Assessing focal spot alignment in clinical linear accelerators: a comprehensive evaluation with triplet phantoms.

A fundamental parameter to evaluate the beam delivery precision and stability on a clinical linear accelerator (linac) is the focal spot position (FSP) measured relative to the collimator axis of the radiation head. The aims of this work were to evaluate comprehensive data on FSP acquired on linacs in clinical use and to establish the ability of alternative phantoms to detect effects on patient plan delivery related to FSP. FSP measurements were conducted using a rigid phantom holding two ball-bearings at two different distances from the radiation source. Images of these ball-bearings were acquired using the electronic portal imaging device (EPID) integrated with each linac. Machine QA was assessed using a radiation head-mounted PTW STARCHECK phantom. Patient plan QA was investigated using the SNC ArcCHECK phantom positioned on the treatment couch, irradiated with VMAT plans across a complete 360° gantry rotation and three X-ray energies. This study covered eight Elekta linacs, including those with 6 MV, 18 MV, and 6 MV flattening-filter-free (FFF) beams. The largest range in the FSP was found for 6 MV FFF. The FSP of one linac, retrofitted with 6 MV FFF, displayed substantial differences in FSP compared to 6 MV FFF beams on other linacs, which all had FSP ranges less than 0.50 mm and 0.25 mm in the lateral and longitudinal directions, respectively. The PTW STARCHECK phantom proved effective in characterising the FSP, while the SNC ArcCHECK measurements could not discern FSP-related features. Minor variations in FSP may be attributed to adjustments in linac parameters, component replacements necessary for beam delivery, and the wear and tear of various linac components, including the magnetron and gun filament. Consideration should be given to the ability of any particular phantom to detect a subsequent impact on the accuracy of patient plan delivery.

Rotational Spectroscopy of the Acetone-Water Complex: Large Amplitude Motions.

Acetone (CH3COCH3), the simplest ketone, has recently attracted considerable attention for its important role in atmospheric chemistry and in the formation of ices in extraterrestrial sources that contain complex organic molecules. In this study, we employed a combination of experimental rotational spectroscopy and quantum chemistry calculations to investigate the structure and dynamics of the acetone-water complex. Our aim was to understand how non-covalent interactions with water affect the methyl internal rotation dynamics of acetone, and how water-centered large amplitude motions alter the observed physical properties compared to those predicted at the equilibrium position. Detailed rotation-tunneling analyses of acetone-H2O and -D2O reveal that the interactions with water disrupt the equivalence of the two methyl rotors, resulting in a noticeably lower methyl rotor barrier for the top with the close-by water compared to that of free acetone. The barrier for the methyl group further from water is also lower, although to a lesser degree. To gain further insights, extensive theoretical modelling was conducted, focusing on the associated large amplitude motions. Furthermore, quantum theory of atoms in molecules and non-covalent interactions analyses were utilized to visualize the underlying causes of the observed trends.

Electric-Field Manipulation of Magnetic Chirality in a Homo-Ferro-Rotational Helimagnet.

Ferro-rotational (FR) materials, renowned for their distinctive material functionalities, present challenges in the growth of homo-FR crystals (i.e., single FR domain). This study explores a cost-effective approach to growing homo-FR helimagnetic RbFe(SO4)2 (RFSO) crystals by lowering the crystal growth temperature below the TFR threshold using the high-pressure hydrothermal method. Through polarized neutron diffraction experiments, it is observed that nearly 86% of RFSO crystals consist of a homo-FR domain. Notably, RFSO displays remarkable stability in the FR phase, with an exceptionally high TFR of ≈573 K. Furthermore, RFSO exhibits a chiral helical magnetic structure with switchable ferroelectric polarization below 4 K. Importantly, external electric fields can induce a single magnetic domain state and manipulate its magnetic chirality. The findings suggest that the search for new FR magnets with outstanding material properties should consider magnetic sulfates as promising candidates.

Filopodia: integrating cellular functions with theoretical models.

Filopodia, widely distributed on cell surfaces, are distinguished by their dynamic extensions, playing pivotal roles in a myriad of biological processes. Their functions span from mechanosensing and guidance to cell-cell communication during cellular organization in the early embryo. Filopodia have significant roles in pathogenic processes, such as cancer invasion and viral dissemination. Molecular mapping of the filopodome has revealed generic components essential for filopodia functions. In parallel, recent insights into biophysical mechanisms governing filopodia dynamics have provided the foundation for broader investigations of filopodia's biological functions. We highlight recent discoveries of engagement of filopodia in various stages of development and pathogenesis and present an overview of intricate molecular and physical features of these cellular structures across a spectrum of cellular activities.

Rigorous Mathematical Derivation of Inclination Angle for Single Cut Rotational Osteotomy for Tibia Deformity Correction.

Background: To rigorously derive easy to use formulae for the inclination angle for single cut rotation osteotomy that can be used for tibia deformity correction. Method: Three theorems were proven using trigonometric identities and concepts of linear algebra. These were rigorously shown. The three concepts were how to convert deformities in an AP/Lateral plane to an oblique plane deformity with a true angular magnitude of deformity; how to project an angular quantity from one plane to another; and the calculation of the inclination angle for the oblique osteotomy plane. All figures in this article were created by the authors of this paper. Results: From the formula derived, a statistical t-test was performed that showed no significant difference between the formula derived in this paper and the original Sangeorzan paper charts (p=0.8782). Conclusions: The formulae described in this article are a method to accurately calculate the inclination angle of the osteotomy for a single cut rotational osteotomy for tibial deformity correction. Clinical Relevance: The article gives a deeper understanding of fundamental concepts behind deformity correction and provides an easy-to-use mathematical formula to calculate the osteotomy inclination for single cut rotational osteotomies.

Creating a master training rotation schedule for emergency medicine residents and challenges in using artificial intelligence.

BACKGROUND: The allocation of resident physicians to clinical rotations presents a complex challenge that requires balancing multiple objectives with the goals of providing optimal patient care, maintaining adequate departmental staffing, and maximizing residents' training experience. While adhering to governing guidelines and training regulations, these physicians must comply with curricular milestones and educational goals for progression that must be achieved within specific time constraints. This manuscript reports on how to create annual master rotation schedules to meet the training requirements for 60 residents, while addressing the requirements detailed above. METHODS: Trainees in the field of Emergency Medicine have to meet variable essential annual curricula requirements. Methods of preparing rotations in different Emergency Departments are presented which usually need early planning to ensure the best coordination and number allocation among the different internal and external collaborative departments. This off-institution and off-service external rotation is an educational necessity regulated by the Saudi Commission of Health Sciences to maximize residents' exposure and meet the expected educational milestones unique to Emergency Medicine training. RESULTS: We report how to create annual master rotation schedules to meet the training requirements for 60 Emergency Medicine residents, while maintaining steady adequate departmental staffing and accommodating the different external rotation capacities, a task that is usually handled by the chief residents and program director. Although some parts of this process can be performed by using scheduling software or with particular decision support management systems, many steps are still filtered and checked manually. External circumstances mandate changes in schedules that require last-minute changes which may overrule training restrictions and make them unfeasible. CONCLUSION: To create such an agile schedule, we maintain a standardized template with preset blocks and rotations. Residents can choose the most suitable track that meets their preference for year-long rotation blocks. Thus, we minimize the individual variability in the preset allocations, guarantee an even distribution, give equal chances to each resident to accommodate and approximate their individual preferences, and decrease the overall workload and time consumed annually.

Arthroscopic Management of Anterior Shoulder Instability: A Study of Functional Outcome and Analysis.

Background The remarkable range of motion of the shoulder comes at the cost of increased instability, especially anterior instability. Arthroscopic Bankart repair with or without remplissage, which is a minimally invasive surgery, is the preferred treatment for recurrent anterior instability. This study investigated the effectiveness of Bankart repair, with or without remplissage, in restoring function, preventing redislocation, and improving patient satisfaction. Methods A prospective observational study examined 40 patients (19-50 years old) with recurrent anterior instability and MRI-confirmed Bankart or Bankart with Hill-Sachs lesions. Patients underwent arthroscopic Bankart repair with or without remplissage based on the inclusion criteria of this study. Preoperative assessments included demographics, history, physical examination, American Shoulder and Elbow Surgeons (ASES) score, Quick Disabilities of the Arm, Shoulder, and Hand (DASH) score, ROWE score, and plain MRI of the shoulder joint. Post-operative radiographs and rehabilitation were advised. Functional recovery was evaluated at three months and six months after surgery. Results All patients underwent Bankart repair. Among them, 22 with engaging Hill-Sachs lesions received an additional remplissage procedure. Both groups showed significant improvements in their functional scores (p<0.05) and returned to their prior activities. However, the additional remplissage group had a slightly reduced mean external rotation (86.59°) compared with the Bankart repair-only group (90°). Notably, the recurrence rate was very low, with only one patient (2.5%) experiencing instability. Conclusion  Our study emphasizes the importance of proper capsulolabral tissue elevation to achieve a sufficient labral bump during Bankart repair. This technique allowed us to efficiently use only two suture anchors in 35 cases (87.5%). Additionally, remplissage was performed on all identified engaging Hill-Sachs lesions. We found that proper anchor placement and suturing techniques were crucial for successful Bankart repair. The emphasis on the potential cost benefits of a two-anchor approach is a valuable contribution to the field.

Surgical maneuvers for long-segment Hirschsprung pull-through in unique patients.

PURPOSE: Patients with Hirschsprung disease affecting the splenic flexure or more proximal segments present a surgical challenge. Mobilizing the transverse colon to the pelvis during a pull-through may obstruct the distal ileum, or the length may be insufficient to reach the lower pelvis. This retrospective study aimed to describe two surgical techniques that facilitate mobilization of the transverse colon and their outcome. METHODS: We included patients operated on between April 2017 and April 2024 and analyzed sex, comorbidities, type of pull- through, age at pull-through, history of previous surgeries, cause of the proximal transverse colon pull-through, technique used (Deloyers or Turnbull), complications , postoperative outcome and follow-up. The first technique used was the maneuver described by Turnbull. This operation creates a mesenteric defect and mobilizes the colon into this mesenteric window at the distal ileum level. The second technique was described by Deloyers and involves a 180-degree rotation of the right colon by dissecting the right colon attachment and the hepatocolic ligament. The cecum and the ileocecal valve are placed in the right upper quadrant, and the distal colon is mobilized into the pelvis. RESULTS: We included 13 patients, 12 boys and 1 girl. Eight patients had previous surgeries in another hospital: five had an initial transverse colostomy, and three had an ileostomy. The remaining five had the initial operation in our hospital: two had an ileostomy, two had a colostomy, and one had a primary pull-through. The median age at pull-through was 16 months (4-59 months). We used the Turnbull technique in four patients whose aganglionosis was limited to the middle transverse colon. The Deloyers technique was used in the remaining patients, with ganglion cells in the proximal transverse colon. We left a protective ileostomy in five patients. The median follow-up was 4.5 years (3 months to 10 years). The stoma takedown is pending in one patient. CONCLUSION: The Turnbull and Deloyers techniques were helpful in patients with aganglionosis affecting the transverse colon.

Optical Studies of Doped Two-Dimensional Lead Halide Perovskites: Evidence for Rashba-Split Branches in the Conduction Band.

Two-dimensional (2D) hybrid organic/inorganic perovskites are an emerging materials class for optoelectronic and spintronic applications due to strong excitonic absorption and emission, large spin-orbit coupling, and Rashba spin-splitting effects. For many of the envisioned applications, tuning the majority charge carrier (electron or hole) concentration is desirable, but electronic doping of metal-halide perovskites has proven to be challenging. Here, we demonstrate electron injection into the lower-energy branch of the Rashba-split conduction band of 2D phenethylammonium lead iodide by means of n-type molecular doping at room temperature. The molecular dopant, benzyl viologen (BV), is shown to compensate adventitious p-type impurities and can lead to a tunable Fermi level above the conduction band minimum and increased conductivity in intrinsic samples. The doping-induced carrier concentration is monitored by the observation of free-carrier absorption and intraband optical transitions in the infrared spectral range. These optical measurements allow for an estimation of the Rashba splitting energy ER ≈38 ± 4 meV. Photoinduced quantum beating measurements demonstrate that the excess electron density reduces the electron spin g-factor by ca. 6%. This work demonstrates controllable carrier concentrations in hybrid organic/inorganic perovskites and yields potential for room temperature spin control through the Rashba effect.

Photovoltaic Rotation and Transportation of a Fragile Fluorescent Microrod Toward Assembling a Tunable Light-Source System.

Continuous rotation of a fragile, photosensitive microrod in a safe, flexible way remains challenging in spite of its importance to microelectro-mechanical systems. We propose a photovoltaic strategy to continuously rotate a fragile, fluorescent microrod on a LiNbO3/Fe (LN/Fe) substrate using a continuous wave visible (473 nm) laser beam with an ultralow power (few tens of µW) and a simple structure (Gaussian profile). This strategy does not require the laser spot to cover the entire microrod nor does it result in a sharp temperature rise on the microrod. Both experiments and simulation reveal that the strongest photovoltaic field generated beside the laser spot firmly traps one corner of the microrod and the axisymmetric photovoltaic field exerts an electrostatic torque on the microrod driving it to rotate continuously around the laser spot. The dependence of the rotation rate on the laser power indicates contributions from both deep and shallow photovoltaic centers. This rotation mode, combined with the transportation mode, enables the controllable movement of an individual microrod along any complex trajectory with any specific orientation. The tuning of the end-emitting spectrum and the photothermal cutting of the fluorescent microrod are also realized by properly configuring the laser illumination. By taking a microrod as the emitter and a polystyrene microsphere as the focusing lens, we demonstrate the photovoltaic assembly of a microscale light-source system with both spectrum and divergence-angle tunabilities, which are realized by adjusting the photoexcitation position along the microrod and the geometry relationship in the system, respectively.

Bacterial and fungal communities regulated directly and indirectly by tobacco-rape rotation promote tobacco production.

Tobacco continuous cropping is prevalent in intensive tobacco agriculture but often leads to microbial community imbalance, soil nutrient deficiency, and decreased crop productivity. While the tobacco-rape rotation has demonstrated significant benefits in increasing tobacco yield. Microorganisms play a crucial role in soil nutrient cycling and crop productivity. However, the internal mechanism of tobacco-rape rotation affecting tobacco yield through microbe-soil interaction is still unclear. In this study, two treatments, tobacco continuous cropping (TC) and tobacco-rape rotation (TR) were used to investigate how planting systems affect soil microbial diversity and community structure, and whether these changes subsequently affect crop yields. The results showed that compared with TC, TR significantly increased the Shannon index, Chao1 index, ACE index of bacteria and fungi, indicating increased microbial α-diversity. On the one hand, TR may directly affect the bacterial and fungal community structure due to the specificity of root morphology and root exudates in rape. Compared with TC, TR significantly increased the proportion of beneficial bacterial and fungal taxa while significantly reduced soil-borne pathogens. Additionally, TR enhanced the scale and complexity of microbial co-occurrence networks, promoting potential synergies between bacterial OTUs. On the other hand, TR indirectly changed microbial community composition by improving soil chemical properties and changing microbial life history strategies. Compared with TC, TR significantly increased the relative abundance of copiotrophs while reduced oligotrophs. Notably, TR significantly increased tobacco yield by 39.6% compared with TC. The relationships among yield, microbial community and soil chemical properties indicated that planting systems had the greatest total effect on tobacco yield, and the microbial community, particularly bacteria, had the greatest direct effect on tobacco yield. Our findings highlighted the potential of tobacco-rape rotation to increase yield by both directly and indirectly optimizing microbial community structure.

Assessment of average femoral component rotation for balancing functionally aligned total knee replacement in varus deformity: Robotic image guidance study.

Introduction and purpose: Ensuring proper femoral component alignment post-Total Knee Arthroplasty (TKA) is crucial for normal patellofemoral (PF) kinematics. However, the customary 3° external rotation relative to the Posterior Condylar Axis (PC Axis) may not universally apply, and the expected final femoral component rotation remains unclear in functionally aligned knees. This study examines the relation between the Transepicondylar Axis (TEA) and PC axis, known as Posterior Condylar Angle (PCA) in Indian patients along with factors influencing PCA, and the feasibility of reproducing patient-specific PCA using image-guided Cuvis joint robot. Methods: Forty patients (52 Knees) with primary osteoarthritis and varus deformity were prospectively evaluated. Native PCA was determined using CT-based J planner. Pre-operative patellar shape, PF tilt, PF shift, final femoral component rotation (representing post-operative PCA), final patellar tracking, and post-operative functional and radiological assessment at 3 months were recorded. Results: Study participants averaged 64.3 years of age, with a female-to-male ratio of 23 to 17. Varus deformities varied, with IA2 being most prevalent, and sagittal plane deformities included fixed flexion (34.6 %) and hyperextension (44.2 %). The average PCA was 1.9° (range: 0°-7.3°), with most knees (41 out of 52) below 3°. The majority had Wiberg type 1 patellae, with pre-operative patellar tilt averaging 5.63°, reducing post-operatively to 4.43°. Most patients (37 out of 40) achieved excellent Knee Society functional scores at the 3-month mark. Complications included one case of delayed wound healing and one femoral array pin breakage. Notably, our study revealed a significant deviation in PCA from the commonly reported 3° in Western literature, underscoring the need for region-specific considerations in TKA planning. Conclusion: PCA of our population is statistically different from customary 3° followed with jig system. Image guided Robotics helps to identify patients specific PCA and reproducing the same was more commonly possible in patients with reducible Varus deformity.

Distinct planting patterns exert legacy effects on the networks and assembly of root-associated microbiomes in subsequent crops.

Soil legacy effects from previous crops can significantly influence plant-soil interactions in crop rotations. However, the microbial mechanism underlying this effect in subsequent root-associated compartments remains unclear. We investigated the effects of planting patterns (four-year continuous maize [MM], three-year winter wheat and one-year maize rotation [WM], and three-year potato and one-year maize rotation [PM]) on the microbial composition and structure of root-associated compartments, the effect of distinct crops on subsequent microbial co-occurrence patterns, and the assembly mechanism by which the root-associated compartments (bulk soil, rhizosphere, and roots) in subsequent crops regulate the microbiome habitat. Compared with MM, the relative abundance of Acidobacteria in WM was 29.7 % lower, whereas that of Bacteroidota in PM was 37.9 % higher in all three compartments. The co-occurrence patterns of the microbial communities exhibited varied responses to different planting patterns. Indicator taxon analysis revealed less shared and specific species in the root bacterial and fungal networks. The planting pattern elicited specific responses from modules within bacterial and fungal co-occurrence networks in all three compartments. Moreover, the planting patterns and root-associated compartments collectively drove the assembly process of root-associated microorganisms. The neutral model showed that, compared with MM, the stochasticity of bacterial assembly decreased under WM and PM but increased for fungal assembly. WM and PM increased the relative effects of the homogenized dispersal of fungal assemblies in roots. We conclude that previous crops exhibit marked legacy effects in the root-associated microbiome. Therefore, soil heritage should not be ignored when discussing microbiome recruitment strategies and co-occurrence patterns in subsequent crops.

Exploring the dynamics of prefrontal cortex in the interaction between orienteering experience and cognitive performance by fNIRS.

Sporting experience plays a pivotal role in shaping exercise habits, with a mutually reinforcing relationship that enhances cognitive performance. The acknowledged plasticity of cognition driven by sports necessitates a comprehensive examination. Hence, this study delves into the dynamic intricacies of the prefrontal cortex, exploring the impact of orienteering experience on cognitive performance. Our findings contribute empirical evidence regarding the functional activation of specific brain regions bridging the nexus between experiential factors and cognitive capabilities. In this cross-sectional study, a cohort of forty-nine athletes was enrolled to meticulously examine behavioral variances and prefrontal cortex dynamics among orienteering athletes of varying experience levels across diverse non-specialized scenarios. These investigations involved the utilization of functional near-infrared spectroscopy (fNIRS) to detect alterations in oxygenated hemoglobin (HbO2). The high-experience expert group exhibited neurological efficiency, demonstrating significantly diminished brain activation in the dorsolateral prefrontal, left ventral lateral prefrontal, and right orbitofrontal regions compared to the low-experience group. Within the low-experience novice group, superior performance in the spatial memory task was observed compared to the mental rotation task, with consistently lower reaction times across all conditions compared to the high-experience group. Notably, cerebral blood oxygenation activation exhibited a significant reduction in the high-experience expert group compared to the low-experience novice group, irrespective of task type. The dorsolateral prefrontal lobe exhibited activation upon task onset, irrespective of experience level. Correct rates in the spatial memory task were consistently higher than those in the mental rotation task, while brain region activation was significantly greater during the mental rotation task than the spatial memory task." This study elucidates disparities in prefrontal cortex dynamics between highly seasoned experts and neophyte novices, showcasing a cognitive edge within the highly experienced cohort and a spatial memory advantage in the inexperienced group. Our findings contribute to the comprehension of the neural mechanisms that underlie the observed cognitive advantage and provide insights into the forebrain resources mobilized by orienteering experience during spatial cognitive tasks."

Rotation Culture of Macroalgae Based on Photosynthetic Physiological Characteristics of Algae.

Seaweed farming has made outstanding contributions to food supply and the restoration of the ecological environment despite the limitations in production and ecological effects due to the current intensive farming of single algae species. These limitations can be overcome by selecting suitable algal species based on their physiological characteristics and by constructing a large-scale seaweed rotation model. This study carried out a trial culture in aquaculture sea areas, and performed in situ monitoring of the environmental conditions and physiological characteristics of Saccharina japonica, Hizikia fusiformis, and Gracilariopsis lemaneiformis. Additionally, a comparative analysis of the three macroalgae at different times was conducted to determine their response characteristics to environmental factors. The results showed that: (1) The three macroalgae had varying light tolerance. The effective quantum yield of Hizikia fusiformis and Gracilariopsis lemaneiformis remained unchanged during the changes in light environment, while that of Saccharina japonica first decreased and then recovered. (2) The relative electron transport rates of the three macroalgae were significantly different under different temperature conditions. Hizikia fusiformis and Saccharina japonica exhibited the highest relative electron transport rates (70.45 and 106.75, respectively) in May (20.3 °C). Notably, Gracilariopsis lemaneiformis demonstrated good growth and exhibited the highest relative electron transport rate (93.07) in September (27.5 °C). These findings collectively support the feasibility of establishing a macroalgae rotation model. Based on the combined environmental conditions of the seas in Shandong, Zhejiang, and Fujian, a macroalgae rotation model was proposed. The application of this model in the construction of artificial seaweed farms in marine ranches can provide a stable output of large-scale seaweed production and ecological benefits.

[Comparison of effectiveness of long and short proximal femoral nail anti-rotation in treatment of type A2.3 intertrochanteric fracture of femur].

Objective: To compare the effectiveness of long and short proximal femoral nail anti-rotation (PFNA) in the treatment of type A2.3 intertrochanteric fracture of femur (IFF). Methods: The clinical data of 54 patients with type A2.3 IFF admitted between January 2020 and December 2022 were retrospectively analyzed. According to the length of PFNA nail used in the operation, they were divided into long nail group (PFNA nail length>240 mm, 24 cases) and short nail group (PFNA nail length≤240 mm, 30 cases). There was no significant difference in baseline data such as gender, age, fracture side, body mass index, and time from fracture to operation between the two groups ( P>0.05). The operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, intraoperative reduction quality score, fracture healing, and complications of the two groups were recorded and compared. Harris score was used to evaluate the hip function of patients at 1 year after operation. According to the relationship between the fracture line of type A2.3 IFF and the lesser trochanter, the two groups of patients were divided into type Ⅰ(the fracture line extends to the level of the lesser trochanter), type Ⅱ(the fracture line extends to less than 2 cm below the lesser trochanter), and type Ⅲ (the fracture line extends to more than 2 cm below the lesser trochanter), and the postoperative stability and internal fixator loosening of each subtype were evaluated. Results: The operation time, intraoperative blood loss, and intraoperative fluoroscopy frequency in short nail group were significantly less than those in long nail group ( P<0.05). There was no significant difference in the intraoperative reduction quality score between the two groups ( P>0.05). Patients in both groups were followed up 12-18 months, with an average of 13.5 months. The postoperative stability score of short nail group was significantly lower than that of long nail group ( P<0.05). The Harris score in the long nail group was significantly higher than that in the short nail group at 1 year after operation ( P<0.05), but there was no significant difference in Harris score grading between the two groups ( P>0.05). Complications occurred in 3 cases of the long nail group (including 1 case of coxa varus caused by external nail entry point and 2 cases of loose internal fixator), and 7 cases of the short nail group (including 1 case of coxa varus caused by external nail entry point and 6 cases of loose internal fixator). Neither group had any anterior femoral arch damage, there was no significant difference in the incidence of complications between the two groups ( P>0.05). The number of type Ⅲ patients was relatively small and not included in the statistics; there was no significant difference in the postoperative stability score and the incidence of internal fixator loosening between the long and short nail groups in type Ⅰ patients ( P>0.05). In type Ⅱ patients, the postoperative stability score and the incidence of internal fixation loosening in the long nail group were significantly better than those in the short nail group ( P<0.05). Conclusion: Long PFNA fixation for type A2.3 IFF has longer operation time and more intraoperative blood loss, but the overall stability of fracture is better after operation. For type A2.3 IFF with fracture line extending to less than 2 cm below the lesser trochanter, long PFNA is used for fixation, although the surgical trauma is large, but the postoperative stability is better than that of short PFNA; for type A2.3 IFF with fracture line extending to the lesser trochanter, there is no significant difference in postoperative stability between long and short PFNAs.

Study of internal heat source, rotation, magnetic field, and initial stress influence on p-waves propagation in a photothermal semiconducting medium.

The purpose of the current study is to establish a novel mathematical model in the p-waves in a photothermal semiconducting medium with an internal heat source. The fundamental equations in the context of isotropic and homogeneous medium have been presented. For the solution of the required problem, the normal mode analysis along with the displacement components, stress components and temperature has been utilized. For graphical representation of different physical quantities such as displacement components, stress components and carrier density as well as the temperature distribution. Using MATLAB R2023a software, a parametric analysis is performed, and the resulting data is represented graphically. A comparison is made to show the effect of the new parameters on the phenomenon. A graphic representation of the relationship between rotation, magnetic field, and initial stress in relation to the fluctuations in non-dimensional field quantities is provided, along with an analysis of the findings.

New Quantum Private Comparison Using Four-Particle Cluster State.

Quantum private comparison (QPC) enables two users to securely conduct private comparisons in a network characterized by mutual distrust while guaranteeing the confidentiality of their private inputs. Most previous QPC protocols were primarily used to determine the equality of private information between two users, which constrained their scalability. In this paper, we propose a QPC protocol that leverages the entanglement correlation between particles in a four-particle cluster state. This protocol can compare the information of two groups of users within one protocol execution, with each group consisting of two users. A semi-honest third party (TP), who will not deviate from the protocol execution or conspire with any participant, is involved in assisting users to achieve private comparisons. Users encode their inputs into specific angles of rotational operations performed on the received quantum sequence, which is then sent back to TP. Security analysis shows that both external attacks and insider threats are ineffective at stealing private data. Finally, we compare our protocol with some previously proposed QPC protocols.

Functional outcomes and center of rotation restoration in total hip arthroplasty after acetabular fracture: A review of 367 hips.

BACKGROUND: Total hip arthroplasty (THA) after acetabular fracture is typically performed months or years later for posttraumatic arthritis after initial conservative treatment. But THA can be performed earlier after open reduction and internal fixation (ORIF) of the fracture. The aim of this study was to determine which strategy is best. The primary outcome measure was the radiological restoration of the hip's center of rotation (COR). The secondary outcome measures were the incidence of complications and the hip's functional scores. MATERIALS AND METHODS: A multicenter cohort was analyzed by splitting patients into three groups: group A (THA within 3weeks of fracture); group B (THA deferred after early ORIF); group C (THA more than 3weeks after fracture, without ORIF). Group B was separated into two subgroups: B- (THA less than 1year after ORIF) and B+ (THA more than 1year after ORIF). The demographics, surgical techniques, COR superior and lateral migration coefficient and functional scores (HHS, HOOS-PS and FJS) were recorded. The functional scores were gathered using PROMs. RESULTS: In all, 367 patients were included: 108 in group A, 69 in group B-, 113 in group B+ and 77 in group C. The mean follow-up was 5.8years [3.4 months-35years]. The mean age of the patients was 69.2years [SD 15; 26-101], 52years [SD 16; 19-83], 49years [SD 16; 16-85] and 58.1years [SD 17; 13-94], respectively (p<0.01). The mean ASA score was 2.13 [SD 0.70], 1.84 [SD 0.65], 1.67 [SD 0.63] and 1.79 [SD 0.60], respectively (p<0.01). A complex Letournel fracture was present in 63 patients (61%), 46 patients (71%), 48 patients (49%) and 38 patients (62%), respectively (p<0.01). A reinforcement cage was implanted in 38 patients (69%), 16 patients (62%), 5 patients (12%) and 19 patients (66%), respectively (p<0.01). Cement was used in 45 patients (45%), 23 patients (35%), 19 patients (18%) and 21 patients (32%), respectively (p<0.01). A graft was needed in 46 patients (46%), 35 patients (53%), 17 patients (16%) and 21 patients (48%), respectively (p<0.01). Posterior ORIF was done in 40 patients (46%), 32 patients (55%), 64 patients (61%) and 9 patients (82%), respectively (p<0.01). The COR lateral migration coefficient was significantly higher in group C with a mean of +0.17 (SD 0.85) [-0.27 to +6] compared to the other groups (p=0.02). The COR superior migration coefficient was comparable between groups, with a mean of +0.77 (SD 2.26) [-0.99 to 27], p>0.05. There were complications in 10 patients (9.2%), 6 patients (8.7%), 6 patients (5.3%) and 3 patients (3.9%), respectively, with no significant difference between groups. The PROMs were completed by 51% of patients. At the final review, the mean HHS was 79.2 (SD 21.8) and the mean HOOS-PS was 77.7 (SD 20.1) in the entire cohort, p>0.05. The mean FJS by group was 55.9 (30.2), 47.7 (SD 36.4), 66.1 (SD 30.4) and 65.8 (SD 30.3), respectively (p=0.02). DISCUSSION AND CONCLUSION: The B strategy (B+) yielded good outcomes in terms of function and COR restoration. When using this strategy, anterior ORIF preserves the native hip for a subsequent THA through a posterior approach. Strategy C also produces good functional outcomes but shifts the COR laterally. This study confirms the poor results of strategy A in previous publications. When the prognosis is poor, immediate mobilization after anterior ORIF followed by THA within 1year appears to be a good strategy (group B-). LEVEL OF EVIDENCE: IV, observational study.

Precise Calibration of Femoral Component Rotation Using the Posterior Condylar Axis as a Reference during Image-free Robot-assisted Total Knee Arthroplasty: A Technical Note.

Introduction: The use of image-free robotic systems for total knee arthroplasty (TKA) is gaining popularity. Although the surgical transepicondylar axis (sTEA) is considered the optimal femoral rotational reference during TKA, it is difficult to define intra-operatively. Conventional and image-free robot-assisted TKA (RA-TKA) therefore rely on the use of Whiteside's axis (WSA) or the posterior condylar axis (PCA) as surrogate references. The PCA is considered to be associated with less variability than the WSA. The authors present a simple technique to permit calibration of femoral component rotation (FCR) using the PCA as a reference for image-free robotic systems that do not permit this option. Technique: The image-free robotic systems used by the authors (Navio and CORI, Smith and Nephew, Memphis, TN, USA) permit calibration of FCR only when the perpendicular to WSA is used as a reference. When the PCA is selected as a reference, a fixed 3° of external rotation is set by the robot. The technique proposed by the authors involves the use of the former setting, followed by internal rotation of the perpendicular to the WSA to co-align it with the PCA. The planning menu subsequently permits virtual surgical planning using the PCA as the femoral rotational reference and permits adjustments in rotational positioning of the femoral component while displaying the effect of rotation on bony resection and vice versa in real time. In addition, coaligning the perpendicular to the anatomic trans-epicondylar axis (aTEA) displays the internal rotation of the PCA with respect to the aTEA. This information can be used for setting rotational boundaries with respect to the PCA while using various alternate alignment strategies, like functional alignment, since the relation between the aTEA and sTEA is less likely to be affected by dyplasia and wear when compared with the PCA or WSA. Conclusion: This simple technique permits optimally calibrated rotational positioning of the femoral component during image-free RA-TKA, using the PCA as a reference. It can be applied for optimizing surgery in knees with altered or outlier anatomy, as well as routinely, especially when alternate alignment strategies are used.