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Background: Distal forearm fractures were defined as distal radius fractures with concomitant distal ulna fractures, except ulna styloid fractures. Distal forearm fractures are common among geriatric populations, particularly those with osteoporosis. Conventionally, distal forearm fractures are reduced by a double incision approach; however, malreduction and instability of the distal radioulnar joint were not uncommon. We introduced a modified volar dual window approach to treat the distal forearm fracture and evaluate the functional outcomes and complications. Methods: From January 2020 to June 2023, 13 patients with distal forearm fractures underwent open reduction by the modified dual window approach with locking plate fixation. After surgery, splints were applied for two weeks, and the patients underwent postoperative hand therapy for three months. The mean Quick Disabilities of the Arm, Shoulder, and Hand scores, range of motions, grip strength, postoperative radiographic parameters, and complications data were collected. Results: The mean follow-up period was 12.1 months, and the mean age was 52.3 years. Average wrist flexion was 67°, extension 69°, pronation 81°, and supination 79°. Grip strength was 28.3 ± 11.5 kg, which was 88% of the uninjured opposite side. The Visual Analog Scale score during activities was recorded as 0.5 ± 0.9. The mean Quick Disabilities of the Arm, Shoulder, and Hand score was 14 ± 11.5. The postoperative radiographic parameters were as follows: radial height: 10.8 ± 1.7 mm, radial inclination: 22.6 ± 3.7°, volar tilting: 4.0 ± 3.9°, and ulnar variance: −0.4 ± 1.4 mm. All the patients achieved bone union at the final follow-up. Two patients underwent ulnar implant removal due to irritation symptoms. Neither infection, nor neurovascular injury, nor malreduction developed in these patients. Conclusions: The modified volar dual window approach can achieve good wrist function and distal forearm fracture reduction without increasing neurovascular or wound healing complications. This method is an alternative approach for distal forearm fracture, especially in comminuted distal ulna fracture or distal radioulnar joint incongruity.

Abstract Backgrounds Cardiopulmonary resuscitation (CPR) training is generally led by instructors in a classroom; thus, conventional teaching materials used in CPR training are often constrained by spatiotemporal factors, limiting learners’ interest and sense of achievement in learning and preventing them from effectively applying what they learn in practice. For greater effectiveness and more flexible application, clinical nursing education has increasingly emphasized contextualization, individualization, and interprofessional learning. This study determined the self-assessed emergency care competencies of nurses who received gamified emergency care training and explored the factors associated with those competencies. Methods Quota sampling of nurses working at a certain regional hospital in central Taiwan was conducted, and a structured questionnaire was administered to the recruited nurses. A total of 194 valid responses were collected. The research tool was a scale measuring the participants’ emergency care competencies after they received gamified emergency care training. The data were analyzed using descriptive and inferential statistics and multiple regression. Results Of the recruited participants, 50.52% were ≤ 30 years old; 48.45% worked in the internal medicine department; 54.64% graduated from 2-year university technical programs; 54.12% were N2 registered nurses; 35.57% and 21.13% had ≥ 10 and 1–3 years of work experience, respectively; and 48.45% worked in general wards. User need (r = 0.52, p = 0.000), perceived usefulness (r = 0.54, p = 0.000), perceived ease of use (r = 0.51, p = 0.000), and usage attitude (r = 0.41, p = 0.000) were positively correlated with emergency care competencies. Furthermore, the multiple regression analysis revealed that perceived usefulness was the primary factor associated with the participants’ emergency care competencies. Conclusions The results of this study may serve as a reference for acute care facility authorities in designing advanced nursing competency standards and emergency care training programs for nurses.

In this study, severe cracking occurred during an investigation of the direct hot rolling of industrial electrolytic nickel plates. To determine the cause of hot-rolling cracking, the microstructure phase composition was analyzed through the utilization of various techniques, including optical microscopy, scanning electron microscopy, electron backscattering diffraction, transmission electron microscopy (TEM), energy-dispersive X-ray spectroscopy (EDS) and electron probe micro-analysis. The comparative microstructural analysis took place between specimens heat treated in atmospheric and vacuum environments. The characterization and analysis of the hot-rolled plates considered the crack microstructure and fracture morphology. It was shown that holes appeared along the large angular grain boundaries after annealing at 1100 °C for 8 h. Possible reason: In a high-temperature environment, the decomposition of residual additives in the electrolytic nickel releases oxidizing gases, which oxidizes the grain boundaries. The reaction with carbon diffused into the grain boundaries and produced carbon monoxide gas, which induced holes and severely reduced the grain boundary plasticity. The heat treatment time did not need to be very long for severe grain boundary degradation to occur. After severe cavitation, the electrolytic nickel was severely cracked at grain boundaries cracks due to a shear force, and brittle fractures occurred along grains with very low plasticity. [ABSTRACT FROM AUTHOR]

Polyetheretherketone (PEEK) is an emerging thermoplastic polymer with good mechanical properties and an elastic modulus similar to that of alveolar bone. PEEK dental prostheses for computer-aided design/computer-aided manufacturing (CAD/CAM) systems on the market often have additives of titanium dioxide (TiO2) to strengthen their mechanical properties. However, the effects of combining aging, simulating a long-term intraoral environment, and TiO2 content on the fracture characteristics of PEEK dental prostheses have rarely been investigated. In this study, two types of commercially available PEEK blocks, containing 20% and 30% TiO2, were used to fabricate dental crowns by CAD/CAM systems and were aged for 5 and 10 h based on the ISO 13356 specifications. The compressive fracture load values of PEEK dental crowns were measured using a universal test machine. The morphology and crystallinity of the fracture surface were analyzed by scanning electron microscopy and an X-ray diffractometer, respectively. Statistical analysis was performed using the paired t-test (α = 0.05). Results showed no significant difference in the fracture load value of the test PEEK crowns with 20% and 30% TiO2 after 5 or 10 h of aging treatment; all test PEEK crowns have satisfactory fracture properties for clinical applications. Fracture surface analysis revealed that all test crowns fractured from the lingual side of the occlusal surface, with the fracture extending along the lingual sulcus to the lingual edge, showing a feather shape at the middle part of the fracture extension path and a coral shape at the end of the fracture. Crystalline analysis showed that PEEK crowns, regardless of aging time and TiO2 content, remained predominantly PEEK matrix and rutile phase TiO2. We would conclude that adding 20% or 30% TiO2 to PEEK crowns may have been sufficient to improve the fracture properties of PEEK crowns after 5 or 10 h of aging. Aging times below 10 h may still be safe for reducing the fracture properties of TiO2-containing PEEK crowns.

LINC00461 is located in the intergenic region between the protein-coding genes MEF2C and TMEM161B. LINC00461 upregulation was associated with the risk of 13 tumors and was strongly associated with clinicopathologic features and poor prognosis in 11 tumors. LINC00461 is involved in resistance to four anticancer drugs, including sunitinib for renal cell carcinoma, cisplatin for head and neck squamous cell carcinoma and rectal cancer, temozolomide for glioma, and docetaxel for breast cancer. LINC00461 can sponge 18 miRNAs to form a complex ceRNA network that regulates the expression of a large number of downstream genes. LINC00461 is involved in the MAPK/ERK signaling pathway and PI3K/AKT signaling pathway, thereby promoting tumorigenesis. Notably, knockdown of LINC00461 in exosomes antagonizes tumor cell proliferation in multiple myeloma. This article summarizes the diagnostic, prognostic, and therapeutic value of LINC00461 in various tumors, and systematically describes the ceRNA network and signaling pathways associated with LINC00461, providing potential directions for future LINC00461 research.

Pneumonia stands as the leading infectious cause of childhood mortality annually, underscoring its significant impact on pediatric health. Although dexamethasone (DXMS) is effective for treating pulmonary inflammation, its therapeutic potential is compromised by systemic side effects and suboptimal carrier systems. To address this issue, the current study introduces solid lipid nanoparticles encapsulating hydrophobic dexamethasone palmitate (DXMS-Pal-SLNs) as an anti-inflammatory nanoplatform to treat pneumonia. The specialized nanoparticle formulation is characterized by high drug loading efficiency, low drug leakage and excellent colloidal stability in particular during nebulization and is proficiently designed to target alveolar macrophages in deep lung regions via local delivery with the nebulization administration. In vitro analyses revealed substantial reductions in the secretions of tumor necrosis factor-α and interleukin-6 from alveolar macrophages, highlighting the potential efficacy of DXMS-Pal-SLNs in alleviating pneumonia-related inflammation. Similarly, in vivo experiments showed a significant reduction in the levels of these cytokines in the lungs of mice experiencing lipopolysaccharide-induced pulmonary inflammation after the administration of DXMS-Pal-SLNs via nebulization. Furthermore, the study demonstrated that DXMS-Pal-SLNs effectively control acute infections without causing pulmonary infiltration or excessive recruitment of immunocytes in lung tissues. These findings highlight the potential of nebulized DXMS-Pal-SLNs as a promising therapeutic strategy for mitigating pneumonia-related inflammations. [ABSTRACT FROM AUTHOR]

On 12 May, 2008, a magnitude 7.9 earthquake struck Wenchuan County, Aba Tibetan and Qiang Autonomous Prefecture, Sichuan Province, causing substantial losses of human life and property. This paper takes ten counties and cities along the road network in the extremely severe disaster areas of the Wenchuan earthquake as research objects and extracts typical road network characteristics for 10 time points during the pre-earthquake, damage and repair processes. Then, it builds three resilience assessment indices, namely, the overall integrity, overall connectivity and effective connectivity with the complex network and resilience framework, to investigate the road network resilience. A resilience curve of the road system based on real data from the extremely severe disaster areas of the Wenchuan earthquake is obtained here for the first time, revealing the total variation characteristics and key sections of the road system in terms of resilience and proposing strategies for resilience optimization.

This paper describes examples of actions taken for the connectivity between soil and society to inspire soil awareness in Taiwan, particularly by the practices of university social responsibility (USR) including workshops of soil survey education in Taiwan (WOSSET) carried out from 2015 to 2019, the Farmers Academy, soil profiles diagnoses for crop growth, the soil museum, and soil art applications. In the WOSSET, the students learned the skills of soil description, classification and interpretation on the impacts of soil management, suitability classes of crop production and land uses. The students considered the experience from the WOSSET as positive impacts on their professional careers making them “seed-spreaders” for soil connectivity between scientists and the general public by promoting their dedication to future practices of USR. In the program of the Farmers Academy, soil concepts related to soil properties, fertilizer, plant nutrition, compost and soil management have been taught by speakers from university faculties; thus the trained young farmers are able to obtain new knowledge of soil science even through the simple observation of soil profile morphology, which are helpful links among crop root growth, soil management and climate change. Inspired by the visual impact from the visits to soil museum in the university, soil was applied as pigments by artists on artistic practices such as painting and fabric. The actions of soil connectivity enable the general public and students to understand soil functions and soil security as well as construct the knowledge foundation of communication on the Sustainable Development Goals (SDGs).

Background: Prosthesis infection is a difficult-to-treat situation. Hydrogel is a novel biomaterial, which can be applied by simply spraying or by coating on implants before surgery and can be easily mixed with antibiotics. Methods: In order to evaluate the potential use of antibiotic-loaded hydrogel, we incorporated vancomycin into oxidized hyaluronic acid (HA) and adipic acid dihydrazide and evaluated the drug release and antimicrobial activity against methicillin-resistant Staphylococcus aureus (ATCC 29213). Results: The average release percentage of vancomycin on day 3 was about 86%. The antibiotic-loaded gel was biocompatible with mesenchymal stem cell, MC3T3, and L929 cell lines. The in vitro inhibition zones of vancomycin-loaded hydrogel [500X minimal inhibition concentration (MIC), 50X MIC, 10X MIC, and blank hydrogel] were 21, 13, 9, and 5 mm, respectively. In the Ti6Al4V implant biofilm model, 0.01–1% vancomycin-loaded gel exhibited significant anti-biofilm activity, measured by the MTT assay. Conclusions: Vancomycin could be loaded onto oxidized HA and adipic acid dihydrazide, which exhibited excellent drug release and in vitro antimicrobial activity with minimal cell toxicity.

Although polyetheretherketone (PEEK) is becoming more widely used in dentistry applications, little is known about how aging will affect this material. Therefore, this study aimed to investigate the influence of an aging treatment on fracture characteristics of PEEK dental crowns. Additionally, the impact of the addition of titanium dioxide (TiO2) into PEEK was examined. Two types of commercial PEEK discs were used in this study, including TiO2-free and 20% TiO2-containing PEEK. The PEEK dental crowns were fabricated and aging-treated at 134 °C and 0.2 MPa for 5 h in accordance with the ISO 13356 specification before being cemented on artificial tooth abutments. The fracture loads of all crown samples were measured under compression tests. Results demonstrated that adding TiO2 enhanced the fracture load of PEEK crowns compared to TiO2-free PEEK crowns before the aging treatment. However, the aging treatment decreased the fracture load of TiO2-containing PEEK crowns while increasing the fracture load of TiO2-free PEEK crowns. The fracture morphology of TiO2-containing PEEK crowns revealed finer feather shapes than that of the TiO2-free PEEK crowns. We concluded that adding TiO2 increased the fracture load of PEEK crowns without aging treatment. Still, the aging treatment influenced the fracture load and microscopic fracture morphology of PEEK crowns, depending on the addition of TiO2.

This paper studies the influence of z‐pins on the impact resistance and residual tensile properties of composite large curvature components through low‐velocity impact and tension‐after‐impact tests to explore the damage mechanism. Unpinned and z‐pinned specimens with different diameters (0.3 and 0.5 mm) and spacing (3, 4, and 5 mm) were impacted at energies of 28 J and 14 J + 14 J and were stretched until failure. The theoretical models were used to predict impact dent depth and tensile strength, and the effectiveness of z‐pins and damage patterns were characterized by force‐time/displacement curves and through visual observation. The agreement between the experiments and predictions can thus validate the presented approach. Through the low‐velocity impact test, it is found that z‐pins with higher density and smaller diameter make the impact dent shallower and the surface damage less, thus showing better performance. Later, the impacted specimens mainly show delamination, explosion, breakage, and splitting after tension. During the first stage of the force‐displacement curves, since z‐pins mitigate the delamination, tensile strength shows a 29.58%–59.17% increase while in the third stage, a decrease of 3.95%–15.12% occurs due to initial damage caused by z‐pins. Highlights: Different impact energies are implemented on large curved CFRP laminates of z‐pins with different diameters and spacing to explore the damage mechanism.Low‐velocity impact and tension‐after‐impact (TAI) tests are used to simulate the centrifugal force of the blade subjected to impact and rotation after impact.Z‐pinned group with a small diameter and high density causes less damage and tensile strength in the first stage increases while decreasing in the third stage compared with the unpinned group. [ABSTRACT FROM AUTHOR]

Background: Titanium (Ti) is one of the most popular implant materials, and its surface titanium dioxide (TiO2) provides good biocompatibility. The coagulation of blood on Ti implants plays a key role in wound healing and cell growth at the implant site; however, researchers have yet to fully elucidate the mechanism underlying this process on TiO2. Methods: This study examined the means by which blood coagulation was affected by the crystal structure of TiO2 thin films (thickness < 50 nm), including anatase, rutile, and mixed anatase/rutile. The films were characterized in terms of roughness using an atomic force microscope, thickness using an X-ray photoelectron spectrometer, and crystal structure using transmission electron microscopy. The surface energy and dielectric constant of the surface films were measured using a contact angle goniometer and the parallel plate method, respectively. Blood coagulation properties (including clotting time, factor XII contact activation, fibrinogen adsorption, fibrin attachment, and platelet adhesion) were then assessed on the various test specimens. Results: All of the TiO2 films were similar in terms of surface roughness, thickness, and surface energy (hydrophilicity); however, the presence of rutile structures was associated with a higher dielectric constant, which induced the activation of factor XII, the formation of fibrin network, and platelet adhesion. Conclusions: This study provides detailed information related to the effects of TiO2 crystal structures on blood coagulation properties on Ti implant surfaces.

A conservative element in seawater, uranium is readily incorporated into the aragonitic skeletons of scleractinian corals, making them an important paleoclimate archive that can be absolutely dated with U-Th techniques. In addition, uranium concentrations (U/Ca ratios) in corals have been suggested to be influenced by the temperature and/or carbonate ion concentration of the ambient seawater based on empirical calibrations. Microsampling techniques have revealed strong heterogeneities in U/Ca within individual specimens in both surface and deep-sea corals, suggesting a biological control on the U incorporation into the skeletons. Here we further explore the mechanism of uranium incorporation in coral skeletons with the deep-sea species Desmophyllum dianthus, an ideal test organism for the biomineralization processes due to its relatively constant growth environment. We find a negative correlation between bulk coral U/Ca and temperature as well as ambient pH and [CO32–] that is consistent with previous studies. By sampling the growth bands of individual corals, we also find a twofold change in U/Ca within individual corals that is strongly correlated with the δ18O, δ13C, and other Me/Ca ratios of the bands. A similar correlation between U/Ca and stable isotopes as well as other Me/Ca ratios are observed in bulk deep-sea coral samples. With a numerical coral calcification model, we interpret the U/Ca-stable isotope correlation as a result of changes in uranium speciation in response to internal pH elevations in the extracellular calcifying fluid (ECF) of the corals, and suggest that the Ca2UO2(CO3)3(aq) complex, the dominant U species in seawater, may be the major species incorporated into the coral skeleton. Therefore, the correlation between U/Ca and ambient [CO32–] is likely a result of the response of the biomineralization process, especially the magnitude of internal pH elevation, to the growth environment of the corals. Our data suggest overall lower alkalinity pump rates in corals from low saturation seawater compared to those from high saturation seawater, and possible increases in Ca2+ supply from active pumping relative to seawater transport in response to the environmental stress of low saturation.

Abstract Background There have been many studies regarding nongeriatric femoral neck fractures (FNFs), which included patients of a wide age range (between 20 and 60 years old). We aimed to determine whether internal fixation provided acceptable outcomes for middle-aged patients with displaced FNFs, and identify predictors of successful internal fixation. Methods A total of 117 patients, aged 50–60 years and who underwent closed reduction and unilateral internal fixation using cannulated screws, were included. The outcomes were classified as either “complications” (varus malunion, femoral neck shortening, non-union/early collapse, avascular necrosis, or arthroplasty during the follow-up) or “optimal outcomes” (no complications). Patients with displaced FNFs (Garden stages III–IV, n = 69) were categorized according to whether they experienced acceptable or unacceptable reduction. We evaluated whether patients’ clinical characteristics could predict optimal outcomes. Results Patients with displaced FNFs generally experienced complications (84.1%). Twenty-two percent of patients experienced optimal outcomes when acceptable reduction was achieved. Patients with unacceptable reductions experienced complications. Optimal outcomes were positively associated with Pauwels’ type II fracture (OR: 8.67, p = 0.025) and negatively associated with excessive alcohol consumption (p = 0.045). Conclusions Compared with the younger age group, complication rates are higher in middle-aged patients with displaced FNFs treated using cannulated screws. If internal fixation is to be used for a displaced FNF, patient selection is essential. Care must be taken to avoid selecting patients with excessive alcohol consumption, while successful internal fixation may be more likely for patients with Pauwels’ type II fracture.

This paper proposes a low-in-plane damage ZPI (Z-pin pre-hole insertion) process. The delamination growth behavior and the influence of Z-pin insertion density on the mode I interlaminar fracture toughness of laminate was explored experimentally and numerically. Meanwhile, Z-pin pull-out and shear tests were conducted in order to provide accurate data for the DCB simulation test. What's more, an infinite-focus microscope was used to scan the specimen's defect caused by the ZPI process. It can be found that the ZPI process can lead to less Z-pin inclination, fibre breaking, and crack initiation at the bonded interface. The DCB test results show that the load-displacement curve can be distinguished into four stages for the pinned specimen. In addition, a specimen pinned with a higher Z-pin volume fraction to more suitable for increasing the G IC . The simulation results show that the simulated maximum load and the G IC of the specimen are 286.63 N and 940.06 J·m−2, with a 0.56% and 10.10% error from the experimental result, indicating that the proposed FE model is validated by comparing the predictions with the experimental results. These results can provide some guidance for fabricating the reinforced laminates via the ZPI process. [ABSTRACT FROM AUTHOR]