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SUMMARY Surgical exposure of the anterior column, anterior wall, pelvic brim, and sacroiliac joint is accessible through the lateral window of the ilioinguinal approach. Residual attachment of the abdominal muscles and inguinal ligament to the anterior superior iliac spine (ASIS) is often a limiting factor to expanded distal and medial exposure, especially in patients with a large abdomen that hangs over the pelvis. An ASIS osteotomy has been described to improve exposure, particularly of the distal anterior wall and joint capsule, pubic ramus, and anterior quadrilateral plate. However, an ASIS osteotomy can be troublesome to reattach. In this study, we introduce a soft tissue release technique to mobilize the abdominal muscles and inguinal ligament to allow expanded surgical access to the distal anterior column/wall and sacroiliac joint and to create a working space for fracture reduction and fixation.

Chlorhexidine skin antisepsis is frequently recommended for most surgical procedures; however, it is unclear if these recommendations should apply to surgery involving traumatic contaminated wounds where povidone-iodine has previously been preferred. We aimed to compare the effect of aqueous 10% povidone-iodine versus aqueous 4% chlorhexidine gluconate on the risk of surgical site infection in patients who required surgery for an open fracture.We conducted a multiple-period, cluster-randomised, crossover trial (Aqueous-PREP) at 14 hospitals in Canada, Spain, and the USA. Eligible patients were adults aged 18 years or older with an open extremity fracture treated with a surgical fixation implant. For inclusion, the open fracture required formal surgical debridement within 72 h of the injury. Participating sites were randomly assigned (1:1) to use either aqueous 10% povidone-iodine or aqueous 4% chlorhexidine gluconate immediately before surgical incision; sites then alternated between the study interventions every 2 months. Participants, health-care providers, and study personnel were aware of the treatment assignment due to the colour of the solutions. The outcome adjudicators and data analysts were masked to treatment allocation. The primary outcome was surgical site infection, guided by the 2017 US Centers for Disease Control and Prevention National Healthcare Safety Network reporting criteria, which included superficial incisional infection within 30 days or deep incisional or organ space infection within 90 days of surgery. The primary analyses followed the intention-to-treat principle and included all participants in the groups to which they were randomly assigned. This study is registered with ClinicalTrials.gov, NCT03385304.Between April 8, 2018, and June 8, 2021, 3619 patients were assessed for eligibility and 1683 were enrolled and randomly assigned to povidone-iodine (n=847) or chlorhexidine gluconate (n=836). The trial's adjudication committee determined that 45 participants were ineligible, leaving 1638 participants in the primary analysis, with 828 in the povidone-iodine group and 810 in the chlorhexidine gluconate group (mean age 44·9 years [SD 18·0]; 629 [38%] were female and 1009 [62%] were male). Among 1571 participants in whom the primary outcome was known, a surgical site infection occurred in 59 (7%) of 787 participants in the povidone-iodine group and 58 (7%) of 784 in the chlorhexidine gluconate group (odds ratio 1·11, 95% CI 0·74 to 1·65; p=0·61; risk difference 0·6%, 95% CI -1·4 to 3·4).For patients who require surgical fixation of an open fracture, either aqueous 10% povidone-iodine or aqueous 4% chlorhexidine gluconate can be selected for skin antisepsis on the basis of solution availability, patient contraindications, or product cost. These findings might also have implications for antisepsis of other traumatic wounds.US Department of Defense, Canadian Institutes of Health Research, McMaster University Surgical Associates, PSI Foundation.

To compare retrograde intramedullary nail (RIMN) and open reduction internal fixation (ORIF) in very distal periprosthetic distal femur fractures (PDFFs) to determine whether RIMN is an acceptable option for these fractures that are often considered too distal for IMN due to limited bone stock.Retrospective comparative series.Level 1 trauma center.Patients were treated with fracture fixation for a very distal PDFF, defined as the fracture extending to the anterior flange of the implant or distal. Fifty-six patients met inclusion criteria, with 8 excluded for less than 12 months of follow-up.The intervention involved fracture fixation with RIMN or ORIF.The primary outcome was unplanned return to surgery. Secondary outcomes included fracture union, radiographic alignment, visual analog score, and Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function (PF) and Pain Interference.The mean follow-up period was 27 months. Twelve patients were treated with ORIF and 36 with RIMN. Twenty-one fractures were at the flange, and 27 extended distal to the flange. There were no differences between fixation methods for reoperation, deep infection, nonunion, malunion, visual analog score pain score, and PROMIS Pain Interference score. The mean PROMIS PF score was higher in the RIMN group compared with that in the ORIF group. There were 5 reoperations in the RIMN group (14%) and 3 in the ORIF group (25%).This is the largest series, to the best of our knowledge, of a subset of very distal PDFFs. The results suggest that RIMN may be an acceptable treatment option for these very difficult fractures.Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

This study proposes a grid-connected inverter for photovoltaic (PV)-powered electric vehicle (EV) charging stations. The significant function of the proposed inverter is to enhance the stability of a microgrid. The proposed inverter can stabilize its grid voltage and frequency by supplying or absorbing active or reactive power to or from a microgrid using EVs and PV generation. Moreover, the proposed inverter can automatically detect an abnormal condition of the grid, such as a blackout, and operate in the islanding mode, which can provide continuous power to local loads using EV vehicle-to-grid service and PV generation. These inverter functions can satisfy the requirements of the grid codes, such as IEEE Standard 1547–2018 and UL 1741 SA. In addition, the proposed inverter can not only enhance the microgrid stability but also charge EVs in an appropriate mode according to the condition of the PV array and EVs. The proposed inverter was verified through experimental results with four scenarios in a lab-scale testbed. These four scenarios include grid normal conditions, grid voltage fluctuations, grid frequency fluctuations, and a power blackout. The experimental results demonstrated that the proposed inverter could enhance the microgrid stability against grid abnormal conditions, fluctuations of grid frequency and voltage, and charge EVs in an appropriate mode.

Representing highly ordered repetitive structures of antigen macromolecular assemblies, virus-like particles (VLPs) serve as a high-priority vaccine platform against emerging viral infections, as alternatives to traditional cell culture-based vaccines. RNAs can function as chaperones (Chaperna) and are extremely effective in promoting protein folding. Beyond their canonical function as translational adaptors, tRNAs may moonlight as chaperones for the kinetic control of macromolecular antigen assembly. Capitalizing on genomic RNA co-assembly in infectious virions, we present the first report of a biomimetic assembly of viral capsids that was assisted by non-viral host RNAs into genome-free, non-infectious empty particles. Here, we demonstrate the assembly of bacterially-produced soluble norovirus VP1 forming VLPs (n = 180) in vitro. A tRNA-interacting domain (tRID) was genetically fused with the VP1 capsid protein, as a tRNA docking tag, in the bacterial host to transduce chaperna function for de novo viral antigen folding. tRID/tRNA removal prompted the in vitro assembly of monomeric antigens into highly ordered repetitive structures that elicited robust protective immune responses after immunization. The chaperna-based assembly of monomeric antigens will impact the development and deployment of VLP vaccines for emerging and re-emerging viral infections.

The aim of the study was to investigate the utility of a simple office-based tool in predicting the need for secondary intervention to obtain union in patients with tibial fractures. All patients 18 years and older with isolated tibial shaft fractures (OTA 41A, 42A-C, and 43A) treated with intramedullary nailing from 2013 to 2017 were screened. Eighty-seven patients met enrollment criteria. Surgeon assessment of the following 3 clinical parameters was performed at routine office visits and scored as follows: (1) pain (none/mild/decreased=1, no change/increased=0); (2) function (minimal limp/able to perform a single-leg stance=1, significant limp/unable to perform single-leg stance=0); and (3) examination (no/minimal pain with manipulation=1, pain with manipulation=0). Radiographic healing was assessed by the adjusted radiographic union scale in tibial fractures (aRUST). The tibial fracture healing score (TFHS) is the sum of 3 clinical scores (0 to 3) and aRUST score (1 to 3) at 3 months postoperatively. The overall nonunion rate was 11%. A RUST score of 5 or less and a sum of the 3 clinical scores of less than 2 at 3 months were found be predictive of nonunion. A TFHS of less than 3 at 3 months was more reliable in identifying patients requiring nonunion repair, especially for those with minimal radiographic healing (RUST score 6 or 7) at 3 months. The TFHS is a simple office-based clinical tool that may identify patients at high risk of nonunion (TFHS Orthopedics . 2020;43(4);e323–e328.]

Electrically conductive polypyrrole (PPy) is an intriguing biomaterial capable of efficient electrical interactions with biological systems. Especially, biomimetic PPy-based biomaterials incorporating biomolecules, such as hyaluronic acid (HA), can impart the characteristic biological interactions with living cells/tissues to the conductive biomaterials. Here we report the effects of the molecular weight (MW) of HA on PPy-based biomaterials. We utilized HA of a wide range of MW (35 × 103 Da–3 × 106 Da) as dopants during the electrochemical production of PPy/HA films and their characterization of materials and cellular interactions. With increases in the MWs of HA dopants, PPy/HA exhibited more hydrophilic, higher electrochemical activity and lower impedance. In vitro studies revealed that PPy films doped with low MW HA were supportive to cell adhesion and growth, while PPy films doped with high MW HA were resistant to cell attachment. Subcutaneous implantation of the PPy/HA films for 4 weeks revealed that all the PPy/HA films were tissue compatible. We successfully demonstrate the importance of HA dopant MWs in modulating the chemical and electrical properties of the materials and cellular responses to the materials. Such materials have potential for various biomedical applications, including as tissue engineering scaffolds and as electrodes for neural recording and neuromodulation. Statement of Significance: Hyaluronic acid (HA)-doped polypyrrole (PPy) films were electrochemically synthesized as novel biomimetic conductive materials capable of efficient electrical signaling and preferential biological interactions. Molecular weights (MWs) of HA varied in a wide range (35 × 103–2 × 106 Da) and critically determine chemical, electrochemical, and biological properties of PPy/HA. Especially, PPy films with low MW HA markedly support cell adhesion and growth, while PPy films with high MW HA are resistant to cell attachment. Furthermore, PPy/HA exhibits greatly improved tissue compatibility and in vivo EMG signal recording ability. We for the first time demonstrate that biomimetic PPy/HA-based biomaterials can serve as versatile and effective platforms for various biomedical applications, such as tissue engineering scaffolds and bioelectrodes. © 2018 Acta Materialia Inc.

Bioelectrodes have been widely used to effectively mediate electrical signals with biological systems for various biomedical applications, such as biosensors and prosthetic probes. However, the electrical properties of bioelectrodes are frequently degraded in the biological milieu due to biofouling of bioelectrode surfaces. Hence, the development of simple and effective strategies for bioelectrode surface modification is important for the mitigation of biofouling. To this end, we electrochemically modify electrodes with dopamine-conjugated hyaluronic acid (DA-HA); the modified electrodes exhibit highly hydrophilic surfaces. In addition, the electrochemical impedance of the DA-HA-modified electrodes remains similar to those of bare electrodes. The DA-HA-modified electrodes showed reduced non-specific protein adsorption and minimal adhesion of fibroblasts. Our novel electrochemical passivation of electrodes using DA-HA will contribute to the further development of fouling-resistant and biocompatible bioelectrodes. The electrodeposition of DA-HA can also be potentially applied for general surface modification of other metallic and conducting materials for various applications.

Dept. of Aerospace Engineering, Sejong UniversityAbstract : Space propulsion system produces required thrust for satellites and space launch vehicles by using chemical reactions of a liquid fuel and a liquid oxidizer typically. Among several liquid propellants, the monomethylhydrazine-dinitrogen tetroxide is expecially preferred for a GEO satellite propellants due to their better storability in liquid phase during a long mission life under a freezing space environment. Recently, a development of the monomethylhydrazine-dinitrogen tetroxide bipropellant system becomes important as the national space program requires the heavier and the more efficient space system. Thus, the objective of the present study is to review a foreign research trend of a chemical reaction between the monomethyhydrazine fuel and the dinitrogen tetroxide oxidizer to understand a fundamental basis of their characteristics to prepare for domestic development in future.Key Words : Space Propulsion, Bipropellant, Monomethylhydrazine, Dinitrogen Tetroxide, Chemical Reaction

Vascular injury to the popliteal artery during knee surgery is uncommon, but it has significant consequences not only for the patient but also to the surgeon since it poses the threat of malpractice litigation. The vascular anatomy of the lower extremity is variable especially when it involves both the popliteal artery and its branches. An aberrant vascular course may increase the risk of iatrogenic vascular injury during surgery. Careful preoperative planning with advanced imaging can decrease the risk of a devastating vascular injury.

This paper is results on Chemisorption of organic compound for the sea water fire fighting line of naval vessels. The quantitative analysis of Chemisorption has been investigated in seawater after immersion in 0.1 % of NaDDTC solutions for 43 hours. The morphology and topography were investigated by FE-SEM and AFM. The chemical elements were analyzed by SEM-EDS, XPS and the depth of chemical elements was measured by depth profiles. The effect of NaDDTC comes from Chemisorption between Copper and Sulfur of NaDDTC. As a result, test results showed that sulfur is helpful to protect a corrosion of seawater line.

CASE A traumatic hemipelvectomy (THP) is a rare life-threatening injury, with limited reports in the civilian population. We present the case of a patient who sustained a massive pelvic injury with an incomplete unilateral THP, a contralateral unstable pelvis, and a fracture of the acetabulum. CONCLUSION With advancements in resuscitative techniques, carefully timed and planned surgical interventions, and a coordinated multidisciplinary approach, a greater number of patients may be able to survive a massive pelvic injury.

The use of intramedullary nails for the treatment of long bone fractures has become increasingly frequent over the last decade with gradually expanding indications and technological advances. Improved biomechanics relative to plates and less direct fracture exposure are some of the potential benefits of intramedullary nails. However, persistent insertion-related pain is common and may limit satisfactory long term outcomes. The etiologies of this phenomenon remain unclear. Proposed theories for which there is a growing body of supporting evidence include hardware prominence, suboptimal nail entry points leading to soft tissue irritation and structural compromise, local heterotrophic ossification, implant instability with persistent fracture micromotion, and poorly defined insertional strain. Many factors that lead to insertion-related pain are iatrogenic, and careful attention to detail and refined surgical techniques will optimize outcomes.

Objectives: The objective of this study was to the effects of spiritual program on anxiety and depression among women in menopause. Methods: Subjects are 20 women in menopause. Structured questionnaires were used for data collection before, after and 6 month later Spiritual program, and descriptive statistics, t-test, ANOVA of SPSS 21.1 program were performed for data analysis. Results: Anxiety(F=8.55, p=.009) and depression(F=8.76, p=.001) has significant difference according to stages. Significant factors influencing anxiety included education(F=4.13, p=.034) and career of christianity(F=10.57, p=.001). Conclusion: Spiritual program is concluded by us it has proven that psychological healing program like anxiety and depression so has been practiced actively. And Spiritual program is needed according to general characteristics. Key Words : Anxiety, Depression, Spiritual program Received 24 February 2014, Revised 25 March 2014Accepted 20 April 2014Corresponding Author: Myoungjin Kwon(Dept. of Nursing, Daejeon University) Email: mjkwon@dju.ac.krⒸ The Society of Digital Policy & Management. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is ISSN: 1738-1916 properly cited.

In this study, high strength bolts of 1100 MPa and 1300 MPa grades were charged with hydrogen to measure the sensitivity of hydrogen embrittlement (HE). Different levels of stress conditions based on various tensile stress and strain rates were applied. The bolts were then examined to see whether cracks were formed on the screw threads. The tensile stress and strain rate condition producing the most number of cracks on the screw thread of the bolt was decided as the most suitable test condition for the measurement of sensitivity of HE. For 1100 MPa grade high strength bolts, the most cracks were observed at the tensile stress ratio of 0.85 (load of 80 kN) and strain rate of 1.6×10E−5/s, while for 1300 MPa grades, the most cracks were observed at tensile stress ratio 0.87 (load of 100 kN) and strain rate of 1.6×10E−5/s. No cracks were found on the screw threads of bolt when the strain rate was increased over 8.3×10E−4/s.

In this letter, a wideband low noise amplifier (LNA) operating at 1–5 GHz is proposed.The circuit is designed with a TSMC 0.18-μm RF CMOS process. To obtain high transconductance with low power consumption, two types of inverters are used. The proposed LNA is expected to reduce the size of chip about 70–80% by using only the single-spiral inductor. The measured voltage gain is 14.4–15.5 dB and noise figure (NF) is 4.3–5.0 dB from 1–5 GHz. The total power consumption of the proposed LNA is 9.8 mW from a 1.4 V supply voltage and chip area occupies only 0.5 × 0.5 mm2. © 2012 Wiley Periodicals, Inc. Microwave Opt Technol Lett 54:2360–2363, 2012; View this article online at wileyonlinelibrary.com. DOI 10.1002/mop.27086

In this paper, an efficiency improvement method in the wireless power transfer system based on magnetic resonance is proposed. A combined helical-spiral structure is adopted for self-resonant coil and source and device coils are designed using circular loop structure. The proposed resonator utilizing combined helical-spiral structure yields 13 % efficiency improvement over that of an existing helical type resonator when the transmitting and receiving coils are separated by 120 mm. In addition, the size can be reduced by 33 % comparing to the previous resonator.

In this letter, we proposed a low power, high gain, compact ultra-wideband (UWB) low noise amplifier (LNA) using TSMC 0.18-μm CMOS technology.To satisfy the wide input matching and high voltage gain requirements with low power consumption, a resistive current reused technique is utilized. The proposed UWB LNA has a voltage gain of 10.4–15.5 dB and a noise figure (NF) of 3.3–4.5 dB over the frequency band of interest (1–8 GHz). The total power consumption of the proposed UWB LNA is 10.4 mW from a 1.4 V supply voltage, and the chip area is 0.8 mm × 0.5 mm. © 2010 Wiley Periodicals, Inc. Microwave Opt Technol Lett 53:345–348, 2011; View this article online at wileyonlinelibrary.com. DOI 10.1002/mop.25747

In this study, a concurrent triple-band low noise amplifier (LNA) is designed for long term evolution (LTE), Mobile-WiMAX (M-WiMAX), and WiMAX services. The main topology of the proposed LNA is a cascode architecture with source degeneration using shunt resistive feedback topology for the triple-resonance characteristic. The LNA is designed using a Taiwan Semiconduction Company (TSMC) 0.18 μm radio frequency CMOS process. To obtain the necessary gains over the operating frequency bands, a series LC branch is added in parallel with an inductor at the drain load of a single band LNA. The peak gains at LTE, M-WiMAX, and WiMAX bands are 17.6, 14.7, and 14.5 dB, respectively, whereas dissipating 8 mA from a 1.4 V supply voltage. The average noise figure over the three operating frequency bands is 4.5 dB. © 2010 Wiley Periodicals, Inc. Microwave Opt Technol Lett 53:415–418, 2011; View this article online at wileyonlinelibrary.com. DOI 10.1002/mop.25743

In this paper, we proposed an ultra-low power low noise amplifier(LNA) using a TSMC 0.18 RF CMOS process. To satisfy the low power consumption with high gain, a current-reused technique is utilized. In addition, a low bias voltage in the subthreshold region is utilized to achieve ultra low power characteristic. The designed LNA has the voltage gain of 13.8 dB and noise figure(NF) of 3.4 dB at 2.4 GHz. The total power consumption of the designed LNA is only 0.63 mW from 0.9 V supply voltage and chip occupies area.

A wideband monopole antenna with dual band-stop function for WLAN (2.4 GHz/5 GHz) is presented. By cutting away an arched slot from the radiation patch and inserting spur-lines into the ground, dual band-stop functions for 2.4 GHz and 5 GHz WLAN bands are obtained. The proposed antenna operates over 1.9–11 GHz for VSWR

A novel compact CPW ultra-wideband (UWB) antenna combined with a compact band-selective fllter is proposed. The proposed antenna without fllter satisfles the return loss requirement of less than i10dB over the frequency range of 3.0GHz to 12.1GHz. The optimized antenna has dimensions of 10£16mm 2 on a Te∞on substrate ("r = 3:48) with good radiation characteristics and is easy to fabricate. The proposed antenna with fllter has the frequency band of 3GHz to 11GHz for VSWR less than 2.0 with a rejection band around 5.0 to 5.9GHz.

The multiband internal antenna for mobile application is proposed. The proposed antenna has wide bandwidth of about 400 MHz (2.3 GHz ∼ 2.69 GHz) for MIMO antenna. The return loss(S 11 and S 22 ) is higher than 10 dB and isolation characteristic(S 12 and S 21 ) is less than −20 dB over the frequency band of interest. The separate monopole antenna has return loss of higher than 10 dB over WCDMA band. The measured antenna gain is higher than 0 dBi and measured efficiency is greater than 60 %.

An internal antenna with a system ground for DVB-H application is proposed. The proposed antenna consists of a meander radiator and two stubs. The designed antenna has a broad impedance bandwidth to cover the whole DVB-H band. Therefore, the proposed antenna can be a good candidate for DVB-H mobile handset application since its size is small enough to satisfy the size constraint imposed on a mobile handset.

A novel, low-profile internal planar inverted-F antenna (PIFA) with broadband characteristics is proposed for GSM/DCS/UMTS/WiBro applications. Broadband characteristics are achieved by inserting an inverted-L patch, and a bent feed line ensures good impedance matching. The optimum design parameters of the proposed antenna are decided by parametric analysis. Good omnidirectional patterns with reasonable gains are achieved at each frequency band of interest.