ApoA1 Deficiency Reshapes the Phenotypic and Molecular Characteristics of Bone Marrow Adipocytes in Mice.

In the present study, we studied the effect of apolipoprotein A-1 (APOA1) on the spatial and molecular characteristics of bone marrow adipocytes, using well-characterized ApoA1 knockout mice. APOA1 is a central regulator of high-density lipoprotein cholesterol (HDL-C) metabolism, and thus HDL; our recent work showed that deficiency of APOA1 increases bone marrow adiposity in mice. We found that ApoA1 deficient mice have greatly elevated adipocytes within their bone marrow compared to wild type counterparts. Morphologically, the increased adipocytes were similar to white adipocytes, and displayed proximal tibial-end localization. Marrow adipocytes from wild type mice were significantly fewer and did not display a bone-end distribution pattern. The mRNA levels of the brown/beige adipocyte-specific markers Ucp1, Dio2, Pat2, and Pgc1a; and the expression of leptin were greatly reduced in the ApoA1 knock-out in comparison to the wild-type mice. In the knock-out mice, adiponectin was remarkably elevated. In keeping with the close ties of hematopoietic stem cells and marrow adipocytes, using flow cytometry we found that the elevated adiposity in the ApoA1 knockout mice is associated with a significant reduction in the compartments of hematopoietic stem cells and common myeloid, but not of the common lymphoid, progenitors. Moreover, the 'beiging'-related marker osteopontin and the angiogenic factor VEGF were also reduced in the ApoA1 knock-out mice, further supporting the notion that APOA1-and most probably HDL-C-regulate bone marrow microenvironment, favoring beige/brown adipocyte characteristics.

Complex Metacarpophalangeal Joint Dislocation (Kaplan's Lesion) of the Index Finger in a 5-year-old Patient: A Case Report.

Introduction: This report highlights a rare case of complex metacarpophalangeal (MCP) joint dislocation, commonly referred to as Kaplan's lesion. This type of dislocation typically results from a hyperextension injury and requires surgical intervention as closed maneuvers are unsuccessful in reducing the dislocation. Surgical reduction for complex MCP joint dislocations is commonly done through classic volar or dorsal approaches. This report presents a case of a complex MCP joint dislocation and the surgical approach taken to address the issue. Case Report: We present a case of a complex MCP joint dislocation in a 5-year-old male patient who sustained a hyperextension injury to his index finger. The patient underwent open reduction surgery using a volar approach due to the buttonholing of the phalangeal head through the volar plate and blockage between the flexor tendons and lumbrical muscle. Following the procedure, the joint was immobilized in a palmar splint at 30° flexion for 2 weeks before being allowed unrestricted mobilization. At the 4-week follow-up, the patient reported being pain-free and had regained nearly full range of motion in the index finger MCP joint. Conclusion: Although there are multiple techniques to address complex MCP dislocation, the classic volar approach is still considered an effective treatment option for pediatric patients with this injury. In such cases, open reduction through a volar approach can enable surgeons to access the joint and address complex dislocations, which are often difficult to manage with closed reduction alone. Consequently, this surgical approach can help achieve a successful reduction and restore the joint's functionality. Therefore, despite the availability of alternative approaches, the classic volar approach should still be considered as a viable option for treating complex MCP joint dislocations in the pediatric population.

A Merkel-cell carcinoma metastatic to the tonsil: a case report and review of the literature.

Metastatic tumors to the palatine tonsils are extremely rare, with nearly 100 cases reported. Only 3 cases of Merkel cell carcinoma of the skin metastasizing to the palatine tonsil have been reported. We present the interesting case of a 61-year-old man with an enlargement of the left palatine tonsil that caused a moderate narrowing of the oropharynx. Three years previously he had been treated for Merkel cell carcinoma (MCC) on skin of his left shoulder. A tonsillectomy followed by palatoplasty was performed. Immunohistochemical staining demonstrated a pronounced reaction for cytokeratin 20, chromogranin, and CD56 histodiagnostic markers. Immunohistochemical studies are useful diagnostic tools in the establishment of the diagnosis of MCC. Treatment includes wide local surgical excision of the tumor, radiotherapy, and chemotherapy. Considering the aggressiveness of MCC, an early diagnosis is critical to enable the choice of adequate therapy at an early stage.

Development and Evaluation of a Novel-Thymol@Natural-Zeolite/Low-Density-Polyethylene Active Packaging Film: Applications for Pork Fillets Preservation.

Sustainability, the circular economy, and the "greenhouse" effect have led the food packaging industry to use naturally available bio-compounds. The integration of such compounds in packaging films increases food safety and extends food shelf-life. The development of an active/antioxidant packaging film based on the widely commercially used low-density polyethylene, natural zeolite, and Thymol, a natural extract from thyme oil, is presented in this work. The obtained active films were characterized using X-Ray Diffraction, Fourier-Transform Infrared Spectroscopy, Scanning Electron Microscopy, and Differential Scanning Calorimetry techniques. The tensile strength, water-oxygen barrier properties, and total antioxidant activity were measured. Low-density polyethylene incorporated with Thymol@Natural Zeolite at a proportion of 15 wt% was the most promising material and was used as film to wrap-up pork fillets. The thiobarbituric acid (TBA) method and heme iron measurements indicated a delayed lipids oxidation using this film. A linear correlation between the TBA method and heme iron values seems to be established, which could result in a fast method to determine the degree of lipid oxidation in pork fillets. Finally, a two-stage diffusion process during Thymol release was observed, and the values of the diffusion coefficient was 2.09 × 10-7 and 1.21 × 10-8 cm2/s for each stage. The applied pseudo-second sorption model provided a rate constant k2 = 0.01647 (s-1). These results indicate the strong potential of such films to be used as food packaging materials free of E-number preservatives.

Development, Characterization, and Evaluation as Food Active Packaging of Low-Density-Polyethylene-Based Films Incorporated with Rich in Thymol Halloysite Nanohybrid for Fresh "Scaloppini" Type Pork Meat Fillets Preservation.

A new era is rising in food packaging and preservation, with a consequent focus on transition to "greener" and environmentally friendly techniques. The environmental problems that are emerging nowadays impose use of natural materials for food packaging applications, replacement of chemical preservatives with natural organic extractions, such as essential oils, and targeting of new achievements, such as further extension of food shelf-life. According to this new philosophy, most of the used materials for food packaging should be recyclable, natural or bio-based, and/or edible. The aim of this work was to investigate use and efficiency of a novel food packaging developed based on commercial LDPE polymer incorporated with natural material halloysite impregnated with natural extract of thyme oil. Moreover, a direct correlation between the stiff TBARS method and the easiest heme iron measurements method was scanned to test food lesions easier and faster. The result of this study was development of the LDPE/10TO@HNT film, which contains the optimum amount of a hybrid nanostructure and is capable to be used as an efficient active food packaging film. Furthermore, a linear correlation seems to connect the TBARS and heme iron measurements.

Thymol@Natural Zeolite Nanohybrids for Chitosan/Polyvinyl-Alcohol-Based Hydrogels Applied as Active Pads.

Currently, food saving, a circular economy, and zero environmental fingerprints are of major interest. Scientific efforts for enhanced food preservation using "green" methods have been intensified. Even though chemicals could achieve such targets effectively, the global trend against the "greenhouse effect" suggests the use of environmentally friendly biobased materials for this purpose. In this study, the promising biopolymer chitosan is incorporated with the promising biodegradable polymer polyvinyl alcohol to produce an improved biopolymeric matrix. This biodegradable biopolymer was further mixed homogeneously with 15% thymol/nano-zeolite nanohybrid material. The properties of the final developed film were improved compared to the relevant values of chitosan/polyvinyl alcohol film. The mechanical properties were enhanced significantly, i.e., there was a 34% increase in Young's modulus and a 4.5% increase in the ultimate tensile strength, while the antioxidant activity increased by 53.4%. The antibacterial activity increased by 134% for Escherichia coli, 87.5% for Staphylococcus aureus, 32% for Listeria monocytogenes, and 9% for Salmonella enterica. The water vapor diffusion coefficient and the oxygen permeability coefficient decreased to -51% and -74%, respectively, and thus, the water vapor and oxygen barrier increased significantly. The active pads were used in strawberries, and the antimicrobial activity evaluation against the mold of fungi was carried out. The visual evaluation shows that the active pads could extend the shelf life duration of strawberries.

Thymol@activated Carbon Nanohybrid for Low-Density Polyethylene-Based Active Packaging Films for Pork Fillets' Shelf-Life Extension.

Τhe replacement of food packaging additives and preservatives with bio-based antioxidant/antibacterial compounds has been a common practice in recent years following the trend of bioeconomy and nanotechnology. Such bio-additives are often enclosed in nanocarriers for a controlled release process. Following this trend in this work, a thymol (TO)-rich activated carbon (AC) nanohybrid was prepared and characterized physicochemically with various techniques. This TO@AC nanohybrid, along with the pure activated carbon, was extruded with low-density polyethylene (LDPE) to develop novel active packaging films. The codenames used in this paper were LDPE/xTO@AC and LDPE/xAC for the nanohybrid and the pure activated carbon, respectively. X-ray diffractometry, Fourier-transform infrared spectroscopy, and scanning electron microscopy measurements showed high dispersity of both the TO@AC nanohybrid and the pure AC in the LDPE matrix, resulting in enhanced mechanical properties. The active film with 15 wt.% of the TO@AC nanohybrid (LDPE/15TO@AC) exhibited a 230% higher water/vapor barrier and 1928% lower oxygen permeability than the pure LDPE film. For this active film, the highest antioxidant activity referred to the DPPH assay (44.4%), the lowest thymol release rate (k2 ≈ 1.5 s-1), and the highest antibacterial activity were recorded, resulting in a 2-day extension of fresh pork fillets' shelf-life.

The Development of a Novel Sodium Alginate-Based Edible Active Hydrogel Coating and Its Application on Traditional Greek Spreadable Cheese.

The necessity of reducing the greenhouse effect by decreasing the carbon dioxide fingerprint directed the food packaging technology to use biobased raw materials. Alginates, which are derived from brown algae species, are one of the most promising biobased biopolymers for the development of edible active coatings capable of protecting food from oxidation/bacterial spoilage. In this study, sodium alginate, which was plasticized with glycerol and mixed with a biobased thymol/natural halloysite nanohybrid, was used to develop novel edible active coatings. Nanocomposite coatings were also developed in this project by mixing pure halloysite with sodium alginate/glycerol matrix and were used as reference material for comparison reasons. Instrumental analysis indicated a higher compatibility of a thymol/halloysite nanohybrid with a sodium alginate/glycerol matrix compared to pure halloysite with a sodium alginate/glycerol matrix. Increased compatibility resulted in improved tensile properties, water/oxygen barrier properties, and total antioxidant activity. These edible active coatings were applied to traditional Greek spread cheese and showed a reduction in the mesophilic microbial population over one log10 unit (cfu/g) compared to uncoated cheese. Moreover, the reduction in the mesophilic microbial population increased with the increase in halloysite and thymol content, indicating such sodium alginate/glycerol/thymol/halloysite hydrogels as promising edible active coatings for dairy products.

Kiwi Fruits Preservation Using Novel Edible Active Coatings Based on Rich Thymol Halloysite Nanostructures and Chitosan/Polyvinyl Alcohol Gels.

The concept of this study is the replacement of previous fossil-based techniques for food packaging and food shelf-life extension, with novel more green processes and materials following the spirit of circular economy and the global trend for environmentally positive fingerprints. A novel adsorption process to produce thymol-halloysite nanohybrids is presented in this work. The high dispersion of this thymol-halloysite nanostructure in chitosan biopolymer is one of the goals of this study. The incorporation of this biodegradable matrix with poly-vinyl-alcohol produced a very promising food-packaging film. Mechanical, water-oxygen barrier, antimicrobial, and antioxidant properties were measured. Transparency levels were also tested using a UV-vis instrument. Moreover, the developed films were tested in-vivo for the preservation and the extension of the shelf-life of kiwi fruits. In all cases, results indicated that the increased fraction of thymol from thyme oil significantly enhances the antimicrobial and antioxidant activity of the prepared chitosan-poly-vinyl- alcohol gel. The use of the halloysite increases the mechanical and water-oxygen barrier properties and leads to a control release process of thymol which extends the preservation and the shelf-life of kiwi fruits. Finally, the results indicated that the halloysite improves the properties of the chitosan/poly-vinyl-alcohol films, and the thymol makes them further advantageous.

The Increase of Soft Cheese Shelf-Life Packaged with Edible Films Based on Novel Hybrid Nanostructures.

This study presents, the development of a green method to produce rich in thymol natural zeolite (TO@NZ) nanostructures. This material was used to prepare sodium-alginate/glycerol/xTO@NZ (ALG/G/TO@NZ) nanocomposite active films for the packaging of soft cheese to extend its shelf-life. Differential scanning calorimetry (DSC), X-ray analysis (XRD), scanning electron microscopy (SEM), and Fourier-transform infrared spectroscopy (FTIR) instruments were used for the characterization of such nanostructures and films, to identify the thymol adsorbed amount, to investigate the thermal behaviour, and to confirm the dispersion of nanostructure powder into the polymer matrix. Water vapor transmission rate, oxygen permeation analyzer, tensile measurements, antioxidant measurements, and antimicrobial measurements were used to estimate the film's water and oxygen barrier, mechanical properties, nanostructure's nanoreinforcement activity, antioxidant and antimicrobial activity. The findings from the study revealed that ALG/G/TO@NZ nanocomposite film could be used as an active packaging film for foods with enhanced, mechanical properties, oxygen and water barrier, antioxidant and antimicrobial activity, and it is capable of extending food shelf-life.

Insights into the Cellular and Molecular Mechanisms That Govern the Fracture-Healing Process: A Narrative Review.

Fracture-healing is a complex multi-stage process that usually progresses flawlessly, resulting in restoration of bone architecture and function. Regrettably, however, a considerable number of fractures fail to heal, resulting in delayed unions or non-unions. This may significantly impact several aspects of a patient's life. Not surprisingly, in the past few years, a substantial amount of research and number of clinical studies have been designed, aiming at shedding light into the cellular and molecular mechanisms that regulate fracture-healing. Herein, we present the current knowledge on the pathobiology of the fracture-healing process. In addition, the role of skeletal cells and the impact of marrow adipose tissue on bone repair is discussed. Unveiling the pathogenetic mechanisms that govern the fracture-healing process may lead to the development of novel, smarter, and more effective therapeutic strategies for the treatment of fractures, especially of those with large bone defects.

Programmed ventricular stimulation predicts arrhythmic events and survival in hypertrophic cardiomyopathy.

BACKGROUND: Sudden cardiac death (SCD) risk stratification in hypertrophic cardiomyopathy (HCM) in the context of primary prevention remains suboptimal. The purpose of this study was to examine the additional contribution of programmed ventricular stimulation (PVS) on established risk assessment. METHODS: Two-hundred-and-three consecutive patients with diagnosed HCM and ≥1 noninvasive risk factors were prospectively enrolled over 19years. Patients were risk stratified, submitted to PVS and received an implantable cardioverter-defibrillator (ICD) according to then-current American Heart Association (AHA) guidelines and inducibility. Participants were prospectively followed-up for primary endpoint occurrence (appropriate ICD therapy or SCD). Contemporary (2015) AHA and European Society of Cardiology (ESC) guidelines were retrospectively assessed. RESULTS: During a median follow-up period of 60months the primary endpoint occurred in 20 patients, 19 of whom were inducible and received an ICD. Overall, 79 patients (38.9%) were inducible and 92 patients (45.3%) received an ICD (PVS sensitivity=95%, specificity=67.2%, positive predictive value=24%, negative predictive value=99.2%). AHA and ESC guidelines application misclassified 3 and 9 primary endpoint-meeting patients, respectively. Inducibility was the most important determinant of event-free survival in multivariate Cox regression (hazard ratio=33.3). A combined approach of ESC score≥6% or AHA indication for ICD with PVS inducibility yielded absolute sensitivity and negative predictive value, the former at a more cost-effective and specific way. CONCLUSIONS: Inducibility at PVS predicts SCD or appropriate device therapy in HCM. Non-inducibility is associated with prolonged event-free survival, while the procedure was proven safe. Reintegration of PVS into established risk stratification models in HCM may improve patient assessment.

Sudden cardiac death: investigation of the classical risk factors in a community-based hypertrophic cardiomyopathy cohort.

INTRODUCTION: The identification of high-risk patients in hypertrophic cardiomyopathy (HCM) is still a challenge. The classical clinical risk factors for sudden death have been reported by studies coming from referral HCM cohorts. So far, other studies of community-based HCM populations have not managed to identify risk factors for sudden cardiac death. The aim of the present study was to determine the clinical course of the disease in a community-based HCM population, as well as to identify the clinical factors of sudden death in such a population. METHODS: Three hundred four (304) consecutive HCM patients (202 males, age 48 ± 18.5 years) from 280 different families were assessed. Referral was based on disease diagnosis, irrespective of clinical status or treatment needs. All patients were examined clinically, echocardiographically, by 24h ambulatory electrocardiographic monitoring, and by cardiopulmonary exercise testing at regular intervals, for a period of 56.4 ± 29.9 months. RESULTS: Most patients (n=264/304, 87.2%) were in New York Heart Association functional class I or II. The disease was familial in 60.5%. At initial examination, maximum left ventricular wall thickness was 19 ± 4.4 mm and a left ventricular outflow gradient >30 mmHg was present in 30.9% patients. The annual sudden death mortality was 1.2%. Familial sudden death, non-sustained ventricular tachycardia, severe left ventricular hypertrophy >30 mm, and young age were predictors of sudden cardiac death. CONCLUSIONS: In this community-based HCM population, the risk factors for sudden death were similar to those found in referral cohorts.