Boosting CO_(2) hydrogenation to high-value olefins with highly stable performance over Ba and Na co-modified Fe catalyst

CO_(2)hydrogenation has been considered to be a highly promising route for the production of high-value olefins(HVOs)while also mitigating CO_(2)emissions.However,it is challenging to achieve high selectivity and maintain stable performance for HVOs(ethylene,propylene,and linear a-olefins)over a prolonged reaction time due to the difficulty in precise control of carbon coupling and rapid catalyst deactivation.Herein,we present a selective Ba and Na co-modified Fe catalyst enriched with Fe_(5)C_(2)and Fe_(3)C active sites that can boost HVO synthesis with up to 66.1%selectivity at an average CO_(2)conversion of 38%for over 500 h.Compared to traditional NaFe catalyst,the combined effect of Ba and Na additives in the NaBaFe-0.5 catalyst suppressed excess oxidation of FeCxsites by H_(2)O.The absence of Fe3O4phase in the spent NaBaFe-0.5 catalyst reflects the stabilization effect of the co-modifiers on the FeCxsites.This study provides a strategy to design Fe-based catalysts that can be scaled up for the stable synthesis of HVOs from CO_(2)hydrogenation.

Patent-based technological developments and surfactants application of lithium-ion batteries fire-extinguishing agent

While newer,more efficient Lithium-ion batteries(LIBs)and extinguishing agents have been developed to reduce the occurrence of thermal runaway accidents,there is still a scarcity of research focused on the application of surfactants in different LIBs extinguishing agents,particularly in terms of patented technologies.The aim of this review paper is to provide an overview of the technological progress of LIBs and LIBs extinguishing agents in terms of patents in Korea,Japan,Europe,the United States,China,etc.The initial part of this review paper is sort out LIBs technology development in different regions.In addition,to compare LIBs extinguishing agent progress and challenges of liquid,solid,combination of multiple,and microencapsulated.The subsequent section of this review focuses on an in-depth analysis dedicated to the efficiency and challenges faced by the surfactants corresponding design principles of LIBs extinguishing agents,such as nonionic and anionic surfactants.A total of 451,760 LIBs-related patent and 20 LIBs-fire-extinguishing agent-related patent were included in the analyses.The extinguishing effect,cooling performance,and anti-recombustion on different agents have been highlighted.After a comprehensive comparison of these agents,this review suggests that temperature-sensitive hydrogel extinguishing agent is ideal for the effective control of LIBs fire.The progress and challenges of surfactants have been extensively examined,focusing on key factors such as surface activity,thermal stability,foaming properties,environmental friendliness,and electrical conductivity.Moreover,it is crucial to emphasize that the selection of a suitable surfactant must align with the extinguishing strategy of the extinguishing agent for optimal firefighting effectiveness.

Phosphatidylserine:An overview on functionality,processing techniques,patents,and prospects

Phosphatidylserine(PS)is the part of cell structure in the body and has many beneficial functions especially in brain-related aging diseases.Although daily foods can provide PS to human body,the amount is very limited due to its poverty in most foods.To overcome the issue,numerous studies based on PS have been reported to develop PS-related supplements.In this review,PS was comprehensively and critically reviewed from the view of resources,functions,processing techniques,patents,and prospects.For resources,animal,plant,and microorganism origins were all covered with their differences in composition profiles.For functions,benefits regarding memory,cognitive enhancement,exercise performance,reducing Alzheimer’s disease,and attention-deficit hyperactivity disorder symptoms were covered as well as the functional differences among animal-,plant-,and microorganism-based PS-related supplements.For processing techniques,traditional extracting methods from animal,plant,and microorganism tissues were comparatively discussed with enzymatic synthesis based on different reaction systems.Finally,patents of PS-related supplements were evaluated as well as their applications.This review could provide scientific and valuable support for PS industry.

Trends in in ovo sexing technologies:insights and interpretation from papers and patents

Numerous researchers and institutions have been developing in ovo sexing technologies to improve animal welfare by identifying male embryos in an early embryonic stage and disposing of them before pain perception.This review gives a complete overview of the technological approaches reported in papers and patents by performing a thorough search using Web of Science and Patstat/Espacenet databases for papers and patents,respectively.Based on a total of 49 papers and 115 patent families reported until May 2023 worldwide,11 technology categories were defined:6 non-optical and 5 optical techniques.Every category was described for its characteristics while assessing its potential for application.Next,the dynamics of the publications of in ovo sexing techniques in both paper and patent fields were described through growth curves,and the interest or actual status was visualized using the number of paper citations and the actual legal status of the patents.When comparing the reported technologies in papers to those in patents,scientific gaps were observed,as some of the patented technologies were not reported in the scientific literature,e.g.,ion mobility and mass spectrometry approaches.Generally,more diverse approaches in all categories were found in patents,although they do require more scientific evidence through papers or industrial adoption to prove their robustness.Moreover,although there is a recent trend for non-invasive techniques,invasive methods like analyzing DNA through PCR or hormones through immunosensing are still being reported(and might continue to be)in papers and patents.It was also observed that none of the technologies complies with all the industry requirements,although 5 companies already entered the market.On the one hand,more research and harmony between consumers,industry,and governments is necessary.On the other hand,close monitoring of the market performance of the currently available techniques will offer valuable insights into the potential and expectations of in ovo sexing techniques in the poultry industry.

Comparative efficacy and safety of Chinese patent medicines of iron deficiency anemia during pregnancy:A network meta-analysis

BACKGROUND Iron deficiency anemia(IDA)is a prevalent nutritional disorder during pregnancy.Clinical studies indicate that incorporating Chinese patent medicines(CPMs)with oral iron(OI)in treating IDA in pregnancy can reduce adverse effects and improve clinical outcomes.Nonetheless,the comparative efficacy of different CPMs remains unclear.AIM To assess the safety and effectiveness of different CPMs for treating IDA during pregnancy using network meta-analysis.METHODS We conducted a search for randomized controlled trials(RCTs)that combined CPM and OI for IDA treatment in pregnancy,spanning from 2013 to the present.Data analysis was performed using Rev Man 5.3 and Stata 14.0 on literature that satisfied the quality criteria.RESULTS The analysis included 45 RCTs,encompassing 4422 pregnant patients with IDA.Six CPMs were examined,including Shengxuebao Mixture,Shengxuening Tablets(SXN),Yiqi Weixue CPMs(YQWX),Jianpi Shengxue CPMs(JPSX),Yiqi Buxue Tablets,and Compound Hongyi Buxue Oral Liquid(FFHY).Findings indicated that FFHY+OI significantly improved the clinical effective rate.SXN+OI was most effective in boosting red blood cells counts and hemoglobin levels.YQWX+OI showed superior results in improving serum ferritin,and SXN+OI was most effective in increasing serum iron levels.JPSX+OI was optimal in reducing adverse pregnancy outcomes,while YQBX+OI effectively minimized adverse events.A cluster analysis suggested that SXN+OI could be the potentially optimal therapeutic regimen for IDA in pregnancy.CONCLUSION This study demonstrates that the combination of OI with CPMs offers better outcomes than OI alone.Based on clinical efficacy and other measured outcomes,SXN+OI emerges as the most effective treatment modality for improving the health of pregnant patients with IDA.

White Matter Lesions in Young-Middle Aged Migraineurs with Patent Foreman Ovale: A Case-Control Study

Background:White matter lesion(WML)is common in aging brain and is associated with cognitive impairment and dementia.However,recent studies reported an association between patent foramen ovale(PFO)and WML in migraineurs,especially in young,middle-aged migraineurs.Our retrospective,case-control study aims to describe the clinical characteristics of WML in this population and to explore potential risk factors.Methods:226 patients with migraine and PFO were consecutively initially screened.Relevant factors were selected by the least absolute shrinkage and selection operator(LASSO)regression and multivariable logistic regression model.A Nomogram was employed to visualize the prediction model conveniently.The discrimination and calibration abilities were evaluated using the Receiver Operating Characteristic(ROC)curve,the Hosmer-Lemeshow test,and calibration curves.Results:One hundred and nineteen participants were ultimately enrolled in our study,with a median age of 36.9±12.7 years and 80.7%of females.Brain magnetic resonance imaging MRI showed 67(56.3%)patients had WML,whereas 52(43.7%)patients were categorized into the non-WML group.LASSO regression screened out potential variables and subsequent multivariate analysisfinally identified age,mean platelet volume,andfibri-nogen(FIB)as independent predictive factors of WML.The area under the ROC curve(AUC)was 0.807.Hos-mer-Lemeshow test and calibration curve verified a consistency between the predicted and actual probability.Conclusion:The predictive nomogram established and validated in our study may assist clinicians in screening WML among young middle-aged migraineurs with PFO and developing individualized preventive and treatment strategies.

Inhibition of hepatitis B virus via selective apoptosis modulation by Chinese patent medicine Liuweiwuling Tablet

BACKGROUND Liuweiwuling Tablet(LWWL)is a Chinese patent medicine approved for the treatment of chronic inflammation caused by hepatitis B virus(HBV)infection.Previous studies have indicated an anti-HBV effect of LWWL,specifically in terms of antigen inhibition,but the underlying mechanism remains unclear.AIM To investigate the potential mechanism of action of LWWL against HBV.METHODS In vitro experiments utilized three HBV-replicating and three non-HBV-replicating cell lines.The in vivo experiment involved a hydrodynamic injectionmediated mouse model with HBV replication.Transcriptomics and metabolomics were used to investigate the underlying mechanisms of action of LWWL.RESULTS In HepG2.1403F cells,LWWL(0.8 mg/mL)exhibited inhibitory effects on HBV DNA,hepatitis B surface antigen and pregenomic RNA(pgRNA)at rates of 51.36%,24.74%and 50.74%,respectively.The inhibition rates of LWWL(0.8mg/mL)on pgRNA/covalently closed circular DNA in HepG2.1403F,HepG2.2.15 and HepG2.A64 cells were 47.78%,39.51%and 46.74%,respectively.Integration of transcriptomics and metabolomics showed that the anti-HBV effect of LWWL was primarily linked to pathways related to apoptosis(PI3K-AKT,CASP8-CASP3 and P53 pathways).Apoptosis flow analysis revealed that the apoptosis rate in the LWWL-treated group was significantly higher than in the control group(CG)among HBV-replicating cell lines,including HepG2.2.15(2.92%±1.01%vs 6.68%±2.04%,P<0.05),HepG2.A64(4.89%±1.28%vs 8.52%±0.50%,P<0.05)and HepG2.1403F(3.76%±1.40%vs 7.57%±1.35%,P<0.05)(CG vs LWWL-treated group).However,there were no significant differences in apoptosis rates between the non-HBV-replicating HepG2 cells(5.04%±0.74%vs 5.51%±1.57%,P>0.05),L02 cells(5.49%±0.80%vs 5.48%±1.01%,P>0.05)and LX2 cells(6.29%±1.54%vs 6.29%±0.88%,P>0.05).TUNEL staining revealed a significantly higher apoptosis rate in the LWWL-treated group than in the CG in the HBVreplicating mouse model,while no noticeable difference in apoptosis rates between the two groups was observed in the non-HBV-replicating mouse model.CONCLUSION Preliminary results suggest that LWWL exerts a potent inhibitory effect on wild-type and drug-resistant HBV,potentially involving selective regulation of apoptosis.These findings offer novel insights into the anti-HBV activities of LWWL and present a novel mechanism for the development of anti-HBV medications.

Multiple paradoxical embolisms caused by central venous catheter thrombus passing through a patent foramen ovale: A case report

BACKGROUND To date,this is the first case of a paradoxical embolism(PDE)that concurrently manifested in the coronary and lower limb arteries and was secondary to a central venous catheter(CVC)thrombus via a patent foramen ovale(PFO).CASE SUMMARY Here,we report a case of simultaneous coronary and lower limb artery embolism in a PFO patient carrier of a CVC.The patient presented to the hospital with acute chest pain and lower limb fatigue.Doppler ultrasound showed a large thrombus in the right internal jugular vein,precisely at the tip of the CVC.Transthoracic and transesophageal echocardiography confirmed the existence of a PFO,with inducible right-to-left shunting by the Valsalva maneuver.The patient was administered an extended course of anticoagulation therapy,and then the CVC was successfully removed.Percutaneous PFO closure was not undertaken.There was no recurrence during follow-up.CONCLUSION Thus,CVC-associated thrombosis is a potential source for multiple PDE in PFO patients.

Simultaneous type III congenital esophageal atresia and patent ductus arteriosus in a low-weight patient: A case report

BACKGROUND We report a low-birth-weight child(1.8 kg)with neonatal type III congenital esophageal atresia(CEA)combined with symptomatic patent ductus arteriosus(PDA).After comprehensive evaluation,esophageal anastomosis was performed on postnatal day 11 after excluding surgical contraindications,and arterial catheter ligation was performed at the same time.Concurrent surgery for CEA combined with PDA has not been clearly reported in the literature.CASE SUMMARY We report a 6-day-old female child with type III CEA and PDA.The patient presented with foam at the mouth after birth,cough and shortness of breath after feeding.At another hospital,she was considered to have neonatal pneumonia,neonatal jaundice and congenital heart disease and transferred to our hospital.After iodine oil radiography of the esophagus and echocardiography we con-firmed diagnosis of CEA and PDA.The diameter of the PDA was 8 mm,with obvious left to right shunting.We performed right rear extrapleural orificium fistula ligation and esophageal anastomosis,and ligation of PDA via left axilla straight incision after 5 d of hospitalization.The operations were successful,and the incision healed after 12 d,and the patient was discharged.We re-examined the patient 1 mo after surgery.She did not vomit when she ate rice flour.Esophageal angiography showed no stricture of the anastomotic stoma.The patient weighed 3.2 kg.CONCLUSION For CEA patients with multiple risk factors,comprehensive,timely and accurate diagnosis and evaluation,and early treatment may improve prognosis.

Clinical research report on traditional Chinese patent medicines and traditional Chinese classic famous prescriptions(2022)

Objective:The paper is to comprehensively summarize and analyze the basic situation and methodological quality of clinical randomized controlled trials(RCTs)of traditional Chinese patent medicines and traditional Chinese classic famous prescriptions published in 2022,to provide evidence and reasonable suggestions for the advancement of clinical research and the formulation of policies and guidelines.Methods:The Evidence Database System of clinical evidence-based evaluation of traditional Chinese medicine was searched,and data from China National Knowledge Infrastructure(CNKI),PubMed,and other databases were supplemented.The search duration was from January 1,2022,to December 31,2022.RCTs of traditional Chinese patent medicines and traditional Chinese classic famous prescriptions were included as the source of clinical evidence,and published information,sample size,intervention,control measures,treatment course,methodological quality,and key link report were analyzed and evaluated.Results:A total of 1,464 RCTs of traditional Chinese patent medicines were included,which comprised 667 types of traditional Chinese patent medicines;“traditional Chinese patent medicines+Western medicine vs.Western medicine”was the most widely used intervention and control setting,involving 417 RCTs(28.48%).A total of 245 RCTs of traditional Chinese classic famous prescriptions were included,comprising 55 types of traditional Chinese classic famous prescriptions.“Decoction+conventional treatment vs.conventional treatment”was the most widely used intervention and control setting,with 87 RCTs(35.51%).Published RCTs on traditional Chinese patent medicines and traditional Chinese classic famous prescriptions were limited by the study design and implementation.Most“allocation concealment”and“blinding of patients and personnel”were rated as medium to high risk.There are insufficient reports on key research links such as experimental registration and ethical approval.Conclusions:The number of RCTs on traditional Chinese patent medicines has decreased in 2022,but there has been a slight improvement in the research quality and impact.There are relatively few studies on traditional Chinese classic famous prescriptions.Measures must be taken to improve clinical trial design,implementation,and reporting.Methodological experts should be invited to provide professional technical guidance on the trial design.In the research implementation process,attention should be paid to quality control,particularly the standardization of the randomized execution.

Exploring the Relationship Between Patent Forward Citation and Stock Return Rate Using Empirical Data of China Stock Market

A novel indicator called price-citation was proposed.Based on the company integrated patent database of China listed companies of common stocks(A-shares)with the stock price and the stock return rate data,more than two thousand of A-shares from 2017 to 2020 were selected.The effect of the traditional patent forward citation and the price-citation for discriminating the stock return rate was thoroughly analyzed via ANOVA.The A-shares of forward citation counts above the average showed higher stock return rate means than the A-shares having patents but receiving no forward citations.The price-citation,combining both the financial and patent attributes,defined as the multiplication of the current stock price and the currently receiving forward citation count,showed its excellence in discriminating the stock return rate.The A-shares of higher price-citation showed significantly higher stock return rate means while the A-shares of lower price-citation showed significantly lowest stock return rate means.The price-citation effect had not been changed by COVID-19 though COVID-19 affected the social and economic environment to a considerable extent in 2020.

The Advancements of Medical Textiles:A Patent Perspective

The healthcare sector is advancing in many aspects,including smart devices,surgical robots,AR/VR consultation,etc.Medical textiles are one such aspect where we have observed tremendous growth in innovation.Before the pandemic,the CAGR of patent filing in medical textiles was~12.5%.Postpandemic,it increased to 42.6%.From the patent publishing data,we saw that the US,Japan,India,and Germany are the top four countries in which innovations in medical textiles are on the rise.The extent of the growth is due to the constant improvements and innovations in both textile technology and medical materials.

Analysis of Patent Application Status of Scutellaria Barbata Industrial Chain Based on Patent Data

Objective To analyze patent application status of Scutellaria Barbata industrial chain and provide some suggestions for its patent application and product development.Methods Patent data were collected through IncoPat patent analysis system.Meanwhile,the patent analysis method combined with text mining method was adopted to analyze the situation and development trend of patent application in China’s Scutellaria Barbata industrial chain by using pie chart,bubble chart,trend chart and other visual charts to display the results.Results and Conclusion The patent application of Scutellaria Barbata in China mainly experienced three stages:Slow development,rapid development,and recession period.The number of patents is large,but the authorization rate is low.Individuals and enterprises are the main applicants for patent applications.Product development is involved in the whole industrial chain,but it basically focuses on its efficacy in downstream drugs,health food and other aspects.Therefore,government should enhance the awareness of patent protection,encourage collaborative innovation in industry-university-research to promote the combination of basic research and market application.Besides,it should provide theoretical support to tackle the problem of short board products,which can promote the transformation of scientific and technological achievements and contribute to the upgrading of Scutellaria Barbata industrial chain.

Analysis of Technical Intelligence of Tumor Cell Therapy Based on Patent Map

Objective To analyze the technical information in the field of tumor cell therapy in China,and to provide reference for identifying technical trends and predicting technical opportunities.Methods Based on the patent data in the field of tumor cell therapy in China,the patent map method was used to construct a scientific technical information analysis model.Then,the technical status of new drug research and development in this field was explored to identify technical opportunities.Results and Conclusion Studies have found that China’s tumor immunotherapy is in the growth stage.The technical innovation regions are mainly distributed in the east and innovative entities are enterprises.Technology hotspots are concentrated in areas such as A61P35,C12N5,and the patented technical efficacy is high.Besides,the technical research and development opportunities identified are closely related to the background in this field.To better promote the development of the industry,enterprises and research institutions should strengthen cooperation in technological innovation Meanwhile,they should pay attention to technical efficacy analysis to identify more technical opportunities,thereby effectively guiding innovation strategic decisions.

Total colectomy in a colon cancer patient with patent foramen ovale:a case of surgical and anesthetic challenges

A patent foramen ovale(PFO)is a clinical condition linked to ischemic stroke,aura migraine,and other pathologies.Current medical consensus posits that PFO closure may mitigate the risk of recurrent strokes.This case report details the management of a 61-year-old female diagnosed with colon cancer for one month.Preoperative transthoracic echocardiography indicated a potential left-to-right shunt through the foramen ovale and mild regurgitation of both the mitral and aortic valves.The patient’s history revealed previous left-sided migraines,and a review of her medical records disclosed multifocal cerebral infarctions identified by a head CT.A pulmonary artery computed tomography angiography suggested embolization in the anterior branch of the right upper pulmonary artery and several branches of the right lower lung’s posterior and lateral basilar artery,along with thickening of the trunk canals of the pulmonary arteries.After a thorough assessment and extensive consultation with the surgical team,the procedure was transitioned from a laparoscopic radical resection to an open total colectomy.Anesthesia induction required careful avoidance of hypoxia,breath-holding,and coughing.Vigilant management of respiratory and circulatory functions was crucial during periods prone to intraoperative embolism formation.Postoperatively,attention was given to the stabilization of respiratory and circulatory functions during extubation,ensuring adequate sputum suction to prevent choking and close monitoring of breathing to avert airway obstruction post-extubation.Additionally,the patient was closely monitored for postoperative nausea and vomiting,a high-risk condition for this patient cohort.Strategies were implemented to minimize the risk of right-to-left shunting,ensuring the patient’s vital signs remained stable throughout the perioperative period.The patient was discharged safely after a 10-day recovery.For patients with cancer and PFO,comprehensive risk assessment and meticulous safety management are paramount.This case confirms the patient’s history of patent foramen ovale through the association between some atypical symptoms such as migraine,pulmonary embolism and cerebral infarction,which provides guidance for the management of anesthesia in the perioperative period,offering significant clinical implications.

Development Trend and Prediction of Stem Cell Technology in China from the Perspective of Patent

Objective To provide new ideas for the effective treatment of many serious diseases and to solve many major medical problems faced by mankind.Methods In this paper,the invention patents in the field of stem cells in China from 2010 to 2020 were taken as the research object,and the technology status quo in the field of stem cells was analyzed to predict the future development direction through quantitative analysis method.Results and Conclusion The development of stem cell technology in China is in a period of growth with great potential.Therefore,it is necessary to strengthen the ability of Chinese universities to combine production,education and research.Nowadays,the hotspots in stem cell technology are using culture medium to improve cell proliferation ability,production efficiency,and to induce differentiated cells.Meanwhile,the production efficiency of embryonic stem cells should be improved,and the immunomodulatory effect of embryonic stem cells can be exerted to screen drugs.Besides,the function of hematopoietic stem cells should be enhanced and apply mesenchymal cells in therapy.Since the potential technological gaps are the improvement of therapy,induced differentiation and efficiency of pluripotent stem cells,the improvement of progenitor cell proliferation and the control of cost,we should strengthen R&D investment in culture medium,embryonic stem cells and other technical fields,and achieve the purpose of reducing R&D costs and improving R&D efficiency.

Research Plan on the Strategic Development of High-value Eco-agriculture in the Middle-lower Reaches of Yangtze River

At present,high-value eco-agriculture research in China is till limited and controversial,theoretical innovation and practices on eco-agriculture should be conducted.The key problems which should be solved urgently on the development of high-value eco-agriculture in the middle-lower reaches of Yangtze River now including：the connotation and characteristics of high-value eco-agriculture,the construction of high-value eco-agriculture system and the policies of the development of high-value eco-agriculture.Therefore,the strategic development research on high-value eco-agriculture mainly includes the following aspects：development of agriculture modernization and theory and practices of eco-economics;theory of high-value eco-agriculture;practice of high-value eco-agriculture in the middle-lower reaches of Yangtze River;construction of high-value eco-agriculture in the middle-lower reaches of Yangtze River;development strategy and system innovation of high-value eco-agriculture in the lower and medium reaches of Yangtze River.

Construction of Energy Diagram of Ecological High-value Agriculture System and Emergry Evaluation Index System

Ecological high-value agriculture research, ecological high-value agricultural is the future of agriculture in China. In the emergy diagram was constructed based on emergy theory, and the mechanism and realization approach were well described. In addition, a set of evaluation index system of emergy was established to deter- mine contribution made by different resources of the system, providing references for further exploration of ecological high-value agricultural production system.

Gauging a Firm's Innovative Performance Using an Integrated Structural Index for Patents

Purpose： In this contribution we try to find new indicators to measure characteristics of a finn＇s patents and their influence on a company＇s profits. Design/methodology/approach： We realize that patentevaluation and influence on a company＇s profits is a complicated issue requiring different perspectives. For this reason we design two types of structural h-indices, derived from the International Patent Classification （IPC）. In a case study we apply not only basic statistics but also a nested case-control methodology. Findings： The resulting indicator values based on a large dataset （19,080 patents in total） from the pharmaceutical industry show that the new structural indices are significantly correlated with a firm＇s profits. Research limitations： The new structural index and the synthetic structural index have just been applied in one case study in the pharmaceutical industry. Practical implications： Our study suggests useful implications for patentometric studies and leads to suggestions for different sized firms to include a healthy research and development （R＆D） policy management. The structural h-index can be used to gauge the profits resulting from the innovative performance of a firm＇s patent portfolio. Originality/value： Traditionally, the breadth and depth of patents of a firm and their citations are considered separately. This approach, however, does not provide an integrated insight in the major characteristics of a firm＇s patents. The Sh（Y） index, proposed in our investigation, can reflect a firm＇s innovation activities, its technological breadth, and its influence in an integrated way.

Patents and intellectual property in orthopaedics and arthroplasty

The provision of musculoskeletal services comes at a cost.This is,in part,due to the expense of patent-protected orthopaedic implants.However,patents have a finite lifespan.Patents of the most successful implants are now beginning to expire.They will be exposed to competition from generic but equivalent implants.The net effect is potentially a dramatic diminution in cost.One company,Orthimo,has taken advantage of this and begun manufacturing generic implants with identical design specifications to the most bio-durable hip prostheses.This will ultimately have a radical impact upon musculoskeletal healthcare provision with regard to cost and accessibility.The expiration of drug patents,with the subsequent use of generic drugs saves£7.1 billion annually in the United Kingdom and$254 billion in the USA.Estimates suggest the introduction of equivalent implants could result in an annual cost saving to the United Kingdom National Health Service of£120 million.Intellectual property remains an enigmatic area of law.It encompasses anodyne principles that seek to protect innovation but are open to manipulation and exploitation.The last decade has seen the emergence of undesirable practices in the medical industry such as"patent trolling".Here we explore patents and their repercussions for musculoskeletal care.