Association of Cobb angle progression and neuraxial abnormality on MRI in asymptomatic Adolescent Idiopathic Scoliosis.

BACKGROUND: Detection of neuraxial abnormality in neurologically asymptomatic adolescent idiopathic scoliosis (AIS) is crucial prior to surgery. It can only be detected on magnetic resonance imaging (MRI), which was not routinely done in this group of patient. On the other hand, whole spine radiographs for measurement of Cobb angle have been routinely included during clinic follow-up. This study aimed to determine the correlation between Cobb angle progression and neuraxial abnormality finding on MRI in asymptomatic AIS. METHODS: A retrospective study was conducted in the Orthopaedic department of a tertiary hospital. Patients with asymptomatic AIS aged 10-20 years who attended scoliosis clinic from year 2007 to 2010 was reviewed. Patients who had whole spine MRI and two vertebral radiographs at least one year apart were further selected. Statistical analysis was done to see the association between Cobb angle progression and neuraxial abnormality on MRI. RESULTS: The mean age at first presentation was 14.4 years old. Female (n=249) to male (n=50) ratio was 5:1. Only 19 patients fulfilled the selection criteria. There were 5 patients (26.3%) who had neuraxial abnormalities. The mean curve progression was 7.05° (range from -5° to 28°). Patients with and without neuroaxial abnormality showed mean curve progression of 0.6° and 9.36° respectively. There was no significant association between Cobb angle progression and neuroaxial abnormality (p=1.000). CONCLUSION: Cobb angle progression is not a reliable indicator for predicting neuroaxial abnormality in patients with asymptomatic AIS. However, this study stressed the need to perform MRI prior to operation to document any associated neuraxial abnormality in clinically asymptomatic AIS patients.

Synthesis of silver nanoparticles dispersed in various aqueous media using laser ablation.

The particle size, morphology, and stability of Ag-NPs were investigated in the present study. A Q-Switched Nd: YAG pulsed laser (λ = 532 nm, 360 mJ/pulse) was used for ablation of a pure Ag plate for 30 min to prepare Ag-NPs in the organic compound such as ethylene glycol (EG) and biopolymer such as chitosan. The media (EG, chitosan) permitted the making of NPs with well dispersed and average size of Ag-NPs in EG is about 22 nm and in chitosan is about 10 nm in spherical form. Particle size, morphology, and stability of NPs were compared with distilled water as a reference. The stability of the samples was studied by measuring UV-visible absorption spectra of samples after one month. The result indicated that the formation efficiency of NPs in chitosan was higher than other media and NPs in chitosan solution were more stable than other media during one month storage. This method for synthesis of silver NPs could be as a green method due to its environmentally friendly nature.

Directional slack-based measure for the inverse data envelopment analysis.

A novel technique has been introduced in this research which lends its basis to the Directional Slack-Based Measure for the inverse Data Envelopment Analysis. In practice, the current research endeavors to elucidate the inverse directional slack-based measure model within a new production possibility set. On one occasion, there is a modification imposed on the output (input) quantities of an efficient decision making unit. In detail, the efficient decision making unit in this method was omitted from the present production possibility set but substituted by the considered efficient decision making unit while its input and output quantities were subsequently modified. The efficiency score of the entire DMUs will be retained in this approach. Also, there would be an improvement in the efficiency score. The proposed approach was investigated in this study with reference to a resource allocation problem. It is possible to simultaneously consider any upsurges (declines) of certain outputs associated with the efficient decision making unit. The significance of the represented model is accentuated by presenting numerical examples.

COVID-19-related mortality and hospital admissions in the VIVALDI study cohort: October 2020 to March 2023.

BACKGROUND: Long-term-care facilities (LTCFs) were heavily affected by COVID-19 early in the pandemic, but the impact of the virus has reduced over time with vaccination campaigns and build-up of immunity from prior infection. OBJECTIVES: To evaluate the mortality and hospital admissions associated with SARS-CoV-2 in LTCFs in England over the course of the VIVALDI study, from October 2020 to March 2023. METHODS: We included residents aged ≥65 years from participating LTCFs who had available follow-up time within the analysis period. We calculated incidence rates (IRs) of COVID-19-linked mortality and hospital admissions per calendar quarter, along with infection fatality ratios (IFRs, within 28 days) and infection hospitalization ratios (IHRs, within 14 days) following positive SARS-CoV-2 test. RESULTS: A total of 26,286 residents were included, with at least one positive test for SARS-CoV-2 in 8513 (32.4%). The IR of COVID-19-related mortality peaked in the first quarter (Q1) of 2021 at 0.47 per 1000 person-days (1 kpd) (around a third of all deaths), in comparison with 0.10 per 1 kpd for Q1 2023 which had a similar IR of SARS-CoV-2 infections. There was a fall in observed IFR for SARS-CoV-2 infections from 24.9% to 6.7% between these periods, with a fall in IHR from 12.1% to 8.8%. The population had high overall IRs for mortality for each quarter evaluated, corresponding to annual mortality probability of 28.8-41.3%. CONCLUSIONS: Standardized real-time monitoring of hospitalization and mortality following infection in LTCFs could inform policy on the need for non-pharmaceutical interventions to prevent transmission.

Selective apoptosis induction in MCF-7 cell line by truncated minimal functional region of Apoptin.

BACKGROUND: Chicken Anemia Virus (CAV) VP3 protein (also known as Apoptin), a basic and proline-rich protein has a unique capability in inducing apoptosis in cancer cells but not in normal cells. Five truncated Apoptin proteins were analyzed to determine their selective ability to migrate into the nucleus of human breast adenocarcinoma MCF-7 cells for inducing apoptosis. METHODS: For identification of the minimal selective domain for apoptosis, the wild-type Apoptin gene had been reconstructed by PCR to generate segmental deletions at the N' terminal and linked with nuclear localization sites (NLS1 and NLS2). All the constructs were fused with maltose-binding protein gene and individually expressed by in vitro Rapid Translation System. Standardized dose of proteins were delivered into human breast adenocarcinoma MCF-7 cells and control human liver Chang cells by cytoplasmic microinjection, and subsequently observed for selective apoptosis effect. RESULTS: Three of the truncated Apoptin proteins with N-terminal deletions spanning amino acid 32-83 retained the cancer selective nature of wild-type Apoptin. The proteins were successfully translocated to the nucleus of MCF-7 cells initiating apoptosis, whereas non-toxic cytoplasmic retention was observed in normal Chang cells. Whilst these truncated proteins retained the tumour-specific death effector ability, the specificity for MCF-7 cells was lost in two other truncated proteins that harbor deletions at amino acid 1-31. The detection of apoptosing normal Chang cells and MCF-7 cells upon cytoplasmic microinjection of these proteins implicated a loss in Apoptin's signature targeting activity. CONCLUSIONS: Therefore, the critical stretch spanning amino acid 1-31 at the upstream of a known hydrophobic leucine-rich stretch (LRS) was strongly suggested as one of the prerequisite region in Apoptin for cancer targeting. Identification of this selective domain provides a platform for developing small targets to facilitating carrier-mediated-transport across cellular membrane, simultaneously promoting protein delivery for selective and effective breast cancer therapy.

Size-related assessment on viability and insulin secretion of caprine islets in vitro.

BACKGROUND: The successful isolation, purification, and culture of caprine islets has recently been reported. The present study shows arange of size distribution in caprine islet diameter from 50 to 250 µm, in which 80% of the total islet yield was comprised of small islets. METHODS: Caprine islets were isolated and purified. Islets were handpicked and the diameter of the islets was recorded using light microscopy. Viablility of the islets was analyzed by confocal microscopy. Insulin secretion assay was carried out and analyzed by ELISA. RESULTS: When tested at 48 h after isolation, these small islets were 29.3% more viable compared to the large-sized islets. Large islets showed a high ratio (P < 0.01) of central core necrosis (29.5% ± 1.92) whilst no significant core death was observed in small islets (2.33% ± 0.59). The annexin assay demonstrated 5.21% ± 0.97 and 7.34% ± 0.78 apoptotic death for small and large islets, respectively. During static incubation, small islets released 2.89-fold (1.39 ± 0.2 ng/IE) higher insulin level under low glucose induction (3.3 mm) and simultaneously 2.92-fold (2.95 ± 0.33 ng/IE) more insulin under high glucose condition (16.7 mm) in comparison to large islets at the same islet equivalents (P < 0.05). CONCLUSION: The present findings evidenced the superior quality of smaller caprine islets compared to larger ones under an optimized basal maintenance condition. As it is equally important to preserve the quality of larger caprine islets, this work warrants further investigation on special culture conditions to support these islets.

Autologous versus pooled human serum for articular chondrocyte growth.

PURPOSE: To evaluate the effect of autologous human serum (AHS) versus pooled human serum (PHS) versus foetal bovine serum (FBS) for growth of articular chondrocytes and formation of chondrocytefibrin constructs. METHODS: Experiments with monolayer culture expansion of human articular chondrocytes were performed using basic culture media supplemented with 10% AHS, PHS, or FBS. Growth kinetics and specific phenotypic expression of the serially expanded chondrocytes were evaluated. Large-scale culture expansion was used to obtain about 30 million cells to form chondrocyte-fibrin constructs. All constructs were implanted subcutaneously at the dorsum part of athymic nude mice for 8 weeks. The in vivo constructs were evaluated using histological and gene expression studies. RESULTS: The morphology of primary cultured chondrocytes (P0) was polygonal and became more elongated and larger after serial passages (P1, P2, and P3). This was comparable for AHS, PHS, and FBS. Total cell yields accumulated for AHS (28 million) and PHS (41 million) were significantly higher than those for FBS (4 million). After 8 weeks of implantation, in vivo chondrocyte-fibrin constructs demonstrated a glistening white and firm texture, comparable to normal hyaline cartilage. All constructs exhibited histo-architectural characteristics of well-distributed cartilage-isolated cells embedded within basophilic ground substance. Presence of accumulated proteoglycans cartilage-rich matrix was indicated by positive orange-red Safranin O staining. During monolayer culture expansion, collagen type II gene expression was down-regulated, while collagen type I gene expression was up-regulated. Collagen type II--the specific chondrogenesis marker--was re-expressed in the in vivo chondrocyte-fibrin construct. CONCLUSION: AHS and PHS are better than FBS for in vitro cultivation of human articular chondrocytes.

Development and validation of a selective, sensitive and stability indicating UPLC-MS/MS method for rapid, simultaneous determination of six process related impurities in darunavir drug substance.

In this study a sensitive and selective gradient reverse phase UPLC-MS/MS method was developed for the simultaneous determination of six process related impurities viz., Imp-I, Imp-II, Imp-III, Imp-IV, Imp-V and Imp-VI in darunavir. The chromatographic separation was performed on Acquity UPLC BEH C18 (50 mm×2.1mm, 1.7µm) column using gradient elution of acetonitrile-methanol (80:20, v/v) and 5.0mM ammonium acetate containing 0.01% formic acid at a flow rate of 0.4mL/min. Both negative and positive electrospray ionization (ESI) modes were operated simultaneously using multiple reaction monitoring (MRM) for the quantification of all six impurities in darunavir. The developed method was fully validated following ICH guidelines with respect to specificity, linearity, limit of detection (LOD), limit of quantification (LOQ), accuracy, precision, robustness and sample solution stability. The method was able to quantitate Imp-I, Imp-IV, Imp-V at 0.3ppm and Imp-II, Imp-III, and Imp-VI at 0.2ppm with respect to 5.0mg/mL of darunavir. The calibration curves showed good linearity over the concentration range of LOQ to 250% for all six impurities. The correlation coefficient obtained was >0.9989 in all the cases. The accuracy of the method lies between 89.90% and 104.60% for all six impurities. Finally, the method has been successfully applied for three formulation batches of darunavir to determine the above mentioned impurities, however no impurity was found beyond the LOQ. This method is a good quality control tool for the trace level quantification of six process related impurities in darunavir during its synthesis.

Does the Quality of Life in Operated Patients with Adolescent Idiopathic Scoliosis correspond with the Radiographic Parameters?

OBJECTIVES: Traditionally, scoliosis surgery is aimed at attaining a fused, balanced and painless spine. With improvement in surgical and instrumentation techniques, spine surgeons strive to achieve higher degree of Cobb's angle and rib hump correction with the idea of greater patient satisfaction. The aim of this study was to determine the patients' satisfaction using SRS-22 questionnaire and their correlations with the radiographic changes. MATERIALS AND METHODS: A prospective study was conducted in a tertiary referral cen re using the Scoliosis Research Society-22 (SRS-22) questionnaire during the patients' annual follow up, betwee February to April 2014. Thirtyseven patients who met the inclusion criteria were enrolled. RESULTS: The mean pre-operative Cobb's angles were 57.8o ± 12.7o and mean post-operative angle of 20.0o ± 10.4o, resulting in average correction of 65.9 ± 14.4%. Mean preoperative rib hump was 61.1 ± 15.4 mm with mean postoperative rib hump of 15.8 ± 17.8 mm, resulting in average reduction of 77.7 ± 23.7%. Mean of post-operative total SRS score was 4.1 ± 0.5. Using Spearman rank correlation, the percentage of Cobb's angle correction versus the SRS-22 score showed correlation of 0.17 (P=0.33) while the percentage of rib hump reduction versus SRS-22 score showed a correlation of 0.11 (P=0.53). CONCLUSION: In this study, the average total SRS-22 score was 4.1 ± 0.5 (range, 3.1-4.9) post-operatively indicating very high satisfaction rate overall. Despite attempts at greater curve correction and rib hump reduction, there is no direct correlation between patient satisfaction and radiographic parameters.

Nucleotide sequencing, cloning, and expression of Capra hircus Heme Oxygenase-1 in caprine islets to promote insulin secretion in vitro.

Transplantation of islets of Langerhans that have been isolated from whole pancreas is an attractive alternative for the reversal of Type 1 diabetes. However, in vitro culture of isolated pancreatic islets has been reported to cause a decrease in glucose response over time. Hence, the improvement in islet culture conditions is an important goal in islet transplantation. Heme Oxygenase-1 (HO-1) is a stress protein that has been described as an inducible protein with the capacity of preventing apoptosis and cytoprotection via radical scavenging. Therefore, this study was aimed to assess the influence of endogenous HO-1 gene transfer on insulin secretion of caprine islets. The full-length cDNA sequence of Capra hircus HO-1 was determined using specific designed primers and rapid amplification of cDNA ends of pancreatic tissue. The HO-1 cDNA was then cloned into the prokaryotic expression vectors and transfected into caprine islets using lipid carriers. Efficiency of lipid carriers to transfect caprine islets was determined by flow cytometry. Insulin secretion assay was carried out by ovine insulin ELISA. The finding demonstrated that endogenous HO-1 gene transfer could improve caprine islet function in in vitro culture. Consequently, strategies using HO-1 gene transfer to islets might lead to better outcome in islet transplantation.

The significance of using pooled human serum in human articular cartilage tissue engineering.

Animal serum is commonly used in chondrocytes culture expansion to promote cell proliferation and shorten the time lag before new tissue reconstruction is possible. However, animal serum is not suitable for regeneration of clinical tissue because it has potential risk of viral and prion related disease transmission particularly mad cow disease and foreign protein contamination that can stimulate immune reaction leading to graft rejection. In this context, human serum as homologous supplement has a greater potential as growth promoting agents for human chondrocytes culture.

In vitro development of autologous tissue engineered human articular neocartilage for orthopaedic surgery.

Treatment of articular cartilage lesions remains a clinical challenge. The uses of prosthetic joint replace allograft and/or autograft transplant carry a risk of complications due to infection, loosening of its component, immunological rejection and morbidity at the donor site. There has been an increasing interest in the management of cartilage damages, owing to the introduction of new therapeutic options. Tissue engineering as a method for tissue restoration begins to provide a potential alternative therapy for autologous grafts transplantations. We aimed to evaluate how well a tissue engineered neocartilage implant, consist of human articular chondrocytes cultured with the presence of autologous serum and mixed in a fresh fibrin derived from patient, would perform in subcutaneous implantation in athymic mice.

Retained intraspinal bullet: a rare case in a visitor to malaysia - a case report.

ABSTRACT: Firearm injuries to the spine commonly present with acute neurology caused by direct penetration or indirectly from concussive effects of bullet impact on the vertebral column. We report a case of delayed neurologic presentation of retained intra-spinal bullet in a 42 year-old African who had chronic low back pain and sciatica with a past history of gunshot injury to the spine and radiograph revealed a bullet at the L4-5 disc level. Intra-operative exploration showed a fibrous mass around the bullet compressing on the L4 existing nerve root and L5 traversing nerve root. Removal of the retained bullet resulted in a good clinical outcome with complete resolution of symptoms. KEY WORDS: Intra-spinal bullet, gunshot injury.

Preparation of silver nanoparticles in virgin coconut oil using laser ablation.

Laser ablation of a silver plate immersed in virgin coconut oil was carried out for fabrication of silver nanoparticles. A Nd:YAG laser at wavelengths of 1064 nm was used for ablation of the plate at different times. The virgin coconut oil allowed formation of nanoparticles with well-dispersed, uniform particle diameters that were stable for a reasonable length of time. The particle sizes and volume fraction of nanoparticles inside the solutions obtained at 15, 30, 45 min ablation times were 4.84, 5.18, 6.33 nm and 1.0 × 10(-8), 1.6 × 10(-8), 2.4 × 10(-8), respectively. The presented method for preparation of silver nanoparticles in virgin coconut oil is environmentally friendly and may be considered a green method.

Synthesis and anti-microbial activity of hydroxylammonium ionic liquids.

Eight hydroxylammonium-based room temperature ionic liquids (ILs) have been synthesized by acid-base neutralization of ethanolamines with organic acids. The ILs were characterized by infrared and nuclear magnetic resonance spectroscopies and elemental analysis. Their anti-microbial activities were determined using the well-diffusion method. All eight ILs were toxic to Staphylococcus aureus, while 2-hydroxyethylammonium lactate and 2-hydroxy-N-(2-hydroxyethyl)-N-methylethanaminium acetate showed high anti-microbial activity against a wide range of human pathogens.

Does the Quality of Life in Operated Patients with Adolescent Idiopathic Scoliosis correspond with the Radiographic Parameters?

Objectives: Traditionally, scoliosis surgery is aimed at attaining a fused, balanced and painless spine. With improvement in surgical and instrumentation techniques, spine surgeons strive to achieve higher degree of Cobb’s angle and rib hump correction with the idea of greater patient satisfaction. The aim of this study was to determine the patients’ satisfaction using SRS-22 questionnaire and their correlations with the radiographic changes. Materials and methods: A prospective study was conducted in a tertiary referral centre using the Scoliosis Research Society-22 (SRS-22) questionnaire during the patients’ annual follow up, between February to April 2014. Thirtyseven patients who met the inclusion criteria were enrolled. Results: The mean pre-operative Cobb’s angles were 57.8o ± 12.7o and mean post-operative angle of 20.0o ± 10.4o, resulting in average correction of 65.9 ± 14.4%. Mean preoperative rib hump was 61.1 ± 15.4 mm with mean postoperative rib hump of 15.8 ± 17.8 mm, resulting in average reduction of 77.7 ± 23.7%. Mean of post-operative total SRS score was 4.1 ± 0.5. Using Spearman rank correlation, the percentage of Cobb’s angle correction versus the SRS-22 score showed correlation of 0.17 (P=0.33) while the percentage of rib hump reduction versus SRS-22 score showed a correlation of 0.11 (P=0.53). Conclusion: In this study, the average total SRS-22 score was 4.1 ± 0.5 (range, 3.1-4.9) post-operatively indicating very high satisfaction rate overall. Despite attempts at greater curve correction and rib hump reduction, there is no direct correlation between patient satisfaction and radiographic parameters.