This article presents the development of a wearable exoskeleton robotic device designed for the motor recovery of the upper limbs following stroke, in which the possibility of integrating soft actuators was explored. The device is designed for multi-joint assistance, with the ability to help patients in recovery training with sequential movements of the elbow, wrist, and fingers in flexion/extension and adduction/abduction. Based on the specific characteristics of each target area, the device integrates three different types of soft actuators, whose force and range of motion characteristics were analysed using numerical and experimental methods. The relatively low force/torque characteristics in the targeted areas of the limb have made it possible to develop a compact, lightweight system that offers comfort during long periods of use. The device is made entirely of soft materials and textiles, and the soft actuators have been designed based on average anthropometric characteristics. The force development and their range of motion were the defining characteristics analysed of the three different types of soft actuators (bellows-type textile actuator, McKibben-type artificial muscles, and PneuNets multisegment actuators -MSA). The device integrates a closed-loop control, increasing performance as well as patients' adaptability. According to the results, the actuators develop sufficient force for recovery training, and preliminary analysis regarding range of motion shows an error of 2.29 % for finger flexion, 4 % and 10.5 % for adduction/abduction, for forearm flexion: 4.4 %, and higher for hand flexion/extension. In accordance with these results, future directions concentrate on investigating the device on stroke patients and augmenting the portability of the mechanism.
Background: Deep squatting is essential for daily activities and sports; however, it is often limited after ankle fracture surgery, and the contributions of posterior ankle soft tissues, including the soleus muscle (SOL), Achilles tendon (AT), flexor hallucis longus muscle (FHL), and Kager's fat pad (KFP), to this limitation remain unclear. This study aimed to determine the relationship between posterior ankle soft tissue properties (including stiffness and echo intensity [EI]) and deep squatting ability after ankle fracture surgery. Methods: This cross-sectional study included 53 patients (49.5 ± 16.1 years, 26 men) who underwent ankle fracture surgery. We measured the shear modulus of the SOL and AT, and the EI of the FHL and Kager's fat pad; ankle range of motion and strength were evaluated. Deep squatting ability was also assessed. Multiple regression and receiver operating characteristic (ROC) analyses were performed to identify predictors of squatting limitation and evaluate discriminative performance. Results: Participants with a deep squatting limitation showed a higher shear modulus in the SOL and AT and higher EI in the FHL compared with those without limitations. SOL and AT shear modulus and FHL EI were significant independent predictors of ankle dorsiflexion angle during deep squatting. ROC analysis showed good discriminative ability for SOL shear modulus and AT shear modulus and modest discriminative ability for FHL EI. Conclusions: Increased stiffness and EI of the SOL, AT, and FHL were associated with reduced deep squatting ability after ankle fracture surgery. Targeted assessment and interventions addressing these tissues may improve postoperative function.
Conductive hydrogels have emerged as promising materials for soft tissue interfacing by combining tissue-like mechanical compliance with electrical conductivity, thereby enabling improved electrical communication with electroactive biological tissues. This work presents an electroconductive composite hydrogel fabricated via light-based vat-polymerization by integrating a choline-based bio-ionic liquid (IL) with gelatin methacryloyl (GelMA). The resulting hydrogels demonstrate tunable conductivity, structural integrity, and high print fidelity when fabricated using digital light processing (DLP) light-based 3D printing. Electrical conductivity was optimized at 20% v/v IL concentration, with the hydrogels demonstrating stable performance for over 28 days. A food-grade photoabsorber was integrated into the formulation to improve DLP resolution and was effectively removed after printing process. The hydrogels supported the human mesenchymal stem cells' viability and proliferation, confirming their cytocompatibility. They also promoted enhanced maturation of primary neurons, demonstrating a supportive microenvironment for neural cells. In vivo implantation of indocyanine green-loaded hydrogels exhibited sustained stability and robust retention of signal over a period of 4 weeks, with histological analysis indicating seamless integration with surrounding tissues. Impedance spectroscopy at both gut and spinal cord interfaces illustrated that GelMA/IL composites achieved the lowest impedance across a range of frequencies, outperforming both GelMA-only and tissue-only conditions. Collectively, these findings position light-based vat-polymerized electroconductive composites as a promising platform for the development of anatomically conformal materials tailored for soft tissue interfacing.
Background and Clinical Significance:Streptococcus pyogenes (group A Streptococcus, GAS) can cause rapidly progressive invasive infections, including necrotizing soft tissue infection (NSTI) and streptococcal toxic shock syndrome (STSS). Although invasive GAS disease is often associated with skin barrier disruption, severe infection may also follow blunt trauma without visible skin injury. Case Presentation: A 22-year-old woman presented with persistent right hip and groin pain four days after a blunt fall during recreational sports activity, without disruption of skin integrity. On admission, she was hypotensive, tachycardic, and intermittently hypoxemic, with local hematoma, swelling, and inflammatory infiltration of the right groin. Laboratory tests showed marked inflammation, acidosis, acute kidney injury (AKI), elevated lactate, creatine kinase, and myoglobin levels. She was admitted to the intensive care unit with septic shock. Empirical antimicrobial therapy was initiated with piperacillin/tazobactam, clindamycin, and linezolid. Computed tomography showed inflammatory changes extending from the right groin to the thigh fascia. On day 3, the patient's condition deteriorated with respiratory failure necessitating endotracheal intubation and mechanical ventilation. Surgical incision revealed inflamed and necrotic subcutaneous tissue with superficial muscle involvement. Deep tissue cultures yielded GAS, whereas blood and urine cultures remained negative; probable STSS was diagnosed. Therapy was de-escalated to penicillin plus clindamycin. Continuous renal replacement therapy with an adsorptive acrylonitrile 69 surface-treated (AN69ST) membrane was initiated for AKI. The patient gradually improved and was transferred to the surgical ward on day 16. Conclusions: Minor blunt trauma without skin disruption may precede life-threatening invasive GAS infection. Rapid recognition, surgical source control, antitoxin antimicrobial therapy, and intensive organ support are essential in suspected STSS.
Cadmium (Cd) is a persistent heavy metal pollutant that accumulates in aquatic organisms and poses severe threats to reptiles. Meanwhile, nano-plastics (NPs), as emerging contaminants, have been detected extensively in aquatic environments and can act as carriers for other pollutants. This study employed Chinese soft-shelled turtle embryonic fibroblast (CSSTEF) as an in vitro model to investigate the individual and combined toxicological effects of Cd and NPs. The objectives were to determine the half-maximal inhibitory concentration (IC50) of Cd in CSSTEF cells, evaluate the cytotoxic interactions between Cd and NPs through multiple endpoints including cell viability, membrane integrity, and oxidative stress biomarkers, and elucidate the underlying molecular mechanisms using transcriptomic and model analyses. Our results demonstrated that Cd exhibited concentration-dependent cytotoxicity with an IC50 value of 102.9 μM at 72 h exposure. Both Cd exposure and combined exposure obviously altered cell morphology and exacerbated oxidative stress. Under combined exposure, antagonistic effects were observed on superoxide dismutase (SOD), catalase activities (CAT) and lactate dehydrogenase (LDH), while additive effects were detected on glutathione S-transferase (GST). Transcriptomic analysis revealed significant enrichment of pathways related to glycosaminoglycan biosynthesis and extracellular matrix (ECM) receptor interactions in the Cd and NPs combined exposure group, indicating activated extracellular matrix metabolism and cellular stress responses. Quantitative real-time polymerase chain reaction confirmed the differential expression of key genes involved in these pathways. These findings establish CSSTEF cells as a valuable model for reptilian toxicology research and highlight the necessity of multi-biomarker approaches in assessing the risks of contaminant mixtures in freshwater ecosystems relevant to turtle conservation.
Fibroblast activation protein (FAP) is highly expressed in various sarcomas, including solitary fibrous tumors (SFTs). In recent years, radiolabeled FAPI tracers have emerged as potential therapeutic targets. In SFTs with high FAP expression, 90Y-FAPI-46 demonstrated promising therapeutic efficacy. These findings highlight the potential of FAPα expression as a clinically relevant biomarker for patient selection and establish 90Y-FAPI-46-based radiopharmaceutical therapy as a promising and meaningful therapeutic option for patients with malignant SFT.
Nanoparticle-protein dispersions constitute complex soft materials in which competing attractive and repulsive interactions can strongly influence their phase behavior, including gelation. In this work, we demonstrate a strategy to utilize interaction between anionic silica nanoparticles and anionic protein bovine serum albumin to achieve heat-induced gels with tunable physical properties. Upon heating, the protein molecules in solution undergo unfolding followed by hydrophobic aggregation, leading to the formation of a three-dimensional gel network. The introduction of negatively charged nanoparticles generates additional electrostatic repulsion that competes with the attractive hydrophobic interactions between partially unfolded proteins. This competition modifies both the structure and mechanical properties of the resulting gels. In particular, nanoparticle-protein gels exhibit markedly enhanced optical transparency (∼90%) compared with gels formed from pure protein solutions (<1%). Rheological measurements further show shear-thinning behavior, with the gel strength decreasing systematically with increasing nanoparticle concentration, leading to progressively softer gels. At sufficiently high nanoparticle content, gelation is completely suppressed, thereby stabilizing the protein dispersion against thermal aggregation. The underlying mechanism is elucidated in terms of interaction potentials obtained by modeling small-angle neutron scattering data measured in situ during gel formation. Finally, we demonstrate that nanoparticle concentration and ionic strength serve as effective parameters to control gel opacity and mechanical rigidity, enabling the formation of both soft and rigid gels. These results demonstrate how nanoparticle-mediated interactions can regulate aggregation and gelation in protein-based soft matter systems.
Computed tomography acquisition parameters, including dose level, slice thickness, and reconstruction kernel, vary substantially across clinical sites, yet artificial intelligence (AI)-assisted lung nodule detection systems are rarely evaluated against this variability. We propose and demonstrate a physics-guided framework for evaluating detection model sensitivity to systematic acquisition parameter variation. 154 cases from the LIDC-IDRI dataset were evaluated using a Medical Open Network for AI (MONAI) RetinaNet model pretrained on LUNA16 (fold 0, no fine-tuning) across six imaging conditions: baseline, 25% dose reduction, 50% dose reduction, 3 mm slice thickness, 5 mm slice thickness, and soft kernel reconstruction. Dose reduction was simulated via image-domain Gaussian noise; slice thickness via z-axis moving average. Detection sensitivity was computed at confidence threshold 0.5 with a 15 mm matching criterion. Baseline sensitivity was 84.8% (95% CI: 80.2-89.8%). Soft kernel and 5 mm slice thickness produced the largest decreases: 74.3% (-10.5 pp, p < 0.05) and 71.6% (-13.2 pp, p < 0.05), respectively. Dose reduction caused moderate asymmetric degradation: 76.0% at 25% dose (-8.8 pp, p < 0.05) and 80.0% at 50% dose (-4.8 pp, p < 0.05). 3 mm slice thickness produced a small but significant reduction (-2.4 pp, p = 0.009). Reductions were most pronounced in the 3-6 mm range and consistent across confidence thresholds. Slice thickness and soft reconstruction kernel represent stronger constraints on AI detection performance than image noise under these conditions. The proposed framework is reproducible, requires no proprietary scanner data, and provides a practical basis for post-deployment acquisition QA.
Colloidal gels assembled from nanoparticles (NPs) are a versatile class of soft network-based materials capable of rich dynamic, mechanical, and even optical or magnetic responses to stimuli. Their behaviors are governed by dynamics of heterogeneous structures coupled across multiple length and timescales. Observable dynamics range from nanoparticle diffusion and clustering to mesoscopic cluster dynamics and interactions to localized or collective network relaxations. Understanding how these hierarchically organized processes relate to macroscopic network properties remains a broad and unresolved problem in soft matter physics. The mechanisms of gel formation can depend sensitively on the pathway and the nature of NP interactions, thus far preventing a unified theoretical bridge between nanoscopic interactions, structural evolution, and network dynamics. Indirect measurement of dynamics using light-scattering techniques provides an experimental means to quantify underlying particle and network motion. The rich dynamic behavior of NP gels warrants consideration of a broad range of models to help interpret nonlinear relaxation phenomena such as anomalous diffusion, nonergodicity, and intrinsically nonequilibrium or mechanically driven dynamics. X-ray photon correlation spectroscopy (XPCS) has emerged as a powerful tool for probing nanoscopic motion in nanoparticle gels but alone cannot resolve the full spatiotemporal spectrum of dynamics that drive gelation, aging, and network mechanical properties. While in situ rheo-XPCS enables simultaneous probing of nanoscale and bulk mechanical responses, complementary light scattering, microscopy, or simulations can extend spatiotemporal characterization and, consequently, understanding of NP gel network physics. Implementing a modular model platform with tunable primary nanoparticle features allows systematic variation of nanoscopic characteristics that drive emergent gel responses and inform the development of theoretical models for a wide range of soft, dynamic, nanostructured materials. Gels formed from particles with unique structural proxies, such as electromagnetic coupling in plasmonic NPs, provide additional metrics for model validation and offer opportunities to develop computational methods for the efficient and accurate replication of NP gel properties. The rapid expansion of XPCS capabilities at fourth-generation light sources, combined with complementary tools and robust model systems, positions the field to move beyond descriptive fundamental studies toward the design of nanoparticle gels with adaptive and programmable behaviors.
Programmable metamaterials that exhibit prescribed mechanical responses and adaptive deformation under external loading are highly desirable for multifunctional engineering applications. However, most existing designs rely on multi-material systems, which pose significant fabrication challenges with conventional additive manufacturing. Inspired by the unique soft-hard heterogeneous architecture of nacre, this study introduces a novel class of dual-phase (DP) metamaterials where spatially encoded soft and hard phases are realized through bending-dominated and stretching-dominated lattice architectures, respectively. By systematically varying the spatial coding patterns of soft-hard phases, representative DP metamaterials are shown to exhibit programmable nonlinear mechanical responses and tailored failure processes, achieved through geometry-based mechanical encoding governed by phase interactions and internal stress redistribution. Notably, the engineered sequenced failure processes and phase-coupling-induced strengthening effects lead to significantly enhanced energy absorption compared with the constituent architectures, while enabling customizable plateau stress. To efficiently explore the vast design space of DP metamaterials, a data-driven framework is then developed to model the relationship between spatial encodings and nonlinear mechanical responses. The trained model enables rapid and accurate inverse design of DP metamaterials matching the complex target responses for multifunctional applications. Overall, this work establishes a new geometry-based strategy for achieving highly programmable mechanical responses in single-material metamaterials.
Microvascular free flaps are standard for complex floor-of-mouth (FOM) reconstruction, but regional options may be preferable for selected soft-tissue defects not requiring bony reconstruction. To compare operative time and early outcomes between sternocleidomastoid (SCM) muscle flaps and microvascular free flaps after oncologic FOM resection. This retrospective cohort study was conducted at Bakırçay University Çiğli Training and Research Hospital. The sample included adult subjects who underwent oncologic FOM resection with immediate soft-tissue reconstruction between January 2022 and May 2026. Subjects were excluded if reconstruction was performed with other regional flaps, required bony reconstruction, or had missing outcome data. Primary FOM reconstruction technique, grouped as SCM muscle flap or microvascular free flap. Primary outcome was operative time. Secondary outcomes were length of stay (LOS), postoperative day of first oral intake, oral intake before discharge, and postoperative complications. Age, sex, American Society of Anesthesiologists class, defect extent, and tumor stage. Bivariate analyses used Mann-Whitney U, χ2, or Fisher's exact tests. Multivariable linear regression was performed for continuous outcomes. The sample included 33 subjects: 17 SCM flaps and 16 free flaps. Operative time was 295.3 (99.9) and 456.8 (156.4) minutes for the SCM and free flap groups, respectively (P = .003). LOS was 13.2 (4.5) and 20.4 (6.1) days, respectively (P = .002). Intensive care unit (ICU) LOS was 0.4 (0.5) and 1.6 (0.6) days, respectively (P < .001). ICU admission occurred in 7 of 17 SCM subjects (41.2%) and 16 of 16 free flap subjects (100%) (P < .001). Postoperative day of first oral intake was 11.0 (6.6) and 12.3 (3.5) days, respectively (P = .1). In adjusted models, free flap reconstruction was associated with longer operative time (b = 204.2 minutes; P = .005), LOS (b = 6.7 days; P = .027), and ICU stay (b = 1.4 days; P < .001). For selected FOM soft-tissue defects not requiring bony reconstruction, SCM muscle flap reconstruction was associated with shorter operative time, shorter hospitalization, and reduced ICU use with comparable early oral intake.
To compare the orthodontic effects of physiological anchorage Spee's-wire system(PASS) appliance and Clear aligner in Angle Class Ⅱ malocclusion. A total of 80 patients with Angle Class Ⅱ malocclusion admitted to Qinghai Provincial Communications Hospital from November 2023 to December 2024 were selected and randomly divided into PASS group and Clear aligner group, with 40 cases in each group. The orthodontic effects, imaging indicators of soft and hard tissues, periodontal indicators, complications, masticatory function and oral health of the patients were compared and analyzed. At 6 months after orthodontic treatment, the peer assessment rating（PAR） score of the PASS group was lower than that of the Clear aligner group (P＜0.05). After treatment, U1-NA angle decreased and L1-NB angle increased in both groups, the improvement in the PASS group was more significant than that in the Clear aligner group (P＜0.05). There was no significant difference in SNA and SNB between the two groups before and after orthodontic treatment (P＞0.05). After treatment,upper and lower lip protrusion (ULP, LLP) decreased, while the Z-angle increased in both groups, the improvement in the PASS group was more significant than that in the Clear aligner group(P＜0.05). After treatment, the probing depth (PD), bleeding index (BI) and gingival index (GI) levels of the two groups were significantly higher than those before treatment (P＜0.05). There was no significant difference in PD, BI and GI between the two groups after treatment (P＞0.05). After treatment, the bite force and chewing efficiency of both groups were significantly increased compared to pre-treatment (P＜0.05), and the increase was more significant in the PASS group (P＜0.05). After orthodontic treatment, the scores of the Oral Health Impact Profile-5 (OHIP-5) in both groups decreased significantly, and the decrease was more significant in the PASS group(P＜0.05). The clinical efficacy of PASS appliance in the treatment of Angle Class Ⅱ malocclusion is good, which can effectively improve the soft and hard tissue indexes and masticatory function of patients, while the Clear aligner has little side effect on the periodontal tissue of patients, and the degree of oral health is better.
Background: Developmental dysplasia of the hip (DDH) is one of the leading causes of secondary hip osteoarthritis and frequently results in severe anatomical alterations that make total hip arthroplasty (THA) technically demanding. Restoration of hip biomechanics, limb length, and joint stability remains challenging, particularly in patients with moderate-to-severe dysplasia. Objective: To evaluate the clinical and radiographic outcomes of cementless total hip arthroplasty combined with soft-tissue balancing, with or without acetabular reconstruction using autologous femoral head graft, in patients affected by osteoarthritis secondary to DDH. Methods: A retrospective single-center case series was conducted on eight female patients (mean age 53.9 ± 14.6 years; range 33-80 years) who underwent primary cementless THA for DDH-related osteoarthritis between 2019 and 2025. Clinical outcomes were assessed using the Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Short Form-36 (SF-36). Radiographic evaluation included implant positioning, osteolysis, heterotopic ossification, bone graft incorporation, and leg-length discrepancy. Data normality was assessed using the Shapiro-Wilk test. Preoperative and postoperative outcomes were compared using paired Student's t-test and confirmed with the Wilcoxon signed-rank test. Implant survival and revision-free status were recorded throughout the follow-up period. Results: At a minimum follow-up of 12 months (range 12 months-6 years), significant improvements were observed in all clinical outcome measures. Mean HHS increased from 49.3 ± 2.5 preoperatively to 90.4 ± 2.7 postoperatively (p < 0.001), while mean WOMAC decreased from 53.5 ± 5.6 to 7.4 ± 3.3 (p < 0.001). Mean SF-36 improved from 47.2 ± 3.8 to 89.9 ± 3.2 (p < 0.001). Wilcoxon analysis confirmed the statistical significance of these findings (all p = 0.0078). Radiographic assessment demonstrated satisfactory implant positioning and stable fixation in all patients, with no evidence of osteolysis or implant loosening. Minor complications included one intraoperative periprosthetic femoral fracture treated successfully with cerclage wiring, two cases of Brooker grade I-II heterotopic ossification, and one case of minimal graft resorption without clinical consequences. No revision procedures were recorded during follow-up, and implant survival was 100%. Conclusions: Cementless THA combined with selective soft-tissue balancing provides excellent clinical, functional, and radiographic outcomes in patients with osteoarthritis secondary to DDH. This approach significantly improves hip function and quality of life while ensuring stable implant fixation, low complication rates, and excellent mid-term implant survival.
Microfluidic devices remain difficult to translate into commercial products, particularly for three-dimensional (3D) applications. While soft lithography offers high-resolution features and biocompatibility, its workflows and planar geometries are limited. Conversely, industry-standard injection moulding enables scalability, but lacks flexibility and incurs high upfront costs. Here, we present an innovative hybrid microfabrication methodology combining stereolithographic 3D printed moulds with flexible wire templating and polydimethylsiloxane (PDMS) casting to create monolithic 3D microfluidic devices. Leveraging injection moulding design principles, this enables the rapid and repeatable fabrication of microfluidic devices with embedded internal channels, variable-height membranes, and curved geometries. Our methodology is validated using a variety of devices, including flexible membranes, plug-based flow distributors for 96-well plates, and high-aspect-ratio bioreactors with integrated electrodes. The resulting devices were leak-proof, reusable, and compatible with standard cell culture systems. This scalable, low-cost methodology retains the advantages of PDMS while allowing for 3D design freedom for both internal channels and external features, making it ideal for emerging applications such as organ-on-chip, bioprinting, diagnostics, and soft robotics.
Instability after total knee arthroplasty (TKA), particularly in the mid-flexion range, is associated with reduced patient satisfaction and poorer functional outcomes. Image-free robot-assisted TKA (rTKA) enables quantitative intraoperative assessment and adjustment of soft-tissue balance and component position; however, it remains unclear which intraoperative component gap (CG) at each flexion angle and in each compartment is most strongly associated with postoperative outcomes and which component-positioning factors determine that gap. This prospective cohort study included 72 consecutive knees that underwent primary image-free rTKA using the Journey II Bi-Cruciate Stabilised knee system between 2021 and 2024. Intraoperative CG was measured at 0°, 30°, 60° and 105° of flexion using an independently tensioned medial-lateral ligament tensioner and was defined as the measured gap minus the thickness of the final insert used. Clinical assessment was performed preoperatively and at 1 year postoperatively using self-reported knee instability (SRKI) and the knee injury and osteoarthritis outcome score (KOOS). Associations of each CG with SRKI and KOOS total at 1 year were examined using regression analyses adjusted for age and body mass index (BMI). In addition, the CG associated with worse postoperative clinical outcomes was used as the dependent variable to analyse its associations with component-positioning factors. Both medial and lateral CGs were significantly smaller at 30° and 60° of flexion than at 0° and 105°. Among all measured gaps, the medial CG at 30° of flexion (Med CG30°) showed the most consistent association with postoperative outcomes. An increase in Med CG30° was significantly associated with SRKI positivity at 1 year and with a lower KOOS total score. In multivariable analysis, Med CG30° was independently associated with femoral coronal, sagittal and rotational alignment, whereas no significant associations were found with tibial component-positioning factors. In image-free rTKA using the Journey II system, an increased medial CG at 30° of flexion was associated with postoperative subjective instability and worse patient-reported clinical outcomes. In soft-tissue balance assessment during TKA, attention should be paid not only to the extension and flexion gaps but also to the Med CG30°. Level II.
Nanocellulose dispersions and hydrogels represent a promising class of sustainable soft materials with dynamic responsiveness to external stimuli. This study employs visualization, statistical analysis, and particle image velocimetry to investigate the dynamic behavior of cationic (CCNF) and TEMPO-oxidized (TOCNF) cellulose nanofibril dispersions under sonication, focusing on hydrogel network formation at varying concentrations (0.5-2.0 wt% for CCNF and 1.0-2.0 wt% for TOCNF). CCNF dispersions rapidly formed physically crosslinked layers even at low concentrations due to attractive interactions via quaternary ammonium groups, resulting in persistent hydrogel networks. In contrast, TOCNF required concentrations over 1.3 wt% to overcome electrostatic repulsion between carboxylate groups and formed weaker, transient gels. Image sequence analysis revealed that crosslinked layer thickness and lifetime increased with concentration for both nanocellulose types, with 2.0 wt% samples exhibiting robust, resilient hydrogel structures throughout sonication. While CCNF showed resistance to ultrasonic disruption, TOCNF networks degraded rapidly due to weaker intermolecular interactions. Results highlight how nanofibril surface chemistry and concentration govern the interplay between ultrasound-induced network formation and its destabilization. The study provides mechanistic insights into sonication-driven gelation and establishes a methodological framework for designing nanocellulose-based materials with tailored real-time structural responsiveness, bridging nanostructural dynamics and macroscopic behavior for advanced soft material applications.
To compare the effect of grinding and bone chiseling maxillary sinus internal lifting in dentition defects of posterior teeth with insufficient vertical bone mass. A total of 92 patients with dentition defects in the posterior teeth area due to insufficient vertical bone mass admitted from January 2020 to December 2021 were selected and divided into the control group (n=46) and the experimental group (n=46) by random number table method. The control group was treated with maxillary sinus floor internal lifting via grinding, while the experimental group was treated with maxillary sinus floor internal lifting via bone chiseling. The operative conditions, bone resorption, residual bone height (RBH), implant success rate, peri-implant soft tissue, patient's satisfaction and postoperative complications were compared between the two groups. There was no significant difference in implant length and diameter between the two groups (P＞0.05). The operation time in the experimental group was significantly longer than in the control group (P＜0.05), and the amount of intraoperative blood loss was significantly higher than in the control group(P＜0.05). One year after surgery, there were no significant differences in probing depth (PD), gingival papillary index, modified sulcular bleeding index (mSBI) and modified plaque index (mPLI) between the two groups (P＞0.05), the satisfaction rate of patients in the experimental group was significantly higher than that in the control group (P＜0.05), and there was no significant difference in the total incidence of complications between the two groups(P＞0.05). Three years after surgery, the bone resorption amounts at the root, distal and near midedge of the implants in both groups increased significantly(P＜0.05), and more prominent in the experimental group (P＜0.05). RBH in both groups increased significantly(P＜0.05), and more prominent in the experimental group (P＜0.05). There was no significant difference in the success rate of the implants between the two groups(P＞0.05). Internal lifting of the maxillary sinus by grinding and bone chiseling has good effect in dentition defects of posterior teeth with insufficient vertical bone mass and has a relatively small impact on the soft tissues around the implants. Internal maxillary sinus lifting with bone chisel can promote bone tissue absorption, increase RBH, and improve patients' satisfaction, with increased intraoperative trauma.
Abutment design in the esthetic zone must support peri‑implant soft tissues while maintaining sufficient mechanical strength. This in vitro study evaluated the fracture resistance of two commercial titanium-base (Ti-base) abutments and two customized Ti‑bases featuring biologically inspired, soft‑tissue-oriented geometries. Four groups were tested: A: commercial Ti‑base (transmucosal height 2.0 mm; bonding-base height 4.0 mm); B: commercial Ti‑base with increased bonding-base height (8.0 mm); C: customized Ti‑base with an anatomically contoured margin (mesial and distal areas 1.5 mm, and palatal area 1.0 mm more coronal than the vestibular margin; transmucosal height 2.5 mm; bonding‑base height 4.0 mm); D: customized Ti‑base with contoured margin and channel for angled screw (transmucosal height 2.5 mm; bonding‑base height 4.0 mm). Abutments were tightened onto implant analogs and subjected to static load-to-fracture testing using a universal testing machine (Instron). One‑way ANOVA and Tukey post‑hoc tests were applied (α = .05). Statistically significant differences were detected among groups (p < 0.0001), however no statistically significant difference was found between group B and D (p = 0.0685). Mean fracture resistance values (N ± SD) were: Group A, 873.2 ± 18.2; Group B, 570.2 ± 34.3; Group C, 1068.5 ± 75.5; Group D, 631.6 ± 66.0. Yield point values were: Group A, 755 ± 17.6; Group B, 468.8 ± 31.8; Group C, 885.2 ± 28.1; Group D, 608.4 ± 85.9. Within the limitations of this in vitro mechanical evaluation, the anatomically contoured customized Ti‑base demonstrated the highest fracture resistance. The use of a Ti-base with anatomically scalloped shoulders (1.5 mm interproximal elevation, 1.0 mm palatal elevation) demonstrated superior mechanical properties (1068.5 N fracture load) compared to conventional designs (873.2 N), suggesting potential clinical advantages for managing esthetic cases with scalloped-thin gingival phenotypes, while maintaining fracture resistance above physiological loads (90-390 N). However, clinical validation and fatigue testing are required before widespread adoption.
Degenerative tendon tears are common, but mechanisms behind initiation and progression are not fully understood. There is a clear need to be able to track microstructural changes during progressive biological degradation to better understand degenerative tendon pathophysiology. The aim of this study was to evaluate the sensitivity of a snapshot Stokes polarimetry technique, quantitative polarized light imaging (QPLI), in monitoring the severity and progression of biologically mediated degeneration in tendon. Leveraging a collagenase mediated in vitro tendon digestion model, we assessed the effect of enzyme degradation on polarimetric outcomes from reflectance and transmission modes of QPLI, second harmonic generation (SHG) imaging, histology, and mechanical testing. Changes observed in reflectance mode QPLI (rQPLI) allowed for characterization of progression of degeneration at all digestion severities tested, whereas data acquired from transmission mode QPLI was only able to discern changes at the most severe digestion level. Outcomes from this study establish rQPLI as a powerful tool in the microstructural evaluation of musculoskeletal soft tissues, particularly in the context of monitoring progressive degradation. The findings from this study also highlight the potential multiscale nature of biological degeneration in tendon and emphasize the importance of better understanding these processes to inform regeneration and repair strategies.
Background and Clinical Significance: Hyperviscosity syndrome (HVS) is a rare complication of primary Sjögren's syndrome (pSS). While therapeutic plasma exchange (TPE) is the standard treatment to clear pathogenic immunoglobulins, its execution can trigger severe, atypical systemic risks. Case Presentation: A 60-year-old woman with pSS and extreme polyclonal hypergammaglobulinemia (total protein 100 g/L, IgM 41 g/L) presented with an acute hyperviscosity crisis, causing retinopathy, neurological deficits, and skin ischemia. Emergency TPE with 5% albumin replacement successfully reduced IgM by ~90% (to 6.39 g/L), resolving HVS symptoms. However, 20 min post-procedure, the patient suffered sudden hemodynamic collapse (BP 50/30 mmHg) and developed multiple massive, expanding soft-tissue hematomas. Laboratory tests revealed a coagulopathy consistent with plasma protein depletion following therapeutic plasma exchange, characterized by severe hypofibrinogenemia (1.35 g/L) and a 50% reduction in total serum protein. TPE was permanently discontinued. The patient was successfully stabilized using aggressive fluid resuscitation, vasopressors, and fresh frozen plasma (FFP) transfusions, followed by maintenance therapy with rituximab. Conclusions: In conclusion, clinicians should remain vigilant that severe hyperviscosity syndrome can be driven by a polyclonal increase in immunoglobulins rather than just monoclonal entities; furthermore, managing this condition requires careful balancing of TPE efficacy against its potential to trigger profound depletion coagulopathy.