Life Expectancy of Patients Undergoing Total Knee Arthroplasty: Comparison With General Population.

BACKGROUND: This study aimed to analyze the life expectancy and cause of death in osteoarthritis (OA) patients who underwent total knee arthroplasty (TKA) and to identify risk factors that affect long-term mortality rate after TKA. METHODS: Among 601 patients, who underwent primary TKA due to OA by a single surgeon from July 2005 to December 2011, we identified patients who died after the operation using data obtained from the National Statistical Office of Korea. We calculated 5-, 10-, and 15-year survival rates of the patients and age-specific standardized mortality ratios (SMRs) compared to general population of South Korea according to the causes of death. We also identified risk factors for death. RESULTS: The 5-year, 10-year, and 15-year survival rates were 94%, 84%, and 75%, respectively. The overall age-specific SMR of the TKA cohort was lower than that of the general population (0.69; P < 0.001). Cause-specific SMRs for circulatory diseases, neoplasms, and digestive diseases after TKA were significantly lower than those of the general population (0.65, 0.58, and 0.16, respectively; all P < 0.05). Male gender, older age, lower body mass index (BMI), anemia, and higher Charlson comorbidity index (CCI) were significant factors associated with higher mortality after TKA. CONCLUSION: TKA is a worthwhile surgery that can improve life expectancy, especially from diseases of the circulatory system, neoplasms, and digestive system, in patients with OA compared to the general population. However, careful follow-up is needed for patients with male gender, older age, lower BMI, anemia, and higher CCI, as these factors may increase long-term mortality risk after TKA. LEVEL OF EVIDENCE: III.

Multiple thromboses, including intracardiac thrombi, accompanied by HIT during ECMO successfully treated with NOACs: A case report.

INTRODUCTION: Unfractionated heparin remains the mainstay of anticoagulation therapy during extracorporeal membrane oxygenation (ECMO) maintenance. However, its continued use in clinical practice exposes patients to the risk of developing heparin-induced thrombocytopenia (HIT). CASE REPORT: A 50-year-old male was diagnosed with multiple thromboses, including an intracardiac thrombi, accompanied by HIT during ECMO after cardiogenic shock related to acute myocardial infarction. The patient was successfully treated with new oral anticoagulants (NOAC), without significant complications. DISCUSSION: HIT during ECMO resulting in multiple thromboses is rare. To our knowledge, this is the first reported case of NOAC use in this context. CONCLUSION: Although thrombocytopenia and thrombosis can occur for various reasons during ECMO maintenance, it is important to consider HIT as a potential cause. NOACs can be considered as a therapeutic option.

A novel paper-based lysis strip for SARS-CoV-2 RNA detection at low resource settings.

Infectious respiratory diseases such as COVID-19 are serious and global concerns from the past to the present. To isolate the spread of infectious diseases even in the absence of a health system, a simple, inexpensive, reliable, sensitive, and selective molecular diagnosis platform for Point of Care Test (POCT) is required. Especially, the nucleic acid extraction step is difficult to perform out of laboratory. Here, we propose a paper-based lysis (PBL) strip for nucleic acid extraction, especially in low-resource settings (LRS). PBL strips are suitable for isolating RNA from viruses with biological interference and inhibitors. We optimized the buffer compositions and membranes of the strip. A simple preparation method using a PBL strip could obtain an eluent for downstream inspection within 20 min. Overall, 104 copies/swaps were detected for 20 min for amplification in combination with Reverse Transcription Loop-Mediated Amplification (RT-LAMP).

Optimal Coverage of Full Frequency Reuse in FFR Networks in Relation to Power Scaling of a Base Station.

As a strategy to coordinate inter-cell interference in cellular networks, a fractional frequency reuse (FFR) system is proposed, in which the frequency bandwidth is split into two orthogonal bands; users staying near the center of a FFR cell use the band with a frequency reuse (FR) factor of one (i.e., full FR), and users located close to the cell edge utilize the band with a FR factor greater than one (i.e., partial FR). Full FR coverage, which identifies full FR and partial FR regions (that is, near-center and near-edge regions) within a FFR cell, has a crucial effect on system performance. Some of the authors of this paper recently investigated the optimization of full FR coverage to maximize system throughput. They analytically showed that under the constraint of satisfying a specified target outage probability, the optimal full FR coverage is a non-increasing function of base station power when all base station powers in the cellular network are scaled at an equal rate. Interestingly, in this paper, it is proven that as the power of a single base station is scaled, the optimal full FR coverage in that cell is a non-decreasing function of base station power. Our results provide useful insight into the design of full FR coverage in relation to the transmit power of a base station. It gives a deeper understanding of the intricate relationship between important FFR system parameters of base station power and full FR coverage.

Rapid and simple detection of influenza virus via isothermal amplification lateral flow assay.

Respiratory illness caused by influenza virus is a serious public health problem worldwide. As the symptoms of influenza virus infection are similar to those of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, it is essential to distinguish these two viruses. Therefore, to properly respond to a pathogen, a detection method that is capable of rapid and accurate diagnosis in a hospital or at home is required. To satisfy this need, we applied loop-mediated isothermal amplification (LAMP) and an isothermal nucleic acid amplification technique, along with a system to analyze the results without specialized equipment, a lateral flow assay (LFA). Using the platform developed in this study, all processes, from sample preparation to detection, can be performed without special equipment. Unlike existing PCR methods, the nucleic acid amplification can be performed in the field because hot packs do not require electricity. Thus, the designed platform can provide rapid results without the need to transport the samples to a laboratory or hospital. These advantages are not limited to operations in developing countries with poor access to medical systems. In conclusion, the developed technology is a promising tool for infectious disease management that allows for rapid identification of infectious diseases and appropriate treatment of patients.

Reduction of postoperative nausea and vomiting risk in the second stage during bilateral total knee arthroplasty with a 1-week interval.

PURPOSE: Total knee arthroplasty (TKA) is often performed sequentially on both sides during a single hospital stay. Patients who experience postoperative nausea and vomiting (PONV) after the first operation are concerned about PONV recurrence after the second operation. However, there are few studies regarding the incidence of PONV in staged bilateral TKA with a ≥ 1-week interval. This study aimed to identify the differences in (1) PONV incidence, (2) use of rescue antiemetics, and (3) the amount of opioid consumption between the first and second operations for staged bilateral TKA with a 1-week interval. Based on our anecdotal experience, the hypothesis of this study was that during staged bilateral TKA at a 1-week interval, the PONV incidence and rescue antiemetic requirement after the second operation will be lower than those after the first operation, regardless of opioid consumption. METHODS: Fifty-eight consecutive patients who underwent staged bilateral TKA with a 1-week interval were retrospectively reviewed. All second-stage operations were performed with the same anaesthesia protocol and perioperative patient management protocol as the first-stage operation. PONV incidence was the primary outcome. The requirement for rescue antiemetic drugs and the amount of opioid consumption were secondary outcome variables. The outcome variables were recorded during three postoperative days (Days 0-2) for each stage and were compared between the first and second operations. RESULTS: The incidence rates of nausea and vomiting on Day 0 (p = 0.001 and p = 0.004, respectively) and nausea on Day 1 (p = 0.008) were significantly lower after the second operation. Rescue antiemetic use on Day 0 was significantly lower after the second operation (p = 0.001). The total opioid consumption 72 h after surgery was significantly higher after the second operation (61.76 vs. 34.28 mg, p < 0.001). CONCLUSION: During staged bilateral TKA with a 1-week interval, PONV incidence was lower after the second operation, even with increased opioid consumption. LEVEL OF EVIDENCE: III.

A simple and innovative sample preparation method for on-site SARS-CoV-2 molecular diagnostics.

Nucleic acid amplification is a widely used diagnostic tool, although it requires a relatively time-consuming and complicated extraction step. To address this issue outside the laboratory, we investigated a sample preparation system and determined that a silica membrane and silica-coated beads are powerful tools for the extraction from raw samples: nucleic acids are kept in the silica membrane, retained during a single wash step, and released at the elution step. The eluent is appropriate for the quantitative real-time polymerase chain reaction (qPCR) and loop-mediated amplification (LAMP) assay in terms of purity and quantity. We also built an innovative equipment-free nucleic acid extraction squeeze system which requires less than 20 min. The sample with improved purity augments the specificity and sensitivity. This system is simple, user-friendly, low-cost, and equipment-free, thus making nucleic acid extraction more accessible and affordable for researchers and untrained users. Furthermore, when combined with the reverse-transcription quantitative real-time polymerase chain reaction method, the method will accelerate the detection of diseases. The same goes when combined with the LAMP assay, especially in developing countries.

Simultaneous Detection of Serum Glucose and Glycated Albumin on a Paper-Based Sensor for Acute Hyperglycemia and Diabetes Mellitus.

Diabetes mellitus is one of the most common chronic diseases worldwide. Generally, the levels of fasting or postprandial blood glucose and other biomarkers, such as glycated albumin, glycated hemoglobin, and 1,5-anhydroglucitol, are used to diagnose or monitor diabetes progression. In the present study, we developed a sensor to simultaneously detect the glucose levels and glycation ratios of human serum albumin using a lateral flow assay. Based on the specific enzymatic reactions and immunoassays, a spiked glucose solution, total human serum albumin, and glycated albumin were measured simultaneously. To test the performance of the developed sensor, clinical serum samples from healthy subjects and patients with diabetes were analyzed. The glucose level and glycation ratios of the clinical samples were determined with reasonable correlation. The R-squared values of glucose level and glycation ratio measurements were 0.932 and 0.930, respectively. The average detection recoveries of the sensor were 85.80% for glucose and 98.32% for the glycation ratio. The glucose level and glycation ratio in our results were crosschecked with reference diagnostic values of diabetes. Based on the outcomes of the present study, we propose that this novel platform can be utilized for the simultaneous detection of glucose and glycation ratios to diagnose and monitor diabetes mellitus.

An innovative blood plasma separation method for a paper-based analytical device using chitosan functionalization.

This study describes a microfluidic paper-based analytical device (µPAD) for separating plasma from whole blood and measuring glucose concentration. A two-dimensional µPAD was fabricated by wax printing, using chromatographic paper and was functionalized by the incorporation of chitosan into the plasma separation zone. Red blood cells were isolated from whole blood in the plasma separation zone consisting of a chitosan polymer structure and a wax barrier. The separated plasma, with buffer, was injected into the test zone to cause a color change. The colorimetric results were digitized with a scanner, and the concentration was calculated using a calibration curve. This µPAD, which separated the plasma from whole blood without a separation membrane, will be useful for constructing point-of-care testing devices that detect analytes in small sample volumes.

On Training Neural Network Decoders of Rate Compatible Polar Codes via Transfer Learning.

Neural network decoders (NNDs) for rate-compatible polar codes are studied in this paper. We consider a family of rate-compatible polar codes which are constructed from a single polar coding sequence as defined by 5G new radios. We propose a transfer learning technique for training multiple NNDs of the rate-compatible polar codes utilizing their inclusion property. The trained NND for a low rate code is taken as the initial state of NND training for the next smallest rate code. The proposed method provides quicker training as compared to separate learning of the NNDs according to numerical results. We additionally show that an underfitting problem of NND training due to low model complexity can be solved by transfer learning techniques.

Nanoclusters prepared from ruthenium(II) and quercetin for fluorometric detection of cobalt(II), and a method for screening their anticancer drug activity.

Ruthenium-quercetin conjugated nanoclusters (Ru-QC NCs) were synthesized via a one-pot reflux reaction. As inhalation of heavy metal ions like cobalt can lead to lung cancer, a fluorescent probe was designed for the determination of Co(II) both in aqueous solutions and living cells. The probe consists of hybrid nanoclusters with an average size of 2 nm that were prepared from ruthenium(II) ions and the flavonoid quercetin. These are termed as Ru-QC NCs. They display strong orange-colored emission with a peak at 558 nm under 465-nm excitation. The Ru-QC NCs are cell viable and enable imaging of cells and intracellular fluorometric detection of Co(II). The anticancer properties of Ru-QC NCs were screened by using non-small cell lung cancer (A549) and human dermal fibroblast (HDFa) cell lines. The Ru-QC NCs exert considerable cytotoxicity in A549 cells (at levels of 20-50 µg·mL-1), whereas no significant cytotoxicity was observed in case of HDFa cells. The anticancer properties of Ru-QC NCs were screened via MTT assay, live-dead staining, and ROS assay, respectively. Morphological changes of cancer cells were observed using atomic force microscopy. The fluorescent probe can detect Co(II) with a detection limit of 9.28 nM and with a linear response in the 0.03-100 µM concentration range. Graphical abstract Schematic representation of ruthenium-quercetin nanoclusters with potential anticancer properties. They are promising fluorescent probes for intracellular sensing of cobalt (Co2+) and bio-imaging. They exhibited efficient fluorometric detection of Co2+ with the limit of detection (LOD) of 9.28 nM.

Electrospun Polythiophene Phenylenes for Tissue Engineering.

This research focuses on the design of biocompatible materials/scaffold suitable for use for tissue engineering. Porous fiber mats were produced through electrospinning of polythiophene phenylene (PThP) conducting polymers blended with poly(lactide- co-glycolic acid) (PLGA). A peptide containing an arginylglycylaspartic acid (RGD) fragment was synthesized using solid phase peptide synthesis and subsequently grafted onto a PThP polymer using azide-alkyne "click" chemistry. The obtained RGD functionalized PThP was also electrospun into a fiber mat. The electrospun mats' morphology, roughness and stiffness were studied by means of scanning electron microscopy (SEM) and atomic force microscopy (AFM) and their electroactivity by cyclic voltammetry. The fibers show excellent cytocompatibility in culture assays with human dermal fibroblasts-adult (HDFa) and human epidermal melanocytes-adult (HEMa) cells. The electrospun fibers' roughness and stiffness changed after exposing the fiber mats to the cell culture medium (measured in dry state), but these changes did not affect the cell proliferation. The cytocompatibility of our porous scaffolds was established for their applicability as cell culture scaffolds by means of investigating mitochondrial activity of HDFa and HEMa cells on the scaffolds. The results revealed that the RGD moieties containing PThP scaffolds hold a promise in biomedical applications, including skin tissue engineering.

Trellis Tone Modulation Multiple-Access for Peer Discovery in D2D Networks.

In this paper, a new non-orthogonal multiple-access scheme, trellis tone modulation multiple-access (TTMMA), is proposed for peer discovery of distributed device-to-device (D2D) communication. The range and capacity of discovery are important performance metrics in peer discovery. The proposed trellis tone modulation uses single-tone transmission and achieves a long discovery range due to its low Peak-to-Average Power Ratio (PAPR). The TTMMA also exploits non-orthogonal resource assignment to increase the discovery capacity. For the multi-user detection of superposed multiple-access signals, a message-passing algorithm with supplementary schemes are proposed. With TTMMA and its message-passing demodulation, approximately 1.5 times the number of devices are discovered compared to the conventional frequency division multiple-access (FDMA)-based discovery.

Influence of Nanotoxicity on Human Health and Environment: The Alternative Strategies.

Currently, nanotechnology revolutionizing both scientific and industrial community due to their applications in the fields of medicine, environmental protection, energy, and space exploration. Despite of the evident benefits of nanoparticles, there are still open questions about the influence of these nanoparticles on human health and environment. This is one of the critical issues that have to be addressed in the near future, before massive production of nanomaterials. Manufactured nanoparticles, which are finding ever-increasing applications in industry and consumer products fall into the category of emerging contaminants with ecological and toxicological effects on populations, communities and ecosystems. The existing experimental knowledge gave evidence that inhaled nanoparticles are less efficiently separated than larger particles by the macrophage clearance mechanisms and these nanoparticles are known to translocate through the lymphatic, circulatory and nervous systems to many tissues and organs, including the brain. In this review we highlight adverse impacts of nanoparticles on human and the environment with special emphasis on green nanoscience as a sustainable alternative.

Recent analytical approaches to detect exhaled breath ammonia with special reference to renal patients.

The ammonia odor from the exhaled breath of renal patients is associated with high levels of blood urea nitrogen. Typically, in the liver, ammonia and ammonium ions are converted into urea through the urea cycle. In the case of renal dysfunction, urea is unable to be removed and that causes a buildup of excessive ammonia. As small molecules, ammonia and ammonium ions can be forced into the blood-lung barrier and occur in exhaled breath. Therefore, people with renal failure have an ammonia (fishy) odor in their exhaled breath. Thus, exhaled breath ammonia can be a potential biomarker for monitoring renal diseases during hemodialyis. In this review, we have summarized the source of ammonia in the breath of end-stage renal disease patient, cause of renal disorders, exhaled breath condensate, and breath sampling. Further, various biosensor approaches to detect exhaled ammonia from renal patients and other ammonia systems are also discussed. We conclude with future perspectives, namely colorimetric-based real-time breathing diagnosis of renal failure, which might be useful for prospective studies.

Recyclable Photo-Thermal Nano-Aggregates of Magnetic Nanoparticle Conjugated Gold Nanorods for Effective Pathogenic Bacteria Lysis.

We describe the nucleophilic hybridization technique for fabricating magnetic nanoparticle (MNP) around gold nanorod (AuNR) for desired photo-thermal lysis on pathogenic bacteria. From the electromagnetic energy conversion into heat to the surrounding medium, a significant and quicker temperature rise was noted after light absorption on nanohybrids, at a controlled laser light output and optimum nanoparticle concentration. We observed a similar photo-thermal pattern for more than three times for the same material up on repeated magnetic separation. Regardless of the cell wall nature, superior pathogenic cell lysis has been observed for the bacteria suspensions of individual and mixed samples of Salmonella typhi (S.typhi) and Bacillus subtilis (B.subtilis) by the photo-heated nanoparticles. The synthesis of short gold nanorod, conjugation with magnetic nanoparticle and its subsequent laser exposure provides a rapid and reiterated photo-thermal effect with enhanced magnetic separation for efficient bactericidal application in water samples. Resultant novel properties of the nano-aggregates makes them a candidate to be used for a rapid, effective, and re-iterated photo-thermal agent against a wide variety of pathogens to attain microbe free water.

Evaluation of UV radiation-induced toxicity and biophysical changes in various skin cells with photo-shielding molecules.

Ultraviolet radiation (UVR) triggers many complex events in different types of skin cells, including benign, malignant and normal cells. Chromophores present in these cells play a crucial role in various cellular processes. Unprecedented methods are required for the real-time monitoring of changes in an in vitro model exposed to intermittent mild and intense UVR to determine the mechanisms underlying cell degeneration and the effects of unexpected toxic, agonist and antagonist agents. This study reports the analytical application of a whole cell-based sensor platform for examining the biophysical effects of UVR. We used human keratinocyte, melanocyte and fibroblast cell lines to determine the normal, pathological and protective roles of UVR. In addition, we examined the real-time morphological, biophysical and biomechanical changes associated with cell degeneration induced by UVR at 254 and 365 nm. Information on UVR-induced changes in the cytoskeleton ultrastructure, cellular integrity, cell spreading area, actin microfilament distribution inflammation, microtubule damage, membrane damage, rupture and death was characterized by examining the loss or increase in biophysical and biomechanical properties of these cells. All cells exposed to UVR at 254 and 365 nm showed a significant increase in surface roughness and stiffness in a time-dependent manner. UVR-induced toxicity in differently pigmented skin cells was compared with that in cells pretreated with melanin, keratin and basic fibroblast growth factor to analyze the shielding efficiency of these agents. Melanin exerted a significant shielding effect compared to the other two agents. The biophysical and biomechanical information obtained in this study could advance our understanding of the UVR-induced degeneration process, and help in developing new interventions strategies.

Label Free Quantitative Immunoassay for Hepatitis B.

Complementary metal oxide semiconductor (CMOS) technology has already been proven in molecular diagnostics. The present research proved that CMOS image sensor based immunodetection is a suitable diagnostic system for hepatitis B virus antigen (HBV-Ag)-antibody (Ab) interaction. The Ag-Ab was interacted on InNP substrate which was analyzed by a CMOS image sensor by photon number variation. The photon passes through the protein adsorbed substrate and hits the sensor surface. The number of photons attained by the sensor depends on the Ag concentration, nanoparticles size and substrates thickness; therein substrate with higher concentrations of Ag were blocked more photons. The number of photons was detected by the sensor and converted into a digital number with the aid of an analog-to-digital-converter (ADC). A topographical study of AFM and fluorescence images have evaluated the morphological changes, height increment, surface roughness of protein treated and non-treated InNP substrates, to prove the efficiency of CMOS image sensor based immunodetection. Also, the study was compared with conventional ELISA method, to find the sensitivity of CMOS image sensor. Hence, the detection of HBV Ag-Ab interactions by CMOS image sensors is suitable for point-of-care diagnosis.

Simultaneous multiple target detection platform based on vertical flow immunoassay.

In general, vertical flow assay (VFA) has a disadvantage of requiring a complex analysis process that involves manually injecting various reagents (target analyte, washing buffer, detection conjugate, etc.) sequentially. However, in this study, we have developed an innovative paper-based VFA device that replaces the complex analysis process with one-step and enables the detection of multiple targets. The fabrication process of the multi-target detection VFA device is as follows: preparation and pre-treatment of the strip materials, design of strip cartridge, design of the multiple detection VFA device, optimization experiments for strip sample flow rates, determination of device analysis time, determination of device limit of detection (LOD), multiple target signal uniformity experiment, immunoglobulin G (IgG) and C-reactive protein (CRP) antigen-antibody multiple detection experiment, and data extraction and analysis method. The use of paper-based materials enables the device to be produced at cost-effective, and cartridge production allowed for uniform array formation. IgG and CRP are used to evaluate the performance of the device as common biomarkers. The device proposed in this study is currently under research. To validate multiple target detection capability of the VFA device proposed in this study, two types of antigens-antibodies (Human IgG and Human CRP) were employed. The detection limit is 0.15 µg/mL for IgG and 0.19 µg/mL for CRP in naked eye. Furthermore, it was confirmed that there is no cross-reactivity caused by the device structure through IgG and CRP antigens. In conclusion, the VFA device proposed in this study consists of a one-step analysis process, and it has been confirmed that it can detect multiple targets simultaneously.

Spatial and temporal trends in food security during the COVID-19 pandemic in Asia Pacific countries: India, Indonesia, Myanmar, and Vietnam.

BACKGROUND/OBJECTIVES: The economic recession caused by the coronavirus disease 2019 pandemic disproportionately affected poor and vulnerable populations globally. Better uunderstanding of vulnerability to shocks in food supply and demand in the Asia Pacific region is needed. SUBJECTS/METHODS: Using secondary data from rapid assessment surveys during the pandemic response (n = 10,420 in mid-2020; n = 6,004 in mid-2021) in India, Indonesia, Myanmar, and Vietnam, this study examined the risk factors for reported income reduction or job loss in mid-2021 and the temporal trend in food security status (household food availability, and market availability and affordability of essential items) from mid-2020 to mid-2021. RESULTS: The proportion of job loss/reduced household income was highest in India (60.4%) and lowest in Indonesia (39.0%). Urban residence (odds ratio [OR] range, 2.20-4.11; countries with significant results only), female respondents (OR range, 1.40-1.69), engagement in daily waged labor (OR range, 1.54-1.68), and running a small trade/business (OR range, 1.66-2.71) were significantly associated with income reduction or job loss in three out of 4 countries (all P < 0.05). Food stock availability increased significantly in 2021 compared to 2020 in all four countries (OR range, 1.91-4.45) (all P < 0.05). Availability of all essential items at markets increased in India (OR range, 1.45-3.99) but decreased for basic foods, hygiene items, and medicine in Vietnam (OR range, 0.81-0.86) in 2021 compared to 2020 (all P < 0.05). In 2021, the affordability of all essential items significantly improved in India (OR range, 1.18-3.49) while the affordability of rent, health care, and loans deteriorated in Indonesia (OR range, 0.23-0.71) when compared to 2020 (all P < 0.05). CONCLUSIONS: Long-term social protection programs need to be carefully designed and implemented to address food insecurity among vulnerable groups, considering each country's market conditions, consumer food purchasing behaviors, and financial support capacity.