Impact of lower limb alignment abnormality (physiologic knee valgus) on the functional recovery outcome of athletes with meniscal injuries.

OBJECTIVE: This study aimed to investigate the impact of lower limb alignment abnormalities, specifically physiological knee valgus, on the functional recovery outcomes of athletes with meniscal injuries. It also examined the factors influencing these abnormalities to provide scientific evidence for treatment and rehabilitation of related sports injuries. METHODS: We conducted a retrospective study of 118 athletes from Guizhou Normal University, who were divided into two groups based on the presence or absence of lower limb alignment abnormalities. The Simple group comprised athletes with isolated meniscal injuries, while the Combined group included athletes with meniscal injuries and concurrent lower limb alignment abnormalities. We assessed the functional status of both groups and analyzed factors influencing lower limb alignment abnormalities. RESULTS: Of the 118 athletes, 46 (38.98%) exhibited lower limb alignment abnormalities, and 72 (61.02%) did not. No significant differences in general characteristics were found between the groups (all P > 0.05). The Combined group displayed higher Visual Analog Scale (VAS) scores and Functional Performance Test (FPT) results (coordinated contraction, shuttle run, CarioCa) compared to the Simple group (P < 0.05). Conversely, joint range of motion (ROM), knee muscle strength (flexors), and International Knee Documentation Committee (IKDC) scores were lower in the Combined group (all P < 0.05). Multivariate logistic regression analysis identified active ROM < 105.32°, passive ROM < 101.66°, and knee muscle strength (flexors) < 84.41 N as risk factors for lower limb alignment abnormalities (P < 0.05), while FPT acted as a protective factor (P < 0.05). The combined testing model demonstrated higher predictive efficacy (AUC = 0.903, 95% CI: 0.852-0.955, P < 0.001). CONCLUSION: Lower limb alignment abnormalities significantly affect the functional recovery outcomes of athletes with meniscal injuries. Factors such as ROM, knee muscle strength, and IKDC score may pose risks for these abnormalities, whereas FPT can provide protective benefits. Timely detection and correction of lower limb alignment abnormalities during the rehabilitation process from meniscal injuries are crucial to enhance recovery and improve prognosis.

Centrifugal Inertia-Induced Directional Alignment of AgNW Network for Preparing Transparent Electromagnetic Interference Shielding Films with Joule Heating Ability.

Transparent electromagnetic interference (EMI) shielding is highly desired in specific visual scenes, but the challenge remains in balancing their EMI shielding effectiveness (SE) and optical transmittance. Herein, this study proposed a directionally aligned silver nanowire (AgNW) network construction strategy to address the requirement of high EMI SE and satisfactory light transmittance using a rotation spraying technique. The orientation distribution of AgNW is induced by centrifugal inertia force generated by a high-speed rotating roller, which overcomes the issue of high contact resistance in random networks and achieves high conductivity even at low AgNW network density. Thus, the obtained transparent conductive film achieved a high light transmittance of 72.9% combined with a low sheet resistance of 4.5 Ω sq-1 and a desirable EMI SE value of 35.2 dB at X band, 38.9 dB in the K-band, with the highest SE of 43.4 dB at 20.4 GHz. Simultaneously, the excellent conductivity endowed the film with outstanding Joule heating performance and defogging/deicing ability, ensuring the visual transparency of windows when shielding electromagnetic waves. Hence, this research presents a highly effective strategy for constructing an aligned AgNW network, offering a promising solution for enhancing the performance of optical-electronic devices.

Effectiveness and safety of preoperative distraction using modified halo-pelvic Ilizarov distraction assembly in patients with severe kyphoscoliosis.

Study Design: A 2-year follow-up study. Purpose: To evaluate the effectiveness of modified halo-pelvic Ilizarov distraction assembly in the management of patients with severe kyphoscoliosis. Overview of Literature: Severe and rigid scoliosis curves are always a challenge for operating surgeons. Preoperative correction through halo-pelvic devices successfully minimizes the severity of the curve; however, cumbersome complications are also reported with its use. Modified assembly could be safe for these cases. Methods: Patients with severe kyphoscoliosis having coronal Cobb angle >90° were applied with modified halo-pelvic Ilizarov distraction assembly preoperatively. The modified assembly consisted of a pelvic component and halo ring, and distraction was given at the rate of 2-3 mm/day for 6-12 weeks. Complete clinical assessments along with pulmonary function tests were performed, and scoliosis series X-ray images were assessed for coronal and sagittal Cobb angle and other spinopelvic parameters before applying the assembly and during 2 years of follow-up. Results: Thirty-four patients (age, 9-27 years; male/female ratio of 18:16) were included. The coronal and sagittal Cobb angles were 116°±16.2° and 84°±28.3°, respectively. Correction rates obtained through modified halo-pelvic assembly were nearly 52% (p=0.001) in coronal and 40% (p=0.001) in sagittal Cobb angles, with improvement in height (p=0.001). Apical vertebral translation and coronal balance were also improved significantly (p=0.001). Further improvements in all the parameters were obtained after definitive surgery, with improvements in the forced expiratory volume in 1 second (p =0.002) and forced vital capacity (p=0.001). Conclusions: Our modified halo-pelvic Ilizarov distraction assembly can achieve good correction in severe spinal deformities without significant risk to neurology, has fewer complications, and promotes good patient compliance.

Can pelvic incidence affect changes in sagittal spino-pelvic parameters between standing and sitting positions in individuals with lumbar degenerative disease?

OBJECTIVE: The aim of this study was to explore the correlation between PI and standing-to-sitting changes of the sagittal alignment in patients with lumbar degenerative diseases, and investigate the differences in posture changes among Roussouly types. METHODS: A total of 209 patients with lumbar degenerative disease were retrospectively included in this study. All the patients received lateral full body imaging in both standing and sitting positions. Sagittal parameters including SVA, OD-HA, PT, PI, PT/PI, SS, LL, TK, Upper LL (L1-L4) and Lower LL (L4-S1) were measured in both standing and sitting position, and the parameters were compared between two positions. The correlations between PI and lumbo-pelvic changes were analyzed. The postural changes were compared among different Roussouly types. RESULTS: From standing to sitting, all the parameters except PI significantly changed, including SVA, OD-HA, PT, PT/PI, SS, LL, TK, Upper LL and Lower LL. The contribution of lower LL was greater to global LL than upper LL. PI had a significant correlation with ΔPT, ΔSS, ΔLL, ΔUpper LL and ΔLower LL. From standing to sitting, type 4 patients had the most pronounced ΔPT, ΔSS and ΔLL, and ΔLower LL of types 3 and 4 were greater than that of types 1 and 2. CONCLUSIONS: In patients with degenerative disease, PI plays an important role in determining the extent of lumbo-pelvic changes from standing to sitting. Among different Roussouly types, type 4 patients have the most pronounced changes of PT, SS and LL, suggesting the relatively greater flexibility of pelvis and lumbar spine.

An unsupervised multi-view contrastive learning framework with attention-based reranking strategy for entity alignment.

Entity alignment is a crucial task in knowledge graphs, aiming to match corresponding entities from different knowledge graphs. Due to the scarcity of pre-aligned entities in real-world scenarios, research focused on unsupervised entity alignment has become more popular. However, current unsupervised entity alignment methods suffer from a lack of informative entity guidance, hindering their ability to accurately predict challenging entities with similar names and structures. To solve these problems, we present an unsupervised multi-view contrastive learning framework with an attention-based reranking strategy for entity alignment, named AR-Align. In AR-Align, two kinds of data augmentation methods are employed to provide a complementary view for neighborhood and attribute, respectively. Next, a multi-view contrastive learning method is introduced to reduce the semantic gap between different views of the augmented entities. Moreover, an attention-based reranking strategy is proposed to rerank the hard entities through calculating their weighted sum of embedding similarities on different structures. Experimental results indicate that AR-Align outperforms most both supervised and unsupervised state-of-the-art methods on three benchmark datasets.

Real-world accuracy of robotic-assisted total knee arthroplasty and its impact on expedited recovery.

Despite total knee arthroplasty (TKA) being the gold standard for end-stage knee osteoarthritis, 20% of patients remain dissatisfied. Robotic-assisted arthroplasty promises unparalleled control of the accuracy of bone cuts, implant positioning, control of gap balance, and resultant hip-knee-ankle (HKA) axis. Patients underwent clinical and radiological assessments, including knee CT scans and patient-reported outcome measures (PROMs), preoperatively. Follow-up assessments were conducted at 2 weeks, 6 weeks, and 3 months post-operatively, with imaging repeated at 6 weeks. A total of 155 patients underwent robotic-assisted TKA and have completed 3 months of follow-up. Mean pre-operative HKA axis was 7.39 ± 5.52 degrees varus, improving to 1.34 ± 2.22 degrees varus post-operatively. Restoration of HKA axis was 0.76 ± 1.9 degrees from intra-operative planning (p < 0.0005). Implant placement accuracy in the coronal plane was 0.08 ± 1.36 degrees (p = 0.458) for the femoral component and 0.71 ± 1.3 degrees (p < 0.0005) for the tibial component. Rotational alignment mean deviation was 0.39 ± 1.49 degrees (p = 0.001). Most patients (98.1%) had ≤ 2 mm difference in extension-flexion gaps. PROM scores showed improvement and exceeded pre-operative scores by 6 weeks post-surgery. Robotic-assisted knee arthroplasty provides precise control over traditionally subjective factors, demonstrating excellent early post-operative outcomes.Level of evidence Prospective observational study-II.

The Effect of Global Spinal Alignment on the Cervical Degeneration in Patients with Degenerative Lumbar Scoliosis.

PURPOSE: To elucidate the effect of global spinal alignment on the cervical degeneration in Patients with Degenerative Lumbar Scoliosis (DLS). METHODS: A total of 117 patients with DLS and 42 controls were analysed. DLS patients (study group) were categorized according to the SRS-Schwab classification. Patients with lumbar spinal stenosis were reviewed as a control group. Spinopelvic parameters were measured in cervical and full-length spine radiographs. Cervical degeneration was assessed using the Cervical Degeneration Index (CDI) scoring system. RESULTS: There were significant differences in C2-7 sagittal vertical axis, T1 Slope, thoracic kyphosis, Lumbar Lordosis (LL), and pelvic tilt between DLS and control groups. Although the DLS and control groups did not differ significantly with regard to CDI scores, a striking difference was noted when sagittal spinopelvic modifiers were considered individually. Patients with a Pelvic Incidence minus Lumbar Lordosis (PI-LL) modifier grade of ++ had significantly higher CDI scores than those with 0, and patients with a PI-LL or Sagittal Vertical Axis (SVA) modifier grade of ++ had significantly higher CDI scores than control group. Disk narrowing scores were highest in patients with a PI-LL modifier grades of ++ followed by those with +. Additionally, CDI scores were more associated with LL rather than cervical lordosis. CONCLUSIONS: Patients with DLS may be at greater risk of cervical spine degeneration, especially those with a PI-LL or SVA modifier grade of ++. Surgical strategy for DLS patients should be more carefully selected considering the restoration of LL.

Matricellular Protein CCN1 Promotes Collagen Alignment and Scar Integrity After Myocardial Infarction.

BACKGROUND: Members of the cellular communication network family (CCN) of matricellular proteins, like CCN1, have long been implicated in the regulation of cellular processes underlying wound healing, tissue fibrogenesis, and collagen dynamics. While many studies suggest antifibrotic actions for CCN1 in the adult heart through the promotion of myofibroblast senescence, they largely relied on exogenous supplementation strategies in in vivo models of cardiac injury where its expression is already induced-which may confound interpretation of its function in this process. The objective of this study was to interrogate the role of the endogenous protein on fibroblast function, collagen structural dynamics, and its associated impact on cardiac fibrosis after myocardial infarction (MI). METHODS/RESULTS: Here, we employed CCN1 loss-of-function methodologies, including both in vitro siRNA-mediated depletion and in vivo fibroblast-specific knockout mice to assess the role of the endogenous protein on cardiac fibroblast fibrotic signaling, and its involvement in acute scar formation after MI. In vitro depletion of CCN1 reduced cardiac fibroblast senescence and proliferation. Although depletion of CCN1 decreased the expression of collagen processing and stabilization enzymes (i.e., P4HA1, PLOD1, and PLOD2), it did not inhibit myofibroblast induction or type I collagen synthesis. Alone, fibroblast-specific removal of CCN1 did not negatively impact ventricular performance or myocardial collagen content but did contribute to disorganization of collagen fibrils and increased matrix compliance. Similarly, Ccn1 ablated animals subjected to MI showed no discernible alterations in cardiac structure or function one week after permanent coronary artery ligation, but exhibited marked increases in incidence of mortality and cardiac rupture. Consistent with our findings that CCN1 depletion does not assuage myofibroblast conversion or type I collagen synthesis in vitro, Ccn1 knockout animals revealed no measurable differences in collagen scar width or mass compared to controls; however, detailed structural analyses via SHG and TEM of scar regions revealed marked alterations in their scar collagen topography-exhibiting changes in numerous macro- and micro-level collagen architectural attributes. Specifically, Ccn1 knockout mice displayed heightened ECM structural complexity in post-MI scar regions, including diminished local alignment and heightened tortuosity of collagen fibers, as well as reduced organizational coherency, packing, and size of collagen fibrils. Associated with these changes in ECM topography with the loss of CCN1 were reductions in fibroblast-matrix interactions, as evidenced by reduced fibroblast nuclear and cellular deformation in vivo and reduced focal-adhesion formation in vitro; findings that ultimately suggest CCN1's ability to influence fibroblast-led collagen alignment may in part be credited to its capacity to augment fibroblast-matrix interactions. CONCLUSIONS: These findings underscore the pivotal role of endogenous CCN1 in the scar formation process occurring after MI, directing the appropriate arrangement of the extracellular matrix's collagenous components in the maturing scar-shaping the mechanical properties that support its structural stability. While this suggests an adaptive role for CCN1 in regulating collagen structural attributes crucial for supporting scar integrity post MI, the long-term protracted expression of CCN1 holds maladaptive implications, potentially diminishing collagen structural complexity and compliance in non-infarct regions. ABSTRACT (SHORT) BACKGROUND: The cellular communication network (CCN) family of matricellular proteins, including CCN1, plays a critical role in regulating cellular processes essential for wound healing, tissue fibrogenesis, and collagen dynamics. However, previous studies predominantly relied on exogenous supplementation strategies in in vivo models of cardiac injury, potentially confounding interpretations of CCN1's function in these processes. This study aimed to investigate the endogenous protein's role in fibroblast function, collagen structural dynamics, and its impact on cardiac fibrosis following myocardial infarction (MI). METHODS/RESULTS: Employing CCN1 loss-of-function approaches, including in vitro siRNA-mediated depletion and in vivo fibroblast-specific knockout mice, we assessed CCN1's influence on cardiac fibroblast fibrotic signaling and acute scar formation post-MI. In vitro CCN1 depletion reduced cardiac fibroblast senescence and proliferation, as well as decreased the expression of enzymes crucial for collagen processing and stabilization. In vivo fibroblast-specific CCN1 removal did not impair ventricular performance or alter myocardial collagen content but led to collagen fibril disorganization and increased matrix compliance. Ccn1 knockout animals exhibited elevated mortality and cardiac rupture post-MI, with no significant differences in collagen scar width or mass compared to wildtype controls. Yet, detailed structural analyses revealed alterations in scar collagen topography, including increased ECM structural complexity and diminished collagen alignment. These changes correlated with reduced fibroblast-matrix interactions, suggesting CCN1's role in influencing collagen alignment through augmenting these interactions. CONCLUSIONS: Endogenous CCN1 plays a pivotal role in scar formation post-MI by orchestrating the arrangement of collagenous components in the maturing scar, thereby shaping its mechanical properties and structural stability. While CCN1's adaptive role in regulating collagen structural attributes crucial for scar integrity is evident, prolonged expression may lead to diminished collagen structural complexity and compliance in non-infarct regions, highlighting potential maladaptive implications in the long-term.

Camptocormia in Parkinson's Disease: Systematic Review of Management Using Spine Surgery.

OBJECTIVE: Postural abnormalities are a debilitating symptom of Parkinson's disease (PD) that may require spinal intervention. Camptocormia is a unique abnormality most seen in PD, defined by a severe forward-flexion of the trunk that completely resolves when supine. The condition presents a challenge due to an undefined pathophysiology and optimal therapeutic approach in a high-risk patient population. In this study, the authors systematically reviewed the literature regarding the use of spine surgery for the treatment of camptocormia in PD. METHODS: PubMed, Embase, Web of Science, and Cochrane Library were systematically queried for studies involving spine surgery as treatment of PD-associated camptocormia. Studies involving nonsurgical management, deep brain stimulation (DBS), non-camptocormic PD patients undergoing surgery, or were out of scope were excluded. RESULTS: The search resulted in 5 studies, with a total of 19 PD patients with camptocormia who underwent spine surgery (73.7% female). The mean age was 69.5 years (range, 59 - 83), and mean PD duration was 69.5 months (range, 36 - 84). Out of 19 patients, 11 required surgical revision (57.9%), with an average of 0.68 revisions per patient (range, 0-2). Radiographic and patient-reported outcomes were inconsistently reported yet showed improvement. Ultimately, 18 patients were reported to have positive outcomes. CONCLUSION: Despite an increased risk of complication and revision that is inherent to PD patients, spine surgery has been proven as a reasonable alternative that should be prospectively studied further, as 18/19 patients had favorable outcomes.

Alignment Techniques in Total Knee Arthroplasty：Where do We Stand Today?

Achieving optimal alignment in total knee arthroplasty (TKA) is a critical factor in ensuring optimal outcomes and long-term implant survival. Traditionally, mechanical alignment has been favored to achieve neutral post-operative joint alignment. However, contemporary approaches, such as kinematic alignments and hybrid techniques including adjusted mechanical, restricted kinematic, inverse kinematic, and functional alignments, are gaining attention for their ability to restore native joint kinematics and anatomical alignment, potentially leading to enhanced functional outcomes and greater patient satisfaction. The ongoing debate on optimal alignment strategies considers the following factors: long-term implant durability, functional improvement, and resolution of individual anatomical variations. Furthermore, advancements of computer-navigated and robotic-assisted surgery has augmented the precision in implant positioning and objective measurements of soft tissue balance. Despite ongoing debates on balancing implant longevity and functional outcomes, there is an increasing advocacy for personalized alignment strategies that are tailored to individual anatomical variations. This review evaluates the spectrum of various alignment techniques in TKA, including mechanical alignment, patient-specific kinematic approaches, and emerging hybrid methods. Each technique is scrutinized based on its fundamental principles, procedural techniques, inherent advantages, and potential limitations, while identifying significant clinical gaps that underscore the need for further investigation.

Kinematic alignment adequately restores trochlear anatomy, patellar kinematics and kinetics in total knee arthroplasty: A systematic review.

PURPOSE: Patellofemoral pain, maltracking and instability remain common and challenging complications after total knee arthroplasty. Controversy exists regarding the effect of kinematic alignment on the patellofemoral joint, as it generally leads to more femoral component valgus and internal rotation compared to mechanical alignment. The aim of this systematic review is to thoroughly examine the influence of kinematic alignment on the third space. METHODS: A systematic search of the Pubmed, Cochrane and Web of Science databases was performed to screen for relevant articles published before 7 April 2024. This led to the final inclusion of 42 articles: 2 cadaveric, 9 radiographic, 12 computer simulation and 19 clinical studies. The risk of bias was evaluated with the risk of bias in non-randomised studies - of interventions tool as the lowest level of evidence of the included clinical studies was IV. The effects of kinematic alignment on patellar kinematics and kinetics, trochlear anatomy reconstruction and patellofemoral complication rate were investigated. RESULTS: Kinematic alignment closely restores native patellar kinematics and kinetics, better reproduces native trochlear anatomy than mechanical alignment and leads to a 0%-11.4% incidence of patellofemoral complications. A more valgus joint line of the distal femur can cause lateral trochlear undercoverage and a trochlear angle orientation medial to the quadriceps vector when applying kinematic alignment, both of which can be solved by using an adjusted design with a 20.5° valgus trochlea. CONCLUSION: Kinematic alignment appears to be a safe strategy for the patellofemoral joint in most knees, provided that certain precautions are taken to minimize the risk of complications. LEVEL OF EVIDENCE: Level IV clinical studies, in vitro research.

Population-based in silico modeling of anatomical shape variation of the knee and its impact on joint loading in knee osteoarthritis.

Anatomical knee joint features and osteoarthritis (OA) severity are associated, however confirming causals link to altered knee loading is challenging. This study leverages statistical shape models (SSM) to investigate the relationship between joint shape/alignment and knee loading during gait in knee OA (KOA) patients to understand their contribution to elevated medial knee loading in OA. Musculoskeletal (MSK) models were created for the mean as well as the first eight SSM principal modes of variation (-3,-2,-1, +1, +2, +3 standard deviations for each mode) and used as input to a MSK modeling framework. Using an identical KOA gait pattern (i.e., joint kinematics and ground reaction forces), we ran simulations for each MSK model and evaluated medial compartment loading magnitude and contact distribution at the instant of first and second peak of knee joint loading. An increase in external rotation, posterior tibia translation and a decrease in medial joint space and medial femoral condylar size predisposed the medial compartment knee joint to overloading during gait. This was coupled with an anterior and medial shift in contact location with increasing external rotated tibial position and increasing posterior tibial translation with respect to the femur. Next, results also highlighted a posterior shift of the medial compartment loading location with decreasing medial joint space. This study provides important population-based insights on how knee shape and alignment predispose individuals with KOA to elevated medial compartmental knee loading. This information can be crucial in assessing the risk for medial KOA development and progression.

Influence of the type of atlantoaxial dislocation secondary to os odontoideum on sagittal alignment and balance of the subaxial cervical spine after posterior atlantoaxial fusion.

OBJECTIVE: This retrospective study aims to investigate the effect of the type of atlantoaxial dislocation due to os odontoideum on the sagittal alignment and balance of the cervical spine after posterior atlantoaxial fusion. METHODS: Data of 48 consecutive patients who underwent posterior C1-C2 fusion to treat atlantoaxial dislocation/instability due to os odontoideum were retrospectively reviewed. Radiographic variables, namely the T1 slope (T1S), C1-C2 angle, C2-C7 angle, C1-C2 sagittal vertical axis (SVA), C2-C7 SVA, and modified atlas-dens interval (MADI), were measured preoperatively, immediate postoperatively, and at final follow-up. Patients were divided into three groups based on the preoperative MADI. Differences within and between groups in radiographic variables and relationships between the investigated variables were analyzed. RESULTS: The MADI was correlated with the preoperative to postoperative changes in the C1-C2 angle (r = 0.776, P < 0.05) and C2-C7 angle (r = - 0.357, P < 0.05). In the group with anterior atlantoaxial dislocation, the C1-C2 angle and C2-C7 SVA were significantly enlarged at final follow-up (P < 0.05), while the C2-C7 angle was significantly reduced (P < 0.05). The changes in C1-C2 angle and C2-C7 angle were opposite between the posterior group and the anterior dislocation group. CONCLUSION: The direction/type of atlantoaxial subluxation correlates with the changes in lower cervical curvature after atlantoaxial fusion. Patients with atlantoaxial posterior dislocation and atlantoaxial instability are less likely than those with atlantoaxial anterior dislocation to develop loss of lordosis after posterior atlantoaxial fusion.

Measuring information alignment in hyperscanning research with representational analyses: moving beyond interbrain synchrony.

Hyperscanning, which enables the recording of brain activity from multiple individuals simultaneously, has been increasingly used to investigate the neuropsychological processes underpinning social interaction. Previous hyperscanning research has primarily focused on interbrain synchrony, demonstrating an enhanced alignment of brain waves across individuals during social interaction. However, using EEG hyperscanning simulations, we here show that interbrain synchrony has low sensitivity to information alignment across people. Surprisingly, interbrain synchrony remains largely unchanged despite manipulating whether two individuals are seeing same or different things at the same time. Furthermore, we show that hyperscanning recordings do contain indices of interpersonal information alignment and that they can be captured using representational analyses. These findings highlight major limitations of current hyperscanning research and offer a promising alternative for investigating interactive minds.

A hybrid approach for predicting transcription factors.

Transcription factors are essential DNA-binding proteins that regulate the transcription rate of several genes and control the expression of genes inside a cell. The prediction of transcription factors with high precision is important for understanding biological processes such as cell differentiation, intracellular signaling, and cell-cycle control. In this study, we developed a hybrid method that combines alignment-based and alignment-free methods for predicting transcription factors with higher accuracy. All models have been trained, tested, and evaluated on a large dataset that contains 19,406 transcription factors and 523,560 non-transcription factor protein sequences. To avoid biases in evaluation, the datasets were divided into training and validation/independent datasets, where 80% of the data was used for training, and the remaining 20% was used for external validation. In the case of alignment-free methods, models were developed using machine learning techniques and the composition-based features of a protein. Our best alignment-free model obtained an AUC of 0.97 on an independent dataset. In the case of the alignment-based method, we used BLAST at different cut-offs to predict the transcription factors. Although the alignment-based method demonstrated excellent performance, it was unable to cover all transcription factors due to instances of no hits. To combine the strengths of both methods, we developed a hybrid method that combines alignment-free and alignment-based methods. In the hybrid method, we added the scores of the alignment-free and alignment-based methods and achieved a maximum AUC of 0.99 on the independent dataset. The method proposed in this study performs better than existing methods. We incorporated the best models in the webserver/Python Package Index/standalone package of "TransFacPred" (https://webs.iiitd.edu.in/raghava/transfacpred).

Composition Modulation-Mediated Band Alignment Engineering from Type I to Type III in 2D vdW Heterostructures.

Band alignment engineering is crucial for facilitating charge separation and transfer in optoelectronic devices, which ultimately dictates the behavior of Van der Waals heterostructures (vdWH)-based photodetectors and light emitting diode (LEDs). However, the impact of the band offset in vdWHs on important figures of merit in optoelectronic devices has not yet been systematically analyzed. Herein, the regulation of band alignment in WSe2/Bi2Te3- xSex vdWHs (0 ≤ x ≤ 3) is demonstrated through the implementation of chemical vapor deposition (CVD). A combination of experimental and theoretical results proved that the synthesized vdWHs can be gradually tuned from Type I (WSe2/Bi2Te3) to Type III (WSe2/Bi2Se3). As the band alignment changes from Type I to Type III, a remarkable responsivity of 58.12 A W-1 and detectivity of 2.91×1012 Jones (in Type I) decrease in the vdWHs-based photodetector, and the ultrafast photoresponse time is 3.2 µs (in Type III). Additionally, Type III vdWH-based LEDs exhibit the highest luminance and electroluminescence (EL) external quantum efficiencies (EQE) among p-n diodes based on Transition Metal Dichalcogenides (TMDs) at room temperature, which is attributed to band alignment-induced distinct interfacial charge injection. This work serves as a valuable reference for the application and expansion of fundamental band alignment principles in the design and fabrication of future optoelectronic devices.

Nanoscale phase management of the 2D/3D heterostructure toward efficient perovskite solar cells.

The stabilization of the formamidinium lead iodide (FAPbI3) structure is pivotal for the development of efficient photovoltaic devices. Employing two-dimensional (2D) layers to passivate the three-dimensional (3D) perovskite is essential for maintaining the α-phase of FAPbI3 and enhancing the power conversion efficiency (PCE) of perovskite solar cells (PSCs). However, the role of bulky ligands in the phase management of 2D perovskites, crucial for the stabilization of FAPbI3, has not yet been elucidated. In this study, we synthesized nanoscale 2D perovskite capping crusts with  = 1 and 2 Ruddlesden-Popper (RP) perovskite layers, respectively, which form a type-II 2D/3D heterostructure. This heterostructure stabilizes the α-phase of FAPbI3, and facilitates ultrafast carrier extraction from the 3D perovskite network to transport contact layer. We introduced tri-fluorinated ligands to mitigate defects caused by the halide vacancies and uncoordinated Pb2+ ions, thereby reducing nonradiative carrier recombination and extending carrier lifetime. The films produced were incorporated into PSCs that not only achieved a PCE of 25.39% but also maintained 95% of their initial efficiency after 2000 h of continuous light exposure without encapsulation. These findings underscore the effectiveness of a phase-pure 2D/3D heterostructure-terminated film in inhibiting phase transitions passivating the iodide anion vacancy defects, facilitating the charge carrier extraction, and boosting the performance of optoelectronic devices.

A proposed evidence-guided algorithm for the adjustment and optimization of multi-function articulated ankle-foot orthoses in the clinical setting.

Individuals with neuromuscular pathologies are often prescribed an ankle-foot orthosis (AFO) to improve their gait mechanics by decreasing pathological movements of the ankle and lower limb. AFOs can resist or assist excessive or absent muscular forces that lead to tripping, instability, and slow inefficient gait. However, selecting the appropriate AFO with mechanical characteristics, which limit pathological ankle motion in certain phases of the gait cycle while facilitating effective ankle movement during other phases, requires careful clinical decision-making. The aim of this study is to propose an explicit methodology for the adjustment of multi-function articulated AFOs in clinical settings. A secondary aim is to outline the evidence supporting this methodology and to identify gaps in the literature as potential areas for future research. An emerging class of AFO, the multi-function articulated AFO, offers features that permit more comprehensive, iterative, and reversible adjustments of AFO ankle alignment and resistance to ankle motion. However, no standard method exists for the application and optimization of these therapeutic devices in the clinical setting. Here we propose an evidence-guided methodology applicable to the adjustment of multi-function articulated AFOs in the clinical setting. Characteristic load-deflection curves are given to illustrate the idealized yet complex resistance-angle behavior of multi-function articulated AFOs. Research is cited to demonstrate how these mechanical characteristics can help mitigate specific pathologic ankle and knee kinematics and kinetics. Evidence is presented to support the effects of systematic adjustment of high resistance, alignable, articulated AFOs to address many typical pathomechanical patterns observed in individuals with neuromuscular disorders. The published evidence supporting most decision points of the algorithm is presented with identified gaps in the evidence. In addition, two hypothetical case examples are given to illustrate the application of the method in optimizing multi-function articulated AFOs for treating specific gait pathomechanics. This method is proposed as an evidence-guided systematic approach for the adjustment of multi-function articulated AFOs. It utilizes observed gait deviations mapped to specific changes in AFO alignment and resistance settings as a clinical tool in orthotic treatment for individuals with complex neuromuscular gait disorders.

Relation between spine alignment and scapular position by plain radiograph examination.

Background: Both scapular dynamics and static scapular position are important in the treatment of shoulder dysfunction. This study aimed to create an index that can evaluate scapular position on plain radiographs and evaluate the relation between scapular position and posture accurately. Methods: Using four fresh frozen cadavers, we developed a glenoid angle grade based on the degree of overlap between the shadow of the coracoid inflection point and the upper edge of the scapula on frontal plain radiographs: grade 1, no overlap; grade 2, overlaps by less than half of the shadow; grade 3, overlaps by more than half. We then performed a retrospective cohort study that included 329 shoulders of 329 patients who underwent spine surgery. Spine alignment parameters (SPAPs), including cervical lordosis (CL), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence, pelvic tilt, sacral slope, and sagittal vertical axis were measured on standing lateral plain radiographs. Glenoid anterior tilt (GAT) and glenoid anteversion angle (GAVA) were calculated on frontal radiographs and three-dimensional computed tomography scans. Correlations between SPAPs and each angle were investigated, and independent influencing factors were sought in multivariate analysis. Individual factors, GAT, GAVA, and SPAPs were compared among the grades. Results: SPAPs associated with GAT were sagittal vertical axis (R = 0.14, P = .011), TK (R = 0.12, P = .026), and LL (R = -0.11, P = .046). Multivariate analysis identified TK and LL as independent influencing factors (TK, P = .001; LL, P = .008). SPAPs associated with GAVA were CL (R = 0.17, P = .002), TK (R = 0.29, P < .001), and LL (R = 0.25, P < .001). Multivariate analysis identified CL, TK, and LL as independent influencing factors (CL, P = .01; TK, P = .03; LL, P = .03). There were 183, 127, and 19 cases categorized as grades 1, 2, and 3. GAT (grade 1, 24.0 ± 7.8; 2, 32.4 ± 7.0; 3, 41.0 ± 7.8), GAVA (1, 29.3 ± 7.6; 2, 33.7 ± 9.5; 3, 31.5 ± 8.3), and TK (1, 30.6 ± 13.6; 2, 35.1 ± 14.2; 3, 43.1 ± 20.4) differed significantly according to grade. Conclusion: We identified factors that influence scapular position and demonstrated that scapular position can be estimated by a grading system using plain radiographs.

Computer Aided Intracranial Aneurysm Treatment Based on 2D/3D Mapping, Virtual Deployment and Online Distal Marker Detection.

PURPOSE: To introduce a computational tool for peri-interventional intracranial aneurysm treatment guidance that maps preoperative planning information from simulation onto real-time X-Ray imaging. METHODS: Preoperatively, multiple flow diverter (FD) devices are simulated based on the 3D mesh of the vessel to treat, to choose the optimal size and location. In the peri-operative stage, this 3D information is aligned and mapped to the continuous 2D-X-Ray scan feed from the operating room. The current flow diverter position in the 3D model is estimated by automatically detecting the distal FD marker locations and mapping them to the treated vessel. This allows to visually assess the possible outcome of releasing the device at the current position, and compare it with the one chosen pre-operatively. RESULTS: The full pipeline was validated using retrospectively collected biplane images from four different patients (5 3D-DSA datasets in total). The distal FD marker detector obtained an average F1-score of 0.67 ( ± 0.224 ) in 412 2D-X-Ray scans. After aligning 3D-DSA + 2D-X-Ray datasets, the average difference between simulated and deployed positions was 0.832 mm ( ± 0.521 mm). Finally, we qualitatively show that the proposed approach is able to display the current location of the FD compared to their pre-operatively planned position. CONCLUSIONS: The proposed method allows to support the FD deployment procedure by merging and presenting preoperative simulation information to the interventionists, aiding them to make more accurate and less risky decisions.