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Aims: Distal femoral resection in conventional total knee arthroplasty (TKA) utilizes an intramedullary guide to determine coronal alignment, commonly planned for 5° of valgus. However, a standard 5° resection angle may contribute to malalignment in patients with variability in the femoral anatomical and mechanical axis angle. The purpose of the study was to leverage deep learning (DL) to measure the femoral mechanical-anatomical axis angle (FMAA) in a heterogeneous cohort. Methods: Patients with full-limb radiographs from the Osteoarthritis Initiative were included. A DL workflow was created to measure the FMAA and validated against human measurements. To reflect potential intramedullary guide placement during manual TKA, two different FMAAs were calculated either using a line approximating the entire diaphyseal shaft, and a line connecting the apex of the femoral intercondylar sulcus to the centre of the diaphysis. The proportion of FMAAs outside a range of 5.0° (SD 2.0°) was calculated for both definitions, and FMAA was compared using univariate analyses across sex, BMI, knee alignment, and femur length. Results: The algorithm measured 1,078 radiographs at a rate of 12.6 s/image (2,156 unique measurements in 3.8 hours). There was no significant difference or bias between reader and algorithm measurements for the FMAA (p = 0.130 to 0.563). The FMAA was 6.3° (SD 1.0°; 25% outside range of 5.0° (SD 2.0°)) using definition one and 4.6° (SD 1.3°; 13% outside range of 5.0° (SD 2.0°)) using definition two. Differences between males and females were observed using definition two (males more valgus; p < 0.001). Conclusion: We developed a rapid and accurate DL tool to quantify the FMAA. Considerable variation with different measurement approaches for the FMAA supports that patient-specific anatomy and surgeon-dependent technique must be accounted for when correcting for the FMAA using an intramedullary guide. The angle between the mechanical and anatomical axes of the femur fell outside the range of 5.0° (SD 2.0°) for nearly a quarter of patients. Cite this article: Bone Jt Open 2024;5(2):101–108.

In sodium systems, leakage is one of the safety concerns; it can cause chemical reactions, which may result in fires. There are contact and non-contact types of leak detectors, and the conventional method of non-contact type detection is by gas sampling. Because of the complexity of this method, there has always been a need for a simple gas sensor, and the resistive-type nanostructure ZnO sensor is a promising option with various advantages. In this study, a ZnO sensor was fabricated, and the concept was tested as a leak detector using a dedicated experiment facility. The experiment results showed distinctive changes in resistance with the presence of sodium aerosol under various conditions. Replacing the conventional gas sampling with the ZnO sensors is expected to enable identification of the leakage location if used as a point-wise instrumentation and to greatly reduce the total cost, making the system simple, light, and effective. For further study, more tests will be performed to evaluate the sensitivity of key parameters under various conditions.

Abstract Objective This study investigated site-specific differences in clinical factors for recurrence in patients who were newly diagnosed and treated for endometrial cancer. A model for predicting recurrence sites was generated. Methods Electronic medical records’ data were retrieved from January 2006 to December 2018 for patients who were diagnosed with endometrial cancer at the National cancer center in Korea. Recurrence sites were classified as local, regional, or distant. We used multinomial logistic regression models that modeled the log-odds for the three recurrence sites relative to non-recurrence as a linear combination of possible risk factors for the recurrence of endometrial cancer. Results The data of 611 patients were selected for analysis; there were 20, 12, and 25 cases of local, regional, and distant recurrence, respectively, and 554 patients had no recurrence. High-grade disease was associated with local recurrence; non-endometrioid histology and parametrial invasion were risk factors for regional recurrence; additionally, parametrial invasion and no lymphadenectomy were associated with distant metastasis. Conclusion We identified different risk factors specific for each type of recurrence site. Using these risk factors, we suggest that individually tailored adjuvant treatments be introduced for patients.

AimsAccurate identification of the ankle joint centre is critical for estimating tibial coronal alignment in total knee arthroplasty (TKA). The purpose of the current study was to leverage artificial intelligence (AI) to determine the accuracy and effect of using different radiological anatomical landmarks to quantify mechanical alignment in relation to a traditionally defined radiological ankle centre.MethodsPatients with full-limb radiographs from the Osteoarthritis Initiative were included. A sub-cohort of 250 radiographs were annotated for landmarks relevant to knee alignment and used to train a deep learning (U-Net) workflow for angle calculation on the entire database. The radiological ankle centre was defined as the midpoint of the superior talus edge/tibial plafond. Knee alignment (hip-knee-ankle angle) was compared against 1) midpoint of the most prominent malleoli points, 2) midpoint of the soft-tissue overlying malleoli, and 3) midpoint of the soft-tissue sulcus above the malleoli.ResultsA total of 932 bilateral full-limb radiographs (1,864 knees) were measured at a rate of 20.63 seconds/image. The knee alignment using the radiological ankle centre was accurate against ground truth radiologist measurements (inter-class correlation coefficient (ICC) = 0.99 (0.98 to 0.99)). Compared to the radiological ankle centre, the mean midpoint of the malleoli was 2.3 mm (SD 1.3) lateral and 5.2 mm (SD 2.4) distal, shifting alignment by 0.34o (SD 2.4o) valgus, whereas the midpoint of the soft-tissue sulcus was 4.69 mm (SD 3.55) lateral and 32.4 mm (SD 12.4) proximal, shifting alignment by 0.65o (SD 0.55o) valgus. On the intermalleolar line, measuring a point at 46% (SD 2%) of the intermalleolar width from the medial malleoli (2.38 mm medial adjustment from midpoint) resulted in knee alignment identical to using the radiological ankle centre.ConclusionThe current study leveraged AI to create a consistent and objective model that can estimate patient-specific adjustments necessary for optimal landmark usage in extramedullary and computer-guided navigation for tibial coronal alignment to match radiological planning.Cite this article: Bone Jt Open 2022;3(10):767–776.

Nalee Kim,1,&ast; Jason Chia-Hsien Cheng,2,&ast; Nitin Ohri,3 Wen-Yen Huang,4 Tomoki Kimura,5 Zhao Chong Zeng,6 Victor Ho Fun Lee,7 Chul Seung Kay,8 Jinsil Seong9 1Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan School of Medicine, Seoul, Republic of Korea; 2Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei City, Taiwan; 3Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; 4Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan; 5Department of Radiation Oncology, Hiroshima University Hospital, Hiroshima, Japan; 6Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China; 7Department of Radiation Oncology, The University of Hong Kong, Hong Kong; 8Department of Radiation Oncology, Jeju Halla Hospital, Jeju, Republic of Korea; 9Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea&ast;These authors contributed equally to this workCorrespondence: Jinsil Seong, Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea, Tel +82-2-2228-8095, Fax +82-2-2227-7823, Email jsseong@yuhs.acBackground/Purpose: The Asian Liver Radiation Therapy Study Group has formed a large and detailed multinational database of outcomes following stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC). Here, we explored the potential impact of HCC etiology on SBRT efficacy. Tumor control probability (TCP) models were established to estimate the likelihood of local control (LC).Methods: Data from 415 patients who were treated with SBRT for HCC were reviewed. Cox proportional hazards models were used to identify key predictors of LC. TCP models accounting for biologic effective dose (BED) and tumor diameter were generated to quantify associations between etiology and LC.Results: Cox models demonstrated that hepatitis C virus (HCV) infection was associated with favorable LC following SBRT (HR=0.52, 95% CI 0.04– 0.96, p=0.036). The 2-year LC rate for patients with HCV etiology was 88%, compared to 78% for other patients. Small tumor and high BED were also associated with favorable LC. TCP models demonstrated a 10– 20% absolute increase in predicted LC across the range of SBRT doses and tumor sizes.Conclusion: We found a novel association between HCV status and LC after SBRT for HCC that warrants further exploration. If validated in other datasets, our findings could help clinicians tailor SBRT schedules.Graphical Abstract: Keywords: tumor control probability, hepatocellular carcinoma, stereotactic body radiation therapy, hepatitis C virus

Aims: Navigation devices are designed to improve a surgeon’s accuracy in positioning the acetabular and femoral components in total hip arthroplasty (THA). The purpose of this study was to both evaluate the accuracy of an optical computer-assisted surgery (CAS) navigation system and determine whether preoperative spinopelvic mobility (categorized as hypermobile, normal, or stiff) increased the risk of acetabular component placement error. Methods: A total of 356 patients undergoing primary THA were prospectively enrolled from November 2016 to March 2018. Clinically relevant error using the CAS system was defined as a difference of > 5° between CAS and 3D radiological reconstruction measurements for acetabular component inclination and anteversion. Univariate and multiple logistic regression analyses were conducted to determine whether hypermobile (Δsacral slope(SS)stand-sit > 30°), or stiff (ΔSSstand-sit < 10°) spinopelvic mobility contributed to increased error rates. Results: The paired absolute difference between CAS and postoperative imaging measurements was 2.3° (standard deviation (SD) 2.6°) for inclination and 3.1° (SD 4.2°) for anteversion. Using a target zone of 40° (± 10°) (inclination) and 20° (± 10°) (anteversion), postoperative standing radiographs measured 96% of acetabular components within the target zone for both inclination and anteversion. Multiple logistic regression analysis controlling for BMI and sex revealed that hypermobile spinopelvic mobility significantly increased error rates for anteversion (odds ratio (OR) 2.48, p = 0.009) and inclination (OR 2.44, p = 0.016), whereas stiff spinopelvic mobility increased error rates for anteversion (OR 1.97, p = 0.028). There were no dislocations at a minimum three-year follow-up. Conclusion: Despite high reliability in acetabular positioning for inclination in a large patient cohort using an optical CAS system, hypermobile and stiff spinopelvic mobility significantly increased the risk of clinically relevant errors. In patients with abnormal spinopelvic mobility, CAS systems should be adjusted for use to avoid acetabular component misalignment and subsequent risk for long-term dislocation. Cite this article: Bone Jt Open 2022;3(6):475–484.

Kangpyo Kim, Joongyo Lee, Jinsil Seong Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of KoreaCorrespondence: Jinsil Seong, Department of Radiation Oncology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea, Tel +82-2-2228-8095, Fax +82-2-2227-7823, Email jsseong@yuhs.acPurpose: Skull base metastasis (SBM) from hepatocellular carcinoma (HCC) presents detrimental survival outcomes with cranial nerve symptoms; however, they have received little attention. This study aimed to investigate the clinical presentation and efficacy of radiation therapy (RT) in patients with SBM from HCC.Patients and Methods: We identified patients with SBM from HCC in Yonsei Cancer Center from 2005 to 2019. Image evaluations and SBM-related symptoms were reviewed. Overall survival was calculated using the Kaplan–Meier method and compared through the Log rank test. The oligometastasis group included patients with less than five foci of tumors, while the extensive metastasis group presented five or more sites.Results: The incidence of SBM from HCC was 1.5% (58/3793 patients), commonly found in the middle cranial fossa. SBM associated symptoms presented in 51 patients, and the most common were head and neck area pain, and orbital symptoms, The palliation rate after RT was 65% (24/39 patients) for overall symptoms and 83.3% (20/24 patients) for cranial nerve symptoms. In whole cohort, overall survival was analyzed, and the median overall survival of patients with oligometastasis was better than extensive metastasis (23.7 months vs 1.8 months, p < 0.001). In subgroup who received RT (39 patients), the median overall survival was 23.7 and 2.7 months for patients with oligo and extensive metastasis, respectively (p < 0.001).Conclusion: This study confirmed clinical features of SBM from HCC. Overall survival was generally poor, but patients presenting oligometastasis seemed to have possibility of relative long-term survival. Although radiation was effective in SBM-induced symptom relief, dose–response relationship in local control rate and overall survival needs further studies with larger number of patients.Keywords: hepatocellular carcinoma, skull base metastasis, oligometastasis, radiotherapy

In this study, a survival analysis of the time to death caused by coronavirus disease 2019 is presented. The analysis of a dataset from the East Asian region with a focus on data from the Philippines revealed that the hazard of time to death was associated with the symptoms and background variables of patients. Machine learning algorithms, i.e., dimensionality reduction and boosting, were used along with conventional Cox regression. Machine learning algorithms solved the diverging problem observed when using traditional Cox regression and improved performance by maximizing the concordance index (C-index). Logistic principal component analysis for dimensionality reduction was significantly efficient in addressing the collinearity problem. In addition, to address the nonlinear pattern, a higher C-index was achieved using extreme gradient boosting (XGBoost). The results of the analysis showed that the symptoms were statistically significant for the hazard rate. Among the symptoms, respiratory and pneumonia symptoms resulted in the highest hazard level, which can help in the preliminary identification of high-risk patients. Among various background variables, the influence of age, chronic disease, and their interaction were identified as significant. The use of XGBoost revealed that the hazards were minimized during middle age and increased for younger and older people without any chronic diseases, with only the elderly having a higher risk of chronic disease. These results imply that patients with respiratory and pneumonia symptoms or older patients should be given medical attention.

Background: Prior investigations of total hip arthroplasty (THA) have studied the effects of prosthetic femoral head size and stem offset on hip range of motion (ROM), impingement risk, and overall hip stability to optimize the return to activities of daily living. However, the relationship between femoral head length and hip ROM, specifically external rotation (ER), has not been evaluated. The aim of our study was to intraoperatively assess how femoral head length affects hip ROM during a posterior approach THA. Methods: Thirty-two patients undergoing a primary elective THA through a posterior approach were prospectively included. After final femoral stem insertion, femoral head trials were performed using the targeted head length, followed by the shorter (−3.0 to −3.5 mm) and longer (+3.0 to +4.0 mm) head length configurations. At each length, hip ER was measured using an intraoperative goniometer from an imageless navigation system. ER values across the three head lengths were compared using a repeated-measures analysis of variance and paired t-tests. Results: Varying femoral head lengths demonstrated a statically significant and reproducible effect on intraoperative ER range (analysis of variance; P < .001) in each patient. An increased femoral head length (mean 3.4 mm) significantly decreased (P < .001) ER range by 10.8 ± 3.3° while a shortened femoral head length (mean 3.5 mm) significantly increased (P < .001) the ER ROM by 6.0 ± 3.8°. Conclusions: The results of this study demonstrate the sensitivity of hip ROM to incremental changes in femoral head length. As ER is important for activities of daily living, inadvertent lengthening should be avoided.

Molecular tethers physically bridge transport vesicles to their target membranes as a prerequisite step for fusion. Here the authors control vesicle tethering using optogenetic approaches to study the interplay between vesicle tethering and fusion.

Kangpyo Kim,1 Tae Hyung Kim,1 Tae Hyun Kim,2 Jinsil Seong1 1Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea; 2Department of Statistics, University of Chicago, Chicago, IL, USACorrespondence: Jinsil SeongDepartment of Radiation Oncology, Yonsei University College of Medicine, Seoul, 03722, Republic of KoreaTel + 82-2-2228-8111Fax + 82-2-2227-7823Email jsseong@yuhs.acPurpose: With respect to various solid cancers, patients with oligometastasis may benefit from local therapy. However, this approach is not widely accepted for hepatocellular carcinoma. This study investigated the efficacy of local therapy for oligometastatic lesions in patients with hepatocellular carcinoma.Patients and Methods: The study included 69 hepatocellular carcinoma patients presenting with oligometastasis to the lung. Characteristics of the patients and treatment options for metastatic lesions were reviewed, and a survival analysis was performed. After propensity score matching, overall survival and progression-free survival were calculated from the time of pulmonary metastasis detection. Factors predicting prognosis were analyzed using a multivariate Cox regression analysis.Results: After propensity score matching, 58 patients with Child-Pugh grade A disease were selected. Among them, 22 patients were treated with systemic therapy alone while 36 patients received local therapy or a combination of local and systemic therapies for metastatic lesions. Survival rates were higher in patients receiving local therapy than in those receiving systemic therapy (2-year overall survival rate, 66.6 vs 31.2%, p< 0.001; 2-year progression-free survival rate, 47.0 vs 10.6%, p=0.005). In the multivariate Cox regression analysis, alpha-fetoprotein levels less than 400 ng/mL and the use of local therapy for metastatic lesions were found to be significant favorable prognostic factors.Conclusion: Local therapy for metastatic lesions improved the oncologic outcomes of patients with hepatocellular carcinoma with pulmonary oligometastasis.Keywords: HCC, local ablation therapy, oligometastasis, propensity score matching

Sojung Han,1,2 Hye Won Lee,1– 3 Jun Yong Park,1– 3 Seung Up Kim,1– 3 Do Young Kim,1– 3 Sang Hoon Ahn,1– 3 Kwang-Hyub Han,1 Jinsil Seong,4 Jong Yun Won,5 Dai Hoon Han,2,6,7,* Beom Kyung Kim1– 3,* 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; 2Yonsei Liver Center, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea; 3Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea; 4Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea; 5Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea; 6Liver Cancer Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of Korea; 7Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea*These authors contributed equally to this work.Correspondence: Dai Hoon HanDepartment of Surgery, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun–Gu, Seoul 03722, Republic of KoreaTel +82-2-2228-2139Fax +82-2-313-8289Email dhhan@yuhs.acBeom Kyung KimDepartment of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun–gu, Seoul 03722, Republic of KoreaTel +82-2-2228-1930Fax +82-2-393-6884Email beomkkim@yuhs.acBackgrounds and Aims: Molecular-targeted agents are acceptable standards to treat advanced-stage hepatocellular carcinoma (HCC), however, their therapeutic benefit, ie, sorafenib, was significantly offset in case of major vessel invasion. Liver-directed concurrent chemo-radiotherapy (LD-CCRT) provided favorable outcomes in terms of survivals and tumor shrinkage, so, we appraised its long-term therapeutic efficacy.Patients and Methods: Advanced HCC patients with portal vein invasion (main trunk or the 1st order branch) were enrolled. During a 5-week radiotherapy course, concurrent hepatic arterial infusion chemotherapy (HAIC) with 5-fluorouracil and leucovorin was administered through an implanted port on the first and last 5 days. Four weeks after LD-CCRT, a maintenance HAIC using 5-fluorouracil and cisplatin was administered every 4 weeks.Results: Among 152 patients, the objective response rates as the best response by modified Response Evaluation Criteria In Solid Tumors were 48.0% after LD-CCRT and 55.3% during subsequent HAIC maintenance. After LD-CCRT, biological responses in alpha-fetoprotein and protein induced by the absence of vitamin K or antagonist-II levels were achieved in 46.2% and 52.6%, respectively. Sixteen patients (10.5%) underwent curative resection or liver transplantation after down-staging. Median overall survival and progression-free survival were 13.5 and 6.9 months, respectively.Conclusion: LD-CCRT followed by maintenance HAIC yielded favorable survival outcomes in advanced HCC patients with major portal vein invasion. Through initial tumor reduction, LD-CCRT induced down-staging with subsequent curative treatment feasible in 10.5% of patients, resulting in long-term survival. Further prospective trials are warranted to confirm these results.Keywords: hepatocellular carcinoma, portal vein invasion, concurrent chemoradiotherapy, prognosis, response

Biology is characterized by smooth, elastic, and nonplanar surfaces; as a consequence, soft electronics that enable interfacing with nonplanar surfaces allow applications that could not be achieved with the rigid and integrated circuits that exist today. Here, we review the latest examples of technologies and methods that can replace elasticity through a structural approach; these approaches can modify mechanical properties, thereby improving performance, while maintaining the existing material integrity. Furthermore, an overview of the recent progress in wave/wrinkle, stretchable interconnect, origami/kirigami, crack, nano/micro, and textile structures is provided. Finally, potential applications and expected developments in soft electronics are discussed.

ObjectiveThis retrospective study is to evaluate the efficacy and toxicity of combination chemotherapy with etoposide and ifosfamide (ETI) in the management of pretreated recurrent or persistent epithelial ovarian cancer (EOC).MethodsPatients with recurrent or persistent EOC who had measurable disease and at least one chemotherapy regimen were to receive etoposide at a dose of 100 mg/m2/day intravenous (IV) on days 1 to 3 in combination with ifosfamide 1 g/m2/day IV on days 1 to 5, every 21 days.ResultsFrom August 2008 to August 2016, 66 patients were treated with ETI regimen. Most patients were heavily pretreated prior to ETI: 53 (80.3%) patients had received 3 or more chemotherapy regimens. The response rate (RR) of ETI chemotherapy was 18.2% and median duration of response was 6.8 months (range, 0–30). Median survival of all patients was 5 months at a median follow up of 7.2 months. Platinum-free interval (PFI) more than 6 months prior to ETI has statistically significant correlation with overall survival (OS; 9.2 vs. 5.6 months; P=0.029) and RR (34.5% vs. 5.4%; P

Precise motion control is important in robotic surgery, especially corneal surgery. This paper develops a new tension-measurement system for forceps used in corneal surgery, wherein contact force is applied only to a specific location for precise control, with precise movements detected by attaching a nano-crack sensor to the corresponding part. The nano-crack sensor used here customizes the working range and sensor sensitivity to match the strain rate of the tip of the forceps. Therefore, the tension in the suture can be sufficiently measured even at suture failure. The printed circuit board attached to the bottom of the system is designed to simultaneously collect data from several sensors, visualizing the direction and magnitude of the tension in order to inform the surgeon of how much tension is being applied. This system was verified by performing pig-corneal suturing.

We consider a stochastic frontier model in which a deviation of output from the production frontier consists of two components, a one-sided technical inefficiency and a two-sided random noise. In such a situation, we develop a semiparametric regression-based test and compare the technical efficiencies of the different decision-making unit groups, assuming that the production frontier function is the same for all the groups. Our test performs better than the previously proposed ones for the same purpose in numerical studies, and also has the theoretical advantage of working under more general assumptions. To illustrate our method, we apply the proposed test to Program for International Student Assessment (PISA) 2015 data and investigate whether an efficiency difference exists between male and female student groups at a specific age in terms of learning time and achievement in mathematics.

Studies on wearable sensors that monitor various movements by attaching them to a body have received considerable attention. Crack-based strain sensors are more sensitive than other sensors. Owing to their high sensitivity, these sensors have been investigated for measuring minute deformations occurring on the skin, such as pulse. However, existing studies have limited sensitivity at low strain range and nonlinearity that renders any calibration process complex and difficult. In this study, we propose a pre-strain and sensor-extending process to improve the sensitivity and linearity of the sensor. By using these pre-strain and sensor-extending processes, we were able to control the morphology and alignment of cracks and regulate the sensitivity and linearity of the sensor. Even if the sensor was fabricated in the same manner, the sensor that involved the pre-strain and extending processes had a sensitivity 100 times greater than normal sensors. Thus, our crack-based strain sensor had high sensitivity (gauge factor > 5000, gauge factor (GF = (△R/R0)/ε), linearity, and low hysteresis at low strain (

Development of flexible strain sensors that can be attached directly onto the skin, such as skin-mountable or wearable electronic devices, has recently attracted attention. However, such flexible sensors are generally exposed to various harsh environments, such as sweat, humidity, or dust, which cause noise and shorten the sensor lifetimes. This study reports the development of a nano-crack-based flexible sensor with mechanically, thermally, and chemically stable electrical characteristics in external environments using a novel one-step laser encapsulation (OLE) method optimized for thin films. The OLE process allows simultaneous patterning, cutting, and encapsulating of a device using laser cutting and thermoplastic polymers. The processes are simplified for economical and rapid production (one sensor in 8 s). Unlike other encapsulation methods, OLE does not degrade the performance of the sensor because the sensing layers remain unaffected. Sensors protected with OLE exhibit mechanical, thermal, and chemical stability under water-, heat-, dust-, and detergent-exposed conditions. Finally, a waterproof, flexible strain sensor is developed to detect motions around the eye, where oil and sweat are generated. OLE-based sensors can be used in several applications that are exposed to a large amount of foreign matter, such as humid or sweaty environments.

This paper details the design of a poly(dimethylsiloxane) (PDMS)-shielded waterproof crack-based stretchable strain sensor, in which the electrical characteristics and sensing performance are not influenced by changes in humidity. This results in a higher number of potential applications for the sensor. A previously developed omni-purpose stretchable strain (OPSS) sensor was used as the basis for this work, which utilizes a metal cracking structure and provides a wide sensing range and high sensitivity. Changes in the conductivity of the OPSS sensor, based on humidity conditions, were investigated along with the potential possibility of using the design as a humidity sensor. However, to prevent conductivity variation, which can decrease the reliability and sensing ability of the OPSS sensor, PDMS was utilized as a shielding layer over the OPSS sensor. The PDMS-shielded OPSS sensor showed approximately the same electrical characteristics as previous designs, including in a high humidity environment, while maintaining its strain sensing capabilities. The developed sensor shows promise for use under high humidity conditions and in underwater applications. Therefore, considering its unique features and reliable sensing performance, the developed PDMS-shielded waterproof OPSS sensor has potential utility in a wide range of applications, such as motion monitoring, medical robotics and wearable healthcare devices.

BackgroundMicrophthalmia, anophthalmia, and coloboma (MAC) spectrum disease encompasses a group of eye malformations which play a role in childhood visual impairment. Although the predominant cause of eye malformations is known to be heritable in nature, with 80% of cases displaying loss-of-function mutations in the ocular developmental genes OTX2 or SOX2, the genetic abnormalities underlying the remaining cases of MAC are incompletely understood. This study intended to identify the novel genes and pathways required for early eye development. Additionally, pathways involved in eye formation during embryogenesis are also incompletely understood. This study aims to identify the novel genes and pathways required for early eye development through systematic forward screening of the mammalian genome.ResultsQuery of the International Mouse Phenotyping Consortium (IMPC) database (data release 17.0, August 01, 2022) identified 74 unique knockout lines (genes) with genetically associated eye defects in mouse embryos. The vast majority of eye abnormalities were small or absent eyes, findings most relevant to MAC spectrum disease in humans. A literature search showed that 27 of the 74 lines had previously published knockout mouse models, of which only 15 had ocular defects identified in the original publications. These 12 previously published gene knockouts with no reported ocular abnormalities and the 47 unpublished knockouts with ocular abnormalities identified by the IMPC represent 59 genes not previously associated with early eye development in mice. Of these 59, we identified 19 genes with a reported human eye phenotype. Overall, mining of the IMPC data yielded 40 previously unimplicated genes linked to mammalian eye development. Bioinformatic analysis showed that several of the IMPC genes colocalized to several protein anabolic and pluripotency pathways in early eye development. Of note, our analysis suggests that the serine-glycine pathway producing glycine, a mitochondrial one-carbon donator to folate one-carbon metabolism (FOCM), is essential for eye formation.ConclusionsUsing genome-wide phenotype screening of single-gene knockout mouse lines, STRING analysis, and bioinformatic methods, this study identified genes heretofore unassociated with MAC phenotypes providing models to research novel molecular and cellular mechanisms involved in eye development. These findings have the potential to hasten the diagnosis and treatment of this congenital blinding disease.

Recently, much research has been focused on stretchable or flexible electronic sensors for the measurement of strain or deformation on movable and variably shaped objects. In this research, to evaluate the performance of stretchable strain sensors, we have designed an integrated evaluation system capable of simultaneously measuring the change in stress and conductance of a strain sensor. Using the designed system, we have successfully evaluated the deformation characteristics, sensing range and sensing sensitivity of a stretchable strain sensor. We believe that the developed integrated evaluation system could be a useful tool for performance evaluation of stretchable strain sensors.

We searched a database of single-gene knockout (KO) mice produced by the International Mouse Phenotyping Consortium (IMPC) to identify candidate ciliopathy genes. We first screened for phenotypes in mouse lines with both ocular and renal or reproductive trait abnormalities. The STRING protein interaction tool was used to identify interactions between known cilia gene products and those encoded by the genes in individual knockout mouse strains in order to generate a list of "candidate ciliopathy genes." From this list, 32 genes encoded proteins predicted to interact with known ciliopathy proteins. Of these, 25 had no previously described roles in ciliary pathobiology. Histological and morphological evidence of phenotypes found in ciliopathies in knockout mouse lines are presented as examples (genes Abi2, Wdr62, Ap4e1, Dync1li1, and Prkab1). Phenotyping data and descriptions generated on IMPC mouse line are useful for mechanistic studies, target discovery, rare disease diagnosis, and preclinical therapeutic development trials. Here we demonstrate the effective use of the IMPC phenotype data to uncover genes with no previous role in ciliary biology, which may be clinically relevant for identification of novel disease genes implicated in ciliopathies.

Background: Polyethylene liner exchange and bone grafting is an effective surgical option for the management of periacetabular osteolysis following total hip arthroplasty with well-fixed cups and intact liner locking mechanisms. Purpose: We aimed to evaluate the revision-free survivorship and radiographic lesion progression after polyethylene liner exchange and bone grafting is performed for periacetabular osteolysis. Methods: A systematic review of the literature was performed. We queried Medline, EMBASE, and Cochrane Library for articles published from January 1999 to January 2023 using the following keywords: "osteolysis" AND "well-fixed," "osteolysis" AND "retro-acetabular," "bone graft" AND ("retention" OR "retained" OR "stable") AND "cup," and "uncemented liner" AND "well-fixed." Results: Of 596 articles found, 9 articles were selected for final inclusion (227 cases, mean follow-up time 43.6 months). The overall cup revision rate after liner exchange was 6.6% (15 hips) due to progressive osteolysis (5 hips), aseptic loosening of the acetabular component (5 hips), dislocation (4 hips), and periprosthetic infection (1 hip). There was either radiographic resolution or regression of periacetabular osteolysis in all reported cases that provided measurements (52 hips) except 1 (1.9%) requiring revision. All studies reporting clinical outcomes indicated improved pain and functional scores. Conclusion: This systematic review found that isolated liner exchange with bone grafting for the management of periacetabular osteolysis was associated with a high revision-free survival rate (93.4%) and minimal radiographic progression (1.9%) of osteolytic lesions at short-term to medium-term follow-up. Liner exchange with bone grafting is recommended for the management of large periacetabular osteolytic lesions (> 450 mm2) in well-fixed acetabular cups. We encourage future studies to develop a grading scale for lesions to guide clinical management and risk stratification for patients. [ABSTRACT FROM AUTHOR]

One of the most compelling characteristics of controlled pro-cessing is our limitation to exercise it. Theories of control allo-cation account for such limitations by assuming a cost of con-trol that constrains how much cognitive control is allocated toa task. However, this leaves open the question of why sucha cost would exist in the first place. Here, we use neural net-work simulations to test the hypothesis that constraints on cog-nitive control may reflect an optimal solution to the stability-flexibility dilemma: allocating more control to a task results ingreater activation of its neural representation but also in greaterpersistence of this activity upon switching to a new task, yield-ing switch costs. We demonstrate that constraints on controlimpair performance of any given task but reduce performancecosts associated with task switches. Critically, we show thatoptimal control constraints are higher in environments with ahigher probability of task switches.

Background: Palmoplantar pustulosis (PPP) and pompholyx are chronic diseases characterized by pustules and vesicles on the palms and soles. These disorders often have similar clinicopathological features, which lead to diagnostic difficulties. We aimed to investigate the expression patterns of keratins and involucrin in PPP and pompholyx using immunohistochemical staining. Methods: Skin biopsies from patients with PPP (n = 40) and pompholyx (n = 22) were immunohistochemically analyzed for Keratin 5, 9, 14, and involucrin expression. Results: K5 expression was higher in PPP than in pompholyx, with diffusely positive expression in the basal, spinous, and granular layers. K14 expression did not differ between groups. K9 expression was observed near the pompholyx vesicle (P = 0.014) and stratum spinosum (P < 0.001) but was almost absent around PPP pustules. Involucrin expression was diffused around the PPP pustules and partially around the pompholyx vesicles, but without statistical significance (P = 0.123). Involucrin expression was elevated in the basal layer of the PPP compared with that in the pompholyx (P = 0.023). Conclusion: PPP and pompholyx exhibited distinctive differentiation in the expression of K5, K9, and involucrin. [ABSTRACT FROM AUTHOR]