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Abstract Severe PM2.5 pollution threatens public health in India. Atmospheric stagnation traps emitted pollutants, worsening their health impacts. Global warming is anticipated to alter future stagnation patterns, impacting the effectiveness of air quality policies. Here, we develop a region-specific index that characterizes meteorological conditions driving stagnation and associated PM2.5 increases. Applying this index to an ensemble of climate models and global warming scenarios, we find that future stagnation changes result from both global CO2-driven circulation changes and local aerosol-driven meteorological responses. By 2100, we project an increase in winter stagnation in the Indo-Gangetic Plain (IGP) of 7 ± 3 days that leads to an increase in PM2.5 of ~7 ug/m3 in a high-warming and high-aerosol scenario. However, annual stagnation occurrences decrease across most of India. Thus, stringent air quality regulations in the IGP during winters will be critical to reduce surface PM2.5 concentrations as climate warms. Such regulations will directly improve air quality while reducing future stagnation occurrences, providing additional air quality benefits.

During the period preceding the vegetation growing season (GS), temperature emerges as the pivotal factor determining phenology in northern terrestrial ecosystems. Despite extensive research on the impact of daily mean temperature (Tmean) during the preseason period, the influence of diurnal temperature range (DTR) on vegetation photosynthetic phenology (i.e., the impact of the plant photosynthetic cycle on seasonal time scale) has largely been neglected. Using a long-term vegetation photosynthetic phenology dataset and historical climate data, we examine vegetation photosynthetic phenology dynamics and responses to climate change across the mid–high latitudes of the Northern Hemisphere from 2001 to 2020. Our data reveal an advancing trend in the start of the GS (SOS) by −0.15 days per year (days yr−1), affecting 72.1% of the studied area. This is particularly pronounced in western Canada, Alaska, eastern Asia, and latitudes north of 60°N. Conversely, the end of the GS (EOS) displays a delaying trend of 0.17 days yr−1, impacting 62.4% of the studied area, especially northern North America and northern Eurasia. The collective influence of an earlier SOS and a delayed EOS has resulted in the notably prolonged length of the GS (LOS) by 0.32 days yr−1 in the last two decades, affecting 70.9% of the studied area, with Eurasia and western North America being particularly noteworthy. Partial correlation coefficients of the SOS with preseason Tmean, DTR, and accumulated precipitation exhibited negative values in 98.4%, 93.0%, and 39.2% of the study area, respectively. However, there were distinct regional variations in the influence of climate factors on the EOS. The partial correlation coefficients of the EOS with preseason Tmean, DTR, and precipitation were positive in 58.6%, 50.1%, and 36.3% of the region, respectively. Our findings unveil the intricate mechanisms influencing vegetation photosynthetic phenology, holding crucial significance in understanding the dynamics of carbon sequestration within terrestrial ecosystems amidst climate change.

Abstract This study investigates how climate sensitivity depends upon the spatial pattern of radiative forcing. Sensitivity experiments using a coupled ocean‐atmosphere model were conducted by adding anomalous incoming solar radiation over the entire globe, Northern Hemisphere mid‐latitudes, Southern Ocean, and tropics. The varied forcing patterns led to highly divergent climate sensitivities. Specifically, the climate is nearly twice as sensitive to Southern Ocean forcing as tropical forcing. Strong coupling between the surface and free troposphere in the tropics increases the inversion strength, leading to smaller cloud feedback in the tropical forcing experiments. In contrast, the extratropics exhibit weaker coupling, a decrease or near‐zero change in the inversion strength, and strong positive cloud feedback. These results contrast with the conventional SST‐pattern effect in which tropical surface temperature changes regulate climate sensitivity. They also have important implications for other potentially asymmetric forcings, such as those from geoengineering, volcanic eruptions, and paleoclimatic changes.

Abstract Background Circular RNA (circ) AFF4 was documented to regulate osteogenesis but the underlying mechanism remains to be elucidated. The preliminary study showed that circ_AFF4 may promote osteogenesis via FNDC5/Irisin. Furthermore, the online prediction tool indicated the interaction of circ_AFF4, insulin-like growth factor-2 mRNA-binding protein 3 (IGF2BP3), FNDC5 and lysine (K)-specific demethylase 1 A (KDM1A). Therefore, this study aims to elucidate the relationships of KDM1A, circ_AFF4, IGF2BP3 and FNDC5/Irisin during osteogenesis. Methods The alkaline phosphatase (ALP) activities and osteogenic-related factors were determined using ALP and alizarin red S (ARS) staining, real-time quantitative PCR(RT-qPCR) and western blot. Immunoprecipitation (RIP), pull-down assay and fluorescence in situ hybridization (FISH) were used to examine the interactions among circ_AFF4/IGF2BP3/FNDC5. A mouse in vivo model was utilized to further confirm the regulatory effect on bone formation. Results Circ_AFF4 and KDM1A expression levels were increased during osteoinduction of BM-MSCs. Knockdown of circ_AFF4 and KDM1A significantly suppressed BM-MSC osteogenesis. We also proved that KDM1A directly bound to circ_AFF4 and FNDC5 promoter and induced circ_AFF4 and FNDC5 expression. Furthermore, circ_AFF4 enhanced the stability of FNDC5 by generating a circ_AFF4, IGF2BP3 and FNDC5 RNA-protein complex, and thereby induced Irisin and osteogenesis. The in vitro data was confirmed with in vivo model. Conclusion These findings elucidate that KDM1A induces circ_AFF4, which promotes promote osteogenesis via IGF2BP3. This study indicates that circ_AFF4 may potentially represent a critical therapeutic target for the diseases.

Abstract Ocean heat uptake (OHU) plays an important role in determining the rate of surface warming under CO2 forcing. We examined the transient response to CO2 forcing in a set of 30 climate models from Coupled Model Intercomparison Project Phase 6 (CMIP6) and found that the intermodel spread in OHU efficiency largely depends on the base‐state ocean stratification, especially in the Southern Ocean. This dependence is primarily traced to ocean salinity rather than ocean temperature. Models with weaker ocean stratification primarily due to higher upper‐ocean salinity tend to sequester heat into the deeper ocean, leading to a lower rate of surface warming, a primary reason for higher OHU efficiency; the stratification impact on total OHU is secondary. We applied the relationship between salinity and OHU efficiency for an emergent constraint on OHU efficiency, suggesting an OHU efficiency higher than the CMIP6 multimodel average and arguing against models with extremely low efficiency.

Digital devices play a critical role in preschoolers’ learning and development. Despite the evidence that digital devices use may facilitate preschoolers’ learning and development, their overuse/problematic use has become a global concern as the popularity and widespread use of digital devices. This scoping review aims to synthesize the empirical evidence to identify the status quo, influential factors, developmental outcomes, and models of overuse/problematic use in preschoolers. This search has identified 36 studies published in international peer-reviewed journals during 2001–2021, converging into four common topics: the current situation, the influential factors, the consequences, and the models. First, the average percentages of overuse and problematic use across the studies collected in this research were 48.34%, and 26.83%, separately. Second, two influential factors were identified: (1) children’s characteristics and (2) parental and family factors. Third, early digital overuse/problematic use was found to have a negative impact on the following domains: (1) physical health, (2) psychosocial health, (3) problematic behaviors, and (4) cognitive development; Fourth, most relevant studies adopted general linear models, while few of them adopted experimental designs. Finally, the implications for future studies and practical improvements are also addressed.

BackgroundsPostoperative wound complication is a major risk factor for the development of Periprosthetic joint infection. We innovatively invented a new dressing system to reduce the occurrence of postoperative wound complications and improve the quality of life of patients after total hip arthroplasty.MethodsA total of 120 patients who underwent primary unilateral total hip arthroplasty were enrolled in this study. The data collected included the number of dressing changes, costs of the dressings, postoperative hospital stay, The Visual Analogue Scale (VAS) score, The Harris Hip Score (HHS), ASEPSIS score, The Stony Brook Scar Evaluation Scale (SBSES), wound complications, the frequency of showers and satisfaction. Data were statistically analyzed.ResultsThe average number of dressing changes was 0.74 ± 0.46, while the average postoperative hospital stay was 3.67 ± 0.97 days. The average cost of the new dressings throughout a treatment cycle was 57.42 ± 15.18 dollars. The VAS score decreased from 5.63 ± 1.09 before the operation to 0.88 ± 0.54 one month after the operation. The HHS score increased from 70.18 ± 7.84 before the operation to 80.36 ± 4.08 one month after the operation. The results of the four indexes of the ASEPSIS score were all 0. The SBSES score was 3.55 ± 0.61 at two weeks after the operation, and 4.38 ± 0.71 at one month after the operation. No wound complications were recorded until one month after the operation when the satisfaction rate was 92.53 ± 3.62%.ConclusionIn this study, we have invented a new dressing system for surgical wounds after total hip arthroplasty and confirmed its efficacy.Chinese Clinical Trial RegistryChiCTR2000033822, Registered 13/ June/2020

Granite is the main material used to enhance geothermal reservoirs, and its mechanical properties play a key role in the safe and efficient development of geothermal materials. High temperature and cold shock issues are often encountered during the process of geothermal development. For this reason, numerous studies have been conducted on the mechanical properties of granite treated at different temperatures and with various cooling methods. In addition, granite is often affected by combined water-air cooling, which affects the development direction and stability of reservoir heat transfer channels. However, few studies on the mechanical properties of granite treated with combined water-air cooling have been conducted thus far. In this study, uniaxial compressive tests were conducted on granite to study the effect of localized water cooling at different temperatures and numbers of heating-cooling cycles. The results show that the thermal cracks in granite subjected to combined cooling treatments exhibited regional distribution characteristics with temperature and cycle times; there were no apparent thermal cracks at 200 °C, thermal cracks were mainly distributed in the water-cooling zone between 300 and 400 °C, and thermal cracks were distributed throughout the granite specimens above 500 °C as the number of cycles increased. Within 300 °C, the peak axial stress and Young's modulus of the granite exhibited slow linear decreasing trends with temperature and cycle times, but the peak axial stress and Young's modulus exhibited nonlinear decreasing characteristics when the temperature exceeded 400 °C. The failure mode gradually changed from brittleness to ductility. Above 500 °C, thermal cracks near the interface of the water-cooling and air-cooling zones became denser than those in the other two areas (the water-cooling and air-cooling zones) as the number of cycles increased, and the splitting failure during loading failure shifted from the water-cooling zone to the interface of water cooling and air cooling. The temperature condition for fracture and peeling between the air-cooling and water-cooling zones of the granite was 600 °C.

PurposeWe devised a novel dressing system to accelerate the recovery after total knee arthroplasty (TKA). The purpose of this study was to assess the clinical outcomes and economic expenses of the new dressing system.MethodsIn this randomized and controlled trial, we enrolled 98 patients who underwent the first unilateral TKA between September 2020 and June 2021. The patients were randomly assigned to one of two groups: the intervention (the new dressing system group) or the control (the traditional gauze dressing) group. We gathered and evaluated patient data including age, gender, body mass index, surgical side, number of dressing changes, post-operative hospital stay, dressing-related expense, satisfaction, pain and function scores, wound scores and wound-related complications.ResultsThe number of dressing changes and post-operative hospital stay in the intervention group were significantly less than in the control group (p = 0.000, p = 0.002). Satisfaction in the intervention group was significantly higher than in the control group's (p = 0.000). There were no significant differences between the two groups in dressing-related expense, pain and function scores. During the one month follow-up, the intervention group's Stony Brook Scar Evaluation Scale (SBSES) was considerably higher than the control group's (p = 0.012).ConclusionThe new dressing system can reduce the number of dressing changes and post-operative hospital stays while increasing patient satisfaction with no difference in medical costs in TKA. This wound dressing system has potential for application in TKAClinical Trial Registrationhttps://clinicaltrials.gov, identifier ChiCTR2000033814.

BackgroundAugmented reality and mixed reality have been used to help surgeons perform complex surgeries. With the development of technology, mixed reality (MR) technology has been used to improve the success rate of complex hip arthroplasty due to its unique advantages. At present, there are few reports on the application of MR technology in total knee arthroplasty. We presented a case of total knee arthroplasty with the help of mixed reality technology.Case PresentationWe presented a case of a 71-year-old woman who was diagnosed with bilateral knee osteoarthritis with varus deformity, especially on the right side. After admission, the right total knee arthroplasty was performed with the assistance of MR technology. Before the operation, the three-dimensional virtual model of the knee joint of the patient was reconstructed for condition analysis, operation plan formulation, and operation simulation. During the operation, the three-dimensional virtual images of the femur and tibia coincided with the real body of the patient, showing the osteotomy plane designed before the operation, which can accurately guide the completion of osteotomy and prosthesis implantation.ConclusionsAs far as we know, this is the first report on total knee arthroplasty under the guidance of mixed reality technology.

Abstract Background To protect and maintain the positivity of self-concept, normal people usually show a self-serving bias (internal attribution of positive events and external attribution of negative events) by the motives of self-enhancement and self-protection. Additionally, self-serving assessments predominantly activate the subcortical-cortical midline structures (CMS) in healthy individuals. However, little is known about self-serving bias and its underlying neural correlates among individuals with Internet gaming disorder (IGD). Methods Twenty-four participants with IGD and 25 recreational Internet gaming users (RGUs) were scanned while attributing the causes of positive/negative self- and other-related events that could occur in both the game-world and real-world contexts. Region-of-interest (within CMS regions) and parametric analysis were performed to investigate the neural correlates of self-serving bias in IGD. Results Behaviorally, the IGD participants attributed more negative and fewer positive events to themselves than RGU participants in both contexts. Neurally, during the attributions of negative events, the IGD participants exhibited increased ventromedial prefrontal cortex (vmPFC) activation in both contexts compared with RGU participants. Higher vmPFC activation was associated with weaker self-protective motivation in the IGD group. Meanwhile, during the attributions of positive events, the IGD participants exhibited decreased precuneus/posterior cingulate cortex activation in the real world compared with RGU participants. Parametric analysis showed a reduced positive correlation between precuneus activation and self-attribution ratings of positive events in the real world in the IGD group relative to the RGU group. Conclusion These results suggest that individuals with IGD show an attenuated self-serving bias and altered brain activity within CMS regions involved in self-attribution, providing evidence for the negative self-concept and weakened abilities in both self-enhancement and self-protection in IGD.

Abstract Background A simulation and model (SM) teaching aid using 3D printing was developed to improve a training course for total hip arthroplasty of adult developmental dysplasia of the hip (adult DDH-THA). We named this new method Surgery Simulation Teaching based on a Real Reconstruction Aid (RRA-SST). A prospective randomized comparison was performed with the traditional surgical live teaching method to evaluate the training effectiveness of RRA-SST for adult DDH-THA. Methods Twenty-six trainees, who were already practicing but were not experienced, participated in the study. We randomly divided the trainees into two groups: Group A (n = 13) received RRA-SST and group B (n = 13) received traditional surgical live teaching. A surgery simulation test and a questionnaire were used for evaluation. Next, each group received training with the other teaching method, and then the test and questionnaire were used again for evaluation. Results After the first test, the RRA-SST method was shown to produce better results than the traditional surgical live teaching method. After the second test, the results showed the training effect in both groups reached the same level, which was level as Group A RRA-SST results. Analysis of the questionnaire results showed that the training effect of RRA-SST was higher than that of traditional surgical live teaching, from multiple perspectives. Conclusions The use of RRA-SST improved participant performance according to simulation assessment. RRA-SST can be helpful for trainees who are already practicing but not experienced when developing proficiency in adult DDH-THA surgical techniques.

Abstract Background Traditional methods for minimally invasive internal fixation (MIIF) of calcaneal fractures require extensive intraoperative fluoroscopy, and fracture recovery is usually not ideal. We developed a new surgical procedure using digital surgical simulation and constructed a patient-specific instrument (PSI) for calcaneal fracture that we used during the operation. This study investigated whether PSI-assisted MIIF of calcaneal fracture enables rapid and accurate execution of the preoperative plan. Methods We retrospectively analyzed patients with Sanders type III or IV fresh calcaneal fractures who had undergone PSI-assisted MIIF at our hospital from January 2016 to December 2018. We analyzed perioperative data including intraoperative fluoroscopy time, concurrence of internal fixation actual usage (IFAU) with the preoperative plan, surgery time, and complications. We also compared pre- and postoperative actual measurements from X-ray radiographs and computed tomography images including Böhler, Gissane, and calcaneus valgus angles; subtalar joint width; and calcaneal volume overlap ratio with the preoperative design. All patients had been followed up and their American Orthopedic Foot and Ankle Score (AOFAS) score was available. Results Mean intraoperative fluoroscopy time was 3.95 ± 1.78 h; IFAU in 16 patients (16 ft) was the same as the preoperative plan; mean surgery time was 28.16 ± 10.70 min; and none of the patients developed complications. Böhler, Gissane, and calcaneus valgus angles and subtalar joint width did not differ between pre- and postoperative plans; however, the actual preoperative values of each of these parameters differed significantly from those measured postoperatively. The calcaneal volume overlap ratio with the preoperative design was 91.2% ± 2.3%. AOFAS scores increased with time, with significant differences in the score at each time point. Conclusions The newly developed PSI-assisted calcaneal fracture MIIF method can rapidly and accurately execute the preoperative plan.

Abstract Background This study aimed to examine the efficacy and safety of the arthroscopic treatment of osteochondral lesion of talus (OLT) and lateral ankle instability. It was hypothesized that the outcome of all-arthroscopic surgery was no worse than that of the combined open and arthroscopic surgery for treating chronic lateral ankle instability accompanied by OLT. Methods The patients diagnosed of chronic lateral ankle instability accompanied by OLT, who were surgically treated between May 2015 and May2017, were targeted for inclusion. Specifically, patients who received the arthroscopic treatment of OLT and lateral ankle instability were enrolled in the all-arthroscopic group, while patients who received the arthroscopic treatment of OLT and open lateral ankle stabilization were enrolled in the combined open and arthroscopic group. All the patients were followed up in terms of the Karlsson Ankle Functional Score, visual analog scale (VAS) score, Tegner activity score, and American Orthopaedic Foot & Ankle Society (AOFAS) score. Meanwhile, the satisfaction and complication rates were evaluated and compared. Results This retrospective study included a total of 67 patients, including 32 patients in the all-arthroscopic group and 35 patients in the combined group. At a minimum of 24-month follow-up, the functional outcomes were significantly improved in both groups in relation to the preoperative condition. However, the two groups did not differ significantly from each other in terms of the Karlsson score (83.1 ± 8.2 vs 81.7 ± 9.1; P = 0.89), the VAS score (1.8 ± 1.6 vs 2.1 ± 1.7; P = 0.73), the Tegner score (5.5 ± 2.3 vs 5.0 ± 2.1; P = 0.72), and the AOFAS score (87.7 ± 7.6 vs 86.9 ± 7.3; P = 0.77). In addition, the satisfaction and complication rates exhibited no significant differences between the two groups. Conclusion In comparison with the open lateral ankle stabilization and arthroscopic treatment of OLT, the all-arthroscopic procedure showed no difference in clinical outcomes at a minimum of 24-month follow-up. Despite the benefits of minimally invasive arthroscopic procedure combined with a relatively aggressive postoperative rehabilitation protocol, the clinical outcomes for patients with chronic lateral ankle instability accompanied by OLT did not yield significant improvement. Trial registration The present study was carried out with the approval issued by the Institutional Review Board of Xiangya Hospital (no. 202002010).

Abstract Background A great deal of research suggests that arthroscopic ankle fusion (AAF) has advantages over open ankle fusion (OAF), but these outcomes would be imprecise because of a selection bias. The purpose of this study is to verify which is better for ankle fusion, AAF or OAF. We regrouped the OAF group into two subgroups according to whether the osseous operation type is the same as AAF group. The goal is to minimize the impact of disease severity, thereby reducing selection bias to some extent. Methods We retrospectively analyzed the data of ankle fusion in our hospital between July 2015 and October 2018. Forty-three patients were enrolled and divided into AAF group (n = 17) and OAF group (n = 26). In order to eliminate selection bias, we divided OAF group into complex osseous operation subgroup (COO subgroup) (n = 15) and simple osseous operation subgroup (SOO subgroup) (n = 11). The osseous operation type of SOO subgroup is the same as AAF group. Then, we compared the differences between these groups. All patients were followed up at least 1 year after operation. We analyzed data, including etiology composition, surgical time, intra-op blood loss, reduction of albumin, total hospital stays, union time, fusion situation, complications, radiological examination, functional score, and questionnaire survey. Then we performed statistical analyses. Results We found that the etiological components of AAF group and OAF group were different; the etiological components of AAF group and SOO subgroup were similar. We found that AAF group has advantages over OAF group and COO subgroup in general. However, except in terms of surgical trauma, hospital stays, and short-term complications occurred, the AAF group has not obvious advantages over SOO subgroup, including intra-op blood loss, fusion condition, postoperative function score, and postoperative patient satisfaction; and AAF group need more surgical time than the SOO subgroup. Conclusions The arthroscopic ankle fusion can bring a good curative effect; however, if the osseous operation type is the same, the arthroscopic ankle fusion only has a limited advantage over the traditional open operation in perioperative soft tissue protection and enhanced recovery after surgery.

Bolted shear connectors have the advantages of being easily fitted and dismantled during construction, the initial elastic stiffness of which has a great influence on the structural performance of the connected composite structures. In this paper, the initial elastic behaviors of three types of bolted shear connectors used in steel-concrete composite structures (i.e., the bolt with nonembedded nut, the bolt with single-embedded nut, and the bolt with double-embedded nuts) are investigated using finite element analysis (FEA). After the FE models are verified against the experimental results in other literature, an extensive parametric study is carried out to investigate the effects of eight parameters of the composite structures on the initial shear stiffness and tension stiffness as well as coupling stiffness. Empirical formulas are subsequently developed for obtaining the initial elastic stiffness of the bolted shear connectors, based on which further FEA is performed. The FEA results are in good agreement with the experimental results, illustrating the effectiveness of the empirical formulas.

The Earth’s global radiation budget depends critically on the relationship between outgoing longwave radiation (OLR) and surface temperature ( $T_\mathrm{s}$ ). Using the fifth generation of European ReAnalysis dataset, we find that although OLR appears to be linearly dependent on $T_\mathrm{s}$ over a wide range, there are significant deviations from the linearity in the OLR– $T_\mathrm{s}$ relationship for regions warmer than 270 K $T_\mathrm{s}$ , which covers 89% of the surface of Earth. While the AMIP runs of CMIP6 models largely capture the overall OLR– $T_\mathrm{s}$ relationship, considerable discrepancies are found in clear-sky OLR at given $T_\mathrm{s}$ ranges. In this study, we investigate physical mechanisms that control the clear-sky OLR– $T_\mathrm{s}$ relationship seen in reanalysis and CMIP6 models by using accurate radiative transfer calculations. Our study identifies three key mechanisms to explain both the linearity and departure from linearity of the clear-sky OLR– $T_\mathrm{s}$ relationship. The first is a surface contribution, controlled by the thermal emission of the surface and the infrared opacity of the atmosphere, accounting for 60% of the observed clear-sky OLR– $T_\mathrm{s}$ linear slope. The second is changes in atmospheric emission induced by a foreign pressure effect on water vapor and other greenhouse gases, which accounts for 30% of the linear slope in a clear-sky condition. The third is changes in atmospheric emission induced by variations in relative humidity (RH), particularly in the mid-troposphere (250 to 750 hPa), which determines the non-linearity in the clear-sky OLR– $T_\mathrm{s}$ relationship and adds to the remaining 10% of the slope. The inter-model spread in mid-tropospheric RH explains a large fraction of the differences in clear-sky OLR across CMIP6 models at given surface temperatures. Furthermore, the three key mechanisms outlined here apply to the OLR– $T_\mathrm{s}$ relationship in all-sky conditions: clouds disguise the surface contribution but increase the atmospheric contribution, retaining a similar linear slope to the clear-sky condition while amplifying the non-linear curvature.

Abstract Background Several approaches to spring ligament reconstruction have been reported. However, a comparative study of nonanatomic and anatomic techniques with respect to biomechanical responses, such as kinematics and contact characteristics, has not been previously performed via a finite element analysis. The purpose of this study was to evaluate the biomechanical results of such spring ligament reconstructions via a finite element analysis. Methods A three-dimensional finite element model of the foot was developed and validated, and four reconstruction methods were simulated. The talonavicular dorsiflexion and abduction, hindfoot valgus, and contact characteristics in the Chopart joints were quantified in each model. Results Nonanatomic reconstructions corrected the talonavicular and hindfoot deformities to a greater extent than the anatomic reconstructions. The anatomic techniques also corrected the abduction and dorsiflexion deformities, although they presented insufficient power to correct for hindfoot valgus. None of the procedures restored the contact characteristics of the talonavicular and calcaneocuboid joints to those of a normal condition. Conclusion Nonanatomic reconstruction of the spring ligament complex provided the greatest correction for midfoot and hindfoot misalignments in flatfoot. Severe deformities with large amounts of midfoot pronation and hindfoot valgus may be better treated with nonanatomic reconstruction methods. The spring ligament reconstruction method may mitigate the need for nonanatomic bony procedures associated with complications and allows for the preservation of the triple joint complex.

Abstract Background It is challenging to create an ideal artificial acetabulum during total hip arthroplasty (THA) in adult DDH. Our team developed a new patient-specific instrument (PSI) that uses the superolateral rim of the acetabulum as a positioning mark to assist in the production of an artificial acetabulum in adult Crowe II/III DDH patients. The purpose of this retrospective study is to verify whether this new PSI can be used to implement the preoperative plan accurately and quickly to create an ideal artificial acetabulum during THA in adult Crowe II/III DDH patients. Methods We selected suitable adult Crowe II/III DDH patients from the registration system for artificial joint surgery at our hospital during April 2016 to March 2018 who underwent THA assisted by a PSI using the superolateral rim of the acetabulum as a positioning mark. We retrospectively analyzed data, including preoperative and postoperative anteversion, inclination, postoperative bilateral rotator center discrepancy (BRCD), surgery time, and the incidence of neurovascular injury. All patients underwent follow-up, and their Harris hip score (HHS) and X-ray data were recorded. Then, we performed statistical analyses on the data described above. Results A total of 20 hip surgeries from 17 patients were included in our study. All patients underwent a successful operation assisted by the PSI. The mean anteversion of the cup in our preoperative plan was 15.1° (range, 10.0° to 20.0°), while the mean postoperative anteversion of the cup was 15.3° (range, 7.0° to 28.6°). The mean inclination of the cup in our preoperative plan was 44.7° (range, 40.0° to 50.0°), while the mean postoperative inclination of the cup was 45.6° (range, 35.0° to 57.6°). Paired-samples t test revealed no significant differences in anteversion and inclination between pre- and postoperation times (P > 0.05). The mean BRCD was 3.38 ± 3.0 mm (range, 0.5 to 11.0 mm). The average operation time was 105.1 ± 15.4 min, and no patients had neurovascular injury complications. All patients’ acetabular components appeared clinically and radiologically stable after surgery. The mean HHS values were significantly improved at 12 weeks (P

Objective: To explore the protective effect of MP on oxidative damage in vivo and in vitro. Methods: A mouse aging model was induced by intraperitoneal injection of D-galactose (D-gal), and pathological changes in the hippocampal ultrastructure were observed by transmission electron microscopy. The activity of glutathione peroxidase (GSH-Px) and the levels of malondialdehyde (MDA) in brain tissues were evaluated with GSH-Px and MDA assay kits. An MTT assay was used to detect the viability of the model SH-SY5Y cells with H2O2-induced damage, and a lactate dehydrogenase (LDH) kit was used to evaluate LDH leakage. Reactive oxygen species (ROS) levels and cell cycle arrest were analyzed by flow cytometry, and cleaved caspase 3 and P53 protein expression was determined by western blot analysis. Results: Demonstrated that MP increased GSH-Px activity, reduced MDA levels, and attenuated the cell damage induced by H2O2. Furthermore, MP protected neuronal cells from oxidative stress through a mechanism including a decrease in LDH leakage and reversal of H2O2-induced cell morphological damage. MP treatment alleviated the H2O2-induced increases in ROS levels, inhibited apoptosis, relieved cell cycle arrest, and downregulated cleaved caspase 3 and P53 protein expression. Conclusions: MP is a novel antioxidant with neuroprotective effects.

An amendment to this paper has been published and can be accessed via the original article.

CH3NH3I, PbI2 and CH3NH3PbI3 films were fabricated by evaporation and characterized with X-ray Photoelectron Spectroscopy (XPS) and X-ray diffraction (XRD). The XPS results indicate that the PbI2 and CH3NH3PbI3 films are more uniform and stable than the CH3NH3I film. The atomic ratio of the CH3NH3I, PbI2 and CH3NH3PbI3 films are C:N:I=1.00:1.01:0.70, Pb:I= 1.00:1.91 and C: N: Pb: I = 1.29:1.07:1.00:2.94, respectively. The atomic ratio of CH3NH3PbI3 is very close to that of the ideal perovskite. Small angle x-ray diffraction results demonstrate that the as evaporated CH3NH3PbI3 film is crystalline. The valence band maximum (VBM) and work function (WF) of the CH3NH3PbI3 film are about 0.85eV and 4.86eV, respectively.