Increased serum asprosin is correlated with diabetes mellitus-induced erectile dysfunction.

OBJECTIVE: Asprosin, a newly identified adipokine, is pathologically increased in type 2 diabetes. The aim of this study is to see whether serum asprosin concentrations are linked to diabetes mellitus-induced erectile dysfunction (DMED). METHODS: 90 male patients with type 2 diabetes were included. According to the International Index of Erectile Function (IIEF-5) score, they were classified into two groups: 45 type 2 diabetes patients without erectile dysfunction (DM group) (IIEF-5 > 21),45 patients with diabetes induced erectile dysfunction (DMED group) (IIEF-5 ≤ 21)0.45 healthy male volunteers with normal blood glucose, IIEF-5 score > 21 points, and age matched with the DMED group were included as the control group. Anthropometric and biochemical variables were determined in all participants. RESULTS: When compared to the controls, T2DM ( Type 2 Diabetes Mellitus)patients had higher serum asprosin levels. The DMED group had significantly higher serum asprosin than the T2DM groups(p < 0.001). After adjusting for multiple variables considered traditional risk factors for ED(erectile dysfunction), Asprosin can still be used as an independent risk factor for ED; The ROC(Receive Operating Characteristic Curve) indicates that asprosin has good sensitivity (97.8%) and specificity (62.2%) in predicting ED, with an area under the curve of 0.843.Correlation analysis shows that asprosin is negatively correlated with SOD(superoxide dismutase ) and positively correlated with MDA (malondialdehyde). CONCLUSION: Serum asprosin concentrations are increased in patients with DMED. Also, asprosin is correlated with oxidative stress indexes (MDA, SOD).

Surfactant effects on electrochemically durable lead halide perovskite electro-catalysts.

Electrochemically durable perovskite electrodes of nickel foam/TiO2/FA(Pb1-xGex)I3, passivated using various surfactants of tetra-n-alkyl ammonium halides (alkyl = ethyl, butyl, hexyl, or octyl; halide = I, I0.5Br0.5, Br, Br0.5Cl0.5, or Cl), were successfully applied as good electro-catalysts on the counter electrodes in dye-sensitized solar cells (DSSCs). The longer alkyl chain of a surfactant resulted in a higher water contact angle, but poorer film conductivity. Based on the optimal tetra-n-hexyl ammonium (THA) cation, shrinking the halide radius of THA from I to I0.5Br0.5 formed an appropriate amount of FAPbBr3 nano-crystals covering on the FA(Pb1-xGex)I3 grain surface. This phenomenon not only suppressed the perovskite decomposition under electrochemical measurements, but also created additional electro-catalytic active sites for triggering the iodide/triiodide redox reaction. Further shrinking the halide radius of THA from I0.5Br0.5 to Cl resulted in a severe self-aggregation of THACl, leading to an insufficient passivation and thereby poor electrochemical performance. In an ambient environment with a relative humidity higher than 75%, the optimal perovskite electrode of nickel foam/TiO2/FA(Pb1-xGex)I3-THAI0.5Br0.5 maintained the good crystallinity of α-FAPbI3 at least for 6 months, without obvious decomposition. Compared to the DSSC couple with a common counter electrode of nickel foam/Pt (8.74%), a better cell performance of 8.87% was achieved using the counter electrode of nickel foam/TiO2/FA(Pb1-xGex)I3-THAI0.5Br0.5, which was attributed to its good intrinsic electro-catalytic activity, large surface area, multiple active sites, and decent thermodynamic stability. Under room light illumination, higher cell efficiencies were obtained at 1 klux (21.5% for an office), 3 klux (22.9% for a shopping window), and 6 klux (22.3% for a lampshade). There is no doubt that air-stable perovskites have great potential in showing high performance for various electrochemical devices.

Biomechanical comparison of different screw-included angles in crossing screw fixation for transverse patellar fracture in level walking: a quasi-dynamic finite element study.

BACKGROUND: A minimally invasive technique with various screw configurations without open surgery is currently used for the fixation of transverse patellar fractures. Percutaneous crossing screw configuration has been reported to have a good bone union rate in patellar fractures. However, the difference in mechanical stability of the fractured patella between different screw-included angles has not been fully investigated. Hence, this study aims to compare the mechanical stability of parallel and crossing screw fixations with different screw-included angles for the fixation of transverse patellar fractures during level walking. METHODS: A finite element knee model containing a patella with a transverse fracture is created. Two headless compression screws with different angles (0°, 30°, 60°, and 90°) are used to fix the fracture. The loading conditions of the knee joint during level walking are used to compare the stability of the fractured patella with different fixation screw configurations. RESULTS: The results indicate that the maximum fracture gap opening distance increased with an increase in the included angle. Two parallel screws yield the smallest gap distance among all screw configurations. The maximum gap opening distances at the anterior leading edge of the fractured patella with two parallel screws and two screws having an included angle of 90° are 0.73 mm and 1.31 mm, respectively, at 15% walking cycle. CONCLUSIONS: Based on these results, the superior performance of two parallel screws over crossing screw fixations in the fixation of transverse patellar fractures is established. Furthermore, the smaller the angle between the crossing screws, the better is the stability of the fractured patella.

Numerical Comparison of Restored Vertebral Body Height after Incomplete Burst Fracture of the Lumbar Spine.

BACKGROUND AND OBJECTIVES: Vertebral compression fracture is a major health care problem worldwide due to its direct and indirect negative influence on health-related quality of life and increased health care costs. Although a percutaneous surgical intervention with balloon kyphoplasty or metal expansion, the SpineJack, along with bone cement augmentation has been shown to efficiently restore and fix the lost vertebral height, 21-30% vertebral body height loss has been reported in the literature. Furthermore, the effect of the augmentation approaches and the loss of body height on the biomechanical responses in physiological activities remains unclear. Hence, this study aimed to compare the mechanical behavior of the fractured lumbar spine with different restored body heights, augmentation approaches, and posterior fixation after kyphoplasty using the finite element method. Furthermore, different augmentation approaches with bone cement and bone cement along with the SpineJack were also considered in the simulation. MATERIALS AND METHODS: A numerical lumbar model with an incomplete burst fracture at L3 was used in this study. Two different degrees of restored body height, namely complete and incomplete restorations, after kyphoplasty were investigated. Furthermore, two different augmentation approaches of the fractured vertebral body with bone cement and SpineJack along with bone cement were considered. A posterior instrument (PI) was also used in this study. Physiological loadings with 400 N + 10 Nm in four directions, namely flexion, extension, lateral bending, and axial rotation, were applied to the lumbar spine with different augmentation approaches for comparison. RESULTS: The results indicated that both the bone cement and bone cement along with the SpineJack could support the fractured vertebral body to react similarly with an intact lumbar spine under identical loadings. When the fractured body height was incompletely restored, the peak stress in the L2-L3 disk above the fractured vertebral body increased by 154% (from 0.93 to 2.37 MPa) and 116% (from 0.18 to 0.39 MPa), respectively, in the annular ground substance and nucleus when compared with the intact one. The use of the PI could reduce the range of motion and facet joint force at the implanted levels but increase the facet joint force at the upper level of the PI. CONCLUSIONS: In the present study, complete restoration of the body height, as possible in kyphoplasty, is suggested for the management of lumbar vertebral fractures.

Triangular configuration with headless compression screws in the fixation of transverse patellar fracture.

A triangular configuration with three parallel cannulated screws is an established treatment for fixing transverse patellar fractures; however, the stability achieved with this approach is slightly lower than that attained with cannulated screws combined with anterior wiring. In the present study, triangular configurations were modified by partially or totally replacing the cannulated screws with headless compression screws (HCSs). Through finite element simulation involving a model of distal femoral, patellar, and proximal tibial fractures, the mechanical stability levels of the modified triangular configurations were compared with that of two cannulated screws combined with anterior wiring. Four triangular screw configurations were developed: three HCSs in a forward and backward triangular configuration, two deep cannulated screws along with one superficial HCS, and two superficial cannulated screws with one deep HCS. Also considered were two parallel cannulated screws (inserted superficially or deeply) combined with anterior wiring. The six approaches were all examined in full knee extension and 45° flexion under physiological loading. The highest stability was obtained with the three HCSs in a backward triangular configuration, as indicated by the least fragment displacement and the smallest fracture gap size. In extension and flexion, this size was smaller than that observed under the use of two deeply placed parallel cannulated screws with anterior wiring by 50.3% (1.53 vs. 0.76 mm) and 43.2% (1.48 vs. 0.84 mm), respectively. Thus, the use of three HCSs in a backward triangular configuration is recommended for the fixation of transverse patellar fractures, especially without the use of anterior wiring.

Quantitative assessment and influence factors of facial wrinkle situation in male construction workers in Beijing.

OBJECTIVE: To investigate current situation of facial wrinkles of male construction workers in Beijing area and to discuss the correlative factors. MATERIALS AND METHODS: A total of 149 male construction works and 63 male non-construction workers in Beijing were required to complete a questionnaire on their exposure to sunlight, dust, noise, and heat in their workplace environment. Their facial wrinkle scores were measured by VISIA Complexion Analysis System. The two-sample t test, chi-square test, and multiple linear regression were used for statistical analysis RESULTS: The exposure to sunlight, dust, noise, and heat of construction workers was significantly higher than that of non-construction workers (P < .01). The wrinkle score of construction workers between 20 and 29 years old was significantly higher than that of non-construction workers (t = 4.077, P < .01). The facial wrinkle score of construction workers(r = 0.657, P < .01) and non-construction workers (r = 0.681, P < .01) was both positively correlated with age. The wrinkle score of construction workers was related to age, sunlight, and noise(P < .01). CONCLUSION: The wrinkle score of male construction workers between 20 and 29 years old is significantly higher than that of non-construction workers in Beijing. Age, sunlight, and noise were the main influencing factors of wrinkle.

Orientation-Adjustable Metal-Organic Framework Nanorods for Efficient Oxygen Evolution Reaction.

A series of orientation-adjustable metal-organic framework (MOF) nanorods, CoFe(dobpdc)-I to CoFe(dobpdc)-III (dobpdc = 4,4'-dihydroxybiphenyl-3,3'-dicarboxylate), is developed on a 3D nickel foam (NF) template. By modulating the solvent composition for synthesis, the feature of MOF nanorods on the template can be varied from disorganized to a unidirectional orientation perpendicular to the NF. Well-aligned, vertically oriented CoFe(dobpdc)-III nanorods are hydrophilic and have more exposed active sites and interfacial charge transfer ability. Consequently, they exhibit a superior activity for oxygen evolution reaction (OER) with ultralow overpotentials of 176 and 240 mV at 10 and 300 mA cm-2 in 1.0 M KOH (aq), respectively. CoFe(dobpdc)-III also shows a record low overpotential of 204 mV at J10 mA cm-2 among the electrocatalysts based on CoFe MOF and an excellent overpotential at a high current density (100 mA cm-2) of 312 mV in 0.1 M KOH (aq). This is the first report of a convenient method to straighten up MOF nanorods on a template for highly efficient OER.

Electroactive and Sustainable Cu-MOF/PEDOT Composite Electrocatalysts for Multiple Redox Mediators and for High-Performance Dye-Sensitized Solar Cells.

An electrically conductive Cu-MOF, {[Cu2(6-mercaptonicotinic acid)(6-mercaptonicotinate)]·NH4}n, was successfully electrodeposited on the conductive substrates via using poly(3,4-ethylenedioxythiophene) (PEDOT) as the binder. Multiple functionalities of the Cu-MOF microparticle within the Cu-MOF/PEDOT composite electrode were systematically vindicated as (1) releasing the cohesive strength among the PEDOT matrix, thus enhancing the film adhesion to substrate, (2) providing excellent intrinsic heterogeneous rate constant via lowering the reaction active energy, (3) supplying numerous active sites at the center or edges on its (-Cu-S-)n honeycomb-like planes, (4) facilitating the electron transfer through its two-dimensional (-Cu-S-)n plains, and (5) benefiting the penetration of the redox mediators through its porous frameworks. In multiple redox mediators (i.e., I-/I3-, cobalt(II/III)-complex, and copper(I/II)-complex), the composite Cu-MOF/PEDOT electrode exhibited superior electrocatalyst activity and kept almost 100% of its initial redox peak currents after continuous cyclic voltammetric scanning for 300 cycles. As a high-performance electrocatalyst for the counter electrode in dye-sensitized solar cells (DSSCs), the composite Cu-MOF/PEDOT electrode rendered its cell a decent solar-to-electricity conversion efficiency of up to 9.45% at 1 sun and 22.80% at room light illumination. Compared to the traditional platinum electrode (7.67%), the low-cost Cu-MOF/PEDOT composite electrode has great possibility to be used for various electrochemical devices and the Internet-of-things applications.

Role of an additional third screw in the fixation of transverse patellar fracture with two parallel cannulated screw and anterior wire.

BACKGROUND: Two parallel cannulated screws along with an anterior wire to construct a tension band is a popular approach in transverse patellar fractures. However, the optimal screw proximity, either deep or superficial screw placements, remains controversial. Hence, a new concept of the addition of a third screw to form a triangular configuration along with the original two parallel screws was proposed in this study. Therefore, the biomechanical effect of the additional third screw on the stability of the fractured patella was investigated with finite element (FE) simulation. METHODS: An FE knee model including the distal femur, proximal tibia, and fractured patella (type AT/OTA 34-C) was developed in this study. Four different screw configurations, including two parallel cannulated screws with superficial (5-mm proximity) and deep (10-mm proximity) placements and two parallel superficial screws plus a third deep screw, and two parallel deep screws plus a third superficial screw, with or without the anterior wire, were considered for the simulation. RESULTS: Results indicated that the addition of a third screw increased stability by reducing the dorsal gap opening when two parallel screws were deeply placed, particularly on the fractured patella without an anterior wire. However, the third screw was of little value when two parallel screws were superficially placed. In the existence of two deep parallel screws and the anterior wire, the third screw reduced the gap opening by 23.5% (from 1.15 mm to 0.88 mm) and 53.6% (from 1.21 mm to 0.61 mm) in knee flexion 45° and full extension, respectively. Furthermore, in the absence of the anterior wire, the third screw reduced the gap opening by 73.5% (from 2 mm to 0.53 mm) and 72.2% (from 1.33 mm to 0.37 mm) in knee flexion 45° and full extension, respectively. CONCLUSION: Based on the results, a third cannulated screw superficially placed (5-mm proximity) is recommended to increase stability and maintain contact of the fractured patella, fixed with two parallel cannulated screws deeply placed (10-mm proximity), particularly when an anterior wire was not used. Furthermore, the third screw deeply placed is not recommended in a fractured patella with two parallel superficial screws.

Computational comparison of different plating strategies in medial open-wedge high tibial osteotomy with lateral hinge fractures.

BACKGROUND: Lateral hinge fracture (LHF) is associated with nonunion and plate breakage in high tibial osteotomy (HTO). Mechanical studies investigating fixation strategies for LHFs to restore stability and avoid plate breakage are absent. This study used computer simulation to compare mechanical stabilities in HTO for different LHFs fixed with medial and bilateral locking plates. METHODS: A finite element knee model was created with HTO and three types of LHF, namely T1, T2, and T3 fractures, based on the Takeuchi classification. Either medial plating or bilateral plating was used to fix the HTO with LHFs. Furthermore, the significance of the locking screw at the combi hole (D-hole) of the medial TomoFix plate was evaluated. RESULTS: The osteotomy gap shortening distance increased from 0.53 to 0.76, 0.79, and 0.72 mm after T1, T2, and T3 LHFs, respectively, with medial plating only. Bilateral plating could efficiently restore stability and maintain the osteotomy gap. Furthermore, using the D-hole screw reduced the peak stress on the medial plate by 28.7% (from 495 to 353 MPa), 26.6% (from 470 to 345 MPa), and 32.6% (from 454 to 306 MPa) in T1, T2, and T3 LHFs, respectively. CONCLUSION: Bilateral plating is a recommended strategy to restore HTO stability in LHFs. Furthermore, using a D-hole locking screw is strongly recommended to reduce the stress on the medial plate for lowering plate breakage risk.

Computational comparison of bone cement and poly aryl-ether-ether-ketone spacer in single-segment posterior lumbar interbody fusion: a pilot study.

Posterior lumbar interbody fusion (PLIF) with a spacer and posterior instrument (PI) via minimally invasive surgery (MIS) restores intervertebral height in degenerated disks. To align with MIS, the spacer has to be shaped with a slim geometry. However, the thin spacer increases the subsidence and migration after PLIF. This study aimed to propose a new lumbar fusion approach using bone cement to achieve a larger supporting area than that achieved by the currently used poly aryl-ether-ether-ketone (PEEK) spacer and assess the feasibility of this approach using a sawbone model. Furthermore, the mechanical responses, including the range of motion (ROM) and bone stress with the bone cement spacer were compared to those noted with the PEEK spacer by finite element (FE) simulation. An FE lumbar L3-L4 model with PEEK and bone cement spacers and PI was developed. Four fixing conditions were considered: intact lumbar L3-L4 segment, lumbar L3-L4 segment with PI, PEEK spacer plus PI, and bone cement spacer plus PI. Four kinds of 10-NM moments (flexion, extension, lateral bending, and rotation) and two different bone qualities (normal and osteoporotic) were considered. The bone cement spacer yielded smaller ROMs in extension and rotation than the PEEK spacer, while the ROMs of the bone cement spacer in flexion and lateral bending were slightly greater than with the PEEK spacer. Compared with the PEEK spacer, peak contact pressure on the superior surface of L4 with the bone cement spacer in rotation decreased by 74% (from 8.68 to 2.25 MPa) and 69.1% (from 9.1 to 2.82 MPa), respectively, in the normal and osteoporotic bone. Use of bone cement as a spacer with PI is a potential approach to decrease the bone stress in lumbar fusion and warrants further research.

Finite element study of the effects of fragment shape and screw configuration on the mechanical behavior of tibial tubercle osteotomy.

PURPOSE: Tibial tubercle osteotomy (TTO) is a surgical technique used in the management of severe fractures of the knee joint and revision total knee arthroplasty. Limited research discusses the performance of the osteotomy and fixation of the TTO with screws. Therefore, this study investigated the effects of fragment shape and screw configuration on the mechanical behavior in the fixation of the TTO using the finite element (FE) method. METHODS: FE TTO models with three fragment shapes and three screw configurations were developed. The three fragment shapes were a step cut, bevel cut, and straight cut. The screw configurations were two parallel horizontal and downward screws and two trapezoidal screws. A 1654-N upward tension force was applied on the tibia tubercle, and the distal end of the tibia was completely fixed. RESULTS: The results indicated that the step cut resulted in higher stability than the bevel and straight cut, but the stress was higher as well. Among the screw configurations, two parallel downward screws resulted in the highest stability, given the same fragment shape. In the horizontal configuration, the step cut tibia developed the largest contact force to achieve stability of the bone fragment under loading. CONCLUSION: The fragment shape with a step cut and fixation with two parallel horizontal or downward screws are suggested for TTO, while the trapezoidal screw configuration is not suggested. Furthermore, the downward screw configuration is a suitable strategy to reduce bone stress.

Gap between the fragment and the tibia affects the stability of tibial tubercle osteotomy: A finite element study.

Tibial tubercle osteotomy (TTO) is commonly performed in cases of complicated juxta-articular trauma or revision total knee arthroplasty. However, strategies for firmly fixing the resulting osteotomy bone fragment are not sufficiently understood. This study aims to investigate the effect of the location of the gap between the fragment and the tibia and with various fixed screw configurations on TTO stability, contact force on the fragment, and bone stress by using the finite element method. A TTO model with a 1-mm gap, either above or below the fragment, was developed. Furthermore, five screw configurations, including two parallel horizontal screws placed at 20- and 30-mm intervals, two parallel downward screws, two trapezoid screws, and two divergent screws, were used. A vertically upward 1600-N force was applied on the tibial tubercle to mimic a worst-case condition. Placing the fragment close to the superior cutting plane (above the gap) yielded greater stability and less stress on the bone than did placing it close to the inferior cutting plane. The superior cutting plane of the tibia generated the largest contact force on the superior plane of the fragment for static balance under loading. Additionally, among all screw configurations, the configuration involving two parallel downward screws resulted in the highest stability but also the greatest stress on the cortical bone. The fragment obtains a solid barrier and support from the tibia immediately after surgery to against the patellar tension force when the fragment is close to the superior cutting plane of the tibia.

Roles of the screw types, proximity and anterior band wiring in the surgical fixation of transverse patellar fractures: a finite element investigation.

BACKGROUND: Cannulated screws with an anterior wire are currently used for managing transverse patellar fracture. However, the addition of anterior wiring with various types of screws via open surgery to increase the mechanical stability is yet to be determined. Hence, this study aimed to compare the mechanical behaviors of a fractured patella fixed with various screws types and at various screw locations with and without the anterior wire. The present study hypothesized that using the anterior wire reduces the fracture gap formation. METHODS: A finite element (FE) model containing a fractured patella fixed with various types of cannulated screws and anterior wiring was created in this study. Three types of screws, namely partial thread, full thread, and headless compression screws, and two screw depths, namely 5 and 10 mm away from the anterior surface of the patella, were included. The effect of the anterior wire was clarified by comparing the results of surgical fixation with and without the wire. Two magnitudes and two loading directions were used to simulate and examine the mechanical responses of the fractured patella with various fixation conditions during knee flexion/extension. RESULTS: Compared with partial thread and headless compression screws, the full thread screw increased the stability of the fractured patella by reducing fragment displacement, fracture gap formation, and contact pressure while increasing the contact area at the fracture site. Under 400-N in the direction 45°, the full thread screw with 5-mm placement reduced the gap formation by 86.7% (from 2.71 to 0.36 mm) and 55.6% (from 0. 81 to 0. 36 mm) compared with the partial thread screw with 10-mm placement, respectively without and with the anterior wire. CONCLUSION: The anterior wire along with the full thread screw is preferentially recommended for maintaining the surgical fixation of the fractured patella. Without the use of anterior wiring, the full thread screw with 5-mm placement may be considered as a less invasive alternative; however, simple screw fixation at a deeper placement (10 mm) is least recommended for the fixation of transverse patellar fracture.

Biomechanical investigation of the type and configuration of screws used in high tibial osteotomy with titanium locking plate and screw fixation.

BACKGROUND: To maintain the corrected alignment after high tibial osteotomy (HTO), fixation with titanium locking plate and screws is widely used in current practice; however, screw breakage is a common complication. Thus, this study was to investigate the mechanical stability of HTO with locking plate and various screw fixations, including the length as well as the type. METHODS: A finite element (FE) model involving a distal femur, meniscus, and a proximal tibia with HTO fixed with a titanium locking plate and screws was created. The angle of the medial open wedge was 12°, and bone graft was not used. Two types of screws, namely conventional locking and far-cortical locking screws, with various lengths and configurations were used. At the proximal tibia, conventional locking screws with different lengths, 30 and 55 mm, were used; at the tibia shaft, different screw fixations including one-cortical, two-cortical, and far-cortical locking screws were used. RESULTS: The use of far-cortical locking screw generated the highest equivalent stress on the screws, which was four times (from 137.3 to 541 MPa) higher than that of the one-cortical screw. Also, it led to the maximum deformation of the tibia and a greater gap deformation at the osteotomy site, which was twice (from 0.222 to 0.442 mm) larger than that of the one-cortical screw. The effect of different locking screw length on tibia deformation and implant stress was minor. CONCLUSION: Thus, far-cortical locking screws and plates increase interfragmentary movement but the screw stress is relatively high. Increasing the protection time (partial weight duration) is suggested to decrease the risk of screw breakage in HTO through fixation with titanium far-cortical locking screws and plates.

Biomechanical analysis of different dynamic sitting techniques: an exploratory study.

Prolonged static sitting in wheelchairs increases the risk of pressure ulcers. This exploratory study proposed three dynamic sitting techniques in order to reduce the risk of developing pressure ulcer during wheelchair sitting, namely lumbar prominent dynamic sitting, femur upward dynamic sitting, and lumbar prominent with femur upward dynamic sitting. The purpose of this study was to analyze the biomechanical effects of these three techniques on interface pressure. 15 able-bodied people were recruited as subjects to compare the aforementioned sitting techniques in a random order. All parameters, including dynamic contact area, dynamic average pressure, and dynamic peak pressure on backrest and seat were measured and compared. In result, when compared with lumbar prominent dynamic sitting, femur upward dynamic sitting and lumbar prominent with femur upward dynamic sitting appeared to yield significantly lower dynamic average and peak pressure on the back part of seat, and significantly higher dynamic average and peak pressure on the front part of seat. This study can serve as a reference point for clinical physicians or wheelchair users to identify a suitable dynamic sitting technique.

Biomechanical investigation of tibial tubercle osteotomy fixed with various screw configurations.

INTRODUCTION: To date, the effects of various screw configurations on the stability of tibial tubercle osteotomy (TTO) are not completely understood. Hence, the first aim of this study is to evaluate the stability of TTO under various screw configurations. The second aim is to evaluate the internal stresses in the bone and the contact forces on the bone fragment that are developed by the tibia and screws in response to the applied load after the equilibrant is revealed. METHODS: To calculate the biomechanical responses of the bone and screw under loading, finite element (FE) method was used in this study. Six types of screw configurations were studied in the simulation: two parallel horizontal screws placed at a 20 mm interval, two parallel horizontal screws placed at a 30 mm interval, two parallel upward screws, two parallel downward screws, two trapezoid screws, and two divergent screws. The displacement of the bone fragment, contact forces on the fragment, and the internal stress in the bone were used as indices for comparison. RESULTS: Among all configurations, the configuration of two parallel downward screws yielded the highest stability with the lowest fragment displacement and gap opening. Although the maximum displacement of the TTO with the configuration of two parallel horizontal screws was slightly higher than that of the downward configuration, the difference was only 0.2 mm. The configuration of two upward screws resulted in the highest fragment displacement and gap deformation between the fragment and tibia. The stress of the osteotomized bone fragment was highest with the configuration of two upward screws. CONCLUSION: Based on the present model, the current configuration of two parallel horizontal screws is recommended for TTO. If this is inappropriate in a specific clinical scenario, then the downward screw configuration may be used as an alternative. By contrast, the configuration of two parallel upward screws is least suggested for the fixation of TTO.

Role of screw proximity in the fixation of transverse patellar fractures with screws and a wire.

PURPOSE: Clinical and biomechanical studies have reported that using supportive screws and a wire instead of the common Kirschner wires for modified tension band wiring improves the stability of fractured patellae. However, the effect of screw proximity on the fixation of a fractured patella remains unclear. Therefore a numerical study was conducted to examine the effects of screw proximity on biomechanical responses in a simulated patellar fracture fixed using two parallel cannulated screws and anterior tension band wiring. METHODS: A patellar model with a transverse fracture and loads simulating patellar tendon forces applied on the patella were used in the present simulation. The surgical fixation consisted of two 4.0-mm parallel partially threaded cannulated screws with a figure-of-eight tension band made using a 1.25-mm stainless steel wire. Biomechanical responses at two screw proximities, 5 and 10 mm from the leading edge of the patella, were investigated. RESULTS: Superficial screw placement (5 mm) yielded higher stability, lower wire loads, and lower bone contact pressures than the deep placement (10 mm). The deep placement of screws exerted a higher load on the wire but a lower force on the screw than superficial placement did. CONCLUSION: This is the first numerical study to examine the effects of screw location on the fixation of a fractured patella using cannulated screws and tension band wiring. Considering the favorable biomechanical responses, superficial placement (5 mm below the leading edge of the patella) is recommended for screw insertion when treating a transverse fractured patella.

Organic Photosensitizers Incorporating Rigid Benzo[1,2-b:6,5-b']dithiophene Segment for High-Performance Dye-Sensitized Solar Cells.

Benzo[1,2-b:6,5-b']dithiophene (BDT) entity with rigid skeleton is introduced into the conjugated spacer of organic dyes, with triphenylamine as the electron donor and 2-cyanoacrylic acid as the acceptor, have been prepared for dye-sensitized solar cells. Inserting an aromatic entity between BDT and the anchor extends the absorption wavelength of the dyes and improves the dark current suppression efficiency, and consequently leads to better cell performance. Addition of chenodeoxycholic acid coadsorbent alleviates dye aggregation and results in better cell efficiency. The dye inserted with 4H-cyclopenta[2,1-b:3,4-b']dithiophene entity achieves the best efficiency (9.11%) when I-/I3- was used as the electrolyte. When Co(phen)32+/3+ was used as the electrolyte, the efficiency further boosts to 9.88%.