A vascular-associated fibroblastic cell controls pancreatic islet immunity.

The immune protection of pancreatic β cells has three layers: anatomical, with their distribution in 1 million islets; central, with the thymic deletion of β cell-specific T cells; and peripheral, with inhibitory cellular networks. The failure of the latter leads to most spontaneous type 1 diabetes and all diabetes induced by checkpoint inhibitor therapy. Because CD4 T cells initiate disease, major histocompatibility complex (MHC) class II-expressing cells are central to the onset.

Use of bony landmarks for more accurate tibiofibular syndesmotic fixation: Validity and safety analysis of the angle bisector method.

Background And Aims: The Angle Bisector Method uses the cortices of the tibia and fibula as reference points and suggests a syndesmotic fixation trajectory through the bisector of the angle formed by two lines tangent to the anterior and posterior aspects of the tibia and fibula. This study aimed to assess whether the Angle Bisector Method can provide a patient- and level-specific syndesmotic fixation angle that is reproducible, safe, and independent of the surgeon in a cadaveric setting.

Methods: Twelve matched above-knee leg specimens from six cadavers, underwent syndesmotic fixation (using either screws or suture-buttons) at two levels-2 cm and 3.

Can Intermittent Teriparatide Facilitate Supraphysiological-Rate Distraction Osteogenesis? A Feasibility Study in the Rabbit Tibial Lengthening Model.

Background: Intermittent teriparatide administration is known to accelerate and promote bone healing. We wanted to investigate if intermittent teriparatide administration could facilitate supraphysiological-rate distraction osteogenesis (DO) in the rabbit tibial lengthening model without compromising on the regenerate quality.

Methods: 24 New Zealand white rabbits underwent tibial lengthening of 10 mm by distraction osteogenesis and were divided into two groups.

Effect of Distal Fragment Length on Construct Stability in an Extra-articular Distal Tibial Fracture Model Fixed With Locked Intramedullary Nailing: A Biomechanical Study.

Introduction  Fractures of the distal tibia are complex injuries with high complication rates, which include delayed union, non-union, and wound complications like dehiscence and infection. The two commonly employed definite internal fixation modalities include locked intramedullary (IM) nailing and plating. There is controversy regarding the superiority of the fixation construct, although nailing is proven to be more biological and devoid of soft tissue complications.

Postoperative Complications After Acute Achilles Tendon Rupture Repair: A Survival Analysis of Minimally Invasive vs Open Techniques.

Background: The complication rates after surgical repair of acute Achilles tendon ruptures (ATRs) using open repair or minimally invasive surgical techniques (MIS) have been debated extensively. Despite significant research, a literature hiatus exists on the timing of these complications between techniques. In this study, we aimed to address this gap by conducting a Kaplan-Meier survival analysis to compare the incidence and timing of complications after open vs MIS repair of acute ATRs and examine associated risk factors.

Talar Malunion and Non-Union.

Talar malunions can cause significant morbidity in the form of hindfoot deformity, pain, and gait abnormalities. Malunion and nonunion may coexist, making treatment more challenging. Reconstruction is feasible in cases where the talar dome cartilage is intact, avascular necrosis is minimal or partial, and no infection.

Fibular-Sided Avulsion of Posterior Inferior Tibiofibular Ligament-Patel-Sharma Fragment: A Case Report.

Case: A 30-year-old man presented with left proximal tibia fracture (open Grade 3A) and a transverse lateral malleolus fracture (Weber B) following direct impact injury. Computed tomography revealed a rare posteromedial tubercle fibula fracture at the posterior inferior tibiofibular ligament (PITFL) insertion, with syndesmosis disruption. Initial damage control included an external fixator.

A microenvironment-driven, HLA-II-associated insulin neoantigen elicits persistent memory T cell activation in diabetes.

The evolving antigenic landscape of autoimmune diabetes reflects a dynamic failure to preserve self-tolerance. Yet, how novel neoantigens emerge in humans remains incompletely understood. Here, we designed an immunopeptidomics-based approach to probe HLA-II-bound, islet-derived neoepitopes in patients with type 1 diabetes (T1D).

Comprehensive single-cell aging atlas of healthy mammary tissues reveals shared epigenomic and transcriptomic signatures of aging and cancer.

Aging is the greatest risk factor for breast cancer; however, how age-related cellular and molecular events impact cancer initiation is unknown. In this study, we investigated how aging rewires transcriptomic and epigenomic programs of mouse mammary glands at single-cell resolution, yielding a comprehensive resource for aging and cancer biology. Aged epithelial cells exhibit epigenetic and transcriptional changes in metabolic, pro-inflammatory and cancer-associated genes.

Concurrent avulsion of posterior cruciate ligament and semimembranosus: a case-based discussion and literature review.

A 30-year-old male sustained a road traffic accident and presented to our trauma centre with injuries to his pelvis and right knee. Radiology showed closed fractures of the right posterior wall and posterior column of the acetabulum and PCL bony avulsion with posteromedial tibial plateau osteochondral fracture, without any distal neurovascular deficit. He was managed with surgical intervention for both injuries.

Congruent Weber-B ankle fractures do not alter tibiotalar contact mechanics.

Current treatment strategy for managing Weber B ankle fractures is mainly governed by mortise congruency, malleolar alignment, deltoid ligament competence and fracture stability. While nonoperative treatment has yielded good functional outcomes in satisfactorily aligned stable injuries, a biomechanical rationale is not firmly established. Furthermore, current radiographic analysis is obscured by observer inaccuracy and beam rotation.

Ipsilateral fractures of the ulnar styloid with distal radius fractures; to fix or not? A systematic review and meta-analysis.

Background: The most common upper limb fracture encountered in clinical practice is distal radius fracture (DRF). They frequently occur due to falls onto an outstretched hand or other traumatic incidents, resulting in a break in the radius near the wrist joint. DRFs often present a spectrum of injuries and are a common reason for emergency department visits, affecting approximately one out of every six patients seeking medical attention in this setting.

Engineering a 3-dimensional tissue construct with adipose-derived stem cells for healing bone defect: An ex vivo study with femur head.

The compatibility of bone graft substitutes (BGS) with mesenchymal stem cells (MSCs) is an important parameter to consider for their use in repairing bone defects as it eventually affects the clinical outcome. In the present study, a few commercially available BGS - β-tricalcium phosphate (β-TCP), calcium sulfate, gelatin sponge, and different forms of hydroxyapatite (HAP) were screened for their interactions with MSCs from adipose tissue (ADSCs). It was demonstrated that HAP block favorably supported ADSC viability, morphology, migration, and differentiation compared to other scaffolds.

Irreducible Complex Posterior Elbow Dislocation with Varus Posteromedial Rotary Instability - A Case Report.

Introduction: Elbow dislocations, particularly those associated with varus posteromedial rotary instability, are relatively uncommon. We present the case of a 25-year-old male initially managed nonoperatively for a posterior elbow dislocation, who subsequently experienced irreducible re-dislocation with characteristic fractures of the anteromedial facet and tip of the coronoid, indicative of varus posteromedial rotary instability.

Case Report: Following an unsuccessful attempt at closed reduction under general anesthesia, open reduction was performed, revealing the interposition of the posterior capsule of the humero-ulnar joint as the cause of irreducibility.

Pattern of Medical Device Adverse Events in a Tertiary Care Hospital in Northern India: An Ambispective Study.

Background: Knowledge about the pattern of adverse events caused by medical devices (MDs) is limited in India. We aimed to assess the pattern of MD adverse events (MDAEs) in a tertiary hospital in Northern India.

Materials And Methods: This descriptive study was conducted ambispectively at various clinical departments of PGIMER, Chandigarh.

Parameters That Can Be Used to Quantify Reduction Accuracy in Talar Neck Fractures and Malunions: A PRISMA-Compliant Scoping Review and Meta-Analysis.

Understanding the three-dimensional anatomy of the talar neck is essential in assessing the accuracy of reduction in talar neck fractures as well as for planning surgical correction for talar malunions. However, the geometrical parameters that describe this anatomy are sparsely reported in the orthopedics literature. We aimed to identify from the existing literature, geometrical parameters that describe the anatomy of the talar neck, determine how these are measured, and their normative values.

Finger millet (Eleusine coracana) enhancement through genomic resources and breeding methods: current implications and potential future interventions.

Finger millet (Eleusine coracana) is an essential staple crop in many regions of Africa and Asia, valued for its nutritional content and resilience in challenging agro-ecological conditions. The enhancement of finger millet through genomic resources and breeding methods represents a promising avenue for addressing food and nutritional security. Current efforts in this field have harnessed genomic technologies to decipher the crop's genetic diversity and identify key traits related to yield, disease resistance, and nutritional content.

Utility of three-dimensional printing in the surgical management of intra-articular distal humerus fractures: a systematic review and meta-analysis of randomized controlled trials.

Background: Clinical outcomes after fixation of distal humerus intraarticular fractures are directly related to the quality of reduction. The use of three-dimensional (3D)-printed fracture models can benefit preoperative planning to ensure good reduction. This review aims to determine if surgery performed with 3D printing assistance are faster and result in fewer complications and improved clinical outcomes than conventional methods.

Repositioning the Early Pathology of Type 1 Diabetes to the Extraislet Vasculature.

Type 1 diabetes (T1D) is a prototypic T cell-mediated autoimmune disease. Because the islets of Langerhans are insulated from blood vessels by a double basement membrane and lack detectable lymphatic drainage, interactions between endocrine and circulating T cells are not permitted. Thus, we hypothesized that initiation and progression of anti-islet immunity required islet neolymphangiogenesis to allow T cell access to the islet.

Ankle fractures with Chaput fragment: A new classification system with insights into morphology and relation to surgical treatment.

Background: The Chaput fragment, a bony avulsion of the anterolateral margin of the distal tibia, is a less commonly discussed fracture pattern in ankle injuries. Its significance in ankle fractures and the optimal fixation technique remains unclear due to limited literature. This study aims to describe the morphology of ankle fractures with Chaput fragment and introduce a new classification system.