Arthroscopic rotator cuff repair with a fibrin scaffold containing growth factors and autologous progenitor cells derived from humeral cBMA improves clinical outcomes in high risk patients

PURPOSE: To report the clinical outcomes after biologically augmented rotator cuff repair (RCR) with a fibrin scaffold derived from autologous whole blood and supplemented with concentrated bone marrow aspirate (cBMA) harvested at the proximal humerus. METHODS: Patients who underwent arthroscopic RCR with biologic augmentation using a fibrin clot scaffold (“Mega- Clot”) containing progenitor cells and growth factors from proximal humerus BMA and autologous whole blood between April 2015 and January 2018 were prospectively followed. Only high-risk patients in primary and revision cases that possessed relevant comorbidities or physically demanding occupation were included. Minimum follow-up for inclusion was 1 year. The visual analog score for pain (VAS), American Shoulder and Elbow Surgeons (ASES), Simple Shoulder Test (SST), Single Assessment Numerical Evaluation (SANE), and Constant-Murley scores were collected preoperatively and at final follow-up. In vitro analyses of the cBMA and fibrin clot using nucleated cell count, colony forming units, and live/dead assays were used to quantify the substrates. RESULTS: Thirteen patients (56.9 ± 7.7 years) were included. The mean follow-up was 26.9 ± 17.7 months (n = 13). There were significant improvements in all outcome scores from the preoperative to the postoperative state: VAS (5.6 ± 2.5 to 3.1 ± 3.2; P < .001), ASES (42.0 ± 17.1 to 65.5 ± 30.6; P < .001), SST (3.2 ± 2.8 to 6.5 ± 4.7; P = .002), SANE (11.5 ± 15.6 to 50.3 ± 36.5; P < .001), and Constant-Murley (38.9 ± 17.5 to 58.1 ± 26.3; P < .001). Six patients (46%) had retears on postoperative MRI, despite all having improvements in pain and function except one. All failures were chronic rotator cuff tears, and all were revision cases except one (1.6 ± 0.5 previous RCRs). The representative sample of harvested cBMA showed an average of 28.5 ± 9.1 × 10(6) nucleated cells per mL. CONCLUSIONS: Arthroscopic rotator cuff repairs that are biologically augmented with a fibrin scaffold containing growth factors and autologous progenitor cells derived from autologous whole blood and humeral cBMA can improve clinical outcomes in primary, as well as revision cases in high-risk patients. However, the incidence of retears remains a concern in this population, demanding further improvements in biologic augmentation. LEVEL OF EVIDENCE: IV, therapeutic case series

A review on the latest advances in extraction and analysis of artemisinin

Introduction: Artemisinin (1), a well-known natural antimalarial drug, is a sesquiterpene lactone that contains a unique peroxide bridge. Since its discovery, the amount of research into the analysis of artemisinin has increased considerably, and it has been further intensified since the Noble Prize win by Tu Youyou in the year 2015 for the discovery of artemisinin. Objective: To review published literature on the extraction and analysis of artemisinin, published during 2017-present, and to present an appraisal of those methods. Methodology: Extensive literature search was carried out which involved, but not limited to, the use of, various databases, like Web of Knowledge, PubMed and Google Scholar, and relevant published materials including published books. The keywords used, in various combinations, with artemisinin being present in all combinations, in the search were artemisinin, Artemisia annua, analysis, extraction, quantitative, qualitative and quality control. Results: During the period covered in this review, there are several methods of analysis of artemisinin have been reported, the most of which were LC-based methods. However, the use of new methods like near infrared analysis, fluorometirc analysis and molecular imprinting, and a significant increase in the use of computational tools have been observed. Mainly several methods involving supercritical fluid extraction and ultrasound-assisted extraction of artemisinin have dominated the extraction area. Conclusions: Newer analytical tools, as well as improved protocols for the known analytical tools, for qualitative and quantitative determination of artemisinin (1), have been made available by various researchers during the period covered by this review. Supercritical fluid extraction and ultrasound-assisted extraction are still the methods of choice for extraction of artemisinin

At the intersection between the subject and the political: a contribution to an ongoing discussion

The issue of subjectivity has recently occasioned a lively discussion in this journal opposing socioculturalism and Lacanian psychoanalysis. By confronting Luis Radford’s cultural theory with Jacques Lacan’s psychoanalysis, Tony Brown sought to show the limitations of socioculturalism. This article takes advantage of that discussion to develop a critique of Radford’s theory of objectification, taken as an exemplary sociocultural theorization of the teaching and learning of mathematics. It does so by extending the criticism made by Brown at the level of the subject, namely by showing what is lost in socioculturalism when it reduces the Hegelian notion of dialectics to a relation between constituted entities; but mostly by exploring the possibility opened by contemporary theory to posit the discussion around subjectivity in the political. While socioculturalism assumes the possibility of a synthesis between person and culture thus making education possible, it will be argued that a theory which assumes the impossibility of education is in a better position to, on the one hand, conceptualize the resistance of many towards the learning of mathematics, and on the other hand, to address the ongoing political failure in achieving the desired goal of “mathematics for all”

Mathematics, capitalism and biosocial research

In my previous work, I criticised studies within the sociopolitical turn for disavowing a comprehension of schools as places of capitalist production. Here, I extend this critique to what is being flagged as a new turn in educational research. I am referring to biosocial research, particularly in the way it is coupled with new materialist and more than human philosophies in the work of Elizabeth de Freitas. I use elements from Marxian theory and Lacanian psychoanalysis to explore the concomitances between mathematics and capitalism, showing how both mathematics and capital need to suture the subject in order to thrive. Biosocial research epitomises this drive towards automation and totality, and, notwithstanding de Freitas’ attempts to rescue it from the logic of control, I will argue that agent-centred intentions dismiss the underlying workings of capital as a real abstraction. I do so by engaging with elements of Deleuze’s philosophy, showing how the more than human frame in which de Freitas’ biosocial research rests contradicts her own perception of how biosocial research can be rescued for inclusive purposes

Distance-based emission factors from vehicle emission remote sensing measurements

Vehicle emission remote sensing has the potential to provide detailed emissions information at a highly disaggregated level owing to the ability to measure thousands of vehicles in a single day. Fundamentally, vehicle emission remote sensing provides a direct measure of the molar volume ratio of a pollutant to carbon dioxide, from which fuel-based emissions factors can readily be calculated. However, vehicle emissions are more commonly expressed in emission per unit distance travelled e.g. grams per km or mile. To express vehicle emission remote sensing data in this way requires an estimate of the fuel consumption at the time of the emission measurement. In this paper, an approach is developed based on vehicle specific power that uses commonly measured or easily obtainable vehicle information such as vehicle speed, acceleration and mass. We test the approach against 55 independent comprehensive PEMS measurements for Euro 5 and 6 gasoline and diesel vehicles over a wide range of driving conditions and find good agreement between the method and PEMS data. The method is applied to individual vehicle model types to quantify distance-based emission factors. The method will be appropriate for application to larger vehicle emission remote sensing databases, thus extending real-world distance-based vehicle emissions information

Contextualising the pervasive impact of macroeconomic austerity on prison health in England: A qualitative study among international policymakers

Background: Prisons offer the state the opportunity to gain access to a population that is at particularly high risk of ill-health. Despite the supportive legal and policy structures surrounding prison rehabilitation, the oppressive nature of the austerity policy in England threatens its advanced improvement.Methods: Using grounded theory methodology, this is the first interdisciplinary qualitative study to explore the impact of macroeconomic austerity on prison health in England from the perspective of 29 international prison policymakers.Results: The far-reaching impact of austerity in England has established a regressive political system that shapes the societal attitude towards social issues, which has exacerbated the existing poor health of the prisoners. Austerity has undermined the notion of social collectivism, imposed a culture of acceptance among prison bureaucrats and the wider community, and normalised the devastating impacts of prison instability. These developments are evidenced by the increasing levels of suicide, violence, radicalisation and prison gangs among prisoners, as well as the imposition of long working hours and the high levels of absenteeism among prison staff.Conclusions: This study underscores an important and yet unarticulated phenomenon that despite being the fifth largest economy in the world, England’s poorest, marginalised and excluded population continues to bear the brunt of austerity. Reducing the prison population, using international obligations as minimum standards to protect prisoners’ right to health and providing greater resources would create a more positive and inclusive system, in line with England’s international and domestic commitments to the humane treatment of all people

Loss of ARNT in skeletal muscle limits muscle regeneration in aging

The ability of skeletal muscle to regenerate declines significantly with aging. The expression of aryl hydrocarbon receptor nuclear translocator (ARNT), a critical component of the hypoxia signaling pathway, was less abundant in skeletal muscle of old (23-25 months old) mice. This loss of ARNT was associated with decreased levels of Notch1 intracellular domain (N1ICD) and impaired regenerative response to injury in comparison to young (2-3 months old) mice. Knockdown of ARNT in a primary muscle cell line impaired differentiation in vitro. Skeletal muscle-specific ARNT deletion in young mice resulted in decreased levels of whole muscle N1ICD and limited muscle regeneration. Administration of a systemic hypoxia pathway activator (ML228), which simulates the actions of ARNT, rescued skeletal muscle regeneration in both old and ARNT-deleted mice. These results suggest that the loss of ARNT in skeletal muscle is partially responsible for diminished myogenic potential in aging and activation of hypoxia signaling holds promise for rescuing regenerative activity in old muscle

Long Distance Seed Dispersal by Forest Elephants

By dispersing seeds long distances, large, fruit-eating animals influence plant population spread and community dynamics. After fruit consumption, animal gut passage time and movement determine seed dispersal patterns and distances. These, in turn, are influenced by extrinsic, environmental variables and intrinsic, individual-level variables. We simulated seed dispersal by forest elephants (Loxodonta cyclotis) by integrating gut passage data from wild elephants with movement data from 96 individuals. On average, elephants dispersed seeds 5.3 km, with 89% of seeds dispersed farther than 1 km. The longest simulated seed dispersal distance was 101 km, with an average maximum dispersal distance of 40.1 km. Seed dispersal distances varied among national parks, perhaps due to unmeasured environmental differences such as habitat heterogeneity and configuration, but not with human disturbance or habitat openness. On average, male elephants dispersed seeds farther than females. Elephant behavioral traits strongly influenced dispersal distances, with bold, exploratory elephants dispersing seeds 1.1 km farther than shy, idler elephants. Protection of forest elephants, particularly males and highly mobile, exploratory individuals, is critical to maintaining long distance seed dispersal services that shape plant communities and tropical forest habitat.Additional co-authors: Tanguy Nkoghe, Médard Obiang Ebanega, Connie J. Clark, Michael J. Fay, Pete Morkel, Joseph Okouy