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Background: Anterior cruciate ligament reconstruction (ACLR) is one of the most common orthopaedic procedures and one of the most well studied. Despite extensive research dedicated to ACLR, there is limited understanding of how chronic inflammatory systemic diseases (CIDs) such as rheumatoid arthritis and systemic lupus erythematosus affect outcomes. Purpose: To compare the outcomes of ACLR in cohorts of patients with and without CID. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective query of a regional data set was conducted for all patients who underwent ACLR from 1990 to 2021 for traumatic ACL rupture. All patients with CID were identified and propensity matched to non-CID controls. Baseline characteristics and clinical outcomes were identified through retrospective chart review, and patients were contacted for subjective outcomes. Results: A total of 30 patients with ACLR and a diagnosis of CID were identified. These patients were propensity matched to 120 non-CID controls. Baseline demographic and surgical characteristics demonstrated no statistical differences. Follow-up duration was similar between the CID and non-CID groups (mean, 14.6 vs 14.2 years; P =.868). The CID cohort had a higher arthrofibrosis rate (16.7% vs 4.3%; P =.031), higher osteoarthritis rate (33.3% vs 16.7%; P =.041), higher total knee arthroplasty (TKA) rate (16.7% vs 3.3%; P =.016), and earlier time to TKA (14.7 vs 23.5 years; P =.032). Knee range of motion, infection rate, retear rate, time to retear, and time to osteoarthritis were not statistically different between the cohorts. The CID cohort had higher visual analog scale pain scores (mean, 2.00 vs 1.20; P =.043) but slightly higher satisfaction (mean, 3.92 vs 3.39; P =.043). There were no differences in preinjury Tegner, postoperative Tegner, change in Tegner, or IKDC score. In a univariate Cox regression model, the CID cohort had a retear hazard ratio of 1.43 (95% CI, 0.46-4.51; P =.537). Kaplan-Meier survival revealed no significant differences in retear-free survival between the CID and non-CID cohorts at 25 years (85.7% vs 87.3%; P =.53). The CID cohort had a TKA hazard ratio of 3.94 (95% CI, 1.05-14.8; P =.042). Kaplan-Meier survival demonstrated significantly decreased TKA-free survival at 25 years in the CID cohort (64.9% vs 91.2%; P =.029). Conclusion: CID increases the incidence of arthrofibrosis, osteoarthritis, and TKA in those undergoing ACLR. Patients with CID also undergo TKA significantly sooner than non-CID counterparts. Notably, the majority of patient-reported outcome measures are no worse in patients who have a CID diagnosis. Thus, ACLR constructs themselves may not necessarily fare worse in patients with CID. Nonetheless, these patients need to be cautiously counseled on the clinical outlook after their ACLR. [ABSTRACT FROM AUTHOR]

This study aimed to provide an updated evidence of superior hypophyseal artery (SHA) aneurysms management, including their clinical implications, predictive factors for rupture, therapeutic approaches, and post-treatment outcomes. This systematic review and meta-analysis, following PRISMA guidelines, assessed the literature on superior hypophyseal artery aneurysms. Studies were selected based on predefined criteria, focusing on coiling and clipping interventions. Data were extracted and analyzed using SPSS and Cochrane RevMan, with assessments of heterogeneity, sensitivity, and publication bias. Study quality was evaluated using the Newcastle-Ottawa Scale and RoB2. A total of 20 studies involving 316 patients were included. The clipping group had a mean age of 53.8 years, while the coiling group had 50.3 years. Most aneurysms were smaller than 7 mm. Aneurysm remnants occurred in 1.1% after clipping and 2.8% after coiling. Clipping was associated with lower recurrence rates (0% vs. 9.3%) and fewer visual disturbances and vasospasms. Mortality was equal (1%) for both groups. The coiling group had better outcomes on the modified Rankin Scale (94% vs. 73% for clipping). Meta-analysis confirmed that clipping had better recurrence and functional outcomes, with no significant differences in aneurysm size or mortality. Surgical clipping is a viable treatment for SHA aneurysms but carries risks, while coil embolization offers a safer, effective alternative. Early intervention, especially for larger aneurysms (> 7 mm), is crucial to prevent rupture. Future research should focus on personalized treatment strategies, as this study's small sample size and study limitations warrant further investigation. [ABSTRACT FROM AUTHOR]

In this article I address three main crises of the Anthropocene: energy and climate, biodiversity and food, and peace and security. To obtain overall sustainability, natural scientists and engineers have developed the Energy Transition Model, the Carbon Transition Model, and the Agri-food-nature Transition Model. From these models two facts stand out. The age of fossil fuels and of livestock farming will come to an end. Because a sustainable society also has sociopolitical and legal, socioeconomic and financial, sociocultural and welfare, and socioenvironmental and ecological aspects, the contribution of human scientists to overall sustainability is also crucial. Keywords: Agri-food-nature Transition Model, Anthropocene, Carbon Transition Model, Energy Transition Model, sustainability, We are running out of time. Fifty years ago the Club of Rome published The Limits to Growth, and today it is worthwhile to reread their conclusions (Meadows et al. [...]

Understanding the enigma of how learners from the Peoples Republic of China enact and engage with creativity and creative design processes can be problematic for VCD educators. Central to the concerns are questions which relate to the relevance of Western creative and creative design process definitions, explanations and models. This review provides an overview and analysis of the literature in this area. Findings indicate challenges attributed to a dearth of empirical evidence from the Asian region. However, a number of studies were found, which enabled learner engagement with creative design process models. Such models may help illuminate complex pictures of learners' interactions, artefacts, social, cultural and historic forces. The review highlights issues and common areas upon which to build and prompts theoretical and methodological approaches for future creative design process research.

Abstract Background As patient-reported outcome measures (PROMs) have become of significant importance in patient evaluation, adequately selecting the appropriate instrument is an integral part of pediatric orthopedic research and clinical practice. This systematic review provides a comprehensive overview of PROMs targeted at children with impairment of the upper limb, and critically appraises and summarizes the quality of their measurement properties by applying the COnsensus-based Standards for selection of health Measurement INstruments (COSMIN) methodology. Methods A systematic search of the MEDLINE and EMBASE databases was performed to identify relevant publications reporting on the development and/or validation of PROMs used for evaluating children with impairment of the upper extremity. Data extraction and quality assessment (including a risk of bias evaluation) of the included studies was undertaken by two reviewers independently and in accordance with COSMIN guidelines. Results Out of 6423 screened publications, 32 original articles were eligible for inclusion in this review, reporting evidence on the measurement properties of 22 self- and/or proxy-reported questionnaires (including seven cultural adaptations) for various pediatric orthopedic conditions, including cerebral palsy (CP) and obstetric brachial plexus palsy (OBPP). The measurement property most frequently evaluated was construct validity. No studies evaluating content validity and only four PROM development studies were included. The methodological quality of these development studies was either ‘doubtful’ or ‘inadequate’. The quantity and quality of the evidence on the other measurement properties of the included questionnaires varied substantially with insufficient sample sizes and/or poor methodological quality resulting in significant downgrading of evidence quality. Conclusion This review provides a comprehensive overview of currently available PROMs for evaluation of the pediatric upper limb. Based on our findings, none of the PROMs demonstrated sufficient evidence on their measurement properties to justify recommending the use of these instruments. These findings provide room for validation studies on existing pediatric orthopedic upper limb PROMs (especially on content validity), and/or the development of new instruments.

Delays in starting potentially curative treatment for locally-advanced cervical cancer (LACC) decrease survival. Reasons for these delays are poorly understood. We conducted a retrospective chart review examining disparities in time from diagnosis of LACC to first clinic visit and to initiation of treatment based on insurance status within a single health system. We analyzed time to treatment using multivariate regression, adjusted for race, age, and insurance status. 25% of patients had Medicaid and 53% had private insurance. Having Medicaid was associated with delayed time from diagnosis to seeing a radiation oncologist (Mean 76.9 v. 31.3 days, p = 0.03). However, time from first radiation oncology visit to starting radiation was not delayed (Mean 22.6 v. 22.2 days, p = 0.67). Patients with locally-advanced cervical cancer and Medicaid had over double the time from pathologic diagnosis of cervical cancer to seeing radiation oncology; insurance disparities were not observed in treatment start after seeing radiation oncology. Improved referral and navigation processes for patients with Medicaid are needed to improve timely receipt of radiation and potentially improve survival.

Pullulanases are the most important industrial group of enzymes in family 13 glycosyl hydrolases. They hydrolyze either α-1,6 and α-1,4 or both glycosidic bonds in pullulan as well as other carbohydrates to produce glucose, maltose, and maltotriose syrups, which have important uses in food and other related sectors. However, very less reports are available on pullulanase production from native strains because of low yield issues. In line with the increasing demands for pullulanase, it has become important to search for novel pullulanase-producing microorganisms with high yields. Moreover, high production costs and low yield are major limitations in the industrial production of pullulanase enzymes. The production cost of pullulanase by using the solid-state fermentation (SSF) process can be minimized by selecting agro-industrial waste. This review summarizes the types, sources, production strategies, and potential applications of pullulanase in different food and other related industries. Researchers should focus on fungal strains producing pullulanase for better yield and low production costs by using agro-waste. It will prove a better enzyme in different food processing industries and will surely reduce the cost of products.

IntroductionThe aggregation of the neuronal protein alpha-synuclein (alpha-syn) is a key feature in the pathology of Parkinson’s disease (PD). Alpha-syn aggregation has been suggested to be induced in the gut cells by pathogenic gut microbes such as Desulfovibrio bacteria, which has been shown to be associated with PD. This study aimed to investigate whether Desulfovibrio bacteria induce alpha-syn aggregation.MethodsFecal samples of ten PD patients and their healthy spouses were collected for molecular detection of Desulfovibrio species, followed by bacterial isolation. Isolated Desulfovibrio strains were used as diets to feed Caenorhabditis elegans nematodes which overexpress human alpha-syn fused with yellow fluorescence protein. Curli-producing Escherichia coli MC4100, which has been shown to facilitate alpha-syn aggregation in animal models, was used as a control bacterial strain, and E. coli LSR11, incapable of producing curli, was used as another control strain. The head sections of the worms were imaged using confocal microscopy. We also performed survival assay to determine the effect of Desulfovibrio bacteria on the survival of the nematodes.Results and DiscussionStatistical analysis revealed that worms fed Desulfovibrio bacteria from PD patients harbored significantly more (P

The increasing demand for food has increased dependence on chemical fertilizers that promote rapid growth and yield as well as produce toxicity and negatively affect nutritional value. Therefore, researchers are focusing on alternatives that are safe for consumption, non-toxic, cost-effective production process, and high yielding, and that require readily available substrates for mass production. The potential industrial applications of microbial enzymes have grown significantly and are still rising in the 21st century to fulfill the needs of a population that is expanding quickly and to deal with the depletion of natural resources. Due to the high demand for such enzymes, phytases have undergone extensive research to lower the amount of phytate in human food and animal feed. They constitute efficient enzymatic groups that can solubilize phytate and thus provide plants with an enriched environment. Phytases can be extracted from a variety of sources such as plants, animals, and microorganisms. Compared to plant and animal-based phytases, microbial phytases have been identified as competent, stable, and promising bioinoculants. Many reports suggest that microbial phytase can undergo mass production procedures with the use of readily available substrates. Phytases neither involve the use of any toxic chemicals during the extraction nor release any such chemicals; thus, they qualify as bioinoculants and support soil sustainability. In addition, phytase genes are now inserted into new plants/crops to enhance transgenic plants reducing the need for supplemental inorganic phosphates and phosphate accumulation in the environment. The current review covers the significance of phytase in the agriculture system, emphasizing its source, action mechanism, and vast applications.

Abstract Today, a few hundred mycotoxins have been identified and the number is rising. Mycotoxin detoxification of food and feed has been a technically uphill task for the industry. In the twenty-first century, the public demand is healthy food with minimum use of chemicals and preservatives. Among all the fungal inhibition and mycotoxin detoxification methods so far developed for food, biopreservation and biodetoxification have been found safe and reliable. Nowadays, lactic acid bacteria (LAB) are of great interest as biological additives in food owing to their Generally Recognized as Safe (GRAS) classification and mycotoxin detoxification capability. The occurrence of fungul growth in the food chain can lead to health problems such as mycotoxicosis and cancer to humans due to producing mycotoxins such as aflatoxins. Biopreservation is among the safest and most reliable methods for inhibition of fungi in food. This review highlights the great potential of LAB as biodetoxificant by summarizing various reported detoxification activities of LAB against fungal mycotoxins released into foods. Mechanisms of mycotoxin detoxification, also the inherent and environmental factors affecting detoxifying properties of LAB are also covered.

Introduction: Tibial osteotomy has a role in various aspects of joint preservation. Proper diagnosis and addressing all aspects of alignment both for focal cartilage lesions to support restorative repair procedures as well as in treatment of earlier phases of knee osteoarthritis in well selected patients. Malalignment of the leg axis is known to result in chronic overloading and thus contributing to the development of focal lesions as well as osteoarthritis. Objectives: To provide a comprehensive summary of the current state of utilization of tibial osteotomies in conjunction with other joint preserving procedures and to synthesize the current scientific evidence for the use of osteotomies in the setting of cartilage injuries. Methods: PubMed, Medline, Cochrane Systematic Reviews, and Clinical Keys were searched by the first author (M.H.) to validate that all papers of relevance to the area studied were included. Databases were searched comprehensively, and original research, systematic reviews, and meta-analysis were included at the authors’ discretion. References of selected articles were analyzed manually. Data from selected publications focused on tibial osteotomy were summarized. Results: Leg axis and patellofemoral alignment must be considered as important risk factors for failure of restorative cartilage procedures in the knee joint. Alignment-correcting osteotomies play a crucial role in enhancing clinical results of cartilage repair surgeries especially in the long-term. Through the redistribution of load, the biomechanical environment of the joint is optimized, and the induced or transplanted repair tissue is protected against overloading, facilitating enhanced tissue maturation. Recent evidence suggests that even small deviations from a neutral axis (

Weissella strains are often detected in spontaneously fermented foods. Because of their abilities to produce lactic acid and functional exopolysaccharides as well as their probiotic traits, Weissella spp. improve not only the sensorial properties but also nutritional values of the fermented food products. However, some Weissella species have been associated with human and animal diseases. In the era of vast genomic sequencing, new genomic/genome data are becoming available to the public on daily pace. Detailed genomic analyses are due to provide a full understanding of individual Weissella species. In this study, the genomes of six Weissella paramesenteroides strains were de novo sequenced. The genomes of 42 W. paramesenteroides strains were compared to discover their metabolic and functional potentials in food fermentation. Comparative genomics and metabolic pathway reconstructions revealed that W. paramesenteroides is a compact group of heterofermentative bacteria with good capacity of producing secondary metabolites and vitamin Bs. Since the strains rarely harbored plasmid DNA, they did not commonly possess the genes associated with bacteriocin production. All 42 strains were shown to bear vanT gene from the glycopeptide resistance gene cluster vanG. Yet none of the strains carried virulence genes.

Background Weight loss effectively reduces cardiometabolic health risks among people with overweight and obesity, but inter-individual variability in weight loss maintenance is large. Here we studied whether baseline gene expression in subcutaneous adipose tissue predicts diet-induced weight loss success. Methods Within the 8-month multicenter dietary intervention study DiOGenes, we classified a low weight-losers (low-WL) group and a high-WL group based on median weight loss percentage (9.9%) from 281 individuals. Using RNA sequencing, we identified the significantly differentially expressed genes between high-WL and low-WL at baseline and their enriched pathways. We used this information together with support vector machines with linear kernel to build classifier models that predict the weight loss classes. Results Prediction models based on a selection of genes that are associated with the discovered pathways ‘lipid metabolism’ (max AUC = 0.74, 95% CI [0.62–0.86]) and ‘response to virus’ (max AUC = 0.72, 95% CI [0.61–0.83]) predicted the weight-loss classes high-WL/low-WL significantly better than models based on randomly selected genes (P < 0.01). The performance of the models based on ‘response to virus’ genes is highly dependent on those genes that are also associated with lipid metabolism. Incorporation of baseline clinical factors into these models did not noticeably enhance the model performance in most of the runs. This study demonstrates that baseline adipose tissue gene expression data, together with supervised machine learning, facilitates the characterization of the determinants of successful weight loss.

Psychrotrophic bacteria of raw milk face the dairy industry with significant spoilage and technological problems due to their ability to produce heat-resistant enzymes and biofilms. Despite extensive information about Gram-negative psychrotrophic bacteria in milk, little is known about Gram-positive psychrotrophic bacteria in milk, and their proteolytic activity and biofilm-forming characteristics. In the present study, Gram-positive, proteolytic, psychrotrophic bacteria of cold raw milk were identified, and their proteolytic activity and biofilm-forming capacity were quantified. In total, 12 genera and 22 species were represented among the bacterial isolates, however 50% belonged to three genera, namely Staphylococcus (19.4%), Bacillus (16.7%), and Enterococcus (13.9%). Different levels of proteolytic activity were detected in the identified isolates, even among the strains belonging to the same species. In addition, proteolytic activity was significantly higher at 25°C than at 7°C for all isolates. The crystal violet staining assay in polystyrene microtitre plates revealed a high level of variation in the biofilm-forming capacity at 7°C. After 72 hours of incubation, 11.1% of the strains did not produce a biofilm, while 27.8%, 52.8%, and 8.3% produced low, moderate, and high amounts of biofilm on polystyrene, respectively. The psychrotrophic bacteria were also able to produce biofilms on the surface of stainless steel coupons in ultra-high temperature milk after 72 h of incubation at 7°C; the number of attached cells ranged from 1.34 to 5.11 log cfu/cm2. These results expand the knowledge related to the proteolytic activity and biofilm-forming capacity of Gram-positive psychrotrophic milk bacteria.

Excessive antibiotic prescriptions as well as their misuse in agriculture are the main causes of antimicrobial resistance which poses a growing threat to public health. It necessitates the search for novel chemicals to combat drug resistance. Since ancient times, naturally occurring medicines have been employed and the enormous variety of bioactive chemicals found in nature has long served as an inspiration for researchers looking for possible therapeutics. Secondary metabolites from microorganisms, particularly those from actinomycetes, have made it incredibly easy to find new molecules. Different actinomycetes species account for more than 70% of naturally generated antibiotics currently used in medicine, and they also produce a variety of secondary metabolites, including pigments, enzymes, and anti-inflammatory compounds. They continue to be a crucial source of fresh chemical diversity and a crucial component of drug discovery. This review summarizes some uncommon sources of antifungal metabolites and highlights the importance of further research on these unusual habitats as a source of novel antimicrobial molecules.

Ketogenic diets and orally administered exogenous ketone supplements are strategies to increase serum ketone bodies serving as an alternative energy fuel for high energy demanding tissues, such as the brain, muscles, and the heart. The ketogenic diet is a low-carbohydrate and fat-rich diet, whereas ketone supplements are usually supplied as esters or salts. Nutritional ketosis, defined as serum ketone concentrations of ≥ 0.5 mmol/L, has a fasting-like effect and results in all sorts of metabolic shifts and thereby enhancing the health status. In this review, we thus discuss the different interventions to reach nutritional ketosis, and summarize the effects on heart diseases, epilepsy, mitochondrial diseases, and neurodegenerative disorders. Interest in the proposed therapeutic benefits of nutritional ketosis has been growing the past recent years. The implication of this nutritional intervention is becoming more evident and has shown interesting potential. Mechanistic insights explaining the overall health effects of the ketogenic state, will lead to precision nutrition for the latter diseases.

In order to develop strategies for preventing biofilm formation in the dairy industry, a deeper understanding of the interaction between different species during biofilm formation is necessary. Bacterial strains of the P. fluorescens group are known as the most important biofilm-formers on the surface of dairy processing equipment that may attract and/or shelter other spoilage or pathogenic bacteria. The present study used different strains of the P. fluorescens group as background microbiota of milk, and evaluated their interaction with Staphylococcus aureus, Bacillus cereus, Escherichia coli O157:H7, and Salmonella Typhimurium during dual-species biofilm formation on stainless steel surfaces. Two separate scenarios for dual-species biofilms were considered: concurrent inoculation of Pseudomonas and pathogen (CI), and delayed inoculation of pathogen to the pre-formed Pseudomonas biofilm (DI). The gram-positive pathogens used in this study did not form dual-species biofilms with P. fluorescens strains unless they were simultaneously inoculated with Pseudomonas strains. E. coli O157:H7 was able to form dual-species biofilms with all seven P. fluorescens group strains, both in concurrent (CI) and delayed (DI) inoculation. However, the percentage of contribution varied depending on the P. fluorescens strains and the inoculation scenario. S. Typhimurium contributed to biofilm formation with all seven P. fluorescens group strains under the CI scenario, with varying degrees of contribution. However, under the DI scenario, S. Typhimurium did not contribute to the biofilm formed by three of the seven P. fluorescens group strains. Overall, these are the first results to illustrate that the strains within the P. fluorescens group have significant differences in the formation of mono-or dual-species biofilms with pathogenic bacteria. Furthermore, the possibility of forming dual-species biofilms with pathogens depends on whether the pathogens form the biofilm simultaneously with the P. fluorescens group strains or whether these strains have already formed a biofilm.

Introduction As patient-reported outcome measures (PROMs) have become of significant importance in evaluation of care and clinical research, adequately selecting the appropriate instrument is an integral part of paediatric orthopaedic research and clinical practice. This systematic review aims to provide a comprehensive overview of PROMs targeted at children with impairment of the lower limb, and to critically appraise and summarise the quality of their measurement properties by applying the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology.Method and analysis A systematic search of the MEDLINE and EMBASE databases will be performed to identify relevant publications reporting on the development and/or validation of PROMs used for evaluating children with impairment of the lower extremity. Data extraction and quality assessment of the included studies will be undertaken by two reviewers independently and in accordance with COSMIN guidelines.Ethics and dissemination It is not necessary to obtain ethical approval for this systematic review. The results will be published in a peer-reviewed journal and will be presented at relevant conferences to enhance information dissemination.PROSPERO registration number CRD42021287323.

In a prior study, we elucidated the biofilm formation of Saccharomyces boulardii on glass surfaces during beer bottle aging. Here, we supplemented brewing wort with curcumin at 25 μg/mL concentration to mitigate S. boulardii biofilm and enhance beer’s functional and sensory attributes. An assessment encompassing biofilm growth and development, fermentation performance, FLO gene expression, yeast ultrastructure, bioactive content, and consumer acceptance of the beer was conducted throughout fermentation and aging. Crystal violet (CV) and XTT reduction assays unveiled a significant (p < 0.05) reduction in biofilm formation and development. Fluorescent staining (FITC-conA) and imaging with confocal laser scanning microscopy provided visual evidence regarding reduced exopolysaccharide content and biofilm thickness. Transcriptional analyses showed that key adhesins (FLO1, FLO5, FLO9, and FLO10) were downregulated, whereas FLO11 expression remained relatively stable. Although there were initial variations in terms of yeast population and fermentation performance, by day 6, the number of S. boulardii in the test group had almost reached the level of the control group (8.3 log CFU/mL) and remained stable thereafter. The supplementation of brewing wort with curcumin led to a significant (p < 0.05) increase in the beer’s total phenolic and flavonoid content. In conclusion, curcumin shows promising potential for use as an additive in beer, offering potential antibiofilm and health benefits without compromising the beer’s overall characteristics.