Reversible dougong structured receptor-ligand recognition for building dynamic extracellular matrix mimics.

Dynamic biomaterials excel at recapitulating the reversible interlocking and remoldable structure of the extracellular matrix (ECM), particularly in manipulating cell behaviors and adapting to tissue morphogenesis. While strategies based on dynamic chemistries have been extensively studied for ECM-mimicking dynamic biomaterials, biocompatible molecular means with biogenicity are still rare. Here, we report a nature-derived strategy for fabrication of dynamic biointerface as well as a three-dimensional (3D) hydrogel structure based on reversible receptor-ligand interaction between the glycopeptide antibiotic vancomycin and dipeptide d-Ala-d-Ala. We demonstrate the reversible regulation of multiple cell types with the dynamic biointerface and successfully implement the dynamic hydrogel as a functional antibacterial 3D scaffold to treat tissue repair. In view of the biogenicity and high applicability, this nature-derived reversible molecular strategy will bring opportunities for malleable biomaterial design with great potential in biomedicine.

Postoperative Bisphosphonates Use is Associated with Reduced Adverse Outcomes After Primary Total Joint Arthroplasty of Hip and Knee: A Nationwide Population-Based Cohort Study.

Bisphosphonates have been associated with a decreased risk of revision surgery after total joint arthroplasty of the hip or knee (TJA) because of their effects on decreased periprosthetic bone loss and prosthetic migration. However, the results in the early literature are inconsistent, and the influence of bisphosphonates on associated complications and subsequent TJA remains unknown. This study investigated the association between the use of bisphosphonates and the risk of adverse outcomes after primary TJA. This matched cohort study utilized the National Health Insurance Research Database in Taiwan to identify patients who underwent primary TJA over a 15-year period (January 2000-December 2015 inclusive). Study participants were further categorized into two groups, bisphosphonate users and nonusers, using propensity score matching. The Kaplan-Meier curve analysis and adjusted hazard ratios (aHRs) of revision surgery, adverse outcomes of primary surgery and subsequent TJA were calculated using Cox regression analysis. This study analyzed data from 6485 patients who underwent total hip arthroplasty (THA) and 20,920 patients who underwent total knee arthroplasty (TKA). The risk of revision hip and knee arthroplasty was significantly lower in the bisphosphonate users than in the nonusers (aHR, 0.54 and 0.53, respectively). Furthermore, the risk of a subsequent total joint arthroplasty, adverse events and all-cause mortality were also significantly reduced in the bisphosphonate users. This study, involving a large cohort of patients who underwent primary arthroplasties, revealed that bisphosphonate treatment may potentially reduce the risk of revision surgery and associated adverse outcomes. Furthermore, the use of bisphosphonates after TJA is also associated with a reduced need for subsequent arthroplasty.Research Registration Unique Identifying Number (UIN): ClinicalTrials.gov Identifier-NCT05623540 ( https://clinicaltrials.gov/show/NCT05623540 ).

An automatic system for recognizing fly courtship patterns via an image processing method.

Fruit fly courtship behaviors composed of a series of actions have always been an important model for behavioral research. While most related studies have focused only on total courtship behaviors, specific courtship elements have often been underestimated. Identifying these courtship element details is extremely labor intensive and would largely benefit from an automatic recognition system. To address this issue, in this study, we established a vision-based fly courtship behavior recognition system. The system based on the proposed image processing methods can precisely distinguish body parts such as the head, thorax, and abdomen and automatically recognize specific courtship elements, including orientation, singing, attempted copulation, copulation and tapping, which was not detectable in previous studies. This system, which has high identity tracking accuracy (99.99%) and high behavioral element recognition rates (> 97.35%), can ensure correct identification even when flies completely overlap. Using this newly developed system, we investigated the total courtship time, and proportion, and transition of courtship elements in flies across different ages and found that male flies adjusted their courtship strategy in response to their physical condition. We also identified differences in courtship patterns between males with and without successful copulation. Our study therefore demonstrated how image processing methods can be applied to automatically recognize complex animal behaviors. The newly developed system will largely help us investigate the details of fly courtship in future research.

The association between remnant cholesterol and rheumatoid arthritis: insights from a large population study.

OBJECTIVES: While lipid metabolism disorder is widely acknowledged as a contributing factor to inflammation, the association between remnant cholesterol (RC), which indicates lipid metabolism, and rheumatoid arthritis (RA) has not been investigated. Accordingly, this study evaluated whether RC is associated with RA disease events. METHODS: Data were collected and specifically extracted from the National Health and Nutrition Examination Survey (NHANES) 1999-2008 database. The RC value was derived by subtracting the combined amount of low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) from the total cholesterol (TC). The association between RC and RA was evaluated using multivariate regression analysis and subgroup analysis. RESULTS: The study analyzed 7777 patients, of which 581 patients (7.47%) were diagnosed with RA. After accounting for different covariates, the multivariate logistic regression analysis revealed a notable correlation between increased RC levels and an increased likelihood of RA (odds ratio OR = 1.54; 95% confidence interval CI: 1.11-2.13; P = 0.0092). The interaction test did not yield statistically significant effects on this association. The linear correlation between RC and RA was observed within restricted cubic spline regression model limitations. CONCLUSION: The results suggest that higher RC levels are associated with increased odds of RA, indicating that RC can serve as a novel and convenient index for forecasting the likelihood of RA in the United States. Additionally, these findings offer insights into early intervention strategies for susceptible populations at risk of developing RA.

Kyphoplasty is associated with reduced mortality risk for osteoporotic vertebral compression fractures: a systematic review and meta-analysis.

BACKGROUND: Vertebral augmentation, such as vertebroplasty (VP) or kyphoplasty (KP), has been utilized for decades to treat OVCFs; however, the precise impact of this procedure on reducing mortality risk remains a topic of controversy. This study aimed to explore the potential protective effects of vertebral augmentation on mortality in patients with osteoporotic vertebral compression fractures (OVCFs) using a large-scale meta-analysis. MATERIALS AND METHODS: Cochrane Library, Embase, MEDLINE, PubMed and Web of Science databases were employed for literature exploration until May 2023. The hazard ratios (HRs) and 95% confidence intervals (CIs) were utilized as a summary statistic via random-effect models. Statistical analysis was executed using Review Manager 5.3 software. RESULTS: After rigorous screening, a total of five studies with substantial sample sizes were included in the quantitative meta-analysis. The total number of participants included in the study was an 2,421,178, comprising of 42,934 cases of vertebral augmentation and 1,991,244 instances of non-operative management. The surgical intervention was found to be significantly associated with an 18% reduction in the risk of mortality (HR 0.82; 95% CI 0.78, 0.85). Subgroup analysis revealed a remarkable 71% reduction in mortality risk following surgical intervention during short-term follow-up (HR 0.29; 95% CI 0.26, 0.32). Furthermore, KP exhibited a superior and more credible decrease in the risk of mortality when compared to VP treatment. CONCLUSIONS: Based on a comprehensive analysis of large samples, vertebral augmentation has been shown to significantly reduce the mortality risk associated with OVCFs, particularly in the early stages following fractures. Furthermore, it has been demonstrated that KP is more reliable and effective than VP in terms of mitigating mortality risk.

Universal Molecular Control Strategy for Scalable Fabrication of Perovskite Light-Emitting Diodes.

Despite the rapid progress in perovskite light-emitting diodes (PeLEDs), the electroluminescence performance of large-area perovskite devices lags far behind that of laboratory-size ones. Here, we report a 3.5 cm × 3.5 cm large-area PeLED with a record-high external quantum efficiency of 12.1% by creating an amphipathic molecular interface modifier of betaine citrate (BC) between the perovskite layer and the underlying hole transport layer (HTL). It is found that the surface wettability for various HTLs can be efficiently improved as a result of the coexistence of methyl and carboxyl groups in the BC molecules that makes favorable groups to selectively contact with the HTL surface and increases the surface free energy, which greatly facilitates the scalable process of solution-processed perovskite films. Moreover, the luminous performance of perovskite emitters is simultaneously enhanced through the coordination between C═O in the carboxyl groups and Pb dangling bonds.

Niobium-Carbide MXene Modified Hybrid Hole Transport Layer Enabling High-Performance Organic Solar Cells Over 19.

Niobium-carbide (Nb2 C) MXene as a new 2D material has shown great potential for application in photovoltaics due to its excellent electrical conductivity, large surface area, and superior transmittance. In this work, a novel solution-processable poly(3,4-ethylenedioxythiophene): poly(styrenesulfonate) (PEDOT:PSS)-Nb2 C hybrid hole transport layer (HTL) is developed to enhance the device performance of organic solar cells (OSCs). By optimizing the doping ratio of Nb2 C MXene in PEDOT:PSS, the best power convention efficiency (PCE) of 19.33% can be achieved for OSCs based on the ternary active layer of PM6:BTP-eC9:L8-BO, which is so far the highest value among those of single junction OSCs using 2D materials. It is found that the addition of Nb2 C MXene can facilitate the phase separation of the PEDOT and PSS segments, thus improving the conductivity and work function of PEDOT:PSS. The significantly enhanced device performance can be attributed to the higher hole mobility and charge extraction capability, as well as lower interface recombination probabilities generated by the hybrid HTL. Additionally, the versatility of the hybrid HTL to improve the performance of OSCs based on different nonfullerene acceptors is demonstrated. These results indicate the promising potential of Nb2 C MXene in the development of high-performance OSCs.

Thermal/Water-Induced Phase Transformation and Photoluminescence of Hybrid Manganese(II)-Based Chloride Single Crystals.

Mn(II)-based hybrid halides have attracted great attention from the optoelectronic fields due to their nontoxicity, special luminescent properties, and structural diversity. Here, two novel organic-inorganic hybrid Mn(II)-based halide single crystals (1-mpip)MnCl4·3H2O and (1-mpip)2MnCl6 (1-mpip = 1-methylpiperazinium, C5H14N2+) were grown by a slow evaporation method in ambient atmosphere. Interestingly, (1-mpip)2MnCl6 single crystals exhibit the green emission with a PL peak at 522 nm and photoluminescence quantum yields (PLQYs) of ≈5.4%, whereas (1-mpip)MnCl4·3H2O single crystals exhibit no emission characteristics. More importantly, there exists a thermal-induced phase transformation from (1-mpip)MnCl4·3H2O to emissive (1-mpip)2MnCl6 at 372 K. Moreover, a reversible luminescent conversion between (1-mpip)MnCl4·3H2O and (1-mpip)2MnCl6 was simply achieved when heated to 383 K and placed in a humid environment or sprayed with water. This work not only deepens the understanding of the thermal-induced phase transformation and humidity-sensitive luminescent conversion of hybrid Mn(II)-based halides, but also provides a guidance for thermal and humidity sensing and anticounterfeiting applications of these hybrid materials.

Microenvironment Created by SnSe2 Vapor and Pre-Selenization to Stabilize the Surface and Back Contact in Kesterite Solar Cells.

The ambient air-processed preparation of kesterite Cu2 ZnSn(S,Se)4 (CZTSSe) thin film is highly promising for the fabrication of low-cost and eco-friendly solar cells. However, the Sn volatilization loss and formation of a thick Mo(S,Se)2 interfacial layer during the traditional selenization process pose challenges for fabricating high-efficiency CZTSSe solar cells. Here, CZTS precursors prepared by a sol-gel process in ambient air are selenized and assisted with SnSe2 vapor via one- and two-step selenization to prepare a CZTSSe absorber on a Mo film and, subsequently, solar cells. For one-step selenization, the thickness of the fine grain and Mo(S,Se)2 layers near the back contact can be significantly reduced with increasing SnSe2 vapor partial pressure in the mixed selenization atmosphere, while the device efficiency is only 7.97% due to the severe interface recombination. For two-step selenization, the desired morphology and stoichiometry of the absorber can be achieved through the assistance of Sn-poor precursors selenized with high SnSe2 vapor partial pressure to regulate the Sn content in CZTSSe, yielding the highest efficiency of 10.85%. This study improves the understanding of the key role of the microenvironment during film growth towards the production of high-efficiency thin film solar cells and other photoelectronic devices.

Temperature-dependence of the band gap in the all-inorganic perovskite CsPbI3 from room to high temperatures.

Understanding the micro-mechanism of the temperature dependence of the band gap in all-inorganic perovskites is of great significance for their optoelectronic and photovoltaic applications in various temperature environments. Herein, based on the recently developed electron-phonon renormalization method, the temperature-dependent band gaps of the optoelectronic perovskite CsPbI3 are studied from 300 K to 750 K (including orthorhombic, tetragonal, and cubic phases). It is found that the temperature-induced structural fluctuation makes the structure of perovskites deviate from the 0 K one, and the corresponding renormalized band gap differs from that at 0 K, especially for the high-temperature cubic phase (e.g., ΔEg is ∼177 meV at 600 K). However, within the temperature range of each CsPbI3 phase, the band gap Eg is enlarged slightly with the increase of temperature (e.g., ΔEg is ∼26 meV from 600 K to 750 K for the cubic phase), showing the insensitivity of the structural fluctuation effect to the temperature change. The reason is that the chemical characters of band edges are determined by PbI3-, and due to the strong correlation between Pb and I, the Pb-I bond lengths and Pb-I-Pb bond angles are almost unchanged as the temperature increases. Our work provides a fundamental understanding of the temperature-dependent band gaps in all-inorganic perovskites and shed light on the commercialization of perovskites.

Chronic liver disease and cirrhosis increase morbidity in geriatric patients treated surgically for hip fractures: analysis of the US Nationwide Inpatient Sample.

BACKGROUND: This study aimed to evaluate the impact of chronic liver disease and cirrhosis on inpatient outcomes of geriatric hip fracture surgery. MATERIALS AND METHODS: Using population-based retrospective study design, this study extracted data from the US Nationwide Inpatient Sample (NIS) database 2005-2014, identifying patients aged ≥ 65 years undergoing hip fracture repair. Main outcomes were in-hospital mortality, any/specific complications, non-routine discharge, extended length of stay (LOS) and hospital costs. Associations between cirrhosis, non-cirrhotic chronic liver disease and outcomes were determined using regression analysis. RESULTS: Data of 347,363 hip fracture patients included 344,035 without liver disease, 1257 with non-cirrhotic chronic liver disease and 2,071 with cirrhosis. After adjustments, non-cirrhotic chronic liver disease was significantly associated with non-routine discharge (OR: 1.247, 95% CI: 1.038-1.498), acute kidney injury (OR: 1.266, 95% CI: 1.039-1.541), extended LOS (OR: 1.285, 95% CI: 1.122-1.473) and hospital costs (beta: 9173.42, 95% CI: 6925.9-11,420.95) compared to no liver disease; while cirrhosis was significantly associated with higher risk of in-hospital mortality (OR: 2.325, 95% CI: 1.849-2.922), any complication (OR: 1.295, 95% CI: 1.143-1.467), acute kidney injury (OR: 1.242, 95% CI: 1.177-1.433), non-routine discharge (OR: 1.650, 95% CI: 1.412-1.928), extended LOS (OR: 1.405, 95% CI: 1.263-1.562) and hospital costs (beta: 6680.24, 95% CI: 4921.53-8438.95) compared to no liver disease. CONCLUSION: In geriatric hip fracture patients undergoing surgical repair, non-cirrhotic chronic liver disease and cirrhosis independently predict non-routine discharge, acute kidney injury, prolonged LOS and greater hospital costs, and cirrhosis is also significantly associated with greater risk of any complication and in-hospital mortality.

Evolution of congenital haemophilia care in Taiwan.

Haemophilia care in Taiwan has come a long way over the past 35 years, from the absence of specialised haemophilia treatment centres before 1984 to the establishment of treatment centers in the majority of medical centers, the listing of haemophilia as a catastrophic illness with full treatment reimbursement by the Taiwan National Health Insurance (NHI), and the implementation of full NHI coverage for prophylaxis therapy. This has led to outcome improvements such as reduced bleed-related morbidity and mortality, fewer viral infections, and enhanced overall multi-modality care. Most people with haemophilia (PWH) are now able to live normal, active lives. Early diagnosis has improved through increased awareness, physician education, and prenatal diagnosis; while comprehensive care, including state of the art rehabilitation and orthopaedic management for haemophilic arthropathy, eradication therapy for chronic hepatitis C, and better treatments for human immunodeficiency virus, allows PWH to enjoy a better quality of life and improved survival. Efforts are now being made to raise prophylaxis rates through full NHI reimbursement and the use of extended half-life recombinant factor products. Overall, Taiwan has made great strides in haemophilia care and we would like to share these experiences for the benefit of all healthcare providers involved in haemophilia care.

S100 calcium-binding protein A9 from tumor-associated macrophage enhances cancer stem cell-like properties of hepatocellular carcinoma.

Tumor-associated macrophages (TAMs) are crucial components of the tumor microenvironment. They play vital roles in hepatocellular carcinoma (HCC) progression. However, the interactions between TAMs and HCC cells have not been fully characterized. In this study, TAMs were induced using human monocytic cell line THP-1 cells in vitro to investigate their functions in HCC progression. S100 calcium-binding protein A9 (S100A9), an inflammatory microenvironment-related secreted protein, was identified to be significantly upregulated in TAMs. S100A9 expression in tumor tissues was associated with poor survival of HCC patients. It could enhance the stem cell-like properties of HepG2 and MHCC-97H cells by activating nuclear factor-kappa B signaling pathway through advanced glycosylation end product-specific receptor in a Ca2+ -dependent manner. Furthermore, we found that, after treatment with S100A9, HepG2 and MHCC-97H cells recruited more macrophages via chemokine (CC motif) ligand 2, which suggests a positive feedback between TAMs and HCC cells. Taken together, our findings reveal that TAMs could upregulate secreted protein S100A9 and enhance the stem cell-like properties of HCC cells and provide a potential therapeutic target for combating HCC.

Temperature-dependent structural fluctuation and its effect on the electronic structure and charge transport in hybrid perovskite CH3 NH3 PbI3.

The recently discovered hybrid organic-inorganic perovskites have been suggested for high-performance optoelectronic applications. Owing to the mechanical flexibility of these compounds, they demonstrate structural fluctuation at finite temperatures that have been widely discussed with respect to their optical properties. However, the effect of temperature-induced structural fluctuation is not clear until now, with respect to the equally important charge transport properties. In the present study, through ab initio molecular dynamics simulations of cubic-phase CH3 NH3 PbI3 at different temperatures, the temperature-dependent electronic structure and charge carrier transport properties are examined. Compared with the significant structural fluctuation of organic cations, the structural change of the inorganic framework is minor. In addition, because the band edge states at R point are mainly influenced by the anti-bonding character of the Pb-I bond, CH3 NH3 PbI3 demonstrates relatively small deformation potentials as well as low temperature dependence of band gaps (ΔEg ≈ 50 meV from 330 K to 400 K) and electron-phonon coupling strengths, despite the large structural fluctuation of organic cations. Furthermore, the effective mass of the valence band increases with the increase of temperature. The predicted mobilities of CH3 NH3 PbI3 can reach above 75 cm2 V-1  s-1 near room temperature, exhibiting an appropriate optoelectronic potential, while the temperature dependence is steeper than T-1.5 of the traditional semiconductors because of the enhanced effective masses.

Surface plasmon enhanced THz emission with nanoporous gold supported CdTe.

Terahertz emission by ultrafast excitation of semiconductor/metal interfaces was found strongly enhanced by plasmon resonance. Here, a three-dimensional nanoporous gold (NPG) was used to form semiconductor/metal compound with cadmium telluride (CdTe). We investigated the specific impact of surface plasmon from randomly nanoporous structure in the ultrafast optoelectronic response for THz generation, and observed a THz amplitude enhancement around an order of magnitude from CdTe on NPG compared to that from CdTe on silicon. Moreover, the plasmon enhancement for THz emission from NPG is stronger than that from gold film, indicating that randomly nanoporous structure is also effective for plasmonic enhancement in THz band.

Incidence of bone metastases in patients with organ-specific cancers: A nationwide population-based cohort study.

BACKGROUND: Bones are the third most common site of metastasis, although bone metastasis (BM) incidence varies widely. This study investigated the incidence of BM in the most common cancers in Taiwan to present the recent treatment landscape in patients with organ-specific cancers. METHODS: Data from the National Health Insurance Research Database of Taiwan were used to identify adult patients diagnosed with organ-specific cancers between January 1, 2000 and December 31, 2015. Kaplan-Meier analysis was used to quantify cumulative BM incidence at follow-up. BM incidences associated with different cancers were calculated comprehensively and stratified by sex, age group and follow-up periods, and age- and sex-adjusted hazard ratios (HRs) of BM were calculated using multivariate Cox regression analysis. RESULTS: Among 938 776 participants (mean follow-up, 9.2 years), liver (19.6%), colorectal (17.1%) and lung (15.1%) cancers were most commonly associated with BM. The mean interval between a primary cancer diagnosis and BM was 2 years. BM incidence varied widely among cancers; lung cancer (3213 per 105 person-years) was associated with the highest BM risk, followed by oesophageal, prostate and breast cancer. HRs of BM were significantly higher for lung cancer (HR = 8.1) than for other cancers. CONCLUSION: The estimated BM incidence provided insight into oncological clinical practice trends in the Asia-Pacific region. BM incidence may vary among populations. Understanding the principles of clinical evaluation in patients with cancer of unknown primary origin can facilitate appropriate treatment recommendations.

Composition Profiling and Authenticity Assessment of Camellia Oil Using High Field and Low Field 1H NMR.

Camellia oil (CA), mainly produced in southern China, has always been called Oriental olive oil (OL) due to its similar physicochemical properties to OL. The high nutritional value and high selling price of CA make mixing it with other low-quality oils prevalent, in order to make huge profits. In this paper, the transverse relaxation time (T2) distribution of different brands of CA and OL, and the variation in transverse relaxation parameters when adulterated with corn oil (CO), were assessed via low field nuclear magnetic resonance (LF-NMR) imagery. The nutritional compositions of CA and OL and their quality indices were obtained via high field NMR (HF-NMR) spectroscopy. The results show that the fatty acid evaluation indices values, including for squalene, oleic acid, linolenic acid and iodine, were higher in CA than in OL, indicating the nutritional value of CA. The adulterated CA with a content of CO more than 20% can be correctly identified by principal component analysis or partial least squares discriminant analysis, and the blended oils could be successfully classified by orthogonal partial least squares discriminant analysis, with an accuracy of 100% when the adulteration ratio was above 30%. These results indicate the practicability of LF-NMR in the rapid screening of food authenticity.

Observation of double indirect interlayer exciton in WSe2/WS2 heterostructure.

Interlayer excitons (IX) are produced by the spatially separated electron-hole pairs due to the robust Coulomb interactions in van der Waals transition metal dichalcogenide (TMDC) heterostructures (HSS). IX is characterized by a larger binding energy, and its lifetime is orders of magnitude longer than that of the direct excitons, providing a significant platform for the manufacture of long-lived exciton devices and the exploration of exciton quantum gas. However, the studies are restricted to the single interlayer exciton, and the simultaneous capture and study of double IX remain challenging in the WSe2/WS2 HS. Here, we demonstrate the existence of double indirect IX in the WSe2/WS2 HS with the emission centers at 1.4585eV (∼25.9meV wide) and 1.4885 eV (∼14.4 meV wide) at cryogenic temperature. Interestingly, the intensities of the double IX emission peaks are almost equal, and the energy difference between them is in a good agreement with the cleavage value of the WS2 conduction band (CB). Additionally, diverse types of excitons in the individual materials were successfully observed in the PL spectra at 8 K. Such unique double IX features, in combination with excellent exciton identification, open up new opportunities for further investigations for new physical properties of TMDCs and explorations for the technological innovation of exciton devices.

Analysis of Cervical Sagittal Balance in Treating Cervical Spondylotic Myelopathy: 1-Level Anterior Cervical Corpectomy and Fusion Versus 2-Level Anterior Cervical Discectomy and Fusion.

BACKGROUND Anterior cervical corpectomy and fusion (ACCF), together with anterior cervical discectomy and fusion (ACDF) are both effective clinical treatments for cervical spondylotic myelopathy (CSM). Cervical sagittal balance is critical to preserving normal alignment, and is also associated with clinical outcomes. MATERIAL AND METHODS We retrospectively reviewed patients who had suffered from CSM and had undergone 1-level ACCF or 2-level ACDF surgery between December 2016 and November 2017. Forty-eight patients were identified: 25 in the ACDF group and 23 in the ACCF group. All patients received follow-up for more than 12 months. The demographic data, radiographic parameters, and clinical efficacy were compared between and within groups, both pre- and postoperatively. RESULTS Both groups acquired good clinical efficacy; both Japanese Orthopedic Association (JOA) scores and Neck Disability Index (NDI) scores improved significantly. At the final follow-up visit, patients in the ACCF and ACDF groups did not differ significantly in C2-C7 Sagittal Vertebral Axis (cSVA), T1 Pelvic Angle (TPA), Neck Tilt (NT), Thoracic Inlet Angle (TIA), JOA, or NDI scores. However, the ACDF group had a significantly larger Cobb angle and T1 Slope (T1S) than the ACCF group. The postoperative Cobb angle increased significantly only in the ACDF group, while postoperative T1S significantly increased in both ACCF and ACDF groups. CONCLUSIONS Anterior cervical surgery may change the sagittal balance in terms of T1S or Cobb angle. No significant difference was found between ACCF and ACDF in clinical outcomes or representative global sagittal parameters. ACDF achieved more lordosis improvement than ACCF, with higher T1S. Surgeons need to pay extra attention to cervical sagittal balance, rather than focusing solely on decompression.

Autologous Chondrocyte Implantation Versus Microfracture in the Knee: A Meta-analysis and Systematic Review.

PURPOSE: To compare clinical outcomes among patients with fractures of knee cartilage who were treated with autologous chondrocyte implantation (ACI) or microfracture (MF). METHODS: A systematic review was made of randomized controlled trials of articular cartilage lesions of the knee treated with ACI or MF that were published between January 2000 and November 2018 and catalogued in 4 major databases. The outcomes of clinical score, quality of life (QoL), pain relief score, and failure rate were assessed. RESULTS: A final group of 12 randomized controlled trials were included that enrolled a total of 659 patients with knee cartilage lesions: 332 patients had received ACI and 327 patients had undergone MF. Patients ranged in age from 25 to 41 years, and the majority were male. Lesion size ranged from 2.3 to 10.0 cm2. Pooled analysis found no significant difference in the improvement in International Knee Documentation Committee and Lysholm scores or overall Knee Injury and Osteoarthritis Outcome Score measures between patients in the ACI and MF groups at 1-year, 2-year, and 5-year follow-up examinations or in failure rate at 2-year, 3-year, and 5-year follow-up timepoints. However, patients treated with ACI had a significant benefit in activities of daily living at follow-up of 5 years or less compared with patients treated with MF. ACI treatment also showed better improvement in QoL and pain relief than MF at 5-year and 2-year follow-up examinations, respectively. CONCLUSIONS: The pooled analysis found no significant difference in the improvement in International Knee Documentation Committee or Lysholm scores or overall Knee Injury and Osteoarthritis Outcome Score measures between patients in the ACI and MF groups at 1 to 5 years of follow-up. Patients treated with ACI may have a significant benefit in activities of daily living, QoL, and pain relief compared with patients treated with MF, although clinical relevance may not be achieved. LEVEL OF EVIDENCE: Level II, systematic review of Level I and II investigations.