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Injury Apr 2024to assess the small-scale 3D printing feasibility and cost estimation of a device for controlled dynamization.
AIM
to assess the small-scale 3D printing feasibility and cost estimation of a device for controlled dynamization.
MATERIALS AND METHOD
The two-part device previously developed by our research group was printed with a carbon fiber-reinforced nylon filament (Gen3 CarbonX™ PA6+CF, 3DXTECH Additive Manufacturing) by a professional 3D printer (FUNMAT HT, Intamsys). Electricity, material, and labor costs for production in a Brazilian city in the Santa Catarina state were calculated.
RESULTS
The devices for controlled dynamization were successfully printed in accordance with the planned design and dimensions. Six out of 38 printed devices presented defects in the bolt hole and were discarded. The average printing time per device was 1.9 h. The average electricity, material, and labor costs per printed device were respectively US$0.71, US$13.55, and US$3.04. The total production cost per device reaches approximately US$20 by adding the average cost of defective devices (15 %).
CONCLUSION
3D printing of the controlled dynamization device is feasible and its cost seems affordable to most healthcare services, which could optimize the consolidation of diaphyseal fractures and reduce treatment time for patients.
PubMed: 38761709
DOI: 10.1016/j.injury.2024.111587 -
PloS One 2024Intraventricular hemorrhage (IVH) is a severe condition with poor outcomes and high mortality. IRRAflow® (IRRAS AB) is a new technology introduced to accelerate IVH...
BACKGROUND
Intraventricular hemorrhage (IVH) is a severe condition with poor outcomes and high mortality. IRRAflow® (IRRAS AB) is a new technology introduced to accelerate IVH clearance by minimally invasive wash-out. The IRRAflow® system performs active and controlled intracranial irrigation and aspiration with physiological saline, while simultaneously monitoring and maintaining a stable intracranial pressure (ICP). We addressed important aspects of the device implementation and intracranial lavage.
METHOD
To allow versatile investigation of multiple device parameters, we designed an ex vivo lab setup. We evaluated 1) compatibility between the IRRAflow® catheter and the Silverline f10 bolt (Spiegelberg), 2) the physiological and hydrodynamic effects of varying the IRRAflow® settings, 3) the accuracy of the IRRAflow® injection volumes, and 4) the reliability of the internal ICP monitor of the IRRAflow®.
RESULTS
The IRRAflow® catheter was not compatible with Silverline bolt fixation, which was associated with leakage and obstruction. Design space exploration of IRRAflow® settings revealed that appropriate settings included irrigation rate 20 ml/h with a drainage bag height at 0 cm, irrigation rate 90 ml/h with a drainage bag height at 19 cm and irrigation rate 180 ml/h with a drainage bag height at 29 cm. We found the injection volume performed by the IRRAflow® to be stable and reliable, while the internal ICP monitor was compromised in several ways. We observed a significant mean drift difference of 3.16 mmHg (variance 0.4, p = 0.05) over a 24-hour test period with a mean 24-hour drift of 3.66 mmHg (variance 0.28) in the pressures measured by the IRRAflow® compared to 0.5 mmHg (variance 1.12) in the Raumedic measured pressures.
CONCLUSION
Bolting of the IRRAflow® catheter using the Medtronic Silverline® bolt is not recommendable. Increased irrigation rates are recommendable followed by a decrease in drainage bag level. ICP measurement using the IRRAflow® device was unreliable and should be accompanied by a control ICP monitor device in clinical settings.
Topics: Humans; Reproducibility of Results; Therapeutic Irrigation; Intracranial Pressure; Monitoring, Physiologic; Cerebral Hemorrhage; Hematoma
PubMed: 38626156
DOI: 10.1371/journal.pone.0297131 -
Translational Animal Science 2024Penetrating captive bolt (PCB) is the primary method of preslaughter stunning for cattle and is also used for on-farm euthanasia. The objective of this study was to...
Penetrating captive bolt (PCB) is the primary method of preslaughter stunning for cattle and is also used for on-farm euthanasia. The objective of this study was to quantify the impact of cooling on the soft tissue thickness, cranial thickness, total tissue thickness, and cross-sectional brain area of cadaver heads collected from mature (> 30 mo of age) dairy cows following the application of a PCB stun in a frontal placement. Hide-on cadaver heads were obtained from culled dairy cows ( = 37) stunned in a frontal location using a handheld PCB device (Jarvis Model PAS-Type C 0.25R Caliber Captive Bolt, Long Bolt) at a commercial slaughter establishment. Following transport to the University of Wisconsin-River Falls, heads were split at midline along the bolt path by a bandsaw and then underwent FRESH, CHILL24, CHILL48, and CHILL72 refrigeration treatments. The FRESH treatment involved images collected immediately after splitting each head, the CHILL24 treatment involved images collected after 24 h of refrigeration, the CHIL48 treatment involved images collected after 48 h of refrigeration, and the CHILL72 treatment involved images collected after 72 h of refrigeration. Measurements of soft tissue thickness, cranial thickness, total tissue thickness, and cross-sectional brain area were recorded for each refrigeration treatment. Soft tissue thickness did not differ caudal to ( = 0.3751) or rostral to ( = 0.2555) the bolt path. Cranial thickness did not differ caudal to ( = 0.9281) or rostral to ( = 0.9051) the bolt path. Total tissue thickness did not differ caudal to ( = 0.9225; FRESH: 24.77 mm, CHILL24: 23.93 mm, CHILL48: 24.27 mm, CHILL72: 42.30, SE: 0.86) or rostral to ( = 0.8931; FRESH: 24.09 mm, CHILL24: 23.99, CHILL48: 24.26, CHILL72: 24.43 mm, SE: 0.79 mm) the bolt path. Cross-sectional brain area was not different ( = 0.0971) between refrigeration treatments (FRESH: 9,829.65 ± 163.87 mm, CHILL24: 10,012.00 ± 163.87 mm, CHILL48: 9,672.43 ± 163.87 mm, CHILL72: 10,235.00 ± 166.34 mm). This study demonstrated that FRESH tissue parameters can be determined from cattle cadaver heads refrigerated for 24, 48, or 72 h.
PubMed: 38562214
DOI: 10.1093/tas/txae042 -
NMC Case Report Journal 2024Stereotactic electroencephalography (SEEG) is an increasingly popular surgical modality for localizing the epileptogenic zone. Robot-guided stereotactic electrode...
Stereotactic electroencephalography (SEEG) is an increasingly popular surgical modality for localizing the epileptogenic zone. Robot-guided stereotactic electrode placement has been covered in Japan by National Health Insurance since 2020. However, several surgical devices, such as the anchor bolt (a thin, hollow, metal shaft that serves as a guide screw or fixing for each electrode), have not been approved. A 14-year-old female who underwent SEEG for intractable epilepsy and required additional surgery to remove a retained depth electrode from the skull after the SEEG monitoring was finished. She had uncontrolled focal seizures consisting of nausea and laryngeal constriction at the onset. After a comprehensive presurgical evaluation, robot-guided stereotactic electrode implantation was performed to evaluate her seizures by SEEG. Nine depth electrodes were implanted through the twist drill hole. The electrodes were sutured to her skin for fixation without anchor bolts. When we attempted to remove the electrodes after 8 days of SEEG monitoring, one of the electrodes was retained. The retained electrode was removed through an additional skin incision and a small craniectomy under general anesthesia. We confirmed narrowing of the twist drill hole pathway in the internal table of the skull due to osteogenesis, which locked the electrode. This complication might be avoided if an anchor bolt had been used. This case report prompts the approval of the anchor bolts to avoid difficulty in electrode removal. Moreover, approval of a depth electrode with a thinner diameter and more consistent hardness is needed.
PubMed: 38454914
DOI: 10.2176/jns-nmc.2023-0242 -
World Neurosurgery May 2024Sacroiliac joint (SIJ) fusion, to treat back pain caused by SIJ dysfunction, can employ open or minimally invasive surgery (MIS) techniques and either cylindrical...
Navigated Simultaneous Lateral Minimally Invasive Tubular and Posterior Mini-Open Access for Removal and Revision of Triangular Sacroiliac Joint Implants: A Technical Note.
BACKGROUND
Sacroiliac joint (SIJ) fusion, to treat back pain caused by SIJ dysfunction, can employ open or minimally invasive surgery (MIS) techniques and either cylindrical (screw-shaped) or triangular (wedge-shaped) implants. Fusion nonunion sometimes explains recurrent SIJ pain following fusion and occasionally requires hardware revision. MIS revision minimizes patient pain, infection, and disability, but due to the triangular implant size and form factor, implant removal can present challenges for MIS access during the explantation and achieving good bony purchase for reinstrumentation. Here, we report a prone single-position lateral MIS/posterior mini-open procedure for triangular-implant SIJ fusion revision.
METHODS
The patient is a 72-year-old female who underwent right SIJ fusion for lower back and leg pain sustained after a fall 2 years prior but experienced recurrent pain over the subsequent 2 years, with imaging findings of right SIJ peri-hardware lucencies and diagnostic injections confirming persistent right-sided sacroiliitis.
RESULTS
The patient underwent hardware removal using the lateral MIS incision with table-mounted tubular access and image-guided navigation to maintain exposure, plus simultaneous reinstrumentation using a navigated S2-alar-iliac screw and iliac bolt construct with connecting rod through the posterior mini-open incision made for the navigation reference frame spinous process clamp.
CONCLUSIONS
The use of navigation and MIS access can significantly decrease the complexity of lateral hardware removal, and mini-open navigated screw-and-rod constructs offer reinstrumentation options accessible to surgeons unfamiliar with specialized posterior SIJ systems.
Topics: Humans; Female; Sacroiliac Joint; Aged; Reoperation; Spinal Fusion; Device Removal; Minimally Invasive Surgical Procedures; Neuronavigation; Low Back Pain; Prostheses and Implants
PubMed: 38403019
DOI: 10.1016/j.wneu.2024.02.098 -
EuroIntervention : Journal of EuroPCR... Feb 2024Outcomes after percutaneous coronary intervention (PCI) for de novo ostial right coronary artery (RCA) lesions are poor.
BACKGROUND
Outcomes after percutaneous coronary intervention (PCI) for de novo ostial right coronary artery (RCA) lesions are poor.
AIMS
We used intravascular ultrasound (IVUS) to clarify the morphological patterns of de novo ostial RCA lesions and their associated clinical outcome.
METHODS
Among 5,102 RCA IVUS studies, 170 de novo ostial RCA stenoses (within 3 mm from the aorto-ostium) were identified. These were classified as 1) isolated ostial lesions (no disease extending beyond 10 mm from the ostium and without a calcified nodule [CN]); 2) ostial CN, typically with diffuse disease (disease extending beyond 10 mm); and 3) ostial lesions with diffuse disease but without a CN. The primary outcome was target lesion failure (TLF: cardiac death, target vessel myocardial infarction, definite stent thrombosis, and ischaemia-driven target lesion revascularisation).
RESULTS
The prevalence of an isolated ostial lesion was 11.8% (n=20), 47.6% (n=81) were ostial CN, and 40.6% (n=69) were ostial lesions with diffuse disease. Compared to ostial lesions with diffuse disease, isolated lesions were more common in women (75.0% vs 42.0%; p=0.01), and CN were associated with older age (median [first, third quartile] 76 [70, 83] vs 69 [63, 81] years old; p=0.002). The Kaplan-Meier rate of TLF at 2 years was significantly higher in patients with CN (21.6%) compared to diffuse lesions (8.2%) (p=0.04), and patients with isolated lesions had no events. A multivariable Cox proportional hazard model revealed that CN were significantly associated with TLF (hazard ratio 6.63, 95% confidence interval: 1.28-34.3; p=0.02).
CONCLUSIONS
Ostial RCA lesions have specific morphologies - detectable by IVUS - that may be associated with long-term clinical outcomes.
Topics: Humans; Female; Aged, 80 and over; Coronary Artery Disease; Percutaneous Coronary Intervention; Drug-Eluting Stents; Treatment Outcome; Risk Factors; Coronary Angiography
PubMed: 38343369
DOI: 10.4244/EIJ-D-23-00406 -
Frontiers in Rehabilitation Sciences 2023Outdoor physical activity (PA) contributes to the physical and mental health and well-being of individuals with a mobility impairment. However, individuals are commonly... (Review)
Review
INTRODUCTION
Outdoor physical activity (PA) contributes to the physical and mental health and well-being of individuals with a mobility impairment. However, individuals are commonly excluded from outdoor PA because of accessibility challenges. No reviews summarizing evidence on factors that facilitate/hinder participation and inclusion of individuals with mobility disabilities in adaptive outdoor PA were identified.. This makes it challenging to establish the key components for implementing inclusive outdoor PA interventions. A scoping review was conducted to identify barriers and facilitators to participation in adaptive outdoor PA and identify suggestions for adaptive outdoor PA design.
METHODS
A scoping review of qualitative and quantitative studies was conducted based on the methodological framework of Arksey and O'Malley with modifications by Levac. Barriers and facilitators were categorized into four levels based on a Social Ecological Model (SEM). Suggestions for interventions designed to overcome accessibility issues of outdoor PA were classified based on Universal Design (UD).
RESULTS
Thirty-seven factors regarding barriers and facilitators of outdoor adaptive PA were extracted from 19 studies published between 2002 and 2023. Barriers and facilitators were identified primarily in four levels of the SEM, including intrapersonal, social-environmental, physical-environmental, and policy-related. Eleven design suggestions were identified and categorized according to the seven principles of UD. This study identified gaps in the presented barriers and facilitators and the design suggestions of the included studies, mainly at the social and environmental level, such as a lack of innovation in program delivery and logistics.
CONCLUSION
This study identified gaps in knowledge about facilitators and barriers to outdoor adaptive PA and in the design of interventions addressing them. Future research should focus on the strategies addressing these gaps by involving individuals with mobility disability in designing interventions to gain a better insight into their needs.
PubMed: 38259872
DOI: 10.3389/fresc.2023.1331971 -
Materials (Basel, Switzerland) Dec 2023Many designs of anchor cables are currently in use for rock support in civil and mining operations. Because of the exposed surface and weak shear performance of the...
Many designs of anchor cables are currently in use for rock support in civil and mining operations. Because of the exposed surface and weak shear performance of the cable bolt's free section (CBFS) in end-anchored structures, breaking failure frequently occurs. Numerical simulations and laboratory experiments were performed in this study to develop measures to improve CBFS resistance to shear failure. Analysis of shear characteristics of the CBFS showed that higher axial tension weakens the cable bolt's shear resistance, and that shear damage on the cable surface and uneven distribution of shear stress aggravate CBFS tensile-shear failure. A high-strength steel pipe is proposed to protect the shear cable bolt, and the preliminary design of a CBFS-strengthening device (CFSD) is presented. Numerical simulation revealed that the CFSD effectively improved CBFS shear resistance and provided protection from harmful shear damage. The optimal performance of a Q-type (slotted steel pipe) CFSD was confirmed. The mechanism of improvement of the cable's shear resistance to surrounding rock by employing the CFSD was analyzed. Double-shear tests were carried out on a bare cable bolt and a cable bolt with a Q-CFSD. The results revealed that the CFSD increased the peak shear force on the joint plane, cable peak axial force, and ultimate shear displacement by 31%, 18%, and 11%, respectively. The proposed device is effective in improving the shear performance of end-anchored cable bolts and enhancing surrounding rock stability.
PubMed: 38204050
DOI: 10.3390/ma17010197 -
Materials (Basel, Switzerland) Nov 2023In recent decades, low-yielding seismic devices based on the use of friction dampers have emerged as an excellent solution for the development of building structures...
In recent decades, low-yielding seismic devices based on the use of friction dampers have emerged as an excellent solution for the development of building structures with improved reparability and resilience. Achieving an optimal design for such low-yielding seismic devices requires precise control of bolt preloading levels and predictability of the friction coefficient (CoF) between the damper interfaces. While various types of friction devices exist that are capable of providing significant energy dissipation, ongoing research is focused on the development of novel friction materials that exhibit a stable hysteretic response, high CoF values, minimal differences between static and dynamic CoF, and predictable slip resistance. In this context, an experimental campaign was conducted at the STRENGTH Laboratory of the University of Salerno to evaluate the behaviour of new friction shims employing specially developed metal alloys. Specifically, the influence of the characteristics of the contact surfaces in the sliding area on the behaviour and performance of the friction device was analysed. The tests followed the loading protocol recommended by EN12159 for seismic device qualification. Monitored parameters included preloading force values and the evolution of slip resistance. The friction value was determined, along with its degradation over time. Finally, the material's performance in terms of hysteretic behaviour was assessed, providing a comparison of the tested specimens in terms of slip force degradation and energy dissipation capacity.
PubMed: 38068079
DOI: 10.3390/ma16237336 -
Sensors (Basel, Switzerland) Dec 2023Rotating machinery condition monitoring and fault diagnosis are important bases for maintenance decisions, as the vibrations generated during operation are usually...
Rotating machinery condition monitoring and fault diagnosis are important bases for maintenance decisions, as the vibrations generated during operation are usually imperceptible to the naked eye. Eulerian video motion magnification (EVMM) can reveal subtle changes and has been widely used in various fields such as medicine, structural analysis, and fault diagnosis, etc. However, the method has a bound relationship among three parameters: spatial wavelength, amplification factor, and displacement function, so it is necessary to adjust the parameters manually in practical applications. In this paper, on the basis of the original method, an automatic solution of spatial cutoff wavelength based on brightness is proposed. First, an input video is decomposed into image sequences, their RGB color spaces are transformed into HSV color spaces, and the Value channel image representing brightness is selected to automatically calculate the spatial cutoff frequency, and then the spatial cutoff wavelength is determined, and the motion magnification video in the specified frequency band is obtained by substituting it into the original method. Then, a publicly available video is taken as an example for simulation analysis. By comparing the time-brightness curves of the three videos (original video, motion magnification video obtained by the original method and the improved method), it is apparent that the proposed method exhibits the most significant brightness variation. Finally, taking an overhung rotor-bearing test device as the object, five conditions are set, respectively: normal, rotor unbalance, loosened anchor bolt of the bearing seat, compound fault, rotor misalignment. The proposed method is adopted to magnify the motion of the characteristic frequency bands including 1X frequency and 2X frequency. The results show that no obvious displacement is found in normal working conditions, and that the rotor unbalance fault has an overall axial shaking, the bearing seat at the loose place has an obvious vertical displacement, while the compound fault combines the both fault characteristics, and the rotor misalignment fault has an obvious axial displacement of the free-end bearing seat. The method proposed in this paper can automatically obtain the space cutoff wavelength, which solves the problem of defects arising from manually adjusting the parameters in the original method, and provides a new method for rotating machinery fault diagnosis and other fields of application.
PubMed: 38067955
DOI: 10.3390/s23239582