A low surface resistivity due to the fine dispersion of MWCNTs in

A low surface resistivity due to the fine dispersion of MWCNTs in FBP-HX and polycarbonate

(PC) is reported. With a solution-casting method, a percolation threshold with the addition of between 0.5 and 1.0 wt % MWCNTs was observed in the MWCNT/PC and MWCNT/FBP-HX composites. Because of the coverage of FBP-HX on the MWCNTs, a higher surface resistivity and a higher percolation ratio of the MWCNT/FBP-HX composites were achieved compared with the values for the MWCNT/PC composites. In the MWCNT/FBP-HX composites, MWCNTs covered with FBP-HX were observed by scanning electronic microscopy. Because of the coverage of FBP-HX on the MWCNTs, FBP-HX interfered with the electrical pathway between the MWCNTs. The MWCNTs in FBP-HX were covered with a 5-nm layer of FBP-HX, but the MWCNTs in the MWCNT/PC composites were in their naked state. MWCNT/PC BMS 345541 sheets demonstrated the specific Raman absorption of the MWCNTs

only with the addition of MWCNTs of 1 wt % or above because of the coverage of the surface of the composite sheet by naked MWCNTs. In contrast, MWCNT/FBP-HX retained the behavior of the matrix resin until a 3 wt % addition of MWCNTs was reached because of the coverage of MWCNTs by the FBP-HX resin, induced by its high wettability. (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 118: 2690-2695, 2010″
“Patients with systemic lupus erythematosus (SLE), especially Selleck Duvelisib Asian Indians, are at increased risk of developing premature atherosclerosis. To find out the prevalence and predictors of carotid intima-medial thickness (IMT) and brachial artery flow-mediated dilatation (FMD). Endothelial dysfunction was assessed by FMD in brachial artery and IMT was measured in common carotid artery in SLE patients and healthy controls. Sixty SLE patients (mean age 31 +/- 9 years) and 38 healthy controls (mean age 34 +/- 6 years) were included. The IMT was higher in SLE patients as compared to controls (0.49 +/- 0.08 mm vs. 0.39 +/- 0.05 mm, p < 0.0001). SLE and damage were independent predictors

of abnormal IMT. FMD was impaired in SLE patients compared to controls (9.97% vs. 18.97%, GDC-0068 p < 0.00001). None of the classical cardiovascular risk factors were predictors of FMD or abnormal IMT. Indian patients with SLE have higher prevalence of subclinical atherosclerosis and endothelial dysfunction. Presence of damage was associated with abnormal IMT in SLE patients.”
“This study tested a new measure of motivation to change as a predictor of smoking behavior following smoking cessation treatment. Participants were adult, regular smokers (N = 191) who took part in a randomized smoking cessation trial in southwestern Germany (Batra et al., 2010). Participants completed smoking and psychological self-report measures before and after a 6-week smoking cessation treatment.


“In this study, bitter and sweet lupin (Lupinus albus L) s


“In this study, bitter and sweet lupin (Lupinus albus L) seed oils (BLO and SLO) were extracted using the soxhlet extraction method. The physicochemical properties, fatty acid compositions, thermal properties, H-1 NMR, FTIR and UV visible spectra of BLO and SLO were evaluated. In addition, the antioxidant properties of bitter and sweet lupin seeds CYT387 and their oils were also studied. The results showed that the bitter and sweet lupin seeds consist of 8% and

12% of oil, respectively. BLO and SLO contained high concentration of oleic acid (46.28 and 48.72%), followed by linoleic acid (21.55 and 20.90%), linolenic acid (7.69 and 8.95%), and palmitic acid (7.39 and 7.5%). The total tocopherol content of BLO and SLO were 184.70 and 317.01 mg/100 g oil, respectively.

TG/DTG curves showed that the process thermal decomposition of the oils occurs in four phases for SLO and three phases for BLO. (C) 2013 Elsevier B.V. All Copanlisib rights reserved.”
“Aim:

To evaluate the value of sonographic measurement of cervical length as a predictor of abortion or delivery within 24 h by misoprostol in second trimester termination of pregnancy (TOP).

Material and Methods:

One hundred and sixty-three women underwent TOP between 14 and 26 weeks of pregnancy due to various indications. The primary outcome was abortion within 24 h. Cervical length was measured before transvaginal administration of misoprostol. The effects of cervical length, total misoprostol dose, parity, and gestational age at diagnosis on successful TOP were evaluated.

Results:

One hundred and sixty-three women were eligible who met the inclusion criteria. TOP occurred

in 80.5% of patients within 24 h. Parous women had shorter prolonged induction to expulsion period over 24 h (14.1% vs 28.6%, P = 0.061). Total misoprostol dose and history of abortion were parameters that affected induction to delivery period (P = 0.002 and P = 0.041). Using an optimum cutoff of 36 mm, 58.2% sensitivity and 68.2% specificity were obtained. In addition, positive and negative learn more predictive values were 85.36% and 33.3%, respectively. Pregnant women whose preinduction cervical length was shorter than 36 mm had a shorter induction time and needed a lower total misoprostol dose to achieve TOP than women with a cervical length longer than 36 mm (P = 0.027 and P = 0.011, respectively).

Conclusion:

Transvaginal measurement of cervical length before administration of prostaglandin analogue was not correlated with successful TOP within 24 h. It cannot be used as a predictor in light of our findings.”
“Hypothesis: Mechanical stimulation through a cochlear third window into the scala tympani in a chinchilla model with normal and fixed stapes can generate cochlear responses equivalent to acoustic stimuli.

Study design The third and fourth premolars of 6 dogs were bilat

Study design. The third and fourth premolars of 6 dogs were bilaterally extracted with AMN-107 in vivo a full-thickness flap, and threaded implants presenting a textured or a polished surface at the cervical regions were placed on the distal root extraction sockets. Submerged healing was allowed for 4 weeks, and bone-to-implant contact (BIC) and buccal and lingual bone loss were morphometrically measured.

Results. The BIC and lingual bone loss were not significantly different between textured and polished groups. Significantly lower buccal bone loss (P < .01) was observed for the textured surface at 4 weeks in vivo.

Conclusion. Textured surface implants placed immediately

after tooth extraction resulted in less bone loss only at the buccal cervical region compared with smooth surface implants. (Oral Selleck CBL0137 Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110: 182-187)”
“Serum hepatitis B virus surface antigen (HBsAg) levels have been suggested to predict interferon response in chronic hepatitis B. A few data are available on the role of HBsAg measurement in nucleos(t)ide analogues (NA) treatment. We retrospectively investigated the relation between HBsAg changes and main treatment outcomes during long-term lamivudine treatment in hepatitis e antigen (HBeAg)negative chronic hepatitis B. A total of 42 HBeAg-negative patients were consecutively enrolled GS-7977 in vitro in an open-label study on long-term lamivudine

monotherapy (150 mg/die). Serum HBsAg levels were quantified every 6 months by Architect assay (Abbott Diagnostics). HBV-DNA was quantified quarterly by real-time PCR (Roche Diagnostics). The median duration of lamivudine treatment was 66 months (20-153). One patient (2%) was a primary nonresponder, 35 (83%) developed virological breakthrough (VB) and the remaining six patients (14%) were classified as long-term on-treatment responders. During treatment, HBsAg levels decreased only in long-term on-treatment responders, while no changes were observed

in resistant patients. Failure to achieve a decrease of 0.7 log(10) IU/mL in serum HBsAg at month six of lamivudine had a positive predictive value of developing VB of 90% and a negative predictive value of 100%. These high predictive values were also maintained in the subgroup of patients negative for HBV-DNA at month six. The results of this study with a small sample size suggest a role of on-treatment HBsAg quantification in the management of lamivudine-treated patients. If validated prospectively in a larger patient cohort, HBsAg measurements would be a useful adjunct to optimize antiviral therapy.”
“We have investigated the influence of the electric bias field on the magnetic and transport properties of (011)-oriented La0.9Ba0.1MnO3 (LBMO) thin film epitaxially grown on (011)-0.7Pb(Mg1/3Nb2/3)O-3-0.3PbTiO(3) (PMN-PT) single crystal substrate.

Their density can be reduced by growth conditions such as migrati

Their density can be reduced by growth conditions such as migration enhanced epitaxy that permit high quality overgrowths at temperatures as low as similar IWR-1-endo to 350 degrees C. Nevertheless, the ultimate performance

limitation of thick MQD based devices resides in the ability to realize low density of the deep levels relative to the density of SAQDs. (C) 2010 American Institute of Physics. [doi: 10.1063/1.3359704]“
“Polyurethane rigid nanocomposite foams were synthesized by in situ-polymerization using both pristine and organically modified layered silicates. The effect of synthesis conditions, in particular the effect of different dispersing techniques, on morphology and mechanical properties of polyurethane nanocomposite foams was studied. To promote dispersion, clays were dispersed either in polyols or isocyanate and were subjected to a well known dispersion method, like ultrasonication, but also to a new dispersion method, based on microwaving. The morphological characterization Cl-amidine of the foams, carried on using X-ray diffraction, scanning electron microscopy, and transmission electron microscopy, proved that the technology

based on microwave processing is able to provide very good silicates dispersion and requires very short application time to be effective. Further confirmations of the importance of the clay organo-modifier are still present. Mechanical characterization of foams show that clay interferes with H-bond formation and then the overall compressive performance of PU nanocomposite foams depends on the competition between the positive reinforcing effect of clay and the negative effect on H-bond formation. (C) 2009 Wiley Periodicals, Inc. J Appl

Polym Sci 115: 3667-3674, 2010″
“Root fractures in nonendodontically treated teeth have been reported to occur primarily in Chinese. Two representative cases of vertical root fractures in nonendodontically treated teeth are presented. In the first case, there were vertical fractures in both mesial and distal roots of the mandibular right first R406 molar. In the second case, there were vertical fractures in the mesial roots of both the mandibular left and right first molars. Their radiographic features were obtained. Both had clinically intact crowns with no or minimal restorations and periodontal defects. Diagnosis could be obtained with the use of radiographic examination. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: e39-e42)”
“Purpose: Evidence suggests that patients who gain knowledge perform better self-care, cope better and are more satisfied. Today, up-to-date and valid instruments for evaluating patient knowledge on chemotherapy are unavailable.

Neurologic deterioration was defined as transient ischemic attack

Neurologic deterioration was defined as transient ischemic attack (TIA), ischemic stroke, or death occurring during hospitalization or within 1 year of diagnosis. Kaplan-Meier curves were used to determine neurologic event-free survival up to 12 months. A total of 69 patients (mean age, 47.8 +/- 14 years; 45 males) with SCCD were included in the study. Eleven patients (16%) experienced in-hospital neurologic deterioration(TIA in 9, ischemicstroke

in 1) or death(1 patient). An additional 8 patients developed neurologic deterioration within 1 year after discharge (TIA in 5, ischemic stroke in 2, and death in 1). The overall 1-year event-free SN-38 DNA Damage inhibitor survival rate was 72%. Women (P = .046), patients with involvement of both vertebral arteries (P = .02), and those with intracranial arterial involvement (P = .018) had significantly higher rates of neurologic deterioration. Our findings indicate that neurologic deterioration is relatively common after SCCD despite medical treatment in women, patients with bilateral vertebral artery involvement, and those with intracranial vessel involvement.”
“Systemic hypertension is a highly prevalent potentially modifiable cardiovascular risk factor. Imaging plays an important role in the diagnosis of underlying causes for hypertension, in assessing cardiovascular complications of hypertension, and in understanding the pathophysiology of the

disease process. Cardiovascular magnetic resonance (CMR) provides accurate and reproducible measures of ventricular Metabolism inhibitor volumes, mass, function and haemodynamics as well as uniquely allowing tissue characterization of diffuse and focal fibrosis. In addition, CMR is well suited for exclusion of common secondary causes for hypertension. We review the current and emerging clinical

and research applications of CMR in hypertension.”
“Introduction: Recent data have associated improved survival after hemorrhagic shock with the early use of plasma-based resuscitation. Our laboratory has shown that FFP5 has decreased hemostatic potential compared with freshly thawed plasma (FFP0). We hypothesized that FFP5 would increase bleeding and mortality compared with FFP0 in a rodent bioassay model of uncontrolled liver hemorrhage.

Methods: Hemostatic potential of plasma was assessed with the ACY-738 ic50 Calibrated Automated Thrombogram (CAT) assay. Rats underwent isovolemic hemodilution by 15% of blood volume with the two human plasma groups (FFP0 and FFP5) and two controls (sham and lactated Ringers). A liver injury was created by excising a portion of liver resulting in uncontrolled hemorrhage. Rats that lived for 30 minutes after liver injury were resuscitated to their baseline blood pressure and followed for 6 hours. Hemostasis was assessed by thromboelastography.

Results: Hemostatic potential of FFP5 decreased significantly in all areas measured in the CAT assay as compared with FFP0 (p < 0.01).

Besides, we extended this (1)H-NMR technique to determine hydroxy

Besides, we extended this (1)H-NMR technique to determine hydroxyl end-group concentrations And therefore the average number of macromolecular weight. To validate learn more (1)H-NMR results, complementary techniques, the chemical titration method and the classical viscosimetric method, were used. The results showed an increase

of hydroxyl end-group concentration and a decrease in the macromolecular weight for the explants. (C) 2009 Wiley Periodicals, Inc. J Appl Polym Sci 113: 2813-2825, 2009″
“Significant advances have been made in bone tissue engineering (TE) in the past decade. However, classical bone TE strategies have been hampered mainly due to the lack of vascularization within the engineered bone constructs, resulting in

poor implant survival and integration. In an effort toward clinical P005091 cost success of engineered constructs, new TE concepts have arisen to develop bone substitutes that potentially mimic native bone tissue structure and function. Large tissue replacements have failed in the past due to the slow penetration of the host vasculature, leading to necrosis at the central region of the engineered tissues. For this reason, multiple microscale strategies have been developed to induce and incorporate vascular networks within engineered bone constructs before implantation in order to achieve successful integration with the host tissue. Previous attempts to engineer vascularized bone tissue only focused on the effect of a single component among the three main components of TE (scaffold, cells, or signaling cues) and have only achieved limited success. However, with efforts to improve the engineered bone tissue substitutes, bone TE approaches have become more complex by combining multiple strategies simultaneously. The driving force behind combining

various TE strategies see more is to produce bone replacements that more closely recapitulate human physiology. Here, we review and discuss the limitations of current bone TE approaches and possible strategies to improve vascularization in bone tissue substitutes.”
“Background: We conducted a prospective, multicenter observational cohort study in Thailand to characterize the epidemiology of extrapulmonary tuberculosis (TB) in HIV-infected persons and to identify risk factors for death.

Methods: From May 2005 to September 2006, we enrolled, interviewed, examined, and performed laboratory tests on HIV-infected adult TB patients and followed them from TB treatment initiation until the end of TB treatment. We conducted multivariate proportional hazards analysis to identify factors associated with death.

Results: Of the 769 patients, pulmonary TB only was diagnosed in 461 (60%), both pulmonary and extrapulmonary TB in 78 (10%), extrapulmonary TB at one site in 223 (29%), and extrapulmonary TB at more than one site in seven (1%) patients.

The causative pathogens were methicillin-resistant Staphylococcus

The causative pathogens were methicillin-resistant Staphylococcus aureus (three), methicillin-sensitive S. aureus (one), coagulase-negative Staphylococci

(two), and Enterococcus selleckchem fecalis (one). All patients underwent complete device removal with no procedure-related complications. Two patients died in the hospital, two were discharged with permanent neurological deficits, and the remaining two recovered with no permanent neurologic sequelae.

Conclusion: Device-related endocarditis must be considered in patients who present with a spinal abscess and bacteremia. Early recognition of this scenario is imperative in order to avoid permanent neurological sequelae and patient mortality. Early imaging, appropriate parenteral antimicrobial therapy, and expedited removal of all cardiac hardware are pivotal for optimal management. (PACE 2012; 35: 269-274)”
“Understanding the binding mode of agonists to adrenergic receptors is crucial to enabling improved rational design of new therapeutic agents. However, so far the high conformational flexibility of G protein-coupled receptors has been an obstacle to obtaining structural

information on agonist binding at atomic resolution. In this study, we report microsecond classical molecular dynamics simulations of beta(1) and beta(2) adrenergic receptors bound to the full agonist isoprenaline and in their unliganded form. These Selleckchem PND-1186 simulations show a novel agonist binding mode that differs from the one found for antagonists in the crystal structures and from the docking poses reported by in silico docking studies performed on rigid receptors. Internal water molecules contribute to the stabilization of novel interactions between ligand and receptor, both at the interface of helices V and VI with the catechol group of isoprenaline as well as at the interface of helices III and VII with the ethanolamine moiety of the ligand. Despite the fact that the characteristic N-C-C-OH motif is identical in the co-crystallized ligands and in

the full agonist isoprenaline, the interaction network between this group and the anchor site formed by Asp(3.32) Selleck Napabucasin and Asn(7.39) is substantially different between agonists and inverse agonists/antagonists due to two water molecules that enter the cavity and contribute to the stabilization of a novel network of interactions. These new binding poses, together with observed conformational changes in the extracellular loops, suggest possible determinants of receptor specificity.”
“The changes of the superconducting depairing current density with applied strain in superconducting films are studied theoretically in this paper. The thin film is assumed to be isotropic. Using phenomenological theory, we obtain the depairing critical current density in the presence of applied strain. The dependence of deparing current density on coupling parameters is discussed.

In the device, an independent input cavity is introduced before t

In the device, an independent input cavity is introduced before the resonant reflector to reduce the leakage power from the input port, and the applied RF signal is injected into the input cavity through a mode convertor and a coaxial waveguide along the magnet, which avoids separating the magnet by the injection waveguide, and suppresses the asymmetric modes excited in the input cavity. For a frequency difference of 15 MHz between the input signal and free-running klystron-like RBWO, an input power of

10 MW is sufficient to control learn more the phase of 10 GW output microwave. (C) 2011 American Institute of Physics. [doi:10.1063/1.3601522]“
“Aims The purpose of the study was to evaluate the response to palliative this website radiotherapy in patients with painful spinal metastatic disease (SMD)

Materials and methods Three hundred and fifty-five patients admitted to the Norwegian Radium Hospital for radiotherapy for painful SMD were included in a prospective study and were followed up 2 months later The Brief Pain Inventory was used to assess pain Analgesic consumption was recalculated into the daily oral morphine-equivalent dose The radiotherapy-related response rates were calculated using the criteria of the International

Bone Metastases Consensus Group (IBMCG) taking into account the use of concomitant analgesics The response to radiotherapy was assessed as complete or partial and non-response as stable pain pain progression or other

Results Brief Pain Inventory forms were obtained at follow-up from 229 of the 355 patients Two months after radiotherapy the median self-reported worst pain decreased significantly but the median oral morphine-equivalent dose increased from 40 to 60 mg (P < 0 001) Forty-three per cent of the patients reported pain relief but a radiotherapy-related response was found in 37% of the patients Overall correspondence between the patients self-reported changes in pain experience https://www.selleckchem.com/products/azd6738.html and the IBMCG-based response categories was obtained in 63% of the patients

Conclusions The radiotherapy-related

response rates in our study were lower than those reported previously in patients with bone metastases in general which possibly indicates the presence of more complex pathophysiological mechanisms of pain in SMD (C) 2010 The Royal College of Radiologists Published by Elsevier Ltd All rights reserved”
“A large number of processes are used to treat the oily water (oil emulsions in water) produced in the petroleum industry. The treatment strategy depends not only on the strictness of the environmental requirements in the jurisdiction where the water is discharged, but also on the relative treatment cost. The present study reports tests to assess the effectiveness of removing oil from oily water by adsorption in polymer nanocomposites.

Additionally, a strategic approach to periprocedural anticoagulat

Additionally, a strategic approach to periprocedural anticoagulation that may include continuation of warfarin, bridging with low-molecular-weight heparin (LMWH), or use of aspirin alone is essential in the balance of thrombotic and hemorrhagic risks. Novel anticoagulants (direct thrombin inhibitors or anti-Xa inhibitors) may add further options.

Summary

The use of atrial fibrillation ablation has increased over the past decade. Along with technique

and technology advances that have improved the success of ablation, strides have been made in minimizing thromboembolic and bleeding risks and in the availability of a broader choice of anticoagulants. Research is ongoing to identify patients most suitable for ablation and to determine the long-term efficacy and safety of this treatment option.”
“With advancements in transplantation and improved long-term allograft learn more survival, the once rare clinical scenario of an abdominal aortic aneurysm (AAA) in a patient with a functioning allograft has become much more frequent. In transplant recipients, AAA repair has the potential to cause irreversible BI 2536 ischaemic injury to the transplanted organ.

Different case series and case reports have mentioned a variety of techniques to offer protection to the transplanted organs during aneurysm repair such as cold perfusion, shunting, temporary surgical bypass and extracorporeal circuits etc. Critical review of these adjuncts seems to suggest that that they do not give any better results than just using a “”clamp and go”" approach. Endovascular aneurysm repair (EVAR) may offer some advantages for transplant patients who have suitable anatomy for endovascular stent deployment. In addition to these surgical techniques,

various aspects of medical management for renal, cardiac and hepatic transplant recipients undergoing AAA repair are discussed. (C) 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.”
“Study design: Cross-sectional check details survey.

Objectives: To examine factors that may enhance and promote resilience in adults with spina bifida.

Setting: Community-based disability organisations within Australia.

Methods: Ninety-seven adults with a diagnosis of spina bifida (SB) completed a survey comprising of demographic questions in addition to standardised self-report measures of physical functioning (Craig Handicap Assessment and Reporting Technique), resilience (Connor-Davidson Resilience Scale, 10 item), self-esteem (Rosenberg Self-esteem Scale), self-compassion (Self-compassion Scale) and psychological distress (Depression Anxiety Stress Scales, 21 item).

Results: The majority (66%) of respondents reported moderate to high resilience. Physical disability impacted on coping, with greater CD-RISC 10 scores reported by individuals who were functionally independent in addition to those who experienced less medical co-morbidities.

These genes code for a pentapeptide repeat protein that protects

These genes code for a pentapeptide repeat protein that protects type II topoisomerases from quinolones. Since then, there have been reports of two other plasmid-mediated resistance mechanisms: the modification of quinolones with a piperazinyl substituent by the acetyltransferase, Aac(6′)-Ib-cr; and active efflux by QepA and OqxAB, pumps related to major facilitator superfamily (MFS) transporters.

These genes have a wide geographic distribution (mainly in Enterobacteriaceae). Because of the difficulties of phenotypic detection of this type of resistance, its real prevalence is only partially known. One important point is that although these mechanisms cause only low-level resistance, they favor and complement the selection of other resistance mechanisms.”
“Transforming growth factor (TGF) is a key regulator associated U0126 MAPK inhibitor with the pathogenesis of gingival overgrowth (GO). Connective tissue growth factor (CTGF/CCN2) is overexpressed in GO tissues. CCN2 promotes and sustains fibrosis initiated by TGF. Previous studies have shown that JNK and Smad3 activation is required for TGF-induced CCN2 expressions in human gingival fibroblasts (HGFs). In this study, we have found that Src is a major signaling mediator for TGF-induced CCN2 expressions in

HGFs. Pre-treatment with 2 GSK3326595 concentration Src kinase inhibitors (PP2, Src inhibitor-1) significantly reduced TGF1-induced CCN2 synthesis and JNK and Smad3 activation in HGFs. These results suggest that Src is an upstream signaling transducer of JNK and Smad3 with respect to TGF1-stimulated CCN2 expression in HGFs. We further found that curcumin significantly abrogated the TGF1-induced CCN2 in HGFs by inhibiting the phosphorylations of Src, JNK, and Smad3. Furthermore, curcumin inhibited TGF1-induced HGF migration

and -SMA expression. Curcumin potentially qualifies as a useful agent for the control of GO.”
“The presence of sulfur in a solvent extract that is to be analyzed chromatographically impairs and sometimes precludes proper interpretation of the chromatogram, as the sulfur peak PXD101 ic50 masks the peaks of other compounds present in the sample, and sulfur also disrupts the operation of the mass detector. This means that discrepancies in the results can lead to erroneous interpretations and false assessments of environmental risk. For this reason, sulfur should be removed from an extract prior to chromatographic analysis and determined in a separate analytical run using an appropriate procedure.

This article presents a critical analysis of known methods for removing elemental sulfur from solvent extracts prior to the final determination step of chemicals in the group comprising polychlorinated biphenyls, polyaromatic hydrocarbons and polybrominated diphenyl ethers. (C) 2011 Elsevier Ltd. All rights reserved.”
“Objective: The results of two randomized clinical trials (RCTs) demonstrate the clinical effectiveness of alternatives to casting for certain ankle and wrist fractures.