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Patient-specific bone models are essential for designing surgical guides and preoperative planning, as they enable the visualization of intricate anatomical structures. However, traditional CT-based approaches for creating bone models are limited to preoperative use due to the low flexibility and high radiation exposure of CT and time-consuming manual delineation. Here, we introduce Semi-Supervised Reconstruction with Knowledge Distillation (SSR-KD), a fast and accurate AI framework to reconstruct high-quality bone models from biplanar X-rays in 30 seconds, with an average error under 1.0 mm, eliminating the dependence on CT and manual work. Additionally, high tibial osteotomy simulation was performed by experts on reconstructed bone models, demonstrating that bone models reconstructed from biplanar X-rays have comparable clinical applicability to those annotated from CT. Overall, our approach accelerates the process, reduces radiation exposure, enables intraoperative guidance, and significantly improves the practicality of bone models, offering transformative applications in orthopedics.
Current hemostatic materials often exhibit insufficient fluid absorption, poor mechanical stability, and limited tissue regenerative capacity. To overcome these limitations, this study proposed the concept of a capillary-driven hemostatic microenvironment. Through acid-enzymatic extraction of collagen from bovine hide (95.7% purity) and ion-exchange purification of carboxymethyl cellulose calcium (CMC-Ca) to enhance Ca2+content, oriented porous collagen/CMC-Ca composite scaffolds were fabricated using directional freeze-drying technology to construct aligned microchannels. The composite exhibited excellentin vitrohemocompatibility with hemolysis rates <3% and 40%-60% accelerated coagulation.In vivoevaluations using Sprague-Dawley rats tail amputation and liver hemorrhage models demonstrated that the optimal formulation (Col@2.5%CMC-Ca) achieved rapid hemostasis (tail: 120 ± 11 s, 0.49 ± 0.05 g blood loss; liver: 24.3 ± 8.7 s, 0.1 ± 0.08 g blood loss), reducing blood loss by 52%-86% compared to commercial controls. Furthermore, the scaffold promoted liver regeneration, showing significant tissue repair at 14 d post-implantation. This study establishes a dual-functional biomaterial integrating rapid hemostasis with proactive tissue repair, offering a promising solution to overcome existing limitations in hemostatic materials.
BACKGROUND AND OBJECTIVES:Remediation during residency training remains underexplored despite unique challenges. Residencies face complex factors including increasing awareness of learning difficulties, greater diversity in training programs, and elevated rates of mental health concerns. Aiming to understand remediation best practices, this study leveraged behavioral science faculty (BSF), who often support early identification, intervention, and remediation for family medicine residency programs. BSF perceptions of the frequency of best practice implementation for early intervention and remediation within family medicine residency programs served as an initial step toward developing a questionnaire to help programs assess their process and infrastructure. METHODS:Seventy BSF from university-based, university-affiliated, and community programs completed a national survey developed through a Delphi process identifying consensus-based best practices (CBBP). The questionnaire assessed the frequency with which BSF observed best practice implementation across their programs. Data were analyzed using χ2 tests, Fisher's exact tests, and factor analysis with Promax rotation to identify underlying dimensions of remediation practices. RESULTS:Implementation of CBBP varied across programs. Preliminary factor analysis revealed two factors that could be used for program evaluation. The two factors emerged as indicators of the remediation process. Organization and follow-up (Factor 1) reflected processes characterized by transparency, predictability, and follow-through. People and development (Factor 2) reflected a culture that normalizes challenges inherent in residency, understands key experiences, and develops faculty skill in effectively delivering feedback. CONCLUSIONS:Effective remediation requires organized processes and culture that support growth and psychological safety. This study presents a preliminary questionnaire assessing these practices from the BSF perspective.
Abstract: Osteoporosis (OP) is a systemic metabolic disease characterized by decreased bone mass, impaired bone structure, and increased fracture risk due to an imbalance between bone formation and bone resorption. OP has become a major public health challenge as the global elderly population increases. Isopsoralen (IPRN), the main active component of the natural flavonoid psoralen, has gained attention in recent years for its potential utility in the prevention and treatment of OP. The purpose of this review is to explore the mechanism of IPRN in the prevention and treatment of OP and summarize that IPRN interferes with the occurrence and development of OP mainly through five signaling pathways, namely Wnt/β-catein, PI3K/AKT, OPG/RANKL/RANK, estrogen- like effect, and Notch signaling pathway. These findings not only contribute to the development of new anti-OP drugs but also may provide new ideas and methods for existing treatment regimens, so as to prevent and treat OP more effectively and improve the quality of life of patients.
