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Objective: To examine the association between obesity and knee and hip arthroplasty for osteoarthritis across a range of physical performance.Method: The body mass index and physical performance (on the 36-item Short Form Health Survey) of 9135 Australian Diabetes, Obesity and Lifestyle Study participants were measured in 1999-2000. The incidence of knee and hip arthroplasty during 2002-2011 was determined by linking the cohort records to the Australian Orthopaedic Association National Joint Replacement Registry.Results: Over 9.1 ± 2.3 years (mean ± sd)) of follow-up, 317 participants had knee and 202 had hip arthroplasty for osteoarthritis. Using those with neither obesity nor significantly impaired physical performance as the reference group, participants with both obesity and significantly impaired physical performance had a higher knee arthroplasty risk [hazard ratio (HR) = 5.25, 95% confidence interval (CI) 3.85-7.14] than those with obesity alone (HR = 2.49, 95% CI 1.81-3.44) or impaired physical performance alone (HR = 2.19, 95% CI 1.59-3.02). Similar results were observed for hip arthroplasty (obesity and impaired physical performance: HR = 2.67, 95% CI 1.72-4.15; obesity alone: HR = 1.65, 95% CI 1.08-2.51; impaired physical performance alone: HR = 1.83, 95% CI 1.26-2.66). Among overweight/obese patients, 5 kg greater baseline weight increased the knee arthroplasty risk across all levels of physical performance, and hip arthroplasty risk in those with the highest level of physical performance.Conclusion: Although impaired physical performance is an independent risk factor for knee and hip arthroplasty, greater weight increased knee arthroplasty for overweight/obese participants at all levels of physical performance, but hip arthroplasty only in those with good physical performance. Targeting weight loss has the potential to reduce the risk of knee arthroplasty and improve patient outcomes, even in those with poor physical performance. [ABSTRACT FROM AUTHOR]

Posterior cruciate ligament (PCL) injuries occur much less frequently than other ligament injuries of the knee such as anterior cruciate ligament injuries. There is general agreement for nonoperative treatment for lower grade injuries such as type I PCL injuries. However, for more severe injuries which may require surgery, there is no consensus on an optimal reconstruction method. Multiple arthroscopic and open techniques exist to reconstruct the PCL. Limited clinical outcomes data reveals good short-term clinical results with different reconstruction options. Biomechanical data has helped further the understanding regarding the performance of different reconstructions. This article will present a surgical technique for single bundle tibial inlay reconstruction of the PCL along with the objective biomechanical data that supports this reconstruction. [ABSTRACT FROM AUTHOR]

BACKGROUND: Patients undergoing chronic hemodialysis (HD) require placement of permanent vascular access with the creation of an arteriovenous fistula (AVF), an arteriovenous prosthetic graft (AVG), or a tunneled central venous catheter. AVFs provide greater long-term patency, fewer complications, and lower infection rates than do either AVGs or catheters. Despite these advantages, women continue to be underrepresented among AVF patients, possibly because of concerns about smaller vascular diameters and higher rates of early primary fistula failure in female HD patients. The numerous clinical benefits of AVF suggest that a greater effort should be made to promote AVF placement in women. OBJECTIVE: This review analyzes risk factors for AVF failure in women and describes clinical strategies to improve AVF utilization and success for female HD patients. METHODS: English-language publications were identified through a MEDLINE database search from January 1997 to March 2007, using the search terms arteriovenous fistula, vascular access, hemodialysis, female, and gender. Reference lists of identified articles were also reviewed. RESULTS: There are significant benefits to using AVFs instead of AVGs or catheters in HD patients: greater long-term fistula patency, superior flow rates, and fewer complications. Vascular anatomical differences between the sexes contribute to the underutilization of AVF in women. AVF placement rates can be improved if patients and staff are adequately educated and provided with the tools to facilitate AVF placement. Noninvasive preoperative screening is important to identify superior access sites in women. Intraoperative monitoring of blood flow is a reliable predictor of early radiocephalic AVF patency. Routine postoperative vascular monitoring may improve overall success with AVF, and exercise may improve vascular diameter and may be even more beneficial for women, who may have smaller preoperative veins. CONCLUSIONS: Concerns about smaller vascular diameters and reports of higher failure rates in women may prevent nephrologists and surgeons from considering AVF for female HD patients. The numerous advantages associated with AVF suggest that a greater effort should be made to increase its utilization in women. With appropriate motivation, care, and diligence by treating clinicians, the success of AVFs in women can approach the good results typically expected in men. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to report the complication of perforation of the superior vena cava (SVC) leading to cardiac tamponade after the insertion of a Trapease IVC filter in the SVC position. A 29-year-old man was hit by motor vehicle and sustained numerous injuries including a left skull fracture, intracerebral hemorrhage, and left open tibial shaft fracture. During his hospitalization, he developed an extensive symptomatic right upper extremity deep venous thrombosis involving the brachial, axillary, subclavian, internal jugular, and brachiocephalic veins. Owing to an intracerebral bleed, anticoagulation was contraindicated. Therefore, a Trapease filter (Cordis Inc.) was placed in the SVC via the left subclavian vein. Four hours later, the patient became hypotensive with associated tachycardia and tachypnea. Computed tomography of his chest revealed a hematoma around the SVC, a moderate amount of fluid within the pericardium, and a moderate-sized right pleural effusion. The patient was taken to the operating room and a pericardial window was performed. Approximately 500 cc of blood was evacuated from the pericardium and immediate improvement in vital signs was noted. The patient was discharged from the hospital 2 weeks later and at 6-month follow-up had made full recovery. This is the first case of SVC perforation leading to cardiac tamponade after the insertion of a Trapease filter. Owing to the rigid structure of the filter and associated motion of the SVC and pericardium, the Trapease filter may be contraindicated in the SVC. [ABSTRACT FROM AUTHOR]

Background: Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are commonly ordered tests in general medical practice. However, their distribution and significance in older adults is understudied. As such, we aimed to evaluate sex-stratified distribution of both ALT and AST in older adults (≥ 70 years) and assess for associations with mortality., Methods: Post-hoc analysis of the ASPirin in Reducing Events in the Elderly (ASPREE) randomised, placebo-controlled trial of daily low-dose aspirin for initially relatively healthy older persons. Univariate analysis and multiple logistic regression were used to explore baseline characteristics. Cox regression and restricted cubic splines were used to examine links between transaminase levels and mortality., Results: Of the 11853 participants with ALT and AST levels, 1054 (8.9%) deaths were recorded over median 6.4 (IQR 5.4-7.6) years. For ALT, the lowest quintiles for males and females were 6-15 U/L and 5-13 U/L respectively; for AST, the lowest quintiles were 8-18 U/L and 7-17 U/L. On both univariate and models adjusted for covariates including age, BMI, frailty, diabetes, and kidney disease, males and females in the lowest quintile of ALT had an increased hazard of mortality (aHR 1.51 [95% CI 1.14-1.99] and aHR 1.39 [95% CI 1.03-1.88] respectively). For the lowest quintile of AST, only males were at increased risk (aHR 1.33 [95% CI 1.04-1.70]). Associations remained significant when removing outliers., Conclusion: Low ALT levels independently confer an increased hazard of mortality for older males and females; low AST only impacted older male survival. Further evaluation of mechanisms would be worthwhile, and re-evaluating the lower limit of normal for ALT in older adults should be considered., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America.)

Background: Flow diversion (FD: flow diversion, flow diverter) is an endovascular treatment for many intracranial aneurysm types; however, limited reports have explored the use of FDs in bifurcation aneurysm management. We analyzed the safety and efficacy of FD for the management of intracranial bifurcation aneurysms., Methods: A systematic review identified original research articles that used FD for treating intracranial bifurcation aneurysms. Articles with >4 patients that reported outcomes on the use of FDs for the management of bifurcation aneurysms along the anterior communicating artery (AComA), internal carotid artery terminus (ICAt), basilar apex (BA), or middle cerebral artery bifurcation (MCAb) were included. Meta-analysis was performed using a random effects model., Results: 19 studies were included with 522 patients harboring 534 bifurcation aneurysms (mean size 9 mm, 78% unruptured). Complete aneurysmal occlusion rate was 68% (95% CI 58.7% to 76.1%, I 2 =67%) at mean angiographic follow-up of 16 months. Subgroup analysis of FD as a standalone treatment estimated a complete occlusion rate of 69% (95% CI 50% to 83%, I 2 =38%). The total complication rate was 22% (95% CI 16.7% to 28.6%, I 2 =51%), largely due to an ischemic complication rate of 16% (95% CI 10.8% to 21.9%, I 2 =55%). The etiologies of ischemic complications were largely due to jailed artery hypoperfusion (47%) and in-stent thrombosis (38%). 7% of patients suffered permanent symptomatic complications (95% CI 4.5% to 9.8%, I 2 =6%)., Conclusion: FD treatment of bifurcation aneurysms has a modest efficacy and relatively unfavorable safety profile. Proceduralists may consider reserving FD as a treatment option if no other surgical or endovascular therapy is deemed feasible., Competing Interests: Competing interests: MB is a consultant for Cerenovus, consultant for Integra, and a member of the advisory board for Stryker. GT is a consultant for Dynamed and a Steering Committee member for Medtronic. GT is an Associate Editor for Journal of Neurointerventional Surgery. All other authors have no conflicts of interest to report., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Baeyer-Villiger oxidation is a well-known reaction utilized for the synthesis of lactones and ester functionalities from ketones. Chiral lactones can be synthesized from chiral or racemic ketones by employing asymmetric Baeyer-Villiger oxidation. These lactones act as key intermediates in the synthesis of most of the biologically active natural products, their analogues, and derivatives. Various monooxygenases and oxidizing agents facilitate BV oxidation, providing a broad range of synthetic applications in organic chemistry. The variety of enzymatic and chemoselective Baeyer-Villiger oxidations and their substantial role in the synthesis of natural products i.e. , alkaloids, polyketides, fatty acids, terpenoids, etc. (reported since 2018) have been summarized in this review article., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Importance: Age-related hearing loss is common in an aging population, affecting communication and contributing to a worsened quality of life. It occurs as a result of cochlear degeneration and may be further exacerbated by inflammation and microvascular changes, as observed in animal models., Objective: To compare the effect of daily low-dose aspirin vs placebo on the progression of age-related hearing loss in healthy older adults., Design, Setting, and Participants: A prespecified secondary analysis was conducted of the Aspirin in Reducing Events in the Elderly (ASPREE) randomized clinical trial. Participants were 279 healthy community-dwelling individuals living in Australia who were aged 70 years or older and free of overt cardiovascular diseases, dementia, and life-limiting illnesses. Participants were recruited between January 1, 2010, and December 31, 2014, and followed up over 3 years. Statistical analysis was completed from June to December 2023., Intervention: A 100-mg daily dose of enteric-coated aspirin or matching placebo., Main Outcomes and Measures: Hearing measures were air conduction audiometry and binaural speech perception in noise. Assessments were conducted at baseline, 18 months, and 3 years. The change from baseline hearing measures were analyzed using an intention to treat approach. Aspirin and placebo were compared using mixed linear regression models adjusting for age, sex, diabetes, and smoking., Results: Of 279 participants, 154 (55%) were male, and the median age at baseline was 73.1 years (IQR, 71.5-76.2 years). A total of 98 of 138 participants (71%) in the aspirin group and 94 of 141 participants (67%) in the placebo group reported experiencing hearing loss at baseline. Compared with placebo, aspirin did not affect the changes in mean (SD) 4-frequency average hearing threshold from baseline to year 3 (aspirin: baseline, 27.8 [13.3] dB; year 3, 30.7 [13.7] dB; difference, 3.3 [3.9] dB; placebo: baseline, 27.5 [12.6] dB; year 3, 30.9 [13.8] dB; difference, 3.0 [4.8] dB; P = .55) nor any other tested frequencies. An increase in air conduction threshold indicates a deterioration in hearing. Similarly, for the mean (SD) speech reception threshold, there was no significant difference observed between the aspirin and placebo group at the year 3 follow-up assessment (aspirin: baseline, -9.9 [3.8] dB; year 3, -9.1 [3.8] dB; difference, 0.9 [2.9] dB; placebo: baseline, -10.5 [7.1] dB; year 3, -9.6 [4.1] dB; difference, 0.9 [5.9] dB; P = .86). The findings were consistent across sex, age groups, diabetic and smoking status., Conclusions and Relevance: In this secondary analysis of the ASPREE randomized clinical trial, low-dose aspirin did not affect the progression of age-related hearing loss. More investigation is warranted on whether a longer follow-up or the use of a more powerful anti-inflammatory agent might prove beneficial., Trial Registration: anzctr.org.au Identifier: ACTRN12614000496617.

Biochar, an organic carbonaceous matter, is a unique feed additive that is now being used in aquaculture industry to formulate a cost-effective and eco-friendly diet. This experiment (in door) was conducted over course of 90 days to determine the most effective form of biochar, produced from various sources, for supplementation in Moringa oleifera seed meal-based diet. These sources were: farmyard manure biochar, parthenium biochar (PB), vegetable waste biochar, poultry waste biochar (PWB) and corncob waste biochar, added at 2 g/kg concentration to determine the effect of supplementation on the growth indices, nutrient absorption, carcass composition, haematology and mineral status of Labeo rohita (rohu) fingerlings. The research design consisted of six test diets with three replications (6 × 3) of each. Total of 270 fingerlings (6.30 ± 0.020 g) were fed at 5% body weight and 15 of them were kept in separate steel tanks. The results indicated that PWB was most effective in improving weight gain (285.58 ± 4.54%) and feed conversion ratio (1.060 ± 0.040) compared to control diet and other test diets. The same type of biochar (PWB) produced the best results for nutrient digestibility, that is, crude protein, crude fat and gross energy and carcass composition. In terms of haematology and mineral status, PWB showed the best results. In conclusion, it was found that PWB significantly enhanced (p < 0.05) L. rohita fingerling's growth, carcass composition, nutrient digestibility, haematological parameters (red blood cells, white blood cells, platelets and haemoglobin) and mineral composition (Ca, Na, P, Mg, Fe, Mn, Zn, K and Cu) whereas PB negatively affected all parameters. It is anticipated that the potential use of biochar will increase in aquaculture industry, as research on its incorporation in fish feeds is still limited., (© 2024 Wiley‐VCH GmbH. Published by John Wiley & Sons Ltd.)

The following investigation was carried out to determine the effects of Selenium nanoparticles (Se NPs) on the growth rates, nutrient digestibility, and hematology of Cirrhinus mrigala fingerlings fed sunflower meal as basal diet. The experiment included seven test diets with varying Se levels (0, 0.5, 1, 1.5, 2, 2.5, and 3 mg/kg) based on Se NPs supplementation. Chromic oxide, an inert maker, was also added. Fingerlings were fed at a rate of 5% of their body weight. The test meal of 1 mg/kg Se NPs resulted in the highest weight gain (12.31 g) and the lowest feed conversion ratio (1.58). Best hematological indices (RBCs 2.84 10 6 mm -3 , WBCs 7.79 10 3 mm -3 , PLT 66, Hb 8.5 g/100 ml, PCV 25% and MCV 190 fl) and maximum nutrient absorption (crude protein 72%, ether extract 73% and gross energy 67%) were also observed in the case of 1 mg/kg supplementation of Se NPs. Hematology studies indicated that when fish were fed 0.5 mg/kg Se NPs, their levels began to rise. Maximum results were achieved with feed containing 1 mg/kg of Se NPs, but when the concentration increased above 1 mg/kg, the values began to decline. Instead, nutrient digestibility began to increase when the concentration of Se NPs increased to 1 mg/kg and abruptly started to decline with a further increase in Se NPs. The results demonstrated that a sunflower meal-based diet supplemented with Se NPs (1 mg/kg) increased the growth performance, nutritional digestibility, and hematology of C. mrigala fingerlings., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier GmbH. All rights reserved.)

Tamarindus indica , a beneficial herb, has many health benefits but there is limited research on its use in fish nutrition industry. The current study investigated the effects of incorporating extracts of T. indica into the canola meal-based diets of Cyprinus carpio (common carp); following which, the growth, digestibility, carcass and hematological markers were assessed. A total of six diets were formulated with varying concentrations of T. indica extracts (TIE) viz, 0 %, 0.5 %, 1 %, 1.5 %, 2 % and 2.5 %. The fish (N = 270, 15 fish/tank with triplicates) in each tank were fed experimental diets for 70 days. The study demonstrated that TIE supplementation significantly improved the growth of common carp when compared to 0 % TIE level (control). The best results were observed at 1 % TIE level for the specific growth rate (1.68 ± 0.03 %), weight gain (15.00 ± 0.57 g), and feed conversion ratio (1.36 ± 0.05). Conversely, the 2.5 % TIE level gave the least improvement in terms of growth performance. Specifically for nutrient digestibility, the maximum values of crude protein (CP, 67.60 ± 0.83 %), crude fat (CF, 67.49 ± 0.45 %) and gross energy (GE, 70.90 ± 0.56 %) were recorded at 1 % TIE level. In addition, the best results of body composition (protein: 63.92 ± 0.06 %, ash: 18.60 ± 0.03 %, fat: 7.12 ± 0.02 % and moisture: 10.36 ± 0.04 %) and hematological indices, were measured in carps fed with 1 % supplementation level. In conclusion, the overall health of C. carpio fingerlings was improved with TIE supplementation in the diet containing 1 % TIE., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Oreochromis niloticus fingerlings (5.15 ± 0.02 g; n = 315) were fed with different types of biochar (BC)-supplemented sunflower meal-based (SFM) diet to investigate the effects of various BC inclusions on their nutritional digestibility, body composition, hematology and mineral status for 60 days. Seven different diets were formulated based on the SFM based diet: one was a control (TD-I, CON) and the other six diets were supplemented with 2% BC derived from different sources. These BCs were derived from the following: cotton stick (CSBC, TD-II), wheat straw (WSBC, TD-III), corn cob (CCBC, TD-IV), house waste (HWBC, TD-V), grass waste (GWBC, TD-VI), and green waste (GwBC, TD-VII) biochar. There were three replicates for each test diet. Each tank had fifteen tilapia fingerlings, and they were fed with 5% of their live wet weight and twice daily. The outcomes showed that the supplementation of CCBC significantly elevated the growth, nutrient absorption, and body composition of the O. niloticus fingerlings (p < 0.05); with concomitant lowering of the quantity of nutrients released into the water bodies whereas HWBC gave negative impacts. The maximal mineral absorption efficiency (Ca, Na, K, Cu, Fe, P, and Zn) was achieved by the supplementation of 2% CCBC. All hematological parameters showed positive improvements (p < 0.05) with CCBC. Interestingly, CCBC significantly improved the growth, digestibility, body composition, hematology, and mineral status of O. niloticus., (© 2024. The Author(s).)