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Purpose: This study explores the effects of CMS reimbursement financial penalties from the Hospital-Acquired Condition Reduction Program (HACRP) on hospital-acquired infections (HAI) in hospitals across the United States. Methods: Hospital-level data for 2896 hospitals in the United States were evaluated using multiple linear regression models with random effects analysis through a difference-in-differences study design to examine HAIs under the HACRP between hospitals that were financially penalized or not from calendar years 2013 to 2020. Results: This study showed significant differences from the pre-program Total HAC scores to the most recent reviewed year, validating the efficacy of the HACRP, and showing a reduction of overall HAIs over the years evaluated in the study. The multiple linear regression model with random effects analysis produced a significant (p < 0.001) interaction term between hospitals expected to be penalized in 2013 and each year evaluated in the study (-0.412 estimate) confirming decreases in HAI scores, and overall decreases in HAIs across the years of the study. Notably, 98% of hospitals in the worst-performing, expected to be financially penalized quartile from 2013, were found to have decreased their HAIs in their facilities, while only 38.8% of hospital in the performing, non-penalized quartiles showed decreases in HAIs across their facilities, by 2020. Conclusion: Our research indicates that implementing financial disincentives through reimbursement reductions could potentially decrease the incidence of HAIs. Our study further suggests that incorporating financial penalties and incentives for HAIs annually across all hospitals may lead to significant reductions in HAIs throughout the US healthcare system.

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Alignment in total ankle replacement is important for success and implant survival. Recently there has been the introduction and adoption of patient specific instrumentation for implantation in total ankle replacement. Current literature does not evaluate the effect of preoperative deformity on accuracy of patient specific instrumentation. A retrospective radiographic analysis was performed on 97 consecutive patients receiving total ankle replacement with patient specific instrumentation to assess the accuracy and reproducibility of the instrumentation. Subgroup analysis evaluated the effect of preoperative deformity. All surgeries were performed by fellowship trained foot and ankle surgeons without industry ties to the implants used. Preoperative and postoperative films were compared to plans based on computerized tomography scans to assess how closely the plan would be implemented in patients. Overall postoperative coronal plane alignment was within 2° of predicted in 87.6% (85 patients). Similarly, overall postoperative sagittal plane alignment was within 2° of predicted in 88.7% (86 patients). Tibial implant size was accurately predicted in 81.4% (79 patients), and talus implant size was correct in 75.3% (73 patients). Patients with preoperative varus deformity had a higher difference between predicted and actual postoperative alignment compared to valgus deformity (1.1° compared to 0.3°, p = .02). A higher average procedure time was found in varus patients, and more adjunctive procedures were needed in patients with varus or valgus deformity, but these were not significant, p > .5. Surgeons can expect a high degree of accuracy when using patient specific instrumentation overall, but less accurate in varus deformity.

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This case report describes the prosthodontic rehabilitation of a middle-aged male patient who underwent bilateral low-level maxillectomy due to post-COVID-19 mucormycosis. The oronasal communication was closed using an anterior base tongue flap. Two patient-specific subperiosteal implants were placed to rehabilitate the patient's bony defect. Using a postsurgical CT scan, a virtually customized subperiosteal titanium framework was created from grade IV titanium alloy. The fabricated framework was implanted over the patient's zygomatic bone bilaterally. Six months later, the right-sided patient-specific implant was infected and had to be surgically removed. After satisfactory healing, an open-tray impression was taken to create a computer-aided design/computer-aided manufacturing titanium Hader bar. An acrylic resin overdenture was then fabricated over this bar. A clasp assembly was fabricated by direct metal laser sintering of cobalt-chromium alloy for additional retention. The metal substructures were incorporated into the overdenture prosthesis to enhance the stability and retention.. This case report unveils an innovative approach to rehabilitating severely compromised maxillary bony defects and impaired oral functioning, offering a viable alternative when traditional reconstruction methods are inadequate. Prosthodontic treatment greatly affects the aesthetics, phonetics, and mastication of the patient, improving the overall quality of life of the patient.

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Soil erosion from agricultural fields is a persistent ecological problem, potentially leading to eutrophication of aquatic habitats in the catchment area. Often used and recommended mitigation measures are vegetated filter strips (VFS) as buffer zones between arable land and water bodies. However, if they are designed and managed poorly, nutrients - especially phosphorus (P) - may accumulate in the soil. Ultimately, VFS can switch from being a nutrient sink to a source. This problem is further aggravated if the field runoff does not occur as uniform sheet flow, but rather in concentrated form, as is usually the case. To assess the impact of concentrated flow on VFS performance, we have taken soil core samples from field-VFS transition zones at six sites in Lower Austria. We determined a multitude of physical and chemical soil parameters, focusing on P fractions and indices. Our results revealed that concentrated flow can lead to an accumulation of P in the VFS. P levels in the VFS inside the area of concentrated runoff can be equal to or higher than in the field, even though they receive no direct fertilization. However, the concentration and distribution of nutrients in the fields and VFSs were also site-specific and affected by local factors such as the age of the VFS, cropping, and fertilization. Accordingly, there is a need for more sophisticated, bespoke VFS designs that can cope with site-specific runoff volumes and movements of nutrients that occur.

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Plants from invasive populations often have higher growth rates than conspecifics from native populations due to better environmental adaptability. However, the roles of improved chlorophyll fluorescence or antioxidant defenses in helping them to grow better under adverse situations are insufficient, even though this is a key physiological question for elucidating mechanisms of plant invasion. Here, we conducted experiments with eight native (China) and eight introduced (USA) populations of Chinese tallow tree (Triadica sebifera). We tested how salinity, nutrients (overall amount or N:P in two separate experiments) and their interaction affected T. sebifera aboveground biomass, leaf area, chlorophyll fluorescence and antioxidant defenses. Plants from introduced populations were larger than those from native populations, but salinity and nutrient shortage (low nutrients or high N:P) reduced this advantage, possibly reflecting differences in chlorophyll fluorescence based on their higher PSII maximum photochemical efficiency (F v/F m) and PSI maximum photo-oxidizable P700 in higher nutrient conditions. Native population plants had lower F v/F m with saline. Except in high nutrients/N:P with salinity, introduced population plants had lower electron transfer rate and photochemical quantum yield. There were no differences in antioxidant defenses between introduced and native populations except accumulation of hydrogen peroxide (H2O2), which was lower for introduced populations. Low nutrients and higher N:P or salinity increased total antioxidant capacity and H2O2. Our results indicate that nutrients and salinity induce differences in H2O2 contents and chlorophyll fluorescence characteristics between introduced and native populations of an invasive plant, illuminating adaptive mechanisms using photosynthetic physiological descriptors in order to predict invasions.

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BACKGROUND: Major depressive disorder (MDD) is a prevalent and disabling mood disorder, thought to be linked with brain white matter (WM) alterations. Prior diffusion tensor imaging (DTI) studies have reported inconsistent changes in fractional anisotropy (FA) across different brain regions in MDD patients. However, none of these studies utilized raw t-map data for WM meta-analysis in MDD. Our study aims to address this gap by conducting a whole-brain-based meta-analysis of FA in MDD using Seed-based d mapping via permutation of subject images (SDM-PSI), combining reported peak coordinates and raw statistical parametric maps. OBJECTIVES: Following PRISMA guidelines, we performed a systematic search and meta-analysis to compare FA in MDD patients with healthy controls (HC). Our goal was to identify WM abnormalities in MDD, using SDM, which could shed light on the disorder's pathogenesis. RESULTS: The meta-analysis included 39 studies with 3696 participants (2094 with MDD, 1602HC). It revealed that MDD patients, in comparison to HC, have lower FA in the corpus callosum (CC) and anterior thalamic projections (ATP). Subgroup analyses indicated that the CC is a more stable pathogenic factor in MDD. Meta-regression analyses showed no linear correlation between the mean age, percentage of female patients, duration of depression, and FA abnormalities. This suggests that WM impairments in interhemispheric connections and anterior thalamocortical circuits are significant in the pathogenesis of MDD.

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In the West, National Early Warning Score 2 (NEWS2) is commonly applied to predict the severity of illness using only bedside variables unlike the extensive Pneumonia Severity Index (PSI). The objective of this study was to compare these scores as mortality predictors in patients admitted with community acquired pneumonia (CAP). This cross-sectional study was conducted in Jinnah Postgraduate Medical Centre, Karachi, Pakistan, for six months in 2020 on 116 patients presenting with CAP. Cases of aspiration pneumonia, hospital acquired pneumonia, pulmonary tuberculosis, pulmonary embolism, and pulmonary oedema were excluded. In-hospital mortality was taken as the outcome of this study. The mean age of the participants was 46.9±20.5 years. The in-hospital mortalities were 45(38.8%). NEWS2 was 97.8% sensitive but only 15.5% specific in predicting the outcome, whereas PSI was less sensitive (68.9%) but more specific (50.7%), which showed that in comparison with PSI, NEWS2 is a more sensitive mortality predicting score among hospitalised CAP patients.

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Depression is a highly prevalent and debilitating mental disorder that often begins in adolescence. However, it remains unclear whether adults and adolescents with depression exhibit common or distinct brain dysfunctions during reward processing. We aimed to identify common and separable neurofunctional alterations during receipt of rewards and brain structure in adolescents and adults with depression. A coordinate-based meta-analysis was employed using Seed-based d mapping with permutation of subject images (SDM-PSI). Compared with healthy controls, both age groups exhibited common activity decreases in the right striatum (putamen, caudate) and subgenual ACC. Adults with depression showed decreased reactivity in the right putamen and subgenual ACC, while adolescents with depression showed decreased activity in the left mid cingulate, right caudate but increased reactivity in the right postcentral gyrus. This meta-analysis revealed shared (caudate) and separable (putamen and mid cingulate cortex) reward-related alterations in adults and adolescents with depression. The findings suggest age-specific neurofunctional alterations and stress the importance of adolescent-specific interventions that target social functions.

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Systemic lupus erythematosus (SLE) is an autoimmune disease with multiple symptoms, and its rapid screening is the research focus of surface-enhanced Raman scattering (SERS) technology. In this study, gold@silver-porous silicon (Au@Ag-PSi) composite substrates were synthesized by electrochemical etching and in-situ reduction methods, which showed excellent sensitivity and accuracy in the detection of rhodamine 6G (R6G) and serum from SLE patients. SERS technology was combined with deep learning algorithms to model serum features using selected CNN, AlexNet, and RF models. 92 % accuracy was achieved in classifying SLE patients by CNN models, and the reliability of these models in accurately identifying sera was verified by ROC curve analysis. This study highlights the great potential of Au@Ag-PSi substrate in SERS detection and introduces a novel deep learning approach for SERS for accurate screening of SLE. The proposed method and composite substrate provide significant value for rapid, accurate, and noninvasive SLE screening and provide insights into SERS-based diagnostic techniques.

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Plant growth and productivity are predicted to be affected by rising CO2 concentrations, drought and temperature stress. The C3 crop model in a changing climate is Chenopodium quinoa Willd-a protein-rich pseudohalphyte (Amaranthaceae). Morphophysiological, biochemical and molecular genetic studies were performed on quinoa grown at ambient (400 ppm, aCO2) and elevated (800 ppm, eCO2) CO2 concentrations, drought (D) and/or high temperature (eT) treatments. Among the single factors, drought caused the greatest stress response, inducing disturbances in the light and dark photosynthesis reactions (PSII, apparent photosynthesis) and increasing oxidative stress (MDA). Futhermore, compensation mechanisms played an important protective role against eT or eCO2. The disruption of the PSII function was accompanied by the activation of the expression of PGR5, a gene of PSI cyclic electron transport (CET). Wherein under these conditions, the constant Rubisco content was maintained due to an increase in its biosynthesis, which was confirmed by the activation of rbcL gene expression. In addition, the combined stress treatments D+eT and eCO2+D+eT caused the greatest negative effect, as measured by increased oxidative stress, decreased water use efficiency, and the functioning of protective mechanisms, such as photorespiration and the activity of antioxidant enzymes. Furthermore, decreased PSII efficiency and increased non-photochemical quenching (NPQ) were not accompanied by the activation of protective mechanisms involving PSI CET. In summary, results show that the greatest stress experienced by C. quinoa plants was caused by drought and the combined stresses D+eT and eCO2+D+eT. Thus, drought consistently played a decisive role, leading to increased oxidative stress and a decrease in defense mechanism effectiveness.

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BACKGROUND: Preoperative planning is an integral aspect of managing complex deformity in reverse shoulder arthroplasty (RSA). The purpose of this study was to compare the success of patient-specific instrumentation (PSI) and 3D computer-assisted planning with standard instrumentation (non-PSI) in achieving planned corrections of the glenoid among patients undergoing RSA with severe bony deformity requiring glenoid bone grafts. METHODS: A retrospective case-control study was performed, including all patients that underwent RSA with combined bone grafting procedures (BIO-RSA or structural bone grafting) for severe glenoid deformity by a single study between June 2016 and July 2023. Patients were required to have preoperative and postoperative CT scans as well as preoperative 3D planning performed for inclusion. Patients were divided into two groups based on the use of 3D computer-assisted planning with or without PSI (PSI vs. non-PSI). The corrected inclination and version were measured by two separate reviewers on preoperative and postoperative 2D CT scans and compared to their corresponding preoperative planning goals utilizing bivariate analyses. RESULTS: We identified 45 patients that met our inclusion criteria (22 PSI and 23 non-PSI). Preoperative inclination (mean ± SD) (PSI 10.12° ± 15.86°, non-PSI 9.43° ± 10.64°; P = .864) and version (PSI -18.78° ± 18.3°, non-PSI -17.82° ± 11.49°; P = .835) measurements were similar between groups. No significant differences in the mean deviation (error) between the postoperative and planned inclination (PSI 5.49° ± 3.72; non-PSI 6.91° ± 5.05; P = .437) and version (PSI 8.37° ± 5.7; non-PSI 5.37° ± 4.43; P = .054) were found between groups. No difference in the rate of outliers (>10° error) was noted in inclination (P = .135) or version (P = .445) between groups. Greater planned version correction was correlated with greater error when PSI was utilized (PSI r = 0.519, P = .013; non-PSI r = 0.362, P = .089). CONCLUSION: Both PSI and 3D computer-assisted planning without PSI (non-PSI) appear to be useful techniques to achieve version and inclination correction among patients undergoing RSA with severe glenoid deformity required glenoid bone grafting with no clear superiority of one method over the other. Surgeons should be aware that when utilizing PSI, slightly greater error in achieving version goals may occur as version correction is increased.

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Photosynthesis, as the primary source of energy for all life forms, plays a crucial role in maintaining the global balance of energy, entropy, and enthalpy in living organisms. Among its various building blocks, photosystem I (PSI) is responsible for light-driven electron transfer, crucial for generating cellular reducing power. PSI acts as a light-driven plastocyanin-ferredoxin oxidoreductase and is situated in the thylakoid membranes of cyanobacteria and the chloroplasts of eukaryotic photosynthetic organisms. Comprehending the structure and function of the photosynthetic machinery is essential for understanding its mode of action. New insights are offered into the structure and function of PSI and its associated light-harvesting proteins, with a specific focus on the remarkable structural conservation of the core complex and high plasticity of the peripheral light-harvesting complexes.

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Woody plants display some photosynthetic activity in stems, but the biological role of stem photosynthesis and the specific contributions of bark and wood to carbon uptake and oxygen evolution remain poorly understood. We aimed to elucidate the functional characteristics of chloroplasts in stems of different ages in Fraxinus ornus. Our investigation employed diverse experimental approaches, including microsensor technology to assess oxygen production rates in whole stem, bark, and wood separately. Additionally, we utilized fluorescence lifetime imaging microscopy (FLIM) to characterize the relative abundance of photosystems I and II (PSI : PSII chlorophyll ratio) in bark and wood. Our findings revealed light-induced increases in O2 production in whole stem, bark, and wood. We present the radial profile of O2 production in F. ornus stems, demonstrating the capability of stem chloroplasts to perform light-dependent electron transport. Younger stems exhibited higher light-induced O2 production and dark respiration rates than older ones. While bark emerged as the primary contributor to net O2 production under light conditions, our data underscored that wood chloroplasts are also photosynthetically active. The FLIM analysis unveiled a lower PSI abundance in wood than in bark, suggesting stem chloroplasts are not only active but also acclimate to the spectral composition of light reaching inner compartments.

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The frontal bone is the vital component of the human skull and forms a part of the anterior skull vault, base, and roof of the orbits. Frontal bone defects may arise secondary to various causes like trauma, congenital defects including craniofacial clefts, tumors in the frontal bone requiring surgical intervention, and infections, like osteomyelitis, that cause osteonecrosis of the frontal bone. Reconstruction of frontal bone has been explored in the literature, and various materials are available for rehabilitation, like auto/allografts, and alloplastic materials, including bone cement, titanium meshes, and patient-specific implant (PSI). All the available materials have their own advantages and disadvantages; hence, depending on the anatomy and physiology of the frontal bone and the involvement of the naso-orbito-ethmoidal (NOE) complex, patient selection and treatment plan become very crucial. This report presents a case of the frontal bone with a NOE defect, secondary to trauma, reconstructed using a PSI and costochondral graft.

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Background: This investigation is both a study of potential non-invasive diagnostic approaches for the bladder cancer biomarker UBC® Rapid test and a study including novel comparative methods for bioassay evaluation and comparison that uses bladder cancer as a useful example. The objective of the paper is not to investigate specific data. It is used only for demonstration, partially to compare ROC methodologies and also to show how both sensitivity/specificity and predictive values can be used in clinical diagnostics and decision making. This study includes ROC curves with integrated cut-off distribution curves for a comparison of sensitivity/specificity (SS) and positive/negative predictive values (PPV/NPV or PV), as well as SS-J index/PV-PSI index-ROC curves and SS-J/PV-PSI index cut-off diagrams (J = Youden, PSI = Predictive Summary Index) for the unified direct comparison of SS-J/PV results achieved via quantitative and/or qualitative bioassays and an identification of optimal separate or unified index cut-off points. Patients and Methods: According to the routine diagnostics, there were 91 patients with confirmed bladder cancer and 1152 patients with no evidence of bladder cancer, leading to a prevalence value of 0.073. This study performed a quantitative investigation of used-up test cassettes from the visual UBC® Rapid qualitative point-of-care assay, which had already been applied in routine diagnostics. Using a photometric reader, quantitative data could also be obtained from the test line of the used cassettes. Interrelations between SS and PV values were evaluated using cumulative distribution analysis (CAD), SS/PV-ROC curves, SS-J/PV-PSI index-ROC curves, and the SS-J/PV-PSI index cut-off diagram. The maximum unified SS-J/PV-PSI index value and its corresponding cut-off value were determined and calculated with the SS-J/PV-PSI index cut-off diagram. Results: The use of SS/PV-ROC curves with integrated cut-off concentration distribution curves provides improved diagnostic information compared to "traditional" ROC curves. The threshold distributions integrated as curves into SS/PV-ROC curves and SS-J/PV-PSI index-ROC curves run in opposite directions. In contrast to the SS-ROC curves, the PV-ROC and the novel PV-PSI index-ROC curves had neither an area under the curve (AUC) nor a range from 0% to 100%. The cut-off level of the qualitative assay was 7.5 µg/L, with a sensitivity of 65.9% and a specificity of 63.3%, and the PPV was 12.4% and the NPV was 95.9%, at a threshold value of 12.5 µg/L. Based on these set concentrations, the reader-based evaluation revealed a graphically estimated 5% increase in sensitivity and a 13% increase in specificity, as compared to the visual qualitative POC test. In the case of predictive values, there was a gain of 8% for PPV and 10% for NPV. The index values and cut-offs were as follows: visual SS-J index, 0.328 and 35 µg/L; visual PV-PSI index, 0.083 and 5.4 µg/L; maximal reader Youden index, 0.0558 and 250 µg/L; and maximal PV-PSI index, 0.459 and 250 µg/L, respectively. The maximum unified SS-J/PV-PSI index value was 0.32, and the cut-off was 43 µg/L. The reciprocal SS-J index correctly detected one out of three patients, while the reciprocal PV-PSI index gave one out of twelve patients a correct diagnosis. Conclusions: ROC curves including cut-off distribution curves supplement the information lost in "traditionally plotted" ROC curves. The novel sets of ROC and index-ROC curves and the new SS/PV index cut-off diagrams enable the simultaneous comparison of sensitivity/specificity and predictive value profiles of diagnostic tools and the identification of optimal cut-off values at maximal index values, even in a unifying SS/PV approach. Because the curves within an SS-J/PV-PSI index cut-off diagram are distributed over the complete cut-off range of a quantitative assay, this field is open for special clinical considerations, with the need to vary the mentioned clinical diagnostic parameters. Complete or partial areas over the x-axis (AOX) can be calculated for summarized quantitative or qualitative effectivity evaluations with respect to single and/or unified SS-J and PV-PSI indices and with respect to single, several, or several unified assays. The SS-J/PV-PSI index-AOX approach is a new tool providing additional joint clinical information, and the reciprocal SS-J indices can predict the number of patients with a correct diagnosis and the number of persons who need to be examined in order to correctly predict a diagnosis of the disease. These methods could be used in applications like medical or plant epidemiology, machine learning algorithms, and neural networks.

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Solar power is a promising source of energy that is environmentally friendly, sustainable, and renewable. Solar photovoltaic (PV) panels are the most common and mature technology used to harness solar energy. Unfortunately, these panels are prone to dust accumulation, which can have a significant impact on their efficiency. To maintain their effectiveness, solar photovoltaics s must be cleaned regularly. Eight main techniques are used to clean solar panels: natural, manual, mechanical, robotic, drone, coating, electrical, and acoustic. This study aims to identify the best cleaning method using multiple criteria decision-making (MCDM) techniques. Using the Analytical Hierarchy Process (AHP), Quality Function Deployment (QFD), Fuzzy Technique for Order of Preference by Similarities to Ideal Solution (FTOPSIS), and Preference Selection Index (PSI), this research evaluates all eight cleaning methods based on several criteria that are categorized under cost, performance, resource requirement, and safety in Abu Dhabi. The data are collected from surveys completed by experts in solar and sustainable energy. The AHP, QFD, and PSI results identified natural, manual, and surface coating as the best and most effective cleaning methods. Natural cleaning involves using rainwater primarily to remove dirt and dust; manual cleaning requires cleaning agents and wiping clothes; and surface coatings involve applying a layer of hydrophobic material to the panels to repel dust. Identifying the most effective cleaning method for dust removal from solar panels can ensure optimal efficiency recovery at minimal costs and resources.

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INTRODUCTION: Patient-specific instrumentation (PSI) systems are used to conduct total knee arthroplasty. PSI reduces operative time, is less invasive and easier to use, and minimizes the risk of errors by providing precise measurements and reducing operating room turnover time. However, a study on the accuracy of Prophecy Evolution PSI (Microport Inc., Arlington, TN, USA) reported that 94% were below the error margin of 1.5 mm and 90% had error margins of 1 mm. This study aimed to evaluate the accuracy of the Prophecy Evolution PSI system in terms of the thickness of "total" bony resection required to achieve adequate extension/flexion gaps and the component match ratio between preoperative planning and actual component size inserted. METHODS: Comparisons were made between the sizes of femoral and tibial components planned with PSI and those inserted. The primary outcome was the average preoperative range of motion with and without matched femoral/tibial components. The study further analyzed the proportions of cases in which both the femoral and tibial components matched, neither matched, and only one of the femoral or tibial components matched. RESULTS: The ratio of the same sizes between the PSI planning and those inserted was 50.8% (33 patients) for both the femoral and tibial components. For the femoral component alone, the ratio was 84.6% (55 patients), and for the tibial component, it was 58.4% (38 patients). A receiver-operating characteristic curve analysis indicated that flexion contracture greater than 20° was a significant prognostic factor for the PSI component match group versus the mismatch group. DISCUSSION: Flexion contracture may cause PSI mismatch. Notably, flexion contracture greater than 20° was a significant risk factor for the PSI component match group versus the mismatch group. During preoperative planning for a patient with flexion contracture, surgeons should prepare for the possibility of inserting an undersized tibial component.

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BACKGROUND: In traditional surgical procedures, significant discrepancies are often observed between the pre-planned templated implant sizes and the actual sizes used, particularly in patients with congenital hip dysplasia. These discrepancies arise not only in preoperative planning but also in the precision of implant placement, especially concerning the acetabular component. Our study aims to enhance the accuracy of implant placement during Total Hip Arthroplasty (THA) by integrating AI-enhanced preoperative planning with Patient-Specific Instrumentation (PSI). We also seek to assess the accuracy and clinical outcomes of the AI-PSI (AIPSI) group in comparison to a manual control group. METHODS: This study included 60 patients diagnosed with congenital hip dysplasia, randomly assigned to either the AIPSI or manual group, with 30 patients in each. No significant demographic differences between were noted the two groups. A direct anterior surgical approach was employed. Postoperative assessments included X-rays and CT scans to measure parameters such as the acetabular cup anteversion angle, acetabular cup inclination angle, femoral stem anteversion angle, femoral offset, and leg length discrepancy. Functional scores were recorded at 3 days, 1 week, 4 weeks, and 12 weeks post-surgery. Data analysis was conducted using SPSS version 22.0, with the significance level was set at α = 0.05. RESULTS AND CONCLUSION: The AIPSI group demonstrated greater prosthesis placement accuracy. With the aid of PSI, AI-planned THA surgery provides surgeons with enhanced precision in prosthesis positioning. This approach potentially offers greater insights and guidelines for managing more complex anatomical variations or cases.

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The photosynthetic acclimation of boreal evergreen conifers is controlled by regulatory and photoprotective mechanisms that allow conifers to cope with extreme environmental changes. However, the underlying dynamics of photosystem II (PSII) and photosystem I (PSI) remain unresolved. Here, we investigated the dynamics of PSII and PSI during the spring recovery of photosynthesis in Pinus sylvestris and Picea abies using a combination of chlorophyll a fluorescence, P700 difference absorbance measurements, and quantification of key thylakoid protein abundances. In particular, we derived a new set of PSI quantum yield equations, correcting for the effects of PSI photoinhibition. Using the corrected equations, we found that the seasonal dynamics of PSII and PSI photochemical yields remained largely in balance, despite substantial seasonal changes in the stoichiometry of PSII and PSI core complexes driven by PSI photoinhibition. Similarly, the previously reported seasonal up-regulation of cyclic electron flow was no longer evident, after accounting for PSI photoinhibition. Overall, our results emphasize the importance of considering the dynamics of PSII and PSI to elucidate the seasonal acclimation of photosynthesis in overwintering evergreens. Beyond the scope of conifers, our corrected PSI quantum yields expand the toolkit for future studies aimed at elucidating the dynamic regulation of PSI.

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BACKGROUND: Rational design of synthetic phage-displayed libraries requires the identification of the most appropriate positions for randomization using defined amino acid sets to recapitulate the natural occurrence. The present study uses position-specific scoring matrixes (PSSMs) for identifying and randomizing Camelidae nanobody (VHH) CDR3. The functionality of a synthetic VHH repertoire designed by this method was tested for discovering new VHH binders to recombinant coagulation factor VII (rfVII). METHODS: Based on PSSM analysis, the CDR3 of cAbBCII10 VHH framework was identified, and a set of amino acids for the substitution of each PSSM-CDR3 position was defined. Using the Rosetta design SwiftLib tool, the final repertoire was back-translated to a degenerate nucleotide sequence. A synthetic phage-displayed library was constructed based on this repertoire and screened for anti-rfVII binders. RESULTS: A synthetic phage-displayed VHH library with 1 × 108 variants was constructed. Three VHH binders to rfVII were isolated from this library with estimated dissociation constants (KD) of 1 × 10-8 M, 5.8 × 10-8 M and 2.6 × 10-7 M. CONCLUSION: PSSM analysis is a simple and efficient way to design synthetic phage-displayed libraries.

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