Outcome Comparison between Carpometacarpal Arthroplasty and Trapeziectomy in Patients with Carpometacarpal Osteoarthritis: A Systematic review.

Background: Osteoarthritis of the carpometacarpal (CMC) is considered a common musculoskeletal disorder. The treatment of carpometacarpal osteoarthritis could be either by conservative or surgical methods. surgical treatment, there are various alternatives, including trapeziectomy and arthroplasty. This study aims to perform a systematic review of the literature to determine the functional outcomes associated with trapeziectomy and arthroplasty in CMC arthritis. Objectives: To determine the functional outcomes associated with trapeziectomy and arthroplasty in CMC arthritis patients. Methods: A systematic review was conducted according to PRISMA guidelines and performed on August 2022 by one independent reviewer (author) using PubMed database, EBSCO Host, EMBASE, and ScienceDirect. The literature search will be based on Patients, Intervention, Control, and Outcome (PICO) criteria, as mentioned in the following: Patients with any carpometacarpal arthritis; with the intervention of using carpometacarpal arthroplasty as their method of surgery; control with trapeziectomy and primary outcome of functional outcome. Clinical outcomes using patient-reported outcome measures and complications were included. The quality of the included studies was evaluated with Cochrane risk-of-bias assessment tools. Quantitative analysis was performed by Review Manager 5.4. Results: Three studies met the inclusion criteria for the systematic review. Both treatments resulted in significant improvements in functional scores. When matching patients according to preoperative function, patients receiving arthroplasty had better postoperative function (Quick DASH: trapeziectomy = 25.1, ARPE = 16.8). Conclusion: This study showed that variable results of clinical outcomes improved after trapezeictomy and arthroplasty in patients with CMC arthritis. Evidence showed that arthroplasty allows for a better improvement in functional outcome.

Examples of cosmological spacetimes without CMC Cauchy surfaces.

CMC (constant mean curvature) Cauchy surfaces play an important role in mathematical relativity as finding solutions to the vacuum Einstein constraint equations is made much simpler by assuming CMC initial data. However, Bartnik (Commun Math Phys 117(4):615-624, 1988) constructed a cosmological spacetime without a CMC Cauchy surface whose spatial topology is the connected sum of two three-dimensional tori. Similarly, Chrusciel et al. (Commun Math Phys 257(1):29-42, 2005) constructed a vacuum cosmological spacetime without CMC Cauchy surfaces whose spatial topology is also the connected sum of two tori. In this article, we enlarge the known number of spatial topologies for cosmological spacetimes without CMC Cauchy surfaces by generalizing Bartnik's construction. Specifically, we show that there are cosmological spacetimes without CMC Cauchy surfaces whose spatial topologies are the connected sum of any compact Euclidean or hyperbolic three-manifold with any another compact Euclidean or hyperbolic three-manifold. Analogous examples in higher spacetime dimensions are also possible. We work with the Tolman-Bondi class of metrics and prove gluing results for variable marginal conditions, which allows for smooth gluing of Schwarzschild to FLRW models.

Industry perspective on regulatory authority (RA) quality reviews of biosimilar applications - an evaluation of RA guidance and expectations for chemical, manufacturing, and controls information through in-depth query analysis.

PURPOSE: Evaluate the type and quantity of quality information (i.e. Chemistry, Manufacturing, and Control) requested by the US FDA and EMA in queries pertaining to biosimilar applications. METHODS: Numbers/types of queries received following regulatory submissions (FDA/EMA, n = 7/n = 5) for seven biosimilars (PF-filgrastim [Nivestym], PF-rituximab [Ruxience®], PF-trastuzumab [Trazimera®], PF-bevacizumab [Zirabev®], PF-pegfilgrastim [Nyvepria®], PF-adalimumab [Abrilada™/Amsparity®], PF-infliximab [Ixifi]) from a single product portfolio were analyzed considering published regulatory authority (RA) guidance and in relation to sections/subsections of Module 3: Quality from the Common Technical Document regulatory dossier and topics based on keyword assignment. RESULTS: Queries were most frequently assigned (FDA/EMA %, range) to Drug Substance Manufacture (subsection 3.2.S.2; 21-35%/13-50%), Control of Drug Substance (3.2.S.4; 3-11%/5-17%), Drug Product Pharmaceutical Development (3.2.P.2; 1-12%/1-15%) and Manufacture (3.2.P.3; 17-41%/2-13%), and Analytical Similarity (3.2.R; 4-21%/4-20%). The proportion of Drug Substance and Drug Product queries was significantly different between RAs (n1 = 952, n2 = 468, p-value <0.001; two-sample proportion z-test). Topic assignments included: Control (12-27%/12-28%), Manufacturing (56-72%/34-66%), Stability (1-12%/2-24%), Biosimilarity (5-16%/5-25%), and Container Closure (0-3%/0-9%). CONCLUSION: The focus of both RAs on topics related to manufacturing and controls is valuable in understanding expectations for scientific and technical content related to gaining biosimilar approval.

Potency Assay Variability Estimation in Practice.

During the drug development process, testing potency plays an important role in the quality assessment required for the manufacturing and marketing of biologics. Due to multiple operational and biological factors, higher variability is usually observed in bioassays compared with physicochemical methods. In this paper, we discuss different sources of bioassay variability and how this variability can be statistically estimated. In addition, we propose an algorithm to estimate the variability of reportable results associated with different numbers of runs and their corresponding OOS rates under a given specification. Numerical experiments are conducted on multiple assay formats to elucidate the empirical distribution of bioassay variability.

Eco-friendly synthesis of N- cholyl mercapto histidine capped silver nanoparticles and its sensing of mercury (II) ions and photo catalytic degradation of methyl orange.

In this report, we have developed highly water soluble and stable silver nanoparticles (Ag NPs) utilizing N-Cholyl Mercapto Histidine (NCMH) as a reducing and stabilizing agent with near the primary critical micellar concentration (CMC) under ambient sunlight irradiation. Moreover, The NCMH was firstly synthesized by demonstrating the reaction between cholic acid and 2- Mercapto Histidine through a simple acid amine coupling approach. The primary and secondary CMC of NCMH surfactant was measured by pyrene (1 × 10-6 M) as a fluorescent probe, and values were found to be 3.2 and 13.1 mM respectively. The synthesized Ag NPs showed at neutral pH and highly stable for more than one year without any noticeable aggregation. The TEM analysis displays the synthesized Ag NPs having a spherical shape and average size of 9.6 ± 0.5 nm. The synthesis of stabilized Ag NPs was used for ultra-sensitive and selective detection of Hg2+ ions in aqueous medium were monitored by Uv-visible spectrometer and naked eyes with a lowest limit of detection (LOD) 7 nM. The photo-catalytic degradation of methyl orange (MO) by utilizing Ag NPs as nano-catalyst exhibits a potential degradation within a study period of 180 min. Concluding that, facile and cost effective green synthesis of NCMH capped Ag NPs possess excellent reducing ability towards the selective detection of Hg2+ ions along with photo-catalytic degradation of MO dye. These true findings detached an innovative pathway of Ag NPs towards the reactivity against the catalytic activity of dye degradation and selective sensing of Hg2+ ions. Thus it paves the way for extensive range of novel potential applications of Ag NPs in various environment friendly approaches of sensitive and analytical protocol in the future.

Optimization of antimicrobial nanocomposite films based on carboxymethyl cellulose incorporating chitosan nanofibers and Guggul gum polysaccharide.

The present study utilized response surface methodology (RSM) to investigate the impact of varying concentrations of carboxymethyl cellulose (CMC: 0.75-1.75 wt%), Commiphora mukul polysaccharide (CMP: 0-1 wt%), and Chitosan Nanofiber (CHNF: 0-1 wt%) on the physical and antimicrobial characteristics of nanocomposite films based on CMC. The optimization process aimed to enhance ultimate tensile strength (UTS), strain at break (SAB), and antibacterial activity, while minimizing water vapor permeability (WVP), solubility, swelling, moisture content, opacity, and total color difference (ΔE). The results revealed that both CMP and CHNF had a positive influence on reducing moisture content, WVP, and increasing UTS. However, higher concentrations of CMP and CHNF had a divergent effect on SAB, ΔE, and swelling. The incorporation of CMP led to increased opacity and solubility, while the inclusion of CHNF resulted in decreased opacity and solubility. Notably, only CHNF addition significantly improved the antibacterial properties of the films. By applying the optimization procedure utilizing RSM, the formulation containing CMC (1.5 wt%), CMP (0.25 wt%), and CHNF (0.75 wt%) demonstrated superior physical, mechanical, and antibacterial properties in the biodegradable film matrix. These findings highlight the potential of utilizing these components to enhance the performance of CMC-based nanocomposite films.

Management of a Traumatic Collapse of the First Carpometacarpal Joint After Trapeziectomy With Suture Suspensionplasty: A Case Report.

Arthritis of the first carpometacarpal (CMC) joint is a common pathology hand surgeons encounter. Treatment begins with conservative measures, but when they fail, surgery is a viable option for providing relief to patients. The most widely used surgical technique is CMC arthroplasty with ligament reconstruction and tendon interposition (LRTI). However, more novel techniques such as trapeziectomy with suspensionplasty are gaining popularity. When surgical measures fail, it is important to identify the mechanism of failure and proper treatment options. There are multiple options for revision surgery at the surgeon's disposal, with no consensus on a superior technique. This case illustrates a patient with painful subsidence secondary to a traumatic collapse of the first CMC joint eight months status post suspensionplasty with trapeziectomy. After conservative measures failed to provide relief, it was decided that a surgical revision was appropriate. The surgeon chose to move forward with suture button suspensionplasty, as it has multiple advantages over LRTI. In the short-term follow-up after revision, the patient experienced improvements in pain and range of motion, along with radiographic evidence of proper alignment of the first metacarpal without subsidence. Regarding the treatment of a case such as this, the authors believe this case should serve as a reference that may be used by future physicians when deciding which surgical technique to employ for the revision of a traumatically collapsed first CMC joint after trapeziectomy with CMC joint suspensionplasty.

Blends of Carboxymethyl Cellulose and Cottonseed Protein as Biodegradable Films.

With the increasing awareness of plastic pollution in the environment and the accumulation of microplastics in water, a significant amount of research and development is ongoing to replace the synthetic plastics in packaging and coatings. In this work, we explored the blends of carboxymethyl cellulose (CMC) and washed cottonseed meal (CSM, consisting mostly of cottonseed protein) as agro-based, biodegradable, and sustainable alternatives to plastics. Glycerol was found to be a suitable plasticizer for these blends. The blends of CMC/CSM were produced as single-layer films from 50 to 90 µm in thickness, consisting of different proportions of the components and plasticizer. The evaluated properties included opacity, water vapor permeability, mechanical properties, thermogravimetric analysis, moisture sorption analysis, and water swelling test. Higher percentages of CSM in the blend resulted in higher opacity and lower water vapor permeation rates. The mechanical strength waned with lower levels of CMC. Possible applications for these blends include their use as water-soluble food packaging and coatings and as dissolvable bags and pouches for detergents and agrochemicals.

Effect of carbon dot-doped Ti-MOF on CMC/Agar film and active packaging application on storage quality of fruits.

Ti-metal organic framework (Ti-MOF) doped with carbon dots (CDs) with enhanced antibacterial potential was synthesized using solvothermal-assisted mechanical stirring and used for the fabrication of CMC/Agar-based active packaging films. The incorporation of CD@Ti-MOF not only improved the tensile strength of the CMC/Agar film by 17.4% but also exhibited strong antioxidant activity with 100% of ABTS and 57.8% of DPPH radical scavenging using 0.64 cm2/mL of CMC/Agar/CD@Ti-MOF film. Furthermore, water vapor permeability, oxygen permeability, and ultraviolet light-blocking ability (95.7% of UV-B and 84.7% of UV-A) were improved significantly. The CMC/Agar/CD@Ti-MOF film showed strong antibacterial activity and could inhibit the progress of E. coli up to 8.2 Log CFU/mL and completely stopped the growth of L.monocytogenes after 12 h of incubation. Additionally, CMC/Agar/CD@Ti-MOF film extended the shelf life of cherry tomatoes preserved at 4 °C and delayed the quality degradation, maintaining the visual aspects of the packaging.

Mesenchymal stem cell therapy using Pal-KTTKS-enriched carboxylated cellulose improves burn wound in rat model.

Despite the great progress in developing wound dressings, delayed wound closure still remains a global challenge. Thus, developing novel wound dressings and employing advanced strategies, including tissue engineering, are urgently desired. The carboxylated cellulose was developed through the in situ synthesis method and further reinforced by incorporating pal-KTTKS to stimulate collagen synthesis and improve wound healing. The developed composites supported cell adhesion and proliferation and showed good biocompatibility. To boost wound-healing performance, adipose-derived mesenchymal stem cells (MSC) were seeded on the pal-KTTKS-enriched composites to be implanted in a rat model of burn wound healing. Healthy male rats were randomly divided into four groups and wound-healing performance of Vaseline gauze (control), carboxylated cellulose (CBC), pal-KTTKS-enriched CBC (KTTKS-CBC), and MSCs seeded on the KTTKS-CBC composites (MSC-KTTKS-CBC) were evaluated on days 3, 7, and 14 post-implantation. In each group, the designed therapeutic dressings were renewed every 5 days to increase wound-healing performance. We found that KTTKS-CBC and MSC-KTTKS-CBC composites exhibited significantly better wound healing capability, as evidenced by significantly alleviated inflammation, increased collagen deposition, improved angiogenesis, and considerably accelerated wound closure. Nevertheless, the best wound-healing performance was observed in the MSC-KTTKS-CBC groups among all four groups. This research suggests that the MSC-KTTKS-CBC composite offers a great deal of promise as a wound dressing to enhance wound regeneration and expedite wound closure in the clinic.

Improvement of gram staining effect by ethanol pretreatment and quantization of staining image by unsupervised machine learning.

In this study, we propose an Ethanol Pretreatment Gram staining method that significantly enhances the color contrast of the stain, thereby improving the accuracy of judgement, and demonstrated the effectiveness of the modification by eliminating unaided-eye observational errors with unsupervised machine learning image analysis. By comparing the traditional Gram staining method with the improved method on various bacterial samples, results showed that the improved method offers distinct color contrast. Using multimodal assessment strategies, including unaided-eye observation, manual image segmentation, and advanced unsupervised machine learning automatic image segmentation, the practicality of ethanol pretreatment on Gram staining was comprehensively validated. In our quantitative analysis, the application of the CIEDE2000, and CMC color difference standards confirmed the significant effect of the method in enhancing the discrimination of Gram staining.This study not only improved the efficacy of Gram staining, but also provided a more accurate and standardized strategy for analyzing Gram staining results, which might provide an useful analytical tool in microbiological diagnostics.

Toxicity of the New Psychoactive Substance (NPS) Clephedrone (4-Chloromethcathinone, 4-CMC): Prediction of Toxicity Using In Silico Methods for Clinical and Forensic Purposes.

This study reports the first application of in silico methods to assess the toxicity of 4-chloromethcathinone (4-CMC), a novel psychoactive substance (NPS). Employing advanced toxicology in silico tools, it was possible to predict crucial aspects of the toxicological profile of 4-CMC, including acute toxicity (LD50), genotoxicity, cardiotoxicity, and its potential for endocrine disruption. The obtained results indicate significant acute toxicity with species-specific variability, moderate genotoxic potential suggesting the risk of DNA damage, and a notable cardiotoxicity risk associated with hERG channel inhibition. Endocrine disruption assessment revealed a low probability of 4-CMC interacting with estrogen receptor alpha (ER-α), suggesting minimal estrogenic activity. These insights, derived from in silico studies, are critical in advancing the understanding of 4-CMC properties in forensic and clinical toxicology. These initial toxicological findings provide a foundation for future research and aid in the formulation of risk assessment and management strategies in the context of the use and abuse of NPSs.

Effects of lactic acid bacteria on rearing water bacterial community in Eriocheir sinensis culture.

The Chinese mitten crab (CMC, Eriocheir sinensi) culture in ponds is a unique aquaculture system. Probiotics are commonly used in the maintenance of the health of pond-cultured CMCs. However, the effects of probiotics on the bacterial community of CMC-culturing water remain unclear. This study utilized 16S rRNA gene amplicon sequencing to assess changes in the bacterial community composition, diversity, assembly, and co-occurrence patterns in CMC-culturing water following probiotic application. The results indicate that the α-diversity of the bacterial community in CMC-culturing water varied with time following probiotic application. The addition of probiotics to the water resulted in an increase in the occurrence of new operational taxonomic units (OTUs). The bacterial community assembly in the CMC-culturing water was shaped by a balance between deterministic and stochastic processes, while commercial probiotics enhanced the proportion of heterogeneous selection. In addition, including OTU2953 (Burkholderiaceae) and OTU3005 (Lactobacillaceae), from the commercial probiotics served as keystone species in the bacterial network of CMC-culturing water. Overall, probiotic application had a significant impact on the bacterial ecology of CMC-culturing water.

3-CMC, 4-CMC, and 4-BMC Human Metabolic Profiling: New Major Pathways to Document Consumption of Methcathinone Analogues?

Synthetic cathinones represent one of the largest and most abused new psychoactive substance classes, and have been involved in numerous intoxications and fatalities worldwide. Methcathinone analogues like 3-methylmethcathinone (3-MMC), 3-chloromethcathinone (3-CMC), and 4-CMC currently constitute most of synthetic cathinone seizures in Europe. Documenting their consumption in clinical/forensic casework is therefore essential to tackle this trend. Targeting metabolite markers is a go-to to document consumption in analytical toxicology, and metabolite profiling is crucial to support investigations. We sought to identify 3-CMC, 4-CMC, and 4-bromomethcathinone (4-BMC) human metabolites. The substances were incubated with human hepatocytes; incubates were screened by liquid chromatography-high-resolution tandem mass spectrometry and data were mined with Compound Discoverer (Themo Scientific). 3-CMC-positive blood, urine, and oral fluid and 4-CMC-positive urine and saliva from clinical/forensic casework were analyzed. Analyses were supported by metabolite predictions with GLORYx freeware. Twelve, ten, and ten metabolites were identified for 3-CMC, 4-CMC, and 4-BMC, respectively, with similar transformations occurring for the three cathinones. Major reactions included ketoreduction and N-demethylation. Surprisingly, predominant metabolites were produced by combination of N-demethylation and ω-carboxylation (main metabolite in 3-CMC-positive urine), and combination of ß-ketoreduction, oxidative deamination, and O-glucuronidation (main metabolite in 4-CMC-positive urine). These latter metabolites were detected in negative-ionization mode only and their non-conjugated form was not detected after glucuronide hydrolysis; this metabolic pathway was never reported for any methcathinone analogue susceptible to undergo the same transformations. These results support the need for comprehensive screening strategies in metabolite identification studies, to avoid overlooking significant metabolites and major markers of consumption.

Bioselective and Radiopaque Zinc-Biopolymeric Complex-Based Porous Biomaterials Promote Mammalian Tissue Ingrowth In Vivo While Inhibiting Microbial Biofilm Gene Expression and Biofilm Formation.

Metal-organic complexes have shown astounding bioactive properties; however, they are rarely explored as biomaterials. Recent studies showed that carboxymethyl-chitosan (CMC) genipin-conjugated zinc biomimetic scaffolds have unique bioselective properties. The biomaterial was reported to be mammalian cell-friendly; at the same time, it was found to discourage microbial biofilm formation on its surface, which seemed to be a promising solution to addressing the problem of trauma-associated biofilm formation and development of antimicrobial resistance. However, the mechanically frail characteristics and zinc overload raise concerns and limit the potential of the said biomaterials. Hence, the present work is focused on improving the strength of the earlier scaffold formulations, testing its in vivo efficacy and reaffirming its action against biofilm-forming microbe Staphylococcus aureus. Scaling up of CMC proportion increased rigidity, and 8% CMC was found to be the ideal concentration for robust scaffold fabrication. Freeze-dried CMC scaffolds with or without genipin (GP) cross-linking were conjugated with zinc using 2 M zinc acetate solution. Characterization results indicated that the CMC-Zn scaffolds, without genipin, showed mechanical properties close to bone fillers, resist in vitro enzymatic degradation until 4 weeks, are porous in nature, and have radiopacity close to mandibular bones. Upon implantation in a subcutaneous pocket of Wistar rats, the scaffolds showed tissue in-growth with simultaneous degradation without any signs of toxicity past 28 days. Neither were there any signs of toxicity in any of the vital organs. Considering many superior properties among the other formulations, the CMC-Zn scaffolds were furthered for biofilm studies. CMC-Zn showed negligible S. aureus biofilm formation on its surface as revealed by an alamar blue-based study. RT-PCR analysis revealed that CMC-Zn downregulated the expression of pro-biofilm effector genes such as icaC and clfB. A protein docking study predicted the inhibitory mechanism of CMC-Zn. Although it binds strongly when alone, at high density, it may cause inactivation of the transmembrane upstream activators of the said genes, thereby preventing their dimerization and subsequent inactivation of the effector genes. In conclusion, zinc-conjugated carboxymethyl-chitosan scaffolds are mechanically robust, porous, yet biodegradable, harmless to the host in the long term, they are radiopaque and prevent biofilm gene expression in notorious microbes; hence, they could be a suitable candidate for bone filler applications.

Computer-simulated TOUCH prosthesis cup malposition and solutions.

INTRODUCTION: Total joint replacement has become significantly more common as a treatment for advanced trapeziometacarpal joint osteoarthritis in recent years. The latest generation of prostheses with dual-mobility designs leads to very good functional results and low rates of loosening and dislocation in the short and medium term. Biomechanical studies showed that central placement and parallel alignment of the cup with respect to the proximal articular surface of the trapezium are crucial for both cup stability and prevention of dislocation. Despite correct positioning of the guidewire, incorrect placement or tilting of the inserted cup may occur, requiring immediate intraoperative revision. METHODS: The existing spherical and conical cup models in sizes 9 mm and 10 mm were transferred to a computer-aided design dataset. Depending on the intraoperative complication (tilting or incorrect placement), the revision options resulting from the various combinations of cup type and size were simulated and analyzed according to the resulting defect area and bony contact area. RESULTS: In well centered cups, a size 9 conical cup could be replaced by a size 9 spherical cup and still be fixed by press-fit. Conversely, a size 9 spherical cup could not be replaced by a size 9 conical cup, but only by a size 10 cup, of whatever shape. When a size 9 conical cup was tilted up to 20°, the best revision option was to resect the sclerotic margin and insert a size 10 conical cup deeper into the cancellous bone, to achieve the largest contact area with the surrounding bone. When a size 9 cup of whatever shape was poorly centered (misplaced with respect to the dorsopalmar or radioulnar line of the trapezium), placement should be corrected using a size 10 cup, combined with autologous bone grafting of the defect. Again, the size 10 conical cup showed the largest bony contact area. CONCLUSION: Our computer-based measurements suggested options for intraoperative cup revision depending on cup shape and size and on type of misalignment with resulting bone defects. These suggestions, however, need to be confirmed in anatomic specimens before introducing them into clinical practice.

Carboxymethyl cellulose/gelatin film incorporated with eggplant peel waste-derived carbon dots for active fruit packaging applications.

Carbon dots (CDs) were derived using eggplant peel by a hydrothermal approach and incorporated into the carboxymethyl cellulose (CMC) and gelatin (Gel) blend to develop sustainable and functional packaging films for fruit preservation. The CD was uniformly dispersed within the CMC/Gel blend to form a dense and continuous film and fashioned a strong interaction with the polymer chain, increasing the tensile strength of the film by 5.0-16.0 %. Also, with the impregnation of CDs, the UV-blocking potential of the CMC/Gel film was greatly improved to the extent of blocking 94.3 % of UV-B and 72.5 % of UV-A, while the water vapor permeability slightly decreased (by 2.7-5.4 %), and the water contact angle of the film marginally expand (by 6.2-19.1 %). The CMC/Gel film with 3 wt% of CD added depicted strong antioxidant efficacy of 100 % against ABTS and 59.1 % against DPPH and displayed strong antibacterial action that inhibited the progress of Listeria monocytogenes and Escherichia coli by 99.8 %. In addition, when table grapes were packaged using a CMC/Gel composite film containing CD and stored at 4 °C for 24 days, the fruits packed with the composite film maintained excellent external quality and extended the shelf life.

The comparison of contribution of GO and rGO produced by green synthesis to the properties of CMC-based wound dressing material.

Herein, GO (graphene oxide) or rGO (reduced graphene oxide) which is produced by the green synthesis method using plant extract (Laurus nobilis) was incorporated into a polymeric structure consisting of carboxymethyl cellulose (CMC) and polyethylene glycol (PEG) to produce a wound dressing material with enhanced mechanical and electrical properties. The effect of GO and rGO on the wound dressing features of the produced materials was investigated and compared to each other. Conductivity tests demonstrated that rGO contributed more significantly to the electrical conductivity than GO. While rGO-CMC/PEG/CA reached 3.01 × 10-6 S.cm-1 as the conductivity value, that of GO-CMC/PEG/CA was determined as 0.85 × 10-6 S.cm-1. As for the mechanical tests, it was seen that rGO achieved the best results in terms of elastic modulus (588.62 N/mm2), tensile strength (94.95 MPa) and elongation at break (17.64 %) compared to GO reinforced and pure hydrogel. Curcumin and ascorbic acid were used for antibiotic-free wound treatment and their release kinetics were also modeled. The results showed that rGO reinforced hydrogel provided a more controlled release. All results assured that both the produced GO reinforced and especially rGO reinforced hydrogels could be utilized as modern wound dressing materials with suitable properties to achieve remarkable results for wound healing.

Influence of Carboxymethyl Cellulose as a Thickening Agent for Glauber's Salt-Based Low Temperature PCM.

This work is focused on a novel, promising low temperature phase change material (PCM), based on the eutectic Glauber's salt composition. To allow phase transition within the refrigeration range of temperatures of +5 °C to +12 °C, combined with a high repeatability of melting-freezing processes, and minimized subcooling, the application of three variants of sodium carboxymethyl cellulose (Na-CMC) with distinct molecular weights (700,000, 250,000, and 90,000) is considered. The primary objective is to optimize the stabilization of this eutectic PCM formulation, while maintaining the desired enthalpy level. Preparation methods are refined to ensure repeatability in mixing components, thereby optimizing performance and stability. Additionally, the influence of Na-CMC molecular weight on stabilization is examined through differential scanning calorimetry (DSC), T-history, and rheology tests. The PCM formulation of interest builds upon prior research in which borax, ammonium chloride, and potassium chloride were used as additives to sodium sulfate decahydrate (Glauber's salt), prioritizing environmentally responsible materials. The results reveal that CMC with molecular weights of 250 kg/mol and 90 kg/mol effectively stabilize the PCM without phase separation issues, slowing crystallization kinetics. Conversely, CMC of 700 kg/mol proved ineffective due to the disruption of gel formation at its low gel point, hindering higher concentrations. Calculations of ionic concentration indicate higher Na ion content in PCM stabilized with 90 kg/mol CMC, suggesting increased ionic interactions and gel strength. A tradeoff is discovered between the faster crystallization in lower molecular weight CMC and the higher concentration required, which increases the amount of inert material that does not participate in the phase transition. After thermal cycling, the best formulation had a latent heat of 130 J/g with no supercooling, demonstrating excellent performance. This work advances PCM's reliability as a thermal energy storage solution for diverse applications and highlights the complex relationship between Na-CMC molecular weight and PCM stabilization.

Comparison of Long-Term Healthcare Cost and Utilisation of Nonoperative and Surgical Management of Thumb CMC Arthritis.

Background: Thumb carpometacarpal joint (CMC) osteoarthritis is the most symptomatic hand arthritis but the long-term healthcare burden for managing this condition is unknown. We sought to compare total healthcare cost and utilisation for operative and nonoperative treatments of thumb CMC arthritis. Methods: We conducted a retrospective longitudinal analysis using a large nationwide insurance claims database. A total of 18,705 patients underwent CMC arthroplasty (trapeziectomy with or without ligament reconstruction tendon interposition) or steroid injections between 1 October 2015 and 31 December 2018. Primary outcomes, healthcare utilisation and costs were measured from 1 year pre-intervention to 3 years post-intervention. Generalised linear mixed effect models adjusted for potentially confounding factors such as the Elixhauser comorbidity score with propensity score matching were applied to evaluate the association between the primary outcomes and treatment type. Results: A total of 13,646 patients underwent treatment through steroid injections, and 5,059 patients underwent CMC arthroplasty. At 1 year preoperatively, the surgery group required $635 more healthcare costs (95% CI [594.28, 675.27]; p < 0.001) and consumed 42% more healthcare utilisation (95% CI [1.38, 1.46]; p < 0.0001) than the steroid injection group. At 3 years postoperatively, the surgery group required $846 less healthcare costs (95% CI [-883.07, -808.51], p < 0.0001) and had 51% less utilisation (95% CI [0.49, 0.53]; p < 0.0001) annually. Cumulatively over 3 years, the surgical group on average was $4,204 costlier than its counterpart secondary to surgical costs. Conclusions: CMC arthritis treatment incurs high healthcare cost and utilisation independent of other medical comorbidities. At 3 years postoperatively, the annual healthcare cost and utilisation for surgical patients were less than those for patients who underwent conservative management, but this difference was insufficient to offset the initial surgical cost. Level of Evidence: Level III (Therapeutic).