Factors influencing and long-term effects of manual myotomy phenomenon during physiotherapy for congenital muscular torticollis.

PURPOSE: To investigate the factors influencing and long-term effects of manual myotomy (MM) occurring during physiotherapy for congenital muscular torticollis (CMT). METHODS: We retrospectively collected the clinical data of children with CMT receiving physiotherapy between 2008 and 2018. The children were divided into manual myotomy (MM) and non-manual myotomy (NMM) groups according to whether MM occurred during treatment. We assessed physiotherapy outcomes in children with CMT using craniofacial asymmetry parameters and the Cheng-Tang rating score. By measuring the ear-eye distance, ear-nose distance, eye-mouth distance, ear-mouth distance, half-head circumference, and half-head top at two sides to evaluate craniofacial asymmetry. Based on the Cheng-Tang assessment criteria, we recorded the range of rotation, range of lateral flexion, the status of the contracted muscle, the hardness of the mass, the extent of head tilting during activities and sleeping, the status of daily activities, face size, type of head shape, cranial changes, and subjective head tilting to assess the effectiveness of treatment. Clinical data and outcome indicators (craniofacial asymmetry parameters and Cheng-Tang rating score) were compared. RESULTS: The MM group had a significantly higher total Cheng-Tang rating score than the NMM group (P < 0.05). Age at initial physiotherapy session was the risk factor for MM during physiotherapy. CONCLUSION: Children with CMT developing MM during physiotherapy generally have a good outcome, although we do not recommend MM as a goal of treatment. Physiotherapists should understand this phenomenon, assess relevant factors to predict risk, and carefully observe treatment to prevent possible complications.

Negatively interactive effect of chromium and cadmium on obesity: Evidence from adults living near ferrochromium factory.

BACKGROUND: Researchers have reported that chromium (Cr) exposure may be associated with metabolism of glucose and lipids in residents living in a long-term Cr polluted area. Previous statistical analysis is mainly focused on individual chromium exposure. Furtherly, we aim to investigated the independent, combined, and interaction effects of the co-exposure of urine Cr (UCr) with cadmium (UCd), lead (UPb) and manganese (UMn) on body mass index (BMI), waist circumference, and the risk of overweight and abdominal obesity. METHOD: We enrolled 1187 participants from annual surveys between 2017 and 2019. Heavy metal concentrations in urine were standardized using covariate-adjusted urine creatinine levels. Multiple linear/logistic regression models were applied to measure the single effect of urine heavy metal concentration on the outcomes. The quantile-based g-computation (g-comp) model was used to evaluate the combined effect of metal mixture on the outcomes and to compare the contribution of each metal. Both additive and multiplicative interactions were measured for UCr with UCd, UPb, UMn on the outcomes. Analysis was performed on the overall population and stratified by smoking habit. RESULTS: For the overall study population, UCr was positively associated with BMI (p trend = 0.023) and waist circumference (p trend = 0.018). For smoking participants, the g-comp model demonstrated that the metal mixture was negatively associated with BMI, with UCr and UCd contributing the most in the positive and negative direction. A negative additive interaction was observed between UCr and UCd on BMI and abdominal obesity. We did not observe a significant interaction effect of UCr with UPb or UMn. CONCLUSION: Our study indicated that Cr and Cd exposure may be associated with BMI and waist circumference, with combined and interaction effects of the heavy metals noted. Further epidemiological and experimental researches could simultaneously consider single and complex mixed exposure to verify the findings and biological mechanisms.

Chitosan-grafted-phenolic acid copolymers against Shewanella putrefaciens by disrupting the permeability of cell membrane.

Chitosan (CS) is a kind of high molecular polymer with antibacterial properties. A copolymer with high bacteriostatic activity can be formed by grafting phenolic acid compounds into the chitosan molecular chain, which can inhibit the growth of dominant spoilage bacteria in aquatic products. The study aimed to investigate the antibacterial effect and mechanism of chitosan-grafted-phenolic acid copolymers on Shewanella putrefaciens (S. putrefaciens). CS-grafted-protocatechuic acid (CS-g-PA) and CS-grafted-gallic acid (CS-g-GA) were attained by EDC/NHS coupling reaction. The antibacterial tests indicated that CS-g-PA and CS-g-GA had the same minimum inhibitory concentration (MIC) (1.25 mg/mL) and minimum bactericidal concentration (MBC) (5.0 mg/mL) against S. putrefaciens. According to the change trend of growth curve, the growth of S. putrefaciens was significantly restrained under 2MIC graft copolymers (P < 0.05). Moreover, the increment of alkaline phosphatase (AKPase) activity and electrical conductivity demonstrated that the cell wall and membrane permeability of S. putrefaciens were damaged respectively. In addition, the increase of lactate dehydrogenase (LDHase) activity, protein and nucleic acid absorbance and the decrease of adenosine triphosphatase (ATPase) activity suggested that the cell membrane was incomplete and poor fluidity. The irregular shape of bacteria and the outflow of intercellular contents were also observed from scanning electron microscope (SEM). The above results manifested a great potential of CS-g-PA and CS-g-GA for use as food preservatives to aquatic products.

Effects of air-abrasion pressure on mechanical and bonding properties of translucent zirconia.

OBJECTIVES: The purpose of this in vitro study was to investigate the effects of different air-abrasion pressures on flexural strength and shear bond strength of a translucent zirconia. MATERIALS AND METHODS: The translucent zirconia surface was treated with 50 µm abrasive alumina particles at different pressure: 0.1 MPa; 0.2 MPa; 0.3 MPa; 0.4 MPa; 0.5 MPa; untreated specimens were used as control group (n = 33). For each group, three-point bending test was used to evaluate the flexural strength, and surface characterizations were analyzed. Following adhesive bonding and water storage for 24 h, specimens were subdivided into groups baseline and aged (5000 thermocycles). Then, shear bond strength was measured and failure mode was recorded. Statistical analysis was performed with one-way ANOVA and Tukey test (α = 0.05). RESULTS: Increasing air-abrasion pressure (0.3 MPa, 0.4 MPa, and 0.5 MPa) decreased the flexural strength. Higher air-abrasion pressure resulted in rougher zirconia surfaces and caused more microcracks. The highest shear bond strength was obtained for zirconia surfaces abraded at 0.2 MPa (15.88 ± 2.70 MPa) and 0.3 MPa (14.32 ± 1.12 MPa). Aging did not decrease the strength for all groups except control group (p < 0.001). CONCLUSIONS: Air-abrasion with 50 µm abrasive alumina particles at 0.2 MPa could achieve good strength for translucent zirconia ceramics while maintaining adequate and durable bonding with resin cement. CLINICAL RELEVANCE: A total of 0.2 MPa is recommended for air-abrasion procedure applied before a dental restoration fabricated with translucent zirconia is bonded to resin cement.

Effects of thermal cycling on bonding properties of novel low-shrinkage resin adhesive.

OBJECTIVES: The current study aimed to investigate the bonding properties of a novel low-shrinkage resin adhesive containing expanding monomer and epoxy resin monomer after thermal cycling aging treatment. METHODS: Expanding monomer of 3,9-diethyl-3,9-dimethylol-1,5,7,11-tetraoxaspiro-[5,5] undecane (DDTU) as an anti-shrinkage additive and unsaturated epoxy monomer of diallyl bisphenol A diglycidyl ether (DBDE) as a coupling agent were synthesized. A blend of DDTU and DBDE at a mass ratio of 1∶1, referred to as "UE", was added into the resin matrix at the mass fraction of 20% to prepare a novel low-shrinkage resin adhesive.Then, the methacrylate resin adhesive without UE was used as the blank control group, and a commercial resin adhesive system was selected as the commercial control group. Moreover, the resin-dentin bonding and micro-leakage testing specimens were prepared for the thermal cycling aging treatment. The bonding strength was tested, the fracture modes were calculated, the bonding fracture surface was observed by scanning electron microscope (SEM), and the dye penetration was used to evaluate the tooth-restoration marginal interface micro-leakage. All the data were analyzed statistically. RESULTS: After aging, the dentin bonding strength of the experimental group was (19.20±1.03) MPa without a significant decrease (P>0.05), that of the blank control group was (11.22±1.48) MPa with a significant decrease (P<0.05) and that of the commercial control group was (19.16±1.68) MPa without a significant decrease (P>0.05). The interface fracture was observed as the main fracture mode in each group after thermal cycling by SEM. The fractured bonding surfaces of the experimental group often occurred on the top of the hybrid layer, whereas those of the blank and commercial control groups mostly occurred on the bottom of the hybrid layer. Micro-leakage rating counts of specimens before and after thermal cycling were as follows: the experimental group was primarily 0 grade, thereby indicating that a relatively ideal marginal sealing effect could be achieved (P>0.05); meanwhile, the blank control group was primarily 1 grade, and the penetration depth of dye significantly increased after thermal cycling (P<0.05); the commercial control group was primarily 0 grade without statistical difference before and after thermal cycling (P>0.05), while a significant difference was observed between the commercial control group and experimental group after thermal cycling (P<0.05). CONCLUSIONS: The novel low-shrinkage resin adhesive containing 20%UE exhibited excellent bonding properties even after thermal cycling aging treatment, thereby showing a promising prospect for dental application.

Development of low-shrinkage dental adhesives via blending with spiroorthocarbonate expanding monomer and unsaturated epoxy resin monomer.

Polymerization shrinkage is one of the main drawbacks of dental resin adhesives. In this study, spiroorthocarbonate expanding monomer 3,9-diethyl-3,9-dimethylol -1,5,7,11-tetraoxaspiro-[5,5] undecane (DDTU) and unsaturated epoxy resin monomer Diallyl bisphenol A diglycidyl ether (DBDE) were synthesized and utilized as anti-shrinkage-coupling additive of methacrylate-based adhesives. Polymerization process and physicochemical properties including double bond conversion, polymerization shrinkage, compatibility, mechanical performance, thermal stability, contact angle, shear bond strength and cytotoxicity were characterized. Results indicated that adhesives containing anti-shrinkage-coupling additive had reduced volume shrinkage, improved compatibility and enhanced shear bond strength. When the amount of additive was 20 wt%, the volume shrinkage was decreased by 45.8% (4.17 ± 0.32%) and the shear bond strength was increased by 49.6% (19.64 ± 0.99 MPa). The results also showed that the use of additive had no adversely affect on double bond conversion and cytotoxicity. Therefore, novel low-shrinkage resin adhesives were prepared via blending with spiroorthocarbonate expanding monomer and unsaturated epoxy resin monomer.

Identifying dermal exposure as the dominant pathway of children's exposure to flame retardants in kindergartens.

Exploration of multiple sources of brominated (BFRs) and organophosphate flame retardants (OPFRs) for children promotes the understanding of exposure pathways and health risk. 10 BFRs and 9 OPFRs were measured in skin wipes from hands, forehead, and arms of 30 children, and surface wipe samples from sills, toys, desks and floors, and indoor air samples of kindergartens from Xinxiang, China. Higher ∑9OPFRs concentrations were observed in the forehead (1840 ng/m2), followed by hand (1420 ng/m2) and arm wipes (1130 ng/m2), and the ∑8BFRs concentrations in forehead, hand and arm wipes were 116, 315 and 165 ng/m2, respectively. The total concentration of OPFRs and BFRs in floor wipes (66.1 and 24.5 ng/m2) were lower than those in toy (205 and 535 ng/m2), sill (227 and 30.1 ng/m2) and desk (84.4 and 139 ng/m2) wipes. Concentrations of FRs in forehead wipes were significantly correlated with those in gaseous air (p < 0.05), moderate correlations were found between the hand wipes and surface wipes (p = 0.054). We estimated the daily average dosages (DADs) of children exposure to FRs via multiple pathways. Compared to DADs via inhalation and hand-to-mouth transfer, dermal exposure was determined to be the predominant exposure pathway to ∑9OPFRs and ∑8BFRs.

Review on Development and Dental Applications of Polyetheretherketone-Based Biomaterials and Restorations.

Polyetheretherketone (PEEK) is an important high-performance thermoplastic. Its excellent strength, stiffness, toughness, fatigue resistance, biocompatibility, chemical stability and radiolucency have made PEEK attractive in dental and orthopedic applications. However, PEEK has an inherently hydrophobic and chemically inert surface, which has restricted its widespread use in clinical applications, especially in bonding with dental resin composites. Cutting edge research on novel methods to improve PEEK applications in dentistry, including oral implant, prosthodontics and orthodontics, is reviewed in this article. In addition, this article also discusses innovative surface modifications of PEEK, which are a focus area of active investigations. Furthermore, this article also discusses the necessary future studies and clinical trials for the use of PEEK in the human oral environment to investigate its feasibility and long-term performance.

[Development of novel self-adhesive resin cement with antibacterial and self-healing properties].

OBJECTIVE: This study aimed to develop novel self-adhesive resin cement with antibacterial and self-healing properties. Furthermore, the dentin bonding strength, mechanical properties, self-healing efficiency, and antibacterial property of the developed cement were measured. METHODS: Novel nano-antibacterial inorganic fillers that contain quaternary ammonium salts with long-chain alkyls were synthesized. These fillers were added into self-adhesive resin cement containing self-healing microcapsules at mass fractions of 0, 2.5%, 5.0%, 7.5%, or 10.0%. The dentin shear bonding test was used to test the bonding strength, whereas the flexural test was used to measure the flexural strength and elastic modulus of the cement. The single-edge V-notched beam method was used to measure self-healing efficiency, and human dental plaque microcosm biofilms were chosen to calculate the antibacterial property. RESULTS: The dentin shear bond strength significantly decreased when the mass fraction of the nano-antibacterial inorganic fillers in the novel cement reached 7.5% (P<0.05). The incorporation of 0, 2.5%, 5.0%, 7.5%, or 10.0% mass fraction of nano-antibacterial inorganic fillers did not adversely affect the flexural strength, elastic modulus, fracture toughness, and self-healing efficiency of the cement (P>0.1). Resin cement containing 2.5% mass fraction or more nano-antibacterial inorganic fillers significantly inhibited the metabolic activity of dental plaque microcosm biofilms, indicating strong antibacterial potency (P<0.05). CONCLUSIONS: The novel self-adhesive resin cement exhibited promising antibacterial and self-healing properties, which enable the cement to be used for dental applications.