As an abundant natural resource, wood has gained great attention for thousands of years, spanning from the primitive construction materials to the modern high‐added‐value engineering materials. The ...unique delicate microstructures and the wonderful properties (e.g., low‐density, high strength and stiffness, good toughness, and environmental sustainability) have made wood a natural source of inspiration that guides researchers to invent various wood‐inspired materials. Herein, as an emerging material system, bioinspired artificial wood, with similar cellular structures and comparable mechanical properties, is discussed in the view of the design concept, fabrication strategy, properties, and possible applications. The present challenges and further research opportunities are also presented for artificial woods to thrive. To achieve the final eco‐friendly artificial wood, more endeavors should be made in biomaterials and biodegradable or recyclable engineering of polymers to gain high mechanical properties and environmental sustainability simultaneously.
Artificial woods have emerged as a novel kind of wood‐inspired engineering material with almost exactly the same channel microstructures and similar wall components. The performances of artificial woods depend on both the oriented channel and wall designs. The rational combination of other engineering polymers and channel‐making techniques hold promise to develop more useful artificial woods.
Soft woods have attracted enormous interest due to their anisotropic cellular microstructure and unique flexibility. The conventional wood-like materials are usually subject to the conflict between ...the superflexibility and robustness. Inspired by the synergistic compositions of soft suberin and rigid lignin of cork wood which has good flexibility and mechanical robustness, an artificial soft wood is reported by freeze-casting the soft-in-rigid (rubber-in-resin) emulsions, where the carboxy nitrile rubber confers softness and rigid melamine resin provides stiffness. The subsequent thermal curing induces micro-scale phase inversion and leads to a continuous soft phase strengthened by interspersed rigid ingredients. The unique configuration ensures crack resistance, structural robustness and superb flexibility, including wide-angle bending, twisting, and stretching abilities in various directions, as well as excellent fatigue resistance and high strength, overwhelming the natural soft wood and most wood-inspired materials. This superflexible artificial soft wood represents a promising substrate for bending-insensitive stress sensors.
Postoperative pneumonia (POP) is a common postoperative complication. Negative consequences associated with POP included prolonged hospital length of stay, more frequent intensive care unit (ICU) ...stays, and a higher rate of sepsis, readmission, and mortality. This meta‐analysis aimed to assess the incidence and risk factors associated with POP after hip fracture surgery in elderly patients. PubMed, Web of Science, and Cochrane Library were searched (up to March 31, 2022). All studies on the risk factors for POP after hip fracture surgery in elderly patients, published in English, were reviewed. The qualities of the included studies were assessed using the Newcastle–Ottawa Scale. Data were pooled, and a meta‐analysis was performed. Ten studies, including 12,084 geriatric patients undergoing hip fracture surgery, were included. Of these 12,084 patients, POP occurred in 809 patients. The results indicated that age (mean difference MD = 4.95, 95% confidence interval CI: 3.22–6.69), male (odds ratio OR = 1.41, 95% CI: 1.02–1.93), the American Society of Anaesthesiologists classification ≥3 (OR = 3.48, 95% CI: 1.87–6.47), dependent functional status (OR = 5.23, 95% CI: 2.18–12.54, P = 0.0002), smoking (OR = 1.33, 95% CI: 1.07–1.65), chronic obstructive pulmonary disease (OR = 3.76, 95% CI: 2.07–6.81), diabetes mellitus (OR = 1.19, 95% CI: 1.01–1.40), coronary heart disease (OR = 1.74, 95% CI: 1.23–2.46), arrhythmia (OR = 1.47, 95% CI: 1.01–2.14), cerebrovascular disease (OR = 1.88, 95% CI: 1.56–2.27), dementia (OR = 2.36, 95% CI: 1.04–5.36), chronic renal failure (OR = 1.85, 95% CI: 1.29–2.67), hip arthroplasty (OR = 1.30, 95% CI: 1.08–1.56), delayed surgery (OR = 6.40, 95% CI: 3.00–13.68), preoperative creatinine (MD = 5.32, 95% CI: 0.55–10.08), and preoperative serum albumin (MD = −3.01, 95% CI: −4.21 – −1.80) were risk factors for POP. Related prophylactic measures should be provided in geriatric patients with the above‐mentioned risk factors to prevent POP after hip fracture surgery.
We found that age, gender, ASA classification ≥ 3, dependent function status, smoking, COPD, diabetes mellitus, coronary heart disease, arrhythmia, cerebrovascular disease, dementia, chronic renal failure, hip arthroplasty, delayed surgery, preoperative creatinine, preoperative serum albumin were the risk factors of POP via meta‐analysis of 10 included studies.
Background
Surgery is the preferred treatment option for the elderly patients with hip fractures. However, the choice of general anesthesia (GA) or regional anesthesia (RA) remains controversial. The ...quality of evidence has further improved with the advent of several high-quality randomized clinical trials (RCTs) in the last two years. The purpose of this study was to compare the clinical outcomes of two anesthetic techniques in elderly patients undergoing hip fracture surgeries.
Methods
Eligible studies were identified from PubMed/MEDLINE, Web of Science, Scopus, EMBASE and reference lists from January 2000 to June 2022 in this current systematic review and meta-analysis. The outcomes included the surgery-related outcomes (duration of surgery, duration of anesthesia, intraoperative blood loss and number of transfusions) and postoperative outcomes (30-day mortality, postoperative delirium,cardiovascular events and other complications).
Results
A total of 10 RCTs were included, and a total of 3594 patients were analyzed. RA was associated with shorter duration of surgery, shorter length of hospital stays and less intraoperative blood loss compared to GA. There were no significant differences between the two groups in the number of blood transfusions, duration of anesthesia, 30-day mortality or postoperative delirium.
Conclusions
Our pooled analysis identified no significant differences in terms of the safety between RA and GA, while RA reduces intraoperative blood loss, length of hospital stays and duration of surgery. These results suggest that RA appears to be preferable for the elderly patients with hip fractures.
Aging can lead to various disorders in organisms and with the escalating impact of population aging, the incidence of age-related diseases is steadily increasing. As a major risk factor for chronic ...illnesses in humans, the prevention and postponement of aging have become focal points of research among numerous scientists. Aging biomarkers, which mirror molecular alterations at diverse levels in organs, tissues, and cells, can be used to monitor and evaluate biological changes associated with aging. Currently, aging biomarkers are primarily categorized into physiological traits, imaging characteristics, histological features, cellular-level alterations, and molecular-level changes that encompass the secretion of aging-related factors. However, in the context of the musculoskeletal soft tissue system, aging-related biological indicators primarily involve microscopic parameters at the cellular and molecular levels, resulting in inconvenience and uncertainty in the assessment of musculoskeletal soft tissue aging. To identify convenient and effective indicators, we conducted a comprehensive literature review to investigate the correlation between ectopic mineralization and age-related changes in the musculoskeletal soft tissue system. Here, we introduce the concept of ectopic mineralization as a macroscopic, reliable, and convenient biomarker for musculoskeletal soft tissue aging and present novel targets and strategies for the future management of age-related musculoskeletal soft tissue disorders.
•A detailed examination of the cellular and molecular mechanisms underlying heterotopic mineralization in aged musculoskeletal soft tissues.•Exploration of the diagnostic and prognostic potential of heterotopic mineralization as an aging biomarker.•An overview of current and emerging therapeutic strategies to mitigate or prevent mineralization-related age-related pathologies.•Discussion of the derangement in the mineralization equilibrium occurring in the aging organism (osteopenia and osteoporosis as opposed to ectopic mineralization).
Postoperative pulmonary complications (PPCs) are prevalent in geriatric patients with hip fractures. Low oxygen level is one of the most important risk factors for PPCs. Prone position has been ...proven efficacy in improving oxygenation and delaying the progress of pulmonary diseases, especially in patients with acute respiratory distress syndrome induced by multiple etiologies. The application of awake prone position (APP) has also attracted widespread attention in recent years. A randomized controlled trial (RCT) will be carried out to measure the effect of postoperative APP in a population of geriatric patients undergoing hip fracture surgery.
This is an RCT. Patients older than 65 years old admitted through the emergency department and diagnosed with an intertrochanteric or femoral neck fracture will be eligible for enrollment and assigned randomly to the control group with routine postoperative management of orthopedics or APP group with an additional prone position for the first three consecutive postoperative days (PODs). Patients receiving conservative treatment will not be eligible for enrollment. We will record the difference in the patient's room-air-breathing arterial partial pressure of oxygen (PaO
) values between the 4
POD (POD 4) and emergency visits, the morbidity of PPCs and other postoperative complications, and length of stay. The incidence of PPCs, readmission rates, and mortality rates will be followed up for 90 PODs.
We describe the protocol for a single-center RCT that will evaluate the efficacy of postoperative APP treatment in reducing pulmonary complications and improving oxygenation in geriatric patients with hip fractures.
This protocol was approved by the independent ethics committee (IEC) for Clinical Research of Zhongda Hospital, Affiliated to Southeast University, and is registered on the Chinese Clinical Trial Registry. The findings of the trial will be disseminated through peer-reviewed journals.
2021ZDSYLL203-P01 TRIAL REGISTRATION: ChiCTR ChiCTR2100049311 . Registered on 29 July 2021.
Recruiting. Recruitment is expected to be completed in December 2024.
Owing to the tissue characteristics of tendons with few blood vessels and cells, the regeneration and repair of injured tendons can present a considerable challenge, which considerably affects the ...motor function of limbs and leads to serious physical and mental pain, along with an economic burden on patients. Herein, we designed and fabricated a dipeptide hydrogel (DPH) using polypeptides P11-4 and P11-8. This hydrogel exhibited self-assembly characteristics and could be administered in vitro. To endow the hydrogel with differentiation and regeneration abilities, we added different concentrations of growth differentiation factor 5 (GDF5) to form GDF5@DPH. GDF5@DPH promoted the aggregation and differentiation of tendon stem/progenitor cells and promoted the regeneration and repair of tendon cells and collagen fibers in injured areas. In addition, GDF5@DPH inhibited inflammatory reactions in the injured area. Owing to its injectable properties, DPH can jointly inhibit adhesion and scar hyperplasia between tissues caused by endogenous inflammation and exogenous surgery and can provide a favorable internal environment for the regeneration and repair of the injured area. Overall, the GDF5@DPH system exhibits considerable promise as a novel approach to treating tendon injury.
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Purpose
To investigate the clinical results and radiological parameters changes after unilateral-approach endoscopic lumbar interbody fusion (Endo-LIF) for lumbar spondylolisthesis with bilateral ...symptoms.
Methods
43 single-level lumbar spondylolisthesis patients with bilateral lower limb symptoms were included from June 2020 to May 2022. All patients underwent unilateral-approach Endo-LIF and postoperative computed tomography. Radiological parameters including disk height (DH), degree of upper vertebral slip (DUVS), and foramen intervertebral parameters including bilateral foraminal height (FH), contralateral foraminal areas (FA) were evaluated. The clinical outcomes including low back pain and bilateral leg pain were evaluated using Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI) before and after surgery.
Results
All cases were successfully completed surgery and followed for average 15.16 ± 5.2 months. DH (44% ± 11%) and DUVS were significantly improvement postoperatively compared with preoperatively (
p
< 0.05). Statistically significant increases in bilateral FH (25% ± 11% on the surgical side, 17% ± 8% on the contralateral side) and contralateral FA (26% ± 6%) were observed (
p
< 0.05). The VAS and the ODI scores were significantly decreased in comparison with the preoperative scores (
p
< 0.05).
Conclusion
Unilateral-approach with contralateral indirect decompression in Endo-LIF can acquire satisfactory clinical outcomes. Therefore, unilateral-approach Endo-LIF may be a promising option for lumbar spondylolisthesis with bilateral symptoms.
Freeze-casting has been wildly exploited to construct porous ceramics but usually requires costly and demanding freeze-drying (high vacuum, size limit, and supercooled chamber), which can be avoided ...by the ambient pressure drying (APD) technique. However, applying APD to freeze-cast ceramic based on an aqueous suspension is still challenging due to inert surface chemistry. Herein, a modified APD strategy is developed to improve the drying process of freeze-cast ceramics by exploiting the simultaneous ice etching, ionic cross-linking, and solvent exchange under mild conditions (−10–0 °C, ambient pressure). This versatile strategy is applicable to various ceramic species, metal ions, and freezing techniques. The incorporated metal ions not only enhance liquid-phase sintering, producing ceramics with higher density and mechanical properties than freeze-cast counterparts, but also render customizable coloration and antibacterial property. The cost-/time-efficient APD is promising for mass production and even successive production of large-size freeze-cast ceramics that exceed the size of commercial freeze-dryers.
Objective: The study aimed to evaluate the short-term clinical efficacy of percutaneous full-endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) for lumbar degenerative diseases (LDD). ...Methods: From July 2020 to July 2021, 93 patients who underwent single-level lumbar fusion procedure were retrospective analysis. The patients were divided into Endo-TLIF group and transforaminal lumbar interbody fusion (TLIF) group. General demographic and perioperative data were recorded, the clinical outcomes were evaluated using visual analogue scale (VAS) and oswestry disability index (ODI). The disk height (DH) was compared between the two groups. Results: All of the surgical procedures were successfully completed, and the patients were followed for a minimum of 2 years. Intraoperative blood loss, drainage volume, time to independent ambulation and hospital length of stay in the Endo-TLIF group were significantly decreased in comparison with the open TLIF group (
p
< 0.05). The VAS for back pain on postoperative 7 day and ODI on postoperative 1 month were lower in the Endo-TLIF group than in the open TLIF group (
P
< 0.05), but no significant difference at 1 year and 2 years postoperatively (
P
> 0.05). The VAS score of leg pain had no demographic statistically significant differences between the groups (
P
> 0.05). The DH were significantly heightened after surgery compared to the preoperative height (
p
< 0.05). Conclusion: Endo-TLIF is a minimally invasive, safety surgery which can achieve comparable short-term effects as open TLIF. It may be a promising option for the treatment of LDD.
