The association between paced left ventricular activation time and cardiac reverse remodeling in heart failure patients with left bundle branch block.

INTRODUCTION: The association between paced LVAT and cardiac structure and function at baseline, as well as whether longer LVAT is associated with worse cardiac reverse remodeling in patients with heart failure (HF) and left bundle branch block (LBBB) has not been well investigated. The purpose of this study is to investigate the association between paced LVAT and baseline echocardiographic parameters and cardiac reverse remodeling at follow-up. METHODS: Patients with HF and LBBB receiving successful left bundle branch pacing (LBBP) from June 2018 to April 2023 were enrolled and grouped based on paced LVAT. NT-proBNP and echocardiographic parameters were recorded during routine follow-up. The relationships between paced LVAT and echocardiographic parameters at baseline and follow-up were analyzed. RESULTS: Eighty-three patients were enrolled (48 males, aged 65 ± 9.8, mean LVEF 32.1 ± 7.5%, mean LVEDD 63.0 ± 8.5 mm, median NT-proBNP 1057[513-3158] pg/mL). The paced QRSd was significantly decreased (177 ± 17.9 vs. 134 ± 18.5, p < .001) and median paced LVAT was 80[72-88] ms. After a median follow-up of 12[9-29] months, LVEF increased to 52.1 ± 11.2%, LVEDD decreased to 52.6 ± 8.8 mm, and NT-proBNP decreased to 215[73-532]pg/mL. Patients were grouped based on paced LVAT: LVAT < 80 ms (n = 39); 80 ≤ LVAT < 90 ms (n = 24); LVAT ≥ 90 ms (n = 20). Patients with longer LVAT had larger LVEDD and lower LVEF (LVEDDbaseline: p < .001; LVEFbaseline: p = .001). The difference in LVEF6M was statistically significant among groups (p < .001) and patients with longer LVAT had lower LVEF6M, while the difference in LVEF1Y was not seen (p = .090). There was no significant correlation between ΔLVEF6M-baseline, ΔLVEF1Y-6M and LVAT respectively (ΔLVEF6M-baseline: p = .261, r = -.126; ΔLVEF1Y-6M: p = .085, r = .218). CONCLUSION: Long paced LVAT was associated with worse echocardiographic parameters at baseline, but did not affect the cardiac reverse remodeling in patients with HF and LBBB. Those with longer LVAT required longer time to recover.

Cardiac resynchronization therapy for patients with heart failure and nonspecific intraventricular conduction delay.

The efficacy of cardiac resynchronization therapy (CRT) in heart failure patients with left bundle branch block (LBBB) is well established with Class I or IIa recommendation according to 2021 ESC Guidelines on cardiac pacing and CRT, whereas non-LBBB morphology is less recommended. There is insufficient evidence that proves patients with NICD could benefit from CRT. As patients with NICD are characterized by heterogeneity, the effect of CRT on these patients is still controversial. Although the proportion of NICD in the population is lower than that of LBBB patients, it is still worth investigating the effects of CRT on patients with NICD in an era of His-Purkinje conduction system pacing (HPCSP).

Parameter study on characteristic pulse diagram of polycystic ovary syndrome based on logistic regression analysis.

This study aimed to explore the parameters of the independent predictive characteristic pulse diagram of polycystic ovary syndrome (PCOS) by analysing the pulse characteristics between healthy women and the PCOS group. A total of 278 women were recruited for this study. Pulse wave parameters were collected by the pulse spectrum analyser. The single-factor analysis of the pulse diagram parameters was used to identify significant indicators, and the logistic regression analysis was carried out on the above indicators with statistical differences to obtain independent predictors. According to the single-factor and multi-factor analyses, h1, h5, h3/h1, t, t1 and t5 were independent predictors of PCOS diagnosis. The results showed that PCOS patients had a faster heart rate, decreased left ventricular systolic function and decreased aortic compliance compared to healthy individuals. These findings suggested that the characteristic pulse parameters screened out are valuable for the diagnosis of PCOS.IMPACT STATEMENTWhat is already known on this subject? Polycystic ovary syndrome (PCOS) is a common gynecological reproductive endocrine and metabolic disease, which is significant for screening and early intervention in the disease. However, due to the lack of pulse's diagnostic evidence of PCOS, there is still an unknown area in the research on the correlation between PCOS and pulse diagram parameters.What do the results of this study add? This study fills the gap between the research on PCOS and pulse wave. The study also shows that the pulse characteristic parameters h1, h5, h3/h1, t, t1, and t5 are independent predictors of PCOS, suggesting that the patients have a higher heart rate, lower ventricular systolic function, and aortic compliance than healthy individuals.What are the implications of these findings for clinical practice and/or further research? Prominent risk factors for pulse parameters associated with the occurrence of PCOS facilitate early screening and diagnosis of the disease. The objectification of pulse diagnosis helps to establish a health management model, which can be used for the accurate assessment and treatment of PCOS by traditional Chinese medicine (TCM). It provides a clinical reference for the study of pulse diagnosis objectification.

Cement augmentation of the proximal femoral nail antirotation for the treatment of two intertrochanteric fractures - a comparative finite element study.

BACKGROUND: There are concerns regarding initial stability and cutout effect in proximal femoral nail antirotation (PFNA) treating intertrochanteric fractures. No study have used finite element analysis (FEA) to investigate the biomechanics. This study aimed to compare the cutout effect, stress and displacement between stable (AO31-A1.3) and unstable (AO31-A2.2) intertrochanteric fractures treated by cement augmented PFNA. METHODS: Four femoral finite element models (FEMs) were constructed and tested under the maximum loading during walking. Non-augmented and augmented PFNA in two different intertrochanteric fractures were respectively simulated, assuming Tip Apex Distance (TAD) < 25 mm within each FEM. The cutout effect, stress and displacement between femur and PFNA were compared in each condition. RESULTS: Cutout effect was observed in both non-augmented femoral head and was more apparently in unstable intertrochanteric fracture model. After reinforced by bone cement, no cutout effect occurred in two models. Stress concentration were observed on medial part of intertrochanteric region and the proximal part of helical blade before augmented while were observed on femoral shaft and the conjunction between blade and nail after augmented in both FEMs. Displacement mainly appeared on femoral head and the helical blade tip before augmented while distributed moderately on intertrochanteric region and the upper part of nail after augmented in both FEMs. The maximum stress and displacement value of femur decreased both in stable and unstable model after augmented but was more significantly in the unstable one. The maximum stress and displacement value of PFNA increased both in stable and unstable model after augmented but was more significantly in the unstable one. CONCLUSION: Our FEA study indicated that the cement augmentation of the PFNA biomechanically enhances the cutout resistance in intertrochanteric fracture, this procedure is especially efficient for the unstable intertrochanteric fracture.

Comparative yield and efficiency of strategies based on risk assessment and fecal immunochemical test in colorectal cancer screening: A cross-sectional population-based analysis.

OBJECTIVE: Integration of risk stratification into fecal immunochemical test (FIT) might aid in the suboptimal detection of advanced neoplasms by FIT in colorectal cancer (CRC) screening. A comparative study was conducted to evaluate the participation and diagnostic yield of the parallel combination of questionnaire-based risk assessment (QRA) and FIT, FIT-only and QRA-only strategies in a CRC screening program in China. METHODS: The study included 29,626 individuals aged 40-74 years and invited to participate in a CRC screening program in China. Participants were first invited to undertake QRA and one-time FIT (OC-sensor). Participants with positive QRA or FIT were deemed to be high-risk individuals who were recommended for subsequent colonoscopy. Participation, detection rate, and resource demand for colonoscopy were calculated and compared. RESULTS: Of the 29,626 invitees, 20,203 completed the parallel combination, 8,592 completed the QRA-only, and 11 completed the FIT-only strategy. For the parallel combination, FIT-only, and QRA-only strategies, the overall positivity rates were 10.2% (2,928/28,806), 5.4% (1,096/20,214), and 6.8% (1,944/28,795), respectively; the yield of advanced neoplasm per 10,000 invitees were 46.9 [95% confidence interval (95% CI): 39.8-55.4], 36.8 (95% CI: 30.5-44.4), and 12.2 (95% CI: 8.8-16.8), respectively; the positive predictive values for detecting advanced neoplasms among participants who completed colonoscopy were 4.7% (95% CI: 4.0%-5.6%), 9.9% (95% CI: 8.3%-11.9%), and 1.9% (95% CI: 1.3%-2.6%), respectively; the number of colonoscopies required to detect one advanced neoplasm was 11.4 (95% CI: 9.8-13.4), 5.7 (95% CI: 4.8-6.7), and 28.4 (95% CI: 20.7-39.2), respectively. CONCLUSIONS: The parallel combination of QRA and FIT did not show superior efficacy for detecting advanced neoplasm compared with FIT alone in this CRC screening program.

Mapping quantitative trait loci for peroxidase activity and developing gene-specific markers for TaPod-A1 on wheat chromosome 3AL.

KEY MESSAGE: Three novel QTL for peroxidase activity were mapped, and gene-specific markers for TaPod-A1 were developed and validated using RILs derived from the Doumai/Shi 4185 cross and 281 wheat cultivars. TaPod-A1 is within one of the three QTL. Peroxidase (POD) activity in grain is an important factor determining the color of flour and end-use products of wheat, such as noodles and steamed bread. Mapping QTL for POD activity, characterization of POD genes and development of gene-specific markers are important for molecular marker-assisted selection in wheat breeding. Quantitative trait loci (QTL) for POD activity in common wheat were mapped using a recombinant inbred line (RIL) population derived from a Doumai/Shi 4185 cross grown in four environments and genotyped using the wheat 90 K iSelect assay. Three novel QTL for POD activity, QPod.caas-3AL, QPod.caas-4BS and QPod.caas-5AS, were identified on chromosomes 3AL, 4BS and 5AS, explaining 5.3-21.2% of phenotypic variance across environments. The full-length genomic DNA (gDNA) sequence of a POD gene, designated TaPod-A1, on chromosome 3A was characterized by homolog cloning and PCR verification. Two complementary dominant sequence-tagged site (STS) markers, POD-3A1 and POD-3A2, were developed based on single nucleotide polymorphisms (SNPs) between two alleles at the TaPod-A1 locus, amplifying 291- and 766-bp fragments in cultivars with lower and higher POD activities, respectively. The two gene-specific markers were mapped on chromosome 3AL using a set of Chinese Spring (CS) nulli-tetrasomic lines, and ditelosomic lines 3AL and 3AS. QTL analysis indicated that QPod.caas-3AL co-segregated with the gene-specific markers POD-3A1 and POD-3A2. POD-3A1 and POD-3A2 were verified on 281 wheat cultivars and advanced lines, and showed significant (P < 0.05) associations with POD activities. POD-3A1 and POD-3A2 may be useful as markers for improving color attributes in wheat breeding programs.

An Evidence-Based Medical Review on Promoting Gastrointestinal Function Recovery After Colorectal Cancer Surgery.

Objective: The objective of this study was to search for, evaluate, and summarize data related to a faster postoperative recovery in patients with colorectal cancer (CRC) based on literature from China as well as internationally. This will serve as an evidence-based foundation for the clinical implementation of enhanced postoperative recovery of gastrointestinal function in patients with CRC. Methods: Based on the hierarchical "6S" evidence model, we conducted a systematic search of computerized decision-support systems, guideline websites, as well as domestic and international databases for evidence, guidelines, expert consensus statements, clinical decision-making, best practices, evidence summaries, and systematic reviews of interventions focusing on accelerating gastrointestinal function rehabilitation after CRC surgery. The time limit for the search was from the date of creation of the database to January 2023. Two researchers evaluated the quality of the literature that was included, and we extracted data and summarized the evidence from those publications that fulfilled the quality criteria. Results: The review included a total of 21 publications, comprising 6 guidelines, 6 systematic reviews, 3 expert consensus statements, 4 randomized controlled trials, and 2 evidence summaries. We summarized 51 best evidence findings across five areas: organizational management, preoperative risk assessment, education, intraoperative monitoring, and postoperative management. Conclusion: There is a wide variety and wealth of information available on interventions to promote enhanced postoperative recovery of gastrointestinal function in patients with CRC. The use of evidence is discussed, keeping in mind the practical situation in China.

[Measuring three-dimensional displacement of tooth-supported rigid fixed bridge under oblique concentrated loading using digital laser speckle photography].

OBJECTIVE: To measure three-dimensional displacements of rigid fixed bridge under oblique concentrated loading and to analyze the effect of displacement on the stability of abutment teeth. METHODS: Right mandible of Beagle dog was used to establish the tooth-supported rigid fixed bridge. Digital laser speckle photography was employed to measure the three-dimensional displacements of the prosthesis under oblique concentrated loading ranging from 200 g to 3000 g. RESULTS: The displacements of prosthesis increased as the load increased. When the load was on the abutment, the buccolingual displacement of the abutment under loading was the biggest but no more than 100 microm. This was followed by mesiodistal and occlusallingual displacements. With slighter loadings, the buccolingual displacements of non-loaded abutment were greater than the mesiodistal displacements. However, as the loading increased greater mesiodistal displacements on non-loaded abutment were found compared to buccolingual displacements. When the bridge was loaded, the biggest displacements of the prosthesis were always shown on the buccolingual direction, followed by the mesiodistal direction and the occlusallingual direction. The displacements with loaded bridge were smaller than those when the load was applied on abutment. CONCLUSION: The displacements of rigid fixed bridge change with different loading positions. This has implications on the design of prosthesis. Lateral force should be minimized and early occlusion contact should be avoided, especially on the feeble abutment. This study has developed a new method for measuring bit shift of teeth.

[Three-dimensional displacement of implant-supported cantilever fixed partial denture under oblique loading].

The purpose of this study was to research the three-dimensional displacements of implant-supported cantilever fixed partial denture (CFPD) under oblique loading. One Beagle dog was used in this experiment. Two immediate implants of ITI were inserted in the mandible of the dog, and the implant-supported CFPD which used the implants as abutments was made in vitro fresh mandible. Then the digital laser speckle technique was employed to measure the three-dimensional displacements of CFPD under different oblique loading. We found that when an oblique loading was exerted on the pontic, the displacement increased with increasing of load. Under equal loading, the displacement of the abutment near to the pontic was smaller than that of the pontic but greater than that of the abut-ment far from the pontic. When oblique loading was exerted on the abutment, the displacement of the direct loaded abutment was greater than that of the other abutment and the pontic. Under the.eeual loading, the displacement of implant-supported CFPD of loading on pontic was greater than that of loading on abutments. The experiments demonstrated that implant-supported cantilever fixed partial denture (CFPD) is an effective and advisable therapy for totally? or partially edentulous patients. However, it is also suggested that the clinicians should avoid exerting oblique loading, especially the obliqe loading of the pontic when th e CPDF is used.

[Study on the digital laser speckle technique of three-dimensional displacement of cantilever fixed partial denture under oblique loading].

The purpose of this study was to investigate the three-dimensional displacement of the cantilever fixed partial denture (CFPD) under an oblique loading. One Beagle dog was used in this experiment. The CFPD, which used the second premolar and the first molar as abutments and the second molar as pontic, was made in vitro fresh mandible of the Beagle dog, and the digital laser speckle (DLS) technique was employed to measure the three-dimensional displacement of the CFPD under the oblique loading for the first time. We found that when an oblique loading was exerted on the pontic, the displacement of CFPD was the greatest, and the displacement of the abutment near the pontic was smaller than that of the pontic but greater than that of the abutment far from the pontic. We also found that when an oblique loading was exerted on the abutment, the displacement of the directly loaded abutment was greater than that of the other abutment and the pontic. Under the oblique loading, the displacement increased with increasing of load. The experiment demonstrated that it would be advisable for the clinicians to avoid oblique loading, especially the oblique loading of the pontic when using the CPDF. The DLS technique may be one kind of methods for measuring the three-dimensional displacements of the small and irregular objects.

[Analysis of the effect of contact strength on three-dimensional displacement of an implant-supported fixed bridge under axial-concentrated load using digital laser speckle photography].

The purpose of this study was to investigate the effect of four kinds of different contact strength on the three-dimensional displacement of an implant-supported fixed bridge using digital laser speckle photography method. An in vitro model of beagle mandible with an implant-supported fixed bridge in its right premolar region was developed. The bridge was Au-Pt metal-ceramic. The contact was recovered to four different tightnesses, named 0, 1, 2, and 3. Different axial concentrated static load was applied to abutments and bridge respectively. The three-dimensional displacement of the implant-supported fixed bridge was measured using digital laser speckle photographic method. The results demonstrated that the influence of contact tightness was mainly on the mesio-distal and buccal lingual parts. When the contact tightness reached number 3, the regularity of displacement distribution was changed. The present study proved that digital laser speckle photography was an effective method of measuring the micro-displacement. One of the criterions of contact recovering decreased the implant displacement effectively without changing the regularity of displacement distribution.

[Effectiveness assessment of 3-D cone beam CT used in human bite marks identification].

The present study was aimed to use the 3-D cone beam CT (CBCT) as a new method in human bite marks identification which was carried out in experimental pigskin to assess its effectiveness in our laboratory. Bite marks were digital photographed according to American Board of Forensic Odontology (ABFO) guidelines. In this study, the data of the suspect's dental casts were collected by scanning in two ways: one was after plate scanning, in which the comparison overlays were generated by Adobe Photoshop 8.0 software; the other was by CBCT, which generated comparison overlays automatically. The bite marks were blind identified with the two kinds of data of the suspect's dental casts respectively. ROC curve was used to analyze the sensitivity, specificity, and 95% confidence interval. The results showed that CBCT method got a larger area under the ROC curve: 0.784 (SE = 0.074, 95% CI = 0.639-0.929), and got a very high specificity (specificity 98.7%, 95% CI = 94.5%-99.8%). Thus, this study illustrates that the CBCT used in bite mark identification is an effective and accurate tool and has stronger ability to exclude suspects compared with the conventional method, but the comparison process needs further study to enhance its effectiveness in bite mark identification.

Polymorphisms of TRIB1 genes for coronary artery disease and stroke risk: A systematic review and meta-analysis.

BACKGROUND AND AIMS: In recent years, the results of the association between Tribbles Pseudokinase 1 (TRIB1) gene polymorphism and the risk of coronary artery disease (CAD) and stroke are inconsistent. This study aimed to systematically review the literature on TRIB1 gene polymorphisms and susceptibility to coronary atherosclerotic heart disease (CAD) and stroke. METHODS: This study collected studies published until May 2022 through a systematic search of PubMed, Web of Science, and Google Scholar databases. After a systematic literature search, pooled odds ratio (OR) and their corresponding 95 % confidence interval (CI) were used to assess the strength of the association. RESULTS: We identified 6 studies on rs17321515, including 12,892 controls and 4583 patients, and 3 on rs2954029, including 1732 controls and 1305 patients. In different genetic models, the rs2954029 genetic polymorphism significantly increased the risk of CAD and stroke. In the codominant model, the AA genotype increased the risk of CAD and stroke (OR = 1.74, 95 % CI = 1.39-2.17, P < 0.001); the TA genotype also increased the prevalence of CAD and stroke risk (OR = 1.39, 95 % CI = 1.18-1.64, P < 0.001). Compared with the control group, the TT + TA genotype increased the risk of CAD and stroke in the dominant genetic model (OR = 1.46, 95 %CI = 1.25-1.71, P < 0.001), and in the recessive model, the TA + AA genotype increased the risk of CAD and stroke (OR = 1.41, 95 % CI = 1.15-1.72, P < 0.001). In addition, the TRIB1 rs17321515 polymorphism was not found to be associated with the risk of CAD and stroke, which may be related to other factors such as race. CONCLUSIONS: The rs2954029 A allele was significantly associated with an increased risk of CAD and stroke, according to the present meta-analysis. However, the association of rs17321515 polymorphism with susceptibility to CAD and stroke has not been found in this study.

Real-world application of a fast stool DNA test for colorectal cancer screening in primary screening positive population.

BACKGROUND: Stool DNA test has been emerged as an effective noninvasive method for colorectal cancer (CRC) screening, but the real-world performance of stool DNA test in Chinese population has rarely been reported. METHODS: A total of 36,527 subjects were recruited in Haining City from January 2021 to December 2021. Participants underwent primary screening by taking both two-samples fecal immunochemical tests (FITs) and high-risk factor questionnaire (HRFQ), and those who tested either positive by FITs or evaluated to be high risk by HRFQ were recommended to undertake subsequent stool DNA test and colonoscopy. RESULTS: Of 36,527 participants, 34,778 (95%) completed both HRFQ and FITs, 9947 (29%) showed positive results during primary screening, and the colonoscopy compliance rate was 49%. Of primary screening positives, 8733 (88%) completed stool sample collections, and colonoscopy results from 4293 eligible participants were used for analyzing the performance of stool DNA test. The sensitivities for detecting CRC and advanced adenomas (AA) were 100% (95% CI: 60-100%) and 40% (95% CI: 34-46%), and the area under curve (AUC) was 0.961 (95% CI:0.954-0.967) and 0.625 (95% CI: 0.609-0.641), respectively. The specificity of stool DNA test was 84% (95% CI: 82-85%). The false-positive rate for stool DNA test is about 10% less than that of primary screening. CONCLUSION: Stool DNA test is a cost-effective and promising alternative strategy for CRC screening in China.

A new model for predicting the occurrence of polycystic ovary syndrome: Based on data of tongue and pulse.

Background and objective: Polycystic ovary syndrome is one of the most common types of endocrine and metabolic diseases in women of reproductive age that needs to be screened early and assessed non-invasively. The objective of the current study was to develop prediction models for polycystic ovary syndrome based on data of tongue and pulse using machine learning techniques. Methods: A dataset of 285 polycystic ovary syndrome patients and 201 healthy women were investigated to identify the significant tongue and pulse parameters for predicting polycystic ovary syndrome. In this study, feature selection was performed using least absolute shrinkage and selection operator regression. Several machine learning algorithms (multilayer perceptron classifier, eXtreme gradient boosting classifier, and support vector machine) were used to construct the classification models to predict the presence of polycystic ovary syndrome. Results: TB-L, TB-a, TB-b, TC-L, TC-a, h3, and h4/h1 in tongue and pulse parameters were statistically associated with polycystic ovary syndrome presence. Among the several machine learning techniques, the support vector machine model was optimal for the comprehensive evaluation of this dataset and deduced the area under the receiver operating characteristic curve, DeLong test, calibration curve, and decision curve analysis. Conclusion: The machine learning model with tongue and pulse factors can predict the existence of polycystic ovary syndrome precisely.

Partial resistance to powdery mildew in German spring wheat 'Naxos' is based on multiple genes with stable effects in diverse environments.

Powdery mildew is one of the most important wheat diseases in temperate regions of the world. Resistance breeding is considered to be an economical and environmentally benign way to control this disease. The German spring wheat cv. 'Naxos' exhibits high levels of partial and race non-specific resistance to powdery mildew in the field and is a valuable source in resistance breeding. The main objective of the present study was to map the genetic factors behind the resistance in Naxos, based on a population of recombinant inbred lines (RIL) from a cross with the susceptible CIMMYT breeding line SHA3/CBRD. Powdery mildew severity was evaluated in six field trials in Norway and four field trials in China. The major quantitative trait locus (QTL) with resistance from Naxos was detected close to the Pm3 locus on 1AS in all environments, and explained up to 35% of the phenotypic variation. Naxos was shown to carry another major QTL on 2DL and minor ones on 2BL and 7DS. QTL with resistance from SHA3/CBRD were detected on 1RS, 2DLc, 6BL and 7AL. The QTL on the 1B/1R translocation showed highly variable effects across environments corresponding to known virulence differences against Pm8. SHA3/CBRD was shown to possess the Pm3 haplotype on 1AS, but none of the known Pm3a-g alleles. The RIL population did not provide any evidence to suggest that the Pm3 allele of SHA3/CBRD acted as a suppressor of Pm8.

Stat3 is involved in the motility, metastasis and prognosis in lingual squamous cell carcinoma.

The signal transducers and activators of transcription 3 (Stat3) has been detected in many types of cancer and plays an important role in tumour-cell survival, proliferation, self-renewal and invasion. To address the possibility that Stat3 may be involved in the metastasis and prognosis in lingual squamous cell carcinoma, we examined whether Stat3 expression associates with metastasis or survival rate in human clinical samples. We found that there was a significant correlation between Stat3 expression and lymph node metastasis (P=0.009), stages (P=0.029), recurrence (P=0.0032) and death (P=0.0356). The specific knockdown of Stat3 by RNA interference strongly inhibited the motile and invasion activity of tumour cells. Our results suggest that Stat3 is involved in the motility, metastasis and progression in human lingual squamous cell carcinoma, and thus, it may be a therapeutic target for human lingual squamous cell carcinoma.

[The effect of notch's angle and depth on crack propagation of zirconia ceramics].

This paper is aimed to study the effect of notch's angle and depth on crack propagation of zirconia ceramics. We fabricated cuboid-shaped zirconia ceramics samples with the standard sizes of 4. 4 mm x 2. 2 mm x 18 mm for the experiments, divided the samples into 6 groups, and prepared notches on these samples with different angles and depth. We placed the samples with loads until they were broke, and observe the fracture curve of each sample. We then drew coordinates and described the points of the fracture curve under a microscope, and made curve fitting by the software-Origin. When the notch angle beta = 90 degrees, the crack propagation is pure type I; when beta = 60 degrees, the crack propagation is mainly type I; and when beta = 30 degrees, the crack propagation is a compound of type I and type III. With the increasing of the notch depth, the effect of notch angles on crack propagation increases. In addition, Notch angle is a very important fracture mechanics parameter for crack propagation of zirconia ceramics. With the increasing of notch depth, the impact of notch angle increases.

Risk of proximal femoral nail antirotation (PFNA) implant failure upon different lateral femoral wall thickness in intertrochanteric fracture: a finite element analysis.

Proximal Femoral Nail Antirotation (PFNA) has been commonly used to treat intertrochanteric fractures, despite the risk of implant failure. The integrity of the femur could influence the risk of implant failure. This study evaluated the influence of lateral femoral wall thickness on the potential of implant failure. A finite element model of the hip was reconstructed from the Computed Tomography of a female patient. Five intertrochanteric fracture models at different lateral femoral wall thickness (T1 = 27.6 mm, T2 = 25.4 mm, T3 = 23.4 mm, T4 = 21.4 mm, and T5 = 19.3 mm) were then created and fixed with PFNA. We simulated a critical loading condition by a high loading case during walking. Elastoplastic material models with yield stress and failure strain were applied to the bone and implant in which breakage can be simulated using the element deletion function. In addition, the stress and displacement of the implant and femur were analysed. Implant breakage occurred at the sides of the proximal nail canal in cases of T4 and T5 which was further supported by the higher maximum von Mises stress and nail displacement. The increased stress and displacement of the implant may implicate a reduction of stability and risk of implant failure. We suggested that precaution shall be taken when the wall thickness was less than 21.4 mm.

One-sample quantitative and two-sample qualitative faecal immunochemical tests for colorectal cancer screening: a cross-sectional study in China.

OBJECTIVES: Quantitative faecal immunochemical tests (FITs) are widely used for colorectal cancer (CRC) screening in the Western countries, whereas qualitative FITs are preferred in China. The present study aimed to compare the screening yield between one-sample quantitative FIT and two-sample qualitative FIT for CRC screening. DESIGN: A cross-sectional study. SETTING: A population-based CRC screening programme was conducted in 28 communities in Haining City, Zhejiang Province, China. PARTICIPANTS: Consecutive participants aged 40-74 years were invited to undergo the CRC screening programme. Two-sample qualitative FITs were offered between January 2019 and December 2019, and one-sample quantitative FIT was offered between August 2019 and February 2020. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes were detection rates of advanced neoplasms, including CRCs and advanced adenomas. Secondary outcomes were positivity rates and colonoscopy resource demand for the two FITs. The positivity thresholds were 20 µg and 1-5 µg haemoglobin per gram of faeces for the quantitative and qualitative FITs, respectively. RESULTS: A total of 19 131 and 28 804 invitees were assigned to the two-sample qualitative and one-sample quantitative groups, respectively. Positivity rates were 14.2% for the two-sample qualitative FIT and 5.4% for the one-sample quantitative FIT. Detection rates of advanced colorectal neoplasms at colonoscopy using one-sample quantitative FIT and two-sample qualitative FIT were 17.6% (95% CI: 14.6% to 20.6%) and 10.5% (95% CI: 8.7% to 12.4%), respectively. Both detection rates of cancer and advanced adenoma were higher in the one-sample quantitative FIT group than those in the two-sample qualitative FIT group. Moreover, one-sample quantitative FIT significantly reduced the colonoscopy load for detection of one advanced neoplasm case (5, 95% CI: 5 to 7) than the two-sample qualitative FIT (10, 95% CI: 8 to 11). CONCLUSIONS: The one-sample quantitative FIT for CRC screening increases the detection rate of advanced neoplasia and reduces the colonoscopy workload compared with the two-sample qualitative FIT.