Metaphyseal Area Research Articles

Is endurantism the folk friendly view of persistence?

AbstractMany philosophers have thought that our folk, or pre-reflective, view of persistence is one on which objects endure. This assumption not only plays a role in disputes about the nature of persistence itself, but is also put to use in several other areas of metaphysics, including debates about the nature of change and temporal passage. In this paper, we empirically test three broad claims. First, that most people (i.e. most non-philosophers) believe that, and it seems to them as though, objects persist by enduring rather than perduring. Second, that most people have a view of change on which enduring but not perduring objects count as changing. Third, that one reason why the folk represent time as dynamical is because it seems to them, and they believe that, they endure through time. We found no evidence to support these claims. While there are certainly plenty of ‘folk’ endurantists in the population we tested, there are also plenty of ‘folk’ perdurantists. We did not find robust evidence that a majority of people believed that, or it seemed to them as though, objects endure rather than perdure. We conclude that many arguments in favour of endurantism that appeal to folk beliefs about, or experiences of, persisting objects and change rest on views about those beliefs and experiences that are empirically unsupported. There is no evidence to suggest that endurantism is the folk friendly view of persistence, and so we should stop treating it as such without argument.

The effect of osteotomy depth and hinge axis orientation on biplanar surgical accuracy in medial opening-wedge high tibial osteotomy-a deeper understanding by 3D simulations.

Not all surgical osteotomy steps have been properly investigated for their potential impact on surgical accuracy. The main study objective was to investigate the osteotomy parameters that have respectively major and minor impact on coronal and sagittal bony accuracy in medial opening-wedge high tibial osteotomy (MOWHTO). Three tibias from an existing 3D MOWHTO osteotomy database were chronologically selected based on segmentation quality, tibial plateau size and the presence of tibial varus. The study consisted of three parts: (I) translating the hinge axis in the coronal plane and switching the osteotomy starting point (30-40 mm) and depth, (II) the hinge axis was rotated stepwise by 10° to perform five simulations, (III) the hinge axis was rotated in the axial plane stepwise by 10° towards anterolateral to perform four simulations (0°, +10°, +20°, +30°). The medial proximal tibial angle (MPTA) and lateral tibial slope were the primary outcomes. Simulations were performed with 5, 10 and 15 mm gap distraction. In the coronal plane, maximum difference in osteotomy depth was 10 mm which represented an MPTA difference of 0.8°-1.1° in 10 mm gap distraction and 1.2°-2.0° in 15 mm gap distraction. Tibial slope remained unchanged. Rotating the hinge axis in the sagittal plane delivered minor changes on both MPTA (<0.5°) and tibial slope (<1.5°) at 10 mm gap distraction. Per 10° of axial rotation of the hinge axis towards anterolateral, the tibial slope increased by 1.0°-1.3° in 10 mm gap distraction while the MPTA remains nearly unchanged. The study showed that the medio-lateral osteotomy length is the main parameter for obtaining bony accuracy in the coronal plane and maintaining a strict perpendicular axial hinge axis position is crucial in preserving the native tibial slope. Correct axial alignment of the hinge axis can be obtained by creating an equal osteotomy depth of the anterior and posterior tibial cortices in the lateral metaphyseal area.

Biomechanical Investigation of the Osseointegration of Titanium Implants With Different Surfaces Placed With Allogeneic Bone Transfer.

Allogeneic grafts can be preferred to autogenous grafts in plastic and oral-maxillofacial surgery for vertical and horizontal bone deficiencies. Implant surface properties are an important factor in osseointegration. This study aims to evaluate the osseointegration levels of titanium implants with machined, sand-blasted, and acid-etched (SLA) and resorbable blast material (RBM) surfaces placed together with allogeneic bone tissue transplantations obtained from the tibia bone using biomechanical method. Twenty-five female Sprague-Dawley rats were included in the study. The rats were divided into groups in which machined (n=7), SLA (n=7), and RBM (n=7) surface implants were placed with the transplantation of bone taken from the tibia. Four rats (both left and right tibias) were used as donors. Grafts and implants were surgically placed in the corticocancellous part of the metaphyseal area of the tibia bones of rats. At the end of the 4-week experimental setup, all rats were killed, and the implants and surrounding bone tissue were subjected to biomechanical reverse torque analysis (N/cm). Sand-blasted acid-etched surface implants were observed to have higher biomechanical osseointegration levels than RBM and machined surface implants ( P <0.05). No statistical difference could be detected between the RBM and machined surface implants ( P >0.05). On the basis of the limited results of this study, it can be concluded that the osseointegration levels of SLA surface implants placed with allogeneic bone transplantation may be better than those of machined and RBM surface implants.

Far cortical locking constructs for fixation of distal femur fractures in an Asian population: A prospective observational study

BackgroundThe stiffness of locked plates suppresses healing process, prompting the introduction of far cortical locking to address this issue. This study aimed to demonstrate the clinical efficacy of far cortical locking constructs in treating distal femoral fractures in an Asian population. MethodsThis multicenter prospective observational study was conducted at four university hospitals between February 2018 and February 2021. Demographic data, the presence of metaphyseal comminution, and surgical fixation details were recorded. Clinical outcomes, including single-leg standing, EQ-5D, and EQ-VAS scores, and radiologic outcomes, including the RUST score of each cortex, were evaluated and compared according to the presence of metaphyseal comminution. ResultsThere were 37 patients (14 men and 23 women) with a mean age of 67.3 ± 11.8 years. Twenty-two patients had metaphyseal comminution (59%), and 15 presented simple fractures in metaphyseal areas. Four patients (13%) could stand on one leg > 10s at 6 weeks, and 24 patients (92%) at 1 year. EQ-5D increased from 0.022 ± 0.388 to 0.692 ± 0.347, and the mean EQ-VAS 51.1 ± 13.1 to 74.1 ± 24.1 between discharge (n = 37) and post-operative 1 year (n = 33), respectively. RUST score presented increment for time, from 6.2 ± 1.8 at 6 week to 11.6 ± 1.1 at 1 year. Radiological healing demonstrated rapid increase from week 6 (16/28, 43%) to month 3 (27/31, 87%), with no obvious increase was observed in 6 months (23/26, 89%) or 12 months (25/28, 89%). Simple metaphyseal fractures presented significantly higher RUST scores at 6 weeks and 3 months, but there was no difference in RUST scores at 6 months or 1 year according to metaphyseal comminution. ConclusionsPlate constructs with far cortical locking screws provided safe and effective fixation for distal femoral fractures, with consistent radiological and clinical results, regardless of metaphyseal comminution.

Relationship of the bone phenotype of the Klotho mutant mouse model of accelerated aging to changes in skeletal architecture that occur with chronological aging.

Due to the relatively long life span of rodent models, in order to expediate the identification of novel therapeutics of age related diseases, mouse models of accelerated aging have been developed. In this study we examined skeletal changes in the male and female Klotho mutant (kl/kl) mice and in male and female chronically aged mice to determine whether the accelerated aging bone phenotype of the kl/kl mouse reflects changes in skeletal architecture that occur with chronological aging. 2, 6 and 20-23 month old C57BL/6 mice were obtained from the National Institute of Aging aged rodent colony and wildtype and kl/kl mice were generated as previously described by M. Kuro-o. Microcomputed tomography analysis was performed ex vivo to examine trabecular and cortical parameters from the proximal metaphyseal and mid-diaphyseal areas, respectively. Serum calcium and phosphate were analyzed using a colorimetric assay. The expression of duodenal Trpv6, which codes for TRPV6, a vitamin D regulated epithelial calcium channel whose expression reflects intestinal calcium absorptive efficiency, was analyzed by quantitative real-time PCR. Trabecular bone volume (BV/TV) and trabecular number decreased continuously with age in males and females. In contrast to aging mice, an increase in trabecular bone volume and trabecular number was observed in both male and female kl/kl mice. Cortical thickness decreased with advancing age and also decreased in male and female kl/kl mice. Serum calcium and phosphate levels were significantly increased in kl/kl mice but did not change with age. Aging resulted in a decline in Trpv6 expression. In the kl/kl mice duodenal Trpv6 was significantly increased. Our findings reflect differences in bone architecture as well as differences in calcium and phosphate homeostasis and expression of Trpv6 between the kl/kl mutant mouse model of accelerated aging and chronological aging. Although the Klotho deficient mouse has provided a new understanding of the regulation of mineral homeostasis and bone metabolism, our findings suggest that changes in bone architecture in the kl/kl mouse reflect in part systemic disturbances that differ from pathophysiological changes that occur with age including dysregulation of calcium homeostasis that contributes to age related bone loss.

Incident fractures of the distal radius: Dual-energy CT-derived metrics for opportunistic risk stratification

BackgroundDual-energy CT (DECT)-derived bone mineral density (BMD) of the distal radius and other CT-derived metrics related to bone health have been suggested for opportunistic osteoporosis screening and risk evaluation for sustaining distal radius fractures (DRFs). MethodsThe distal radius of patients who underwent DECT between 01/2016 and 08/2021 was retrospectively analyzed. Cortical Hounsfield Unit (HU), trabecular HU, cortical thickness, and DECT-based BMD were acquired from a non-fractured, metaphyseal area in all examinations. Receiver-operating characteristic (ROC) analysis was conducted to determine the area under the curve (AUC) values for predicting DRFs based on DECT-derived BMD, HU values, and cortical thickness. Logistic regression models were then employed to assess the associations of these parameters with the occurrence of DRFs. ResultsIn this study, 263 patients (median age: 52 years; interquartile range: 36–64; 132 women; 192 fractures) were included. ROC curve analysis revealed a higher area under the curve (AUC) value for DECT-derived BMD compared to cortical HU, trabecular HU, and cortical thickness (0.91 vs. 0.61, 0.64, and 0.69, respectively; p <.001). Logistic regression models confirmed the association between lower DECT-derived BMD and the occurrence of DRFs (Odds Ratio, 0.83; p <.001); however, no influence was observed for cortical HU, trabecular HU, or cortical thickness. ConclusionsDECT can be used to assess the BMD of the distal radius without dedicated equipment such as calibration phantoms to increase the detection rates of osteoporosis and stratify the individual risk to sustain DRFs. In contrast, assessing HU-based values and cortical thickness does not provide clinical benefit.

Случай вторичной гипертрофической остеоартропатии у женщины из погребения некрополя Соборного холма г. Вязьмы (XIII в.)

The necropolis at the Cathedral Hill in Vyazma is mainly dated to the late 13th c. AD, and likely contains burials of the citizens of a high social status. A complete and well-preserved skeleton of a 35–40 year old female was excavated from Burial 15 of the necropolis. Almost all the bones of both upper and lower limbs were deformed due to excessive deposits of bone (periostitis) in the diaphyseal and metaphyseal areas. A combination of macroscopic and radiological – x-ray and microfocus computed tomography – has revealed that the lesions were likely manifestations of the Pierre-Marie-Bamberger syndrome, or secondary hypertrophic osteoarthropathy (HOA). This bone pathology accompanies some chronic diseases of the lungs and pleura (including benign and malignant tumors, tuberculous lesions, etc.), mediastinum and heart, and also, less frequently, other organs and systems. The exact disease that caused the observed bone lesions cannot be determined due to the absence of soft tissues. However, a detailed description of the skeletal manifestation of this pathology, in our opinion, can facilitate the detection and interpretation of periostitis of this type and localization in archeological remains of varying preservation and completeness. Noteworthy, this syndrome is, in 80% of clinical cases, associated with various lung diseases.

Mesoporous Bioactive Glass-Incorporated Injectable Strontium-Containing Calcium Phosphate Cement Enhanced Osteoconductivity in a Critical-Sized Metaphyseal Defect in Osteoporotic Rats.

In this study, the in vitro and in vivo bone formation behavior of mesoporous bioactive glass (MBG) particles incorporated in a pasty strontium-containing calcium phosphate bone cement (pS100G10) was studied in a metaphyseal fracture-defect model in ovariectomized rats and compared to a plain pasty strontium-containing calcium phosphate bone cement (pS100) and control (empty defect) group, respectively. In vitro testing showed good cytocompatibility on human preosteoblasts and ongoing dissolution of the MBG component. Neither the released strontium nor the BMG particles from the pS100G10 had a negative influence on cell viability. Forty-five female Sprague-Dawley rats were randomly assigned to three different treatment groups: (1) pS100 (n = 15), (2) pS100G10 (n = 15), and (3) empty defect (n = 15). Twelve weeks after bilateral ovariectomy and multi-deficient diet, a 4 mm wedge-shaped fracture-defect was created at the metaphyseal area of the left femur in all animals. The originated fracture-defect was substituted with pS100 or pS100G10 or left empty. After six weeks, histomorphometrical analysis revealed a statistically significant higher bone volume/tissue volume ratio in the pS100G10 group compared to the pS100 (p = 0.03) and empty defect groups (p = 0.0001), indicating enhanced osteoconductivity with the incorporation of MBG. Immunohistochemistry revealed a significant decrease in the RANKL/OPG ratio for pS100 (p = 0.004) and pS100G10 (p = 0.003) compared to the empty defect group. pS100G10 showed a statistically higher expression of BMP-2. In addition, a statistically significant higher gene expression of alkaline phosphatase, osteoprotegerin, collagen1a1, collagen10a1 with a simultaneous decrease in RANKL, and carbonic anhydrase was seen in the pS100 and pS100G10 groups compared to the empty defect group. Mass spectrometric imaging by time-of-flight secondary ion mass spectrometry (ToF-SIMS) showed the release of Sr2+ ions from both pS100 and pS100G10, with a gradient into the interface region. ToF-SIMS imaging also revealed that resorption of the MBG particles allowed for new bone formation in cement pores. In summary, the current work shows better bone formation of the injectable pasty strontium-containing calcium phosphate bone cement with incorporated mesoporous bioactive glass compared to the bioactive-free bone cement and empty defects and can be considered for clinical application for osteopenic fracture defects in the future.

Précis: Interdisciplinary Foundations

In the following précis, I provide a summary of Interdisciplinary Foundations for the Science of Emotion. Much of what I say can be found in the “About the “Book” section of my book, although I provide some elaborations here. My summary focuses primarily on the central aim of the book, and the general strategy that I take in order to achieve my aim. What I present is a proposal for an interdisciplinary science of emotion. That proposal goes by the name of meta-semantic pluralisme, and a central principle of this proposal is what I refer to as the α-ωe principle. My summary includes chapter summaries, which provides not only a more detailed account of my general strategy, but also a summary of the fruitfulness of this first principle for interdisciplinary research and theorizing in the science of emotion, including the work it can do in the areas of metaphysics, language, consciousness, intentionality, rationality, and epistemology. Finally, one should note that some of the contents of this précis should also provide a response to at least some of the commentators’ requests for clarification, and I address the concerns not covered in this précis in my subsequent replies.

Principles Treatment Of Septic Arthritis Of The Knee: A Brief Review

Septic arthritis is an emergency condition in which infection occurs in the synovial joints, resulting in the formation of pus in the synovial spaces. Theincidence of septic arthritis increases in patients with an increased risk such as rheumatoid arthritis. The etiology of septic arthritis is mainly bacterial. Risk factors include iatrogenic procedures (surgery, implant placement, joint puncture) and systemic conditions (diabetes mellitus, rheumatoid arthritis receiving immunosuppressants, etc). Pathophysiology of septic arthritis is due to blood flow stasis in metaphyseal areas especially in children and intraarticular minimal blood circulation. Clinical pictures include sudden onset of fever, malaise, localized pain in the infected joint, joint swelling, and reduced range of motion. Examination for septic arthritis is a physical examination carried out are inspection (see), palpation (touch), and movement. supporting examinations include blotestsest, PCR, radiological and joint fluid tests. Treatments include non-pharmacological such as rest and physical therapy, pharmacological the form of antibiotics, and surgicaltherapy such as drainage incision. This study is a brief review of the current Principles Treatment Of Septic Arthritis Of The Knee. The reference to this review was taken from the latest journal up to 5 years and the latest book up to 10 years.

Ground, Essence, and the Metaphysics of Metanormative Non-Naturalism

The past few decades have witnessed an extraordinary revival of interest in metanormative non-naturalism. Despite this interest, it is still unclear how to understand the distinctive metaphysical commitments of this view. We illustrate the relevant difficulties by examining what is arguably the most prominent class of contemporary attempts to formulate non-naturalism’s metaphysical commitments. This class of proposals, exemplified in work by Gideon Rosen and Stephanie Leary, characterizes the distinctive metaphysical commitments of non-naturalism in terms of metaphysical grounding and essence. We argue that these proposals overgeneralize: they either misclassify intuitively naturalistic hypotheses about the metaphysics of normativity as “non-naturalist”, or misclassify hypotheses in other areas of metaphysics. We argue that this problem stems from features of grounding itself. We suggest a more promising alternative for formulating non-naturalism, which revolves around the notion of objective similarity between classes of properties. We conclude by drawing some general lessons for inquiry about the metaphysics of normativity, and about metaphysics in general.

Minimum 5-Year Clinical Outcomes and Survivorship for a Single Revision Total Knee Arthroplasty System Using Hybrid Fixation and Press-Fit Stems

BackgroundHybrid fixation, utilizing diaphyseal press-fit stems and cement fixation in the tibial and femoral metaphyseal areas, has long been a strategy for revision total knee arthroplasty (rTKA). The purpose of this study was to evaluate the clinical outcomes and survivorships of hybrid fixation using a single rTKA revision system with a minimum of 5 years follow-up. MethodsWe reviewed our prospectively collected database to identify 281 patients who underwent rTKA using a single revision system with hybrid fixation and press-fit stems between July 2006 and August 2016. We reviewed the clinical outcome scores, including the Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis index, and Veterans RAND 12 Item Health Survey. We also evaluated the 5 and 10-year survivorships and the indications for reoperations. The cohort had a mean age of 70 years (range, 45.2 to 92.0) and a mean body mass index of 33.4 (range, 17.3 to 55.8). The mean time from rTKA surgery was 11.1 years (range, 5.3 to 15.5). ResultsPaired t-test analyses showed significant improvements from preoperative versus postoperative clinical outcome scores (P < .001) for Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis, and Veterans RAND 12 Item Health Survey Physical component. Prosthetic joint infections after index rTKA were the most common failure mode with 29 patients requiring reoperations. Rerevision due to aseptic loosening was uncommon (6 patients) with a cumulative survival rate of 95.2% at 5 years and 94.2% at 10 years. ConclusionThe use of this single rTKA system utilizing press fit stems combined with hybrid fixation provided significant improvements in the clinical outcomes and excellent survivorships at 5 and 10 years.

Can we safely place the distal volar locking plate screws into the subchondral zone of a distal radius fracture using a 45° supination oblique view under fluoroscopic guidance?

Careful distal locking screw insertion into the subchondral zone is necessary to obtain proper mechanical strength of unstable distal radius fractures using volar locking plating. However, subchondral zone screw insertion increases the risk of intra-articular screw penetration, which may remain unrecognized during surgery due to complex distal radial anatomy. The purpose of this study was to evaluate the role of fluoroscopic guidance with a 45° supination oblique view technique for placing distal screws into the subchondral zone during volar locking plating for unstable distal radius fractures and to explore the factors associated with poor screw placement. We retrospectively analyzed 171 wrists of 169 patients treated with variable-angle volar locking plates for unstable radius fractures. The subchondral zone was defined as the metaphyseal area within 4mm of the articular margin of the distal radius. The location of the distal locking screws and radiographic parameters, including the teardrop angle, were measured using computed tomography scans and X-rays. Clinical and radiographic factors were examined to determine their possible associations with screw placement failure. Of 581 distal screws inserted, 559 screws (96.2%) were inserted into the subchondral zone and 17 screws into the metaphyseal zone (2.9%). Five screws (0.7%) in three wrists showed intra-articular placement: four screws were placed into the lunate fossa and one into the scaphoid fossa. These three wrists also exhibited significantly reduced teardrop angles. The distal screws were significantly closer to the joint line in the lunate fossa than the scaphoid fossa (1.9±0.9mm vs. 2.8±1mm, P < 0.000). The 45° supination oblique view technique is a useful fluoroscopic guiding technique for accurate and safe distal screw placement in the subchondral zone in volar locking plate fixation for distal radial fractures. However, a decreased teardrop angle or extended lunate fossa should be corrected before distal screw insertion to avoid intra-articular screw placement.

Chronic kidney disease to osteoporosis: histopathological analysis on animal model with unilateral ureteral obstruction method

Background: One of the most frequent complications due to the progression of chronic kidney disease (CKD) is the occurrence of disturbances in mineral metabolism.. Increased bone remodeling results in osteopenia, which can progressively lead to osteoporosis. Wistar albino rats (Rattus norvegicus) are one of the most well-known and easy-to-obtain laboratory test animals. Data regarding the duration of bone pathological progression in CKD-induced Wistar strain rats by the unilateral ureteral obstruction method are limited. Methods: This was a descriptive observational study, with a prospective cohort approach. The aim was to determine the histopathological onset of osteoporosis in Wistar rats with the CKD model. We used 13 male Wistar rats (Rattus norvegicus). The CKD rat models were randomized and put into four containers, each containing three rats. Each group was treated in the same way for predetermined durations, which were the 7th day, 14th day, 21st day, and 28th day after CKD modeling, before being sacrificed for femoral bone histopathological collection. Results: On the 7th day after CKD modeling, we discovered thickening of the periosteal fibrous tissue. On the 14th and 21st days, there was an increase in the thickness of the periosteal fibrous tissue in the metaphyseal and diaphyseal areas. This thickening progression was in line with the length of treatment time. On the 21st day, we began to see the increasing gap between the trabecular tissues. On the 28th day, the histopathological analysis of femoral bone tissue showed thinning of the bone trabecular tissue and the most distant inter-trabecular spaces, suggesting the appearance of osteoporosis. Conclusion: The histopathological picture of osteoporosis in the Wistar strain rat model of CKD appeared most clearly and worst on the 28th day after CKD. It was marked by the thinning of the trabecular bone tissue and the most distant spaces between the trabeculae.

Extensive Lesser Toes Plantar Plate Tears Reconstruction

Category: Lesser Toes Introduction/Purpose: The plantar plate is a fibrocartilaginous structure that plays a fundamental role in the sagittal stability of the metatarsophalangeal joint (MTPJ). Traumatic and degenerative lesions affecting the plantar plate have the potential to cause instability, swelling, pain and deformity. Extensive plantar plate tears (grade IV) still challenge surgeons as primary repair is impossible, demanding a reconstructive procedure which, unfortunately, can be associated with high morbidity such as stiffness, persistence of discomfort, vascular compromise to the digit and amputation. The purpose of this work is to describe a new technique that uses a synthetic tape and one absorbable screw to achieve the MTPJ stabilization in plantar plate grade IV tears. We believe that this procedure can achieve better results than other techniques described in the literature. Methods: Two bone tunnels are made at the base of the proximal phalanx. Both medial and lateral tunnels are directed in a light oblique fashion from a distal-dorsal entry point to a proximal, justarticular plantar exit. Two new oblique dorsal-plantar bone tunnels - medial and lateral - are made at the distal metaphyseal metatarsal area. A #2 FiberTape is passed through the bone tunnels guided by a Nitinol wire, creating a mesh for the plantar stabilization of the MTPJ. Then both Fiber Tapes limbs are driven, with the help of a nitinol loop, through the plantar orifices of corresponding sides of the metatarsal bone tunnels, exiting in its dorsal aspect. One of the limbs of the tape is passed from dorsal to plantar trough the other metatarsal orifice. Both limbs are tensioned, and the toe should be kept at neutral sagittal position (flexion-extension). Fixation is made with a Biotenodesis screw. Results: Only a few patients were submitted to this technique. At one year follow up, none of them presented with complaints or complications. Conclusion: The surgical technique described in this article can change the way physicians treat plantar complex plantar plate tears when there is no viable biologic tissue to repair. A lesser complication rate it's also expected. Nonetheless comparative, and biomechanical studies are still needed to confirm our hypothesis.

Рецепция философских концепций Вл.С. Соловьева в эпистолярном наследии А. Белого

The article presents results of research of Vl.S. Solovyov’s sophiological and theurgic concepts reception in the epistolary heritage of A. Beliy – first of all, the early period of philosopher and symbolist poet until 1905. It is argued, that of all the Young Symbolists, it was Beliy who was the closest to understanding Solovyov's sophiology and creating his own integral system of theurgic symbolism on its basis. It is substantiated, that the starting point in the construction of this system is the direction to synthesis of eschatology, World Soul doctrine and theurgic role of the life-creator artist. The purpose of this research is to trace the origin of Beliy's doctrine of symbolism as a worldview, a self-conscious soul and a collective personality, presented in detail much later, but rooted in the original reading of Solovyov. An appeal to the correspondence between Beliy and A.A. Blok, E.K. Metner, N.I. Petrovskaya, A.S. Petrovskiy and others, is justified by the fact that it is in these letters that the general ideological contours of his concepts are outlined. Later, they turned out to be eclectically complicated in many ways, which makes it difficult for modern researchers to fully understand them, but the epistolary material is a kind of compass in the confused area of Beliy's metaphysics. The epistolary material analysis provides the method of understanding Beliy's metaphysics, taken into account, that later his system concepts turned out to be complicated by the thinker himself, which makes it difficult for modern researchers to understand them holistically.

Long Bone Mineral Loss, Bone Microstructural Changes and Oxidative Stress After Eimeria Challenge in Broilers.

The objective of this study was to evaluate the impact of coccidiosis on bone quality and antioxidant status in the liver and bone marrow of broiler chickens. A total of 360 13-day old male broilers (Cobb 500) were randomly assigned to different groups (negative control, low, medium-low, medium-high, and highest dose groups) and orally gavaged with different concentrations of Eimeria oocysts solution. Broiler tibia and tibia bone marrow were collected at 6 days post-infection (6 dpi) for bone 3-D structural analyses and the gene expression related to osteogenesis, oxidative stress, and adipogenesis using micro-computed tomography (micro-CT) and real-time qPCR analysis, respectively. Metaphyseal bone mineral density and content were reduced in response to the increase of Eimeria challenge dose, and poor trabecular bone traits were observed in the high inoculation group. However, there were no significant structural changes in metaphyseal cortical bone. Medium-high Eimeria challenge dose significantly increased level of peroxisome proliferator-activated receptor gamma (PPARG, p < 0.05) and decreased levels of bone gamma-carboxyglutamate protein coding gene (BGLAP, p < 0.05) and fatty acid synthase coding gene (FASN, p < 0.05) in bone marrow. An increased mRNA level of superoxide dismutase type 1 (SOD1, p < 0.05) and heme oxygenase 1 (HMOX1, p < 0.05), and increased enzyme activity of superoxide dismutase (SOD, p < 0.05) were found in bone marrow of Eimeria challenged groups compared with that of non-infected control. Similarly, enzyme activity of SOD and the mRNA level of SOD1, HMOX1 and aflatoxin aldehyde reductase (AKE7A2) were increased in the liver of infected broilers (p < 0.05), whereas glutathione (GSH) content was lower in the medium-high challenge group (p < 0.05) compared with non-challenged control. Moreover, the mRNA expression of catalase (CAT) and nuclear factor kappa B1 (NFKB1) showed dose-depend response in the liver, where expression of CAT and NFKB1 was upregulated in the low challenge group but decreased with the higher Eimeria challenge dosage (p < 0.05). In conclusion, high challenge dose of Eimeria infection negatively affected the long bone development. The structural changes of tibia and decreased mineral content were mainly located at the trabecular bone of metaphyseal area. The change of redox and impaired antioxidant status following the Eimeria infection were observed in the liver and bone marrow of broilers.

Inactivation of Osteoblast PKC Signaling Reduces Cortical Bone Mass and Density and Aggravates Renal Osteodystrophy in Mice with Chronic Kidney Disease on High Phosphate Diet.

Chronic kidney disease (CKD) frequently leads to hyperphosphatemia and hyperparathyroidism, mineral bone disorder (CKD-MBD), ectopic calcifications and cardiovascular mortality. PTH activates the osteoanabolic Gαs/PKA and the Gαq/11/PKC pathways in osteoblasts, the specific impact of the latter in CKD-MBD is unknown. We generated osteoblast specific Gαq/11 knockout (KO) mice and established CKD-MBD by subtotal nephrectomy and dietary phosphate load. Bone morphology was assessed by micro-CT, osteoblast function by bone planar scintigraphy at week 10 and 22 and by histomorphometry. Osteoblasts isolated from Gαq/11 KO mice increased cAMP but not IP3 in response to PTH 1-34, demonstrating the specific KO of the PKC signaling pathway. Osteoblast specific Gαq/11 KO mice exhibited increased serum calcium and reduced bone cortical thickness and mineral density at 24 weeks. CKD Gαq/11 KO mice had similar bone morphology compared to WT, while CKD Gαq/11-KO on high phosphate diet developed decreased metaphyseal and diaphyseal cortical thickness and area, as well as a reduction in trabecular number. Gαq/11-KO increased bone scintigraphic tracer uptake at week 10 and mitigated tracer uptake in CKD mice at week 22. Histological bone parameters indicated similar trends. Gαq/11-KO in osteoblast modulates calcium homeostasis, bone formation rate, bone morphometry, and bone mineral density. In CKD and high dietary phosphate intake, osteoblast Gαq/11/PKC KO further aggravates mineral bone disease.

Subsequent ipsi- and contralateral femoral fractures after intramedullary nailing of a trochanteric or subtrochanteric fracture: a cohort study on 2012 patients

BackgroundThe literature is inconclusive as to whether an intramedullary nail changes the distribution of a subsequent ipsi- or contralateral fracture of the femur. We have compared the incidence, localisation, and fracture pattern of subsequent femoral fractures after intramedullary nailing of trochanteric or subtrochanteric fractures in patients without previous implants in either femur at the time of surgery.MethodsRetrospective analysis was performed of a two-centre cohort of 2012 patients treated with a short or long intramedullary nail for the management of trochanteric or subtrochanteric fracture between January 2005 and December 2018. Subsequent presentations with ipsi- and contralateral femoral fractures were documented. Only patients with no previous femoral surgery performed, other than the index nailing were followed. Odds ratios (ORs) for subsequent femoral fracture were calculated using robust variance estimates in logistic regression.ResultsThe mean age of the cohort was 82.4 years and 72.1% were female. The total number of patients presenting with subsequent femoral fractures was 299 (14.9%). The number of patients presenting with subsequent ipsilateral and contralateral femoral fractures was 51 (2.5%) and 248 (12.3%) respectively (OR 5.0; CI 3.7–6.9). Twenty-six (8.7%) of all subsequent femoral fractures occured in the ipsilateral shaft, 14 (4.7%) in the ipsilateral metaphyseal area, one (0.33%) in the contralateral shaft, and three (1.0%) in the contralateral metaphysis (OR 10; CI 3.6–29).ConclusionAn intramedullary nail significantly changes the fracture pattern in the event of a second low-energy trauma, reducing the risk of subsequent proximal ipsilateral femoral fractures and increasing the risk of subsequent ipsilateral femoral fractures in the shaft and distal metaphyseal area compared with the native contralateral femur.

Osteomyelitis in a slaughter turkey flock caused by Yersinia pseudotuberculosis sequence type ST42

A Yersinia pseudotuberculosis outbreak was diagnosed in a male turkey flock in Finland. Y. pseudotuberculosis is a quite rare zoonotic bacterium, which typically causes enteritis in humans and sudden death in animals. In this study, osteomyelitis was diagnosed in small, lame, 11- to 12-wk-old male turkeys. Lameness and slower growth among the turkeys was observed on the farm. During pathological examination, multiple lesions were found in the metaphyseal and physeal areas of the femurs, tibiotarsi, and tarsometatarsi, with multifocal to coalescing mixed heterophilic/granulomatous necrotizing osteomyelitis. Y. pseudotuberculosis was isolated from the femoral and tibiotarsal bones or from the joints of six lame turkeys sent for necropsy. The isolation required homogenizing of lesion tissue in phosphate-mannitol-peptone broth, which was cultured directly - and, if needed, after cold enrichment – on selective cefsulodin-irgasan-novobiocin agar. Whole-genome sequencing was used for identification and typing. All isolates belonged to bio/serotype 1/O:1a and sequence type ST42 (Achtman scheme), which is commonly reported in both human and animal Y. pseudotuberculosis infections in Europe. The isolates from all six turkeys showed only one to two allele differences in the core genome comparison, indicating a common source of infection. All asymptomatic turkeys were slaughtered at the age of 17 weeks. Whole and partial carcass condemnation rates at the slaughterhouse were high, but no macroscopic changes in the skeletal system were found, showing that food chain information is essential. This study confirms earlier findings that Y. pseudotuberculosis can cause osteomyelitis in fattening turkeys, leading to lameness. Food chain information is essential for slaughterhouse operations, to protect the workers and emphasize good working hygiene during slaughter.