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Objectives: To detect concomitant Kaplan fibers (KF) and anterolateral ligament (ALL) injury in knees with anterior cruciate ligament (ACL) injury using magnetic resonance imaging (MRI) in both adult and pediatric patients and compare the effect of KF injury and multiple risk factors (concomitant injury to the ALL, medial collateral ligament [MCL], or anterior, central, or posterior part of the medial or lateral meniscus) on anterolateral rotatory laxity as measured by the pivot-shift test in a clinical setting. Methods: The study included 540 patients with primary ACL tears (71 pediatric patients and 469 adults) whose MRI examination and pivot-shift test were conducted within 14 days after injury. KF and ALL injury were assessed by MRI according to previously reported criteria. At the time of ACL reconstruction, the pivot-shift test was performed manually with the patient under anesthesia. Manual grading of the pivot shift was performed according to guidelines of the International Knee Documentation Committee (IKDC). Data were statistically compared between the adult and pediatric groups using the chi-square test and Fisher’s exact test (p < 0.05). Results:  Logistic regression analysis with backward elimination was used to identify risk factors associated with a high-grade pivot shift. Of the 12 initially included predictive variables, only four significantly increased the risk of a high-grade pivot shift: sex (odds ratio: 2.268 in total and 2.248 in adults), ALL disruption (odds ratio: 0.488 in total and 0.445 in adults), KF injury (odds ratio: 0.193 in pediatric patients), and injury to the posterior horn of the lateral meniscus (odds ratio: 0.545 in total and 0.559 in adults). Logistic regression analysis with backward elimination was also used to identify risk factors associated with KF injury. Of the 3 initially included predictive variables, 2 significantly increased the risk of KF injury: ALL injury (odds ratio: 0.271 in total and 0.206 in adults) and ALL disruption (odds ratio 0.267 in pediatric patients, odds ratio 0.580 in adults and 0.552 in total). Conclusions: Concomitant KF injury significantly affects the pivot-shift phenomenon in pediatric patients with acute ACL injury. These findings suggest that KFs may play an important role in controlling anterolateral rotatory knee laxity in pediatric patients.

Automated defect detection from UAV imagery of transmission lines is a challenging task due to the small size, ambiguity, and complex backgrounds of defects. This paper proposes TinyDef-DETR, a DETR-based framework designed to achieve accurate and efficient detection of transmission line defects from UAV-acquired images. The model integrates four major components: an edge-enhanced ResNet backbone to strengthen boundary-sensitive representations, a stride-free space-to-depth module to enable detail-preserving downsampling, a cross-stage dual-domain multi-scale attention mechanism to jointly model global context and local cues, and a Focaler-Wise-SIoU regression loss to improve the localization of small and difficult objects. Together, these designs effectively mitigate the limitations of conventional detectors. Extensive experiments on both public and real-world datasets demonstrate that TinyDef-DETR achieves superior detection performance and strong generalization capability, while maintaining modest computational overhead. The accuracy and efficiency of TinyDef-DETR make it a suitable method for UAV-based transmission line defect detection, particularly in scenarios involving small and ambiguous objects.

This study utilized NHANES data from 2007 to 2018 to investigate the correlation between frailty and the Conicity Index (CI) in individuals aged 60 and above in the United States. The study used NHANES data from 2007 to 2018.CI was calculated as CI = wc / [0.109 × sqrt(bw / Height)]. Frailty was assessed by the frailty index (≥ 0.25). Weighted multivariate logistic regression analysis, subgroup analyses, and interaction tests were used to investigate the connection between CI and the prevalence of frailty. Generalized additive modeling (GAM) was employed to address any non-linear patterns, and the predictive capability of CI for frailty was evaluated by receiver operating characteristic (ROC) analysis. With a 69% rise in the prevalence of frailty for every 0.1 unit increase in the fully adjusted model, the results demonstrated a strong and positive relationship between CI and frailty prevalence (OR: 1.69, 95% CI: 1.53,1.86; P < 0.001). When CI was categorized, the group with the highest CI had a significantly higher prevalence of frailty than the group with the lowest CI (OR = 2.79, 95% CI: 2.22,3.51; P < 0.001). The association between CI and prevalence of frailty was significant in all subgroups. In addition, statistically significant interactions were present in most subgroups. When the CI > reached 1.35, the GAM model demonstrated a threshold effect and a significant nonlinear connection, with a 105% rise in the prevalence of frailty for every 0.1 unit increase in CI. In the male group, CI was a significantly greater indicator of the prevalence of frailty than both BMI and WC. According to this study, frailty in older persons is substantially correlated with a higher CI. Although greater confirmation in large-scale prospective research is required, this study indicates that increased CI is a more reliable predictor of the prevalence of frailty in older men and is significantly linked with its occurrence.

This study investigated the relationship between periodontitis and the Conicity Index (C-index) in the United States. The National Health and Nutrition Examination Survey (NHANES), conducted from 2009 to 2014, found that 5233 out of 10,327 respondents aged 30 years or older had periodontitis. After adjusting for all confounding variables, the likelihood of periodontitis prevalence increased by 13% for every unit rise in the C-index (OR 1.13, 95% CI 1.05, 1.21). A three-category sensitivity analysis of the C-index revealed that the highest group had a 24% greater prevalence of periodontitis compared to the lowest group (OR 1.24, 95% CI 1.07, 1.43). There was no gender difference in the linear and positive correlation between the C-index and the prevalence of periodontitis. Subgroup analyses demonstrated no significant interactions in most subgroups. Additionally, sensitivity analyses that adjusted for missing covariates and physical activity further validated the robustness of the results, confirming that the C-index is independently associated with periodontitis prevalence. Finally, Receiver Operating Characteristic (ROC) analysis indicated that the C-index outperformed Body Mass Index (BMI) and Waist Circumference (WC) in predicting periodontitis, suggesting its potential for early screening. Overall, the C-index, as an indicator of abdominal obesity, reflects not only generalized obesity but is also independently associated with periodontitis prevalence, providing a new and potentially valuable tool for early screening. Notably, the predictive ability of the C-index for periodontitis was significantly superior to that of traditional BMI and WC, indicating higher sensitivity in the early diagnosis and assessment of periodontitis. The clinical application of the C-index can assist healthcare professionals in identifying high-risk individuals at an early stage, enabling timely interventions that may reduce the incidence of periodontitis and subsequent oral health issues.

PurposeTo investigate the perioperative complications of lateral anterior lumbar interbody fusion (LaLIF) surgery.MethodsThe participants were patients who underwent LaLIF surgery for degenerative lumbar diseases between April 2016 and November 2020. The collected data were classified into intraoperative and early-stage postoperative (1 month) complications. Intraoperative complications were subcategorized into nerve root injury, sympathetic chain injury, segmental artery injury, iliolumbar vein injury, peritoneum laceration, temporary psoas injury, endplate damage, and vertebral body fractures. Postoperative complications were subcategorized into surgical site infection, cage migration, cage subsidence and psoas major hematoma.ResultsIn the 255 included patients, 39 complications (15.3%) were reported. One patient (0.4%) had residual neurological symptoms (numbness) at the last follow-up after conservative management. The most common complications were temporary psoas injury (3.9%), followed by sympathetic chain injury (2.7%) and endplate damage (2.0%). The most frequent postoperative complication was cage migration (1.6%), followed by cage subsidence (1.2%), and surgical site infection (0.8%).ConclusionThe complication rates for LaLIF are generally low and comparable to those for conventional OLIF and XLIF that have been reported in other studies. Almost all complications were transient after LaLIF. Severe complications can be avoided by using sufficient muscle relaxant, instruments with the required characteristics and vertical trajectories in multiple steps.

Excitotoxicity represents the primary cause of neuronal death following spinal cord injury (SCI). While autophagy plays a critical and intricate role in SCI, the specific mechanism underlying the relationship between excitotoxicity and autophagy in SCI has been largely overlooked. In this study, we isolated primary spinal cord neurons from neonatal rats and induced excitotoxic neuronal injury by high concentrations of glutamic acid, mimicking an excitotoxic injury model. Subsequently, we performed transcriptome sequencing. Leveraging machine learning algorithms, including weighted correlation network analysis (WGCNA), random forest analysis (RF), and least absolute shrinkage and selection operator analysis (LASSO), we conducted a comprehensive investigation into key genes associated with spinal cord neuron injury. We also utilized protein-protein interaction network (PPI) analysis to identify pivotal proteins regulating key gene expression and analyzed key genes from public datasets (GSE2599, GSE20907, GSE45006, and GSE174549). Our findings revealed that six genes—Anxa2, S100a10, Ccng1, Timp1, Hspb1, and Lgals3—were significantly upregulated not only in vitro in neurons subjected to excitotoxic injury but also in rats with subacute SCI. Furthermore, Hspb1 and Lgals3 were closely linked to neuronal autophagy induced by excitotoxicity. Our findings contribute to a better understanding of excitotoxicity and autophagy, offering potential targets and a theoretical foundation for SCI diagnosis and treatment.

Due to recalcitrant microangiopathy and chronic infection, traditional treatments do not easily produce satisfactory results for chronic diabetic ulcers. In recent years, due to the advantages of high biocompatibility and modifiability, an increasing number of hydrogel materials have been applied to the treatment of chronic wounds in diabetic patients. Research on composite hydrogels has received increasing attention since loading different components can greatly increase the ability of composite hydrogels to treat chronic diabetic wounds. This review summarizes and details a variety of newly loaded components currently used in hydrogel composites for the treatment of chronic diabetic ulcers, such as polymer/polysaccharides/organic chemicals, stem cells/exosomes/progenitor cells, chelating agents/metal ions, plant extracts, proteins (cytokines/peptides/enzymes) and nucleoside products, and medicines/drugs, to help researchers understand the characteristics of these components in the treatment of diabetic chronic wounds. This review also discusses a number of components that have not yet been applied but have the potential to be loaded into hydrogels, all of which play roles in the biomedical field and may become important loading components in the future. This review provides a “loading component shelf” for researchers of composite hydrogels and a theoretical basis for the future construction of “all-in-one” hydrogels.

Healthcare-associated infections (HAIs) are a major problem in hospital infection control. Although HAIs can be suppressed using contact precautions, such precautions are expensive, and we can only apply them to a small fraction of patients (i.e., a limited budget). In this work, we focus on two clinical problems arising from the limited budget: (a) choosing the best patients to be placed under precaution given a limited budget to minimize the spread (the isolation problem), and (b) choosing the best patients to release when limited budget requires some of the patients to be cleared from precaution (the clearance problem). A critical challenge in addressing them is that HAIs have multiple transmission pathways such that locations can also accumulate ‘load’ and spread the disease. One of the most common practices when placing patients under contact precautions is the regular clearance of pathogen loads. However, standard propagation models like independent cascade (IC)/susceptible-infectious-susceptible (SIS) cannot capture such mechanisms directly. Hence to account for this challenge, using non-linear system theory, we develop a novel spectral characterization of a recently proposed pathogen load based model, 2-Mode-SIS model, on people/location networks to capture spread dynamics of HAIs. We formulate the two clinical problems using this spectral characterization and develop effective and efficient algorithms for them. Our experiments show that our methods outperform several natural structural and clinical approaches on real-world hospital testbeds and pick meaningful solutions.

In this study, the thermal stability and CO2 adsorption property of ZIF-8 were effectively improved by using parallel flow-drop solvothermal method. -NH2 was successfully introduced into the surface of ZIF-8 and their structures by pre-modification with polyaniline. XRD analysis shown that the intensity of ZIF-8 characteristic peak increased with the increase doped content of polyaniline, but the crystal structure of ZIF-8 remained unchanged. FTIR analysis shown that the two new peaks at 1609 and 690 cm−1 can be attributed to the -NH2 bonding of ZIF-8. TGA analysis shown that the thermal stability of NH2-ZIF-8 was 632.71 °C. SEM analysis shown that the increase of CO2 adsorption property was due to the increase of NH2-ZIF-8 cubic crystal system. It was found that BET surface area was 789.7 m2g−1, micropore volume was 0.55 cm3g−1, pore size was 0.99 nm by taking the molar ratio of metal ions to ligands being 1:2, and the molar ratios of polyaniline to metal ions being 12%.

PurposeTo analyze correlations between the realistic surgical difficulty of LaLIF and anatomic characteristics in radiographic images, in order to develop a simple classification to provide guiding information for case selection and evaluate the potential risks of the technique.MethodsNinety-six consecutive cases who underwent LaLIF surgeries at the L4-5 level with MR T2-weighted images were analyzed. A novel classification based on the anatomic relationships among the disk, great vessels, and psoas muscle was used for grouping. Clinical outcomes and realistic surgical difficulty parameters were recorded, and comparisons were made among different types of classifications.ResultsOf the 96 analyzed cases, the time of surgical exposure was significantly longer for type C than for type B, and both of these were longer than that of type A. The VAS and ODI were significantly improved at a 1-year follow-up. There was no statistically significant difference among the three types. Type C had the highest incidence of complications, while Type A had the lowest. Analyses of another 304 MRI cases obtained in outpatient clinics showed that the distribution of the three types among these cases was consistent with that of the surgical cohort.ConclusionOur novel and simple classification provides useful information for case selection. Type A provided the best indication and is most appropriate for a beginner in this technique. Type C includes the most challenging situations, which may have a high incidence of complications and require sophisticated surgical skills to achieve satisfactory outcomes and avoid approach-related complications.