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Background: There is paucity in studies reporting long-term results following anterior cruciate ligament (ACL) rupture. A UK national ligament registry (NLR) designed to collect demographic, clinical and outcome data on patients undergoing ACL reconstruction was launched in 2013. There was therefore an emergent question on the role of such registry as an additional source of evidence. Study aims: A framework analysis aimed to provide a basis for the evaluation of outcomes following ACL management and formulate a structure of the evidence, which can be derived from the registry. Methods: A systematic approach was adopted to select relevant studies. Qualitative thematic and meta-narrative analyses were conducted. Level-1 registry data were recorded for all primary ACL reconstruction procedures from January to June 2016. Registry data content and validity were evaluated. Results: Seven studies were suitable for analyses yet none defined the pattern of meniscal injury following initial treatment. When reported the incidence varied markedly between 23% and 80%. There was evidence of collection of at least one principal outcome measure in at least 85% of participants across all studies. Thematic analysis identified four key domains of outcome measures (1) intervention selection, (2) Knee stability evaluation, (3) Patient reported outcomes, (4) Radiographic evaluation and risk of secondary osteoarthritis. Graft choice, rate of meniscal and chondral injuries and cumulative risk of revision surgery had incomplete and inconsistent reports. Comparison of demographic and clinical data with the first registry report demonstrated: predominately younger patient population; older female patients at time of intervention; and higher incidence of meniscal tears. Conclusions: Registry data driven quality and research improvement open a new paradigm in ACL reconstruction evidence base and future practice. Early observations have consolidated the importance of associated meniscal injuries in the management of ACL rupture. Further work is needed to improve registry data completeness, accuracy and validity. A proposed data migration process using available technologies can help harmonise data collection without the added burden on clinical services.

Public-Private Partnership (PPP) road projects are being promoted worldwide to encourage road investments; however, research on the appropriate rate of return for these projects is insufficient. This is likely because the return on investment for PPP road projects is determined through negotiations between the government and the private sector, a process that remains confidential. The rate of return for PPP road projects is not only a key indicator for evaluating project performance but also a potential driver for future government financial subsidies. Therefore, research on the appropriate rate of return for PPP road projects is necessary for the sustainability of these projects.This study, based on the concept that both the government and the private sector share the anticipated risks of the project, quantifies six types of risks and proposes a model for predicting the appropriate rate of return. The model is able to explain approximately 68% of the cases in South Korea’s PPP road projects. The risk with the greatest influence on the rate of return was found to be an economic risk, while the least influential was regulation change risk.Due to the confidentiality of data related to PPP road projects, this study only utilized 54 cases from South Korea. It is hoped that a wider range of data will be collected and further research on the appropriate rate of return will continue to enhance the sustainability of PPP road projects.

Everyone can be placed somewhere on an exercise continuum with the idle at one end and the hyperactive at the other. At both extremes, health suffers. Exercise is essential to health and managing it is the responsibility of individuals but few know what they should do. Doctors seldom teach how to be healthy and act only when repair is needed.

Purpose: Here, we report the complications of endoprosthesis with threaded cups according to our application in cases of complicated acetabulum (hip revisions and femoroacetabular impingement (FAI)). Methods: A total of 504 patients was analyzed, including 189 men and 315 women. For re-implanted patients (n = 49), the mean time to re-implantation was 6.3 years and the average age at re-implantation was 54.7 years. For censored patients (n = 455), the mean time to censoring was 5.5 years and the average age of the implant was 55.7 years. Among the patients that were censored, 77 died and 378 patients did not experience an event necessitating re-implantation. Results: For the total study population, the Kaplan-Meier estimate of 5 year survival is 0.94 and of 10 year survival is 0.85. 90% of the implants survived 7 years, 80% of the implants survived almost 12 years and 70% of implants survived almost 15 years. Kaplan-Meier survival analysis suggests that men have higher survival than women. Age of the patient at the time of implant was not a statistically significant factor for re-implantation (p value = 0.21) but sex was (p value = 0.02). Women had 2.25 times more risk of being re-implanted than men. Conclusions: In our case series, the failure rate, as a result of aseptic loosening, was 7.4% (n = 51). More than half the failure cases (56%) required re-implantation. Over one-third (37%) of the primary arthrosis cases, were found to be FAI, lessening the frequency of diagnosis of the former. In our clinic, the threaded cup seems to be indispensable in hip revision surgery and in treating FAI.

The aim of the paper is to determine the effects of physiotherapy and rehabilitation (PHTR) on a child with Pallister-Killian Syndrome (PKS). Gross Motor Function Measure (GMFM) and duration of grasping ping pong ball were the primary outcome measures which were conducted at the beginning, 12th, and 24th month. Neurodevelopmental Therapy and Sensory Integration Therapy were used as intervention methods. The most increase with around 50% was acquired in Section A of the GMFM. Duration of holding a ping pong ball gradually increased. As a result, this is the first paper presenting a PHTR shedule and its results in a child with PKS.

The manifestation of non-force electromagnetic fields in nature and in experiments on Earth is interesting and important in the part that would confirm the numerous physical models that have been calculated and presented in the scientific literature [5,6,15,17].

Background: Some studies have shown an association between spinal curvature and strabismus, but the genetic association has not been clarified. Therefore, the present study is proposed to be a Mendelian randomization study aiming to investigate the genetic causal association between spinal curvature and strabismus.Purpose: Genetic causal associations between strabismus, convergent concomitant strabismus (Ccs), Divergent concomitant strabismus (Dcs), Other specified and unspecified strabismus (Osus), Other strabismus (Os) and spinal curvature were investigated by a bidirectionalMendelian randomization study to provide a basis for the prevention and treatment of spinal curvature.Methods: Significant and independent Single Nucleotide Polymorphisms (SNPs) in genome-wide association studies were selected as Instrumental Variables (IVs) for Mendelian Randomization (MR) analysis. Inverse Variance Weighted (IVW), MR-Egger regression, Weighted Median (WME), Simple Mode (SM), and weighted mode (WM) were used to analyze causal association; Heterogeneity and multiplicity tests were also performed and analyzed using the leave-one-out method to assess the stability of the results.Results: MR and reverse MR were utilized to assess the impact of scoliosis on strabismus, revealing that the 95% confidence intervals of all instrumental variables’ OR values spanned 1 and the p values were all above 0.05. These results indicate a lack of evidence supporting a causal relationship between scoliosis and strabismus. Conclusion: There is currently no conclusive evidence of a genetic causal relationship between scoliosis and strabismus, including their subtypes. Further laboratory studies are needed to confirm these findings, and future research with larger sample sizes is necessary to provide more robust support.

Citrus sinensis is a rich source of bioactive compounds  and has attracted attention due to its medicinal benefits. Historically regarded as agricultural waste, orange peel is rich in flavonoids, polyphenols, tannins, and essential oils with antibacterial, anti-inflammatory, and antioxidant qualities. The phytochemicals in Citrus sinensis peel were used as natural reducing and stabilizing agents in the green synthesis method used in this work to create silver nanoparticles (AgNPs). This method is an environmentally friendly alternative to conventional nanoparticle production, eliminating the need for hazardous chemicals. Based on the study’s results, green-synthesized silver nanoparticles derived from Citrus sinensis peel extract offer a sustainable and biocompatible substitute for biomedical applications. The pharmaceutical and healthcare industries may find therapeutic uses for them due to their exceptional antibacterial, antioxidant, and anticancer properties.

Background: Nutritional awareness among caregivers plays a crucial role in ensuring optimal pediatric health and development. This study assesses the level of nutritional awareness among caregivers and examines its association with demographic factors.Objectives: This study aimed to assess the knowledge and awareness of caregivers regarding dietary advice and complementary feeding for children under five years at Wad-Albasheir Family Health Center, Um-Bada locality.Methods: A cross-sectional study was conducted among caregivers in selected healthcare facilities. Data were collected using a structured questionnaire and analyzed using SPSS version 23. Descriptive statistics and chi-square tests were used to evaluate associations between variables.Results: The majority of caregivers demonstrated moderate awareness (60%), while 22.5% had low awareness and 17.5% had high awareness. A significant association was observed between education level and awareness (p < 0.05). Employment status also influenced awareness levels, with employed caregivers showing higher knowledge scores.Conclusion: Nutritional awareness is a key determinant of pediatric health. Strengthening educational programs targeting caregivers can improve child nutrition outcomes.