Development and validation of a nomogram for predicting the risk of postoperative fracture blister after pilon fracture.

Background: Fracture blister (FB) is one of the most common complications in pilon fractures. This study aimed to construct and validate a nomogram for predicting postoperative FB risk in patients with pilon fractures. Methods: We retrospectively collected information on 1,119 patients with lower extremity fractures in the 3rd Hospital of Hebei Medical University between January 2023 and January 2024. Patients with FBs were considered as the FB group and those without FB as the non-FB group. Variables with a significance level of P < 0.05 in the univariate analysis were included in the multivariate logistic regression analysis. The backward stepwise regression method was applied to identify independent risk factors associated with FB. The selected predictors were then entered into R software for further analysis and Nomogram construction. Results: In our research, the rate of FB (119 of 1,119) was 10.63%. Several predictors of FB were found using univariate analysis, including body mass index (BMI) (p < 0.001), the presence of DVT (p < 0.001), closed fractures (p < 0.001), time from injury to admission (p < 0.001), smoking history (p < 0.01), not utilizing dehydrating agents (p < 0.010), fixation mode of fracture (p < 0.001), the mode of surgical suture (p < 0.001), postoperative infection (p < 0.001) and Elixhauser comorbidity index (ECI) (p < 0.01). In addition, FB group exhibited significantly higher levels of blood serum indicators, such as EOS (p = 0.029), HCT (p < 0.01), LYM (p = 0.01), MPV (p = 0.014), NEU (p < 0.01), CKMB (p < 0.01), PLT (p < 0.01), ALB (p < 0.01), ALP (p < 0.01), AST (p < 0.01), CK (p = 0.019), CREA(p < 0.01), DBIL (p < 0.01), GLU (p < 0.01), Na (p < 0.01), P (p < 0.01), TC (p = 0.024), ALT (p < 0.01), TCO2 (p < 0.01), TG (p < 0.01), TP (p < 0.01), UA (p = 0.018), UREA (p = 0.033) compared to the non-FB group. According to the stepwise logistic regression analysis, higher BMI (p = 0.011, OR 0.873, 95% CI 0.785-0.970), NEU (p = 0.036, OR 0.982, 95% CI 0.865-0.995) and CKMB (p < 0.014, OR 0.994, 95% CI 0.989-0.999) were associated with increased FB risk, while plate fixation (p = 0.017, OR 0.371, 95% CI 0.123-0.817), the mode of surgical suture (p < 0.01, OR 0.348, 95% CI 0.161-0.749), and postoperative infection (p = 0.020, OR 0.406, 95% CI 0.190-0.866) were also correlated with increased FB risk. The nomogram was established based on 6 predictors independently related to FB. Conclusions: Our investigation has shown that BMI, NEU, CKMB, plate fixation, the mode of surgical suture, and postoperative infection are independent risk factors for FB in patients with pilon fractures. The predictors identified by the nomogram could potentially be used to assess the possibility of blister formation, which could be a sign of fascial compartmental pressure release.

Mulberry (Morus alba L.) leaf powder modified the processing of meat alternatives: Principal component analysis from apparent properties to chemical bonds.

For texture control in plant-meat alternatives, the interrelationship between apparent characteristics and chemical bonds in high-fiber formulations remains unclear. The influence of mulberry leaf powder on apparent characteristics and chemical bonds of raw materials, block and strip products at addition amounts of 0.5-25% was analyzed. The results showed that 8% addition significantly increased the chewiness of the block by 98.12%. The strips' texture shows a downward trend, and the processing produced more redness and color difference. Additives promoted the formation of voids, lamellar and filamentous structures, and the strip produced more striped structures. Disulfide bonds significantly increased in the block, and the ß-turn in the secondary structure enhanced by 12.20%. The ß-turn transformed into a ß-sheet in strips. Principal component analysis revealed that the texture improvement was associated with producing disulfide bonds and ß-turn, providing a basis for high-fiber components to improve products' apparent characteristics by chemical bonds.

A new technique of autologous bone grafting for open-wedge high tibial osteotomy.

Purpose: This study aimed to demonstrate the application of orthotopic bone flap transplantation with a fibula transplantation (OBFT-FT) in open-wedge high tibial osteotomy (OW-HTO) and to assess the effect of OBFT-FT on gap healing. Patients and methods: From January to July 2020, 18 patients who underwent OW-HTO with OBFT-FT were reviewed for this study. Demographics, postoperative complications, and radiological and clinical outcomes of patients were collected. Finally, the clinical outcomes of patients were analyzed. Results: A total of 14 patients were included in this study. The average age and body mass index were 59.6 ± 9.2 years and 28.1 ± 4.5 kg/m2, respectively. The average correction angle and gap width were 9.5 ± 1.8° and 10.2 ± 2.7 mm, respectively. The rates of radiological gap healing at sixth week, third month, and sixth month were 42.9%, 85.7%, and 100%, respectively. The mean Lysholm score, International Knee Documentation Committee score, and visual analog scale scores at sixth-month follow-up were significantly better than the preoperative scores (p < 0.001, p < 0.001, p = 0.001, respectively). And, no delayed union or non-union, collapse, loss of correction, or surgical site infection were found. Conclusions: As a new technique for autologous bone graft, the OBFT-FT could be successfully applied in the treatment of gap healing after OW-HTO, and excellent radiological and clinical outcomes could be seen on patients' short-term follow-up.

Response of microbial communities to exogenous nitrate nitrogen input in black and odorous sediment.

Since nitrate nitrogen (NO3--N) input has proved an effective approach for the treatment of black and odorous river waterbody, it was controversial whether the total nitrogen concentration standard should be raised when the effluent from the sewage treatment plant is discharged into the polluted river. To reveal the effect of exogenous nitrate (NO3--N) on black odorous waterbody, sediments with different features from contaminated rivers were collected, and the changes of physical and chemical characteristics and microbial community structure in sediments before and after the addition of exogenous NO3--N were investigated. The results showed that after the input of NO3--N, reducing substances such as acid volatile sulfide (AVS) in the sediment decreased by 80 % on average, ferrous (Fe2+) decreased by 50 %, yet the changing trend of ammonia nitrogen (NH4+-N) in some sediment samples increased while others decreased. High-throughput sequencing results showed that the abundance of Thiobacillus at most sites increased significantly, becoming the dominant genus in the sediment, and the abundance of functional genes in the metabolome increased, such as soxA, soxX, soxY, soxZ. Network analysis showed that sediment microorganisms evolved from a single sulfur oxidation ecological function to diverse ecological functions, such as nitrogen cycle nirB, nirD, nirK, nosZ, and aerobic decomposition. In summary, inputting an appropriate amount of exogenous NO3--N is beneficial for restoring and maintaining the oxidation states of river sediment ecosystems.

Biochemical and protein nutritional potential of mulberry (Morus alba L.) leaf: partial substitution improves the nutrition of conventional protein.

BACKGROUND: With the requirements of environmental, cost and economic sustainability, new sources of alternative proteins in the livestock industry are receiving increasing attention. Mulberry (Morus alba L.) leaves are a unique feed resource because of their high protein content and large availability. Therefore, mining sustainable protein suitable for the animal husbandry industry in sericulture resources could achieve a win-win situation. RESULTS: The protein content in mulberry leaves is 232.10-386.16 g kg-1 , and the mean value of crude fat content is 43.76 ± 8.48 g kg-1 , which has the advantages of protein content and energy. In addition, the average content of phytic acid in mulberry leaves is only 1.88 ± 0.56 g kg-1 , which means that it is not inhibited in terms of nutrient absorption. Meanwhile, the digestibility of protein was Bean pulp > Sample 8 ≈ Alfalfa ≈ Sample 13 ≈ Cottonseed meal > Fish meal, and the ß-turn and particle size of mulberry leaf protein are more conducive to digestion in vitro. Furthermore, the protein of Sample 13 had the richest essential amino acids (252.00 g kg-1 ) and the highest essential amino acid index (EAAI), which was superior to conventional feed protein. In addition, the partial substitution of mulberry leaf protein (15%) significantly increased the EAAI value of conventional feed protein. However, to balance nutrition, it is necessary to combine mulberry leaf protein with other proteins to further broaden its application field. CONCLUSION: Mulberry leaves are a new source of feed protein, which helps to alleviate the two major problems of mulberry resource surplus and feed protein resource shortage. © 2023 Society of Chemical Industry.

Femtosecond Laser Direct Writing of Gecko-Inspired Switchable Adhesion Interfaces on a Flexible Substrate.

Biomimetic switchable adhesion interfaces (BSAIs) with dynamic adhesion states have demonstrated significant advantages in micro-manipulation and bio-detection. Among them, gecko-inspired adhesives have garnered considerable attention due to their exceptional adaptability to extreme environments. However, their high adhesion strength poses challenges in achieving flexible control. Herein, we propose an elegant and efficient approach by fabricating three-dimensional mushroom-shaped polydimethylsiloxane (PDMS) micropillars on a flexible PDMS substrate to mimic the bending and stretching of gecko footpads. The fabrication process that employs two-photon polymerization ensures high spatial resolution, resulting in micropillars with exquisite structures and ultra-smooth surfaces, even for tip/stem ratios exceeding 2 (a critical factor for maintaining adhesion strength). Furthermore, these adhesive structures display outstanding resilience, enduring 175% deformation and severe bending without collapse, ascribing to the excellent compatibility of the micropillar's composition and physical properties with the substrate. Our BSAIs can achieve highly controllable adhesion force and rapid manipulation of liquid droplets through mechanical bending and stretching of the PDMS substrate. By adjusting the spacing between the micropillars, precise control of adhesion strength is achieved. These intriguing properties make them promising candidates for various applications in the fields of microfluidics, micro-assembly, flexible electronics, and beyond.

Combination of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio with plasma D-dimer level to improve the diagnosis of deep venous thrombosis (DVT) following ankle fracture.

PURPOSE: To investigate the relationship between neutrophil to lymphocyte ratio (NLR)/platelet to lymphocyte ratio (PLR) with deep venous thrombosis (DVT) following ankle fracture and the diagnostic ability of combination model. METHOD: This retrospective study included patients with a diagnosis of ankle fracture who had undergone preoperative Duplex ultrasound (DUS) examination for detecting the possible deep venous thrombosis (DVT). The variables of interest, the calculated NLR and PLR and others (demographics, injury, lifestyles and comorbidities) were extracted from the medical records. Two independent multivariate logistics regression models were used to detect the relationship between NLR or PLR and DVT. If any, combination diagnostic model was constructed and its diagnostic ability was evaluated. RESULTS: There were 1103 patients included, and 92 (8.3%) were found to have preoperative DVT. The NLR and PLR, which had respective optimal cut-off point of 4 and 200, were significantly different between patients with and without DVT either in continuous or categorical variable. After adjustment for covariates, both NLR and PLR were identified as independent risk factors associated with DVT, with odd ratio of 2.16 and 2.84, respectively. The combination diagnostic model, including NLR, PLR and D-dimer, demonstrated to significantly improved the diagnostic performance than any one alone or combined (all P < 0.05), and the area under the curve was 0.729 (95% CI 0.701-0.755). CONCLUSION: We concluded the relatively low incidence rate of preoperative DVT after ankle fracture, and both NLR and PLR were independently associated with DVT. The combination diagnostic model can be considered as a useful auxiliary tool for identifying high-risk patients for DUS examination.

A Novel Low Molecule Peptides-calcium Chelate from Silkworm Pupae Protein Hydrolysate: Preparation, Antioxidant Activity, and Bioavailability.

BACKGROUND: The antioxidant properties of active peptides from silkworm pupae protein hydrolysate are of interest, and it serves as a novel source of calcium supplement. METHODS: Optimize the preparation parameters of silkworm pupae bioactive peptide-calcium chelate, and investigate the mechanism and bioavailability of silkworm pupae active peptide as a transport carrier to promote calcium ion absorption using simulated gastrointestinal digestion and Caco-2 monolayer cell model. RESULTS: The optimal process parameters for preparing peptide calcium chelate were the peptide calcium mass ratio of 3:1, pH of 6.7, a temperature of 35.6°C, and time of 32.8 min by Box-Behnken design, and the calciumchelating rate reached 84.67%. The DPPH radical scavenging activity of silkworm pupae protein hydrolysatecalcium chelate was 79.36 ± 4.31%, significantly higher than silkworm pupae protein hydrolysate (61.00 ± 9.56%). Fourier transform infrared spectroscopy shows that the COO-, N-H, C-H, and C-O groups participated in the formation of silkworm pupae protein hydrolysate-calcium chelate. The particle size of the silkworm pupae protein hydrolysate-calcium chelate was 970.75 ± 30.12 nm, which was significantly higher than that of silkworm pupae protein hydrolysate (253.14 ± 5.72 nm). The silkworm pupae protein hydrolysate-calcium chelate showed a calcium dissolution rate of 71.01 ± 1.91% in the simulated intestinal phase, significantly higher than that of CaCl2 (59.34 ± 1.24%). In the Caco-2 cell monolayers, the silkworm pupae protein hydrolysatecalcium chelate was more favorable for calcium transport. CONCLUSION: A novel silkworm pupa protein hydrolysate-calcium chelate with high antioxidant activity was successfully prepared to improve the bioavailability of calcium.

Green-solvent-processed formamidinium-based perovskite solar cells with uniform grain growth and strengthened interfacial contact via a nanostructured tin oxide layer.

Green-solvent-processed perovskite solar cells (PSCs) have reached an efficiency of 20%, showing great promise in safe industrial production. However, the nucleation process in green-solvent-based deposition is rarely optimized, resulting in randomized crystallization and much lowered reported efficiencies. Herein, a nanostructured tin oxide nanorods (SnO2-NRs) substrate is utilized to prepare a high-quality formamidinium (FA)-based perovskite film processed from a green solvent of triethyl phosphate (TEP) with a low toxic antisolvent of dibutyl ether (DEE). Compared with SnO2 nanoparticles, the oriented SnO2-NRs can accelerate the formation of heterogeneous nucleation sites and retard the crystal growth process of the perovskite film, resulting in a high-quality perovskite film with uniform grain growth. Furthermore, a chlorine-terminated bifunctional supramolecule (Cl-BSM) is introduced to passivate the increasing interfacial defects due to the vast contact area in SnO2-NRs. Correspondingly, the substrate design of SnO2-NRs with Cl-BSM increases the power conversion efficiency (PCE) of green-solvent-processed PSCs to 22.42% with an open-circuit voltage improvement from 1.02 to 1.12 V, which can be attributed to the uniform grain growth and reduced carrier recombination at the SnO2-NRs/perovskite interface. More importantly, the photo and humidity stabilities of the unencapsulated device for up to 500 and 1000 hours are also achieved with negligible interfacial delamination after aging. This work provides a new perspective on the future industrial scale production of PSCs using environment-friendly solvents with compatible substrate design.

An urban-level prediction of lockdown measures impact on the prevalence of the COVID-19 pandemic.

The world still suffers from the COVID-19 pandemic, which was identified in late 2019. The number of COVID-19 confirmed cases are increasing every day, and many governments are taking various measures and policies, such as city lockdown. It seriously treats people's lives and health conditions, and it is highly required to immediately take appropriate actions to minimise the virus spread and manage the COVID-19 outbreak. This paper aims to study the impact of the lockdown schedule on pandemic prevention and control in Ningbo, China. For this, machine learning techniques such as the K-nearest neighbours and Random Forest are used to predict the number of COVID-19 confirmed cases according to five scenarios, including no lockdown and 2 weeks, 1, 3, and 6 months postponed lockdown. According to the results, the random forest machine learning technique outperforms the K-nearest neighbours model in terms of mean squared error and R-square. The results support that taking an early lockdown measure minimises the number of COVID-19 confirmed cases in a city and addresses that late actions lead to a sharp COVID-19 outbreak.

Microfluidic preparation of a novel phoxim nanoemulsion pesticide against Spodoptera litura.

With continuous development of pesticide dosage forms, emulsifiable concentrates using large amounts of organic solvents are gradually obsoleted. Nanoemulsions with high water content have been developed and the preparation processes also evolved, but these processes still exist some problems, such as poor controllability and high energy consumption. Microfluidic is a controllable nanoemulsion preparation system which mainly applied to pharmaceutical synthesis. In this study, the pesticide phoxim nanoemulsion was prepared by microfluidic technology. The optimized formulation of phoxim nanoemulsion was composed of Tween 80 and pesticide emulsifier 500 as surfactant, hexyl acetate as oil, and n-propanol as co-surfactant. Moreover, when the flow rates of water and oil in the microfluidic system were adjusted to 5 µL/min and 20 µL/min, phoxim nanoemulsion was obtained with a cloud point/boiling point of 109 °C, a particle size of 21.5 ± 0.8 nm and a potential value of - 18.7 ± 0.6 mV. Furthermore, the nanoemulsion had a rapid release effect in vitro which could be fitted by the Ritger-Peppas model. The feeding toxicity of the phoxim nanoemulsion was higher than that of commercial formulation while the contact killing effect was higher than that of the active ingredient. Therefore, pesticide dosage was reduced and the insecticidal effect was enhanced by using phoxim nanoemulsions. These results also confirm the potential of microfluidics as a green process to produce pesticide nanoemulsions.

Surface-Anchored Acetylcholine Regulates Band-Edge States and Suppresses Ion Migration in a 21%-Efficient Quadruple-Cation Perovskite Solar Cell.

Although incorporating multiple halogen (bromine) anions and alkali (rubidium) cations can improve the open-circuit voltage (Voc ) of perovskite solar cells (PSCs), severe voltage loss and poor stability have remained pivotal limitations to their further commercialization. In this study, acetylcholine (ACh+ ) is anchored to the surface of a quadruple-cation perovskite to provide additional electron states near the valence band maximum of the perovskite surface, thereby enhancing the band alignment and minimizing the Voc loss significantly. Moreover, the quaternary ammonium and carbonyl units of ACh+ passivate the antisite and vacancy defects of the organic/inorganic hybrid perovskite. Because of strong interactions between ACh+ and the perovskite, the formation of lead clusters and the migration of halogen anions in the perovskite film are suppressed. As a result, the device prepared with ACh+ post-treatment delivers a power conversion efficiency (PCE) (21.56%) and a value of Voc (1.21 V) that are much higher than those of the pristine device, along with a twofold decrease in the hysteresis index. After storage for 720 h in humid air, the device subjected to ACh+ treatment maintained 70% of its initial PCE. Thus, post-treatment with ACh+ appears to be a useful strategy for preparing efficient and stable PSCs.

Aerobic α,ß-C(sp3)-H Bond Difunctionalization and C-N Bond Cleavage of Triethylamine: Difunctional Ammonium Iodide Enabling the Regioselective Synthesis of 4-Arylpyrimido[1,2-b]indazoles.

A novel method for the regioselective synthesis of 4-arylpyrimido[1,2-b]indazoles has been developed via the dual C(sp3)-H bond functionalization and C-N bond cleavage of triethylamine. The elusive acyclic enamine intermediates are effectively in situ generated and captured by aromatic aldehydes to form a wide array of tricyclic products from 3-aminoindazoles under the NH4I-mediated aerobic oxidative conditions. This reaction features easily available feedstock, green and economic conditions, and valuable products.