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Introduction: The present inquiry seeks to investigate whether the current regimens of QSEs (Quadriceps-Strengthening Exercises) aggravate the disease while mitigating symptoms. Materials and methods: A comparative study was conducted on 32 patients with medial compartment osteoarthritis of knees. While the neutral group of 16 patients was constituted of those with an anatomical-lateral-femoro-tibial-angle (aFTA) 176-180º, varus group comprised an equal number of patients with an aFTA >180º. A home-based 12-week strength-training program involving weekly visitsto hospital for supervised sessions was administered. The outcome measures were visual-analog-scale (VAS), medial patello-femoral joint tenderness (MPFJT), time-up-and-go-test (TUGT), stair-climb test, step test, WOMAC, IKDC scores, aFTA, hip-knee-ankle (HKA) angle, lateral-tibio-femoral-joint-separation (LTFJS), and horizontal-distance-from-centre-of-knee-to-Mikulicz-line. Results: There was a significant increase in quadriceps strength (p

Paul J Lynch,1 Goran Tubic,2 Jeffrey M Foster,3 Shawn Puri,4 Candice A Burnette,5 Jon E Block6 1Arizona Pain, Scottsdale, AZ, USA; 2Chicagoland Pain Management, Bolingbrook, IL, USA; 3Saint Luke’s Hospital Pain Management Clinic, Kansas City, MO, USA; 4Relievus Pain Management, Havertown, PA, USA; 5Modern Pain Management, Sugar Land, TX, USA; 6Private Practice, San Francisco, CA, USACorrespondence: Jon E Block, Email jb@drjonblock.comAbstract: Minimally invasive sacroiliac joint (SIJ) fusion is the preferred surgical method for managing patients with recalcitrant, chronically severe SIJ pain and dysfunction refractory to conservative medical measures. The primary surgical objective of all minimally invasive SIJ fusion procedures is to provide immediate stabilization within the joint space to support osseous consolidation and the development of a mechanically solid arthrodesis. The intra-articular surgical approach to the SIJ with allograft bone placement utilizes a trajectory and easily identifiable landmarks that allow the surgeon to control the risk of violating important neuro-vascular structures. The intra-articular approach can employ a superior or inferior operative trajectory, with the former restricted to allograft placement in the ligamentous portion of the SIJ. The inferior approach utilizes decortication to surgically create a channel originating in the purely articular portion of the joint space allowing for truly intra-articular implant placement within the osseous confines of the ilium and sacrum. Positioning the implant along the natural joint line and securing it within the underlying sub-chondral bone, mortise and tenon fashion provides stabilization and large surface area contact at the bone implant interface. The inferior, intra-articular approach also places the implant perpendicular to the S1 endplate, near the sacral axis of rotation, which addresses the most significant biomechanical forces across the joint. Short-term, post-surgical observational data from a 57 patient multi-center registry using the inferior, intra-articular approach show uniform and statistically significant improvement in all clinical outcomes (p < 0.001 for all comparisons), including an average 3-point improvement in back pain severity from 6.8 preoperatively to 3.8 at 6 months. Further clinical evaluation with longer-term follow-up of the inferior, intra-articular SIJ fusion procedure is encouraged.Keywords: sacroiliac, fusion, intra-articular, minimally invasive, allograft

Epigallocatechin gallate (EGCG) is a major component of green tea polyphenols having a potent anti-oxidant potential. Besides inhibiting the growth of many cancer cell types and inducing proliferation and differentiation in keratinocytes, it has been shown to promote reduction of body fat. The fact that mesenchymal stem cells (MSCs) have ability to self-renew and differentiate into the cells of mesodermal lineages, such as fat and bone, it is, thus, possible that EGCG may directly be involved in affecting fat metabolism through its effect on mesenchymal stem cells. Hence, with this aim, the present study was designed to determine the effect of EGCG on mouse mesenchymal stem cells, C3H10T1/2 cells differentiation into adipocytes. To understand this process, the cells were incubated with varying concentrations of EGCG (1 µM, 5 µM, 10 µM, 50 µM) in the presence and /or absence of adipogenic medium for 9 days. The results demonstrated that, EGCG inhibited the cells proliferation, migration and also prevented their differentiation to adipogenic lineage. These effects were analyzed through the inhibition of wound healing activity, reduction in Oil red O stained cells, together with decrease in the expression of Adipisin gene following EGCG treatment. These observations thus demonstrated anti-adipogenic effect of EGCG with a possibility of its role in the therapeutic intervention of obesity.

Ian C Han,1 Sidharth Puri,1 Jiangxia Wang,2 Shameema Sikder1 1Wilmer Eye Institute, Johns Hopkins University School of Medicine, 2Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA Purpose: The purpose of this study was to evaluate whether subspecialty training of the initial treating surgeon affects visual acuity and surgical outcomes in patients with open globe injuries.Design: This study is a single-institution, retrospective case series.Methods: The charts of adult patients with open globe injuries requiring surgical repair at the Wilmer Eye Institute between July 1, 2007 and July 1, 2012 were retrospectively reviewed. Clinical findings at presentation were recorded, and details of initial repair and follow-up surgeries were analyzed. Differences in visual acuity and surgical outcomes were compared based on subspecialty training of the initial surgeon.Results: The charts of 282 adult patients were analyzed, and 193 eyes had at least 6 months of follow-up for analysis. Eighty-six eyes (44.6%) required follow-up surgery within the first year, and 39 eyes (20.2%) were enucleated. Eyes initially treated by a vitreoretinal (VR) surgeon were 2.3 times (P=0.003) more likely to improve by one Ocular Trauma Score (OTS) visual acuity category and 1.9 times (P=0.027) more likely to have at least one more follow-up surgery at 6 months compared to eyes treated by non-VR surgeons. Patients with more anterior injuries treated by a VR surgeon were more likely to improve by one OTS visual acuity category compared to those treated by non-VR surgeons (P=0.004 and 0.016 for Zones I and II, respectively). There was no difference in visual acuity outcomes for eyes with posterior injuries (P=0.515 for Zone III).Conclusion: Eyes initially treated by a VR surgeon are more likely to improve by one OTS visual acuity category than those initially treated by a non-VR surgeon. However, patients initially treated by a VR surgeon also undergo more follow-up surgical rehabilitation, and improvement in visual acuity is more likely for anterior (Zone I and II injuries) than posterior (Zone III) injuries. Keywords: surgical repair, follow-up surgery, visual acuity, Ocular Trauma Score, vitreoretinal surgeon, afferent pupillary defect

Sidharth Puri,1 Amanda E Kiely,2 Jiangxia Wang,3 Alonzo S Woodfield,4 Saras Ramanathan,5 Shameema Sikder21Johns Hopkins School of Medicine, Baltimore, MD, 2Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 3Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 4Kaiser Permanente South Sacramento Medical Center, Sacramento, 5San Francisco School of Medicine, University of California, San Francisco, CA, USAPurpose: To determine whether supervision by an attending new to surgical teaching or an experienced attending measurably influences intraoperative complications rates or outcomes in phacoemulsification performed by ophthalmology residents.Setting: Single tertiary hospital.Design: Retrospective cohort study. Methods: Resident-performed phacoemulsification cases supervised by one novice attending (N=189) and experienced attending (N=172) over 1 year were included. Data included: resident year, patient age, sex, preoperative risk factors (4+ dense/white/brunescent cataracts, Flomax, zonular dialysis, pseudoexfoliation, glaucoma risk, post-vitrectomy), intraoperative risk factors (Trypan blue, iris hooks), and intraoperative complications (capsule tears, vitreous loss, zonular dialysis, zonular dehiscence, burns, nuclear fragment loss, Descemet’s tear). Experienced attending data were compared against those of the novice attending.Results: Regarding preoperative risks, experienced attending cases more likely involved 4+ cataract (P=0.005), Flomax (P

Ranjit Suresh Mandwe,1 Swapna Puri,2 Shrikant Shingane,1 Ganesh Pawar,1 Vivek Ramdas Kolhe,1 Atul Alsi31Oral and Maxillofacial Surgery Department, VYWS Dental College and Hospital, Amaravati, Maharashatra, India; 2Orthodontia Department, SDK Dental College and Hospital, Nagpur, Maharashatra, India; 3Prosthodontics Department, VYWS Dental College and Hospital, Amaravati, Maharashatra, IndiaAims and objectives: To assess the effect of presurgical nasoalveolar molding (PNAM) therapy in the management of patients with nonsyndromic unilateral cleft lip and palate (UCLP).Material and method: Ten patients with UCLP treated from 2009 to 2012. The initiation for PNAM treatment was 7 days and the average time of the treatment was 175 days. Measurements on patients and of casts were made, and statistical analysis was used to evaluate the changes in pre- and posttreatment measurements.Results: Subsequent to PNAM treatment, there was a statistically considerable rise in cleft nostril height and columellar width. There was reduction in both intraoral cleft width and columellar deviation, which was significant statistically.Conclusion: PNAM treatment reduces alveolar cleft width. It enhances symmetry of the nose by changing columellar angulation, preserving alar width bilaterally, gaining height of the nostril on the affected side, and increasing columellar length.Keywords: unilateral cleft lip and palate, UCLP, presurgical nasoalveolar molding, PNAM, orthodontic resin, cleft lip

A rapid decline in self-renewability, viability and function, of isolated stem cells are major hurdles in developing cell based therapies. There has been an increasing interest towards identifying a support material for maintaining stem cell features of the isolated cells. Pioneering observations of the present paper, demonstrate functionally diverse potential of Solid Lipid Nanoparticles (SLNs) in deciding the fate & behavior of mouse mesenchymal stem cell. The evidences are provided to show the dual nature of the SLNs for being a scaffold for the stem cell attachment, to retain stemness, and as reagent for inducing stem cell differentiation. Scanning electron microscopic examinations together with expression analysis were used to conform to such observations. Results of the study thus suggest that Solid lipid nanoparticles can be used as a good support material when functionalized to achieve adhesive properties and as a molecular paradigm for studying the adipocytic differentiation. We envisage a new role of SLNs towards regulating stem cell character by orchestrating the structural alignment during preparation of Solid lipid nanoparticles.

Transforming stand-alone qubits into a functional, general-purpose quantum processing unit requires an architecture where many-body quantum entanglement can be generated and controlled in a coherent, modular, and measurable fashion. Electronic circuits promise a well-developed pathway for large-scale integration once a mature library of quantum-compatible elements have been developed. In the domain of superconducting circuits, fluxonium has recently emerged as a promising qubit due to its high-coherence and large anharmonicity, yet its scalability has not been systematically explored. In this work, we present a blueprint for a high-performance fluxonium-based quantum processor that addresses the challenges of frequency crowding, and both quantum and classical crosstalk. The main ingredients of this architecture include high-anharmonicity circuits, multipath couplers to entangle qubits where spurious longitudinal coupling can be nulled, circuit designs that are compatible with multiplexed microwave circuitry, and strongly coupled readout channels that do not require complex, frequency-sculpted elements to maintain coherence. In addition, we explore robust and resource-efficient protocols for quantum logical operations, then perform numerical simulations to validate the expected performance of this proposed processor with respect to gate fidelity, fabrication yield, and logical error suppression. Lastly, we discuss practical considerations to implement the architecture and achieve the anticipated performance.

Quantum superpositions of macroscopically distinct classical states--so-called Schrödinger cat states--are a resource for quantum metrology, quantum communication and quantum computation. In particular, the superpositions of two opposite-phase coherent states in an oscillator encode a qubit protected against phase-flip errors.sup.1,2. However, several challenges have to be overcome for this concept to become a practical way to encode and manipulate error-protected quantum information. The protection must be maintained by stabilizing these highly excited states and, at the same time, the system has to be compatible with fast gates on the encoded qubit and a quantum non-demolition readout of the encoded information. Here we experimentally demonstrate a method for the generation and stabilization of Schrödinger cat states based on the interplay between Kerr nonlinearity and single-mode squeezing.sup.1,3 in a superconducting microwave resonator.sup.4. We show an increase in the transverse relaxation time of the stabilized, error-protected qubit of more than one order of magnitude compared with the single-photon Fock-state encoding. We perform all single-qubit gate operations on timescales more than sixty times faster than the shortest coherence time and demonstrate single-shot readout of the protected qubit under stabilization. Our results showcase the combination of fast quantum control and robustness against errors, which is intrinsic to stabilized macroscopic states, as well as the potential of of these states as resources in quantum information processing.sup.5-8. A qubit generated and stabilized in a superconducting microwave resonator by encoding it into Schrödinger cat states produced by Kerr nonlinearity and single-mode squeezing shows intrinsic robustness to phase-flip errors., Author(s): A. Grimm [sup.1] [sup.4] , N. E. Frattini [sup.1] , S. Puri [sup.2] , S. O. Mundhada [sup.1] , S. Touzard [sup.1] , M. Mirrahimi [sup.3] , S. M. [...]

Mutations in the human homolog of the Vhlh gene [encoding the von-Hippel Lindau (VHL) protein] lead to tumor development. In mice, depletion of Vhlh in pancreatic ß-cells causes perturbed glucose homeostasis, but the role of this gene in other pancreatic c

Given the success of Delhi’s CNG vehicle program, energy stakeholders are now investigating a transition to hydrogen-compressed natural gas (H-CNG) blends. Past research has shown H-CNG can reduce tailpipe emissions of both criteria and greenhouse gas pollutants relative to diesel and CNG. Here, we examine hydrogen production via gasification of three abundant, non-fodder residues: rice straw, cotton stalk, and mustard stalk. The total availability of these three residues in districts within 150 km of Delhi is 4,717 kilotons (KTs) per year, enough to produce 270.7 KT per year of hydrogen using gasification. This amount far exceeds what is needed to support the current CNG vehicle population with 18%-82% H-CNG blends. The cost of each step of the biohydrogen supply chain is reported in terms of rupees per kg of hydrogen and the total cost of using biohydrogen in Delhi is estimated to be 149.6 rupees (`) ($3.39) per kg.