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Following publication of the original article [1], the authors identified that the original colours did not display correctly in Table 2. The correct table is given below. (Table presented.) Correlations between PROMIS scales and the OKS PROMIS Patient Reported Outcomes Measurement Information System; OKS Oxford Knee Score; PAIN pain intensity; PI pain interference; PF physical function; black versus grey font color: the confidence interval of the correlation does not overlap/overlaps with the preset correlation threshold aSpearman's rank correlation coefficient, rs bPearson’s correlation coefficient, r The original article [1] has been updated.

The in-plant recycling routes of side streams produced in electric arc furnace (EAF) steelmaking remain underexplored. Briquetting is an attractive technique to enable their recycle. Briquettes introduced into EAF must possess certain mechanical and chemical properties. However, no standard is available to determine the suitability of briquettes used in the EAF process. Herein, eight side streams are characterized, and used to produce seven different briquettes to be used in EAF. Briquettes tested consist of four self-reducing briquettes and three slag-forming briquettes produced using different recipes. The briquettes are subjected to several mechanical and thermal tests which reflect their intended use in EAF. The mechanical tests include compression and drop tests, and the thermal tests include optical dilatometry, thermogravimetric analysis (TGA)–derivative thermogravimetry (DTG)–mass spectrometry (MS), and full-scale briquette reduction tests. Moreover, melting trials are performed to assess the melting behavior of selected briquettes and their interaction with slag. Suitability of briquettes characteristics is assessed based on values from the literature and against reference ferroalloys and lime stones used in one of the steel plants. Two briquettes are deemed suitable for EAF use, while three briquettes are deemed unsuitable, and two briquettes are considered of limited use.

In addition to the blast furnace converter route, electric steel production in the electric arc furnace (EAF) is one of the two main production routes for crude steel. In 2019, the global share of crude steel produced via the electric steel route was 28%, which in numbers is 517 million metric tons of crude steel. The production and processing of steel leads to the output of a variety of by-products, such as dusts, fines, sludges and scales. At the moment, 10–67% of these by-products are landfilled and not recycled. These by-products contain metal oxides and minerals including iron oxide, zinc oxide, magnesia or alumina. Apart from the wasted valuable materials, the restriction of landfill space and stricter environmental laws are additional motivations to avoid landfill. The aim of the Fines2EAF project, funded by the European Research Fund for Coal and Steel, is to develop a low-cost and flexible solution for the recycling of fines, dusts, slags and scales from electric steel production. During this project, an easy, on-site solution for the agglomeration of fine by-products from steel production has to be developed from lab scale to pilot production for industrial tests in steel plants. The solution is based on the stamp press as the central element of the agglomeration process. The stamp press provides the benefit of being easily adapted to different raw materials and different pressing parameters, such as pressing-force and -speed, or mold geometry. Further benefits are that the stamp press process requires less binding material than the pelletizing process, and that no drying process is required as is the case with the pelletizing process. Before advancing the agglomeration of by-products via stamp press to an industrial scale, different material recipes are produced in lab-scale experiments and the finished agglomerates are tested for their use as secondary raw materials in the EAF. Therefore, the tests focus on the chemical and thermal behavior of t

The use of secondary raw materials in metallurgical processes such as steelmaking is an important contribution to the circular economy aspired to by EU members and many other countries. The agglomeration of dusts, fines and sludges is an important pretreatment step to enable the use of these materials in subsequent melting processes, such as steelmaking in electric arc furnaces (EAFs). It also reduces the amount of by-products and waste materials that are currently waste for disposal and are landfilled. The presented research is part of the Fines2EAF project, which aims to increase the value of steelmaking residues by internal recycling and use or reuse in the form of agglomerates. The approach followed in this project is the use of a hydraulic stamp press and alternative binder systems to produce cement-free agglomerates. The first results of lab-scale agglomeration tests of six different recipes with varying pressing forces are presented in this paper. It is shown that the addition of fibres from paper recycling has a strong effect on the cold compression stability of the agglomerates, by far exceeding other effects such as increased pressing force. Overall, the agglomerates produced in the lab show promising characteristics, for example, cold compression stability and abrasion resistance, which should allow for use in EAF steelmaking.

Purpose: Early prosthetic joint infection (PJI) can be treated with an intensive surgical debridement and implant retention (DAIR) of the prosthesis if (1) the prosthesis is stable, (2) the pathogen is not a difficult-to-treat microorganism, (3) symptoms have lasted for <3weeks and (4) a sinus tract is absent. Methods: We retrospectively evaluated the treatment outcome of early PJI in the hip and knee in a single orthopaedic centre. An early PJI was defined as a prosthesis infection within 3months after primary implantation or revision surgery for a non-infectious cause. Results: We identified 69 patients with confirmed early PJI, with a median age of 71 (range 33-84) years. Only 64% presented with ≥2 acute signs of infection. The most commonly isolated bacteria were coagulase-negative staphylococci (38%) and Staphylococcus aureus (25%). Surgical procedures included DAIR (50 cases, 69%) and two-stage exchange (19 cases, 31%). At last follow-up, five ofremaining living 67 patients (7.5%) had a relapse of infection. The overall relapse-free survival of the prosthesis after 2 yearswas 92.3% (95% confidence interval 82-97%) with no significant difference between DAIR and exchange of prosthesis. Conclusion: Our data suggest that an early PJI should be treated with DAIR as a less invasive procedure whenever possible according to the established treatment algorithm.

PURPOSE: To examine the measurement properties of the German International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) in knee disorder patients. METHODS: Three hundred twelve consecutive patients undergoing surgery for anterior cruciate ligament, meniscus and/or cartilage injuries completed the IKDC-SKF, Lysholm Score, Tegner Activity Scale, and Short Form-12 Health Survey before and 6 months post-surgery. IKDC-SKF measurement properties were calculated and patients were also asked to rate the relevance/comprehensibility of the questionnaire items. RESULTS: Reliability was good with high Cronbach's alpha and intraclass correlation coefficients, and standard error of measurement values of 4.4 to 6.0. The smallest detectable change (SDC) ranged from 12.3 to 16.7 points. Validity was good with 90% of all hypotheses confirmed. Confirmatory factor analysis did not show adequate fitting indices within the model. Over half of the items were rated as essential, and all were well comprehended. The majority of hypotheses for responsiveness were confirmed. No floor and ceiling effects were observed. The area under the curve ranged from 0.82 to 0.89 and the minimal important difference was smaller than the SDC. CONCLUSIONS: The German IKDC-SKF is a reliable outcome measure with good hypotheses testing and responsiveness, but its MIC and structural/content validity need further analysis.

© 2018, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: Studies comparing the outcome of spine surgery with that of large-joint replacement report equivocal findings. The patient-reported outcome measures (PROMs) used in such studies are typically generic and may not be sufficiently sensitive to the successes/failures of treatment. This study compared different indices of “success” in patients undergoing surgery for degenerative disorders of the lumbar spine, hip, or knee, using a validated, multidimensional, and joint-specific PROM. Methods: Preoperatively and 12 months postoperatively, 4594 patients (3937 lumbar spine, 368 hip, 269 knee) undergoing first-time surgery completed a PROM that included the Core Outcome Measures Index (COMI) for the affected joint. The latter comprises a set of single items on pain, function, symptom-specific well-being, quality of life, and disability—all in relation to the specified joint problem. Other single-item ratings of treatment success were made 12 months postoperatively. Results: In multiple regression analyses, controlling for confounders, the mean improvement in COMI at 12 months was greatest for the hip patients and lowest for those with degenerative spinal deformity (= the statistical reference group) (p < 0.05). Compared with spinal deformity, the odds of achieving “success” were: higher for hip (OR 4.6; 95% CI 2.5–8.5) and knee (OR 4.0; 95% CI 2.1–7.7) (no difference between spine subgroups) for “satisfaction with care”; higher for hip (OR 16.9; 95% CI 7.3–39.6), knee (OR 6.3; 95% CI 3.4–11.6), degenerative spondylolisthesis (OR 1.6; 95% CI 1.2–2.2), and herniated disc (OR 1.7; 95% CI 1.2–2.4) for “global treatment outcome”; and higher for hip (OR 13.8; 95% CI 8.8–21.6), knee (OR 5.3; 95% CI 3.6–7.8), degenerative spondylolisthesis (OR 1.6; 95% CI 1.3–2.1), and herniated disc (1.5; 95% CI 1.1–2.0) for “patient-acceptable symptom state”. Patient-rated complications were the greatest in degenerative spinal

BACKGROUND: The Core Outcome Measure Index (COMI) is a very short outcome instrument used in spine patients. The aim of this study was to examine the utility of a knee version of the COMI in patients undergoing total knee arthroplasty (TKA) by assessing the reproducibility, construct and discriminant validity, and responsiveness. METHODS: Preoperatively, 224 patients completed the Oxford Knee Score (OKS), EuroQoL (EQ-5D) and the COMI-Knee; 189 (84) % also completed the questionnaires at follow-up and 73 patients completed preoperatively the COMI-knee twice. RESULTS: The weighted kappa values for the COMI-knee single items ranged from 0.80 to 0.89 and the ICC for the COMI-knee (composite score), 0.86. The absolute SEM for COMI-knee was 0.4 points, i.e. four percent of the maximum value (10 points) and six percent of the average value (6.6 points). The Area Under the Curve derived from the Receiver Operating Characteristic method for the COMI-knee was 0.97 (95% CI, 0.93 to 0.99), with a cut-off value for indicating a "good" result of 2.3 (100% specificity, 87% sensitivity). Correlations between the COMI-knee and the OKS were -0.72 at baseline and -0.87 at six months. The correlations between the change scores for the COMI-knee and the change scores for the OKS and EQ5D index were 0.77 and 0.69, respectively. CONCLUSIONS: The measurement properties of the COMI-knee satisfy international quality criteria and hence support its use in assessing patients undergoing TKA.

Purpose: Early prosthetic joint infection (PJI) can be treated with an intensive surgical debridement and implant retention (DAIR) of the prosthesis if (1) the prosthesis is stable, (2) the pathogen is not a difficult-to-treat microorganism, (3) symptoms have lasted for <3 weeks and (4) a sinus tract is absent. Methods: We retrospectively evaluated the treatment outcome of early PJI in the hip and knee in a single orthopaedic centre. An early PJI was defined as a prosthesis infection within 3 months after primary implantation or revision surgery for a non-infectious cause. Results: We identified 69 patients with confirmed early PJI, with a median age of 71 (range 33-84) years. Only 64 % presented with ≥2 acute signs of infection. The most commonly isolated bacteria were coagulase-negative staphylococci (38 %) and Staphylococcus aureus (25 %). Surgical procedures included DAIR (50 cases, 69 %) and two-stage exchange (19 cases, 31 %). At last follow-up, five of remaining living 67 patients (7.5 %) had a relapse of infection. The overall relapse-free survival of the prosthesis after 2 years was 92.3 % (95 % confidence interval 82-97 %) with no significant difference between DAIR and exchange of prosthesis. Conclusion: Our data suggest that an early PJI should be treated with DAIR as a less invasive procedure whenever possible according to the established treatment algorithm.

Hepatitis B virus (HBV) infection is a major cause of liver-related morbidity and mortality. Toll-like receptors (TLRs) have recently been recognized to play an important role in the pathogenesis of chronic hepatitis B (CH-B). Furthermore, manipulation of TLR signalling pathways shows potential as an antiviral therapeutic strategy. Whether hepatocytes themselves possess intact TLR signalling pathways remains controversial. It is critical that cell culture models be developed to allow investigation of the interaction between HBV and the TLR signalling pathways. We have screened three hepatocyte cell lines for the integrity of pro-inflammatory responses and antiviral cytokines following stimulation with interleukin-1 (IL-1) and different TLR ligands. We observed that Huh-7, HepG2 and PH5CH8 cells selectively responded to IL-1 and TLR2 ligands, leading to the activation of NF-kappaB. In addition, the PH5CH8 cell lines were able to induce type 1 interferon (IFN) via both TLR3 and RIG-I following stimulation with poly I:C, HepG2 cells mounted an IFN response via RIG-I only, whereas Huh-7 cells were unresponsive. We conclude that the hepatocyte cell lines investigated display a repertoire of TLR signalling, albeit limited, suggesting that hepatocytes may themselves play an active role in innate immune responses to viruses such as HBV. Furthermore, particular hepatoma cell lines are suitable for investigating the interaction between HBV and hepatocyte-expressed pattern recognition receptors. © 2008 The Authors.

Signalling activated by Toll-like receptors (TLRs) can result in the production of tumour necrosis factor alpha (TNF-alpha) which is implicated in hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection. No study has examined or compared hepatic expression of TLRs in both HCV and HCV/HIV. Liver and peripheral blood mononuclear cells (PBMCs) were obtained from HCV & HCV/HIV-infected patients and PBMCs from HIV-infected patients. Liver RNA was analysed by microarray and reverse transcription quantitative PCR (RT-qPCR). PBMCs were analysed by flow cytometry. Associations with hepatic histology and infection type were sought. Forty-six HCV, 20 HIV and 27 HCV/HIV-infected patients were recruited. Increasing Metavir inflammatory activity score was associated with increased hepatic TLR mRNA by RT-qPCR: TLR2 (P <= 0.001), TLR4 (P = 0.008) and TNF-alpha (P a;circ 0.001). A high degree of correlation was seen between hepatic mRNA expression of TNF-alphavs TLR2 (r2 = 0.66, P < 0.0001) and TLR4 (r2 = 0.60, P < 0.0001). No differences in TLR gene or protein expression was observed between HCV, HCV/HIV- or HIV-infected groups. Hepatic TLR2, TLR4 and TNF-alpha mRNA are associated with hepatic inflammation in both HCV and HCV/HIV infection. High correlation between TNF-alpha and TLR2/TLR4 suggests a role for the innate immune response in TNF-alpha production. Activation of the innate immune response appears to be independent of infection type. © 2010 Blackwell Publishing Ltd.

The -1G mutant HBV is more prevalent in individuals co-infected with HIV/HBV than in individuals infected with HBV alone and in some cases is the dominant virus in circulation. This mutant is created by the deletion of a dGMP (-1G) from the guanine rich homopolymer sequence located at nts 2,085-2,090 (numbering from EcoRI site as position 1) in the HBV core gene. This deletion causes a frameshift generating a premature stop codon at (64) Asn in the HBV core gene (codon 93 in the precore gene), that truncates the precore protein, precursor of the secreted hepatitis B "e" antigen (HBeAg), and the core protein which forms the viral nucleocapsid. However, the replication phenotype of the -1G mutant HBV is unknown. An in vitro cell culture model in which hepatoma cells were transiently transfected with infectious cDNAs was used to show that the -1G mutant HBV is incapable of autonomous replication and, as expected, replication was restored to wild-type (wt) levels by supplying HBV core protein in trans. Although the -1G mutation had no deleterious effect on intracellular HBV-DNA levels, high levels of -1G mutant HBV relative to wt HBV reduced virus secretion and HBeAg secretion relative to empty vector controls. Importantly, the -1G mutant HBV also caused intracellular retention of truncated precore protein in the endoplasmic reticulum (ER) and Golgi apparatus. Together, these effects may be contributing to the increased pathology observed in the setting of HIV/HBV co-infection.

Aim: As door handles represent a transmission route for viruses and micro-organisms, a door opening and closing mechanism should be developed without manual operation.Method: To solve the problem, a device for opening the door with the help of a foot pedal was built into the door leaf.Results: The design enables mechanical opening of the door with a foot pedal without manual operation. Subsequently, the door closes with the help of a mechanical locking mechanism.Discussion: The foot-operated door opener constitutes an additional option to the door handle. Together with the equipment of a soft closing mechanism, it is possible to prevent noise emanating from the door latch impinging on the door frame. Using this construction, the door handle as a transmission vector is eliminated. In addition, the transport of goods held with two hands simultaneously is facilitated.Conclusion: With a foot-operated door opener instead of the traditional manual door handle, it is possible to open doors with a foot pedal. This prevents contamination of door handles with pathogens., Zielsetzung: Da Türklinken ein Übertragungsweg für Viren und Mikroorganismen sind, sollte ein Türöffnungs- und Schließmechanismus ohne manuelle Betätigung entwickelt werden.Methode: Zur Lösung der Aufgabenstellung wurde in das Türblatt eine Vorrichtung zum Öffnen der Tür mit dem Fuß mit Hilfe eines Pedals eingebaut. Ergebnisse: Die Konstruktion ermöglicht ein mechanisches Öffnen der Tür ohne manuelle Betätigung mit einem Fußpedal. Danach schließt sich die Tür mit einem mechanischen Schließmechanismus.Diskussion: Der Fußtüröffner ist eine zusätzliche Option zur Türklinke. Als Zusatzausstattung mit einem Leiseschließmechanismus ist es möglich, die Geräuschentwicklung beim Aufschlagen der Türfalle auf den Türrahmen zu verhindern. Mit der Konstruktion ist es möglich, die Türklinke als Übertragungsvektor auszuschalten. Zusätzlich wird der Transport von mit beiden Händen zu tragenden Gegenständen erleichtert. Schlussfolgerung: Mit einem Fußtüröffner anstelle traditioneller manueller Türöffnung ist es möglich, Türen mit einem Fußpedal zu öffnen. Dadurch wird eine Kontamination von Türklinken mit Pathogenen vermieden.

During mammalian sex determination, SOX9 is translocated into the nuclei of Sertoli cells within the developing XY gonad. The N-terminal nuclear localization signal (NLS) is contained within a SOX consensus calmodulin (CaM) binding region, thereby implicating CaM in nuclear import of SOX9. By fluorescence spectroscopy and glutaraldehyde cross-linking, we show that the SOX9 HMG domain and CaM interact in vitro. The formation of a SOX9.CaM binary complex is calcium-dependent and is accompanied by a conformational change in SOX9. A CaM antagonist, calmidazolium chloride (CDZ), was observed to block CaM recognition of SOX9 in vitro and inhibit both nuclear import and consequent transcriptional activity of SOX9 in treated cells. The significance of the SOX9-CaM interaction was high-lighted by analysis of a missense SOX9 mutation, A158T, identified from a XY female with campomelic dysplasia/ autosomal sex reversal (CD/SRA). This mutant binds importin beta normally despite defective nuclear import. Fluorescence and quenching studies indicate that in the unbound state, the A158T mutant shows a similar conformation to that of the WT SOX9, but in the presence of CaM, the mutant undergoes unusual conformational changes. Furthermore, SOX9-mediated transcriptional activation by cells expressing the A158T mutant is more sensitive to CDZ than cells expressing WT SOX9. These results suggest first that CaM is involved in the nuclear transport of SOX9 in a process likely to involve direct interaction and second, that CD/SRA can arise, at least in part, from a defect in CaM recognition, ultimately leading to reduced ability of SOX9 to activate transcription of cartilage and testes-forming genes.