Porcine submucosal extracellular matrix wrapping of the ulnar nerve in revision cubital tunnel surgery.

The wrapping technique aims to protect the nerve when the nerve bed is compromised or more commonly to prevent the recurrence of scar tethering following neurolysis. A wrap provides a physical barrier to scar and helps restore the paraneurial gliding layer. This study aimed to evaluate the results of the AxoGuard® nerve protector, a porcine-derived submucosal extracellular matrix (PECM), used as an adjunct in persistent or recurrent cubital tunnel syndrome (CuTS). This retrospective cohort study evaluated patients diagnosed, between 2012 and 2020, with neuropathic pain who underwent revision surgery. Patients were categorised into Group A (revision surgery only) and Group B (revision surgery and adjunctive PECM nerve wrapping). Disease severity was scored at the baseline and six months post-operatively using the McGowan classification. A linear regression model was used to assess the effect of wrapping the ulnar nerve on the clinical outcome at six months. Fifty-nine nerves were treated; among them, adjunctive PECM wrapping was used in 32 nerves. Disease severity at baseline was similar between the groups. After adjusting for differences in baseline characteristics, participants in Group B improved with a significant difference of 0.43 McGowan points over Group A (95% CI (0.01-0.86), p = 0.049). There were no implant-related complications. Group B improved with excellent or good outcomes in 84.4% patients at the final follow-up. Persistent or recurrent CuTS were associated with neuropathic pain and significant nerve scar tether. The use of PECM appears to lead to improved clinical symptoms, possibly by reducing adhesions and encouraging physiological glide. LEVEL OF EVIDENCE: Level III evidence.

MRI scan with the "feed and wrap" technique and with an optimized anesthesia protocol: a retrospective analysis of a single-center experience.

Introduction: MRI examinations in the pediatric population require acquiring motionless images in the safest possible manner. At our institute, we have developed a protocol called "Good Practice" aimed at avoiding anesthesia in newborns and infants through the use of the "feed and wrap" technique, as well as preventing hospitalization for older children requiring anesthesia with an optimized sedation protocol. We evaluated this protocol in terms of patient safety, imaging quality, and parental satisfaction. Materials and methods: Patient data were collected retrospectively. In the feed and wrap group, image quality and the necessity of repeating the examination were evaluated. In the optimized anesthesiologic protocol group, various parameters were analyzed to assess the safety of the protocol. Parental satisfaction was determined through a questionnaire. Results: A total of 132 patients were included, with 82 undergoing the feed and wrap technique and 50 receiving the optimized anesthesiologic protocol. In the feed and wrap group, images were classified as follows: 4.87% poor, 18.29% sufficient, 37.80% good, and 39.92% excellent. In only 2 cases a new MRI examination was required. In the optimized anesthesiologic protocol group, no adverse effects were observed, and no post-anesthesia hospitalizations were needed. 100% of parents of babies examined with the feed and wrap technique rated it as excellent. Furthermore, 85.6% of parents considered the optimized anesthesiologic protocol excellent, and 13.6% rated it as good. Conclusion: At our institute, the feed and wrap technique proved to be effective in obtaining high-quality images. Anesthesia using propofol showed no adverse effects and proved to be successful in avoiding hospitalization. Parents expressed relief at the avoidance of anesthesia and hospitalization for their children.

Assessing plastic pollution in farmland: Impact of agricultural practices on bird nesting materials.

Farmland, a vital terrestrial environment, has seen significant changes due to intensified agricultural practices and plastic pollution. Assessing plastic pollution in farmed areas remains challenging, and understanding its impacts on agricultural ecosystems is limited. The aim of the was to determine whether plastic pollution in agricultural landscapes depends on the type of crops. We used the Red-backed Shrike (Lanius collurio), an indicator bird species and investigated plastic contamination of 122 of its nests. We found plastic waste in 82.1 % of nests, totalling 6234 items weighing 197.2 g. On average, each nest contained 55.7 waste items, constituting approximately 4.3 % of the nest's mass. Plastic string fibres were predominant, making up 95.6 % of the items and 90.7 % of the mass. This variation may be due to different straw and hay management practices and varying levels of vigilance in removing plastic remnants. Contamination levels varied significantly among farmland types, with cultivated fields showing the highest contamination and meadows the lowest.

Prevalence of Blunt and Hemp Wrap Use Among Young Adults in the United States, 2022.

INTRODUCTION: Blunt and hemp wraps, as a means of consuming cannabis, have emerged into the retail space where the prevalence has been increasing since 2017. There is limited epidemiological research on the prevalence of use of these products across the U.S. particularly among young adults who are at greater risk of tobacco and cannabis use. METHODS: This study draws from a U.S. national representative sample of young adults (n = 1178) captured in May 2022. Respondents participated in an online survey about their use of blunt and hemp wraps. Multinomial regression was used to examine differences in sociodemographic characteristics (gender, race/ethnicity, sexual orientation, educational attainment, and region) in relation to use of each wrap type. RESULTS: One quarter (22.7%) of young adults reported ever having used a blunt wrap, 3.2% in the past 30-days. One in seven (14.3%) had ever used a hemp wrap, 2.3% in the past 30-days. Non-Hispanic Black young adults were 1.55 and 2.91 times as likely to have ever used blunt or hemp wraps, respectively, compared to non-Hispanic Whites. Similarly, participants who identified as gay or lesbian or bisexual similarly had greater odds of having ever used blunt or hemp wraps. Hispanic young adults were 2.49 times as likely to have used hempwraps compared to non-Hispanic Whites. CONCLUSION: Blunt and hemp wrap use is prevalent among young adults, particularly among minoritized populations. Continued research and surveillance of use of these products is needed to fully evaluate the impact their use may have on the broader population.

Exploring the Complexities of Atopic Dermatitis: Pathophysiological Mechanisms and Therapeutic Approaches.

Atopic dermatitis (AD) is a prevalent inflammatory skin condition impacting both children and adults globally, with a prevalence of 15-30%. It ranks as the most prevalent skin disorder based on disability-adjusted life-years by the World Health Organization. It presents with symptoms like skin irritation, redness, dryness, itchiness, and vesicular blisters and commonly coexists with other atopic symptoms like allergic rhinitis, asthma, and food allergies. The pathophysiology involves a complex interplay of genetic predispositions, immunological dysfunctions, and environmental factors leading to tissue inflammation and disrupted skin barrier integrity. Alopecia areata is characterized by nonscarring hair loss and shares correlations with AD including a higher prevalence of atopic diseases, shared intracellular mechanisms involving the JAK-STAT pathway, and potential treatment overlap such as dupilumab. These correlations could direct new areas of research and increased insight for both diseases. Treatment of AD requires a personalized approach due to its complex, multifactorial nature integrating nonpharmacological interventions like skin hydration and trigger avoidance as well as topical and systemic approaches, if necessary, with topical corticosteroids being the first line for flares; long term corticosteroid use poses risk for adverse effects like skin atrophy. Severe cases may require systemic treatments or phototherapy. Future treatment prospects include targeting the dysbiotic microbiome and identifying biomarkers for tailored therapeutic strategies, emphasizing the importance of personalized medicine in optimizing AD management.

Understanding Higher-Order Interactions in Information Space.

Methods used in topological data analysis naturally capture higher-order interactions in point cloud data embedded in a metric space. This methodology was recently extended to data living in an information space, by which we mean a space measured with an information theoretical distance. One such setting is a finite collection of discrete probability distributions embedded in the probability simplex measured with the relative entropy (Kullback-Leibler divergence). More generally, one can work with a Bregman divergence parameterized by a different notion of entropy. While theoretical algorithms exist for this setup, there is a paucity of implementations for exploring and comparing geometric-topological properties of various information spaces. The interest of this work is therefore twofold. First, we propose the first robust algorithms and software for geometric and topological data analysis in information space. Perhaps surprisingly, despite working with Bregman divergences, our design reuses robust libraries for the Euclidean case. Second, using the new software, we take the first steps towards understanding the geometric-topological structure of these spaces. In particular, we compare them with the more familiar spaces equipped with the Euclidean and Fisher metrics.

Treatment of Vertical Maxillary Excess and Skeletal Class II Malocclusion: A Case Report.

Class II malocclusion is a recurrent problem that may occur at a young age. If treated initially, the malocclusion can be corrected by redirecting the growth without invasive modalities and avoiding orthognathic surgeries. A female patient aged 10 years three months came to the department of orthodontics having a complaint of upper front teeth placed forwardly, diagnosed with skeletal class II due to retrusive mandible and vertical maxillary excess with hyper divergent growth pattern with increased anterior facial height, with Angle's molar class II division 1 malocclusion, increased overjet of 13 mm and overbite of 7 mm, acute nasolabial angle, deep mentolabial sulcus, and hyperactive mentalis. It was treated using an activator with medium-high-pull headgear (modified Herren activator) passing through the maxillary center of resistance. A fixed mechanotherapy with high-pull headgear was given using the anterior inclined plane acrylic plate in the maxilla and McLaughlin, Bennett, and Trevisi (MBT). Begg's wrap was used for the retention plan. This case report shows the significance of proper treatment results obtained due to correct identification and planning in treating malocclusion. This case report shows the significance of proper treatment results obtained due to correct identification and planning in treating malocclusion.

Widely targeted metabolomic analysis reveals metabolite changes induced by incorporating black tea fermentation techniques in oolong tea processing for quality improvement.

Oolong tea, a semi-fermented tea, has a prominent fruity and floral aroma, resembling green tea's astringency and pungency but lacking black tea's mellowness. Oolong tea incorporating black tea fermentation techniques (OT-IBTFT) not only retained its excellent floral and fruity aroma but also reduced astringency and enriched taste. However, metabolite changes remain unknown. In this study, widely targeted metabolomic analysis showed OT-IBTFT reduced prunin, gallocatechin, methyl gallate, and increased loliolide by changing the flavonoid biosynthesis and biosynthesis of secondary metabolites pathways, thereby reducing the astringency and increasing the mellow taste and richness to improve oolong tea quality. In addition, Wrap-rolling 5 times increased fermentation, improving the color and aroma of oolong tea by increasing theaflavic acid and 2-furoic acid, is more significant than wrap-rolling once. In conclusion, these findings provide a theoretical basis for the improvement of oolong tea processing techniques and flavor and quality control.

Bioengineered Nerve Conduits and Wraps.

Peripheral nerve injuries are prevalent and their treatments present significant challenges. Among the various reconstructive options, nerve conduits and wraps are popular choices. Advances in bioengineering and regenerative medicine have led to the development of new biocompatible materials and implant designs that offer the potential for enhanced neural recovery. Cost, nerve injury type, and implant size must be considered when deciding on the ideal reconstructive option.

Retention efficacy and patient experience with customized clear retainer and wrap-around circumferential retainer among non-extraction orthodontic patients: A 12-month follow-up cohort study.

OBJECTIVE: The aim of this study was to evaluate retention efficacy by assessing retention stability and patient perspectives according to type of circumferential retainer: the wrap-around circumferential retainer (WCR) and customized clear retainer (CCR). MATERIALS AND METHODS: This cohort follow-up study involved 52 patients aged 18-62 who underwent fixed-appliance orthodontic treatment without extractions or orthognathic surgery. Following screening consenting participants were divided into WCR and CCR groups. All participants before follow-up received fixed retainers for the upper and lower anteriors and respective removable retainers within 2 weeks post-debond. Intraoral scans and lateral cephalograms were taken immediately after debonding (T0) and again 12 months later. Dentoalveolar changes in several measurements were compared to evaluate retention efficacy. Surveys were conducted at 1 month (T1) and 12 months (T2) post-debonding to assess changes in patient experiences. Outcome assessments were blinded. Paired T-tests and independent T-tests were used for intragroup and intergroup comparisons of dentoalveolar measurements, respectively. Survey responses were analysed using the Pearson Chi-Square test. RESULTS: The final assessment included 32 participants. Model analysis revealed no significant differences between the groups, except for maxillary intermolar width (p = .033). In the WCR group, the cephalometric analysis indicated a significant increase in the incisor mandibular plane angle (p = .002) and a decrease in the interincisal angle (p = .014), while changes in the CCR group were statistically non-significant. Patient attitude evaluation showed similar trends for wear time and overall satisfaction. However, a higher percentage of respondents in the WCR group reported irritation when wearing the retainers (p = .037) at T1 and discomfort related to speech (p = .038) at T2. CONCLUSIONS: CCR showed better retention efficacy in terms of lower incisor inclination. Patients experienced relatively less irritation and speech discomfort with CCRs.

Advancement of an Environmentally Friendly and Innovative Sustainable Rubber Wrap Film with Superior Sealing Properties.

Common kitchen wraps like plastic and aluminum foil create significant environmental burdens. Plastic wrap, typically made from non-renewable fossil fuels, often ends up in landfills for centuries, breaking down into harmful microplastics. Aluminum foil, while effective, requires a large amount of energy to produce, and recycling it at home can be impractical due to food residue. A promising new alternative, low-nitrosamine rubber wrap film, aims to reduce waste by offering a reusable option compared to traditional single-use plastic wrap. The film is environmentally friendly, durable, and effective in sealing containers and keeping food fresh or crispy. The raw materials used to make the product were studied, namely fresh and concentrated natural rubber latex. No nitrosamines were found in either the fresh or concentrated latex, which is important as nitrosamines are known to be carcinogenic. The absence of nitrosamines in the raw materials suggests that the universal rubber wrap film is safe for use. In this study, the rubber formulation and properties of rubber used to make rubber wrap film were studied. The content of additives affecting the rubber properties was varied to find the optimum rubber formulation for making rubber wrap films. The rubber formulation with the least amount of chemicals that met the following criteria was selected: tensile strength of at least 15 MPa, elongation at break of at least 600%, and nitrosamine content below 6 ppm. It was found experimentally that the optimum rubber formulation for making a translucent rubber film had 0.7 phr zinc oxide and 1.0 phr sulfur. Performance tests revealed the rubber wrap film's superior sealing capabilities. Its elasticity allows for a tighter fit on containers, effectively conforming to various shapes and creating an optimal seal compared to plastic wrap and aluminum foil. The results of this study provide valuable information for developing a universal rubber wrap film that is safe with low nitrosamines.

Comparison of "Semiocclusive Dressing" Treatment Using Plastic Wrap or Low-Adherent Absorbent Wound Dressings Versus Occlusive Dressing Treatment for Stage III/IV Pressure Injuries in the Inflammatory Phase: A Randomized Controlled Trial.

Objective: To compare the effectiveness of "semiocclusive dressing (SOD)" treatment using plastic wrap or low-adherent absorbent wound dressings with that of occlusive dressing (OD) treatment for National Pressure Injury Advisory Panel stage III/IV pressure injuries in the inflammatory phase. Approach: This 12-week, open-label, randomized controlled trial was conducted at one hospital and three care facilities. Seventy-seven participants were enrolled; 40 comprised the SOD group and 37 comprised the OD group. The primary outcome was the surface area reduction. Secondary outcomes included the Bates-Jensen Wound Assessment Tool (BWAT) score reductions, incidence of adverse events, and material cost. This trial met the recommendations of the CONSORT 2010 statement. Results: The surface area reduction of the SOD group was greater than that of the OD group throughout the study period. The significant interaction was revealed between treatment and time course (p < 0.0001). The 95% confidence interval of the difference at 12 weeks was 3.4 to 21.9. The median BWAT score reduction of the SOD group at 12 weeks was 23, and that of the OD group was 18.5 (p = 0.0077). The incidence of adverse events was comparable between groups. The OD treatment cost was 3.0 times higher than the SOD treatment cost (p = 0.0012). Innovation: Because the SOD does not completely occlude the wound, excess exudate drains from the wound. Therefore, SOD can treat the wound with abundant exudate effectively and safely. Conclusion: SOD treatment is more effective and less expensive than OD treatment for stage III/IV pressure injuries. Clinical Trial Registration: UMIN Clinical Trials Registry [UMIN000023412]. Registered on July 31, 2016.

"Feed-and-wrap" technique versus deep sedation for neonatal magnetic resonance imaging: a retrospective comparative study.

OBJECTIVES: Neonatal MRI is usually performed under deep sedation, which is challenging-especially in low-weight premature patients. In addition, long-term side effects, such as neurotoxicity, are of concern. An alternative to sedation is to induce natural sleep by feeding and immobilising the child, the "feed-and-wrap" technique (FWT). The objective of this study was to evaluate differences in image quality between neonates examined under sedation and by using the FWT during the first four months of life. MATERIALS AND METHODS: We retrospectively assessed image quality (based on a 4-point semiquantitative scale) of all MRI examinations in neonates performed at our institution between July 2009 and August 2022. Differences in image quality between examinations under sedation versus FWT were evaluated. RESULTS: We included 432 consecutive patients, 243 (56%) using sedation and 189 (44%) using the FWT. Corrected age and body weight (mean ± SD: 3.7 ± 1.1 versus 4.5 ± 1.3 kg, p < 0.001) were significantly lower in the FWT group. The overall success rate in the FWT group was 95%. Image quality was slightly lower when using the FWT (mean ± SD: 3.7 ± 0.43 versus 3.96 ± 0.11, p < 0.001). Multivariate analysis showed a higher risk of acquiring sequences with diagnostic limitations in the FWT group (p < 0.001), increasing with corrected age (p = 0.048). CONCLUSION: The FWT is a highly successful method to perform MRI scans in term and preterm neonates. Overall image quality is only slightly lower than under sedation. Especially in immature low-weight preterm patients, the FWT is a reliable option to perform MRI studies without exposing the child to risks associated with sedation. CLINICAL RELEVANCE STATEMENT: The "feed-and-wrap" technique enables high-quality MRI examinations in neonates, including low-weight premature patients. Deep sedation for diagnostic MRI procedures in this age group, which has the risk of short- and long-term complications, can often be avoided. KEY POINTS: Deeply sedating neonates for MR examinations comes with risks. Image quality is only slightly lower when using the "feed-and-wrap" technique. The "feed-and-wrap" technique is feasible even in low-weight premature infants.

Decompression and collagen wrapping of a fibrolipomatous hamartoma of the median nerve: a new approach for a rare and difficult problem.

Fibrolipomatous hamartoma is a rare benign slow growing fibrofatty tumor of peripheral nerves of unknown etiology. Clinical presentation may mimic carpal tunnel syndrome when involving the median nerve. We present a case of FLH of the median nerve in a 59-year-old female treated with decompression and collagen nerve wrapping.

Image rectangling network based on reparameterized transformer and assisted learning.

Stitched images can offer a broader field of view, but their boundaries can be irregular and unpleasant. To address this issue, current methods for rectangling images start by distorting local grids multiple times to obtain rectangular images with regular boundaries. However, these methods can result in content distortion and missing boundary information. We have developed an image rectangling solution using the reparameterized transformer structure, focusing on single distortion. Additionally, we have designed an assisted learning network to aid in the process of the image rectangling network. To improve the network's parallel efficiency, we have introduced a local thin-plate spline Transform strategy to achieve efficient local deformation. Ultimately, the proposed method achieves state-of-the-art performance in stitched image rectangling with a low number of parameters while maintaining high content fidelity. The code is available at https://github.com/MelodYanglc/TransRectangling .

Phase offset method of ptychographic contrast reversal correction.

The contrast transfer function of direct ptychography methods such as the single side band (SSB) method are single signed, yet these methods still sometimes exhibit contrast reversals, most often where the projected potentials are strong. In thicker samples central focusing often provides the best ptychographic contrast as this leads to defocus variations within the sample canceling out. However focusing away from the entrance surface is often undesirable as this degrades the annular dark field (ADF) signal. Here we discuss how phase wrap asymptotes in the frequency response of SSB ptychography give rise to contrast reversals, without the need for dynamical scattering, and how these can be counteracted by manipulating the phases such that the asymptotes are either shifted to higher frequencies or damped via amplitude modulation. This is what enables post collection defocus correction of contrast reversals. However, the phase offset method of counteracting contrast reversals we introduce here is generally found to be superior to post collection application of defocus, with greater reliability and generally stronger contrast. Importantly, the phase offset method also works for thin and thick samples where central focusing does not. Finally, the independence of the method from focus is useful for optical sectioning involving ptychography, improving interpretability by better disentangling the effects of strong potentials and focus.

Arc plasma for high-efficiency ionization and scavenging of plasticizers in wrap films.

Herein, ambient electric arc ionization mass spectrometry was used to examine 16 plasticizers in various wrap films, demonstrating high sensitivity (detection limit: <0.2 ng/mg) and precision (intra-/inter-day precision: <12 %). The ease of operation helps in the identification of wrap film and plasticizer analysis. In addition, the introduction of a cold arc plasma treatment presents a practical and innovative method for effectively eliminating plasticizers. This innovative strategy has implications for both environmental protection and food safety.

Free neurovascular toe-(joint)-transfers compared to alternative reconstructive procedures for amputation injuries of two and tripartite fingers with substance loss.

BACKGROUND: Complex injuries of the hand frequently result in loss of essential functional features. Common reconstructive procedures for soft tissue defects of the thumb or phalanges are locoregional flaps like Moberg-, Foucher-, Cross-Finger- or Littler flaps. Microneurovascular toe (joint-) transfers complete the arsenal of operative reconstructive procedures and allow for most detailed reconstructions. Our experiences with free toe transplants are reported and diversely discussed regarding contending procedures. METHODS: From 2010 until 2019 14 patients who received emergency or elective partial or complete toe transfers were compared with a control group (n = 12) treated with contending reconstructive procedures. Aim of the reconstructions was to cover the defect with well-vascularized, sensate tissue, while preserving length and range of motion in a reliable manner. RESULTS: The Kapandji score showed a significant difference (p- value = 0.04) with a score of 9.8 in comparison to control group (Kapandji index = 8.0). CONCLUSION: In our heterogenic patient collective free toe transplants have proven to achieve comparable functional results for reconstruction of two and tripartite phalanxes as opposed to common local reconstructive procedures.

Surgical instrument wrap: a pilot recycling initiative.

BACKGROUND: Seven per cent of general waste and 20% of healthcare risk waste produced in acute hospitals in Ireland comes from operating theatres. Surgical wrap comprises 11% of operating theatre waste. AIMS: The primary aim of this study was to pilot the implementation of a recycling initiative for surgical instrument set wrap in an operating theatre in Ireland. Secondary aims included quantification of the surgical wrap diverted from general waste to recycling streams over a 5-week period and estimation of the annual carbon emissions associated with gynaecology surgical wrap use in Cork. METHODS: The amount of polypropylene surgical wrap generated by a single gynaecology theatre at Cork University Maternity Hospital was prospectively quantified from 24/1/22 to 1/3/22. At the end of the study period, individual sheets of polypropylene wrap were counted and dimensions were measured to calculate the total surface area of surgical wrap saved for recycling. RESULTS: A total of 66 surgeries were performed over the 5-week study period. Two hundred twenty-one individual sheets of surgical wrap were collected, equating to 282.1 m2 of polypropylene wrap. An estimated 11,564 m2 of surgical wrap could be recycled annually from the gynaecology theatre service in Cork with an associated annual carbon emissions equivalent of at least 2.2 tonnes of CO2. CONCLUSION: Diversion of surgical wrap from general waste and clinical waste streams to the recycling stream is achievable in every operating theatre. Small changes to operating theatre waste disposal practices have the potential to yield significant reductions to theatre waste outputs and to hospital carbon emissions.

One-Step Cooperative Growth of High Reaction Kinetics Composite Homogeneous Core-Shell Heterostructure.

Reaction kinetics can be improved by the enhanced electrical contact between different components growing symbiotically. But so far, due to the necessity for material synthesis conditions match, the component structures of cooperative growth are similar, and the materials are of the same type. The collaborative growth of high-reaction kinetics composite homogeneous core-shell heterostructure between various materials is innovatively proposed with different structures in one step. The NiCo-LDH and PPy successfully symbiotically grow on activated carbon fiber fabric in one step. The open channel structure of the NiCo-LDH nanosheets is preserved while PPy effectively wrapped around the NiCo-LDH. The well-defined nanostructure with abundant active sites and convenient ion diffusion paths is favorable for electrolyte entry into the entire nanoarrays. In addition, owing to the enhanced electronic interaction between different components through XPS analysis, the NiCo-LDH@PPy electrode shows outstanding reaction kinetics and structural stability. The as-synthesized NiCo-LDH@PPy exhibited excellent super-capacitive storage capabilities, robust capacitive activity, and good rate survival. Furthermore, an asymmetric supercapacitor (ASC) device made of NiCo-LDH@PPy and activated carbon (AC) is able to maintain a long cycle life while achieving high power and energy densities.