Digital roots: harnessing digital platforms in advancing traditional and complementary medicine for cancer care in Sub-Saharan Africa.

The rise in cancer rates in Sub-Saharan Africa (SSA), combined with limited access to Western pharmaceuticals, has sparked growing adoption of traditional and complementary medicine (T&CM) for cancer treatment in the region. However, many challenges exist, including the lack of reliable evidence-based research on these products, scarcity of standardized documentation as part of cancer registries, limited physician expertise, and negative effects on mortality. Nonetheless, herbal medicines also present opportunities for further research, development, and stakeholder education, potentially benefiting the regional healthcare systems in SSA countries and global health as whole. Recent trends highlight the willingness of patients to use mobile-based applications that provide accurate information on herbal therapeutics, reflecting the increasing adoption of internet and smart/mobile phone services in SSA. To maximize the potential benefits of traditional and complementary medicine, it is necessary to bridge the trust gap between the public, local practitioners, and Western healthcare providers. Sustained funding and policy support are needed to complement these initiatives. Our preliminary survey hopes to inspire the community and policymakers to embrace innovative solutions, fostering a forward-looking approach to cancer care in SSA.

15-Year Follow-Up of Mobile Bearing Medial Unicompartmental Knee Arthroplasty.

INTRODUCTION: Medial unicompartmental knee arthroplasty (UKA) is a successful treatment for antero-medial osteoarthritis. However, there are few published studies on the long-term survival of this procedure. The purpose of this study was to review the 15-year minimum outcomes and survival of a mobile-bearing medial UKA. METHODS: A retrospective review was performed between July 2004 and December 2006 of all patients who underwent a medial UKA eligible for a minimum of 15-year follow-up. The initial query revealed 299 patients (349 knees). One hundred-seventeen patients died or were lost to follow-up, leaving 182 patients (219 knees) for analyses. Clinical outcomes and survivorship were analyzed. RESULTS: There were 59 implant-related reoperations which occurred at a mean of 10 years (range, 0 to 16 years). The most common reasons for reoperation were arthritic progression (9.1%) and aseptic loosening (9.1%). The 10-year survival with revision to TKA was 89% (95% confidence interval: 86% to 92.4%), and the 15-year survival was 84.1% (95% confidence interval: 80.3% to 88%). There were no statistically significant differences in survival between sex, body mass index, and age. Patients who were not revised had statistically significant improvements in knee range of motion and Knee Society scores. CONCLUSIONS: This study found similar long-term survival of a medial mobile-bearing UKA to published total knee arthroplasty outcomes. The implant evaluated in this study has undergone subsequent improvements in instrumentation and design. Further analyses should be performed on the long-term outcomes of the current implant platform.

The Effects of Victim Gender Identity, Juror Gender, and Judicial Instructions on Victim Blaming, Crime Severity Ratings, and Verdicts in Sexual Assault Trials.

Transgender individuals may experience social discrimination and unfair legal considerations as crime victims. The current purpose was to investigate the relationship between the participant/jurors' gender, the victims' gender identity, and judge's instructions to ignore the gender identity of the victim on perceptions of the victim and the crime and verdicts rendered in a sexual assault case. Overall, crime severity ratings were significantly lower for the trans male victim compared to the cisgender female victim. Male participants reported lower crime severity ratings for trials involving transgender victims compared to cisgender victims. However, victim blaming, likelihood that the defendant committed the crime, sentencing recommendations, verdict confidence, and conviction rates did not vary by the victim's gender identity, the participant's gender identity, nor the judge's instructions. Participant gender as a predictor of verdict approached significance, indicating a trend for males to render more not guilty verdicts and females to render more guilty verdicts. In summary, male jurors perceived the crimes involving transgender victims as less severe and this may have impacted the rate of not guilty verdicts.

Survivorship of a Metal-on-Metal Total Hip Implant With Modular Titanium Adapter.

BACKGROUND: Use of metal-on-metal (MoM) articulations in total hip arthroplasty (THA) has sharply declined due to high failure rates from metal-related complications. Although certain MoM designs have demonstrated only 46% survival, not all MoM designs have performed the same. The purpose of this study is to evaluate mid-term to long-term survival of a specific MoM implant with a modular titanium taper adapter. METHODS: A retrospective review was performed on all patients who underwent primary THA at our center with the M2a-Magnum system (Zimmer Biomet, Warsaw, IN). Of 829 patients (956 hips) identified, 754 patients (869 hips) met inclusion criteria of signed research consent, minimum 2-year follow-up, and/or any revision surgery. RESULTS: Mean follow-up was 11.0 years (range 2-16; ±3.5). Mean cup angle of inclination was 42.8° (range 24°-70°, ±6.3°), with 88.0% reconstructed within the 40° ± 10° safe zone. There were 64 revisions (7.36%): 7 (0.81%) septic and 57 (6.56%) aseptic. Of those, 32 (3.68%) were adverse reactions to metal debris. Kaplan-Meier survival free of revision for all causes was 88.6% at 16 years (95% confidence interval 86.8-90.4). Univariate analysis of risk factors for all-cause, aseptic, and adverse reaction to metal debris revision found no relationship with female gender, age ≥65 years, body mass index >30 kg/m2, higher activity level, or inclination angle outlier. CONCLUSION: The results of this study demonstrate a more favorable mid-term to long-term survivorship with this specific MoM implant compared to other designs. Although our institution no longer performs MoM THA, further investigation into differences in MoM implant designs is warranted.

Does a Triple-Wedge, Broach-Only Stem Design Reduce Early Postoperative Fracture in Anterior Total Hip Arthroplasty?

INTRODUCTION: The direct anterior (DA) approach for total hip arthroplasty (THA) is gaining popularity; however, this approach still poses a higher risk for femoral complications, including fracture. The design of cementless stems can also impact the risk of fracture. The purpose of this study is to evaluate the early postoperative femoral complications with a short, triple-wedge broach-only tapered stem used in primary THA via a DA approach. MATERIALS AND METHODS: A retrospective review of our institution's arthroplasty registry from 2015 through 2018 was performed to identify all patients who underwent a primary total hip arthroplasty via a direct anterior approach with the Klassic® Blade Stem (Total Joint Orthopedics, Inc., Salt Lake City, Utah). Patients were excluded if the stem was used for a revision surgery, within 90 days of surgery, or if research consent was refused. Two-hundred forty-five patients (289 hips) met inclusion criteria. Clinical and operative notes were reviewed, along with postoperative radiographs. RESULTS: Average follow up was 0.6 years (range, 0.25 to 3.6 years). Mean patient age was 62.9 years and mean body mass index (BMI) was 29.4 kg/m2. Gender was male in 130 patients (53%) and female in 115 patients (47%). No patients sustained an early postoperative periprosthetic femur fracture. No femoral revisions have been performed at most recent follow up. All 150 patients with >90-day postoperative radiographs demonstrated bony ingrowth of the stem. Early outcomes scores showed a mean postoperative Harris Hip Scores (HHS) of 80.1 (range, 10 to 100) and a pain score of 35.9 (range, 0 to 44). CONCLUSION: This triple-wedge broach-only implant demonstrated low rates of early perioperative femoral complications in primary THA via a direct anterior approach. The authors will continue to monitor the longer-term survival and patient outcomes with this implant.