Biochar and theaflavins mitigate the antibiotic resistome and antibiotic-resistant pathogens in a soil-lettuce continuum.

Antibiotic resistance can be transferred into the food chain, leading to increased risks to human health from ready-to-eat vegetables. Mitigating the transmission of antibiotic resistance from soil to vegetables by green materials is of great significance. Here, we deciphered the roles of biochar and theaflavins in mitigating antibiotic resistance genes (ARGs) and antibiotic-resistant pathogens (ARPs) in a soil-lettuce continuum. Metagenomic results showed that biochar led to a significant decrease in the abundance of ARGs in lettuce leaves, while theaflavins contributed to a significant reduction in the diversity and abundance of ARGs in soil, particularly targeting dominant ARG types such as sulfonamide and aminoglycoside resistance genes. Meanwhile, biochar and theaflavins alleviated the potential mobility of ARGs, in lettuce leaves and soil, respectively, including the spread of ARGs to human pathogens. In addition, the diversity of ARG hosts was reduced in the soil-lettuce continuum and ARPs were not detected in lettuce leaves after the application of biochar or theaflavins. Overall, this study provides a novel perspective on green materials for mitigating the antibiotic resistome and ARPs in the soil-lettuce continuum, contributing to food security and human health.

3D PRINTING IN COMPLEX TIBIAL FRACTURE CLASSIFICATION & PLANNING.

Objective: Tibial plateau fractures are common intra-articular fractures that pose classification and treatment challenges for orthopedic surgeons. Objective: This study examines the value of 3D printing for classifying and planning surgery for complex tibial plateau fractures. Methods: We reviewed 54 complex tibial plateau fractures treated at our hospital from January 2017 to January 2019. Patients underwent preoperative spiral CT scans, with DICOM data processed using Mimics software. 3D printing technology created accurate 1:1 scale models of the fractures. These models helped subdivide the fractures into seven types based on the tibial plateau's geometric planes. Surgical approaches and simulated operations, including fracture reduction and plate placement, were planned using these models. Results: The 3D models accurately depicted the direction and extent of fracture displacement and plateau collapse. They facilitated the preoperative planning, allowing for precise reconstruction strategies and matching intraoperative details with the pre-printed models. Post-surgery, the anatomical structure of the tibial plateau was significantly improved in all 54 cases. Conclusion: 3D printing effectively aids in the classification and preoperative planning of complex tibial plateau fractures, enhancing surgical outcomes and anatomical restoration. Level of Evidence IV, Prospective Study.

Objetivo: As fraturas do planalto tibial são fraturas intra-articulares comuns de classificação e tratamento desafiadores aos cirurgiões ortopédicos. Objetivo: Este estudo investiga o uso de impressão 3D para classificar e planejar a cirurgia de fraturas complexas do planalto tibial. Métodos: 54 fraturas complexas do planalto tibial tratadas em nosso hospital de janeiro de 2017 a janeiro de 2019 foram revisadas. Os pacientes foram submetidos a tomografias computadorizadas em espiral pré-operatórias, com dados DICOM processados usando o software Mimics. A tecnologia de impressão 3D gerou modelos precisos em escala 1:1 das fraturas. Estes modelos ajudaram a subdividir as fraturas em sete tipos com base nos planos geométricos do planalto tibial. As abordagens cirúrgicas e as operações simuladas, incluindo a redução da fratura e a colocação de placa, foram planejadas utilizando estes modelos. Resultados: Os modelos 3D representaram com precisão a direção e a extensão da deslocação da fratura e do colapso do planalto. Os modelos facilitaram o planejamento pré-operatório, viabilizando estratégias de reconstrução precisas e a correspondência dos detalhes intraoperatórios com os modelos pré-impressos. Após a cirurgia, a estrutura anatômica do planalto tibial melhorou significativamente em todos os 54 casos. Conclusão: A impressão 3D ajuda na classificação e no planejamento pré-operatório de fraturas complexas do planalto tibial, melhorando os resultados cirúrgicos e a restauração anatômica. Nível de Evidência IV, Estudo Prospectivo.

Beneficial effects of duck-derived lactic acid bacteria on growth performance and meat quality through modulation of gut histomorphology and intestinal microflora in Muscovy ducks.

Duck-derived lactic acid bacteria (DDL) are a crucial beneficial bacterium in the intestines, contributing significantly to the health of ducks. However, the mechanism by which these DDL improves the growth performance and meat quality of Muscovy duck is not clear. In this study, A total of 800 male Muscovy ducks, initially weighing 50.15 ± 5.37 g, were randomly allocated into 4 groups, each with 4 replicates, consisting of 50 ducks per replicate. The control group consumed deep well water, while the experimental groups were given water supplemented with 1%, 3%, and 5% DDL (1.59×108 CFU/mL). The study duration was 70 d. The results revealed that Muscovy ducks drinks with the DDL significant reduced the feed conversion ratio (FCR) (P < 0.05) and increased the sweetness and richness of duck meat, among which the 5% drinking group has the most significant difference. Further study finding, the DDL significantly increased the height of villi, the ratio of villi height/crypt depth (V/C) on jejunum and colon, and the ratio of acidic mucus, neutral mucus, and glycogen to tissue area in both the duodenum and ileum of Muscovy ducks, and significantly decreased the tunel positive cells. Moreover, DDL significantly enhanced the abundance of genus beneficial bacterium (Bacillus, lentilactobacillus, Bacterodies, Lactobacillus) on duodenum and ileum. Additionally, drink with the DDL elevated the level of IgG in blood and the immune indices of the thymus and the fabricius bursa (P<0.05). Meanwhile, the meat composition analysis demonstrated that Muscovy duck drinks with the DDL raised the level of the saturated fatty acid rate(C12:0), and polyunsaturated fatty acid (C18:2 n-6 and C20:5 n-3,), and the monounsaturated (C18:1 n-7, and C18:1 n-9). Furthermore, correlation analysis finding that the growth performance of Muscovy ducks was positively correlated with the height of villi, the ratio of villi height/crypt depth (V/C), the abundance of genus beneficial bacterium. And the meat quality of Muscovy ducks has positively correlated with genus beneficial bacterium in intestinal, glutamic acid, saturated fatty acid rate and polyunsaturated fatty acid. This finding suggest DDL is an effective strategy to improve the growth performance and meat quality of Muscovy ducks by gut histomorphology and intestinal microflora.

Formation and culture of cell spheroids by using magnetic nanostructures resembling a crown of thorns.

In contrast to traditional two-dimensional cell-culture conditions, three-dimensional (3D) cell-culture models closely mimic complexin vivoconditions. However, constructing 3D cell culture models still faces challenges. In this paper, by using micro/nano fabrication method, including lithography, deposition, etching, and lift-off, we designed magnetic nanostructures resembling a crown of thorns. This magnetic crown of thorns (MCT) nanostructure enables the isolation of cells that have endocytosed magnetic particles. To assess the utility of this nanostructure, we used high-flux acquisition of Jurkat cells, an acute-leukemia cell line exhibiting the native phenotype, as an example. The novel structure enabled Jurkat cells to form spheroids within just 30 min by leveraging mild magnetic forces to bring together endocytosed magnetic particles. The size, volume, and arrangement of these spheroids were precisely regulated by the dimensions of the MCT nanostructure and the array configuration. The resulting magnetic cell clusters were uniform in size and reached saturation after 1400 s. Notably, these cell clusters could be easily separated from the MCT nanostructure through enzymatic digestion while maintaining their integrity. These clusters displayed a strong proliferation rate and survival capabilities, lasting for an impressive 96 h. Compared with existing 3D cell-culture models, the approach presented in this study offers the advantage of rapid formation of uniform spheroids that can mimicin vivomicroenvironments. These findings underscore the high potential of the MCT in cell-culture models and magnetic tissue enginerring.

Enhancing the adsorption-photocatalytic efficiency of BiOBr for Congo red degradation by tuning the surface charge and bandgap via an Y3+-I- co-doping strategy.

Metal-ion doping and halogen substitution have been largely applied to tune the bandgap of bismuth oxybromide (BiOBr) to upgrade its photodegradation capacity. In this work, the adsorption capacity and photocatalytic behavior of solvothermally synthesized BiOBr photocatalysts can be optimized via the synergistic effect of Y3+- and I--doping. After an adsorption reaction in the dark and exposure for another 80 min to visible light, pure BiOBr can remove 46.5% of Congo red (CR) from water with an initial CR concentration of 50 mg L-1. Meanwhile, Bi0.8Y0.20OBr0.97I0.03, the co-doped catalyst, displays total degradation rates exceeding 98% and 92% with CR dosages of 50 and 100 mg L-1, respectively, demonstrating a doubled degradation capacity. With the co-doping solution, the negative charges on the catalysts reduce, more oxygen vacancies are generated, the bandgap remarkably narrows, and the photoabsorption range broadens for derivation of photoinduced electron-hole pairs. The mechanism for optimized photodegradation behavior and dramatically increased adsorption capacity are discussed based on analyses of the structural evolution, surface properties including the chemical state and surface charge, electrochemical performance and the yield/type of photogenerated species. Density functional theory (DFT) simulations were conducted to investigate the structural state, density of states (DOS) and electrostatic potential.

Risk assessment of China's Eastern Route of the South-to-north Water Diversion Project from the perspective of Phthalate Esters occurrence in the impounded lakes.

Phthalate esters (PAEs) are widely utilized and can accumulate in lacustrine ecosystems, posing significant ecological and human health hazards. Most studies on PAEs focus on individual lakes, lacking a comprehensive and systematic perspective. In response, we have focused our investigation on characteristic lakes situated along the Eastern Route of the South-to-north Water Diversion Project (SNWDP-ER) in China. We have detected 16 PAE compounds in the impounded lakes of the SNWDP-ER by collecting surface water samples using solid-phase extraction followed by gas chromatography analysis. The concentration of PAEs were found to between 0.80 to 12.92 µg L-1. Among them, Bis (2-ethylhexyl) phthalate (DEHP) was the most prevalent, with mean concentration of 1.56 ±â€¯0.62 µg L-1 (48.44%), followed by Diisobutyl phthalate (DIBP), 0.64 ±â€¯1.40 µg L-1 (19.87%). Spatial distribution showed an increasing trend in the direction of water flow. Retention of DEHP and DIBP has led to increased environmental risks. DEHP, Dimethyl phthalate (DMP) etc. determined by agriculture and human activities. Additionally, Dibutyl phthalate (DBP) and DIBP mainly related to the use of agricultural products. To mitigate the PAEs risk, focusing on integrated management of the lakes, along with the implementation of stringent regulations to control the use of plasticizes in products.

Comparison of behavioral and physiological changes in postpartum healthy and inflammatory diseased cows.

During parturition, cows often experience intense pain and stress, which increases the risk of inflammatory diseases. This study aimed to compare the postpartum health status between healthy cows and those diagnoses with inflammatory diseases by examining behavioral and heart rate (HR) variability (HRV) changes, to provide information before the onset of disease. Eight Holstein cows were used in this study. HR, parameters of HRV (low-frequency power: LF; high-frequency power: HF; LF/HF ratio, and total power) and time budget of individual maintenance behaviors (standing, recumbency, feeding, rumination while standing and lying, and sleep) were continuously recorded from 0 to 168 h postpartum. Milk and blood samples were collected daily. Cows were categorized as diseases based on the positive result of California mastitis test and/or serum haptoglobin concentration that exceeded 50 µg/ml after all blood samples have been collected. Compared to healthy individuals (n = 3), diseased cows (n = 5) exhibited higher HR, LF/HF, and lower total power (p < 0.05), suggesting the dominance of the sympathetic nervous system in cows with inflammatory diseases. Additionally, diseased cows showed an increased standing time budget and reduced recumbency (p < 0.05), which may be a behavioral strategy in response to discomfort from inflammation.

Effects of SGLT2 Inhibitors with and without Metformin in High-Risk, Treatment-Naïve Patients with Diabetes.

Background: Contemporary evidence supports the cardiovascular and renal benefits of sodium-glucose co-transporter-2 inhibitors (SGLT2is) in patients with diabetes. While metformin has traditionally been recommended as a first-line treatment, its exact role in improving cardiovascular outcomes remains uncertain. This study aims to evaluate the impact of combination therapy with metformin on the cardiovascular and renal outcomes in high-risk, treatment-naïve diabetic patients who have undergone SGLT2i therapy. Methods: Using the National Health Insurance Research Database in Taiwan, a retrospective cohort study was conducted. Treatment-naïve patients with diabetes and established atherosclerotic cardiovascular disease (ASCVD) undertaking SGLT2i therapy from 1 January 2016 to 31 December 2021 were included. Patients were categorized based on the concomitant use of metformin. Propensity score matching was employed to minimize confounding factors. The primary outcome was major adverse cardiovascular events (MACEs), with secondary outcomes including cardiovascular death, hospitalization for heart failure, and renal outcomes. Results: In total, 10,151 treatment-naïve diabetic patients with ASCVD were identified, with 2570 in the only SGLT2i therapy group and 7581 in the SGLT2i plus metformin group. In total, 2262 pairs were analyzed after propensity score adjustment. The risk of MACEs (36.6 vs. 42.1 events per 1000 person-years; hazard ratio 0.87, 95% confidence interval 0.70-1.09) and other outcomes did not significantly differ between the two treatment groups. Conclusions: In high-risk, treatment-naïve diabetic patients, initiating SGLT2i therapy alone or in combination with metformin resulted in comparable cardiovascular and renal outcomes. These findings suggest that metformin might not be mandatory as a first-line treatment for achieving cardiovascular benefits in such patients.

Insights into tolerance mechanisms of earthworms (Eisenia fetida) in copper-contaminated soils by integrating multi-omics analyses.

Earthworms can resist high levels of soil copper (Cu) contamination and play an essential role in absorbing them effectively. However, the molecular mechanisms underlying Cu tolerance in earthworms are poorly understood. To address this research gap, we studied alterations of Eisenia fetida in antioxidant enzymes, gut microbiota, metabolites, and genes under varying levels of Cu exposure soils (0, 67.58, 168.96, 337.92 mg/kg). Our results revealed a reduction in antioxidant enzyme activities across all treatment groups, indicating an adaptive response to alleviate Cu-induced oxidative stress. Analysis of gut microbiota revealed a significant increase in the abundance of bacteria associated with nutrient uptake and Cu2+ excretion under Cu stress. Furthermore, metabolomic analysis discovered an increase in certain metabolites associated with energy metabolism, such as pyruvic acid, L-malic acid, and fumaric acid, as Cu concentration escalated. These results suggested that enhanced energy supply contributes to the elevated tolerance of E. fetida towards Cu. Additionally, transcriptome analysis not only identified crucial detoxification genes (Hsp70, CTSL, GST, CHAC, and GCLC), but also confirmed the critical role of glutathione metabolism as a key pathway in E. fetida Cu detoxification processes. These findings provide a new perspective on the molecular mechanisms of Cu tolerance in earthworms.

Progesterone in Pregnancy: Evidence-Based Strategies to Reduce Miscarriage and Enhance Assisted Reproductive Technology.

The incidence of miscarriage in early pregnancy, between 5-20 weeks, is common, with a prevalence of between 5-22% of all pregnancies. Miscarriage can have physical, social, and mental health impacts on women and their families. In societies such as Taiwan, where the birth rate is falling and life expectancy is increasing, there is concern that factors that reduce birth rates will have detrimental economic and societal effects. Progesterone has a significant role in maintaining early and successful pregnancy to term. Evidence from preclinical and clinical research on the roles of progesterone has supported recent clinical guidelines in obstetrics and gynecology to reduce rates of early miscarriage and improve methods of assisted reproductive technology (ART). This article aims to present an evidence-based review of current recommendations for the use of progesterone in early pregnancy to reduce miscarriage rates and in luteal phase support for ART, including embryo transfer.

The DFT and Machine Learning Method Accelerated the Discovery of DMSCs with High ORR and OER Catalytic Activities.

The oxygen reduction reaction (ORR) and the oxygen evolution reaction (OER) are crucial for the conversion of clean energy. Recently, dual-metal-site catalysts (DMSCs) have gained much attention due to their high atom utilization, stronger stability, and better catalytic performance. An advanced method that combines density functional theory (DFT) and machine learning (ML) has been employed in this study to investigate the adsorption free energies of adsorbates on hundreds of potential catalysts, with the aim of screening for catalysts that are highly active for the ORR and OER. The result of this study is that 30 DMSCs with ORR activity superior to Pt, 10 DMSCs with OER activity superior to RuO2, and 4 bifunctional catalysts for the OER and ORR are identified. This work provides guidance for the rational selection of metals on DMSCs to prepare catalysts with a high electrocatalytic performance for renewable energy applications.

Heart rate variability and behavioral alterations during prepartum period in dairy cows as predictors of calving: a preliminary study.

OBJECTIVE: Parturition is crucial for dams, their calves, and cow managers. The prediction of calving time, which assists cow managers to decide on the relocation of cows to maternity pens and necessity of human supervision, is a pivotal aspect of livestock farming. However, existing methods of predicting calving time in dairy cows based on hormonal changes and clinical symptoms are time-consuming and yield unreliable predictions. Accordingly, we investigated whether heart rate variability (HRV) which is a non-invasive assessment of autonomic nervous system (ANS) activity and behavior during the prepartum period would be useful for predicting calving time in dairy cows. METHODS: Eight pregnant cows were surveilled under electrocardiogram and video recordings for HRV and behavioral analyses, respectively. HRV parameters in time and frequency domains were evaluated. A 24-h time budget was calculated for each of six types of behavior (standing and lying with or without rumination, sleeping, and eating). RESULTS: Heart rate on calving day is considerably higher than those recorded on the days preceding calving. Low frequency power declined, whereas high frequency power escalated on the calving day compared to the period between 24 and 48 h before calving. The time budget for ruminating while lying decreased and that while standing increased markedly on the calving day compared to those allocated on the preceding days; nonetheless, the total time budget for ruminating did not differ during the prepartum period. CONCLUSION: We elucidated the ANS activity and behavioral profiles during prepartum period. Our results confirm that HRV parameters and behavior are useful for predicting calving time, and interestingly indicate that the time budget for ruminating while standing (or lying) may serve as a valuable predictor of calving. Collectively, our findings lay the foundation for future investigations to determine other potential predictors and formulate an algorithm for predicting calving time.

Post-exercise left atrial conduit strain predicted hemodynamic change in heart failure with preserved ejection fraction.

OBJECTIVES: Left ventricle function directly impacts left atrial (LA) conduit function, and LA conduit strain is associated with exercise intolerance in patients with heart failure with preserved ejection fraction (HFpEF). Pulmonary capillary wedge pressure (PCWP) before and during exercise is the current gold standard for diagnosing HFpEF. Post-exercise ΔPCWP can lead to worse long-term outcomes. This study examined the correlation between LA strain and post-exercise ΔPCWP in patients with HFpEF. METHODS: We enrolled 100 subjects, including 74 with HFpEF and 26 with non-cardiac dyspnea, from November 2017 to December 2020. Subjects underwent echocardiography, invasive cardiac catheterization, and expired gas analysis at rest and during exercise. Arterial blood pressure, right atrial pressure, pulmonary artery pressure, and PCWP were recorded during cardiac catheterization. Cardiac output, stroke volume, pulmonary vascular resistance, pulmonary artery compliance, systemic vascular resistance, and LV stroke work were calculated using standard formulas. RESULTS: Exercise LA conduit strain significantly correlated with both post-exercise ΔPCWP (r = - 0.707, p < 0.001) and exercise PCWP (r = - 0.659; p < 0.001). Exercise LA conduit strain differentiated patients who did and did not meet the 2016 European Society of Cardiology HFpEF criteria with an area under the curve of 0.69 (95% confidence interval, 0.548-0.831) using a cutoff value of 14.25, with a sensitivity of 0.64 and a specificity of 0.68. CONCLUSIONS: Exercise LA conduit strain significantly correlates with post-exercise ΔPCWP and has a comparable power to identify patients with HFpEF. Additional studies are warranted to confirm the ability of LA conduit strain to predict long-term outcomes among patients with HFpEF. CLINICAL RELEVANCE STATEMENT: Exercise left atrial conduit strain was highly associated with the difference of post-exercise pulmonary capillary wedge pressure and may indicate increased mortality risk in patients with heart failure with preserved ejection fraction, and also has comparable diagnostic ability. KEY POINTS: • Left atrial conduit strain is associated with exercise intolerance in patients with heart failure with preserved ejection fraction. • Left atrial conduit strain during exercise can identify patients with heart failure with preserved ejection fraction. • Exercise left atrial conduit strain significantly correlates with the difference of pulmonary capillary wedge pressure during and before exercise which might predict the long-term outcomes of heart failure with preserved ejection fraction patients.

The persistence and antitumor efficacy of CAR-T cells are modulated by tonic signaling within the CDR.

Chimeric antigen receptor (CAR) T cell therapy has demonstrated remarkable clinical efficacy, but challenges related to relapse and CAR-T cell exhaustion persist. One contributing factor to this exhaustion is CAR tonic signaling, where CAR-T cells self-activate without antigen stimulation, leading to reduced persistence and impaired antitumor activity. To address this issue, we conducted a preclinical study evaluating tonic signaling using nanobody-derived CAR-T cells. Our investigation revealed that specific characteristics of the complementary determining regions (CDRs), including low solubility, polarity, positive charge, energy, and area of ionic and positive CDR patches of amino acids, were associated with low antigen-independent tonic signaling. Significantly, we observed that stronger tonic signaling directly impacted CAR-T cell proliferation in vitro, consequently leading to CAR-T cell exhaustion and diminished persistence and effectiveness in vivo. Our findings provide compelling preclinical evidence and lay the foundation for the clinical assessment of CAR-T cells with distinct tonic signaling patterns. Understanding the role of CDRs in modulating tonic signaling holds promise for advancing the development of more efficient and durable CAR-T cell therapies, thereby enhancing the treatment of cancer and addressing the challenges of relapse in CAR-T cell therapy.

Right Ventricular-Vascular Uncoupling Predicts Pulmonary Hypertension in Clinically Diagnosed Heart Failure With Preserved Ejection Fraction.

BACKGROUND: Pulmonary hypertension (PH) is highly prevalent in patients with heart failure with preserved ejection fraction (HFpEF), and it is a strong predictor of adverse outcomes. We aimed to determine possible echocardiographic parameters to predict the presence of PH in patients with HFpEF. METHODS AND RESULTS: A total of 113 patients with HFpEF were prospectively enrolled from November 2017 to July 2022. The patients underwent invasive cardiac catheterization and simultaneous echocardiography at rest and during exercise. The parameters indicating right ventricle-pulmonary artery uncoupling, including tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) and tricuspid annular systolic velocity (TAS')/PASP were calculated. Receiver operating characteristic curve analysis was used to determine the optimal cut-off points of TAPSE/PASP and TAS'/PASP to differentiate patients with HFpEF with PH from those without PH. Sixty-eight patients with HFpEF with PH and 45 without PH were included. Those with PH had lower TAPSE/PASP and TAS'/PASP at rest and during exercise compared with those without PH. Both resting/stress TAPSE/PASP and TAS'/PASP were correlated with rest/exercise pulmonary capillary wedge pressure and mean pulmonary artery pressure. In multivariable regression analysis, TAPSE/PASP remained a significant predictor of exercise pulmonary capillary wedge pressure and mean pulmonary artery pressure. In receiver operating characteristic curve analysis, the optimal cut-off points of TAPSE/PASP and TAS'/PASP to differentiate patients with HFpEF with PH from those without PH were ≤0.62 and ≤0.47, respectively. CONCLUSIONS: Right ventricle-pulmonary artery uncoupling is closely correlated with abnormal rest/exercise hemodynamics (pulmonary capillary wedge pressure and mean pulmonary artery pressure) in patients with HFpEF. TAPSE/PASP and TAS'/PASP can be useful parameters to detect PH in patients with HFpEF.

3D PRINTING IN COMPLEX TIBIAL FRACTURE CLASSIFICATION & PLANNING / Impressão 3d para a classificação e planejamento de fraturas tibiais complexas

ABSTRACT Objective: Tibial plateau fractures are common intra-articular fractures that pose classification and treatment challenges for orthopedic surgeons. Objective: This study examines the value of 3D printing for classifying and planning surgery for complex tibial plateau fractures. Methods: We reviewed 54 complex tibial plateau fractures treated at our hospital from January 2017 to January 2019. Patients underwent preoperative spiral CT scans, with DICOM data processed using Mimics software. 3D printing technology created accurate 1:1 scale models of the fractures. These models helped subdivide the fractures into seven types based on the tibial plateau's geometric planes. Surgical approaches and simulated operations, including fracture reduction and plate placement, were planned using these models. Results: The 3D models accurately depicted the direction and extent of fracture displacement and plateau collapse. They facilitated the preoperative planning, allowing for precise reconstruction strategies and matching intraoperative details with the pre-printed models. Post-surgery, the anatomical structure of the tibial plateau was significantly improved in all 54 cases. Conclusion: 3D printing effectively aids in the classification and preoperative planning of complex tibial plateau fractures, enhancing surgical outcomes and anatomical restoration. Level of Evidence IV, Prospective Study.

RESUMO Objetivo: As fraturas do planalto tibial são fraturas intra-articulares comuns de classificação e tratamento desafiadores aos cirurgiões ortopédicos. Objetivo: Este estudo investiga o uso de impressão 3D para classificar e planejar a cirurgia de fraturas complexas do planalto tibial. Métodos: 54 fraturas complexas do planalto tibial tratadas em nosso hospital de janeiro de 2017 a janeiro de 2019 foram revisadas. Os pacientes foram submetidos a tomografias computadorizadas em espiral pré-operatórias, com dados DICOM processados usando o software Mimics. A tecnologia de impressão 3D gerou modelos precisos em escala 1:1 das fraturas. Estes modelos ajudaram a subdividir as fraturas em sete tipos com base nos planos geométricos do planalto tibial. As abordagens cirúrgicas e as operações simuladas, incluindo a redução da fratura e a colocação de placa, foram planejadas utilizando estes modelos. Resultados: Os modelos 3D representaram com precisão a direção e a extensão da deslocação da fratura e do colapso do planalto. Os modelos facilitaram o planejamento pré-operatório, viabilizando estratégias de reconstrução precisas e a correspondência dos detalhes intraoperatórios com os modelos pré-impressos. Após a cirurgia, a estrutura anatômica do planalto tibial melhorou significativamente em todos os 54 casos. Conclusão: A impressão 3D ajuda na classificação e no planejamento pré-operatório de fraturas complexas do planalto tibial, melhorando os resultados cirúrgicos e a restauração anatômica. Nível de Evidência IV, Estudo Prospectivo.

Research on risk contagion mechanism of big fintech based on the SIRS model.

In recent years, while the relationship between the new financial institutions, represented by financial technology companies, and the traditional financial institutions(banks, securities, insurance, etc.) has been steadily enhanced, a New Relational Network has silently emerged. Along with the rapid expansion of big fintech companies, the possibility of financial risk breeding and spreading in the New Relational Network is also rising. This article analyzes and simulates the risk contagion mechanism of big fintech risks based on the SIRS epidemic model. The study's findings imply that: when the number of big fintech companies infected with risk exceeds the risk threshold, the big fintech risk will spread in the New Relational Network. At this time, the number of big fintech companies infected with risk can be reduced below the threshold by enhancing the risk warning, risk management, risk buffering and blocking capabilities, and timely improving risk prevention and control measures in the post-infection phase. It means that the big fintech risk is controlled. For big fintech risks, proactive interventions are more effective than post-incident response measures. This paper makes the following recommendations for preventing big fintech risks: creating a risk monitoring and early warning system to raise the Big Fintech companies' direct immunization rates; strengthening the big fintech companies' risk management and risk mitigation capabilities; enhancing the internal and external supervision to achieve sustainable development of big fintech companies.

BNM-CDGNN: Batch Normalization Multilayer Perceptron Crystal Distance Graph Neural Network for Excellent-Performance Crystal Property Prediction.

Recently, in the field of crystal property prediction, the graph neural network (GNN) model has made rapid progress. The GNN model can effectively capture high-dimensional crystal features from the crystal structure, thereby achieving optimal performance in property prediction. However, the existing GNN model faces limitations in handling the hidden layer after the pooling layer, which restricts the training performance of the model. In the present research, we propose a novel GNN model called the batch normalization multilayer perceptron crystal distance graph neural network (BNM-CDGNN). BNM-CDGNN encodes the crystal's geometry structure only based on the distance vector between atoms. The graph convolutional layer utilizes the radial basis function as the attention mask, ensuring the crystal's rotation invariance and adding the geometric information on the crystal. Subsequently, the average pooling layer is connected after the convolutional layer to enhance the model's ability to learn precise information. BNM-CDGNN connects multiple hidden layers after the average pooling layers, and these layers are processed by the batch normalization layer. Finally, the fully connected layer maps the results to the target property. BNM-CDGNN significantly enhances the accuracy of crystal property prediction compared with previous baseline models such as SchNet, MPNN, CGCNN, MEGNet, and GATGNN.

Prediction of microdissection testicular sperm extraction outcomes of azoospermic patients post-chemotherapy using cyclophosphamide equivalent dose.

PURPOSE: We determined the sperm retrieval rate in men with persistent azoospermia post-chemotherapy in relation to cyclophosphamide equivalent dose (CED), a unit for quantifying alkylating agent exposure. METHODS: Medical records were retrospectively reviewed of 1098 patients diagnosed with non-obstructive azoospermia who had undergone microdissection testicular sperm extraction (mTESE) between January 2010 and 2021 at our institution. Twenty-three patients with a prior history of chemotherapy were included in the study. Oncological data, chemotherapy regime, and dosage were reviewed. The pretreatment hormone profile, CED, and mTESE outcomes were analyzed. RESULTS: Testicular spermatozoa were successfully retrieved from 11 patients (47%). The mean patient age was 37.3 years (range, 27-41 years), and mean time interval from chemotherapy to mTESE, 11.8 years (range, 1-45 years). Patients exposed to alkylating agents had significantly lower sperm retrieval rates than those not exposed to alkylating agents (1/9, 11% vs. 10/14, 71%, p = 0.009). No men with CED > 4000 mg/m2 (n = 6) had viable sperm in the testes during mTESE. Moreover, patients diagnosed with testicular non-seminomatous germ cell tumors had a favorable sperm retrieval rate (67%) compared to patients with lymphoma (20%) or leukemia (33%). CONCLUSION: Patients with permanent azoospermia post-chemotherapy have a lower testicular sperm retrieval rate when the chemotherapy regimen included alkylating agents. In cases where patients have undergone more intensive gonadotoxic treatments, such as higher CED, the likelihood of successful sperm retrieval is low. It is advisable to counsel such patients using the CED model prior to considering surgical sperm retrieval.