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Silver nanoplates (SNPs) are particularly attractive in surface-enhanced Raman scattering (SERS) activity due to their unique physicochemical properties, including localized surface plasmon resonance (LSPR) and strongly electromagnetic "hot spots" in the vicinity of their tips and edges. In this study, we report a novel, rapid, and simplified methodology for preparing SNPs using a one-pot synthesis approach with AgNO3, NaBH4, TSC, PVP, and an oxidation agent, H2O2. By adjusting precursor ratios, the LSPR peak can be easily adjusted from 400 to 800 nm, with a change in morphology from spherical, undefined structures, nano-disks, and triangular. In this study, Na2CO3 was added to the reaction to react with excess H2O2 to obtain long-term stable nanoparticles in a colloidal solution for 21 days. Crystal violet (CV) dye was used as a Raman probe to evaluate the SERS performance of SNP substrates at different diameters (35, 60, 120, 210 nm). The results showed that SERS activity was inverse to the SNP diameter. The finite-difference time domain (FDTD) was employed to compute the E-field around SNPs, indicating that E-field intensity depends on the SNPs' size, shape, and LSPR peak position. The 35 nm SNP substrates exhibited high sensitivity and good reproductivity in detecting CV dye, with a limit of detection (LOD) of 0.020 mg L−1 and a limit of quantification (LOQ) of 0.060 mg L−1. Additionally, SNP substrates can detect sulfathiazole (STZ) at trace-level concentrations, with LOD and LOQ of 0.031 and 0.095 mg L−1, respectively. These studies on silver nanoplate substrates displayed potential for further ultra-trace analysis applications in organic compounds. [ABSTRACT FROM AUTHOR]

The article presents unique research conducted in Bidoup-Nui Ba National Park, Vietnam, focusing on the biogeochemical element migration in soil and plants. The study aimed to identify element content changes, biological accumulation, and biogeochemical mobility during wet and dry seasons across different landscape conditions. The research revealed the active elements involved in migration and accumulation, assessed mobility and accumulation in bamboo organs, and highlighted the peculiarities within the "soil-plant" system. The study found that the uptake of certain microelements by plants is influenced by landscape facies and moisture conditions. For example, Zn, Cu, and Co were introduced through plant litter during the wet season and accumulated, while Mo accumulation was more pronounced in the dry season. Furthermore, the research observed variations in biological uptake by bamboo organs, with different landscape conditions and seasons playing a role. The biogeochemical mobility of elements in bamboo organs increased significantly with soil moisture during the wet season. Overall, the research provided insights into element accumulation and biogeochemical migration. Notably, the accumulation of element B was found to increase with soil moisture, while its reduction was associated with slope process activation during the wet season.

Tropical ecosystems play an important role in the environment. Coastal areas are subjected to a wide range of impacts and pollution, which have drawn worldwide attention over the past few decades. Comprehensive studies of heavy metal content in soils worldwide are extremely important for assessing and predicting ecological risks. Very few studies have been devoted to a complete study of the physicochemical characteristics of soils, assessment of heavy metal accumulation in coastal zones along the Djibouti coast, and potential ecological risks. The study investigated the physico-chemical characteristics of soil, assessed the accumulation of heavy metals in coastal zones along the Djibouti coast, and analyzed the potential environmental risks associated with the presence of heavy metals in the studied soils. Analysis of heavy metals and trace elements in the soils of the coastal areas of Djibouti revealed that the levels of these elements are lower than in soils of the Red Sea coast and are in line with WHO and other international standards. All heavy metals in the soil of the studied area demonstrate low levels of potential ecological risk. The soils of the studied areas, overall, have not undergone significant heavy metal pollution and can be considered suitable for various types of use.

The study of technogenic pollution of soils with heavy metals (HM) is an essential task for ecology. The analysis of the content of HMs in the park's soils shows the degree of pollution and the sources of its occurrence. The study of the elemental composition of soils is an objective method for assessing the state of the ecosystem. To determine the current state of heavy metal contamination in forest soils, the concentrations of their total forms were analyzed. Heavy metals, including Zn, Pb, Cr, Cu, Hg, Cd, and As, were found in the study area. In addition, the threat of contamination with Cd and As has been identified. The calculation of the total pollution coefficient allows us to assess the level of pollution for the dry season (Zc = 18.45-28.24, average 22.45) as average (moderately hazardous) and for the wet season (Zc = 0.01-5.11, average 1.96) as permissible. This indicates an unfavorable environmental situation. The content of heavy metals in soils depends on the season. Observations show that at the end of the wet season, the concentration of heavy metals decreases, while it increases in the period after the dry season.

Article Highlights - Camellia dalatensis and Camellia capitata are critically endangered species. - Habitat loss and deforestation threaten the survival of these Camellia species. - Vegetative propagation aids conservation of critically endangered Camellia species. - Rooting success depends on cutting types, growth regulators, and substrate mix. - Research aids conservation efforts for Vietnam’s rare and vulnerable flora. Abstract Camellia dalatensis (V. D. Luong, Ninh & Hakoda) and Camellia capitata (Orel, Curry & Luu) are classified as critically endangered (CR) by the IUCN. Conservation solutions for these two species have not yet been fully implemented, while wild populations are declining. This research on vegetative propagation examined the efficacy of indole-3-butyric acid (IBA in solution or in powdered activated charcoal), cutting types (terminal shoot or stem cuttings), and substrates for the growth of cuttings (sand-coir dust mixes) on rooting efficiency. The highest rooting of C. dalatensis was observed in terminal shoot cuttings at 1,000 ppm IBA, and 25% sand and 75% coir dust substrate. Maximum values obtained were survival 95.6%, rooting percentage 88.9%, number of roots per cutting 6.9, root length 6.2 cm, and rooting index 42.9. For C. capitata, superior rooting was obtained with semi-hardwood cuttings, at 1,500 ppm IBA, and equal parts of sand and coir dust as substrate. Camellia capitata was more difficult to root, with maximum values of 65.6% survival, 52.2% rooting, 2.8 roots per cutting, 2.9 cm root length, and rooting index of 8.1. The results of this study can be used to support further propagation and conservation of these two endangered species.

Background Radiotherapy is an essential component of cancer treatment, yet many countries do not have adequate capacity to serve all patients who would benefit from it. Allocation systems are needed to guide patient prioritization for radiotherapy in resource-limited contexts. These systems should be informed by allocation principles deemed relevant to stakeholders. This study explores the ethical dilemmas and views of decision-makers engaged in real-world prioritization of scarce radiotherapy resources at a cancer center in Rwanda in order to identify relevant principles. Methods Semi-structured interviews were conducted with a purposive sample of 22 oncology clinicians, program leaders, and clinical advisors. Interviews explored the factors considered by decision-makers when prioritizing patients for radiotherapy. The framework method of thematic analysis was used to characterize these factors. Bioethical analysis was then applied to determine their underlying normative principles. Results Participants considered both clinical and non-clinical factors relevant to patient prioritization for radiotherapy. They widely agreed that disease curability should be the primary overarching driver of prioritization, with the goal of saving the most lives. However, they described tension between curability and competing factors including age, palliative benefit, and waiting time. They were divided about the role that non-clinical factors such as social value should play, and agreed that poverty should not be a barrier. Conclusions Multiple competing principles create tension with the agreed upon overarching goal of maximizing lives saved, including another utilitarian approach of maximizing life-years saved as well as non-utilitarian principles, such as egalitarianism, prioritarianism, and deontology. Clinical guidelines for patient prioritization for radiotherapy can combine multiple principles into a single allocation system to a significant extent. However, conflicting views about the role that social factors should play, and the dynamic nature of resource availability, highlight the need for ongoing work to evaluate and refine priority setting systems based on stakeholder views.

The Caspian region represents a complex and unique system of terrestrial, coastal, and aquatic environments, marked by an exceptional landscape and biological diversity. This diversity, however, is increasingly threatened by substantial anthropogenic pressures. One notable impact of this human influence is the rising concentration of pollutants atypical for the atmosphere. Advances in science and technology now make it possible to detect certain atmospheric pollutants using remote Earth observation techniques, specifically through data from the Sentinel-5 satellite, which provides continuous insights into atmospheric contamination. This article investigates the dynamics of atmospheric pollution in the southwestern part of the Caspian Sea basin using Sentinel-5P satellite data and the cloud-computing capabilities of the Google Earth Engine (GEE) platform. The study encompasses an analysis of concentrations of seven key pollutants: nitrogen dioxide (NO2), formaldehyde (HCHO), carbon monoxide (CO), ozone (O3), sulfur dioxide (SO2), methane (CH4), and the Aerosol Index (AI). Spatial and temporal variations in pollution fields were examined for the Caspian region and the basins of the seven rivers (key areas) flowing into the Caspian Sea: Sunzha, Sulak, Ulluchay, Karachay, Atachay, Haraz, and Gorgan. The research methodology is based on the use of data from the Sentinel-5 satellite, SRTM DEM data on absolute elevations, surface temperature data, and population density data. Data processing is performed using the Google Earth Engine cloud-computing platform and the ArcGIS software suite. The main aim of this study is to evaluate the spatiotemporal variability of pollutant concentration fields in these regions from 2018 to 2023 and to identify the primary factors influencing pollution distribution. The study’s findings reveal that the Heraz and Gorgan River basins have the highest concentrations of nitrogen dioxide and Aerosol Index levels, marking these basins as the most vulnerable to atmospheric pollution among those assessed. Additionally, the Gorgan basin exhibited elevated carbon monoxide levels, while the highest ozone concentrations were detected in the Sunzha basin. Our temporal analysis demonstrated a substantial influence of the COVID-19 pandemic on pollutant dispersion patterns. Our correlation analysis identified absolute elevation as a key factor affecting pollutant distribution, particularly for carbon monoxide, ozone, and aerosol indices. Population density showed the strongest correlation with nitrogen dioxide distribution. Other pollutants exhibited more complex distribution patterns, influenced by diverse mechanisms associated with local emission sources and atmospheric dynamics.

A new species of Sterculia from Vietnam – S. konchurangensis – is described, illustrated, and compared with the similar S. lanceolata. S. konchurangensis differs from S. lanceolata by the length of the petiole (7.0–9.5 vs. 25–35 mm), shape of the leaf blade (obovate or elliptic vs. elliptic, lanceolate or elliptic-lanceolate), length of the leaf blade (6–8 vs. 9–20 cm), and length of the calyx lobe (11–12.5 vs. 4–6 mm). A diagnostic key of the 22 Sterculia species occurring in Vietnam is also provided.

Since the end of the 20th century, the use of geographic information systems and digital elevation models has reduced the time required for and improved the quality of morphometric analysis of the relief within river basins. However, researchers are constantly faced with the problem of choosing the most accurate and suitable digital terrain model for their task. Many global, regional, and local digital elevation models are available. In this study, we comparatively analyzed the accuracy of the ASTER GDEM, ALOS World 3D, Copernicus DEM, and SRTM DEM spatial datasets for the purpose of catchment basin modeling for the river basins of the northwestern slope of the Crimean Mountains (Zapadnyy Bulganak, Alma, Kacha, Belbek, and Chernaya Rivers) as an example. For each river basin, we calculated the systematic, root mean square, mean absolute, standard root mean square (Bessel’s correction), and centered mean absolute errors by comparing ASTER GDEM, ALOS World 3D, Copernicus DEM, and SRTM DEM data with a 1:100,000 topographic map within the considered river basins. We found the smallest error values for the Copernicus DEM and ALOS World 3D datasets; furthermore, we used the Copernicus DEM dataset to model the river basins and sub-basins of the northwestern slope of the Crimean Mountains. As a result, we identified these river basins and sub-basins for the Zapadnyy Bulganak, Alma, Kacha, Belbek, and Chernaya Rivers, which are represented by stream basins, valleys, gullies, and ravine systems.

BackgroundThe number of mobile health apps is rapidly increasing. This means that consumers are faced with a bewildering array of choices, and finding the benefit of such apps may be challenging. The significant international burden of breast cancer (BC) and the potential of mobile health apps to improve medical and public health practices mean that such apps will likely be important because of their functionalities in daily life. As the app market has grown exponentially, several review studies have scrutinized cancer- or BC-related apps. However, those reviews concentrated on the availability of the apps and relied on user ratings to decide on app quality. To minimize subjectivity in quality assessment, quantitative methods to assess BC-related apps are required. ObjectiveThe purpose of this study is to analyze the content and quality of BC-related apps to provide useful information for end users and clinicians. MethodsBased on a stepwise systematic approach, we analyzed apps related to BC, including those related to prevention, detection, treatment, and survivor support. We used the keywords “breast cancer” in English and Korean to identify commercially available apps in the Google Play and App Store. The apps were then independently evaluated by 2 investigators to determine their eligibility for inclusion. The content and quality of the apps were analyzed using objective frameworks and the Mobile App Rating Scale (MARS), respectively. ResultsThe initial search identified 1148 apps, 69 (6%) of which were included. Most BC-related apps provided information, and some recorded patient-generated health data, provided psychological support, and assisted with medication management. The Kendall coefficient of concordance between the raters was 0.91 (P2 years ago, or by individuals, had significantly lower MARS scores compared to other apps (P

PURPOSENephroblastoma is a highly curable pediatric cancer that requires multidisciplinary care. Few reports have assessed long-term treatment outcomes in low-resource settings using a task-shifting model of care. We report outcomes of a large cohort and factors associated with survival.METHODSWe performed a retrospective chart review of all patients with nephroblastoma presenting to the Butaro Cancer Center of Excellence in Rwanda between July 2012 and June 2018.RESULTSIn total, 136 patients were identified and treated according to International Society of Pediatric Oncology guidelines for low-income settings. Median age at diagnosis was 39.7 months (interquartile range, 25.3-61.8 months); 56.6% were female. Sixty-one (44.9%) patients presented with stage I-III disease, 35 (25.7%) with stage IV disease, and 6 (4.4%) with stage V disease; the remainder were unstaged (n = 34; 25.0%). Most patients completed surgery (n = 97; 71.3%) and postoperative chemotherapy (n = 82; 60.2%); 17 patients received radiotherapy. With a median follow-up time of 18.1 months, 44.9% of patients were alive, 41.9% had died, 8.8% were lost to follow-up, and 4.4% were referred for palliative care or declined further care at the end of the study. Three-year overall survival was 57.5% (95% CI, 48.1 to 65.8) for the entire cohort, and 80.1% (95% CI, 66.8 to 88.5) and 44.0% (95% CI, 26.8 to 60.0) for stages I-III and IV-V, respectively.CONCLUSIONWe demonstrate that patients with nephroblastoma can be successfully treated in a low-resource setting. Survival remains lower than in high-income countries, in part due to early deaths, contributing to approximately 30% of patients not being medically able to receive surgical intervention. Next steps include the development of strategies that focus on earlier diagnosis, supportive care during the early phases of therapy, and efficient and timely transitions between specialties for multimodal care.

PURPOSEIn describing our ten-year experience with treating chronic myeloid leukemia (CML) as part of the Glivec Patient Assistance Program (GIPAP) in rural Rwanda, we evaluate (1) patient characteristics and treatment outcomes, (2) resource-adapted management strategies, and (3) the impact of diagnostic capacity development.METHODSWe retrospectively reviewed all patients with BCR-ABL–positive CML enrolled in this GIPAP program between 2009 and 2018. Clinical data were analyzed using descriptive statistics, Kaplan-Meier methods, proportional hazards regression, and the Kruskal-Wallis test.RESULTSOne hundred twenty-four patients were included. The median age at diagnosis was 34 (range 8-81) years. On imatinib, 91% achieved complete hematologic response (CHR) after a median of 49 days. Seven (6%) and 12 (11%) patients had primary and secondary imatinib resistance, respectively. The 3-year overall survival was 80% (95% CI, 72 to 87) for the cohort, with superior survival in imatinib responders compared with those with primary and secondary resistance. The median time from imatinib initiation to CHR was 59 versus 38 days (P = .040) before and after in-country diagnostic testing, whereas the median time to diagnosis (P = .056) and imatinib initiation (P = .170) was not significantly different.CONCLUSIONCoupling molecular diagnostics with affordable access to imatinib within a comprehensive cancer care delivery program is a successful long-term strategy to treat CML in resource-constrained settings. Our patients are younger and have higher rates of imatinib resistance compared with historic cohorts in high-income countries. High imatinib resistance rates highlight the need for access to molecular monitoring, resistance testing, and second-generation tyrosine kinase inhibitors, as well as systems to support drug adherence. Hematologic response is an accurate resource-adapted predictor of survival in this setting. Local diagnostic capacity development has allowed for continuous, timely CML care delivery in Rwanda.

Sepsis is a major cause of neonatal mortality and children born in low- and middle-income countries (LMICs) are at greater risk of severe neonatal infections than those in higher-income countries. Despite this disparity, there are limited contemporaneous data linking the clinical features of neonatal sepsis with outcome in LMICs. Here, we aimed to identify factors associated with mortality from neonatal sepsis in Vietnam. We conducted a prospective, observational study to describe the clinical features, laboratory characteristics, and mortality rate of neonatal sepsis at a major children's hospital in Ho Chi Minh City. All in-patient neonates clinically diagnosed with probable or culture-confirmed sepsis meeting inclusion criteria from January 2017 to June 2018 were enrolled. We performed univariable analysis and logistic regression to identify factors independently associated with mortality. 524 neonates were recruited. Most cases were defined as late-onset neonatal sepsis and were hospital-acquired (91.4% and 73.3%, respectively). The median (IQR) duration of hospital stay was 23 (13-41) days, 344/524 (65.6%) had a positive blood culture (of which 393 non-contaminant organisms were isolated), and 69/524 (13.2%) patients died. Coagulase-negative staphylococci (232/405; 57.3%), Klebsiella spp. (28/405; 6.9%), and Escherichia coli (27/405; 6.7%) were the most isolated organisms. Sclerema (OR = 11.4), leukopenia 4 mmol/L (OR = 3.4), extremely low birth weight (OR = 3.2), and hyperglycaemia >180 mg/dL (OR = 2.6) were all significantly (p

Background: The mRNA-1345 vaccine demonstrated efficacy against respiratory syncytial virus (RSV) disease with acceptable safety in adults aged ≥60 years in the ConquerRSV trial. Here, humoral immunogenicity results from the trial are presented., Methods: This phase 2/3 trial randomly assigned adults (≥60 years) to mRNA-1345 50-µg encoding prefusion F (preF) glycoprotein (n = 17 793) vaccine or placebo (n = 17 748). RSV-A and RSV-B neutralizing antibody (nAb) and preF binding antibody (bAb) levels at baseline and day 29 postvaccination were assessed in a per-protocol immunogenicity subset (PPIS; mRNA-1345, n = 1515; placebo, n = 333)., Results: Day 29 nAb geometric mean titers (GMTs) increased 8.4-fold against RSV-A and 5.1-fold against RSV-B from baseline. Seroresponses (4-fold rise from baseline) in the mRNA-1345 groups were 74.2% and 56.5% for RSV-A and RSV-B, respectively. Baseline GMTs were lower among participants who met the seroresponse criteria than those who did not. mRNA-1345 induced preF bAbs at day 29, with a pattern similar to nAbs. Day 29 antibody responses across demographic and risk subgroups were generally consistent with the overall PPIS., Conclusions: mRNA-1345 enhanced RSV-A and RSV-B nAbs and preF bAbs in adults (≥60 years) across various subgroups, including those at risk for severe disease, consistent with its demonstrated efficacy in the prevention of RSV disease., Clinical Trials Registration: NCT05127434., Competing Interests: Potential conflicts of interest. G. P. M. reports funding from Moderna, Merck, Sanofi, Pfizer, Universidad Nacional de San Martín, Medicago, GSK, and Cassara. C. J. A. D. reports receiving grants from the Medical Research Council and Wellcome, a consultancy for Synarigen, and is a member of the data and safety monitoring board at Oxford University. J. G., L. L., J. D., A. K., S. M., W. H., H. Z., S. K. S., F. P., N. L., C. A. S., E. W., J. M. M., and R. D. are employees of Moderna, Inc., and may hold stock/stock options in the company. N. L. C., K. S., and J. E. T. are consultants for Moderna, Inc. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

The large melting point depressions characterising deep eutectic solvents (DESs) are related to negative deviations from ideal mixing behaviour characterised by the excess Gibbs energy. Favourable excess Gibbs energies result from a balance between the excess entropy and enthalpy of mixing, which was experimentally determined for three choline chloride (ChCl) based mixtures using calorimetry. While the excess Gibbs energy of H 2 O + ChCl is enthalpy dominated, those of ethylene glycol (EG) + ChCl and 1,3-propanediol + ChCl are entropy dominated. Molecular dynamics simulations using polarisable force-fields show intermolecular hydrogen bonds between DES constituents for H 2 O + ChCl and EG + ChCl. Hence, inter-species hydrogen bonding does not guarantee enthalpy-dominated melting point depressions. We suggest future research to focus on tuning the entropy-enthalpy balance via the chemical nature of the DES constituents.

Soil carbon stabilization is mainly driven by organo-mineral interactions. Coprecipitates, of organic matter with short-range order minerals, detected through indirect chemical extraction methods, are increasingly recognized as key carbon sequestration phases. Yet the atomic structure of these coprecipitates is still rather conceptual. We used transmission electron microscopy imaging combined with energy-dispersive X-ray and electron energy loss spectroscopy chemical mappings, which enabled direct nanoscale characterization of coprecipitates from Andosols. A comparison with reference synthetic coprecipitates showed that the natural coprecipitates were structured by an amorphous Al, Si, and Fe inorganic skeleton associated with C and were therefore even less organized than short-range order minerals usually described. These amorphous types of coprecipitates resembled previously conceptualized nanosized coprecipitates of inorganic oligomers with organics (nanoCLICs) with heterogeneous elemental proportions (of C, Al, Si, and Fe) at nanoscale. These results mark a new step in the high-resolution imaging of organo-mineral associations, while shedding further light on the mechanisms that control carbon stabilization in soil and more broadly in aquatic colloid, sediment, and extraterrestrial samples.

Ideal bone tissue engineering is to induce bone regeneration through the synergistic integration of biomaterial scaffolds, bone progenitor cells, and bone-forming factors. Biomimetic scaffolds imitate the native extracellular matrix (ECM) and are often utilized in vitro as analogues of the natural ECM to facilitate investigations of cell-ECM interactions and processes. In vivo , the cellular microenvironment has a crucial impact on regulating cell behavior and functions. A PET surface was activated and then functionalized with mimetic peptides to promote human mesenchymal stem cell (hMSC) adhesion and differentiation into an osteogenic lineage. Spray technology was used to randomly micropattern peptides (RGD and BMP-2 mimetic peptides) on the PET surface. The distribution of the peptides grafted on the surface, the roughness of the surfaces and the chemistry of the surfaces in each step of the treatment were ascertained by atomic force microscopy, fluorescence microscopy, time-of-flight secondary ion mass spectrometry, Toluidine Blue O assay, and X-ray photoelectron spectroscopy. Subsequently, cell lineage differentiation was evaluated by quantifying the expression of immunofluorescence markers: osteoblast markers (Runx-2, OPN) and osteocyte markers (E11, DMP1, and SOST). In this article, we hypothesized that a unique combination of bioactive micro/nanopatterns on a polymer surface improves the rate of morphology change and enhances hMSC differentiation. In DMEM, after 14 days, disordered micropatterned surfaces with RGD and BMP-2 led to a higher osteoblast marker expression than surfaces with a homogeneous dual peptide conjugation. Finally, hMSCs cultured in osteogenic differentiation medium (ODM) showed accelerated cell differentiation. In ODM, our results highlighted the expression of osteocyte markers when hMSCs were seeded on PET surfaces with random micropatterns.

Objectives: The standard surgical method for primary gonarthrosis in advanced stages is total knee arthroplasty (TKA), despite the risk of bleeding that requires transfusion. Blood transfusions are potentially dangerous. The aim of this study was to determine whether there is a statistical difference in the amount of bleeding and the need for transfusion between patients who received and did not receive perioperative local tranexamic acid in TKA., Methods: The hospital data system was used to access the data of patients who underwent TKA in our clinic between January 2015 and January 2022 with a diagnosis of gonarthrosis. Patients who underwent TKA and had gonarthrosis as the primary diagnosis were included in the study. They were separated into two groups: A control group (Group C) and a group that received perioperative local tranexamic acid (Group LTXA). The amount of bleeding was compared by taking into account patients' hemogram follow-ups, the amount of blood from their drains, and their transfusion needs during the postoperative period., Results: The findings demonstrated that TKA patients who received local tranexamic acid administration experienced a significant decrease in perioperative blood loss and needed lesser transfusions., Conclusion: The findings of our investigation are consistent with other studies and are in favor of the usage of TXA in TKA. To validate our findings and establish the ideal TXA dosage and administration method in TKA, additional research is required., Competing Interests: None declared., (©Copyright 2023 by The Medical Bulletin of Sisli Etfal Hospital.)

Background: Developing a safe and immunogenic vaccine against Zika virus remains an unmet medical need. We did two phase 1 studies that evaluated the safety and immunogenicity of two mRNA-based Zika virus vaccines (mRNA-1325 and mRNA-1893) in adults., Methods: Two randomised, placebo-controlled, dose-ranging, multicentre, phase 1 trials, one of mRNA-1325 (mRNA-1325 trial) and one of mRNA-1893 (mRNA-1893 trial), were done. For both studies, eligible participants were healthy adults (aged 18-49 years) who were flavivirus seronegative or flavivirus seropositive at baseline. Participants in the mRNA-1325 trial, which was done at three centres in the USA, were randomly assigned centrally (1:4), using a randomisation table, to the placebo group or one of three mRNA-1325 dose groups (10, 25, or 100 μg). All participants received two doses. The mRNA-1325 vaccine encoded the premembrane and envelope E structural proteins (prME) from a Micronesia 2007 Zika virus isolate. Participants in the mRNA-1893 trial, which was done at three centres in the USA and one centre in Puerto Rico, were randomly assigned (1:4) to the placebo group or one of four mRNA-1893 dose groups (10, 30, 100, or 250 μg) using centralised interactive response technology. All participants in the mRNA-1893 trial received dose one on day 1 and then dose two on day 29. The mRNA-1893 vaccine encoded the prME from the RIO-U1 Zika virus isolate. Safety was the primary outcome of each study, which was evaluated in the respective safety populations (mRNA-1325 trial: participants who received at least one dose and provided safety data; mRNA-1893 trial: participants who received at least one dose) and the solicited safety population (mRNA-1893 trial only: received at least 1 dose and contributed solicited adverse reaction data). Endpoints in both trials included solicited adverse reactions within 7 days after vaccination and unsolicited adverse events within 28 days after vaccination. The secondary outcome of both trials was immunogenicity assessed by Zika virus-specific neutralising antibodies (nAbs) in the per-protocol populations in either trial (participants with no major protocol deviations received full dose[s] of assigned dose level within the acceptable time window, had samples drawn within acceptable time window, and had prevaccination and corresponding post-vaccination serum samples for testing). These were descriptive studies, with no formal hypothesis testing in either trial. Both trials are registered with ClinicalTrials.gov, NCT03014089 (mRNA-1325 trial) and NCT04064905 (mRNA-1893 trial)., Findings: The mRNA-1325 trial was done from Dec 14, 2016, to Aug 16, 2018. 90 participants were enrolled: 53 (59%) participants were women and 37 (41%) were men; 84 (93%) were White; and 74 (82%) were not Hispanic or Latino. All three dose levels of mRNA-1325 (10, 25, and 100 μg) were generally well tolerated, but the vaccine elicited poor Zika virus-specific nAb responses. At 28 days after dose two, geometric mean titres (GMTs) were highest for mRNA-1325 10 μg (10·3 [95% CI 5·9-18·2]). The mRNA-1893 trial was done from July 23, 2019, to March 22, 2021. 120 participants (70 [58%] women and 50 [42%] men) were enrolled, most participants were White (89 [74%]), and not Hispanic or Latino (91 [76%]). In the mRNA-1893 trial, solicited adverse reactions in participants who received a vaccine were mostly grade 1 or 2 and occurred more frequently at higher dose levels and after dose two. No participants withdrew due to an unsolicited treatment-emergent adverse event and most of these events were not treatment related. On day 57, all evaluated mRNA-1893 dose levels induced robust Zika virus-specific nAb responses, independent of flavivirus serostatus, that persisted until month 13. At day 57 in participants who were flavivirus seronegative, plaque reduction neutralisation titre test nAb GMTs were highest for mRNA-1893 100 μg (454·2 [330·0-619·6]); in participants who were flavivirus seropositive, GMTs were highest for mRNA-1893 10 μg (224·1 [43·5-1153·5]) and mRNA-1893 100 μg (190·5 [19·2-1887·2])., Interpretation: These findings support the continued development of mRNA-1893 against Zika virus, which was well tolerated at all evaluated dose levels and induced strong Zika virus-specific serum nAb responses after two doses, regardless of baseline flavivirus serostatus., Funding: Biomedical Advanced Research and Development Authority and Moderna., Competing Interests: Declaration of interests HB, VF, RP, YDP, BB, SW, JD, SK, and BL are employees of and shareholders in Moderna. NLC is an independent consultant for Moderna. All other authors declare no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: This study reviewed the outcomes of Lisfranc injuries treated by primary partial arthrodesis (PPA) or closed re-duction and internal fixation (CRIF)., Methods: A retrospective review was made of patients who underwent PPA or CRIF for a Lisfranc injury after low-energy trauma, and follow-up was assessed according to radiographic, and clinical outcomes. A total of 45 patients with a median age of 38 years were followed up for an average of 47 months., Results: The average American orthopaedic foot and ankle society (AOFAS) score was 83.6 points in the PPA group and 86.2 points in CRIF group (p>0.05). The mean pain score was 32.9 in the PPA group, 33.7 in the CRIF group (p>0.05). Secondary surgery for symptomatic hardware was required in 78% of the CRIF group and in 42% of the PPA group (p<0.05)., Conclusion: Treatment of low-energy Lisfranc injuries with either PPA or closed reduction and fixation produced good clinical and radiological outcomes. The total AOFAS scores were comparable between two groups. However, the function and pain scores were seen to improve more with closed reduction and fixation while there was a greater requirement for secondary surgery in the CRIF group.

Objectives: The aim of this study was to evaluate the effectiveness of using cross finger and thenar flaps in treatment of distal fingers amputations with reposition-flap method., Patients and Methods: Between September 2017 and January 2020, a total of 20 fingers of 19 patients (15 males, 4 females; mean age: 31.6±10.4 years; range, 19 to 52 years) who were treated with repositioning using a cross finger or thenar flap were retrospectively analyzed. Finger length, flap status, pain, cold intolerance, two-point discrimination, bone healing and appearance of the nail were recorded. Functional evaluation was performed using the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) score and range of motion., Results: The mean follow-up was 19.5±5.2 months. A poor result was seen in one patient with the development of necrosis in the flap. With the exception of one finger with necrosis in the flap, no major complications were observed. Union was achieved in all other bones. The mean shortness was 3.7±1.9 mm. The mean Quick-DASH score was 4.5±5.0 and the mean two-point discrimination test was measured as 6.8±0.9., Conclusion: In fingertip amputations repositioning with a cross finger or thenar flap can achieve a near-normal fingertip appearance with the advantages for the surgeon of a short learning curve and no requirement for microsurgery experience. If replantation cannot be applied in fingertip amputations, this method should be considered among the treatment options, particularly for patients with high aesthetic expectations.

Objectives: This study aimed to compare minimal invasive locking plate and retrograde intramedullary nailing in the treatment of supracondylar femur fracture following total knee arthroplasty (TKA) in respect of fracture healing, complications, and functional results., Methods: A retrospective analysis was made of 32 supracondylar femur fractures comprising 20 cases treated with minimal invasive locking plate fixation and 12 with retrograde femoral nailing. The two techniques were compared in respect of range of motion (ROM), functional scores, intraoperative blood loss, surgery time, and radiological examination findings., Results: The mean functional scores did not differ between the nailing and plate fixation groups. In the minimal invasive locking plate group, 2 (10%) patients had delayed union, so revision surgery was applied. The mean post-operative ROM was comparable between two groups (86.2° vs. 86°). Reduction quality in the sagittal plane and maintenance of the initial reduction were better in the minimal invasive locking plate group. Greater shortening of the lower extremity was seen in the retrograde femoral nailing group than in the minimal invasive locking plate group (20.3 vs. 9.3 mm). Perioperative blood loss was greater (2 units vs. 1.2 units) and mean operating time was longer in the minimal invasive locking plate group (126.5 min vs. 102.2 min)., Conclusion: In patients with good bone stock, supracondylar femur fracture following TKA can be treated successfully with retrograde nailing or minimal invasive locking plate. Retrograde femoral nailing has the advantage of less blood loss and a shorter operating time. Reduction quality may be improved with the minimal invasive locking plate fixation technique. Both surgery techniques can be successfully used by orthopedic surgeons taking a case-by-case approach., (Copyright © by The Medical Bulletin of Sisli Etfal Hospital.)