The freeze-avoiding mountain pine beetle (Dendroctonus ponderosae) survives prolonged exposure to stressful cold by mitigating ionoregulatory collapse.

Insect performance is linked to environmental temperature, and surviving through winter represents a key challenge for temperate, alpine and polar species. To overwinter, insects have adapted a range of strategies to become truly cold hardy. However, although the mechanisms underlying the ability to avoid or tolerate freezing have been well studied, little attention has been given to the challenge of maintaining ion homeostasis at frigid temperatures in these species, despite this limiting cold tolerance for insects susceptible to mild chilling. Here, we investigated how prolonged exposure to temperatures just above the supercooling point affects ion balance in freeze-avoidant mountain pine beetle (Dendroctonus ponderosae) larvae in autumn, mid-winter and spring, and related it to organismal recovery times and survival. Hemolymph ion balance was gradually disrupted during the first day of exposure, characterized by hyperkalemia and hyponatremia, after which a plateau was reached and maintained for the rest of the 7-day experiment. The degree of ionoregulatory collapse correlated strongly with recovery times, which followed a similar asymptotical progression. Mortality increased slightly during extensive cold exposures, where hemolymph K+ concentration was highest, and a sigmoidal relationship was found between survival and hyperkalemia. Thus, the cold tolerance of the freeze-avoiding larvae of D. ponderosae appears limited by the ability to prevent ionoregulatory collapse in a manner similar to that of chill-susceptible insects, albeit at much lower temperatures. Based on these results, we propose that a prerequisite for the evolution of insect freeze avoidance may be a convergent or ancestral ability to maintain ion homeostasis during extreme cold stress.

Ferumoxytol-enhanced MR venography for mapping lower-extremity venous networks and evaluating varicose veins in patients with diabetes.

OBJECTIVES: Comprehensive evaluation of lower-extremity varicose veins (VVs) in patients with diabetes is crucial for treatment strategizing. The study aims to assess the feasibility of using ferumoxytol-enhanced MR venography (FE-MRV) for lower-extremity venous mapping and the detection of VVs in patients with diabetes. MATERIALS AND METHODS: As part of a phase II clinical trial of a generic brand of ferumoxytol, documented patients with diabetes were enrolled and underwent FE-MRV on a 3-Τ MRI system. Two observers assessed FE-MRV images for image quality, signal intensity ratio (SIR), perforator (PV) diameter, and luminal signal uniformity in deep-to-superficial venous networks with the assessment of intra- and inter-rater reliability. FE-MRV was used to detect lower-extremity VVs. RESULTS: Eleven patients underwent FE-MRV without adverse events. The average image quality, as scored by the two observers who assessed 275 venous segments, was 3.4 ± 0.6. Two observers strongly agreed on image quality (κ = 0.90) and SIR measurements (interclass correlation coefficient [ICC]: 0.72) and had good agreement on PV diameter (ICC: 0.64). FE-MRV revealed uniform luminal signals in deep and saphenous venous networks (0.13 ± 0.05 vs 0.08 ± 0.03). Below-knee segments exhibited a significantly higher heterogeneity index than above-knee (p = 0.039) segments. Superficial VVs were observed in 55% (12/22) of legs in 64% (7/11) of patients. Calf muscle VVs were present in 64% (14/22) of legs in 9 patients. CONCLUSION: FE-MRV safely and robustly mapped entire lower-extremity venous networks, enabling the detection and pre-treatment evaluation of both superficial, and deep VVs in patients with diabetes. CLINICAL RELEVANCE STATEMENT: Ferumoxytol-enhanced magnetic resonance venography offers a "one-stop" imaging strategy for the detection and pre-operative evaluation of both superficial and deep VVs in diabetic patients. KEY POINTS: Diabetic patients with VVs are at a higher risk of ulcer-related complications. FE-MRV allowed rapid and comprehensive visualization of the lower-limb venous networks and abdominopelvic veins in diabetic patients. This technique allowed for the detection of superficial and deep VVs in diabetic patients before the development of severe peripheral artery disease.

Small-Intensity Rainfall Triggers Greater Contamination of Rubber-Derived Chemicals in Road Stormwater Runoff from Various Functional Areas in Megalopolis Cities.

Rubber-derived chemicals (RDCs) originating from tire and road wear particles are transported into road stormwater runoff, potentially threatening organisms in receiving watersheds. However, there is a lack of knowledge on time variation of novel RDCs in runoff, limiting initial rainwater treatment and subsequent rainwater resource utilization. In this study, we investigated the levels and time-concentration profiles of 35 target RDCs in road stormwater runoff from eight functional areas in the Greater Bay Area, South China. The results showed that the total concentrations of RDCs were the highest on the expressway compared with other seven functional areas. N-(1,3-Dimethylbutyl)-N'-phenyl-p-phenylenediamine (6PPD), 6PPD-quinone, benzothiazole, and 1,3-diphenylguanidine were the top four highlighted RDCs (ND-228840 ng/L). Seasonal and spatial differences revealed higher RDC concentrations in the dry season as well as in less-developed regions. A lag effect of reaching RDC peak concentrations in road stormwater runoff was revealed, with a lag time of 10-90 min on expressways. Small-intensity rainfall triggers greater contamination of rubber-derived chemicals in road stormwater runoff. Environmental risk assessment indicated that 35% of the RDCs posed a high risk, especially PPD-quinones (risk quotient up to 2663). Our findings contribute to a better understanding of managing road stormwater runoff for RDC pollution.

Characterising polycyclic aromatic hydrocarbons in road dusts and stormwater in urban environments.

The presence of polycyclic aromatic hydrocarbons (PAHs) pollution on urban road surfaces is one of the major environmental concerns. However, knowledge on the distribution variability of PAHs in road dusts (RDS) and stormwater is limited, which would restrict the further risk evaluation and mitigation implementation of PAHs in road stormwater runoff. This study collected RDS samples and stormwater samples on fourteen urban roads in Shenzhen, China. This study investigated the variation of sixteen PAHs species in RDS and stormwater, and further evaluated the intrinsic and extrinsic factors which influence PAHs accumulation on urban road surfaces. The research outcomes showed significant differences on spatial distribution of PAHs in RDS and in stormwater. The land use types, industrial, commercial and port areas and vehicular volume have a positive relationship with PAHs abundance while dust particle size showed a negative correlation with PAHs abundance. For two phases in stormwater, fluctuation of PAHs with the rainfall duration in total dissolved solid (TDS) was more intensive than in dissolved liquid phase (DLP). This indicated when PAHs attached to RDS enter stormwater, most of PAHs still tend to be on solid particles than in liquid. The study outcomes are expected to contribute to efficient designs of PAHs polluted stormwater mitigation.

Deep Learning Algorithm Enables Cerebral Venous Thrombosis Detection With Routine Brain Magnetic Resonance Imaging.

BACKGROUND: Cerebral venous thrombosis (CVT) is a rare cerebrovascular disease. Routine brain magnetic resonance imaging is commonly used to diagnose CVT. This study aimed to develop and evaluate a novel deep learning (DL) algorithm for detecting CVT using routine brain magnetic resonance imaging. METHODS: Routine brain magnetic resonance imaging, including T1-weighted, T2-weighted, and fluid-attenuated inversion recovery images of patients suspected of CVT from April 2014 through December 2019 who were enrolled from a CVT registry, were collected. The images were divided into 2 data sets: a development set and a test set. Different DL algorithms were constructed in the development set using 5-fold cross-validation. Four radiologists with various levels of expertise independently read the images and performed diagnosis within the test set. The diagnostic performance on per-patient and per-segment diagnosis levels of the DL algorithms and radiologist's assessment were evaluated and compared. RESULTS: A total of 392 patients, including 294 patients with CVT (37±14 years, 151 women) and 98 patients without CVT (42±15 years, 65 women), were enrolled. Of these, 100 patients (50 CVT and 50 non-CVT) were randomly assigned to the test set, and the other 292 patients comprised the development set. In the test set, the optimal DL algorithm (multisequence multitask deep learning algorithm) achieved an area under the curve of 0.96, with a sensitivity of 96% (48/50) and a specificity of 88% (44/50) on per-patient diagnosis level, as well as a sensitivity of 88% (129/146) and a specificity of 80% (521/654) on per-segment diagnosis level. Compared with 4 radiologists, multisequence multitask deep learning algorithm showed higher sensitivity both on per-patient (all P<0.05) and per-segment diagnosis levels (all P<0.001). CONCLUSIONS: The CVT-detected DL algorithm herein improved diagnostic performance of routine brain magnetic resonance imaging, with high sensitivity and specificity, which provides a promising approach for detecting CVT.

Adsorption and Sensing Performances of a TiO2 Cluster-Doped Graphene Monolayer toward SOF2 and SO2F2.

Due to the high surface activity of metal atoms, it is difficult for doped metals to maintain long-term stability. Compared with other metal oxides, TiO2 graphene sensors have a higher sensing response and a larger specific surface area. However, there is currently no literature comparing and analyzing the effect of graphene-doped TiO2 on the adsorption performance of SF6 decomposition components. Therefore, this article investigated the adsorption performance of SF6 decomposition products: the distribution of SOF2 and SO2F2 on nTiO2 (n = 1,2,3)-doped graphene. In order to explore the interaction mechanism between gas molecules and these modified systems, their Eads, charge transfer, DOS, and PDOS were systematically studied. The doping of nTiO2 significantly improves the adsorption ability of graphene to gas molecules, discovers and enriches the online monitoring methods of GIS, and improves the engineering application value of GIS.

Diagnostic performance of MR black-blood thrombus imaging for cerebral venous thrombosis in real-world clinical practice.

OBJECTIVES: MR black-blood thrombus imaging (BTI) has been developed for the detection of cerebral venous thrombosis (CVT). Yet, there is a lack of real-world data to verifying its clinical performance. This study aims to evaluate the performance of BTI in diagnosing and staging CVT in a 5-year period. METHODS: Patients suspected of CVT were enrolled between 2014 and 2019. Patients with or without BTI scans were classified into group A and group B, respectively. The prevalence of correct diagnosis of CVT and patients with evaluable clot age were compared. The diagnostic performance of BTI including sensitivity, specificity, and specific staging information was further analyzed. RESULTS: Two hundred and twenty-one of the 308 patients suspected of CVT were eligible in the current study (114 in group A and 97 in group B), with 125 diagnosed by multidisciplinary teams to have CVTs (56 in group A, 69 in group B). The rate of correct diagnosis of CVT was higher in group A than that in group B (94.7% vs 60.8%, p < 0.001, x2 = 36.517) after adding BTI images. The percent of patients with evaluable staged segments between the two groups were 96.4% and 33.9%, respectively (x2 = 48.191, p < 0.001). BTI showed a sensitivity of 96.4% and 87.9% in the detection of CVT on per-patient and per-segment level, respectively. Up to 98.1% of all thrombosed segments could be staged by BTI and 59.6% of them were matched with clinical staging. CONCLUSIONS: In the actual clinical practice, BTI improves diagnostic confidence and has an excellent performance in confirming and staging CVT. KEY POINTS: • Black-blood thrombus imaging has good diagnostic performance in detecting cerebral venous thrombosis compared to traditional imaging methods with strong evidence in the actual clinical setting. • BTI helps clinicians to diagnose CVT with more accuracy and confidence, which can be served as a promising imaging examination. • BTI can also provide additional information of different thrombus ages objectively, the valuable reference for clinical strategy.

Schottky diodes based on blue phosphorene nanoribbon homojunctions.

Diodes have been widely studied as one of the most commonly used electronic components in circuits, and it is important to find diodes with an excellent rectification performance. Herein, we investigate the electronic and transport properties of Schottky contact diodes based on zigzag hydrogenated blue phosphorene nanoribbons, by employing density functional theory combined with the non-equilibrium Green's function. It is found that the adsorption of transition metal atoms Sc/Cr/Ti and Ni on the top site of blue phosphorene nanoribbons leads to metallic and semiconducting properties, respectively. Devices consisting of the planar contact of the metallic and semiconducting nanoribbons show rectifying behavior due to the Schottky barriers of the homojunctions. The current is preferential to flow from the semiconducting side to the metallic side. The rectification ratio of the Sc-Ni device and the Cr-Ni device can reach up to 108, which is much higher than that of traditional p-n junctions of about 105-107. The high rectification ratio at low bias regions, together with the low threshold voltages and negligible reverse currents, make blue phosphorene nanoribbon homojunctions ideal rectifier diodes.

Biochar and exogenous calcium assisted alleviation of Pb phytotoxicity in water spinach (Ipomoea aquatica Forsk) cultivated in Pb-spiked soil.

The consumption of vegetables grown in Pb-polluted soils causes serious threats to human health around the globe. In this study, we evaluated the Pb toxicity alleviation in water spinach grown of pot experiments in Pb-spiked soil treated with biochar and exogenous calcium. The results showed that both biochar and exogenous calcium alleviated Pb stress in water spinach, which was mainly manifested on its improved soil health and increased growth and decreased Pb uptake. Incorporation of 3% biochar significantly reduced CaCl2 extracted Pb by 53.6% and decreased Pb accumulation in roots (67.1%) and shoots (80.8%). Our also findings indicated that Pb detoxification mechanism of biochar and exogenous calcium was totally different, while they can induce a synergistic impact on water spinach Pb stress alleviation. The combination of biochar and exogenous calcium in Pb-contaminated soil remediation may complement each other and reduce Pb entry into the human body through vegetables.

Validation of choroidal anastomosis on high-resolution magnetic resonance imaging as an imaging biomarker in hemorrhagic moyamoya disease.

OBJECTIVES: This study aimed to investigate the association between dilation and proliferation and anastomosis of perforating arteries, and intracranial hemorrhage in moyamoya disease (MMD) patients, using high-resolution magnetic resonance imaging (HRMRI). METHODS: Adult patients with MMD at advanced stages were prospectively enrolled and underwent HRMRI exams. Dilation and proliferation of the lenticulostriate artery (LSA), medullary artery, and anterior or posterior choroidal arteries (AChA or PChA) were assessed. Abnormal anastomoses were identified between (1) the LSA and the medullary or insular arteries; (2) the thalamo-geniculate, thalamo-tuberal, or thalamo-perforating arteries and the medullary or insular arteries; and (3) the AChA or PChA and the medullary or insular arteries. The association between these variables and hemorrhagic events was calculated using univariate and multivariate analyses. RESULTS: Fifty patients (14 men; mean age, 35.4 ± 9.7 years) were finally analyzed, including 17 hemorrhagic patients and 33 non-hemorrhagic patients. The inter-rater agreement for the qualitative evaluation of perforating arteries was good. Dilation and proliferation of the AChA or PChA (88.2% versus 54.5%, p = 0.027), and choroidal anastomosis (64.7% versus 18.2%, p = 0.002) were more frequently observed in patients with hemorrhage. Multivariate logistic regression showed that choroidal anastomosis remained significantly associated with hemorrhage (odds ratio = 5.95, 95% confidence interval = 1.21-29.25, p = 0.028). CONCLUSIONS: Choroidal anastomosis is independently associated with hemorrhagic events in adult patients with MMD at advanced stages. HRMRI can provide detailed information on both the anatomies and abnormal collaterals in MMD, which facilitates risk estimates of bleeding in MMD. KEY POINTS: • High-resolution magnetic resonance imaging allows for the evaluation of perforating arteries in patients with moyamoya disease. • Choroidal anastomosis is associated with hemorrhagic events in patients with moyamoya disease. • High-resolution magnetic resonance imaging might facilitate further grading and classification of moyamoya vessels.

Systemic immune-inflammation index independently predicts poor survival of older adults with hip fracture: a prospective cohort study.

BACKGROUND: The systemic immune-inflammation index (SII), based on peripheral platelet, neutrophil and lymphocyte counts, has been proven to be a promising prognostic indicator in various diseases. Hip fracture is a common injury among the older adults, and has become a global public health problem with high mortality and disability rates. However, the relationship between SII and the prognosis of hip fracture is not yet well-known. The aim of the this study was to explore the predictive value of SII in older adults with hip fracture undergoing surgery. METHODS: This was a prospective cohort study performed from January 2014 to December 2018 at a orthopaedic center, China. The SII was calculated as platelet×neutrophil/lymphocyte counts. Univariable and multivariable Cox proportional hazard models were used to assess the association between SII and all-cause mortality. RESULTS: A total of 290 older adults with hip fracture were included, and the mean (SD) age was 77.6 (8.6) years, and 189 (65.2%) were female. The median (IQR) SII was 759.4 (519.0-1128.7) × 109/L. After a median follow-up time of 33.4 months, 13 (4.5%), 26 (9.0%) and 54 (18.6%) patients died within the 30-day, 1-year and last follow-up, respectively. Multivariable Cox analysis revealed that each increase of 100 units of SII was associated with a 8% increased hazard of death at 1-year follow-up (HR = 1.08, 95% CI: 1.01-1.17, p = 0.033), and 9% increased hazard of death at last follow-up (HR = 1.09, 95% CI: 1.03-1.15, p = 0.003). CONCLUSIONS: SII is associated with poor all-cause mortality in older adults with hip fracture undergoing surgery, and deserves further investigation and application in clinical practice.

A new preoperative risk score for predicting mortality of elderly hip fracture patients: an external validation study.

BACKGROUND: Hip fractures are common in the elderly and have a high risk of mortality. Several risk prediction models for mortality of hip fracture have been developed, but most of them are difficult to apply accurately in clinical practice. AIMS: The objective of the present study was to perform an external validation of a new published preoperative risk score for predicting mortality. METHODS: We carried out a retrospective cohort study from January 2014 to December 2018 for elderly hip fracture patients discharged from a orthopedic center in China. The preoperative risk score was calculated for each patient, and further divided into two groups: low-risk group (score < 24 points) and high-risk group (score ≥ 24 points) using the receiver operating characteristic (ROC) curve. The outcome was 30-day, 6-month and 1-year all-cause mortality, and the relationship between the risk score and mortality was assessed by univariate and multivariate Cox proportional hazard models. The area under the curve (AUC), Hosmer-Lemeshow test and calibration plots were used to test the discrimination and calibration. RESULTS: A total of 460 consecutive patients were included in the study, and high-risk score was an independent risk factor for 30-day mortality [Hazard ratio (HR) 6.70; 95% Confidence interval (CI) 1.82-24.69; p = 0.004], 6-month mortality (HR 2.94; 95% CI 1.68-5.17; p < 0.001) and 1-year mortality (HR 3.30; 95% CI 2.09-5.20; p < 0.001). Also, each point increase in the risk score resulted in a 11% increase in 30-day mortality (HR 1.11; 95% CI 1.07-1.16; p < 0.001), 6% increase in 6-month mortality (HR 1.06; 95% CI 1.04-1.09; p < 0.001), and 5% increase in 1-year mortality (HR 1.05; 95% CI 1.03-1.07; p < 0.001). Moreover, the risk score had an AUC of 0.89 (95% CI 0.80-0.98) for 30-day mortality, 0.77 (95% CI 0.70-0.83) for 6-month mortality, and 0.76 (95% CI 0.70-0.81) for 1-year mortality. Calibration plots showed a good calibration between observed and predicted mortality, which was also demonstrated by the Hosmer-Lemeshow test. CONCLUSION: Our present study findings indicated that the preoperative risk score was an accurate mortality risk assessment tool for elderly hip fracture patients, regardless of short- and long-term follow-up.

Coronal subluxation of the tibiofemoral joint before and after anterior cruciate ligament reconstruction.

BACKGROUND: Studies have shown that medial subluxation of the tibia occurs after anterior cruciate ligament (ACL) rupture. However, it is unclear whether anterior cruciate ligament reconstruction (ACLR) can correct tibial coronal subluxation. PURPOSE: To determine whether the tibia is medially subluxated after ACL rupture, and whether ACLR can correct medial subluxation of the tibia. STUDY DESIGN: Case series; Level of evidence, 4, Retrospective clinical study. METHODS: The distance of tibial coronal subluxation before and after ACLR surgery was measured in 48 patients with ACL rupture and meniscus injury. Tibiofemoral subluxation was defined as the perpendicular distance between the long axis of the tibia and a second parallel line originating at the most proximal aspect of the femoral intercondylar notch. To determine the long axis of the tibia, two circles separated by 5 cm were centered on the proximal tibia. The proximal circle is 5 cm from the tibial plateau, and the distal circle is 5 cm from the proximal circle. The line passing through the center of the two circles was considered the long axis of the proximal tibia. Care was taken to ensure that each patient lied on the back with their patellae facing upward, to minimize rotational variation among the radiographs. At the same time, 30 patients with simple meniscus injury who underwent arthroscopy during the same period were selected to determine the degree of tibiofemoral coronal subluxation as the baseline value. The changes before and after operation were compared, as well as the differences with the baseline data. RESULT: The average follow-up period was 21.2 ± 5.8 months. The average distance of tibial coronal subluxation before ACLR was 5.5 ± 2.1 mm, which was significantly different from that of baseline group (7.3 ± 2.1 mm) (P < 0.001). The tibial subluxation after ACLR was 7.7 ± 2.6 mm, which was significantly different from that before operation (P < 0.001). There was no significant difference in the distance between postoperative tibial subluxation and baseline group (P = 0.472). CONCLUSION: The tibia was coronally medially subluxated after ACL rupture. ACLR can correct the medial subluxation of tibia. This finding is helpful in the diagnosis of ACL rupture, and can be used to assess the imaging status of the tibiofemoral joint on the coronal plane during or after ACLR.

Low serum calcium is associated with perioperative blood loss and transfusion rate in elderly patients with hip fracture: a retrospective study.

BACKGROUND: To investigate whether hypocalcemia influenced total blood loss and transfusion rate in elderly patients with hip fracture. METHODS: From our hip fracture database, patients were consecutively included between January 2014 and December 2020. Serum calcium level was corrected for albumin concentration, and hypocalcaemia was defined as corrected calcium < 2.11 mmol/L. Hemoglobin and hematocrit were obtained on admission day and postoperative day, and blood transfusions were collected. According to the combination formulas of Nadler and Gross, the total blood loss of each patient was calculated. Risk factors were further analyzed by multivariate linear regression. RESULTS: A total of 583 consecutive elderly hip fracture patients were finally included (mean age 79.32 ± 8.18 years, 68.61% female). On admission, the mean serum corrected calcium level was 2.17 ± 0.14 mmol/L, and the prevalence of hypocalcemia was 33.11% (95% CI: 29.42-37.02). When comparing patients with normal calcium, hypocalcemia patients exhibited a higher blood transfusion rate (7.69% vs 16.06%, P < 0.05), and significantly larger total blood loss (607.86 ± 497.07 ml vs 719.18 ± 569.98 ml, P < 0.05). Multivariate linear regression analysis showed that male, anemia on admission, time from injury to hospital, intertrochanteric fracture, blood transfusion and hypocalcemia were independently associated with increased total blood loss (P < 0.05). CONCLUSION: Hypocalcemia is common in elderly patients with hip fracture, and significantly associated with more total blood loss and blood transfusion. The other risk factors for increased total blood loss are male, anemia on admission, time from injury to hospital, intertrochanteric fracture, and blood transfusion. LEVEL OF EVIDENCE: Level III, retrospective study.

Uptake, elimination, and toxicokinetics of selected pharmaceuticals in multiple tissues of Nile tilapia (Oreochromis niloticus) exposed to environmentally relevant concentrations.

Pharmaceuticals in aquatic environment displayed adverse effects to fish. The effects are usually related to the internal levels of pharmaceuticals accumulated in specific fish tissues. In this study, we investigated the uptake, elimination, and toxicokinetics of six pharmaceuticals, e.g. naproxen (NAX), diclofenac (DCF), ibuprofen (IBU), carbamazepine (CBZ), fluoxetine (FLX), and sertraline (SER), in 11 fish tissues of Nile tilapia. The experiments were conducted in a flow-through system with an 8-day uptake/8-day elimination periods. The fish exposure groups involved the control, single FLX, and mixture of six pharmaceuticals at environmentally relevant concentration of 4 µg/L. FLX and SER showed the maximum concentrations of 145 and 201 ng/g wet weight, respectively, in fish spleen tissue, while NAX and IBU were not detected in any tissue. The mean concentrations for the pharmaceuticals in Nile tilapia tissues generally followed the order: bile> kidney, gut, stomach, liver> brain, gill, spleen> plasma, skin, muscle. The steady-state bioconcentration factors in various tissues generally range at 0.74-437.58 L/kg. The uptake and elimination toxicokinetics illustrated the rapid accumulation and depuration of pharmaceuticals in fish tissues. The results help to understand the internal bioconcentration, tissue distribution, and toxicokinetics of pharmaceuticals in multiple fish biological compartments.

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture.

PURPOSE: The platelet-to-lymphocyte ratio (PLR) has been extensively studied in various diseases. However, the relationship between PLR and hip fracture remains unknown. The aim of this study was to evaluate whether PLR would be an independent prognostic factor in elderly hip fracture patients. METHODS: Between January 2014 and December 2018, a retrospective cohort study was conducted in a orthopaedic centre, China. A total of 460 hip fracture patients were included. PLR was calculated as the ratio of platelet to lymphocyte counts and divided into high PLR group (≥ 189) and low PLR group (< 189) by using the receiver operating characteristic (ROC) curve. The relationship between PLR and one year all-cause mortality rate was assessed by univariate and multivariate Cox proportional hazard models. Further subgroup analysis stratified by different clinical and biological characteristics was performed to make the results more accurate. RESULTS: After a median follow-up of 32.0 months (range, 12.0-75.4), 92 patients (mortality rate: 20.0%) died within one year. PLR was significantly higher in dead patients compared with alive patients (p < 0.05), and high PLR group also had a high mortality rate (32.21% vs. 14.15%, p < 0.001). After multivariate adjustment, high PLR remained an independent predictor for one year all-cause mortality (adjusted hazard ratio (HR) 1.56, 95% confidence interval (CI) 1.02-2.41, p = 0.041). Moreover, advanced age (HR 1.05, 95% CI 1.01-1.08), male (HR 1.62, 95% CI 1.06-2.45), CCI ≥ 2 (HR 2.83, 95% CI 1.64-4.89), conservative treatment (HR 5.94, 95% CI 3.71-9.73), low haemoglobin level (HR 1.02, 95% CI 1.01-1.04), and low albumin level (HR 1.07, 95% CI 1.02-1.13) were independent risk factors for survival. Furthermore, subgroup analysis results were consistent with the main findings in most stratified groups. CONCLUSION: This study highlights that high PLR (≥ 189) is associated with increased one year all-cause mortality in elderly hip fracture patients. As PLR is a simple indicator that can be calculated from the blood routine test, it can be easily performed in usual clinical practice.

Identification of differentially expressed miRNAs and mRNAs in synovial of osteoarthritis via RNA-sequencing.

BACKGROUND: Osteoarthritis (OA) is the most common form of arthritis and a leading cause of disability. This study attempted to investigate the key mRNAs and miRNAs related to OA. PATIENTS AND METHODS: From April 17th, 2018 to May 17th, 2018, five patients with OA and three normal controls were enrolled in this present study. To identify the differentially expressed mRNAs (DEmRNAs) and miRNAs (DEmiRNAs) between patients with OA and normal controls, RNA-sequencing was performed. Then, DEmiRNA-target DEmRNAs analysis and functional annotation of DEmiRNA-target DEmRNAs were performed. To validate the RNA-sequencing results, quantitative real time-PCR (RT-PCR) and western blot analysis were performed as well. RESULTS: A total of 1068 DEmRNAs, 21 DEmiRNAs and 395 DEmiRNA-DEmRNA pairs were identified in synovial tissues of patients with OA. The functional annotation of DEmiRNA-target DEmRNAs revealed that Pathways in cancer and PI3K-Akt signaling pathway were significantly enriched Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. QRT-PCR and western blot results revealed that except for TLR7, the expression level of the others was consistent with the RNA-sequencing results, generally. CONCLUSION: The findings of this present study may provide new clues for the roles of DEmRNAs and DEmiRNAs in the pathogenesis of OA.

Quantitative Susceptibility Mapping for Characterization of Intraplaque Hemorrhage and Calcification in Carotid Atherosclerotic Disease.

BACKGROUND: Carotid artery intraplaque hemorrhage (IPH), an unstable component of atherosclerosis, is associated with an increased risk of stroke. PURPOSE: To investigate quantitative susceptibility mapping (QSM) as a tool for the evaluation of IPH and calcification in vivo. STUDY TYPE: Prospective. POPULATION: Ten healthy volunteers and 15 patients. FIELD STRENGTH/SEQUENCE: 3.0T Susceptibility-weighted imaging (SWI), magnetization-prepared rapid acquisition with gradient echo (MP-RAGE), T1 -weighted sampling perfection with application of optimized contrasts using different flip angle evolution (T1 -SPACE), T2 -weighted turbo spin-echo (T2 WI), and time-of-flight (TOF) sequences. ASSESSMENT: The vessel wall area of the carotid artery was measured with QSM and compared with T1 -SPACE on healthy volunteers. Four radiologists, blinded to clinical history and patient identity, determined the presence and area of IPH on MP-RAGE and QSM, as well as the area of calcification on T1 -SPACE and QSM. STATISTICAL TESTS: Bland-Altman analysis, Pearson correlation coefficients, linear regression analyses were performed to evaluate the concordance of area measurements. Cohen's kappa (κ) was analyzed to determine the agreement between IPH detections. The paired t-test was used to compare the group differences. RESULTS: In 423 matched slices, 20.1% (85/423) and 19.6% (83/423) were detected to have IPH on MP-RAGE and QSM, respectively. IPH detection by QSM and MP-RAGE showed good agreement (κ = 0.822, P < 0.001) between the two methods. There was no significant difference in IPH area measurements between QSM and MP-RAGE (7.28 mm2 ± 6.41 vs. 7.16 mm2 ± 5.99, P = 0.575). There was no significant difference in calcification area measurement between QSM and T1 -SPACE (3.51 mm2 ± 1.78 vs. 3.41 mm2 ± 2.02, P = 0.783). DATA CONCLUSION: QSM is a novel imaging tool for the identification of IPH in patients with carotid atherosclerosis and enables differentiation of IPH and calcification. EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 1 J. Magn. Reson. Imaging 2020;52:534-541.

A decreased ratio of height of lateral femoral condyle to anteroposterior diameter is a risk factor for anterior cruciate ligament rupture.

BACKGROUND: Studies have shown that the spherical shape of the lateral femoral condyle has a clear relationship with the relative axial movement of tibiofemoral joint and the anterior cruciate ligament (ACL) rupture. The purpose of this study was to describe the distal curvature of the lateral femoral condyle by ratio of height of lateral femoral condyle to anteroposterior diameter (HAPR), and evaluate its correlation with ACL rupture. METHODS: A retrospective case-control study of 64 patients was conducted. Two age-and sex-matched cohorts (each n = 32) were analyzed: primary ACL ruptures, and a control group consisting of isolated meniscal tears. On the radiograph, the distance from the intersection of the axis of the distal femur and the anteriorly diameter of the lateral femoral condyle to the lower point of the lateral femoral condyle divided by the anteriorly diameter of the lateral femoral condyle is HAPR. The HAPR was measured by digital radiograph imaging systems (DR) to quantify femoral sphericity. Cutoff values were defined; and diagnostic performance of the risk factors was assessed. Meanwhile, we measured the posterior tibial slope (PTS) on radiograph and compared the two methods to evaluate the significance of HAPR in predicting ACL rupture. RESULTS: A total of sixty-four patients who met the inclusion criteria were included in the final analysis (32 with primary ACL rupture, 32 controls). The HAPR was smaller in the knees with primary ACL rupture (0.31 ± 0.02) than that of the control group (0.33 ± 0.02) (p < 0.01). The PTS was bigger in the knees with primary ACL rupture (8.18 ± 2.77) than that of the control group (6.61 ± 2.85) (p = 0.036). The AUC of HAPR was bigger (0.825; 95% CI, 0.72-0.93) than that of PTS (0.675; 95%CI, 0.85-0.81). The calculated cutoff of HAPR of 0.32 (Youden index, 0.56) was associated with an increased risk for ACL rupture, with sensitivity of 75% and specificity of 81% to predict an ACL rupture. CONCLUSIONS: This study showed that a decreased HAPR is associated with an ACL rupture, and the decrease of HAPR was more significant in predicting ACL ruptures than the PTS. This helps clinicians identify susceptible individuals who may benefit from targeted ACL rupture prevention counseling and intervention.

High-Resolution Magnetic Resonance Imaging of Cervicocranial Artery Dissection: Imaging Features Associated With Stroke.

Background and Purpose- We aimed to systematically investigate the characteristics of cervicocranial artery dissection (CCAD) on high-resolution magnetic resonance imaging that are associated with acute ischemic stroke. Methods- Patients with CCAD were recruited and divided into stroke and nonstroke groups. The lesion location, the presence of a double lumen, intimal flap, intramural hematoma, pseudoaneurysm, irregular surface, intraluminal thrombus, and other quantitative parameters of each dissected segment were reviewed. Multiple logistic regression was used to examine the association between imaging features of CCAD and ischemic stroke. Results- A total of 145 affected vessels from 118 patients with CCAD were analyzed. Anterior circulation, intramural hematoma, irregular surface, intraluminal thrombus, and severe stenosis (>70%) on high-resolution magnetic resonance imaging were more prevalent in CCAD patient with stroke (54.4% versus 36.4%; P=0.030, 96.2% versus 84.8%; P=0.017, 74.7% versus 37.9%; P<0.001, 44.3% versus 4.5%; P<0.001, and 54.4% versus 31.8%; P=0.008, respectively). In multivariable logistic regression analysis, the presence of irregular surface and intraluminal thrombus on imaging were independently associated with acute ischemic stroke in CCAD with odds ratios of 4.29 (95% CI, 1.61-11.46, P=0.004) and 7.48 (95% CI, 1.64-34.07, P=0.009). Conclusions- The current findings supported that the presence of irregular surface and intraluminal thrombus were related to stroke occurrence in patients with CCAD. High-resolution magnetic resonance imaging might give insights into pathogenesis of ischemic stroke in CCAD. It may be useful for individual prediction of ischemic stroke early in CCAD.