Search

Abstract Objectives To develop and validate a novel interpretable artificial intelligence (AI) model that integrates radiomic features, deep learning features, and imaging features at multiple semantic levels to predict the prognosis of intracerebral hemorrhage (ICH) patients at 6 months post-onset. Materials and methods Retrospectively enrolled 222 patients with ICH for Non-contrast Computed Tomography (NCCT) images and clinical data, who were divided into a training cohort (n = 186, medical center 1) and an external testing cohort (n = 36, medical center 2). Following image preprocessing, the entire hematoma region was segmented by two radiologists as the volume of interest (VOI). Pyradiomics algorithm library was utilized to extract 1762 radiomics features, while a deep convolutional neural network (EfficientnetV2-L) was employed to extract 1000 deep learning features. Additionally, radiologists evaluated imaging features. Based on the three different modalities of features mentioned above, the Random Forest (RF) model was trained, resulting in three models (Radiomics Model, Radiomics-Clinical Model, and DL-Radiomics-Clinical Model). The performance and clinical utility of the models were assessed using the Area Under the Receiver Operating Characteristic Curve (AUC), calibration curve, and Decision Curve Analysis (DCA), with AUC compared using the DeLong test. Furthermore, this study employs three methods, Shapley Additive Explanations (SHAP), Grad-CAM, and Guided Grad-CAM, to conduct a multidimensional interpretability analysis of model decisions. Results The Radiomics-Clinical Model and DL-Radiomics-Clinical Model exhibited relatively good predictive performance, with an AUC of 0.86 [95% Confidence Intervals (CI): 0.71, 0.95; P

ObjectivesTo investigate the value of interpretable machine learning model and nomogram based on clinical factors, MRI imaging features, and radiomic features to predict Ki-67 expression in primary central nervous system lymphomas (PCNSL).Materials and methodsMRI images and clinical information of 92 PCNSL patients were retrospectively collected, which were divided into 53 cases in the training set and 39 cases in the external validation set according to different medical centers. A 3D brain tumor segmentation model was trained based on nnU-NetV2, and two prediction models, interpretable Random Forest (RF) incorporating the SHapley Additive exPlanations (SHAP) method and nomogram based on multivariate logistic regression, were proposed for the task of Ki-67 expression status prediction.ResultsThe mean dice Similarity Coefficient (DSC) score of the 3D segmentation model on the validation set was 0.85. On the Ki-67 expression prediction task, the AUC of the interpretable RF model on the validation set was 0.84 (95% CI:0.81, 0.86; p

This experiment was conducted to investigate the effect of dietary calcium (Ca) or phosphorus (P) deficiency on bone development and related Ca or P metabolic utilization parameters of broilers from 22 to 42 days of age based on our previous study, which indicated that dietary Ca or P deficiency impaired the bone development by regulating related Ca or P metabolic utilization parameters of broilers from 1 to 21 days of age. A total of 504 one-day-old Arbor Acres male broilers were randomly assigned to 1 of 4 treatments with 7 replicates in a completely randomized design, and fed the normal control and Ca- or P-deficient diets from 1 to 21 days of age. At 22 days of age, the broilers were further fed the normal control diet (0.90% Ca+0.35% non-phytate P (NPP)), the P-deficient diet (0.90% Ca+0.18% NPP), the Ca-deficient diet (0.30% Ca+0.35% NPP) or the Ca and P-deficient diet (0.30% Ca+0.18% NPP), respectively. The results showed that dietary Ca or P deficiency decreased (P

Cinnamon essential oil (CEO) and its combination with bamboo leaf flavonoid (BLF) have been shown to exhibit an additive antibacterial effect in vitro, but their functions in broilers were not clear. An experiment was conducted to investigate the effects of dietary graded levels of CEO and its combination with BLF on the growth performance, immune responses, antioxidative ability, and intestinal morphology and microbiota of broilers fed a corn-soybean meal basal diet. A total of 576 1-d-old Arbor Acres commercial male broilers were randomly allotted to 9 treatments with 8 replicates of 8 birds each in a completely randomized design. Birds were fed on a basal corn-soybean meal diet (control, without plant extracts and antibiotics), or the basal diet supplemented with 50 mg of aureomycin kg−1, 50, 100, 200, 400, or 800 mg of CEO kg−1, a combination of 100 mg of CEO and 16.7 mg of BLF kg−1, or a combination of 200 mg of CEO kg−1 and 33.3 mg of BLF kg−1 for 42 d. Dietary treatment affected (P0.16) on all other measured indices. The addition of 400 mg of CEO kg−1 or a combination of 200 mg CEO kg−1 and 33.3 mg BLF kg−1 increased (P

Purpose: The distal tibiofibular syndesmosis is an important structure for ankle stability. The objective of this study was to evaluate the motion of the syndesmosis under different loading patterns and determine the characteristics of the syndesmotic motion. Methods: Six fresh cadaveric lower extremity specimens with the knee reserved were tested in this study. The skin and muscles were removed with all ligaments around the syndesmosis and knee and ankle joint intact. An axial load of 600 N was applied to the specimens with the ankle joint in 10° dorsiflexion, neutral position, and 15° plantar flexion using a universal material testing machine. Then, with the ankle joint positioned neutrally, a combination of 600-N axial and 5-Nm torsional external rotation loading was applied to the specimens. The medial–lateral and anterior–posterior displacement and rotation of the distal fibula relative to the distal tibia were measured. Results: Under the axial loading, the distal fibula tended to move medially and anteriorly and rotate internally with the ankle positioned from the neutral position to 15° plantar flexion. Meanwhile, when the ankle was positioned from the neutral position to 10° dorsiflexion, the distal fibula tended to move laterally and posteriorly and rotate externally. Under the combined loading, with respect to the isolated axial loading, the distal fibula tended to move medially and posteriorly, and rotate externally relative to the distal tibia. Conclusion: Micro motion existed in the syndesmosis. The relative motion of the syndesmosis was correlated to the ankle position and loading patterns.

ABSTRACT Objective: To investigate the effect of second toe-to-hand transfer on the plantar pressure distribution of the donor foot. Methods: Twelve normal fresh-frozen cadaveric foot specimens were subjected to an axial load of 600 N. An F-Scan plantar pressure analysis system was used to measure the forefoot plantar pressure. The testing was performed under the conditions of intact second toe, second toe removal with the second metatarsal head reserved, and second toe removal in combination with the distal one-third of the second metatarsal, respectively. Results: The peak pressure of the second metatarsal head was greater than other four forefoot plantar regions. There was no statistically significant change in the forefoot plantar pressure distribution after the second toe was removed (p > 0.05). When the second toe and the distal one-third of the second metatarsal were removed, the forefoot plantar pressure distribution changed significantly (p < 0.05). Conclusions: An intact second metatarsal is essential for the normal distribution of plantar pressure. Removal of the second toe with the second metatarsal head reserved had little influence on the plantar pressure distribution of the donor foot. Removal of the second toe and distal one-third of the second metatarsal resulted in abnormal plantar pressure distribution. Level of Evidence II, Experimental Study.

Purpose: This study aimed to investigate the therapeutic effects and complications of minimally invasive surgery in treating displaced avulsion fractures (2–3 mm) of fifth metatarsal base zone I in young adults or athletes. Methods: Forty-six patients with displaced fifth metatarsal base avulsion fractures were assigned to operative and nonoperative groups by randomization. Patients in nonoperative group were immobilized with plaster, while patients in operative group were treated with closed reduction and fixation with a percutaneous screw. Results: All patients were followed up for 14 months on average (ranging from 12 to 24 months). All cases got primary union except for three patients in nonoperative group with malunion and two with frequent mild to moderate plantar pain. The American Orthopaedic Foot and Ankle Society score was significantly better in operative group at 6 months after treatment ( p < 0.05) but not significantly different at 12 months after treatment ( p > 0.05). The average time of full weight bearing and returning to work was significantly shorter in operative group than nonoperative group ( p < 0.05). Conclusion: In young adults or athletes with displaced avulsion fractures of fifth metatarsal base zone I, closed reduction and percutaneous screw fixation provides anatomical stable fixation and early mobilization.

Objective: Posterior pilon fractures are rare injuries and have not yet gained well recognition. The purpose of this study was to present the treatment outcome for patients with posterior pilon fractures treated with buttress plate. Method: In this retrospective study we identified patients with posterior pilon fractures of the distal tibia who had undergone open reduction and internal fixation at our institute. Between January 2007 and December 2009, 10 patients (mean age, 46.5 years) who had undergone buttress plating via either a posterolateral approach or a dual posterolateral-posteromedial approach, were selected. All 10 patients were available for follow-up. The clinical outcome was evaluated with the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the visual analogue scale (VAS). The radiological evaluation was performed using the osteoarthritis-score (OA-score). Results: Satisfactory reduction and stable fixation were accomplished in all patients. At a mean follow-up of 36.2 months, all patients had good radiological results and showed satisfactory clinical recovery. The mean AOFAS sore was 87.8, the mean OA-score was 0.6, and the mean VAS scores during rest, active motion, and weight-bearing walking were 0.6, 0.8, and 1.4, respectively. Conclusion: Buttress plating for posterior pilon fractures gave satisfactory clinical outcomes. It also ensured rigid fixation which in turn enabled earlier postoperative mobilization. Level of Evidence IV, Retrospective Study.

OBJETIVO: Apresentar nossas experiências no tratamento de más uniões ou não consolidações talares. MÉTODO: Entre janeiro de 2000 e setembro de 2009, 26 pacientes com má união ou não-união depois de fraturas do tálus foram submetidos a tratamento cirúrgico de acordo com os diferentes tipos de deformidade talar. Os desfechos do tratamento foram avaliados pela escala tornozelo-retropé da AOFAS, assim como por radiografias simples. RESULTADOS: 20 pacientes ficaram disponíveis para acompanhamento por 30 (24 a 60) meses. Não houve problema de cicatrização ou infecção das feridas e foram obtidas uniões sólidas em todos os pacientes. As uniões radiológicas foram atingidas em tempo médio de 14 (faixa de 12 a 18) semanas. O tempo médio para concluir o apoio de carga foi 16 (faixa de 14 a 20) semanas. O escore AOFAS médio aumentou significantemente de 36,2 (27 a 43) para 85,8 (74 a 98). CONCLUSÃO: as intervenções cirúrgicas das fraturas mal-unidas ou não consolidadas dos tálus podem produzir resultados satisfatórios e o procedimento apropriado deve ser adotado, de acordo com diferentes tipos de deformidades pós-traumáticas. Nível de Evidência: IV, Estudo retrospectivo.

Purpose To compare the outcome following conservative or surgical treatment for displaced fracture of the medial process of the calcaneal tuberosity. Methods 14 men and 4 women aged 20 to 44 years chose to undergo conservative (9 feet) or surgical (10 feet) treatment by a single surgeon for closed displaced fracture of the medial process of the calcaneal tuberosity. The injury mechanism was a fall from a height of

OBJECTIVES: To explore the anatomy of the plantar aponeurosis (PA) and its biomechanical effects on the first metatarsophalangeal (MTP) joint and foot arch. METHODS: Anatomic parameters (length, width and thickness of each central PA bundle and the main body of the central part) were measured in 8 cadaveric specimens. The ratios of the length and width of each bundle to the length and width of the central part were used to describe these bundles. Six cadaveric specimens were used to measure the range of motion of the first MTP joint before and after releasing the first bundle of the PA. Another 6 specimens were used to evaluate simulated static weight-bearing. Changes in foot arch height and plantar pressure were measured before and after dividing the first bundle. RESULTS: The average width and thickness of the origin of the central part at the calcaneal tubercle were 15.45 mm and 2.79 mm respectively. The ratio of the length of each bundle to the length of the central part was (from medial to lateral) 0.29, 0.30, 0.28, 0.25, and 0.27, respectively. Similarly, the ratio of the widths was 0.26, 0.25, 0.23, 0.19 and 0.17. The thickness of each bundle at the bifurcation of the PA into bundles was (from medial to lateral) 1.26 mm, 1.04 mm, 0.91 mm, 0.84 mm and 0.72 mm. The average dorsiflexion of the first MTP joint increased 10.16° after the first bundle was divided. Marked acute changes in the foot arch height and the plantar pressure were not observed after division. CONCLUSIONS: The first PA bundle was not the longest, widest, or the thickest bundle. Releasing the first bundle increased the range of motion of the first MTP joint, but did not acutely change foot arch height or plantar pressure during static load testing.

Objective: To observe the effect of vitaminD3 on airway inflammation and osteopontin (OPN) expression on cough variant asthma (CVA) models. Methods: SD rats were randomly divided into blank group, model group and treatment group, each group with 10 rats. The CVA model was induced by intraperitoneal injection combined with aerosolized ovalbumin (OVA), the treatment group was given 100 mg / ml of vitaminD3 30 minutes before challenge by administered orally. Airway hyperreaction were measured by airway resistance after inhalation of acetylcholine (Ach). Wright-Gimsa staining was used to observe the inflammatory cells in bronchoalveolar lavage fluid (BALF). HE and PAS were used to observe the morphological changes of lung tissue. OPN expression was detected by immunohistochemistry. Results: 1) Airway hyperreaction: airway resistance after inhalation Ach in model group and treatment group were significantly higher than that in blank group (P <0.01), airway resistance in treatment group were lower than that in model group (P <0.01); 2) Classification of inflammatory cells: The percentage of macrophages, lymphocytes, neutrophils, and eosinophils in the BALF of the model group and the treatment group were increased compared with the blank group (P <0.01),furthermore, the number of treatment group were lower than the model group(P <0.05); 3) Morphological changes of lung tissue: a large amount of inflammatory cells and goblet cell proliferation were observed in the lung tissue of the model group, and these changes were slight in treatment group compared with model group; OPN expression in lung tissue: The expression of OPN in model and treatment group were increased compared with blank group (P <0.05), and the treatment group was lower than that of model group (P <0.05). The OPN content was positively correlated with the percentage of inflammatory cells in BALF (P < 0.05). Conclusions: Vitamin D3 can reduce airway hyperreaction and airway inflammation in CVA rats. The mechanism may be related to the intervention of OPN expression in lung tissue. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of low-frequency rTMS combined with fasudil on neurological function in patients with acute cerebral infarction and its mechanism. Method:120 patients with acute cerebral infarction admitted from January 2016 to January 2019 were randomly divided into four groups: control group (n = 30), fasudil group (n = 30), rTMS group (n = 30), fasudil + rTMS group (n = 30). The changes of NIHSS score, ADL score, serum GAP- 43, serum RhoA and serum ROCK-II were observed and recorded before and after treatment. Results: The ADL scores and serum GAP-43 levels of the four groups after treatment were higher than those before treatment (P < 0.05); the NIHSS scores, serum RhoA and serum ROCK-II levels of the four groups after treatment were lower than those before treatment (P < 0.05); After treatment, ADL score and serum GAP-43 level in fasudil+rTMS group were higher than those in other three groups (P < 0.05); After treatment, NIHSS score, serum RhoA and serum ROCK-II levels in fasudil+rTMS group were lower than those in other three groups (P < 0.05). After treatment, NIHSS score was positively correlated with RhoA and ROCK-II content, negatively correlated with GAP-43 content and ADL score. Conclusions: Low-frequency rTMS combined with fasudil in the treatment of acute cerebral infarction can significantly improve neurological deficits, improve daily living ability, promote axonal remodeling and regeneration. It may be one of its mechanisms by increasing the expression of GAP-43 in serum and reducing the expression levels of RhoA and ROCK-II in serum. It has high clinical value. [ABSTRACT FROM AUTHOR]

Traditional kernel density estimation method only depends on a given sample, in which the same weight of kernel function reduces the ability to distinguish the category of image region, though it has certain advantages in image segmentation. A novel method based on asymmetric kernel density estimation is introduced for more accurately integrating the differences among color features of samples marked by users. The method differently treats the kernel function, and the weight coefficient is introduced in the kernel density estimation function to express each kernel function's contribution to the overall estimation. Simulation experimental results show that our proposed method is more powerful in category description and distinguishing, which enhances the regional information constraints and robustness of the segmentation model and the integrity of the target region, and more accurately segments thin elongated region when compared with traditional kernel density estimation method. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Posterior Pilon Fractures: A Retrospective Case Series and Proposed Classification System." by G. Klammer et al.

The article reports on research which was conducted to investigate the outcomes of patients who had undergone a reconstruction of calcaneal fracture malunion with osteotomy and subtalar joint salvage. Researchers evaluated 24 patients with calcaneal malunions. They found that restoring the subtalar joint with a reconstructive osteotomy and autogenous bone graft was an effective treatment method for selected calcaneal fracture malunions.

The article discusses research which was conducted to investigate the biomechanical analysis of the calcaneocuboid joint pressure after sequential lengthening of the lateral column in patients with flatfoot. Researchers evaluated six cadavers. They found that lateral column lengthening within a certain extent will decrease the pressure in calcaneocuboid joint with a flatfoot deformity.

A new copolyamide, nylon 6/66/11, used for hot-melt adhesives, was prepared by hydrolytic polymerization and melt polycondensation. Intrinsic viscosity, melting point, glass transition temperature, cold crystallization, thermogravimetry (TG) and adhesion strength of the resultant hot-melt adhesives were investigated. DSC thermograms of the copolyamide showed that both the melting point and glass transition (Tg) temperatures decreased as the molar fraction of aminoundecanoic acid increased. The Tg practically did not change as the mole fraction of aminoundecanoic acid increased from 60% to 80%, but cold crystallinity of the copolyamide decreased. The thermal gravimetric analysis indicated that the resultant copolyamide had a high thermal stability. The copolyamide had the best combination of properties when the molar fraction of aminoundecanoic acid was about 65%. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Quantitative analysis of torsional stiffness in supplemental one-third tubular plate fixation in the management of isolated syndesmosis injuries: a biomeehanieal study" by T. O. Clanton in the volume 34, 2013 edition.

A letter to the editor is presented in response to the article "Mitchell's Osteotomy With Mini-Plate and Screw Fixation for Hallux Valgus" by A. M. Kalendar et al.