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Abstract Aims Following Failed Internal Fixation of Intertrochanteric Fractures (FIF-ITF), the choice of treatment remains a clinical challenge. This study introduces a novel classification system to guide the selection of femoral prostheses in hip arthroplasty (HA) and validates its clinical efficacy. Methods Retrospectively, we analyzed 108 cases from three university-affiliated hospitals between December 2012 and February 2023 involving patients who underwent hip arthroplasty due to Failed Internal Fixation of Intertrochanteric Fractures (FIF-ITF). Patients were classified into three categories based on fracture healing, proximal femoral support, and the severity of femoral cortical defects, with subtypes identified. Surgical outcomes and complication rates were compared between the Classification-based Decision Group and the Non-classification Decision Group. Results The Classification-based Decision Group did not differ significantly from the Non-classification Decision Group in operation time, blood loss, or the use of cemented stems. However, the classification system markedly reduced the risk of periprosthetic fractures intraoperatively from 22.5 to 4.4% and postoperatively from 10 to 1.4%. The Classification-based Decision Group also demonstrated higher postoperative Harris Hip Score (HHS) and Visual Analog Scale (VAS) scores. Conclusion The proposed classification system serves as an innovative clinical tool for femoral prosthesis selection in hip arthroplasty post-FIF-ITF, effectively reducing complications and enhancing hip function in the Classification-based Decision Group, underscoring its significant clinical utility.

Abstract Microparticle manipulation is a critical concern across various fields including microfabrication, flexible electronics and tissue engineering. Acoustic-activated sharp structures have been designed as simple and flexible tools to manipulate microparticles with their good compatibility, fast response, and broad tunability. However, there still lacks rational acoustic-structure design for effective energy concentration at the acoustic-activated sharp structures for microparticle manipulation. Here, we present the acoustic black hole (ABH) effect as enhancement for the acoustic micro-manipulator. It provides great reliability, simplicity and ease of use, supporting custom design of high-throughput patterning modes. Moreover, compared to commonly used configurations, such as cylindrical or conical microneedles, those microneedles with ABH profile exhibit superior acoustic energy focusing at the tip and induce stronger acoustofluidic effects. The average acoustic flow velocity induced by the ABH microneedle is 154 times greater than that of the conical one and 45 times greater than that of the cylindrical microneedle. Besides, the average acoustic radiation force (ARF) produced by the ABH microneedle against acrylic microparticles is about 319 times greater than that of the cylindrical one and 16 times greater than that of the conical one. These results indicate that ABH design significantly enhances microparticle manipulation. We demonstrate this concept with ABH effect enhanced microparticle manipulation and study the parameters influencing its performance including operating frequency, operating voltage and particle diameter. Furthermore, considering the flexibility of this system, we employ it for various patterning and high-throughput microparticle manipulation. This work paves the way for controllable microparticle manipulation, holding great potential for applications in microfabrication and biomedicine.

Abstract Background Research has elucidated that homeobox B9 (HOXB9), an important transcriptional activator, plays a pivotal role in promoting the invasion and metastasis of hepatocellular carcinoma (HCC) cells. However, the mechanism by which HOXB9 promotes the invasion and metastasis of HCC cells is incompletely understood and needs further exploration. Methods HOXB9 and snail family transcriptional repressor 2 (SNAI2) expression were analyzed using qRT-PCR and western blotting. The invasion and metastasis of hepatocellular carcinoma (HCC) cells were investigated using in vitro and in vivo assays. The H3K27me3 enrichment and HOXB9 interaction with microRNA 203a (MIR203A) or SNAI2 were detected using ChIP-qPCR. Transcriptional activities of SNAI2 and MIR203A promoter were detected using dual-luciferase reporter assays. Co-IP and GST pull-down assays were performed to confirm the binding between HOXB9 and EZH2. Results HOXB9 and SNAI2 were highly expressed in HCC tissues and their expression was positively intercorrelated and associated with poor prognosis in patients with HCC. In vitro and in vivo experiments confirmed that HOXB9 can upregulate the expression of SNAI2 to promote the invasion and metastasis of HCC cells. Furthermore, HOXB9 elevated SNAI2 expression by inhibiting MIR203A expression, a tumor suppressor gene, in HCC cells. Mechanistically, HOXB9 recruited enhancer of zeste 2 polycomb repressive complex 2 subunit (EZH2) through interaction with its WD-binding domain, which increased EZH2-mediated histone H3 lysine 27 trimethylation (H3K27me3) at the MIR203A promoter region, in turn repressing the transcriptional activity and expression of MIR203A and consequently increasing the SNAI2 level in HCC cells. Finally, empirical evidence from in vitro and in vivo studies confirmed that mitigation of the HOXB9-mediated enhancement of epigenetic silencing of MIR203A inhibited SNAI2 expression, impeding the invasion and metastasis of HCC cells. Conclusions Our study reveals a novel mechanism by which HOXB9 promotes the invasion and metastasis of HCC cells and expands the understanding of the function of HOXB9 in tumor progression and provides a novel therapeutic strategy for curtailing HCC invasion and metastasis.

Abstract Pancreatic cancer (PC) is a highly malignant solid tumor whose resistance to gemcitabine (GEM) chemotherapy is a major cause of poor patient prognosis. Although PC is known to thrive on malnutrition, the mechanism underlying its chemotherapy resistance remains unclear. The current study analyzed clinical tissue sample databases using bioinformatics tools and observed significantly upregulated expression of the deubiquitinase STAMBP in PC tissues. Functional experiments revealed that STAMBP knockdown remarkably increases GEM sensitivity in PC cells. Multiple omics analyses suggested that STAMBP enhances aerobic glycolysis and suppresses mitochondrial respiration to increase GEM resistance in PC both in vitro and in vivo. STAMBP knockdown decreased PDK1 levels, an essential regulator of the aerobic glycolytic process, in several cancers. Mechanistically, STAMBP promoted the PDK1-mediated Warburg effect and chemotherapy resistance by modulating E2F1 via direct binding to E2F1 and suppressing its degradation and ubiquitination. High-throughput compound library screening using three-dimensional protein structure analysis and drug screening identified the FDA drug entrectinib as a potent GEM sensitizer and STAMBP inhibitor, augmenting the antitumor effect of GEM in a patient-derived xenograft (PDX) model. Overall, we established a novel mechanism, via the STAMBP–E2F1–PDK1 axis, by which PC cells become chemoresistant in a nutrient-poor tumor microenvironment.

Aims: This aim of this study was to analyze the detection rate of rare pathogens in bone and joint infections (BJIs) using metagenomic next-generation sequencing (mNGS), and the impact of mNGS on clinical diagnosis and treatment. Methods: A retrospective analysis was conducted on 235 patients with BJIs who were treated at our hospital between January 2015 and December 2021. Patients were divided into the no-mNGS group (microbial culture only) and the mNGS group (mNGS testing and microbial culture) based on whether mNGS testing was used or not. Results: A total of 147 patients were included in the no-mNGS group and 88 in the mNGS group. The mNGS group had a higher detection rate of rare pathogens than the no-mNGS group (21.6% vs 10.2%, p = 0.016). However, the mNGS group had lower rates of antibiotic-related complications, shorter hospital stays, and higher infection control rates compared with the no-mNGS group (p = 0.017, p = 0.003, and p = 0.028, respectively), while there was no significant difference in the duration of antibiotic use (p = 0.957). In culture-negative cases, the mNGS group had lower rates of antibiotic-related complications, shorter hospital stays, and a higher infection control rate than the no-mNGS group (p = 0.036, p = 0.033, p = 0.022, respectively), while there was no significant difference in the duration of antibiotic use (p = 0.748). Conclusion: mNGS improves detection of rare pathogens in BJIs. mNGS testing reduces antibiotic-related complications, shortens hospital stay and antibiotic use duration, and improves treatment success rate, benefits which are particularly evident in culture-negative cases. Cite this article: Bone Joint Res 2024;13(8):401–410.

Objective The management of the infrapatellar fat pad (IPFP) during total knee arthroplasty (TKA) remains controversial. This study aimed to evaluate a novel IPFP preservation technique—“the medially pedicled IPFP flap”—for reducing postoperative pain, wound complications, and improving functional recovery after TKA. Methods A retrospective analysis was conducted on TKA cases at our institution from 2018 to 2021, including those with IPFP preservation (medially pedicled flap) versus IPFP complete resection. Patient demographics, perioperative parameters (blood loss, operative time, length of hospital stay, visual analogue scale [VAS] score, white cell count [WBC], C‐reactive protein [CRP], erythrocyte sedimentation rate [ESR], and wound oozing), and postoperative follow‐up data (VAS, Knee Society [KSS], or Knee Society functional assessment [KSFA] scores) were compared between groups. Independent sample t‐tests were used to compare continuous data and chi‐squared tests were used to compare categorical data between groups. Results Six hundred thirty patients were included, with 278 in the medial pedicled IPFP flap group (preservation group) and 352 in the IPFP resection group (resection group). The operative time was significantly shorter in the preservation versus resection group (125.5 ± 23.2 vs 130.3 ± 28.7 mins, p = 0.03), as was the length of hospital stay (8.4 ± 2.7 vs 9.2 ± 2.3 days, p

Abstract The Apple polysaccharides (AP), extracted from the fruit of apple, has been used to treat multiple pathological diseases. In this study, we evaluated the effects of AP on cognitive impairment and intestinal aging in naturally aging mice. As a result, it was found that AP could improve spatial learning and memory impairment in aging mice through the Morris water maze experiment. Additionally, AP intervention can upregulate the expression of nerve growth factor (BDNF), postsynaptic marker (PSD95), and presynaptic marker (SYP) proteins. Moreover, AP can enhance total antioxidant capacity, reduce the level of pro-inflammatory cytokine, and inhibit the activation of the NF-κB signaling pathway, exerting anti-inflammatory and antioxidant functions. And the administration of AP restored intestinal mucosal barrier function, reduced the expression of aging and apoptosis related proteins. The administration of AP also altered the gut microbiota of mice. At the genus level, AP decreased the abundance of Helicobacter and Bilophila, while increased the abundance of Lactobacillus and Bacteroides. In summary, these data demonstrate that AP treatment can alleviate cognitive impairment, oxidative stress, and inflammatory reactions, repair the intestinal mucosal barrier, reduce intestinal aging, and alter specific microbial characteristics, ultimately improving the health of the elderly.

Aims: To explore the clinical efficacy of using two different types of articulating spacers in two-stage revision for chronic knee periprosthetic joint infection (kPJI). Methods: A retrospective cohort study of 50 chronic kPJI patients treated with two types of articulating spacers between January 2014 and March 2022 was conducted. The clinical outcomes and functional status of the different articulating spacers were compared. Overall, 17 patients were treated with prosthetic spacers (prosthetic group (PG)), and 33 patients were treated with cement spacers (cement group (CG)). The CG had a longer mean follow-up period (46.67 months (SD 26.61)) than the PG (24.82 months (SD 16.46); p = 0.001). Results: Infection was eradicated in 45 patients overall (90%). The PG had a better knee range of motion (ROM) and Knee Society Score (KSS) after the first-stage revision (p = 0.004; p = 0.002), while both groups had similar ROMs and KSSs at the last follow-up (p = 0.136; p = 0.895). The KSS in the CG was significantly better at the last follow-up (p = 0.013), while a larger percentage (10 in 17, 58.82%) of patients in the PG chose to retain the spacer (p = 0.008). Conclusion: Prosthetic spacers and cement spacers are both effective at treating chronic kPJI because they encourage infection control, and the former improved knee function status between stages. For some patients, prosthetic spacers may not require reimplantation. Cite this article: Bone Joint Res 2024;13(6):306–314.

Abstract MEMS/NEMS resonant sensors hold promise for minute mass and force sensing. However, one major challenge is that conventional externally driven sensors inevitably encounter undesired intrinsic noise, which imposes a fundamental limitation upon their signal-to-noise ratio (SNR) and, consequently, the resolution. Particularly, this restriction becomes increasingly pronounced as sensors shrink to the nanoscale. In this work, we propose a counterintuitive paradigm shift that turns intrinsic thermal noise from an impediment to a constituent of the sensor by harvesting it as the driving force, obviating the need for external actuation and realizing ‘noise-driven’ sensors. Those sensors employ the dynamically amplified response to thermal noise at resonances for stimulus detection. We demonstrate that lightly damped and highly compliant nano-structures with high aspect ratios are promising candidates for this class of sensors. To overcome the phase incoherence of the drive force, three noise-enabled quantitative sensing mechanisms are developed. We validated our sensor paradigm by experimental demonstrating noise-driven pressure and temperature sensors. Noise-driven sensors offer a new opportunity for delivering practical NEMS sensors that can function at room temperature and under ambient pressure, and a development that suggests a path to cheaper, simpler, and low-power-consumption sensors.

Coal spontaneous combustion (CSC) brings great danger to mine safety. Although traditional colloidal fire-fighting materials can reside at high fire source points, their permeability and fluidity are poor, and such materials focus on their water absorption, but pay less attention to water retention and resistance, which makes their fire-fighting effect not good. This paper proposed a new type of mining fire prevention colloid material (CPS-α), which had good solid water gel formation, viscosity, fluidity, and blocking properties to compensate for traditional colloids' shortcomings. According to the single-factor experiment, polymeric polyacrylamide (PAM) as the base material, sodium carboxymethyl cellulose (CMC) as the coagulant, modified starch (SS) as the flame retardant and reduced ascorbic acid were determined. After gel treatment, compared with raw coal, the critical temperature point of spontaneous combustion of coal was increased by about 28 °C, the time to reach the critical temperature point was delayed by 190s, and the characteristic temperature points were significantly increased; the overlap area of coal and water increases by about 20 % after adding gel, and the change slope of the diffusion coefficient of water decreases, which indicated that CPS-α had good flame retardant effect.

Introduction: The efficacy of anti-vascular endothelial growth factor (VEGF) therapy is limited. However, the key factors involved in limiting the efficacy of anti-VEGF therapy and the underlying mechanisms remain unclear. Objectives: To investigate the effects and mechanisms of human leukocyte antigen F locus-adjacent transcript 10 (FAT10), a ubiquitin-like protein, in limiting the efficacy of anti-VEGF therapy in hepatocellular carcinoma (HCC) cells. Methods: FAT10 was knocked out in HCC cells using the clustered regularly interspaced short palindromic repeats (CRISPR)–CRISPR-associated protein 9 technology. Bevacizumab (BV), an anti-VEGF monoclonal antibody, was used to evaluate the efficacy of anti-VEGF therapy in vivo. Mechanisms of FAT10 action were assessed by RNA sequencing, glutathione S-transferase pulldown assays and in vivo ubiquitination assays. Results: FAT10 accelerated VEGF-independent angiogenesis in HCC cells which limited BV efficacy and BV-aggravated hypoxia and inflammation promoted FAT10 expression. FAT10 overexpression increased levels of proteins involved in several signaling pathways in HCC cells, resulting in upregulation of VEGF and multiple non-VEGF proangiogenic factors. Upregulation of multiple FAT10-mediated non-VEGF signals compensated for the inhibition of VEGF signaling by BV, enhancing VEGF-independent angiogenesis and promoting HCC growth. Conclusions: Our preclinical findings identify FAT10 in HCC cells as a key factor limiting the efficacy of anti-VEGF therapy and elucidate its underlying mechanisms. This study provides new mechanistic insights into the development of antiangiogenic therapies.

Modern suspension bridges exhibit a trend of lighter structures, more diversified structural forms, and longer spans, the latter already exceeding two kilometers. Bridge performance under dead and live loads depends on their structural and main cable systems, while cable-supported bridges especially rely on the design analysis and construction control of the main cable. This literary survey systematically analyzes the research progress and state-of-the-art status quo in the structural systems and design theories of suspension bridges, focusing on the structural systems, main cable shape analyses, live load effect analyses, and emerging lucrative research directions. More than 100 reliable references have been surveyed. (1) Multi-span or multi-main cable schemes appeal to increasing attention, which may become a better choice in terms of structural systems in scenarios with extremely long spans and heavy loads. The cable layouts, such as spatial main cables and hybrid cable-stayed suspension systems have also become feasible approaches for enhancing structural stiffness. (2) The shape-finding analysis during the construction phase is more complex and has more essential factors than that of the completed bridge state. Refined theories combining analytical methods and finite element methods are more suitable for the shape-finding analysis of complex cable systems than any single theory of the two, especially for novel cable systems. (3) The live load effect analysis methods based on traditional deflection theory or modified/improved deflection theories still have wide applications, but the refined theory of treating hangers as discrete members is also constantly developing, which is expected to provide new ideas for more complex structural analysis under the different types of live loads and their distribution forms.

With the promotion of national “carbon neutral” and “green mine” strategies, pure electric mining vehicles are crucial in promoting energy conservation and emission reduction in the mining industry. However, “mileage anxiety” is the primary problem limiting their promotion and application. Regenerative braking is an essential technology for improving energy efficiency and reducing the life-cycle costs of pure electric vehicles. However, because of harsh driving conditions and substantial changes in load capacity and road slope, the scale and fluctuation characteristics of energy demand vary sharply during operation, affecting the feedback efficiency and battery life of an electric mining dump truck. Therefore, designing reasonable regenerative braking strategies for pure electric mining dump trucks is crucial. This paper uses a 50-ton pure electric mining truck as the research object and proposes a regenerative braking feedback strategy based on the deep reinforcement learning optimization algorithm. First, a mathematical model of a pure electric mining dump truck was established, which included a permanent magnet synchronous motor, power battery, four-speed automated mechanical transmission, and vehicle longitudinal dynamic model. Furthermore, power performance verification based on the Matlab/Simulink simulation platform was performed. Subsequently, an energy management strategy was proposed based on the soft actor–critic (SAC) algorithm and the deep deterministic strategy gradient (DDPG) deep reinforcement learning algorithm considering load and slope changes. In particular, the state variables include vehicle speed, acceleration, vehicle mass, road slope, battery state of charge (SOC), and battery charge–discharge rate. The transmission gear is selected as the action variable of the proposed strategy. Battery SOC and battery lifetime are used as reward functions. Furthermore, an automatic entropy adjustment mechanism is introduced to improve the adaptability of the proposed control strategy to different operating conditions. Simulation results show that compared to the rule-based control strategy, the energy efficiency of the control strategy based on dynamic programming and the proposed optimization control strategy based on the SAC and DDPG algorithms are improved by 18.15%, 17.18%, and 16.63%, respectively, and the battery lifetime is improved by 57.31%, 56.87%, and 57.38%, respect ively. Finally, the proposed energy management strategy is compared with the control strategy based on DDPG to further verify its superiority by comparing the reward curves. The results demonstrate the feasibility of the proposed control strategy based on the SAC algorithm, which has improved convergence speed by 166.7%.

ObjectivesMusculoskeletal pain after COVID-19 infection remains a concerning long-term complication of COVID-19. Here, our study aimed to investigate the prevalence of musculoskeletal pain associated with COVID-19 (MSPC) and healthcare-seeking behaviors, as well as the associating factors.MethodsA cross-sectional survey was conducted using convenience sampling and distributed to participants anonymously through the online platform Credamo. Demographic and characteristic data of the participants were collected and analyzed. Logistic regression analysis was employed to investigate potential factors associated with MSPC and healthcare-seeking tendencies.ResultsA total of 1,510 participants responded to the survey, with 42.6% (643 individuals) exhibiting MSPC. Higher education level and a greater number of concomitant symptoms were significant risk factors for MSPC, while longer exercise duration and higher PSS-10 scores were protective factors. Additionally, higher income level, frequency and severity of pain, and greater PSS-10 scores increased healthcare-seeking intention.ConclusionA significant proportion of individuals experience MSPC. Education level and concomitant symptoms were risk factors for MSPC, while exercise duration and PSS-10 score were potential protective factors. Income level, frequency and severity of pain, and PSS-10 score are significantly related to the willingness to seek medical treatment for MSPC.

Abstract Bioinspired micropillar adhesives have shown broad application prospects in space capture and docking, due to their strong adhesion, good environmental adaptability, and reusability. However, when performing space missions, unavoidable contact collision with target objects may cause large deformation of the micropillars, resulting in the loss of adhesion ability. This study reports a novel micropillar adhesive through the in‐plane combination of micropillars (IPCM) with different aspect ratios, consisting of small pillars for retaining strong adhesion and large ones for resisting overload‐induced adhesion failure. It is demonstrated that the IPCM array can still maintain 85% of the adhesion peak after static large deformation compared to a general micropillar array composed of the same pillars. The impact of element size and layout of the IPCM, as well as detachment velocity on adhesion performance under high preload is discussed. Furthermore, finite element contact analysis qualitatively reproduces the experimentally observed micropillar deformations and attributes the overload‐induced adhesion failure to the redistribution of surface normal stress. Finally, the potential application of the IPCM in dynamic capture is demonstrated on different objects. The proposed IPCM opens up new design concepts for practical applications of bioinspired adhesives in space capture and docking.

Self-sensing adaptability is a high-level intelligence in living creatures and is highly desired for their biomimetic soft robots for efficient interaction with the surroundings. Self-sensing adaptability can be achieved in soft robots by the integration of sensors and actuators. However, current strategies simply assemble discrete sensors and actuators into one robotic system and, thus, dilute their synergistic and complementary connections, causing low-level adaptability and poor decision-making capability. Here, inspired by vertebrate animals supported by highly evolved backbones, we propose a concept of a bionic spine that integrates sensing and actuation into one shared body based on the reversible piezoelectric effect and a decoupling mechanism to extract the environmental feedback. We demonstrate that the soft robots equipped with the bionic spines feature locomotion speed improvements between 39.5% and 80% for various environmental terrains. More importantly, it can also enable the robots to accurately recognize and actively adapt to changing environments with obstacle avoidance capability by learning-based gait adjustments. We envision that the proposed bionic spine could serve as a building block for locomotive soft robots toward more intelligent machine-environment interactions in the future.

Abstract Soft material‐based robots, known for their safety and compliance, are expected to play an irreplaceable role in human‐robot collaboration. However, this expectation is far from real industrial applications due to their complex programmability and poor motion precision, brought by the super elasticity and large hysteresis of soft materials. Here, a soft collaborative robot (Soft Co‐bot) with intuitive and easy programming by contact‐based drag teaching, and also with exceptional motion repeatability (< 0.30% of body length) and ultra‐low hysteresis (< 2.0%) is reported. Such an unprecedented capability is achieved by a biomimetic antagonistic design within a pneumatic soft robot, in which cables are threaded to servo motors through tension sensors to form a self‐sensing system, thus providing both precise actuation and dragging‐aware collaboration. Hence, the Soft Co‐bots can be first taught by human drag and then precisely repeat various tasks on their own, such as electronics assembling, machine tool installation, etc. The proposed Soft Co‐bots exhibit a high potential for safe and intuitive human‐robot collaboration in unstructured environments, promoting the immediate practical application of soft robots.

Abstract Background The interaction between the nervous system and the immune system can affect the outcome of a bacterial infection. Staphylococcus aureus skin infection is a common infectious disease, and elucidating the relationship between the nervous system and immune system may help to improve treatment strategies. Results In this study, we found that the local release of calcitonin gene-related peptide (CGRP) increased during S. aureus skin infection, and S. aureus could promote the release of CGRP from transient receptor potential cation channel subfamily V member 1 (TRPV1+) neurons in vitro. The existence of TRPV1+ neurons inhibited the recruitment of neutrophils to the infected region and regulated the polarization of macrophages toward M2 while inhibiting polarization toward M1. This reduces the level of inflammation in the infected area, which aggravates the local infection. Furthermore, this study demonstrates that TRPV1 may be a target for the treatment of S. aureus skin infections and that botulinum neurotoxin A (BoNT/A) and BIBN4096 may reverse the inhibited inflammatory effect of CGRP, making them potential therapeutics for the treatment of skin infection in S. aureus. Conclusions In S. aureus skin infection, TRPV1+ neurons inhibit neutrophil recruitment and regulate macrophage polarization by releasing CGRP. BoNT/A and BIBN4096 may be potential therapeutic agents for S. aureus skin infection.

Artificial multi-enzyme cascades bear great potential for bioconversion of C1 compounds to value-added chemicals. Over the past decade, massive efforts have been devoted to constructing multi-enzyme cascades to produce glycolic acid, rare functional sugars and even starch from C1 compounds. However, in contrast to traditional fermentation utilizing C1 compounds with the expectation of competitive economic performance in future industrialization, multi-enzyme cascades systems in the proof-of-concept phase are facing the challenges of upscaling. Here, we offered an overview of the recent advances in the construction of in vitro multi-enzyme cascades and whole-cell transformation using C1 compounds as substrate. In addition, the existing challenges and possible solutions were also discussed aiming to combine the strengths of in vitro and in vivo multi-enzyme cascades systems for upscaling.

ObjectivesThis study aimed to determine whether combined of pathogen detection strategies, including specimen acquisition, culture conditions, and molecular diagnostics, can improve treatment outcomes in patients with periprosthetic joint infections (PJI).MethodsThis retrospective study included suspected PJI cases from three sequential stages at our institution: Stage A (July 2012 to June 2015), Stage B (July 2015 to June 2018), and Stage C (July 2018 to June 2021). Cases were categorized into PJI and aseptic failure (AF) groups based on European Bone and Joint Infection Society (EBJIS) criteria. Utilization of pathogen diagnostic strategies, pathogen detection rates, targeted antibiotic prescription rates, and treatment outcomes were analyzed and compared across the three stages.ResultsA total of 165 PJI cases and 38 AF cases were included in this study. With the progressive implementation of the three optimization approaches across stages A, B and C, pathogen detection rates exhibited a gradual increase (χ2 = 8.282, P=0.016). Similarly, utilization of targeted antibiotic therapy increased stepwise from 57.1% in Stage A, to 82.3% in Stage B, and to 84% in Stage C (χ2 = 9.515, P=0.009). The 2-year infection control rate exceeded 90% in both stages B and C, surpassing stage A (71.4%) (χ2 = 8.317, P=0.011). Combined application of all three optimized protocols yielded the highest sensitivity of 91.21% for pathogen detection, while retaining higher specificity of 92.11%.ConclusionThe utilization of combined pathogen diagnostic strategies in PJI can increase pathogen detection rates, improve targeted antibiotic prescription, reduce the occurrence of antibiotic complications, and achieve better treatment outcomes.

Abstract Cell‐laden hydrogel fibers/tubules are one of the fundamentals of tissue engineering. They have been proven as a promising method for constructing biomimetic tissues, such as muscle fibers, nerve conduits, tendon and vessels, etc. However, current hydrogel fiber/tubule production methods have limitations in ordered cell arrangements, thus impeding the biomimetic configurations. Acoustic cell patterning is a cell manipulation method that has good biocompatibility, wide tunability, and is contact‐free. However, there are few studies on acoustic cell patterning for fiber production, especially on the radial figure cell arrangements, which mimic many native tissue‐like cell arrangements. Here, an acoustic cell patterning system that can be used to produce hydrogel fibers/tubules with tunable cell patterns is shown. Cells can be pre‐patterned in the liquid hydrogel before being extruded as cross‐linked hydrogel fibers/tubules. The radial patterns can be tuned with different complexities based on the acoustic resonances. Cell viability assays after 72 h confirm good cell viability and proliferation. Considering the biocompatibility and reliability, the present method can be further used for a variety of biomimetic fabrications.

The pretreatment of lignocellulosic biomass with acid generates phenolic and furanyl compounds that function as toxins by inhibiting microbial growth and metabolism. Therefore, it is necessary to detoxify acid-pretreated lignocellulosic biomass for better utilization. Among the various detoxification methods that are available, biodetoxification offers advantages that include mild reaction conditions and low energy consumption. In this study, a newly isolated Rhodococcus aetherivorans strain, N1, was found to effectively degrade various lignin-derived aromatic compounds, such as p-coumarate, ferulate, syringaldehyde, furfural, and 5-hydroxymethylfurfural. Furthermore, the metabolic pathway and genes responsible for this degradation were also identified. In addition, the overexpression of a demethylase (DesA) and 3,4-dioxygenase (DesZ) in strain N1 generated a recombinant strain, N1-S, which showed an enhanced ability to degrade syringaldehyde and 80.5% furfural, 50.7% 5-hydroxymethylfurfural, and 71.5% phenolic compounds in corn cob hydrolysate. The resulting detoxified hydrolysate was used directly as a feedstock for succinate production by Escherichia coli suc260. This afforded 35.3 g/l succinate, which was 6.5 times greater than the concentration afforded when nondetoxified hydrolysate was used. Overall, the results of this study demonstrate that strain N1-S is a valuable microbe for the biodetoxification of lignocellulosic biomass.

Inflammatory macrophages play a crucial role in atherosclerosis development. The long non-coding RNA growth arrest-specific 5 (GAS5) regulates THP-1 macrophage inflammation by sponging microRNAs. The purpose of this study was to investigate the regulatory mechanism of GAS5 in atherosclerosis development. GSE40231, GSE21545, and GSE28829 datasets from the Gene Expression Omnibus database were integrated after adjusting for batch effect. Differential analysis was performed on the integrated dataset and validated using the Genotype-Tissue Expression and GSE57691 datasets. Potential biological functions of GAS5 and annexin A2 (ANXA2) were identified using gene set enrichment analysis (GSEA). ssGSEA, CIBERSORTx, and ImmuCellAI algorithms were used to identify immune infiltration in plaque samples. GAS5 and ANXA2 expression levels in RAW264.7 cells treated with oxidized low-density lipoprotein (ox-LDL) were measured by qRT-PCR and Western blot. Small interfering and short hairpin RNA were used to silence GAS5 expression. Plasmids of ANXA2 were used to establish ANXA2 overexpression. Apoptosis and inflammatory markers in macrophages were detected by Western blot. Aortic samples from APOE−/− mice were collected to validate the expression of GAS5 and ANXA2. GAS5 expression was significantly increased during atherosclerosis. GAS5 expression was positively correlated with macrophage activation and ANXA2 expression in plaques. Furthermore, ANXA2 upregulation was also related to the activation of macrophage. GSEA indicated similar biological functions for GAS5 and ANXA2 in plaques. Moreover, in vitro experiments showed that both GAS5 and ANXA2 contributed to macrophage apoptosis and inflammation. Rescue assays revealed that the inflammatory effects of GAS5 on macrophages were ANXA2-dependent. In vivo experiments confirmed the highly expression of Gas5 and Anxa2 in the plaque group. We identified the atherogenic roles of GAS5 and ANXA2 in the inflammatory response of macrophages. The inflammatory response in ox-LDL-treated macrophages was found to be mediated by GAS5-ANXA2 regulation, opening new avenues for atherosclerosis therapy.

For potato production, continuous cropping (CC) could lead to autotoxicity buildup and microflora imbalance in the field soil, which may result in failure of crops and reduction in yield. In this study, non-targeted metabolomics (via liquid chromatography with tandem mass spectrometry (LC–MS/MS)) combined with metagenomic profiling (via high-throughput amplicon sequencing) were used to evaluate correlations between metabolomics of potato root exudates and communities of bacteria and fungi around potato plants to illustrate the impacts of CC. Potato plants were grown in soil collected from fields with various CC years (0, 1, 4, and 7 years). Metabolomic analysis showed that the contents and types of potential autotoxins in potato root exudates increased significantly in CC4 and CC7 plants (i.e., grown in soils with 4 and 7 years of CC). The differentially expressed metabolites were mainly produced via alpha-linolenic acid metabolism in plant groups CC0 and CC1 (i.e., no CC or 1 year CC). The metabolomics of the groups CC4 and CC7 became dominated by styrene degradation, biosynthesis of siderophore group non-ribosomal peptides, phenylpropanoid biosynthesis, and biosynthesis of various plant secondary metabolites. Continuous cropping beyond 4 years significantly changed the bacterial and fungal communities in the soil around the potato crops, with significant reduction of beneficial bacteria and accumulation of harmful fungi. Correlations between DEMs and microflora biomarkers were established with strong significances. These results suggested that continuous cropping of potato crops changed their metabolism as reflected in the plant root exudates and drove rhizosphere microflora to directions less favorable to plant growth, and it needs to be well managed to assure potato yield.

Abstract MEMS resonators exhibit rich dynamic behaviors under the internal resonance regime. In this work, we present a novel MEMS bifurcation sensor that exploits frequency unlocking due to a 1:3 internal resonance between two electrostatically coupled micro-resonators. The proposed detection mechanism allows the sensor to operate in binary (digital) and analog modes, depending on whether the sensor merely detects a significant jump event in the peak frequency upon unlocking or measures the shift in the peak frequency after unlocking and uses it in conjunction with a calibration curve to estimate the corresponding change in stimulus. We validate the success of this sensor paradigm by experimentally demonstrating charge detection. High charge resolutions are achieved in binary mode, up to 0.137 fC, and in analog mode, up to 0.01 fC. The proposed binary sensor enables extraordinarily high detection resolutions due to the excellent frequency stability under internal resonance and the high signal-to-noise ratio of the shift in peak frequency. Our findings offer new opportunities for high-performance ultrasensitive sensors.

Abstract The mechanisms controlling transport and retention of microplastics (MPs) in riverine systems are not understood well. We investigated the impact of large roughness elements (LREs) on in-stream transport and retention of the ubiquitous polystyrene-microplastics (PS-MPs). Scaled experiments were conducted with and without LREs under various shear Reynolds numbers (Re*) in an ecohydraulics flume. Our results, for the first time, demonstrated a clear dependence of the MPs’ velocity on Re* in LREs-dominated channel. Two distinct regimes and thresholds were identified: lower Re* (≤ 15,000) regime corresponding to higher velocities of MPs ( $${U}_{MPs}^{*}$$ U MPs ∗ > 0.45), and higher Re* (> 15,000) to lower $${U}_{MPs}^{*} ($$ U MPs ∗ ( < 0.45). The presence and higher density of LREs increased Re*, decreased $${U}_{MPs}^{*}$$ U MPs ∗ , and enhanced the PS-MPs capture. The LREs-generated turbulence kinetic energy (TKE) was found to be a good predictor of PS-MPs transport and retention rates, indicating the effectiveness of LREs in retaining PS-MPs in streams and rivers.

To balance the relationship between current THD and switching loss, an optimal predictive control method using single and double vector hybrid modulation of NPC-3L inverter is proposed. Firstly, the relationship of the THD of output current and the Aoc&rc(the Area enclosed by output current and reference current) is built. Secondly, the current threshold is defined to control the switching time of single/double vectors, which is used to balance the current THD and switching loss and determined by the target current THD value. Thirdly, the output of single vector or double vector is determined by comparing the output real-time current value with the set current threshold. That is, when the output current is greater than the current threshold, a single vector is used to reduce the switching loss. When the output current is less than the current threshold, the THD of the output current is raised by using output double vectors. At the same time, by using this control method, the disadvantages of single/dual vector independent operation are mutually offset. Finally, a simulation model is built to verify the proposed control method. Compared with traditional methods, the simulation results show that the proposed method is correct and effective.

Abstract Friction is a fundamental force that impacts almost all interface-related applications. Over the past decade, there is a revival in our basic understanding and practical applications of the friction. In this review, we discuss the recent progress on solid-liquid interfacial friction from the perspective of interfaces. We first discuss the fundamentals and theoretical evolution of solid-liquid interfacial friction based on both bulk interactions and molecular interactions. Then, we summarize the interfacial friction regulation strategies manifested in both natural surfaces and artificial systems, focusing on how liquid, solid, gas, and hydrodynamic coupling actions mediate interfacial friction. Next, we discuss some practical applications that are inhibited or reinforced by interfacial friction. At last, we present the challenges to further understand and regulate interfacial friction.

Abstract Background 1,3-Propanediol (1,3-PDO) is a platform compound, which has been widely used in food, pharmaceutical and cosmetic industries. Compared with chemical methods, the biological synthesis of 1,3-PDO has shown promising applications owing to its mild conditions and environmental friendliness. However, the biological synthesis of 1,3-PDO still has the problem of low titer and yield due to the shortage of reducing powers. Results In this study, Klebsiella sp. strain YT7 was successfully isolated, which can synthesize 11.30 g/L of 1,3-PDO from glycerol in flasks. The intracellular redox regulation strategy based on the addition of electron mediators can increase the 1,3-PDO titer to 28.01 g/L. Furthermore, a co-culturing system consisting of strain YT7 and Shewanella oneidensis MR-1 was established, which can eliminate the supplementation of exogenous electron mediators and reduce the by-products accumulation. The 1,3-PDO yield reached 0.44 g/g and the final titer reached 62.90 g/L. The increased titer and yield were attributed to the increased redox levels and the consumption of by-products. Conclusions A two-bacterium co-culture system with Klebsiella sp. strain YT7 and S. oneidensis strain MR-1 was established, which realized the substitution of exogenous electron mediators and the reduction of by-product accumulation. Results provided theoretical basis for the high titer of 1,3-PDO production with low by-product concentration.

Improving water quality is imperative for many sea bays, including Laizhou Bay, China, to achieve sustainable marine development. In 2010, two 17.3 km long sand-retaining embankments were built in southwestern Laizhou Bay, which weakened the nearshore hydrodynamics and seriously impacted the water quality. To mitigate this issue, this study proposes connecting the two rivers on both sides of the embankments to improve the hydrodynamics and thus water exchange in the sea bay. The effectiveness was examined with a numerical model using Mike 21, which was validated for both tidal current velocity and direction at six monitoring locations in the sea bay. The results show that over 53% of the core research area displays an increase (0.0–0.4 m/s) in tidal current speed after the connection, primarily in and around the Haihengwei Fishing Port. Meanwhile, the Eulerian residual currents in the Haihengwei Fishing Port, Mi River estuary and Bailang River estuary become substantially larger (with a maximum increase of 0.16 m/s). In addition, the net transport distance of particles released near the connection increases by up to 39.89 km in one month. Overall, this case study demonstrates that connecting rivers next to a harbor can effectively improve hydrodynamics and thus improve water quality in the bay.

Introduction“Probiotic therapy” to regulate gut microbiota and intervene in intestinal diseases such as inflammatory bowel disease (IBD) has become a research hotspot. Bacteroides acidifaciens, as a new generation of probiotics, has shown beneficial effects on various diseases.MethodsIn this study, we utilized a mouse colitis model induced by dextran sodium sulfate (DSS) to investigate how B. acidifaciens positively affects IBD. We evaluated the effects ofB. acidifaciens, fecal microbiota transplantation, and bacterial extracellular vesicles (EVs) on DSS-induced colitis in mice. We monitored the phenotype of mouse colitis, detected serum inflammatory factors using ELISA, evaluated intestinal mucosal barrier function using Western blotting and tissue staining, evaluated gut microbiota using 16S rRNA sequencing, and analyzed differences in EVs protein composition derived from B. acidifaciens using proteomics to explore how B. acidifaciens has a positive impact on mouse colitis.ResultsWe confirmed that B. acidifaciens has a protective effect on colitis, including alleviating the colitis phenotype, reducing inflammatory response, and improving intestinal barrier function, accompanied by an increase in the relative abundance of B. acidifaciens and Ruminococcus callidus but a decrease in the relative abundance of B. fragilis. Further fecal bacterial transplantation or fecal filtrate transplantation confirmed the protective effect of eosinophil-regulated gut microbiota and metabolites on DSS-induced colitis. Finally, we validated that EVs derived from B. acidifaciens contain rich functional proteins that can contribute to the relief of colitis.ConclusionTherefore, B. acidifaciens and its derived EVs can alleviate DSS-induced colitis by reducing mucosal damage to colon tissue, reducing inflammatory response, promoting mucosal barrier repair, restoring gut microbiota diversity, and restoring gut microbiota balance in mice. The results of this study provide a theoretical basis for the preclinical application of the new generation of probiotics.

Abstract Post‐infectious irritable bowel syndrome (PI‐IBS) occurs after acute infectious diarrhea, and dysbiosis can be involved in its pathogenesis. Here, the role of chlorogenic acid (CGA) is investigated, a natural compound with several pharmacological properties, in alleviating PI‐IBS in rats. It is elucidated that the gut microbiota plays a key role in PI‐IBS pathogenesis and that rectal administration of CGA alleviated PI‐IBS by modulating the gut microbiota and its metabolites. CGA supplementation significantly increased fecal Bacteroides acidifaciens abundance and glycine levels. Glycine structurally altered B. acidifaciens extracellular vesicles (EVs) and enriched functional proteins in the EVs; glycine‐induced EVs alleviated PI‐IBS by reducing inflammation and hypersensitivity of the intestinal viscera and maintaining mucosal barrier function. Moreover, B. acidifaciens EVs are enriched in the brain tissue. Thus, CGA mediates the mitigation of PI‐IBS through the gut microbiota and its metabolites. This study proposes a novel mechanism of signal exchange between the gut microenvironment and the host.

Aims: This study aimed to explore the diagnostic value of synovial fluid neutrophil extracellular traps (SF-NETs) in periprosthetic joint infection (PJI) diagnosis, and compare it with that of microbial culture, serum ESR and CRP, synovial white blood cell (WBC) count, and polymorphonuclear neutrophil percentage (PMN%). Methods: In a single health centre, patients with suspected PJI were enrolled from January 2013 to December 2021. The inclusion criteria were: 1) patients who were suspected to have PJI; 2) patients with complete medical records; and 3) patients from whom sufficient synovial fluid was obtained for microbial culture and NET test. Patients who received revision surgeries due to aseptic failure (AF) were selected as controls. Synovial fluid was collected for microbial culture and SF-WBC, SF-PNM%, and SF-NET detection. The receiver operating characteristic curve (ROC) of synovial NET, WBC, PMN%, and area under the curve (AUC) were obtained; the diagnostic efficacies of these diagnostic indexes were calculated and compared. Results: The levels of SF-NETs in the PJI group were significantly higher than those of the AF group. The AUC of SF-NET was 0.971 (95% confidence interval (CI) 0.903 to 0.996), the sensitivity was 93.48% (95% CI 82.10% to 98.63%), the specificity was 96.43% (95% CI 81.65% to 99.91%), the accuracy was 94.60% (95% CI 86.73% to 98.50%), the positive predictive value was 97.73%, and the negative predictive value was 90%. Further analysis showed that SF-NET could improve the diagnosis of culture-negative PJI, patients with PJI who received antibiotic treatment preoperatively, and fungal PJI. Conclusion: SF-NET is a novel and ideal synovial fluid biomarker for PJI diagnosis, which could improve PJI diagnosis greatly. Cite this article: Bone Joint Res 2023;12(2):113–120.

Achieving efficiently reprogrammable actuation and high operational dimensionality for soft robots with a limited number of actuators are challenging. Here, Li et al. use the vector control to manipulate electromagnetic soft robots enabling reprogrammable shape morphing and multimodal locomotion.

Objective Failed internal fixation of intertrochanteric fractures (FIF‐ITF) is often treated by conversion hip arthroplasty (CHA). This study aimed to evaluate the results and complications of using standard and long femoral stems in this operation. Methods This retrospective, multi‐center study enrolled 31 total hip arthroplasty (THA) and 23 hemiarthroplasties (HA) cases (30 women, 24 men; mean age 76 years) after FIF‐ITF between 2012 and 2019, divided into two groups: standard stem group (n = 20) and long stem group (n = 34). The initial internal fixation includes 38 cases of proximal femoral nail anti‐rotation (PFNA), eight cases of the dynamic hip screw (DHS), and eight cases of locking proximal femoral plate (LPFP). The indications for CHA included 38 cases of failure of fixation, seven cases of nonunion, and nine cases of avascular necrosis or posttraumatic osteoarthritis. Perioperative data and complications related to fracture and operation were collected, and preoperative and postoperative clinical and radiological data were analyzed. Clinical outcomes were assessed using Harris hip score (HHS) and 36‐item Short Form survey (SF‐36: including physical function (PF) score and body pain (BP) score). Statistical analyses were performed using the chi‐square or Fisher's exact test, and the 2‐sample t‐test or Wilcoxon rank sum test. Results At an average of 5.6 years with a minimum of 2 years follow‐up. A significant overall surgeon‐related complication rate was detected (27.8% [15/54]), five cases had an intraoperative femur fracture, one case had a late periprosthetic femoral fracture, two cases had a stem penetration, one case had a cement leakage, and two patients had an early postoperative dislocation, one infection and three cases of stem loosening or subsidence. Long stems had an increased risk of complication (13/34) compared to standard stems (2/20) (P = 0.031). The operation time and blood loss in the long stem group were higher than those in the standard stem group (P = 0.002; 0.017). HHS and SF‐36 significantly improved in both groups from preoperative to the final follow‐up and did not present significant differences at the final follow‐up (P > 0.05). Conclusion CHA following FIF‐ITF showed a successful mid‐term clinical result, long stem arthroplasty should be approached with caution for the risks of higher complication rate, especially intraoperative femoral fractures.

Background Coxiella burnetii (C. burnetii) is the causative agent of Q fever and is found worldwide; however, prosthetic joint infections caused by C. burnetii are rarely seen. Because of advances in molecular diagnostic techniques, prosthetic joint infection (PJI) caused by C. burnetii can now be diagnosed. Case Presentation A 77‐year‐old male who had undergone total knee arthroplasty had a displaced prosthesis and periprosthetic osteolysis; he had no obvious signs of infection, and microbiological culture was negative. However, C. burnetii was detected by metagenomic next‐generation sequencing (mNGS) and pathogen‐targeted next‐generation sequencing (ptNGS). Finally, polymerase chain reaction (PCR) confirmed the diagnosis of C. burnetii prosthetic joint infection (PJI). After revision surgery (one‐stage revision) and oral antibiotics (doxycycline and moxifloxacin hydrochloride), the patient's symptoms disappeared, and he regained the ability to walk. During the 6‐month follow‐up, the patient's knee showed no signs of swelling, pain or the recurrence of infection, and he experienced no significant complications. We also present a review of the literature for other cases of C. burnetii PJI. Conclusions The symptoms of C. burnetii PJI may be different from those of Q fever, which may lead to misdiagnosis. mNGS and ptNGS may be helpful for the identification of C. burnetii. Once the diagnosis of C. burnetii PJI is confirmed, doxycycline in combination with a fluoroquinolone can be effectively administered after revision surgery.

The mechanics of reconfigurable supramolecular polymer networks are governed by their dynamic crosslinking chemistry and the resulting stress relaxations. Here, the authors use reversible wrinkling patterns to visualize localized stress relaxations, due to molecular network rearrangements.

AimsThis study aimed to explore the role of small colony variants (SCVs) of Staphylococcus aureus in intraosseous invasion and colonization in patients with periprosthetic joint infection (PJI).MethodsA PJI diagnosis was made according to the MusculoSkeletal Infection Society (MSIS) for PJI. Bone and tissue samples were collected intraoperatively and the intracellular invasion and intraosseous colonization were detected. Transcriptomics of PJI samples were analyzed and verified by polymerase chain reaction (PCR).ResultsSCVs can be isolated from samples collected from chronic PJIs intraoperatively. Transmission electron microscopy (TEM) and immunofluorescence (IF) showed that there was more S. aureus in bone samples collected from chronic PJIs, but much less in bone samples from acute PJIs, providing a potential mechanism of PJI. Immunofluorescence results showed that SCVs of S. aureus were more likely to invade osteoblasts in vitro. Furthermore, TEM and IF also demonstrated that SCVs of S. aureus were more likely to invade and colonize in vivo. Cluster analysis and principal component analysis (PCA) showed that there were substantial differences in gene expression profiles between chronic and acute PJI. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that these differentially expressed genes were enriched to chemokine-related signal pathways. PCR also verified these results.ConclusionOur study has shown that the S. aureus SCVs have a greater ability to invade and colonize in bone, resulting in S. aureus remaining in bone tissues long-term, thus explaining the pathogenesis of chronic PJI.Cite this article: Bone Joint Res 2022;11(12):843–853.

Objectives: Neutrophil gelatinase-associated lipocalin (NGAL) in synovial fluid (SF) may have potential diagnostic value for prosthetic joint infection (PJI). This study aimed to study (i) the diagnostic performance of SF-NGAL levels for diagnosing PJI and (ii) the impact of previous antibiotic use on the SF-NGAL levels. Methods: Consecutive patients who needed hip or knee revision surgery were included prospectively from January 2017 to September 2018. The patients were divided into the PJI group and the aseptic failure group. An enzyme-linked immunosorbent assay was used to determine the SF-NGAL level. Results: A total of 50 of 78 included patients were diagnosed with PJI. The median SF-NGAL level was 3633 ng/ml (interquartile range [IQR], 1332-10,737) in the PJI group and 26.8 ng/ml (IQR, 12.4-52.5) in the aseptic failure group (P

Objectives: This study aimed to analyze the pathogenic bacteria spectrum in invasive and primary osteoarticular infection (IOI and POI) and compare the pathogen detection rate of metagenomic next-generation sequencing (mNGS) and microbial culture in IOI and POI. Methods: The suspected POI and IOI cases from 2014-2021 were included. The diagnosis of POI or IOI was made by at least two orthopedic surgeons, two infectious diseases specialists, and one senior microbiologist. Demographic characteristics, microbial culture results, and so on were recorded. The pathogenic bacteria spectrum in IOI and POI were analyzed, and the ability of mNGS and microbial culture in pathogen detection in IOI and POI were compared. Results: There were 52 POI cases and 92 IOI cases; the common pathogen in POI and IOI were both Staphylococcus aureus. There are more cases with negative microbial culture results and multiple infections in IOI, and many cases were caused by rare and fastidious bacteria. The introduction of the mNGS could significantly increase the pathogen detection rate to 92.39% in IOI, which was 8.69% higher than that of microbial culture (P = 0.007), whereas the improvement in POI was limited to about 2%. Conclusion: mNGS is an promising tool for IOI pathogen detection.

BackgroundAnkylosing Spondylitis (AS) is an inflammatory condition affecting the spine, which may lead to complications such as osteoporosis (OP). Many observational studies have demonstrated a close relationship with strong evidence between OP and AS. The combination of AS and OP is already an indisputable fact, but the exact mechanism of AS complicated with OP is unclear. To better prevent and treat OP in patients with AS, it is necessary to understand the specific mechanism of OP in these patients. In addition, there is a study showing that OP is a risk factor for AS, but the causal relationship between them is not yet clear. Therefore, we conducted a bidirectional Mendelian randomization (MR) analysis to determine whether there is a direct causal effect between AS and OP and to investigate the co-inherited genetic information between the two.MethodsBone mineral density (BMD) was used as a phenotype for OP. The AS dataset was taken from the IGAS consortium and included people of European ancestry (9,069 cases and 13,578 controls). BMD datasets were obtained from the GEFOS consortium, a large GWAS meta-analysis study, and the UK Biobank and were categorized based on site (total body (TB): 56,284 cases; lumbar spine (LS): 28,498 cases; femoral neck (FN): 32,735 cases; forearm (FA): 8,143 cases; and heel: 265,627 cases) and age (0-15: 11,807 cases; 15-30: 4,180 cases; 30-45: 10,062 cases; 45-60: 18,062 cases; and over 60: 22,504 cases).To obtain the casual estimates, the inverse variant weighted (IVW) method was mainly used due to its good statistical power and robustness. The presence of heterogeneity was evaluated using Cochran’s Q test. Pleiotropy was assessed utilizing MR-Egger regression and MR-pleiotropy residual sum and outlier (MR-PRESSO).ResultsGenerally, there were no significant causal associations between genetically predicted AS and decreased BMD levels. The results of MR-Egger regression, Weighted Median, and Weighted Mode methods were consistent with those of the IVW method. However, there was a sign of a connection between genetically elevated BMD levels and a decreased risk of AS (Heel-BMD: OR = 0.879, 95% CI: 0.795-0.971, P = 0.012; Total-BMD: OR = 0.948, 95% CI: 0.907-0.990, P = 0.017; LS-BMD: OR = 0.919, 95% CI: 0.861-0.980, P = 0.010). The results were confirmed to be reliable by sensitivity analysis.ConclusionThis MR study found that the causal association between genetic liability to AS and the risk of OP or lower BMD in the European population was not evident, which highlights the second effect (e.g., mechanical reasons such as limited movement) of AS on OP. However, genetically predicted decreased BMD/OP is a risk factor for AS with a causal relationship, implying that patients with OP should be aware of the potential risk of developing AS. Moreover, OP and AS share similar pathogenesis and pathways.

Manipulation of micro-objects have been playing an essential role in biochemical analysis or clinical diagnostics. Among the diverse technologies for micromanipulation, acoustic methods show the advantages of good biocompatibility, wide tunability, a label-free and contactless manner. Thus, acoustic micromanipulations have been widely exploited in micro-analysis systems. In this article, we reviewed the acoustic micromanipulation systems that were actuated by sub-MHz acoustic waves. In contrast to the high-frequency range, the acoustic microsystems operating at sub-MHz acoustic frequency are more accessible, whose acoustic sources are at low cost and even available from daily acoustic devices (e.g. buzzers, speakers, piezoelectric plates). The broad availability, with the addition of the advantages of acoustic micromanipulation, make sub-MHz microsystems promising for a variety of biomedical applications. Here, we review recent progresses in sub-MHz acoustic micromanipulation technologies, focusing on their applications in biomedical fields. These technologies are based on the basic acoustic phenomenon, such as cavitation, acoustic radiation force, and acoustic streaming. And categorized by their applications, we introduce these systems for mixing, pumping and droplet generation, separation and enrichment, patterning, rotation, propulsion and actuation. The diverse applications of these systems hold great promise for a wide range of enhancements in biomedicines and attract increasing interest for further investigation.

Atrial remodeling is a major contributor to the onset of atrial fibrillation (AF) after myocardial infarction (MI). Tripartite motif-containing protein 21 (TRIM21), an E3 ubiquitin protein ligase, is associated with pathological cardiac remodeling and dysfunction. However, the role of TRIM21 in postmyocardial infarction atrial remodeling and subsequent AF remains unclear. This study investigated the role of TRIM21 in post myocardial infarction atrial remodeling using TRIM21 knockout mice and explored the underlying mechanisms by overexpressing TRIM21 in HL-1 atrial myocytes using a lentiviral vector. The expression of TRIM21 in the left atrium of the mouse MI model was significantly elevated. TRIM21 deficiency alleviated MI-induced atrial oxidative damage, Cx43 downregulation, atrial fibrosis and enlargement, and abnormalities in electrocardiogram parameters (prolongation of the P-wave and PR interval). TRIM21 overexpression in atrial myocyte HL-1 cells further enhanced oxidative damage and Cx43 downregulation, whereas these effects were reversed by the reactive oxygen species scavenger N-acetylcysteine. The findings suggest that TRIM21 likely induces Nox2 expression mechanistically by activating the NF-κB pathway, which in turn leads to myocardial oxidative damage, inflammation, and atrial remodeling.

Objective To compare the clinical outcomes of culture‐negative periprosthetic joint infection (CN PJI) with those of culture‐positive periprosthetic joint infection (CP PJI). Methods This study retrospectively examined data from 77 patients who underwent revision surgery due to periprosthetic joint infection (PJI) after hip and knee arthroplasty at our center from January 2012 to June 2017. There were 37 males and 40 females, with an average age of 63.6 year. All patients were classified by Tsukayama type, according to the bacterial culture results of synovial fluid and pre‐ and intraoperative tissues, 24 cases were included in the CN PJI group, and 53 cases were included in the CP PJI group. All patients underwent routine blood tests, liver, renal function tests, erythrocyte sedimentation rate (ESR) and C‐reactive protein (CRP) measurements. The remission rates of CN PJI and CP PJI were compared. The effects of the culture results on the curative effect were further compared by survival analysis. Results The patients were followed regularly with an average of 29.2 months (range, 12–76 months). In total, there were 24 cases of CN PJI, with an incidence of 29.63%. The overall success rate of CN PJI group was 86.4% (19/22), and overall success rate of CP PJI group was 87.5% (42/48). The relative efficacy of various surgical options was: one‐stage revision 100% (7/7), two‐stage revision 96.3% (26/27), debridement and implant retention 64.3% (9/14), respectively. There was no significant difference in the success rate between the CN PJI group and the CP PJI group. The incidence of antibiotic‐related complications for the CN PJI group was significantly higher than that of the CP PJI group, with 58.3% for CN PJI and 11.3% for CP PJI, respectively. Conclusion When CN PJI was treated according to the strict standards for the diagnosis and treatment, the success rate of treatment for the CN PJI group was similar to that for the CP PJI group. The incidence of antibiotic‐related complications from the CN PJI group was higher than that from the CP PJI group.