Search

Polydimethylsiloxane (PDMS) adhesive films have increasingly attracted attention due to their inherent properties such as biocompatibility, high flexibility, optical transparency, and many others. In this contribution, dopamine‐functionalized polydimethylsiloxane polymer conetworks prepared from poly(pentafluorophenyl acrylate)‐l‐polydimethylsiloxane (PFPA‐l‐PDMS) amphiphilic polymer conetwork precursors are proposed. This straightforward approach gives easy access to polydopamine‐functionalized PDMS polymer conetworks with a different composition, stiffness of the polymer conetwork, and their corresponding nanoscale phase‐separated morphologies. The adhesive property of the polymer films on the glass substrate obtained by lap shear testing gives a maximum adhesive strength of 0.85 ± 0.08 MPa thanks to phase‐separated morphologies at the nanometer scale and the high flexibility inherent to polysiloxane. The proposed approach provides an easy and straightforward way to introduce dopamine into a polymer conetwork with tunable adhesive properties. [ABSTRACT FROM AUTHOR]

Triple-shape polymers can memorize two independent shapes during a controlled recovery process. This work reports the 4D printing of electro-active triple-shape composites based on thermoplastic blends. Composite blends comprising polyester urethane (PEU), polylactic acid (PLA), and multiwall carbon nanotubes (MWCNTs) as conductive fillers were prepared by conventional melt processing methods. Morphological analysis of the composites revealed a phase separated morphology with aggregates of MWCNTs uniformly dispersed in the blend. Thermal analysis showed two different transition temperatures based on the melting point of the crystallizable switching domain of the PEU (Tm~50 ± 1 °C) and the glass transition temperature of amorphous PLA (Tg~61 ± 1 °C). The composites were suitable for 3D printing by fused filament fabrication (FFF). 3D models based on single or multiple materials were printed to demonstrate and quantify the triple-shape effect. The resulting parts were subjected to resistive heating by passing electric current at different voltages. The printed demonstrators were programmed by a thermo-mechanical programming procedure and the triple-shape effect was realized by increasing the voltage in a stepwise fashion. The 3D printing of such electroactive composites paves the way for more complex shapes with defined geometries and novel methods for triggering shape memory, with potential applications in space, robotics, and actuation technologies. [ABSTRACT FROM AUTHOR]

Background: Health-care expenditures in the U.S. are continually rising, prompting providers, patients, and payers to search for solutions to reduce costs while maintaining quality. The present study seeks to define the out-of-pocket price that patients undergoing hand surgery are willing to pay, and also queries the potential cost-cutting measures that patients are most and least comfortable with. We hypothesized that respondents would be less accepting of higher out-of-pocket costs.Methods: A survey was developed and distributed to paid, anonymous respondents through Amazon Mechanical Turk. The survey introduced 3 procedures: carpal tunnel release, cubital tunnel release, and open reduction and internal fixation of a distal radial fracture. Respondents were randomized to 1 of 5 out-of-pocket price options for each procedure and asked if they would pay that price. Respondents were then presented with various cost-saving methods and asked to select the options that made them most uncomfortable, even if those would save them out-of-pocket costs.Results: There were 1,408 respondents with a mean age of 37 years (range, 18 to 74 years). Nearly 80% of respondents were willing to pay for all 3 of the procedures regardless of which price they were presented. Carpal tunnel release was the most price-sensitive, with rejection rates of 17% at the highest price ($3,000) and 6% at the lowest ($250). Open reduction and internal fixation was the least price-sensitive, with rejection rates of 11% and 6% at the highest and lowest price, respectively. The use of older-generation implants was the least acceptable cost-cutting measure, at 50% of respondents.Conclusions: The present study showed that most patients are willing to pay a considerable amount of money out of pocket for hand surgery after the condition, treatment, and outcomes are explained to them. Furthermore, respondents are hesitant to sacrifice advanced technology despite increased costs. [ABSTRACT FROM AUTHOR]

Introduction: Opioid sparing protocols should be formulated with appropriate demand. Specific fracture location has been hypothesized as an important predictor of post-operative pain. The purpose of this study is to evaluate the impact of fracture location on perioperative opioid demand after surgery with the hypothesis that this factor would be significantly associated with perioperative opioid demand in upper extremity fracture surgery.Methods: A national database was used to identify1-month pre-operative to 1-year postdischarge opioid demand in oxycodone 5-mg equivalents in 336,493 patients undergoing fracture fixation of the clavicle through distal radius between 2010 and 2020. Three timeframes were evaluated: 1-month pre-op to 90-days post-discharge, 3 months post-discharge to 1-year post-discharge, and 1-month pre-op to 1-year postdischarge. Multivariable main effects linear and logistic regression models were constructed to evaluate the changes in opioids filled, opioid prescriptions, and odds of two or more opioid prescriptions in these timeframes based on fracture location with adjustment for age, sex, obesity, pre-operative opioid usage, and polytrauma.Results: Compared to distal radius fracture fixation, fixation of elbow, distal humerus, humeral shaft, and proximal humerus fractures were associated with large, significant increases in 1-month pre-op to 1-year post-discharge opioid filling (33.5 - 63.4 additional oxycodone 5-mg equivalents, all p<0.05) and number of filled prescriptions (0.33 - 0.92 additional prescriptions, all p<0.05) compared to patients with other operatively treated upper extremity injuries.Discussion: Fracture location was a significant predictor of perioperative opioid demand. Elbow, distal humerus, humeral shaft, and proximal humerus fracture fixation was associated with the largest increases in opioid demand after upper extremity fracture fixation. Patients with these injuries may be at highest risk of extensive opioid consumption.Level Of Evidence: Level III, retrospective, observational cohort study. [ABSTRACT FROM AUTHOR]

Introduction: Heterotopic ossification (HO) is a well-known sequela after an elbow injury and is widely studied given the associated morbidity. The anatomic location of HO development for specific elbow injuries has not been reported. The purpose of this study was to describe the precise, anatomic location of HO development after different peri-articular elbow injuries. Methods: A retrospective chart review was performed for patients with peri-articular elbow fracture and/or dislocation who underwent an elbow contracture release. The injuries were grouped into coronal shear distal humerus/AO 13.B3 (CSDH), distal humerus/AO 13.A, 13.B1, B2 or 13.C (DH), olecranon/AO 21.B1 (OL), radial head/AO 21.B2 (RH), extra-articular proximal radius and ulna/AO 21.A (EAPRU) fractures and elbow dislocations (DL). The HO location was determined by reviewing elbow radiographs and CT scans and were classified as anterior capsule, medial or lateral collateral ligaments, and posterior capsule/triceps insertion. Results: The study consisted of 49 patients, such as 6 CSDH, 13 DH, 6 OL, 21 RH, 4 EAPRU fractures and 20 elbow DL. All CSDH and RH fractures and 19/20 elbow DL developed HO in the collateral ligaments, while 12/13 DH fractures developed an anterior capsule HO. All 6 OL fractures developed HO posteriorly, and 3/4 EAPRU fractures developed a proximal radioulnar synostosis. Conclusions: Our findings suggest that the location of HO development is specific to the injury type and is influenced by the soft tissues involved. This is consistent with the understanding that HO is the abnormal ossification of normal structures. [ABSTRACT FROM AUTHOR]