Bipedicular percutaneous kyphoplasty versus unipedicular percutaneous kyphoplasty in the treatment of asymmetric osteoporotic vertebral compression fractures: a case control study.

BACKGROUND: Bipedicular/unipedicular percutaneous kyphoplasty are common treatments for OVCF, and there are no studies to show which is more beneficial for AVCF. The purpose of this study was to investigate the clinical efficacy of BPKP or UPKP in the treatment of AVCF. METHODS: The clinical data of AVCF patients treated by PKP were retrospectively analyzed. They were divided into two groups according to the surgical approach. General demographic data, perioperative complications, and general information related to surgery were recorded for both groups. The preoperative and postoperative vertebral height difference, vertebral local Cobb angle, lumbar pain VAS score and lumbar JOA score were counted for both groups. The above data were compared preoperatively, postoperatively and between the two groups. RESULTS: 25 patients with AVCF were successfully included and all were followed up for at least 12 months, with no complications during the follow-up period. 10 patients in the BPKP group and 15 patients in the UPKP group, with no statistically significant differences in general information between the two groups. The VAS scores of patients in the BPKP group were lower than those in the UPKP group at 12 months after surgery, and the differences were statistically significant, and there were no statistically significant differences between the two groups at other follow-up time points. In the BPKP group, 80% of patients had symmetrical and more homogeneous bone cement dispersion. 50% of patients in the UPKP group had a lateral distribution of bone cement and uneven bone cement distribution, and the difference in bone cement distribution between the two groups was statistically significant. CONCLUSION: For the treatment of AVCF, the clinical efficacy of both surgical approaches is basically the same. The distribution of cement is more symmetrical and uniformly diffused in the BPKP group, and the clinical efficacy VAS score is lower in the long-term follow-up. Bipedicular percutaneous kyphoplasty is recommended for the treatment of AVCF. THE ETHICAL REVIEW BATCH NUMBER: XZXY-LJ-20161208-047.

Influence of waste polyethylene/WCO composite on physical and chemical properties of asphalt.

The use of waste polyethylene (WPE) in modified asphalt is frequently employed to reduce environmental pollution and improve asphalt properties. However, research has shown that using WPE alone as a modifier does not effectively enhance the low-temperature flexibility of asphalt. This study aims to investigate the potential of utilizing WPE and waste cooking oil (WCO) as composite modifiers to enhance the properties of virgin asphalt under both high and low-temperature conditions. The contents of WPE and WCO were used, and the preparation process for the modified asphalt was optimized through an orthogonal experiment. The experimental results indicate that the optimal formulation for the WPE/WCO composite modified asphalt (WPE/WCO-A) is obtained with an additive dosage of 8% and 1% by mass of virgin asphalt for WPE and WCO, respectively, as well as the maintenance process at a temperature of 140 °C and a duration of 2 h. Dynamic shear rheometer (DSR) results reveal that WPE/WCO composite modifier can greatly improve the high-temperature deformation resistance of asphalt. Bending beam rheometer (BBR) tests confirm that WPE adversely affects the low-temperature flexibility of asphalt, while the addition of WCO can improve it. WPE/WCO-A has even better low-temperature properties than virgin asphalt (VA). The Fourier transform infrared spectroscopy (FT-IR) results suggest that the composite modification of asphalt by WPE/WCO modifiers is dominated by physical action. Furthermore, the fluorescence microscopy test results demonstrate that WCO can promote WPE swelling in asphalt. This study offers a novel approach to improve the comprehensive properties of asphalt through composite modification using WPE and WCO.

Chloride Ions-Responsive Intelligent Coatings for the Active Protection of Degradable Biomedical Mg Alloys.

In this work, the hydroxyapatite (HA) microspheres are utilized as carriers for 8-hydroxyquinoline (8-HQ) inhibitors with a sodium alginate-silver nitrate layer (Ag-SA) added to confer chloride-responsive properties. These 8-HQ@Ag-SA-HA microspheres are subsequently integrated into poly(lactic acid) (PLA) coatings to produce biocompatible coatings. The resulting 8-HQ@Ag-SA-HA microsphere exhibits a spherical structure with a diameter of 3.16 µm. Thermogravimetric analysis indicates that the encapsulated 8-HQ inhibitors are approximately 11.83 wt %. Furthermore, the incorporation of these microspheres fills the micropores within the PLA coating, leading to a denser coating surface, enhanced wettability (contact angle value = 88°), and improved adhesion strength, thereby reinforcing the physical barrier effect. Corrosion tests reveal that the coatings exhibit increased resistance to corrosion in simulated body fluid (SBF) solutions. The released 8-HQ inhibitors in response to chloride ions form a protective layer of Mg(HQ)2, providing the coatings with self-healing properties and ensuring their durability in the SBF environment. Additionally, the cell test demonstrates a significant presence of MG-63 cells, accompanied by a low hemolysis rate of 3.81%, confirming the exceptional biocompatibility of the coatings. These findings offer valuable insights into the development of stimuli-responsive biocompatible coatings for effectively protecting Mg alloys.

Clinical outcomes with second injection after insufficient bone cement distribution in unilateral kyphoplasty for osteoporotic vertebral compressive fracture: a cohort retrospective study.

BACKGROUND: Bone cement distribution is an important factor affecting pain relief and long-term prognosis of osteoporotic vertebral compression fracture (OVCF) treated with vertebral augmentation. Unilateral percutaneous kyphoplasty (PKP) is the most common procedure, and insufficient bone cement distribution is more common than bilateral PKP. However, effective remedies are remain lack. In this study, sufficient cement distribution was achieved by adjusting the working channel followed by second cement injection as a remedy in cases with insufficient cement distribution, and the purpose was to evaluate the clinical outcomes by a retrospective cohort study. METHODS: From July 1, 2017 to July 31, 2020, OVCF patients treated with unilateral PKP were included in this retrospective cohort study. According to the bone cement distribution (insufficient cement distribution was confirmed when the cement did not exceed the mid line of the vertebral body in frontal film or/and the cement did not contact the upper/lower vertebral endplates in the lateral film.) and whether second injection was performed during surgery, the patients were divided into three groups. Insufficient group: patients with insufficient cement distribution confirmed by fluoroscopy or postoperative x-ray. Second injection group: patients with insufficient cement distribution was found during the procedure, and second injection was performed to improve the cement distribution. CONTROL GROUP: patients with sufficient cement distribution in one injection. The Primary outcome was cemented vertebrae re-collapse rate. The secondary outcomes included operative time, radiation exposure, cement leakage rate, VAS, ODI, and adjacent vertebral fracture rate. RESULTS: There are 34 cases in insufficient group, 45 cases in second injection group, and 241 cases in control group. There was no significant difference in baseline data and follow-up time among the three groups. PRIMARY OUTCOME: The injured vertebrae re-collapse rate of insufficient group was significantly higher than that of second injection group (42.22% vs 20.59%, P = 0.000) and control group (42.22% vs. 18.26%, P = 0.000). Kaplan-Meier survival analysis showed that there was no significant difference in the survival time between second injection group and control group (P = 0.741, Log-rank test), both of which were significant less than that in insufficient group (P = 0.032 and 0.000, respectively). SECONDARY OUTCOMES: There was no significant difference in VAS score and ODI after operation between second injection group and control group, both of which were superior to those in insufficient group (P = 0.000). At the final follow-up, there was no significant difference in VAS and ODI among the three groups (P > 0.05). The operation time of second injection group was significantly higher than that of insufficient group (53.41 ± 8.85 vs 44.18 ± 7.41, P = 0.000) and control group (53.41 ± 8.85 vs 44.28 ± 7.22, P = 0.000). The radiation exposure of the second injection group was significantly higher than that of insufficient group (40.09 ± 8.39 vs 30.38 ± 6.87, P = 0.000) and control group (40.09 ± 8.39 vs 31.31 ± 6.49, P = 0.000). The cement leakage rate of second injection group (20.59%) was comparable with that of insufficient group (24.44%) and control group (21.26%) (P = 0.877). The length of hospital stay of the second injection group (4.38 ± 1.72) was comparable with that of insufficient group (4.18 ± 1.60) and control group (4.52 ± 1.46) (P = 0.431). CONCLUSIONS: When cement distribution is insufficient during unilateral PKP, second injection may relieve early pain, reduce the incidence of cemented vertebral re-collapse and adjacent vertebral fracture, without increasing the cement leakage rate, although this procedure may increase the operation time and radiation exposure.

DHI-GAN: Improving Dental-Based Human Identification Using Generative Adversarial Networks.

In this work, a novel semisupervised framework is proposed to tackle the small-sample problem of dental-based human identification (DHI), achieving enhanced performance via a "classifying while generating" paradigm. A generative adversarial network (GAN), called the DHI-GAN, is presented to implement this idea, in which an extra classifier is also dedicatedly proposed to achieve an efficient training procedure. Considering the complex specificities of this problem, except for the noise input of the generator, an identity embedding-guided architecture is proposed to retain informative features for each individual. A parallel spatial and channel fusion attention block is innovatively designed to encourage the model to learn discriminative and informative features by focusing on different regional details and abstract concepts. The attention block is also widely applied to the overall classifier to learn identity-dependent information. A loss combination of the ArcFace and focal loss is utilized to address the small-sample problem. Two parameters are proposed to control the generated samples that are fed into the classifier during the optimization procedure. The proposed DHI-GAN framework is finally validated on a real-world dataset, and the experimental results demonstrate that it outperforms other baselines, achieving a 92.5% top-one accuracy rate. Most importantly, the proposed GAN-based semisupervised training strategy is able to reduce the required number of training samples (individuals) and can also be incorporated into other classification models. Our code will be available at https://github.com/sculyi/MedicalImages/.

2,6-Azulene-based Homopolymers: Design, Synthesis, and Application in Proton Exchange Membrane Fuel Cells.

Azulene-based homopolymers are of great interest from the point view of chemistry and material science. Herein, by means of Friedel-Crafts acylation to introduce solubilizing chains on the 1-position of azulene, we designed and synthesized two examples of 2,6-azulene-based homopolymers RP(Az-AC16) and P(Az-AC16). The arrangement of 2,6-azulene units is irregular for RP(Az-AC16), while P(Az-AC16) has head-to-head/tail-to-tail arranged 2,6-azulene units. Proton-responsive studies demonstrate that RP(Az-AC16) and P(Az-AC16) show reversible proton responsiveness in both solution and thin film. To utilize the dynamically reversible proton-responsive property of these polymers in thin films, RP(Az-AC16) and P(Az-AC16) were incorporated into a Nafion matrix as proton exchange membranes, wherein the Nafion/P(Az-AC16) composite membrane exhibits significant increases in proton conductivity relative to the Nafion membrane at different temperatures of each relative humidity (RH), which further results in a 64% improvement in hydrogen fuel cell output power under 30% RH at 80 °C. Our studies have realized the first solution synthesis of 2,6-azulene-based homopolymers and the first application of azulene-based π-systems in hydrogen fuel cells.

Double-edged effects of polyvinyl chloride addition on heavy metal separation and biochar production during pyrolysis of Cd/Zn hyperaccumulator.

Pyrolysis is a promising technique to achieve the sustainable utilization of heavy metal hyperaccumulator derived from phytoremediation of contaminated soils. To investigate the feasibility of synergistic treatment of hyperaccumulator and plastic waste (i.e. polyvinyl chloride, PVC), co-pyrolysis of Sedum alfredii and different mass percentages of PVC (5-25 wt%) was conducted at 300-900 °C in the present study. High pyrolysis temperature and low PVC addition amount (5 wt%) effectively promoted the volatilization of Cd and Zn from S. alfredii, while high PVC addition amount (15 wt% and 25 wt%) caused a significant suppression effect at insufficient pyrolysis temperatures. After PVC addition, the yields of biochar increased by 5.18-37.19% as compared with the theoretical values. However, the concentrations of Cd and Zn leached from biochar significantly elevated with increasing PVC addition amount, indicating that the addition of PVC improved the mobility of Cd and Zn in biochar. Moreover, S. alfredii derived biochars showed considerable sorption capacity for Cd (87.6-198.3 mg/g). These results imply that the addition of PVC has double-edged effects on heavy metal separation and biochar production during pyrolysis of Cd/Zn hyperaccumulator, and low PVC addition amount and sufficient pyrolysis temperature are beneficial for the further utilization of biochar.

Fully Passive Flexible Wireless Neural Recorder for the Acquisition of Neuropotentials from a Rat Model.

Wireless implantable neural interfaces can record high-resolution neuropotentials without constraining patient movement. Existing wireless systems often require intracranial wires to connect implanted electrodes to an external head stage or/and deploy an application-specific integrated circuit (ASIC), which is battery-powered or externally power-transferred, raising safety concerns such as infection, electronics failure, or heat-induced tissue damage. This work presents a biocompatible, flexible, implantable neural recorder capable of wireless acquisition of neuropotentials without wires, batteries, energy harvesting units, or active electronics. The recorder, fabricated on a thin polyimide substrate, features a small footprint of 9 mm × 8 mm × 0.3 mm and is composed of passive electronic components. The absence of active electronics on the device leads to near zero power consumption, inherently avoiding the catastrophic failure of active electronics. We performed both in vitro validation in a tissue-simulating phantom and in vivo validation in an epileptic rat. The fully passive wireless recorder was implanted under rat scalp to measure neuropotentials from its contact electrodes. The implanted wireless recorder demonstrated its capability to capture low voltage neuropotentials, including somatosensory evoked potentials (SSEPs), and interictal epileptiform discharges (IEDs). Wirelessly recorded SSEP and IED signals were directly compared to those from wired electrodes to demonstrate the efficacy of the wireless data. In addition, a convoluted neural network-based machine learning algorithm successfully achieved IED signal recognition accuracy as high as 100 and 91% in wired and wireless IED data, respectively. These results strongly support the fully passive wireless neural recorder's capability to measure neuropotentials as low as tens of microvolts. With further improvement, the recorder system presented in this work may find wide applications in future brain machine interface systems.

Emerging chitin nanogels/rectorite nanocomposites for safe and effective hemorrhage control.

Excessive bleeding due to trauma, surgery and diseases may cause severe mortalities. Here, an emerging chitin nanogel/rectorite nanocomposite is developed for effective hemorrhage control. Chitin chains are intercalated into rectorite and subsequent mechanical high speed stirring generates chitin nanogels, which assemble on the surface of the rectorite nanoplates through electrostatic interactions to form a sandwich structure. The in vitro experiments reveal that the nanocomposite exhibits favorable biocompatibility and negligible hemolysis (<3.5%) as compared to rectorite (40%). The nanocomposite stops bleeding in 121 s in rat tail incision and exhibits higher hemostatic activity in the rabbit artery injury model as compared to a commercialized chitosan hemostat, Celox. The efficient blood clotting activity is attributed to the induction of a coagulation cascade by rectorite and the quick adsorption and aggregation of platelets and red blood cells by chitin. The enhanced biocompatibility and hemostatic activity of the chitin/rectorite nanocomposite make it a safe and cost effective hemostat to control bleeding.

A simple mechanical agitation method to fabricate chitin nanogels directly from chitin solution and subsequent surface modification.

The development of physical approaches and green technologies to construct novel chitin materials is essential for the exquisite utilization of the renewable and valuable resource of chitin. In the present study, chitin nanogels were simply fabricated from a chitin solution dissolved in 8% NaOH/4% urea aqueous solvent by high speed stirring. The mechanical stirring generated in situ heat that induced the regeneration of chitin chains and ensured good dispersion of the nanogels. The prepared nanogels were composed of spherical nanoparticles of size 20 to 30 nm with some aggregates. The formation of chitin nanogels was confirmed to be a physical process without using organic solvent or chemical crosslinking. Rheological tests revealed a shear thinning behavior of the nanogels and injectable hydrogels were developed accordingly. The chitin nanogels showed no toxicity to L929 cells and cell attachment on the surface of the nanogel was observed. Further, monodispersed cationic nanogels and anionic nanogels were facilely obtained by deacetylating and TEMPO-mediated oxidizing chitin nanogels, and demonstrated different antibacterial properties.

An Accelerated Release Method of Risperidone Loaded PLGA Microspheres with Good IVIVC.

BACKGROUND: A long release period lasting several days or several weeks is always needed and thereby it is tedious and time consuming to screen formulations of such microspheres with so long release period and evaluate their release profiles in vitro with conventional long-term or "real-time" release method. So, an accelerated release testing of such system is necessary for formulation design as well as quality control purpose. The purpose of this study is to obtain an accelerated release method of risperidone loaded poly(lactic-co-glycolic acid) (PLGA) microspheres with good in vitro/in vivo correlation (IVIVC). METHODS: Two formulations of risperidone loaded PLGA microspheres used for evaluating IVIVC were prepared by O/W method. The accelerated release condition was optimized by investigating the effect of pH, osmotic pressure, temperature and ethanol concentration on the release of risperidone from microspheres and the in vitro accelerated release profiles of risperidone from PLGA microspheres were obtained under this optimized accelerated release condition. The plasma concentration of risperidone were also detected after subcutaneous injection of risperidone loaded microspheres to rats. The in vivo cumulative absorption profiles were then calculated using Wagner-Nelson model, Loo- Riegelman model and numerical convolution model, respectively. The correlation between in vitro accelerated release and in vivo cumulative absorption were finally evaluated with Least Square Method. RESULTS: It was shown that temperature and ethanol concentration significantly affected the release of risperidone from the microspheres while pH and osmotic pressure of release media slightly affected the release behavior of risperidone. The in vitro release of risperidone from microspheres were finally undergone in PBS (pH7.0, 300mosm) with 20% (V/V) ethanol at 45°C. The sustained and complete release of risperidone was observed in both formulations under the accelerated release condition although these two release profiles were dissimilar. The correlation coefficients (R2) of IVIVC were all above 0.95 and the slopes were all between 0.9564 and 1.1868 in spite of fitted model and microsphere formulation. CONCLUSION: An in vitro accelerated release method of risperidone microspheres with good IVIVC was established in this paper and this accelerated release method was supposed to have great potential in both in vivo performance prediction and quality control for risperidone loaded PLGA microspheres.

Multi-responsive hydrogel based on lotus root starch.

The lotus root starch-based hydrogel was synthesized by free radical copolymerization. Fourier Transform Infrared Spectroscopy (FTIR) demonstrated that the formation of target product. X-ray diffraction (XRD) analysis showed the change of the starch's crystallization. The morphology and pore structure of the hydrogel were evaluated by Field Emission Scanning Electron Microscope (FESEM) and Biomicroscope. Thermogravimetric analysis revealed the better thermal stability of hydrogel. Furthermore, the swelling in CaCl2 and AlCl3 solutions/temperature (25°C-65°C) displayed the "overshooting effect" swelling-deswelling phenomenon with prolonging the swelling time. The hydrogel can rapidly response to various pH value as well.

Toward accurate tooth segmentation from computed tomography images using a hybrid level set model.

PURPOSE: A three-dimensional (3D) model of the teeth provides important information for orthodontic diagnosis and treatment planning. Tooth segmentation is an essential step in generating the 3D digital model from computed tomography (CT) images. The aim of this study is to develop an accurate and efficient tooth segmentation method from CT images. METHODS: The 3D dental CT volumetric images are segmented slice by slice in a two-dimensional (2D) transverse plane. The 2D segmentation is composed of a manual initialization step and an automatic slice by slice segmentation step. In the manual initialization step, the user manually picks a starting slice and selects a seed point for each tooth in this slice. In the automatic slice segmentation step, a developed hybrid level set model is applied to segment tooth contours from each slice. Tooth contour propagation strategy is employed to initialize the level set function automatically. Cone beam CT (CBCT) images of two subjects were used to tune the parameters. Images of 16 additional subjects were used to validate the performance of the method. Volume overlap metrics and surface distance metrics were adopted to assess the segmentation accuracy quantitatively. The volume overlap metrics were volume difference (VD, mm(3)) and Dice similarity coefficient (DSC, %). The surface distance metrics were average symmetric surface distance (ASSD, mm), RMS (root mean square) symmetric surface distance (RMSSSD, mm), and maximum symmetric surface distance (MSSD, mm). Computation time was recorded to assess the efficiency. The performance of the proposed method has been compared with two state-of-the-art methods. RESULTS: For the tested CBCT images, the VD, DSC, ASSD, RMSSSD, and MSSD for the incisor were 38.16 ± 12.94 mm(3), 88.82 ± 2.14%, 0.29 ± 0.03 mm, 0.32 ± 0.08 mm, and 1.25 ± 0.58 mm, respectively; the VD, DSC, ASSD, RMSSSD, and MSSD for the canine were 49.12 ± 9.33 mm(3), 91.57 ± 0.82%, 0.27 ± 0.02 mm, 0.28 ± 0.03 mm, and 1.06 ± 0.40 mm, respectively; the VD, DSC, ASSD, RMSSSD, and MSSD for the premolar were 37.95 ± 10.13 mm(3), 92.45 ± 2.29%, 0.29 ± 0.06 mm, 0.33 ± 0.10 mm, and 1.28 ± 0.72 mm, respectively; the VD, DSC, ASSD, RMSSSD, and MSSD for the molar were 52.38 ± 17.27 mm(3), 94.12 ± 1.38%, 0.30 ± 0.08 mm, 0.35 ± 0.17 mm, and 1.52 ± 0.75 mm, respectively. The computation time of the proposed method for segmenting CBCT images of one subject was 7.25 ± 0.73 min. Compared with two other methods, the proposed method achieves significant improvement in terms of accuracy. CONCLUSIONS: The presented tooth segmentation method can be used to segment tooth contours from CT images accurately and efficiently.

[Reconstruction of tissue defects by infrahyoid myocutaneous flap in elder patients after oral cancer surgery].

PURPOSE: To investigate the role of repairing tissue defects by infrahyoid myocutaneous flap after oral cancer surgery in elder patients. METHODS: From December 2005 to November 2010, we used infrahyoid myocutaneous flaps to reconstruct soft tissue defects in 19 elder patients after radical operation of oral cancer. There were 11 males and 8 females with the age range of 65 to 89 years (average: 72.8) .The lesions included 10 tongue cancers, 2 buccal cancers, 6 mouth floor cancers and 1 gingival cancer. RESULTS: All wound healed uneventfully, and all the 19 infrahyoid myocutaneous flaps survived without total or partial necrosis. The results were satisfactory both in appearance and functions. The patients were followed up for 6 months to 5 years, no tumour relapse and metastasis occurred. CONCLUSIONS: The procedure of preparing the infrahyoid myocutaneous flap is simple and the result is reliable. The flap is useful for reconstruction of soft tissue defects in elder patients.

[Application of orthognathic surgery in treating long-standing maxillofacial fracture].

PURPOSE: To explore the application of orthognathic surgery to treat malunioned fracture of maxillofacial bone, and the methods in reconstructing facial shape and occlusion. METHODS: 20 patients with maxillofacial malunioned fracture were involved in this study, the site of osteotomy and plan of operation were determined preoperatively with three-dimensional CT reconstruction, cephalometric analysis and model surgery. Occlusal guide plate was made in cases with malocclusion. Then osteotomies were performed in planned sites. Rigid internal fixation was conducted after restoring occlusion and facial contour. RESULTS: All patients were recovered to normal facial contour after operation, and the occlusion was satisfactory. Four cases with maxillary osteotomy developed bone unhealing in the lateral wall of the maxilla, with oral antral fistula in 2 patients. CONCLUSIONS: With orthognathic surgery and rigid internal fixation, it is easy to reduce long-standing maxillofacial fracture and recover normal occlusion.

Exoribonuclease R in Mycoplasma genitalium can carry out both RNA processing and degradative functions and is sensitive to RNA ribose methylation.

Mycoplasma genitalium, a small bacterium having minimal genome size, has only one identified exoribonuclease, RNase R (MgR). We have purified MgR to homogeneity, and compared its RNA degradative properties to those of its Escherichia coli homologs RNase R (EcR) and RNase II (EcII). MgR is active on a number of substrates including oligoribonucleotides, poly(A), rRNA, and precursors to tRNA. Unlike EcR, which degrades rRNA and pre-tRNA without formation of intermediate products, MgR appears sensitive to certain RNA structural features and forms specific products from these stable RNA substrates. The 3'-ends of two MgR degradation products of 23S rRNA were mapped by RT-PCR to positions 2499 and 2553, each being 1 nucleotide downstream of a 2'-O-methylation site. The sensitivity of MgR to ribose methylation is further demonstrated by the degradation patterns of 16S rRNA and a synthetic methylated oligoribonucleotide. Remarkably, MgR removes the 3'-trailer sequence from a pre-tRNA, generating product with the mature 3'-end more efficiently than EcII does. In contrast, EcR degrades this pre-tRNA without the formation of specific products. Our results suggest that MgR shares some properties of both EcR and EcII and can carry out a broad range of RNA processing and degradative functions.