Correlation of magnetic resonance (EPR, ssNMR) parameters and crystal-microstrain in marbles as a tool to probe their provenance.

Marbles constitute a significant family of materials, for antiquities, as well as modern constructions. Herein, we have studied Greek marbles, using electron paramagnetic resonance (EPR) and solid-state nuclear magnetic resonance (ssNMR) spectroscopies, focusing on their structural microenvironment. Spin-Hamiltonian parameters derived from EPR spectra of naturally occurring 55Mn2+ (S = 5/2, I = 5/2) atoms in marbles, were studied as structural-probes. EPR data at 300 K provide a library of 55Mn2+ zero-field-splitting parameters (E, D). The effect of temperature (300 up to 700 K) on 55Mn2+-ZFS (E, D) and the strain of the D-tensor (Dstrain) was studied by high-temperature EPR spectroscopy. The EPR data, combined with 13C-ssNMR, provide detailed physicochemical information of the calcite and dolomite crystal phases in the marbles. In parallel, we have analyzed the lattice-microstrain (ε0) of the marbles' crystallites using high-resolution XRD data. Analysis of the correlation between the D-values of Mn2+ centers and (ε0)-XRD, reveals trends that reflect the provenance of the marbles. In this context, we discuss the correlation between the D-values of Mn2+ centers and (ε0)-microstrain as a novel tool to elucidate the provenance of marbles.

Just Soaping Them: The Simplest Method for Converting Metal Organic Frameworks into Superhydrophobic Materials.

The incorporation of superhydrophobic properties into metal organic framework (MOF) materials is highly desirable to enhance their hydrolytic stability, gas capture selectivity in the presence of humidity and efficiency in oil-water separations, among others. The existing strategies for inducing superhydrophobicity into MOFs have several weaknesses, such as increased cost, utilization of toxic reagents and solvents, applicability for limited MOFs, etc. Here, we report the simplest, most eco-friendly, and cost-effective process to impart superhydrophobicity to MOFs, involving a rapid (90 min) treatment of MOF materials with solutions of sodium oleate, a main component of soap. The method can be applied to both hydrolytically stable and unstable MOFs, with the porosity of modified MOFs approaching, in most cases, that of the pristine materials. Interestingly, this approach was used to isolate superhydrophobic magnetic MOF composites, and one of these materials formed stable liquid marbles, whose motion could be easily guided using an external magnetic field. We also successfully fabricated superhydrophobic MOF-coated cotton fabric and fiber composites. These composites exhibited exceptional oil sorption properties achieving rapid removal of floating crude oil from water, as well as efficient purification of oil-in-water emulsions. They are also regenerable and reusable for multiple sorption processes. Overall, the results described here pave the way for an unprecedented expansion of the family of MOF-based superhydrophobic materials, as virtually any MOF could be converted into a superhydrophobic compound by applying the new synthetic approach.

One portal simultaneous bilateral endoscopic carpal tunnel release under local anaesthesia. Do the results justify the effort?

PURPOSE: The purpose of this study was to evaluate whether simultaneous bilateral endoscopic carpal tunnel release could be effectively and safely performed under local anaesthesia. METHODS: We prospectively evaluated 85 consecutive patients (62 females) who underwent simultaneous one portal endoscopic bilateral carpal tunnel release with subcutaneous injection of 2 mL 2 % lidocaine. In case of pain after discharge, all patients were advised to take paracetamol (i.e., acetaminophen) and to record the dose of drug taken. Patients were reviewed at regular intervals until one year postoperatively. RESULTS: The mean operative time was 31.2 min. Postoperatively, only nine patients (10.6 %) received on average 611 mg of paracetamol. Significant improvement was noticed in the parameters of numbness, pain, positive Phalen and Tinel tests, pinch strength, grip strength, tip pinch strength and Quick DASH Score. Patients returned fully to work after surgery in average 2.2 weeks. Conversion to open release took place in four wrists (2.4 %). Discomfort and pain from tourniquet pressure was reported from two patients (2.4 %). Two wrists (1.2 %) required revision surgery. One patient (1.2 %) reported temporary thenar numbness and another (1.2 %) had slight scar hypersensitivity. CONCLUSIONS: Simultaneous bilateral endoscopic carpal tunnel release under local anaesthesia is well tolerated by patients. The technique may be of benefit in young, active, high-demand patients who require fast recovery, early return to work and less disability time.

Advanced Flame Spray Pyrolysis (FSP) Technologies for Engineering Multifunctional Nanostructures and Nanodevices.

Flame spray pyrolysis (FSP) is an industrially scalable technology that enables the engineering of a wide range of metal-based nanomaterials with tailored properties nanoparticles. In the present review, we discuss the recent state-of-the-art advances in FSP technology with regard to nanostructure engineering as well as the FSP reactor setup designs. The challenges of in situ incorporation of nanoparticles into complex functional arrays are reviewed, underscoring FSP's transformative potential in next-generation nanodevice fabrication. Key areas of focus include the integration of FSP into the technology readiness level (TRL) for nanomaterials production, the FSP process design, and recent advancements in nanodevice development. With a comprehensive overview of engineering methodologies such as the oxygen-deficient process, double-nozzle configuration, and in situ coatings deposition, this review charts the trajectory of FSP from its foundational roots to its contemporary applications in intricate nanostructure and nanodevice synthesis.

Bulk RNA sequencing analysis of developing human induced pluripotent cell-derived retinal organoids.

Retinogenesis involves the transformation of the anterior developing brain into organized retinal lamellae coordinated by intricate gene signalling networks. This complex process has been investigated in several model organisms such as birds, fish, mammals and amphibians, yet many facets of retinal development are different in humans and remain unexplored. In this regard, human pluripotent stem cell (hPSC)-derived 3D retinal organoids and Next Generation Sequencing (NGS) have emerged as key technologies that have facilitated the discovery of previously unknown details about cell fate specification and gene regulation in the retina. Here we utilized hPSCs integrated with fluorescent reporter genes (SIX6-p2A-eGFP/CRX-p2A-h2b-mRuby3) to generate retinal organoids and carry out bulk RNA sequencing of samples encompassing the majority of retinogenesis (D0-D280). This data set will serve as a valuable reference for the vision research community to characterize differentially expressed genes in the developing human eye.

Tricortical Bone Grafting with Limited Midcarpal and Carpometacarpal Fusion for the Treatment of Giant Cell Tumor of the Capitate.

Background Giant cell tumor (GCT) of capitate is a rare lesion that is challenging to treat. Case Description We present a case of a 12-year-old girl suffering from a GCT of the capitate. Wide excision combined with adjuvant treatment including hydrogen peroxide, alcohol, tricortical bone grafting, and limited midcarpal and carpometacarpal fusion achieved good functional result without evidence of tumor recurrence or radiocarpal degeneration at 8 years postoperatively. Clinical Relevance In this case with long-term follow-up, surgical treatment of capitate GCT with limited midcarpal and carpometacarpal fusion led to a satisfactory outcome despite the alteration of wrist kinematics.

The effect of transverse carpal ligament lengthening on carpal tunnel volumetry: a comparison between four techniques.

Transverse carpal ligament (TCL) reconstruction after open carpal tunnel release has been advocated to restore wrist kinematics and grip strength. This study investigates the effect of TCL reconstruction in carpal tunnel volume (CTV). Thirty-eight cadaveric wrists were volarly approached and TCL was exposed to its proximal and distal edges. Carpal tunnel contents were removed and the CTV was measured considering that carpal tunnel resembled the shape of a truncated cone. TCL was then dissected and subsequently reconstructed by using 4 different surgical lengthening techniques. Three of these techniques were retrieved from the literature. The fourth was proposed and performed by the authors. Postreconstruction calculation of CTV was done with the same method. In 6 cadavers, a magnetic resonance imaging-based measurement of CTV was performed to assess the validity and reliability of simulation method. The average increase of CTV ranged from 31% to 44% (P < 0.001 for all techniques). However, no statistical significant difference was found between the 4 techniques (P = 0.097). Magnetic resonance imaging volumetric values were equal to simulation measured values before and after reconstruction of TCL (P = 0.224 and P = 0.674, respectively). Lengthening of TCL substantially increases the carpal tunnel capacity regardless the applied surgical technique. The simulation model method seems to be an accurate, precise, and cost-effective approach for the evaluation of CTV.

Intratendinous Ganglion Cyst of the Hand: A Case Report and Review of the Literature.

Intratendinous ganglion of the hand is an extremely rare benign tumor, and only few cases have been reported so far in the literature. We present a case with an intratendinous ganglion of the extensor digitorum communis that treated with en bloc resection and subsequent tendon repair. According to the review of the literature and published data, the ganglion is predominantly located at hand extensor tendons (82%), and it is more frequent among females (75%) and shows a high incidence in 5th and 6th decades of life (94.5%). Surgical excision with or without side-to-side repair and/or tendon transfer leads to excellent outcome and low potential for recurrence.

Heterogeneous colonic content: A prenatal sonographic manifestation of lysinuric protein intolerance.

We report a fetus with heterogeneous colonic content, an isolated sonographic prenatal sign of lysinuric protein intolerance, a very rare metabolic disease. Familial genetic enquiries confirmed heterozygote mutation in the implicated gene in parents. The prenatal diagnosis led to neonatal dietary adaptation and avoided acute complications.

Aspiration alone versus aspiration and bupivacaine injection in the treatment of undisplaced radial head fractures: a prospective randomized study.

HYPOTHESIS: Some physicians advocate that aspiration of elbow joint hematoma in radial head fractures is helpful not only for determining a mechanical block to motion from a fracture fragment but also for improving the elbow motion and pain. However, the supplementary role of intra-articular anaesthetic injection is unclear. MATERIALS AND METHODS: In this prospective randomized study, 40 patients with undisplaced radial head fractures (Mason I) were treated with elbow joint aspiration alone (20 patients) or aspiration plus intra-articular injection of 3 mL of bupivacaine 0.5% (20 patients). Active elbow exercises were immediately commenced. The patients were evaluated at 1 day, 1, 3, and 6 weeks, 3 and 6 months, and 1 year. RESULTS: No difference was found in terms of range of motion, pain and elbow function between the 2 groups in all the examined time points. The improvement in the above parameters achieved a plateau at 3 weeks in both groups. DISCUSSION: Intra-articular use of local anaesthetic after joint aspiration does not offer any benefit over aspiration alone in the treatment of undisplaced radial head fractures and its routine application is not supported by the clinical data.

One-stage shoulder and elbow arthroplasty after ipsilateral fractures of the proximal and distal humerus.

We report a case of 1-stage ipsilateral shoulder and elbow arthroplasty after comminuted fractures of both joints in a 77-year-old woman. The postoperative course was uneventful, and the patient showed prompt functional improvement and a good clinical result. Despite the higher risk of periprosthetic humeral fracture in cases of ipsilateral shoulder and elbow arthroplasty, the 1-stage procedure may be a promising and reliable solution for the treatment of complex upper limb fractures in elderly inactive patients.

Intercalary bone grafting for the reconstruction of phalangeal osteolysis in disappearing bone disease: case report.

Disappearing bone disease (DBD) is a rare condition of unknown etiology that may cause massive hand deformity due to severe osteolysis and soft-tissue atrophy. Bone grafting of the affected metacarpal bones or wrist has been described with moderate success in only 4 cases, but phalanx reconstruction has not been attempted. We report a case with multicentric DBD that was treated with staged intercalary iliac bone grafting of the phalanges of the dominant thumb and index finger. After 3 years, no graft resorption was noticed and the patient reported considerable functional improvement.

Modified ulnar translocation technique for the reconstruction of giant cell tumor of the distal radius.

Giant cell tumors of the distal radius have been frequently described as difficult to treat, chiefly because of their close proximity to multiple tendons, median nerve, radial artery and carpus.The aim of treatment is to remove the tumor completely and preserve the radiocarpal and radioulnar joints.However, this is not always feasible as giant cell tumors seem to behave more aggressively and have a higher recurrence rate in the distal radius, even if local adjuvant treatment with phenolmethylmethacrylate or liquid nitrogen is applied. The above incidence is increased in Campanacci grade III lesions, which are characterized by fuzzy borders, loss of cortical continuity, and extension into soft tissues. In these cases, wide excision instead of intralesional excision may be advocated, particularly when the tumor breaks through the cortex, violates the articular surface, and destroys >50% of the surrounding metaphysis. Several reconstructive options (e.g., resection arthroplasty, prosthetic replacement, arthrodesis, ulnar translocation, centralization of the carpus over the remaining ulna, use of a nonvascularized, or vascularized fibular graft [with or without arthrodesis], and allograft replacement) have been described for the treatment of either recurrent or primary grade III giant cell tumor with destruction of the bone cortex and associated soft tissue mass. Ulnar translocation has been mentioned rarely in the literature, and, according to our knowledge, only 10 cases have been previously reported. This article presents a case of a woman with a grade III giant cell tumor of the distal radius. Wide excision of the tumor followed by reconstruction of the distal forearm with a modified ulnar translocation technique and wrist arthrodesis led to optimum results and no mass recurrence at 13 years postoperatively.

Acute management of clavicle fractures. A long term functional outcome study.

The purpose of this study was to evaluate the long-term results after acute treatment of clavicle fractures. We reviewed 139 patients with an average age of 39.3 years (range: 18 to 74) who sustained a clavicle fracture either isolated or as part of a polytrauma. Besides demographic data, both clinical result and residual symptoms were also recorded. The average follow-up was 7.2 years (range: 4 to 13). The fracture showed a higher prevalence in young men and older women. The most frequent mechanism of injury was a fall (39.6%) and coexisting injuries were found in 12.9% of patients. Conservatively treated fractures united in 96.9% of cases and the time to union was no different with a sling or figure-of-eight bandage. Fracture location did not influence the functional outcome. One third of patients were still complaining of mild pain and discomfort during overhead activities and polytrauma patients had a lower Constant score.

Talonavicular Dislocation-What Lies Beneath?

BACKGROUND: The talonavicular joint is a rare site of dislocation. Its etiology varies and can be the result of either acute trauma or a chronic degenerative process that most commonly occurs in patients with rheumatoid arthritis or Charcot arthropathy. Our aim is to highlight the relationship between the underlying pathology of talonavicular dislocations and the final outcome in the case of operative management. METHODS: We present three cases of talonavicular dislocation with the dislocation itself as the only common denominator, and a completely different etiology, natural history, treatment, and prognosis among them. RESULTS: There was one case of a traumatic talocalcaneonavicular dislocation in a healthy individual, one case in a rheumatoid arthritis patient, and one case in a patient with diabetes mellitus. All patients were treated surgically. The outcomes were excellent, fair, and poor, respectively. CONCLUSIONS: Among many factors that influence prognosis, it is equally critical to evaluate the overall background in which the dislocation occurs so as to apply the suitable treatment. The surgeon not only needs to treat the local incident but also appreciate the general medical condition to provide the best final outcome to the patient.

Carpal tunnel syndrome due to an atypical deep soft tissue leiomyoma: The risk of misdiagnosis and mismanagement.

BACKGROUND: Leiomyomas of the deep soft tissue are quite uncommon and occur even more rarely in upper extremity. CASE PRESENTATION: A 32-year old manual laborer man presented with a two-year history of numbness, tingling and burning pain in the palmar surface of the left hand and fingers. His medical history was unremarkable and no trauma episode was reported. According to the clinical examination and the result of median nerve conduction study (NCS) the diagnosis of carpal tunnel syndrome was established. Operative release of the transverse carpal ligament was subsequently performed but the patient experienced only temporary relief of his symptoms. MRI examination revealed a deep palmary located mass with well-defined margins and ovoid shape. Intraoperatively, the tumor was in continuity with the flexor digitorum superficialis tendon of the middle finger causing substantial compression to median nerve. Histopathological findings of the resected mass were consistent with leiomyoma. After two years the patient was pain-free without signs of tumor recurrence. CONCLUSION: Despite the fact that reports on deep soft tissue leiomyoma are exceptional, this tumor had to be considered as differential diagnosis in painful non-traumatic hand syndromes especially in young patients.

Imaging of Juvenile Idiopathic Arthritis.

Juvenile idiopathic arthritis is an umbrella term covering several distinct categories that share common features. The European League Against Rheumatism and the Pediatric Rheumatology European Society have published a consensus article with recommendations to guide radiologists and clinicians in choosing the best imaging technique for each particular clinical setting. A reproducible, accurate, validated, and long-established scoring system to use in everyday practice for monitoring and predicting long-term response to therapy is still to be developed on MR imaging for each joint.

High-grade dysplastic spondylolisthesis and spondyloptosis: report of three cases with surgical treatment and review of the literature.

High-grade dysplastic spondylolisthesis is extremely rare and always involves the L5-S1 level. It is attributed to congenital dysplasia of the superior articular process of the sacrum. It can remain asymptomatic for a long time and can progress to a more severe grade of olisthesis and spondyloptosis. Surgical treatment has varied from posterior-only in situ fusion to anterior and posterior fusion with complete reduction. Three cases of symptomatic high-grade (4th and 5th grade) dysplastic spondylolisthesis treated surgically with reduction and fusion are presented. Interbody fusion at the level of olisthesis is crucial.

Cuff width increases the serum biochemical markers of tourniquet-induced skeletal muscle ischemia in rabbits.

Tourniquet application is a widely accepted adjuvant technique in extremity surgery. The purpose of this prospective, randomized trial was to evaluate the effect of cuff width on skeletal muscle ischemia-reperfusion injury. A 2- or 4-cm wide curved tourniquet cuff was applied around the midthigh of 36 New Zealand White rabbits and inflated to a pressure of 200 or 400 mm Hg for 2 hours: group A=2 cm to 200 mm Hg; group B=2 cm to 400 mm Hg; group C=4 cm to 200 mm Hg; group D=4 cm to 400 mm Hg. Blood levels of potassium, lactic acid, urea, lactic dehydrogenase, and creatinine phosphokinase MM isoenzyme (CPK-MM) were measured as basic indicators for limb ischemia before tourniquet inflation and 1, 5, and 30 minutes after cuff release.Potassium values did not differ among the 4 groups. Lactic acid and urea concentrations were always higher in the 400 mm Hg groups (B and D) (P<.001). However, cuff width did not affect their levels (P>.16). Lactic dehydrogenase and CPK-MM values were also greater in the 400 mm Hg groups at all times (P<.001). Further subgroup analysis of 200 mm Hg pressure groups showed higher lactic dehydrogenase (P<.02) but not CPK-MM (P>.9) concentrations in group C than in group A during the 30-minute period. At 400 mm Hg, lactic dehydrogenase and CPK-MM values were higher in group D compared with group B only 30 minutes after cuff deflation (P<.001). Broad tourniquets are associated with significantly greater and prolonged elevation of serum biochemical markers of inducible skeletal muscle ischemia-reperfusion injury compared with narrow ones. This difference is more prominent when a wide cuff is inflated to a high pressure.