[Comparative study of total knee arthroplasty assisted by robot and remote sensing navigation system].

OBJECTIVE: To compare clinical efficacy of robot-assisted (RA) and remote sensing navigation alignment (RSNA) system-assisted total knee arthroplasty (TKA). METHODS: From March 2023 to June 2023, 60 patients who underwent the first unilateral TKA due to severe knee osteoarthritis (KOA) were admitted and divided into RSNA group and RA group according to different treatment methods, with 30 patients in each group. There were 5 males and 25 females in RSNA group, aged from 56 to 81 years old with an average of(66.33±7.16) years old;body mass index(BMI) ranged from 19.87 to 38.54 kg·m-2 with an average of (28.40±6.18) kg·m-2;the courses of disease ranged from 5 to 36 months with an average of (18.20±8.98) months; RSNA system was used to assist the positioning of osteotomy. There were 7 males and 23 females in RA group, aged from 55 to 82 years old with an average of (67.83±8.61) years old;BMI ranged from 19.67 to 37.25 kg·m-2 with an average of (28.01±4.89) kg·m-2; the courses of disease ranged from 3 to 33 months with an average of (17.93±9.20) months;RA was performed. Operation time, incision length, latent blood loss at 2 weeks after operation and incidence of lower extremity thrombosis were compared between two groups. Hip-knee ankle angle (HKAA), HKAA deviation, lateral distal femoral angle ( LDFA), medial proximal tibial angle (MPTA) and posterior tibial slope (PTS) were compared between two groups;Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society score (KSS) were used to evaluate functional recovery before operation, 3 and 6 months after operation. RESULTS: The operation was performed successfully in both groups, and there were no serious complications such as vascular and nerve injury during operation. The wound healed well at stageⅠafter operation, and the follow-up time was 6 months. The operation time, latent blood loss at 2 weeks after operation and incision length in RSNA group were (94.35±5.75) min, (130.54±17.53) ml and (14.73±2.14) cm, respectively;while (102.57±6.88) min, (146.33±19.47) ml and (16.78±2.32) cm in RA group, respectively. RSNA group was better than RA group (P<0.05). No deep vein thrombosis occurred in both groups at 2 weeks after operation, 5 patients occurred intermuscular vein thrombosisin in RSNA group and 8 patients in RA group, the difference was not statistically significant (P>0.05). In RSNA group, HKAA, LDFA and MPTA were (173.00±5.54) °, (86.96±3.45) °, (82.79±3.35) ° before operation, and (178.34±1.85) °, (89.92±0.42) °, (89.84±0.73) ° at 1 week after operation, respectively. In RA group, HKAA, LDFA and MPTA were (173.31±6.48) °, (87.15±3.40) ° and (82.99±3.05) ° before operation, and (178.52±1.79) °, (90.03±0.39) ° and (90.15±0.47) ° at 1 week after operation, respectively. HKAA, LDFA and MPTA were significantly improved in both groups at 1 week after operation (P<0.05). There were no significant difference in HKAA, LDFA, MPTA and PTS between two groups before operation and 1 week after operation (P>0.05). There was no significant difference in deviation distribution of HKAA at 1 week after operation (χ2=2.611, P=0.456). There were no significant difference in WOMAC and KSS between two groups before operation, 3 and 6 months after operation (P>0.05), and postoperative WOMAC and KSS at 3 and 6 months between two groups were improved compared with those before operation (P<0.05). CONCLUSION: Both RA and RSNA system assisted TKA could obtain accurate osteotomy, RA has higher surgical accuracy, RSNA system assisted operation has less trauma, and operation is simpler.

[Application of remote sensing navigation system in total knee arthroplasty].

OBJECTIVE: To explore clinical accuracy of remote sensing navigation alignment (RSNA) system in total knee arthroplasty (TKA) and its influence on postoperative clinical efficacy. METHODS: From May 2021 to May 2022, 60 knee osteoarthritis (KOA) patients with Kellgren-Lawrence (K-L) grade Ⅲ to Ⅳ treated by unilateral primary TKA were selected and divided into RSNA group and traditional operation group according to treatment methods, and 30 patients in each group. There were 6 males and 24 females in RSNA group, aged from 55 to 86 years old with an average of (68.06±8.23) years old;body mass index (BMI) ranged from 22.15 to 34.58 kg·m-2 with an average of (28.20±3.01) kg·m-2;the courses of disease ranged from 2 to 60 months with an average of (18.80±14.80) months;13 patients with grade Ⅲ and 17 patients with grade Ⅳ according to K-L grading. In traditional operation group, there were 8 males and 22 females, aged from 57 to 85 years old with an average of (67.26±6.32) years old;BMI ranged from 23.94 to 34.55 kg·m-2 with an average of (27.49±2.32) kg·m-2;the courses of disease ranged from 3 to 60 months with an average of (21.30±16.44) months;14 patients with grade Ⅲ and 16 patients with grade Ⅳ according to K-L grading. Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and Knee Society score(KSS) were used to evaluate functional recovery of patients. Hip-knee-ankle angle (HKAA), distal femoral valgus angle (FVA) and distal fermoral flexion angle (DFFA) were measured before operation. HKAA and HKAA deviation angle were measured at 1 week after operation, and defective rate of lower limb force line, femur prosthesis valgus angle (FPVA) and femoral prosthesis flexion angle (FPFA), respectively, were calculated. RESULTS: There were no serious complications such as vascular and nerve injury during operation, and wound healed at stage Ⅰ. Both groups were followed up for 6 months. There were no significant difference in WOMAC index, KSS, HKAA, FVA and DFFA between two groups before operation (P>0.05). The force line defect rate, HKAA, HKAA deviation angle, FPVA deviation angle and FPFA of RSNA group were 6.7%, (178.74±1.56) °, (1.25±1.56) °, (1.84±0.16) ° and (4.85±2.46) °, respectively;while in traditional operation group were 20%, (176.73±3.46) °, (3.27±3.46) °, (2.44±0.26) °, (6.60±1.86) °;the difference between two groups were statistically significant (P<0.05). There were no significant difference in WOMAC index and KSS between two groups at 3 and 6 months after operation (P>0.05). CONCLUSION: RSNA system could reduce defective rate of lower limb force line, FPVA deviation angle and FPFA after TKA, which is more accurate and easy to operate than traditional intramedullary localization surgery while ensuring postoperative efficacy.

A nationwide study of heavy metal(loid)s in agricultural soils and the soil-grown black morel Morchella sextelata in China.

The accumulation of heavy metal(loid)s (HMs) in soil-grown mushrooms poses potential health risks. Morchella sextelata (black morel) is a typical soil-grown mushroom with a rapidly expanding cultivation area. This study investigated the distribution of arsenic, cadmium, chromium, copper, mercury, nickel, lead, and zinc in 213 pairs of soil and morel samples collected from 29 provincial administrative regions in China, together with the nutritional contents in the morel samples. The HM contents in the arable soils used to cultivate morels were 2.4-33.1 times higher than those in desert soils, while the HM contents in arable-soil morels were 2.9-155.9 times higher than desert morels. The HM contents of morels and their cultivation soils were significantly correlated (0.465 ≤ R ≤ 0.778, P < 0.001). Furthermore, the enrichment factors of most HMs were higher in arable soils than in desert soils (P < 0.05), except Hg. A considerable proportion of the arable soils produced morels with HMs exceeding the risk control standards (RCSs) for food and the health-risk thresholds of dietary intake. In comparison, HMs in morels from desert soils were far below the RCSs and health-risk thresholds. In addition, desert morels contained higher contents of crude proteins, total polysaccharides, and free amino acids (P < 0.001). These findings indicate that growing morels in desert soils is a way of green production that provides mushroom products with improved safety and nutrition.

Risk assessment of antimony-arsenic contaminated soil remediated using zero-valent iron at different pH values combined with freeze-thaw cycles.

Soil in mining wastelands is seriously polluted with heavy metals. Zero-valent iron (ZVI) is widely used for remediation of heavy metal-polluted soil because of its excellent adsorption properties; however, the remediation process is affected by complex environmental conditions, such as acid rain and freeze-thaw cycles. In this study, the effects of different pH values and freeze-thaw cycles on remediation of antimony (Sb)- and arsenic (As)-contaminated soil by ZVI were investigated in laboratory simulation experiments. The stability and potential human health risks associated with the remediated soil were evaluated. The results showed that ZVI has a significant stabilizing effect on Sb and As in both acidic and alkaline soils contaminated with dual levels of Sb and As, and the freeze-thaw process in different pH value solution systems further enhances the ability of ZVI to stabilize Sb and As, especially in acidic soils. However, it should be noted that apart from the pH=1.0 solution environment, ZVI's ability to stabilize As is attenuated under other circumstances, potentially leading to leaching of its unstable form and thereby increasing contamination risks. This indicates that the F1 (2% ZVI+pH=1 solution+freeze-thaw cycle) processing exhibits superior effectiveness. After F1 treatment, the bioavailability of Sb and As in both soils also significantly decreased during the gastric and intestinal stages (about 60.00%), the non-carcinogenic and carcinogenic risks of Sb and As in alkaline soils are eliminated for children and adults, with a decrease ranging from 60.00% to 70.00%, while in acidic soil, the non-carcinogenic and carcinogenic risks of As to adults and children is acceptable, but Sb still poses non-carcinogenic risks to children, despite reductions of about 65.00%. These findings demonstrate that soil pH is a crucial factor influencing the efficacy of ZVI in stabilizing Sb and As contaminants during freeze-thaw cycles. This provides a solid theoretical foundation for utilizing ZVI in the remediation of Sb- and As-contaminated soils, emphasizing the significance of considering both pH levels and freeze-thaw conditions to ensure effective and safe treatment.

Dynamic transcriptome analysis unravels key regulatory genes of maize root growth and development in response to potassium deficiency.

MAIN CONCLUSION: Integrated root phenotypes and transcriptome analysis have revealed key candidate genes responsible for maize root growth and development in potassium deficiency. Potassium (K) is a vital macronutrient for plant growth, but our understanding of its regulatory mechanisms in maize root system architecture (RSA) and K+ uptake remains limited. To address this, we conducted hydroponic and field trials at different growth stages. K+ deficiency significantly inhibited maize root growth, with metrics like total root length, primary root length, width and maximum root number reduced by 50% to 80% during early seedling stages. In the field, RSA traits exhibited maximum values at the silking stage but continued to decline thereafter. Furthermore, K deprivation had a pronounced negative impact on root morphology and RSA growth and grain yield. RNA-Seq analysis identified 5972 differentially expressed genes (DEGs), including 17 associated with K+ signaling, transcription factors, and transporters. Weighted gene co-expression network analysis revealed 23 co-expressed modules, with enrichment of transcription factors at different developmental stages under K deficiency. Several DEGs and transcription factors were predicted as potential candidate genes responsible for maize root growth and development. Interestingly, some of these genes exhibited homology to well-known regulators of root architecture or development in Arabidopsis, such as Zm00001d014467 (AtRCI3), Zm00001d011237 (AtWRKY9), and Zm00001d030862 (AtAP2/ERF). Identifying these key genes helps to provide a deeper understanding of the molecular mechanisms governing maize root growth and development under nutrient deficient conditions offering potential benefits for enhancing maize production and improving stress resistance through targeted manipulation of RSA traits in modern breeding efforts.

Micro Electromechanical System Navigation Assists Femoral Extramedullary Alignment Osteotomy in Total Knee Arthroplasty: A Single-Blind Randomizing Study.

OBJECTIVE: A micro-electromechanical system (MEMS) was developed based on spatial alignment and navigation technology to assist femoral extramedullary alignment osteotomy (FEAO) in total knee arthroplasty (TKA). The system can locate and adjust the femoral distal condylar osteotomy (FDCO) to obtain a better femoral prosthesis placement. It is a portable navigation device and provides an innovative approach for FDCO. METHODS: Sixty patients who suffered from severe knee osteoarthritis who underwent unilateral TKA from May 14, 2021 to May 30, 2022 were randomly divided into a MEMS-FEAO group and a conventional femoral intramedullary alignment osteotomy (FIAO) group, with 30 cases in each group for a controlled retrospective study. The hip-knee-ankle angle (HKAA) of the lower limb was measured before and after surgery, the femoral valgus angle (FVA) was measured preoperatively, and the femoral prosthesis valgus angle (FPVA) and the femoral prosthesis flexion angle (FPFA) were measured postoperatively following computed tomography imaging protocols. Measurement data is statistically described as mean ± standard deviation c. The count data is described by frequency (constituent ratio) using the rank sum test. RESULT: A total of 6.7% (2/30) of FEAO compared to 20.0% (6/30) of FIAO cases were postoperative deviations where the HKAA exceeded ±3° of neutral alignment (p < 0.05). The postoperative HKAA was 178.74° ± 1.56° versus 176.64° ± 3.39° (p < 0.05), the HKAA deviation was 1.25° ± 1.56° versus 3.36° ± 3.40° (p < 0.05), and the FPFA was 4.85° ± 2.46° versus 6.60° ± 1.86°(p < 0.05). Therefore, the differences were all statistically significant between the two groups. However, the FPVA was -0.59° ± 2.73° versus -0.80° ± 2.85° (p > 0.05), and there was no statistical significance between the two groups. CONCLUSION: The MEMS-FEAO system can improve the accurate alignment and can be utilized as a locator to obtain the best femoral prosthesis placement in TKA and significantly reduce the rate of poor force line of the lower limb.

Tracking cadmium pollution from source to receptor: A health-risk focused transfer continuum approach.

Cadmium (Cd) exposure poses a substantial risk to human health. Despite this, the multi-stage process through which Cd is released to the environment before being taken up and impacting human receptors has rarely been investigated. Here we utilized an integrated model involving Cd emissions, atmospheric transport, deposition, uptake by rice, receptor ingestion and metabolic processing in quantifying the critical emission sources and human health risks of Cd. Atmospheric Cd emissions in the study area in southeastern China were estimated at 147 kg (2016), with >53 % of emissions from non-ferrous metals (NFM) smelting activities. Atmospheric Cd depositions caused elevated Cd content in soil and rice, accounting for 3-79 % and 50-85 % of, respectively, soil and rice Cd. Cumulative frequency analysis showed that an estimated 1.3 % of predicted urine Cd through the consumption of Cd-contaminated rice and exceeded existing safety standards (1 µg g-1), thus highlighting the risks posed to health from high levels of Cd pollution. Applying stricter industrial emission standards to the NFM sector in particular and effective soil management practices could substantially reduce exposure to Cd pollution. The results contribute to understanding of the Cd transfer process and draw attention to the relative health benefits of interventions aimed at mitigating Cd levels and exposure risks at different stages along the Cd transfer continuum from source to receptor.

A synthesis framework using machine learning and spatial bivariate analysis to identify drivers and hotspots of heavy metal pollution of agricultural soils.

Source apportionment can be an effective tool in mitigating soil pollution but its efficacy is often limited by a lack of information on the factors that influence the accumulation of pollutants at a site. In response to this limitation and focusing on a suite of heavy metals identified as priorities for pollution control, the study established a comprehensive pollution control framework using factor identification coupled with spatial agglomeration for agricultural soils in an industrialized part of Zhejiang Province, China. In addition to elucidating the key role of industrial and traffic activities on heavy metal accumulation through implementing a receptor model, specific influencing factors were identified using a random forest model. The distance from the soil sample location to the nearest likely industrial source was the most important factor in determining cadmium and copper concentrations, while distance to the nearest road was more important for lead and zinc pollution. Soil parent materials, pH, organic matter, and clay particle size were the key factors influencing accumulation of arsenic, chromium, and nickel. Spatial auto-correlation between levels of soil metal pollution and industrial agglomeration can enable a more targeted approach to pollution control measures. Overall, the approach and results provide a basis for improved accuracy in source apportionment, and thus improved soil pollution control, at the regional scale.

Policy adjustment impacts Cd, Cu, Ni, Pb and Zn contamination in soils around e-waste area: Concentrations, sources and health risks.

Pollution control policies (PCP) have been implemented in some e-waste dismantling areas in China to curb metal contamination since 2012. We investigated the effects of policy intervention on the concentrations, sources and health risks of heavy metals in soils. Post-implementation, among Cd, Cu, Ni, Pb and Zn, Pb levels declined while the Cd, Cu, Ni and Zn concentrations in soils were not impacted. Changes in their pollution indices and health risks were also similar. After the PCP, the contribution of traffic emission significantly decreased, while natural and industrial contribution increased due to the heighten background input and relocation of small e-waste dismantling workshops. Risk assessment showed that total cancer risk of five metals also slightly increased. Thus, policy intervention might be effective in controlling the release of some metals from e-waste dismantling. However, the performance of control measures varied depending on both source emission and geochemical properties of the metals. This study reveal the ongoing need of stricter supervision, targeted emission reduction and more-effective soil remediation actions to alleviate soil contamination from e-waste dismantling.

Spatiotemporal modeling of soil heavy metals and early warnings from scenarios-based prediction.

Prediction of soil heavy metal concentrations based on continuous site specific investigation can provide reference for soil metal contamination prevention and early warning of soil environmental quality. In this study, the spatiotemporal variations of soil heavy metals (Cd, Ni, Zn, Pb and Cu) in Wenling were analyzed with 132 and 169 soil samples gathered in 2011 and 2016. In addition, we adopted a scenario-simulation model to predict future dynamic concentrations of soil heavy metals under optimistic (the pollution inputs are zero under strict environmental policy) and default (the pollution status maintain constant) conditions. Results indicated that the paddy soil was contaminated mainly by Cd and Cu. Spatiotemporal maps revealed distinct patterns in the joint area, where soil Cd, Ni, Zn, Pb and Cu all increased in northwest. Soil heavy metal concentrations as well as the associated ecological risks would decline gradually under optimistic scenario, while sharply increase when no control acts are taken over long term in default condition. The percentages of soil Cd and Cu that exceeding their corresponding risk screening value (RSV) under the default condition would be 1.6 and 1.3 times higher than those under optimistic scenario 10 years later. The probability of high potential ecological risk in default condition would be twice higher than that under optimistic scenario in 2026. Overall, strengthening the control of pollution sources and strict environmental policy are very important for soil heavy metals contamination prevention and control.

Simultaneous adsorption of Cd(II)andAs(III)by a novel biochar-supported nanoscale zero-valent iron in aqueous systems.

Biochar-supported nanoscale zero-valent iron (nZVI-BC) is a promising material for Cd(II) and As(III) removal from aqueous systems. In this study, simplified nZVI-BC composites were successfully synthesized and characterized via scanning electron microscopy (SEM), X-ray diffraction spectroscopy (XRD), X-ray photoelectron spectrometry (XPS), and Fourier transform infrared spectroscopy (FTIR) to understand the underlying adsorption mechanism. SEM and FTIR confirmed that nZVI particles were distributed evenly on the biochar surface. XRD and XPS revealed that metal ions were separated from solutions via electrostatic adsorption, complexation, oxidation, precipitation/co-precipitation, and the formation of type B ternary surface complex. Batch experiments showed that nZVI-BC (1:1) had a high removal efficiency in a wide pH range of 5.0-8.0 for Cd(II) and 3.0-8.0 for As(III), the maximum Cd(II) and As(III) adsorption capacities were 33.81 and 148.5 mg/g within 2 and 1 h, respectively. Additionally, synergisticeffects considerably enhanced the adsorption capacity of nZVI-BC(1:1) in mixed adsorption systems, the adsorption capacities of Cd(II) and As(III) reached 179.9 and 158.5 mg/g, respectively. Hence, nZVI-BC(1:1) is an ideal candidate for Cd(II) and As(III) pollution treatment.

An integrated analysis on source-exposure risk of heavy metals in agricultural soils near intense electronic waste recycling activities.

Conducting integrated analysis of the source, exposure and health risk of heavy metals is critical for developing mitigation strategies of soil contamination. Taking the former electronic waste (e-waste) dismantling center in China as an example this study quantitatively apportioned source contribution of soil heavy metals in this area by statistical analysis and positive matrix factorization (PMF) model. Furthermore, the human health risk of identified sources were quantified by combining source profiles and exposure risk assessment. The seven heavy metals investigated were arsenic (As), cadmium (Cd), copper (Cu), chromium (Cr), nickel (Ni), lead (Pb) and Zinc (Zn). Results indicated that agricultural soils were mainly contaminated with Cd and Cu. Parent material and pesticide, fertilizer application, industrial discharge, and vehicle emission accounted for 46.6, 22.2, and 31.2%, respectively, of the accumulation of metals in the soil. Moreover, these sources contributed 52.9, 19.0, and 28.1%, respectively of the total non-cancer risk. For the total cancer risk, the contribution of these three sources was 39.2, 45.3, and 15.5%, respectively. Despite that industrial discharge contributed the least to the accumulation of metals (22.2%), it contributed the most to the total cancer risk (45.3%). Reducing industrial emission was crucial for minimizing the heavy metal input to agricultural soils and preventing potential health hazard. These findings could provide support for environmental protection authority to improve the management and risk prevention of contaminated farmland.

Reduction in the exposure risk of farmer from e-waste recycling site following environmental policy adjustment: A regional scale view of PAHs in paddy fields.

Farmland contamination by polycyclic aromatic hydrocarbons (PAHs) has drawn increasing attention across China with enhanced regulations and environmental policies proposed by government to protect soil environment safety. As the informal electronic waste (e-waste) dismantling activities were forbidden under recent environmental regulation, this study compared levels, compositions, spatial distributions, human health risks of PAHs in paddy soil within the vicinity of an e-waste recycling area in southeastern China, with 129 and 150 soil samples collected in 2011 and 2016, respectively. The soil contamination was dominated with high molecular weight PAHs. The mean concentration of EPA 16 PAHs decreased from 590.4 ±â€¯337.2 µg kg-1 in 2011 to 407.3 ±â€¯232.2 µg kg-1 in 2016. Distribution maps of soil PAHs concentration displayed the temporal change in spatial. Principal component analysis together with diagnostic ratios revealed the combustion of biomass and coal in industrial and unregulated e-waste dismantling were the main sources of PAHs in the study area. Both deterministic and probabilistic assessments demonstrated reduced exposure risk for farmers from 2011 to 2016. Sensitivity analysis revealed that exposure frequency (EF) is the most influential parameter for the total variance in the risk assessment model. This study implied that the more stringent environmental policy and regulation can lead reductions in soil contamination with PAHs.

Ten-year regional monitoring of soil-rice grain contamination by heavy metals with implications for target remediation and food safety.

Farmland soil heavy metal contamination could pose potential risks to ecosystems, food safety and human health ultimately. Regional researches on the long-term monitoring of heavy metals in a soil-rice grain system, changed with environmental policy adjustment, have been hindered by limited detailed data. In this study, we collected 169 paired paddy rice grain and corresponding soil samples from a former intensive electronic-waste dismantling region to survey the current status of heavy metal contamination, and to reveal the temporal trends over the past decade based on the previous data obtained in 2006 and 2011. Moderate contaminations of Cd, Cu, Zn and Ni were observed in soil currently. Furthermore, 20.7% of rice grain samples exceeded the Cd threshold value. Cd, Cu, Zn and Pb shared the similar spatial distribution pattern with higher concentrations in northwest, which were contrary to Cr, Ni and As. Risk assessment indicated that much attention is required for the carcinogenic risk of Cr, Cd and As and non-carcinogen risk of Cr. Combining the spatial distribution of heavy metals in soil and rice grains, and the potential ecological risks, with the human health risks, the middle-west rice paddies were identified and proposed as priority areas. Percentage of soil Pb, Cd and Zn decreased in most area and slightly increased in northwest and east. Cu decreased in southwest and increased in central part, while Ni slightly increased in the whole region between 2006 and 2016. With the scrutiny of strict environmental policy, Cd still remained relatively constant levels in soil and rice grains during the last decade, which confirmed that the heavy metals were persisted over the long duration. Target sustainable and ongoing green remediation methods should be adopted urgently in specific area to guarantee food safety and human health for local residents.