Risk Factor Prediction and Categorization for Glenohumeral Osteoarthritis: A Classification and Regression Tree (CART) Analysis.

OBJECTIVE: This study aimed to apply Classification and Regression Tree (CART) analysis to determine factors associated with glenohumeral osteoarthritis (GH OA) and establish specific cut-off points for risk factors based on this methodology. DESIGN: The cross-sectional study included 3,383 participants with shoulder pain. Cases were selected for GH OA. Patients with other shoulder pathologies were included as controls. 33 potential risk factors were assessed. The CART analysis was used to determine the highest-ranked risk factors associated with GH OA. Multivariable logistic regression analysis was then performed using the cut-off points obtained from the CART analysis. RESULTS: The CART analysis showed that age and body mass index (BMI) were the two most significant risk factors for GH OA. Multivariable logistic regression revealed that age categories ≥31- < 58 years (OR = 8.92), ≥58- < 64 years (OR = 20.20), and ≥ 64 years (OR = 42.20), and BMI categories ≥25-30 kg/ m2 (OR = 1.47) and ≥ 30 kg/ m2 (OR = 1.71) had higher odds of developing GH OA compared to age < 31 years and BMI <25 kg/m2. CONCLUSION: This was the first study to use CART analysis to evaluate significant risk factors for GH OA and establish cut-off points for increased risk. The findings present age categories that are distinct from the arbitrary age groups used in previous studies.

Peripheral Nerve Stimulation of the Axillary Nerve Improves Chronic Shoulder Pain and Dysfunction Following Reverse Total Shoulder Arthroplasty: A Case Report.

ABSTRACT: Reverse total shoulder arthroplasty (rTSA) is an effective procedure to improve shoulder pain, range of motion, and function for a variety of conditions, including glenohumeral osteoarthritis and rotator cuff arthropathy. However, up to 22% of patients have persistent shoulder pain 12 to 24 months following rTSA, even in the absence of surgical complications. Currently, there are no widely accepted non-pharmacological treatments for persistent postoperative pain after rTSA. This case report details the successful management of a 64-year-old woman with chronic postoperative shoulder pain following rTSA. She was treated with single-lead percutaneous peripheral nerve stimulation to the right axillary nerve for eight weeks with 12 Hz motor-level stimulation. She demonstrated improvement in shoulder flexion active range of motion, shoulder flexion strength, and shoulder abduction strength. Her Shoulder Pain and Disability Index total score improved from 26.93% to 8.46% one year following treatment. She reported an overall Global Rating of Change of +7 one year following treatment. This case's success demonstrates that short term peripheral nerve stimulation may provide long-term improvement of persistent post-operative pain and dysfunction in patients with painful rTSA.

Obesity is associated with muscle atrophy in rotator cuff tear.

Objective: The primary goal of this study is to evaluate the relationship between Body Mass Index (BMI) and muscle atrophy in individuals with rotator cuff tears. Methods: This study consists of patients with rotator cuff tears identified by MRI from two independent cohorts, the Rotator Cuff Outcomes Workgroup (ROW) and the Multicenter Orthopaedic Outcomes Network (MOON). Presence of atrophy (yes/no) and severity of atrophy (as an ordinal variable) were assessed on MRI by expert physicians. We used multivariable regression models to evaluate the relationship between BMI and muscle atrophy while adjusting for age and sex in each study, conducted sensitivity analyses for full-thickness tear and combined results using inverse variance-weighted meta-analysis. Results: A total of 539 patients (MOON=395, ROW=144) from the combined cohorts had MRI data available on muscle atrophy. Among these patients, 246 (46%) had atrophy of at least one of the muscles of the rotator cuff and 282 (52%) had full-thickness tears. In meta-analysis across both cohorts, each 5 kg/m2 increase in BMI was associated with a 21% (aOR=1.21, 95% CI=1.02, 1.43) increased odds of having muscle atrophy among individuals with any tear size, and 36% (aOR=1.36, 95% CI=1.01-1.81) increased odds among individuals with full-thickness tear. Conclusions: Higher BMI was associated with significantly higher odds of muscle atrophy in patiens with rotator cuff tears. More study is needed to unders1tand why and how this relationship exists, as well as whether interventions to reduce BMI may help improve outcomes for these patients. Level of Evidence: III.

Design, synthesis and molecular docking study of novel triazole-quinazolinone hybrids as antimalarial and antitubercular agents.

In a quest to discover new antimalarial and antitubercular drugs, we have designed and synthesized a series of novel triazole-quinazolinone hybrids. The in vitro screening of the triazole-quinazolinone hybrid entities against the plasmodium species P. falciparum offered potent antimalarial molecules 6c, 6d, 6f, 6g, 6j & 6k owing comparable activity to the reference drugs. Furthermore, the target compounds were evaluated in vitro against Mycobacterium tuberculosis (MTB) H37Rv strain. Among the screened compounds, 6c, 6d and 6l were found to be the most active molecules with a MIC values of 19.57-40.68 µM. The cytotoxicity of the most active compounds was studied against RAW 264.7 cell line by MTT assay and no toxicity was observed. The computational study including drug likeness and ADMET profiling, DFT, and molecular docking study was done to explore the features of target molecules. The compounds 6a, 6g, and 6k exhibited highest binding affinity of -10.3 kcal/mol with docked molecular targets from M. tuberculosis. Molecular docking study indicates that all the molecules are binding to the falcipain 2 protease (PDB: 6SSZ) of the P. falciparum. Our findings indicated that these new triazole-quinazolinone hybrids may be considered hit molecules for further optimization studies.

Advances in glioblastoma multiforme: Integrating therapy and pathology perspectives.

Glioblastoma, a highly lethal form of brain cancer, is characterized by its aggressive growth and resistance to conventional treatments, often resulting in limited survival. The response to therapy is notably influenced by various patient-specific genetic factors, underscoring the disease's complexity. Despite the utilization of diverse treatment modalities such as surgery, radiation, and chemotherapy, many patients experience local relapse, emphasizing the critical need for improved therapeutic strategies to effectively target these formidable tumors. Recent years have witnessed a surge in interest in natural products derived from plants, particularly alkaloids, for their potential anticancer effects. Alkaloids have shown promise in cancer chemotherapy by selectively targeting crucial signaling pathways implicated in tumor progression and survival. Specifically, they modulate the NF-κB and MAPK pathways, resulting in reduced tumor growth and altered gene expression across various cancer types. Additionally, alkaloids exhibit the capacity to induce cell cycle arrest, further impeding tumor proliferation in several malignancies. This review aims to delineate recent advances in understanding the pathology of glioblastoma multiforme (GBM) and to explore the potential therapeutic implications of alkaloids in managing this deadly disease. By segregating discussions on GBM pathology from those on alkaloid-based therapies, we provide a structured overview of the current challenges in GBM treatment and the promising opportunities presented by alkaloid-based interventions. Furthermore, we briefly discuss potential future directions in GBM research and therapy beyond alkaloids, including emerging treatment modalities or areas of investigation that hold promise for improving patient outcomes. In conclusion, our efforts offer hope for enhanced outcomes and improved quality of life for GBM patients through alkaloid-based therapies. By integrating insights from pathology and therapeutic perspectives, we underscore the significance of a comprehensive approach in addressing this devastating disease.

To Compare the Effects of Post-tonsillectomy Intra-operative Infiltration of Ropivacaine Versus Bupivacaine in Tonsillar Fossa.

Tonsillectomy is one of the most common surgical procedures practiced in Otorhinolaryngology. A significant obstacle for the speedy and smooth recovery is early post- operative pain. Pain leads to negative outcomes such as poor intake, tachycardia, anxiety, delayed wound healing and insomnia. Aim to assess and compare the effect of post-incisional infiltration of 0.75% Ropivacaine v/s 0.5% Bupivacaine on post tonsillectomy pain, the on start of oral intake and stay in hospital and to investigate any complications that can arise due to infiltration of the said drugs. 60 Patients above the age of 5 years were posted for tonsillectomy or adenotonsillectomy under general anesthesia. Patients were blinded about the group in which they will be enrolled. Group A received Inj. ropivacaine (0.75%) 2 ml and Group B: received Inj. Bupivacaine (0.50%) 2 ml in each fossa. After surgery, no analgesics were given & patients were observed for the intensity of post-operative pain in the immediate post-operative period, at 2, 4, 6, 12, 24, 48 h and further if not discharged using VISUAL ANALOGUE SCORE (VAS) and VERBAL RATING SCALE(VRS). Post-operative pain assessment was done using VAS and VRS at 2nd, 4th, 6th, 12th, 24th and 48th hour which was found to be lower in Group 'A'. Patients in Group 'A' also started their oral intake sooner, had lesser hospitalization days than group 'B' patients. Longer time for Rescue analgesic and reduced total dose of analgesic required was seen in Group A compared to Group B. This comparative study on Post-incisional infiltration of 2 ml 0.75% Ropivacaine v/s 2 ml 0.5% Bupivacaine has shown that Ropivacaine is a more effective drug in reducing post-operative pain in comparison to Bupivacaine, proven statistically.

Cell-Based Therapies for Rotator Cuff Injuries: An Updated Review of the Literature.

This review focuses on non-surgical treatment options for rotator cuff injuries and highlights the potential of mesenchymal stem cells (MSCs) as a potential regenerative approach. MSCs, sourced from various tissues like bone marrow and adipose tissue, exhibit promising mechanisms in vitro, influencing tendon-related gene expression and microenvironment modulation. Animal studies support this, showcasing MSCs' ability to reduce inflammation, improve tissue remodeling, and enhance repaired tendon strength. Human trials, while varied and limited, suggest that MSCs might lower retear rates and enhance post-repair outcomes, but randomized controlled trials yield mixed results, emphasizing the necessity for standardized investigations. Ultimately, while cell-based therapies demonstrate an excellent safety profile, more rigorous clinical trials are necessary to determine their efficacy in improving patient outcomes and achieving lasting structural changes in rotator cuff injuries.

Changing Stimulation Frequency Improves Implanted Peripheral Nerve Stimulator Effects After Posttraumatic Total Hip Arthroplasty: A Case Report.

ABSTRACT: Total hip arthroplasty is an effective procedure to improve pain, range of motion, and function for a variety of conditions, including osteoarthritis and posttraumatic arthritis. Up to 28% of patients had persistent pain at the surgical site 12-18 mos after total hip arthroplasty, even in the absence of surgical complications. Currently, there are no widely accepted nonpharmacological treatments for persistent postoperative pain for total hip arthroplasty. This case report details the successful management of a 53-yr-old man with chronic pain and weakness after posttraumatic total hip arthroplasty. He was initially treated with a single-lead percutaneous peripheral nerve stimulator near the right femoral nerve for 4 weeks with 100-Hz frequency sensory-level parameters. Four weeks after implantation, the frequency was changed to 12 Hz with a goal of motor-level stimulation. During the after 3-week time period, his hip flexion strength improved from 10.36 kg to 23.04 kg. His Lower Extremity Functional Scale improved from 35/80 (43.75%) to 54/80 (67.5%) within a 5-wk time period. This case's success demonstrates how peripheral nerve stimulation may help improve postoperative persistent pain and weakness in many patients, including those with posttraumatic arthroplasty.

In situ evaluation of the impact of metformin or verapamil coadministration with vildagliptin on its regional absorption from the rabbit's intestine.

This research aims to identify regional differences in vildagliptin absorption across the intestinal membrane. Furthermore, it was to investigate the effect of verapamil or metformin on vildagliptin absorptive clearance. The study utilized an in situ rabbit intestinal perfusion technique to determine vildagliptin oral absorption from duodenum, jejunum, ileum, and ascending colon. This was conducted both with and without perfusion of metformin or verapamil. The findings revealed that the vildagliptin absorptive clearance per unit length varied by site and was in the order as follows: ileum < jejunum < duodenum < ascending colon, implying that P-gp is significant in the reduction of vildagliptin absorption. Also, the arrangement cannot reverse intestinal P-gp, but the observations suggest that P-gp is significant in reducing vildagliptin absorption. Verapamil co-perfusion significantly increased the vildagliptin absorptive clearance by 2.4 and 3.2 fold through the jejunum and ileum, respectively. Metformin co-administration showed a non-significant decrease in vildagliptin absorptive clearance through all tested segments. Vildagliptin absorption was site-dependent and may be related to the intestinal P-glycoprotein content. This may aid in understanding the important elements that influence vildagliptin absorption, besides drug-drug interactions that can occur in type 2 diabetic patients taking vildagliptin in conjunction with other drugs that can modify the P-glycoprotein level.

Non-coding RNAs as Key Regulators of the Notch Signaling Pathway in Glioblastoma: Diagnostic, Prognostic, and Therapeutic Targets.

Glioblastoma multiforme (GBM) is a highly invasive brain malignancy originating from astrocytes, accounting for approximately 30% of central nervous system malignancies. Despite advancements in therapeutic strategies including surgery, chemotherapy, and radiopharmaceutical drugs, the prognosis for GBM patients remains dismal. The aggressive nature of GBM necessitates the identification of molecular targets and the exploration of effective treatments to inhibit its proliferation. The Notch signaling pathway, which plays a critical role in cellular homeostasis, becomes deregulated in GBM, leading to increased expression of pathway target genes such as MYC, Hes1, and Hey1, thereby promoting cellular proliferation and differentiation. Recent research has highlighted the regulatory role of non-coding RNAs (ncRNAs) in modulating Notch signaling by targeting critical mRNA expression at the post-transcriptional or transcriptional levels. Specifically, various types of ncRNAs, including long non-coding RNAs (lncRNAs) and microRNAs (miRNAs), have been shown to control multiple target genes and significantly contribute to the carcinogenesis of GBM. Furthermore, these ncRNAs hold promise as prognostic and predictive markers for GBM. This review aims to summarize the latest studies investigating the regulatory effects of ncRNAs on the Notch signaling pathway in GBM.

Association of Age and Sex at Onset With Glenohumeral Osteoarthritis: A Systematic Review and Meta-analysis.

OBJECTIVE: The aim of the present systematic review is to synthesize existing evidence (qualitative and quantitative) regarding age- and sex-specific differences with glenohumeral osteoarthritis. DESIGN: The electronic databases PubMed, MEDLINE, and Web of Science were searched up to March 15, 2023. Articles reporting on the association of risk factors (age and sex) with glenohumeral osteoarthritis were considered. We used Newcastle-Ottawa Scale to assess study quality. Meta-analysis was conducted to quantitatively summarize the association of age and sex with glenohumeral osteoarthritis. RESULTS: A total of 24 articles were retrieved for full-text review. Of 24 articles, 8 reporting age-specific and 5 articles reporting sex-specific associations with glenohumeral osteoarthritis were included. The odds ratio for the age (odds ratio = 3.18; 95% confidence interval = 1.10-15.92) and female sex (odds ratio = 1.78; 95% confidence interval = 0.95-3.42) were increased and observed statistically significant. CONCLUSIONS: The present systematic review and meta-analysis suggests the role of increasing age as one of the significant contributors to glenohumeral osteoarthritis. However, association of female sex with glenohumeral osteoarthritis is least convincing. Future studies are required to understand the molecular mechanisms behind the contributory role of increasing age and female sex in the establishment of glenohumeral osteoarthritis.

Cellular signaling in the hypoxic cancer microenvironment: Implications for drug resistance and therapeutic targeting.

The rewiring of cellular metabolism is a defining characteristic of cancer, as tumor cells adapt to acquire essential nutrients from a nutrient-poor environment to sustain their viability and biomass. While hypoxia has been identified as a major factor depriving cancer cells of nutrients, recent studies have revealed that cancer cells distant from supporting blood vessels also face nutrient limitations. To overcome this challenge, hypoxic cancer cells, which heavily rely on glucose as an energy source, employ alternative pathways such as glycogen metabolism and reductive carboxylation of glutamine to meet their energy requirements for survival. Our preliminary studies, alongside others in the field, have shown that under glucose-deficient conditions, hypoxic cells can utilize mannose and maltose as alternative energy sources. This review aims to comprehensively examine the hypoxic cancer microenvironment, its association with drug resistance, and potential therapeutic strategies for targeting this unique niche. Furthermore, we will critically evaluate the current literature on hypoxic cancer microenvironments and explore state-of-the-art techniques used to analyze alternate carbohydrates, specifically mannose and maltose, in complex biological fluids. We will also propose the most effective analytical methods for quantifying mannose and maltose in such biological samples. By gaining a deeper understanding of the hypoxic cancer cell microenvironment and its role in drug resistance, novel therapeutic approaches can be developed to exploit this knowledge.

Intravenous Iron Technique Evaluation in Chronic Heart Failure With Iron Deficiency Anemia.

OBJECTIVE: This study aimed to investigate and assess whether IV iron improves symptoms of chronic heart failure (CHF) in patients with iron deficiency anemia (IDA). METHOD: A total of 66 subjects with heart failure (HF) seeking therapy in the Department of Medicine's Inpatient Department (IPD) and Outpatient Department (OPD) were included. The data were collected during an outpatient or inpatient visit, documented in a predesigned and pretested proforma and then evaluated. All subjects received history-taking, examinations and regular laboratory tests after being informed and signing an agreement. On admission, the following data was collected: name, age, gender and comorbidities. The examination of subjects included a general examination and a systematic examination. Hematological parameters including hemoglobin (Haemometer, Top Tech Bio Medicals Mumbai), serum iron (Roche Cobas c501, USA), total iron binding capacity (TIBC, Beckman Coulter AU480, India), transferrin saturation percentage (TSAT% = (serum iron/TIBC) × 100), left ventricular ejection fraction (LVEF, 2D echocardiography, Nivan Healthcare Solutions, India) and ferritin (Abbott Architect Ferritin Assay, Delhi) are also important. Other blood tests like liver and renal function tests include an electrocardiogram (12-lead ECG) and two-dimensional echocardiography on admission and follow-up. RESULTS:  In our study, 66 patients in total received IV iron as a treatment option to improve the symptoms of CHF with IDA; the New York Heart Association (NYHA) classification showed significant improvement (p-value <0.001). Before the intervention, 57.58% of patients had NYHA class II and 42.4% of patients had NYHA class III. After treatment, 33.33% of patients showed NYHA class II and 19.70% of patients showed NYHA class III. After iron therapy treatment, out of 29 cases of NYHA class III, nine (31.03%) cases converted to NYHA class I, seven (24.14%) cases converted to NYHA class II, and 13 (44.83%) cases belonged to the same NYHA class. Out of 37 cases of NYHA class II, 22 (59.45%) cases converted to NYHA class I, and 15 (40.54%) cases belong to the same NYHA class. CONCLUSION: Thus, we come to the conclusion that the NYHA classification has exhibited notable enhancement subsequent to the administration of parenteral iron therapy. Sufficient evidence exists to substantiate the advantageous effects of intravenous iron therapy in the treatment of iron deficiency anemia. The administration of iron therapy has been observed to yield favorable outcomes in the mitigation of symptoms among individuals afflicted with cardiac insufficiency.

Impact of COVID-19 on Physical Fitness in Central Indian Athletes Aged 20-30 Years: A Cross-Sectional Pilot Study.

Background Physical fitness is of utmost importance to athletes as it ensures better performance in competitive sports. Athletes who contracted COVID-19 frequently experienced persistent symptoms for weeks or months afterward. Due to the direct effects of COVID-19 infection on pulmonary, cardiovascular, and neurological systems, combined with the negative effects of isolation and inactivity, it has been observed that physical fitness decreases in individuals. This study aimed to evaluate the physical fitness of young athletes in the age group of 20 to 30 years after mild-to-moderate COVID-19 infection and compare them with unaffected athletes of the same age group. Methodology A field-based, cross-sectional, comparative study was conducted from July 2022 to August 2022 in Nagpur, India. Physical fitness levels of 50 young athletes in the age group of 20-30 years who never got infected with COVID-19 were compared to 50 athletes with a recent history of mild-to-moderate COVID-19 infection using the Harvard step test, breath-holding test, and peak expiratory flow rate measurement. Participants were included based on COVID-19 diagnosis using standard procedures and confirmation of recovery through negative reverse transcriptase polymerase chain reaction tests. Results Overall physical fitness of athletes who suffered from mild-to-moderate COVID-19 infection was significantly less than those who were not infected. Compared to their non-COVID-19 counterparts, the COVID-19-recovered athletes showed reduced physical fitness index (p < 0.0001 for males and p = 0.0003 for females), reduced peak expiratory flow rate (p < 0.0001 for males and p < 0.0001 for females), and reduced breath-holding time (p < 0.0001 for males and p < 0.0001 for females). Conclusions COVID-19 had a significant impact on various components of physical fitness which may potentially affect the athletic performance and overall well-being of young athletes.

Possible handle for broadening the catalysis regime towards low temperatures: proof of concept and mechanistic studies with CO oxidation on surface modified Pd-TiO2.

The present work demonstrates the effect of temperature-dependent surface modification (SM) treatment and its influence in broadening the catalysis regime with Pd-TiO2 catalysts prepared by various methods. Due to SM induced changes, a shift in the onset of CO oxidation activity as well as broadening of the oxidation catalysis regime by 30 to 65 K to lower temperatures is observed compared to the temperature required for virgin counterparts. SM carried out at 523 K for PdPhoto-TiO2 exhibits the lowest onset (10% CO2 production - T10) and T100 for CO oxidation at 360 and 392 K, respectively, while its virgin counterpart shows T10 and T100 at 393 and 433 K, respectively. The SMd Pd-TiO2 catalysts were investigated using X-ray photoelectron spectroscopy (XPS), ultra-violet photoelectron spectroscopy (UPS) and atomic force microscopy (AFM). It is observed that diffusion of atomic oxygen into Pd-subsurfaces leads to SM and changes the nature of the surface significantly. These changes are demonstrated by work function (ϕ), surface potential, catalytic activity, and correlation among them. UPS results demonstrate the maximum increase in ϕ by 0.5 eV for PdPhoto-TiO2 after SM, compared to all other catalysts. XPS study shows a moderate to severe change in the oxidation states of Pd due to atomic oxygen diffusion into the subsurface layers of Pd. Kelvin probe force microscopy (KPFM) study also reveals corroborating evidence that the surface potential increases linearly with increasing temperature deployed for SM up to 523 K, followed by a marginal decrease at 573 K. The ϕ measured by KPFM and UPS shows a similar trend and correlates well with the changes in catalysis observed. Our results indicate that there is a strong correlation between surface physical and chemical properties, and ϕ changes could be considered as a global marker for chemical reactivity.

Photonic nanoparticles: emerging theranostics in cancer treatment.

This review explores the potential of photonic nanoparticles for cancer theranostics. Photonic nanoparticles offer unique properties and photonics capabilities that make them promising materials for cancer treatment, particularly in the presence of near-infrared light. However, the size of the particles is crucial to their absorption of near-infrared light and therapeutic potential. The limitations and challenges associated with the clinical use of photonic nanoparticles, such as toxicity, immune system clearance, and targeted delivery to the tumor are also discussed. Researchers are investigating strategies such as surface modification, biodegradable nanoparticles, and targeting strategies to improve biocompatibility and accumulation in the tumor. Ongoing research suggests that photonic nanoparticles have potential for cancer theranostics, further investigation and development are necessary for clinical use.

Tiny particles called 'photonic nanoparticles' can be used to help treat cancer. These particles have special properties that allow them to be used with special light to treat cancer. However, the size of the particles is really important, so scientists are trying to find ways to make sure they are the right size. There are also some challenges with using these particles in people, like making sure they don't harm the body and that they go to the right place. Scientists are working on ways to improve the safety of these particles and make sure they go where they need to.

Impact of exosome therapy on pancreatic cancer and its progression.

Pancreatic cancer, one of the most aggressive tumors, has a dismal prognosis because of the low rates of early identification, fast progression, difficulties following surgery, and the ineffectiveness of current oncologic therapies. There are no imaging techniques or biomarkers that can accurately identify, categorize, or predict the biological behavior of this tumor. Exosomes are extracellular vesicles that play a crucial rule in the progression, metastasis, and chemoresistance of pancreatic cancer. They have been verified to be potential biomarkers for pancreatic cancer management. Studying the role of exosomes in pancreatic cancer is substantial. Exosomes are secreted by most eukaryotic cells and participated in intercellular communication. The components of exosomes, including proteins, DNA, mRNA, microRNA, long non-coding RNA, circular RNA, etc., play a crucial role in regulating tumor growth, metastasis, and angiogenesis in the process of cancer development, and can be used as a prognostic marker and/or grading basis for tumor patients. Hereby, in this concise review, we intend to summarize exosomes components and isolation, exosome secretion, function, importance of exosomes in the progression of pancreatic cancer and exosomal miRNAs as possible pancreatic cancer biomarkers. Finally, the application potential of exosomes in the treatment of pancreatic cancer, which provides theoretical supports for using exosomes to serve precise tumor treatment in the clinic, will be discussed.

Applications of trimetallic nanomaterials as Non-Enzymatic glucose sensors.

OBJECTIVE: This article critically reviews recent research on the use of trimetallic nanomaterials for the fabrication of non-enzymatic glucose sensors (NEGS), also known as fourth-generation glucose sensors (FGGS). SIGNIFICANCE: Diabetes is a prevalent chronic disease worldwide, and glucose monitoring is crucial for its management. However, conventional enzymatic glucose sensors suffer from several technological drawbacks, and there is a need to develop new-generation glucose sensors that can overcome these limitations. NEGS, particularly those composed of trimetallic nanocomposites, have demonstrated promising results in terms of improved shelf life, higher sensitivity, and simplicity of operation during glucose measurement. METHODS: In this review, we discuss the different trimetallic nanomaterials developed and used by researchers in recent years for glucose detection, including their mechanisms of action. We also provide a brief discussion of the advantages and disadvantages of FGGS-based trimetallic nanomaterials, as well as the industrial challenges in this area of research. RESULTS: Trimetallic nanomaterials for FGGS have shown excellent reproducibility and high stability, making them suitable for continuous glucose monitoring. The different types of trimetallic nanomaterials have varying sensing properties, and their performance can be tuned by controlling their synthesis parameters. CONCLUSION: Trimetallic nanomaterials are a promising avenue for the development of FGGS, recent research has demonstrated their potential for glucose monitoring. However, there are still some challenges that need to be addressed before their widespread adoption, such as their long-term stability and cost-effectiveness. Further research in this area is needed to overcome these challenges and to develop commercially viable FGGS for diabetes management.

Emerging Role of Quantitative Ultrasound-Based Imaging Techniques for Characterizing Rotator Cuff Tears: A Scoping Review.

Rotator cuff myosteatosis following cuff tears is very common and one of the most important prognostic factors in clinical management. Quantitative ultrasound-based imaging techniques (QUBIT) are frequently used along with magnetic resonance imaging (MRI) to evaluate rotator cuff fatty degeneration. However, the examination of rotator cuff tissue integrity by QUBIT is lacking a standardized imaging protocol and procedural methodologies. In this scoping review, we synthesized the current state of QUBIT against the reference imaging modalities in patients with rotator cuff tears. The literature search was extracted from 963 studies, with 22 studies included in the final review in accordance with the preferred reporting items for systematic reviews and meta-analyses extensions for scoping reviews. The selected studies included human participants and focused on measuring at least one prognostic or diagnostic factor using ultrasonography-based imaging with reference to MRI. The findings suggest both conventional B-mode ultrasound and shear wave elastography imaging were comparable to MRI-based imaging techniques for the evaluation of fatty infiltration and rotator cuff tear characterization. This review establishes guidelines for reporting shoulder-specific QUBIT aimed at developing a standardized imaging protocol. The objective was to enhance the diagnostic and prognostic capabilities of QUBIT in the clinical setting.