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This data demonstrated that DON exerts certain toxic effect on PHNCs, induced apoptosis and autophagy. PI3K/Akt/mTOR signaling pathway plays a negative regulatory role in DON-induced autophagy of PHNCs. At the same time, autophagy plays a protective role in DON-induced PHNCs injury. Immune-mediated necrotising myopathy (IMNM) is a recently described entity. We describe a cohort of South Australian IMNM patients in order to define the spectrum of disease, characterise features that distinguish IMNM from other idiopathic inflammatory myopathy (IIM) subtypes and identify factors associated with clinically severe disease. Subjects were identified from the South Australian Myositis Database (SAMD), a histologically defined registry. Consecutive muscle sections from patients with IMNM (n = 62), other forms of IIM (n = 60) and histologically normal muscle (n = 17) were stained using immunohistochemistry and graded. Clinical information was collected from the SAMD and through retrospective chart review. IMNM patients displayed clinical and histological heterogeneity. While most (67%) were profoundly weak at presentation, 24% exhibited mild to moderate weakness and 9% had normal power. Histological myonecrosis ranged from minor to florid. The amount of myofibre complement deposition was closely associated with clinical severity. Patients of Aboriginal and Torres Strait Islander heritage and those with anti-SRP autoantibodies present with a severe phenotype. Despite intense immunotherapy, few IMNM patients recovered full power at one year follow up. The identification of clinical, serological and histological features which are associated with severe forms of the disease may have diagnostic and therapeutic utility. BACKGROUND Suture bridge repair has been widely used as one of the standard procedures in the arthroscopic rotator cuff repair. We compared the intratendinous stress distribution between single and double suture passing techniques in the suture bridge repair using a 2-mm tape and clarified the roles of tensioning in this procedure. METHODS A board-like model of the supraspinatus tendon and humeral head was used in order to standardize conditions and exclude the influence of anatomical variations between individuals. Reattachment of the supraspinatus tendon to the bone was simulated using both single and double suture passing techniques for the suture bridge repair using a 2-mm tape. A tensile load was applied to the medial end of the tendon, and the stress distribution pattern was observed. Elastic analysis enabled comparison of the von Mises equivalent and maximum principal stresses between the single and double suture passing techniques. The tape configuration was subsequently translated 1 mm toward the insertion points of lateral anchors to simulate the tensioning maneuver. RESULTS Although the distribution pattern of both the equivalent and the maximum principal stresses was similar for both models, areas with a high stress concentration were smaller in the single suture passing model than those in the double suture passing model. The equivalent stress concentrated within the tendon beneath the tapes as well as in the area between the crossing tapes and the lateral end of the tendon, whereas the maximum principal stress concentrated medial to the sites of suture penetration. check details CONCLUSIONS Single suture passing technique can reduce the extent of intratendinous stress concentration compared with double suture passing technique, which might be beneficial to reduce the incidence of type 2 retear after suture bridge repair of rotator cuff tendon using a 2-mm tape. V.BACKGROUND This study assessed the reliability and validity of the modified Unified Classification System for femur fractures after hip arthroplasty. METHODS Four hundred and two cases were evaluated by 6 observers, 3 experts and 3 trainee surgeons. Each observer read the radiographs on 2 separate occasions and classified each case as to its type. Reliability was assessed by looking at the intraobserver and interobserver agreement using the Kappa statistic. Validity was assessed within the B group by looking at the agreement between the radiographic classification and the intraoperative findings. Interobserver and intraobserver agreement and validity were analyzed, using weighted kappa statistics. RESULTS The mean k value for interobserver agreement was found to be 0.882 (0.833-0.929) for consultants (almost perfect agreement) and 0.776 (0.706-0.836) for the trainees (substantial agreement). Intraobserver k values ranged from 0.701 to 0.972, showing substantial to almost perfect agreement. Validity analysis of 299 type B cases revealed 89.854% agreement with a mean k value of 0.849 (0.770-0.946) (almost perfect agreement). CONCLUSIONS This study has shown that the modified Unified Classification System is reliable and valid. We believe it is useful to improve the judgment of the implant stability, and establish the therapeutic strategy for periprosthetic femoral fracture. OBJECTIVES this study aimed to synthesize AgNPs from green tea (GT) extract, forming GT-AgNPs, and to coat their surfaces with silica, resulting in light-colored Ag@SiO2 nanoparticles. MATERIALS AND METHODS particles were characterized and tested for minimal inhibitory concentration (MIC), biofilm formation against Streptococcus mutans and cytotoxicity evaluation on dental pulp fibroblasts. RESULTS X-ray diffraction (XRD) confirmed the formation of pure AgNPs, whereas energy dispersive X-ray spectroscopy (EDS) mapped their elemental atoms. Dynamic light scattering (DLS) demonstrated formation of particles at nanoscale, with moderate polydispersity and negative zeta potential, in agreement with nanoparticle tracking analysis (NTA) size measurements. Fourier-transformed infrared (FTIR) spectroscopy confirmed the successful condensation of silica, which significantly increased surface area by 50%, as assayed by surface area analysis (BET). Thermogravimetric analysis showed a 18%-mass of silica on the surface of Ag@SiO2NPs. Transmission electron microscopy (TEM) displayed the spherical shape of nanoparticles and average size of 11 nm for GT-AgNPs and Ag@SiO2NPs. Ag@SiO2NPs demonstrated potent antimicrobial action against S. mutans, with MIC determined as 600 μg/mL, and inhibition of approximately 44% (p  less then  0.05) of biofilm formation. At the MIC concentrations, both NPs did not exhibit cytotoxicity. CONCLUSION Ag@SiO2NPs might have a useful application in dental materials. CLINICAL SIGNIFICANCE The possibility of incorporating antimicrobial properties in restorative materials without compromising esthetics makes the AgNPs@SiO2 NPs promising agents against S. mutans biofilm formation, hence the prevention of dental caries. This represents a great step towards the development of more interactive biomaterials in dentistry to overcome clinical problems.