Hierarchical Yolk-Shell Porous Ionic Liquids with Lower Viscosity for Efficient C3H6/C3H8 Adsorption and Separation.

Yolk-shell metal-organic framework (YS-MOF) liquids are candidate materials in large-size species with high-efficiency separation, owing to their hierarchical porosity, faster mass transfer, better compatibility, and higher solution processability than MOF liquids with micropores. Nevertheless, facile synthesis strategies of yolk-shell porous ionic liquids (YSPILs) with regulations of size and morphology are an ongoing challenge. Herein, we propose a general strategy to construct YSPILs based on Z67@PDA with tunable core sizes and morphologies. Benefiting from the unique hierarchical yolk-shell structure, as-prepared YSPILs exhibit promise in C3H6/C3H8 capture and separation with the increased sizes of core in yolk-shell ZIF-67@PDA. Advanced YS-MOF liquids have improved the adsorption properties and increased our ability to tailor chemical composition and pore architecture. Impressively, the adsorption capacity of C3H6 and C3H8 of YSPILs exhibits an approximately 3-fold enhancement compared with that of the neat ILs, confirming that the accessible porosities are retained. Effective C3H6/C3H8 separation performance of YSPILs over PILs based on ZIF-67, revealing the hierarchical porosity of YS-Z67@PDA liquids, benefits larger-size gas separation. Therefore, we believe that this work can not only help us to rationally design novel hierarchically porous ionic liquids but also promote candidate applications in large-size species separation, catalysis, and nanoreactors.

Full-sized realistic 3D printed models of liver and tumour anatomy: a useful tool for the clinical medicine education of beginning trainees.

BACKGROUND: Simulation-based medical education (SBME) and three-dimensional printed (3DP) models are increasingly used in continuing medical education and clinical training. However, our understanding of their role and value in improving trainees' understanding of the anatomical and surgical procedures associated with liver surgery remains limited. Furthermore, gender bias is also a potential factor in the evaluation of medical education. Therefore, the aim of this study was to evaluate the educational benefits trainees receive from the use of novel 3DP liver models while considering trainees' experience and gender. METHODS: Full-sized 3DP liver models were developed and printed using transparent material based on anonymous CT scans. We used printed 3D models and conventional 2D CT scans of the liver to investigate thirty trainees with various levels of experience and different genders in the context of both small group teaching and formative assessment. We adopted a mixed methods approach involving both questionnaires and focus groups to collect the views of different trainees and monitors to assess trainees' educational benefits and perceptions after progressing through different training programs. We used Objective Structured Clinical Examination (OSCE) and Likert scales to support thematic analysis of the responses to the questionnaires by trainees and monitors, respectively. Descriptive analyses were conducted using SPSS statistical software version 21.0. RESULTS: Overall, a 3DP model of the liver is of great significance for improving trainees' understanding of surgical procedures and cooperation during operation. After viewing the personalized full-sized 3DP liver model, all trainees at the various levels exhibited significant improvements in their understanding of the key points of surgery (p < 0.05), especially regarding the planned surgical procedure and key details of the surgical procedures. More importantly, the trainees exhibited higher levels of satisfaction and self-confidence during the operation regardless of gender. However, with regard to gender, the results showed that the improvement of male trainees after training with the 3DP liver model was more significant than that of female trainees in understanding and cooperation during the surgical procedure, while no such trend was found with regard to their understanding of the base knowledge. CONCLUSION: Trainees and monitors agreed that the use of 3DP liver models was acceptable. The improvement of the learning effect for practical skills and theoretical understanding after training with the 3DP liver models was significant. This study also indicated that training with personalized 3DP liver models can improve all trainees' presurgical understanding of liver tumours and surgery and males show more advantage in understanding and cooperation during the surgical procedure as compared to females. Full-sized realistic 3DP models of the liver are an effective auxiliary teaching tool for SBME teaching in Chinese continuing medical education.

3D printing technique applied in vaginoplasty: A case report.

Background: We present the first case report of the treatment of congenital vaginal atresia by 3D-printed patient-specific vaginal scaffold from China. Case presentation: A 17-year-old female patient was referred to our department for treatment of congenital vaginal atresia and complications arising from previous failed operations. Pelvic examination was conducted to understand the morphological characteristics and severity of stenosis, and based on which we designed our prototypes of vaginal scaffold using software UG NX10.0. We finally obtained our patient-specific mold, which was 50 mm in length, 28 mm in diameter, 2 mm of thickness with a whole weight of 7.6 g, and it was made of polycaprolactone. After removing scar tissues caused by vaginal stenosis, an 8 cm long artificial tunnel was created, and then the polycaprolactone (PCL) vaginal mold was placed and sutured. The patient had no discomfort after surgery and was discharged 3 days after the surgery. Follow-up for 1 year after surgery, through hysteroscopy and colposcopy, it was found that the cervix was smooth, the vaginal wall was covered with stratified squamous epithelium, and the vaginal wall was soft and lubricated, which was close to a normal vagina. The incompletely absorbed mold was taken out one year after the operation. Hysteroscopy and colposcopy were performed one year and two years after the mold was taken out. The vagina was unobstructed and the length was about 12 cm. The appearance of the vaginal wrinkles was normal. The patient's quality of sexual life was good. Conclusion: Our team tried to treat congenital vaginal atresia by 3D-printed patient-specific vaginal scaffold, which can effectively reduce patient complications and reduce patient pain. Through long-term follow-up, we found that this technique has achieved favorable results and improved the patient's quality of sexual life.

Can Environmental Regulation Promote Green Innovation and Productivity? The Moderating Role of Government Interventions in Urban China.

Can environmental regulation promote green innovation and the productivity of cities? The "Compliance Cost" (CC) perspective and the "Porter Hypothesis" (PH) offer contrasting views, whereas the existing empirical results are inconclusive. This paper aims to highlight the roles of multifaceted government interventions, including government-to-firm subsidies, tax levies on firms, and environmental infrastructure provisions, in moderating environmental regulation for realizing PH. Based on the fixed-effects models for Chinese prefecture cities from 2005-2013, we found that environmental regulation positively impacted green innovation but negatively affected productivity. The results of moderating effects suggest that environmental regulation can better promote green innovation if it is compounded with more government-to-firm subsidies, lower firm tax burdens, and increased environmental infrastructure provisions. We further decomposed the impacts of these interventions across seven fields of green innovation and found that subsidy and tax burden relief were especially effective in facilitating more GI in the sector of transportation and alternative energy production. This paper amplifies the theoretical framework of PH by accentuating the analytical lens of multifaceted government interventions but also provides insights into how local governments can effectively design "carrot-and-stick" policies to realize PH at the city level.

Preliminary application of three-dimensional printing in congenital uterine anomalies based on three-dimensional transvaginal ultrasonographic data.

BACKGROUND: The three-dimensional (3D) printing technology has remarkable potential as an auxiliary tool for representing anatomical structures, facilitating diagnosis and therapy, and enhancing training and teaching in the medical field. As the most available diagnostic tool and it is routinely used as the first approach in diagnosis of the uterine anomalies, 3D transvaginal ultrasonography (3D-TVS) has been proposed as non-invasive "gold standard" approach for these malformations due to high diagnostic accuracy. Despite holding promise of manufacturing 3D printed models based on 3D-TVS data, relevant reports about 3D-TVS derived gynecological 3D printing haven't been reported to the best of our knowledge. We found an opportunity to explore the feasibility of building 3D printed models for the abnormal uterus based on the data acquired by 3D-TVS. METHODS: The women suspected with congenital uterine anomalies (CUAs) were enrolled in the study. The diagnose of CUAs were made by 3D-TVS scanning and further confirmed under the hysteroscopy examination. One volunteer with normal uterus was enrolled as control. All subjects underwent 3D-TVS scanning for 3D printing data collection. Acquired images were stored and extracted as DICOM files, then processed by professional software to portray and model the boundary of the uterine inner and outer walls separately. After the computer 3D models were constructed, the data were saved and output as STL files for further surface restoration and smoothing. The colors of endometrium and uterine body were specified, respectively, in the print preview mode. Then the uncured photosensitive resin was cleaned and polished to obtain a smooth and transparent solid model after printed models were cooled down. RESULTS: 3D printing models of normal uterus, incomplete septate uterus, complete septate uterus, uterus didelphys and unicornuate uterus were produced on ultrasonographic data of 3D-TVS. CONCLUSIONS: Our research and practice made the first try in modeling CUAs successfully based on ultrasonographic data entirely, verifying that it's a feasible way to build 3D printed models of high-quality through 3D-TVS scanning.

Custom-Made Antibiotic Cement-Coated Nail for the Treatment of Infected Bone Defect.

BACKGROUND: Longbone infected bone defect remains a great challenge due to multiple surgeries, long-term treatment duration, and uncertain prognosis. Treatment principles include eradication/debridement, stabilization, and antibiotic administration. An antibiotic cement-coated nail has shown great prospects due to both local antibiotic elution and stabilization of bone defects. However, the current fabrication technique remains to be improved. METHODS: For the first time, we described a new method for custom-made cement-coated nail fabrication based on a 3D printing technique. A retrospective study of 19 consecutive patients with long bone infected bone defects from one medical center was conducted who met the inclusion and exclusion criteria from November 2016 to May 2020. The treatment involved thorough debridement, custom-made antibiotic cement-coated nail filling, and culture-specific systemic antibiotic treatment guided by a multidisciplinary team. Clinical and radiographic examinations (X-ray and CT scans) were used to evaluate bony union. Clinical and laboratory examinations were used to evaluate the infection control. The SF-36 score was used to evaluate patients' quality of life pre- and postoperatively. RESULTS: The mean follow-up was 98.8 weeks (ranging from 40 to 192). All cases achieved infection control, 3 cases achieved bone healing after one-stage operation, and 12 cases achieved bone healing after a two-stage bone graft procedure. At the last follow-up, none of the 19 patients had infection recurrence or 1 case had failure of the protective plate. The pre- and postoperative SF-36 score showed that there were statistical differences in all the 9 aspects. CONCLUSIONS: The precise custom-made antibiotic cement-coated intramedullary nail through the 3D printing technique used in this study is an effective strategy for the treatment of infected bone defects of long bone. This technique may help to increase the infection control rate and promote bone healing.

3D-Printed PEEK Extravascular Stent in the Treatment of Nutcracker Syndrome: Imaging Evaluation and Short-Term Clinical Outcome.

Minimally invasive options are safe and reliable alternatives for the treatment of nutcracker syndrome (NCS). After continued efforts, our team successfully devised a new and effective therapeutic method: 3D-printed extravascular stenting of the left renal vein. From December 2017 to May 2019, 28 patients (25 men and 3 women) from different parts of China between 18 and 37 years old (mean, 23.6 years) diagnosed with NCS were admitted for laparoscopic 3D-printed extravascular stenting treatment. The post-operative follow-up duration was 6-24 months (median, 16.3 months). Technical success of the operation was achieved in all patients. After treatment, the NCS symptoms all patients resolved or improved during the follow-up period, without relapse. Most symptoms, including macro-/microhematuria, proteinuria, and flank/abdominal pain, tended to resolve within 3-6 months after the surgery; other symptoms, such as left-sided varicocele, also showed varying degrees of improvement at different times post-operatively. Perioperative complications were noted in two patients, including transient and mild lymphatic leakage, without any adverse effects. All extravascular stents were visualized on computed tomography and Doppler ultrasound scans, and no migration or any side effects occurred during the entire follow-up period. Compared to endovascular stenting or polytetrafluoroethylene artificial vessel procedures, 3D-printed polyetheretherketone extravascular stenting has more advantages in terms of stent design and rigidity and approach rationality while successfully preventing stent migration and thrombosis. Therefore, this method may serve as an accurate and effective treatment for NCS patients.

Cost-effectiveness of School Hearing Screening Programs: A Scoping Review.

OBJECTIVE: School hearing screening is a public health intervention that can improve care for children who experience hearing loss that is not detected on or develops after newborn screening. However, implementation of school hearing screening is sporadic and supported by mixed evidence to its economic benefit. This scoping review provides a summary of all published cost-effectiveness studies regarding school hearing screening programs globally. At the time of this review, there were no previously published reviews of a similar nature. DATA SOURCES: A structured search was applied to 4 databases: PubMed (Medline), Embase, CINAHL, and Cochrane Library. REVIEW METHODS: The database search was carried out by 2 independent researchers, and results were reported in accordance with the PRISMA-ScR checklist and the JBI methodology for scoping reviews. Studies that included a cost analysis of screening programs for school-aged children in the school environment were eligible for inclusion. Studies that involved evaluations of only neonatal or preschool programs were excluded. RESULTS: Four of the 5 studies that conducted a cost-effectiveness analysis reported that school hearing screening was cost-effective through the calculation of incremental cost-effectiveness ratios (ICERs) via either quality- or disability-adjusted life years. One study reported that a new school hearing screening program dominated the existing program; 2 studies reported ICERs ranging from 1079 to 4304 international dollars; and 1 study reported an ICER of £2445. One study reported that school-entry hearing screening was not cost-effective versus no screening. CONCLUSION: The majority of studies concluded that school hearing screening was cost-effective. However, significant differences in methodology and region-specific estimates of model inputs limit the generalizability of these findings.

Three-dimensional printing flexible models: a novel technique for Nuss procedure planning of pectus excavatum repair.

BACKGROUND: Pectus excavatum (PE), one of the most common congenital chest wall deformities, is characterized by posterior depression of the sternum and lower costal cartilages. In this study, we demonstrated the application of flexible three-dimensional printing thoracic models for surgical approach planning of extrapleural Nuss procedure for patients with pectus excavatum. METHODS: Six patients with pectus excavatum were referred to our hospital for extrapleural Nuss procedure. Each patient's chest was reconstructed based on their computed tomography imaging data, and the three-dimensional (3D) thoracic model was manufactured with flexible material using 3D printing technique. The individual surgical approach and custom-made steel bars were designed and produced using these models. RESULTS: The surgical approach was evaluated by using the three-dimensional thoracic model. In all patients received extrapleural Nuss surgery, it has been proven the uniformity of repair efficacy in both models and patients. Moreover, an individualized and well-fitting steel bar can be fabricated once the surgical approach was confirmed. All the steel bars were loaded against the ribs rigorously and seamlessly. CONCLUSIONS: The flexible three-dimensional thoracic models were very helpful for the preoperative planning of extrapleural Nuss procedure.

Clinical application of 3D printed titanium chest and rib implants in chest wall reconstruction / 中国胸心血管外科临床杂志

@#Objective    In this study, three-dimensional printed (3DP) titanium implants were used for skeletal reconstructions after wide excision of chest wall. 3DP titanium implants were expected to provide a valid option with perfect anatomic fitting and personalized design in chest wall reconstruction. Methods    There were 13 patients [mean age of 46 (24-78) years with 9 males and 4 females] who underwent adequate radical wide excision for tumors and chest wall reconstruction using 3DP titanium implants. Surgical data including patient demographic characteristics, perioperative clinical data and data from 1-year follow-up were collected and analyzed. Results    Six patients of rib tumors, six patients of sternal tumors and one patient of sternal pyogenic osteomyelitis were finally selected for the study. The chest wall defect area was 221.0±206.0 cm2. All patients were able to maintain the integrity of the chest wall after surgery, and no abnormal breathing was found, achieving personalized and anatomical repair. Thirteen patients were successfully discharged from the hospital. Two patients developed pneumonia in the perioperative period. During the follow-up period in the first year after surgery, no implant related adverse reaction was observed, including implant rupture, implant shift, rejection reaction and allergies. One patient had wound ulcer after chemotherapy. Three patients had tumor recurrence, with the recurrence rate of 25.0%. Two patients died of tumor recurrence, with a mortality rate of 16.7%. Conclusion    3DP titanium implant is a safe and effective material for chest wall reconstruction. 

Chromate nanorods/nanobelts: general synthesis, characterization, and properties.

A general synthesis route to a family of single-crystal chromate nanorods/nanobelts has been established. The effects of pH and surfactant on phase and morphology of these microcrystalline materials have been investigated. The physical properties of the as-synthesized chromate nanocrystals such as dielectric, electrochemical, UV-vis absorbance, and photoluminescent properties have also been studied. The present general synthesis of various low-dimensional chromate nanomaterials provides useful information on the possible synthesis of other microcrystalline transition metal oxysalts.

[Photoluminescence of tetragonal ZrO2 nanoparticles synthesized by severral methods].

Five methods for the preparation of stabilized ZrO2 nano-powders have been used. They are hydro-thermal method, alcohol-thermal method, sol-gel method, microwave-irradiation, and sonochemical method. XRD (X-ray diffraction) and PLspectra (Photoluminescence spectra) have been utilized to characterize these samples. Stable tetragonal nanometre ZrQ powders have been synthesized by these methods. From the XRD pattern, it is clear that the ZrO2 samples we obtained are crystal and distributed well. The PL pattern shows that the nano-ZrO2 powders can emit clear red and blue light when they are excited by the ultraviolet. The emphasis of this thesis is to discuss the ZrO2 emission nanocrystals' luminescent procedures.

Photoluminescence of tetragonal ZrO(2) nanoparticles synthesized by microwave irradiation.

Polymer-stabilized tetragonal ZrO(2) nanopowders with average size of ca. 2.0 nm have been prepared by microwave heating in an aqueous solution containing Zr(NO(3))(4) x 5H(2)O, PVA, and NaOH. The photoluminescence of the synthesized ZrO(2) fine particles has been investigated.