Experimental Study on Restoration of Deteriorated Timber due to Termites by Resin Filling

There are many valuable wooden buildings in the world, because timber has been used all over the world as a building material for a long time. However, there is an issue that timber deteriorates due to various factors. Therefore, in order to preserve these valuable wooden buildings, it is necessary to appropriately repair or reinforce treatment. One of the treatments is the resin filling method. In this method, filling the resin in order to restore the strength into an internal cavity caused by deterioration. It has become clear that it is possible to recover the strength using this method, however, we are still conducting construction based on the rule of thumb. Therefore, authors examined the resin characteristics in order to inject the resin in stable manner and ensure strength recovery. Authors focused on deteriorated timber due to termites, because Japan has a very high amount of such type of timber. Authors reports the following four aspects of the characteristics of resin filling into timber. 1. The Area velocity is determined by the injection pressure, width of the gap, and viscosity of the resin. 2. The resin spreads concentrically in the gap of wood, but there is no regularity in the random gap like deteriorated timber due to termites. 3. Authors proposed a new coefficient for the application, of a theoretical formula to deteriorated timber due to termites. 4. Authors proposed a flowchart of resin filling method to perform stable construction.

Effect of Electromyographic Biofeedback Therapy on Muscle Strength Recovery in Children with Guillain–Barré Syndrome

GBS, as an immune-mediated acute inflammatory peripheral neuropathy (Tan and Halpin et al.), with the characteristics of acute onset and rapid progression, is mainly manifested with damages in nerve root and peripheral nerve. The purpose of the study was to investigate the effect of electromyographic biofeedback therapy on muscle strength recovery in children with Guillain–Barré syndrome (GBS). A total of 62 GBS children patients admitted to our hospital from June 2014 to December 2018 were selected and divided into control group (n = 30) and experimental group (n = 32) according to the order of admission. The children patients in the control group received physical therapy combined with occupational therapy (PT + OT), while based on the treatment in the control group, the experimental group children patients were treated with electromyographic biofeedback therapy. After that, the recovery of nerve and muscle at different time points, muscle strength score, gross motor function measure (GMFM) score, and Barthel index (BI) score of the children patients before and after treatment were compared between the two groups. There were no significant differences in the recovery of nerve and muscle of the children patients between the two groups at T0 and T1 ( P > 0.05), and the recovery of nerve and muscle of the children patients in the experimental group was significantly better than that in the control group at T2, T3, and T4 (P < 0.001); the muscle strength score, GMFM score, and BI score of the children patients in the experimental group were significantly better than those in the control group after treatment ( P < 0.001). The application of electromyographic biofeedback therapy for the treatment of GBS can effectively relieve clinical symptoms, promote rapid recovery, and improve treatment efficacy in children patients, which is worthy of application and promotion.

Segmental analysis in cervical spinal cord injury reveals the recovery potential of hand muscles with preserved corticospinal tract: Insights beyond impairment scales

Cervical spinal cord injury (SCI) severely impacts widespread bodily functions with extensive impairments for individuals, who prioritize regaining hand function. Although prior work has focused on the recovery at the person-level, the factors determining the recovery potential of individual muscles are poorly understood. There is a need for changing this paradigm in the field by moving beyond person-level classification of residual strength and sacral sparing to a muscle-specific analysis with a focus on the role of corticospinal tract (CST) sparing. The most striking part of human evolution involved the development of dextrous hand use with a respective expansion of the sensorimotor cortex controlling hand movements, which, because of the extensive CST projections, may constitute a drawback after SCI. Here, we investigated the muscle-specific natural recovery after cervical SCI in 748 patients from the European Multicenter Study about SCI (EMSCI), one of the largest datasets analysed to date. All participants were assessed within the first 4 weeks after SCI and re-assessed at 12, 24, and 48 weeks. Subsets of individuals underwent electrophysiological multimodal evaluations to discern CST and lower motor neuron (LMN) integrity [motor evoked potentials (MEP): N = 203; somatosensory evoked potentials (SSEP): N = 313; nerve conduction studies (NCS): N = 280]. We show the first evidence of the importance of CST sparing for proportional recovery in SCI, which is known in stroke survivors to represent the biological limits of structural and functional plasticity. In AIS D, baseline strength is a good predictor of segmental muscle strength recovery, while the proportionality in relation to baseline strength is lower for AIS B/C and breaks for AIS A. More severely impaired individuals showed non-linear and more variable recovery profiles, especially for hand muscles, while measures of CST sparing (by means of MEP) improved the prediction of hand muscle strength recovery. Therefore, assessment strategies for muscle-specific motor recovery in acute SCI improve by accounting for CST sparing and complement gross person-level predictions. The latter is of paramount importance for clinical trial outcomes and to target neurorehabilitation of upper limb function, where any single muscle function impacts the outcome of independence in cervical SCI.

Evaluation of the Compatibility of Modified Encapsulated Sodium Silicate for Self-Healing of Cementitious Composites

Healing agent carriers play a significant role in defining the performance of the autonomous self-healing system. Particularly, the ability to survive during the mixing process and the release of the healing agent when cracks occur without affecting the mechanical properties of the cementitious composite. Up to now, these issues are still a concern since glass capsules are unable to survive the mixing process, while some types of microcapsules were reported to cause a decrement in strength as well as limited strength recovery. Therefore, this study was twofold, addressing the surface treatment of polystyrene (PS) capsules and the evaluation of the compatibility of the modified capsules for cement-based applications. Secondly, assessing the healing performance of modified PS capsules in cementitious composites. Furthermore, the study also evaluates the potential healing performance due to the synergic effect between the encapsulation method and the autogenous self-healing mechanism. The investigation was carried out by measuring the changes in the pH of pore solution, FTIR analysis, survival ratio, and bonding strength. For self-healing assessment, the compression cracks on the cement paste were created at an early age and the strength recovery was measured at the age of 28 and 56 days. To identify the chemical compounds responsible for the healing process, SEM-EDX tests were conducted. Moreover, the effect of silica fume (SF) on bonding strength and self-healing was also evaluated. Based on the results, the modified PS capsules by roughing approach showed promising performance in terms of survivability, bonding, and recovery. The modified PS capsule increased the strength recovery by about 12.5–15% for 100%OPC and 95%OPC + 5%SF, respectively. The finding observed that the combining of modified PS capsules and the inclusion of SF gave high strength recovery of about 20% compared to 100%OPC without capsules. Thus, the modified PS capsule has a good potential for self-healing of cementitious-based applications.

Image-Free Handheld Robot for Total Knee Arthroplasty Improves Early Functional Recovery Compared with Conventional Total Knee Arthroplasty

This study aimed to examine whether it is advantageous in robotic-assisted TKA (RA-TKA) compared with conventional TKA throughout a 14 postoperative days (PODs). A total of 113 knees (100 patients) were reviewed and divided into the control group (55 knees) and the RA-TKA group (58 knees). We assessed postoperative pain intensity using a visual analogue scale at rest (rVAS) and during movement (mVAS), evaluated lower extremity functional recovery through quadriceps muscle strength and knee range of motion (ROM), preoperatively and on PODs 3, 7, 10, and 14. We also assessed the rescue analgesia intake and postoperative implant coronal alignment. The mean rVAS and mVAS scores did not differ significantly between the two groups. Muscle strength recovery was significantly faster in the RA-TKA group than in the control group on every PODs. ROM recovery was better in the RA-TKA group than in the control group on POD 10. The amount of postoperative analgesia was significantly lower in the RA-TKA group than in the control group. Attainment of a β angle <2° significantly better in RA-TKA. This study demonstrated better functional recovery in RA-TKA, particularly for muscle strength and ROM. RA-TKA reduced rescue drug intake and provided better implant positioning.

Pfizer Vaccine-Associated Parsonage-Turner Syndrome

Parsonage-Turner syndrome, a rare condition with a reported overall incidence of 1.64 cases per 100,000 people. PTS is also characterized by associated delayed upper extremity weakness, muscle atrophy, and painless paresthesias, which tend to diminish slowly and resolve gradually; Although most patients report 80% to 90% muscle strength recovery within 2-3 years, more than 70% of patients experience residual paresis and exercise intolerance. As described in the existing bibliography, the patients reported initial pain in the shoulder and weakness after vaccination that, as it worsened, led them to visit the emergency department. Vaccination is a known cause of this syndrome although there is difficulty in early identification, it is often overlooked or misdiagnosed, Possible immune-mediated mechanisms include molecular simulation and bystander activation, which can occur after any infection or vaccination.

Scaffold biomaterials and nano-based therapeutic strategies for skeletal muscle regeneration

Skeletal muscle is integral to the functioning of the human body. Several pathological conditions, such as trauma (primary lesion) or genetic diseases such as Duchenne muscular dystrophy (DMD), can affect and impair its functions or exceed its regeneration capacity. Tissue engineering (TE) based on natural, synthetic and hybrid biomaterials provides a robust platform for developing scaffolds that promote skeletal muscle regeneration, strength recovery, vascularization and innervation. Recent 3D-cell printing technology and the use of nanocarriers for the release of drugs, peptides and antisense oligonucleotides support unique therapeutic alternatives. Here, the authors present recent advances in scaffold biomaterials and nano-based therapeutic strategies for skeletal muscle regeneration and perspectives for future endeavors.

Anterior Interosseous Nerve to Ulnar Nerve Transfers: A Systematic Review

Background There has been an increasing utilization of end-to-end (ETE) and reverse “supercharged” end-to-side (SETS) anterior interosseous nerve (AIN) to ulnar nerve transfers (NTs) for treatment of high ulnar nerve injury. This study aimed to review the potential indications for, and outcomes of, ETE and SETS AIN–ulnar NT. Methods A literature review was performed, and 10 articles with 156 patients who had sufficient follow-up to evaluate functional outcomes were included. English studies were included if they reported the outcome of patients with ulnar nerve injuries treated with AIN to ulnar motor NT. Outcomes were analyzed based on the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire scores, grip and key pinch strength, and interosseous Medical Research Council–graded motor strength. Comparisons were made using the independent t-test and the chi-square test. No nerve graft control group was required for eligibility. Ulnar nerve injury types varied. Results NT resulted in 77% of patients achieving M3+ recovery, 53.7 ± 19.8 lb grip strength recovery, 61 ± 21% key pinch recovery, and a mean DASH score of 33.4 ± 16. In this diverse group, NT resulted in significantly greater M3+ recovery and grip strength recovery measured in pounds than in the nerve graft/conventional treatment group, and ETE repairs had significantly better outcomes compared with SETS repairs for grip strength, key pinch strength, and DASH scores, but heterogeneity limits interpretation. Conclusion ETE and SETS AIN–ulnar NTs produce significant restoration of ulnar nerve motor function for high ulnar nerve injuries. For ulnar nerve transection injuries at or above the elbow, ETE NT results in superior motor recovery compared with nerve grafting/conventional repair. However, further research is needed to determine the best treatment for other types of ulnar nerve injury and the role of SETS NT.

The Impact of Meniscal Treatment on Functional Outcomes Six Months After Anterior Cruciate Ligament Reconstruction (107)

Objectives: The incidence of anterior cruciate ligament (ACL) injuries continues to rise, and meniscal injuries are commonly associated with these tears. Treatment of meniscal injuries can impart delayed weightbearing range-of-motion restrictions, which can affect the post-operative rehabilitation protocol. These limitations after a meniscal repair could change how patients are managed and progressed through rehab. The effect of the meniscal treatment and subsequent restrictions on strength recovery after ACL reconstruction (ACLR) is unclear and may affect return-to-play assessments. The purpose of this study was to compare strength, jumping performance and patient reported outcomes between isolated ACLR patients and those undergoing surgical intervention for meniscal pathology at the time of ACLR surgery at a scheduled functional testing assessment an average of 6 months after surgery. Our hypothesis is that those undergoing meniscal repair will have lower strength recovery due to post-operative restrictions. Methods: In this retrospective cohort study, ACLR patients and healthy controls completed patient-reported outcomes (IKDC and KOOS), underwent bilateral isokinetic and isometric strength tests of the knee extensor and flexor groups, as well as functional hop testing as part of a return-to-sport test battery at 5-7 months post-operatively. ACLR patients were stratified as isolated ACLR, ACLR+Meniscectomy (ACLR-MS), ACLR+Meniscal Repair (ACLR-MR) and compared to healthy controls. Patients treated with meniscus repair were restricted to partial weight bearing and to 90 degrees of knee flexion for the first 6 weeks post-surgery. Comparisons were performed between meniscal treatment groups with regard to demographics, patient reported outcomes scales, knee extensor and flexor strength, while stratifying by graft type. Results: 305 participants, including 165 ACLR patients (50 isolated ACLR, 71 ACLR + Meniscal Repair, 44 ACLR + Meniscectomy) and 140 healthy controls were included with an average time post-operatively to functional testing of 5.96±0.47 months. Heathy controls demonstrated higher subjective knee function, unilateral peak extensor torque, and limb symmetry than all meniscal subgroups (p<.001). There were no differences between the IKDC, KOOS subscales, or in unilateral or limb symmetry measures of peak knee extensor or flexor torque between ACLR, ACLR+MS, and ACLR+MR patients (all p-values>.05). Conclusions: Persistent weakness, asymmetry and reduced subjective outcome scores measured at approximately 6 months post index surgery were not influenced by meniscus treatment. Knee flexor and extensor strength, limb symmetry, and patient reported outcomes did not significantly differ across patients undergoing isolated ACLR, ACL + Meniscus Repair, and ACL + meniscectomy. These findings suggest that the weightbearing and range-of-motion restrictions associated with meniscus repair recovery do not result in loss of early strength or patient reported outcomes, and they can be progressed through therapy accordingly.

Effect of Meniscal Treatment on Functional Outcomes 6 Months After Anterior Cruciate Ligament Reconstruction

Background: Meniscal injuries are commonly associated with anterior cruciate ligament (ACL) tears. Treatment of meniscal injuries can impart delayed weightbearing and range of motion restrictions, which can affect the rehabilitation protocol. The effect of meniscal treatment and subsequent restrictions on strength recovery after ACL reconstruction is unclear. Purpose/Hypothesis: The purpose of this study was to compare strength, jumping performance, and patient-reported outcomes between patients who underwent isolated ACL reconstruction (ACLR) and those who underwent surgical intervention for meniscal pathology at the time of ACLR. Our hypothesis was that patients who underwent concurrent meniscal repair (MR) would have lower strength recovery owing to postoperative restrictions. Study Design: Cohort study; Level of evidence, 3. Methods: Patients with ACLR were stratified into isolated ACLR, ACLR and meniscectomy (ACLR-MS), or ACLR-MR groups and were compared with healthy controls. The ACLR-MR group was restricted to partial weightbearing and to 90° of knee flexion for the first 6 weeks postoperatively. All participants completed patient-reported outcomes (International Knee Documentation Committee [IKDC] and Knee injury and Osteoarthritis Outcome Score [KOOS]) and underwent bilateral isokinetic and isometric strength tests of the knee extensor and flexor groups as part of a return-to-sports test battery at 5 to 7 months postoperatively. Results: A total of 165 patients with ACLR (50 with isolated ACLR, 44 with ACLR-MS, and 71 with ACLR-MR) and 140 healthy controls were included in the study. Follow-up occurred at a mean of 5.96 ± 0.47 months postoperatively. The control group demonstrated higher subjective knee function, unilateral peak extensor torque, and limb symmetry than did the ACLR-MS and ACLR-MR groups combined ( P < .001 for all). There were no differences in IKDC, KOOS subscales, or unilateral or limb symmetry measures of peak knee extensor or flexor torque among the isolated ACLR, ACLR-MS, and ACLR-MR groups. Conclusion: Persistent weakness, asymmetry, and reduced subjective outcome scores at 6-month follow-up after ACLR were not influenced by meniscal treatment. These findings suggested that the weightbearing and range of motion restrictions associated with meniscal repair recovery do not result in loss of early strength or worse patient-reported outcomes.