bluuebunny/crossref_metadata_2025 huggingface dataset:
Phylogenomics and functional analysis of Glycerol‐3‐Phosphate Acyltransferase (GPAT) Genes: A critical role in lipid biosynthesis
Authors: Li Yanli , Xiao Lichuan , Cao Heping , Cao Yunpeng , Zhang Lin
Published: August 2024

The tung tree (Vernicia fordii Hemsl.), an economically important woody plant, is widely planted for the production of high‐quality tung oil. Glycerol‐3‐phosphate acyltransferases (GPATs), the rate‐limiting enzymes in triacylglycerol synthesis, play an important role in seed oil biosynthesis. In this study, we performed a genome‐wide analysis of VfGPATs. A total of 9 VfGPATs were identified from the whole tung genome, and phylogenetic analysis divided the VfGPATs into three major clades: clade II (VfGPAT9), clade III (VfATS1) and clade IV (VfGPAT1 ~ 8). Subcellular localization analysis revealed that five VfGPATs (1, 5, 6, 8, and 9) are localized in the endoplasmic reticulum, and four VfGPATs (3–1, 3–2, 3–3, and ATS1) are localized in the chloroplast. Overexpression of VfGPATs in Arabidopsis thaliana revealed that the oil content in VfGPAT8‐ and VfGPAT9‐transgenic plants were significantly increased by 26.60 and 55.94% compared to the wild‐type. Transient expression of VfGPAT8 + VfFADX and VfGPAT9 + VfFADX could promote the synthesis of α‐eleostearic acid and enhance the accumulation of lipid droplets in tobacco (Nicotiana benthamiana) leaves. We further tested the enzymatic activities of VfGPAT8 and VfGPAT9 with the yeast double mutant strain ZAFU1. The results showed that VfGPAT8 complemented the phosphatidate biosynthetic defect in the double mutant, while VfGPAT9 could not, suggesting that VfGPAT8 has a high acetyltransferase activity. However, altering serine (S) residue at position 113 of VfGPAT9 to threonine (T) could restore its enzymatic activity. This study provided important insights into the evolutionary history of VfGPATs and will promote the genetic improvement of tung trees and related species.
The effect of traditional Chinese medicine on psychological conditions among elderly patients with cancer: a scoping review
Authors: Zhang Renchuan , Shi Pei , Chou Ying , Liu Wei , Zhang Chunyu
Published: August 2024

Coping with cancer presents a multitude of challenges that encompass every aspect of a patient's life. These challenges not only strain the body but also weigh heavily on the mind, often culminating in profound psychological distress for cancer patients. The cumulative burden of these experiences can heighten the risk of developing psychiatric disorders, exacerbating the already daunting landscape of cancer care. Therefore, this study reviewed the available research with the aim of investigating the effects of traditional Chinese medicine on psychological conditions in elderly cancer patients. In this scoping review, we applied specific criteria to select studies that focused on elderly patients with cancer. We performed an extensive search across electronic databases, including Embase, Science Direct, PubMed, Google Scholar, Scopus, Cochrane Library and Web of Science. In our investigation, we identified a total of 3870 articles related to the topic under review. Following a meticulous screening process that involved evaluating titles, abstracts, and full texts, we ultimately selected five articles deemed relevant for inclusion in this review. Among these articles, three were randomised studies, while the remaining two were review articles. The outcomes of our analysis revealed that herbal decoctions, nutritional counselling, Tai Chi and acupressure, can effectively improve various psychological outcomes in elderly cancer patients. These interventions reduce fatigue, depression, anxiety, and stress, while also enhancing sleep quality and overall mental health. The present study highlights the importance of traditional Chinese medicine in addressing the needs of elderly patients with cancer. As a result, it is recommended that further extensive research be conducted to comprehensively assess the efficacy and safety of traditional Chinese medicine in managing cancer in the elderly.
Corneal nerve fibre loss as a marker to identify the impact of diabetes on Parkinson's disease
Authors: Niu Xuebin , Yin Peixiao , Shao Qiuyue , Chen Lu , Cui Guiyun , Xu Chuanying , Zan Kun
Published: August 2024

Background

Patients with Parkinson's disease (PD) suffer from serious quality of life problems. Diabetes has been demonstrated as an independent risk element for PD, aggravating its severity and accelerating its progression. There are currently no suitable biomarkers to reveal the impact of diabetes on PD. The purpose of our research was to study the impact of diabetes on PD using corneal confocal microscopy (CCM), a non‐invasive and objective test.

Methods

Fourteen PD patients with diabetes (PD‐DM), 60 PD patients without diabetes (PD‐NDM), and 30 healthy controls (HC) were included in the study. The clinical symptoms of patients with PD were assessed using the Unified Parkinson's Disease Rating Scale‐3 (UPDRS‐3) and the Parkinson's Disease Autonomic Symptom Prognosis Scale (SCOPA‐AUT). Participants underwent CCM to quantify the corneal nerve fibres.

Results

Corneal nerve fibre density (CNFD) and corneal nerve fibre length (CNFL) in patients with PD were lower than HC. Furthermore, CNFD in PD‐DM was lower than in PD‐NDM (P < 0.01). We also assessed the relationship between CCM parameters and clinical scores. CNFL and Hamilton anxiety (HAMA) have a negative correlation (r = −0.261, P = 0.032), but this study did not observe a significant correlation between CCM parameters and SCOPA‐AUT. Additionally, CNFD could distinguish PD‐DM from PD‐NDM, achieving an area under the curve of 75.06% (95% CI, 61.76%–88.36%).

Conclusions

The CCM could be served as an objective and sensitive biomarker to investigate the impact of diabetes in PD.
The Unique and Important Jewish Responses to Proposition 8 and Marriage Equality
Authors: Reeder Terry Hawley
Published: August 2024

Marriage equality is a nascent and fragile civil right in the United States. To protect this civil right we must articulate and preserve diverse religious, ethical, and legal positions from the marriage equality debates. Sadly, and incorrectly, both the popular and scholarly narratives of religions' public role and ethics on marriage equality have been told with a Christocentric and “God versus Gay” framing. Here I push the borders of that frame to include the crucially important story of Judaism and the Prop 8 marriage equality debates. Judaism made and still makes vital and unique contributions to the battle for marriage equality: the majority of Jewish congregations and organizations are in favor of marriage equality, as opposed to the majority of Christianities which are against it. Judaism models diversity within the tradition, for example how to be opposed to same‐sex marriage but not expect that it will be illegal. Jewish positions on marriage equality in the public sphere model how the civil rights of marriage equality and religious liberty can coexist and thrive.
Epidemiology of supplemental oxygen in patients with pulmonary hypertension
Authors: Torres‐Castro Rodrigo , Hinojosa Williams , Martínez‐Meñaca Amaya , Sala Llinas Ernest , Jiménez Arjona Josefa , Rueda Soriano Joaquín , Aurtenetxe Agueda , Barberà Joan Albert , Escribano‐Subías Pilar , Blanco Isabel ,   REHAP Investigators
Published: August 2024

Background and Objective

Patients with pulmonary hypertension (PH) may present with hypoxaemia at rest or during daily activities. There is no epidemiological data on the prescription of long‐term oxygen therapy (LTOT) in patients with PH. The study sought to analyse the prevalence and incidence of LTOT prescription among patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) in Spain and to determine predictors for this prescription.

Methods

A retrospective analysis was performed from the Spanish Registry of Pulmonary Arterial Hypertension (REHAP). Collected data included demographics and anthropometric measurements, functional class (FC), arterial blood gases, pulmonary function tests, haemodynamic measurements, six‐minute walking distance (6MWD) and LTOT prescription. In addition, we assessed the prevalence and incidence of LTOT prescription by PH group and subtype and potential predictors for LTOT initiation in the first 5 years after diagnosis.

Results

We analysed 4533 patients (69.9% PAH and 30.1% CTEPH), mostly female (64.5%), with a mean age of 53.0 ± 18.3 years. The prevalence of LTOT was 19.3% for all patients. The incidence of LTOT prescriptions decreased from 5.6% to 1.6% between 2010 and 2019, respectively. Predictors for LTOT prescription, excluding those that represent the indication for oxygen therapy were: FC (HR: 1.813), 6MWD (HR: 1.002), mean pulmonary arterial pressure (mPAP) (HR: 1.014), cardiac index (CI) (HR: 1.253), pulmonary vascular resistance (PVR) (HR: 1.023) and diffusing capacity of carbon monoxide (DLCO) (HR: 1.294).

Conclusion

The prevalence of LTOT in PAH and CTEPH patients is close to 20%. FC, 6MWD, mPAP, CI, PVR and DLCO were predictors for LTOT prescription.

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Using machine learning to unveil the predictors of intergenerational mobility
Authors: Clemente‐Casinhas Luís , Ferreira‐Lopes Alexandra , Martins Luís Filipe
Published: August 2024

We assess the predictors of intergenerational mobility in income and education for a sample of 137 countries, between 1960 and 2018, using the World Bank's Global Database on Intergenerational Mobility (GDIM). The Rigorous LASSO and the Random Forest and Gradient Boosting algorithms are considered, to avoid the consequences of an ad‐hoc model selection in our high dimensionality context. We obtain variable importance plots and analyze the relationships between mobility and its predictors through Shapley values. Results show that intergenerational income mobility is expected to be positively predicted by the parental average education, the share of married individuals and negatively predicted by the share of children that have completed less than primary education, the growth rate of population density, and inequality. Mobility in education is expected to have a positive relationship with the adult literacy, government expenditures on primary education, and the stock of migrants. The unemployment and poverty rates matter for income mobility, although the direction of their relationship is not clear. The same occurs for education mobility and the growth rate of real GDP per capita, the degree of urbanization, the share of female population, and income mobility. Income mobility is found to be greater for the 1960s cohort. Countries belonging to the Latin America and Caribbean region present lower mobility in income and education. We find a positive relationship between predicted income mobility and observed mobility in education.
Effect of sequential delivery of 1‐ and 2‐MHz bipolar microneedling radiofrequency energy on thermal tissue reactions in a minipig model
Authors: Cho Sung Bin , Kang Sun Young , Lee Yea‐Jin , Choi Min , Kim Bora , Ahn Jin‐Chul
Published: August 2024

Background

Bipolar microneedling radiofrequency (RF) treatment generates different patterns of thermal reactions, depending on the skin impedance and RF treatment parameters, including the frequency, power, conduction time, settings of sub‐pulse packs, and penetrating depth and type of microneedles used. We compared the effect of sequential delivery of 1‐ and 2‐MHz bipolar RF energy to in vivo minipig skin on thermal tissue reaction.

Methods

RF treatments at frequencies of 1 and 2 MHz were sequentially delivered to minipigs’ skin in vivo. A histological study was performed to analyze RF‐induced skin reactions at 1‐h and at 3‐, 7‐, and 14‐days post‐treatment.

Results

The skin specimens demonstrated that the two different frequencies of RF treatment generated mixed patterns of the peri‐electrode coagulative necrosis (PECN) according to the experimental settings and tissue impedance. In the PECN zone, the tissue coagulation induced by the first RF treatment was surrounded by the effect of the later RF treatment at the other RF frequency. In the inter‐electrode non‐necrotic thermal reaction zone, the effect of the latter RF treatment was widespread and deep through the dermis, which had received RF treatment at the other frequency first. The delivery of pulsed‐type RF energy at sub‐pulse packs of 6 or 10 provided effective RF delivery over long conduction time without excessive thermal damage of the epidermis. Nonetheless, by sequential delivery of two different RF frequencies, RF‐induced tissue reactions were found to be markedly enhanced.

Conclusion

The sequential delivery of 1‐ and 2‐MHz RF energy induces novel histological patterns of tissue reactions, which can synergistically enhance the thermostimulatory effects of each RF setting. Moreover, variations in patterns of tissue reactions can be generated by regulating the order of frequencies and the number of sub‐pulse packs of RF used.
Catalytic divergence of O‐methyltransferases shapes the chemo‐diversity of polymethoxylated bibenzyls in Dendrobium catenatum
Authors: Ta He , Yang Ya‐Hui , Zhu Ting‐Ting , Du Ni‐Hong , Hao Yue , Fu Jie , Xu Dan‐Dan , Xu Ze‐Jun , Cheng Ai‐Xia , Lou Hong‐Xiang
Published: August 2024

Erianin, crepidatin, and chrysotobibenzyl are typical medicinal polymethoxylated bibenzyls (PMBs) that are commercially produced in Dendrobium species. PMBs' chemo‐diversity is mediated by the manifold combinations of O‐methylation and hydroxylation in a definite order, which remains unsolved. To unequivocally elucidate the methylation mechanism of PMBs, 15 possible intermediates in the biosynthetic pathway of PMBs were chemically synthesized. DcOMT1–5 were highly expressed in tissues where PMBs were biosynthesized, and their expression patterns were well‐correlated with the accumulation profiles of PMBs. Moreover, cell‐free orthogonal tests based on the synthesized intermediates further confirmed that DcOMT1‐5 exhibited distinct substrate preferences and displayed hydroxyl‐group regiospecificity during the sequential methylation process. The stepwise methylation of PMBs was discovered from SAM to dihydro‐piceatannol (P) in the following order: P → 3‐MeP → 4‐OH‐3‐MeP → 4‐OH‐3,5‐diMeP → 3,3'(4′),5‐triMeP → 3,4,4′,5‐tetraMeP (erianin) or 3,3′,4,5‐tetraMeP (crepidatin) → 3,3′,4,4′,5‐pentaMeP (chrysotobibenzyl). Furthermore, the regioselectivities of DcOMTs were investigated by ligand docking analyses which corresponded precisely with the catalytic activities. In summary, the findings shed light on the sequential catalytic mechanisms of PMB biosynthesis and provide a comprehensive PMB biosynthetic network in D. catenatum. The knowledge gained from this study may also contribute to the development of plant‐based medicinal applications and the production of high‐value PMBs.
Effect of ear cleaning on treatment outcome for canine otitis externa
Authors: Corb Erin , Griffin Craig E. , Bidot Willie , Hall Melissa , Kirby Allison , Rosenkrantz Wayne
Published: August 2024

Background

Ear cleaning is often recommended for management of canine otitis externa (OE). Few in vivo studies evaluate how ear cleaning affects treatment outcome.

Hypothesis/Objectives

To determine the effect of ear cleaning on canine OE by comparing treatment outcome in cleaned versus noncleaned ears.

Animals

Twenty‐three client‐owned dogs with ceruminous or purulent OE.

Materials and Methods

Forty ears were randomised to one of two groups: 20 ears were wiped with dry or saline‐moistened gauze (grp1), and 20 external ear canals received manual cleaning (grp2) with a commercial product. One millilitre of a commercial otic suspension containing hydrocortisone aceponate, miconazole nitrate and gentamicin sulfate was applied to affected ears every 24 h for five days. Cytological scores, modified otitis index score (OTIS3), pruritus Visual Analog Scale (PVAS), modified PVAS and client questionnaire were compared on Day (D)0 and D7.

Results

There were no statistical differences between cytological scores, modified OTIS3, PVAS, modified PVAS or client assessments between groups at D7. Both groups had significant reduction in all treatment parameters from D0 to D7 with the exception of cytological rod scores that were only significantly decreased in cleaned ears. There was a significant difference in OTIS3 before and after cleaning on D0.

Conclusions and Clinical Relevance

Both groups achieved successful outcome regardless of cleaning. Ear cleaning may be more important when rod‐shaped bacteria are present.
Correlation between meibomian gland dysfunction and sebaceous adenitis in dogs
Authors: Striuli Giulia , Vandenabeele Sophie , Nachtegaele Filip , Devriendt Nausikaa
Published: August 2024

Background

Sebaceous adenitis (SA) is an immune‐mediated disease targeting the sebaceous glands. Meibomian gland dysfunction is a disease affecting meibomian glands with inflammatory features. Sebaceous and meibomian glands share anatomical, physiological and embryological similarities. The involvement of meibomian glands in dogs with SA is currently unknown.

Objectives

To evaluate meibomian glands in dogs affected by SA and compare them with healthy dogs.

Animals

Eighteen dogs were enrolled. Nine dogs with SA were retrospectively identified from clinical records and represented the case group. Nine healthy, breed‐ and age‐matched dogs were prospectively enrolled in the control group.

Materials and Methods

Both groups underwent dermatological examination, Schirmer tear test‐1 (STT‐1), tear meniscus height (TMH), slit‐lamp biomicroscopy, interferometry (INT) and noncontact infrared meibography (NIM).

Results

One third of SA dogs presented subepithelial crystalline opacities. No significant difference between groups was observed in TMH (p = 0.944) and STT‐1 values (p = 0.066). INT (p = 0.016) and NIM grades (p = 0.010) were significantly higher and lower in the SA group compared to the control group, respectively. INT values decreased with age (η = 0.930), while NIM scores (η = 0.935) increased.

Conclusions

Clinical Relevance: Subepithelial crystalline opacities in SA dogs might reflect a reduced tear film quality. In the absence of standardised methods, INT and NIM proved to be noninvasive and useful methods to examine meibomian glands. Dogs with SA showed a thinner lacrimal lipid layer and more severe meibomian gland abnormalities than control dogs, which seemed to progress with age.
One-Step Solving the Robot-World and Hand–Eye Calibration Based on the Principle of Transference
Authors: Wang Xiao , Song Hanwen
Published: August 2024

Principle of transference is very important in the kinematic analysis of spatial mechanisms, which enables the extension of point transformations to line transformations inbuilt with the dual mapping. An ideal conceptualization for applying kinematic calibration is to extend the solution of the rotational equations to the kinematic equations via dual mapping. However, this necessitates an analytic representation of the rotational solution, a task that is typically unachievable. Duffy and his coauthors used the principle of transference to generate the spatial equations from the spherical equations. Therefore, the application of the principle of transference to kinematic calibration allows one to start with the process of deriving and solving the equations of kinematics. In this article, the kinematic calibration problem is used as an application to discuss the implementation process of principle of transference in detail. First, the process of transforming the rotational equations into a linear null-space computational system based on quaternion matrix operators is reviewed. Then, fusing the dual matrix operators converts the kinematic equations into the dual linear system of equations, which reflects the forward process of principle of transference. Finally, eliminating the dual operations in the dual linear system of equations turns it into a high-dimensional linear null-space computational system, which embodies the inverse process of principle of transference. This article provides a new closed-form solution for the AX=YB problem.
Advanced Exergy Analysis of GT-sCO2 Combined Cycle
Authors: Wang Du , Xue Mujie , Ren Xin , Hu Yuxuan , Wang Zhigang
Published: August 2024

The use of the supercritical carbon dioxide Brayton cycle (SCBC) for waste heat recovery from the gas turbine cycle (GTC) can enhance system performance and reduce CO2 emissions. To analyze the possibility of component optimization and the characteristics of the exergy destruction, a model of a gas turbine-supercritical carbon dioxide (GT-sCO2) combined system with a triple cascade layout has been established, and the exergy destruction of the GT-sCO2 combined system has been analyzed for the first time using an advanced exergy analysis based on a conventional exergy analysis, which further classified the exergy destruction into endogenous, exogenous, avoidable, and unavoidable, and pointed out the direction for the optimization of the new system. The results reveal that the GTC subsystem has larger destruction than the SCBC subsystem. The endogenous exergy destruction ratio of the GT-sCO2 combined cycle is 88.86%, while the endogenous avoidable part is 20.94%. The combustion chamber has the largest endogenous avoidable exergy destruction in the GTC subsystem (51.42 MW), while the sCO2 compressor has the largest endogenous avoidable exergy destruction in the SCBC subsystem (1.89 MW). Depending on the endogenous avoidable exergy destruction, the order of optimization of components is: combustion chamber, gas turbine, air compressor, sCO2 compressor, high-temperature sCO2 turbine, cooler, high-temperature recuperator, low-temperature sCO2 turbine, and low-temperature recuperator, and the corresponding component improvement suggestions are made to aid in subsequent optimization efforts.
Methodology for Real-Time Torque Estimation in a Ship Propulsion Digital Twin
Authors: Purcell Etienne , Nejad Amir R. , Bekker Anriëtte
Published: August 2024

The safe operation of ships requires the condition of propulsion components to be maintained. Digital twins are a promising alternative for intelligent monitoring of these complex systems. Digital twins require models which ensure that the digital representation is able to mimic the behavior of the physical system. Alternate modeling solutions must be found when intellectual property restrictions or lack of available information limit the usability of physics-based models. This paper considers such a case where a system model of the propulsion system requires a real-time capable model of the propeller hydrodynamic torque. The creation of a data-driven hydrodynamic torque model based on full-scale, operational measurements is discussed. The described method focuses on the significant challenges associated with data cleaning and preparation while also evaluating whether well-known machine learning methods are suited for this application. The methods use speed-over-ground, heading, course, rotational speed, and propeller pitch as inputs. The outputs of the models are the single quadrant propeller torque coefficient and the amplitude of harmonic torsional excitation. These outputs are then combined to create a holistic prediction of the torque. Results indicate that both a polynomial least-squares fit and a shallow neural network predict the mean and the amplitude of harmonic components of the torque well. This prediction can be used to isolate the hydrodynamic torque when more than one torque source is present or to simulate what-if scenarios in a digital twin environment.
A Review on Mechanical and Wear Characteristics of Magnesium Metal Matrix Composites
Authors: Ammisetti Dhanunjay Kumar , Sai Sarath K , Kruthiventi S. S. Harish
Published: August 2024

Magnesium (Mg) and its alloys provide a desirable mixture of characteristics, including minimal density and an excellent strength/weight ratio. Nevertheless, these materials have limitations in relation to their thermal conductivity, wear and corrosion resistance, among various other attributes. The limits described above place restrictions on the use of these alloys in various applications. Currently, various methods are being employed to efficiently address and alleviate those limitations through the utilization of composite materials. The incorporation of micro/nanosized elements has been utilized to elevate the properties of Mg. Various methods are utilized to provide a homogeneous dispersal of reinforcement throughout the matrix, resulting in the production of magnesium metal matrix composites (MgMMCs). The use of MgMMCs has experienced a notable rise across many sectors such as aerospace, defense, automotive, and biomedical. This may be attributed to their exceptional attributes, which consist of enhanced specific strength, reduced weight, and congruence with biological systems. The current study objective is to perform an exhaustive examination of the different reinforcements employed in the fabrication of MgMMCs and their impact on mechanical and tribological characteristics. Furthermore, the study presented in this paper showcases the development of prediction models for the wear properties of MgMMCs through the utilization of diverse machine learning approaches.
Non-Invasive, Portable Optical Imaging Device for Early Detection of Melanoma in Aging Populations Using Diffuse Reflectance Spectroscopy
Authors: Kim Jeff J.H. , Lee James W.Y. , Bhaththiwala Hrishikesh , Sandu Shashank , Dhingra Shaurya , Yeh Hyelin
Published: August 2024

Skin cancer is the most prevalent form of cancer, with melanoma being the most deadly form. Early detection is crucial for effective treatment, yet it remains challenging, as accurate diagnosis often requires expert medical knowledge. This study presents a novel, portable, and non-invasive optical imaging device designed for early detection of melanoma in clinical and non-clinical settings. By leveraging diffuse reflectance spectroscopy and incorporating a new 'Z criterion' into the established ABCD rule (Asymmetry, Border, Color, Diameter), the device offers an enhanced assessment. The preliminary study on a cohort of elderly patients demonstrated the device's feasibility in detecting melanoma, showing significant promise for application in portable diagnostics and athome care.
Feasibility Testing of a Novel Suture and Scaffold Dressing Device as an Alternative to Gauze Pad Compression for Wound Dressings
Authors: Tan Kordell Mitchell
Published: August 2024

The properties of a novel 3D-printed medical dressing accessory, designed to provide additional support for wound compression, are explored. Traditional wound dressings often require multiple layers of gauze or other absorbable dressings to provide sufficient pressure for blood coagulation and wound healing. This research investigates the magnitude of compressive force exerted by the novel device when applied to simulated skin and its durability as a substitute for soft fabric materials usually used to pack wound dressings. This is an early-stage study that investigates the feasibility of this device to provide better compression, due to its rigid material and higher tensile modulus, and compares the compressive force of the hard dressing device with commonly used gauze dressings. A force sensor is used to capture and quantify the applied pressure. A linear static finite element analysis simulates the displacement of the device when its peak maximum rated force is exerted on it, confirming weak points under load. The results demonstrate that the novel dressing device exhibits a greater natural compressive force than gauze pads when compared using similar dressing configurations, contributing valuable insights into the mechanical characteristics of supportive wound care devices, and aiding in the development of more effective medical dressings.
On Lead Durability: Materials with Performance for Extreme Service Implantable Leads
Authors: Schaffer Jeremy E. , Griebel Adam J. , Foster Art J.
Published: August 2024

In this work, lead subcomponent performance is examined with a drop-in nitinol-silver composite wire system expected to deliver 50% improved flexibility, shape memory capability, and 50% improved strain-fatigue durability for next generation, extreme mechanical service, implantable leads. Leads produced from this advanced conductor could be useful in a variety of applications including service life extension of cardiac pacing, defibrillation, and nerve stimulation and sensing.
Design of a Segmented Brace for Optimal 3D Printing
Authors: Rizza Robert , Liu XueCheng , Anewenter Vince
Published: August 2024

For stabilization of scoliotic curves the Thoracic Lumbar Sacral Orthosis (TLSO) has become very popular. This device applies flexion, extension and lateral bending forces to the torso to decrease the curvature of the scoliotic spine. The brace is typically worn 23 hours per day.

3D printing is being applied to the manufacture of these braces as it offers the ability to manufacture the brace quickly, accurately and with much lower labor costs. However, the application of this method to adolescent braces requires the use of larger, more expensive printers making these large sized braces commercially unviable.

Rather than print the brace in one piece it is possible to print the brace in multiple pieces and assemble these pieces into a functional brace. The pieces may be printed on smaller printers so that upon assembly, a commercially competitive functional brace may be obtained.

In this study, a full size adolescent brace printed in several pieces was designed, assembled and tested. It is shown that the pieces may be assembled using a joint which is stronger than the substrate material. Furthermore, brace provides the structural integrity needed to generate the corrective biomechanical forces to stabilize the scoliotic spine.
Designing Accessible VR Games to Assist Stroke Rehabilitation
Authors: Patil Shashidhar , Dubey Venketesh N. , Holi Pavitra , Geffard Franck
Published: August 2024

VR games have become an important part of rehabilitation therapy for stroke survivors particularly to recover limb movements. The success of recovery is dependent on the repetitive movement of limbs over a considerable amount of time. It has been shown that VR game-based rehabilitation can offer promising results for repetitive movements as compared to conventional therapies. To improve the effectiveness of VR games it has been argued that – specifically designed games offer better stroke rehabilitation to keep patients engaged and motivated. This paper presents the development of non-immersive accessible VR games designed for upper limb movements without overloading patients. These games are designed based on the suggestions received from clinicians and physiotherapists. The games provide a non-immersive yet quite engaging environment with real-time scoring of performance. A preliminary test of the games with the exoskeleton robot and discussions are presented.
Innovative Pediatric Box Trainer for Laparoscopy: Insights from Force Measurement
Authors: Wu Hang-Ling , Elsaadany Israa , Miller Scarlett , Moore Jason
Published: August 2024

This study explores the design and development of a laparoscopic surgery Pediatric Box trainer used with augmented reality (AR) training. A cohort of 11 medical residents from Hershey Medical Center, with varied experience in laparoscopic surgery, participated in a peg transfer task to assess hand-eye coordination, dexterity, and ambidexterity while interacting with the Pediatric Box trainer. Results showed the average force exerting on the needle holder averaged 0.43 N and 0.33 N for the dominant and non-dominate hands, respectively. Individual laparoscopic grasping profiles were shown to uniquely vary among users. Future work will further develop the system to provide more effective AR training feedback based on the grasping force sensed.
Design of a Sensorized Original Syringe (SOS) for a Training System for Central Venous Catheterization
Authors: Kaul Aayod , Brown Dailen , Moore Jason Z. , Miller Scarlett R.
Published: August 2024

A Sensorized Original Syringe (SOS) was designed for use to improve medical training for Central Venous Catheterization (CVC). The syringe provides a lower cost alternative to the robotic-assisted syringes previously utilized in such training. At the same time, it supports additional CVC training steps, such as the ability to place the guidewire through the needle and proper aspiration (pulling back on the syringe) follow-through. The SOS has been integrated into the Advanced Dynamic Haptic Robotic Trainer (DHRT+) system to train medical residents to safely perform central venous catheterization. An experiment was conducted to identify and compare the forces required by both types of syringes (SOS and robotic assisted) to insert the needle, as well as aspirate. The results illustrated that while the SOS was ergonomically closer to the medical syringe (comparing dimensions and range of motion), the robotic assisted syringe aspiration force and needle insertion force profile were closer to those of the medical syringe and allowed for diversity of force profiles to be trained. This design will be improved by utilizing methods to implement diverse, haptic feedback and improve the realism of aspiration force profiles.
Research and Development of a “Blind” Esophageal Food Bolus Disimpaction Device
Authors: Thurston Theresa , Farhangui Alexandra , Narwankar Medha , Fan Christopher
Published: August 2024

Esophageal food bolus impaction (EFBI) occurs when peristalsis fails and food becomes stuck within the esophagus. Without resolution, the patient is at risk of bolus aspiration, inability to clear oral secretions, dehydration, esophageal perforation, and possibly death. This is a common occurrence that requires emergent diagnosis and management, with approximately 10-20% of cases requiring endoscopic intervention [1]. The endoscope toolkit consists of the scope camera, a channel that allows for passage of therapeutic tools such as graspers that can slowly tease off bits of the bolus, roth nets for bolus capture, and CRE balloons that can dilate the lumen but do not allow the scope or other tools to pass. A better equipped device would be capable of a retrograde path for bolus removal without the need for camera guidance or gastroenterologist operational expertise. With EFBI being one of the most common non-biliary GI emergencies, there is a strong interest from clinicians to have more effective tools.
The Micro-CT Scanning of Human Hearts with Previously Implanted Clinical Devices: Subsequent Generation of High-Resolution Computational Models
Authors: Wethington Audrey , Boman Sophia , DeVos Amanda , Brigham John , Iaizzo Paul A.
Published: August 2024

The generation of high-resolution models of human hearts post-implantation is a very important tool for ultimately improving device designs and one's understanding of clinical outcomes. Cardiac device designs are always evolving and such is critical for ongoing treatment of specific cardiac diseases and abnormalities. A micro-computed tomography (μCT) scanner was used to generate high-resolution, 3-dimensional scans of perfusion-fixed human hearts that contained previously implanted devices. Following scanning, the generation of high-resolution computational models, >90 microns, allowed for visualization of the device-tissue interfaces as well as the creation of various 3-D prints. The post-implantation device-tissue interactions down to 10 microns could be analyzed. For this project, we aimed to collect optimal scanning parameters for each heart, which in turn could be used in future studies to guide more efficient and targeted imaging. The scanning parameters included voltage, current, and frames per second. They were specific to and varied between hearts containing stents, pacemakers, implantable cardioverter defibrillators (ICD), and aortic valve replacements. This unique database should aid in the understanding of these device-tissue interactions by clinicians, students, and medical device designers.
Design, Verification and Validation of a Dynamic Model for an Intramuscular Autoinjector
Authors: Magubane Ntokozo , Ngoepe Malebogo , Sivarasu Sudesh
Published: August 2024

The development of new injectable molecules for different diseases and reformation of first-generation pharmaceuticals has led to growing interest in making autoinjectors usable for different medications. The major challenge in this quest is the complexity of injecting highly viscous drugs in large volumes. This research aims to develop a dynamic model to describe the influence of drug viscosity and volume on the injection process and evaluate the sensitivity of medication fluid behaviour to variations in component dimensions of the autoinjector fluid delivery system.

Using mathematical modelling, the plunger motion is characterised by the spring, fluid resistance and frictional forces between the vial and plunger. It displaces linearly and accelerates until maximum velocity is reached. Slow plunger motion is associated with increasing glide and break-loose force. Wall shear stress captured via Computational Fluid Dynamics (CFD) modelling is directly proportional to the medication viscosity and it increases linearly for Newtonian and shear-thinning medications.

Separation flow is observed in the syringe for viscosities between 15 - 80 cP. This represents decreasing flow as pressure increases, increasing the chances of needle deformation and injection pain due to tissue damage. Injecting highly-viscous drugs is possible via considerations of kinematic and rheological properties.
Design Consideration and Development of an MRI-Compatilbe Robot for Prostate Interventions
Authors: Lafreniere Samuel , Konh Bardia
Published: August 2024

Systematic (12-core) ultrasound-guided prostate biopsy is a poor technique traditionally used for detection of prostate cancer, originated in a time predating MRI technology. While ultrasound can reveal the position of the prostate and the needle, it is incapable of locating cancers within the gland— a capability that MRI possesses. Blind systematic biopsies are associated with significant rates of underdiagnosis and overdiagnosis. MRI has introduced the ability to locate the tumor, presenting a unique opportunity to perform targeted prostate biopsies. However, in-bore MRI prostate biopsy is not widely practiced, primarily because the procedure is time-consuming and expensive. Robotic teleoperated instruments that could expedite the operation could be the solution. This work presents design considerations and development of an MRI-compatible robot capable of performing in-bore teleoperative MRI-guided prostate biopsy.
Tactical Field Care Simulation: Evaluating Gender-Dependent Error Rates and Training Gaps
Authors: Drahos Bradley A. , Mabry Marshall L. , Craig Curtis M. , Schwieters Katelyn R. , Floersch Eugene , Morris Nichole L.
Published: August 2024

Simulation-based training is a primary method for ensuring skill acquisition and retention, particularly within medicine. The use of simulated training in combat medicine is one of the only methods for soldiers to practice lifesaving skills prior to the battlefield, thus it is imperative that soldiers have ample opportunity to experience high quality training scenarios. The current study assesses the relationship between errors made in a tactical field care simulation and the participants previous simulated training experience. Twenty-eight soldiers and ROTC cadets with CLS or equivalent training completed two tactical field care simulations providing treatment to a male and female simulator, in random order, both experiencing a GSW to the chest and trauma amputation to the leg. Errors in treating patient injuries were coded for analysis. The results indicate that participants committed more errors when treating the female simulator. Errors during tourniquet application, GSW treatment, and undressing were most common when the female was presented first. Previous simulation training experience was correlated with error rates, particularly in regard to undressing, indicating that a lack of undressing training correlated to increased undressing errors. Findings suggest a pronounced gap in simulation-based training using female simulators within the CLS training curriculum.
Accuracy of Mediapipe Visual Hand Tracking for use in Medical Training Procedures
Authors: Budzinski Cynthia , Wu Hang-Ling , Sarraf Elie , Miller Scarlett , Moore Jason
Published: August 2024

This paper explores the need for individualized feedback in medical simulation training for procedures such as endotracheal intubations and colonoscopies. Current pass-fail assessments lack the specificity required for skill refinement, leading to potential complications in critical procedures. This experiment investigates the application of visual hand tracking technology, specifically Google's MediaPipe, to offer quantitative feedback. Using a wooden hand model on a linear motor with a depth camera, this experiment explores tracking hand movements in real time. Google's MediaPipe software tracks 3D hand motions, generating data points for analysis. Results demonstrated consistent patterns in hand movements corresponding to linear motor actions. Total distance traveled by each point of interest and error analysis, averaging 3.1 mm, provided insights into the accuracy of visually measured hand movements. Visual hand tracking, such as MediaPipe, may prove to be a promising tool for refining operator techniques in critical medical procedures. The experiment explores the technology's accuracy and underscores its potential application in medical training, addressing a gap in current practices and emphasizing the importance of tailored feedback for improved patient outcomes.
Influence of Tissue Prestress and Calcification Levels on Iliac Balloon Angioplasty Biomechanics
Authors: Subramaniam Dhananjay Radhakrishnan , Kossuth Mary Beth
Published: August 2024

Balloon angioplasty is a well-established technique to treat lesions in the common and external iliac arteries. A potential unfavorable post-operative outcome of this procedure is rupture of the diseased artery wall. The objective of our study was to virtually evaluate the biomechanical responses of the diseased iliac artery wall resulting from deployment of a balloon, using finite-element analysis. To achieve this, we created a three-dimensional, anatomically accurate finite-element model of the diseased iliac artery. We prestressed the artery wall and computed the balloon-expansion induced stresses in the artery and plaque for different calcification levels. Our analyses showed that the vessel wall prestress was one order of magnitude smaller than those resulting from balloon expansion. Interestingly, our analyses also showed that moderate calcification levels result in higher arterial stresses when compared to those arising from low and heavy calcification levels. The results of our computational study could potentially assist in enhancing the design characteristics of angioplasty balloons to minimize the risk of post-operative iliac artery rupture.
A Modular Articulated Instrument for Manual Laparoscopic Manipulation
Authors: Scholnik Lily , Nelson Carl A.
Published: August 2024

Articulation can play a role in laparoscopic surgical instruments to increase access to surgical sites and avoid unwanted interference between instruments or between instruments and other tissues. The effect of articulation on instrument shape can also be influential in the feasibility of specialized surgical approaches such as single-incision laparoscopic surgery. In this paper, we present a modular instrument with an articulated shaft. The unique design allows preoperative configuration of the instrument’s shape to best suit the minimally invasive access path to the surgical site. The details of the design, prototyping efforts, and validation in simulation are presented.
Retainair: A New Line of Defense Against the Asthma Epidemic
Authors: Bednarz Patrick , Kang Mingyo , Lei Jacob , Somawardana Suran , Srinivasa Mira , Wu Moyuan
Published: August 2024

Asthma is a severe respiratory disease impacting almost 25 million Americans. Characterized by airway inflammation, asthma manifests in symptoms such as wheezing, chest tightness, and coughs. External triggers such as allergens initiate asthma attacks, which can be life-threatening. Thus, early detection of attacks is crucial and necessitates constant tracking of airway inflammation biomarkers. Fractional exhaled nitric oxide (FeNO) is a reliable inflammatory biomarker, positively correlated with poor asthma control, increased asthma risk, and reduced lung function. Currently, no devices provide comprehensive asthma risk assessments, and all current FeNO measurement methods lack portability and continuous monitoring. To address this gap, we propose RetainAIR: a personalized smart retainer that offers portable, comfortable, non-invasive, and continuous monitoring; enables point-of-care risk assessments; and permits timely intervention. RetainAIR detects FeNO fluctuations through electrochemical changes in an ionogel sensor, which are then sent to a machine learning algorithm that calculates FeNO fluctuations from baseline. The model demonstrates promising sensitivity and specificity values of 0.75 and 0.99, respectively. All values are then sent to a user-friendly app where patients can access their data. By continuously tracking and analyzing respiratory NO levels, RetainAIR provides asthma patients with a personalized device, timely warnings of imminent asthma attacks, and an overall analysis of asthma status to increase quality of life, lower economic burdens, and save lives.
A Novel Approach to Thromboembolic Event Detection: An Initial Evaluation
Authors: Alias Basil P. , Lo Emily , Toprani Divek , Lim Wesley
Published: August 2024

Electrical impedance tomography utilizes the electrical conductivity of a material to generate non-ionizing continuous cross-sectional imaging between a group of electrodes placed equidistant from each other in a conductive solution. Here we explore the use of electrical impedance tomography for detection of thromboembolic events through integration with inferior vena cava filters. We constructed a proof of concept prototype with electrodes spaced around the periphery of a simulated vessel and created software to control AC injection patterns through the electrodes in order to generate cross-sectional maps of relative resistance across the vessel. This initial study focused on quantifying the sensitivity of the initial device by utilizing a low-conductivity material in a conductive fluid to represent a thromboembolus in blood. The prototype successfully created cross-sectional, two-dimensional electrical resistance maps that detected both the presence and the general location of low-conductivity test materials within a conductive fluid. These results demonstrate the potential to utilize intravascular electrical impedance tomography to detect thromboemboli caught within an intravascular filter.