Search Results (16)

Compared with capillary electrophoresis (CE), gel electrophoresis (GE) is a traditional method for the analysis of nucleic acids because of its low cost, although the operation process is complicated. The electropherogram from CE can offer more information (e.g., DNA size and its concentration) for researchers. Based on the self-built integrated biochip GE system, we proposed a computational method that converts conventional agarose GE images into CE-like fluorescence profiles for enhanced DNA analysis. The gel images were processed using an image-based algorithm involving median filtering to remove background noise and pixel-wise intensity summation along the migration axis to generate one-dimensional records of electrophoretic separations. Each DNA band in the gel was thereby transformed into a distinct fluorescence peak, reflecting its migration distance and relative intensity. To further enhance resolution and peak separation, Gaussian modeling was applied to fit the fluorescence intensity distribution, providing smoother and more distinguishable spectral peaks. To validate the method, three periodontal pathogens—Porphyromonas gingivalis (P.g), Treponema denticola (T.d), and Tannerella forsythia (T.f)—were amplified using PCR and analyzed by gel electrophoresis. The method successfully identified distinct electrophoretic patterns for the three pathogens by using a 50 bp DNA ladder as an internal calibration reference. The results demonstrate that image-based reconstruction of electrophoretic data provides a reliable, quantitative, and visually interpretable representation of DNA migration, comparable to CE output. This approach bridges a gap between traditional GE and modern capillary systems, allowing for the semi-quantitative analysis of DNA fragments without specialized CE instrument. The proposed method offers a valuable analysis method for the separation of DNA, RNA, protein and polypeptides. Full article

Introduction: Biodegradable Temporizing Matrix (BTM) is a new synthetic dermal substitute suitable for wound closure and tissue regeneration. The data in paediatric population remain limited. The study purpose is to review the indications for BTM application in paediatric patients, evaluate the short-term and long-term results, including complications and functional outcomes, as well as to share some unique observations regarding the use of BTM in paediatric population. Patients and Methods: Patients undergoing reconstructive surgery and BTM application during the last three years were included. Data collected included patient demographics, primary diagnosis, previous surgical management, post-operative complications and final outcomes. BTM was used in 32 patients. The indications varied including epidermolysis bullosa (n = 6), burns (n = 4), trauma (n = 7), infection (n = 4), ischemia or necrosis (n = 11). Results: The results were satisfying with acceptable aesthetic and functional outcomes. Complications included haematoma underneath the BTM leading to BTM removal and re-application (n = 1), BTM infection (n = 1) and split-thickness skin graft failure on top of BTM requiring re-grafting (n = 2). Conclusions: BTM can be a good alternative to large skin grafts, locoregional flaps or even free flaps. The big advantages over other dermal substitutes or skin grafts are that BTM is less prone to infection and offers excellent scarring by preserving the normal skin architecture. Specifically in children, BTM might not require grafting, resulting in spontaneous healing with good scarring. In critically ill patients, BTM reduces the operation time and there is no donor site morbidity. BTM should be considered in the reconstructive ladder when discussing defect coverage options in children and young people. Full article

Fragility fractures of the pelvis (FFPs) are common in elderly patients, particularly those with osteoporosis. FFPs can be associated with high mortality, morbidity, and functional decline. Known risk factors include being over 80 years old and delays in surgical intervention when this is required. While the role of surgery in FFPs remains less defined than in proximal femoral fractures in the elderly, studies indicate that surgical fixation offers improved survival and functional outcomes. Similarly, the choice of fixation method, whether posterior or anterior, and their combinations, vary between clinicians. It depends on the fracture type and patient-specific factors, such as bone quality and comorbidities, as well as the surgeon’s experience and the availability of resources. Additionally, orthobiologic adjuncts such as cement augmentation and sacroplasty can enhance the stability of an osteoporotic fracture during surgical intervention. Furthermore, medical treatments for osteoporosis, especially the use of teriparatide, have demonstrated beneficial effects in reducing fractures and promoting healing of the FFPs. Return to pre-injury activities is often limited, with independence rates remaining low at mid-term follow-up. Factors that influence clinical outcomes include fracture type, with Type III and IV fractures generally leading to poorer outcomes, and patient age, functional reserve, and comorbidities. The present tutorial aims to summarise the relevant evidence on all aspects of FFPs, inform an updated management strategy, and provide a template of the reconstruction ladder referring to the most available surgical techniques and treatment methods. Further research, based on large-scale studies, is needed to address the open questions described in this manuscript and refine surgical techniques, as well as determine optimal treatment pathways for this vulnerable patient population. Full article

With the rapid development of video encoding technology in the field of computer vision, the demand for tasks such as video frame reconstruction, denoising, and super-resolution has been continuously increasing. However, traditional video encoding methods typically focus on extracting spatial or temporal domain information, often facing challenges of insufficient accuracy and information loss when reconstructing high-frequency details, edges, and textures of images. To address this issue, this paper proposes an innovative LadderConv framework, which combines discrete wavelet transform (DWT) with spatial and channel attention mechanisms. By progressively recovering wavelet subbands, it effectively enhances the video frame encoding quality. Specifically, the LadderConv framework adopts a stepwise recovery approach for wavelet subbands, first processing high-frequency detail subbands with relatively less information, then enhancing the interaction between these subbands, and ultimately synthesizing a high-quality reconstructed image through inverse wavelet transform. Moreover, the framework introduces spatial and channel attention mechanisms, which further strengthen the focus on key regions and channel features, leading to notable improvements in detail restoration and image reconstruction accuracy. To optimize the performance of the LadderConv framework, particularly in detail recovery and high-frequency information extraction tasks, this paper designs an innovative ResGroup module. By using multi-layer convolution operations along with feature map compression and recovery, the ResGroup module enhances the network’s expressive capability and effectively reduces computational complexity. The ResGroup module captures multi-level features from low level to high level and retains rich feature information through residual connections, thus improving the overall reconstruction performance of the model. In experiments, the combination of the LadderConv framework and the ResGroup module demonstrates superior performance in video frame reconstruction tasks, particularly in recovering high-frequency information, image clarity, and detail representation. Full article

Background/Objectives: Over the past 25 years, reconstructive techniques and patient management advancements have significantly improved outcomes in mangled lower extremity injuries. Functional results of limb salvage have been demonstrated to surpass those of primary amputations. Developments such as local fasciocutaneous flaps, vacuum-assisted closure, and hyperbaric oxygen therapy have enhanced the reconstructive ladder. Despite progress, the utility of the Mangled Extremity Severity Score (MESS) and Gustilo–Anderson classification remains debated, particularly in their prognostic value for limb salvage decisions. In the study, we aimed to evaluate the outcomes of optimizing mangled lower extremity reconstruction in 93 patients, focusing on their functional scores retrospectively. Methods: This retrospective study analyzed 93 patients treated for mangled lower extremities between January 2015 and October 2022. Patients were assessed for age, gender, injury location, MESSs, Gustilo–Anderson classifications, surgical methods, and functional outcomes using the Lower Extremity Functional Scale (LEFS). Surgical interventions included internal and external fixation, skin grafts, local flaps, muscle flaps, and free tissue transfer. LEFS scores were categorized into disability levels for functional evaluation. Correlations were drawn between LEFS and variables such as MESS, Gustilo–Anderson types, and nerve injuries. Results: Among the 93 patients, 16 had MESSs ≥ 7, and 77 had MESSs < 7. Reconstruction methods included local fasciocutaneous and muscle flaps (37 patients), free tissue transfer (29 patients), and skin grafting with vacuum-assisted closure (27 patients). Smoking was associated with delayed union and increased infection rates. LEFS scores were significantly lower in patients with MESSs ≥ 7, Gustilo grade 3C fractures, and tibial nerve injuries. Flap failures and a higher number of surgeries (>3) also correlated with poorer functional outcomes. The average soft tissue healing time was 18 days, and bone union time was 17 weeks. Conclusions: Lower extremity reconstruction demands precise surgical planning and execution, prioritizing functional restoration. MESSs and Gustilo–Anderson classifications provide practical frameworks but have limitations in predicting long-term functionality. Factors such as joint involvement, nerve injuries, and flap selection significantly influence outcomes. Smoking and delayed healing remain critical challenges. While free flaps are essential for complex defects, more straightforward methods yield better outcomes in suitable cases. LEFS emerged as a reliable tool. Full article

The escalation of climate-induced disasters underscores how climatic variability has become a main question in designing risk-sensitive policies in advanced and developing countries. The macroeconomic implications of Natural Hazards (NHs) are extremely significant, as they can compromise financial stability and long-term prosperity. To mitigate risks and close the knowledge, protection, and development gaps can free resources, speeding up reconstruction of infrastructure, recovering from disruption of supply chains, and returning to pre-disaster levels of activities. This is not a simple task involving different steps of a “ladder approach”, sharing the burden of cost and responsibilities across the relevant stakeholders and reducing moral hazard. This approach rests on Public–Private Partnerships (PPPs) and technological R&D public investments able to crowd private ones in and establish useful Public–Private Insurance Schemes enhancing the disaster risk management role of the state. This paper proposes leveraging innovation technology both to enhance risk assessment and reduce uncertainty for climate-related NHs such as landslides. It is an important interdisciplinary question; in fact, despite the unequivocal acknowledgment of the global warming system, the precise ramifications of global warming and associated climatic shifts on NHs like landslides remain still elusive. The advanced modeling technique implemented by our interdisciplinary PPP contributes to geographically circumscribe the areas eventually subjected to landslides and constantly monitor the vulnerability of their structures, infrastructures, economic activities, and hence population. The reliable data that we can produce through remote sensing acquisition systems are necessary inputs to contain risk exposure both physically and financially. Full article

Skin and soft tissue reconstruction has long been based on the reconstructive ladder. However, a skin substitute has become popular due to its predictable outcomes, without donor-site morbidity. The biodegradable temporizing matrix (BTM; NovoSorb, PolyNovo Ltd., Port Melbourne, Australia) is a synthetic skin substitute that has recently gained its clinical application. Compared with those of other dermal templates, the clinical efficacy and performance of the BTM are not well established, especially among the Asian population. This study aims to share our experience and strategy of using BTM in various wound conditions. The data of patients who underwent skin and soft tissue reconstruction with BTM at a single institution between January 2022 and December 2023 were reviewed. The patient demographics, wound characteristics, surgical details, secondary procedures, and complications were recorded and analyzed. Postoperative 6-month photographs were collected and independently evaluated by two plastic surgeons and two wound care center nurses using the Manchester Scar Scale (MSS). This study included 37 patients, consisting of 22 males and 15 females with a mean age of 51.8 years (range, 18–86 years old). The wound etiologies included trauma (67.6%), necrotizing soft tissue infection (16.2%), burns (10.8%), toe gangrene (2.7%), and scar excision (2.7%). The average wound area covered by BTM was 50.6 ± 47.6 cm². Among the patients, eight received concomitant flap surgery and BTM implantation, 20 (54.1%) underwent subsequent split-thickness skin grafts (STSG), and 17 had small wounds (mean: 21.6 cm²) healed by secondary intention. Infection was the most common complication, affecting six patients (n = 6 [16.2%]), five of whom were treated conservatively, and only one required debridement. Thirty-three patients (89.2%) had good BTM take, and only four had BTM failure, requiring further reconstruction. At the last follow-up, 35 out of the 37 patients (94.6%) achieved successful wound closure, and the total MSS score was 10.44 ± 2.94, indicating a satisfactory scar condition. The patients who underwent BTM grafting without STSG had better scar scores than those who received STSG (8.71 ± 2.60 vs. 11.18 ± 2.84, p = 0.039). In conclusion, the BTM is effective and feasible in treating various wounds, with relatively low complication rates, and it can thus be considered as an alternative for skin and soft tissue reconstruction. When combined with adipofasical flap reconstruction, it achieves a more comprehensive anatomical restoration. Full article

Abdominal wall reconstruction is a common and necessary surgery, two factors that drive innovation. This review article examines recent developments in ventral hernia repair including primary fascial closure, mesh selection between biologic, permanent synthetic, and biosynthetic meshes, component separation, and functional abdominal wall reconstruction from a plastic surgery perspective, exploring the full range of hernia repair’s own reconstructive ladder. New materials and techniques are examined to explore the ever-increasing options available to surgeons who work within the sphere of ventral hernia repair and provide updates for evolving trends in the field. Full article

Plastic surgeons have used the reconstructive ladder for many decades as a standard directory for complex trauma reconstruction with the goal of repairing body structures and restoring functionality. This consists of different surgical maneuvers, such as secondary intention and direct tissue closure, as well as more complex methods such as local tissue transfer and free flap. The reconstructive ladder represents widely known options achievable for tissue reconstruction and wound closure that puts at the bottom rung the simplest methods of reconstruction and strengthens the complexity by moving upward. Regenerative medicine and surgery constitute a quickly spreading area of translational research that can be employed by minimally invasive surgical strategies, with the aim of regenerating cells and tissues in vivo in order to reestablish normal function through the intrinsic potential of cells, in combination with biomaterials and appropriate biochemical stimuli. These translational procedures have the aim of creating an appropriate microenvironment capable of supporting the physiological cellular function to generate the desired cells or tissues and to generate parenchymal, stromal, and vascular components on demand, and above all to produce intelligent materials capable of determining the fate of cells. Smart technologies have been grown that give extra “rungs” on the classic reconstructive ladder to integrate a more holistic, patient-based approach with improved outcomes. This commentary presents the evolution of the traditional concept of the reconstructive ladder in the field of plastic surgery into a new course with the aim of achieving excellent results for soft tissue reconstruction by applying innovative technologies and biologically active molecules for a wide range of surgical diseases. Full article

Predictive accuracy in wildland fire behavior is contingent on a thorough understanding of the 3D fuel distribution. However, this task is complicated by the complex nature of fuel forms and the associated constraints in sampling and quantification. In this study, twelve terrestrial laser scanning (TLS) plot scans were sampled within the mountain pine beetle-impacted forests of Jasper National Park, Canada. The TLS point clouds were delineated into eight classes, namely individual-tree stems, branches, foliage, downed woody logs, sapling stems, below-canopy branches, grass layer, and ground-surface points using a transformer-based deep learning classifier. The fine-scale 3D architecture of trees and branches was reconstructed using a quantitative structural model (QSM) based on the multi-class components from the previous step, with volume attributes extracted and analyzed at the branch, tree, and plot levels. The classification accuracy was evaluated by partially validating the results through field measurements of tree height, diameter-at-breast height (DBH), and live crown base height (LCBH). The extraction and reconstruction of 3D wood components enable advanced fuel characterization with high heterogeneity. The existence of ladder trees was found to increase the vertical overlap of volumes between tree branches and below-canopy branches from 8.4% to 10.8%. Full article

Aiming at the existing problem of unmanned aerial vehicle (UAV) aerial photography for riders’ helmet wearing detection, a novel aerial remote sensing detection paradigm is proposed by combining super-resolution reconstruction, residual transformer-spatial attention, and you only look once version 5 (YOLOv5) image classifier. Due to its small target size, significant size change, and strong motion blur in UAV aerial images, the helmet detection model for riders has weak generalization ability and low accuracy. First, a ladder-type multi-attention network (LMNet) for target detection is designed to conquer these difficulties. The LMNet enables information interaction and fusion at each stage, fully extracts image features, and minimizes information loss. Second, the Residual Transformer 3D-spatial Attention Module (RT3DsAM) is proposed in this work, which digests information from global data that is important for feature representation and final classification detection. It also builds self-attention and enhances correlation between information. Third, the rider images detected by LMNet are cropped out and reconstructed by the enhanced super-resolution generative adversarial networks (ESRGAN) to restore more realistic texture information and sharp edges. Finally, the reconstructed images of riders are classified by the YOLOv5 classifier. The results of the experiment show that, when compared with the existing methods, our method improves the detection accuracy of riders’ helmets in aerial photography scenes, with the target detection mean average precision (mAP) evaluation indicator reaching 91.67%, and the image classification top1 accuracy (TOP1 ACC) gaining 94.23%. Full article

Neurogenesis is a physiological response after cerebral ischemic injury to possibly repair the damaged neural network. Therefore, promoting neurogenesis is very important for functional recovery after cerebral ischemic injury. Our previous research indicated that hyperbaric oxygen therapy (HBOT) exerted neuroprotective effects, such as reducing cerebral infarction volume. The purposes of this study were to further explore the effects of HBOT on the neurogenesis and the expressions of cell migration factors, including the stromal cell-derived factor 1 (SDF1) and its target receptor, the CXC chemokine receptor 4 (CXCR4). Thirty-two Sprague–Dawley rats were divided into the control or HBO group after receiving transient middle cerebral artery occlusion (MCAO). HBOT began to intervene 24 h after MCAO under the pressure of 3 atmospheres for one hour per day for 21 days. Rats in the control group were placed in the same acrylic box without HBOT during the experiment. After the final intervention, half of the rats in each group were cardio-perfused with ice-cold saline followed by 4% paraformaldehyde under anesthesia. The brains were removed, dehydrated and cut into serial 20μm coronal sections for immunofluorescence staining to detect the markers of newborn cell (BrdU⁺), mature neuron cell (NeuN⁺), SDF1, and CXCR4. The affected motor cortex of the other half rats in each group was separated under anesthesia and used to detect the expressions of brain-derived neurotrophic factor (BDNF), SDF1, and CXCR4. Motor function was tested by a ladder-climbing test before and after the experiment. HBOT significantly enhanced neurogenesis in the penumbra area and promoted the expressions of SDF1 and CXCR4. The numbers of BrdU⁺/SDF1⁺, BrdU⁺/CXCR4⁺, and BrdU⁺/NeuN⁺ cells and BDNF concentrations in the penumbra were all significantly increased in the HBO group when compared with the control group. The motor functions were improved in both groups, but there was a significant difference between groups in the post-test. Our results indicated that HBOT for 21 days enhanced neurogenesis and promoted cell migration toward the penumbra area in transient brain ischemic rats. HBOT also increased BDNF expression, which might further promote the reconstructions of the impaired neural networks and restore motor function. Full article

Interrupted sampling repeater jamming (ISRJ) is becoming more widely used in electronic countermeasures (ECM), thanks to the development of digital radio frequency memory (DRFM). Radar electronic counter-countermeasure (ECCM) is much more difficult when the jamming signal is coherent with the emitted signal. Due to the intermittent transmission feature of ISRJ, the energy accumulation of jamming on the matched filter shows a ‘ladder’ characteristic, whereas the real target signal is continuous. As a consequence, the time delay and distribution of the jamming slice can be obtained based on searching the truncated-matched-filter (TMF) matrix. That is composed of pulse compression (PC) results under matched filters with different lengths. Based on the above theory, this paper proposes a truncated matched filter method by the reconstruction of jamming slices to suppress ISRJ of linear frequency modulation (LFM) radars. The numerical simulations indicate the effectiveness of the proposed method and validate the theoretical analysis. Full article

The treatment of soft tissue defects in multimorbid frail patients requires optimized preoperative and perioperative management with a differentiated interdisciplinary approach. Preoperative assessment with established scores, such as the ASA score, is important in order to stratify the operative complication risk. Following the reconstructive ladder is important to avoid unnecessary long operations and consecutively higher operative risks. In cases where a free flap procedure is needed, infections should be treated properly, and vascular status and coagulation should be optimized before performing a free flap procedure. Attention should be paid to maintain independency, functionality and quality of life while choosing the best treatment option. Full article

Usually, cutaneous wound healing does not get impeded and processes uneventfully, reaching wound closure easily. The goal of this repair process is to restore the integrity of the body surface by creating a resilient and stable scar. Surgical practice and strategies have an impact on the course of wound healing and the later appearance of the scar. By considering elementary surgical principles, such as the appropriate suture material, suture technique, and timing, optimal conditions for wound healing can be created. Wounds can be differentiated into clean wounds, clean–contaminated wounds, contaminated, and infected/dirty wounds, based on the degree of colonization or infection. Furthermore, a distinction is made between acute and chronic wounds. The latter are wounds that persist for longer than 4–6 weeks. Care should be taken to avoid surgical site infections in the management of wounds by maintaining sterile working conditions, using antimicrobial working techniques, and implementing the principles of preoperative antibiotics. Successful wound closure is influenced by wound debridement. Wound debridement removes necrotic tissue, senescent and non-migratory cells, bacteria, and foreign bodies that impede wound healing. Additionally, the reconstructive ladder is a viable and partially overlapping treatment algorithm in plastic surgery to achieve successful wound closure. Full article