X-ray diffraction with micrometre spatial resolution for highly absorbing samples.

X-ray diffraction with high spatial resolution is commonly used to characterize (poly)crystalline samples with, for example, respect to local strain, residual stress, grain boundaries and texture. However, the investigation of highly absorbing samples or the simultaneous assessment of high-Z materials by X-ray fluorescence have been limited due to the utilization of low photon energies. Here, a goniometer-based setup implemented at the P06 beamline of PETRA III that allows for micrometre spatial resolution with a photon energy of 35 keV and above is reported. A highly focused beam was achieved by using compound refractive lenses, and high-precision sample manipulation was enabled by a goniometer that allows up to 5D scans (three rotations and two translations). As experimental examples, the determination of local strain variations in martensitic steel samples with micrometre spatial resolution, as well as the simultaneous elemental distribution for high-Z materials in a thin-film solar cell, are demonstrated. The proposed approach allows users from the materials-science community to determine micro-structural properties even in highly absorbing samples.

Successful return to sport in patients with symptomatic borderline dysplasia following hip arthroscopy and T-shaped capsular plication.

PURPOSE: This study aims to evaluate the return to sport and correlations of patients with symptomatic borderline hip dysplasia (BHD) after hip arthroscopy and T-shaped capsular plication at a minimum follow-up of 24 months. METHODS: Twenty-five patients who underwent hip arthroscopy and T-shaped capsular plication for symptomatic BHD were included in the study. All the patients were evaluated clinically prior to surgery (T0) and at two consecutive follow-ups (T1:15 ± 1.2 months and T2: 53.9 ± 23.2 months) using the visual analogue scale (VAS) pain score, whereas sports activity was assessed by the Hip Outcome Score Sport Specific Subscale (HOS-SSS), the University of California, Los Angeles (UCLA) activity scale, the Tegner score and the physical component (PCS) of the Short Form-12 (SF-12). Furthermore, the presence of correlations and the possible differences between subgroups were evaluated and analysed. RESULTS: A significant difference was found for HOS-SSS, VAS, Tegner, UCLA and PCS with the Friedman test for repeated measures through time points (p < 0.0001). Moreover, all the scores reported significant improvement compared to the previous time point (p < 0.0001) except the HOS-SSS between T1 and T2 (n.s.). Body Mass Index (BMI) was negatively correlated with HOS-SSS at T0 (rho = - 0.526 p = 0.006) and T1 (rho = - 0.425; p = 0.034), with Tegner at each follow-up (T0: rho = - 0470 p = 0.017; T1: rho = - 0.450; p = 0.024; T2: rho = - 0.448; p = 0.024), with UCLA at T1 (rho = - 0.396 p = 0.049), with pre-operative PCS (rho = - 0.413 p = 0.0401), and positively correlated with pre-operative VAS (rho = 0.436 p = 0.0291). CONCLUSIONS: Hip arthroscopy and T-shaped capsular plication in young patients with symptomatic BHD demonstrates a significant increase in return to sport and physical activity and low risk of complications. T-shaped capsular plication procedure may be considered in young and active patients for whom non-operative treatment failed and who have a significant limitation in sports activity; in these patterns of patients, the ideal treatment should reliably allow fast recovery in combination with very low invasiveness which will prevent osteoarthritis. The results of this study provide more accurate information regarding return to sport in patients with BHD after hip arthroscopy and T-shaped capsular plication. LEVEL OF EVIDENCE: Level IV.

Sub-national prevalence survey of tuberculosis in rural communities of Ethiopia.

BACKGROUND: Tuberculosis is a major public health problem with varying prevalence in different settings. National prevalence surveys provide evidence for planning and decision making. However, they lack the capacity to estimate subnational magnitude that affected the capacity to make selected intervention based on the prevalence. Ethiopia is among high TB burden countries with estimated prevalence of 108 per 100,000 population varying by regions. We aimed to study sub national prevalence of smear-positive TB in rural communities of southern Ethiopia. METHODS: This cross-sectional study, enrolled community members aged over 14 years who had cough of at least two weeks duration. Two sputum samples were collected and examined by using smear microscopy. RESULTS: 38,304 eligible people were enumerated (10,779 from Hadiya, 10,059 from Gurage and 17,466 from Sidama) and indentified 960 presumptive cases. 16, 14 and 14 smear-positive pulmonary TB cases were identified respectively. The point prevalence of smear-positive TB were 148 per 100,000 population (95% CI: 91-241) in Hadiya, 139 per 100,000 population (95% CI: 83-234) in Gurage and 80/100,000 population (95%CI: 48-135) in Sidama zone. Gurage zone had the highest prevalent to notified cases of seven to one. CONCLUSIONS: The prevalence of smear positive TB varies by districts and is high in rural southern Ethiopia compared to the estimated national prevalence. More TB patients remain missed and unreached, impacting negatively on health outcomes. TB case finding approaches should be revisited and innovative approaches and tools to identify missing people with TB should be scaled up.

An ethnobotanical study of wild edible fruits in miombo woodlands of Tabora region in Western Tanzania.

BACKGROUND: Wild edible fruits found in Tanzania's miombo woods are an indispensable source of food and medicine. Unfortunately, with the rapid expansion of human activities and urbanisation in the Tabora rural, Uyui and Sikonge districts of Western Tanzania, some wild fruits are disappearing due to the loss of plant diversity. The objectives of this study wereL: to document the knowledge related to wild edible fruits; to quantify the use and cultural significance, and to determine their threats. METHODS: The ethnobotanical study was conducted from June 2022 to February 2023 involving 244 local informants. The study used field visits, the collection of plant parts, and semi-structured interviews with locals for its data collection. Descriptive statistics and correlation test were used to analyse the knowledge related to wild fruits. Frequency citation (f) and use reports (UR) were computed to understand the diversity and cultural significance (CI). RESULTS: The study documented 27 wild edible fruit species used for food and medicine. The life form constituted deciduous shrubs or trees (64%), shrub trees (21%) and evergreen or deciduous trees (15%). About (56%) of wild edible fruits were collected from June to August after the rainy season, (33%) were harvested between December and May during the rainy season, and (11%) were gathered from September and November before the rainy season. Household size and sex of the respondents were significantly correlated to the knowledge of wild edible fruits. Higher utilisation frequency (f) was recorded for Vitex mombassae Vatke (f = 0.84), Strychnos spinosa Lam. (f = 0.82), Vitex payos (Lour.) Merr. (f = 0.56), Phyllogeiton discolor (Klotzsch) Herzog. (f = 0.45), Vangueria infausta Burchell (f = 0.45), Tamarindus indica L. (f = 0.38), Parinari curatellifolia (f = 0.25), Landolphia parvifolia K.Schum. (f = 0.22) and Microcos conocarpa Burret (f = 0.22) fruits species. Additionally, Phyllogeiton discolor (Klotzsch) Herzog. (UR = 56), Vitex mombassae Vatke (UR = 56), Tamarindus indica L. (UR = 37), Strychnos spinosa Lam. (UR = 14) and Friesodielsia obovata (Benth.) Verdc. (UR = 11), have higher use reports (UR) and considered culturally important. Wild fruits were used to cure diabetes, gastrointestinal, reproductive, and respiratory infections ailments. DISCUSSION AND CONCLUSION: Multiple uses as well as the related knowledge of wild fruits have been documented. Friesodielsia obovata, Grewia flavescens Juss and Thespesia garckeana F.Hoffm. are the medicinal fruit species reported for the first time. Harvesting of wood plants, charcoal activities, crop cultivation, grazing expansion, and environmental change, have had an impact on the diversity of wild edible fruit plants. Over the past three decades, the use of wild fruits has been impacted by the loss of plant diversity due to decline of cultural norms on the forests management. Given the variety of uses for wild fruits, promoting markets for native fruits, sensitising the locals about the cultural importance and innovation on processing techniques are necessary to spur conservation efforts.

Higher Infection Rate after ACL Reconstruction with Hamstrings Tendon Autografts Compared with Bone Patellar Bone Tendon Autografts: A Review.

Infection after anterior cruciate ligament reconstruction is a rare but devastating complication resulting in a deleterious impact on knee function as well as an increased related cost for treatment and rehabilitation for the patients. There are conflicting reports regarding the rate of infection between bone patellar tendon bone (BPTB) and hamstrings tendon (HT) autografts for anterior cruciate ligament reconstruction. Therefore, we performed this review to summarize all the available data regarding the risk of infection after ACL reconstruction, to provide insight on the infection risk between BPTB and HT autografts, and to discuss current recommendations for the diagnosis and treatment of these infections. The incidence and risk of infection after ACL reconstruction with HT graft is higher compared with BPTB grafts. The most commonly subacute and late infections, quadruple type, need for cannulated instruments for harvesting, size and shape and fixation of the extra-tunnel material of the HT are important risk factors for infection. Combined antibiotics administration and adequate arthroscopic lavage and debridement are the optimal treatments for ACL reconstruction infection. Early diagnosis and treatment is the most important predictor for graft retention, which accounts more commonly for BPTB grafts. The treating physicians should be aware of the higher incidence of infection after ACL reconstruction with HT graft, as well as for the need for a high clinical suspicion for early diagnosis of the infection. These will increase the possibility of eradication of the infection and retention of the graft.

Clinical and Radiological Outcomes of Anteromedial Portal Versus Transtibial Technique in ACL Reconstruction: A Systematic Review.

BACKGROUND: The drilling technique used to make a femoral tunnel is critically important for determining outcomes after anterior cruciate ligament (ACL) reconstruction. The 2 most common methods are the transtibial (TT) and anteromedial (AM) techniques. PURPOSE: To determine whether graft orientation and placement affect clinical outcomes by comparing clinical and radiological outcomes after single-bundle ACL reconstruction with the AM versus TT technique. STUDY DESIGN: Systematic review; Level of evidence, 3. METHODS: Articles in PubMed, EMBASE, the Cochrane Library, ISI Web of Science, Scopus, and MEDLINE were searched from inception until April 25, 2020, using the following Boolean operators: transtibial OR trans-tibial AND (anteromedial OR trans-portal OR independent OR three portal OR accessory portal) AND anterior cruciate ligament. RESULTS: Of 1270 studies retrieved, 39 studies involving 11,207 patients were included. Of these studies, 14 were clinical, 13 were radiological, and 12 were mixed. Results suggested that compared with the TT technique, the AM technique led to significantly improved anteroposterior and rotational knee stability, International Knee Documentation Committee (IKDC) scores, and recovery time from surgery. A higher proportion of negative Lachman (P = .0005) and pivot-shift test (P = .0001) results, lower KT-1000 arthrometer maximum manual displacement (P = .00001), higher Lysholm score (P = .001), a higher incidence of IKDC grade A/B (P = .05), and better visual analog scale score for satisfaction (P = .00001) were observed with the AM technique compared with the TT technique. The AM drilling technique demonstrated a significantly shorter tunnel length (P = .00001). Significant differences were seen between the femoral and tibial graft angles in both techniques. Low overall complication and revision rates were observed for ACL reconstruction with the AM drilling technique, similar to the TT drilling technique. CONCLUSION: In single-bundle ACL reconstruction, the AM drilling technique was superior to the TT drilling technique based on physical examination, scoring systems, and radiographic results. The AM portal technique provided a more reproducible anatomic graft placement compared with the TT technique.

Identifying improvement potentials in cement production with life cycle assessment.

Cement production is an environmentally relevant process responsible for 5% of total anthropogenic carbon dioxide emissions and 7% of industrial fuel use. In this study, life cycle assessment is used to evaluate improvement potentials in the cement production process in Europe and the USA. With a current fuel substitution rate of 18% in Europe and 11% in the USA, both regions have a substantial potential to reduce greenhouse gas emissions and save virgin resources by further increasing the coprocessing of waste fuels. Upgrading production technology would be particularly effective in the USA where many kiln systems with very low energy efficiency are still in operation. Using best available technology and a thermal substitution rate of 50% for fuels, greenhouse gas emissions could be reduced by 9% for Europe and 18% for the USA per tonne of cement. Since clinker production is the dominant pollution producing step in cement production, the substitution of clinker with mineral components such as ground granulated blast furnace slag or fly ash is an efficient measure to reduce the environmental impact. Blended cements exhibit substantially lower environmental footprints than Portland cement, even if the substitutes feature lower grindability and require additional drying and large transport distances. The highest savings in CO(2) emissions and resource consumption are achieved with a combination of measures in clinker production and cement blending.

Differences in graft orientation using the transtibial and anteromedial portal technique in anterior cruciate ligament reconstruction: a magnetic resonance imaging study.

The purpose of this study was to evaluate differences in graft orientation between transtibial (TT) and anteromedial (AM) portal technique using magnetic resonance imaging (MRI) in anterior cruciate ligament (ACL) reconstruction. Fifty-six patients who were undergoing ACL reconstruction underwent MRI of their healthy and reconstructed knee. Thirty patients had ACL reconstruction using the TT (group A), while in the remaining 26 the AM (group B) was used. In the femoral part graft orientation was evaluated in the coronal plane using the femoral graft angle (FGA). The FGA was defined as the angle between the axis of the femoral tunnel and the joint line. In the tibial part graft orientation was evaluated in the sagittal plane using the tibial graft angle (TGA). The TGA was defined as the angle between the axis of the tibial tunnel and a line perpendicular to the long axis of the tibia. The ACL angle of the normal knee in the sagittal view was also calculated. The mean FGA for group A was 72 degrees, while for the group B was 53 degrees and this was statistically significant (P < 0.001). The mean TGA for group A was 64 degrees, while for the group B was 63 degrees (P = 0.256). The mean intact ACL angle for group A was 52 degrees, while for the group B was 51 degrees. The difference between TGA and intact ACL angle was statistically significant (P < 0.001) for both groups. Using the AM portal technique, the ACL graft is placed in a more oblique direction in comparison with the TT technique in the femoral part. However, there are no differences between the two techniques in graft orientation in the tibial part. Normal sagittal obliquity is not restored with both techniques.

Model for cradle-to-gate life cycle assessment of clinker production.

A model for input- and technology-dependent cradle-to-gate life cycle assessments (LCA)was constructed to quantify emissions and resource consumption of various clinker production options. The model was compiled using data of more than 100 clinker production lines and complemented with literature data and best judgment from experts. It can be applied by the cement industry for the selection of alternative fuels and raw materials (AFR) and by authorities for decision-support regarding the permission of waste co-processing in cement kilns. In the field of sustainable construction, the model can be used to compare clinker production options. Two case studies are presented. First, co-processing of four different types of waste is analyzed at a modern precalciner kiln system. Second, clinker production is compared between five kiln systems. Results show that the use of waste (tires, prepared industrial waste, dried sewage sludge, blast furnace slag) led to reduced greenhouse gas emissions, decreased resource consumption, and mostly to reduced aggregated environmental impacts. Regarding the different kiln systems, the environmental impact generally increased with decreasing energy efficiency.

Bullous adult T-cell lymphoma/leukemia and human T-cell lymphotropic virus-1 associated myelopathy in a 60-year-old man.

Here we report a case of vesiculobullous adult T-cell lymphoma/leukemia (ATLL); to our knowledge the first such report of this presentation. We emphasize the difficulty in clinically distinguishing ATLL from cutaneous t-cell lymphoma. The case is further distinguished by the simultaneous presentation of human T-cell lymphotropic virus-1-related myelopathy in this patient, an unusual occurrence.

HOXB4 homeodomain protein is expressed in developing epidermis and skin disorders and modulates keratinocyte proliferation.

The HOX homeodomain proteins are fundamental regulators of organ and tissue development, where they are thought to function as transcription factors, and HOX gene expression has been associated with numerous types of cancers. Previous studies have demonstrated that enforced expression of the HOXB4 protein transforms cultured fibroblasts and leads to a selective expansion of the hematopoietic stem cell pool, suggesting that this protein might play a role in cellular proliferation. In support of this concept, we now show that enforced expression of HOXB4 in human neonatal keratinocytes results in increased cellular proliferation and colony formation as well as decreased expression of the alpha-2-integrin and CD44 cell surface adhesion molecules. We previously have reported HOXB4 gene expression in the basal and suprabasal layers of developing human skin and now show extensive HOXB4 mRNA in psoriatic skin and basal cell carcinoma. In fetal human skin HOXB4 protein expression was both nuclear and cytoplasmic within epidermal basal cells and in hair follicle inner and outer root sheath cells, whereas strong nuclear signals were observed in the bulge region. In adult skin, HOXB4 protein expression was both nuclear and cytoplasmic, but was predominantly localized to the intermediate and differentiated cell layers. In contrast to the striking gradient patterns of HOX gene and protein expression previously described in developing spinal cord and limb, HOXB4 protein was uniformly detected in all regions of the fetal and adult skin. Although little HOXB4 signal localized to proliferative cell layers, as marked by proliferating cell nuclear antigen (PCNA) staining, in normal adult epidermis, nuclear HOXB4 protein expression substantially overlapped with PCNA-positive cell in a series of samples of hyperproliferative skin. Taken together, these data suggest that nuclear HOXB4 protein may play a role in the regulation of cellular proliferation/adhesion in developing fetal human epidermis and in hyperproliferation conditions, including cancers, in adult epidermis. Published 2002 Wiley-Liss, Inc.