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The global problem of water scarcity continues to grow because of population growth and climate change. Membrane distillation (MD) stands out as a progressing technology, demonstrating the potential for integration with operating systems powered by solar energy. Despite the increasing interest in solar-powered MD, existing literature primarily focuses on the technical aspects of the technology. There is a notable lack of comprehensive analyses that explore broader research trends, key contributors, and thematic evolution within this field. This paper addresses this gap by employing bibliometric analysis and machine learning approaches to explore trends in solar membrane desalination based on publications from 2014 to 2023. 991 publications were analyzed from various aspects, such as publications, countries, institutions, and research trends. Hot keywords include “membrane distillation”, “reverse osmosis”, “energy efficiency”, and “evaporation”. China had the highest number of publications and h-index, followed by the United States, and Saudi Arabia. The study clustered the keywords into three themes: membrane distillation, membrane materials, and reverse osmosis. Analysis of the thematic map reveals seven main research topics in solar-powered membrane desalination, classified according to their degree of relevance. Finally, future directions of membrane desalination are highlighted, including exploring economic and environmental aspects.

Pakistan faces social and health issues due to the mismanagement of municipal solid waste (MSW) in urban and rural areas. Unhygienic conditions due to roadside disposal of MSW negatively affect society, aesthetics, economy, and tourism. This study aims to determine the potential of thermal energy-based MSW incineration technology for electricity generation and waste volume reduction in six major cities in Punjab, namely Lahore, Rawalpindi, Islamabad, Faisalabad, Gujranwala, and Sialkot. In this study, the heat content was calculated using the modified Dulong's equation for the calorific value (CV). Population, waste generation rate, waste characteristics, moisture content, and local public practices also affect energy potential and were considered in the calculations of electricity generation potential. Furthermore, three different sensitivity analysis trials of the power generation capacity were performed with various waste-to-energy (WtE) plant output efficiencies. The analysis of greenhouse gas (GHG) emissions from MSW incineration and CO2 reduction was compared with existing local practices. For WtE potential, Lahore has an energy recovery of 552 kWh/ton of MSW. Carbon footprints can be reduced by incinerating waste rather than disposal through pollution-generating local practices, such as open burning. The study results showed that MSW handling in Punjab can be utilized for WtE generation, a potential alternative to fossil fuel combustion for sustainable energy solutions.

This study introduces a new and waste-to-waste treatment approach to isolate cellulose from lignocellulosic biomass. Rejected brine solution from desalination plant was utilized to remove noncellulosic components from the date palm leaves. Free chlorine available in rejected brine solution was responsible for the separation of cellulose from lignocellulosic structure. The proximate analysis revealed that the isolated cellulose exhibited a substantial volatile content of 83.70%, rendering it well-suited to produce bio-oil. Various other analytical techniques including FTIR, chemical composition analysis, proximate and ultimate analysis, X-ray diffraction (XRD), differential scanning calorimetry (DSC), and thermogravimetric analysis (TGA) were employed to confirm the cellulose enrichment. Cellulose fibers with needle−shaped morphology were obtained. Cellulose fibers were having high thermal stability (Tonset = 250 ○C) and crystallinity index (64.75%) compared to raw waste (Tonset = 226 ○C; 53.58%). In addition, the activation energy (Ea) of both date palm leaves and isolated cellulose were investigated using the Coats−Redfern model−fitting method. The activation energy values obtained were 79.39 kJ/mol for date palm leaves and 103.27 kJ/mol for isolated cellulose. This research shows a completely new process for pretreatment of lignocellulosic wastes to isolate cellulose. This approach helps reduce the waste management cost associated with date palm waste and desalination plants to promote the concept of circular economy. Moreover, enriched cellulose derived from waste palm leaves using desalination brine presents sustainable options for eco−friendly packaging, textiles, biodegradable composites, and enhanced bio-oil production applications.

This study aims to evaluate the microstructure and mechanical behavior of aluminum 2024 and stainless steel 304 dissimilar joints. The gas tungsten arc welding (GTAW) process has been employed to weld base metals by inserting copper-nickel-based (Cu-10%Ni) filler metal. The effects of GTAW parameters such as welding current, welding speed, and gas flow on microstructure and tensile strength have been analyzed through the Taguchi method. Results revealed that tensile strength is primarily influenced by welding current, followed by speed and gas flow rate. The excellent joint strength of 138 MPa has been achieved by using Cu-10%Ni filler metal. The optimal combination of parameters, i.e., welding current of level 2 (80 A), welding speed of level 1 (100 mm/min), and gas flow rate of level 3 (10 l/min), has been obtained through SN ratio optimization. Microstructure and EDS analysis depicted that the weld zone of a high-strength joint contained fine dendrites and CuAl and NiAl solid solutions, while the weld zone of a low-strength joint featured coarse dendrites and brittle FeAl phases.

Two oilseed rape genotypes (Jiu-Er-13XI and Zheyou-50), differing in seed oil content, were subjected to cadmium (Cd) stress in hydroponic experiment. Genotypic differences were observed in terms of tolerance to Cd exposure. Cd treatment negatively affected both genotypes, but the effects were more devastating in Jiu-Er-13XI (low seed oil content) than in Zheyou-50 (high seed oil content). Jiu-Er-13XI accumulated more reactive oxygen species (ROS), which destroyed chloroplast structure and decreased photosynthetic pigments, than Zheyou-50. Total fatty acids, especially 18:2 and 18:3, severely decreased as suggested by increase in MDA content. Roots and shoots of Jiu-Er-13XI plants accumulated more Cd content, while less amount of tocopherol (Toc) was observed under Cd stress, than Zheyou-50. Conversely, Zheyou-50 was less affected by Cd stress than its counterpart. It accumulated comparatively less amount of Cd in roots and shoots, along with reduced accumulation of malondialdehyde (MDA) and ROS under Cd stress, than Jiu-Er-13XI. Further, the level of Toc, especially α-Tocopherol, was much higher in Zheyou-50 than in Jiu-Er-13XI, which was also supported by high expression of Toc biosynthesis genes in Zheyou-50 during early hours. Toc not only restricted the absorption of Cd by roots and its translocation to shoot but also scavenged the ROS generated during oxidative stresses. The low level of MDA shows that polyunsaturated fatty acids in chloroplast membranes remained intact. In the present study the tolerance of Zheyou-50 to Cd stress, over Jiu-Er-13XI, is attributed to the activities of Toc. This study shows that plants with high seed oil content are tolerant to Cd stress due to high production of Toc.

Cadmium, a high toxicity element, is a potential threat to plant and human health, and a dangerous pollutant in the environment. Uptake and accumulation by crops represent the main entry pathway for potentially health-threatening toxic metals into human and animal food. Crops and other plants take up Cd from the soil or water and may distribute it in their roots and shoots. Soil and/or water are usually contaminated with Cd through natural sources, industrial effluent, and anthropogenic activities. In this review, the sources of Cd contamination, evaluation of the phytotoxic effects on plants, and mode of action of Cd toxicity, were summarized. Plant defensive strategies upon excess Cd are also considered in this review. Cd-induced effects include oxidative stress, disintegration of the photosynthetic apparatus, reduction in gas exchange parameters, nutrient imbalance, and subcellular organelle degradation. In addition, Cd severely impairs biomolecules such as DNA, protein, and lipids. Although plants are sessile in nature, they are equipped with certain mechanisms to cope with unfavorable conditions. These mechanisms include synthesis of metal-helating proteins, expression of enzymatic and non-enzymatic antioxidants, organic acids, and plant root–mycorrhiza association. The built-in system of plant tolerance to Cd can be further enhanced by the application of exogenous organic and inorganic metal sources. This review will broaden the knowledge about the Cd accumulation in plants and the responses to metal exposure, as well as our understanding of metal tolerance and overcoming this serious issue for sustainable agriculture and human health worldwide. Highlights Cd accumulation has harmful effects in an organism. Cd has been listed 7th out of 275 compounds in the priority list of hazardous materials. Cd remains in the soil for 15–1100 years. Plants usually imply certain strategies to overcome Cd toxicity. Plants built-in systems can be enhanced to overwhelmed this problem.

Unlabelled: Current stratification of prognosis in patients with epithelioid sarcoma (ES) is based largely on data reported by individual centers with a limited number of patients. We sought to identify the important prognostic parameters using the Surveillance, Epidemiology, and End Results (SEER) database. We identified 441 patients with ES in the database and extracted information regarding patient demographics and clinical characteristics. Kaplan-Meier, log-rank, and Cox regression were used for analysis. Disease-specific survival declined until 100 months after diagnosis after which survival was unrelated to epithelioid sarcoma. The overall incidence of ES during 2005 was 0.041 per 100,000. The reported incidence has increased since 1973, with an annual percentage change of 5.217%. On multivariate analysis, only age younger than 16 years, local stage of disease, or negative nodes and surgical resection of the tumor predicted better disease-specific survival. We observed no increase in survival by comparing decades of diagnosis since 1986. The SEER database shows only age younger than 16 years, negative nodes, or local stage of disease and operability of primary disease independently predict survival in patients with ES.Level Of Evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

Development of the new crop cultivars with high yield under low nitrogen (N) input is a fundamental approach to enhance agricultural sustainability, which is dependent on the exploitation of the elite germplasm. In the present study, four barley genotypes (two Tibetan wild and two cultivated), differing in N use efficiency (NUE), were characterized for their physiological and biochemical responses to different N levels. Higher N levels significantly increased the contents of other essential nutrients (P, K, Ca, Fe, Cu and Mn), and the increase was more obvious for the N-efficient genotypes (ZD9 and XZ149). The observation of ultrastructure showed that chloroplast structure was severely damaged under low nitrogen, and the two high N efficient genotypes were relatively less affected. The activities of the five N metabolism related enzymes, i.e., nitrate reductase (NR), glutamine synthetase (GS), nitrite reductase (NiR), glutamate synthase (GOGAT) and glutamate dehydrogenase (GDH) all showed the substantial increase with the increased N level in the culture medium. However the increased extent differed among the four genotypes, with the two N efficient genotypes showing more increase in comparison with the other two genotypes with relative N inefficiency (HXRL and XZ56). The current findings showed that a huge difference exists in low N tolerance among barley genotypes, and improvement of some physiological traits (such as enzymes) could be helpful for increasing N utilization efficiency.

Effect of high temperature (HT) on anthocyanin (ANS) accumulation and its relationship with reactive oxygen species (ROS) generation in color rice kernel was investigated by using a black kernel mutant (9311bk) and its wildtype (WT). 9311bk showed strikingly higher ANS content in the kernel than WT. Just like the starch accumulation in rice kernels, ANS accumulation in the 9311bk kernel increased progressively along with kernel development, with the highest level of ANS at kernel maturity. HT exposure evidently decreased ANS accumulation in 9311bk kernel, but it increased ROS and MDA concentrations. The extent of HT-induced decline in kernel starch accumulation was genotype-dependent, which was much larger for WT than 9311bk. Under HT exposure, 9311bk had a relatively lower increase in ROS and MDA contents than its WT. This occurrence was just opposite to the genotype-dependent alteration in the activities of antioxidant enzymes (SOD, CAT and APX) in response to HT exposure, suggesting more efficiently ROS detoxification and relatively stronger heat tolerance for 9311bk than its WT. Hence, the extent of HT-induced declines in grain weight and kernel starch content was much smaller for 9311bk relative to its WT. HT exposure suppressed the transcripts of OsCHS, OsF3’H, OsDFR and OsANS and impaired the ANS biosynthesis in rice kernel, which was strongly responsible for HT-induced decline in the accumulation of ANS, C3G, and P3G in 9311bk kernels. These results could provide valuable information to cope with global warming and achieving high quality for color rice production.

Steam methane reforming (SMR) is a dominant technology for hydrogen production. For the highly energy-efficient operation, robust energy analysis is crucial. In particular, exergy analysis has received the attention of researchers due to its advantage over the conventional energy analysis. In this work, an exergy analysis based on the computational fluid dynamics (CFD)-based method was applied to a monolith microreactor of SMR. Initially, a CFD model of SMR was developed using literature data. Then, the design and operating conditions of the microreactor were optimized based on the developed CFD model to achieve higher conversion efficiency and shorter length. Exergy analysis of the optimized microreactor was performed using the custom field function (CFF) integrated with the CFD environment. The optimized catalytic monolith microreactor of SMR achieved higher conversion efficiency at a smaller consumption of energy, catalyst, and material of construction than the reactor reported in the literature. The exergy analysis algorithm helped in evaluating length-wise profiles of all three types of exergy, namely, physical exergy, chemical exergy, and mixing exergy, in the microreactor.

Abstract Background Previous reports suggest an as yet unidentifiable subset of patients with plasmacytoma will progress to myeloma. The current study sought to establish the risk of developing myeloma and determine the prognostic factors affecting the progression of disease. Methods Patients with plasmacytoma diagnosed between 1973 and 2005 were identified in the SEER database(1164 patients). Patient demographics and clinical characteristics, treatment(s), cause of death, and survival were extracted. Kaplan-Meier, log-rank, and Cox regression were used to analyze prognostic factors. Results The five year survival among patients initially diagnosed with plasmacytoma that later progressed to multiple myeloma and those initially diagnosed with multiple myeloma were almost identical (25% and 23%; respectively). Five year survival for patients with plasmacytoma that did not progress to multiple myeloma was significantly better (72%). Age > 60 years was the only factor that correlated with progression of disease (p = 0.027). Discussion Plasmacytoma consists of two cohorts of patients with different overall survival; those patients that do not progress to systemic disease and those that develop myeloma. Age > 60 years is associated with disease progression. Identifying patients with systemic disease early in the treatment will permit aggressive and novel treatment strategies to be implemented.

Introduction: Radiolucent lines occasionally develop around the proximal aspect of fully hydroxyapatite (HA)-coated tapered femoral stems after total hip arthroplasty (THA). It was hypothesised that distal wedging of stems may predispose to proximal radiolucent line formation, which may negatively impact clinical outcome., Methods: All primary THA performed with a collarless fully HA-coated stem that had a minimum of 1 year of radiographic follow-up were identified in a surgical database ( n =  244). Radiographic measures of proximal femoral morphology and femoral canal fill at the middle and distal thirds of the stem were analysed for association with the presence of proximal radiolucent lines. Linear regression was used to explore any association between radiolucent lines and patient reported outcome measures (PROMs), available in 61% of patients., Results: Proximal radiolucent lines developed in 31 cases (12.7%) at final follow-up. Dorr A femoral morphology and increased canal-fill at the distal ⅓ of the stem correlated with the development of radiolucent lines ( p <  0.001). No correlation was observed between pain or PROMs and the presence of proximal radiolucent lines., Discussion: We observed an unexpectedly high incidence of proximal femoral radiolucent lines about collarless fully HA coated stems. Distal-only implant wedging in Dorr A bone may compromise proximal fixation. Although this finding did not correlate with short-term outcomes, the long-term clinical impact requires further study., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Musculoskeletal oncology is a clinical specialty dealing with a diverse population of patients with metastatic bone disease, hematological malignancies with musculoskeletal manifestations, primary bone malignancies and soft tissue sarcomas. There are wide-spread disparities including socioeconomic (SES) and insurance-related disparities reported in the literature. In this review, we'll summarize the disparities surrounding the musculoskeletal oncology., (© 2023 Wiley Periodicals LLC.)

Background: Approximately 5% of cancer patients in the United States presented with metastatic bone disease (MBD) at diagnosis. Current study explores the disparities in survival for patients with MBD., Methods: Patients with the diagnosis of MBD at presentation for the five most common primary anatomical sites were extracted from Surveillance, Epidemiology, and End Results Census tract-level dataset (2010-2016). Kaplan-Meier and Cox Proportional Hazard models were used to evaluate survival, and prognostic factors for each cohort. Prognostic significance of socioeconomic status (SES) and insurance status were ascertained., Results: The five most common anatomical-sites with MBD at presentation included "lung" (n = 59 739), "prostate" (n = 19 732), "breast" (n = 16 244), "renal and urothelium" (n = 7718) and "colon" (n= 3068). Lower SES was an independent risk factor for worse disease-specific survival (DSS) for patients with MBD originating from lung, prostate, breast and colon. Lack of insurance was an independent risk factor for worse DSS for MBD patients with primary tumors in lung and breast., Conclusions: MBD patients from the five most common primary sites demonstrated SES and insurance-related disparities in disease-specific survival. This is the first and largest study to explore SES and insurance-related disparities among patients specifically afflicted with MBD. Our findings highlight vulnerability of patients with MBD across multiple primary sites to financial toxicity., (© 2022 Wiley Periodicals LLC.)

In order to determine the impact of COVID-19 on the treatment and outcomes in patients with proximal femoral fracture’s (PFF), we analyzed a national US sample. This is a retrospective review of American College of Surgery’s (ACS) National Surgical Quality Improvement Program (NSQIP) for patients with proximal femoral fractures. A total of 26,830 and 26,300 patients sustaining PFF and undergoing surgical treatment were sampled during 2019 and 2020, respectively. On multivariable logistic regression, patients were less likely to have ‘presence of non-healing wound’ (p < 0.001), functional status ‘independent’ (p = 0.012), undergo surgical procedures of ‘hemiarthroplasty’(p = 0.002) and ‘ORIF IT, Peritroch, Subtroch with plates and screws’ (p < 0.001) and to be ‘alive at 30-days post-op’ (p = 0.001) in 2020 as compared to 2019. Patients were more likely to have a case status ‘emergent’, ‘loss of ≥10% body weight’, discharge destination of ‘home’ (p < 0.001 for each) or ‘leaving against medical advice’ (p = 0.026), postoperative ‘acute renal failure (ARF)’ (p = 0.011), ‘myocardial infarction (MI)’ (p = 0.006), ‘pulmonary embolism (PE)’ (p = 0.047), and ‘deep venous thrombosis (DVT)’ (p = 0.049) in 2020 as compared to 2019. Patients sustaining PFF and undergoing surgical treatment during pandemic year 2020 differed significantly in preoperative characteristics and 30-day postoperative complications when compared to patients from the previous year.

Background: Cutaneous soft-tissue sarcoma (CSTS) of the head and neck are rare and are known to have aggressive clinical course. The current study utilizes a population-based registry in the U.S. to characterize these malignancies and explore disparities., Methods: National Cancer Institute's (NCI) Surveillance, Epidemiology and End Result (SEER) database from 2000 to 2018 was queried to report incidence and survival data in 4253 cases in the U.S., Results: Males were 5.37 times more likely and Non-Hispanic-White people (NHW) were 4.62 times more likely than females and Non-Hispanic-Black people (NHB) to develop CSTS of the head and neck. The overall incidence was 0.27 per 100,000 persons in 2018, with a significant increase since 2000. Advanced age and stage, histologic group other than 'fibromatous sarcoma' and lower SES groups were independent factors for worse overall survival., Conclusions: CSTS of the head and neck demonstrate sex and racial/ethnic disparities in incidence and socioeconomic disparities in overall survival., Level of Evidence: II.

Purpose: The ideal local treatment modality for pelvic and sacral Ewing sarcoma (EWS) is controversial., Methods: We present the data from the American College of Surgeon's National Cancer Database (NCDB) and the National Cancer Institute's Surveillance, Epidemiology and End Result (SEER) database to investigate the impact of local treatment modalities on survival for nonmetastatic pelvic and sacral Ewing sarcoma. Local treatment includes "surgery," "radiation," and a combination of "surgery and radiation.", Results: A total of 235 cases from SEER and 285 cases from NCDB were analyzed. Patients with "localized" stage (intraosseous) in the SEER database did not show any statistically significant difference in the disease-specific survival (DSS) for any of the local treatment modalities. Similar findings were observed for overall survival among patients with American Joint Committee on Cancer (AJCC) stage II and III in the NCDB database. However, patients with nonmetastatic disease, particularly regional disease (extraosseous), showed improved DSS with surgery only, in the SEER., Conclusion: We found similar levels of efficacy for different treatment modalities for patients with intraosseous and AJCC II and III pelvic and sacral EWS. "Radiotherapy" is the most common local treatment modality employed in the United States. A prospective, randomized controlled trial with a direct head-to-head comparison is needed for a definitive conclusion., (© 2022 Wiley Periodicals LLC.)

Introduction: Advances in diagnostic and treatment modalities for high grade bone sarcomas (HGBS) of lower extremity (LE) have enabled limb salvage resections as a feasible first-line surgical option. However, amputations are still performed. Impact of amputation on survival and predictive factors for amputation and the stage at presentation for HGBS of LE remain unknown., Methods: National Cancer Database was used to extract 5781 cases of high-grade bone sarcoma of the LE from 2004 to 2017. Kaplan-Meier and Cox regression were used to determine the impact of amputation on survival. Chi square test and logistic regression were used to assess the correlation of predictive factors with amputation and stage at presentation., Results: Amputation [hazard ratio (HR) 1.516; 95% confidence interval (CI) 1.259-1.826; p < 0.001] and advanced stage (HR 0.248; 95% CI 0.176-0.351; p < 0.001) were independent predictors of poor overall survival. The impact of amputation on survival was most pronounced for pediatric and adolescents and young adults (AYA) age groups (18% decrease in 10-year survival). Amputation was more likely to be performed among those with nonprivate insurance (HR 1.736; 95% CI 1.191-2.531; p = 0.004), a finding that was mirrored for advanced stage at presentation (HR 0.611; 95% CI 0.414-0.902; p = 0.013)., Discussion: Amputation is an independent predictor of poor outcomes among patients with HGBS of LE. The impact of amputation on survival is the highest for the pediatric and AYA age group. Nonprivate insurance is associated with increased likelihood of amputation and an advanced stage at presentation among patients with high-grade bone sarcoma of the LE. This is the largest study highlighting insurance-related disparities in this cohort., (© 2022. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.)

Background: We have analyzed sex, race/ethnicity or socioeconomic disparities in the incidence of metastatic bone disease (MBD)., Methods: Patients with the diagnosis of MBD at presentation for five most common primary anatomical sites was extracted from Surveillance, Epidemiology, and End Results Census tract-level dataset. Mean incidence of MBD for different sex, racial/ethnic and socioeconomic groups were compared., Results: The five most common anatomical sites with MBD at presentation include "lung: (n = 59 739), "prostate" (n = 19 732), "breast" (n = 16 244), "renal" (n = 7718) and "colon" (n = 3068). There was an increase in incidence of MBD among cancers originating from prostate (annual percentage change [APC] 4.94), renal (APC 2.55), and colon (APC 3.21) (p < 0.05 for all). Non-Hispanic Blacks had higher incidence of MBD for prostate and breast primary sites (p < 0.001). Non-Hispanic American Indian Alaskan Native had higher incidence of MBD for cancers originating from renal (p < 0.001) and colon (p = 0.049). A higher incidence of MBD was seen in lower socioeconomic status (SES) groups for the selected sites (p < 0.001)., Conclusions: These findings suggest that there are multiple sex-related, racial/ethnic and SES disparities in the incidence of MBD from the 5 most common primary sites. Higher incidence seen among lower SES suggests delay in diagnosis and limited access to screening modalities., (© 2021 Wiley Periodicals LLC.)

Purpose: Neoplasms originating from the "small bones of the lower limb and the overlapping joints" are rare but portend a serious prognosis. Current study utilizes a population-based registry in the United States to characterize the malignancies of the foot., Methods: National Cancer Institute's Surveillance, Epidemiology and End Result database from 1975 to 2017 was queried to report incidence and survival data in 514 patients in the Uited States. Kaplan-Meier and Cox Regression were used to determine the prognostic factors affecting survival. Chi square test was used to assess the correlation., Results: Hematological malignancies constituted 14.8% of the entire cohort. Incidence of the foot neoplasms was 0.024 per 100 000 persons in 2017 and has not significantly changed since 1975 (p > 0.05). Disease-specific-5-year survival for the entire cohort was 73%. On multivariate analysis younger age groups, "localized" stage and extent of surgical resection were predictors of improved outcomes. A significant correlation was found between amputation with male sex and Hispanic ethnicity., Conclusions: The current study analyzes data from population-based registry reporting incidence and survival data for patients with neoplasms of the foot. Independent prognostic factors include age, stage and extent of surgical resection. Amputation was found to be associated with male sex and Hispanic ethnicity., (© 2021 Wiley Periodicals LLC.)

Background: Primary sarcomas originating from the bones of hand and wrist are rare but carry a significant burden of morbidity., Methods: National Cancer Institute's Surveillance, Epidemiology and End Result database from 1975 to 2017 was queried to report incidence and survival data in 237 patients in the United States. Kaplan-Meier and Cox regression were used to determine the prognostic factors affecting survival. χ 2 test was used to assess the correlation., Results: Incidence of hand and wrist sarcoma was 0.017 per 100 000 persons in 2017 and has not significantly changed since 1975 (p > 0.05). Disease-specific 5-year and 10-year survival for the entire cohort was 90% and 84%, respectively. On multivariate analysis race "others," histology other than "osteosarcoma," "undifferentiated" grade, and size "≥6 cm" were predictors of worse disease-specific survival. Cross-tabulation of race with other significant prognostic factors on univariate analysis revealed a significant correlation of race with every other significant prognostic factor except for grade., Conclusions: The current study is an analysis of a population-based registry reporting incidence and survival data for patients with sarcoma of hand and wrist. Independent prognostic factors include race, histology, grade, and size. There is a lack of improvement in survival over the last four decades., (© 2021 Wiley Periodicals LLC.)

Background: Primary sarcomas originating from the mobile spine portends a particularly sinister outcome. Rarity of the disease process has resulted in inconsistent data due to small sample size and heterogeneity in patient selection and analytics., Methods: Surveillance, Epidemiology and End Result (SEER) database from 1975 to 2017 was queried to report incidence and survival data in 712 patients in the United States. Kaplan-Meier and Cox Regression were used to determine the prognostic factors affecting survival., Results: Incidence of spinal sarcoma was 0.019 per 100,000 persons in 2017 and has not significantly changed since 2000 (p > 0.05). Disease-specific 5-year survival for the entire cohort was 57%. Osteosarcoma has the worst 5-year survival (39%) and chondrosarcoma has the best 5-year survival (69%). Independent predictors of survival for the entire cohort included age, grade, and stage. Stage was an independent predictor of survival for every histologic subtype. Additional predictors of survival for spinal osteosarcoma, Ewing sarcoma, and chondrosarcoma included age, size, and grade, respectively., Conclusions: The current study is an analysis of a population-based registry reporting incidence survival data for patients with sarcoma of mobile vertebral column. Survival and prognostic factors vary by histologic subtypes. There is lack of improvement in survival over the last three decades., (© 2021 Wiley Periodicals LLC.)

The trans-sulfuration enzyme cystathionine-β-synthase (CBS) and its product hydrogen sulfide (H2S) are aberrantly upregulated in colorectal cancers, where they contribute to tumor growth and progression by both autocrine and paracrine mechanisms. However, it is unknown whether the CBS/H2S axis plays a role in colorectal carcinogenesis. Here, we report upregulation of CBS in human biopsies of precancerous adenomatous polyps and show that forced upregulation of CBS in an adenoma-like colonic epithelial cell line is sufficient to induce metabolic and gene expression profiles characteristic of colorectal cancer cells. Differentially expressed metabolites (65 increased and 20 decreased) clustered into the glycolytic pathway, nucleotide sugars, intermediates of the pentose phosphate pathway, and lipogenesis, including primarily phospholipids, sphingolipids, and bile acids. CBS upregulation induced broad changes in the NCM356 cell transcriptome with over 350 differentially expressed genes. These genes overlapped significantly with gene sets related to glycolysis, hypoxia, and a colon cancer cell phenotype, including genes regulated by NF-κB , KRAS , p53 , and Wnt signaling, genes downregulated after E-cadherin knockdown, and genes related to increased extracellular matrix, cell adhesion, and epithelial-to-mesenchymal transition. The CBS-induced switch to an anabolic metabolism was associated with increased NCM356 cell bioenergetics, proliferation, invasion through Matrigel, resistance to anoikis, and CBS-dependent tumorigenesis in immunocompromised mice. Genetic ablation of CBS in CBS heterozygous mice ( CBS +/- ) reduced the number of mutagen-induced aberrant colonic crypt foci. Taken together, these results establish that activation of the CBS/H2S axis promotes colon carcinogenesis. Cancer Res; 77(21); 5741-54. ©2017 AACR ., (©2017 American Association for Cancer Research.)

Metallic endoprostheses are used for oncological reconstruction around the proximal femur and hip joint. Common modes of failure with hemiarthroplasty or standard hip arthroplasty after proximal femoral replacement include dislocation, late hip pain, and infection. The authors reviewed hospital records to identify patients undergoing constrained tripolar hip arthroplasty for oncological reasons between 2002 and 2012. Inclusion criterion was at least 12-cm proximal femoral resection, including patients with total femur reconstruction. A total of 33 patients were reviewed. Information regarding demographics, length of follow-up, treatment characteristics, and patient outcomes was extracted. Average follow-up for all patients was 912.33 days (30.4 months). Average follow-up was 1396.1 days for living patients and 428.6 days for deceased patients. Average estimated blood loss was 462.12 cc: an average of 1080 cc for patients undergoing total femoral resection and replacement and 315.8 cc for patients undergoing proximal femoral resection and replacement. Average operative time was 137.7 minutes: an average of 205 minutes for patients undergoing total femoral resection and replacement and 119.1 minutes for patients undergoing proximal femoral resection and replacement. Average Musculoskeletal Tumor Society score was 21.7. There were no dislocations in the cohort. A constrained tripolar device can be safely used for oncological proximal femoral reconstructions while minimizing the risk of dislocation. Positioning of the acetabular implant in neutral anatomic version in conjunction with a neutral-placed femoral component provides the greatest range of motion, reduction of liner impingement, and improved hip stability., (Copyright 2014, SLACK Incorporated.)

Sclerostin is a glycoprotein secreted by osteocytes and inhibits osteoblastogenesis via inhibition of Wnt signaling. We hypothesized that sclerostin antibody (Scl-AbIII) would accelerate the healing of a murine femoral non-critical size bone defect model. A unilateral and unicortical 0.8 mm-sized drill hole was made in the proximal femoral shaft of adult female nude mice. One group of mice received subcutaneous injections of Scl-AbIII and a second group received vehicle only. Reporter MC3T3 osteoprogenitor cells were injected via the tail vein 3 days after surgery to monitor systemic trafficking of exogenous osteoprogenitors. Bioluminescence imaging (BLI), microcomputed tomography (microCT), micropositron emission tomography (microPET) and histological analysis were used to compare the bone healing responses to Scl-AbIII treatment. Bone mineral density (BMD) significantly increased at the defect site after week 1, and was significantly higher in the treatment compared with the control group at all time points. This finding was also confirmed on histological analysis by increased deposition of new woven bone. MicroPET scanning showed a trend for greater activity in the control group at day 21 compared with the Scl-AbIII group, indicating early bone maturation following treatment with Scl-AbIII. Whereas the BLI signals derived from the injected osteoprogenitor cells showed no differences between vehicle and Scl-AbIII treated groups, systemic migration of MC3T3 cells to the bone defect was clearly identified in both groups using immunohistochemistry. Systemic administration of Scl-AbIII resulted in earlier healing and maturation of a non-critical size bone defect. These findings underscore the potential use of Scl-AbIII for treatment of complicated fractures, non-unions, and other clinical scenarios., (Copyright © 2012 Orthopaedic Research Society.)

Although iliac crest autologous bone graft remains the gold standard for treatment of bone defects, delayed- and nonunions, and arthrodeses, several alternative strategies have been attempted, including the use of mesenchymal stem cells. Whether cells from the osteoblast lineage demonstrate systemic recruitment to an acute bone defect or fracture, and whether these cells directly participate in bone healing is controversial. This study tests two hypotheses: (1) that exogenous murine MC3T3-E1 osteoprogenitor cells with a high propensity for osteoblast differentiation are able to systemically migrate to a bone defect and (2) that the migrated MC3T3-E1 cells enhance bone healing. Two groups of nude mice were used; a bone defect was drilled in the left femoral shaft in both groups. MC3T3-E1 were used as reporter cells and injected in the left ventricle of the heart, to avoid sequestration in the lungs. Injection of saline served as a control. We used bioluminescence and microCT to assay cell recruitment and bone mineral density (BMD). Immunohistochemical staining was used to confirm the migration of reporter cells. MC3T3-E1 cells were found to systemically migrate to the bone defect. Further, BMD at the defect was significantly increased when cells were injected. Systemic cell therapy using osteoprogenitor cells may be a potential strategy to enhance bone healing.

Background: We sought to identify the significant prognostic parameters of patients with osteosarcoma over the past three decades using a population-based registry., Methods: A total of 3765 patients with osteosarcoma were identified in the SEER database. Information regarding patient demographics, clinical and treatment characteristics, cause of death and survival were extracted. Kaplan-Meier, Log-Rank, and Cox regression were used for analysis., Results: On multivariate analysis only age group '<25 years', 'local' stage and 'low' grade, 'appendicular skeleton' and employment of 'surgical resection' showed a disease-specific survival benefit with a P value < 0.001. The long-term survival improved in the interval from 1973 to 1985 from approximately 55 to 65% but subsequent improvement has been limited only to patients with high-grade disease., Conclusion: When comparing survival rates by decade of diagnosis, it appears that improvement in survival since 1985 is limited to patients with high-grade disease only., Level of Evidence: The level of evidence for this article is 2.

Background: Treatment of malignant sarcomas of the pelvis poses a challenge for local disease control and oncologic outcome. Many reports have described the dismal outcomes. Most studies are retrospective series coming out of single centers, thus biased toward patient selection and are of limited statistical power., Methods: The authors used the Surveillance, Epidemiology, and End Results database to analyze 1185 pelvic sarcoma cases from 1987 to 2006. Kaplan-Meier and Cox regression were used to analyze the significance of prognostic factors. The analysis was repeated for different histopathological subtypes to determine specific prognostic factors in each case., Results: Incidence of pelvic sarcoma in 2006 was 89 per 100,000 persons; it has significantly increased since 1973 (P < .05). The overall 5-year survival for all the patients with pelvic sarcoma was 47%, with osteosarcoma having the worst 5-year survival at 19% and patients with chordoma having the best 5-year survival at 60%. Independent prognostic factors included age, stage, grade, size of primary lesion, histopathology, and treatment-related factors. Comparing the patients only with high-grade lesions, patients with Ewing sarcoma have the best prognosis., Conclusions: This is an analysis of patients with pelvic sarcomas derived from a population-based registry. Survival and prognostics vary with histopathological diagnoses. Although surgical resection was associated with superior outcomes for osteosarcoma and chondrosarcoma, there was no significant difference in outcomes of patients with Ewing sarcoma treated with surgery and/or radiotherapy., (Copyright © 2010 American Cancer Society.)

In carcinomas stromal cells participate in cancer progression by producing proteases such as MMPs. The expression MMP1 is a prognostic factor in human chondrosarcoma, however the role in tumor progression is unknown. Laser capture microdissection and In Situ hybridization were used to determine cellular origin of MMP1 in human sarcomas. A xenogenic model of tumor progression was then used and mice were divided in two groups: each harboring either the control or a stably MMP1 silenced cell line. Animals were sacrificed; the neovascularization, primary tumor volumes, and metastatic burden were assessed. LCM and RNA-ISH analysis revealed MMP1 expression was predominantly localized to the tumor cells in all samples of sarcoma (p = 0.05). The percentage lung metastatic volume at 5 weeks (p = 0.08) and number of spontaneous deaths secondary to systemic tumor burden were lower in MMP1 silenced cell bearing mice. Interestingly, this group also demonstrated a larger primary tumor size (p<0.04) and increased angiogenesis (p<0.01). These findings were found to be consistent when experiment was repeated using a second independent MMP1 silencing sequence. Prior clinical trials employing MMP1 inhibitors failed because of a poor understanding of the role of MMPs in tumor progression. The current findings indicating tumor cell production of MMP1 by sarcoma cells is novel and highlights the fundamental differences in MMP biology between carcinomas and sarcomas. The results also emphasize the complex roles of MMP in tumor progression of sarcomas. Not only does metastasis seem to be affected by MMP1 silencing, but also local tumor growth and angiogenesis are affected inversely.

Purpose: To measure the morphology of the proximal femur in a Pakistani population., Methods: Standardised anteroposterior pelvic radiographs of 116 male and 20 female healthy volunteers aged 20 to 50 (mean, 33) years were taken. Morphologic dimensions of the proximal femur were measured, including canal flare index (CFI), morphological cortical index (MCI), femoral head offset, femoral head diameter, and femoral head position., Results: Based on the CFI, 67% of the subjects had normal canal shapes (CFI, 3.0-4.7), whereas 1% and 33% of the subjects had stovepipe shapes (CFI, <3) and champagne-flute shapes (CFI, 4.7-6.5), respectively. Based on the MCI, 29% of the subjects had cylindrical shapes (MCI, <2.7) and 71% had trumpet shapes (MCI, >2.7)., Conclusion: Morphology of the proximal femur in our study population differed significantly from those in western populations, indicating regional variation. It could also be due to the younger age of our population.

Background: The low incidence of primary lymphoma of bone (PLB) has led to discrepancies in classification as well as difficulty in prognostication. The authors of this report used the Surveillance, Epidemiology, and End Results (SEER) database to analyze a large, population-based cohort of adult patients with this disease. The database provides a standardized classification and documentation of outcomes and enables a meaningful evaluation of prognostic factors., Methods: The SEER database was used to identify all patients who were diagnosed with PLB from 1973 through 2005. Survival was analyzed with the Kaplan-Meier method, and the influence of clinical parameters on survival was analyzed with the log-rank test. A Cox proportional hazards model was used for multivariate analysis., Results: Fifteen hundred adult patients with PLB were analyzed. The 5-year and 10-year survival rates for adult patients were 58% and 45%, respectively. Multivariate analysis revealed that younger age and localized disease were independent predictors of survival. It is noteworthy that the incidence of disease, as determined by the annual percentage change, increased during the study period (P < .05)., Conclusions: This analysis of a large cohort of adults with PLB indicated that the only identifiable prognostic indicators were localized disease and younger age. The authors concluded that future treatment for patients with PLB need to be based on strict staging criteria and adherence to successful published protocols using collaborative clinical trials.

Study Design: Retrospective database review using Surveillance, Epidemiology, and End Results database, National Cancer Institute., Objective: To determine current treatment outcomes and demographic characteristics and to define the prognostic factors and impact of surgery on survival., Summary of the Background Data: Rarity of the disease has limited the number of population-based studies addressing the issues of prognostic factors and the current treatment outcomes., Methods: A total of 962 patients with chordoma, diagnosed between 1973 and 2005, were identified in the Surveillance, Epidemiology, and End Results database. Patient demographics and clinical characteristics, incidence, year of diagnosis, location, size and stage at diagnosis, treatment(s), and survival were extracted. Kaplan-Meier, log-rank, and Cox regression were used to analyze the significance of prognostic factors., Results: Race specific incidence per 100,000 persons in 2005 shows whites to have the highest (0.473) incidence, followed by Asians/Pacific Islanders (0.091), and Afro-Americans (zero), respectively. The incidence difference between whites and Afro-Americans over time is statistically significant (P < 0.001). The age adjusted incidence reveals a peak in eighth decade of life. Survival was not impacted by race. Age category <59, Hispanic ethnicity, size <8 cm, and surgical resection were all independent predictors of better overall survival. Analysis revealed that survival outcomes were very similar in patients with "in-operable disease" and those in which "surgery was recommended but not performed" suggesting that benefits of resection cannot be solely attributed to selection bias., Conclusion: With high local recurrence rates and the significant functional morbidity associated with surgical resections, clinicians are left wondering if surgery constitutes an appropriate treatment option. Our study clearly demonstrates that surgery significantly improves the overall survival for patients with chordoma. We have further identified age <59 and size of primary tumor <8 cm as important prognostic factors determining the outcome with substantial statistical significance.

Background: Previous reports suggest an as yet unidentifiable subset of patients with plasmacytoma will progress to myeloma. The current study sought to establish the risk of developing myeloma and determine the prognostic factors affecting the progression of disease., Methods: Patients with plasmacytoma diagnosed between 1973 and 2005 were identified in the SEER database(1164 patients). Patient demographics and clinical characteristics, treatment(s), cause of death, and survival were extracted. Kaplan-Meier, log-rank, and Cox regression were used to analyze prognostic factors., Results: The five year survival among patients initially diagnosed with plasmacytoma that later progressed to multiple myeloma and those initially diagnosed with multiple myeloma were almost identical (25% and 23%; respectively). Five year survival for patients with plasmacytoma that did not progress to multiple myeloma was significantly better (72%). Age > 60 years was the only factor that correlated with progression of disease (p = 0.027)., Discussion: Plasmacytoma consists of two cohorts of patients with different overall survival; those patients that do not progress to systemic disease and those that develop myeloma. Age > 60 years is associated with disease progression. Identifying patients with systemic disease early in the treatment will permit aggressive and novel treatment strategies to be implemented.

Background: Previous reports of Ewing sarcoma cohorts suggested that there is a difference in incidence according to racial origin. However, to the authors' knowledge, this finding has never been tested in a population-based database, and the impact of race on clinical outcome and the significance of known risk factors stratified to racial groups have not been reported., Methods: Patients who had Ewing sarcoma diagnosed between 1973 and 2005 were identified in the Surveillance, Epidemiology, and End Results database. Patient demographic and clinical characteristics; incidence; year of diagnosis; tumor location, tumor size, and disease stage at diagnosis; treatment(s); cause of death; and survival were extracted. Kaplan-Meier, log-rank, and Cox regressions were used to analyze the significance of prognostic factors., Results: Race-specific incidence indicated that Caucasians have the highest incidence (0.155), followed by Asians/Pacific Islanders (0.082), and African Americans (0.017). The difference in incidence between Caucasians and African Americans was 9-fold and significant (P<.001). The incidence of Ewing sarcoma increased over the past 3 decades among Caucasians (P<.05). Survival was not impacted by race. Local disease stage, primary tumor location in the appendicular skeleton, and tumor size

We carried out a cross-sectional study to measure the association of the seven acetabular parameters with pelvic morphometry and prevalence of hip dysplasia in our population. Convenience sampling was carried out and 250 consecutive patients who came to AKUH for intravenous pyelogram and had no complaints in the region of the hip joint were enrolled in the study. Post-micturition standardized plain antero-posterior pelvic radiographs of 250 asymptomatic adults (500 hip joints) was studied. There were 136 males (54.4%) and 114 females (45.6%). Mean age of our study population was 38 years (15-78 years). The average center edge angle was 35.5±6.6° standard deviation (SD), acetabular angle was 37.76±4.37°, depth to width ratio was 0.31±4.6°, roof obliquity was 10.6±6.2°, extrusion index was 0.1±5.8, lateral subluxation 8.9±2.7 mm, and peak to edge distance 17±3.98 mm. There was significant influence (p<0.05) of age in all angles except depth to width ratio. A total of seven hip joints (1.4%) were dysplastic with CE angle <25° while four of the seven hips were severely dysplastic with CE angle <20°. In the dysplastic group there was significant correlation (p<0.05) of CE angle with acetabular angle, depth to width ratio, extrusion index and peak to edge distance. Prevalence of hip dysplasia was found to be very low in our population. These results are consistent with the findings of studies carried out in other Asian countries.