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In this paper, based on the viscosity approximation method and the hybrid steepest-descent iterative method, a new implicit iterative algorithm is presented for finding the common fixed points set of a finite family of nonexpansive mappings in a reflexive Hilbert space, which is called a symmetric space. We prove that the sequence generated by this new implicit rule strongly converges to the unique solution of a class of variational inequalities under certain appropriate conditions of the parameters. Moreover, we also study the applications to a broader family of strictly pseudo-contractive mappings and generalized equilibrium problems that involve several variational inequality problems, optimization problems, and fixed-point problems. Finally, numerical results are provided to clarify the stability and effectiveness of the algorithm and to compare with some existing iterative algorithms. [ABSTRACT FROM AUTHOR]

Mycotoxins are metabolites produced by fungi growing in food or feed, which can produce toxic effects and seriously threaten the health of humans and animals. Mycotoxins are commonly found in food and feed, and are of significant concern due to their hepatotoxicity, nephrotoxicity, carcinogenicity, mutagenicity, and ability to damage the immune and reproductive systems. Traditional physical and chemical detoxification methods to treat mycotoxins in food and feed products have limitations, such as loss of nutrients, reagent residues, and secondary pollution to the environment. Thus, there is an urgent need for new detoxification methods to effectively control mycotoxins and treat mycotoxin pollution. In recent years, microbial detoxification technology has been widely used for the degradation of mycotoxins in food and feed because this approach offers the potential for treatment with high efficiency, low toxicity, and strong specificity, without damage to nutrients. This article reviews the application of microbial detoxification technology for removal of common mycotoxins such as Aflatoxin, Ochratoxin, Zearalenone, Deoxynivalenol, and Fumonisins, and discusses the development trend of this important technology. [ABSTRACT FROM AUTHOR]

Little is known about why and how biomechanics govern the hypothesis that three-Lag-Screw (3LS) fixation is a preferred therapeutic technique. A series models of surgical internal-fixation for femoral neck fractures of Pauwells-II will be constructed by an innovative approach of finite element so as to determine the most stable fixation by comparison of their biomechanical performance. Seventeen sets of CT scanned femora were imported onto Mimics extracting 3D models; these specimens were transferred to Geomagic Studio for a simulative osteotomy and kyrtograph; then, they underwent UG to fit simulative solid models; three sorts of internal fixators were expressed virtually by Pro-Engineer. Processed by Hypermesh, all compartments were assembled onto three systems actually as "Dynamic hip screw (DHS), 3LS and DHS+LS". Eventually, numerical models of Finite Elemental Analysis (FEA) were exported to AnSys for solution. Three models for fixtures of Pauwells-II were established, validated and analyzed with the following findings: Femoral-shaft stress for c (3LS) is the least; Internal-fixator stress (MPa) for a (DHS) = 1 9 6. 9 7 > b (DHS + LS) = 8 8. 3 7 > c (3 LS) = 6 3. 8 1 ; Integral stress (MPa) for a (DHS) = 1 9 5. 3 5 > b (DHS + LS) = 8 6. 7 2 > c (3 LS) = 6 4. 6 0 ; displacement of femoral head (mm) for a (DHS) = 1. 0 6 8 > c (3 LS) = 1. 0 1 0 > b (DHS+LS) = 0.735; displacement of femoral shaft (mm) for c (3 LS) = 0. 7 1 4 > a (DHS) = 0. 5 3 3 > b (DHS+LS) = 0. 4 7 5 ; and displacement of fixators for c (3 LS) = 0. 9 8 2 > a (DHS) = 0. 9 7 3 > b (DHS + LS) = 0. 7 0 6. Mechanical comparisons for other femoral parks are insignificantly different, and these data can be abstracted as follows: the stress of 3LS-system was checked to be the least, and an interfragmentary displacement of DHS+LS assemblages was assessed to be the least". A 3LS-system should be recommended to clinically optimize a Pauwells-II facture; if treated by this therapeutic fixation, breakage of fixators or secondary fracture is supposed to occur rarely. The strength of this study is that it was performed by a computer-aided simulation, allowing for design of a preoperative strategy that could provide acute correction and decrease procedure time, without harming to humans or animals. [ABSTRACT FROM AUTHOR]

Introduction: Bernese-type triple pelvic osteotomy (BTPO) combines periacetabular and triple innominate osteotomy techniques. However, studies that evaluate the clinical and radiographic outcomes of BTPO are scarce. The aim of this study is to report on the clinical and radiographic outcomes of ambulatory children with developmental dysplasia of the hip (DDH) or Legg-Calvé-Perthes disease (LCPD) managed with BTPO that were older than five years of age at the time of surgery.Materials and Methods: We retrospectively reviewed the records of 27 consecutive patients with DDH or LCPD (mean age 7.6 ± 1.8; 28 hips) who were treated with the reported technique. All patients had regular clinical and radiographic follow-up. Post-operatively, changes in the acetabular index (AI) and centre-edge angle of Wiberg (CEA) were measured in all patients. The presence/absence of avascular necrosis of the femoral epiphysis was also noted in patients with DDH. Final radiographic results were evaluated with the Severin and Stulberg classifications. The Harris hip score was used in the functional evaluation of all patients.Results: In patients with DDH, the mean age at the time of surgery was 7.5 ± 1.8 years and the mean follow-up time was 22.2 ± 10.7 months. Prior to surgery, the mean AI was 37.9° ± 7.6°. At their final follow-up visit, the mean AI and CEA were 10.8° ± 5.4° and 40.9° ± 8.6°, respectively. Moreover, 66.7% of hips (14/21) were graded as Severin type I, and 33.3% (7/21) were graded as type II. The overall AVN rate was 14.3% (3/21). The mean Harris score was 92.1 ± 7.7. In patients with LCPD, the mean age at the time of surgery was 7.9 ± 1.8 years, and the mean follow-up time was 18.4 ± 6.1 months. Prior to surgery, 85.7% of hips were graded as Herring C, and 14.3% were graded as grade B. Prior to surgery, the mean AI and CEA were 19.4° ± 5.3° and 19.1° ± 12.6°, respectively. At the final follow-up visit, the mean AI and CEA were 5.8° ± 3.4° and 50.3° ± 12.0°, respectively, and 57.1% of hips were graded as Stulberg II. The mean Harris score was 94 ± 5.4. Ischial osteotomy non-unions were recorded in three patients (10.7%).Conclusions: BTPO through a modified anterior Smith-Peterson approach is an alternative treatment for DDH and LCPD in older children who are skeletally immature. It not only provides for a large acetabular correction but also achieves good biomechanical stability. [ABSTRACT FROM AUTHOR]

• PDA selectively adsorbs aflatoxins and ochratoxins from edible vegetable oil. • The process of PDA@Fe 3 O 4 -MWCNTs is physical multi-molecular layer adsorption. • The recovery was 70.15-89.25%, RSD was ≤6.3%, show that the method is reliable. A new, green, and cost-effective magnetic solid-phase extraction of aflatoxins and ochratoxins from edible vegetable oils samples was developed using polydopamine-coated magnetic multi-walled carbon nanotubes (PDA@Fe 3 O 4 -MWCNTs) as the absorbent. PDA@Fe 3 O 4 -MWCNTs nanomaterials were prepared by chemical co-precipitation and in situ oxidation and self-polymerization of dopamine and was characterized. Factors affecting MSPE and the adsorption behavior of the adsorbent to mycotoxins were studied, and the optimal extraction conditions of MSPE and the complexity of the adsorption process were determined. Based on this, the magnetic solid-phase extraction-high-performance liquid chromatography-fluorescence detection method (MSPE-HPLC-FLD) was established for determining six mycotoxins [aflatoxin B 1 (AFB 1), AFB 2 , AFG 1 , and AFG 2 , and ochratoxin A (OTA) and OTB)] in vegetable oils. The recovery was 70.15%~89.25%, and RSD was ≤6.4%. PDA@Fe 3 O 4 -MWCNTs showed a high affinity toward aflatoxins and ochratoxins, allowing selective extraction and quantification of aflatoxins and ochratoxins from complex sample matrices. [ABSTRACT FROM AUTHOR]

The interval exponential state estimation and robust exponential stability for the switched interval neural networks with discrete and distributed time delays are considered. Firstly, by combining the theories of the switched systems and the interval neural networks, the mathematical model of the switched interval neural networks with discrete and distributed time delays and the interval estimation error system are established. Secondly, by applying the augmented Lyapunov- Krasovskii functional approach and available output measurements, the dynamics of estimation error system is proved to be globally exponentially stable for all admissible time delays. Both the existence conditions and the explicit characterization of desired estimator are derived in terms of linear matrix inequalities (LMIs). Moreover, a delay-dependent criterion is also developed, which guarantees the robust exponential stability of the switched interval neural networks with discrete and distributed time delays. Finally, two numerical examples are provided to illustrate the validity of the theoretical results. [ABSTRACT FROM AUTHOR]

• Femoral neck fracture problematic. • Choose best Pauwels-III implant by comparison. • Stress & displacement of 5 implants analyzed. • Locking Plate/HemiArthroplasty is recommended as optimization. • Preoperative strategy by simulation provides acute correction. There are many fixation methods for Pauwels- III fracture, the most common implants are Locking Plate (LP), Dynamic Hip Screw (DHS), Multiple Lag Screw (MLS), and mixed fixture (DHS+MLS) implants, the common procedure is HemiArthroplasty (HA). However, how these fixtures biomechanically function is not clear. The aims of this study are to compare the mechanical behaviors of these five implants by finite element modeling and determinate the most suitable procedure for individuals with Pauwels- III fractures. We gathered 20 sets of femur images from CT scans in the *.dicom format first, and then processed them by using reverse engineering software programs, such as Mimics, Geomagic Studio, UG-8, Pro-Engineer and HyperMesh. Finally, we assembled and analyzed the five types of fixture models, the LP, DHS, MLS, DHS+LS and HA models, by AnSys. These numerical models of Pauwels III fractures, including fixators and a simulative HA, were validated by a previous study and a cadaver test. Our analytical findings include the following: the displacements of all fixtures were between 0.3801 and 1.0834 mm, and the differences were not statistically significantly different; the resulting average peaks in stress were e(Ha) = 43.859 ≤ d(LP) = 60.435 ≤ b(MLS) = 68.678 < c(LS+DHS) = 98.478 < a(DHS) = 248.595 in Mpa, indicating that the stress of DHS and DHS+LS are greater than those of LP, HA and MLS, while the last 3 models were not significantly different. To optimize the treatment for Pauwels III factures clinically, HA and LP should be proposed. Image, graphical abstract [ABSTRACT FROM AUTHOR]

Purpose: This systematic review and meta-analysis aimed to determine the incidence of total hip arthroplasty (THA) in patients with Legg-Calve-Perthes disease (LCPD) treated conservatively or surgically and factors influencing the incidence of THA. Methods: Long-term follow-up studies on the conservative or surgical treatments of LCPD from 1950 to 2021 were conducted using six public databases. Articles were screened by two investigators (PRISMA guidelines), and the quality of the included publications (n = 27) was assessed (MINORS criteria). R version 4.2.1 was used for statistical analysis. Results: The overall incidences of THA were 6.8% and 5.14% in patients who were treated conservatively and surgically, respectively. At disease onset, the incidences of THA were 6.79% and 6.17% after conservative treatment and surgery in patients aged < seven years, respectively, and 16.97% and 3.61% in patients aged > seven years, respectively. The incidences of THA were 4.91%, 5.19%, and 23.18% in patients who were treated conservatively with ≤ 30, 30–40, and > 40 years of follow-up, respectively, and 3.68%, 3.11%, 9.66%, and 17.92% in patients who were treated surgically with ≤ ten, ten to 20, 20–40, and > 40 years of follow-up, respectively. In patients who received conservative treatment, the incidences of THA were 5.79% and 5.29% in patients with Stulberg I–II and III–V, respectively. In surgically treated patients, the incidence of THA was 0% in Stulberg I-II and 8% in Stulberg III-V. Conclusion: Patients with LCPD had relatively low incidences of THA. The greater the age at disease onset and longer the follow-up, the higher the incidence of THA; however, the Stulberg classification was not directly associated with the incidence of THA. [ABSTRACT FROM AUTHOR]

Background: Distal arthrogryposis (DA) is a group of congenital autosomal‐dominant disorders secondary to defects in joint and muscle function, characterized by multiple joint contractures of the hands and feet. DA can be divided into 10 types according to clinical features. DA has been confirmed to be caused by mutations in genes encoding components of the contractile apparatus of skeletal muscle fibers, such as troponin I2 (TNNI2). Methods: In this study, we report a three‐generation DA family belonging to the DA2B type. The clinical characteristics of affected members are genetically stable and consistent, with severe deformities in hands and feet, and two affected adults had short stature. None exhibited facial abnormalities. Blood from three affected and three healthy members were collected for whole‐exome sequencing and Sanger sequencing. Results: A missense variant in TNNI2 (NM_003282.4: c.525G>T: p.K175N) was successfully identified, which resulted in the substitution of amino acid at position 175 of TNNI2 from lysine to asparagines. Conclusion: The variant c.525G>T in TNNI2 explains the cause of DA in the family. This variant was identified in Chinese people for the first time, and the same variant had been reported in another study but no description of clinical symptoms. Our study comprehensively characterized the c.525G>T variant in TNNI2. [ABSTRACT FROM AUTHOR]

Purpose: The management of type 3 lateral condyle fractures (LCFs) remains controversial. The main goal of this study was to evaluate the feasibility of closed reduction and percutaneous pinning (CRPP) in patients with type 3 LCFs and to assess the outcome of such injuries according to the type of treatment, CRPP, or open reduction and internal fixation (ORIF).Methods: This is a retrospective review of prospectively enrolled children with type 3 LCF managed by CRPP or ORIF between 2018 and 2021. All patients were followed for at least 12 months. Patients were divided into two groups according to the type of treatment, CRPP or ORIF. Demographic characteristics were recorded for all patients. Standard radiographs were used to identify, evaluate, and classify each fracture and to detect the presence of other concomitant bone lesions. The clinical outcome was assessed according to the Hardacre et al. criteria.Results: Seventy-eight children with type 3 LCF were included; 42 were treated by CRPP (53.8%) and 36 by ORIF (46.2%); the mean follow-up time was 17.7 months (range, 12.3-40.9). The baseline characteristics did not differ between the two groups of patients. Overall, successful CRPP could be achieved in 39 out of 42 patients (92.9%). The mean surgical time was 63.4 and 84.5 min in patients treated by CRPP and ORIF, respectively (p = 0.01). Fluoroscopy time was significantly shorter in patients managed by ORIF than in those treated by CRPP (12 versus 40 s, respectively; p < 0.001). Clinical outcome according to the Hardacre et al. criteria was excellent in 37 out of 39 (94.4%) and in 35 out of 36 patients (97.2%) treated by CRPP and ORIF, respectively (p = 0.09).Conclusions: CRPP management of paediatric type 3 LCF has clinical and radiographic outcomes similar to ORIF; if satisfactory reduction cannot be achieved by CRPP, conversion to ORIF should be considered. [ABSTRACT FROM AUTHOR]

[Display omitted] • PAW pre-exposure and subsequent US treatment has energy-efficient in MRSA inactivation. • The enhanced inactivation was partly due to the in-situ generation of RONS. • Elevated arginine levels induced the formation of VBNC bacteria. • Regrowth potential of MRSA cells was negligible. Methicillin-resistant Staphylococcus aureus (MRSA) and antibiotic resistance gene (mecA) are considered emerging contaminants that have been extensively identified in aqueous environments due to their high resistance to disinfectants. Herein, we report for the first time the inactivation of MRSA through a sequential application of plasma-activated water and ultrasound (PAW-SU). While the impact of PAW alone on bacterial culturability and mecA integrity was negligible, the combined PAW-SU treatment outperformed the inactivation method involving PAW with direct US (PAW-DU). It exhibited a shorter lag phase and a higher maximum inactivation rate constant. We numerically demonstrated that sonolysis processes induced by external ultrasound sources considerably improved the intracellular and extracellular reactive oxygen and nitrogen species (RONS) of MRSA in PAW system, thereby increasing the PAW reactivity and applicability. The highest inactivation efficiency of PAW-SU can be attributed to the synergistic effect of enhanced intracellular RONS (i.e., peroxynitrite and singlet oxygen) and membrane disruption induced by US, resulting in irreparable oxidative damage to the Save our Soul response and energy metabolic system. In particular, the elevated arginine metabolites in MRSA cells were primarily responsible for the formation of the viable but nonculturable state (VBNC) bacteria associated with high resistance to PAW system. Surprisingly, a decrease in arginine synthesis capacity was observed to expedite the flow of the tricarboxylic acid cycle, accelerating the detrimental effects of PAW-SU on intracellular components in VBNC bacteria. Finally, the limited regrowth potential of injured MRSA caused by cyclic inactivation of PAW-SU process was further confirmed in wastewater from meat and dairy models and therefore, advocates the possible real-world applications. [ABSTRACT FROM AUTHOR]

Background: Idiopathic congenital talipes equinovarus (ICTEV) is one of the most common congenital deformities of children, and dysplasia of the striated muscle may be one of the causes of ICTEV. Previous studies have shown that polymorphisms of the rs4075583 SNP in the tropomyosin gene 1 (TPM1) were associated with ICTEV in Caucasian children. However, there are no studies investigating the correlations of TPM gene polymorphisms with the risk of ICTEV in Chinese children. Methods: We conducted a case–control study, including 430 children with ICTEV and 891 ICTEV-free children. We explored the potential correlations of three TPM gene polymorphisms (TPM1/rs4075583 G>A, tropomyosin gene 2 (TPM2)/rs2145925 C>T, and TPM2/rs2025126 G>A) with ICTEV risk. The three single nucleotide polymorphisms (SNPs) were genotyped using a TaqMan method. We calculated the odds ratios (ORs) and adjusted ORs and their 95% confidence intervals (CIs) to explore the associations between these selected SNP polymorphisms and ICTEV. Results:TPM1 rs4075583 A was found to be associated with an increased ICTEV risk (AA vs. GG: adjusted OR = 1.70, 95% CI = 1.15–2.49, p = 0.007; and GG/GA vs. AA: adjusted OR = 1.62, 95% CI = 1.14–2.31, p = 0.0071) after adjusting for age and sex. In addition, a risk effect of rs4075583 GA/AA with ICETV was observed for patients with affected right feet (adjusted OR = 1.62, 95% CI = 1.10–2.39, p = 0.014) in the stratified analysis. However, there were no significant differences in the risk for ICTEV associated with the rs2145925 and rs2025126 polymorphisms. Conclusion: These results indicate that the TPM1 rs4075583 G > A polymorphism is associated with ICTEV risk in a southern Chinese population; however, this finding needs to be confirmed in larger studies and through mechanistic studies. [ABSTRACT FROM AUTHOR]

Purpose: Severe cervical kyphosis (CK) in neurofibromatosis type 1 (NF-1) is associated with a high risk for progression and neurologic impairment in children. We present our surgical technique and mid-term outcomes of uninstrumented anterior tibial strut grafting for severe CK secondary to NF-1.Case report. The Consensus-based Clinical Case Reporting Guideline Development (CARE) guidelines were followed.Two paediatric patients (8- and 3-year-old) presented with severe CK secondary to NF-1. A halo body jacket (HV) allowed the progressive distraction of the cervical spine, avoiding neurological compromise and deformity progression. Circumferential fusion was obtained with anterior tibial strut autograft and posterior onlay bone graft. Cervical spine fusion was successfully maintained at a minimum 4-year follow-up in both patients.In children with severe CK secondary to NF-1, cervical distraction and immobilisation with a HV followed by uninstrumented anterior tibial strut grafting and posterior bone grafting, provided spinal fusion and stability without increasing the risk of neurological injury and donor site morbidity. The reported surgical technique appears to be a valuable tool in the armamentarium of the spinal surgeon.Methods: Severe cervical kyphosis (CK) in neurofibromatosis type 1 (NF-1) is associated with a high risk for progression and neurologic impairment in children. We present our surgical technique and mid-term outcomes of uninstrumented anterior tibial strut grafting for severe CK secondary to NF-1.Case report. The Consensus-based Clinical Case Reporting Guideline Development (CARE) guidelines were followed.Two paediatric patients (8- and 3-year-old) presented with severe CK secondary to NF-1. A halo body jacket (HV) allowed the progressive distraction of the cervical spine, avoiding neurological compromise and deformity progression. Circumferential fusion was obtained with anterior tibial strut autograft and posterior onlay bone graft. Cervical spine fusion was successfully maintained at a minimum 4-year follow-up in both patients.In children with severe CK secondary to NF-1, cervical distraction and immobilisation with a HV followed by uninstrumented anterior tibial strut grafting and posterior bone grafting, provided spinal fusion and stability without increasing the risk of neurological injury and donor site morbidity. The reported surgical technique appears to be a valuable tool in the armamentarium of the spinal surgeon.Results: Severe cervical kyphosis (CK) in neurofibromatosis type 1 (NF-1) is associated with a high risk for progression and neurologic impairment in children. We present our surgical technique and mid-term outcomes of uninstrumented anterior tibial strut grafting for severe CK secondary to NF-1.Case report. The Consensus-based Clinical Case Reporting Guideline Development (CARE) guidelines were followed.Two paediatric patients (8- and 3-year-old) presented with severe CK secondary to NF-1. A halo body jacket (HV) allowed the progressive distraction of the cervical spine, avoiding neurological compromise and deformity progression. Circumferential fusion was obtained with anterior tibial strut autograft and posterior onlay bone graft. Cervical spine fusion was successfully maintained at a minimum 4-year follow-up in both patients.In children with severe CK secondary to NF-1, cervical distraction and immobilisation with a HV followed by uninstrumented anterior tibial strut grafting and posterior bone grafting, provided spinal fusion and stability without increasing the risk of neurological injury and donor site morbidity. The reported surgical technique appears to be a valuable tool in the armamentarium of the spinal surgeon.Conclusion: Severe cervical kyphosis (CK) in neurofibromatosis type 1 (NF-1) is associated with a high risk for progression and neurologic impairment in children. We present our surgical technique and mid-term outcomes of uninstrumented anterior tibial strut grafting for severe CK secondary to NF-1.Case report. The Consensus-based Clinical Case Reporting Guideline Development (CARE) guidelines were followed.Two paediatric patients (8- and 3-year-old) presented with severe CK secondary to NF-1. A halo body jacket (HV) allowed the progressive distraction of the cervical spine, avoiding neurological compromise and deformity progression. Circumferential fusion was obtained with anterior tibial strut autograft and posterior onlay bone graft. Cervical spine fusion was successfully maintained at a minimum 4-year follow-up in both patients.In children with severe CK secondary to NF-1, cervical distraction and immobilisation with a HV followed by uninstrumented anterior tibial strut grafting and posterior bone grafting, provided spinal fusion and stability without increasing the risk of neurological injury and donor site morbidity. The reported surgical technique appears to be a valuable tool in the armamentarium of the spinal surgeon. [ABSTRACT FROM AUTHOR]

Although the main causative genes for hereditary multiple exostoses (HME) are exostosin (EXT)-1 and EXT-2, there are numerous patients with HME without EXT-1 and EXT-2 mutations. The present study aimed to identify novel candidate genes for the development of HME in patients without EXT-1 and EXT-2 mutations. Whole-exome sequencing was performed in a Chinese family with HME and without EXT-1 and EXT-2 mutations, followed by a combined bioinformatics pipeline including annotation and filtering processes to identify candidate variants. Candidate variants were then validated using Sanger sequencing. A total of 1,830 original variants were revealed to be heterozygous mutations in three patients with HME which were not present in healthy controls. Two mutations [c.C1849T in solute carrier family 20 member 2 (SLC20A2) and c.G506A in leucine zipper and EF-hand containing transmembrane protein 1 (LETM1)] were identified as possible causative variants for HME through a bioinformatics filtering procedure and harmful prediction. Sanger sequencing results confirmed these two mutations in all patients with HME. A mutation in SLC20A2 (c.C1849T) led to a change in an amino acid (p.R617C), which may be involved in the development of HME by inducing metabolic disorders of phosphate and abnormal proliferation and differentiation in chondrocytes. In conclusion, the present study revealed two mutations [SLC20A2 (c.C1849T) and LETM1 (c.G506A) in a Chinese family with HME. The mutation in SLC20A2 (c.C1849T)] was more likely to be involved in the development of HME. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate (1) the probability to achieve normal pelvic radiographs in children with developmental dysplasia of the hip (DDH) treated by closed reduction and (2) the amount of time needed to achieve normal pelvic radiographs and to assess what factors influence both probability and time to achieve normal radiographic parameters following CR and spica cast immobilization for DDH.Methods: We retrospectively reviewed 436 patients (393 girls, 43 boys; 507 hips) with DDH treated by closed reduction (CR). Tönnis grade, AVN, acetabular index (AI), centre-edge angle (CEA), and Severin radiographic grade were evaluated on plain radiographs. Criteria to rate pelvis radiographs as normal were established. Cox regression was used to evaluate the factors influencing the probability and the time to achieve normal radiographs.Results: According to our criteria, 167 hips (32.9%) achieved normal radiographic parameters during follow-up. The overall amount of time to achieve normal pelvis radiographs was 36.1 ± 15.5 months. Patients older than 24 months of age at the time of CR needed longer time to achieve normal radiographic parameters (55.2 ± 28 months) compared with other age groups. Cox regression analysis suggested the overall cumulative probability of recovery increased by 46% at five years following CR, then it tended to plateau with an annual increase less than 5%. Age older than 24 months, bilateral dislocation, pre-operative AI greater than 40°, and AVN were risk factors for reduced probability of achieving normal radiographic parameters.Conclusions: The cumulative probability of achieving normal pelvis radiographs increases linearly during the first five years following CR, then it tends to plateau. Age older than 24 months and Tönnis grade III and IV are associated with longer time to achieve normal radiographic parameters. Age older than 24 months, bilateral dislocation, pre-operative AI greater than 40°, and AVN are risk factors for reduced probability of achieving normal radiographic parameters in children with DDH treated by closed means. [ABSTRACT FROM AUTHOR]

Purpose: Increased femoral anteversion can be associated with hip instability, redislocation after closed reduction, and subsequent early degenerative arthritis. Our study compared proximal femoral anteversion of affected and unaffected sides of patients with unilateral developmental dysplasia of the hip (DDH) on two-dimensional computed tomography. The primary aim was to evaluate whether femoral anteversion at the time of treatment affected the outcome of patients with unilateral DDH treated by closed reduction.Methods: A retrospective review of 89 patients (82 females; 53 left; mean age: 26.6 months) with unilateral DDH was performed. Anteversion angle (AA) of the femur and acetabular index (AI) of both affected (AAa; AIa) and unaffected (AAu; AIu) hips were measured on two-dimensional CT scan performed no more than seven days prior to the index surgical procedure.Results: Among the 89 patients, 50 underwent closed reduction (56.2%), 38 underwent open reduction with or without pelvic osteotomy (42.7%), and one patient refused treatment (1.1%). Overall, the mean AAa was 28.1° ± 10.2° (range: 6.3°-54°) and mean AAu was 25.2° ± 9.9° (range: 1.9°-52.5°) (t = 3.2, p = 0.002). Tönnis type 2 hips did not show any statistically significant difference between AAa and AAu (p = 0.386), while Tönnis types 3 and 4 hips had significantly higher AAa than did AAu (t = 3.7, p = 0.001). There were significant correlations between age and AAa (coefficient = 0.4; p < 0.001) and AAu (coefficient = 0.304; p = 0.004). Correlation analysis showed that AIa did not improve with age in any Tönnis group (r: - 0.24, p = 0.823; F = 0.039, p = 0.962). AAa, AIa, AAD, AID, and Tönnis grade distribution were similar in patients with good (no redislocation) and poor outcomes (redislocation) (p > 0.05).Conclusion: In patients with unilateral DDH, anteversion angle (AA) was found to be significantly different between affected and unaffected sides. However, the difference had very limited or no clinical significance, as redislocation/sub-luxation was not influenced by AA values. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the radiographic outcomes, rate of redislocation, and avascular necrosis of proximal femoral epiphysis (AVN) in patients aged 24 to 36 months with developmental dysplasia of the hip (DDH) treated by closed reduction (CR) and spica cast immobilization in human position.Material and Methods: We reviewed the medical records of 39 patients (51 hips) aged 24 to 36 months with DDH treated by CR and spica cast immobilization in human position. The Tönnis grade, rate of redislocation and AVN, acetabular index (AI), centre-edge angle (CEA), and Severin radiographic grade were evaluated on plain radiographs.Results: Among the included 39 patients (51 hips), 15 hips (29.4%) were Tönnis grade II, 24 hips (47.1%) were grade III, and 12 hips (23.5%) were grade IV. In 47 hips (92.2%), the ossific nucleus was present at the time of CR. Stable reduction was achieved by CR in 39/51 hips (76.5%) and redislocation occurred in 12/51 hips (23.5%). Among the 12 hips that redislocated, 11 underwent open reduction and one repeated CR. Two out of 40 hips (5%) treated by CR developed AVN. Overall, 54.6% of the hips had satisfactory outcomes (39.2% Severin type I and 17.6% type II), while 45.4% had unsatisfactory outcomes (39.2% Severin type III and 3.9% type IV). Of the 40 hips treated by CR, 57.5% and 42.5% of cases had satisfactory outcomes and residual acetabular dysplasia, respectively. Six out of 11 hips (54.6%) treated by open reduction and pelvic osteotomy had satisfactory outcomes.Conclusions: Our study showed that stable CR could be achieved in 76.5% of patients aged 24 to 36 months with DDH at the time of index procedure. Satisfactory outcomes can be expected in 56.4% of the cases (5.0% AVN rate), although late acetabular dysplasia may develop in 43.6% of the hips. [ABSTRACT FROM AUTHOR]

Background: Closed reduction and spica cast is still the preferred treatment option for children presenting with developmental dysplasia of the hip (DDH) after the age of 6 months. This study aims to investigate the outcomes of patients with DDH treated by closed reduction and dynamic cast immobilization.Methods: In total, 159 patients (mean age 15.6 ± 4.2 months; 172 hips) were treated with a dynamic cast immobilization for 3 months, followed by an abduction brace until a stable concentric reduction was achieved. Radiological examination was performed at each follow-up visit to assess reduction, redislocation rate and presence of avascular necrosis (AVN) of the femoral epiphysis. Final radiographic results were evaluated with the Severin classification.Results: The redislocation rate was 4.1% (7/172); the overall AVN rate was 14.5% (grade II: 16 hips; grade III: 5 hips; grade IV: 3 hips). At last follow-up visit, the mean age of patients was 61.6 ± 21.3 months (range 30.8-141), and the mean acetabular index was 22.6° ± 5.6°; 67.3% of the hips had Severin type I radiographic criteria, 8.5% had type II, 23.6% had type III, and 0.6% had type IV.Conclusions: Dynamic cast is an alternative to spica cast immobilization in DDH patients undergoing closed reduction. It has similar redislocation and AVN rates compared to standard spica cast immobilization, as reported by previous studies. [ABSTRACT FROM AUTHOR]

Purpose: Closed reduction and spica cast immobilization are routinely used for young patients with developmental dysplasia of the hip with reducible hips. Our primary objective was to assess the interpretation quality of immediate post-operative pelvis radiographs after treatment.Methods: A series of 28 randomly selected patients (30 hips) with pre- and post-operative pelvis radiographs and post-operative magnetic resonance imaging were included. Each was presented twice with an interval of two weeks, in alternating orders. Raters with different experience and specialties from different institutions rated the quality of reduction (hip in or out) after treatment.Results: Thirteen surgeons and three radiologists evaluated 30 hips (28 patients). Agreement was not satisfactory (κ = 0.12). Experienced clinicians demonstrated similar agreement to inexperienced raters (κ = 0.04). Consistency at a two week interval was moderate (κ = 0.48, percent of agreement at 82%). The mean number of errors from the two ratings were 8.6 ± 2.5 and 8.9 ± 2.7, respectively (P = 0.72). There was no significant difference between surgeons with different levels of experience; radiologists did better than surgeons, but the difference was insignificant. Raters from different institutions had similar performance in poor judgment.Conclusions: Our results show poor concordance between observers and ratings. Post-operative radiographs are unreliable for assessing the quality of hip reduction. The level of experience, subspecialty, and geographical origin do not impact the radiographic assessment. Based on the present findings, we recommend performing post-operative magnetic resonance imaging rather than anteroposterior pelvis radiograph to assess the hip. Compared to standard radiographs, magnetic resonance imaging allows more reliable interpretation while decreasing radiation exposure. [ABSTRACT FROM AUTHOR]

Purpose: Our objective was to find the best predictor of late residual acetabular dysplasia in developmental dysplasia of the hip (DDH) after closed reduction (CR) and discuss the indications for secondary surgery.Methods: We retrospectively reviewed the records of 89 patients with DDH (mean age 16.1 ± 4.6 months; 99 hips) who were treated by CR. Hips were divided into three groups according to final outcomes: satisfactory, unsatisfactory and operation. The changes in the acetabular index (AI), centre-edge angle of Wiberg (CEA), Reimer's index (RI) and centre-head distance discrepancy (CHDD) over time among groups were compared. The power of predictors for late residual acetabular dysplasia of AI, CEA, RI and CHDD at different time points was analysed by logistic regression analysis. Receiver operating characteristics (ROC) curve analysis was used to determine cutoff values and corresponding sensitivity, specificity and diagnostic accuracy for these parameters.Results: Both AI and CEA improved in all groups of patients following CR. In the satisfactory group, AI progressively decreased until seven to eight years, while CEA increased until nine to ten years (P < 0.05). In the unsatisfactory group, AI and CEA ceased to improve three and two years after CR, respectively (P < 0.05). CEA and RI were significantly better in the satisfactory group compared with the unsatisfactory group at all time points (P < 0.05). Following CR, both RI and CHDD remained stable over time in all groups. Final outcome following CR could be predicted by AI, CEA and RI at all time points (P < 0.01). Cutoff values of AI, CEA and RI were 28.4°, 13.9° and 34.5%, respectively, at one year and 25°, 20° and 27%, respectively, at two to four years post-CR. A total of 80-88% of hips had an unsatisfactory outcome if AI > 28.4° and >25 at one and two to four years following CR, respectively. However, if CEA was less than or RI was larger than the cutoff values at each time point, only 40-60% of hips had an unsatisfactory outcome. Mean sensitivity (0.889), specificity (0.933) and diagnostic accuracy (92.1%) of AI to predict an unsatisfactory outcome were significantly better compared with CEA (0.731; 0.904; 78.2%) and RI (0.8; 0.655; 70.8%) (P < 0.05).Conclusions: Satisfactory and unsatisfactory hips show different patterns of acetabular development after reduction. AI, CEA and RI are all predictors of final radiographic outcomes in DDH treated by CR, although AI showed the best results. AI continues to improve until seven years after CR in hips with satisfactory outcomes, while it ceases to improve three to four years after CR in hips with unsatisfactory outcomes. According to our results, surgery is indicated if AI >28° 1 year following CR or AI >25° two to four years after CR. CEA and RI should be used as a secondary index to aid in the selection of patients requiring surgery. [ABSTRACT FROM AUTHOR]

• A strategy was proposed to enhance sensitivity of immunochromatographic assay (ICA). • Two probes were constructed based on quantum dot nanobeads, protein A and anti-IgG antibody. • The probes are oriented to Fc region of anti-E2 antibody to fully expose Fab region. • The ICA based on universal probes achieved high-sensitivity and rapid detection of E2 in milk. • The prepared universal probes could be applied for the detection of any antigen per strip. The pollution caused by estrogens in the environment and food has received increasing attention. It is still challenging for on-site immunochromatographic assay (ICA) detection of estrogens. The performance of the prepared probes plays a decisive role in the sensitivity and stability of the ICA system. The published probes usually directly couple the detection antibody to the label, ignoring the influence of the label on the activity of the antibody. In this study, 17β-estradiol (E 2) was used as a model analyte for the ICA system. Two universal probes were constructed based on quantum dot nanobeads (QBs), recombinant protein A (SPA, from Staphylococcus aureus), and rabbit anti-mouse immunoglobulin G antibody (anti-IgG). The probes were prepared by coupling QBs with SPA, releasing anti-E 2 monoclonal antibody (mAb), and maintaining its activity. The prepared universal probes can orient recognize the Fc region of mAb and fully expose its Fab region, improving the detection sensitivity of the ICA system. The free anti-E 2 mAb and the universal probe (QBs@SPA or QBs@SPA@anti-IgG) were used as the detection antibodies and signal donors, respectively. The results show that the proposed ICA based on QBs@SPA and QBs@SPA@anti-IgG probes could detect E 2 with IC 50 of 8.83 and 0.93 ng/mL, respectively, within 15 min under optimal conditions. The recovery results of ICA based on QBs@SPA and QBs@SPA@anti-IgG probes showed good agreement with the findings of the high-performance liquid chromatography (HPLC) analysis for spiked samples. The developed ICA system based on universal probes was superior in terms of sensitivity, rapidity, and applicability, and held great promise for its implementation in detecting environmental and food small-molecule pollutants. [ABSTRACT FROM AUTHOR]

Neurofibromatosis type I (NF1) is an autosomal dominant genetic disease that is caused by mutations in the NF1 gene. Various studies have previously demonstrated that the mTOR complex 1 signaling pathway is essential for the NF1-modulated osteogenic differentiation of bone mesenchymal stem cells (BMSCs). Additionally, the mTOR signaling pathway plays a notable role in autophagy. The present study hypothesized that NF1 could modulate the osteogenic differentiation of BMSCs by regulating the autophagic activities of BMSCs. In the present study, human BMSCs were cultured in an osteogenic induction medium. The expression of the NF1 gene was either knocked down or overexpressed by transfection with a specific small interfering RNA (siRNA) targeting NF1 or the pcDNA3.0 NF1-overexpression plasmid, respectively. Autophagic activities of BMSCs (Beclin-1, P62, LC3B I, and LC3B II) were determined using western blotting, electron microscopy, acridine orange (AO) staining and autophagic flux/lysosomal detection by fluorescence microscopy. In addition, the autophagy activator rapamycin (RAPA) and inhibitor 3-methyladenine (3-MA) were used to investigate the effects of autophagy on NF1-modulated osteogenic differentiation in BMSCs. Inhibiting NF1 with siRNA significantly decreased the expression levels of autophagy markers Beclin-1 and LC3B-II, in addition to osteogenic differentiation markers osterix, runt-related transcription factor 2 and alkaline phosphatase. By contrast, overexpressing NF1 with pcDNA3.0 significantly increased their levels. Transmission electron microscopy, AO staining and autophagic flux/lysosomal detection assays revealed that the extent of autophagosome formation was significantly decreased in the NF1-siRNA group but significantly increased in the NF1-pcDNA3.0 group when compared with the NC-siRNA and pcDNA3.0 groups, respectively. In addition, the activity of the PI3K/AKT/mTOR pathway [phosphorylated (p)-PI3K, p-AKT, p-mTOR and p-p70S6 kinase] was significantly upregulated in the NF1-siRNA group compared with the NC-siRNA group, and significantly inhibited in the NF1-pcDNA3.0 group, compared with the pcDNA3.0 group. The knockdown effects of NF1-siRNA on the autophagy and osteogenic differentiation of BMSCs were reversed by the autophagy activator RAPA, while the overexpression effects of NF1-pcDNA3.0 on the autophagy and osteogenic differentiation of BMSCs were reversed by the autophagy inhibitor 3-MA. In conclusion, results from the present study suggest at the involvement of autophagy in the NF1-modulated osteogenic differentiation of BMSCs. Furthermore, NF1 may partially regulate the autophagic activity of BMSCs through the PI3K/AKT/mTOR signaling pathway. [ABSTRACT FROM AUTHOR]

Antibacterial hydrogels have received attention for preventing infections and for their biomedical applications. However, traditional antibiotics-containing and metal nanoparticle-containing hydrogels often cause bacterial resistance, exhibit low biocompatibility, and lack real-time monitoring capability. Here, a fluorescent antibacterial hydrogel with antibacterial ability, excellent optical performance, and high biocompatibility was developed based on cationic carbon dots (CDs), pectin, and acrylic acid triggered construction of the hydrogel network by cross-linker. The antibacterial high-cationic CDs (+51.20 mV) were synthesized by a simple hydrothermal method and released from hydrogel in response to broken hydrogen bonds due to a change in the ambient environment caused by the growing bacteria. The hydrogel showed long-term potent broad-spectrum antibacterial ability (even drug-resistant bacteria) due to the bacterial membrane seriously damaged by the released CDs. The inhibitory capability of this hydrogel was 108.5-fold higher than the other hydrogel. After implantation or incubation with cells, no obvious cytotoxicity or tissue toxicity was observed for the antibacterial hydrogel. This hydrogel enhanced both the application of CDs in vivo and the biosafety of hydrogel. Furthermore, the multicolor fluorescence emission produced by CD provides a potential idea for the development of dual-function hydrogels with in situ monitoring and prevention of bacterial infections to treat wounds. ga1 • The antibacterial high-cationic carbon dots (CDs) were synthesized by a hydrothermal method. • Fluorescent antibacterial hydrogel was synthesized and released CDs in response to pH. • The CDs-releasing hydrogels enhanced both the application of CDs in vivo and the biosafety of hydrogel. • The prepared hydrogel showed high antibacterial ability, excellent optical performance, and good biocompatibility. [ABSTRACT FROM AUTHOR]