Management of Length Unstable Femur Fractures in Children by Flexible Intramedullary Nails: A Systematic Review.

PURPOSE OF THE STUDY: Surgical options for paediatric femoral fractures include fl exible intramedullary nailing (FIN), plating, and external fi xators. Length unstable fractures are usually spiral, long oblique, or comminuted and are often associated with > 2 cm of shortening. The purpose of this study was to see whether FIN is effective for managing unstable femur fractures in children. MATERIAL AND METHODS: An electronic literature search was performed up to 25 February 2022 in Cochrane Library, PubMed, and Embase databases using a combination of MeSH search terms and keywords related to the population (e.g., "child" AND "diaphyses" AND "femur"), and intervention (e.g., "nail" OR "ESIN"). The data extracted included the study details, Demographic data, surgical details, postoperative immobilization, complications, and outcome. RESULTS: Eight studies with a total sample size of 369 patients were reviewed. The mean operative time, blood loss, and length of stay in the hospital were 67.62±12.32 minutes, 33.82±16.82 ml, and 4.9±1.27 days, respectively. The results were excellent in 61.92% of the patients, satisfactory in 32.61%, and poor in 5.43%. 4.54% of patients had major complications requiring reoperation and 32.46% of patients had minor complications. the most common complication was nail prominence seen in 26.30% of patients. Locked Ender's nail was associated with the least reoperation, malunion, and LLD rate compared to other types of FIN. CONCLUSIONS: FIN along with a single walking spica cast is a good choice in all forms of paediatric femoral fracture patterns allowing proper alignment and rotation. Locked Ender's nail is safe and effective for managing unstable paediatric femur fracture. KEY WORDS: pediatric femur fracture, length unstable, fl exible intramedullary nailing, submuscular plating, Flynn criterion.

A Meta-Analysis on Comparison of Open vs Closed Reduction of Gartland Type 3 Supracondylar Humerus Fractures in Children.

PURPOSE OF THE STUDY Although there are numerous studies on outcomes and comparison of open and closed reduction but there is no clarity on relationship between outcomes and complications with type of surgical intervention done for Type 3 Gartland supracondylar humerus fracture. The aim of this study is to compare the outcomes and complications of closed vs open reduction in Type 3 Gartland supracondylar humerus fractures. MATERIAL AND METHODS Electronic literature searches of Embase, MEDLINE and the Cochrane Library was conducted in February 2022 using the terms "supracondylar", "humerus", "fracture", "Gartland type 3" and synonymous. The data extracted included the study details, demographic data, procedure performed, final functional and cosmetic outcome according to Flynn criteria and complications of included studies. RESULTS Pooled data analysis revealed no significant difference in mean satisfactory outcome rate according to Flynn cosmetic criteria in open group (97%, 95% CI 95.5%-98.5%), as compared to closed group (97.5%, 95% CI 96.3%-98.7%), although a statistically significant difference in mean satisfactory rate according to Flynn functional criteria in open group (93.4%, 95% CI 90.8%- 96.1%) as compared to closed group (98.5%, 95% CI 97.5%-99.4%) was noted. On separate comparison of the two-arm studies, closed reduction favoured better functional outcomes (RR 0.92, 95% CI 0.86-0.99). CONCLUSIONS Closed reduction and percutaneous fixation have better functional outcome than open reduction with K-wire fixation. But there was no significant difference in cosmetic outcomes, overall complication rate and nerve injury with either open or closed reduction. The threshold of converting a closed reduction to an open reduction in supracondylar humerus fractures of children should be high. Key words: supracondylar humerus, open reduction, percutaneous pinning, Flynn criteria.

A systematic review of complications following selective dorsal rhizotomy in cerebral palsy.

PURPOSE: The literature lacks a concise overview of complications secondary to selective dorsal rhizotomy (SDR). The aim of this study was to systematically review the literature regarding post-SDR complications, and to present them concisely. METHODS: The protocol of the review was registered on Open Science Framework. Studies on SDR in cerebral palsy were included. The studies to be included used SDR for management of spasticity in patients with cerebral palsy. The long-term complications of SDR mentioned in the articles were inventoried. RESULTS: Thirty studies were included for qualitative review. Twenty-one types of complication were identified. Structural complications were the commonest: scoliosis (214/1,043, 20.5%), hyperlordosis (101/552, 18.2%), spondylolysis (55/574, 9.5%) and kyphosis (67/797, 8.4%). Neurological complications comprised constipation (70/485, 14.4%), hip subluxation (3/29, 10.3%), spastic syndrome (4/47, 8.5%), sensory changes (106/1290, 8.2%) and urinary incontinence (61/1013, 6%). CONCLUSION: This review should help surgeons and parents alike to know about the potential complications of SDR. Complications may affect quality of life and should be weighed. Although the majority of these complications were managed conservatively, there would still be a physical, psychological and financial burden which should be taken into account. Screening should be continued vigorously throughout skeletal growth and at reduced frequency thereafter, for timely intervention in case of structural complications.

Association mapping for protein, total soluble sugars, starch, amylose and chlorophyll content in rice.

BACKGROUND: Protein, starch, amylose and total soluble sugars are basic metabolites of seed that influence the eating, cooking and nutritional qualities of rice. Chlorophyll is responsible for the absorption and utilization of the light energy influencing photosynthetic efficiency in rice plant. Mapping of these traits are very important for detection of more number of robust markers for improvement of these traits through molecular breeding approaches. RESULTS: A representative panel population was developed by including 120 germplasm lines from the initial shortlisted 274 lines for mapping of the six biochemical traits using 136 microsatellite markers through association mapping. A wide genetic variation was detected for the traits, total protein, starch, amylose, total soluble sugars, chlorophyll a, and chlorophyll b content in the population. Specific allele frequency, gene diversity, informative markers and other diversity parameters obtained from the population indicated the effectiveness of utilization of the population and markers for mapping of these traits. The fixation indices values estimated from the population indicated the existence of linkage disequilibrium for the six traits. The population genetic structure at K = 3 showed correspondence with majority of the members in each group for the six traits. The reported QTL, qProt1, qPC6.2, and qPC8.2 for protein content; qTSS8.1 for total soluble sugar; qAC1.2 for amylose content; qCH2 and qSLCHH for chlorophyll a (Chl. a) while qChl5D for chlorophyll b (Chl. b) were validated in this population. The QTL controlling total protein content qPC1.2; qTSS7.1, qTSS8.2 and qTSS12.1 for total soluble sugars; qSC2.1, qSC2.2, qSC6.1 and qSC11.1 for starch content; qAC11.1, qAC11.2 and qAC11.3 for amylose content; qChla8.1 for Chl. a content and qChlb7.1 and qChlb8.1 for Chl. b identified by both Generalized Linear Model and Mixed Linear Model were detected as novel QTL. The chromosomal regions on chromosome 8 at 234 cM for grain protein content and total soluble sugars and at 363 cM for Chl. a and Chl. b along with the position at 48 cM on chromosome 11 for starch and amylose content are genetic hot spots for these traits. CONCLUSION: The validated, co-localized and the novel QTL detected in this study will be useful for improvement of protein, starch, amylose, total soluble sugars and chlorophyll content in rice.

Realizing certainty in an uncertain future climate: modeling suitable areas for conserving wild Citrus species under different change scenarios in India.

Citrus is an important horticultural crop of India and is often prone to diseases, particularly under increased temperature scenarios. For developing disease-resistant Citrus varieties, conservation of wild relatives is extremely important. However, our knowledge on temperature tolerance of these wild relatives of Citrus to varied climate change scenarios is extremely limited. Therefore, we determined the climatic niche of six wild relatives of cultivated Citrus species (C. indica Tanaka, C. karna Rafin., C. latipes (Swingle) Tanaka, C. macroptera Montrouz., C. medica L., and C. sinensis (L.) Osbeck.) and identified the geographical areas in India that would remain climatically stable in future through ecological niche modeling (ENM). Raster data on 19 bioclimatic variables with a resolution of 0.04° were used to generate niche models for each Citrus species that delineated their potential distribution areas. Future species distribution predictions for the year 2050 were made using the climate change scenarios from the most appropriate climate models, i.e., IPSL-CM5A-LR and NIMR-HADGEM2-AO with four Representative Concentration Pathways (RCPs). Ensemble of current and future projections was used to identify climatically stable areas for each species. Precipitation-related bioclimatic variables were the key climatic determinants for the modeled distribution pattern. The consensus of current and future projections suggests that most areas with stable climates for the species in the future would be available in the northeastern states of Arunachal Pradesh, Meghalaya, Mizoram, and Tripura. Efforts for in situ conservation and establishment of germplasm banks and citrus orchards may be encouraged in these identified areas.

Bioclimatic modeling and FACE study forecast a bleak future for wheat production in India.

Since the impact of future climate change on wheat productivity is inconsistent, we studied geographic distribution and yield of wheat using two global General Circulation Models (GCMs) and Free Air CO2/O3 Enrichment (FACE) experiments. The GCMs (IPSL-CM5A-LR and NIMR-HADGEM2-AO) with four Representative Concentration Pathways (RCPs) and 19 bioclimatic variables were used for distribution/ecological niche modeling (ENM). Currently cultivated eight wheat cultivars were exposed to individual treatment of (i) ambient CO2, temperature, and ozone (ACO + AO + AT) representing the present climate scenario, and (ii) elevated CO2 (550 ppm) (ECO), (iii) elevated temperature (+ 2 °C) (ET), (iv) elevated O3 (ambient + 20 ppb) (EO), (v) elevated CO2 + elevated O3 (ECO + EO), and (vi) elevated CO2 + elevated temperature + elevated O3 (ECO + EO + ET) under FACE facility simulating the future climate change scenarios in 2050. The niche models predicted a reduction in climatically suitable areas for wheat, and identified "maximum temperature" as the most influencing factor for area reduction. The elevated CO2, O3, and temperature individually and in combinations had differential impacts on the yield of wheat cultivars. Only two cultivars, viz., DBW 184 and DBW 187 did not exhibit yield decline suggesting their suitability in the future climate change scenario. Since the performance of six out of eight cultivars significantly declined under simulated FACE experiment, and ENM predicted reduction in wheat cultivation area under RCP 8.5 in 2050, it was concluded that future of wheat cultivation in India is bleak. The study further indicates that coupling of bioclimatic modeling and FACE experiment can effectively predict the impact of climate change on different crops.

Bioavailability of metals in coastal lagoon sediments and their influence on benthic foraminifera.

Coastal lagoons experience removal and leaching of metals due to seasonal fluctuation of salinity coupled with pH and dissolved oxygen variability. Benthic foraminifers are susceptible to seasonal variation in physicochemical conditions. Assessment of bioavailable fraction of selected metals in sediments along the salinity gradient of the largest brackish lagoon in Asia- Chilika was carried out. Further, population density and abnormality index of foraminifera in the sediments were calculated to understand the influence of bioavailable metal on benthic foraminifera. Metal concentrations were higher in the low salinity regions and decreased towards the high salinity regions. This suggests river discharge controls the metal input and distribution in the lagoon. Overall, metal concentrations are high in the residual fraction (F4) followed by interplay within the reducible (F2) or oxidizable (F3) fractions, except for Mn. The seasonal fluctuations of pH and cyclic oxygen deficiency intensified the leaching of Fe, Cr, Cu, Pb, and Zn in the bioavailable fraction in the low salinity region of the lagoon. The presence of metals in bioavailable fractions impacted the normal growth of the abundant Ammonia species. Despite low bioavailable metal concentrations, higher morphological abnormalities were observed in the high salinity regions due to higher energy conditions near the sea. Therefore, abnormalities in the benthic foraminifera are attributed to bioavailability of metals from sediments and natural stress conditions in the coastal lagoon environment.

Results of ala carte Posteromedial Soft Tissue Release in Idiopathic Clubfoot.

INTRODUCTION: The aim of this study is to assess the outcomes of ala carte posteromedial release in children over two years of age who were not responding to the Ponseti method of treatment of idiopathic clubfoot. MATERIAL AND METHODS: A retrospective observational study from September 2013 to August 2015 was conducted at a tertiary level medical teaching institution. The clubfeet were classified according to the Harold and Walker classification. Radiographic parameters assessed were the talocalcaneal angle (AP, lateral), talus-first metatarsal angle (AP, lateral) and calcaneal-fifth metatarsal angle. The scar and the functional score, according to Laaveg and Ponseti, were evaluated as outcome measures at the final follow-up. RESULTS: Twenty-four children with a mean age of 43.7 ± 24.7 months were enrolled in the study. There was a total of 36 clubfeet: 21 (65.6%) with a poor functional outcome; 12 (37.4%) with excellent to good scar in both horizontal and vertical components. There was a statistical significance between the pre-operative and post-operative radiological parameters (p<0.05). None of the patients presented with any limitation of activities of daily living despite the poor functional outcome in many of the children. There was no significant association between the qualities of scar (horizontal, vertical) and the functional outcome with age at presentation, pre-operative Harold and Walker classification and pre-operative radiographic angles. CONCLUSION: Surgical intervention in terms of ala carte posteromedial soft tissue release could not produce a good outcome over four years in CTEV. The threshold for surgery in CTEV should be high, given the poor results.

Characterization and bioremediation potential of native heavy-metal tolerant bacteria isolated from rat-hole coal mine environment.

Identification and characterization of endogenous and stress adapted bacterial species, from rat-hole coal mines in Meghalaya, amplify the ambit of bioremediation for eco-restoration. 52 native bacterial isolates, drawn from soil and water samples of these mines, were analysed for bioremediation potential, based on growth and metal tolerance parameters. 12 of these isolates were metal tolerant with Bacillus spp. being the most promising taxon. Three isolates, namely, Serratia marcescens KH-CC, Bacillus altitudinis KH-16F and Bacillus siamensis KH-12A, exhibited high Maximum Tolerable Concentration (MTC) against Fe (500 ppm), Mn (830 ppm) and Pb (1400 ppm). B. siamensis showed highest Fe remediation with 48.34% removal capacity, while maximum removal for Mn and Pb was exhibited by Serratia marcescens at 72.5 and 83%, respectively. The growth profile of the isolates indicated their ability to survive under pH, temperature and salt stress conditions. In vitro growth kinetics studies of the isolates revealed their ability to decrease the acidity of growth media and improve alkalinity from an initial of pH 4.8-5.2 to an alkaline level of pH 8.5-9. These native bacteria, extracted from the stressed coal mine habitat, are potential germane applicants for rehabilitation and eco-restoration of ecologically degraded mine sites.

Results of ala carte Posteromedial Soft Tissue Release in Idiopathic Clubfoot

@#Introduction: The aim of this study is to assess the outcomes of ala carte posteromedial release in children over two years of age who were not responding to the Ponseti method of treatment of idiopathic clubfoot. Materials and Methods: A retrospective observational study from September 2013 to August 2015 was conducted at a tertiary level medical teaching institution. The clubfeet were classified according to the Harold and Walker classification. Radiographic parameters assessed were the talocalcaneal angle (AP, lateral), talus-first metatarsal angle (AP, lateral) and calcaneal-fifth metatarsal angle. The scar and the functional score, according to Laaveg and Ponseti, were evaluated as outcome measures at the final follow-up. Results: Twenty-four children with a mean age of 43.7 ± 24.7 months were enrolled in the study. There was a total of 36 clubfeet: 21 (65.6%) with a poor functional outcome; 12 (37.4%) with excellent to good scar in both horizontal and vertical components. There was a statistical significance between the pre-operative and post-operative radiological parameters (p<0.05). None of the patients presented with any limitation of activities of daily living despite the poor functional outcome in many of the children. There was no significant association between the qualities of scar (horizontal, vertical) and the functional outcome with age at presentation, pre-operative Harold and Walker classification and pre-operative radiographic angles. Conclusion: Surgical intervention in terms of ala carte posteromedial soft tissue release could not produce a good outcome over four years in CTEV. The threshold for surgery in CTEV should be high, given the poor results.

Linkage disequilibrium mapping for grain Fe and Zn enhancing QTLs useful for nutrient dense rice breeding.

BACKGROUND: High yielding rice varieties are usually low in grain iron (Fe) and zinc (Zn) content. These two micronutrients are involved in many enzymatic activities, lack of which cause many disorders in human body. Bio-fortification is a cheaper and easier way to improve the content of these nutrients in rice grain. RESULTS: A population panel was prepared representing all the phenotypic classes for grain Fe-Zn content from 485 germplasm lines. The panel was studied for genetic diversity, population structure and association mapping of grain Fe-Zn content in the milled rice. The population showed linkage disequilibrium showing deviation of Hardy-Weinberg's expectation for Fe-Zn content in rice. Population structure at K = 3 categorized the panel population into distinct sub-populations corroborating with their grain Fe-Zn content. STRUCTURE analysis revealed a common primary ancestor for each sub-population. Novel quantitative trait loci (QTLs) namely qFe3.3 and qFe7.3 for grain Fe and qZn2.2, qZn8.3 and qZn12.3 for Zn content were detected using association mapping. Four QTLs, namely qFe3.3, qFe7.3, qFe8.1 and qFe12.2 for grain Fe content were detected to be co-localized with qZn3.1, qZn7, qZn8.3 and qZn12.3 QTLs controlling grain Zn content, respectively. Additionally, some Fe-Zn controlling QTLs were co-localized with the yield component QTLs, qTBGW, OsSPL14 and qPN. The QTLs qFe1.1, qFe3.1, qFe5.1, qFe7.1, qFe8.1, qZn6, qZn7 and gRMm9-1 for grain Fe-Zn content reported in earlier studies were validated in this study. CONCLUSION: Novel QTLs, qFe3.3 and qFe7.3 for grain Fe and qZn2.2, qZn8.3 and qZn12.3 for Zn content were detected for these two traits. Four Fe-Zn controlling QTLs and few yield component QTLs were detected to be co-localized. The QTLs, qFe1.1, qFe3.1, qFe5.1, qFe7.1, qFe8.1, qFe3.3, qFe7.3, qZn6, qZn7, qZn2.2, qZn8.3 and qZn12.3 will be useful for biofortification of the micronutrients. Simultaneous enhancement of Fe-Zn content may be possible with yield component traits in rice.

Plant diversity, net primary productivity and soil nutrient contents of a humid subtropical grassland remained low even after 50 years of post-disturbance recovery from coal mining.

Assessment of environmental impact of coal mining on natural ecosystems and monitoring of subsequent ecological restoration process of mined areas are essential for devising reclamation strategies for mining-affected landscapes. The present study was designed to assess the post-disturbance recovery of vegetation, primary productivity and soil nutrient build-up of a humid subtropical grassland ecosystem following coal mining activities. Two replicate sites each for the undisturbed grasslands (UG), mining-affected (MG) and recovering grasslands of 15 (RG15) and 50 (RG50) years old were selected. There was a distinct pattern of species colonization and replacement during different years of recovery. Species richness, biomass, net primary productivity and soil pH declined following disturbance but increased with recovery age. Soil organic C and total N were high in the MG sites but significantly declined with recovery age. Soil total P and exchangeable K and Mg were low even at the 50th year of recovery indicating extremely slow recovery rate of these nutrients. Considering the extremely slow natural recovery of vegetation and soil nutrients, it is recommended to carry out artificial or aided vegetation restoration using native grass species tolerant to disturbance. Six species which are well-adapted to the mining environment and were present in both undisturbed and mining-affected recovering grasslands, viz. Arundinella khaseana, Cyanotis vaga, Eragrostis nigra, Polygonum bistorta and Fimbristylis hookeriana, are recommended for aided vegetation regeneration.

Extra-Spinal Osteoarticular Tuberculosis: A Retrospective Analysis of 103 Cases.

INTRODUCTION: Many studies in the literature deals with epidemiology, diagnosis and management of spinal tuberculosis but there is scant amount of such data for extraspinal osteoarticular TB. MATERIAL AND METHODS: Demographic patient data like age, sex, bone and joint involved, side involved, duration of symptoms was noted. All suspected cases of extra-spinal musculoskeletal TB with positive acid-fast bacilli (AFB) staining or positive cartridge based nucleic acid amplification test (CBNAAT) or histopathological evidence of granulomatous infection and minimum 1 year follow up after completion of 12-month ATT were included in the study. Outcome evaluation was done on the basis of residual pain, range of motion of joint along with deformity of the affected part, if any. RESULTS: A total of 103 patients (55 males, 48 females) were analyzed. The mean duration of treatment was 14.2±2.8 months. The mean age of the patients at presentation was 30.5±18.5 years. The most common site affected was the ankle joint followed by hip and knee. 95 cases (92.2%) were diagnosed by histopathological examination of synovial tissue or material obtained from core biopsy. 90 cases (87.3%) were treated conservatively on oral drugs only while 13 cases (12.7%) were treated operatively. Outcome after completion of ATT were graded as good in 46 (46.9%), fair and poor each in 26 patients (26.5%). CONCLUSION: Extraspinal osteoarticular TB can be managed effectively by 12-month ATT if diagnosed early. Some cases with advanced arthritis can be salvaged with implant arthroplasty or arthrodesis under cover of ATT.

Use of satellite remote sensing as a monitoring tool for land and water resources development activities in an Indian tropical site.

With the availability of satellite data from free data domain, remote sensing has increasingly become a fast-hand tool for monitoring of land and water resources development activities with minimal cost and time. Here, we verified construction of check dams and implementation of plantation activities in two districts of Tripura state using Landsat and Sentinel-2 images for the years 2008 and 2016-2017, respectively. We applied spectral reflectance curves and index-based proxies to quantify these activities for two time periods. A subset of the total check dams and plantation sites was chosen on the basis of site condition, nature of check dams, and planted species for identification on satellite images, and another subset was randomly chosen to validate identification procedure. The normalized difference water index (NDWI) derived from Landsat and Senitnel-2 were used to quantify water area evolved, qualify the water quality, and influence of associated tree shadows. Three types of check dams were observed, i.e., full, partial, and fully soil exposed on the basis of the presence of grass or scrub on the check dams. Based on the nature of check dam and site characteristics, we classified the water bodies under 11-categories using six interpretation keys (size, shape, water depth, quality, shadow of associated trees, catchment area). The check dams constructed on existing narrow gullies totally covered by branches or associated plants were not identified without field verification. Further, use of EVI enabled us to approve the plantation activities and adjudge the corresponding increase in vegetation vigor. The plantation activities were established based on the presence and absence of existing vegetation. Clearing on the plantation sites for plantation shows differential increase in EVI values during the initial years. The 403 plantation sites were categorized into 12 major groups on the basis of presence of dominant species and site conditions. The dominant species were Areca catechu, Musa paradisiaca, Ananas comosus, Bambusa sp., and mix plantation of A. catechu and M. paradisiaca. However, the highest maximum increase in average EVI was observed for the pine apple plantation sites (0.11), followed by Bambussa sp. (0.10). These sites were fully covered with plantation without any exposed soil. The present study successfully demonstrates a satellite-based survey supplemented with ground information evaluating the changes in vegetation profile due to plantation activities, locations of check dams, extent of water bodies, downstream irrigation, and catchment area of water bodies.

Electrochemical process for electrode material of spent lithium ion batteries.

Electrochemical method for recovering cobalt and manganese from electrode materials of spent lithium ion batteries was studied. Electrochemical leaching of cobalt and manganese from electrode material was optimized by varying different process parameters such as time, acid concentration and current density. Both cobalt and manganese could effectively be leached out at a current density of 400A/m2 in 3h using 2M sulphuric acid. In the subsequent study, the metallic cobalt and electrolytic manganese dioxides was recovered from the leach liquor at 200A/m2, pH 2-2.5 and 90°C after removing aluminum. The commercial feasibility of the study was tested in pilot scale. Overall recovery of Co, Cu and Mn was above 96%, 97% and 99%, respectively.

A hydrometallurgical process for recovering total metal values from waste monolithic ceramic capacitors.

A hydrometallurgical process for recovering the total metal values from waste monolithic ceramic capacitors was investigated. The process parameters such as time, temperature, acid concentration, hydrogen peroxide concentration and other reagents (amount of zinc dust and sodium formate) were optimized. Base metals such as Ba, Ti, Sn, Cu and Ni are leached out in two stages using HCl in stage 1 and HCl with H2O2 in stage 2. More than 99% of leaching efficiency for base metals (Cu, Ni, Ba, Ti and Sn) was achieved. Precious metals such as Au and Pd are leached out using aquaregia and nitric acid was used for the leaching of Ag. Base metals (Ba, Ti, Sn, Cu and Ni) are recovered by selective precipitation using H2SO4 and NaOH solution. In case of precious metals, Au and Pd from the leach solution were precipitated out using sodium metabisulphite and sodium formate, respectively. Sodium chloride was used for the precipitation of Ag from leach solution. Overall recovery for base metals and precious metals are 95% and 92%, respectively. Based on the results of the present study, a process flow diagram was proposed for commercial application.

Protein tyrosine phosphatase 1B negatively regulates S100A9-mediated lung damage during respiratory syncytial virus exacerbations.

Protein tyrosine phosphatase 1B (PTP1B) has anti-inflammatory potential but PTP1B responses are desensitized in the lung by prolonged cigarette smoke exposure. Here we investigate whether PTP1B expression affects lung disease severity during respiratory syncytial viral (RSV) exacerbations of chronic obstructive pulmonary disease (COPD). Ptp1b(-/-) mice infected with RSV exhibit exaggerated immune cell infiltration, damaged epithelial cell barriers, cytokine production, and increased apoptosis. Elevated expression of S100A9, a damage-associated molecular pattern molecule, was observed in the lungs of Ptp1b(-/-) mice during RSV infection. Utilizing a neutralizing anti-S100A9 IgG antibody, it was determined that extracellular S100A9 signaling significantly affects lung damage during RSV infection. Preexposure to cigarette smoke desensitized PTP1B activity that coincided with enhanced S100A9 secretion and inflammation in wild-type animals during RSV infection. S100A9 levels in human bronchoalveolar lavage fluid had an inverse relationship with lung function in healthy subjects, smokers, and COPD subjects. Fully differentiated human bronchial epithelial cells isolated from COPD donors cultured at the air liquid interface secreted more S100A9 than cells from healthy donors or smokers following RSV infection. Together, these findings show that reduced PTP1B responses contribute to disease symptoms in part by enhancing S100A9 expression during viral-associated COPD exacerbations.

An innovative approach to recover the metal values from spent lithium-ion batteries.

A new approach to recover metal values from spent lithium-ion batteries with a simple and environmentally friendly method is investigated. Two stages of water washing of the mixed black powder resulted in satisfactory separation of cobalt and lithium. Lithium in the wash liquor is precipitated using saturated sodium carbonate solution. Cobalt oxide in the residue is purified by removing organic matrix through roasting followed by dilute acid washing. The purities of the products obtained during the processes are analyzed by Microwave Plasma-Atomic Emission Spectrophotometer and confirmed from X-ray diffraction analysis. The overall process is safe, economic and can be scaled up for commercial production. Based on the process steps involved, a flow sheet is proposed for industrial application.

Duplication of Conventional Multiport Laparoscopic Radical Hysterectomy Steps with Other Minimal Access Modalities (LESS, OASIS, Robotic).

STUDY OBJECTIVE: To duplicate the steps of conventional multiport laparoscopic radical hysterectomy by 3 other minimal access modalities: robotic radical hysterectomy, laparoendoscopic single-site surgery (LESS), and orifice-assisted small-incision surgery (OASIS). DESIGN: Institutional Review Board approval was obtained. Between January 2009 and December 2012, the charts of the patients who had undergone radical hysterectomy by these 4 minimal access modalities were analyzed. SETTING: Galaxy Care Laparoscopy Institute, Pune, India. PATIENTS: Fifteen patients in each arm with stage IB1 cervical cancer with a histopathological report of squamous cell carcinoma were analyzed. All patients had undergone radical hysterectomy by a conventional multiport, robotic, LESS, or OASIS technique. The type of procedure was decided by joint consultancies of doctor and patient. All patients were analyzed retrospectively for time, blood loss, oncologic clearance, and complications. The median follow-up of all patients was 12 months (range, 8-18 months). INTERVENTION: The "Pune technique" of radical hysterectomy consists of 6 steps: (1) posterior U cut; (2) dissection of pouch of Douglas; (3) pararectal space dissection; (4) anterior U cut; (5) uretric tunnel dissection; and (6) ilio-obturator lymph node dissection. CONCLUSION: The radical hysterectomy is a type B radical hysterectomy. Proper patient selection plays an important role in radical hysterectomy with different minimal access operative modalities. Parametrium clearance of 2.25 to 3.5 cm can be obtained with different modalities [1-5]. As of the writing of this report, none of the 60 patients evaluated had experienced recurrence, and all are disease-free. The study period was 4 years. To conclude, our data indicate that the steps of conventional multiport radical hysterectomy by the Pune technique can be duplicated by other minimal access modalities, including robotic radical hysterectomy, LESS, and OASIS.