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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

美国对自决原则的立场演变分析

自决原则兴起于两次世界大战期间,是二战后确立的国际规则体系的主要内容之一,但在冷战特别是后冷战时期面临着日益严峻的冲击和挑战。本文以两次世界大战期间、二战结束初期、非殖民化及冷战时期、后冷战时期等国际秩序发生重大变动的四个时期为基础,结合自决原则兴起、制度化、扩散和重塑等不同阶段,分析美国在霸权的不同时期对待自决原则的立场和行动差异。在自决理念的兴起阶段,虽然美国与苏联都是该理念的重要倡导者,但是威尔逊与列宁所倡导的自决理念存在重大的差异,包括自决理论的政治和意识形态起源的不同,以及对实施自决的态度差异。这决定了两次世界大战期间美国对自决原则支持的限度,也加速了美国在价值和利益层面与世界非殖民化进程的背离。自决原则在二战后的制度化及扩散阶段,美国与苏联及广大新独立国家围绕自决原则的内涵及适用性展开了激烈争论,美国公开反对新独立国家保障经济、社会和文化发展权利,以及实现经济自决的诉求。美国对自决原则最直接的挑战体现在它对该原则的修正主义立场和行动,一是将自决意识形态化和工具化,二是以“人权高于主权”对自决原则进行重塑。与美国鼓吹“以规则为基础的国际秩序”而将自身塑造为国际规则的创建者和领导者的形象不同,美国并非自决原则的唯一倡导者,而是规范争论者;既非自决原则的一贯遵守者,而是修正主义者。美国对自决原则的结果性逻辑决定了它的立场和行动。

The Extended Hybrid Carrier-Based Multiple Access Technology for High Mobility Scenarios

The hybrid carrier(HC)system rooted in the carrier fusion concept is gradually garnering attention.In this paper,we study the extended hybrid carrier(EHC)multiple access scheme to ensure reliable wireless communication.By employing the EHC modulation,a power layered multiplexing framework is realized,which exhibits enhanced interference suppression capability owing to the more uniform energy distribution design.The implementation method and advantage mechanism are explicated respectively for the uplink and downlink,and the performance analysis under varying channel conditions is provided.In addition,considering the connectivity demand,we explore the non-orthogonal multiple access(NOMA)method of the EHC system and develop the EHC sparse code multiple access scheme.The proposed scheme melds the energy spread superiority of EHC with the access capacity of NOMA,facilitating superior support for massive connectivity in high mobility environments.Simulation results have verified the feasibility and advantages of the proposed scheme.Compared with existing HC multiple access schemes,the proposed scheme exhibits robust bit error rate performance and can better guarantee multiple access performance in complex scenarios of nextgeneration communications.

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.

A revision of Clematis sect.Atragene(Ranunculaceae)

Clematis sect. Atragene is revised in this paper based on the examination of a large number of herbarium specimens, extensive field observations, and morphometric analyses. Brief taxonomic history and geographical distribution of the section are given, the relationships among the species are discussed, and the evolutionary trends of some characters in the section are evaluated. The staminodes of the plants in this section may have evolved from the outer stamens with petaloid filaments and gradually disappearing anthers. Subsequently, they may have evolved in two different ways. One possibility is that the staminodes elongate and become lanceolate, as long as sepals, and their apices turn into attenuate. The other is that the staminodes are spathulate, but not elongating, as long as stamens, and their apices turn into retuse from obtuse and rounded. The evolutionary trend of sepals may be from thin to thick in texture, and the veins from non-prominent to prominent. As a result, five new series are established and nine species, two subspecies and nine varieties （including three new ranks） are recognized in this section. An identification key is provided, and each taxon is described and illustrated. Clematis sibirica and Clematis ochotensis are treated as subspecies of Clematis alpina due to their subtle differences and lack of, or few, overlapping distributions. Clematis fusijamana and Clematisfauriei are recognized as varieties of C. alpina ssp. ochotensis for the continuous variation of the velutinous strips on the sepal margins. Clematis iliensis is treated as variety of C. alpina ssp. sibirica for the continuous variation of leaf division types. Extensive variations in sepal color and basal caruncle size support degrading Clematis chiisanensis as a variety of Clematis koreana. The North American ser. Occientales may be primitive, whereas ser. Macropetalae may be the most advanced taxon in this section. Ser. Alpinae and ser. Koreanae are closely related to each other. However, the systematic position of ser. Tomentosae cannot be determined based on morphological characters alone in the present study.

Taxonomic revision of Lepisorus(J.Sm.) Ching sect.Lepisorus(Polypodiaceae) from China

The taxonomy of Lepisorus （J. Sm.） Ching sect. Lepisorus in China was revised based on herbarium specimen examinations, field observations, and microscopic study of rhizome scales, soral paraphyses, leaf epidermis, and spores. As a result, nine species were recognized： Lepisorus macrosphaerus （Baker） Ching, Lepisorus asterolepis （Baker） Ching, Lepisorus marginatus Ching, Lepisorus kuchenensis （Y.C. Wu） Ching, Lepisorus megasorus （C. Chr.） Ching, Lepisorus kawakamii （Hayata） Tagawa, Lepisorus subsessilis Ching ＆ Y.X. Lin, Lepisorus affinis Ching, and Lepisorus nudus （Hook.） Ching. Lepisorus kawakamii （Hayata） Tagawa was reinstated; Lepisorus gyirongensis Ching ＆ S.K. Wu and Lepisorus longus Ching were reduced to synonyms ofL. nudus and L. affinis, respectively. The subdivision ofLepisorus macrosphaerus was not accepted. Rhizome scales and paraphyses are the most useful characters for species delimitation as well as for infrageneric classification. Characteristics of the leaf epidermis and spore ornamentation are usually stable and thus of great significance in understanding the relationships among groups within the genus.

Highly Aromatic Norditerpenoid Heterodimers and Monomers from Trigonostemon fragilis

Four new norditerpenoid heterodimers with different dimerization patterns-namely,trigofragiloids A-C(denoted as compounds 1-3)and(+)-and(-)-trigofragiloid D(compound 4)-and three new phenanthrenone norditerpenoids-namely,trigofragiloids E-G(compounds 5-7)-were isolated from Trigonostemon fragilis.Compounds 1 and 2 feature a novel heterodimeric carbon skeleton formed by the conjugation of a tetra-norditerpenoid and an ennea-norditerpenoid;they have been identified as class 2 atropisomers by means of quantum chemical calculations.Compound 3 is an unprecedented phenylpropanoid-norditerpenoid adduct with a new dimerization pattern.Compounds(+)-and(-)-4 are the first example of S-shaped 1,4-dioxane-fused norditerpenoid dimers.Inspired by the structure elucidation of compound 4,two co-occurring analogues,actephilol A and epiactephilol A,were structurally revised as a pair of geometrical isomers and were identified as two pairs of enantiomers,(+)-and(-)-8 and(+)-and(-)-9,respectively.Their structures were characterized using a combined method.Notably,compound 7 exhibits remarkable adenosine triphosphate-citrate lyase(ACLY)inhibition with a halfmaximal inhibition concentration(IC50)value of(0.46±0.11)lmol·L^(-1),as active as the positive control BMS-303141,and a molecular docking study offers deep insight into the interaction between compound 7 and ACLY.

Erratum to:Influence law of modified glutinous rice-based materials on gravel soil reinforcement and water erosion process

The original online version of this article was revised.The first author is“ZHANG Weng-xiang”in the original article.The first author’s name has been corrected to“ZHANG Wen-xiang”.

Guidelines for Authors

We now differentiate between the requirements for new and revised submissions.You may choose to submit your manuscript as a single Word or PDF file to be used in the refereeing process.Only when your paper is at the revision stage,will you be requested to put your paper into a’correct format’for acceptance and provide the items required for the publication of your article.Please write your text in good English (American or British usage is accepted,but not a mixture of these).

Guidelines for Authors

We now differentiate between the requirements for new and revised submissions.You may choose to submit your manuscript as a single Word or PDF file to be used in the refereeing process.Only when your paper is at the revision stage,will you be requested to put your paper into a'correct format'for acceptance and provide the items required for the publication of your article.Please write your text in good English(American or British usage is accepted,but not a mixture of these).