Rate Of Scarring Research Articles

Renal scarring in children with febrile urinary tract infection.

The authors aim to evaluate characteristics of children with fUTI and results of renal bladder ultrasonography (RBUS) and late dimercaptosuccinicacid (DMSA) scan. This study is designed as retrospective analysis of RBUS and DMSA reports of children with fUTI. Age, gender, number of fUTI, presence of constipation and vesicouretheral reflux (VUR) were recorded. The study included 160 children with fUTI with a median age of 7 years (6 months 18 years old). The majority of children in this study were girls (86.3 %), older than 60 months (73.1 %) and had one episode of fUTI. The recurrence rates of UTI were similar in both girls and boys. The total rate of constipation was 21.9 %. The rate of renal scarring on DMSA was 16.9 %. The rates of renal scarring were similar at three age groups and both genders. The rate of renal scarring was higher in children with recurrent UTI compared to those with one episode of fUTI (26.4 % and 12.5 %, respectively; p = 0.04). The rate of constipation in children with renal scarring and normal DMSA was similar (p = 0.07). The rate of trabeculation and thick bladder wall was higher in children with renal scarring at DMSA than children with no renal scarring (p = 0.03). The present study demonstrated that 16.9 % of children with fUTI had renal scarring. The rates of renal scarring were similar in both gender and age groups. Children with recurrent UTI and abnormal bladder results at RBUS had higher rates of renal scarring.

P0206 Skin deep connections: patients with stricturing Crohn’s disease are more likely to have a history of skin scarring than those with non-stricturing Crohn’s and non-IBD controls

Abstract Background The mechanism and prediction of stricturing Crohn’s disease (CD) to guide medical therapy remains elusive. Formation of hypertrophic and keloid skin scars have not been previously studied in IBD. This study aimed to evaluate the nature of skin scars in patients with CD, and their association with different phenotypes. Methods Adult patients attending a tertiary IBD service were invited to participate in this cross-sectional observational study. Patients were divided into three groups (non-IBD controls, non-structuring/non-penetrating CD and stricturing/penetrating CD). A patient survey tool, consisting of 8 questions was administered to assess for the presence of scars and their type. Disease characteristics were ascertained using electronic medical records. The primary outcome of the study was the prevalence of either hypertrophic or keloid scarring across the 3 groups. Secondary outcomes included the rates of scarring overall as well as keloid and hypertrophic scars individually between the three groups. The chi-square test along with pair-wise comparison differences was used to assess for differences between groups. Results 189 patients were recruited for this study with baseline characteristics presented in table 1 below. Control patients were older than the other groups (p = 0.013). Patients with stricturing/penetrating CD were more likely to be male. Patients with stricturing/penetrating CD (36.5%) were more likely to have either hypertrophic or keloid scars than those with non-stricturing/non-penetrating CD (11.1%) and non-IBD controls (6.3%), p = <0.0001. Pairwise comparisons revealed differences individually between the stricturing/penetrating and non-stricturing/non-penetrating (p = 0.001) and healthy controls (p < 0.001), but not between the latter two groups (p = 0.52). 8 patients with structuring/penetrating CD had a history of keloid scars, but none in the other 2 groups (p < 0.001). Across the 3 groups, there was no difference in the rates of normal scars (p = 0.112). Conclusion In this pilot cross-sectional study, a higher rate of hypertrophic or keloid scarring was demonstrated in patients with stricturing or penetrating disease in comparison to healthy controls and those with non-stricturing/non-penetrating disease, suggesting potential underlying common pathophysiology. Future studies confirming this novel association may provide an avenue for further study of predictive and therapeutic targets for IBD.

Comparison of Aspiration Versus Incision and Drainage in the Treatment of Breast Abscess, in terms of Recurrence: An Analytical Cross-Sectional Study

Objective: To assess and compare the treatment outcomes of breast abscess using two different methods aspiration versus incision and drainage. Methods: This analytical cross-sectional study was conducted at Combined Military Hospital, Karachi, Pakistan, from October 2022 to March 2023. Females aged 18 to 50 years with ultrasound-diagnosed acute breast abscesses up to 5 cm, presenting with signs and symptoms such as breast pain, localized swelling, erythema, tenderness, and fever, were included. Patients were randomly assigned to receive needle aspiration or incision and drainage. Outcomes were assessed based on recurrence and scarring. Recurrence was defined as the reappearance of similar signs and symptoms after complete resolution. Patients were monitored for one-month post-treatment. Results: Of total 124 patients, the mean age was 38.10 ±5.21 years. The mean duration of procedure was 26.33 ±10.58 minutes. A significantly longer mean duration of the procedure was observed in the aspiration group as compared to the incision and drainage group i.e., 36.61 ± 2.82 minutes vs. 16.04 ± 1.67 minutes (p-value <0.001). A significant association found between the two groups in terms of parity (p-value <0.001) and site of abscess (p-value 0.001). Treatment outcome showed higher rate of recurrence and scarring in the aspiration group compared to the incision and drainage group i.e., 8 (66.7%) vs. 4 (33.3%) and 5 (100.0%) vs. 0 (0.0%). However, a significant association of scar (p-value 0.022) was observed between groups. Conclusion: Incision and drainage proved more effective than aspiration for treating breast abscesses, with lower rates of recurrence and scarring.

Wound closure techniques for spinoplastic surgery: a review of the literature.

The approach to skin closure in spinal surgery is dependent on surgeon preference and experience. Wound complications, including dehiscence and surgical site infection (SSI), are common following spine surgery. The authors reviewed various wound closure techniques employed in spinal surgery. A systematic review was conducted to identify articles comparing wound closure techniques after posterior spinal surgery. Articles that employed experimental or observational cohort study designs and reported rates of SSI, dehiscence, or scarring following spinal surgery were included. Eight studies examining closure techniques of the skin were identified: five retrospective cohort studies and three randomized-controlled trials. No differences in the incidence of SSI were reported based on suture technique, although staples were associated with higher SSI rates in single level spinal fusion, and barbed suture resulted in decreased wound complications. The use of intracutaneous sutures was associated with a higher incidence of wound dehiscence when compared to tension-relieving far-near near-far suture (FNS) and far-near near-far interrupted point (FNP) sutures. However, the latter two also resulted in the highest rates of delayed wound healing (i.e., time to fully heal). Modified Allgöwer-Donati suture (MADS) resulted in smaller scar area when compared to vertical mattress suture. Significant differences exist in wound healing when comparing suture techniques in spinal surgery. Surgical staples allow for faster closing time, but are also associated with higher wound complications. Intracutaneous sutures appear to have higher rates of dehiscence compared to vertical mattress suture but display faster wound healing. Future studies are necessary to elucidate contributory factors, including local ischemia and changes in tensile forces. Level IV.

Alexis® Orthopedic Protector Provides Wound Protection and Aids in Hypertrophic Scar Prevention in Total Hip Arthroplasty.

Total hip arthroplasty (THA) is one of the most widely performed orthopedic surgeries. Techniques for small skin incisions and preservation of muscles and tendons have been developed. However, avoiding skin complications and muscle damage due to forced deployment and surgical manipulation is challenging. This study aimed to investigate whether the use of Alexis® Orthopedic Protector (Applied Medical Resources Corp., Rancho Santa Margarita, CA, USA) affects postoperative outcomes. This was a retrospective cohort study including 118 patients who underwent primary THA by the same surgeon at our single institution between March 2021 and March 2023. Protectors were used alternately for each operation. Fifty-nine patients were in the protector-using group (P group), and 59 were in the nonprotector-using group (N group), with comparisons made between groups. Protectors were placed under the fascia in all patients. Preoperative blood tests showed no difference in renal and hepatic function between the two groups. No differences in postoperative C-reactive protein (CRP) and creatine kinase (CK) values or in the Japanese Orthopedic Association Hip Disease Evaluation Questionnaire (JHEQ) and Numerical Rating Scale (NRS) scores were observed. Postoperative redness was significantly higher in the N group than in the P group (49.2% vs. 7%). The percentage of hypertrophic scars at three months postoperatively was 18.6% in the N group and 7% in the P group. Furthermore, the Japan Scar Workshop Scar Scale (JSS) indicated that hypertrophic scars were significantly worse in the N group than in the P group (p = 0.0012). Alexis® Orthopedic Protectors can not only provide short-term wound protection but also reduce the rate and degree of hypertrophic scarring.

Comparison of the Effects of Postoperative Arm Restraints and Mittens on Cleft Lip Scar Quality after Primary Repair.

Introduction: Postoperative management following primary cleft lip repair varies across institutions, cleft care teams, and individual surgeons. Postoperative precautions employed after cleft lip repair include dietary restrictions, pacifier limitations, and immobilization, with arm restraints long being used. Yet, restraint distress has led to the exploration of other forms of immobilization. Thus, this study aims to assess cleft lip scar quality and complication rates after postoperative immobilization with arm restraints versus hand mittens. Methods: A retrospective review of patients with unilateral cleft who underwent primary repair with the senior surgeon was done. Data on demographics, surgical characteristics, and immobilization utilized were gathered. A survey with pictures of postoperative scars were sent to laypeople who assessed scar quality with Modified Scar-Rating Scale scores for surface appearance, height, and color of the scar tissue. Statistical analysis was carried out for significance. Results: Twenty-eight patients with a unilateral cleft underwent arm restraints after primary lip repair, and twenty-seven utilized mittens. In total, 42 medical students completed the scar assessment. Photographs were taken an average of 23.9 (±5.8) and 28.2 (±11.9) months postoperatively in the restraint and mitten groups, respectively (p = 0.239). There were no statistically significant differences in scores between scar surface, height, color, or overall scar appearance. Complication rates were also similar between groups. Conclusions: Arm restraints appear to have no additional benefit relative to scar quality, as compared to mittens. Considering the arm restraints' burden of care, mittens should be considered as a measure to protect the lip after primary repair.

Twelve Steps to Optimize Scar Outcomes in External Rhinoplasty.

A well-healed scar extends beyond a mere superficial concern, reflecting the precision and care underlying the surgery. This study addresses the lack of recent literature on the complete closure technique for external rhinoplasty scars, emphasizing its potential impact on patient satisfaction and overall aesthetic quality. The main purpose of this article was to introduce and assess the efficacy of a novel closing suture technique for external rhinoplasty and emphasize on 12 specific steps for wound closure. A cohort of 104 patients who underwent external rhinoplasty utilizing the proposed closing suture technique were evaluated. Standardized photographic documentation and scar assessment were performed using the Vancouver-Manchester scale, considering notching, skin level differences, pigmentation, and overall appearance. The surgical approach involved a combination of vertical mattress and interrupted simple sutures, creating an effective closure framework. Analysis revealed an absence of poor scars, with 83.6% classified as good. Note that 65.5% of the good scars achieved a perfect 6-point score. While one moderate scar scored 3 points, the majority demonstrated optimal outcomes. Clinical photographs further illustrated the technique's success, showcasing imperceptible scars and reinforcing the efficacy of the complete closure approach. Our study introduces and assesses the efficacy of the complete closure technique for external rhinoplasty scars. The approach consistently yields positive outcomes, with an emphasis on almost imperceptible scars. While not achieving a 100% imperceptible scar rate, this study underscores the need for ongoing research to refine techniques and enhance patient satisfaction in external rhinoplasty. The proposed technique contributes significantly to scar management practices and encourages further exploration within the evolving landscape of rhinoplasty.

Ex Vivo Fluorescence Confocal Microscopy of MRI-Guided Targeted Prostate Biopsies for Rapid Detection of Clinically Significant Carcinomas-A Feasibility Study.

MRI-guided prostate biopsies from visible tumor-specific lesions (TBx) can be used to diagnose clinically significant carcinomas (csPCa) requiring treatment more selectively than conventional systematic biopsies (SBx). Ex vivo fluorescence confocal microscopy (FCM) is a novel technique that can be used to examine TBx prior to conventional histologic workup. TBx from 150 patients were examined with FCM on the day of collection. Preliminary findings were reported within 2 h of collection. The results were statistically compared with the final histology. 27/40 (68%) of the csPCa were already recognized in the intraday FCM in accordance with the results of conventional histology. Even non-significant carcinomas (cisPCa) of the intermediate and high-risk groups (serum prostate-specific antigen (PSA) > 10 or 20 ng/mL) according to conventional risk stratifications were reliably detectable. In contrast, small foci of cisPCa were often not detected or were difficult to distinguish from reactive changes. The rapid reporting of preliminary FCM findings helps to reduce the psychological stress on patients, and can improve the clinical management of csPCa. Additional SBx can be avoided in individual cases, leading to lower rates of complications and scarring in the future surgical area. Additional staging examinations can be arranged without losing time. FCM represents a promising basis for future AI-based diagnostic algorithms.

Three-component tear substitute as preoperative support in glaucoma surgery

This study investigates the effect of preoperative preparation with the three-component tear substitute Stillavit on the outcomes of glaucoma surgery in patients on long-term topical glaucoma therapy. The study included 63 patients (63 eyes) with glaucoma, among them 30 (30 eyes) were women and 33 (33 eyes) were men. Group 1 consisted of 33 patients (33 eyes) receiving long-term topical antihypertensive therapy with preservatives and tear substitute Stillavit 3 times a day for 1 month as preoperative preparation. Group 2 included 30 patients (30 eyes) receiving similar antihypertensive therapy who were not prescribed preoperative medications. All patients underwent a comprehensive ophthalmological examination and computer tomography of the filtering blebs (FB) on Visante system (Carl Zeiss Meditec, Germany) before surgery, as well as 1 week, 1, 3, and 6 months after surgery. Mean intraocular pressure (IOP) elevation at 6 months postoperatively was significantly higher in the group that did not undergo preoperative preparation with a tear substitute, compared to the group of patients who received the tear substitute Stillavit preoperatively. According to anterior segment optical coherence tomography, a greater number of favorable diffuse FB were noted in the group that received the tear substitute Stillavit in preparation for surgery - 87.9%, while in group 2 (without preparation) - 66.7%. Odds ratio calculation between the two groups revealed that preoperative preparation with the tear substitute Stillavit reduced the odds of IOP elevation to 20 mm Hg or higher at 3 months postoperatively by more than 10 times. The use of tear substitute Stillavit in preparation for anti-glaucoma surgery reduces the chances of IOP elevation in the early postoperative period by more than 10 times, which may indicate a reduction in the rate of FB scarring due to the beneficial effect of the drug's components on the precorneal tear film.

Long-term obstetric, perinatal, and surgical complications in singleton pregnancies following previous cesarean myomectomy: a retrospective multicentric study.

The safety of cesarean myomectomy has been proven by previous studies. Our study aimed to reveal the long-term perinatal, obstetric, and surgical outcomes of cesarean myomectomy (CM) by comparing different CM techniques. This retrospective multicentric case-control study involved 7 hospitals and included 226 singleton pregnancies that underwent repeated cesarean section (CS) between 2015 and 2020. Among these pregnancies, 113 of 226 cases had CM (Group A), and 113 had only CS (Group B). Of the 113 cases in which CM was performed, 58 underwent endometrial myomectomy (EM) (Subgroup A1) and 55 underwent serosal myomectomy (SM) (Subgroup A2). The groups were compared in terms of obstetric, perinatal, and surgical outcomes, and fibroid recurrence, myomectomy scar healing rate, and adhesion formation were noted. There was no significant difference between the groups in terms of maternal age, body mass index, gravidity, parity, and fibroid diameter in previous CS (p > 0.05). In the perinatal and obstetric evaluation of the groups, there was no significant difference between the groups in terms of neonatal weight, Apgar score, fetal growth restriction, preterm premature rupture of membranes, preterm delivery, hypertension in pregnancy, and diabetes mellitus (p > 0.05). The fibroid recurrence rate was 28.3%, and the myomectomy scar good healing rate was 99.1%. There was no difference between the groups in terms of CS duration, preoperative and postoperative hemoglobin levels, perioperative blood transfusion rates, febrile morbidity, and prolonged hospitalization (p > 0.05). In terms of adhesion formation, although the adhesion rate of the SM group was higher than that of the EM group, no statistically significant difference was detected between the groups. This study showed that in pregnancies following CM, obstetrical, perinatal, and surgical outcomes were unaffected. Obstetricians can safely use CM, either the trans-endometrial or serosal technique, as it is a safe and effective method with long-term results.

Complication rates and safety of pulsed dye laser treatment for port-wine stain: a systematic review and meta-analysis.

Pulsed dye laser (PDL) is the most commonly used method for port-wine stain (PWS); however, no studies have reported the safety of PDL. This review aimed to collect and summarize complications reported in relevant literature, assess complication rates in treating PWS with PDL, and explore the relevant influencing factors. A systematic review and meta-analysis were conducted to search for related studies in PubMed, Embase, and the Cochrane Library until August 2022. Two reviewers independently evaluated the risk of bias of included studies. Stata Software version 17.0 was used for the analysis. All complications reported in the literature are divided into acute phase complications and long-term complications. Overall pooled purpura, edema, crusting, blistering, hyperpigmentation, hypopigmentation, and scarring rates were 98.3%, 97.6%, 21.5%, 8.7%, 12.8%, 0.9%, and 0.2%, respectively. Although the acute adverse reactions were found to be common, the long-term permanent complications clearly have a lower frequency, and the occurrence of scarring is much lower than that initially thought. This indicates that effective protective measures after treatment are very important for preventing scar formation. Overall, PDL treatment for PWS shows a high level of safety and low chances of causing long-term complications.

Transvaginal natural orifice transluminal endoscopic surgery-assisted versus transumbilical laparoendoscopic single-site ovarian cystectomy for ovarian mature cystic teratoma. A randomized controlled trial.

Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and transumbilical laparoendoscopic single-site surgery (LESS) have shown the prospection as minimally invasive procedures. Here we aimed to compare ovarian cystectomy assisted by vNOTES and by LESS for ovarian mature cystic teratoma (OMCT). A total of 81 premenopausal women with OMCT were randomized to undergo ovarian cystectomy assisted by either vNOTES (n = 41) or LESS (n = 40). The main outcome was the operative time. Secondary outcomes included the length of hospital stay, visual analog scale (VAS) pain scores, abdominal contamination by teratoma contents, and intraoperative and postoperative complications. There were no intergroup differences in age, body mass index, tumor size, or bilaterality of tumor. The operative time for the vNOTES group was significantly shorter than that for the LESS group (68.41 ± 20.92 min vs 85.05 ± 32.94 min, p = 0.008). The highest VAS pain score 24 hours postoperatively was 1.21 ± 0.48 in the vNOTES group and 2.43 ± 0.57 in the LESS group (p < 0.001). Twenty-four of the 40 patients in the LESS group experienced teratoma rupture intraoperatively, leading to abdominal contamination by the teratoma content, while 5 abdominal contamination was observed in the vNOTES group （p = 0.005. No significant differences between the two groups were observed in the other outcomes. vNOTES assisted ovarian cystectomy has short operative time, fast recovery, no scarring, less pain, and low rate of abdominal contamination. Consequently, vNOTES might be superior to LESS for treating OMCTs.

The first experience of treating linear types of capillary angiodysplasia of the skin in children with green laser light λ 520 ± 10.0 nm

Introduction. The linear type of capillary angiodysplasia (LCA) is represented by pathologically dilated vessels of the capillary flow located between the epidermis and hypodermis. LCA may be both congenital and acquired. By the type of blood supply, LCA are arterial, venous and mixed. Local infections and injuries, excessive solar insolation and hormonal imbalance are noted among LCA causes. LCAs are benign lesions, but they may have complications which may be triggered, for example, by traumatic damage to a pathologically enlarged vessel. There is a large number of non-invasive and invasive curative methods of LCA removal: cryotherapy, electrocoagulation, sclerotherapy, laser photodestruction and others. Among disadvantages, various authors mark: high risk of scarring, hyperpigmentation and high rate of disease relapse.Purpose. To improve results of treatment of children with LCA by using laser light.Material and methods. 32 children having LCA were treated with transcutaneous selective photodestruction ( green laser light, wavelength of 520 ± 10.0 nm generated by Russian-made laser device "Malachit") in Clinical and Research Institute of Emergency Pediatric Surgery and Trauma in 2021–2022.Results. After treatment, 31 child had good results without residual vascular elements and scar deformation in the photodestruction zone. One patient required a repeated laser session because of remained residual elements after which she also had good results.Conclusion. The presented clinical trial has demonstrated that transcutaneous selective laser photodestruction with consideration of spatial localization of LCA structural elements in the skin, provides a precise treatment of pathological dilated vascular structures, practically without skin damage, and allows to achieve radical good clinical and aesthetic outcomes.

Synthetic multi-contrast late gadolinium enhancement imaging using post-contrast magnetic resonance fingerprinting.

Late gadolinium enhancement (LGE) MRI is the non-invasive reference standard for identifying myocardial scar and fibrosis but has limitations, including difficulty delineating subendocardial scar and operator dependence on image quality. The purpose of this work is to assess the feasibility of generating multi-contrast synthetic LGE images from post-contrast T1 and T2 maps acquired using magnetic resonance fingerprinting (MRF). Fifteen consecutive patients with a history of prior ischemic cardiomyopathy (12 men; mean age 63 13 years) were prospectively scanned at 1.5 T between Oct 2020 and May 2021 using conventional LGE and MRF after injection of gadolinium contrast. Three classes of synthetic LGE images were derived from MRF post-contrast T1 and T2 maps: bright-blood phase-sensitive inversion recovery (PSIR), black- and gray-blood T2 -prepared PSIR (T2 -PSIR), and a novel "tissue-optimized" image to enhance differentiation among scar, viable myocardium, and blood. Image quality was assessed on a 1-5 Likert scale by two cardiologists, and contrast was quantified as the mean absolute difference (MAD) in pixel intensities between two tissues, with different methods compared using Kruskal-Wallis with Bonferroni post hoc tests. Per-patient and per-segment scar detection rates were evaluated using conventional LGE images as reference. Image quality scores were highest for synthetic PSIR (4.0) and reference images (3.8), followed by synthetic tissue-optimized (3.3), gray-blood T2 -PSIR (3.0), and black-blood T2 -PSIR (2.6). Among synthetic images, PSIR yielded the highest myocardium/scar contrast (MAD = 0.42) but the lowest blood/scar contrast (MAD = 0.05), and vice versa for T2 -PSIR, while tissue-optimized images achieved a balance among all tissues (myocardium/scar MAD = 0.16, blood/scar MAD = 0.26, myocardium/blood MAD = 0.10). Based on reference mid-ventricular LGE scans, 13/15 patients had myocardial scar. The per-patient sensitivity/accuracy for synthetic images were the following: PSIR, 85/87%; black-blood T2 -PSIR, 62/53%; gray-blood T2 -PSIR, 100/93%; tissue optimized, 100/93%. Synthetic multi-contrast LGE images can be generated from post-contrast MRF data without additional scan time, with initial feasibility shown in ischemic cardiomyopathy patients.

Comparative efficacy of esomeprazole vs. rabeprazole in post-endoscopic submucosal d i s s e c t i o n g a s t r i c u l c e r s : a p r o s p e c t i v e randomized trial

Background and objectives: There is inadequate data on the clinical outcomes of proton pump inhibitors in patients with post-endoscopic submucosal dissection (ESD) gastric ulcers (PESDGU). The clinical course of PESDGU is affected by various ESD methods, including the types of devices and endoscopists’ skills. No previous reports have compared the clinical outcomes of different proton pump inhibitors for PESDGU healing in patients who underwent the same ESD method using the same device by the same well-trained endoscopist. This study aims to compare the clinical outcome of esomeprazole vs. rabeprazole in PESDGU using the same ESD method and by the same endoscopist. Methods: Sixty patients with gastric tumors participated in this randomized clinical trial. Patients who underwent ESD using the Clutch Cutter (ESDCC) method by the same endoscopist were prospectively randomly assigned to esomeprazole 20 mg (EM) or rabeprazole 20 mg (RM) monotherapy groups. All patients received 20 mg omeprazole intravenously daily for the first 2 days post-ESDCC, followed by oral administration of EM or RM for 8 weeks. All patients remained hospitalized for 7 days postoperation to monitor any ESD-related complications. Esophagogastroduodenoscopy was performed 8 weeks post-ESD to evaluate the healing status of each artificial ulcer. Results: Of the 60 patients in this study, 30 each were assigned to the EMand RM groups. Eight patients from both groups did not complete the regimen and were excluded. Exactly 52 patients completed the study, with 27 and 25 in the EM and RM groups, respectively. There were no significant differences in the demographic characteristics of the two groups. There were no post-ESD perforations in either group. Post-ESD bleeding occurred in one patient in the RM group 5 days post-ESD. Scarring rates at the endpoint 8 weeks after ESD in the EM and RM groups were 96% and 76%, respectively. There were no significant differences between the two groups in the scarring stage (S1 or S2) at 8 weeks post-ESD. Conclusion: EM and RM have equivalent therapeutic effects on PESDGUs.

Inhibitory effects of Bacillus vallismortis T27 against apple Valsa canker caused by Valsa mali

Apple Valsa canker caused by the pathogenic fungus Valsa mali, are one of the most destructive diseases of woody plants worldwide. One rhizosphere microbe strain, designated as T27 and subsequently identified as Bacillus vallismortis based on morphological and phylogenetic analyses, was studied as a potential biocontrol agent. Inoculation assay showed the B. vallismortis T27 suppressed the mycelial growth of V. mali with 81.33% antifungal effect on dual culture plates and caused hyphal deformities, wrinkles. The T27 fermentation broth significantly suppress the fungi's ability to acidify the surrounding environment. The addition of T27 cell-free supernatant (CFS) caused the pH of the fungal culture medium to increase from 3.60 to 5.10. B. vallismortis T27 showed the presence of Surfactin, IturinA and Bacilysin antimicrobial biosynthetic genes by the PCR assay. In addition, the B. vallismortis T27 was able to promote plant growth by producing siderophores and solubilizing phosphorus. The application of 2% fermentation broth of T27 resulted in a significant increase of 55.99% in the height of tomato plants and a 33.03% increase in the fresh weight of tomatoes. Under laboratory and field conditions, the B. vallismortis T27 exhibited strong antifungal activities on detached twigs and intact plants. The treatment of T27 resulted in a 35.9% reduction in lesion area on detached twigs. Furthermore, when applied to intact plants, T27 demonstrated a scar healing rate of 85.7%, surpassing the 77.8% observed in the treatment with tebuconazole. Comparative transcriptome analysis showed down-regulation of the genes associated with the fungal cell wall and cell membrane's synthesis and composition during V. mali treated with the B. vallismortis T27. In addition, gene transcription level analysis under treatment with B. vallismortis T27 revealed a significant increase in the expression levels of genes associated with diterpene biosynthesis, alanine, aspartic acid and glutamate metabolism, and plant hormone signaling in the apple, consistent with qRT-PCR and RNA-seq results. In this study, B. vallismortis T27 isolated from rhizosphere soil and identified as a novel biological control agent against apple Valsa canker. It exhibited effectively control over Valsa canker through multiple mechanisms, including disrupting the fungal cell membrane structure, altering the fungal growth environment, activating the plant MAPK pathway, and inducing upregulation of plant terpene biosynthetic genes. These findings highlight the potential of B. vallismortis T27 as a promising and multifaceted approach for managing apple Valsa canker.

Experimental analysis of tribological performance of base ficus carica vegetable oil with different polymers as additives using four ball tribometer

The need to use vegetable lubricants has been driven by the widespread concern for environmental issues, especially in industries that overuse petroleum lubricants. This research examined the tribological characteristics of vegetable-based lubricants by adding additives such as ethylene–vinyl acetate (EVA) and Eichhornia crassipes carboxymethyl cellulose (EC-CMC) polymers to study the viscometric response of the lubricants. The test was conducted using four ball-tester, and analyzed in terms of coefficient of friction (COF), wear scar diameter (WSD), and wear scar rate, respectively. The results showed that with the addition of each additive enhanced the tribological properties significantly but yielded poor results with 0.5% additives for both samples. The characterization investigation showed that ficus carica (Fig) oil responded effectively to the addition of various additives when conducted thermogravimetric analysis (TGA) and Fourier transform infrared (FT-IR) spectroscopy. Under 100 kg load and speed of 1200 rpm, base Fig lubricant yielded a higher COF of 0.193, while blended EVA and EC-CMC gave lower COF of 0.161 and 0.171, while the lowest wear scar diameter was with 1.5 wt% EVA (0.39 mm) and 1 wt% EVA (0.41 mm), respectively. Comparing all the lubricants under 1500 rpm, the base Fig lubricant yielded 0.317, while 1.5 wt% EVA, 1.5 wt% EC-CMC, SEA 5W 30 gives COF of 0.287, 0.263, and 0.239, respectively. The study revealed that the reduction in the COF and wear scar diameter was due to the formation of the film by the included additive.

FEM wear prediction of ceramic hip replacement bearings under dynamic edge loading conditions

Hard-on-Hard hip implants, specifically ceramic tribo-pair, have produced the highest in-vivo wear resistance, biocompatibility, superior corrosion resistance, and high fracture toughness. However, this ceramic tribo-pair suffers from edge loading, sharply increasing wear and accelerating early implant failures due to micro-separation. Even though in-vitro studies have tested the occurrence of wear due to dynamic edge loading, the Finite Element Method (FEM) gives the advantage of accurately estimating the wear, minimizing the experimental time and cost. A new fundamental FEM model is developed to predict wear for ceramic hip replacement bearings under dynamic edge loading conditions for a fixed separation and fixed inclination angle. The model is directly validated with the existing hip simulator data up to 3 million cycles in terms of wear depth, wear scar and volumetric wear rate. The results from the model show that the accuracy in wear prediction was more than 98% for the wear depth and volumetric wear rate for the dynamic edge loading condition. A stripe wear scar is captured, depicting the edge loading conditions. The developed model from this study can predict wear under pure standard and dynamic edge loading conditions.

High temperature sliding wear behavior of detonation sprayed Ni-5wt%Al coating

The tribological behavior of detonation (DSC) sprayed Ni-5%wtAl coatings at room temperature (25 °C) and elevated temperature (850 °C) has been studied in this work. Dry sliding wear experiments were done by using alumina (Al2O3) ball-on-disc tribometer. FESEM-EDS and a non-contact 3D profilometer microanalysis were used to evaluate the worn scar and wear rate and identify the wear mechanism. X-ray diffraction (XRD) investigation indicated that the Ni-5wt%Al coating predominantly consists of γ-Ni phases at 25 °C and 850 °C conditions. The phase evolution, thermal expansion, crystallite size, and lattice strain were evaluated using in-situ high-temperature X-ray diffraction (HT-XRD). The crystallite size (D) and lattice strain (ε) were determined by Williamson-Hall analysis using a uniform deformation model (UDM), employing X-ray peak profile analysis (XPPA). In high-temperature conditions, the thermal expansion mismatch between the coating and substrate is negligible, with reduced spallation and cracking at the interface. The findings of the wear tests revealed that as the temperature increased, the coefficient of friction (CoF) and wear rate (ω) significantly decreased as the wear mechanism changed from abrasive to adhesive. The improvement of wear resistance of Ni-5wt%Al coating at high temperatures has been evaluated and discussed from the perspective of thermal expansion and tribo-layer formation.

Prophylactic use of steroids for a mucosal defect with a circumference of less than three-fourths prevents both symptomatic and asymptomatic stricture after esophageal endoscopic submucosal dissection.

Subclinical stricture after esophageal endoscopic submucosal dissection (ESD) makes the detection and re-ESD of metachronous lesions difficult. This study aimed to investigate the effectiveness of prophylactic steroid use after esophageal ESD for mucosal defects with a circumference less than 75% for the prevention of symptomatic and asymptomatic stricture. In 80 retrospectively enrolled patients, we collected paired endoscopic images of a mucosal defects immediately after resection and a scar thereafter. After calculating circumference by image analysis software, all patients were classified into three groups in reference to mucosal defect circumference (MDC; ≤ 50%, 50-75%, ≥ 75%). Frequency of steroid use and symptomatic stricture were compared, and in < 75% MDC patients, a degree of asymptomatic stricture with or without steroid was compared by calculating a scar contraction rate (SCR). In the ≤ 50% (43 patients), 50-75% (27 patients) and ≥ 75% (10 patients) MDC groups, steroids were used in 12%, 59% and 100%, respectively, and symptomatic stricture occurred in 0%, 7% and 40%, respectively. In < 75% MDC patients, SCR in the steroid cohort was significantly lower than that in the nonsteroid cohort (42% vs. 65%, p = 0.002). No steroid-related adverse events occurred. Steroid use even for mucosal defects with < 75% circumference appears effective for the reduction of the risk on both symptomatic and asymptomatic stricture after esophageal ESD.