Search Results (143)

Background: Mortality risk in patients with hip fractures is influenced by multiple factors, including age, pre-existing medical conditions, and frailty. This study aims to compare the predictive ability of 6-month mortality between traditional risk models—the American Society of Anesthesiologists (ASA) classification, the Hip Fracture Estimator of Mortality of Amsterdam (HEMA), and the Nottingham Hip Fracture Score (NHFS)—and frailty assessment. Methods: This retrospective study included patients who were admitted to the Orthopedics and Traumatology Clinic with intracapsular femoral neck fractures treated with hemiarthroplasty and with extracapsular intertrochanteric fractures treated with intramedullary nailing between 1 January 2023 and 31 December 2023. Demographic and clinical data were retrieved from medical records, and survival status at 6 months post-admission was determined using the Turkish Death Registry System. The frailty status was determined retrospectively from electronic medical records using the Clinical Frailty Scale (CFS) by a trained specialist. Results: A total of 164 patients were analyzed, with a mean age of 78.2 ± 8.9 years, and 64.6% (n = 106) were female. The 6-month mortality rate was 31.1% (n = 51). Frailty, as measured by CFS, was significantly associated with increased mortality risk [hazard ratio: 4.465, 95% confidence interval (CI): 2.588–7.703, p < 0.001]. Receiver Operating Characteristic (ROC) analysis demonstrated that all risk models were predictive of 6-month mortality, with CFS exhibiting the highest area under the curve (AUC) (CFS: AUC = 0.879 (95% CI: 0.824–0.934, p < 0.001). Conclusions: In this cohort, several perioperative risk scores were associated with mortality; however, frailty measured by the CFS provided stronger discrimination for medium-term prognosis after hip fracture surgery. Incorporating frailty assessment alongside perioperative risk evaluation may improve risk stratification and support orthogeriatric care planning and postoperative management in this high-risk population. Full article

The antibiotic and drug resistance of various bacterial and fungal strains poses a significant challenge to medicine and industry. The subject of numerous studies is how to limit the spread of microorganisms and biofilm formation on various surfaces. This research focuses on the antibacterial and antifungal properties of cross-linked methacrylate-based composites for specific applications. These composites were modified using 10 wt.% of compounds with scientifically proven antimicrobial properties. These include nanosilver, copper sulphate, benzethonium chloride, and zinc oxide. The antimicrobial potential against the following bacteria and fungi was determined: Gram-positive bacteria (Staphylococcus aureus); Gram-negative bacteria (Pseudomonas aeruginosa and Escherichia coli); and the pathogenic fungi Candida albicans and Aspergillus niger. Using the modified disc-diffusion method alongside a serial dilution method demonstrated an inhibitory effect on the viability and formation of bacterial and fungal biofilms. It was demonstrated that—in liquid cultures—composites containing benzethonium chloride inhibited the growth of P. aeruginosa by over 75%, more than 50% of E. coli and more than 70% of S. aureus. Growth inhibition of C. albicans exceeded 80% for selected composites (BPA.DM + NVP + CuSO₄, BPA.DM + NVP + ZnO), while all composites inhibited the growth of A. niger by more than 45%, and in some cases (BPA.DM + HEMA + CuSO₄, BPA.DM + HEMA + Ag, BPA.DM + MMA + Ag and BPA.DM + AEH + CuSO₄) by more than 90%. Additionally, these composites significantly reduced biofilm formation on their surfaces. Modification with zinc oxide and benzethonium chloride resulted in materials that were non-toxic to normal human skin fibroblasts. To sum up the obtained results, it can be stated that these multifunctional materials with antibacterial properties could be used in medical devices, coatings, and other specialised applications where microbial contamination is a significant issue. Full article

The demand for sustainable, high-performance biomaterials has driven intense research towards natural polysaccharide hydrogels. Accordingly, this study aimed to synthesize novel starch-based hydrogel materials, considering their inherent hydrogel-forming capabilities together with diverse potential applications (e.g., pharmaceuticals, medicine, and the cleaning application for the artifacts). To obtain hydrogels with enhanced mechanical and physico-chemical properties, starch was combined with other polymeric species (i.e., alginate, polyvinyl alcohol, and polyvinylpyrrolidone), and a gelling process was induced by using calcium cations or borate anions. Two distinct hydrogels (named S-Ca and S-SB, respectively) were prepared and characterized by a range of instrumental and experimental techniques. The assessed properties included water and solvent resistance, equilibrium water content, water-releasing capacity, morphology and microstructural features with their composition by SEM-EDS analysis, and mechanical properties (tensile strength, elasticity, Young’s modulus, and hardness). The results indicated that the investigated hydrogels exhibited suitable properties for a variety of applications, including surface cleaning processes in the field of cultural heritage conservation. For instance, they showed equilibrium water content (between 80 and 90%) comparable with other hydrogels commonly used as cleaning tools (e.g., agar and p(HEMA)/PVP) and quite low water-releasing capacity (between 10 and 17 mgcm⁻²). Moreover, the S-SB hydrogel displayed distinctly better tensile strength and elongation at break than hydrogel prepared in the presence of Ca²⁺ (S-Ca). Notably, S-SB experienced considerable elasticity improvement after freezing–thawing cycles, as indicated by a decrease in tensile strength (from 275 to 102 kPa) and an increase in elongation at break (from 121 to 275%). However, it should be noted that the hydrogel selection depends on the requirements of the target application, as different processes demand materials with distinct characteristics. Hence, both S-Ca and S-SB hydrogels were tested as cleaning tools for the removal of artificially aged acrylic coating (i.e., Paraloid B-72) from the surface of marble and wood specimens, respectively. The tests provided positive results, as aged coating was satisfactorily removed by applying the hydrogels loaded with a nanostructured emulsion (NSE). These novel starch-based hydrogels demonstrate significant potential as high-performance alternatives to conventional hydrogel systems currently used in conservation science as well as in other industrial applications. Full article

Pre-warehouse last-mile delivery is currently constrained by service radiuses and intense delivery pressures. Meanwhile, national policies are increasingly promoting a transition toward green logistics. By undertaking deliveries to remote or dispersed locations, UAVs can streamline truck routes and minimize the fuel consumption and emissions typically exacerbated by urban traffic congestion. Accordingly, this paper establishes a Ground-Vehicle and Drone Parallel Distribution Model with Priorities (PW-PDSVRP-P), quantifying customer priorities via delivery delay functions to align efficiency with social service requirements. A master–slave hybrid Large Neighborhood Search algorithm is developed and validated through a Hema Fresh case study in Xuzhou. Results define a clear “economic advantage zone” for drone adoption and reveal an adaptive assignment strategy: drones serve as mass-delivery tools in low-cost scenarios but act as “surgical tools” to prune inefficient truck segments in high-cost environments. These findings confirm that air–ground collaboration fosters a more resilient urban distribution system by balancing operational costs with environmental and social sustainability goals. Full article

Catheter-associated urinary tract infections are often caused by biofilm formation on device surfaces. This paper presents an antimicrobial catheter-coating hydrogel comprising p(HEMA) and carboxyl-functionalized p(HEMA-co-MA), loaded with benzalkonium chloride (BAC) to increase hydrophilicity, pH responsiveness, and antibiofilm activity. Hydrogels were prepared by free-radical polymerization, loaded with BAC via swelling, and their physicochemical properties were characterized. Furthermore, microbiological assessment focused on the detection of MIC/MBC/MFC, disk diffusion, biofilm assays, SEM imaging, and RT-qPCR sequencing were used to determine the impact on biofilm-related gene expression to evaluate antimicrobial activity against major catheter-associated urinary tract infection (CAUTI)-associated pathogens and identify the higher BAC loading p(HEMA) and enhanced hydrophilicity and pH-responsive swelling (p(HEMA-co-MA)). The two hydrogels exhibited a wide range of antimicrobial activity and provided lasting inhibition for up to 8 days. It is worth noting that the MA-functionalized hydrogel exhibited a high intrinsic antifouling property, and biofilm development was reduced by more than 85% in BAC-loaded formulations. SEM and gene-expression studies showed reduced microbial adhesion and substantial repression of virulence and biofilm-associated genes. In summary, BAC-loaded p(HEMA) and p(HEMA-co-MA) coatings exhibit strong antimicrobial and antiadhesive properties, and the incorporation of MA results in more effective biofilm suppression, which supports their future use as advanced catheter coatings to prevent the development of device-related infections. Full article

Hypertension has been traditionally known to be highlighted by mean blood pressure; however, emerging evidence exhibits that blood pressure variability (BPV), including short-term, day-to-day, and visit-to-visit fluctuations can have an implication across multiple body systems. Elevated BPV reflects repetitive hemodynamic stress, affecting the physiologic hemostasis contributing to vascular injury and end organ damage. This narrative review is a compilation of recent evidence on the prognostic value of BPV, explained by pathophysiology, various devices with its measurement approaches, and, essentially, the clinical implication of BPV and the use of such devices utilizing artificial intelligence. A comprehensive literature search across PubMed, Cochrane Library, Scopus, and Web of Science were conducted, focusing on observational studies, cohorts, randomized trials, and meta-analyses. Higher BPV has been associated with an increased risk of cardiovascular mortality, stroke, coronary events, and heart failure, the progression of chronic kidney disease, cognitive decline, and preeclampsia, among other end organ damage, despite mean blood pressure. The various pathophysiologic mechanisms include autonomic dysregulation, arterial stiffness, endothelial dysfunction, circadian rhythm alteration, and systemic inflammation, which result in vascular remodeling and multisystem damage. Antihypertensive medications such as calcium channel blockers and renin–angiotensin–aldosterone system inhibitors seem to reduce BPV; randomized trials have not specifically investigated their BPV-reducing effects. The aim of this review is to highlight that BPV is a dynamic marker of multisystem risk, and question how various AI-based devices can aid continuous BPV monitoring and patient specific risk stratification. Full article

Background: Mediastinal gray zone lymphoma (MGZL) is a rare B-cell lymphoma characterized by overlapping clinicopathologic and molecular features of primary mediastinal B-cell lymphoma (PMBL) and classical Hodgkin lymphoma (CHL). Under current WHO-HEMA5 and International Consensus Classification (ICC) frameworks, MGZL is restricted to EBV-negative lymphomas arising in the mediastinum. Methods: This review summarizes current evidence on epidemiology, clinical presentation, pathology, molecular characteristics, diagnostic challenges, and therapeutic approaches to MGZL, with data derived from retrospective series, limited prospective cohorts, and recent molecular studies. Results: MGZL predominantly affects young adults and commonly presents with bulky mediastinal disease. Diagnosis is challenging due to transitional morphology, pleomorphic Reed–Sternberg-like cells, and variable expression of B-cell and activation markers. Molecular studies demonstrate shared alterations with PMBL and CHL, including 9p24.1 (JAK2/PD-L1/PD-L2) gains, while additional reported features such as HOXA5 hypomethylation and MYC copy number gains support its biological distinctiveness, although evidence remains limited. Frontline treatment commonly involves intensive chemoimmunotherapy regimens such as DA-EPOCH-R; however, outcomes remain inferior to PMBL and CHL, with 5-year overall survival rates of approximately 40–60%. Relapsed or refractory disease frequently requires salvage chemotherapy and autologous stem cell transplantation. Immune-based therapies, including brentuximab vedotin and PD-1 inhibitors, have shown promising activity, particularly in combination. Conclusions: MGZL remains a diagnostically challenging and therapeutically complex lymphoma with inferior outcomes compared with related mediastinal lymphomas. Advances in molecular profiling and immunotherapy offer promising avenues toward more personalized treatment; however, prospective clinical trials and international collaboration are urgently needed to establish evidence-based management strategies for this rare entity. Full article

Pb (II) contamination in wastewater represents a grave threat to the environment and ecosystems. Consequently, there is an urgent need to prepare low-cost and highly efficient Pb (II) adsorbents. To address this need, abundant and low-cost natural silica-based desert sand (DS) was innovatively utilized as a carrier to develop efficient and selective Pb (II) adsorbents. Modified desert sand (MDS) was first prepared via 1 M HCl pretreatment for 2 h and subsequent KH550 silane modification. Pb (II)-imprinted composites (Pb (II)-IIP@MDS) were then fabricated via ion-imprinted polymerization, using Pb (II) as the template ion and N-hydroxymethacrylamide (NHMA)/hydroxyethyl methacrylate (HEMA) as dual functional monomers with a molar ratio of 1:1. The synthesized Pb (II)-IIP@MDS was comprehensively characterized by X-ray photoelectron spectrometer (XPS), scanning electron microscopy (SEM), and Fourier transform infrared spectroscopy (FT-IR). The adsorption capacity, selectivity, and reusability of this material for lead ions were evaluated through three experiments conducted within the optimized pH range of 6–7, with error bars indicated. In adsorption isotherm experiments, the initial Pb (II) concentration ranged from 50 to 500 mg·L⁻¹, conforming to the Langmuir model (R² = 0.992), with a theoretical maximum adsorption capacity reaching 107.44 mg·g⁻¹; this indicates that the adsorbate forms a monolayer adsorption on the homogeneous imprinted sites. Kinetics data indicate that the process best fits a quasi-first-order kinetic model (R² ≥ 0.988), while the favorable quasi-second-order kinetic fit (R² ≥ 0.982) reflects the synergistic effect of physical diffusion and ion-imprinting chemistry, reaching equilibrium within 120 min. Thermodynamic parameters (ΔH⁰ = 12.51 kJ·mol⁻¹, ΔS⁰ = 101.19 J·mol⁻¹·K⁻¹, ΔG⁰ < 0) confirmed endothermic, entropy-increasing, spontaneous adsorption. In multicomponent systems, Pb (II)-IIP@MDS showed distinct Pb (II) selectivity. It retained 80.3% adsorption efficiency after eight cycles. This work provides a promising strategy for fabricating low-cost, high-performance Pb (II) adsorbents, and Pb (II)-IIP@MDS stands as a practical candidate for the remediation of Pb (II)-contaminated wastewater. Full article

The paper analyses the effect of the solvent amount and nature on the structure and mechanical properties of hydrogels based on copolymers of 2-hydroxyethylmethacrylate (HEMA) with polyvinylpyrrolidone (PVP). The synthesis of pHEMA-gr-PVP copolymers was carried out by the copolymerization method in the presence of metal ions of variable oxidation states in solvents with various nature: water, dimethyl sulfoxide (DMSO), diethylene glycol (DEG), and cyclohexanol (HOCy). The structure of the copolymers was evaluated by the PVP grafting efficiency, its actual content in the copolymer, and the molecular weight between crosslinks (M_C). Taking the example of water, an increase in the solvent content up to 50 mass parts causes an increase in the efficiency of PVP grafting, which occurs due to enhanced macromolecule mobility through the dilution of the starting composition, hence the decrease in its viscosity. It was established that the nature of the solvent significantly affects the crosslinking density of the polymer network in the series H₂O, DEG, DMSO, HOCy, an increase in the M_C is observed causing a decrease in the hardness and elasticity of hydrogels and an increase in their water-retention capacity and swelling coefficient. The obtained results prove the possibility of targeted regulation within wide limits of the structure and properties of hydrogels based on pHEMA-gr-PVP copolymers through control of polymerization conditions (selection of the type and concentration of solvent). Full article

Background/Objectives: Achieving durable intraoral repairs of fractured metal and zirconia restorations requires optimal adhesion. This in vitro study evaluated the effects of mechanical surface treatments and commercial repair systems on the shear bond strength (SBS) of composite resin to nickel–chromium (Ni-Cr) alloy and zirconia, including the influence of thermocycling aging. Methods: In this study, 144 Ni-Cr and zirconia discs (12 × 12 × 2 mm) were randomly assigned to three surface treatments: untreated control, airborne particle abrasion (50 µm Al₂O₃), and medium grit diamond bur grinding. Each group was further subdivided to assess two intraoral repair kits (GC Corp (Tokyo, Japan). and Bisco Inc. (Schaumburg, IL, USA)). Composite resin cylinders were bonded following the manufacturer’s instructions. Half of the specimens (n = 12/subgroup) underwent 5000 thermocycles (5–55 °C). Micro-shear bond strength testing was performed, and failure modes were analyzed. Data were analyzed using three-way ANOVA and post hoc tests (p < 0.05). Results: Air abrasion significantly increased SBS compared to control and bur grinding for metal (p < 0.001). For zirconia, both air abrasion and bur grinding yielded similarly improved SBS over the control (p < 0.001). The GC repair kit demonstrated significantly superior bond stability after thermocycling across both substrates. Aging significantly reduced SBS in all groups (p < 0.001), with the most substantial reductions observed in untreated controls and groups repaired with the Bisco system. Conclusions: Airborne particle abrasion combined with a HEMA-free, 10-MDP-containing universal adhesive achieved the strongest and most durable resin bonds to both metal and zirconia, supporting its clinical use for the intraoral repair of ceramic and metal restorations. Full article

As a chitosan (CTS)-based drug carrier (DC) for doxorubicin (DOX) delivery, poly(2-hydroxyethyl methacrylate-co-2-hydroxy-4-N-methacrylamidobenzoic acid) [poly(HEMA-co-2-HMBA)] (PHCH) was successfully grafted onto chitosan to fabricate DOX-loaded microparticles, and their in vitro release behavior was systematicaly investigated. Morphological characteristics were analyzed using scanning electron microscopy (SEM) and transmission electron microscopy (TEM), while DOX loading was validated through Fourier-transform infrared (FTIR) spectroscopy and thermogravimetric analysis (TGA), comparing pure and drug-loaded microparticles. The maximum loading capacity (~91%) was attributed to the presence of abundant carboxylic acid groups, which imparted pH responsiveness during in vitro DOX release. Furthermore, density functional theory (DFT) calculations revealed that hydrogen bonding interactions between DOX and the functional groups of the microparticles strongly influenced encapsulation efficiency (EE%), drug loading (DL%), and release behavior. The fabricated microparticles exhibited pH-dependent DOX release, with accelerated and more complete release at tumor microenvironment pH 5.5 compared to physiological pH 7.4. These results demonstrate that PHCH grafted CTS microparticles are promising candidates for controlled and site-specific anticancer drug delivery. Full article

Wearable and skin-mounted electronics demand encapsulation designs that simultaneously provide strong barrier performance, mechanical reliability, and transferability under ultrathin conditions. In this study, a residual stress-balanced transferable encapsulation platform was developed by integrating a urethane-based copolymer superstrate [p(IEM-co-HEMA)] with inorganic thin films. The polymer, deposited via initiated chemical vapor deposition (iCVD), offered over 90% optical transmittance, low RMS roughness (1–3 nm), and excellent solvent resistance, providing a stable base for inorganic barrier integration. An ALD Al₂O₃/ZnO nano-stratified barrier initially delivered effective moisture blocking, but tensile stress accumulation imposed a critical thickness of 30 nm, where the WVTR plateaued at ~2.5 × 10⁻⁴ g/m²/day. To overcome this limitation, a 40 nm e-beam SiO₂ capping layer was added, introducing compressive stress via atomic peening and stabilizing Al₂O₃ interfaces through Si–O–Al bonding. This stress-balanced design doubled the critical thickness to 60 nm and reduced the WVTR to 3.75 × 10⁻⁵ g/m²/day, representing an order-of-magnitude improvement. OLEDs fabricated on this ultrathin platform preserved J–V–L characteristics and efficiency (~4.5–5.0 cd/A) after water-assisted transfer and on-skin deformation, while maintaining LT80 lifetimes of 140–190 h at 400 cd/m² and stable emission for over 20 days in ambient storage. These results demonstrate that the stress-balanced encapsulation platform provides a practical route to meet the durability and reliability requirements of next-generation wearable optoelectronic devices. Full article

An optical fiber sensor based on a HEMA/AM/SA interpenetrating polymer network (IPN) hydrogel is proposed for monitoring the concentration of Pb²⁺. The Fabry–Perot interference cavity is constructed from a single-mode fiber, a ceramic ferrule, and an IPN hydrogel layer. P (HEMA co AM)/SA IPN hydrogel films were prepared by a step-by-step crosslinking method, which had good mechanical properties, swelling properties, and Pb²⁺ adsorption capacity. The Pb²⁺ concentration changes cause the interference spectrum shift of the sensor. By monitoring the wavelength shift under different Pb²⁺ concentrations, the sensor sensitivity in the range of 0~1 ppm Pb²⁺ concentration in solution is 5.0743 nm/ppm with 0.994 linearity. The influence of different proportions of IPN hydrogel on the performance of the sensor was studied. In the range of 10–90% HEMA, higher sensitivity is obtained by a small weight ratio of HEMA/AM. The sensor stability, repeatability, selectivity, dynamic response, and temperature response are also investigated in experiments. Experimental results demonstrate that the proposed sensor exhibits good stability, sensitivity, repeatability, and selectivity. Owing to its compact structure, straightforward fabrication, low cost, and good sensing performance, this sensor shows strong potential for application in monitoring Pb²⁺ concentrations. Full article

Anion exchange membranes (AEMs) are vital for electrochemical energy devices such as alkaline fuel cells and water electrolyzers, enabling the use of non-precious metal catalysts despite challenges from alkaline degradation. Hyperbranched polymers (hbPs) with their globular structure, high functional group density, and simple synthesis, offer a promising platform for enhancing transport and stability. In this study, multifunctional hbPs were synthesized from 4-vinylbenzyl chloride (VBC) and 2-hydroxyethyl methacrylate (HEMA) via atom transfer radical self-condensing vinyl polymerization (ATR-SCVP) and crosslinked into polyurethane-based AEMs. Characterization confirmed successful copolymerization and crosslinking, with excellent alkaline stability. Membranes crosslinked with higher molecular weight (MW) and VBC-richer hbPs (e.g., OH-hbP1-PU) exhibited high water uptake (75%) but low ion-exchange capacity (1.54 mmol/g) and conductivity (186 µS/cm), attributed to steric hindrance and insufficient ionic network connectivity. In contrast, OH-hbP2-PU exhibited optimal properties, with the highest OH⁻ conductivity (338 µS/cm) and IEC (2.64 mmol/g), highlighting a balanced structure for efficient ion transport. This work offers a tunable strategy for high-performance AEM development through tailored hbP architecture. Full article

To address the limitations of traditional endotoxin adsorbents, which exhibit poor endotoxin removal efficiency and low sample recovery when processing high-concentration samples, a novel cryogel, CG(HEMA-co-AM), based on acrylamide (AM) and hydroxyethyl methacrylate (HEMA) as the second monomer, was successfully designed and synthesized. After optimizing the epoxidation and polymyxin B (PMB) conjugation processes, leading to the successful preparation of the functionalized cryogel CG(HEMA-co-AM)@ECH@PMB, flow-through experiments showed that in Tris-HCl buffer at a flow rate of 6 mL/min, the endotoxin removal efficiency reached 99.82%, with a maximum adsorption capacity of 1408.38 EU/mg. In a complex protein system containing BSA, HSA, Hb, LYS, and OVA (each at 10 mg/mL), the maximum endotoxin removal efficiency was 99.62%. Further investigations revealed that pH and ionic strength critically influenced the regulation of hydrophobic and electrostatic interactions, thus significantly affecting the endotoxin adsorption efficiency. Additionally, weakly hydrophobic and basic lysozyme exhibited significantly higher recovery rates compared to strongly hydrophobic and acidic proteins such as BSA and OVA. This functionalized cryogel integrates a high adsorption capacity with excellent specificity and features a macroporous structure suitable for dynamic chromatographic separation. It offers a novel, reusable adsorbent material for endotoxin removal in protein preparation, biopharmaceutical production, and clinical blood purification applications. Full article