Printed Three-dimensional Anatomic Templates for Virtual Preoperative Planning Before Reconstruction of Old Pelvic Injuries: Initial Results

Background: Old pelvis fractures are among the most challenging fractures to treat because of their complex anatomy, difficult-to-access surgical sites, and the relatively low incidence of such cases. Proper evaluation and surgical planning are necessary to achieve the pelvic ring symmetry and stable fixation of the fracture. The goal of this study was to assess the use of three-dimensional (3D) printing techniques for surgical management of old pelvic fractures. Methods: First, 16 dried human cadaveric pelvises were used to confirm the anatomical accuracy of the 3D models printed based on radiographic data. Next, nine clinical cases between January 2009 and April 2013 were used to evaluate the surgical reconstruction based on the 3D printed models. The pelvic injuries were all type C, and the average time from injury to reconstruction was 11 weeks (range: 8-17 weeks). The workflow consisted of: (1) Printing patient-specific bone models based on preoperative computed tomography (CT) scans, (2) virtual fracture reduction using the printed 3D anatomic template, (3) virtual fracture fixation using Kirschner wires, and (4) preoperatively measuring the osteotomy and implant position relative to landmarks using the virtually defined deformation. These models aided communication between surgical team members during the procedure. This technique was validated by comparing the preoperative planning to the intraoperative procedure. Results: The accuracy of the 3D printed models was within specification. Production of a model from standard CT DICOM data took 7 hours (range: 6-9 hours). Preoperative planning using the 3D printed models was feasible in all cases. Good correlation was found between the preoperative planning and postoperative follow-up X-ray in all nine cases. The patients were followed for 3-29 months (median: 5 months). The fracture healing time was 9-17 weeks (mean: 10 weeks). No delayed incision healing, wound infection, or nonunions occurred. The results were excellent in two cases, good in five, and poor in two based on the Majeed score. Conclusions: The 3D printing planning technique for pelvic surgery was successfully integrated into a clinical workflow to improve patient-specific preoperative planning by providing a visual and haptic model of the injury and allowing patient-specific adaptation of each osteosynthesis implant to the virtually reduced pelvis

Enhanced mechanical property and flame resistance of graphene oxide nanocomposite paper modified with functionalized silica nanoparticles

Graphene oxide (GO) paper with outstanding integrated multiple functionalities (good mechanical performance, thermal stability and flame resistance, etc.) is strongly needed for numerous potential applications in cutting-edge fields. In this work, we report a facile and green process to fabricate GO-based nanocomposite papers via introducing functionalized silica (f-SiO2) nanoparticles. The results reveal that addition of f-SiO2 produces simultaneous improvements in mechanical strength, stiffness and flame resistance for GO paper. With incorporation of 10 wt% f-SiO2, the tensile strength, elastic modulus and toughness of the GO/f-SiO2 nanocomposite papers can be increased by about 51%, 317%, and 69%, respectively. Various characterizations disclose that hydrogen bonds and covalent interactions between GO sheets and f-SiO2 mainly contribute to the effective load transfer and energy dissipation between them, and thus leading to the improvements of mechanical properties. Based on the structural observation and analysis, the improved flame resistance of the GO/f-SiO2 papers should be attributed to the formation of rGO/SiO2 protective char, which are derived from the decomposition and redeposition of the grafted silane molecules and inorganic SiO2 and thermal reduction of GO into rGO. Our results suggest that the mechanical and thermal properties of GO papers can be tuned by introducing inorganic/organic f-SiO2, providing a new route for the rational designing and development of mechanically flexible and flame-retardant GO-based nanocomposite paper materials

Folic acid deficiency impairs the gill health status associated with the NF-kappa B, MLCK and Nrf2 signaling pathways in the gills of young grass carp (Ctenopharyngodon idella)

The aim of this study was to investigate the effect of dietary folic acid on fish growth, the immune and barrier functions of fish gills, and the potential mechanisms of these effects. Young grass carp (Ctenophatyngodon idella) were fed diets containing graded levels of folic acid at 0.10 (basal diet), 0.47, 1.03, 1.48, 1.88 and 3.12 mg kg(-1) diet for 8 weeks. The results showed that acid phosphatase and lysozyme activities and the complement component 3 content in fish gills decreased with folic acid deficiency (P < 0.05). Folic acid deficiency up-regulated liver-expressed antimicrobial peptide 1, interleukin 1 beta, interleukin 8, tumor necrosis factor alpha, nuclear factor kappa B p65, I kappa B kinase alpha (IKK-alpha), IKK-beta and IKK-gamma gene expression. Folic acid deficiency down-regulated interleukin 10, transforming growth factor beta, I kappa B and target of rapamycin gene expression in fish gills (P < 0.05). These results showed that limited folic acid decreased fish gill immune status. Furthermore, folic acid deficiency down-regulated claudin-b, claudin-c, claudin-3, occludin and zonula occludens 1 gene expression, whereas folic acid deficiency up-regulated claudin-12, claudin-15, myosin light chain kinase and p38 mitogen activated protein kinase gene expression in fish gills (P < 0.05). These results suggested that folic acid deficiency disrupted tight junction-mediated fish gill barrier function. Additionally, folic acid deficiency increased the content of reactive oxygen species, protein carbonyl and malondialdehyde (MDA); Mn superoxide dismutase activity and gene expression; and Kelch-like-ECH-associated protein 1a (Keap1a) and Keap1b gene expression (P < 0.05). Conversely, folic acid deficiency decreased Cu/Zn superoxide dismutase, catalase, glutathione peroxidase, glutathione s-transferases and glutathione reductase activities and gene expression as well as NF-E2-related factor 2 gene expression in fish gills (P < 0.05). All of these results indicated that folic acid deficiency impaired fish gill health status via regulating gene expression of cytokines, tight junction proteins, antioxidant enzymes, NF-kappa B p65, MLCK and Nrf2. Based on percent weight gain, LZ activity and MDA content in the gills, the dietary folic acid requirements for young grass carp were 1.60, 2.07 and 2.08 mg kg(-1), respectively. (C) 2015 Published by Elsevier Ltd

Bio-inspired, sustainable and mechanically robust graphene oxide-based hybrid networks for efficient fire protection and warning

Effective utilization of natural biomass-derivatives for developing sustainable, mechanically robust, and fireproof materials remains a huge challenge in fire safety and prevention field. Herein, based on bionic design, the hybrid interconnected networks composed of two-dimensional (2D) graphene oxide (GO) nanosheets, renewable one-dimensional (1D) phosphorylated-cellulose nanofibrils (P-CNFs) and tannic acid molecules (TA) were prepared via a green and facile evaporation-induced self-assembly strategy. Through construction of the multiple synergistic interactions among the TA, P-CNFs and GO, the optimized 1D/2D interconnected networks with hierarchical nacre-like structure were achieved and exhibited improved mechanical properties (tensile strength and Young’s modulus up to ∼132 MPa and ∼7 GPa, i.e. ∼3.6 and ∼14 times higher than that of the pure GO paper), good structural stability in various environments (aqueous solutions with different pH values), excellent flame retardancy (keeping structural integrity after flame attack), and ultrasensitive fire alarm functions (e.g., ultrafast flame alarm time of <1 s and sensitive fire warning responses). Further, such 1D/2D interconnected networks can act as effective flame-retardant nanocoatings to significantly improve the flame retardancy of combustible PU foam materials (e.g., ∼48% decrease in peak heat release rate at only 10 wt.% content). Based on the structure observation and analysis, the related synergistic reinforcing and flame-retardant mechanisms were proposed and clarified. Clearly, this work provides a new route for design and development of environmentally friendly fireproof and fire alarm materials based on utilization of natural biomass-derivatives

Mitochondrial genome evidence reveals successful Late Paleolithic settlement on the Tibetan Plateau

Due to its numerous environmental extremes, the Tibetan Plateau—the world's highest plateau—is one of the most challenging areas of modern human settlement. Archaeological evidence dates the earliest settlement on the plateau to the Late Paleolithic, while previous genetic studies have traced the colonization event(s) to no earlier than the Neolithic. To explore whether the genetic continuity on the plateau has an exclusively Neolithic time depth, we studied mitochondrial DNA (mtDNA) genome variation within 6 regional Tibetan populations sampled from Tibet and neighboring areas. Our results confirm that the vast majority of Tibetan matrilineal components can trace their ancestry to Epipaleolithic and Neolithic immigrants from northern China during the mid-Holocene. Significantly, we also identified an infrequent novel haplogroup, M16, that branched off directly from the Eurasian M founder type. Its nearly exclusive distribution in Tibetan populations and ancient age (>21 kya) suggest that M16 may represent the genetic relics of the Late Paleolithic inhabitants on the plateau. This partial genetic continuity between the Paleolithic inhabitants and the contemporary Tibetan populations bridges the results and inferences from archaeology, history, and genetics