Retrieval analysis of PEEK rods pedicle screw system: three cases analysis.

PURPOSE: To analyze the characteristics of PEEK rods retrieved in vivo, specifically their wear and deformation, biodegradability, histocompatibility, and mechanical properties. METHOD: Six PEEK rods were retrieved from revision surgeries along with periprosthetic tissue. The retrieved PEEK rods were evaluated for surface damage and internal changes using Micro-CT, while light and electron microscopy were utilized to determine any histological changes in periprosthetic tissues. Patient history was gathered from medical records. Two intact and retrieved PEEK rods were used for fatigue testing analysis by sinusoidal load to the spinal construct. RESULTS: All implants showed evidence of plastic deformation around the screw-rod interface, while the inner structure of PEEK rods appeared unchanged with no visible voids or cracks. Examining images captured through light and electron microscopy indicated that phagocytosis of macrophages around PEEK rods was less severe in comparison to the screw-rod interface. The results of an energy spectrum analysis suggested that the distribution of tissue elements around PEEK rods did not differ significantly from normal tissue. During fatigue testing, it was found that the retrieved PEEK rods cracked after 1.36 million tests, whereas the intact PEEK rods completed 5 million fatigue tests without any failure. CONCLUSION: PEEK rods demonstrate satisfactory biocompatibility, corrosion resistance, chemical stability, and mechanical properties. Nevertheless, it is observed that the indentation at the junction between the nut and the rod exhibits relatively weak strength, making it susceptible to breakage. As a precautionary measure, it is recommended to secure the nut with a counter wrench, applying the preset torque to prevent overtightening.

Wearable Flexible Strain Sensor Based on Three-Dimensional Wavy Laser-Induced Graphene and Silicone Rubber.

Laser-induced graphene (LIG) has the advantages of one-step fabrication, prominent mechanical performance, as well as high conductivity; it acts as the ideal material to fabricate flexible strain sensors. In this study, a wearable flexible strain sensor consisting of three-dimensional (3D) wavy LIG and silicone rubber was reported. With a laser to scan on a polyimide film, 3D wavy LIG could be synthesized on the wavy surface of a mold. The wavy-LIG strain sensor was developed by transferring LIG to silicone rubber substrate and then packaging. For stress concentration, the ultimate strain primarily took place in the troughs of wavy LIG, resulting in higher sensitivity and less damage to LIG during stretching. As a result, the wavy-LIG strain sensor achieved high sensitivity (gauge factor was 37.8 in a range from 0% to 31.8%, better than the planar-LIG sensor), low hysteresis (1.39%) and wide working range (from 0% to 47.7%). The wavy-LIG strain sensor had a stable and rapid dynamic response; its reversibility and repeatability were demonstrated. After 5000 cycles, the signal peak varied by only 2.32%, demonstrating the long-term durability. Besides, its applications in detecting facial skin expansion, muscle movement, and joint movement, were discussed. It is considered a simple, efficient, and low-cost method to fabricate a flexible strain sensor with high sensitivity and structural robustness. Furthermore, the wavy-LIG strain senor can be developed into wearable sensing devices for virtual/augmented reality or electronic skin.

Is clavicular reconstruction imperative for total and subtotal claviculectomy? A systematic review.

BACKGROUND: The effects of clavicular reconstruction on total and subtotal claviculectomy are controversial. The aim of this study is to disclose the impact of clavicular reconstruction on the efficacy of this rare surgical procedure. METHODS: This is a systematic review of multiple medical databases for level I through IV evidence. RESULTS: Eleven studies (level IV) with a mean follow-up duration of 53 months (range, 12-156 months) met the inclusion criteria. There were 70 subjects (70 shoulders) including 36 male patients (51%), and the average age at operation was 30 years (range, 2-77 years). The etiology included tumors in 34 subjects (49%) and other disorders in 36 (51%). Of the patients, 41 (59%) underwent total claviculectomy whereas 29 (41%) underwent subtotal clavicular excision. Clavicular reconstruction was performed in 14 subjects (20%), with bone allograft in 8, autograft in 1, and a bone cement prosthesis in 5. Objective measurement disclosed compromised strength and mobility in aclaviculate limbs; however, no studies investigating clavicular reconstruction used similar means of measurement. Functional assessment scales implied global limb function following the 2 procedures was similar (American Shoulder and Elbow Surgeons score, P = .13; Constant score, P = .38). Claviculectomy with and without reconstruction resulted in a similar incidence of complications (P = .45); however, isolated claviculectomy was related to fewer further surgical procedures (P <.001) and faster recovery (P <.001). The 2 procedures were associated with similar satisfaction rates (P > .99). CONCLUSIONS: No evidence suggested clavicular reconstruction led to clinical outcomes superior to those of isolated claviculectomy. It is noteworthy that isolated excision of the clavicle was associated with a lower risk of further surgery and faster rehabilitation.

Non-fusion procedure using PEEK rod systems for lumbar degenerative diseases: clinical experience with a 2-year follow-up.

BACKGROUND: Polyetheretherketone (PEEK) rod system is a novel pedicle-based dynamic stabilization system. This study evaluated clinical and radiographic outcomes of non-fusion surgery by PEEK rod systems for treatment of degenerative lumbar diseases with a 2-year follow-up. METHODS: From February 2012 to October 2012, 38 patients who underwent non-fusion surgery using PEEK rod systems were included in the study. Data on Oswestry Disability Index (ODI) score and Japanese Orthopaedics Association (JOA) score were collected and radiographs were obtained to evaluate disc height index (DHI) and range of motion (ROM) at each interval. RESULTS: Both JOA and ODI scores significantly improved postoperatively. DHI showed a slight increase immediately after the surgery but gradually dropped below preoperative levels. Mean ROM values changed from 8.8° preoperatively to 1.8° at the 2-year follow-up point. Screw loosening occurred in one case at the 2-year follow-up. CONCLUSIONS: The preliminary results indicated a significant improvement in clinical outcomes and advantageous implant safety. The non-fusion procedure using PEEK rod systems might be a viable alternative for treatment of lumbar degenerative diseases. The distraction technique needs to be improved for better postoperative DHI.

Surface integrity optimization for ball-end hard milling of AISI D2 steel based on response surface methodology.

This study focuses on systematically revealing how cutting parameters influence the surface integrity of ball-end hard milled surface of AISI D2 steel and proposing optimization scheme from surface integrity, wear resistance and fatigue resistance perspective based on response surface methodology respectively. Results can be summarized into three aspects. Firstly, radial depth of cut with percent contribution ratio (PCR) 62.05% has a decisive influence on surface roughness, followed by spindle speed 13.25% and feed per tooth 6.63%. The work hardening degree was raised from 12.5% to 38.4% when spindle speed changed from 8000 rpm to 2000 rpm. Spindle speed and radial depth of cut are the most significant factor influencing residual stress. The PCR of spindle speed and radial depth of cut reached 73.47% and 18.63% for residual stress in feed direction, 47.11% and 37.51% in step-over direction, respectively. High residual compressive stress can be generated by lowering spindle speed and radial depth of cut benefiting from the aggravated squeeze between ball-end milling cutter and workpiece. Secondly, too small feed per tooth or too small radial depth of cut should be avoided from wear resistance point because though the surface microhardness can be improved, the surface quality will also be deteriorated. The combination of high spindle speed, small feed per tooth together with small radial depth of cut can meet the wear resistance and the machining efficiency requirement. Finally, a medium-sized cutting parameter combination should be adopted to realize satisfying material removal rate and fatigue resistance. This study can be used to guide the selection of cutting parameters during ball-end milling of hardened AISI D2 steel for dies/molds manufacturing industries.

A contact-polymerizable hemostatic powder for rapid hemostasis.

The immediate control of a hemorrhage is crucial for reducing fatalities in critical situations such as battlefields, traffic accidents, natural disasters, etc. Most existing commercial hemostatic powders have weak adhesion capability and poor biodegradability, restricting their clinical use. In this paper, a new poly(ethylene glycol)-di(cyanoacrylate) (CA-PEG-CA)-based hemostatic powder with tissue-contact-triggered strong adhesion and controlled fast degradation is proposed. The monomers quickly underwent crosslinking polymerization while in contact with tissue or blood, forming an in situ gel on the wound. The hemostatic mechanism was demonstrated to depend on both adhesive-based sealing and the aggregation of platelets and erythrocytes. The powder showed excellent hemostatic effects both in vitro and in vivo, even in a rat model with a weakened native hemostatic capacity. In addition, the poly-CA-PEG-CA gel could be rapidly biodegraded by ester bond hydrolysis. Notably, a cysteamine (CS)-containing solution could accelerate the degradation rate, endowing the gel with an on-demand removal property. This hemostatic powder not only can be used to efficiently control bleeding in emergency scenarios, but it can also allow nontraumatic re-exposure of wounds during subsequent surgical care. These properties make the CA-PEG-CA powder a promising candidate to act as a multifunctional wound care agent for first aid.

A Robust Extraction Approach of Auditory Brainstem Response Using Adaptive Kalman Filtering Method.

OBJECTIVE: The Auditory brainstem response (ABR) can provide valuable information on the function of the auditory pathway. However, the ABR signal has a very small amplitude, and it is easily submerged in different background noises with large amplitude. Conventional ABR extraction methods such as time-domain averaging (TDA) and Kalman filter (KF) were greatly affected by noise intensity, and the result relies on the empirical settings of parameters. ABR extraction method that can automatically adjust parameters to adapt different background noises was needed. METHODS: An adaptive Kalman filtering (AKF) based ABR signal extraction method was proposed, in which two recursive rules were introduced to constantly update the parameters according to the real-time noise properties. It was used for ABR extraction from recordings in noises with different orders of larger magnitude. RESULTS: The AKF method demonstrated the best performance in obtaining reliable ABR waveform morphologies in the presence of large EMG noises compared with traditional methods of TDA or KF. It could extract satisfactory ABR signal with fewer trials of acoustic stimulus repetition, even from noise 10000 times larger than ABR signal. The AKF results also showed smaller absolute errors and higher correlation coefficients with the target ABR signal when different types (gum chewing, mouth opening and milk drinking) or levels of noises were introduced. CONCLUSION: The proposed AKF method is a great candidate to increase the robustness of current ABR measurements. SIGNIFICANCE: It could provide reduced testing time and relaxed recording conditions for ABR and other evoked potentials extraction.

Melt electrohydrodynamic 3D printed poly (ε-caprolactone)/polyethylene glycol/roxithromycin scaffold as a potential anti-infective implant in bone repair.

Implanted scaffold or bone substitute is a common method to treat bone defects. However, the possible bone infection caused by orthopaedic surgery has created a challenging clinical problem and generally invalidate bone repair and regeneration. In this study, a poly (ε-caprolactone) (PCL)/polyethylene glycol (PEG)/roxithromycin (ROX) composite scaffold was prepared via melt electrohydrodynamic (EHD) 3D printing. Fourier transform infrared spectroscopy (FTIR) spectroscopy was performed to verify the existence of PEG and ROX in the scaffolds. By water contact angle measurement, the addition of both PEG and ROX was found to improve the hydrophilicity of the scaffolds. By in vitro drug release assay, the PCL/PEG/ROX scaffolds showed an initial burst drug release and subsequent long-term sustained release behaviour, which is favourable for the prevention and treatment of bone infections. The antibacterial assays against E. coli and S. aureus demonstrated that the composite scaffold with ROX possessed effective antibacterial activity, especially for S. aureus, the main cause of bone infection. The immunostaining and MTT assay with human osteoblast-like cells (MG63) indicated that cells showed good viability and growth on the scaffolds. Therefore, the melt EHD 3D printed PCL/PEG/ROX scaffold could be a promising anti-infective implant for bone tissue engineering.

Direct electrochemistry of hemoglobin in egg-phosphatidylcholine films and its catalysis to H(2)O(2).

Direct electrochemistry of hemoglobin was observed in stable thin film composed of a natural lipid (egg-phosphatidylcholine) and hemoglobin on pyrolytic graphite (PG) electrode. Hemoglobin in lipid films shows thin layer electrochemistry behavior. The formal potential E degrees ' of hemoglobin in the lipid film was linearly varied with pH in the range from 3.5 to 7.0 with a slope of -46.4 mV pH(-1). Hemoglobin in the lipid film exhibited elegant catalytic activity for electrochemical reduction of H(2)O(2), based which a unmediated biosensor for H(2)O(2) was developed.

Hydrogen peroxide biosensor based on microperoxidase-11 entrapped in lipid membrane.

A highly catalytic activity microperoxidase-11 (MP-11) biosensor for H(2)O(2) was developed to immobilizing the heme peptide in didodecyldimethylammonium bromide (DDAB) lipid membrane. The enzyme electrode thus obtained responded to H(2)O(2) without electron mediator or promoter, at a potential of +0.10 V versus Agmid R:AgCl. A linear calibration curve is obtained over the range from 2.0 x 10(-5) to 2.4 x 10(-3) M. The biosensor responds to hydrogen peroxide in 15 s and has a detection limit of 8 x 10(-7) M (S/N=3) Providing a natural environment with lipid membrane for protein immobilization and maintenance of protein functions is a suitable option for the design of biosensors.

Concentration-dependent behavior of nisin interaction with supported bilayer lipid membrane.

Nisin is a positively charged antibacterial peptide that binds to the negatively charged membranes of gram-positive bacteria. The initial interaction of the peptide with the model membrane of negatively charged DPPG (dipalmitoylphosphatidylglycerol) was studied by cyclic voltammetry and a.c. impedance spectroscopy. Nisin could induce pores in the supported bilayer lipid membrane, thus, it led to the marker ions Fe(CN)(6)(3-/4-) crossing the lipid membrane and giving the redox reaction on the glassy carbon electrode (GCE). Experimental results suggested that the pore formation on supported bilayer lipid membrane was dependent on the concentration of nisin and it included three main concentration stages: low, middling, high concentration.

Liposome-mediated conformation transition of DNA detected by molecular probe: methyl green.

Recent studies have focused on the structural features of DNA-lipid assemblies. In this paper, we take methyl green (MG) as a probe molecule to detect the conformational change of DNA molecule induced by dimethyldioctadecylammonium bromide (DDAB) liposomes before the condensation process of DNA begins. DDAB-induced DNA topology changes were investigated by cyclic voltammetry (CV), circular dichroism (CD) and UV-VIS spectrometry. We find that upon binding to DNA, positively charged liposomes induce a conformational transition of DNA molecules from the native B-form to the C motif. Conformational transition in DNA results in the binding modes of MG to DNA, changing and being isolated from DNA to the solution. More stable complexes are formed between DNA and DDAB. That is also proved by the melting study of DNA.

Downhill kinetics of biomolecular interface binding: globally connected scenario.

We study the kinetics of the biomolecular binding process at the interface using energy landscape theory. The global kinetic connectivity case is considered for a downhill funneled energy landscape. By solving the kinetic master equation, the kinetic time for binding is obtained and shown to have a U-shape curve-dependence on the temperature. The kinetic minimum of the binding time monotonically decreases when the ratio of the underlying energy gap between native state and average non-native states versus the roughness or the fluctuations of the landscape increases. At intermediate temperatures, fluctuations measured by the higher moments of the binding time lead to non-Poissonian, non-exponential kinetics. At both high and very low temperatures, the kinetics is nearly Poissonian and exponential.

Ion channel behavior of amphotericin B in sterol-free and cholesterol- or ergosterol-containing supported phosphatidylcholine bilayer model membranes investigated by electrochemistry and spectroscopy.

Amphotericin B (AmB) is a popular drug frequently applied in the treatment of systemic fungal infections. In the presence of ruthenium (II) as the maker ion, the behavior of AmB to form ion channels in sterol-free and cholesterol- or ergosterol-containing supported phosphatidylcholine bilayer model membranes were studied by cyclic votammetry, AC impedance spectroscopy, and UV/visible absorbance spectroscopy. Different concentrations of AmB ranging from a molecularly dispersed to a highly aggregated state of the drug were investigated. In a fixed cholesterol or ergosterol content (5 mol %) in glassy carbon electrode-supported model membranes, our results showed that no matter what form of AmB, monomeric or aggregated, AmB could form ion channels in supported ergosterol-containing phosphatidylcholine bilayer model membranes. However, AmB could not form ion channels in its monomeric form in sterol-free and cholesterol-containing supported model membranes. On the one hand, when AmB is present as an aggregated state, it can form ion channels in cholesterol-containing supported model membranes; on the other hand, only when AmB is present as a relatively highly aggregated state can it form ion channels in sterol-free supported phosphatidylcholine bilayer model membranes. The results showed that the state of AmB played an important role in forming ion channels in sterol-free and cholesterol-containing supported phosphatidylcholine bilayer model membranes.