Residual varus alignment after posterior-stabilized total knee arthroplasty limits medial soft tissue remodeling.

BACKGROUND: Proper lower limb alignment and soft tissue balance are significant indicators to measure the success of total knee arthroplasty (TKA). Previous studies have confirmed that soft tissue relaxation around the knee after TKA will change over time; however, the relationship between lower limb alignment and soft tissue balance after TKA remains unclear. We studied (1) whether the change of soft tissue balance around the knee with time after posterior-stabilized (PS) TKA would affect the alignment of the lower limbs; (2) Whether the accuracy of lower limb alignment during PS TKA affects postoperative soft tissue remodeling. METHODS: In this study, 100 patients were recruited after PS TKA. Among them, 50 patients with a hip knee ankle (HKA) angle of ≤ ± 3° were set as the neutral group, and 50 patients with an HKA angle of > ± 3° were set as the deviation group. The imaging results measured the HKA angle before the operation as well as the HKA, varus, and valgus angles at 1, 3, 6, 12, and 24 months after TKA. Clinical assessment included range of motion (ROM), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Society Score (KSS). RESULTS: Eight people were excluded from the study. After the exclusion, the study enrolled 47 patients in the neutral group and 45 patients in the deviant group and were followed for up to 2 years. There was no statistical significance in mean varus angles as well as HKA angle changes during the follow-up phase of each groups (P > 0.05). The mean valgus angles of the patients in the neutral group group were 2.47°, 3.45°, 3.63°, 3.60° and 3.63°, and in the deviation group were 2.45° (P = 0.841), 2.88° (P < 0.001), 3.07° (P < 0.001), 3.06° (P < 0.001), and 3.10° (P < 0.001). ROM, WOMAC and KSS of the two groups were significantly improved after operation, with no difference between the two groups. CONCLUSION: This study shows that whether the alignment is accurate or not in the early stage after TKA, the relaxation of the medial and lateral soft tissues of the knee joint change; however, this change will not significantly affect the alignment of the lower limbs. Postoperative residual varus deformity limits medial soft tissue remodeling. LEVEL OF EVIDENCE: III.

Pavement Roughness Grade Recognition Based on One-dimensional Residual Convolutional Neural Network.

A pavement's roughness seriously affects its service life and driving comfort. Considering the complexity and low accuracy of the current recognition algorithms for the roughness grade of pavements, this paper proposes a real-time pavement roughness recognition method with a lightweight residual convolutional network and time-series acceleration. Firstly, a random input pavement model is established by the white noise method, and the pavement roughness of a 1/4 vehicle vibration model is simulated to obtain the vehicle vibration response data. Then, the residual convolutional network is used to learn the deep-level information of the sample signal. The residual convolutional neural network recognizes the pavement roughness grade quickly and accurately. The experimental results show that the residual convolutional neural network has a robust feature-capturing ability for vehicle vibration signals, and the classification features can be obtained quickly. The accuracy of pavement roughness classification is as high as 98.7%, which significantly improves the accuracy and reduces the computational effort of the recognition algorithm, and is suitable for pavement roughness grade classification.

Performance Optimization in Frequency Estimation of Noisy Signals: Ds-IpDTFT Estimator.

This research presents a comprehensive study of the dichotomous search iterative parabolic discrete time Fourier transform (Ds-IpDTFT) estimator, a novel approach for fine frequency estimation in noisy exponential signals. The proposed estimator leverages a dichotomous search process before iterative interpolation estimation, which significantly reduces computational complexity while maintaining high estimation accuracy. An in-depth exploration of the relationship between the optimal parameter p and the unknown parameter δ forms the backbone of the methodology. Through extensive simulations and real-world experiments, the Ds-IpDTFT estimator exhibits superior performance relative to other established estimators, demonstrating robustness in noisy conditions and stability across varying frequencies. This efficient and accurate estimation method is a significant contribution to the field of signal processing and offers promising potential for practical applications.

A case report: anatomical translocation in tibial insertion of semitendinosus tendon after tibial lengthening.

BACKGROUND: There is the most common method for arthroscopic anterior cruciate ligament (ACL) reconstruction by using the semitendinosus and gracilis tendons and single-tunnel technique. However, anatomic translocation of hamstring tendon attachment is very rare. CASE PRESENTATION: A 45-year-old male who need to receive right knee ACL reconstruction due to sprain injury while playing table tennis was found to have a translocation at tibial attachment of semitendinosus tendon. The tibial insertion of left semitendinosus was then explored by ultrasound and found to be identical to the contralateral limb. The patient has a history of bilateral tibial lengthening. CONCLUSIONS: This is the first case as far as we know that reported anatomic translocation of the tibial attachment of the hamstring tendon after tibial lengthening. Surgeons should be aware of this specific situation when hamstring tendon need to be harvested to avoid unnecessary complications.

Electroencephalogram-Based ConvMixer Architecture for Recognizing Attention Deficit Hyperactivity Disorder in Children.

Attention deficit hyperactivity disorder (ADHD) is a neuro-developmental disorder that affects approximately 5-10% of school-aged children worldwide. Early diagnosis and intervention are essential to improve the quality of life of patients and their families. In this study, we propose ConvMixer-ECA, a novel deep learning architecture that combines ConvMixer with efficient channel attention (ECA) blocks for the accurate diagnosis of ADHD using electroencephalogram (EEG) signals. The model was trained and evaluated using EEG recordings from 60 healthy children and 61 children with ADHD. A series of experiments were conducted to evaluate the performance of the ConvMixer-ECA. The results showed that the ConvMixer-ECA performed well in ADHD recognition with 94.52% accuracy. The incorporation of attentional mechanisms, in particular ECA, improved the performance of ConvMixer; it outperformed other attention-based variants. In addition, ConvMixer-ECA outperformed state-of-the-art deep learning models including EEGNet, CNN, RNN, LSTM, and GRU. t-SNE visualization of the output of this model layer validated the effectiveness of ConvMixer-ECA in capturing the underlying patterns and features that separate ADHD from typically developing individuals through hierarchical feature learning. These outcomes demonstrate the potential of ConvMixer-ECA as a valuable tool to assist clinicians in the early diagnosis and intervention of ADHD in children.

Comparison of the Clinical Outcomes between All-inside and Standard Technique in Anterior Cruciate Ligament Reconstruction with 6-strand Hamstring Tendon Autograft.

OBJECTIVE: All-inside and standard techniques with 4-strand hamstrings graft have been widely used in anterior cruciate ligament (ACL) reconstruction. However, the graft diameter of less than 8 mm will significantly increase the rate of surgical failure, and the 6-strand graft can solve this problem. The purpose of this study is to compare all-inside ACL reconstruction using suspensory cortical button fixation on both tibia and femur with standard ACL reconstruction using suspensory femoral fixation and a bioabsorbable tibial interference screw with a 6-strand hamstring tendon autograft in postoperative clinical outcomes. METHODS: From January 2020 to December 2020, 48 patients performed ACL reconstruction were divided into the all-side group and the standard group according to the different surgical techniques. Magnetic resonance imaging (MRI) and subjective function scores was used to assess clinical outcomes at least 24 months following ACL reconstruction. MRI was used to measure the value of bone tunnel widening in articular and middle portions. Subjective function scores included the Lysholm knee score, the International Knee Documentation Committee (IKDC) score, the Knee Society Score (KSS) for pain and function, and KT-1000. The t-test was used assuming the distribution of the patients which follows the normal distribution and we used non-parametric tests if these two conditions were not satisfied. RESULTS: At the final follow-up, there were 22 patients in the all-inside group and 24 patients in the standard group. No significant differences were found with respect to femoral tunnel widening and subjective function scores. However, a significant increase in tibial tunnel widening was found in the middle portion of the standard group (2.25 ± 0.74) compared to the all-inside group (0.76 ± 0.24) (p < 0.01) and also in the articular portion of the standard group (2.07 ± 0.77) compared to the all-inside group (1.52 ± 0.54) (p = 0.02). In addition, the value of the KT-1000 was 1.81 ± 0.45 for the all-inside group and 2.12 ± 0.44 in the standard group (p = 0.016). CONCLUSION: The objective stability of the knee was relatively better in the all-inside group than in the standard group. And tunnel widening after ACL reconstruction was significantly greater in the standard technique when compared to the all-inside technique on the tibia side.

Safety, pharmacokinetics, and food effect of sudapyridine (WX-081), a novel anti-tuberculosis candidate in healthy Chinese subjects.

This study aimed to assess the safety, pharmacokinetics, and food impact on sudapyridine (WX-081), a novel drug designed to inhibit mycobacterium ATP synthase, with clinical applications for drug-resistant tuberculosis (TB) treatment. The research comprised two arms: a single ascending dose (SAD) arm (30 to 600 mg, N = 52) and a multiple ascending dose (MAD) arm (200 to 400 mg, N = 30). The influence of food was evaluated using a 400 mg dose within an SAD cohort. Plasma concentrations of WX-081 and M3 (main metabolite of WX-081) were analyzed using a validated liquid-chromatography tandem mass spectrometry method. In the SAD arm, mean residence time (MRT0-t), terminal half-life, and clearance of WX-081 ranged from 18.87 to 52.8 h, 31.39 to 236.57 h, and 6.4 to 80.34 L/h, respectively. The area under the curve from time zero to the last measurable timepoint (AUC0-t) of WX-081 showed dose-proportional increases in the SAD arm. The disparity between fasted and fed states of WX-081 was significant (p < 0.05), with fed dosing resulting in a 984.07% higher AUC0-t and 961.55% higher maximum plasma concentration. In both the SAD and MAD arms, one case each exhibited a 1 degree atrioventricular block. No QTc elongation was observed, and adverse events were not dose-dependent. Favorable exposure, tolerability, safety, and an extended MRT0-t suggest that WX-081 holds promise as a phase II development candidate for drug-resistant TB treatment.

Detection of ASD Children through Deep-Learning Application of fMRI.

Autism spectrum disorder (ASD) necessitates prompt diagnostic scrutiny to enable immediate, targeted interventions. This study unveils an advanced convolutional-neural-network (CNN) algorithm that was meticulously engineered to examine resting-state functional magnetic resonance imaging (fMRI) for early ASD detection in pediatric cohorts. The CNN architecture amalgamates convolutional, pooling, batch-normalization, dropout, and fully connected layers, optimized for high-dimensional data interpretation. Rigorous preprocessing yielded 22,176 two-dimensional echo planar samples from 126 subjects (56 ASD, 70 controls) who were sourced from the Autism Brain Imaging Data Exchange (ABIDE I) repository. The model, trained on 17,740 samples across 50 epochs, demonstrated unparalleled diagnostic metrics-accuracy of 99.39%, recall of 98.80%, precision of 99.85%, and an F1 score of 99.32%-and thereby eclipsed extant computational methodologies. Feature map analyses substantiated the model's hierarchical feature extraction capabilities. This research elucidates a deep learning framework for computer-assisted ASD screening via fMRI, with transformative implications for early diagnosis and intervention.

How Do the Morphological Abnormalities of Femoral Head and Neck, Femoral Shaft and Femoral Condyle Affect the Occurrence and Development of Medial Knee Osteoarthritis.

OBJECTIVE: At present, the main viewpoint is that tibial varus is the main reason of medial knee osteoarthritis (OA), and high tibial osteotomy (HTO) is also the main alignment correction method to correct medial knee OA. In contrast, the impact of the anatomical alignment of the femur on medial knee OA is often overlooked. We evaluated the increased risk for medial knee OA because a varus alignment could be attributed to the anatomical reasons that include hip anatomy, femoral shaft bowing (FSB) and femoral condylar dysplasia. METHODS: The present research adopted a cross-sectional study method. We selected 62 patients with HTO in the Third Hospital of Hebei Medical University from June 2021 to March 2022 as the HTO group and 55 healthy volunteers as the control group. Femoral neck-shaft angle (NSA), lateral FSB, mechanical lateral distal femoral angle (mLDFA) and hip-knee-ankle (HKA) was radiographically examined within the two groups. The femoral neck length and offset were also measured, and the ratio is represented by the ratio of the femoral neck length to off-set (N/O). The 2-tailed Student t-test was used to compare the differences between groups when the data were in accordance with a normal distribution. Otherwise, the Mann-Whitney U tests was used to compare the differences between groups. RESULT: Compared to the control group, the HTO group had a higher offset (p < 0.05), greater femoral neck length (p < 0.05), and decreased (more varus) NSA (p < 0.05). The HKA in the HTO group was 172.20 ° (3.50°), which was significantly lower than that of the control group 177.00° (3.05°), (p < 0.001), while the medial OA was associated with more varus HKA. The mean mLDFA was 89.10 ° (2.35°) and 87.50° (2.85°) in the HTO and control groups (p < 0.005), respectively. The mean lateral FSB values of the full-length radiographs were larger (p < 0.001) in the HTO group (4.24° ± 3.25°) than that in control group (1.16° ± 2.32°). CONCLUSION: The reduction of NSA (coxa vara) and the increase of the mLDFA can lead to medial knee OA, while the lateral FSB also affects medial OA. We believe that femoral deformity is also one of the cause of the medial knee OA. Therefore, it is necessary to evaluate the joint deformity of the femur and tibia before surgery in order to determine whether to use HTO alone to correct the lower limb alignment.

Behavior Management Training for Parents of Children with Preschool ADHD Based on Parent-Child Interactions: A Multicenter Randomized Controlled, Follow-Up Study.

Objective: There is a need to develop optimized, evidence-based parent training programs tailored for preschoolers with attention deficit hyperactivity disorder (ADHD). The objective of this study was to explore a behavioral management training program aimed at the parents of preschool children with ADHD, which directly analyzes parent-child interaction from the perspective of system theory, and the intervention effect on ADHD in preschool children. Methods: A multicenter randomized controlled study was conducted using system-based group therapy with 62 parents of preschool children with ADHD aged four to six years. ADHD symptoms, behavioral and emotional problems, and social functioning were compared with 61 control children whose parents did not receive training by applying the ADHD Rating Scale (ADHD-RS), Strengths and Difficulties Questionnaire (SDQ), and Questionnaire-Children with Difficulties (QCD) at the time of subject entry and at two and six months of entry, respectively. Results: The results of the ADHD-RS assessment showed that children in the intervention group had significantly lower factor scores for attention deficit, hyperactivity, and impulsivity than the children in the control group after parental training and at follow-up (P < 0.05). Total scores on the SDQ scale, as well as character problems, hyperactivity, and peer interaction scores, significantly decreased with statistically significant differences (all P < 0.05), and emotional symptoms and prosocial behavior did not notable decline (P > 0.05). Compared with the control group, the total scores of the QCD scale and the scores of each factor in the intervention group remained significantly higher at the follow-up (P < 0.05). Conclusion: After continuous intervention for eight weeks, parents were able to help the children with preschool ADHD to improve their ADHD symptoms and emotional behavioral and social functioning significantly, and the efficacy was maintained at the four-month follow-up; the systemic-based parent training in behavior management (PTBM) is applicable to the treatment of preschool ADHD and is worth promoting.

Towards-Person Vocalization Effect on Screening for Autism Spectrum Disorders in the Context of Frustration.

The purpose of this study is to investigate the vocalization characteristics of infants with autism spectrum disorder (ASD) in the context of frustration. The duration and frequency of vocalization in 48 infants with ASD and 65 infants with typical development (TD) were followed up to 24 months later for subsequent diagnosis. The typical vocalizations of infants with ASD were retrospectively analyzed, such as speech-like vocalizations, nonspeech vocalizations, vocalizations towards the person and non-social vocalizations. The results showed that, compared with the TD group, vocalizations of infants with ASD during the still-face period had lower typical vocalizations and characteristics associated with social intention, and that these characteristics were closely related to the clinical symptoms of ASD, among which vocalizations towards the person accompanied by social intention had discriminative efficacy.

Medial Patellofemoral Ligament Reconstruction Using Suture Tape for Patellofemoral Joint Instability.

OBJECTIVE: To describe a surgical technique using suture tape for reconstruction of the medial patellofemoral ligament (MPFL). This technique restores the stability of the reconstructed ligament and has excellent postoperative outcomes. METHOD: This is a retrospective analysis. From January 2016 to June 2018, 17 patients underwent MPFL reconstruction using high-strength suture (FiberTape; Arthrex) augmentation, with at least 12 months of follow up. There were 11 female and 6 male patients. The mean age at the time of MPFL reconstruction was 22.1 years (range 13-34 years). Clinical outcomes included pain level, knee range of motion, passive patellar hypermobility, and maltracking at follow-up. The lateral patellofemoral angles, congruence angles, and patellar tilt angles were measured in a skyline view by CT at 30° of knee flexion at 12 months. Functional outcomes were assessed using the Lysholm knee scoring scale, the SF-12 score, the Tegner score, and the Crosby and Insall grading system at yearly follow-up. RESULT: No patients were lost at the last follow up. One patient had recurrence of patellar dislocation and none of the others had serious complications. The success rate of MPFL repair for preventing recurrent dislocations was 94.1% (16 of 17 knees). Fifteen knees had full range of motion of more than 130°. At follow-up, 2 knees were judged to have mild hypermobility and none had severe hypermobility or maltracking. Using the Crosby and Insall grading system, 12 knees (70.6%) were graded as excellent, 4 knees (23.5%) as good, 1 knee (5.9%) as fair to poor, and none as worse at the last follow-up assessment. In all patients, the Lysholm knee score (55.12 ± 13.52 vs 79.88 ± 7.50, P < 0.01), the SF-12 score (47 ± 9.53 vs 65.24 ± 12.82, P < 0.01), and the Tegner score (2.76 ± 1.39 vs 6.53 ± 1.70, P < 0.01) had improved at their 12-month follow up. Compared with preoperative radiological findings, there was a significant improvement in lateral patellofemoral angle (-10.24 ± 7.10 vs 6 ± 5.43, P < 0.01), patellar tilt angle (26.53 ± 7.23 vs 9.88 ± 4.24, P < 0.01), and congruence angle (29.59 ± 11.95 vs -8.65 ± 4.86, P < 0.01). CONCLUSION: The use of FiberTape in MPFL reconstruction can improve the stability of the knee following surgery and has good midterm clinical results and low complication rates.

Electrochemical Characteristics and Transport Properties of V(II)/V(III) Redox Couple in a Deep Eutectic Solvent: Magnetic Field Effect.

Compared with conventional aqueous electrolytes, deep eutectic solvent (DES) has a wider electrochemical stability window, simple preparation, potential biodegradability, and lower cost, leading to its utilization as electrolyte for non-aqueous redox flow batteries (RFB). However, the large viscosity and inferior transport properties hinder the wide spread of DES electrolyte. To circumvent these issues, various additives as well as external fields can be applied separately or synergistically. This work reports a study on the inclusion of a DC magnetic field to the glycol-based DES electrolyte of a RFB. The effects of magnetic field on the physical and electrochemical characteristics of the electrolyte and the active redox couple on mass transfer are studied by cyclic voltammetry and electrochemical impedance spectroscopy. The experimental results show that the viscosity of the vanadium DES electrolyte decreases and the conductivity increases after adding a magnetic field. With the intensity of the added magnetic field increases, the oxidation and reduction peak current densities of the vanadium DES electrolyte keep increasing. Under the magnetic field intensity of 605 mT, the oxidation peak current density and the reduction peak current density increases 41.56 and 30.74%, respectively, compared with those of no added magnetic field. The ohmic resistance and electrochemical reaction resistance of the vanadium DES electrolyte are reduced when adding the magnetic field, reaching to 40.55 and 43.28%, respectively, with a magnetic field intensity of 605 mT. This study shows an effective yet simple way to improve the physical and electrochemical properties of DES electrolyte, which owns the potential to be widely applied in non-aqueous redox flow batteries.

Impact of post-abortion family planning services on contraceptive use and abortion rate among young women in China: a cluster randomised trial.

OBJECTIVES: To compare two post-abortion family planning (FP) service packages on contraceptive use and repeat abortion rate among young women in three cities in China. METHODS: In this cluster-randomized trial, one FP service package included provision of limited information and referral to existing FP services, and the other, more comprehensive, package consisted--in addition to the above simple package--of individual counselling, free provision of contraceptive materials, and involvement of the male partner. Eight matched pairs of hospitals were certified by centralized randomization. Women undergoing abortion were followed up for six months, and data were collected in two rounds, before and after the intervention. RESULTS: We followed a total of 2336 women younger than 25 years (555 before and 555 after the simple intervention package; 634 before and 592 after the comprehensive intervention package). Both packages increased use of any contraceptive method, but the comprehensive approach also increased use of more effective methods. Odds ratios for consistent and correct use of condoms were 2.32 (95% confidence interval 1.55-3.46) and 2.78 (1.81-4.26), respectively, compared with the simple package. The rates of unwanted pregnancies and repeat abortions were somewhat reduced for both packages, with no significant statistical difference between them. CONCLUSION: Couples who received the comprehensive post-abortion FP service appear to use more effective contraceptive methods and show better compliance.

The need for integrating family planning and postabortion care in China.

OBJECTIVE: To assess the need for integrating postabortion care with family planning services in China. METHOD: We collected data from a clinic-based study of 24 abortion clinics in 3 large cities in China. RESULTS: There was a total of 287 (10.3%) high-risk abortions among the 2780 respondents, 974 (35%) of whom had had repeated abortions and 48.4% had had 2 abortions within 1 year; 63.7% of the current pregnancies resulted from not using contraceptives; 28.8% and 19.8% of these new pregnancies, respectively, were due to the failure of the rhythm or the withdrawal method; only 9.7% of the respondents consistently used condoms; and only 9.1% could identify the correct time of their first ovulation following an abortion. CONCLUSION: Contraceptive neglect and the high rates of repeated and high-risk abortions call for the integration of postabortion care with family planning services in China.

Will the Europe Union's Traditional Herbal Medicinal Products Directive (Directive 2004/24/EC) be against traditional Chinese medicine in EU market?

As human civilization develops, biomedicine stays robust. Faced with the challenge of Europe Union's Traditional Herbal Medicinal Products Directive, if traditional Chinese medicine (TCM) wants to be still used as one kind of medicine to treat patients, China should be in line with scientific law, that is, each claim that TCM treats any disease or indication should be supported by the data of evidence-based randomized clinical trials. As a priority, there is an urgent need to conduct more scientific experiments and clinical trials to verify the concepts and mechanisms of TCM. Also, China is encouraged to get rid of non-scientific concepts and theories of TCM.

[Study on the risk factors of repeated abortion among unmarried adolescents].

OBJECTIVE: To find out the rate of repeated induced abortion among unmarried abortion women and to study the relevant risk factors. METHODS: From July to September 2005, we used the method of hospital based descriptive epidemiological study to investigate 2295 abortion women below 25 years of age in Beijing, Shanghai and Zhengzhou. Case-control study was used as the method. We considered the women with history of repeated abortion as case group (736 women) and considered the women without history of repeated abortion as control group (1559 women). RESULTS: The mean age of respondents was 21.92 years with minimal age as 15 years. 17.2 % aborted women aged below 20 years with 32. 1% of them were ever having a history of previous induced abortion. Among 736 women with repeated abortion, 75.3 % of them had one time of induced abortion previously, 18.1% having two times, 4.2% having 3 times, 13 women having 4 times and 4 women having 5 times and one even with the maximum of having 8 times of previous abortion. In comparison with control group, the case group had higher rate among women whose first sex was below 18 years (16.2% vs. 9.4% , P<0.01). There were higher rates of women under following conditions: having exposed to sexual behavior for more than 3 years (33.6% vs. 6.6 % , P<0.01), having cohabited with male partner for over 1 year (64.6% vs. 23.9%, P <0.01), having regular sexual life (48.5 % vs. 37. 1%, P < 0.05), having multiple sexual partners (36.0% vs. 15.0%,P<0.01) having unwanted sex (6.0% vs. 3.9%, P<0.05), whose current pregnancy resulted from contraceptive failure (39.3% vs. 31.6%, P< 0.01), having a history of high-risk abortion (30.8% vs. 3.1%, P< 0.01) etc. In comparison with the control group, the case group showed higher rates of male partners not supporting this induced abortion, male partner not participating in decision-making on abortion and male partner not accompanying the female partners to seek for abortion service (rates of the three major factors in case group and in control group were 10.3% vs. 5.9%, P< 0.01, 30.3% vs. 24.0%, and 27.5% vs. 23.5%, P<0.01, respectively). CONCLUSION: The rate of repeated induced abortion among unmarried abortion women was relatively high. The risk factors for females would include: younger age of sex debut, longer duration from the beginning of first sex to the current abortion, cohabitation, regular sexual life, multiple sexual partners, unwanted sex, contraceptive failure and high risk induced abortion. Meanwhile, unmarried but repeated abortion was related to the differences of gender between males and females and male partner's concern on induced abortion.