Good Rate Research Articles

Comparison of the Predictive and Prognostic Capacities of Neutrophil, Lymphocyte and Platelet Counts and Tumor-infiltrating Lymphocytes in Triple-negative Breast Cancer: Preliminary Results of the PERCEPTION Study.

Triple-negative breast cancer (TNBC) is the most heterogeneous breast cancer subtype, posing numerous challenges in clinical decision-making. Biomarkers are essential to personalize management of TNBC patients. While tumor infiltrating lymphocytes (TILs) are validated prognostic biomarkers, the requirement for tumor biopsy limits their routine use. Therefore, more accessible and reliable quantitative biomarkers are needed. Given the significant role of systemic inflammatory response in tumor onset and progression, assessing inflammatory cells via liquid biopsies emerges as a promising alternative. The PERCEPTION study, conducted at Centre Jean Perrin in France, aims to determine the correlation between TILs and peripheral blood components at diagnosis. An interim analysis was conducted after enrolling 50% of the estimated population, to evaluate study feasibility and preliminary correlations between blood cell counts and TILs. Sixty-one patients were enrolled over 4.5 years, demonstrating a good inclusion rate with minimal missing data. Preliminary results for 36 analyzable patients showed no correlation between the neutrophil-to-lymphocyte ratio (NLR) and TILs (rs=-0.19, 95%CI=-0.49-0.16, p=0.3). However, a moderate, positive, statistically significant correlation was found between NLR and the CD8/FoxP3 TILs ratio (rs=0.36, 95%CI=0.03-0.64, p=0.043). The probabilistic index of 0.7 (p=0.06) between NLR-high and NLR-low groups for this ratio supports the correlation. The interim analysis of the PERCEPTION study confirms the feasibility of correlating blood cell counts with TILs in TNBC. Although no significant correlation was observed between NLR and TILs, the moderate positive correlation between the CD8/FoxP3 ratio and TILs suggests a potential link between systemic inflammation and local immune response. These findings underscore the potential of blood-based markers as non-invasive surrogates for TILs, encouraging further research to enhance prognosis and guide treatment strategies in TNBC.

Self-adaptive reconstructed high-entropy sulfide catalysts with optimized surface electronic structure for lithium-oxygen batteries

Nonaqueous lithium-oxygen batteries have attracted immense attention owing to their high theoretical energy density. High-entropy based materials, encompassing both high-entropy alloys and high-entropy oxides (sulfides), have emerged as promising candidates for cathode catalysts. However, current fabrication methods for high-entropy materials, particularly high-entropy sulfides, remain complex and expensive. And the catalytic mechanism of high-entropy sulfides under oxygen-mediated reactions remains elusive and warrants further investigation. Herein, we propose a novel synthesis method for high-entropy sulfides, involving a hydrogel-xerogel conversion followed by a duplex treatment (low-temperature sulfuration and high-temperature calcination) processes. The synthesized (CoFeNiMnCu)9S8 high-entropy sulfide catalyst achieves elemental equilibrium and exhibits an optimized surface charge distribution. During oxygen-based battery reactions, the catalyst undergoes self-adaptive surface reconstruction, resulting in the formation of a nanoscale polycrystalline layer. This surface modification facilitates charge transfer between Co and Ni elements, and further modulates the localized electronic structure. Benefiting from the reconstructed (CoFeNiMnCu)9S8 cathode catalysts, lithium-oxygen batteries exhibit high reversible specific capacity (15100 mAh g−1), good rate capability, and enhanced long-term cycling stability.

Percutaneous hollow nail internal fixation treatment for fractures of the pubic symphysis and its adjacent areas.

To explore the percutaneous minimally invasive treatment of pubic symphysis and its adjacent fractures. Since May 2021, 13 cases of fractures involving the pubic symphysis and its adjacent parts were treated with x-ray fluoroscopic localization and percutaneous cannulated screw fixation across the symphysis pubis, the guide pin pierced the symphysis pubis and the fracture end and stopped at the inner edge of the acetabulum. Visual analogue scale (VAS) was used to evaluate the effect of the operation, and the patients were followed up. The screw insertion operation time was 25-40 min, with an average of 31.45 min; The number of perspectives is 20-40, with an average of 28.75. The average intraoperative blood loss was 10 ml, and there were no puncture complications such as nerve or vascular damage. The initial stability of the fractured end of the patient after surgery was good. The VAS score decreased from preoperative 8-10 points to postoperative 1-2 points (average of 1.5 points). The follow-up time was 3-25 months, with an average of 8.5 months. At the last follow-up, the excellent and good rate of pelvic function according to Majeed pelvic function scoring system was 100%. One patient had screws removed 1.5 years after surgery, while the remaining twelve patients did not have screws removed. All patients did not experience any discomfort symptoms caused by pubic symphysis fixation. Percutaneous hollow nail internal fixation is an effective method for treating fractures of the pubic symphysis and its adjacent parts.

Vertically stacked heterostructure in MoS2/rGO to accelerate ion diffusion kinetics for aqueous zinc ion batteries

The two-dimensional (2D) layered MoS2 is highly desirable as a host cathode material for aqueous zinc ion batteries (AZIBs) due to the typical lamellar structure bonded with weak van der Waals interlayer forces. Nevertheless, sluggish kinetics of Zn2+ diffusion in MoS2 usually leads to inferior Zn2+ storage capability. Herein, a vertically stacked heterostructure of reduced graphene oxide (rGO) and 1 T-2H phase mixed MoS2 (1 T-2H MoS2/rGO) is successfully realized through a bottom-up assembly method. The presence of graphene in the interlayer of MoS2 not only increases the interlayer spacing but also induces the phase transition of MoS2. The flower-like nanocomposite is featured with expanded interlayer spacing of 9.6 Å, abundant 1 T phase, and good hydrophilicity, which facilitate Zn2+ diffusion, charges transfer and electrolyte infiltration. Consequently, the 1 T-2H MoS2/rGO based AZIB achieves exceptional electrochemical performance: admirable specific capacity of 294.6 mAh g−1 at 0.2 A g−1, good rate capability (130.9 mAh g−1 at 4 A g−1), and excellent long-term stability (96.8 % capacity retention after 1600 cycles at 3 A g−1). Experimental and density functional theory (DFT) calculation results reveal that the vertical-stacked structure of MoS2/rGO accelerates Zn2+ diffusion kinetics and charges transfer by reducing the ions migrate energy barrier and band gap. The multiple ex situ characterizations demonstrate that the Zn2+ insertion/extraction process is accompanied by highly reversible phase transition between 2H and 1 T MoS2. This bottom-up assembly strategy can be extended to design more 2D materials with vertically stacked heterostructure as cathodes for high-performance AZIBs.

Rational Synthesis of Spongy Fe3N@N-Doped Carbon Nanorods with Controlled Topography and Porosity for Enhanced Energy Storage Anodes in Lithium-Ion Batteries.

Iron nitrides with the merits of high theoretical capacities, cost-effectiveness, and good electronic/ionic conductivity have been recognized as attractive anode candidates for lithium-ion batteries (LIBs). Carbon compositing, pore engineering, and nanostructure construction have proved to be effective strategies to prepare high-performance metal nitride anodes for LIBs. Herein, we synthesized a series of Fe3N-embedded and N-doped carbon nanorods (Fe3N@NCNR) with a hierarchical porous system and controllable topography by metal-catalyzed graphitization-nitridization of the Fe(III)-triazole framework (Fe-MOF) and thermal evaporation of the triblock copolymer F127 template assembled in Fe-MOF via hydrogen bonding interaction, followed by the air oxidation and urea-assisted ammonolysis processes. The Fe3N@NCNR as anodes for LIBs display extraordinary lithium storage capabilities with a high reversible capacity of 830 mA h g-1 at 0.1 C, a good rate performance of 576 mAh g-1 at 5 C, and a long-term cycling stability of 742 mA h g-1 over 600 cycles at 1 C. Such outstanding performance benefits from the spongy carbon nanorods with rich macropores for rapid electronic/ionic transport and effective accommodation of electrode volume expansion, abundant N-doped meso-/microporous carbon for the additional storage of Li+ via capacitive effect, and the efficient utilization of Fe3N nanoparticles uniformly distributed through carbon nanorods. Importantly, this work introduces an effective strategy to construct superior performance nitride anodes from MOF surfactants based on hydrogen bonding-driven interface self-assembly and provides insight into the preparation of highly efficient nanoarchitectures for Li+ storage.

Long-term clinical and imaging outcomes of patients undergoing percutaneous femoral intervention following TAVI-related vascular access complications

Abstract Introdcution: Vascular access complications (VAC) are the most common in-hospital adverse event following transcatheter aortic valve implantation (TAVI). Often, ileo-femoral VAC requires bail-out percutaneous interventions with either prolonged balloon inflation and/or stent implantation. The long-term outcomes of these procedures have not been characterized. We aim to assess the clinical and imaging outcomes of patients who underwent bailout percutaneous vascular interventions due to VAC following TAVI. Methods Single-centre prospective study including all consecutive patients with a VAC following trans-femoral TAVI, between 2015-July 2023. VAC was defined as uncontrolled bleeding, acute occlusion or flow limiting stenosis of the femoral vessel leading to percutaneous treatment. Clinical and imaging follow-up was performed with bilateral arterial ultrasound (US) Doppler to assess patency and peak systolic velocity of common femoral arteries. Results A total of 1518 patients underwent TF-TAVI, of which 107 (7%) underwent concomitant ileo-femoral percutaneous angioplasty (PTA) intervention in the same day as TAVI. In patients submitted to PTA, 7 were treated to gain access for TAVI, and 100 (7%) were performed to treat vascular access complications. At a mean follow-up time of 23±3 months, 37 patients died (37%), 6 (16%) from in-hospital complications and 31 (84%) from non-vascular causes after discharge. From the surviving 63 patients (study group) – mean age 83±6 years-old, 29% male, 46% with previous peripheral arterial disease –, 24 underwent bilateral US. Unable to perform imaging on 39 patients due to geographical or mobility issues. At a mean follow-up time of 30±23 months, only 6 patients (10%) reported intermittent claudication, of which 4 (67%) had pre-TAVI symptoms. No patient had at rest symptoms or amputation history. All but one had patent vessel on US. The mean peak systolic velocity of the treated vessel and the contralateral vessel were 71.1±22.9cm/s and 73.1±23.8cm/s, respectively, with no statistically significant difference between them in each patient (mean difference 1.9±25.4, p=0.709). We found no statistically significant differences between peak systolic velocities between both vessels in each patient, accordingly with the treated vessel (Table 2). Conclusion This prospective study shows that patients submitted to percutaneous bailout iliofemoral interventions have a very low rate of lower limb adverse events with very good patency rates at mean follow up of 2.5 years.

Demographic, clinical characteristics, managements strategies and in-hospital outcomes of patients enrolled in prospective nationwide SCAD registry

Abstract Spontaneous coronary artery dissection (SCAD) is an uncommon yet increasingly recognized cause of acute coronary syndrome (ACS), particularly in young to middle-aged women. This multicentric, prospective nation-wide registry aimed to elucidate the demographic characteristics, clinical presentation, management strategies, and outcomes of patients with SCAD. A total of 95 patients with SCAD were enrolled in 10 centers, with females constituting 81% of the cohort, and with an average age of 49.7±11.9 years. Among the traditional risk factors, prior hypertension was observed in 49%, followed by hyperlipidemia in 43%, diabetes mellitus in 9% and prior or current smoking in 47% of patients. The presentation of SCAD as ST-elevation myocardial infarction (STEMI) was predominant, occurring in 61% of cases, with the left anterior descending artery (LAD) being the most involved vessel (68%). Regarding the classification of SCAD, type 2 SCAD was the most frequent (53%), followed by type 1 (24%) and type 4 (16%). Notably, involvement of the distal segment of the culprit artery was observed in 68% of cases, while baseline TIMI 3 flow was noted in 52% of patients. Percutaneous coronary intervention (PCI) was performed in 52% of cases, with pre-interventional TIMI 0-2 flow (62% Vs. 28%; p<0.05) and proximal artery involvement (41% Vs. 13%; p<0.05) being more prevalent compared to conservatively managed patients. Final stent implantation was performed in 67% of PCI cases, with TIMI 3 flow restoration in 76% of patients undergoing PCI. The average left ventricular ejection fraction prior to discharge was 51±9.9%. In-hospital mortality was reported in three female patients, undergoing attempted PCI with left main and LAD involvement. The use of antiplatelet therapy was widespread, with aspirin administered to 98% and P2Y12 inhibitors to 75% of patients at discharge. Data from this prospective nationwide multicentric SCAD registry show that SCAD occurs predominantly in relatively young female patients, with moderately prevalent traditional cardiovascular risk factors, usually presents as STEMI, with good overall survival rates despite half of the patients managed conservatively. PCI was often attempted in SCAD lesion with compromised arterial flow and located proximally, with lower rates of stent implantation and procedure success compared to traditionally observed rates in primary PCI. This underscores the importance of heightened awareness and tailored management approaches for this unique subset of ACS patients in order to refine risk stratification, optimize treatment strategies, and improve outcomes in this population.

Social listening applied to tailor communication on immunization in the Republic of Moldova.

Although the Republic of Moldova had good vaccination rates, anti-vax messages have recently begun to spread, eroding the population's confidence. Vaccination coverage against measles, mumps, and rubella at the target age of 12 months decreased from 95% in 2008 to 83% in 2021. The recent measles outbreak in Romania and three confirmed cases in Moldova, combined with the refugee crisis, have highlighted the importance of vaccination and sparked online conversations on this subject. A mixed-methods study was conducted, involving social listening activities on immunization using the Talkwalker software and qualitative analysis of the identified narratives. Out of 450 identified comments, 30 were selected for further analysis. Over 5 months, a total of 865 results were obtained, with an engagement rate of 6300. The peak in results occurred between 11 and 18 December, driven by the recent measles outbreak in Romania, which saw several confirmed cases and one death, as well as the first cases of measles in Moldova after 3 years. However, no significant increase in the engagement rate was recorded. Comments on immunization tended to reflect distrust in authorities and doctors, political and ideological views, and a lack of knowledge about the risks of vaccine-preventable diseases. The analysed conversations are assessed as having a low risk of spreading, though some employ techniques to influence or manipulate behaviours. The topic of vaccination is used to promote political ideologies through messages issued by the mass media. The information vacuum must be filled with messages designed to produce attitude change regarding vaccination.

Performance and trend of core measures among oral cancer patients: A population-based cohort study

Abstract Objectives This study explores the performance and trend of core measures, which were established as evidence-based indicators to assess and improve the quality of care for oral cancer patients. Methods This retrospective cohort study uses the National Health Insurance Research Database (NHIRD), Taiwan Cancer Registry, and Cause of Death Statistics, provided by the Health and Welfare Data Science Center (HWDC), Ministry of Health and Welfare (MOHW). The study population was adult patients hospitalized for oral cancer surgery with stage I-IV between 2014 and 2021. The trend tests and the generalized linear mixed model (GLMM) were applied. Results A total of 23392 oral cancer patients were enrolled. The core measure set used in this study included five indicators (two process-related and three outcome-related indicators). Process indicators’ mean achievement rates significantly increased from 82.6% to 85.7% (p = 0.018, trend test). On the other hand, most patients demonstrated good achievement rates to the outcome indicators (98.9% to 99.3%) (p = 0.218, trend test). Overall indicators’ 100% achievement rate increased over time from 62.9% in 2014 to 66.2% in 2021 (p < 0.001, trend test). Subgroup analyses were performed by age, stage, and comorbidity score. The analysis of the GLMM revealed that the 100% achievement to overall indicators was positively associated with age<45, not-low socioeconomic status, body mass index ≥ 24, squamous cell carcinoma, recent treatment year, treated with surgery only, negative surgical margins, and receiving care in a high-volume hospital (all p < 0.01). Conclusions The results highlight a significant measurable improvement in the quality of oral cancer care. However, there is still room for enhancement in process indicator performance. Key messages • The results highlight a significant measurable improvement in the quality of oral cancer care. • There is still room for enhancement in process indicator performance.

Clinical effect of modified Henry approach in treating AO type B and C distal radius fractures

To investigate the clinical effect in treating AO type B and C distal radius fractures with modified Henry approach. Retrospectively analysis of 20 patients with AO type B and C distal radius fractures between June 2021 and May 2022, they were treated by modified Henry approach. There were 6 males and 14 females, aged from 35 to 78 years old, 8 patients on the left and 12 on the right. The patients' general data, fracture healing time, postoperative complications, last-time follow up radiographic parameters(volar inclination angle, ulnar deviation angle and radius height), wrist range of motion, range of forearm rotation and functional outcoming of the wrist joint according to Mayo scoring were observed of each patient. All patients were followed-up, the time was (13.3±2.3) months, ranged from 12 to 18 months. All the fractures were healed, the fracture healing time was (12.6±2.5) weeks, ranged from 10 to 16 weeks. There were no complications such as poor wound healing, incision infection, iatrogenic median nerve injury, delayed union, nonunion and malunion during the postoperative follow up. According to the X-ray measurement in the last-time follow up, the volar inclination angle was (11.4±4.0) °, the ulnar deviation angle was (20.9±2.2) ° and the radius height was (10.3±1.2) mm. The wrist range of motion was (65.3±5.8) ° for volar flexion, (60.2±4.2) ° for dorsal extension, (37.8±4.1) ° for ulnar deviation, (27.0±3.7) ° for radial deviation. The range of forearm rotation was(80.4±4.1) ° for pronation, (78.6±3.7) ° for supination. According to Mayo scoring, the wrist function was evaluated as excellent in 12 cases, good in 6 cases and fair in 2 cases, the excellent and good rate was 90%. Modified Henry approach can better expose the ulnar and volar fragments in distal radius, especially useful for reducting the distal radius with complex bi-columnar fractures.

Prostate Cancer, Pathophysiology and Recent Developments in Management: A Narrative Review.

Prostate cancer is the second most common cancer in men. The different stages of prostate cancer which include localised (low, intermediate, and high risk) disease, locally advanced, non-metastatic castration-resistant prostate cancer (M0 CRPCa), and metastatic disease. The main treatment of locally advanced disease is external beam radiotherapy with hormonal therapy which are associated with good prognosis. Current treatments for M0 CRPCa include androgen deprivation therapy in combination with apalutamide, darolutamide or enzalutamide, all of which are associated with good metastatic-free survival rates in clinical trials. Hormone-naive metastatic prostate cancer comprises the same treatments as M0 CRPCa, whereas further treatment includes docetaxel and abiraterone. Metastatic castration-resistant prostate cancer treatments include sipuleucel-T, radium-223, abiraterone, enzalutamide and cabazitaxel, which aim to slow down the progression of the disease and to prolong life. This article also provides insight into the development of new drugs recently approved for metastatic castration prostate cancer, which include PARP inhibitors and Lutetium-177 which have shown to have significantly good overall survival and to improve radiographic progression-free survival. In addition, new clinical trials are ongoing to test new medications such as cabozantinb and chimeric-antigen receptor T-cell therapy for the treatment of advanced prostate cancer. With the aim to slow down the progression of the disease and to prolong life, new drug developments are underway to hopefully provide a positive impact on overall survival and improve progression-free survival, especially in advanced prostate cancer.

Impressive electrochemical characteristics of freeze-dried nanosheet structured Mn2P2O7 for affordable electrochemical capacitor

The electrochemical capacitive performance of supercapacitors (SCs) is mainly evaluated by active electrode material, which plays a critical participation. At present, transitional metallic pyrophosphates (TMPs) have grabbed more interest as active electrodes in SC configuration. In this work scenario, we informed a novel strategic synthesis route for constructing Mn2P2O7 (MP) through an ultrasonic probe-assisted chemical reaction approach. The electrode in the form of a monoclinic, freeze-dried nanosheet structure characterized by XRD, FESEM- TEM, and its signature chemical bonds and chemical composition were confirmed via FTIR and EDS analysis, respectively. As prepared active sample was successfully sent into electrochemical investigation tools such as Cyclic Voltagrams (CV), Galvanostatic charge/discharge (GCD), electrochemical impedance analysis (EIS), and Cycling life span (stability) using three and two-electrode set-up. These tests indicate that the active sample holds an impressive capacitive value of 558 F/g at scanning range of 2 mV/s, a specific capacity of 420 C/g at 1 A g-1, magnificent rate capability, 90 % retention over 10,000 successive voltammograms in three-electrode measurements. Additionally, the fabricated symmetric supercapacitor device shows superior energy density, power density, and good rate capability in two electrode investigations. The mentioned prominent results reflect that engineered MP and its characteristics are the efficient fruits in manufacturing affordable electrochemical capacitors.

Comprehensive classification and its value of capitellar cartilage injury concomitant with radial head fracture

BackgroundThere are defects in the existing classification of capitellar cartilage injury (CCI) concomitant with radial head fracture (RHF). This study aimed to introduce a comprehensive classification of CCI and to analyze its surgical guidance value.MethodsAccording to the affected site and severity, CCI was classified into four types: Type I - partial-thickness loss of articular cartilage, Type II - full-thickness loss of articular cartilage, Type III - full-thickness loss of articular cartilage with subchondral bone loss, Type IV - full-thickness loss of articular cartilage with thin cortex loss on the border of the capitellum; Different types suggest different surgical methods. Between January 2017 and January 2023, this comprehensive CCI classification was applied in 31 operated patients with CCI concomitant with RHF. The ranges of motion (ROM), Mayo Elbow Performance Index (MEPI) score, Hospital for Special Surgery (HSS) score and visual analog scale (VAS) for pain, were used to evaluate the functional recovery of the affected limb.ResultsMason Type I-IV RHF accounted for 6.45%, 38.71%, 48.39%, and 6.45%, respectively. Type I-IV CCI accounted for 12.90%, 35.48%, 45.16% and 6.45%, respectively. There was no relationship between the CCI and RHF types (p > 0.05). At the end of the follow-up period of 11–26 months with an average of 16 months, the elbow flexion and extension ROM recovered to (147.39 ± 9.84)°, forearm rotation ROM recovered to (168.74 ± 11.70)°, MEPI score recovered to (89.19 ± 4.17), HSS score recovered to (88.74 ± 4.62), VAS score recovered to (0.50 ± 0.57), indicating significant differences compared to preoperative measurements (p < 0.05). According to the MEPI and HSS scores, the excellent and good rate of functional recovery was 100%.ConclusionDifferent types of CCI differ not only in pathology but also in treatment methods. Surgical strategy according to the comprehensive CCI classification introduced in this paper may lead to a satisfactory outcome.

Preparation of high strength and rigidity carbon layer on SiO material surface by dynamic CVD method using gas carbon source C2H2

The main issue in the application of silicon-based negative electrode materials is the inevitable volume expansion, leading to negative electrode material fracture, which severely impacts the performance of batteries. This study employed Chemical Vapor Deposition (CVD) (C2H2@SiO), solid-phase coating method (Pitch@SiO), and liquid-phase coating method (RGFQ@SiO) to coat the surface of SiO materials with a dense amorphous carbon structure. Material property analysis revealed that C2H2@SiO has a relatively small specific surface area (1.8 m2 g−1) and surface carbon increment (2.4 %). It exhibited high reversible specific capacity (1563.4 mAh g−1), high initial Coulombic efficiency (81.45 %), and low volume expansion rate (9.3 %). Mechanical performance testing indicated that the surface carbon layer Young's modulus of C2H2@SiO was the highest (35 GPa), suggesting that using the CVD method to obtain a dense carbon layer can enhance the structural strength of the material. Based on the electrochemical-mechanical coupling theory simulation analysis of the stress during the charge-discharge process of electrode materials, the evolution of concentration and stress field during lithium insertion process was obtained, showing that the coating can further improve the electrochemical and mechanical performance of the negative electrode materials effectively. Additionally, the negative electrode sheets fabricated using sample C2H2@SiO were assembled into 18650 cylindrical batteries, exhibiting excellent cycling performance in 1000 cycles at 25 °C with a capacity retention rate of 85.7 %, along with good rate capability and high/low-temperature performance. The conclusions of this study provide certain guidance for the design and optimization of negative electrode materials for battery electrodes.

Application of distal radius coronal bone structure matching in the treatment of distal radius fractures

To investigate the clinical effect of coronal bone structure matching(CBSM)in the treatment of distal radius fracture. A total of 39 cases of distal radius fracture between Jannary 2018 and Jannary 2022 were included in this study. Among them there were 22 males and 17 females with an average age of (48.9±16.3) years old, ranged from 22 to 65 years old. All patients were treated with open reduction and internal fixation with plates. Based on the measurement of CBSM value on the X-ray film the next day after surgery. All patients were divided into matched group and mismatched group according to the coronal bone structure matching in the normal range or not. There were 27 patients in the matched group, including 15 males and 12 females, the age ranged from 22 to 64 years old with an average of (48.0±16.2) years old. AO classification of fracture was C1 in 6 cases and C2 in 21 cases;the operation time ranged from 1 to 6 days after injury;9 cases were complicated with ulnar styloid process fracture. There were 12 patients in the mismatched group, including 7 males and 5 females;the age ranged from 22 to 65 years old with an average of (48.8±15.8) years old. AO classification of fracture was C1 in 4 cases and C2 in 8 cases;the time from injury to operation ranged from 1 to 5 days;4 cases were complicated with ulnar styloid process fracture. The X-ray films were used to evaluate fracture healing, humeral height, ulnar angle and palm tilt angle at 3 months after operation. The range of wrist motion(pronation, supination, palmar inclination and dorsiflexion), function outcomes(Gartland-Werley score) and pain levels (visual analogue scale, VAS) were compared between the two groups at the last follow-up. The average follow-up time of 39 patients were(9.5±4.3)months, ranged from 6 to 14 months. All patients healed in one stage without postoperative infection, fracture nonunion and fracture displacement occurred. Compared with match group at the last follow-up, the VAS in the mismatch group was increased[(2.5±1.3)points vs (1.6±1.0)points], the wrist pronation were decreased[(70.5±12.6)° vs (80.5±9.4)°], with statistically significant difference(P<0.05). There was no significant difference in the range of motion(supination, palmar inclination, dorsiflexion)and excellent good rate between the two groups at last follow-up after operation (P>0.05). Wrist dysfunction, limited pronation, and wrist pain may occur when the postoperative matching degree of the distal radius fracture is not within the normal range.

Catheter Exchange With Elongation of Tunnel (CEET) Procedure-A Novel Technique for Cuff Extrusion of Tunneled Dialysis Catheter: Surgical Experience and Early Outcomes.

Cuff extrusion of tunneled dialysis catheter (TDC) leads to catheter dysfunction, leading to loss of vascular access and the need for new catheter. Definitive management is to remove TDC and reinsert new catheter by new venous puncture and tunnel, which may not be possible in all cases. The study evaluated the surgical experience and early outcomes of a novel "Catheter Exchange with Elongation of Tunnel (CEET)" procedure for cuff extrusion. The retrospective study included all cases of hemodialysis with TDC with partial or complete cuff extrusion and excluded complete catheter dislodgement, tunnel infection, or any catheter related infection. All patients also underwent the CEET procedure under fluoroscopy guidance, and the clinical details and outcomes were analyzed. Eleven cases of TDC cuff extrusion underwent the CEET procedure of which three (27.2%) had previous and four (36.4%) had partial cuff extrusion, and seven cases (63.6%) had short tunnel length, which likely predisposed to cuff extrusion. CEET procedure was successful in 10 cases (success rate 90.1%) with desired position of catheter tip and good blood flow. Study population was divided into early and late cuff extrusion (≥1 month). Short tunnel length was associated with late extrusion (p = 0.05), whereas premature removal of TDC anchor sutures was associated with early cuff extrusion (p = 0.04). CEET procedure is a successful alternative technique for correction of cuff extrusion of TDC with good success rate. Premature removal of anchor sutures was associated with early cuff extrusion, whereas short tunnel length was associated with late cuff extrusion.

Comprehensive Classification of the Capitellar Injury Concurrent with Radial Head Fracture.

Capitellar injury (CI) includes capitellar cartilage injury (CCI) and capitellar fracture (CF). A comprehensive classification of CI concurrent with radial head fracture (RHF) that can guide surgical strategy is lacking in the literature. Therefore, this study aimed to introduce a comprehensive classification of CI concurrent with RHF and investigate its value. A total of 35 patients with CI concurrent with RHF confirmed by surgical exploration were retrospectively analyzed, includingmales in 19 cases and females in 16 cases. RHF was classified according to the Mason classification, and CI was classified into six types, including 3 types of CCI and CF, each based on the site and degrees of injuries (comprehensive classification method proposed in this study). The classification results were analyzed. Two radiologists were selected to independently classify the CI, and the inter- and intra-observer agreements were analyzed with kappa statistics. Mason Type I, II, III, and IV RHF accounted for 14.3%, 48.6%, 37.1%, and 0% of cases, respectively. Type I, II, III, IV, V, and VI CIs accounted for 22.9%, 34.3%, 25.7%, 11.4%, 2.9%, and 2.9% of cases, respectively. Therewas no obvious relationship between the CI and RHF types (p > 0.05). All Type I CIs underwent removal, 9 Type II CIs underwent microfracture repair, and 3 Type II CIs underwent removal. All Type III CIs underwent fixation, one Type IV CI underwent removal, and 3 Type IV CIs underwent fixation, one Type V CI underwent fixation, and one Type VI CI underwent arthroplasty. The inter- and intra-observer kappa coefficients were 0.830 ~ 0.905 and 0.805 ~ 0.892, respectively. At 12 months postoperatively, the elbow function evaluated by MEPS was 91, with an excellent and good rate of 97%. Different types of CI differ not only in pathology but also in treatment methods. The CI comprehensive classification put forth in this paper for the first time reflects different types of pathology well, with high consistency and repeatability, and can guide the selection of surgical methods, leading to satisfactory postoperative results.

Halogen-Bonding Nanoarchitectonics in Supramolecular Plasticizers for Breaking the Trade-Off between Ion Transport and Mechanical Strength of Polymer Electrolytes for High-Voltage Li-Metal Batteries.

The low ionic conductivity of poly(ethylene oxide) (PEO)-based polymer electrolytes at room temperature impedes their practical applications. The addition of a plasticizer into polymer electrolytes could significantly promote ion transport while inevitably decreasing their mechanical strength. Herein, we report a supramolecular plasticizer (SMP) to break the trade-off effect between ionic conductivity and mechanical properties in PEO-based polymer electrolytes. Accordingly, the SMP is constructed by tetraethylene glycol dimethyl ether (G4) and SbF3 through halogen bonds. The SMP-plasticized PEO electrolyte (PEO/SMP) presents a simultaneously enhanced ionic conductivity of 2.4 × 10-4 S cm-1 (25 °C) and a high mechanical strength of 8.1 MPa, compared to those of pristine PEO-based electrolytes. Benefiting from the halogen bonds between G4 and SbF3, the Li-O coordination in PEO/SMP is evidently weakened, and thus rapid Li+ transport is achieved. Furthermore, the PEO/SMP electrolyte possesses a wide electrochemical stability window of 4.5 V and, importantly, derives an inorganic-rich SEI with a low interfacial resistance on a lithium metal surface. By using PEO/SMP, the lithium-metal battery with the LiNi0.5Co0.2Mn0.3O2 cathode exhibits a good rate and long-term cycling performance with a capacity retention of 75.3% (500 cycles). This work offers a rational guideline for the design of polymer electrolytes suitable for high-performance lithium-metal batteries.

Alterations in Small Non-coding MicroRNAs (miRNAs) and the Potential Role in the Development of Aseptic Loosening After Total Hip Replacement: Study Protocol for an Observational, Cross-Sectional Study.

Total hip arthroplasty (THA) is one of the most successful and effective surgeries for the treatment of hip osteoarthritis, with good rates in terms of survival, pain relief, and patient functional recovery. Aseptic loosening (AL) accompanied by periprosthetic osteolysis (PPOL) is the most frequent late complication, accounting for almost 50% of all revision surgeries. The primary purpose of this observational, cross-sectional study is to identify alterations in small, non-coding RNAs, miRNAs, that could be involved in the pathogenesis of AL and PPOL following THA. Sixty-three patients will be included in this study and will be divided into three groups (21 in each group): Group A (control group), including patients undergoing primary THA due to degenerative hip osteoarthritis, Group B including patients without clinical and radiological evidence of PPOL/AL following primary THA, and Group C including patients with clinical and radiological evidence of PPOL and AL undergoing revision surgery following primary THA. Blood samples will be collected from all patients. Peripheral blood samples from Group A and C patients will be collected prior to surgery while synovial membrane samples will also be collected intraoperatively. Synovial membrane samples will not be collected from Group B patients since they are not candidates for any surgical intervention. The relative expression of miRNAs let-7i-5p, let-7e-5p, miR-15a-5p, miR-30a-3p, and miR-130a-3p, will be measured using real-time quantitative PCR (qRT-PCR) at baseline from all patients. The primary goal is to identify the expression of inflammation-related miRNAs that could play a role in the pathophysiology of AL and highlight the differences among patients with confirmed AL, patients with degenerative hip disease, and patients with no signs of AL following THA. The secondary goal is to use these miRNAs as biomarkers to estimate the possibility for a patient to develop AL after total hip replacement, and also as possible treatment targets. Our study has been registered with an International Standard Randomized Controlled Trial Number ID: ISRCTN25839413.

Skin feature point tracking using deep feature encodings

AbstractFacial feature tracking is a key component of imaging ballistocardiography (BCG) where accurate quantification of the displacement of facial keypoints is needed for good heart rate estimation. Skin feature tracking enables video-based quantification of motor degradation in Parkinson’s disease. While traditional computer vision algorithms like Scale Invariant Feature Transform (SIFT), Speeded-Up Robust Features (SURF), and Lucas-Kanade method (LK) have been benchmarks due to their efficiency and accuracy, they often struggle with challenges like affine transformations and changes in illumination. In response, we propose a pipeline for feature tracking, that applies a convolutional stacked autoencoder to identify the most similar crop in an image to a reference crop containing the feature of interest. The autoencoder learns to represent image crops into deep feature encodings specific to the object category it is trained upon. We train the autoencoder on facial images and validate its ability to track skin features in general using manually labelled face and hand videos of small and large motion recorded in our lab. Our evaluation protocol is comprehensive, including quantification of errors in human annotation. The tracking errors of distinctive skin features (moles) are so small that we cannot exclude the fact that they stem from the manual labelling based on a $$\chi ^2$$ χ 2 -test. With a mean error of 0.6–3.3 pixels, our method outperformed the other methods in all but one scenario. More importantly, our method was the only one that did not diverge. We also compare our method with the latest state-of-the-art transformer for feature matching by Google—Omnimotion. Our results indicate that our method is superior at tracking different skin features under large motion conditions and that it creates better feature descriptors for tracking, matching, and image registration compared to both traditional algorithms and the latest Omnimotion.