Prospective Randomized Controlled Trial Comparing Absorbable and Nonabsorbable Sutures in A1 Pulley Release.

BACKGROUND: Both absorbable and nonabsorbable sutures are used to correct palmar incisions or lacerations. Nonabsorbable sutures have been used without complications but require removal at a follow-up appointment. Alternatively, the use of absorbable sutures has increased in popularity as postoperative suture removal is not required but is associated with local immunological and inflammatory responses. In this study, we compared the scar quality and outcomes of nonabsorbable and absorbable sutures in A1 pulley release. METHODS: Patients who underwent A1 pulley release were randomized to 1 of 2 suture materials. The Patient Scar Assessment Scale, Observer Scar Assessment Scale, Visual Analogue Scale, and Disabilities of the Arm, Shoulder, and Hand scores were collected at 2, 6, and 12 weeks postoperatively. Among the 41 patients included in the study, 23 were randomized to the nonabsorbable suture group, and 18 to the absorbable suture group. RESULTS: There were no significant differences between the two suture groups in the aforementioned assessments. Complication rates were higher in the nonabsorbable suture group, but the difference was not statistically significant. Notably, 1 case in the absorbable suture group had uncontrolled postoperative bleeding and required reoperation. CONCLUSION: We found no significant difference between the two materials in terms of the Patient or Observer Scar Assessment Scales, overall complication rates, symptom scores, or pain scores. Therefore, the choice using absorbable or nonabsorbable can be guided by other factors such as physician or patient preference, availability, and cost.

Longer Operative Time and the Use of Anticoagulants Are Associated With Increased Blood Loss in Elderly Patients Undergoing Arthroscopic Rotator Cuff Repair.

Purpose: To study the effects of rotator cuff tear size, operation time, and the use of anticoagulant on blood loss in elderly patients undergoing arthroscopic rotator cuff surgery. Methods: Patients aged older than 65 years who underwent arthroscopic rotator cuff repair with subacromial decompression at our hospital from January 2015 to December 2021 were identified. We measured hemoglobin levels preoperatively, postoperatively, and 7 days after surgery. First, subjects were divided according to the operation time (group I, <90 minutes; group II, <120 minutes; group III <150 minutes; and group IV, >150 minutes). Second, we classified the subjects by the size of the rotator cuff tear (group A, <3 cm; group B, <5 cm; and group C, >5 cm). Lastly, we categorized the subjects into 2 groups according to the use of anticoagulant medication. Results: A total of 566 patients were included. The mean hemoglobin (Hgb) levels were 13.8 ± 1.4 g/dL preoperatively, 13.2 ± 1.4 g/dL postoperatively, and 12.8 ± 1.3 g/dL 7 days after surgery, and the differences among them were statistically significant (P < .001). The Hgb level changes 7 days after surgery showed a significant decrease in the group with a longer operation time, and the Hgb loss increased from group 1 to group 4 (P < .001). They did not show any difference in the Hgb levels among the groups according to the size of a cuff tear preoperatively, postoperatively, and 7 days after surgery. The subjects with anticoagulant use showed more decrease in Hgb levels between immediately after the surgery and 7 days after the surgery (P = .031). Still, both groups did not show a statistical difference in the Hgb level 7 days after surgery (P = .115). Conclusions: In this study, blood loss after arthroscopic rotator cuff repair in elderly patients was greater than expected. Bleeding increased in elderly patients who had longer surgical times or were taking anticoagulant medications after surgery. Tear size was not associated with a decrease in Hgb levels. Level of Evidence: Level III, retrospective comparative study.

Smart Floor Mats for a Health Monitoring System Based on Textile Pressure Sensing: Development and Usability Study.

BACKGROUND: The rise in single-person households has resulted in social problems like loneliness and isolation, commonly known as "death by loneliness." Various factors contribute to this increase, including a desire for independent living and communication challenges within families due to societal changes. Older individuals living alone are particularly susceptible to loneliness and isolation due to limited family communication and a lack of social activities. Addressing these issues is crucial, and proactive solutions are needed. It is important to explore diverse measures to tackle the challenges of single-person households and prevent deaths due to loneliness in our society. OBJECTIVE: Non-face-to-face health care service systems have gained widespread interest owing to the rapid development of smart home technology. Particularly, a health monitoring system must be developed to manage patients' health status and send alerts for dangerous situations based on their activity. Therefore, in this study, we present a novel health monitoring system based on the auto-mapping method, which uses real-time position sensing mats. METHODS: The smart floor mats are operated as piezo-resistive devices, which are composed of a carbon nanotube-based conductive textile, electrodes, main processor circuit, and a mat. The developed smart floor system acquires real-time position information using a multiconnection method between the modules based on the auto-mapping algorithm, which automatically creates a spatial map. The auto-mapping algorithm allows the user to freely set various activity areas through floor mapping. Then, the monitoring system was evaluated in a room with an area of 41.3 m2, which is embedded with the manufactured floor mats and monitoring application. RESULTS: This monitoring system automatically acquires information on the total number, location, and direction of the mats and creates a spatial map. The position sensing mats can be easily configured with a simple structure by using a carbon nanotube-based piezo-resistive textile. The mats detect the activity in real time and record location information since they are connected through auto-mapping technology. CONCLUSIONS: This system allows for the analysis of patients' behavior patterns and the management of health care on the web by providing important basic information for activity patterns in the monitoring system. The proposed smart floor system can serve as the foundation for smart home applications in the future, which include health care, intelligent automation, and home security, owing to its advantages of low cost, large area, and high reliability.

Radiologic evaluation and clinical effect of calcification in medial epicondylitis.

BACKGROUND: Although most radiologic findings of medial epicondylitis (ME) are normal, up to 25% show calcification, and little is known about the clinical relevance of soft-tissue calcification in ME. The purposes of this study were to reveal the characteristics of calcification in ME and to identify their clinical relevance. METHODS: This study included 187 patients (222 elbows) with a diagnosis of ME. We classified calcification according to its anatomic location and further evaluated its distribution. Logistic regression analysis was performed to calculate the odds ratios and 95% confidence intervals for possible factors that may affect calcification in ME: age, sex, laterality, hand dominance, visual analog scale (VAS) pain score, Mayo Elbow Performance Score, symptom duration, history of steroid injection, number of steroid injections, concomitant ulnar neuropathy, and treatment method in terms of conservative treatment or surgery. RESULTS: Of a total of 222 elbows, 53% (118 of 222 elbows) showed calcification in radiologic findings. The VAS pain score, the number of steroid injections, and concomitant ulnar neuropathy were significantly associated with calcification in ME. Calcification was most commonly identified at the anatomic insertion site of the common flexor tendon (33%), followed by the pronator teres (18%) and the medial collateral ligament (10%). Of the total cases of calcification, 45% were distributed at multiple sites, and age was strongly associated with multiple-site distribution. CONCLUSIONS: Calcification in ME was more commonly identified than previously reported and was distributed over a relatively broad area. Calcification was associated with a higher VAS pain score, a history of steroid injection, and combined ulnar neuropathy. The anatomic insertion site of the common flexor tendon most commonly showed calcification, and age was a strong indicator of a broad distribution of calcification.

ZrSnO4: A Solution-Processed Robust Electron Transport Layer of Efficient Planar-Heterojunction Perovskite Solar Cells.

A robust electron transport layer (ETL) is an essential component in planar-heterojunction perovskite solar cells (PSCs). Herein, a sol-gel-driven ZrSnO4 thin film is synthesized and its optoelectronic properties are systematically investigated. The optimized processing conditions for sol-gel synthesis produce a ZrSnO4 thin film that exhibits high optical transmittance in the UV-Vis-NIR range, a suitable conduction band maximum, and good electrical conductivity, revealing its potential for application in the ETL of planar-heterojunction PSCs. Consequently, the ZrSnO4 ETL-based devices deliver promising power conversion efficiency (PCE) up to 19.05% from CH3NH3PbI3-based planar-heterojunction devices. Furthermore, the optimal ZrSnO4 ETL also contributes to decent long-term stability of the non-encapsulated device for 360 h in an ambient atmosphere (T~25 °C, RH~55%,), suggesting great potential of the sol-gel-driven ZrSnO4 thin film for a robust solution-processed ETL material in high-performance PSCs.

Easy and effective analytical method of carbendazim, dimethomorph, and fenoxanil from Protaetia brevitarsis seulensis using LC-MS/MS.

Traditionally in Korea, Protaetia brevitarsis seulensis (white-spotted flower chafer) has been used as a medicine, and recently has attracted increased attention due to its antithrombotic efficacy. Some of spent mushroom compost or fermented oak sawdust, a feedstock for P. brevitarsis, were contaminated with three fungicides, carbendazim, dimethomorph, and fenoxanil, which could be transferred to the insect. This study was aimed to optimize a simple extraction method combined with liquid chromatography tandem mass spectrometry and apply it to the real samples. After the pulverized samples (5 g) were extracted with acetonitrile (10 mL) and formic acid (100 µL), fat and lipids in the samples were slowly precipitated at -20°C for 24 hours. After eight different clean-up methods were investigated, the mixture of 150 mg MgSO4/25 mg PSA/25 mg C18 was selected due to optimal recovery of the target compounds. Recovery (77.9%‒80.8% for carbendazim, 111.2%‒116.7% for dimethomorph, and 111.9%‒112.5% for fenoxanil) was achieved with reasonable relative standard deviation (<5.5%) The analytical method developed in this study was used to analyze three compounds in the 24 insect samples donated by the insect farm owners but no target compounds were detected. These results can provide important data for establishing the pesticide safety standards for P. brevitarsis before the medical applications.

Dissipation and Distribution of Picarbutrazox Residue Following Spraying with an Unmanned Aerial Vehicle on Chinese Cabbage (Brassica campestris var. pekinensis).

We assessed the residual distribution and temporal trend of picarbutrazox sprayed by agricultural multicopters on Chinese cabbage and considered fortification levels and flying speeds. In plot 2, 14 days after the last spraying, the residues decreased by ~91.3% compared with those in the samples on day 0. The residues in the crops decreased by ~40.8% of the initial concentration owing to growth (dilution effect) and by ~50.6% after excluding the dilution effect. As the flight speed increased, picarbutrazox residues decreased (p < 0.05, least significant deviation [LSD]). At 2 m s-1 flight speed, the residual distribution differed from the dilution rate of the spraying solution. The average range of picarbutrazox residues at all sampling points was 0.007 to 0.486, below the limit of quantitation -0.395, 0.005-0.316, and 0.005-0.289 mg kg-1 in plots 1, 2, 3, and 4, respectively, showing significant differences (p < 0.05, LSD). These results indicated that the residual distribution of picarbutrazox sprayed by using a multicopter on the Chinese cabbages was not uniform. However, the residues were less than the maximum residue limit in all plots. Accordingly, picarbutrazox was considered to have a low risk to human health if it was sprayed on cabbage according to the recommended spraying conditions.

Effective and rugged analysis of glyphosate, glufosinate, and metabolites in Tenebrio molitor larva (mealworms) using liquid chromatography tandem mass spectrometry.

Tenebrio molitor larva (mealworms) has recently attracted attention as a protein source for food and feed. The larva is generally fed with wheat bran, which can be possibly contaminated with glyphosate. To establish food safe standards, a rugged and effective analytical method for glyphosate, aminomethylphosphonic acid, glufosinate, and their metabolites including 3-methylphosphinico-propionic acid, and N-acetyl glufosinate, in mealworms was optimized using liquid chromatography tandem mass spectrometry. An anionic polar pesticide column was used due to its high suitability for glyphosate. Acidified water and acetonitrile were used to extract the target compounds without contribution from various fatty and pigment interferences derived from brownish insects. Seven different clean-up procedures ((1) 50 mg C18 (2) 20 mg C18/Z-sep (3) PRiME hydrophilic-lipophilic balance (HLB) cartridge (4) 75 mg Z-sep, (5) 75 mg Z-sep+, (6) EMR-lipid cartridge, and (7) 50 mg ENVI-Carb) were compared. Due to its simplicity and cost-effectiveness, PRiME HLB was selected for clean-up. The recoveries of the target compounds were ranged from 86 to 96% with < 20% relative standard deviations. Therefore, this simple and effective method can be applied for the two pesticides and their metabolites in other edible insects or high-fat matrices.

Facile Post Treatment of Ag Nanowire/Polymer Composites for Flexible Transparent Electrodes and Thin Film Heaters.

Typical polyol-based synthesis of silver nanowire employs insulating polymer as a surfactant for the silver nanowire growth, which limits direct contact between each nanowire and thus its optoelectronic properties. We herein demonstrate that a simple solvent treatment effectively removes the insulating polymer around Ag NWs, leading to significantly decreased sheet resistance (~12 Ω/sq) with an increased transmittance (81% @ T550), as compared to other post-treatments. We successfully demonstrate the transparent film heaters using the solvent-treated Ag NWs network, which rapidly exhibited 150 °C under a bias of 5 V. Flexible film heaters on plastic substrate is also demonstrated, suggesting a great potential of the solvent treatment process of Ag NWs for flexible transparent electrode and film heater applications.

Morphological characteristics of fractures of the anteromedial facet of the coronoid in posteromedial rotatory instability of the elbow: a three-dimensional CT remodeling study.

BACKGROUND: Fractures of the anteromedial facet of the coronoid in posteromedial rotatory instability of the elbow are classified into 3 subtypes based on their location. The purpose of this study was to analyze the fracture morphology of anteromedial facet fractures in their 3 subtypes (anteromedial rim, anteromedial rim + tip, and anteromedial rim + sublime tubercle [±tip]). METHODS: Three-dimensional computed tomography remodeling was used to evaluate anteromedial facet fractures in a consecutive series of 40 patients, all of whom were affected by posteromedial rotatory instability of the elbow. Characteristics of the fractures, including the number of fragments, size of fragments, plane of the fracture line, and involvement of the sublime tubercle and radial notch, were measured for each subtype of the anteromedial facet fractures. RESULTS: Each subtype had a typical fracture pattern and distinct size. The fracture subtype 1 showed a single-fragment fracture, subtype 2 showed either a single- or dual-fragment fracture, and subtype 3 showed either a dual- or triple-fragment fracture. The angle between the fracture line and the coronal plane was greatest in subtype 3 fractures. The surface area of the fragment was largest in subtype 3 fractures. The percentages of articular involvement of the sublime tubercle were 0% in subtype 1, 47% in subtype 2, and 79% in subtype 3. The percentages of articular involvement of the radial notch were 0% in subtype 1, 7% in subtype 2, and 8% in subtype 3. CONCLUSION: Analysis with quantitative 3-dimensional computed tomography showed the characteristic morphology of each subtype of anteromedial facet fracture. Subtype 1 comprised 1 fragment with the smallest fragment size. Subtype 2 was a single- or dual-fragment fracture, the size of which should be considered in the treatment plan. Subtype 3 was a large fragment comprising the sublime tubercle. Our findings are significant because they highlight unique fracture morphology that may help surgeons to distinguish one fracture subtype from another in clinical practice.

Liquid Chromatography-Tandem Mass Spectrometry for the Simultaneous Analysis of 353 Pesticides in the Edible Insect Tenebrio molitor Larvae (Mealworms).

Tenebrio molitor larvae (mealworm) is an edible insect and is considered a future food. Using liquid chromatography-tandem mass spectrometry (LC-MS/MS), a novel method for simultaneous analysis of 353 target analytes was developed and validated. Various sample preparation steps including "quick, easy, cheap, effective, rugged, and safe" (QuEChERS) extraction conditions, number of acetonitrile-hexane partitions, and dispersive-solid phase extraction (dSPE) sorbents were compared, and the optimal conditions were determined. In the established method, 5 g of homogenized mealworms was extracted with acetonitrile and treated with QuEChERS EN 15662 salts. The crude extract was subjected to three rounds of acetonitrile-hexane partitioning, and the acetonitrile layer was cleaned with C18 dSPE. The final solution was matrix-matched and injected into LC-MS/MS (2 µL). For target analytes, the limits of quantitation (LOQs) were ≤10 µg/kg, and the correlation coefficient (r2) of calibration was >0.990. In recovery tests, more than 90% of the pesticides showed an excellent recovery range (70-120%) with relative standard deviation (RSD) ≤20%. For more than 94% of pesticides, a negligible matrix effect (within ±20%) was observed. The analytical method was successfully applied and used for the detection of three urea pesticides in 4 of 11 mealworm samples.

Comparison of Ulnar Collateral Ligament Reconstruction Techniques in the Elbow of Sports Players.

Ulnar collateral ligament injuries have been increasingly common in overhead throwing athletes. Ulnar collateral ligament reconstruction is the current gold standard for managing ulnar collateral ligament insufficiency, and numerous reconstruction techniques have been described. Although good clinical outcomes have been reported regarding return to sports, there are still several technical issues including exposure, graft selection and fixation, and ulnar nerve management. This review article summarizes a variety of surgical techniques of ulnar collateral ligament reconstructions and compares clinical outcomes and biomechanics.

Colorimetric Textile Sensor for the Simultaneous Detection of NH3 and HCl Gases.

For the immediate detection of strong gaseous alkalis and acids, colorimetric textile sensors based on halochromic dyes are highly valuable for monitoring gas leakages. To date, colorimetric textile sensors for dual-gas detection have usually been fabricated by electrospinning methods. Although nanofibrous sensors have excellent pH sensitivity, they are difficult to use commercially because of their low durability, low productivity, and high production costs. In this study, we introduce novel textile sensors with high pH sensitivity and durability via a facile and low-cost screen-printing method. To fabricate these textiles sensors, Dye 3 and RhYK dyes were both incorporated into a polyester fabric. The fabricated sensors exhibited high detection rates (<10 s) and distinctive color changes under alkaline or acidic conditions, even at low gas concentrations. Furthermore, the fabricated sensors showed an outstanding durability and reversibility after washing and drying and were confirmed to contain limited amounts of hazardous materials. Thus, our results show that the fabricated textile sensors could be used in safety apparel that changes its color in the presence of harmful gases.

Relationship between the tilt angle of bipolar radial head prostheses and radiological radiocapitellar instability.

OBJECTIVE: This study aimed to radiologically assess the relationship between the tilt angle of the bipolar radial head prostheses and radiocapitellar instability. METHODS: In this radiological study, 28 consecutive patients (13 females and 15 males: mean age=47 years and age range=23-77 years) who underwent cemented bipolar radial head arthroplasty (Judet CRF II) because of comminuted radial head fracture with elbow instability were retrospectively reviewed. RESULTS: There was excellent intra- and interobserver reliability for the measurements of the tilt angle and the radiocapitellar distance. ICC for interobserver reliability of the tilt angle was 0.93, and ICC for intraobserver reliability for the 2 observers was 0.96 and 0.97, respectively. ICC for interobserver reliability of the radiocapitellar distance was 0.87, and ICC for intraobserver reliability for the 2 observers was 0.91 and 0.93, respectively. The mean tilt angle was 17.6° (range=1°-35°), and the mean radiocapitellar distance was 8 mm (range=1-17 mm). Pearson's correlation revealed a strong significant positive correlation between the tilt angle and the radiocapitellar distance (r=0.77 and p<0.001). CONCLUSION: Evidence from this study has demonstrated a strong positive correlation between the tilt angle of bipolar radial head prostheses and radiocapitellar instability. The tilt angle can be used as an indicator of radiocapitellar joint instability following bipolar radial head prostheses. LEVEL OF EVIDENCE: Level IV, Diagnostic study.

Management of Periprosthetic Hip Joint Infection.

Total hip joint replacement offers dramatic improvement in the quality of life but periprosthetic joint infection (PJI) is the most devastating complication of this procedure. The infection threatens the function of the joint, the preservation of the limb, and occasionally even the life of the patient due to long term hospitalization and high cost. For the surgeon it is a disastrous burden, which requires repeated, complicated procedures to eradicate infection and to provide a mobile joint without pain. Yet in the absence of a true gold standard, the diagnosis of PJI can be elusive. Synovial fluid aspiration, diagnostic imaging, traditional culture, peripheral serum inflammatory markers, and intraoperative frozen sections each have their limitations but continue to be the mainstay for diagnosis of PJI. Treatment options mainly include thorough irrigation and debridement with prosthesis retention, or a two-stage prosthesis exchange with intervening placement of an antibiotic-loaded spacer. Success in treating PJI depends on extensive surgical debridement and adequate and effective antibiotic therapy. Treatment in two stages using a spacer is recommended for most chronic PJI. Debridement, antibiotics and implant retention is the obvious choice for treatment of acute PJI, with good success rates in selected patients. This article presents an overview of recent management concepts for PJI of the hip emphasizing diagnosis and the clinical approach, and also share own experience at our institution.

The effect of heating insufflation gas on acid-base alterations and core temperature during laparoscopic major abdominal surgery.

BACKGROUND: Carbon dioxide (CO(2)) has different biophysical properties under different thermal conditions, which may affect its rate of absorption in the blood and the related adverse events. The present study was aimed to investigate the effects of heating of CO(2) on acid-base balance using Stewart's physiochemical approach, and body temperature during laparoscopy. METHODS: Thirty adult patients undergoing laparoscopic major abdominal surgery were randomized to receive either room temperature CO(2) (control group, n = 15) or heated CO(2) (heated group, n = 15). The acid-base parameters were measured 10 min after the induction of anesthesia (T1), 40 min after pneumoperitoneum (T2), at the end of surgery (T3) and 1 h after surgery (T4). Body temperature was measured at 15-min intervals until the end of the surgery. RESULTS: There were no significant differences in pH, PaCO(2), the apparent strong ion difference, the strong ion gap, bicarbonate ion, or lactate between two groups throughout the whole investigation period. At T2, pH was decreased whereas PaCO(2) was increased in both groups compared with T1 but these changes were not significantly different. Body temperatures in the heated group were significantly higher than those in the control group from 30 to 90 min after pneumoperitoneum. CONCLUSIONS: The heating of insufflating CO(2) did not affect changes in the acid-base status and PaCO(2) in patients undergoing laparoscopic abdominal surgery when the ventilator was set to maintain constant end-tidal CO(2). However, the heated CO(2) reduced the decrease in the core body temperature 30 min after the pneumoperitoneum.

Enhancement in corrosion barrier properties of polyurethane films on steel by embedding MgO nanoparticles.

The effect of nanosized MgO loading on the corrosion barrier characteristics of polyurethane (PU) films on mild steel has been investigated. It was found that small amount of MgO loading even as low as 0.03 vol% significantly improved the corrosion retardation ability of PU films. Both the enhanced adhesion strength and the formation of chemically strong -NCO radicals between nano-MgO and PU matrix seem to be responsible for the enhancement.

Anesthetic management of a patient with pulmonary arteriovenous malformation under total intravenous anesthesia : A case report.

A 23-year-old woman with pulmonary arteriovenous malformation was scheduled for open reduction and internal fixation due to her mandible fracture. Total intravenous anesthesia using propofol and remifentanil was selected as the anesthetic method in order to avoid the inhibition of hypoxic pulmonary vasoconstriction and the exacerbation of intrapulmonary shunting. After the standard monitoring devices were applied, anesthesia was then induced and maintained with a target controlled infusion of propofol and remifentanil in the range of 2.5-3.0 microg/ml and 2-3 ng/ml, respectively. Anesthesia was performed uneventfully and the patient was discharged without complication.