A Modified Fixation Method for Talonavicular Arthrodesis in the Treatment of Müller-Weiss Disease: The Use of the Shape-Memory Alloy Staple as an Adjunct.

OBJECTIVE: Arthrodesis, usage of metallic implants for internal fixation, is commonly employed as the primary treatment modality for Müller-Weiss disease (MWD). Nevertheless, the efficacy of the current methods of fixation leaves room for improvement. Inadequate fixation strength and the risk of fixation failure are both critical concerns requiring attention. This study explored the clinical effects of implementing a modified fixation technique in talonavicular arthrodesis for the treatment of MWD. METHODS: A total of 14 cases diagnosed with MWD undergoing talonavicular (TN) arthrodesis from January 2021 toMarch 2023 were included in the retrospective study. The fixation method for fusion involved the use of screws, with additional support from the shape-memory alloy (SMA) staple. Relevant clinical outcomes and complications were evaluated preoperatively and postoperatively. Paired-samples t-test was used for all data comparisons. RESULTS: Radiographic evidence confirmed solid fusion, and follow-up evaluations showed satisfactory results in all cases. The American Orthopedic Foot and Ankle Society (AOFAS) scores were elevated from 32.21 ± 4.0 (range: 22-38) preoperatively to 86.5 ± 2.7 (range: 81-90) postoperatively (p < 0.001). The visual analog scale (VAS) scores declined from 7.40 ± 0.8 (range: 6-8.5) preoperatively to 1.21 ± 1.1 (range: 0-3) postoperatively (p < 0.001). The lateral Meary's angle changed from 13.50 ± 5.2 (range: 8-24) preoperatively to 4.14 ± 2.9 (range: 1-11) degrees postoperatively (p < 0.001). The calcaneal pitch angle increased from 10.07 ± 4.0 (range: 5-19) preoperatively to 14.35 ± 4.0 (range: 8-21) degrees postoperatively (p < 0.001). The talar-first metatarsal angle decreased from 11.71 ± 3.8 (range: 8-18) preoperatively to 4.28 ± 3.1 (range: 0-9) degrees postoperatively (p < 0.001). One patient was observed to experience delayed wound healing and wound infection. No nerve damage, malunion, pseudoarthrosis, or fixation failure were observed. CONCLUSION: The results indicated that the fusion of the TN joint using a combination of screws and shape memory alloy staples, could lead to favorable clinical outcomes and significantly enhance the quality of life for patients with MWD. This technique is not only safe and effective but also straightforward to perform.

Neural dysfunction underlying working memory processing at different stages of the illness course in schizophrenia: a comparative meta-analysis.

Schizophrenia, as a chronic and persistent disorder, exhibits working memory deficits across various stages of the disorder, yet the neural mechanisms underlying these deficits remain elusive with inconsistent neuroimaging findings. We aimed to compare the brain functional changes of working memory in patients at different stages: clinical high risk, first-episode psychosis, and long-term schizophrenia, using meta-analyses of functional magnetic resonance imaging studies. Following a systematic literature search, 56 whole-brain task-based functional magnetic resonance imaging studies (15 for clinical high risk, 16 for first-episode psychosis, and 25 for long-term schizophrenia) were included. The separate and pooled neurofunctional mechanisms among clinical high risk, first-episode psychosis, and long-term schizophrenia were generated by Seed-based d Mapping toolbox. The clinical high risk and first-episode psychosis groups exhibited overlapping hypoactivation in the right inferior parietal lobule, right middle frontal gyrus, and left superior parietal lobule, indicating key lesion sites in the early phase of schizophrenia. Individuals with first-episode psychosis showed lower activation in left inferior parietal lobule than those with long-term schizophrenia, reflecting a possible recovery process or more neural inefficiency. We concluded that SCZ represent as a continuum in the early stage of illness progression, while the neural bases are inversely changed with the development of illness course to long-term course.

Prognostic significance of fibrinogen and neutrophil/lymphocyte ratio score and D-dimer/Albumin ratio for prognosis in patients with aneurysmal subarachnoid hemorrhage.

BACKGROUND: Recent research indicates that systemic inflammation significantly affects the overall prognosis of individuals with aneurysmal subarachnoid hemorrhage. To delve deeper into this issue, a retrospective study was undertaken. The study aimed to investigate the relationship between fibrinogen and neutrophil/lymphocyte ratio scores, D-dimer/Albumin ratios, and the Glasgow Outcome Scale at 6 months post-discharge for patients with aSAH. METHODS: A retrospective analysis was conducted on 321 patients who experienced aneurysmal subarachnoid hemorrhage. These patients were monitored using the Glasgow Outcome Scale six months after being discharged from Huizhou Central People's Hospital. Patients with GOS scores between 1 and 3 were classified as having a poor prognosis, while those with scores ranging from 4 to 5 were considered to have a good prognosis. To create distinct sets, patients were randomly divided into both training and validation groups. The best cut-off value for the D-dimer/Albumin ratio was established through ROC curves, and the scores for fibrinogen and the neutrophil/lymphocyte ratio were calculated. Utilizing multivariate logistic regression analysis, independent risk factors linked to an unfavorable prognosis in aSAH patients were identified. A nomogram model was developed and validated based on these findings, providing an improved approach for evaluating the prognostic influence of risk factors. To gauge the model's predictive performance, several analytical tools such as ROC curves, calibration curves, and decision curve analysis were employed. This comprehensive approach ensured a thorough assessment of the prognostic prediction capabilities of the model. RESULTS: Multivariate regression analysis revealed that Age (OR=3.87, 95%CI=1.54-9.73, p=0.004), Pneumonia (OR=3.54, 95%CI=1.41-8.86, p=0.007), WFNS (OR=3.24, 95%CI=1.23-8.54, p=0.017), DAR (OR=2.88, 95%CI=1.13-7.34, p=0.027), and F-NLR (OR=3.12, 95%CI=1.22-7.97, p=0.017) were identified as independent risk factors influencing the prognosis of patients with aSAH. Additionally, the area under the ROC curve was 0.866 (95%CI=0.805-0.927) for the training set and 0.924 (95%CI=0.849-0.999) for the validation set. The calibration curve analysis demonstrated a minor error of 0.02 for the training set and 0.051 for the validation set. Furthermore, both the training set and validation set displayed significant clinical benefits according to the DCA curves, underscoring the meaningful utility of the developed nomogram. CONCLUSIONS: Fibrinogen and neutrophil/lymphocyte ratio scores, and the D-dimer/Albumin ratio emerged as significant independent risk factors for prognosticating the outcomes of patients with aSAH. Leveraging these factors, a robust nomogram model was meticulously developed, showcasing its impressive precision in prognostic predictions. These results underscore the promising clinical applicability of these biomarkers as effective prognostic indicators for individuals afflicted by aSAH.

The impact of COVID-19 vaccination on psychiatric symptoms in schizophrenia patients: A retrospective study.

The objective was to investigate the impact of COVID-19 vaccination on anxiety, depression, stress perception, and psychiatric symptoms in patients with schizophrenia, and to explore severity of psychiatric symptoms is associated with vaccine hesitancy in individuals with schizophrenia. Mental health symptoms were evaluated in 273 hospitalized schizophrenia patients who received COVID-19 vaccination, and in 80 patients who refused vaccination, both before and after immunization. The study assessed the effects of vaccination on psychiatric symptoms and the potential association between vaccination behavior and psychological distress. Our findings suggest that COVID-19 vaccination is associated with a small worsening of schizophrenia symptoms in older inpatients. Moreover, vaccination behavior may increase anxiety, depression, and stress perception in hospitalized schizophrenia patients, which has implications for the mental health care team working in the context of the pandemic. The study highlights the importance of monitoring the mental health status of patients with schizophrenia during the COVID-19 pandemic, particularly in relation to vaccination behavior. Further research is needed to better understand the mechanisms underlying the observed effects of COVID-19 vaccination on psychiatric symptoms in patients with schizophrenia.

Economy and carbon emissions optimization of different countries or areas in the world using an improved Attention mechanism based long short term memory neural network.

The combustion of fossil fuels produces a large amount of carbon dioxide (CO2), which leads to global warming in the world. How to rationally consume fossil energy and control CO2 emissions has become an unavoidable problem for human beings while vigorously developing economy. This paper proposes a novel economy and CO2 emissions prediction model using an improved Attention mechanism based long short term memory (LSTM) neural network (Attention-LSTM) to analyze and optimize the energy consumption structures in different countries or areas. The Attention mechanism can add the weight of different inputs in the previous information or related factors to realize the indirect correlation between output and related inputs of the LSTM. Therefore, the Attention-LSTM can allocate more computing resources to the parts with a higher relevance of correlation in the case of limited computing power. Through inputs with the consumption of oil, natural gas, coal, hydroelectricity and renewable energy, the desirable output with the per capita gross domestic product (GDP) and the undesirable output with CO2 emissions prediction model of different countries and areas is established based on the Attention-LSTM. The experimental results show that compared with the normal LSTM, the back propagation (BP), the radial basis function (RBF) and the extreme learning machine (ELM) neural networks, the Attention-LSTM is more accurate and practical. Meanwhile, the proposed model provides guidance for optimizing energy structures to develop economy and reasonably control CO2 emissions.

Economy and carbon dioxide emissions effects of energy structures in the world: Evidence based on SBM-DEA model.

Nowadays, the increasing global warming phenomenon caused by large carbon dioxide (CO2) emissions has a huge impact on the economic and social sustainable development in the world. And CO2 emissions come mainly from the burning of fossil energy, such as oil, natural gas and coal. Therefore, a novel economy and CO2 emissions evaluation model based on the slacks-based measure integrating the data envelopment analysis (SBM-DEA) is proposed to analyze and optimize energy structures of some countries and regions in the world. The consumption of oil, natural gas and coal are inputs of the proposed method. In addition, per capita gross domestic product (GDP) value is the desirable output and CO2 emission is the undesirable output. Then the economy and CO2 emissions evaluation model of some countries and regions in the world is built. The results show that the overall efficiency of developed countries and regions is higher than that of developing countries. Moreover, due to the optimal configuration of slack variables of inputs and the undesirable output, the efficiency values of some inefficient countries and regions can be improved greatly. Furthermore, whether in 2017 or 2018, the average efficiency values of Europe and Oceania are both relatively high, and these two years average efficiency values of Asia are all the lowest among the five continents.

[Risk factors of radius shortening in adult with distal radius fracture after conservative treatment].

OBJECTIVE: To analyze the of risk factors of radius shortening in adult with distal radius fracture after conservative treatment by Logistic analysis. METHODS: From May 2009 to March 2015, 137 adults patients with distal radius fracture treated by conservative treatment were retrospective analyzed, and 36 patients occurred radius shortening, including 7 males and 29 females with an average age of (58.33±14.06) years old, 8 patients were type A, 34 patients were type B and 12 patients were type C according to fracture classification; 101 patients were without radius shortening, including 23 males and 78 females with an average age of (52.49±12.79) years old, 48 patients were type A, 34 patients were type B and 19 patients were type C according to fracture classification. Ages, gender, BMI , time from injuries to reduction, fracture classification, fixed form and loading time were collected and screened risk factors by Logistic analysis. RESULTS: All patients were followed up from 8 to 16 months. Ages, time from injuries to reduction, fracture classification, earlier loading could obviously affect radius shortening by univariate analysis, multivariate logistic analysis revealed the risk factor including ages [OR=1.045(1.008-1.083), P=0.015], time from injury to reduction[OR=2.853(1.178-6.909), P=0.020], fracture classification(Type C fracture was more relevant to radius shortening than other two type fractures)[OR=4.854(1.506-15.640), P=0.008], and earlier loading[OR=3.038(1.138-8.111), P=0.027]. CONCLUSIONS: Ages, time from injury to reduction, fracture classification, and earlier load are the risk factors of radius shortening, so corresponding preventive measures and appropriate treatment should be applied to according to different risk factor.