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BackgroundDistal radius fracture is common in the general population. Fracture management includes a plaster cast, splint and synthetic material cast to immobilise the injured arm. Casting complications are common in those conventional casting technologies. 3D printing technology is a rapidly increasing application in rehabilitation. However, there is no clinical study investigating the application of a 3D–printed orthopaedic cast for the treatment of bone fractures. We have developed a patient-specific casting technology fabricated by 3D printing. This pioneering study aims to use 3D–printed casts we developed for the treatment of distal radius fractures, to provide the foundation for conducting additional clinical trials, and to perform clinical assessments.MethodTen patients with ages between 5 and 78 years are involved in the clinical trial. Patients are applied 3D–printed casts we developed. Orthopaedic surgeons carried out a six-week follow-up to examine clinical outcomes. Two questionnaires were developed for the assessment of clinical efficacy and patients’ satisfaction. These questionnaires are completed by physicians and participating patients.ResultsA 3D–printed cast creates a custom-fitted design to maintain the fractured bone alignment. No loss of reduction is found in all patients. Compartment syndrome and pressure sores are not present. Patient comfort gets positive scores on the questionnaire. All (100%) of the patients opt for the 3D–printed cast instead of the conventional plaster cast.DiscussionA patient-specific, 3D–printed cast offers a proper fit to immobilise an injured arm and holds the fracture reduction appropriately. A custom-fitted structure reduces the risk of pressure-related complications due to the high and concentrated local stress. The ventilated and lightweight design minimises interference with a patient’s daily activities and reduces the risk of cutaneous complications. Patients express a strong preference for using a 3D–printed cast instead of a plaster cast. Limitations of the novel cast include a slight odour after heavy sweating and the relatively high cost due to the limitations of current 3D printing technologies.ConclusionsThis pioneering study is the first clinical trial on the application of a 3D–printed cast for the treatment of forearm fractures. The novel casting technology heals the fracture effectively without casting complications. The 3D–printed cast is patient-specific and ventilated as well as lightweight, and it features both increased patient comfort and satisfaction.

In this study, hollow olive-shaped BiVO(4) and n-p core-shell BiVO(4)@Bi(2)O(3) microspheres were synthesized by a novel sodium bis(2-ethylhexyl)sulfosuccinate (AOT)-assisted mixed solvothermal route and a thermal solution of NaOH etching process under hydrothermal conditions for the first time, respectively. The as-obtained products were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy, Brunauer-Emmett-Teller surface area, and UV-vis diffuse-reflectance spectroscopy in detail. The influence of AOT and solvent ratios on the final products was studied. On the basis of SEM observations and XRD analyses of the samples synthesized at different reaction stages, the formation mechanism of hollow olive-shaped BiVO(4) microspheres was proposed. The photocatalytic activities of hollow olive-shaped BiVO(4) and core-shell BiVO(4)@Bi(2)O(3) microspheres were evaluated on the degradation of rhodamine B under visible-light irradiation (λ > 400 nm). The results indicated that core-shell BiVO(4)@Bi(2)O(3) exhibited much higher photocatalytic activities than pure olive-shaped BiVO(4). The mechanism of enhanced photocatalytic activity of core-shell BiVO(4)@Bi(2)O(3) microspheres was discussed on the basis of the calculated energy band positions as well. The present study provides a new strategy to enhancing the photocatalytic activity of visible-light-responsive Bi-based photocatalysts by p-n heterojunction.

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Children with acute lymphoblastic leukemia (ALL) are generally instructed to take mercaptopurine (6-MP) in the evening and without food or dairy products. This study examines the association between 6-MP ingestion habits and 6-MP adherence, red cell thioguanine nucleotide (TGN) levels, and risk of relapse in children with TMPT wild-type genotype. MethodsParticipants included 441 children with ALL receiving oral 6-MP for maintenance. Adherence was monitored over 48,086 patient-days using the Medication Event Monitoring System; nonadherence was defined as adherence rate , 95%. 6-MP ingestion habits examined included: takes 6-MP with versus never with food, takes 6-MP with versus never with dairy, and takes 6-MP in the evening versus morning versus varying times. ResultsMedian age at study was 6 years (range, 2 to 20 years); 43.8% were nonadherent. Certain 6-MP ingestion habits were associated with nonadherence (taking 6-MP with dairy [odds ratio (OR), 1.9; 95% CI, 1.3 to 2.9; P = .003] and at varying times [OR, 3.4; 95% CI, 1.8 to 6.3; P = .0001]). After adjusting for adherence and other prognosticators, there was no association between 6-MP ingestion habits and relapse risk (6-MP with food: hazard ratio [HR], 0.7; 95% CI, 0.3 to 1.9; P = .5; with dairy: HR, 0.3; 95% CI, 0.07 to 1.5; P = .2; taken in evening/night: HR, 1.1; 95% CI, 0.2 to 7.8; P = .9; at varying times: HR, 0.3; 95% CI, 0.04 to 2.7; P = .3). Among adherent patients, there was no association between red cell TGN levels and taking 6-MP with food versus without (206.1 6 107.1 v 220.6 6 121.6; P = .5), with dairy versus without (220.1 6 87.8 v 216.3 6 121.3; P =.7), or in the evening/night versus morning/ midday versus varying times (218.8 6 119.7 v 195.5 6 82.3 v 174.8 6 93.4; P = .6). ConclusionCommonly practiced restrictions surrounding 6-MP ingestion might not influence outcome but may hinder adherence. Future recommendations regarding 6-MP intake during maintenance therapy for childhood ALL should aim to simplify administration.