Cost Effectiveness of Primary Total Hip Arthroplasty for Varying Levels of BMI

The demand for hip arthroplasty is increasing rapidly due to a combination of an aging population as well as an increasing level of obesity in the country. The purpose of this study is to evaluate the risks and benefits of arthroplasty for patients of different obesity classes. The first two parts were to use a systematic review with meta-analysis and retrospective chart review to quantify the risks and benefits in different obesity classes. The third part was to perform a cost-effectiveness analysis to weight the balance between the two. We found that higher obesity classes are at higher risk of complications and comparable improvement after an arthroplasty. Our cost-effectiveness analysis determined that greater obesity levels had a higher incremental cost-effectiveness ratio than lower obesity levels, but was within generally used willingness-to-pay thresholds. In conclusion, patients of all obesity levels have a greater benefit to cost ratio for total hip arthroplasty

Molecular genetic analysis of FGFR1 signalling reveals distinct roles of MAPK and PLCγ1 activation for self-renewal of adult neural stem cells

<p>Abstract</p> <p>Background</p> <p>Neural stem cells (NSCs) are present in the adult mammalian brain and sustain life-long adult neurogenesis in the dentate gyrus of the hippocampus. In culture, fibroblast growth factor-2 (FGF-2) is sufficient to maintain the self-renewal of adult NSCs derived from the adult rat hippocampus. The underlying signalling mechanism is not fully understood.</p> <p>Results</p> <p>In the established adult rat NSC culture, FGF-2 promotes self-renewal by increasing proliferation and inhibiting spontaneous differentiation of adult NSCs, accompanied with activation of MAPK and PLC pathways. Using a molecular genetic approach, we demonstrate that activation of FGF receptor 1 (FGFR1), largely through two key cytoplasmic amino acid residues that are linked to MAPK and PLC activation, suffices to promote adult NSC self-renewal. The canonical MAPK, Erk1/2 activation, is both required and sufficient for the NSC expansion and anti-differentiation effects of FGF-2. In contrast, PLC activation is integral to the maintenance of adult NSC characteristics, including the full capacity for neuronal and oligodendroglial differentiation.</p> <p>Conclusion</p> <p>These studies reveal two amino acid residues in FGFR1 with linked downstream intracellular signal transduction pathways that are essential for maintaining adult NSC self-renewal. The findings provide novel insights into the molecular mechanism regulating adult NSC self-renewal, and pose implications for using these cells in potential therapeutic applications.</p

Exposure and risk assessment of urinary trans, trans-Muconic acid in school-age children in the vicinity of a petrochemical complex in Central Taiwan

School-age children living near large petrochemical factories may be at high risk of exposure to benzene released during manufacturing processes. We aimed to investigate the urinary concentrations of trans, trans-muconic acid (t,t-MA) in school-age children living near a petrochemical complex and to estimate their cumulative risk of benzene exposure. We examined an established cohort (Taiwan Petrochemical Complex Cohort for Children, TPE3C) of school-age children (aged 6–13 years) who lived near large petrochemical factories in central Taiwan between October 2013 and September 2014. The cohort comprised 297 children from five elementary schools, namely S.-C. Branch (n = 63, school A, ~0.9 km), F.-A. (n = 51, school B, ~2.7 km), C.-T. (n = 63, school C, ~5.5 km), M.-L. (n = 54, school D, ~6.9 km), and L.-F. (n = 66, school E, ~8.6 km). We analyzed the urinary t,t-MA levels of each participant and estimated their daily intake of benzene. We also performed multiple regression analysis to investigate potential risk factors for a high urinary t,t-MA level in the study cohort. The median urinary t,t-MA levels and median estimated benzene daily intake of the children from each school were as follows: school A, 64.07 ng/mL, 11.13 μg/kg/day; school B, 61.01 ng/mL, 15.32 μg/kg/day; school C, 59.38 ng/mL, 14.81 μg/kg/day; school D, 42.35 ng/mL, 11.67 μg/kg/day; school E, undetected, 0.14 μg/kg/day. The distance between a school and a petrochemical complex (greater distance: β = −0.26, 95% confidence interval [CI] = −0.52 to 0.00, p = 0.053), and the age of the children (older age: β = −3.44, 95% CI = −5.90 to −1.46, p &lt; 0.001) were identified as potential risk factors. After confounders were adjusted for, the creatinine adjusted urinary t,t-MA levels of the school-age children tended to be lower when the distance between their school and a petrochemical complex was greater

Does varicocele repair improve conventional semen parameters? A meta-analytic study of before-after data

Purpose The purpose of this meta-analysis is to study the impact of varicocele repair in the largest cohort of infertile males with clinical varicocele by including all available studies, with no language restrictions, comparing intra-person conventional semen parameters before and after the repair of varicoceles. Materials and Methods The meta-analysis was performed according to PRISMA-P and MOOSE guidelines. A systematic search was performed in Scopus, PubMed, Cochrane, and Embase databases. Eligible studies were selected according to the PICOS model (Population: infertile male patients with clinical varicocele; Intervention: varicocele repair; Comparison: intra-person before-after varicocele repair; Outcome: conventional semen parameters; Study type: randomized controlled trials [RCTs], observational and case-control studies). Results Out of 1,632 screened abstracts, 351 articles (23 RCTs, 292 observational, and 36 case-control studies) were included in the quantitative analysis. The before-and-after analysis showed significant improvements in all semen parameters after varicocele repair (except sperm vitality); semen volume: standardized mean difference (SMD) 0.203, 95% CI: 0.129–0.278; p<0.001; I2=83.62%, Egger’s p=0.3329; sperm concentration: SMD 1.590, 95% CI: 1.474–1.706; p<0.001; I2=97.86%, Egger’s p<0.0001; total sperm count: SMD 1.824, 95% CI: 1.526–2.121; p<0.001; I2=97.88%, Egger’s p=0.0063; total motile sperm count: SMD 1.643, 95% CI: 1.318–1.968; p<0.001; I2=98.65%, Egger’s p=0.0003; progressive sperm motility: SMD 1.845, 95% CI: 1.537%–2.153%; p<0.001; I2=98.97%, Egger’s p<0.0001; total sperm motility: SMD 1.613, 95% CI 1.467%–1.759%; p<0.001; l2=97.98%, Egger’s p<0.001; sperm morphology: SMD 1.066, 95% CI 0.992%–1.211%; p<0.001; I2=97.87%, Egger’s p=0.1864. Conclusions The current meta-analysis is the largest to date using paired analysis on varicocele patients. In the current meta-analysis, almost all conventional semen parameters improved significantly following varicocele repair in infertile patients with clinical varicocele. Keywords Controlled before-after studies; Infertility, male; Meta-analysis; Varicocel

Analysis on ψ-Hilfer Fractional Impulsive Differential Equations

In this manuscript, we establish the existence of results of fractional impulsive differential equations involving ψ-Hilfer fractional derivative and almost sectorial operators using Schauder fixed-point theorem. We discuss two cases, if the associated semigroup is compact and noncompact, respectively. We consider here the higher-dimensional system of integral equations. We present herewith new theoretical results, structural investigations, and new models and approaches. Some special cases of the results are discussed as well. Due to the nature of measurement of noncompactness theory, there exists a strong relationship between the sectorial operator and symmetry. When working on either of the concepts, it can be applied to the other one as well. Finally, a case study is presented to demonstrate the major theory

Biofilm in Endodontic Infection and its Advanced Therapeutic Options – An Updated Review

Pulpal and periapical pathosis are biofilm-induced infections. Understanding the complex nature of endodontic biofilm would help to create a new disinfection strategy to eliminate the microorganism from the root canal system. The intricate canal structure creates challenges for proper disinfection, necessitating the need to understand the biofilm structure, composition, and mechanism within the biofilm community. This paper describes the endodontic biofilm structure, formation of biofilm, and advanced therapeutic options for combating the biofilm community within the root canal system

Not Available

Not AvailableThe contribution of fish to global diets has reached a record of almost 17 kg per person on an average, supplying over three billion people with at least 15 percent of their average animal protein intake. This increase is mainly due to the ever-growing production of aquaculture which is set to overtake capture fisheries as a source of food fish (FAO, 2011, http://www.fao.org/news/story/en/item/50260/icode/). In India, as per the MPEDA's figures for the year 2009-10, out of the total Indian fishery export to the value of Rs. 10,048 crores about 24 % (Rs. 2398 crores) has been contributed by the aquacultured shrimp. The significant increase in aquaculture production must be supported by a corresponding increase in the production of formulated feeds for the increase in targeted shrimp production. The sustainability and profitability of commercial aquaculture operations depend largely on feeds as they constitute over 50 percent of operating costs. In India, modern shrimp farming, as monoculture, has shown marked growth in the past two decades and has emerged as a commercial enterprise. In consonance with this, shrimp feed market has shown impressive growth of more than 1,00,000 tonnes per annum during this period.Not Availabl

Comparison of antimicrobial efficacy of green tea extract and Triphala as root canal irrigants against Fusobacterium nucleatum using real-time polymerase chain reaction – An in vitro study

Aim: Fusobacterium nucleatum has gained attention in the endodontic literature as it is a predominant microorganism in primary, secondary, and persistent root canal infections. Current irrigants have lot of drawbacks and are unlikely to predictably achieve a bacteria-free root canal system, which can lead to these failures. Herbal alternatives are now gaining popularity in the field of endodontics, paving a new way in the disinfection of root canals. The aim of this study is to evaluate the antimicrobial efficacy of green tea extract and Triphala as root canal irrigants against F. nucleatum using real-time Polymerase chain reaction (PCR). Methods: Extracted teeth were taken and inoculated with F. nucleatum, which was grown in a Mueller–Hinton agar plate under anaerobic conditions. The samples were cleaned and shaped and irrigated with green tea extract, Triphala extract, and dimethyl sulfoxide, which were compared to the widely used irrigant, sodium hypochlorite. Cycle threshold value was used to calculate the efficacy of the irrigant against F. nucleatum after which the samples were subjected to reverse transcriptase PCR. The data were analyzed and the data between the group were compared using the one-way ANOVA followed by a post hoc Tukey's test. Results: Triphala extract demonstrated high antimicrobial activity against F. nucleatum. It revealed statistically significant differences between Triphala extract and sodium hypochlorite (NaOCL) (P = 0.001). Green tea extract also displayed antimicrobial activity. Both the Triphala and green tea extracts showed a significant difference (P < 0.001). Conclusion: Triphala extract showed better antibacterial efficacy when compared to 3% NaOCl and green tea extract against F. nucleatum

Eco-friendly fabrication of nonenzymatic electrochemical sensor based on cobalt/polymelamine/nitrogen-doped graphitic-porous carbon nanohybrid material for glucose monitoring in human blood

The design and development of eco-friendly fabrication of cost-effective electrochemical nonenzymatic biosensors with enhanced sensitivity and selectivity are one of the emerging area in nanomaterial and analytical chemistry. In this aspect, we developed a facile fabrication of tertiary nanocomposite material based on cobalt and polymelamine/nitrogen-doped graphitic porous carbon nanohybrid composite (Co-PM-NDGPC/SPE) for the application as a nonenzymatic electrochemical sensor to quantify glucose in human blood samples. Co-PM-NDGPC/SPE nanocomposite electrode fabrication was achieved using a single-step electrodeposition method under cyclic voltammetry (CV) technique under 1 M NH4Cl solution at 20 constitutive CV cycles (sweep rate 20 mV/s). Notably, the fabricated nonenzymatic electroactive nanocomposite material exhibited excellent electrocatalytic sensing towards the quantification of glucose in 0.1 M NaOH over a wide concentration range from 0.03 to 1.071 mM with a sensitive limit of detection 7.8 μM. Moreover, the Co-PM-NDGPC nanocomposite electrode with low charge transfer resistance (Rct∼81 Ω) and high ionic diffusion indicates excellent stability, reproducibility, and high sensitivity. The fabricated nanocomposite materials exhibit a commendable sensing response toward glucose molecules present in the blood serum samples recommends its usage in real-time applications