio', in the area surrounding the city of Lecce, in southern Italy. Radiographs showed an evident detachment of the distal humeral epiphysis, compatible with a type II Salter-Harris fracture, as well as a transverse fracture of the diaphysis. After the surgical fracture reduction, radiographic follow-up was performed at 2, 4, 12, 16, and 24 months, showing a progressive healing and the formation of poorly mineralized callus tissue. Unfortunately, three months after his release at sea, the turtle was caught dead at a depth of 40 m. Histological and histomorphometric examinations of the surgically treated humerus were carried out on the corpse to collect further information about the bone tissue repair mechanisms in these animals. [ABSTRACT FROM AUTHOR]

Background: Despite its well-established limitations, culture remains the gold standard for microbial identification in periprosthetic joint infection (PJI). However, there are no benchmarks for the time to positivity (TTP) on culture for specific microorganisms. This study aimed to determine the TTP for pathogens commonly encountered in PJI. Methods: This retrospective, multicenter study reviewed prospectively maintained institutional PJI databases to identify patients who underwent hip or knee revision arthroplasty from 2017 to 2021 at 2 tertiary centers in the United States and Germany. Only patients who met the 2018 International Consensus Meeting (ICM) criteria for PJI and had a positive intraoperative culture were included. TTP on culture media was recorded for each sample taken intraoperatively. The median TTP was compared among different microbial species and different specimen types. Data are presented either as the mean and the standard deviation or as the median and the interquartile range (IQR). Results: A total of 536 ICM-positive patients with positive cultures were included. The mean number of positive cultures per patient was 3.9 ± 2.6. The median TTP, in days, for all positive cultures was 3.3 (IQR, 1.9 to 5.4). Overall, gram-negative organisms (TTP, 1.99 [1.1 to 4.1]; n = 225) grew significantly faster on culture compared with gram-positive organisms (TTP, 3.33 [1.9 to 5.8]; n = 1,774). Methicillin-resistant Staphylococcus aureus (TTP, 1.42 [1.0 to 2.8]; n = 85) had the fastest TTP, followed by gram-negative rods (TTP, 1.92 [1.0 to 3.9]; n = 163), methicillin-sensitive Staphylococcus aureus (TTP, 1.95 [1.1 to 3.3] n = 393), Streptococcus species (TTP, 2.92 [1.2 to 4.3]; n = 230), Staphylococcus epidermidis (TTP, 4.20 [2.4 to 5.5]; n = 555), Candida species (TTP, 5.30 [3.1 to 10]; n = 63), and Cutibacterium acnes (TTP, 6.97 [5.9 to 8.2]; n = 197). When evaluating the median TTP according to specimen type, synovial fluid (TTP, 1.97 [1.1 to 3.1]; n = 112) exhibited the shortest TTP, followed by soft tissue (TTP, 3.17 [1.4 to 5.3]; n = 1,199) and bone (TTP, 4.16 [2.3 to 5.9]; n = 782). Conclusions: To our knowledge, this is the first study to examine the TTP of common microorganisms that are known to cause PJI. Increased awareness of these data may help to guide the selection of appropriate antimicrobial therapy and to predict treatment outcomes in the future. Nonetheless, additional studies with larger cohorts are needed to validate these benchmarks. Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

This document is a letter to the editor of the journal International Orthopaedics. The authors of the letter are responding to a recent publication by Sanpera et al. that examines the outcomes of malrotated elbow supracondylar fractures in children. The authors of the letter raise concerns about biases in the study and question the measurement techniques used to detect loss of rotational reduction. They also suggest that the authors should have considered the Beighton hypermobility scale and its impact on shoulder rotation. Overall, the letter provides a critical analysis of the original study and raises important questions about its methodology and findings. [Extracted from the article]

BACKGROUND: Periprosthetic joint infection, a serious complication after artificial joint arthroplasty, has always been a thorny problem in clinical practice. At present, the research on the characteristics of the pathogenic bacteria is insufficient, and more research is needed to help clinical diagnosis and treatment. OBJECTIVE: To explore the distribution and drug resistance of pathogens in periprosthetic joint infection after knee and hip arthroplasties, and to compare the characteristics of different pathogen culture results. METHODS: A retrospective single-center research was used to study the data of 102 cases of periprosthetic joint infection in the Department of Orthopedics, First Affiliated Hospital of Zhengzhou University from September 2013 to September 2020. Pathogen culture results, drug resistance, and other diagnosis and treatment information were collected. According to the results of pathogen culture, the patients were divided into four groups: gram-positive bacteria, gramnegative bacteria, fungi, and negative culture. The differences in general condition, clinical features, operation methods, and infection control were compared among the four groups. RESULTS AND CONCLUSION: (1) Totally 66 of 102 patients with periprosthetic joint infection were cultured positive for pathogenic bacteria, and 71 strains of pathogenic bacteria were detected. Gram-positive bacteria accounted for 57.8%. Staphylococcus epidermidis (21.1%) and Staphylococcus aureus (15.5%) were the most common. Gram-negative bacteria accounted for 29.6% and Escherichia coli (12.7%) was the most common. Fungi accounted for 12.7%, with Candida parapsilosis (5.6%) being the most common. (2) Gram-positive bacteria had high resistance rates to penicillin G, oxacillin, clindamycin, and erythromycin, and 0% to vancomycin, tigecycline, and linezolid. Gram-negative bacteria had a high resistance rate to antibiotics such as quinolones, gentamicin, ampicillin, and cefazolin; no drug-resistant fungi had been found. (3) There was no significant difference in sex, age, basic disease, operation site, infection type, sinus, operation mode, and infection control rate among the four groups (P > 0.05). In early infection, the C reactive protein in culture negative group was lower than that in gram-positive bacteria group (P < 0.05), and red serum sedimentation rate and white blood cell count in culture negative group were significantly lower than those in gram-negative bacteria group (P < 0.05). Leukocyte, C-reactive protein, and erythrocyte sedimentation rate of hip periprosthetic infection were higher than those of knee periprosthetic infection (P < 0.05). (4) It is concluded that the main pathogen causing periprosthetic joint infection is still gram-positive bacteria, of which Staphylococcus accounts for the largest proportion. The increase of Candida parapsilosis infection is worthy of attention. Multiple pathogenic bacteria have a high drug resistance rate to some conventional antibiotics, so the use of antibiotics should be adjusted in time according to the results of drug susceptibility and efficacy. [ABSTRACT FROM AUTHOR]

Objectives: Olfactory dysfunction is a common complaint in patients with chronic rhinosinusitis (CRS). The study aimed to evaluate the effectiveness of olfactory training (OT) in patients with CRS after sinonasal surgery. Methods: We enrolled 111 patients with CRS who underwent sinonasal surgery. Prior to surgery and 3 months after starting OT, the participants were assessed by both an olfactory function test and endoscopy. The Korean version of the Sniffin' Stick II (KVSS‐II) was used to perform the olfactory function test. Over the course of 3 months, five odorants were used in OT (rose, lemon, cinnamon, orange, and peach). Results: Over a 12‐week duration, 37% of the participants in the OT group showed clinically relevant increase in olfactory function. The OT group had significantly higher olfactory outcomes for the total KVSS‐II and identification scores than the non‐OT group between the initial and follow‐up assessments. The initial score influenced the degree of olfactory improvement after OT. Conclusions: Patients with OT exhibited significantly higher total KVSS‐II scores compared with non‐OT patients following sinonasal surgery; in particular, the odor identification score was different between the two groups. The results of this study demonstrated that a 12‐week period of repeated short‐term exposure to various odors could be useful in enhancing olfactory activity in patients who underwent sinonasal surgery for the improvement of sensory‐neural olfactory impairment. Level of evidence: 2c. [ABSTRACT FROM AUTHOR]

To develop and validate a non-contrast free-breathing whole-heart 3D cine steady-state free precession (SSFP) sequence with a novel 3D radial leaf trajectory. We used a respiratory navigator to trigger acquisition of 3D cine data at end-expiration to minimize respiratory motion in our 3D cine SSFP sequence. We developed a novel 3D radial leaf trajectory to reduce gradient jumps and associated eddy-current artifacts. We then reconstructed the 3D cine images with a resolution of 2.0mm3 using an iterative nonlinear optimization algorithm. Prospective validation was performed by comparing ventricular volumetric measurements from a conventional breath-hold 2D cine ventricular short-axis stack against the non-contrast free-breathing whole-heart 3D cine dataset in each patient (n = 13). All 3D cine SSFP acquisitions were successful and mean scan time was 07:09 ± 01:31 min. End-diastolic ventricular volumes for left ventricle (LV) and right ventricle (RV) measured from the 3D datasets were smaller than those from 2D (LV: 159.99 ± 42.99 vs. 173.16 ± 47.42; RV: 180.35 ± 46.08 vs. 193.13 ± 49.38; p -value≤0.044; bias<8%), whereas ventricular end-systolic volumes were more comparable (LV: 79.12 ± 26.78 vs. 78.46 ± 25.35; RV: 97.18 ± 32.35 vs. 102.42 ± 32.53; p-value≥0.190, bias<6%). The 3D cine data had a lower subjective image quality score. Our non-contrast free-breathing whole-heart 3D cine sequence with novel leaf trajectory was robust and yielded smaller ventricular end-diastolic volumes compared to 2D cine imaging. It has the potential to make examinations easier and more comfortable for patients. [ABSTRACT FROM AUTHOR]

The silica-scaled chrysophyte flora of some lakes and rivers of the Altai Mountains was investigated by means of electron microscopy. Teletskoye Lake; the Biya, Chulyshman, and Katun Rivers; and small lakes around the area were studied. A total of sixteen taxa were recorded, including eight belonging to Mallomonas, five to Synura, and three to Paraphysomonas. A revision of previously reported taxa of scaled chrysophytes in this region was carried out. One species new to science from the genus Mallomonas was found and described. Mallomonas altaica sp. nov. belongs to the section Striatae and is characterised by scales with ribs covering only the anterior part of the shield and a posterior flange almost completely covered with the secondary siliceous layer. This species was discovered only at Teletskoye Lake. [ABSTRACT FROM AUTHOR]

The increasingly large size of the graphical and numerical data sets collected with modern technologies requires constant update and upgrade of the statistical models, methods and procedures to be used for their analysis in order to optimize learning and maximize knowledge and understanding. This is the case for plant CT scanning (CT: computed tomography), including applications aimed at studying leaf canopies and the structural complexity of the branching patterns that support them in trees. Therefore, we first show after a brief review, how the CT scanning data can be leveraged by constructing an analytical representation of a tree branching structure where each branch is represented by a line segment in 3D and classified in a level of a hierarchy, starting with the trunk (level 1). Each segment, or branch, is characterized by four variables: (i) the position on its parent, (ii) its orientation, a unit vector in 3D, (iii) its length, and (iv) the number of offspring that it bears. The branching structure of a tree can then be investigated by calculating descriptive statistics on these four variables. A deeper analysis, based on statistical models aiming to explain how the characteristics of a branch are associated with those of its parents, is also presented. The branching patterns of three miniature trees that were CT scanned are used to showcase the statistical modeling framework, and the differences in their structural complexity are reflected in the results. Overall, the most important determinant of a tree structure appears to be the length of the branches attached to the trunk. This variable impacts the characteristics of all the other branches of the tree. [ABSTRACT FROM AUTHOR]

Cataract surgery impinges on the spatial properties and wavelength distribution of retinal images, which changes the degree of light-induced visual discomfort/photophobia. However, no study has analyzed the alteration in photophobia before and after cataract surgery or the association between retinal spatial property and photophobia. Here, we measured the higher-order aberrations (HOAs) of the entire eye and the subjective photophobia score. This study investigated 71 eyes in 71 patients who received conventional cataract surgery. Scaling of photophobia was based on the following grading system: when the patient is outdoor on a sunny day, score of 0 and 10 points were assigned to the absence of photophobia and the presence of severe photophobia prevents eye-opening, respectively. We decomposed wavefront errors using Zernike polynomials for a 3-mm pupil diameter and analyzed the association between photophobia scores and HOAs with Spearman's rank sum correlation (rs). We classified patients into two groups: photophobia (PP) unconcerned included patients who selected 0 both preoperatively or postoperatively and PP concerned included the remaining patients. After cataract surgery, photophobia scores increased, remained unchanged (stable), and decreased in 3, 41, and 27 cases, respectively. In the stable group, 35 of 41 cases belonged to PP unconcerned. In PP concerned, there were significant correlations between photophobia score and postoperative root-mean-square values of total HOAs (rs = 0.52, p = 0.002), total coma (rs = 0.52, p = 0.002), total trefoil (rs = 0.47, p = 0.006), and third-order group (rs = 0.53, p = 0.002). In contrast, there was no significant correlation between photophobia scores and preoperative HOAs. Our results suggest that the spatial properties of retinal image modified by HOAs may affect the degree of photophobia. Scattering light due to cataracts could contribute to photophobia more than HOAs, which may mask the effect of HOAs for photophobia preoperatively. [ABSTRACT FROM AUTHOR]

Summary: Xylem embolism impairs hydraulic conductivity in trees and drives drought‐induced mortality. While embolism has been monitored in vivo in potted plants, and research has revealed evidence of embolism in field‐grown trees, continuous in situ monitoring of cavitation in forests is lacking.Seasonal patterns of embolism were monitored in branchlets of Aleppo pine (Pinus halepensis) trees growing in a dry Mediterranean forest. Optical visualization (OV) sensors were installed on terminal branches, in addition to monthly sampling for micro computed tomography scans.We detected 208 cavitation events among four trees, which represented an embolism increase from zero to c. 12% along the dry season. Virtually all the cavitation events occurred during daytime hours, with 77% occurring between 10:00 and 17:00 h. The probability for cavitation in a given hour increased as vapor pressure deficit (VPD) increased, up to a probability of 42% for cavitation when VPD > 5 kPa.The findings uniquely reveal the instantaneous environmental conditions that lead to cavitation. The increased likelihood of cavitation events under high VPD in water‐stressed pines is the first empirical support for this long hypothesized relationship. Our observations suggest that low levels of embolism are common in Aleppo pine trees at the dry edge of their distribution. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to identify risk factors for preoperative nasal carriage of resistant bacteria - MRSA methicillin-resistant Staphylococcus (S.) aureus, MRSE (methicillin-resistant Staphylococcus epidermidis), and MRCNS (methicillin-resistant coagulase negative staphylococci) in total hip and knee arthroplasty (THA and TKA) patients.Methods: Nasal cultures were obtained from 538 patients before THA (262 primary and 26 revision) and TKA (241 primary and 9 revision). These were classified either as methicillin-resistant bacteria (group MR) or methicillin-susceptible bacteria (including culture-negative) (group MS). Patient characteristics were compared between these groups using logistic regression models.Results: The resistant bacteria were preoperatively present in 33.1% (178 patients) among all patients. MRSE, MRCNS, and MRSA were detected in 27.5% (148 patients), 3.7% (20 patients), and 1.9% (10 patients). In the unadjusted comparisons of the patient characteristics between the groups MR and MS, a significant difference was found in the percentages of diabetic patients (15.2% vs. 9.2%, P = 0.04); the association remained after the multivariable adjustment for possible risk factors (P < 0.001). In addition, the diabetic patients in the group MR showed a higher percentage of receiving insulin injection than those in the group MS (25.9% vs. 6.1%, P = 0.063), and their mean levels of HbA1c were significantly higher in the group MR than the MS (6.8% vs. 6.4%, P = 0.03).Conclusions: We identified diabetes as a risk factor for the preoperative nasal carriage of resistant bacteria. Our results suggest that, in order to prevent a surgical site infection (SSI), extra care should be taken in performing joint arthroplasties for diabetic patients, especially using insulin and with high HbA1c levels (≥6.6%) prior to the surgical procedures. [ABSTRACT FROM AUTHOR]

Premise of research. The Eocene flora of Republic, Washington, is well known for its diversity of conifers and broad-leaved deciduous forest elements. Previously, the only representative of the family Platanaceae known from this flora was the leaves of Macginitiea and their associated fruiting heads. We offer evidence based on leaves and newly recognized stipules and inflorescences that another member of Platanaceae lived in the Republic flora. The affinity of this plant was previously overlooked because the leaves, which are assigned to the fossil genus Langeria Wolfe & Wehr, are usually unlobed. Methodology. We examined leaves, stipules, and inflorescences from the Eocene Klondike Mountain Formation of Republic, Washington. We macerated carbonaceous pieces from compressed capitula to reveal in situ pollen, which was examined with reflected light microscopy and scanning electron microscopy. Computed tomography scans were used to examine floral morphology hidden beneath the matrix. Pivotal results. The combination of characters, including petioles with flared hollow bases; serrated laminae with rounded sinuses and glandular teeth; distinctive features of venation, such as infrasecondary veins; and the association with large, suborbicular, lobed, sheathing stipules, confirms the identity of these leaves as members of Platanaceae. These affinities with Platanaceae are further supported by co-occurring globose capitula with numerous florets. We establish a new genus, Langeranthus gen. nov., to accommodate these pistillate and staminate capitula. The fruiting heads of Langeranthus dillhoffiorum sp. nov. are larger than those of the co-occurring Macginicarpa and have more elongate, narrow achenes, shorter style remnants, and a shorter perianth and are borne in florets of four rather than five. Although the majority of the laminae are unlobed, we also find evidence that Langeria magnifica rarely developed trilobed laminae. Conclusions. The Langeria-Langeranthus plant, in conjunction with previously recognized fossils of Macginitiea , indicates that Platanaceae were prominent members of the Republic floral community. [ABSTRACT FROM AUTHOR]

Premise of research. Hydrophyllaceae are characterized by simple floral organization contrasting with a peculiar floral architecture resulting from complex compartments formed by stamen–corolla tube modifications. Additionally, the internal ovary architecture of Hydrophyllaceae shows significant variation, while the developmental trajectory of the gynoecium is relatively conserved. Despite insights from recent studies of the flower and fruit evolution of the family, there are only a few ontogenetic studies of Hydrophyllaceae, and a complete understanding of the underlying processes has not yet been achieved. Methodology. Here, we use scanning electron microscopy and micro–computed tomography to investigate the flower and fruit ontogeny of two genera of Hydrophylleae, Emmenanthe and Pholistoma , with a particular focus on the gynoecium and modifications of the stamen–corolla tube. Pivotal results. Our results complement two previously published data sets, broadening our understanding of Hydrophylleae evolution. Hydrophylleae comprise only a few monotypic or small genera, but their floral evolution appears to be remarkably complex, in terms of both gynoecial structure and perianth modifications. We find 10 stamen–corolla tube modifications, although these may be rudimentary in species previously considered as lacking them altogether (e.g., Emmenanthe). The relative conservation of perianth architecture contrasts with the highly variable internal ovary architecture of Hydrophylleae. There is considerable divergence in ovule/seed number, as well as in the details of (parietal) placentation and septation, and we propose a hypothetical evolutionary series for the internal ovary architectural diversity of Hydrophyllaceae. Conclusions. We propose that—starting from a fairly conserved floral organization—minor heterochronous shifts in both perianth and ovary development can explain most of the morphological diversity found in the flowers and fruits of Hydrophylleae. [ABSTRACT FROM AUTHOR]

Additive manufacturing enabled the development of personalized, ideally fitting medical devices. The topography of the surface of the 3D-printed implant may not only facilitate its integration but also cause its rejection, as the surface may become a reservoir for different bacterial strains. In this study, the innovative, raw, 3D- printed fracture fixation plates, manufactured by using selective laser melting (SLM) from Ti-6Al-4V were compared with commercially available, surface-modified plates commonly used in orthopedic surgery. The topography surface of the plates was studied by atomic force microscopy. Susceptibility to the development of biofilm was tested for Staphylococcus epidermidis, Staphylococcus aureus and Streptococcus mutans by using crystal violet staining of biomass, confocal, and scanning electron microscopy (SEM). 3D- printed plates showed higher roughness (Sa=131.0 nm) than commercial plates (CP1 and CP2), Sa= 60.67 nm and Sa=55.48 nm, respectively. All strains of bacteria colonized 3D- printed raw plates more densely than commercial plates. The microscopic visualization showed biofilm mostly in irregular cavities of printed plates while on commercial plates it was mainly located along the edges. The research has indicated that there is need for further development of this technology to optimize its effectiveness and safety. [ABSTRACT FROM AUTHOR]

Background: This retrospective, cross-sectional study investigated changes in corneal lower- and higher-order aberrations that cause visual disturbance after lateral rectus recession and medial rectus resection in children. Methods: Eighty-five eyes of 85 patients (44 boys; 8.64±2.88 years) who underwent lateral rectus recession and medial rectus resection to correct intermittent exotropia were assessed. The Galilei G4 Dual Scheimpflug Analyzer was used for wavefront analysis. Risk factors (age, sex, amount of surgery, preoperative axial length, preoperative intraocular pressure) were determined. Outcome measures included simulated and ray-tracing mode keratometry with secondary defocus, oblique, and vertical astigmatism (for lower-order aberrations) and the root mean square, 3rd-order vertical and horizontal coma, oblique and horizontal trefoil, 4th-order spherical aberration, oblique and vertical secondary astigmatism, and oblique and vertical quadrafoil (2nd‒8th sums) (for higher-order aberrations). Results: Myopic with-the-rule changes in low-order aberrations and increases in simulated and ray-tracing mode keratometry during the 3 months following lateral rectus recession and medial rectus resection were attributed to muscle healing and stability changes. High-order aberrations altered in the week following surgery almost returned to normal within 3 months. Axial length, the amount of surgery, age, and sex affected astigmatism due to differences in patients' scleral states. Conclusions: Clinicians should consider changes in high-order aberrations of young individuals who underwent lateral rectus recession and medial rectus resection and may not be able to verbalize changes in vision. [ABSTRACT FROM AUTHOR]

Background: The cross-sectional area of three parallel screws might affect the stability of the internal fixation of femoral neck fractures. The screws fixed in the oblique-triangle configuration (OTC) were assumed to have a larger cross-sectional area, but the biomechanical stability has not yet been validated. In this study, finite element analyses were performed to compare the biomechanical properties of the internal fixation fixed by the OTC and the traditional Inverted Equilateral Triangle Configuration (IETC).Method: Pauwels type III fracture was established on the three-dimensional femoral model and three cannulated screws with the OTC and traditional IETC methods were applied. The oblique-triangle configuration with the largest area inscribed the femoral neck isthmus by the three screws was determined, the area and circumference of the cross-section formed by the OTC and IETC model were compared. Stress, strain, and displacement peaks of the two configuration models under different loads were compared. Twelve pairs of nodes on the fracture ends were selected and the displacement of the fracture ends was evaluated through the displacement between these nodes.Results: The area and circumference of the cross-section formed by the OTC were larger than those in the IETC model. The degree of stress dispersion around the screw holes in the OTC model was better than that of the IETC, but the stress distribution order of the three screws in the two models was consistent. The maximum stress, strain, displacement, and displacement of the fracture end in the OTC model were smaller than those in the IETC model. The stress, strain, displacement, and fracture end displacement peaks of the two fixed models gradually increase with the increase of loads.Conclusion: The oblique-triangle configuration showed superior mechanical properties than the IETC in finite element analyses. This study suggests that when three screws are fixed in parallel method, the larger the cross-sectional area of the screw configuration, the better stability of the internal fixation might be obtained. Furthermore, the biomechanical properties of various spatial configurations and screw holes of the three parallel screws need to be considered before clinical practice. [ABSTRACT FROM AUTHOR]

The maize (Zea mays) stem is a biological structure that must balance both biotic and structural load bearing duties. These competing requirements are particularly relevant in the design of new bioenergy crops. Although increased stem digestibility is typically associated with a lower structural strength and higher propensity for lodging, with the right balance between structural and biological activities it may be possible to design crops that are high-yielding and have digestible biomass. This study investigates the hypothesis that geometric factors are much more influential in determining structural strength than tissue properties. To study these influences, both physical and in silico experiments were used. First, maize stems were tested in three-point bending. Specimen-specific finite element models were created based on x-ray computed tomography scans. Models were validated by comparison with experimental data. Sensitivity analyses were used to assess the influence of structural parameters such as geometric and material properties. As hypothesized, geometry was found to have a much stronger influence on structural stability than material properties. This information reinforces the notion that deficiencies in tissue strength could be offset by manipulation of stalk morphology, thus allowing the creation of stalks which are both resilient and digestible. [ABSTRACT FROM AUTHOR]

In cases of severe bone tissue injuries, the use of metallic bioimplants is quite widespread due to their high strength, high fracture toughness, hardness, and corrosion resistance. However, they lack adequate biocompatibility and show poor metal-tissue integration during the post-operative phase. To mitigate this drawback, it is beneficial to add a biocompatible polymer layer to ensure a quick growth of cell or tissue over the surface of metallic bioimplant material. Furthermore, this additional layer should possess good adherence with the underlying material and also accompany a rapid bonding between the tissue and the implant material, in order to reduce the recovery time for the patient. Therefore, in this work, we report a novel green electroplating route for growing porous hydroxyapatite-brushite coatings on a stainless steel surface. The malic acid used for the production of hydroxyapatite-brushite coatings has been obtained from an extract of locally available apple fruit (Malus domestica). We demonstrate the effect of electroplating parameters on the structural morphology of the electroplated composite layer via XRD, SEM with EDS, and FTIR characterization techniques and report an optimized set of electroplating parameters that will yield the best composite coating in terms of thickness, adherence to substrate and speed. The hemocompatibility and osteocompatibility studies on the electroplated composites coating show this technology's effectiveness and potential applicability in biomedical applications. Compared to other routes reported in the literature, this electroplating route is quicker and yields better composite coatings with faster bone tissue growth potential. [ABSTRACT FROM AUTHOR]

To compare the detection value of third-generation sequencing (TGS) with pathogenic microbial culture in prosthetic joint infection (PJI). Arthrocentesis was performed on 29 patients who underwent hip and knee revision surgeries. In the PJI group, TGS detected 85.71 % of positive cases, while pathogenic microbial culture detected only 42.85 %. TGS identified 17 different pathogenic microorganisms, including Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus lactis, and Mycobacterium tuberculosis complex. In the loosening group, TGS was positive in one patient, while microbial culture was negative in all cases. TGS showed higher sensitivity (85.71 % vs. 42.85 %), comparable specificity (93.33 % vs. 100 %), and similar positive predictive value (92.31 % vs. 100 %) compared to culture.However, TGS had a higher negative predictive value (87.5 % vs. 65.22 %).Additionally, TGS provided faster results (mean time 23.8±3.6 h) compared to microbial culture (mean time 108.0±9.4 h).These findings suggest that TGS holds promise for detecting pathogenic microorganisms in PJI and has potential for clinical application. [ABSTRACT FROM AUTHOR]

The role of extracellular matrix (ECM) remodeling in the axial elongation associated with myopia has not been fully elucidated, although it is considered a significant factor. EFEMP1, a regulator of ECM, has been associated with various pathological conditions. This study aimed to examine the involvement of EFEMP1 in scleral remodeling during form deprivation myopia. The results indicate a progressive increase in EFEMP1 expression following prolonged form deprivation treatment, followed by a subsequent decrease upon recovery. To gain a deeper understanding of the mechanism of EFEMP1, we conducted transcriptome sequencing on primary scleral fibroblasts that were subjected to lentivirus-mediated overexpression of EFEMP1. Validation was performed using lentivirus-induced overexpression and shRNA targeting EFEMP1 in combination with LY294002, a PI3K inhibitor. Our findings suggest that EFEMP1 may be involved in the development of FDM by regulating the expression of the PI3K/AKT/MMP2 axis. The AAV-mediated injection of shEFEMP1 under Tenon's capsule in guinea pigs was observed to effectively delay the progression of myopia and posterior scleral remodeling. In contrast, the AAV-mediated overexpression of EFEMP1 exacerbated the development of myopia and resulted in further thinning of collagen fibers in the posterior sclera. In summary, adjusting EFEMP1 concentrations could potentially serve as a viable approach to prevent and treat myopia by influencing the remodeling process of the posterior sclera. • The expression of EFEMP1 in guinea pig sclera increased during FDM development and subsequently decreased after recovery. • EFEMP1 modulated the expression levels of Collagen I and ACAN in scleral fibroblasts through the PI3K/AKT/MMP2 axis. • EFEMP1 is involved in the development of FDM by regulating scleral remodeling through the PI3K/AKT/MMP2 axis. [ABSTRACT FROM AUTHOR]

This study is aimed at predicting the characteristics of vibration and sound radiation of violins and understanding the relationships among the properties of its wood, vibration, and sound radiation. Numerical simulations of the vibration mode of a violin body are performed, and the sound radiated by it are analyzed using the finite element method. The geometry of a real violin is scanned using a micro-computed tomography scanner, and the orthotropic properties of spruce and maple, such as Young's modulus, rigidity modulus, and Poisson's ratio, are set as the parameters of the numerical simulation. The main vibration modes, such as A0 and center bout rotation, and the acoustic pressure level around the violin body are calculated. This paper describes the influence of the density and longitudinal stiffness on the eigenfrequencies and sound radiation. [ABSTRACT FROM AUTHOR]

Background: Recruitment to surgical randomised controlled trials (RCTs) can be challenging. The Sunflower study is a large-scale multi-centre RCT that seeks to establish the clinical and cost effectiveness of pre-operative imaging versus expectant management in patients with symptomatic gallstones undergoing laparoscopic cholecystectomy at low or moderate risk of common bile duct stones. Trials such as Sunflower, with a large recruitment target, rely on teamworking. Recruitment can be optimised by embedding a QuinteT Recruitment Intervention (QRI). Additionally, engaging surgical trainees can contribute to successful recruitment, and the NIHR Associate Principal Investigator (API) scheme provides a framework to acknowledge their contributions.Methods: This was a mixed-methods study that formed a component part of an embedded QRI for the Sunflower RCT. The aim of this study was to understand factors that supported and hindered the participation of surgical trainees in a large-scale RCT and their participation in the API scheme. It comprised semi-structured telephone interviews with consultant surgeons and surgical trainees involved in screening and recruitment of patients, and descriptive analysis of screening and recruitment data. Interviews were analysed thematically to explore the perspectives of-and roles undertaken by-surgical trainees.Results: Interviews were undertaken with 34 clinicians (17 consultant surgeons, 17 surgical trainees) from 22 UK hospital trusts. Surgical trainees contributed to patient screening, approaches and randomisation, with a major contribution to the randomisation of patients from acute admissions. They were often encouraged to participate in the study by their centre principal investigator, and career development was a typical motivating factor for their participation in the study. The study was registered with the API scheme, and a majority of the trainees interviewed (n = 14) were participating in the scheme.Conclusion: Surgical trainees can contribute substantial activity to a large-scale multi-centre RCT. Benefits of trainee engagement were identified for trainees themselves, for local sites and for the study as a whole. The API scheme provided a formal framework to acknowledge engagement. Ensuring that training and support for trainees are provided by the trial team is key to optimise success for all stakeholders. [ABSTRACT FROM AUTHOR]

The huge rise in seaweed-derived bioactive compounds demands immediate attention of under-explored seaweed species. The oceanic bio-resources in the tidal stretch of the Andaman Islands are relatively unknown. The present study explores seven intertidal regions of South Andaman Island to understand the species richness and existing seaweed biomass. Biochemical and fatty acid components were assessed for 15 seaweed species, commonly available in the study sites. A total of 67 species of seaweeds were collected during a one-year survey, most of which belonged to Chlorophyta, Rhodophyta and a few in Phaeophyta. The species richness was higher in sandy and coarse substrata, while highest species density was found on rocky shores. The P value for species richness at 5.05E-15 also validated the variation in seaweed distribution and diversity in the selected locations. The nutritional composition varied significantly among the species and was mostly characterized by higher levels of carbohydrate especially in Gracilaria spp. Carbohydrate content ranging from 3.52–48.22% accounted for most of the nutrient component. The overall protein ranged between 2.41–18.67%, whereas the total lipid varied from 2.16–11.90% and about 10% of total lipid content was available in most species. The significant outcome of this study was the detection of 6.34% EPA in Boergesenia forbesii and 2.40% of gamma linolenic acid in Acetabularia acetabulum which could be of significant importance in the food, bioenergy, pharmaceutical and cosmetic industries. [ABSTRACT FROM AUTHOR]

The loggerhead sea turtle, Caretta caretta (Linnaeus, 1758), is the most common sea turtle species in the Mediterranean Sea, where it can experience severe anthropogenic impacts. Although C. caretta is known to host more than 200 epibiotic taxa (crustaceans, algae and cyanobacteria), no reports have included a detailed evaluation of the microbial community of its carapace scutes. Thus, this study aimed to determine the diversity and composition of the visible and invisible communities on the carapace scutes of wild loggerhead turtles from the Aeolian Archipelago (Southern Tyrrhenian Sea, Italy) by using a combined approach of morphological/spatial examination and molecular analyses. Altogether, our results displayed a higher abundance of crustaceans, macroalgae and Proteobacteria on the posterior carapace scutes, while Firmicutes were more abundant on the anterior scutes. For the first time, this study showed the complexity of the microbial (invisible) and visible epibionts of the loggerhead sea turtles from the Mediterranean Sea and suggests the importance of including evaluation of the microbial components when studying epibiont communities. [ABSTRACT FROM AUTHOR]

Here, we present new transcriptome sequencing data from seven species of Dasycladales (Ulvophyceae) and a phylogenomic analysis of the Chlorophyta with a particular focus on Ulvophyceae. We have focused on a broad selection of green algal groups and carefully selected genes suitable for reconstructing deep eukaryote evolutionary histories. Increasing the taxon sampling of Dasycladales restructures the Ulvophyceae by identifying Dasycladales as closely related to Scotinosphaerales and Oltmannsiellopsidales. Contrary to previous studies, we do not find support for a close relationship between Dasycladales and a group with Cladophorales and Trentepohliales. Instead, the latter group is sister to the remainder of the Ulvophyceae. Furthermore, our analyses show high and consistent statistical support for a sister relationship between Bryopsidales and Chlorophyceae in trees generated with both homogeneous and heterogeneous (heterotachy) evolutionary models. Our study provides a new framework for interpreting the evolutionary history of Ulvophyceae and the evolution of cellular morphologies. [ABSTRACT FROM AUTHOR]

The metaphyseal osteopathy can occur in young cats, predominantly in males, overweight, non-traumatic, and can be one or both femoral necks. It's characteristic radiographic called "apple core". Histopathological examination revealed the presence of tissue fibrosis and irregular chondrocytes and ungrouped. Orthopedic clinical evaluation shows intermittent claudication during walking, pain on palpation, crackling on manipulation of the affected limb. This study aims to report the occurrence of the disease in ten cats, including female, in which the surgical resolution consisted of excisional arthroplasty of the head and femoral neck. Therefore, metaphyseal osteopathy should be included as an orthopedic clinical suspicion in cats with this type of symptomatology, without presenting a pre-disposition for the onset of this condition. [ABSTRACT FROM AUTHOR]