Analysis of the causes of primary revision after unicompartmental knee arthroplasty: A case series

BACKGROUND Unicompartmental knee arthroplasty(UKA)has great advantages in the treatment of unicompartmental knee osteoarthritis,but its revision rate is higher than that of total knee arthroplasty.AIM To summarize and analyse the causes of revision after UKA.METHODS This is a retrospective case series study in which the reasons for the first revision after UKA are summarized.We analysed the clinical symptoms,medical histories,laboratory test results,imaging examination results and treatment processes of the patients who underwent revision and summarized the reasons for primary revision after UKA.RESULTS A total of 13 patients,including 3 males and 10 females,underwent revision surgery after UKA.The average age of the included patients was 67.62 years.The prosthesis was used for 3 d to 72 months.The main reasons for revision after UKA were improper suturing of the surgical opening(1 patient),osteophytes(2 patients),intra-articular loose bodies(2 patients),tibial prosthesis loosening(2 patients),rheumatoid arthritis(1 patient),gasket dislocation(3 patients),anterior cruciate ligament injury(1 patient),and medial collateral ligament injury with residual bone cement(1 patient).CONCLUSION The causes of primary revision after UKA were gasket dislocation,osteophytes,intra-articular loose bodies and tibial prosthesis loosening.Avoidance of these factors may greatly reduce the rate of revision after UKA,improve patient satisfaction and reduce medical burden.

New Data on Coal, Gypsum, Iron and Silica Sand Deposits and Geochemical Exploration (Pakistan): Revision of 25 Years History of Dinosaur Discoveries from Pakistan

Discoveries of many coal seams at depths by drilling carried by Geological Survey of Pakistan in Sor Range and Harnai Gochina, extended the coal seams at depth which is challenge for mine owners to exploit feasibly. Bed to bed gypsum samplings (and their chemical analyses) of huge gypsum deposits from Sulaiman foldbelt is a base for industrialist and also planers to develop cement and gypsum industries to increase export and foreign exchange for the development of area and Pakistan. Low and high grade sedimentary iron deposits, silica sand and uranium host rocks and their extensions in Sulaiman and Kirthar foldbelts are presented. Anomalies of a few base metals arise as a result of geochemical exploration carried at part of Loralai District of Balochistan. Theropod dinosaurs were frequent in India, while Poripuchian titanosaurs (Sauropoda, Dinosauria) were frequent in Pakistan. Besides some ichnotaxa, many bone taxa such as 1 titanosauriform, 14 titanosaurian sauropod (including one new titanosaur), and 3 theropod dinosaurs are established from Pakistan. Among these 12 titanosaur species and 3 theropod species are named in about 10 km2 area of Vitakri dome and 2 titanosaur species are named in about a few hundred square meter area of Mari Bohri (Kachi Bohri) which is about 10 km westward from Vitakri dome. Pakistan is a unique country which discoverd 14 diversified titanosaurs in a short area and also in a short period (67 - 66 million years ago/Ma). About 400 bones found from a few meter thick upper part of upper shale horizon of latest Maastrichtian Vitakri Formation which is base for titanosaur taxa. Cranial material is in low fraction (but include significant diverse snouts), caudal vertebrae are prominent, the cervicals, dorsals and sacrals have significant numbers, forelimb and hind limb bones have balanced fraction. Humeri, femora and tibiae are most common. To know the position of Pakistani titanosaurs among titanosaurs and sauropods, there is a need to extend list of characters for phylogenetic analyses. This broad feature list should include main characters of titanosaurs from Pakistan and also from global world.

How to manage and avoid revision after unicompartmental knee arthroplasty?

The article by Zhao et al presents a retrospective case series on the reasons for initial revision after unicompartmental knee arthroplasty(UKA).Clarifying the reasons that may cause UKA revision can further reduce the rate of revision UKA,focusing on gasket dislocation,osteophytes,intra-articular loose bodies,and tibial prosthesis loosening.This article provides valuable insights,not only by detailing the revision status of 13 patients who underwent revision after initial UKA but also by providing a comprehensive analysis of the incidence of revision after initial UKA.By reviewing and analyzing the causes,they established references for the early detection of risk factors for revision in clinical practice and for formulating surgical strategies and rehabilitation programmes.This commentary emphasizes the need for a meticulous understanding and an analysis of the revision rate following initial UKA and related management strategies.The implant rates,regional variation,and benefits of uncemented Oxford UKA have been explored,particularly in terms of bone preservation,appropriate surgical techniques,and weight management to control complications and improve patient prognosis.

Gouty destruction of a patellar tendon reconstruction and novel revision reconstruction technique: A case report

BACKGROUND Gout is a disease characterized by hyperuricemia,and resultant deposition of uric acid crystals in tissues.While typically manifested as intraarticular crystals or tophi,gout can also cause pathology at entheses.Gouty deposition within tendinous structures put them at risk for traumatic and degenerative rupture.Furthermore,allografts can also be at risk of rupture in the setting of severe gout.We present the case of a 56-year-old female with severe gouty disease who sustained a re-rupture of a patellar tendon allograft reconstruction.CASE SUMMARY A 56-year-old female presented to clinic after feeling her left knee pop and collapse beneath her while descending stairs.She had a history of tophaceous gout and left patellar tendon rupture with reconstruction and multiple revisions over the course of 19 years.This patient presented with pain and extensor lag.A magnetic resonance image demonstrated a ruptured patellar tendon allograft reconstruction and avulsion fracture at the tibial tubercle.The patient was treated with a novel intervention of Achilles allograft with bone block in a unique configuration with a dermal allograft incorporated into the reconstruction.She was made non-weight bearing in the operative extremity in extension for the first four weeks postoperatively and was then progressed to active flexion over the course of eight weeks.At twelve weeks,she was able to fully extend her operative knee and at five months she was resuming her normal activities and exercises.CONCLUSION Failed patellar tendon reconstruction due to gouty infiltration is treated with dermal allograft augmented Achilles tendon reconstruction with bone block.

Is there sufficient evidence to support the use of antibiotic holiday just before the second stage of an infected total hip or knee arthroplasty revision surgery?

The practice of implementing an antibiotic holiday before the second stage of hip or knee arthroplasty is currently controversial due to limited evidence for this approach,as per the International Consensus Meeting 2018 on Musculoskeletal Infection.A greater understanding of this issue could augment the quality of Alrayes and Sukeik’s mini-review(2023)on diagnosing,managing,and treating periprosthetic knee infections.However,a significant lack of literature exists concerning the optimal duration for the antibiotic holiday,calling for more research before establishing any clinical guidelines.

United States Healthcare Data Breaches: Insights for NIST SP 800-66 Revision 2 from a Review of the NIST SP 800-66 Revision 1

Healthcare security and privacy breaches are occurring in the United States (US), and increased substantially during the pandemic. This paper reviews the National Institute of Standards and Technology (NIST) publication base as an effective solution. The NIST Special Publication 800-66 Revision 1 was an essential standard in US healthcare, which was withdrawn in February 2024 and superseded by SP 800-66 Revision 2. This review investigates the academic papers concerning the application of the NIST SP 800-66 Revision 1 standard in the US healthcare literature. A systematic review method was used in this study to determine current knowledge gaps of the SP 800-66 Revision 1. Some limitations were employed in the search to enforce validity. A total of eleven articles were found eligible for the study. Consequently, this study suggests the necessity for additional academic papers pertaining to SP 800-66 Revision 2 in the US healthcare literature. In turn, it will enhance awareness of safeguarding electronic protected health information (ePHI), help to mitigate potential future risks, and eventually reduce breaches.

The Impact of Comment Style on Learners’ Essay Revisions

This paper investigates how the type of written feedback provided by teachers affects learners’ ability to revise essays. A total of 120 participants participated in two rounds of essay composition and feedback delivery. The findings indicate that learners who receive comments in the form of questions are more prone to make revisions compared to those receiving statements or imperatives. These results hold significant implications for educators and the ways they utilize written feedback to enhance learners’ writing skills.

Unicompartimental knee arthroplasty metallosis treated with uni-onuni revision:A case report

BACKGROUND Metallosis is the result of metallic wear debris in the soft tissues and is associated to both local and systemic inflammatory response.Metallosis has been reported after total hip and total knee arthroplasty(TKA),but rarely after a unicompartimental knee arthroplasty(UKA).In the context of UKA metallosis,surgeons often opt for revision using a TKA.However,in this paper,the authors successfully treated UKA revising the metal back only.CASE SUMMARY Prior to treat our patient we conducted a literature research through which we identified eleven cases of metallosis after UKA,ten(90.9%)were treated revising using though a TKA.Only one case was managed through a uni-on-uni revision,reporting high knee function.Our patient complained worsening pain and function after a snap occurred at 16 mo after UKA implantation.At 18 mo following surgical debridment and uni-on-uni revision surgery,our patient exhibited a relevant improvement in Oxford Knee Score and a reduction of metal ion levels in the blood.CONCLUSION Our study highlights that in case of metallosis after UKA,the treatment may be based on surgical debridement and just revising the mobilized components.

Transoral outlet reduction:Outcomes of endoscopic Roux-en-Y gastric bypass revision in 284 patients at a community practice

BACKGROUND Transoral outlet reduction(TORe)is a minimally invasive endoscopic revision of Roux-en-Y gastric bypass(RYGB)for weight recurrence;however,little has been published on its clinical implementation in the community setting.AIM To characterize the safety and efficacy of TORe in the community setting for adults with weight recurrence after RYGB.METHODS This is a retrospective cohort study of argon plasma coagulation and purse-string suturing for gastric outlet reduction in consecutive adults with weight recurrence after RYGB at a single community center from September 2020 to September 2022.Patients were provided longitudinal nutritional support via virtual visits.The primary outcome was total body weight loss(TBWL)at twelve months from TORe.Secondary outcomes included TBWL at three months and six months;excess weight loss(EWL)at three,six,and twelve months;twelve-month TBWL by obesity class;predictors of twelve-month TBWL;rates of post-TORe stenosis;and serious adverse events(SAE).Outcomes were reported with descriptive statistics.RESULTS Two hundred eighty-four adults(91.9%female,age 51.3 years,body mass index 39.3 kg/m^(2))underwent TORe an average of 13.3 years after RYGB.Median pre-and post-TORe outlet diameter was 35 mm and 8 mm,respectively.TBWL was 11.7%±4.6%at three months,14.3%±6.3%at six months,and 17.3%±7.9%at twelve months.EWL was 38.4%±28.2%at three months,46.5%±35.4%at six months,and 53.5%±39.2%at twelve months.The number of follow-up visits attended was the strongest predictor of TBWL at twelve months(R^(2)=0.0139,P=0.0005).Outlet stenosis occurred in 11 patients(3.9%)and was successfully managed with endoscopic dilation.There was one instance of post-procedural nausea requiring overnight observation(SAE rate 0.4%).CONCLUSION When performed by an experienced endoscopist and combined with longitudinal nutritional support,purse-string TORe is safe and effective in the community setting for adults with weight recurrence after RYGB.

Two-stage revision in periprosthetic knee joint infections

Periprosthetic joint infection(PJI)following total knee arthroplasty is one of the most catastrophic and costly complications that carries significant patient wellness as well as economic burdens.The road to efficiently diagnosing and treating PJI is challenging,as there is still no gold standard method to reach the diagnosis as early as desired.There are also international controversies with respect to the best approach to manage PJI cases.In this review,we highlight recent advances in managing PJI following knee arthroplasty surgery and discuss in depth the two-stage revision method.

Cemented versus uncemented stems for revision total hip replacement:A systematic review and meta-analysis

BACKGROUND The popularity of uncemented stems in revision total hip arthroplasty(THA)has increased in the last decade.AIM To assess the outcomes of both cemented and uncemented stems after mid-term follow up.METHODS This study was performed following both the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement and the Cochrane Handbook for systematic reviews and meta-analysis guidelines.Articles were chosen irrespective of country of origin or language utilized for the article full texts.This paper included studies that reviewed revision THA for both cemented or uncemented long stems.RESULTS Three eligible studies were included in the meta-analysis.Analysis was conducted by using Review Manager version 5.3.We computed the risk ratio as a measure of the treatment effect,taking into account heterogeneity.We used random-effect models.There were no significant differences found for intraoperative periprosthetic fractures[risk ratio(RR)=1.25;95%confidence interval(CI):0.29-5.32;P=0.76],aseptic loosening(RR=2.15,95%CI:0.81-5.70;P=0.13),dislocation rate(RR=0.50;95%CI:0.10-2.47;P=0.39),or infection rate(RR=0.99,95%CI:0.82-1.19;P=0.89),between the uncemented and the cemented long stems for revision THA after mid-term follow-up.CONCLUSION This study has evaluated the mid-term outcomes of both cemented and uncemented stems at first-time revision THA.In summary,there were no significant differences in the dislocation rate,aseptic loosening,intraoperative periprosthetic fracture and infection rate between the two cohorts.

Research on revision of relevant provisions of high-speed railway emergency disposal in the regulations on railway technical management(RRTM)

Purpose–This study aims to improve the rules and regulations system of high-speed rail emergency disposal.Design/methodology/approach–Based on the analysis of the demands,rules and regulations of China concerning on-site high-speed rail emergency disposal,basic principles for revising the regulations on railway technical management(RRTM)are proposed and suggestions and evaluation methods according to the main clauses are put forward.Findings–Basic principles for revising the RRTM are proposed,namely“to meet the actual needs of on-site high-speed railway emergency disposal,standardize the emergency disposal process,improve the efficiency of emergency disposal and keep the consistency between provisions of emergency disposal”.Existing provisions related to emergency disposal efficiency,scenarios,safety and service quality are made up for the deficiencies.To make up for the deficiencies of the existing provisions related to emergency disposal efficiency,improvement of emergency disposal scenarios and guarantee of emergency disposal safety and quality,this paper puts forward suggestions on revising 15 emergency disposal provisions of the RRTM with regard to earthquake monitoring and warning,in-station foreign body invasion warning,air conditioning failure of EMU trains and forced parking of trains in sections.A fuzzy comprehensive evaluation model based on the analytic hierarchy process(AHP)is constructed to evaluate the proposed revision scheme and suggestions,which has been highly recognized by experts.Originality/value–This study implements the goal of high-quality railway development.

Celebrating 20 Years of Progress RSPO to release revised global standards for sustainable palm oil

The Roundtable on Sustainable Palm Oil(RSPO)held its annual conference(RT2023)in Jakarta,Indonesia,from November 20 to 22,2023.Themed“Partners for the Next 20,”the meeting highlighted what RSPO’s members and partners have achieved over the last two decades.Nearly a thousand delegates from the global sustainable palm oil industry held discussions on the core challenges facing the industry including mitigating climate change,increasing uptake of certified sustainable palm oil(CSPO),protecting labor rights,and facilitating greater smallholder inclusion in green supply chains through compliance with emerging international regulations.

A REVISION OF THE GENUS GONERILIA SHIRO ZU ET YAMAMOTO (LEPIDOPTERA: LYCAENIDAE)

onerilia, an endemic genus confined to China, is revised. A new species G. pesthis from Mt. Qinling in Shaanxi Province is described and illustrated. Five species are included in the genus so far, e.g., G. seraphim, G. thespis, G. buddha, G. okamurai, G. pesthis. Information on distribution and host plants of the genus is summerized, together with the discussion of its systematic position.

REVISION OF THE GENUS HARTEMITA CAMERON (HYMENOPTERA: BRACONIDAE: CARDIOCHILINAE) FROM CHINA

The species of the genus Hartemita Cameron (Hymenoptera: Braconidae: Cardiochilinae) from China are revised. Six species of this genus are described from China in this paper, four of which are new species: Hartemita chinensis sp. nov., H. excavata sp. nov., H. flava sp. nov. and H. punctata sp. nov..All the type specimens are kept in the Insect Collection of Zhejiang Agricultural University.

Revision of the subgenus Orthostegana(Diptera:Drosophilidae:Stegana) from Eastern Asia

The Eastern Asian species of the subgenus Orthostegana in the genus Stegana are reviewed based on the results of Li et al.＇s phylogenetic analysis. The subgenus Anastega is fused with the subgenus Orthostegana as syn. nov.. Four new species are described from Yunnan, China： Stegana （Orthostegana） flavicauda Zhang ＆ Chen sp. nov., S. （O.） hirsutinna Zhang ＆ Chen sp. nov., S. （O.） hylecoeta Zhang ＆ Chen, sp. nov. and S. （O.） multicardua Zhang ＆ Chen sp. nov.. Two known species： S. （O.） curvinervis （Hendel, 1914） and S. （O.） singularis Sidorenko, 1990, comb. nov. are described complementally. A table showing uncorrected pairwise p-distance among the DNA sequences of the mitochondrial COl and ND2 genes of six Orthostegana species is provided.

A Revision of the Genus Milesia Latreilla (Diptera: Syrphidae) from China

All Chinese species of the genus Milesia is revised in this paper. Six new synonyms were proposed, which are M. ruiliana Yang et Cheng and M. Tachina Yang et Cheng as synonyms of M. cretosa Hippa; M. maolana Cheng et Yang as synonym of M. ferruginosa Brunetti; M. atricorporis Yang et Cheng as synomym of M. quantula Hippa; M. vesparia Shiraki and M. turgidiverticis Yang et Cheng as synonyms of M. verticalis Brunetti. As far as we know, there are thirteen species distributing in China, among which, M. variegata Brunetti is recorded for the first time to China. An abdominal figure of each species is provided in this paper. Meanwhile, a key to all the Chinese species and a map of geographical distribution of these species are given.

A TAXONOMIC REVISION OF THE CHINESE SPECIES OF ECTOMOCORIS MAYR (HEMIPTERA: REDUVIIDAE: PEIRATINAE)

Five Chinese species of the genus Ectomocoris are revised, keyed and well illustrated by 28 figures. Biarmocoris subgen. n. is established for E. yayeyamae. E. maldonadoi sp. n. is described. E. distanti Cai et Lu is a new name for E. erebus Distant 1904, junior homonym of E. erebus (Distant, 1903). Lectotypes are designated. E. fiavomaculatus is not represented in China. All the male genitalia are reported for the first time.

Efficacy of Peer Revision in Process-oriented Writing

Peer revision is a collaborative activity during which student writers can exchange drafts and make suggestions for improvement. It has been widely used at present in process-oriented writing instruction. In this paper, the researcher carried out an empirical study about the effects and efficacy of peer revision on a group of Chinese Juniors majoring in English. It was found that student writers focused specially on grammar and vocabulary in PE session and organization was the least attended to. PE was quite effective in improving the overall writing quality, as the participants did incorporate most of the revisions suggested by their peers. However, the influences of students'writing proficiencies and of the rhetorical modes of the writing tasks on the effects of PE were proved to be not very significant.

On the Generic Taxonomy of Opisthotropis balteata(Cope, 1895)(Squamata: Colubridae: Natricinae): Taxonomic Revision of Two Natricine Genera

The single prefrontal configuration has historically been used as an important diagnostic character for many natricine taxa. For example, the genus Trimerodytes Cope, 1895 was long been regarded as a junior synonym of Opisthotropis Günther, 1872 for their similar prefrontal configurations and the type species, T. balteatus Cope, 1895, has been assigned to the genus Opisthotropis. However, as the number and arrangement of prefrontal vary frequently both at species and generic level, it is questionable whether the synonymization of Trimerodytes reflects their evolutionary relationships. On the basis of recently collected specimens of O. balteata, the generic status of the species was assessed using both molecular and morphological data. Opisthotropis was recovered as polyphyletic with reference to O. balteata, because O. balteata is nested within the genus Sinonatrix Rossman and Eberle, 1977 and is the sister species of the type species of Sinonatrix. Consequently, we herein resurrect the long-overlooked synonym Trimerodytes from Opisthotropis and synonymize the junior generic nomen Sinonatrix with Trimerodytes. In addition, based on morphological similarities between the monotypic genus Paratapinophis Angel, 1929 and Trimerodytes, we doubt about the validity of Paratapinophis. Following taxonomic changes in this work, the taxonomic account of the genus Trimerodytes, updated descriptions of its type species, and diagnostic key to Trimerodytes species are provided.