Single Button Research Articles

Enhanced stability of the distal radioulnar joint with double suture button construct: a cadaveric study

BackgroundDistal radioulnar joint (DRUJ) instability is a common post-traumatic complication, often leading to chronic pain and dysfunction. Current reconstructive techniques, such as the single suture button construct, offer suboptimal stabilization in certain motions. This study aimed to evaluate whether a double suture button construct provides greater stability than the single construct in a cadaver model of DRUJ instability. We hypothesized that the double suture button construct would more effectively minimize dorsal translation of the radius relative to the ulna.MethodsWe used nine freshly frozen human cadaver upper extremities, destabilized the DRUJ, and then reconstructed the joint using three different suture button constructs: single transverse, double (transverse + oblique), and single oblique. The specimens were secured in a custom-designed testing apparatus to measure dorsal translation of the radius. The study proceeded in five stages: stable DRUJ, unstable DRUJ, and reconstruction using a single transverse, double (transverse + oblique), and single oblique suture button construct. Dorsal translation was measured at neutral, 45° pronation, and 45° supination. Statistical comparisons of mean values were conducted for each stage.ResultsReconstruction with the transverse, transverse plus oblique, and oblique suture button constructs resulted in statistically significant reductions in dorsal translation compared to the unstable DRUJ (p < 0.001 for all). The double-suture button construct significantly minimized dorsal translation in all positions, restoring stability comparable to a stable DRUJ: neutral (p = 1.000), pronation (p = 0.963), and supination (p = 1.000). In contrast, single constructs failed to fully restore stability in pronation and supination.ConclusionThe double suture button construct provides significantly greater stabilization of the DRUJ compared to the single construct. These findings suggest that the double construct could be a more effective option for treating DRUJ instability, particularly in restoring normal joint function during various motions. Further research is warranted to confirm these results in clinical settings.

Long-term electrochemical characterization of novel Sr2FeMo0.65Ni0.35O6−δ fuel electrode for high-temperature steam electrolysis in solid oxide cells

The present study focuses on the highly catalytic double-perovskite Sr2FeMo0.65Ni0.35O6−δ (SFMNi) fuel electrode material for Solid Oxide Electrolysis Cells (SOECs). The electrolyte-supported single button cells with the highly active SFMNi fuel electrode were electrochemically characterized between 900 °C down to 750 °C in steam and co-electrolysis conditions using DC- and AC-techniques. The cells achieved current densities of −1.62 A cm−2 and −1.74 A cm−2 at 900 °C under steam and co-electrolysis conditions, respectively, exceeding the performance of cells with Ni-8YSZ fuel electrodes by ∼65–79 % and Ni-GDC fuel electrodes by 24–28 %. The post-test SEM-EDX analyses of the as-prepared and tested cells’ cross-section showed increased pore formation and particle growth of the SFMNi fuel electrode after testing in the humidified atmosphere for 500 h.

Erroneous saccade co-execution during manual action control is independent of oculomotor stimulus-response translation ease

Recent multiple action control studies have demonstrated difficulties with single-action (vs. dual-action) execution when accompanied by the requirement to inhibit a prepotent additional response (e.g., a highly automatic eye movement). Such a dual-action performance benefit is typically characterized by frequent false-positive executions of the currently unwarranted response. Here, we investigated whether the frequency of false-positive saccades is affected by the ease of translating a stimulus into a spatial oculomotor response (S-R translation ease): Is it harder to inhibit a saccade that is more automatically triggered via the stimulus? Participants switched on a trial-by-trial basis between executing a single saccade, a single manual button press, and a saccadic-manual dual action in response to a single visual stimulus. Importantly, we employed three different stimulus modes that varied in oculomotor S-R translation ease (peripheral square > central arrow > central shape). The hierarchy of S-R translation ease was reflected by increasing saccade and manual reaction times. Critically, however, the frequency of false-positive saccades in single manual trials was not substantially affected by the stimulus mode. Our results rule out explanations related to limited capacity sharing (between inhibitory control and S-R translation demands) as well as accounts related to the time available for the completion of saccade inhibition. Instead, the findings suggest that the erroneous co-activation of the oculomotor system was elicited by the mere execution of a (frequently associated) manual response (action-based co-activation).

Arthroscopic intercruciate trans-septal posterior cruciate ligament avulsion fixation with pull-through technique using a single button adjustable loop device

Numerous arthroscopic techniques have been described for the fixation of posterior cruciate ligament avulsion, including the pull-out technique with suture or tape fixed with a knot tied over a free cortical button on the anterior tibial cortex, and the adjustable loop with double cortical buttons. We present a modification of the suture pull-out method utilizing the readily available adjustable loop with a single cortical loop button for fixation on the anteromedial tibial cortex. The surgery is performed through an intercruciate trans-septal approach with the suture bridge configuration and cross-over of suture tapes, with two diverging tibial tunnels with a single anterior opening forming a “Y-shaped tunnel.” The advantages of the suture pull-through method and the adjustable loop device can be combined using this technique modification.

Online imaging system for component integrity test

A large number of tests have been performed on piping components of Indian Nuclear Power Plants, to study their fracture behavior and generate the fracture properties, and to validate the failure models. The materials of these piping components are carbon steel and stainless-steel welds, and tests were conducted under monotonic/cyclic loading conditions. During these component tests the crack growth data measurements in sync with the applied load and load line displacement (LLD) were required to facilitate post- test calculation of fracture resistance J-R curve. Unlike in small specimens (like CT, TPB, etc.), the compliance function for large components like pipes and elbows are not available. Further, it is known that in these materials the crack growth happens in out- of-plane and, the angle at which it grows cannot be anticipated in advance. This phenomenon imposes further limitation on usage of conventional methods like compliance based / potential drop-based method used for crack growth measurement. Therefore, a new Imaging based technique was developed in-house in 2018 and used to measure crack growth during these tests during 2020-21. In this technique the synchronous images of both the crack tips and related image of computer screen showing values of applied load, LLD, etc. are acquired using single click button. The software required for synchronous acquisition of images from various cameras during fracture experiments was developed. Each image set contains images of both crack tips, and Load and LLD image. Subsequently, the crack tip images were manually analyzed to obtain the magnitude of crack growth with applied loading. This paper narrates the developed imaging system setup followed by a discussion on the software for image acquisition.

IoT-Based Smart Stick for Visually Impaired People

This paper presents the development of a smart stick to enhance visually impaired individuals' mobility, safety, and independence. The study aimed to integrate various features into a cohesive and user-centric device. The stick incorporates GSM/GPS tracking for continuous user location monitoring. This smart home automation mechanism allows the user to turn utilities ON/OFF with a single button press, obstacle detection using ultrasonic sensors, battery optimization techniques including solar charging and voltage supply to the battery by use of a stepper motor, emergency communication through GSM technology, and stick tracking within a certain radius using RF modules. The study's findings demonstrate the successful integration and functionality of the proposed features, cover the gaps identified with the help of extensive research and critical literature review and extend a gateway into the ocean of future study and diverse feature employment that could be incorporated in the smart stick.

The Easy and Versatile Neural Recording Platform (T-REX): Design and Development Study

Background Recording time in invasive neuroscientific research is limited and must be used as efficiently as possible. Time is often lost due to a long setup time and errors by the researcher, driven by the number of manually performed steps. Currently, recording solutions that automate experimental overhead are either custom-made by researchers or provided as a submodule in comprehensive neuroscientific toolboxes, and there are no platforms focused explicitly on recording. Objective Minimizing the number of manual actions may reduce error rates and experimental overhead. However, automation should avoid reducing the flexibility of the system. Therefore, we developed a software package named T-REX (Standalone Recorder of Experiments) that specifically simplifies the recording of experiments while focusing on retaining flexibility. Methods The proposed solution is a standalone webpage that the researcher can provide without an active internet connection. It is built using Bootstrap5 for the frontend and the Python package Flask for the backend. Only Python 3.7+ and a few dependencies are required to start the different experiments. Data synchronization is implemented using Lab Streaming Layer, an open-source networked synchronization ecosystem, enabling all major programming languages and toolboxes to be used for developing and executing the experiments. Additionally, T-REX runs on Windows, Linux, and macOS. Results The system reduces experimental overhead during recordings to a minimum. Multiple experiments are centralized in a simple local web interface that reduces an experiment’s setup, start, and stop to a single button press. In principle, any type of experiment, regardless of the scientific field (eg, behavioral or cognitive sciences, and electrophysiology), can be executed with the platform. T-REX includes an easy-to-use interface that can be adjusted to specific recording modalities, amplifiers, and participants. Because of the automated setup, easy recording, and easy-to-use interface, participants may even start and stop experiments by themselves, thus potentially providing data without the researcher’s presence. Conclusions We developed a new recording platform that is operating system independent, user friendly, and robust. We provide researchers with a solution that can greatly increase the time spent on recording instead of setting up (with its possible errors).

Tunnel-free acromioclavicular joint reconstruction is associated with improved initial reduction and higher patient satisfaction

Many surgical techniques have been described for acromioclavicular (AC) joint reconstruction. Creation of bone tunnels through the clavicle or coracoid has been shown to be a risk factor for fracture. Use of an AC reconstruction technique that does not create bone tunnels may obviate this risk. This study aims to evaluate clinical outcomes of AC joint reconstruction using a tunnel-free technique compared to reconstruction using a cortical button and clavicular drill holes. Consecutive patients who underwent AC joint reconstruction by a single surgeon in a subspecialty referral practice were included. One group of patients received cortical button fixation (button group), in which sutures were passed around the coracoid, brought up through a drill hole in the clavicle, and tied over a cortical button. The other group of patients received tunnel-free fixation, in which a self-locking tape suture was passed in a cerclage fashion around the base of the coracoid and the clavicle and tensioned with a tensioning device (cerclage group). Both groups underwent reconstruction of the coracoclavicular (CC) ligament and AC joint capsule using tibialis anterior allograft. Patient-reported outcome scores and satisfaction were collected and compared between groups. Radiographs were reviewed to evaluate CC ligament distance and loss of reduction. Twenty-two patients were included in the study (button n= 10, cerclage n= 12). Preoperative demographics and injury characteristics were not different between groups. Average radiographic follow-up was not different between groups (button: 231 days, cerclage: 105 days). Postoperative American Shoulder and Elbow Surgeons, visual analog scale, and Single Assessment Numeric Evaluation scores were similar between groups. Two postoperative clavicle fractures were sustained in the button group. These occurred through clavicular drill holes and were preceded by tunnel widening. No fractures occurred in the cerclage group. CC distance at initial follow-up was significantly less in the cerclage group (button: 11.2 ± 4.5 mm, cerclage: 7.0 ± 2.9 mm, P=.023). Loss of reduction was similar throughout the postoperative period (button: 4.3 ± 2.6 mm, cerclage: 4.8 ± 4.1 mm, P >.05. Forty percent of patients were unsatisfied with their clavicle after button fixation (n= 4/10), compared with zero after cerclage fixation (n= 0/12, P=.03). Reasons for dissatisfaction were fracture (n= 2) and persistent cosmetic deformity (n= 2). Tunnel-free AC joint reconstruction is associated with improved initial radiographic appearance and patient satisfaction compared to single cortical button fixation. Postoperative clavicle fracture and persistent cosmetic deformity drive patient dissatisfaction, which may be minimized by avoiding clavicular drill holes and using a tensioned self-locking cerclage suture to improve initial reduction.

Biomechanical profile of varying suture button constructs in cadaveric specimens: a systematic review and meta-analysis.

Suture button fixation of syndesmotic injuries allows for more physiologic motion of the ankle joint while maintaining adequate reduction and may avoid the need for additional surgeries, given the lower risk of syndesmotic diastasis and implant failure. Few studies have examined the optimal number and configuration of suture buttons for syndesmotic disruption. The purpose of this systematic review and meta-analysis is to compare different suture button configurations from the cadaveric literature and to assess their relative effect on the stability of the syndesmotic reduction and functional movement of the ankle. A literature search in the databases MEDLINE via PubMed, Embase via Elsevier, Scopus via Elsevier, and SPORTDiscus via EBSCO were searched through December 2022 to identify studies related to cadaveric modeling of the syndesmosis. Only cadaveric studies with suture button fixation and studies in English were included. The quality of cadaveric studies was assessed using the Quality Assessment for Cadaveric Studies (QUACS) tool. Revman 5.3 software was used to perform the meta-analysis. The meta-analysis included 5 studies and 86 limbs. The systematic review included 15 studies. When comparing single and double suture button configurations, no difference was found between groups with regard to fibular rotation (MD =-0.9; 95% CI: -2.09 to 0.27; I2=79%; P=0.13) and both groups had similar rotational stability. The double suture button technique did demonstrate less sagittal fibular translation compared to the single suture button (MD =0.48; 95% CI: 0.02-0.94; I2=66%; P=0.04). When comparing two suture buttons in parallel and divergent configurations, studies did not find any differences with regard to strength or stability. There were no significant differences in biomechanical parameters when comparing single and double suture button constructs. While single button suture constructs result in minimal fibular rotation, double suture button constructs minimize fibular translation. This review may serve as a guide for clinicians when approaching these injuries.

Implementation of Building Component Drawing Automation to Improve Time Efficiency and Accuracy in the Construction Planning Process

The use of automation in drawing within AutoCAD® based on NET C# is one solution for time efficiency and accuracy in building component drawings. Typically, AutoCAD® follows a command syntax concept of one command for one object (usual command, UC) in building component drawings. However, utilizing automation in AutoCAD® based on NET C# allows a single command syntax to be applied to multiple objects, generating multiple outcomes (automatic command, AC). Through this automation, typical drawings can be created by inputting data in a form and executing it with a single button click, resulting in the immediate creation of typical drawings. The automation of building component drawings aims to enhance time efficiency and accuracy in drawing. The research methodology employs a quantitative approach with a comparative design between two paired samples. A comparative study was conducted with 10 respondents, allowing them to draw building components using two methods: UC and a second method using AC. The time taken for drawing using UC and AC was recorded, and from the recorded time data, an analysis of time efficiency and drawing accuracy was performed. Time analysis was conducted using IBM SPSS 26 and Excel applications. The analysis procedure used a paired sample two-tailed t-test with the condition that if the sig. value &lt; 0.05, then H0 is rejected and Ha is accepted, or if the calculated t-value &gt; tabulated t-value, then H0 is rejected and Ha is accepted. The analysis results revealed a significant difference in time efficiency between the usual command (UC) and automatic command (AC) methods. During the testing process, accuracy testing of the automation program was also conducted, yielding high accuracy results for the automation program. The research findings indicate that the implementation of automation in drawing based on AutoCAD® and NET C# significantly contributes to enhancing time efficiency and accuracy in building component drawings

A biomechanical analysis of double screw, double button and screw button fixation constructs in PSI guided Latarjet procedure.

The Latarjet coracoid transfer procedure reliably stabilizes the glenohumeral joint for shoulder instability. However, complications such as graft osteolysis, non-union and fracture continue to affect patient clinical outcomes. The double screw (SS) construct is regarded as the gold standard method of fixation. SS constructs are associated with graft osteolysis. More recently, a double button technique (BB) has been suggested to minimize graft related complications. However, BB constructs are associated with fibrous non-union. To mitigate this risk, a single screw combined with a single button (SB) construct has been proposed. It is thought that this technique incorporates the strength of the SS construct and allows micromotion superiorly to mitigate stress shielding related graft osteolysis. The primary aim of this study was to compare the failure load of SS, BB and SB constructs under a standardized biomechanical loading protocol. The secondary aim was to characterize the displacement of each construct throughout testing. Computed tomography scans of twenty matched-pair cadaveric scapulae were performed. Specimens were harvested and dissected free of soft tissue. SS and BB techniques were randomly assigned to specimens for matched-pair comparison with SB trials. A patient specific instrument (PSI) guided Latarjet procedure was performed on each scapula. Specimens were tested using a uniaxial mechanical testing device under cyclic loading (100 cycles, 1Hz, 200N/s) followed by a load-to-failure protocol (0.5mm/s). Construct failure was defined by graft fracture, screw avulsion and/or graft displacement of more than 5mm. Forty scapulae from twenty fresh frozen cadavers with a mean age of 69.3 years underwent testing. On average, SS constructs failed at 537.8N (SD 296.8), while BB constructs failed at 135.1N (SD 71.4). SB constructs required a significantly greater load to fail compared to BB constructs (283.5N, SD 162.8, p=0.039). Additionally, SS (1.9mm, IQR 0.87) had a significantly lower maximum total graft displacement during the cyclical loading protocol compared to SB (3.8mm, IQR 2.4, p=0.007) and BB (7.4mm, IQR 3.1, p<0.001) constructs. These findings support the potential of the SB fixation technique as a viable alternative to SS and BB constructs. Clinically, the SB technique could reduce the incidence of loading-related graft complications seen in the first three months of BB Latarjet cases. The study is limited to time-specific results and does not account for bone union or osteolysis.

Low-Resolution Raman Enables a Low-Cost, Fully Automated Raman Microscope for Microspectroscopic Analysis

The high cost of Raman micro-spectroscopy limits its application to laboratory settings, while prior low-cost Raman systems are limited to simple bulk analysis. Using the “Low Resolution Raman” concept, we sacrifice the spectral resolution to increase the SNR while maintaining analytic power. With a low-spectral resolution, we eliminate the need for a high quality laser, camera, and optical filters. Combined with a low-cost, automated sample stage we create a fully automated Raman microscope capable of sampling thousands of microscopic objects without user intervention. We demonstrate the performance on classifications of standard microspheres and identifying the fatty acid ratio of fat globules in goat and cow milk, where thousands of spectra are acquired with a single button press. As the cost of the system is >10-fold less than conventional Raman microscopes, it holds great application prospects for truly pervasive Raman spectroscopy.

Soft microfiber-based hollow microneedle array for stretchable microfluidic biosensing patch with negative pressure-driven sampling

Wearable point-of-care testing devices are essential for personalized and decentralized healthcare. They can collect biofluid samples from the human body and use an analyzer to detect biomolecules. However, creating an integrated system is challenging due to the difficulty of achieving conformality to the human body, regulating the collection and transport of biofluids, developing a biosensor patch capable of precise biomolecule detection, and establishing a simple operation protocol that requires minimal wearer attention. In this study, we propose using a hollow microneedle (HMN) based on soft hollow microfibers and a microneedle-integrated microfluidic biosensor patch (MIMBP) capable of integrated blood sampling and electrochemical biosensing of biomolecules. The soft MIMBP includes a stretchable microfluidic device, a flexible electrochemical biosensor, and a HMN array made from flexible hollow microfibers. The HMNs are fabricated by electroplating flexible and mechanically durable hollow microfibers made from a nanocomposite matrix of polyimide, a poly (vinylidene fluoride-co-trifluoroethylene) copolymer, and single-walled carbon nanotubes. The MIMBP uses the negative pressure generated by a single button push to collect blood and deliver it to a flexible electrochemical biosensor modified with a gold nanostructure and Pt nanoparticles. We have demonstrated that glucose can be accurately measured up to the molar range in whole human blood collected through the microneedle. The MIMBP platform with HMNs has great potential as a foundation for the future development of simple, wearable, self-testing systems for minimally invasive biomolecule detection. This platform capable of sequential blood collection and high sensitivity glucose detection, which are ideal for personalized and decentralized healthcare.

AI Diet Consultant Android APP

Today, where eating unhealthy foods and leading sedentary lives have become the norm, diet is extremely important. The maintenance of optimum health, the prevention of chronic diseases, and the promotion of general well-being all depend on proper nutrition. Health and proper nutrition both depend on a balanced diet. Several deteriorations, and non-communicable diseases are protected from you. For optimal health, a balanced diet with low amounts of salt, sugar, saturated fats, and Tran’s fats from industrial manufacture is essential. The significance of a balanced diet for living a healthy life cannot be exaggerated. You may lead a healthy life by eating a balanced diet and making sure you get all the essential nutrients your body needs. Maintaining healthy body weight and reducing the threat of habitual conditions like diabetes, cardiovascular complaint, and colorful cancers are both eased by a sound diet plan. This application gives users access to a sophisticated algorithm that may generate a customized diet plan for them. With the suggested system, users would have access to a simple user interface where they can register for an account, manage it, and order the diet with the click of a single button. The suggested system requires users to first register before requesting their login information. A diet plan that contains meals and other options that must be consumed every day shows after logging into the system. The system then logs the user's diet, and the user can access his or her diet history.

Management of Acute High-Grade Acromioclavicular Joint Dislocations: Comparable Clinical and Radiological Outcomes After Bidirectional Arthroscopic-Assisted Stabilization With the Single Low-Profile Suture Button Technique Versus Double-Suture Button Technique

This study was to compare the two-year clinical and radiological outcomes of an arthroscopic-assisted bidirectional stabilization procedure using single low-profile (LPSB) or double suture button (DSB) techniques with additional percutaneous acromioclavicular (AC) cerclage fixation for patients with acute high-grade AC joint dislocation. This retrospective cohort study compared male patients aged between 18-56 years with acute high-grade AC joint dislocation fixed with either a LPSB or DSB technique. Patients were examined at least 24 months post-surgery. Subjective Shoulder Value (SSV), Taft (TF) and Acromioclavicular Joint Instability scores (ACJI) were evaluated. Coracoclavicular difference, ossification, AC joint osteoarthritis and dynamic posterior translation (DPT) were assessed on bilateral anteroposterior stress radiographs and modified Alexander views. The revision rate due to implant conflict and duration of surgery were reported. Group outcome differences were analyzed using standardized hypothesis tests. 28 patients aged 39.2 (LPSB) and 36.4 years (DSB) (p=0.319; CI -2.77 - 8.34) were eligible per cohort. The follow-up was 30.5 (LPSB) and 37.4 months (DSB) (p=0.02; CI -12.73 - -1.08). LPSB patients rated a significantly higher SSV (93.2% vs. 81.9% (DSB); p=0.004). TF and ACJI scores were similar between groups. Coracoclavicular difference markedly decreased from 12 mm to 3 mm for both cohorts (p<0.001). Ossification was identified in over 85% in both cohorts (p=0.160; CI -0.77 - 0.13) and osteoarthritis in 21.4% (LPSB) and 39.3% (DSB) (p=0.150). Persistent DPT was found in around 30% for both cohorts (p=0.561; CI -0.26 - 0.48). The revision rates were 0% (LPSB) and 7% (DSB) (p=0.491). LPSB surgery was shorter (59.7 vs. 71.5 mins [DSB]) (p=0.011). The results of the LPSB and DSB techniques with additional percutaneous AC cerclage fixation showed comparable outcomes with excellent clinical and satisfactory radiological results. The assessment of the subjective patients satisfaction was in favor of the LPSB technique and no postoperative revision event was observed following this procedure.

Biomechanical Comparison of Distal Biceps Tendon Repair Techniques: Extracortical Single-Button Inlay Fixation Versus Intracortical Double-Button Onlay Anatomic Footprint Fixation

Background: Extracortical single-button (SB) inlay repair is a commonly used distal biceps tendon technique. However, complications (eg, neurovascular injury) and nonanatomic repairs have led to the development of intracortical fixation techniques. Purpose: To compare the biomechanical stability of extracortical SB repair with an anatomic intracortical double-button (DB) repair technique. Study Design: Controlled laboratory study. Methods: The distal biceps tendon was transected in 18 cadaveric elbows from 9 donors. One elbow of each donor was randomly assigned to the extracortical SB or anatomic DB group. Both groups were cyclically loaded with 60 N over 1000 cycles between 90° of flexion and full extension. The elbow was then fixed in 90° of flexion and the repair construct loaded to failure. Gap formation and construct stiffness during cyclic loading and ultimate load to failure were analyzed. Results: When compared with the extracortical SB technique after 1000 cycles, the anatomic DB technique showed significantly less gap formation (mean ± SD, 2.7 ± 0.8 vs 1.5 ± 0.9 mm; P = .017) and significantly more construct stiffness (87.4 ± 32.7 vs 119.9 ± 31.6 N/mm; P = .023). Ultimate load to failure was not significantly different between the groups (277 ± 93 vs 285 ± 135 N; P = .859). The failure mode in the anatomic DB group was significantly different from that of the extracortical SB technique (P = .002) and was due to fracture avulsion of the cortical button in 7 of 9 specimens (vs none in the SB group). Conclusion: Our study shows that the intracortical DB technique produces equivalent or superior biomechanical performance to that of the SB technique. The DB technique may offer a clinically viable alternative to the SB repair technique. Clinical Relevance: This study suggests, at worst, an equivalent and, at best, a superior biomechanical performance of intracortical anatomic DB footprint repair at the time of surgery. However, the mode of failure suggests that this technique should not be used in patients with poor bone quality.

IoT based Smart Book Reader for Visually Impaired

Abstract: This paper presents an IoT- based smart book reader for visually impaired individuals, using a Raspberry Pi computer and various software tools. The system allows users to capture images of printed material using a camera, which are then processed using Tesseract OCR software to extract text. The extracted text is then translated from English to Marathi using the Google Cloud Translation API, and converted to speech using the Google Text-to-Speech API. The system is designed to be operated using a single hardware button, making it easy and intuitive for users with visual impairments. The proposed system offers a low-cost and portable solution for visually impaired individuals to access printed material, and has the potential to improve their quality of life.

Dynamic syndesmotic stabilisation and reinforcement of the antero-inferior tibiofibular ligament with internal brace

PurposeSyndesmotic injuries are associated with long recovery times and high morbidity. Systematic reviews show a trend toward better outcomes of suture buttons compared to screw fixation. The anteroinferior tibiofibular ligament (AITFL) confers the most significant component of translational and rotatory stability. Techniques have developed which reinforce the AITFL. This study aimed to assess results of syndesmotic stabilisation with dynamic stabilisation and reinforcement of the AITFL, with an early mobilisation program. Materials and methodsRetrospective case series of 30 patients (mean age 31 years). Syndesmotic instability was confirmed with clinical examination, MRI and weightbearing-CT. Dynamic syndesmotic stabilisation with a single suture button was performed followed by the placement of an Internal Brace over the AITFL. A standardised postoperative rehabilitation protocol was established. Foot and Ankle Ability Measure (FAAM) scores were collected postoperatively. ResultsThe average follow-up was 13 months. The total FAAM score for ADL was 95 ± 4.9 % (range, 83 – 100 %) and for sport activities 87 ± 13.6 % (range, 50 – 100 %). The rating of mean postoperative function for ADL was 94 ± 5.5 % (range, 80 – 100 %) and 90 ± 13 % (range, 35 – 100 %) for sportv. The difference between acute and chronic injuries was statistically higher (p < 0.05) for daily activities and sport, but the rating of current level of sport activites as well as for daily activites did not show a significant difference (p = 0.9296 and p = 0.1615, respectively). Twenty-seven patients (90 %) rated their overall current level of function as normal or nearly normal. ConclusionThis technique aims to directly stabilise the AITFL and the interosseous components of the syndesmosis, and allow early mobilisation and return to sport at 10 weeks. Early results show the procedure is safe, with comparable results to the literature. Acute injuries showed better results of the FAAM score than chronic injuries.

BIOMECHANICAL COMPARISON OF DISTAL BICEPS REPAIR TECHNIQUES: SINGLE EXTRACORTICAL BUTTON INLAY FIXATION VERSUS DOUBLE INTRACORTICAL BUTTON ONLAY ANATOMICAL FOOTPRINT FIXATION

The extracortical single-button (SB) inlay repair is one of the most preferred distal biceps tendon repair techniques. However, specific complications such as neurovascular injury and non-anatomic repairs have led to the development of techniques that utilize intracortical double-button (DB) fixation.To compare the biomechanical stability of the extracortical SB repair with the anatomical DB repair technique.Controlled laboratory study.The distal biceps tendon was transected in 18 cadaveric elbows from 9 donors. One elbow of each donor was randomly assigned to the extracortical SBor anatomical DB group. Both groups were cyclically loaded with 60N over 1000 cycles between 90° of flexion and full extension. The elbow was then fixed in 90° of flexion and the repair construct loaded to failure. Gap-formation and construct stiffness during cyclic loading, and ultimate load to failure was analysed.After 1000 cycles, the anatomical DB technique compared with the extracortical SB technique showed significantly less gap-formation (mean difference 1.2 mm; p=0.017) and significantly more construct stiffness (mean difference 31 N/mm; p=0.023). Ultimate load to failure was not significantly different comparing both groups (SB, 277 N ±92 vs. DB, 285 N ±135; p=0.859). The failure mode in the anatomical DB group was significantly different compared with the extracortical SB technique (p=0.002) and was due to fracture avulsion of the BicepsButton in 7 out of 9 specimens (vs. none in SB group).Our study shows that the intracortical DB technique produces equivalent or superior biomechanical performance to the SB technique. The DB repair technique reduces the risk of nerve injury and better restores the anatomical footprint of biceps tendon. The DB technique may offer a clinically viable alternative to the SB repair technique.

The "Three Cherries Technique" for glaucoma drainage devices

Small sponges are used to apply antimetabolites in order to reduce the risk of fibrosis in filtering glaucoma surgery. Due to the posterior location of the filtering bleb in glaucoma drainage implants, there is arisk that the sponges can dislocate in this area and cannot be retrieved after the exposure time has elapsed. We use the "three cherries technique" to minimize the risk. The term "three cherries technique" was coined by us and has not been used before in the literature. The three sponges that are used for mitomycinC application are each connected by single button sutures with a7.0 vicryl thread. At the end of the application time, the sponges can be quickly removed by pulling the thread.