Safety and efficacy of ultrasonography of tension after zone II flexor tendon repair: A randomized controlled trial.

BACKGROUND: Primary flexor tendon repairs of lacerations in zone II of the hand are fraught with problems. Traditionally, exercise (active and passive), orthoses, and physical agents are common interventions for the rehabilitation of patients experiencing these issues. One area of focus in this field is how to safely utilize tension to lengthen gliding distance following zone II injury. Finding effective solutions in this area is a key priority for improving patient outcomes and quality of life. PURPOSE: To identify the optimal immobilization position that meets safety standards for tension and is the most efficient, and consequently, to validate our clinical effectiveness. STUDY DESIGN: A cross-sectional study was adopted for the first part of the research (Research 1). A prospective, parallel, 2-group, randomized trial was conducted with concealed allocation and single blinding in the second part of the research (Research 2). METHODS: A total of 60 healthy adults were recruited to select the best-fit protective immobilization position in Research 1, which was confirmed by tendon tension (via Young's modulus) and excursion (via gliding distance). We then randomly assigned 45 patients after zone II flexor tendon repair into two groups in Research 2 to compare functional outcomes. The control group underwent the conventional modified Duran protocol with early passive motion, while the experimental group received the protocol (optimized by Research 1) with early active motion. Ultrasonography was used to measure the tension and excursion of the flexor tendons. The outcomes measured at 16 weeks post-repair included total active motion, strength, the Disabilities of the Arm, Shoulder and Hand, and Strickland scores. RESULTS: Three participants were unable to participate in Research 2 due to medical issues and poor attendance. The investigation found that the safe tendon threshold was 345.09 ± 87.74 kPa for partial active digital motion among the 60 participants. The optimal immobilization position requires the wrist to be neutral with a flexion angle of 30° at the metacarpophalangeal joint. The grip strengths (p = 0.012), ratio of grip strength (p = 0.015), the Disabilities of the Arm, Shoulder and Hand (p = 0.036), and total active motion (p = 0.023) differed significantly between the two groups. CONCLUSIONS: Protective immobilization of the wrist in a neutral flexion position and with the metacarpophalangeal joint flexed at 30° can secure the repaired flexor tendon safely and efficiently. The effects of an early active motion protocol may improve the grip strength and upper limb mobility of individuals after zone II flexor tendon repair. CLINICAL TRIAL REGISTRATION: ChiCTR2000030592.

Effects of acid etching and adhesive treatments on host-derived cysteine cathepsin activity in dentin.

PURPOSE: To analyze the effects of different processes during bonding on endogenous cysteine cathepsin activity in dentin. MATERIALS AND METHODS: Dentin powder, prepared from extracted human third molars, was divided into 10 groups. Two lots of dentin powder were used to detect the effects of the procedure of protein extraction on endogenous cathepsin activity. The others were used to study effects of different acid-etching or adhesive treatments on enzyme activity. Concentrations of 37% phosphoric acid or 10% phosphoric acid, two etch-and-rinse adhesive systems, and two self-etching adhesive systems were used as dentin powder treatments. The untreated mineralized dentin powder was set as the control. After treatment, the proteins of each group were extracted. The total cathepsin activity in the extracts of each group was monitored with a fluorescence reader. RESULTS: In the control group, there were no significant differences in cathepsin activity between the protein extract before EDTA treatment and the protein extract after EDTA treatment (p > 0.05). The cathepsin activities of the three different extracts in the 37% phosphoric acid-treated group were different from each other (p < 0.05). The two acid-etching groups and two etch-and-rinse groups showed significant enzyme activity reduction vs the control group (p < 0.05). There were no significant differences between those four groups (p > 0.05). Treating the dentin powder with any of the two self-etching adhesives resulted in an increase in cathepsin activity (p < 0.05). CONCLUSIONS: The activity of cysteine cathepsins can be detected in dentin powder. Treatment with EDTA during protein extraction exerted an influence on cathepsin activity. Acid etching or etch-and-rinse adhesive systems may reduce the activity of endogenous cathepsins in dentin. Self-etching adhesive systems may increase the enzyme activity.

Monocular BEV Perception of Road Scenes Via Front-to-Top View Projection.

HD map reconstruction is crucial for autonomous driving. LiDAR-based methods are limited due to expensive sensors and time-consuming computation. Camera-based methods usually need to perform road segmentation and view transformation separately, which often causes distortion and missing content. To push the limits of the technology, we present a novel framework that reconstructs a local map formed by road layout and vehicle occupancy in the bird's-eye view given a front-view monocular image only. We propose a front-to-top view projection (FTVP) module, which takes the constraint of cycle consistency between views into account and makes full use of their correlation to strengthen the view transformation and scene understanding. In addition, we apply multi-scale FTVP modules to propagate the rich spatial information of low-level features to mitigate spatial deviation of the predicted object location. Experiments on public benchmarks show that our method achieves various tasks on road layout estimation, vehicle occupancy estimation, and multi-class semantic estimation, at a performance level comparable to the state-of-the-arts, while maintaining superior efficiency.

Controllable and Stable Deformation of a Self-Healing Photo-Responsive Supramolecular Assembly for an Optically Actuated Manipulator Arm.

It is highly challenging to achieve an optically deformable polymer with good controllability, stability, and self-healability for fabricating an optically controlled microrobotics. Here, we present a photo-responsive self-healing supramolecular assembly cross-linked by 3,3',5,5'-azobenzenetetracarboxylic acid (t-Azo) enabling the controllable and stable deformation. The network (PAA-u) of polyacrylic acid (PAA) grafted with 2-ureido-4[1 H]-pyrimidinone (UPy) is formed via multiple intermolecular hydrogen bonds (H-bonds) between UPy and t-Azo moieties. Molecular H-bonds stabilize the cis-isomer, enables stress transfer at the interface, and also contributes to fast healability. The PAA-u/t-Azo assembly shows a green-light-induced bending deformation, which recovers its shape under the irradiation of UV light. On the basis of this controllable and reversible deformation, the PAA-u/t-Azo "hand" realizes reversible light-driven grabbing and releasing of an object by optimizing bending and recovery. The assembly also shows a fast and excellent self-healing performance irradiated by green light during deformation. The multiple-H-bonding-cross-linked assembly with stable deformation and fast self-healability can be used for the development of a multitude of advanced microrobotics.

Controlling Heat Release from a Close-Packed Bisazobenzene-Reduced-Graphene-Oxide Assembly Film for High-Energy Solid-State Photothermal Fuels.

A closed-cycle system for light-harvesting, storage, and heat release is important for utilizing and managing renewable energy. However, combining a high-energy, stable photochromic material with a controllable trigger for solid-state heat release remains a great challenge for developing photothermal fuels (PTFs). This paper presents a uniform PTF film fabricated by the assembly of close-packed bisazobenzene (bisAzo) grafted onto reduced graphene oxide (rGO). The assembled rGO-bisAzo template exhibited a high energy density of 131 Wh kg-1 and a long half-life of 37 days owing to inter- or intramolecular H-bonding and steric hindrance. The rGO-bisAzo PTF film released and accumulated heat to realize a maximum temperature difference (DT) of 15 °C and a DT of over 10 °C for 30 min when the temperature difference of the environment was greater than100 °C. Controlling heat release in the solid-state assembly paves the way to develop highly efficient and high-energy PTFs for a multitude of applications.

[Effect of different molarity cathepsins specific inhibitor E-64 on dentin-resin bonding durability].

OBJECTIVE: To investigate, in vitro, the effect of cathepsins specific inhibitor N-(trans-epoxysuccinyl)-L-leucine 4-guanidinobutylamide(E-64) on dental endogenous cathepsins and to find its most effective molarity to elevate dentin-resin bonding durability. METHODS: Fifty recently extracted human third molars were divided into five groups according to random number table, and treated with different molarity of E-64 as follow: 0, 2.5, 5.0, 10.0 and 20.0 µmol/L. The group 0 µmol/L was control group. Then 20 specimens of dentin-resin composite were fabricated in each group. Half of the specimens were tested after 24 h water storage(37 °C) and the other half were tested after 90 days water storage(37 °C) followed by 3000 cycles'thermocyling(5-55 °C) as aging treatment. Fractured specimens were analyzed using scanning electron microscopy(SEM). RESULTS: After 24 h water storage, no significant differences were found in micro-tensile bond strength(µTBS) of samples between different groups (P > 0.05). However, after ageing treatment, µTBS of the samples in group 2.5, 5.0, 10.0 and 20.0 µmol/L [(18.7 ± 2.7), (20.8 ± 3.4), (18.3 ± 2.8) and (19.1 ± 2.7) MPa] were significantly higher than that in group 0 µmol/L [(15.1 ± 3.0) MPa] (P < 0.05). Only in the group 5.0 µmol/L no significant difference was found between the original and the decreased value of µTBS(P > 0.05), while the µTBS in other groups decreased significantly after aging treatment(P < 0.05). Failure types were almost adhesive and mixed types. Collagens in hybrid layer were less degraded in the groups using E-64 after aging treatment than control group. CONCLUSIONS: E-64 was effective on inhibiting cathepsins activity in dentin, and induced less collagens degradation in smear layer for better dentin-resin bond durability.