[PACS and Photoshop assisted isosceles triangle osteotomy and Kirschner wire tension buckle fixation in the treatment of cubitus varus in children].

OBJECTIVE: To investigate the clinical efficacy of picture archiving and communication system (PACS) and Photoshop assisted isosceles triangle osteotomy and Kirschner wire fixation with tension band in the treatment of cubitus varus in children. METHODS: The clinic data of 20 children with cubitus varus treated with isosceles triangle osteotomy of distal humerus and Kirschner wire fixation with tension band from October 2014 to October 2019, were retrospectively analyzed. There were 13 males and 7 females, aged from 3.2 to 13.5 years old, the median age was 6.65 years old. PACS system was applied for the osteotomy design preoperatively, simulating and measuring the side length of isosceles triangle osteotomy. Then, Photoshop system was used to simulate the preoperative and postoperative osteotomy graphics, which could guide precise osteotomy during operation. RESULTS: All the 20 patients were followed up for 20 to 24 months, with a median of 22.5 months. At the last follow-up, the carrying angle of the affected limb was 5 ° to 13 °, with a median of 8.3 °. The clinical efficacy was evaluated according to the Flynn elbow function score:excellent in 16 cases, good in 2 cases, and fair in 2 cases. CONCLUSION: The treatment of cubitus varus in children by isosceles triangle osteotomy and Kirschner wire fixation with tension band assisted by PACS and Photoshop system has shown good clinical outcome.

Engineering viscoelastic mismatch for temporal morphing of tough supramolecular hydrogels.

Viscoelasticity is a generic characteristic of soft biotissues and polymeric materials, endowing them with unique time- and rate-dependent properties. Here, by spatiotemporally tailoring the viscoelasticity in tough supramolecular hydrogels, we demonstrate reprogrammable morphing of the gels based on differential viscoelastic recovery processes that lead to internal strain mismatch. The spatial heterogeneity of viscoelasticity is encoded through integrating dissimilar hydrogels or by site-specific treatment of a singular hydrogel. The temporal morphing behavior of tough gels, including a fast deformation process and then a slow shape-recovery process, is related to the kinetics of associative interactions and the entropic elasticity of supramolecular networks after pre-stretching and release, which takes place spontaneously in the absence of external stimuli. Such a kinetically driven morphing mechanism resolves the trade-off between the mechanical robustness and shape-changing speed in tough hydrogels with dense entanglements and physical associations, and should be applicable to other viscoelastic materials. A numerical theory for the temporal morphing of tough supramolecular gels has been formulated by dynamic coupling of viscoelastic recovery and mechanics of deformations, which is further implemented to predict the sophisticated morphed structures. Furthermore, magnetic particles are incorporated into the morphed tough hydrogels to devise versatile soft actuators and robots for specific applications.

Manta Ray Inspired Soft Robot Fish with Tough Hydrogels as Structural Elements.

The design of soft robots capable of navigation underwater has received tremendous research interest due to the robots' versatile applications in marine explorations. Inspired by marine animals such as jellyfish, scientists have developed various soft robotic fishes by using elastomers as the major material. However, elastomers have a hydrophobic network without embedded water, which is different from the gel-state body of the prototypes and results in high contrast to the surrounding environment and thus poor acoustic stealth. Here, we demonstrate a manta ray-inspired soft robot fish with tailored swimming motions by using tough and stiff hydrogels as the structural elements, as well as a dielectric elastomer as the actuating unit. The switching between actuated and relaxed states of this unit under wired power leads to the flapping of the pectoral fins and swimming of the gel fish. This robot fish has good stability and swims with a fast speed (∼10 cm/s) in freshwater and seawater over a wide temperature range (4-50 °C). The high water content (i.e., ∼70 wt %) of the robot fish affords good optical and acoustic stealth properties under water. The excellent mechanical properties of the gels also enable easy integration of other functional units/systems with the robot fish. As proof-of-concept examples, a temperature sensing system and a soft gripper are assembled, allowing the robot fish to monitor the local temperature, raise warning signals by lighting, and grab and transport an object on demand. Such a robot fish should find applications in environmental detection and execution tasks under water. This work should also be informative for the design of other soft actuators and robots with tough hydrogels as the building blocks.

Healable, Recyclable, and Multifunctional Soft Electronics Based on Biopolymer Hydrogel and Patterned Liquid Metal.

Recent years have witnessed the rapid development of sustainable materials. Along this line, developing biodegradable or recyclable soft electronics is challenging yet important due to their versatile applications in biomedical devices, soft robots, and wearables. Although some degradable bulk hydrogels are directly used as the soft electronics, the sensing performances are usually limited due to the absence of distributed conducting circuits. Here, sustainable hydrogel-based soft electronics (HSE) are reported that integrate sensing elements and patterned liquid metal (LM) in the gelatin-alginate hybrid hydrogel. The biopolymer hydrogel is transparent, robust, resilient, and recyclable. The HSE is multifunctional; it can sense strain, temperature, heart rate (electrocardiogram), and pH. The strain sensing is sufficiently sensitive to detect a human pulse. In addition, the device serves as a model system for iontophoretic drug delivery by using patterned LM as the soft conductor and electrode. Noncontact detection of nearby objects is also achieved based on electrostatic-field-induced voltage. The LM and biopolymer hydrogel are healable, recyclable, and degradable, favoring sustainable applications and reconstruction of the device with new functions. Such HSE with multiple functions and favorable attributes should open opportunities in next-generation electronic skins and hydrogel machines.

Engineering Tough Metallosupramolecular Hydrogel Films with Kirigami Structures for Compliant Soft Electronics.

A simple and effective approach is demonstrated to fabricate tough metallosupramolecular hydrogel films of poly(acrylic acid) by one-pot photopolymerization of the precursor solution in the presence of Zr4+ ions that form coordination complexes with the carboxyl groups and serve as the physical crosslinks of the matrix. Both as-prepared and equilibrated hydrogel films are transparent, tough, and stable over a wide range of temperature, ionic strength, and pH. The thickness of the films can be easily tailored with minimum value of ≈7 µm. Owing to the fast polymerization and gelation process, kirigami structures can be facilely encoded to the gel films by photolithographic polymerization, affording versatile functions such as additional stretchability and better compliance of the planar films to encapsulate objects with sophisticated geometries that are important for the design of soft electronics. By stencil printing of liquid metal on the hydrogel film with a kirigami structure, the integrated soft electronics shows good compliance to cover curved surfaces and high sensitivity to monitor human motions. Furthermore, this strategy is applied to diverse natural and synthetic macromolecules containing carboxyl groups to develop tough hydrogel films, which will open opportunities for the applications of hydrogel films in biomedical and engineering fields.

CaCO3 blowing agent mixing method for biomass composites improved buffer packaging performance.

Biodegradable composites with an open-cell structure were developed to replace petroleum-based buffer packaging materials. To overcome the problem of uneven and insufficient foam in the composites, CaCO3 was used as a nucleating agent to prepare porous composites. At 5 wt% CaCO3, more uniform and dense composite cells with better cushioning performance were obtained. A further increase in the CaCO3 content caused the density of the cells and the cushioning properties of the composites to decrease. The addition of CaCO3 improved the thermal stability and water barrier properties. The moisture absorption was reduced by 15%. X-ray diffraction analysis indicated that the addition of CaCO3 destroyed the crystalline structure of the starch and produced a new crystalline peak, resulting in a significant reduction in the crystallinity. The decrease in the crystallinity of the starch resulted in the formation of a homogeneous slurry that produced a uniform foam in the composites.

Thermally stable, enhanced water barrier, high strength starch bio-composite reinforced with lignin containing cellulose nanofibrils.

Lignin containing cellulose nanofibrils (LCNF) were obtained by mechanically fibrillating unbleached tree bark after alkaline extraction and used as a reinforcement in thermoplastic starch (TPS) to develop novel biodegradable composite films. With the addition of 15 wt % LCNF, the tensile strength and modulus of the composites increased by 319 % and 800 % compared to neat TPS films, respectively. The crystalline property of cellulose and the high interaction between TPS and LCNF improved the mechanical property of the composite films. The composite film Tonset and Tmax were 263.1 °C and 316.5 °C, respectively, compared to 250.5 °C and 297.3 °C for neat TPS. The composite films also showed higher water barrier property. Experimental results showed that LCNF features a high lignin content. Lignin, a natural polymer, contains hydrophobic and aromatic groups and, thus, can increase the water barrier property and thermal stability of TPS/LCNF composite films.

Clinical study on combining femtosecond thin- flap and LASIK with the Triple-A profile for high myopia correction.

BACKGROUND: Femtosecond laser-assisted LASIK (FS-LASIK) can make ultra-thin corneal flap accurately. MEL 90 excimer laser provides Triple-A ablation mode, which significantly reduces the amount of corneal tissue cutting. This study aimed to investigate the visual and refractive outcomes in patients with high myopia after thin-flap FS-LASIK using the 500 Hz pulse rate of the Triple-A profile. METHODS: This prospective study included 90 eyes from 90 patients received thin-flap FS-LASIK using the 500 Hz pulse rate of the Triple-A profile. According to the pre-operative spherical equivalence (SE), the treated eyes were divided into two groups: the first group (ranged from - 9.0D to - 6.0D) and the second group (ranged from - 11.15D to - 9.0 D). The parameters evaluated pre-operatively and 6 month post-operatively included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), SE, efficacy and safety index, posterior central elevation, and corneal higher-order aberrations (HOAs). RESULTS: The efficacy indexes were 1.149 ± 0.150 for the first group and 1.173 ± 0.136 for the second group (P > 0.05), whereas safety indexes were 1.135 ± 0.154 and 1.158 ± 0.137 (P > 0.05) respectively. Moreover, 93.8 and 90.6% of patients had an UDVA of 20/20, 51.2 and 49.8% had a UDVA of 20/16 for the first and second groups, respectively; yet, there were no significant differences between both groups at the 20/20 and the 20/16 levels (P > 0.05). 84 and 100% of the firse group patients had a SE within ±0.5 D and ± 1.0 D, and 82 and 100% of the second group patients. There was no significant myopia regression in both groups after 6 months follow-up. At 1, 3 and 6-month after surgery, there were no significant differences in the posterior central elevation between the two groups (P > 0.05). The induction of total HOAs, spherical aberration, and horizontal coma in the first group were significantly less than that in the second group at the 6- month follow-up (P < 0.05), while the differences of the RMS value of vertical coma between both groups were not significant (P > 0.05). The ablation was significantly associated with the post-operative increase in total HOAs, spherical aberration and horizontal coma (P < 0.05),but not with vertical coma (P > 0.05). CONCLUSION: Our results indicate that using the Triple-A ablation profile of the MEL 90 excimer laser associated with thin-flap is a safe, efficient, and predictable method to correct SE up to - 11.15D. However, for patients with high myopia, under the premise of ensuring a certain optical zone diameter, the ablation depth should be minimized to reduce the increase of the post-operative HOAs so as to improve the visual quality.

Effect of poly-methyltriethoxysilane on the waterproof property of starch/fiber composites with open cell structures.

Novel starch/fiber composites with open cell structures were proposed through thermo-cavity molding. To overcome the disadvantage of the water sensitivity of the resulting composites, poly-methyltriethoxysilane (PTS) was added as a waterproofing agent. The results showed that the addition of PTS improved the waterproof property of the composites. The composites with 15 g PTS (PTS-15) exhibited an optimal waterproof property. The water contact angle and drop absorption of the PTS-15 composites improved by 59.9% and 223.5%, respectively, compared with the values for those without PTS. Moreover, the addition of PTS could effectively prevent the degradation of the mechanical properties of the composites after water absorption. The rate of tensile property degradation for the PTS-15 composites reached 5.3%, whereas that for the PTS-0 composites totaled 56.6%. The chemical bonds and micro-structure of the composites were investigated to reveal the inherent mechanism of property changes. Fourier transform infrared spectra revealed the formation of new hydrogen bonds between starch and PTS. Hydrophobic groups, including Si-O-Si, Si-C, and Si-OH, were found in the resulting composites, thereby explaining the waterproof property changes. Scanning electron microscopy images showed that the open cell structure of the composites initially became denser and then loosened with the increase in the PTS content, resulting in the initial enhancement and the subsequent weakening of their mechanical properties.

Effects of magnesium hydroxide on the properties of starch/plant fiber composites with foam structure.

In this study, magnesium hydroxide (MH) flame-retarded starch/plant fiber composites containing various MH contents (0%, 5%, 15%, 15%) were prepared and named as TF-MH0, TF-MH5, TF-MH10, TF-MH15. Thermal degradation, flame retardancy, mechanical and microscopic characteristics were discussed. The reduction in the maximum thermal degradation rate revealed that the addition of MH provided improvement in the thermal stability of the composite. The horizontal burning test and the limiting oxygen index analysis suggested enhancement in flame retardancy with increasing MH content. Moreover, the density of composites initially decreased and then increased as the MH content increased. The tensile strength was positively correlated with the density, whereas the cushioning performance was negatively correlated with the density. Microscopic analysis showed that there was an interfacial interaction between MH and thermoplastic starch, which not only improves the thermal stability, but also promotes bubble nucleation as a nucleating agent. The cells of TF-MH10 were uniform and dense, thus TF-MH10 had the best buffering performance. Furthermore, the cell structure of TF-MH15 was short in diameter, small in number, and large in skeleton thickness; therefore, TF-MH15 had the highest tensile strength.

Optimisation of compatibility for improving elongation at break of chitosan/starch films.

When chitosan/starch films were used as agricultural mulch films, the problem of rupture often occurred. In order to improve the elongation at break, chitosan/starch blend films were prepared by casting with different formulations (different ratios of chitosan to starch, different plasticizing components and different plasticizer ratios) in this research. The elongation at break of the film reached up to 104.1% when chitosan was plasticized with 10% glycerol and 0.94% ethylene glycol alone and then mixed according to a 1 : 0.6 chitosan-starch ratio. The fact that plasticizing starch, plasticizing chitosan or co-plasticizing starch and chitosan made a big difference to the mechanical properties of the films was discovered for the first time. The films with different plasticizing components were characterized by their mechanical properties, crystal structures and surface morphologies. Mechanical properties of the films were related to their crystallinity. The higher the crystallinity, the higher the elongation at break. Plasticizing starch alone facilitated the formation of hydrogen bonds and massive structures. Plasticizing chitosan alone was beneficial to the formation of network structures of the films and exhibited anti-plasticization at low plasticizer concentration.

Effects of single-modification/cross-modification of starch on the mechanical properties of new biodegradable composites.

Starch-based composites with different modified starches were prepared by combining starches with sisal fibers to investigate the effects of single-modification/cross-modification of starch on the mechanical properties of new biodegradable composites. Mechanical test results showed that cross-modification of starch improved the toughness of the composites, whereas single-modification improved the tensile strength. The oxidized esterified starch-based composite (OESC) exhibited the best toughness, with improved elongation at break and Young's modulus by 136.1% and 54.3%, respectively, compared with a native starch-based composite. Meanwhile, the tensile strength of the esterified starch-based composite (ESC) improved by 61.6%. The hydrogen bonds, crystallinity, and micro-structure of the composites were investigated to reveal the inherent mechanism of the changes in performance. Fourier transform infrared spectroscopy showed that modification of starch changed the functional groups of starch. Thus, the ESC formed the strongest hydrogen bonds. X-ray diffraction analysis showed that the crystallinity decreased after the starches were modified. The OESC exhibited the lowest crystallinity, with a severely damaged structure. Many starch branches were combined with sisal fibers so that the composite was not easily pulled off. Scanning electron microscopy images showed that the OESC formed good cell structures internally when starch uniformly attached to the surface of the fibers.

Mechanistic insight into the formation of acetic acid from the direct conversion of methane and carbon dioxide on zinc-modified H-ZSM-5 zeolite.

Methane and carbon dioxide are known greenhouse gases, and the conversion of these two C1-building blocks into useful fuels and chemicals is a subject of great importance. By solid-state NMR spectroscopy, we found that methane and carbon dioxide can be co-converted on a zinc-modified H-ZSM-5 zeolite (denoted as Zn/H-ZSM-5) to form acetic acid at a low temperature range of 523-773 K. Solid-state (13)C and (1)H MAS NMR investigation indicates that the unique nature of the bifunctional Zn/H-ZSM-5 catalyst is responsible for this highly selective transformation. The zinc sites efficiently activate CH4 to form zinc methyl species (-Zn-CH3), the Zn-C bond of which is further subject to the CO2 insertion to produce surface acetate species (-Zn-OOCCH3). Moreover, the Brønsted acid sites play an important role for the final formation of acetic acid by the proton transfer to the surface acetate species. The results disclosed herein may offer the new possibility for the efficient activation and selective transformation of methane at low temperatures through the co-conversion strategy. Also, the mechanistic understanding of this process will help to the rational design of robust catalytic systems for the practical conversion of greenhouse gases into useful chemicals.

[Model-based FTIR reflectometry measurement system for deep trench structures of DRAM].

A method and system for measuring deep trench structures of dynamic random access memory (DRAM) based on Fourier transform infrared (FTIR) reflectometry is proposed. The principle of the measurement system is presented, along with a detailed description of the optical path design. By regulating the slit aperture to decrease the size of the detection spot and optimizing the incidence angle onto the wafer, the reflection from the backside of the wafer is suppressed, thus the signal-to-noise ratio (SNR) of the measurement is increased significantly. The experiments carried out on the deep trench structures of DRAM demonstrate that the trench geometric parameters can be extracted with a nanometer scale accuracy using the proposed system, thus the technique is proven to provide a non-contact, nondestructive, time-effective, low-cost and high resolution tool for the measurement of deep trench structures. It is expected that the proposed technique will find potential applications in the on-line monitoring and process control for microelectronics and microelectromechanical system (MEMS) manufacturing.