Intramedullary nailing for irreducible spiral subtrochanteric fractures: A comparison of cerclage and non-cerclage wiring.

PURPOSE: Intramedullary nailing is the preferred internal fixation technique for the treatment of subtrochanteric fractures because of its biomechanical advantages. However, no definitive conclusion has been reached regarding whether combined cable cerclage is required during intramedullary nailing treatment. This study was performed to compare the clinical effects of intramedullary nailing with cerclage and non-cerclage wiring in the treatment of irreducible spiral subtrochanteric fractures. METHODS: Patients with subtrochanteric fractures admitted to our center from January 2013 to December 2021 were retrospectively analyzed. The patients were enrolled in the case-control study according to the inclusion and exclusion criteria and divided into the non-cerclage group and the cerclage group. The patients' clinical data, including the operative time, intraoperative blood loss, hospital stay, reoperation rate, fracture union time, and Harris hip score, were compared between these 2 groups. Categorical variables were compared using Chi-square or Fisher's exact test. Continuous variables with normal distribution were presented as mean ± standard deviation and analyzed with Student's t-test. Non-normally distributed variables were expressed as median (Q1, Q3) and assessed using the Mann-Whitney test. A p value < 0.05 was considered significant. RESULTS: In total, 69 patients were included in the study (35 patients in the non-cerclage group and 34 patients in the cerclage group). The baseline data of the 2 groups were comparable. There were no significant difference in the length of hospital stay (z = -0.391, p = 0.696), operative time (z = -1.289, p = 0.197), or intraoperative blood loss (z = -1.321, p = 0.186). However, compared with non-cerclage group, the fracture union time was shorter (z = -5.587, p < 0.001), the rate of nonunion was lower (χ2 = 6.030, p = 0.03), the anatomical reduction rate was higher (χ2 = 5.449, p = 0.03), and the Harris hip score was higher (z = -2.99, p = 0.003) in the cerclage group, all with statistically significant differences. CONCLUSIONS: Intramedullary nailing combined with cable cerclage wiring is a safe and reliable technique for the treatment of irreducible subtrochanteric fractures. This technique can improve the reduction effect, increase the stability of fracture fixation, shorten the fracture union time, reduce the occurrence of nonunion, and contribute to the recovery of hip joint function.

Fabrication of Ultra-Durable and Flexible NiPx -Based Electrode toward High-Efficient Alkaline Seawater Splitting at Industrial Grade Current Density.

Designing nonprecious metal-based electrocatalysts to yield sustainable hydrogen energy by large-scale seawater electrolysis is challenging to global emissions of carbon neutrality and carbon peaking. Herein, a series of highly efficient, economical, and robust Ni-P-based nanoballs grown on the flexible and anti-corrosive hydrophobic asbestos (NiPx @HA) is synthesized by electroless plating at 25 °C toward alkaline simulated seawater splitting. On the basis of the strong chemical attachment between 2D layered substrate and nickel-rich components, robust hexagonal Ni5 P4 crystalline modification, and fast electron transfer capability, the overpotentials during hydrogen/oxygen evolution reaction (HER/OER) are 208 and 392 mV at 200 mA cm-2 , and the chronopotentiometric measurement at 500 mA cm-2 lasts for over 40 days. Additionally, the versatile strategy is broadly profitable for industrial applications and enables multi-elemental doping (iron/cobalt/molybdenum/boron/tungsten), flexible substrate employment (nickel foam/filter paper/hydrophilic cloth), and scalable synthesis (22 cm × 22 cm). Density functional theory (DFT) also reveals that the optimized performance is due to the fundamental effect of incorporating O-source into Ni5 P4 . Therefore, this work exhibits a complementary strategy in the construction of NiPx -based electrodes and offers bright opportunities to produce scalable hydrogen effectively and stably in alkaline corrosive electrolytes.

Boosting Type-I and Type-II ROS Production of Water-Soluble Porphyrin for Efficient Hypoxic Tumor Therapy.

As the most successful clinically approved photosensitizers, porphyrins have been extensively employed in the photodynamic therapy (PDT) of cancers. However, their poor water solubility, aggregation-induced self-quenching on ROS generation, and a low tolerance for a hypoxic condition usually result in unsatisfied therapeutic outcomes. Therefore, great efforts have been dedicated to improving the PDT efficacy of porphyrin-type photosensitizers in treating hypoxic tumors, including combination with additional active components or therapies, which can significantly complicate the therapeutic process. Herein, we report a novel water-soluble porphyrin with O-linked cationic side chains, which exhibits good water solubility, high photostability, and significantly enhanced ROS generation efficacy in both type-I and type-II photodynamic pathways. We have also found that the end charges of side chains can dramatically affect the ROS generation of the porphyrin. The cationic porphyrin exhibited high in vitro PDT efficacy with low IC50 values both in normoxia and hypoxia. Hence, during in vivo PDT study, the cationic porphyrin displayed highly effective tumor ablation capability. This study demonstrates the power of side-chain chemistry in tuning the photodynamic property of porphyrin, which offers a new effective strategy to enhance the anticancer performance of photosensitizers for fulfilling the increasing demands for cancer therapy in clinics.

Mild Construction of "Midas Touch" Metal-Organic Framework-Based Catalytic Electrodes for Highly Efficient Overall Seawater Splitting.

Mild construction of highly efficient and durable practical electrodes for overall water splitting (OWS) at industrial-grade current density is currently a significant challenge. Herein, metal-organic framework (MOF) materials are grown in situ on the surface of carbon cloth (CC) at 25 °C, and quickly "interspersed" by cobalt-boron (Co-B) via electroless plating for 30 min to obtain a highly efficient and stable CoB@MOF@CC self-supporting electrode. Owing to the large specific surface area, abundant active sites, and porous structure, the MOF-based CC modified by bamboo leaf-like ultrathin CoB has remarkable electrochemical catalysis efficiency. The CoB@MOF@CC electrode exhibits excellent performance during the hydrogen evolution reaction (η10  = 57 mV, η500  = 266 mV) and oxygen evolution reaction (η10  = 209 mV, η500  = 423 mV) in alkaline simulated seawater, and is durable for 2500 h at 500 mA cm-2 . The OWS performance is obviously enhanced by employing the prepared electrode, which only requires 1.49 V to achieve 10 mA cm-2 and is durable for over 360 h at industrial-grade current densities in alkaline high-salt, real seawater, rainwater, and urea electrolytes.

Base-Promoted Three-Component Cascade Reaction of α-Hydroxy Ketones, Malonodinitrile, and Alcohols: Direct Access to Tetrasubstituted NH-Pyrroles.

A base-promoted three-component cascade reaction of α-hydroxy ketones, malonodinitrile, and alcohols has been developed, providing a direct and efficient route to a range of structurally diverse and synthetically useful 2-alkyloxy-1H-pyrrole-3-carbonitrile derivatives. The reaction involved three different bond (C-C, C-O, and C-N) formations in a single step, and its regioselectivity was depended on the structure of the α-hydroxy ketones employed. The use of easily available starting materials, wide substrate scope, good functional group tolerance, operational simplicity, and high atom economy are attractive features of the new method.

Domino C-H Sulfonylation and Pyrazole Annulation for Fully Substituted Pyrazole Synthesis in Water Using Hydrophilic Enaminones.

The cascade reactions between NH2-functionalized enaminones and sulfonyl hydrazines have been developed for the synthesis of fully substituted pyrazoles. By making use of the hydrophilic primary amino group in the enaminones, the reactions proceed well in the medium of pure water in the presence of molecular iodine, TBHP, and NaHCO3 via cascade C-H sulfonylation and pyrazole annulation. The cleavage of the C-N bond in enaminones is confirmed by the experiment using 15 N-labeled enaminone.

Time-Dependent Hormetic Response of Soil Alkaline Phosphatase Induced by Cd and the Association with Bacterial Community Composition.

Hormetic dose-response that involved Cd in soils is increasingly paid attentions for risk assessment of Cd toxicity, but insufficient studies were conducted to define the temporary modification of soil enzyme and the potential microbial responses. The present study chooses soil alkaline phosphatase (ALP) as endpoint to uncover the time-dependent hormetic responses to low doses of Cd and its association with bacterial community composition. The results showed that addition of 0.01-3.0 mg kg-1 Cd significantly increased ALP's activities with maximum stimulatory magnitude of 11.4-27.2%, indicating a typical hormesis. The response started at 12 h after Cd addition and maintained about 24 h. This demonstrated that the hormetic response is time-dependent and transient. Changes of soil bacterial community composition showed that, at 6 h, relative abundances (RAs) of Proteobacteria and Firmicutes at phylum and Pontibacter, Bacillaceae-Bacillus, Bacillaceae1-Bacillus, and Paenisporosarcina at genus significantly correlated with ALP's activities at 12-36 h (P < 0.05). This suggests that soil bacteria likely showed an earlier response to Cd and potentially contributes to the subsequent soil enzyme's hormesis. In addition, it was found that Gram-negative bacteria other than Gram-positive bacteria are prone to exhibiting a hormetic response under Cd stress. Our findings provide much insight into ecotoxicological risk assessment for soil Cd pollution.

Magnitude of the mixture hormetic response of soil alkaline phosphatase can be predicted based on single conditions of Cd and Pb.

In soil ecosystems, it is very challenging to predict mixture hormesis effects. In the present study, soil alkaline phosphatase (ALP) was selected to investigate and predict its potential hormetic responses under Cd and Pb stresses. Typical reverse U-shaped dose-response relationships between ALP activities and the single and combined Cd and Pb were observed, showing a hormetic response of soil itself. The maximum stimulatory magnitudes ranged in 8.0 - 8.6% under 0.004 - 0.2 mg/kg Cd and 80 - 400 mg/kg Pb, respectively. An enhanced stimulation of 15.7% occurred under the binary mixtures of 0.6 mg/kg Cd and 200 mg/kg Pb. In addition, a dosage-independent binary linear regression model was proposed based on an assumption of a linear relationship between the single and combined hormetic responses under Cd and Pb. Our model can well predict ALP's responses in the presence of the two metals' mixtures (p < 0.1). Our findings provided new understandings to hormesis in soil.

Facile Synthesis of Unsolvated Alkali Metal Octahydrotriborate Salts MB3 H8 (M=K, Rb, and Cs), Mechanisms of Formation, and the Crystal Structure of KB3 H8.

A facile synthesis of heavy alkali metal octahydrotriborates (MB3 H8 ; M=K, Rb, and Cs) has been developed. It is simply based on reactions of the pure alkali metals with THF⋅BH3 , does not require the use of electron carriers or the addition of other reaction media such as mercury, silica gel, or inert salts as for previous procedures, and delivers the desired products at room temperature in very high yields. However, no reactions were observed when pure Li or Na was used. The reaction mechanisms for the heavy alkali metals were investigated both experimentally and computationally. The low sublimation energies of K, Rb, and Cs were found to be key for initiation of the reactions. The syntheses can be carried out at room temperature because all of the elementary reaction steps have low energy barriers, whereas reactions of LiBH4 /NaBH4 with THF⋅BH3 have to be carried out under reflux. The high stability and solubility of KB3 H8 were examined, and a crystal structure thereof was obtained for the first time.

A Multi-Server Two-Factor Authentication Scheme with Un-Traceability Using Elliptic Curve Cryptography.

To provide secure communication, the authentication-and-key-agreement scheme plays a vital role in multi-server environments, Internet of Things (IoT), wireless sensor networks (WSNs), etc. This scheme enables users and servers to negotiate for a common session initiation key. Our proposal first analyzes Amin et al.'s authentication scheme based on RSA and proves that it cannot provide perfect forward secrecy and user un-traceability, and is susceptible to offline password guessing attack and key-compromise user impersonation attack. Secondly, we provide that Srinivas et al.'s multi-server authentication scheme is not secured against offline password guessing attack and key-compromise user impersonation attack, and is unable to ensure user un-traceability. To remedy such limitations and improve computational efficiency, we present a multi-server two-factor authentication scheme using elliptic curve cryptography (ECC). Subsequently, employing heuristic analysis and Burrows⁻Abadi⁻Needham logic (BAN-Logic) proof, it is proven that the presented scheme provides security against all known attacks, and in particular provides user un-traceability and perfect forward security. Finally, appropriate comparisons with prevalent works demonstrate the robustness and feasibility of the presented solution in multi-server environments.

Transition-metal-free synthesis of 3-sulfenylated chromones via KIO3-catalyzed radical C(sp2)-H sulfenylation.

The reactions between o-hydroxylphenyl-functionalized enaminones and sulfonyl hydrazines providing 3-sulfenylated chromones via domino chromone ring construction and C(sp2)-H bond sulfenylation have been achieved under transition-metal-free conditions by using KIO3 as the only catalyst.

Synthesis of Ammonia Borane Nanoparticles and the Diammoniate of Diborane by Direct Combination of Diborane and Ammonia.

Pure nanoparticle ammonia borane (NH3 BH3 , AB) was first prepared through a solvent-free, ambient-temperature gas-phase combination of B2 H6 with NH3 . The prepared AB nanoparticle exhibits improved dehydrogenation behavior giving 13.6 wt. % H2 at the temperature range of 80-175 °C without severe foaming. Ammonia diborane (NH3 BH2 (µ-H)BH3 , AaDB) is proposed as the intermediate in the reaction of B2 H6 with NH3 based on theoretical studies. This method can also be used to prepare pure diammoniate of diborane ([H2 B(NH3 )2 ][BH4 ], DADB) by adjusting the ratio and concentration of B2 H6 to NH3 .

Silver-Catalyzed Coupling of Ethynylbenziodoxolones with CO2 and Amines to Afford O-ß-Oxoalkyl Carbamates.

A novel three-component coupling reaction of ethynylbenziodoxolones (EBXs) with CO2 and amines has been achieved via silver catalysis, thereby providing an efficient method for the construction of a range of structurally diverse and valuable O-ß-oxoalkyl carbamates. The transformation proceeds under mild reaction conditions and exhibits a wide substrate scope and good functional group compatibility. In addition, this strategy could be extended to the synthesis of α-acyloxyketones using carboxylic acids as the nucleophiles to react with EBXs.

Estimating sliding drop width via side-view features using recurrent neural networks.

High speed side-view videos of sliding drops enable researchers to investigate drop dynamics and surface properties. However, understanding the physics of sliding requires knowledge of the drop width. A front-view perspective of the drop is necessary. In particular, the drop's width is a crucial parameter owing to its association with the friction force. Incorporating extra cameras or mirrors to monitor changes in the width of drops from a front-view perspective is cumbersome and limits the viewing area. This limitation impedes a comprehensive analysis of sliding drops, especially when they interact with surface defects. Our study explores the use of various regression and multivariate sequence analysis (MSA) models to estimate the drop width at a solid surface solely from side-view videos. This approach eliminates the need to incorporate additional equipment into the experimental setup. In addition, it ensures an unlimited viewing area of sliding drops. The Long Short Term Memory (LSTM) model with a 20 sliding window size has the best performance with the lowest root mean square error (RMSE) of 67 µm. Within the spectrum of drop widths in our dataset, ranging from 1.6 to 4.4 mm, this RMSE indicates that we can predict the width of sliding drops with an error of 2.4%. Furthermore, the applied LSTM model provides a drop width across the whole sliding length of 5 cm, previously unattainable.

Suppressing ACQ of molecular photosensitizers by distorting the conjugated-plane for enhanced tumor photodynamic therapy.

Non-AIE-type molecular photosensitizers (PSs) suffer from the aggregation-caused-quenching (ACQ) effect in an aqueous medium due to the strong hydrophobic and π-π interactions of their conjugated planes, which significantly hinders the enhancement of tumor photodynamic therapy (PDT). So far, some ionic PSs have been reported with good water-solubility, though the ACQ effect can still be induced in a biological environment rich in ions, leading to unsatisfactory in vivo delivery and fluorescence imaging performance. Hence, designing molecular PSs with outstanding anti-ACQ properties in water is highly desirable, but it remains a tough challenge for non-AIE-type fluorophores. Herein, we demonstrated a strategy for the design of porphyrin-type molecular PSs with remarkable solubility and anti-ACQ properties in an aqueous medium, which was assisted by quantum chemical simulations. It was found that cationic branched side chains can induce serious plane distortion in diphenyl porphyrin (DPP), which was not observed for tetraphenyl porphyrin (TPP) with the same side chains. Moreover, the hydrophilicity of the chain spacer is also crucial to the plane distortion for attaining the desired anti-ACQ properties. Compared to ACQ porphyrin, anti-ACQ porphyrin displayed type-I ROS generation in hypoxia and much higher tumor accumulation efficacy by blood circulation, leading to highly efficient in vivo PDT for hypoxic tumors. This study demonstrates the power of sidechain chemistry in tuning the configuration and aggregation behaviors of porphyrins in water, offering a new path to boost the performance of PSs to fulfill the increasing clinical demands on cancer theranostics.

Construction and Application of a PD-L1-Targeted Multimodal Diagnostic and Dual-Functional Theranostics Nanoprobe.

Background: In recent years, PD-L1 has been primarily utilized as an immune checkpoint marker in cancer immunotherapy. However, due to tumor heterogeneity, the response rate to such therapies often falls short of expectations. In addition to its role in immunotherapy, PD-L1 serves as a specific target on the surface of tumor cells for targeted diagnostic and therapeutic interventions. There is an absence of a fully developed PD-L1-targeted diagnostic and therapeutic probe for clinical use, which constrains the exploration and clinical exploitation of this target. Methods and Results: In this study, we engineered a PD-L1-targeted probe with multimodal imaging and dual therapeutic functionalities utilizing organic melanin nanoparticles. Functionalization with the WL12-SH peptide endowed the nanoprobe with specific targeting capabilities. Subsequent radiolabeling with 89Zr (half-life: 100.8 hours) and chelation of Mn2+ ions afforded the probe the capacity for simultaneous PET and MRI imaging modalities. Cellular uptake assays revealed pronounced specificity, with -positive cells exhibiting significantly higher uptake than -negative counterparts (p < 0.05). Dual-modal PET/MRI imaging delineated rapid and sustained accumulation at the neoplastic site, yielding tumor-to-non-tumor (T/NT) signal ratios at 24 hours post-injection of 16.67±3.45 for PET and 6.63±0.64 for MRI, respectively. We conjugated the therapeutic radionuclide 131I (half-life: 8.02 days) to the construct and combined low-dose radiotherapy and photothermal treatment (PTT), culminating in superior antitumor efficacy while preserving a high safety profile. The tumors in the cohort receiving the dual-modality therapy exhibited significantly reduced volume and weight compared to those in the control and monotherapy groups. Conclusion: We developed and applied a novel -targeted multimodal theranostic nanoprobe, characterized by its high specificity and superior imaging capabilities as demonstrated in PET/MRI modalities. Furthermore, this nanoprobe facilitates potent therapeutic efficacy at lower radionuclide doses when used in conjunction with PTT.

Endogenous cAMP elevation in Brassica napus causes changes in phytohormone levels.

In higher plants, the regulatory roles of cAMP (cyclic adenosine 3',5'-monophosphate) signaling remain elusive until now. Cellular cAMP levels are generally much lower in higher plants than in animals and transiently elevated for triggering downstream signaling events. Moreover, plant adenylate cyclase (AC) activities are found in different moonlighting multifunctional proteins, which may pose additional complications in distinguishing a specific signaling role for cAMP. Here, we have developed rapeseed (Brassica napus L.) transgenic plants that overexpress an inducible plant-origin AC activity for generating high AC levels much like that in animal cells, which served the genetic model disturbing native cAMP signaling as a whole in plants. We found that overexpression of the soluble AC activity had significant impacts on the contents of indole-3-acetic acid (IAA) and stress phytohormones, i.e. jasmonic acid (JA), abscisic acid (ABA), and salicylic acid (SA) in the transgenic plants. Acute induction of the AC activity caused IAA overaccumulation, and upregulation of TAA1 and CYP83B1 in the IAA biosynthesis pathways, but also simultaneously the hyper-induction of PR4 and KIN2 expression indicating activation of JA and ABA signaling pathways. We observed typical overgrowth phenotypes related to IAA excess in the transgenic plants, including significant increases in plant height, internode length, width of leaf blade, petiole length, root length, and fresh shoot biomass, as well as the precocious seed development, as compared to wild-type plants. In addition, we identified a set of 1465 cAMP-responsive genes (CRGs), which are most significantly enriched in plant hormone signal transduction pathway, and function mainly in relevance to hormonal, abiotic and biotic stress responses, as well as growth and development. Collectively, our results support that cAMP elevation impacts phytohormone homeostasis and signaling, and modulates plant growth and development. We proposed that cAMP signaling may be critical in configuring the coordinated regulation of growth and development in higher plants.

Photoredox-catalyzed coupling of aryl sulfonium salts with CO2 and amines to access O-aryl carbamates.

An efficient photoredox-catalyzed three-component coupling reaction of aryl sulfonium salts, carbon dioxide and amines has been developed for the first time. This reaction provides a new strategy for the synthesis of a range of valuable O-aryl carbamates from readily available arenes via a site-selective thianthrenation/carbamoyloxylation two-step process. Mild conditions, broad substrate scope and good functional group tolerance are the features of the transformation. The synthetic utility of the method was demonstrated by the late-stage modification of bioactive molecules and pharmaceuticals.

Mechanisms of hyponatremia and diabetes insipidus after acute spinal cord injury: a critical review.

The incidence of hyponatremia after spinal cord injury was reported to be between 25 and 80%. Hyponatremia can lead to a variety of clinical symptoms, from mild to severe and even life-threatening. Hyponatremia is often associated with diabetes insipidus, which refers to insufficient arginine vasopressin (AVP) secretion or defective renal response to AVP, with clinical manifestations of syndromes such as hypoosmolality, polydipsia, and polydipsia. Recent mechanistic studies on hyponatremia and diabetes insipidus after acute spinal cord injury have been performed in isolation, without integrating the above two symptoms into different pathological manifestations that occur in the same injury state and without considering the acute spinal cord injury patient's condition as a whole. The therapeutic principles of CSWS and SIADH are in opposition to one another. It is not easy to identify the mechanism of hyponatremia in clinical practice, which makes selecting the treatment difficult. According to the existing theories, treatments for hyponatremia and diabetes insipidus together are contraindicated, whether the mechanism of hyponatremia is thought to be CSWS or SIADH. In this paper, we review the mechanism of these two pathological manifestations and suggest that our current understanding of the mechanisms of hyponatremia and diabetes insipidus after high acute cervical SCI is insufficient, and it is likely that there are other undetected pathogenetic mechanisms.

A Novel Fuzzy Relative-Position-Coding Transformer for Breast Cancer Diagnosis Using Ultrasonography.

Breast cancer is a leading cause of death in women worldwide, and early detection is crucial for successful treatment. Computer-aided diagnosis (CAD) systems have been developed to assist doctors in identifying breast cancer on ultrasound images. In this paper, we propose a novel fuzzy relative-position-coding (FRPC) Transformer to classify breast ultrasound (BUS) images for breast cancer diagnosis. The proposed FRPC Transformer utilizes the self-attention mechanism of Transformer networks combined with fuzzy relative-position-coding to capture global and local features of the BUS images. The performance of the proposed method is evaluated on one benchmark dataset and compared with those obtained by existing Transformer approaches using various metrics. The experimental outcomes distinctly establish the superiority of the proposed method in achieving elevated levels of accuracy, sensitivity, specificity, and F1 score (all at 90.52%), as well as a heightened area under the receiver operating characteristic (ROC) curve (0.91), surpassing those attained by the original Transformer model (at 89.54%, 89.54%, 89.54%, and 0.89, respectively). Overall, the proposed FRPC Transformer is a promising approach for breast cancer diagnosis. It has potential applications in clinical practice and can contribute to the early detection of breast cancer.