Predominance of A2063G mutant strains in the Mycoplasma pneumoniae epidemic in children-a clinical and epidemiological study in 2023 in Wuhan, China.

OBJECTIVES: The prevalence of respiratory infectious diseases has changed in the post Covid-19 epidemic era, and mycoplasma pneumoniae (MP) infection in children has attracted wide attention. METHODS: Children hospitalized for pneumonia in Wuhan, China, in 2023 were enrolled. Respiratory secretions were obtained for the targeted next-generation sequencing (tNGS) including mutation of MP. Pulmonary inflammation was divided into bronchopneumonia and pulmonary consolidation/atelectasis according to lung CT imaging. RESULTS: Of the 667 pediatric pneumonia, 478 were MP positive (72%). The positive rate of MP detected by tNGS increased from April, and MP had become the primary pathogen of pneumonia in children in year 2023. The 23S rRNA mutations were all A2063G, accounting for 85% of detected MP. The clinical symptoms of the mutant and wild type strains were similar, with half of them experiencing atelectasis and lung consolidation. Early bronchoscopic lavage combined with azithromycin in pediatric pulmonary consolidation was an effective therapy strategy, which could be an alternative selection to MPP treatment. CONCLUSION: A2063G mutant strain MP was the primary pathogen of mycoplasma pneumoniae in children recently, which was often complicated by extra-pulmonary symptoms and complications.

Biomechanical effects of clear aligner with different shape design at extraction space area during anterior teeth retraction.

OBJECTIVE: This study aimed to investigate the biomechanical effects of clear aligner (CA) with different shape designs at extraction space (CAES) area during space closing. MATERIALS AND METHODS: A finite-element method (FEM) model of mandibular dentition, periodontal ligaments, attachments, and corresponding CA was established. The connecting rod design of CAES was modelled for the control group. Eight test groups with different heights of CAES from -4 mm to +4 mm were designed. Tooth displacement tendencies were calculated. The maximum principal stress in PDLs, teeth, and CAs was analysed. Both global coordinate system and local coordinate system were also used to evaluate individual tooth movements. RESULTS: Across all groups, stresses concentrated on the lingual outer surface of CAESs. For the lowered CAES groups, both the stress value and the stress distribution area at CAESs were increased. The lowered CAES groups showed reduced movement in anterior teeth and less tipping tendency of the canines. CONCLUSION: The shape of CAES has a biomechanical impact on anterior teeth movement and should be considered in aligner design. The results suggest that increasing the height of CAES can enhance anterior teeth retraction, while lowered CAES may facilitate controlled root movement. Changes in the shape of CAES represent a potential direction for biomechanical improvement of clear aligner in extraction cases and are worth exploring.

Outcomes After Double-Layer Repair Versus En Masse Repair for Delaminated Rotator Cuff Injury: A Systematic Review and Meta-analysis.

Background: Delamination of rotator cuff tears during arthroscopic shoulder surgery has an incidence of 38% to 92%. Double-layer (DL) repair and en masse (EM) repair are most commonly used in this situation. Purpose: To compare the clinical results of the DL versus EM repair techniques for delaminated rotator cuff tears using a meta-analysis. Study Design: Systematic review; level of evidence, 3. Methods: We identified relevant studies comparing the clinical results of DL and EM repair for delaminated rotator cuff injuries in the PubMed, Embase, and Cochrane databases after the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The primary outcomes were the Constant score and retear rate. Additionally, we compared other postoperative shoulder functional scores, shoulder range of motion, and visual analog scale (VAS) pain scores between the 2 suture methods using a meta-analysis. The mean difference (MD) was compared for continuous outcomes, and the odds ratios (ORs) were compared for categorical outcomes. Results: Of the 197 studies initially identified, 6 studies were included in this analysis. There were significant differences in the Constant score (MD, 8.64 [95% CI, 4.47 to 12.8]; P < .05) and external rotation (MD, 5.10 [95% CI, 2.63 to 7.56]; P < .05) between the 2 techniques, with DL repair having superior outcomes. No significant differences were observed between the 2 techniques in forward flexion (MD, 0.62 [95% CI, -1.18 to 2.43]; P = .50), VAS pain (MD, -0.03 [95% CI, -0.34 to 0.27]; P = .84), or retear rate (OR, 0.73 [95% CI, 0.37 to 1.41]; P = .35). Conclusion: Results of this review and meta-analysis suggest that DL repair was more beneficial than EM repair in terms of the Constant score and shoulder external rotation in patients with delaminated rotator cuff injuries.

A comparison between knotted and knotless medial row of suture bridge technique in arthroscopic rotator cuff repair surgery: a meta-analysis.

BACKGROUND: The shoulder arthroscopic suture bridge technique is currently very popular, but scientific evidence relating to the clinical outcomes of the medial row with or without knots has not been systematic reviewed. PURPOSE: The purpose of this study was to compare the clinical outcomes of knotted versus knotless double-row suture bridges for rotator cuff repairs. STUDY DESIGN: Meta-analysis. METHOD: Five databases that contain literature in English were searched (Medline, PubMed, Embase, Web of Science, and the Cochrane Library), with a focus on works published between 2011 and 2022. Clinical data relating to arthroscopic rotator cuff repair with the suture bridge approach was examined and the outcomes of medial row knotting contrasted with that of the knotless technique. The search phrase used was: (double row) AND (rotator cuff) AND (repair), and the search method is subject term plus free word search. Literature quality evaluation was performed using the Cochrane "risk of bias" tool 1.0 and the Newcastle-Ottawa scale quality assessment instrument. RESULTS: One randomized controlled trial, four prospective cohort studies, and five retrospective cohort studies were included in this meta-analysis. Data pertaining to 1146 patients was drawn from these ten original papers and analyzed. Meta-analyses that were performed on 11 postoperative outcomes revealed that none of the differences were statistically significant (P > 0.05) and that the publications were unbiased (P > 0.05). Postoperative retear rate and postoperative retear categorization were the outcomes assessed. Scores on postoperative pain, forward flexion, abduction, and external rotation mobility were collated and evaluated. The University of California, Los Angeles scoring systems in the first year following surgery, the American Shoulder and Elbow Surgeons score and Constant scales in the first and second years after surgery were the secondary outcomes spotlighted in this study. CONCLUSION: The clinical outcomes of shoulder arthroscopic rotator cuff repair with the suture bridge technique with or without a knotted medial row was proven to be equivalent. These outcomes are about postoperative retear, postoperative retear classification, postoperative shoulder function score, postoperative shoulder mobility, and postoperative pain, respectively. It should be noted that the conclusions are based on short-term clinical follow-up data.

The effect of maxillary molar distalization with clear aligner: a 4D finite-element study with staging simulation.

INTRODUCTION: Long-term simulation of tooth movement is crucial for clear aligner (CA) treatment. This study aimed to investigate the effect of maxillary molar distalization with CA via an automatic staging simulation. METHOD: A finite-element method (FEM) model of maxillary dentition, periodontal ligaments, attachments, and corresponding CA was established, and a prescribed 2-mm distalization with 0.1 mm each step of the second molar was simulated. The long-term tooth movement under orthodontic force was simulated with an iterative computation method. The morphologic changes of CA during staging were simulated with the thermal expansion method. RESULTS: Twenty steps of molar distalization were simulated. Significant distal tilting of the second molar was revealed, along with the proclination of anterior teeth, which caused the 'reversed bow effect'. For the second molar, 4.63°distal tilting at the 20th step was revealed. The intrusion of the incisors and the second molar were 0.43 mm, 0.39 mm, and 0.45 mm, respectively, at step 20. All the anterior teeth showed a proclination of approximately 1.41°-2.01° at the 20th step. The expression rate of the designed distalization of the second molar was relatively low (approximately 68%) compared to the high efficacy of interdental space opening between molars with CA (approximately 89%). CONCLUSION: A novel method of simulating long-term molar distalization with CA with FEM was developed. The FEM results suggested distal tilting of the second molar and the proclination of anterior teeth during the molar distalization.

Effect of Different Anchorage Reinforcement Methods on Long-Term Maxillary Whole Arch Distalization with Clear Aligner: A 4D Finite Element Study with Staging Simulation.

The objective of this study was to examine how various anchorage methods impact long-term maxillary whole arch distalization using clear aligners (CAs) through an automated staging simulation. Three different anchorage reinforcement methods, namely, Class II elastics, buccal temporary anchorage device (TAD), and palatal TAD, were designed. Orthodontic tooth movement induced by orthodontic forces was simulated using an iterative computation method. Additionally, the automatic adjustment of the CA was simulated through the application of the thermal expansion method. The results indicated that the palatal TAD group had the largest retraction of incisors, followed by the buccal TAD group and the Class II elastic group, while the least was in the control group. The largest distal displacements and efficiency of molar distalization for the first and the second molars were noticed in the palatal TAD group. Arch width increased at the molar and premolar levels in all groups. The FEM results suggested palatal TAD had the best performance considering anterior teeth anchorage maintenance, both sagittally and vertically. However, attention should be paid to the possible increasement of arch width.

Risk Factors and Corresponding Management for Suture Anchor Pullout during Arthroscopic Rotator Cuff Repair.

INTRODUCTION: Due to the aging of the population, the incidence of rotator cuff tears is growing. For rotator cuff repair, arthroscopic suture-anchor repair has gradually replaced open transosseous repair, so suture anchors are now considered increasingly important in rotator cuff tear reconstruction. There are some but limited studies of suture anchor pullout after arthroscopic rotator cuff repair. However, there is no body of knowledge in this area, which makes it difficult for clinicians to predict the risk of anchor pullout comprehensively and manage it accordingly. METHODS: The literature search included rotator cuff repair as well as anchor pullout strength. A review of the literature was performed including all articles published in PubMed until September 2021. Articles of all in vitro biomechanical and clinical trial levels in English were included. After assessing all abstracts (n = 275), the full text and the bibliographies of the relevant articles were analyzed for the questions posed (n = 80). Articles including outcomes without the area of interest were excluded (n = 22). The final literature research revealed 58 relevant articles. Narrative synthesis was undertaken to bring together the findings from studies included in this review. RESULT: Based on the presented studies, the overall incidence of anchor pullout is not low, and the incidence of intraoperative anchor pullout is slightly higher than in the early postoperative period. The risk factors for anchor pullout are mainly related to bone quality, insertion depth, insertion angle, size of rotator cuff tear, preoperative corticosteroid injections, anchor design, the materials used to produce anchors, etc. In response to the above issues, we have introduced and evaluated management techniques. They include changing the implant site of anchors, cement augmentation for suture anchors, increasing the number of suture limbs, using all-suture anchors, using an arthroscopic transosseous knotless anchor, the Buddy anchor technique, Steinmann pin anchoring, and transosseous suture repair technology. DISCUSSION: However, not many of the management techniques have been widely used in clinical practice. Most of them come from in vitro biomechanical studies, so in vivo randomized controlled trials with larger sample sizes are needed to see if they can help patients in the long run.

The health consequences of greenhouse gas emissions: a potential pathway.

Excessive greenhouse gas emissions might be the major culprit for environmental degradation, which have direct and indirect adverse impacts in various ways. As the largest emitter of carbon emissions, China suffered great harm from climate change during the past 40 years. Therefore, it becomes necessary to study the impact of carbon emissions on health issues and their potential mechanism. Using the panel data from 30 provinces in China between 2002 and 2017, this study employes and extends the Stochastic Impacts by Regression on Population, Affluence, and Technology (STIRPAT) model and mediating effect model to analyze the direct and indirect effects of carbon emissions. The main results are as follows: (1) Carbon emissions has a certain negative impact on public health, which would increase with the rise of temperature. (2) The increase in carbon emissions has a more significant negative effect on health with the average temperature exceeding 17.75 °C, indicating that the temperature has a threshold effect. (3) The potential health risks become higher with the development of urbanization, but there is no obvious spillover effect in the health consequences. The results remain robust after controlling other factors. This study supplements the literature of climate governance and human health, potentially contributing to the next stage of high-quality and sustainable development.

Do carbon emissions impact the health of residents? Considering China's industrialization and urbanization.

Industrialization and urbanization have aggravated the contradiction between environmental protection and economic growth, leading to health issues. While there are considerable interests in understanding the health effects of carbon emissions in the context of climate change, little is observed at regional scale and by econometric methods. Applying regression analysis on 2002-2017 Chinese provincial-level panel data, this study explores the intermediary mechanisms and regional differences of carbon emissions on residents' health. The results indicate that: (1) Carbon emissions have a long-term adverse impact on residents' health-a 1% rise in carbon emission adds 0.298% more outpatients and 0.162% more inpatients; (2) The rise in carbon emissions impairs residents' health mainly by raising the temperature; (3) In areas with high levels of industrialization and urbanization, increased carbon emissions bring greater health risks; and (4) In terms of China's unique "leading industrialization and lagging urbanization" situation, only by upgrading industrial structure, improving urbanization quality, and promoting coordinated industrialization and urbanization can the harm of carbon emissions to residents' health be reduced. Therefore, the "one-size-fits-all" policy model is not suitable for China's current situation. To address global "climate change" issues, China must act according to local conditions by applying mitigating (adaptive) measures in economically developed (less developed) regions. Simultaneously, the authorities must focus on the interaction and synergy between industrialization and urbanization.

Poly(vinylidene fluoride) Flexible Nanocomposite Films with Dopamine-Coated Giant Dielectric Ceramic Nanopowders, Ba(Fe0.5Ta0.5)O3, for High Energy-Storage Density at Low Electric Field.

Ba(Fe0.5Ta0.5)O3/poly(vinylidene fluoride) (BFT/PVDF) flexible nanocomposite films are fabricated by tape casting using dopamine (DA)-modified BFT nanopowders and PVDF as a matrix polymer. After a surface modification of installing a DA layer with a thickness of 5 nm, the interfacial couple interaction between BFT and PVDF is enhanced, resulting in less hole defects at the interface. Then the dielectric constant (ε'), loss tangent (tan δ), and AC conductivity of nanocomposite films are reduced. Meanwhile, the value of the reduced dielectric constant (Δε') and the strength of interfacial polarization (k) are introduced to illustrate the effect of DA on the dielectric behavior of nanocomposite films. Δε' can be used to calculate the magnitude of interfacial polarization, and the strength of the dielectric constant contributed by the interface can be expressed as k. Most importantly, the energy-storage density and energy-storage efficiency of nanocomposite films with a small BFT@DA filler content of 1 vol % at a low electric field of 150 MV/m are enhanced by about 15% and 120%, respectively, after DA modification. The high energy-storage density of 1.81 J/cm3 is obtained in the sample. This value is much larger than the reported polymer-based nanocomposite films. In addition, the outstanding cycle and bending stability of the nanocomposite films make it a promising candidate for future flexible portable energy devices.