Coxa Magna (CM) is defined as a condition in which the horizontal (transverse) diameter of the femoral head is larger on the affected side than on the intact side. CM can occur as a manifestation of avascular necrosis (AVN) following treatment for the developmental dysplasia of the hip (DDH). Alternatively, it can also be secondary to other hip disorders, such as Perthes' disease. This study aimed to determine the prevalence and indicators of CM and AVN of the femoral head that can be detected during follow-up in patients with unilateral DDH treated with closed reduction (CR) or open reduction (OR) surgery. The files of 143 patients treated for unilateral DDH between January 1997 and December 2017 were reviewed retrospectively. A total of 104 patients, including Group 1 (n = 49) patients who underwent CR under general anesthesia and Group 2 (n = 55) patients who underwent OR were included in the study. CM; It was considered as the case where the femoral head was 15% or more larger than the intact side. A total of 104 patients were followed up for 77.27 ± 13.96 months, with a mean age of 15.43 ± 7.76 months. When Group 1 and Group 2 were compared, there was no statistical difference in terms of sex, side, adductor tenotomy, and AVN (P > 0.05). CM developed in 22.4% (n = 11) of the patients in Group 1 and in 49.1% (n = 27) in Group 2, and the difference was statistically significant (P = 0.008). When the effect of independent variables on the development of CM is evaluated with the multivariate logistic regression model, the risk of developing CM is 3474 times higher in those who underwent iliopsoas tenotomy compared with those who did not. The primary outcome of this study is that CM is more frequent in patients treated with OR for DDH. CM may be a nonpathological condition that occurs in connection with iliopsoas tenotomy or surgical treatment. Prospective studies with a larger number of cases, designed to minimize confounding factors, are required.

The sphere decoding (SD) algorithm can provide (sub)optimal solutions with reduced computational complexity of maximum likelihood (ML) detection for multi-input multi-output (MIMO) communication systems. In this paper, we propose a novel low complexity symmetric-coded based SD algorithm for short polar codes with low rate. At the encoding stage, the first N/2 sub-channels transmit the frozen bits, while the information bits are selected from the latter N/2 sub-channels. Two symmetric codes are generated due to the mathematical structure of the generator matrix, which is well conditioned to the SD search. At the decoding stage, the presented SD algorithm computes the Euclidean distance value by the combined signals to estimate the latter N/2 input bits. Furthermore, the backtrack operation starts from the earlier [Formula: see text]-th bit, which can significantly reduce the average visited nodes (AVN). Simulation results show that, compared to the original SD algorithm, the presented variant of the SD algorithm can reduce the AVN to [Formula: see text] for the polar code P(64, 14) at SNR = 1 dB with a performance loss within 0.2 dB. The presented SD algorithm may find applications in MIMO systems where the complexity of the standar ML detection increases exponentially with the transmitting antennas.

(1) Background: To evaluate the performance of a deep learning model to automatically segment femoral head necrosis (FHN) based on a standard 2D MRI sequence compared to manual segmentations for 3D quantification of FHN. (2) Methods: Twenty-six patients (thirty hips) with avascular necrosis underwent preoperative MR arthrography including a coronal 2D PD-w sequence and a 3D T1 VIBE sequence. Manual ground truth segmentations of the necrotic and unaffected bone were then performed by an expert reader to train a self-configuring nnU-Net model. Testing of the network performance was performed using a 5-fold cross-validation and Dice coefficients were calculated. In addition, performance across the three segmentations were compared using six parameters: volume of necrosis, volume of unaffected bone, percent of necrotic bone volume, surface of necrotic bone, unaffected femoral head surface, and percent of necrotic femoral head surface area. (3) Results: Comparison between the manual 3D and manual 2D segmentations as well as 2D with the automatic model yielded significant, strong correlations (Rp > 0.9) across all six parameters of necrosis. Dice coefficients between manual- and automated 2D segmentations of necrotic- and unaffected bone were 75 ± 15% and 91 ± 5%, respectively. None of the six parameters of FHN differed between the manual and automated 2D segmentations and showed strong correlations (Rp > 0.9). Necrotic volume and surface area showed significant differences (all p < 0.05) between early and advanced ARCO grading as opposed to the modified Kerboul angle, which was comparable between both groups (p > 0.05). (4) Conclusions: Our deep learning model to automatically segment femoral necrosis based on a routine hip MRI was highly accurate. Coupled with improved quantification for volume and surface area, as opposed to 2D angles, staging and course of treatment can become better tailored to patients with varying degrees of AVN.

Stress fracture in general is a well-known condition that can be found commonly in healthy athletes and military personnel. These fractures occur due to bone fatigue in response to the repetitive stress of exercise. Although few reports on stress fractures among military personnel and active young athletes can be found in previous literature, we present this case report of a young military soldier that had a completely displaced neck of femur fracture with no functional limitation for seven days prior to seeking medical advice; the patient was operated on and followed for three years after and did not develop complications associated with this kind of fracture. A reduction of neck of femur fracture and fixation in valgus position to maintain good reduction with weight-bearing as done in our case have assisted in reducing avascular necrosis (AVN) risk despite the high displacement and delayed operative intervention due to the patient's late presentation.

Avascular necrosis (AVN) and posttraumatic arthritis (PTA) are common complications following both conservative treatment and open reduction and internal fixation (ORIF) of proximal humerus fractures (PHFs). Despite the frequent utilization of ORIF, information regarding these leading causes of failure is limited. This review includes a discussion of incidence, risk factors, and evaluation of AVN and PTA following PHF. The mechanisms of treatment options and associated outcomes are also reviewed.

Atrioventricular nodal re-entrant tachycardia (AVNRT) is humans' most frequent regular tachycardia. In this review, we describe the most recent discoveries regarding the anatomical, physiological and molecular biological features of the AV junction that could underlie the typical slow-fast AVNRT mechanisms, as these insights could lead to the proposal of a new theory concerning the circuit of this arrhythmia. Despite several models have been proposed over the years, the precise anatomical site of the re-entrant circuit and the pathway involved in the slow-fast AVNRT have not been conclusively defined. One possible way to evaluate all the hypotheses regarding the nodal tachycardia circuit in humans is to map this circuit. Thus, we tried to identify the slow potential of nodal and inferior extension structures by using automated mapping of atrial activation during both sinus rhythm and typical slow-fast AVNRT. This constitutes a first step towards the definition of nodal area activation in sinus rhythm and during slow-fast AVNRT. Further studies and technical improvements in recording the potentials of the AVN structures are necessary to confirm our initial results.

Avascular necrosis (AVN) or joint osteonecrosis is a debilitating complication of sickle cell disease, increasing the disease burden on both patients and healthcare systems. AVN can be radiologically categorized into early and late stages depending on the extent of the disease. Management of AVN is challenging and controversial. Generally, it includes conservative measures for early disease to preserve the joint for as long as possible and surgical management for more advanced diseases. Hyperbaric oxygen (HBO) therapy can be used as primary or adjunctive therapy for different medical disorders. Currently, the main rule of HBO in AVN is an adjunctive therapy to control symptoms and improve the quality of life of a patient; however, the concept of using HBO as a primary treatment choice for AVN in patients with sickle cell disease is not well evaluated yet. In this case study, we reported a 15-year-old boy with sickle cell disease who was suffering from stage II AVN in bilateral femoral and right shoulder joints. A total of 57 sessions of HBO resulted in the complete resolution of AVN in post-treatment MRI.

Avascular necrosis (AVN) of multiple carpal bones is a very rare condition. This case report presents a patient with concomitant AVN of the lunate and proximal pole of the scaphoid that had led to severe joint space narrowing and degenerative arthritis in the radiocarpal and distal radioulnar joints (DRUJs). She was known to have thalassemia minor hemoglobinopathy. Wrist arthrodesis and distal ulna hemiresection-interposition arthroplasty (Bowers technique) for a DRUJ were offered and performed. The patient was satisfied with the clinical outcomes.

Avascular necrosis (AVN) involves ischemic cell death of the bone. AVN leaves an abundance of necrotic lipids and debris in the bone marrow, which instigates inflammatory bone repair. Consequently, the necrotic bone microenvironment stimulates excessive bone resorption, leading to joint deformities and osteoarthritis. Here, we performed a detergent-assisted bone wash using poloxamer 407 (P407) to clean the necrotic bone environment by removing lipids and necrotic debris. The new concept was tested using an established ex vivo AVN model of porcine cadaver humeral heads. The P407 wash was performed using P407 solution and followed with saline via two intraosseous needles. Visual inspection and image analyses of average pixel light intensity showed that the P407 wash produced a better-cleaned bone than the saline wash. Analyses of the collected bone wash solution showed a two-fold increase in triglycerides (101 vs. 53 mmol/head, p = 0.006) and a 10-fold increase in the dry weight of the removed debris (1.34 vs. 0.13 g/head, p = 0.02) with the P407 wash compared to saline. The histological evaluation showed significantly decreased Oil-Red-O (fats) staining in the P407-washed bone compared with the saline-washed bone. The in vitro assays of Alizarin red and qPCR showed the P407 wash neither altered the osteogenic behaviors of porcine bone marrow-derived mesenchymal cells (pBMMCs) nor raised inflammatory responses of porcine bone marrow-derived macrophages (pBMMs). In conclusion, detergent-assisted bone wash using P407 produced a better removal of nonsoluble debris from the bone marrow space than the saline wash without causing changes to osteogenesis or inflammatory reactions.

Agricultural crops especially fruit trees are constrained by edaphic stresses in shallow soils with low water retention and poor fertility. Therefore, interventions of shifting to trench planting for better root anchorage and replacing the filling soil were evaluated for 8 years in dragon fruit (Hylocereus undatus) cultivated in Deccan Plateau of peninsular India. When averaged for last 5-years, 44 % higher fruit yield (18.2 ± 1.0 Mg ha-1) was harvested from trees planted in trenches filled with 1:1 mixture (T-mixed) of native soil (loamy sand with 26.7 % stones (>2mm), field capacity, FC 0.20 cm3 cm-3; organic carbon, OC 0.17 %; Av-N 54.6 kg ha-1) and a black soil (clay 54.4 %; FC 0.42 cm3 cm-3; OC 0.70 %; Av-N 157.1 kg ha-1) than the recommended pit planting (12.4 ± 1.2 Mg ha-1). Improvements in fruit yields with trenches filled with black (T-black) and native (T-native) soil were 32 and 13 %, respectively. Yield losses (total- marketable yield) were reduced by 40, 20 and 18 % over pit method with T-mixed, T-black and T-native soil, respectively. Marketable quality attributes like fruit weight, fruit size metrics and pulp/peel content were further improved under T-mixed soil. Accumulation of total soluble solids (TSS), sugar content, phenolic and flavonoid compounds were higher in fruits from T-native soil. During storage, fruits from T-native soil and pit planting exhibited minimum physiological weight loss and retained more firmness, TSS, sugars, titratable acidity, phenolic-flavonoids contents, FARP and DPPH activities. T-mixed soil provided better hydrozone and nutrients for resilience of fruit plants while protecting from aeration problems envisaged in poorly drained black soils. With B:C ratio (1.85) and lower payback period (4-years), T-mixed soil showed superior economic viability. Therefore, soil management module of planting in trenches filled-in with mixture of native and black soils can be recommended to boost productivity of fruits from shallow soils under water scarce degraded regions without penalising agro-ecosystem.

Avascular necrosis (AVN) of the humeral head is an uncommon clinical entity which can result in significant morbidity for patients. Compared to femoral head AVN, the volume of literature concerning humeral head AVN is a distant second. This could be due to the relatively rarity of the condition and poorly understood nature. Despite being first described decades ago, the underlying pathophysiology leading to humeral head AVN is still poorly defined. Numerous causes have been identified, which only adds to the complexity of the condition. While the staging of humeral head AVN is well described, not much is known about prognosticating factors to predict the eventual course of the disease. Most of the management options so far are based on that of femoral head AVN, and even so, there is a paucity of good quality clinical trials in the literature. This current concept paper describes what is known about humeral head AVN from the literature thus far, and attempts to propose a possible management algorithm to guide clinicians.

Avascular osteonecrosis (AVN) is caused by the disrupted blood supply to the bone. Most AVN cases occur in the femoral head, but other sites might be affected as well, including the jaw or distal bones of the extremities. Previous studies suggested that diabetes could increase the risk of AVN of the jaw, but the relationship between diabetes and AVN in other bone sites is unclear. This systematic review and meta-analysis aimed to summarize the evidence from studies that had reported on the occurrence of AVN in sites other than the jaw, depending on the diagnosis of diabetes. Overall, we included 6 observational studies carried out in different populations: primary or secondary AVN of the femoral head, Takayasu arteritis, general population, kidney transplant recipients, systemic lupus erythematosus, and primary brain tumors. A random-effects meta-analysis showed that the risk of AVN in sites other than the jaw was non-significantly increased in patients with diabetes (odds ratio: 1.90, 95% confidence interval: 0.93-3.91). The pooled estimate increased and was significant after the exclusion of one study (2.46, 1.14-5.32). There was a significant heterogeneity (I2 = 65%, tau2 = 0.48, p = 0.01; prediction interval, 0.21-16.84). There was no significant publication bias (p = 0.432). In conclusion, diabetes could increase the risk of AVN in sites other than the jaw, but the available evidence is limited. There is a need for large, well-designed, population-based studies.