Local delivery of linezolid in the treatment of complex orthopedic bone and joint infections in patients with vancomycin allergy: a case series.

Introduction: Osteomyelitis is a challenging bone infection associated with ischemia, trauma, or various surgical procedures (e.g., joint reconstruction). Treatment involves eradicating infected bone and soft tissue, local antibiotic delivery, and a 6-week course of antibiotics. Methicillin-resistant Staphylococcus aureus (MRSA) infections are common, and vancomycin is the standard treatment, but alternatives like linezolid are needed in vancomycin-resistant and vancomycin-allergic patients. Methods: A retrospective chart review was conducted on patients treated by the senior author between 2013 and 2021. The study included patients who received local delivery of linezolid for bone and/or joint infection with documented evidence of vancomycin allergy. Patient demographics, surgical details, linezolid delivery method, and outcomes were recorded. Clinical outcomes and subsequent procedures leading to infection eradication were documented. Results: A total of 13 patients were treated with linezolid-antibiotic-laden spacers with polymethyl methacrylate (PMMA) carrier. Nine patients were successfully treated using limb-salvage techniques and were still infection-free after a mean follow-up of 55.5 months. Conclusions: Linezolid-loaded bone cement is an option for managing chronic bone and joint infections, particularly MRSA, in patients with vancomycin allergy.

Outcomes after Conversion from Video-Assisted Thoracoscopic Lobectomy to Thoracotomy.

BACKGROUND: Lung cancer resections are increasingly being performed via video-assisted thoracoscopic surgery (VATS). Conversion to thoracotomy can occur for many reasons and may affect outcomes. The objective of this study was to investigate the impact of VATS conversion on short- and mid-term outcomes and identify reasons for conversion. METHODS: Consecutive patients undergoing lobectomy for primary non-small cell lung cancer between 2012 and 2019 in a single UK center were included. Primary outcomes were 90-day mortality, intraoperative conversion, and overall survival. Reasons for conversion were defined as bleeding or nonbleeding. Outcomes were compared between groups using univariable analysis. Multivariable logistic regression analysis was performed to identify risk factors for conversion. RESULTS: A total of 2,622 patients were included with 20.6% (n = 541) completing surgery via VATS and 79.4% (n = 2,081) via thoracotomy. The rate of completed VATS surgery increased significantly over time (2012: 6.9%, 2019: 55.1%, p < 0.001). Overall conversion rate was 14.3% (n = 90/631) and has reduced significantly over time (p < 0.001). The rate of conversion due to intraoperative bleeding was 31.1% (n = 28/90). Obesity, male sex, and stage III disease were independent risk factors for conversion. The 90-day mortality rate after conversion was not significantly different from the rate for planned thoracotomy (3.3 vs. 3.4%, p = 0.987). There was no significant difference in overall survival between patients experiencing intraoperative conversion and those undergoing planned thoracotomy (p = 0.135). CONCLUSION: This study demonstrates comparable outcomes for patients undergoing conversion from VATS to those undergoing planned surgery via thoracotomy. It remains unclear if reason for conversion is associated with outcomes.

Different GCMs yet similar outcome: predicting the habitat distribution of Shorea robusta C.F. Gaertn. in the Indian Himalayas using CMIP5 and CMIP6 climate models.

Climate change impact on the habitat distribution of umbrella species presents a critical threat to the entire regional ecosystem. This is further perilous if the species is economically important. Sal (Shorea robusta C.F. Gaertn.), a climax forest forming Central Himalayan tree species, is one of the most valuable timber species and provides several ecological services. Sal forests are under threat due to over-exploitation, habitat destruction, and climate change. Sal's poor natural regeneration and its unimodal density-diameter distribution in the region illustrate the peril to its habitat. We, modelled the current as well as future distribution of suitable sal habitats under different climate scenarios using 179 sal occurrence points and 8 bioclimatic environmental variables (non-collinear). The CMIP5-based RCP4.5 and CMIP6-based SSP245 climate models under 2041-2060 and 2061-2080 periods were used to predict the impact of climate change on sal's future potential distribution area. The niche model results predict the mean annual temperature and precipitation seasonality as the most influential sal habitat governing variables in the region. The current high suitability region for sal was 4.36% of the total geographic area, which shows a drastic decline to 1.31% and 0.07% under SSP245 for 2041-60 and 2061-80, respectively. The RCP-based models predicted more severe impact than SSP; however, both RCP and SSP models showed complete loss of high suitability regions and overall shift of species northwards in the Uttarakhand state. We could identify the current and future suitable habitats for conserving sal population through assisted regeneration and management of other regional issues.

Enhanced photocatalytic degradation of Reactive Red 120 dye under solar light using BiPO4@g-C3N4 nanocomposite photocatalyst.

Azo dyes such as Reactive Red 120 raise great concerns about their increased harmfulness. Photocatalytic degradation is considered to be one of the most efficient techniques for Reactive Red 120 degradation. Herein, a highly solar active graphitic carbon nitride-assisted bismuth phosphate nanocomposite (BiPO4@g-C3N4) was synthesized by the thermal decomposition of melamine followed by the co-precipitation method. Various analytical techniques were utilized to characterize the prepared BiPO4, g-C3N4, and BiPO4@g-C3N4 nanocomposites. Scanning electron microscopy (SEM) shows the nanorods and particle morphology of the bare BiPO4 and g-C3N4 respectively. Furthermore, the optical band gap energies of the BiPO4, g-C3N4, and BiPO4@g-C3N4 nanocomposite have been calculated to be 4.20, 2.66, and 2.68 eV respectively. Under sunlight, the BiPO4@g-C3N4 nanocomposite showed higher photocatalytic activity towards the degradation of RR120. The BiPO4@g-C3N4 nanocomposite efficiently degrades the RR120 under sunlight with a higher first-order reaction rate constant of 0.0145 min-1. This is seven times higher than that of bare BiPO4 (0.0019 min-1) nanorods and four times greater than g-C3N4 (0.0036 min-1). The photocatalytic efficiency was found to be maximum at pH 4 and decreased as the pH of the solution increased. Even after five recycle runs, the catalyst performance of the RR120 dye has decreased by less than 5%, indicating the high stability of the BiPO4@g-C3N4 nanocomposite. Furthermore, the radical trapping experiment demonstrates that the active species in the dye degradation process are holes and hydroxide radicals. The photocatalytic mechanism was proposed for the BiPO4@g-C3N4 nanocomposite and further validated by the electrochemical impedance spectroscopy analysis.

Catalytic C-H Bond Activation and Knoevenagel Condensation Using Pyridine-2,3-Dicarboxylate-Based Metal-Organic Frameworks.

Three 1D coordination polymers (CPs) [M(pdca)(H2O)2] n (M = Zn, Cd, and Co; 1-3), and a 3D coordination framework {[(CH3)2NH2][CuK(2,3-pdca)(pa)(NO3)2]} n (4) (2,3-pdca = pyridine-2,3-dicarboxylate and pa = picolinic acid), have been synthesized adopting a solvothermal reaction strategy. The CPs have been thoroughly characterized using various spectral techniques, that is, elemental analyses, FT-IR, TGA, DSC, UV/vis, and luminescence. Structural information on 1-4 was obtained by PXRD and X-ray single-crystal analyses, whereas morphological insights were attained through FESEM, AFM, EDX, HRTEM, and BET surface area analyses. Roughness parameters were calculated from AFM analysis, whereas dimensions of small domains and interplanar spacing were defined with the aid of HRTEM. CPs 1-3 are 1D isostructural networks, whereas 4 is a 3D framework. Moreover, 1-4 display moderate luminescence at rt. In addition, 1-4 have been applied as economic and efficient porous catalysts for the Knoevenagel condensation reaction and C-H bond activation under mild conditions with good yields (95-98 and 97-99%), respectively. Notably, 1-3 can be reused up to seven cycles, whereas 4 can be reused up to five catalytic cycles with retained catalytic efficiency. Relative catalytic efficacy toward the Knoevenagel condensation reaction follows in the order 2 > 1 > 3 > 4, whereas 2 > 4 > 1 > 3 for C-H activation. The present result demonstrates synthetic, structural, optical, morphological, and catalytic aspects of 1-4.

A systematic review on high conservation value assessment (HCVs): Challenges and framework for future research on conservation strategy.

Various scholars and research institutions have attempted to assess High Conservation Values (HCVs) using different methodologies and approaches. Various countries have developed toolkits to determine High Conservation Value Areas (HCVAs) according to their needs and conservation strategies but there is no global agreement on them. The present study attempts to review research papers and assessment reports from 1999 until 2018 on approaches and methodologies used for HCVs all over the world and provide a review into HCV research systematically, with due consideration to the linkages between Biodiversity, Ecosystem Services and Socio-Economic-Cultural values. We analyzed and examined the trends which are emerging and gaps present in HCV assessments evident from literature reviewed by experts, including the spatial spread of research, the evolving use and content of the concept, and consultation with stakeholders. A total, 80 articles were taken from Scopus and various reputed journals and reports using keywords like HCV and Forest Stewardship Council (FSC) to specifically focus on the application and evolution of the concept designed by FSC. The study was done in the hope to help in analyzing different HCV components as a conservation planning tool and guide new research in methodologies to fill the current gaps and enhance HCV assessments at different levels of application. The review result revealed that the HCV approach is an effective tool for delineating the conservation priority areas and reduce the uncontrolled extraction of natural resources. The findings display the focus area in HCV research that are surveying methods, fields of application and the dynamics between social and environmental components of HCV categories.

Comparative study of evaluation of the oral stereognostic ability between diabetic and nondiabetic complete denture wearers with and without denture.

BACKGROUND: The diabetic subjects would have impaired oral stereognostic ability (OSA) compared with normal subjects due to diabetic neuropathy and microcirculatory disturbances. This study was conducted to compare the OSA between diabetic and nondiabetic complete denture wearers with and without denture. MATERIALS AND METHODS: In this in vivo study the present comparative study comprised of seventy edentulous subjects (36 males and 34 females), aged from 35 to 84 rehabilitated with complete dentures (among them 35 were diabetic and 35 subjects were nondiabetic complete denture wearer). The OSA tests were conducted using acrylic test samples of 12 shaped forms, which were placed in patient's mouth for a given period of time for identification and scored according to three-point scale as OSA score and the identification time was also recorded. The data obtained were analyzed using Chi-square test, t-test, and Pearson's correlation coefficient (P < 0.05). RESULTS: In this study, diabetic complete denture wearers got the mean OSA score of 12.43 ± 3.93 without dentures, which was lower than nondiabetic complete denture wearer group (14.82 ± 4.44). There was a significant difference (P = 0.020*) in the identification of test pieces. CONCLUSION: Within limitations of this study, diabetic complete denture wearers showed decreased OSA than nondiabetic subjects, particularly it was significant while not wearing dentures. Oral stereognosis may be used as one of the clinical aids in predicting patient's performance to a prosthesis. Based on their response, we can educate the patient about the prognosis.

Multitemporal analysis of forest fragmentation in Hindu Kush Himalaya-a case study from Khangchendzonga Biosphere Reserve, Sikkim, India.

Forests in the mountains are a treasure trove; harbour a large biodiversity; and provide fodder, firewood, timber and non-timber forest products; all of these are essential for human survival in the highest mountains on earth. The present paper attempts a spatiotemporal assessment of forest fragmentation and changes in land use land cover (LULC) pattern using multitemporal satellite data over a time span of around a decade (2000-2009), within the third highest protected area (PA) in the world. The fragmentation analysis using Landscape Fragmentation Tool (LFT) depicts a decrease in large core, edge and patches areas by 5.93, 3.64 and 0.66 %, respectively, while an increase in non-forest and perforated areas by 6.59 and 4.01 %, respectively. The land cover dynamics shows a decrease in open forest, alpine scrub, alpine meadows, snow and hill shadow areas by 2.81, 0.39, 8.18, 3.46 and 0.60 %, respectively, and there is an increase in dense forest and glacier area by 4.79 and 10.65 %, respectively. The change analysis shows a major transformation in areas from open forest to dense forest and from alpine meadows to alpine scrub. In order to quantify changes induced by forest fragmentation and to characterize composition and configuration of LULC mosaics, fragmentation indices were computed using Fragstats at class level, showing the signs of accelerated fragmentation. The outcome of the analysis revealed the effectiveness of geospatial tools coupled with landscape ecology in characterization and quantification of forest fragmentation and land cover changes. The present study provides a baseline database for sustainable conservation planning that will benefit the subsistence livelihoods in the region. Recommendations made based on the present analysis will help to recover forest and halt the pessimistic effects of fragmentation and land cover changes on biodiversity and ecosystem services in the region.

An in-vivo correlation analysis of the distance between lingual frenal attachment and mandibular incisal edge position as an aid in establishing mandibular occlusal plane in South Indian population.

STATEMENT OF PROBLEM: The aim of the study is to find the reliability in measuring the distance between the anterior attachment of the lingual frenum and the incisal edge of the mandibular central incisor on casts to be used as a pre-extraction record. PURPOSE: The objective of this study is to give a range of numerical values from anterior attachment of lingual frenum to mandibular central incisors in a class I ridge relation in south Indian population, which may be used in establishing the vertical dimension of the edentulous patient and also to locate the mandibular incisors in teeth arrangement of complete denture fabrication. MATERIALS AND METHODS: One hundred subjects (50 males and 50 females) under the age group of 21-28y, with class I dental relationship and who have never undergone orthodontic treatment were selected. Two models were made for each subject using irreversible hydrocolloid impression material and type III gypsum product to obtain an average value for each subject. The distance between the incisal edges of the lower central incisor and the anterior attachment of the lingual frenum is measured using a divider and digital vernier caliper. STATISTICAL ANALYSIS: Mean and Standard deviation using descriptive statistics tool using SPSS software version 18. RESULT: The distance between the anterior attachment of the lingual frenum and incisal edges of mandibular central incisors among the 100 subjects was 14.50mm ± 2.2245 mm. CONCLUSION: The value obtained aided in establishing the vertical dimension easier by making a pre-determined height of mandibular occlusal rim.