Effects of Different Physical Therapy Interventions in Improving Flexibility in University Students with Hamstring Tightness - A Systematic Review and Network Meta-analysis.

The aim of the present study was to identify the different interventions for hamstring flexibility among university students with hamstring tightness and to determine the better treatment method. Design: Systematic review and network meta-analysis. An electronic search of the databases: Medline, Pubmed, Cochrane, EMBASE, CINAHL, Physiotherapy Evidence Database (PEDro) was conducted. A total of 11 articles were included in the review. Of these articles, 02 were case-control studies, 02 were interventional pre-post studies and 07 were RCTs. The 07 RCTs were included for network meta-analysis. The findings of the initial network meta-analysis (NMA) which compared control i.e., no intervention with other interventions revealed that all the physical therapy interventions: stretching, electrotherapy combined with stretching, massage, dry needling and neurodynamic exercises combined with stretching and neurodynamics alone were superior to control. Since most studies included stretching as an intervention, a second NMA was conducted to compare the different physical therapy interventions with stretching. The results suggested that US-guided neuromodulation (WMD: -5.80, CI: -12.11, 0.51) had large effects on hamstring flexibility compared to stretching and stretching combined with electrotherapy i.e., cryotherapy and ultrasound (WMD: 0.25, CI: -1.14 to 1.64), MET (WMD: 3.10, CI: -3.28 to 9.48) and massage (WMD: 8.05, CI: -11.90 to 27.18) were inferior to stretching. To further investigate the effects of these interventions three meta-analysis were performed. The results revealed that stretching was more effective (SMD 2.27, 95% 0.72 to 3.81, p < 0.01) compared to control (no intervention). Neurodynamic exercises combined with stretching and neurodynamics alone were found to be superior to stretching alone ((SMD -0.69, 95% -1.35 to -0.03, p < 0.01) and stretching combined with electrotherapy was not significantly better than stretching alone ((SMD -0.07, 95% -1.00 to 0.87, p=0.88). Neurodynamic exercises combined with stretching and neurodynamics alone showed to be superior to the other physical therapy interventions in improving hamstring flexibility for hamstring tightness among university students, however, the reliability of the evidence is low.

Efficacy of a high-intensity home stretching device and traditional physical therapy in non-operative management of adhesive capsulitis - a prospective, randomized control trial.

BACKGROUND: Historically, in-person physical therapy serves as a foundational component of nonoperative treatment of adhesive capsulitis (AC). This study compares the effectiveness of an at-home high-intensity stretch (HIS) device to traditional physical therapy (PT) and to PT in combination with the HIS device. We hypothesize that the HIS device will be as effective as PT alone or as combination therapy in the first-line treatment of AC and use of the HIS device will exhibit improvement at higher rate. METHODS: Thirty-four patients with idiopathic adhesive capsulitis and a minimum of 12 months follow-up were included in this study. Patients were randomized into one of the three groups: HIS device, PT alone, or HIS device + PT. Passive range of motion (ROM), American Shoulder and Elbow Surgeons (ASES), and Simple Shoulder Test (SST) scores were measured. Additionally, patient satisfaction, compliance and complications were recorded. Paired t-test, ANOVA and Chi-squared tests were used in analysis. RESULTS: Final ROM in all planes improved for all groups compared to baseline (p < 0.001), with only HIS device group able to restore > 95% of contralateral ROM in all planes at final follow-up. Patients with PT alone were on average slowest to improve ROM from baseline, at 3 months, 6 months, and 1 year in all planes except internal rotation. ASES and SST scores improved for all groups when compared to baseline (p < 0.001). Use of HIS-device resulted in greater improvement in SST and ASES Total scores compared to PT alone (p = 0.045, and p = 0.048, respectively). CONCLUSIONS: Use of an at-home high-intensity stretching device for conservative treatment of idiopathic adhesive capsulitis improves outcomes in ROM and in ASES and SST scores both when used as an adjunct to physical therapy and when used alone. TRIAL REGISTRATION: The study protocol was registered at www. CLINICALTRIALS: gov (20/05/2022, NCT05384093).

Effects of Chronic Static Stretching on Maximal Strength and Muscle Hypertrophy: A Systematic Review and Meta-Analysis with Meta-Regression.

BACKGROUND: Increases in maximal strength and muscle volume represent central aims of training interventions. Recent research suggested that the chronic application of stretch may be effective in inducing hypertrophy. The present systematic review therefore aimed to syntheisize the evidence on changes of strength and muscle volume following chronic static stretching. METHODS: Three data bases were sceened to conduct a systematic review with meta-analysis. Studies using randomized, controlled trials with longitudinal (≥ 2 weeks) design, investigating strength and muscle volume following static stretching in humans, were included. Study quality was rated by two examiners using the PEDro scale. RESULTS: A total of 42 studies with 1318 cumulative participants were identified. Meta-analyses using robust variance estimation showed small stretch-mediated maximal strength increases (d = 0.30 p < 0.001) with stretching duration and intervention time as significant moderators. Including all studies, stretching induced small magnitude, but significant hypertrophy effects (d = 0.20). Longer stretching durations and intervention periods as well as higher training frequencies revealed small (d = 0.26-0.28), but significant effects (p < 0.001-0.005), while lower dosage did not reach the level of significance (p = 0.13-0.39). CONCLUSIONS: While of minor effectiveness, chronic static stretching represents a possible alternative to resistance training when aiming to improve strength and increase muscle size. As a dose-response relationship may exist, higher stretch durations and frequencies as well as long program durations should be further elaborated.

Comparison of Supervised versus Self-Administered Stretching on Bench Press Maximal Strength and Force Development.

PURPOSE: While there is reported superior effectiveness with supervised training, it usually requires specialized exercise facilities and instructors. It is reported in the literature that high-volume stretching improves pectoralis muscles strength under supervised conditions while practical relevance is discussed. Therefore, the study objective was to compare the effects of volume equated, supervised- and self-administered home-based stretching on strength performance. METHODS: Sixty-three recreational participants were equally assigned to either a supervised static stretching, home-based stretching, or control group. The effects of 15 min pectoralis stretching, 4 days per week for 8 weeks, were assessed on dynamic and isometric bench press strength and force development. RESULTS: While there was a large magnitude maximal strength increase (p < 0.001-0.023, ƞ2 = 0.118-0.351), force development remained unaffected. Dynamic maximal strength in both groups demonstrated large magnitude increases compared to the control group (p < 0.001-0.001, d = 1.227-0.905). No differences between the intervention group for maximal strength (p = 0.518-0.821, d = 0.101-0.322) could be detected. CONCLUSIONS: The results could potentially be attributed to stretch-induced tension (mechanical overload) with subsequent anabolic adaptations, and alternative explanatory approaches are discussed. Nevertheless, home-based stretching seems a practical alternative to supervised training with potential meaningful applications in different settings.

Darcy Forchhiemer imposed exponential heat source-sink and activation energy with the effects of bioconvection over radially stretching disc.

The Darcy-Forchheimer model is a commonly used and accurate method for simulating flow in porous media, proving beneficial for fluid separation, heat exchange, subsurface fluid transfer, filtration, and purification. The current study aims to describe heat and mass transfer in ternary nanofluid flow on a radially stretched sheet with activation energy. The velocity equation includes Darcy-Fochheimer porous media effects. The novelty of this study is enhanced by incorporating gyrotactic microorganisms which are versatile and in nanofluid can greatly improve the thermal conductivity and heat transfer properties of the base fluid, resulting in more efficient heat transfer systems. Furthermore, the governing PDEs are reduced to ODEs via appropriate similarity transformations. The influence of numerous parameters is expanded and physically depicted through the graphical illustration. As the Forchheimer number escalates, so do the medium's porosity and drag coefficient, resulting in more resistive forces and, as a result, lowering fluid velocity. It has been discovered that increasing the exponential heat source/sink causes convective flows that are deficient to transport heat away efficiently, resulting in a slower heat transfer rate. The concentration profile accumulates when the activation energy is large, resulting in a drop in the mass transfer rate. It is observed that the density of motile microorganisms increases with a rise in the Peclet number. Further, the results of the major engineering coefficients Skin-friction, Nusselt number, Sherwood number, and Microorganism density number are numerically examined and tabulated. Also, the numerical outcomes were found to be identical to the previous study.

Thermal and solutal transport by Cattaneo-Christov model for the magnetohydrodynamic Williamson fluid with joule heating and heat source/sink.

This article scrutinizes the 2-dimensional and boundary layer flow of magnetohydrodynamic Williamson fluid flowing on a stretchable surface with variable viscosity. The thermal and solutal rates are examined through the Cattaneo-Christov model with Joule heating, heat source/sink, and chemical reaction. The authors are motivated to conduct this study because of its practical and scientific significance in various processes, including polymer processing, textile industries, food industries, solar energy, biomedical science, wind turbine blades, oil spill clean-up, metal rolling, and forging. With the mentioned assumptions, the partial differential equations are achieved by using the basic governing laws, including momentum law, energy law, and concentration law. This non-linear system of equations is transmuted into ordinary differential equations by taking similarity transformations. The main novelty behind the conduction of this work is the numerical technique, namely the 'Adams-Milne (Predictor-Corrector)' method along with the Runge-Kutta technique on Matlab software, which has not previously been studied by any researcher in the literature. The analytical solution of the determined equations is not possible due to their highly non-linear nature; therefore the multistep numerical method namely the 'Adams-Milne (Predictor-Corrector)' method, along with the Runge-Kutta technique is used to determine the numerical results. The outcomes are noted due to numerous parameters for velocity, temperature, and concentration profiles. The explanation of graphical and numerical results is discussed here. The graphical impression of the Williamson parameter reveals that the velocity and temperature curves diminish for higher inputs of this parameter. The movement of fluid shows the declining behavior for the Hartmann number and viscosity parameter. The solutal and thermal findings due to Cattaneo-Christov heat and mass relaxation coefficients mark the reducing behaviour in respective field. The rise in reaction coefficient decreases the mass distribution. The analyses of comparison of results are also presented here.

Effects of chronic static stretching interventions on jumping and sprinting performance-a systematic review with multilevel meta-analysis.

When improving athletic performance in sports with high-speed strength demands such as soccer, basketball, or track and field, the most common training method might be resistance training and plyometrics. Since a link between strength capacity and speed strength exists and recently published literature suggested chronic stretching routines may enhance maximum strength and hypertrophy, this review was performed to explore potential benefits on athletic performance. Based on current literature, a beneficial effect of static stretching on jumping and sprinting performance was hypothesized. A systematic literature search was conducted using PubMed, Web of Science and Google scholar. In general, 14 studies revealed 29 effect sizes (ES) (20 for jumping, nine for sprinting). Subgroup analyses for jump performance were conducted for short- long- and no stretch shortening cycle trials. Qualitative evaluation was supplemented by performing a multilevel meta-analysis via R (Package: metafor). Significant positive results were documented in six out of 20 jump tests and in six out of nine sprint tests, while two studies reported negative adaptations. Quantitative data analyses indicated a positive but trivial magnitude of change on jumping performance (ES:0.16, p = 0.04), while all subgroup analyses did not support a positive effect (p = 0.09-0.44). No significant influence of static stretching on sprint performance was obtained (p = 0.08). Stretching does not seem to induce a sufficient stimulus to meaningfully enhance jumping and sprinting performance, which could possibly attributed to small weekly training volumes or lack of intensity.

Investigation on the Correlation between Biaxial Stretching Process and Macroscopic Properties of BOPA6 Film.

Biaxially oriented polyamide 6 (BOPA6) films were prepared by extrusion casting and biaxial stretching with polyamide 6. The effects of different biaxially oriented on the macroscopic properties of BOPA6 were investigated by characterizing the rheological, crystallization, optical, barrier and mechanical properties. The results show that the increase of stretching temperature leads to the diffusion and regular stacking rate of BOPA6 chain segments towards crystal nuclei increases, the relative crystallinity increases, reaching 27.87% at 180 °C, and the mechanical strength and optical performance decrease. Heat-induced crystallization promotes the transformation of ß-crystals to α-crystals in BOPA6, resulting in a more perfect crystalline structure and enhancing oxygen barrier properties. BOPA6 chains are oriented, and strain-induced crystallization (SIC) occurs during the biaxial stretching. Further increasing the stretch ratio, the relative crystallinity increased to 30.34%. The machine direction (MD) and transverse direction (TD) tensile strength of BOPA6 (B-33) are nearly two times higher than the unstretched film, reaching 134.33 MPa and 155.28 MPa, respectively. In addition, the permeation decreases to 57.61 cc·mil/(m2 day), and the oxygen barrier performance has improved by nearly 30% compared to the sample B-22. BOPA6 has a high storage modulus at a high stretching rate (300%/s). Rapid chain relaxation would promote the molecular chain disorientation, destroy the entangled network of the molecular chain, and lead to a decrease in tensile strength, reducing to about 110 MPa.

Innovative Use of Mouth Props/Bite Blocks in Postoperative Mouth Opening Exercises.

Context: Postoperative jaw physiotherapy in the form of mouth opening exercises is an integral part of surgical treatment in oral submucous fibrosis and temporomandibular joint ankylosis. The literature has outlined multiple physical therapy modalities and modifications to aid in assisted mouth-opening exercises. Purpose: To overcome shortcomings associated with the use of conventional devices, the authors describe an innovative use and modification of a prefabricated soft silicone bite block/mouth prop as an adjunct to the devices to aid in achieving optimal mouth opening.

Microbiological Quality and Safety of Brazilian Mozzarella Cheese During Production Stages.

This study assessed the microbiological quality and safety of mozzarella during various production stages in northern Tocantins, Brazil, by identifying critical biological points in the industrial environment within a tropical climatic region. Batches of mozzarella were evaluated, from raw milk to primary packaging, with a shelf life of 120 d at 4°C. Indicator microorganisms were quantified, and through microbiological and biomolecular approaches, Salmonella spp. and Listeria monocytogenes were identified. In addition, the toxigenic potential of coagulase-positive staphylococci (CPS) was characterized. Results indicated that the raw milk used for mozzarella production had low microbiological quality; pasteurization of raw milk effectively eliminated all identified pathogens and reduced microbiological counts (p > 0.05). An increase in bacterial counts (>2 log colony-forming unit [CFU]/g) and recontamination with Salmonella spp. and CPS, which potentially produce staphylococcal enterotoxin B, were observed during milk coagulation and curd draining. Stretching of the fermented curd reduced the enterobacteria, total coliforms, and Escherichia coli median values by 2.56, 2.64, and 2.3 log CFU/mL, respectively. Similarly, brining the pieces by immersion reduced the quantity of enterobacteria and total coliforms by 2.3 and 1.6 log CFU/mL, respectively. Of interest, in the freshly finished product, Salmonella spp. was present but L. monocytogenes was absent; however, after the shelf-life period, L. monocytogenes was present but Salmonella spp. was absent. Considering the environmental conditions that can promote the multiplication and preservation of pathogens and spoilage of dairy products in tropical climates, it is necessary to review operational hygiene procedures, particularly in milk coagulation vats and fermentation tables. This will ensure the production of high-quality mozzarella cheese with a reduced consumption risk.

Development of a multifunctional bioreactor to evaluate the promotion effects of cyclic stretching and electrical stimulation on muscle differentiation.

A multifunctional bioreactor was fabricated in this study to investigate the facilitation efficiency of electrical and mechanical stimulations on myogenic differentiation. This bioreactor consisted of a highly stretchable conductive membrane prepared by depositing polypyrrole (PPy) on a flexible polydimethylsiloxane (PDMS) film. The tensile deformation of the PPy/PDMS membrane can be tuned by adjusting the channel depth. In addition, PPy/PDMS maintained its electrical conductivity under continuous cyclic stretching in the strain range of 6.5%-13% for 24 h. This device can be used to individually or simultaneously perform cyclic stretching and electrical stimulation. The results of single stimulation showed that either cyclic stretching or electrical stimulation upregulated myogenic gene expression and promoted myotube formation, where electrical stimulation improved better than cyclic stretching. However, only cyclic stretching can align C2C12 cells perpendicular to the stretching direction, and electrical stimulation did not affect cell morphology. Myosin heavy chain (MHC) immunostaining demonstrated that oriented cells under cyclic stretching resulted in parallel myotubes. The combination of these two stimuli exhibited synergetic effects on both myogenic gene regulation and myotube formation, and the incorporated electrical field did not affect the orientation effect of the cyclic stretching. These results suggested that these two treatments likely influenced cells through different pathways. Overall, the simultaneous application of cyclic stretching and electrical stimulation preserved both stimuli's advantages, so myo-differentiation can be highly improved to obtain abundant parallel myotubes, suggesting that our developed multifunctional bioreactor should benefit muscle tissue engineering applications.

What are optimum cycles for immediate primary closure of large cutaneous defects?

BACKGROUND: In the reconstruction of large complex cutaneous wounds, a myriad of mechanical devices has been designed to facilitate primary wound closure. However, there is a dearth of studies elucidating how best to achieve optimum use and efficiency of skin stretching (SS) when using the device for immediate primary closure of defects. METHODS: Skin defect wounds (7 × 7 cm) were prepared on the back of three Bama miniature pigs. A total of 15 cycles of SS (cycle loading) were subsequently performed on the skin edges of the wound by EASApprox® SS system. Then, the changes in equidistant points were recorded after each cycle. After the SS test, all wounds were sutured under low tension. RESULTS: Skin elongation was observed at all equidistant points on the back wounds of three Bama miniature pigs. Up to an additional 1.10 to 3.75 cm of tissue was garnered. The maximum skin elongation was typically achieved within eight cycles of stretching and relaxation. Beyond this range, additional stretching cycles did not result in further skin extension. CONCLUSION: There may be a close link between mobilization range and the times of acute cyclic stretching (cycle loading) during the process of primary wound closure. However, larger studies are required to further evaluate the accuracy and effectiveness.

Assessing the Role of Yarn Placement in Plated Knit Strain Sensors: A Detailed Study of Their Electromechanical Properties and Applicability in Bending Cycle Monitoring.

In this study, we explore how the strategic positioning of conductive yarns influences the performance of plated knit strain sensors fabricated using commercial knitting machines with both conductive and non-conductive yarns. Our study reveals that sensors with conductive yarns located at the rear, referred to as 'purl plated sensors', exhibit superior performance in comparison to those with conductive yarns at the front, or 'knit plated sensors'. Specifically, purl plated sensors demonstrate a higher sensitivity, evidenced by a gauge factor ranging from 3 to 18, and a minimized strain delay, indicated by a 1% strain in their electromechanical response. To elucidate the mechanisms behind these observations, we developed an equivalent circuit model. This model examines the role of contact resistance within varying yarn configurations on the sensors' sensitivity, highlighting the critical influence of contact resistance in conductive yarns subjected to wale-wise stretching on sensor responsiveness. Furthermore, our findings illustrate that the purl plated sensors benefit from the vertical movement of non-conductive yarns, which promotes enhanced contact between adjacent conductive yarns, thereby improving both the stability and sensitivity of the sensors. The practicality of these sensors is confirmed through bending cycle tests with an in situ monitoring system, showcasing the purl plated sensors' exceptional reproducibility, with a standard deviation of 0.015 across 1000 cycles, and their superior sensitivity, making them ideal for wearable devices designed for real-time joint movement monitoring. This research highlights the critical importance of conductive yarn placement in sensor efficacy, providing valuable guidance for crafting advanced textile-based strain sensors.

Application of mobility training methods in sporting populations: A systematic review of performance adaptations.

This systematic review investigates influences of mobility training in sporting populations on performance outcomes. The search strategy involved Embase, MEDLINE Complete, Sports Discus and manual search from inception to March 2022. Mobility training studies with a minimum three-week, or 10-session duration in healthy sporting populations of any age were included. Twenty-two studies comprising predominantly young adult or junior athletes were analysed from 319 retrieved articles. Performance outcomes were strength, speed, change of direction, jumping, balance, and sport-specific skills. Fifteen studies randomized participants with only four indicating systematic allocation concealment and blinding of outcomes assessors in only one study. In 20 of 22 studies mobility training was of some benefit or helped to maintain sports performance to a larger degree than control conditions. Control conditions, which were generally no activity conditions, were primarily non-significant. The majority of evidence suggests that a range of mobility training methods may improve key sports performance variables or are unlikely to impair performance over time. Therefore, coaches can consider the potential benefits of including comprehensive mobility programmes with minimal risk of impairing performance. Higher-quality studies in homogenous populations are necessary to confirm performance changes.

Perception-Action Approach Versus Standard Care for Infants With Congenital Muscular Torticollis: A Pilot Single-Blind Randomized Controlled Trial.

OBJECTIVE: The purposes of this pilot study were to compare short-term outcomes of the Perception-Action Approach (P-AA) and standard care based on 5 components of first-choice interventions listed in the congenital muscular torticollis (CMT) clinical practice guideline. Changes in postural alignment, symmetrical use of both sides of the body during movement and play, gross motor development, and behavior observed during therapy were considered. METHODS: Thirty-two participants were enrolled in a 2-group (P-AA and standard care) randomized, single-blind trial with pre-posttest measures. Participants were infants with CMT, age range 5 to 35 weeks at enrollment. Outcome measures administered at initial and final evaluations included still photography, arthrodial goniometry, Muscle Function Scale, Alberta Infant Motor Scale, and Functional Symmetry Observation Scale. Participants in both groups attended 3 intervention sessions. Their behavior exhibited during therapy was compared using the Therapy Behavior Scale Version 2.2. RESULTS: Data collection was interrupted by the COVID-19 pandemic lockdown. Twenty-four infants completed the study (10 in P-AA and 14 in the standard care group). There were no significant differences between the groups in performance at initial and final evaluations. Both groups improved on most outcome measures. The P-AA group made greater gains on the Functional Symmetry Observation Scale, and the Therapy Behavior Scale Version 2.2 scores were higher in the P-AA group; however, these results did not reach significance. CONCLUSION: Results suggest that similar short-term outcomes may be obtained in infants with CMT undergoing P-AA and standard care interventions. Definitive conclusions regarding the efficacy of the P-AA in infants with CMT cannot be made at this time. Nevertheless, the pilot findings provide valuable preliminary data for a future efficacy trial, which will require funding. IMPACT: This was the first randomized controlled trial to provide evidence for use of P-AA intervention in infants with CMT. LAY SUMMARY: Compared to standard treatment, the Perception-Action Approach (P-AA) provided similar short-term benefits to infants with congenital muscular torticollis. The P-AA group participants demonstrated higher symmetry and behavior scores, which needs to be confirmed in a larger future study.

Efficacy of trigger point injection therapy in noncardiac chest pain: A randomized controlled trial.

Objectives: This study aimed to compare the effects of trigger point injections and stretching exercises in patients with noncardiac chest pain (NCCP) associated with myofascial pain syndrome. Patients and methods: This prospective randomized controlled trial included 50 patients with noncardiac chest pain and trigger points in the pectoralis muscles between October 2019 and June 2020. The patients were randomly assigned to receive trigger point injections into the pectoralis muscles and exercise (n=25; 15 males, 10 females; mean age: 42.8±9.2 years; range, 25 to 57 years) or only perform exercise (n=25; 11 males, 14 females; mean age: 41.8±11.2 years; range, 18 to 60 years). The primary outcome was pain intensity at the first month and three months after the first treatment session, measured using the Visual Analog Scale from 0 to 100. The secondary outcome was the Nottingham Health Profile score. Results: Treatment with stretching exercises and trigger point injection resulted in significant pain reduction compared to stretching exercises alone, and the reduction was persistent at the three-month follow-up (p<0.001). A between-group comparison showed no significant difference in the Nottingham Health Profile (p=0.522). Complications related to the procedure or severe adverse events attributable to treatment were not reported. Conclusion: Trigger point injection combined with stretching exercises is an efficient treatment for noncardiac chest pain related to myofascial pain syndrome compared to exercise treatment alone.

Experience in the treatment of long-gap esophageal atresia by intraluminal esophageal stretching elongation.

Objective: To summarize the experience with intraluminal esophageal stretching elongation (ILESE) in the successful treatment of long-gap esophageal atresia (LGEA) at a single center. Methods: Clinical data of 68 neonates who underwent LGEA between February 2015 and January 2022 were retrospectively analyzed. Four patients died of multiple associated severe malformations and did not undergo ILESE. Esophageal anastomosis was successfully performed in 60 cases (93.75%) and failed in 4 cases (6.25%) treated with ILESE. The ILESE techniques, esophageal reconstruction, results, postoperative complications, and follow-up treatment were analyzed. Results: The beginning time of performing ILESE preoperation was 53.4 ± 39.4 days after birth, and the age of esophageal reconstruction was 122.2 ± 70.3 days after birth in 60 cases. The gap length of proximal and distal esophageal segments which were evaluated the first time at admission was 4.8 ± 1.3 vertebral bodies, whereas the gap before anastomosis was -0.46 ± 0.90 vertebral bodies. Among the patients with esophageal primary-anastomosis, 55 received thoracoscopic surgery, and 5 underwent thoracotomy in the early stage. Of the 60 children with ILESE, 58 underwent end-to-end esophagostomy, of which 17 cases were combined with circular esophagotomy (livaditis), and 2 cases of esophageal lengthening were combined with the reversal of the ligulate loop of the proximal esophagus (flap). Overall, 59 cases were cured (98.3%), and 1 patient died of respiratory failure postoperatively. All patients were followed up for 7-96 months. Postoperative anastomotic leakage occurred in 16 patients (27.6%), all of whom were successfully treated conservatively. Anastomotic stenosis occurred in 49 cases (83.1%), all of which were successfully managed by non-surgical treatment, including 12.7 ± 9.3 times of esophageal balloon dilatation and 2 cases of stent dilatation. Gastroesophageal reflux occurred in 44 patients (74.6%), including associated or acquired esophageal hiatal hernia in 22 patients, and Nissen fundoplication was performed in 17 patients. Conclusions: ILESE is an effective method for prolonging the proximal and distal esophagus of the LGEA to reconstruct esophageal continuity using its esophageal tissue, with an efficacy rate of 93.75%. Postoperative anastomotic stricture and gastroesophageal reflux are common and require long-term, standardized follow-up and treatment.

Does the sequence of plyometric and dynamic stretching exercises influence subsequent sprint performance? A randomized crossover intervention study.

The objectives of this study were to evaluate the acute effects of the sequence order of drop jumps (DJ) and dynamic stretching (DS) on sprinting performances in competitive athletes and to investigate the relationships between post-activation performance enhancement (PAPE) in sprint performance and lower limb power. Thirteen male jumpers and sprinters participated in this study (19 ± 2 years; 177 ± 7 cm; 71.7 ± 5.6 kg). Through a randomized crossover design, the athletes were exposed to three different conditions after a standardized warm-up: DS+DJ, DJ+DS, and control. Sprinting performance over 40 m was analysed with consideration of initial (0 to 20 m) and final acceleration (20 to 40 m) phases. The effect of intervention was examined by two-way repeated-measures of ANOVA. Pearson's correlation test was used to determine the association between PAPE during sprinting and jump performance. There was no effect of any factor on 40-m sprint performance. Meanwhile, the performance at 20-40 m was higher after the DS+DJ condition when compared to baseline (8.79 ± 0.43 vs. 8.91 ± 0.35 m/s; p = 0.015). However, the initial acceleration was worsened in the DJ+DS condition when compared to baseline (6.26 ± 0.25 vs. 6.22 ± 0.26 m/s; p = 0.002). There was a negative correlation between CMJ height and the improvement in final acceleration (r = -0.741; p = 0.004). The use of DS prior to DJ is an effective strategy to improve performance in the final acceleration phase (20-40 m). The athletes with lower levels of lower limb power benefited the most from this PAPE strategy.

Tetraphenylethene-modified polysiloxanes: Synthesis, AIE properties and multi-stimuli responsive fluorescence.

Herein, polysiloxane-based aggregation-induced emission (AIE) polymers and rubbers were prepared which display interesting multi-stimuli responsive fluorescence. TPE-modified polydimethylsiloxanes (PDMS-TPE) as polysiloxane-based AIE polymers were synthesized through Heck reaction of bromo-substituted tetraphenylethene (TPE-Br) and vinyl polysiloxanes. As expected, TPE moiety endows the modified polysiloxane with typical AIE behavior. However, limited by the long polymer chains, the aggregation process of PDMS-TPE shows obvious differences compared with the small molecule TPE-Br. The fluorescence of PDMS-TPE in THF/H2O starts to increase when the H2O fraction (fw) is 70% while TPE-Br is nearly non-luminous until the fw is up to 99%. The fluorescence intensity ratio (I/I0) of PDMS-TPE in the aggregated state and dispersed state is over 1300, greater than that of TPE-Br (I/I0 = 380). More importantly, the exceptional thermal motion of Si-O-Si chains and AIE characteristic of TPE moiety work together, enabling PDMS-TPE to show specific temperature-dependent fluorescence with a wider response range of room temperature to 190°C, which is distinguished from TPE-Br. And such fluorescence responsiveness possess good fatigue-resistance. Furthermore, fluorescent silicone rubbers, r-PDMS-TPE were prepared by using PDMS-TPE as additive of the base gum. They display interesting solvent-controllable fluorescence and higher tensile strength (4.42 MPa) than the control sample without TPE component (1.96 MPa). Notably, a unique stretching-enhanced emission (SEE) phenomenon is observed from these TPE-modified silicone rubbers. When being stretched, the rubbers' fluorescent emission intensity could increase by 143%.

Hierarchically Biomimetic Scaffolds with Anisotropic Micropores and Nanotopological Patterns to Promote Bone Regeneration via Geometric Modulation.

Structural engineering is an appealing means to modulate osteogenesis without the intervention of exogenous cells or therapeutic agents. In this work, a novel 3D scaffold with anisotropic micropores and nanotopographical patterns is developed. Scaffolds with oriented pores are fabricated via the selective extraction of water-soluble polyethylene oxide from its poly(ε-caprolactone) co-continuous mixture and uniaxial stretching. The plate apatite-like lamellae are subsequently hatched on the pore walls through surface-induced epitaxial crystallization. Such a unique geometric architecture yields a synergistic effect on the osteogenic capability. The prepared scaffold leads to a 19.2% and 128.0% increase in the alkaline phosphatase activity of rat bone mesenchymal stem cells compared to that of the scaffolds with only oriented pores and only nanotopographical patterns, respectively. It also induces the greatest upregulation of osteogenic-related gene expression in vitro. The cranial defect repair results demonstrate that the prepared scaffold effectively promotes new bone regeneration, as indicated by a 350% increase in collagen I expression in vivo compared to the isotropic porous scaffold without surface nanotopology after implantation for 14 weeks. Overall, this work provides geometric motifs for the transduction of biophysical cues in 3D porous scaffolds, which is a promising option for tissue engineering applications.