Rehabilitation management of patients with spinal tuberculosis (Review)

Spinal tuberculosis (ST) is a serious condition and a global health concern, accounting for a significant portion of musculoskeletal tuberculosis cases. It can lead to sever spinal and neurological complications. The management of ST involves a multidisciplinary approach, including medical treatment, surgery and rehabilitation. Rehabilitation is crucial through the course of the disease's and is tailored for each stage according to the patients' complaints, and clinical and functional complications. In the case of neurological issues due to spinal compression, rehabilitation aims at overcoming bed confinement complications, involving mobilization techniques, strengthening exercises and related vesico-sphincter disorders (urodynamics, catheterizing). The role of rehabilitation for the management of pain in patients with ST is based on bracing (restricting movements and relieving the pressure on harmed structures), and analgesic physical means (electrical stimulation and massage techniques). Several rehabilitation options may be used to address musculoskeletal complications. Range of motion exercises, muscle strengthening, and posture and balance correction using sensory perception and proprioception techniques, are commonly involved. Cardiorespiratory reconditioning is required to improve respiratory function, walking ability and cardiovascular endurance. Ultimately, rehabilitation allows for the minimization of disability and the prevention of the loss of autonomy, particularly in elderly patients. The advantage of the rehabilitation approach is its multi-optional characteristics including physical therapy, occupational therapy, ergonomic advices and assistive equipment. Despite its crucial role, rehabilitation remains understudied in the management of ST. Thus, the present mini-review aimed to address the rehabilitation options for the clinical features and complications of ST, according to the course of the disease.

Negative Pressure Wound Therapy-A Vacuum-Mediated Positive Pressure Wound Therapy and a Closer Look at the Role of the Laser Doppler

Background: Negative pressure wound therapy (NPWT) is an intensely investigated topic, but its mechanism of action accounts for one of the least understood ones in the area of wound healing. Apart from a misleading nomenclature, by far the most used diagnostic tool to investigate NPWT, the laser Doppler, also has its weaknesses regarding the detection of changes in blood flow and velocity. The aim of the present study is to explain laser Doppler readings within the context of NPWT influence. Methods: The cutaneous microcirculation beneath an NPWT system of 10 healthy volunteers was assessed using two different laser Dopplers (O2C/Rad-97®). This was combined with an in vitro experiment simulating the compressing and displacing forces of NPWT on the arterial and venous system. Results: Using the O2C, a baseline value of 194 and 70 arbitrary units was measured for the flow and relative hemoglobin, respectively. There was an increase in flow to 230 arbitrary units (p = 0.09) when the NPWT device was switched on. No change was seen in the relative hemoglobin (p = 0.77). With the Rad-97®, a baseline of 92.91% and 0.17% was measured for the saturation and perfusion index, respectively. No significant change in saturation was noted during the NPWT treatment phase, but the perfusion index increased to 0.32% (p = 0.04). Applying NPWT compared to the arteriovenous-vessel model resulted in a 28 mm and 10 mm increase in the venous and arterial water column, respectively. Conclusions: We suspect the vacuum-mediated positive pressure of the NPWT results in a differential displacement of the venous and arterial blood column, with stronger displacement of the venous side. This ratio may explain the increased perfusion index of the laser Doppler. Our in vitro setup supports this finding as compressive forces on the bottom of two water columns within a manometer with different resistances results in unequal displacement.

Hypoglossal Nerve Neuropathies-Analysis of Causes and Anatomical Background

The hypoglossal nerve is the last, and often neglected, cranial nerve. It is mainly responsible for motor innervation of the tongue and therefore the process of chewing and articulation. However, tumors, aneurysms, dissections, trauma, and various iatrogenic factors such as complications after surgeries, radiotherapy, or airway management can result in dysfunction. Correct differential diagnosis and suitable treatment require a thorough knowledge of the anatomical background of the region. This review presents the broad spectrum of hypoglossal neuropathies, paying particular attention to these with a compressive background. As many of these etiologies are not common and can be easily overlooked without prior preparation, it is important to have a comprehensive understanding of the special relations and characteristic traits of these medical conditions, as well as the most common concomitant disorders and morphological traits, influencing the clinical image. Due to the diverse etiology of hypoglossal neuropathies, specialists from many different medical branches might expect to encounter patients presenting such symptoms.

Solvent-Free and Cost-Efficient Fabrication of a High-Performance Nanocomposite Sensor for Recording of Electrophysiological Signals

Carbon nanotube (CNT)-based nanocomposites have found applications in making sensors for various types of physiological sensing. However, the sensors' fabrication process is usually complex, multistep, and requires longtime mixing and hazardous solvents that can be harmful to the environment. Here, we report a flexible dry silver (Ag)/CNT/polydimethylsiloxane (PDMS) nanocomposite-based sensor made by a solvent-free, low-temperature, time-effective, and simple approach for electrophysiological recording. By mechanical compression and thermal treatment of Ag/CNT, a connected conductive network of the fillers was formed, after which the PDMS was added as a polymer matrix. The CNTs make a continuous network for electrons transport, endowing the nanocomposite with high electrical conductivity, mechanical strength, and durability. This process is solvent-free and does not require a high temperature or complex mixing procedure. The sensor shows high flexibility and good conductivity. High-quality electroencephalography (EEG) and electrooculography (EOG) were performed using fabricated dry sensors. Our results show that the Ag/CNT/PDMS sensor has comparable skin-sensor interface impedance with commercial Ag/AgCl-coated dry electrodes, better performance for noninvasive electrophysiological signal recording, and a higher signal-to-noise ratio (SNR) even after 8 months of storage. The SNR of electrophysiological signal recording was measured to be 26.83 dB for our developed sensors versus 25.23 dB for commercial Ag/AgCl-coated dry electrodes. Our process of compress-heating the functional fillers provides a universal approach to fabricate various types of nanocomposites with different nanofillers and desired electrical and mechanical properties.

Treating Femoral Artery Pseudoaneurysm by Tumescence Anesthesia and Echo-Guided Compression Technique (TACT): Clinical Outcome in 82 Consecutive Patients

PURPOSE

Pseudoaneurysm (PA) of the access artery is a common and potentially severe complication after percutaneous endovascular interventions. Most PA require interventional therapy, including thrombin injection, covered stent implantation, or surgical repair, which are costly and associated with other complications. Treating PA by external compression is uncomfortable and time consuming, with a low success rate. By injecting local tumescence anesthesia around the PA and close to its neck, the tumescence anesthesia and echo-guided compression technique (TACT) aims to improve efficacy and patient's comfort.

MATERIALS AND METHODS

We retrospectively reviewed all consecutive patients treated for femoral PA in our center from May 2009 to July 2019 and estimated efficacy and safety. Vascular specialists performed TACT according to a standardized protocol including ultrasound-guided injection of tumescence solution (45 ml of 0.9% saline, 15 ml of lidocaine 1%/epinephrine 5 μg/ml) in the soft tissue around the PA and its neck, local compression with the sonography probe until PA closure, and external compression by elastic belt for 3 hours.

RESULTS

Among a total of 125 patients with femoral artery PA, 82 (65.6%) were treated by TACT (including 3 patients with haemorrhagic shock), 14 (11.2%) by thrombin injection; 12 (9.6%) by endovascular interventions; 8 (6.4%) by open surgery; and 9 (7.2%) conservatively. In patients treated by TACT, PA neck was short (<1 cm) in 51.8% and mean cavity diameter 30 ± 23 mm. After injection of 58 ± 8 ml of tumescence solution, mean time of echo-guided compression was 12 ± 8 minutes. Pseudoaneurysm was successfully closed in 92.7% after the first attempt and in 96.3% after the second attempt. The intervention was well tolerated, without any adverse event.

CONCLUSION

Tumescence anesthesia and echo-guided compression technique (TACT) is an effective and safe treatment for PA. Compared to other therapies, TACT is minimally invasive and widely available for minimal costs, even for large PA and in unstable patients.

CLINICAL IMPACT

Tumescence anesthesia and echo-guided compression technique seems to be an efficient, safe, and a fair economical choice in comparison with alternative techniques. The implementation of this procedure is simple with low risk of complications. Based on the results of this study, we believe that TACT should be considered as the first-line treatment of most iatrogenic PA.

Tissue Flossing: A Commentary on Clinical Practice Recommendations

Tissue flossing is an emerging myofascial intervention used by sports medicine professionals with a growing body of research evidence. Sports medicine professionals may use tissue flossing to increase myofascial mobility, improve joint ROM, enhance athletic performance, and reduce pain. Despite the increasing use, there is no consensus on clinical practice recommendations for this intervention. The purpose of this commentary is to discuss proposed clinical practice recommendations for tissue flossing and to encourage sports medicine professionals and researchers to contribute their expertise to further develop best practices.

Level of Evidence

5.

Irruption and Absorption: A 'Black-Box' Framework for How Mind and Matter Make a Difference to Each Other

Cognitive science is confronted by several fundamental anomalies deriving from the mind-body problem. Most prominent is the problem of mental causation and the hard problem of consciousness, which can be generalized into the hard problem of agential efficacy and the hard problem of mental content. Here, it is proposed to accept these explanatory gaps at face value and to take them as positive indications of a complex relation: mind and matter are one, but they are not the same. They are related in an efficacious yet non-reducible, non-observable, and even non-intelligible manner. Natural science is well equipped to handle the effects of non-observables, and so the mind is treated as equivalent to a hidden 'black box' coupled to the body. Two concepts are introduced given that there are two directions of coupling influence: (1) irruption denotes the unobservable mind hiddenly making a difference to observable matter, and (2) absorption denotes observable matter hiddenly making a difference to the unobservable mind. The concepts of irruption and absorption are methodologically compatible with existing information-theoretic approaches to neuroscience, such as measuring cognitive activity and subjective qualia in terms of entropy and compression, respectively. By offering novel responses to otherwise intractable theoretical problems from first principles, and by doing so in a way that is closely connected with empirical advances, irruption theory is poised to set the agenda for the future of the mind sciences.

The application of a dual-lead locking screw could enhance the reduction and fixation stability of the proximal humerus fractures: a biomechanical evaluation

Introduction

Bicortical screw fixation, which penetrates and fixes the near and far cortex of bone, has been conventionally used to achieve compressive fixation for fracture using screws. Open reduction and internal fixation using the locking plate are widely used for treating proximal humerus fractures. However, minimal contact between the bone and the locking plate can lead to an insufficient reduction. Theoretically, a dual-lead locking screw with different leads for the screw head and body could enhance the reduction and fixation stability of fragments in proximal humeral fractures without bicortical fixation, and achieve additional compression at the bone-plate-screw interface. This study assessed the insertion mechanics of the lead ratio of the dual-lead locking screw and its effect on the fixation stability of the proximal humerus fracture.

Methods

A Multi-Fix® locking plating system composed of ∅ 3.5 mm locking screws and a locking plate was used to make a locked plating for Sawbone bone blocks and fourth-generation composite humeri. Two different types of Sawbone bone blocks were used to simulate the osteoporotic (10 PCF) and normal cancellous (20 PCF) bones. The lead of the screw head thread (L head ) was 0.8 mm, and that of the screw body (L body ) was 0.8, 1.25, 1.6, 2.0, and 2.4 mm, whose lead ratios (R lead = L body / L head ) were 1.0, 1.56, 2.0, 2.5, and 3.0, respectively.

Results

The dual-lead locking screw elevated the compression between the locking plate and the bone. The elevation in the compression due to the dual-lead thread became weaker for the cancellous bone when the lead of the screw body was more than twice that of the screw head. The plate/humerus compression with strong bone quality withstood higher dual-lead-driven compression.

Discussion

A dual-lead locking screw of L body = 1.25 mm (R lead = 1.56 ) is recommended for maximum rotational stability for the locked humerus plating. The screws with over L body = 1.6 mm (R lead = 2 ) have no advantage in terms of the failure torque and maximum torsional deformation. Any locking dual-lead screw with a body thread lead of <1.6 mm (R lead = 2 ) can be used without the risk of bone crush when surgeons require additional compression to the locked cancellous bone plating.

A 3D Meso-Scale Model and Numerical Uniaxial Compression Tests on Concrete with the Consideration of the Friction Effect

Achieving the real mechanical performance of construction materials is significantly important for the design and engineering of structures. However, previous researchers have shown that contact friction performs an important role in the results of uniaxial compression tests. Strong discreteness generally appears in concrete-like construction materials due to the random distribution of the components. A numerical meso-scale finite-element (FE) method provides the possibility of generating an ideal material with the same component percentages and distribution. Thus, a well-designed meso-FE model was employed to investigate the effect of friction on the mechanical behavior and failure characteristics of concrete under uniaxial compression loading. The results showed that the mechanical behavior and failure profiles of the simulation matched well with the experimental results. Based on this model, the effect of friction was determined by changing the contact friction coefficient from 0.0 to 0.7. It was found that frictional contact had a slight influence on the elastic compressive mechanical behavior of concrete. However, the nonlinear hardening behavior of the stress-strain curves showed a fairly strong relationship with the frictional contact. The final failure profiles of the experiments showed a "sand-glass" shape that might be expected to result from the contact friction. Thus, the numerical meso-scale FE model showed that contact friction had a significant influence on both the mechanical performance and the failure profiles of concrete.

Multiscale Static Compressive Damage Characteristics of Kiwifruit Based on the Finite Element Method

In the handling or processing process, fruits are easily crushed by external loads. This type of damage in fruit often leads to the internal pulp browning and rotting, with the severity largely dependent on the fruit tissue's geometric and mechanical properties. In kiwifruits, with their thin skin and dark-colored flesh, it is particularly challenging to observe and analyze the damage caused by extrusion through traditional experimental methods. The objective of this research is to construct a multi-scale finite element model encompassing the skin, flesh, and core by measuring the geometric and mechanical properties of kiwifruit, to assess and predict the damage characteristics under compression, and to verify the accuracy of the finite element model through experiments. The results indicated that kiwifruits demonstrated different compressive strengths in different directions during compression. The compressive strength in the axial direction was higher than that in the radial direction, and there was little difference between the long and short radial directions. The flesh tissue is the most vulnerable to mechanical damage under external compression, followed by the core. At strain levels below 5%, there was no noticeable damage in the axial or radial directions of the kiwifruit. However, when strain exceeded 5%, damage began to manifest in some of the flesh tissue. To maintain fruit quality during storage and transportation, the stacking height should not exceed 77 fruits in the axial direction, 48 in the long direction, and 53 in the short direction. The finite element analysis showed that the established model can effectively simulate and predict the internal damage behavior of kiwifruits under compression loads, which is helpful for a deeper understanding of the mechanical properties of fruits and provides a theoretical basis and technical guidance for minimizing mechanical damage during fruit handling.

Numerical model of pressure generated by elastic compression garments on a compressible human limb analogue

OBJECTIVE

This study aimed to formulate a numerical approach (finite element modelling (FEM)) to calculate pressure values generated by compression garments on a compressible limb analogue, and to validate the numerical approach using experimental measurements. Existing models were also compared.

METHOD

Experimentally measured pressure values and deformation caused by compression bands on a compressible human limb analogue were compared with values predicted using the Young-Laplace equation, a previously formulated analytical model and the FEM.

RESULTS

The FEM provided greater accuracy in predicting the pressure generated by compression bands compared to existing models. The FEM also predicted deformation of the limb analogue with good agreement relative to experimental values.

CONCLUSION

It was concluded that modelling the non-uniform manner in which the way a limb analogue is compressed should be incorporated into future modelling of the pressures generated by compression garments on a compressible limb analogue.

DECLARATION OF INTEREST

The authors have no conflicts of interest to declare.

An Evaluation of Variations in the Carpal Tunnel Dimensions of Adult Subjects in a Hospital-Based Population: An Ultrasonographic Cross-Sectional Study

Background The carpal tunnel is a groove that spans the palm as a 'U.' The ulnar and radial sides of the wrist are made up of the scaphoid tubercle and trapezium while the palmar aspect is made up of carpal bones. Our study aimed to see whether there were differences in carpal tunnel size between men and women. Material and methods The study was conducted on 65 healthy adults, 13 (20%) were males and 52 (80%) were females (both non-pregnant and pregnant). Inclusion criteria were healthy adults and bilaterally symmetrical limbs. Exclusion criteria were chronic disease, diabetes, hypertension, immunological disorders, any visible abnormalities, and a history of upper extremity pain on either side. A high-resolution ultrasound machine with a linear transducer was used to perform an ultrasound scan of the carpal tunnel. The anteroposterior dimension was measured at the midline, or along the axis of the middle finger, and the transverse diameter was measured at the midpoint of the flexor retinaculum. The cross-sectional area of the tunnel was measured at its largest diameter within the carpal tunnel. All the dimensions were measured in centimeters. Results The mean transverse diameter of the right side was 1.824 ± 0.223 cm (p-value 0.002) and of the left side was 1.742 ± 0.197 cm (p-value 0.004). The mean cross-sectional area of the carpal tunnel on the right side was 1.417 ± 0.379 cm2 (p-value 0.008) and on the left side was 1.306 ± 0.303 cm2 (p-value 0.004), respectively. Age, sex, weight, and BMI were discussed. The carpal tunnels of females were found to be comparatively squarer and smaller than those of males. Conclusion The transverse diameter and cross-sectional area of the carpal tunnel and their correlation with carpal tunnel syndrome are predicted by age, sex, weight, and BMI. Both sexes had the same wrist ratio.

Studying large language models as compression algorithms for human culture

Large language models (LLMs) extract and reproduce the statistical regularities in their training data. Researchers can use these models to study the conceptual relationships encoded in this training data (i.e., the open internet), providing a remarkable opportunity to understand the cultural distinctions embedded within much of recorded human communication.

Characterization of Antimicrobial Poly(Lactic Acid)- and Polyurethane-Based Materials Enduring Closed-Loop Recycling with Applications in Space

Recent studies have shown that astronauts experience altered immune response behavior during spaceflight, resulting in heightened susceptibility to illness. Resources and resupply shuttles will become scarcer with longer duration spaceflight, limiting access to potentially necessary medical treatment and facilities. Thus, there is a need for preventative health countermeasures that can exploit in situ resource utilization technologies during spaceflight, such as additive manufacturing (i.e., 3D printing). The purpose of the current study was to test and validate recyclable antimicrobial materials compatible with additive manufacturing. Antimicrobial poly(lactic acid)- and polyurethane-based materials compatible with 3D printing were assessed for antimicrobial, mechanical, and chemical characteristics before and after one closed-loop recycling cycle. Our results show high biocidal efficacy (>90%) of both poly(lactic acid) and polyurethane materials while retaining efficacy post recycling, except for recycled-state polyurethane which dropped from 98.91% to 0% efficacy post 1-year accelerated aging. Significant differences in tensile and compression characteristics were observed post recycling, although no significant changes to functional chemical groups were found. Proof-of-concept medical devices developed show the potential for the on-demand manufacturing and recyclability of typically single-use medical devices using antimicrobial materials that could serve as preventative health countermeasures for immunocompromised populations, such as astronauts during spaceflight.

Highly Electroconductive Metal-Polymer Hybrid Foams Based on Silver Nanowires: Manufacturing and Characterization

Due to their electroconductive properties, flexible open-cell polyurethane foam/silver nanowire (PUF/AgNW) structures can provide an alternative for the construction of cheap pressure transducers with limited lifetimes or used as filter media for air conditioning units, presenting bactericidal and antifungal properties. In this paper, highly electroconductive metal-polymer hybrid foams (MPHFs) based on AgNWs were manufactured and characterized. The electrical resistance of MPHFs with various degrees of AgNW coating was measured during repeated compression. For low degrees of AgNW coating, the decrease in electrical resistance during compression occurs in steps and is not reproducible with repeated compression cycles due to the reduced number of electroconductive zones involved in obtaining electrical conductivity. For high AgNW coating degrees, the decrease in resistance is quasi-linear and reproducible after the first compression cycle. However, after compression, cracks appear in the foam cell structure, which increases the electrical resistance and decreases the mechanical strength. It can be considered that PUFs coated with AgNWs have a compression memory effect and can be used as cheap solutions in industrial processes in which high precision is not required, such as exceeding a maximum admissible load or as ohmic seals for product security.

Strain-Modulated and Nanorod-Waveguided Fluorescence in Single Zinc Oxide Nanorod-Based Immunodetection

Mechanical strain has been shown to be a versatile and tunable means to control various properties of nanomaterials. In this work, we investigate how strain applied to individual ZnO nanorods (NRs) can affect the fluorescence signals originated from external sources of bioanalytes, which are subsequently coupled and guided onto the NRs. Specifically, we determine how factors such as the NR length and protein concentration can influence the strain-induced changes in the waveguided fluorescence intensity along the NRs. We employ a protein of tumor necrosis factor-α (TNF-α) and a fluorophore-labeled antibody in a model immunoassay reaction, after which Alexa488-TNF-α immunocomplex is formed on ZnO NRs. We elucidate the relationships between the types as well as amounts of strain on the NRs and the fluorescence intensity originated from the Alexa488-TNF-α immunocomplexes. We show that tensile (compressive) strain applied to the NR leads to an increase (decrease) in the waveguided fluorescence signals. By assessing important optical phenomena such as fluorescence intensification on nanorod ends (FINE) and degree of FINE (DoF), we confirm their linear dependence with both the types and amounts of strain. Furthermore, the strain-induced changes in both FINE and DoF are found to be independent of protein concentration. We determine that NR length plays a critical role in obtaining high strain-dependence of the measured fluorescence signals. Particularly, we ascertain that longer NRs yield larger changes in both FINE and DoF in response to the applied strain, relative to shorter ones. In addition, longer NRs permit higher linear correlation between the protein concentration and the waveguided fluorescence intensity. These outcomes provide valuable insight into exploiting strain to enhance the detection of optical signals from bioanalytes, thus enabling their quantifications even at ultra-trace levels. Coupled with the use of individual ZnO NRs demonstrated in our measurements, this work may contribute to the development of a miniaturized, highly sensitive biosensor whose signal transduction is best optimized by the application of strain.

Expansion Injection Molding Process Using Clamping Force for Melt Compression

Melt expansion followed by compression has been utilized for high-speed filling. In general, this technology was developed for a machine level. Recently, mold-level technology has been tried. In this study, an expansion injection molding process was examined, which included compressing a polymer melt through cylinder action facilitated by the movement of the platen, followed by the expansion of the polymer melt into a mold cavity. A mold system including temperature control and valve actions, similar to hot runner systems, was designed and built. The test results show good filling when the injection pressure was high. Simulations were also carried out, highlighting consistent pressure and filling trends, while revealing limitations tied to the characteristics of the state model. This research indicates promise for expansion injection molding through platen compression but emphasizes the need for the seamless integration of valve action with the injection molding machine for large-scale production.

Psychological Changes During Inpatient Conservative Treatment for Lymphedema

Background: Learning self-care for lymphedema is essential for patients to maintain their quality of life; however, it is sometimes difficult and stressful. There are only few studies about the psychological changes in patients hospitalized for conservative therapy. The purpose of this study was to evaluate the psychological changes in patients admitted for conservative therapy and training in self-care for lymphedema. Methods and Results: Nine patients who were hospitalized for conservative treatment of lymphedema of the lower limbs were administered the Profile of Moods States questionnaire twice: day of admission or the following day and after 5 days of hospital stay. Eight female patients and one male patient were included in this retrospective study. The mean age was 67.2 years. We provided standard compression therapy, manual lymph drainage, and exercise therapy to the patients. The Profile of Moods States 2nd edition, Japanese version of the Profile of Moods States, was used as an evaluation method of the psychological state. The results of the psychological tests were evaluated by a certified public psychologist. The scores for negative mood (anger or hostility, confusion or bewilderment, depression or rejection, fatigue or inertia, and tension and anxiety) were all lower on the fifth day of hospitalization compared with those at admission. In particular, the tension or anxiety scores decreased significantly (p = 0.019). However, the vigor or activity scores tended to increase. Conclusions: It was found that inpatient conservative therapy for lymphedema had a positive effect on the psychological state of the patients. Despite stressors such as a change in environment and introduction of new treatments (compression therapy and exercise therapy), the improvement in edema helped elevate the mood of the patients by the fifth day of hospitalization.

Multi-scale in silico and ex silico mechanics of 3D printed cochlear implants for local drug delivery

The currently available treatments for inner ear disorders often involve systemic drug administration, leading to suboptimal drug concentrations and side effects. Cochlear implants offer a potential solution by providing localized and sustained drug delivery to the cochlea. While the mechanical characterization of both the implants and their constituent material is crucial to ensure functional performance and structural integrity during implantation, this aspect has been mostly overlooked. This study proposes a novel methodology for the mechanical characterization of our recently developed cochlear implant design, namely, rectangular and cylindrical, fabricated using two-photon polymerization (2 PP) with a novel photosensitive resin (IP-Q™). We used in silico computational models and ex silico experiments to study the mechanics of our newly designed implants when subjected to torsion mimicking the foreseeable implantation procedure. Torsion testing on the actual-sized implants was not feasible due to their small size (0.6 × 0.6 × 2.4 mm³). Therefore, scaled-up rectangular cochlear implants (5 × 5 × 20 mm³, 10 × 10 × 40 mm³, and 20 × 20 × 80 mm³) were fabricated using stereolithography and subjected to torsion testing. Finite element analysis (FEA) accurately represented the linear behavior observed in the torsion experiments. We then used the validated Finite element analysis models to study the mechanical behavior of real-sized implants fabricated from the IP-Q resin. Mechanical characterization of both implant designs, with different inner porous structures (pore size: 20 μm and 60 μm) and a hollow version, revealed that the cylindrical implants exhibited approximately three times higher stiffness and mechanical strength as compared to the rectangular ones. The influence of the pore sizes on the mechanical behavior of these implant designs was found to be small. Based on these findings, the cylindrical design, regardless of the pore size, is recommended for further research and development efforts.

Factors affecting radiographers' use of dose-reduction measures

This study investigates radiographers' views on implementing dose-reduction measures, with a focus on verifying patient identity and pregnancy status, practising gonad shielding in men and using compression. An electronic questionnaire was distributed to radiographers working in general radiography and/or computed tomography. The questionnaire was based on factors from a framework for analysing risk and safety in clinical medicine. Ordered logistic regressions were used to analyse associations among factors and use of dose-reduction measures. In total, 466 questionnaires were distributed and 170 radiographers (36%) completed them. Clear instructions and routines, support from colleagues, knowledge and experience, a strong safety culture, managerial support and access to proper equipment influence the likelihood of using dose-reduction measures. The strongest associations were found between support from colleagues and verifying pregnancy status (OR = 5.65,P= 0.026), safety culture and use of gonad shielding (OR = 2.36,P= 0.042), and having enough time and use of compression (OR = 2.11,P= 0.003). A strong safety culture and a supportive work environment appears to be essential for the use of dose-reduction measures, and education, training and stress management can improve utilisation of dose-reduction measures.

Machine Learning and Symptom Patterns in Degenerative Cervical Myelopathy: Web-Based Survey Study

BACKGROUND

Degenerative cervical myelopathy (DCM), a progressive spinal cord injury caused by spinal cord compression from degenerative pathology, often presents with neck pain, sensorimotor dysfunction in the upper or lower limbs, gait disturbance, and bladder or bowel dysfunction. Its symptomatology is very heterogeneous, making early detection as well as the measurement or understanding of the underlying factors and their consequences challenging. Increasingly, evidence suggests that DCM may consist of subgroups of the disease, which are yet to be defined.

OBJECTIVE

This study aimed to explore whether machine learning can identify clinically meaningful groups of patients based solely on clinical features.

METHODS

A survey was conducted wherein participants were asked to specify the clinical features they had experienced, their principal presenting complaint, and time to diagnosis as well as demographic information, including disease severity, age, and sex. K-means clustering was used to divide respondents into clusters according to their clinical features using the Euclidean distance measure and the Hartigan-Wong algorithm. The clinical significance of groups was subsequently explored by comparing their time to presentation, time with disease severity, and other demographics.

RESULTS

After a review of both ancillary and cluster data, it was determined by consensus that the optimal number of DCM response groups was 3. In Cluster 1, there were 40 respondents, and the ratio of male to female participants was 13:21. In Cluster 2, there were 92 respondents, with a male to female participant ratio of 27:65. Cluster 3 had 57 respondents, with a male to female participant ratio of 9:48. A total of 6 people did not report biological sex in Cluster 1. The mean age in this Cluster was 56.2 (SD 10.5) years; in Cluster 2, it was 54.7 (SD 9.63) years; and in Cluster 3, it was 51.8 (SD 8.4) years. Patients across clusters significantly differed in the total number of clinical features reported, with more clinical features in Cluster 3 and the least clinical features in Cluster 1 (Kruskal-Wallis rank sum test: χ22=159.46; P<.001). There was no relationship between the pattern of clinical features and severity. There were also no differences between clusters regarding time since diagnosis and time with DCM.

CONCLUSIONS

Using machine learning and patient-reported experience, 3 groups of patients with DCM were defined, which were different in the number of clinical features but not in the severity of DCM or time with DCM. Although a clearer biological basis for the clusters may have been missed, the findings are consistent with the emerging observation that DCM is a heterogeneous disease, difficult to diagnose or stratify. There is a place for machine learning methods to efficiently assist with pattern recognition. However, the challenge lies in creating quality data sets necessary to derive benefit from such approaches.

Compressive Behavior of Some Balls Manufactured by 3D Printing from Ceramic-Polymer Composite Materials

It is known that ceramic-polymer composite materials can be used to manufacture spherical bodies in the category of balls. Since balls are frequently subjected to compression loads, the paper presents some research results on the compression behavior of balls made of ceramic composite materials with a polymer matrix. The mathematical model of the pressure variation inside the balls highlights the existence of maximum values in the areas of contact with other parts. Experimental research was carried out on balls with a diameter of 20 mm, manufactured by 3D printing from four ceramic-polymer composite materials with a polymer matrix: pottery clay, terracotta, concrete, and granite. The same ceramic-polymer composite material was used, but different dyes were added to it. A gravimetric analysis revealed similar behavior of the four materials upon controlled heating. Through the mathematical processing of the experimental results obtained by compression tests, empirical mathematical models of the power-type function type were determined. These models highlight the influence exerted by different factors on the force at which the initiation of cracks in the ball materials occurs. The decisive influence of the infill factor on the size of the force at which the cracking of the balls begins was found.

A Literature Review: The Mechanisms and Treatment of Neuropathic Pain-A Brief Discussion

Classically, neuropathic pain is described as a pain caused by a lesion or disease of the somatosensory system. However, one must note that the presence of somatosensory pathology alone does not guarantee a progression to neuropathic pain. This is due, in part, to the fact that neuropathic pain is a notoriously complex disease process, involving sensitization of both the central and peripheral nervous systems. Its causes are also numerous and varied, including trauma, the compression of a nerve, autoimmune disorders, diabetes, and infections. Due to the various manifestations, causes, and symptoms of neuropathic pain, the treatment of this disease process has proved challenging for generations of physicians. This section aims to elaborate on newly proposed mechanisms for pharmacological and targeted therapies, such as neurostimulation, which aim to reduce the negative somatosensory effects of neuropathic pain.

Impact of Stoma Baseplate Convexity on Tension and Compression Around the Stoma Site: A Finite Element Analysis

For patients living with intestinal or urinary stomas, skin barriers play an essential role in protecting the peristomal skin and preventing peristomal complications. Convex baseplates press into the peristomal skin and are suitable for retracted stomas that do not protrude, peristomal skin with creases, folds, or dips, and stomas where frequent leaking can occur with flat pouching systems. However, there is a lack of data on the magnitude and location of tension applied to the abdomen by convex baseplates. We evaluated the impact of a range of convex baseplates applied to a simulated stoma site. A comparative finite element analysis investigation was conducted to evaluate the impact of eight different convex stoma system baseplates applied to an idealised flat abdomen, representing skin, subcutaneous tissue, and musculature layers. The baseplates considered had varying convexity with depths of 3.5 mm and 7 mm and internal structural diameters between ~30 mm and ~60 mm. The convex product range provided tension in the skin (maximum principal strain) and compression through the fat layer (minimum principal strain). Large differences in the locations and magnitudes of skin tension and fat layer compression were seen between the baseplates under analysis, with both the depth and diameter of convexity influencing the strain experienced across the abdominal topography. The results generated highlight the importance of having an appropriate range of convexity products available and selecting an appropriate option for use based on the stoma type and condition of the peristomal skin.

Crashworthiness of Additively Manufactured Auxetic Lattices: Repeated Impacts and Penetration Resistance

Auxetic materials have recently attracted interest in the field of crashworthiness thanks to their peculiar negative Poisson ratio, leading to densification under compression and potentially being the basis of superior behavior upon impact with respect to conventional cellular cores or standard solutions. However, the empirical demonstration of the applicability of auxeticity under impact is limited for most known geometries. As such, the present work strives to advance the investigation of the impact behavior of auxetic meta-materials: first by selecting and testing representative specimens, then by proceeding with an experimental and numerical study of repeated impact behavior and penetration resistance, and finally by proposing a new design of a metallic auxetic absorber optimized for additive manufacturing and targeted at high-performance crash applications.

The effect of compression on repetitive behaviors and task participation in children with autism spectrum disorder

Compression clothes are marketed to relieve anxiety and decrease hyperactivity in children with autism. However, few studies have examined the impact of compression for individuals with autism spectrum disorder (ASD). In this study, nine children with autism were observed during Applied Behavioral Analysis therapy sessions while wearing compression clothing. The participants were randomly assigned to wear compression clothing for either their first five sessions or their last five sessions. Videos of the therapy sessions were reviewed and each child's "off task" behavior was identified in the following domains: motor, verbal, and visual. In addition, frequency of the child's repetitive behaviors and external visual stimuli were recorded. The compression clothes failed to increase task participation or reduce the participants' repetitive behavior suggesting that the clothing may not contribute to professional practice of ABA therapy.

Ultra-Large Compressive Plasticity of E-Ga2 O3 Thin Films at the Submicron Scale

Gallium oxide (Ga2 O3 ) usually fractures in the brittle form, and achieving large plastic deformability to avoid catastrophic failure is in high demand. Here, ε-Ga2 O3 thin films with columnar crystals and partial unoccupied Ga sites are synthesized, and it is demonstrated that the ε-Ga2 O3 at the submicron scale can be compressed to an ultra-large plastic strain of 48.5% without cracking. The compressive behavior and related mechanisms are investigated by in situ transmission electron microscope nanomechanical testing combined with atomic-resolution characterizations. The serrated plastic flow and large strain burst are two major deformation forms of ε-Ga2 O3 during compression, which are attributed to the dislocation nucleation and avalanches, formation of new grains, and amorphization. The ultra-large compressive plasticity of ε-Ga2 O3 thin films at the submicron scale can inspire new applications of Ga2 O3 in micro- or nano- electronic and optoelectronic devices, especially those that require impact resistance during processing or service.

A new compression stocking with well-defined pressure-a randomized controlled pilot study

BACKGROUND

To evaluate an innovative class I compression stocking with predetermined uniform pressure in comparison to a graduated class III compression stocking system, regarding edema reduction, interface pressure, and patient comfort.

METHOD

Twenty-five patients with chronic venous disease, were randomized: 12 to investigational stocking, 13 to comparator stocking. Data collected at baseline and after 14 days.

RESULTS

Edema was significantly equal reduced to follow-up; mean -129.0 cm3 (SD 105; p = .004, Class I) and -223.7 cm3 (SD 120; p = .002, Class III), respectively. The investigational stocking lost significantly less compression pressure than the comparator stocking (p ≤ .013). Participants in both groups perceived significant improvement regarding leg heaviness, leg swelling, and feelings of tightness and tingling (p ≤ .016).

CONCLUSION

The innovative investigational class I stocking appears to offer similar edema reduction and benefits to the comparator class III stocking. However, a larger and prolonged study is required. The study was registered in the ISRCTN-registry, ISRCTN17356077, https://www.isrctn.com/ISRCTN17356077.

What we have learned from in-vitro studies of the chimney endovascular technique for treatment of complex abdominal aortic aneurysms: A systematic review

BACKGROUND

A considerable number of patients with abdominal aortic aneurysms (AAA) is not eligible for standard endovascular repair. These complex cases require alternative surgical approaches including the readily available chimney graft endovascular aneurysm repair (Ch-EVAR) or sealing (Ch-EVAS). The optimal configuration for Ch-EVAR or Ch-EVAS is important for success but not yet known.

OBJECTIVE

The aim of the present study was to analyze current data of the outcomes of in-vitro chimney graft treatment in complex AAA.

METHODS

A systematic review following PRISMA guidelines was conducted including studies reporting on gutter size, main graft compression, and chimney graft compression in in-vitro configurations.

RESULTS

The search resulted in 285 articles. 11 studies considering 219 individual tests could be included. Gutter size was comparable between Ch-EVAR and Ch-EVAS configurations. In Ch-EVAR set-ups, the deployed BECG were Advanta V12, VIABAHN®, and BeGraft. One type of SECG was used: VIABAHN®. The four types of main grafts (MG) deployed were: Endurant™ I/II; EXCLUDER Conformable AAA Endoprosthesis and AAA Endoprosthesis, and AFX™ Endovascular AAA Delivery System. In the EVAS-configurations, the Nellix® EVAS system was deployed. In general, SECG presented smaller gutters with higher chimney graft compression. 30% main grafts oversizing seems to give the smallest gutters without high risk of infolding of MG. Oversizing, EndoAnchors, and secondary endobag filling (in Ch-EVAS) reduced gutter sizes. CG ballooning during the entire polymer injection in Ch-EVAS prevented CG compression.

CONCLUSION

In-vitro investigations provide insight in optimal Ch-EVAR and Ch-EVAS configurations for simulated complex AAA repair. The findings above might aid physicians in their planning to potential CG set-ups and can be used in future research to refine the most optimal configuration for chimney graft technique in complex AAA.

The effect of medical grade compression garments on the repeated-bout effect in non-resistance-trained men

NEW FINDINGS

What is the central question of this study? What are the effects of compression garments on recovery from unaccustomed damaging exercise and subsequent protective adaptations? What is the main finding and its importance? Compression did not influence recovery, but was associated with blunted protective adaptations for isokinetic performance, which were completely absent at high velocities. Based on these findings, the use of compression garments for recovery would not be recommended following unaccustomed exercise, particularly if the maintenance of high-velocity performance following exercise-induced muscle damage is desirable.

ABSTRACT

Whilst compression garments (CG) may enhance recovery from exercise-induced muscle damage (EIMD), many recovery strategies can attenuate adaptative responses. Therefore, the effects of CG on recovery from EIMD, and the rapid protective adaptations known as the repeated bout effect (RBE) were investigated. Thirty-four non-resistance-trained males (18-45 years) randomly received class II medical-grade CG or placebo for 72 h following eccentrically-focused lower-body exercise, in a double-blind, randomised controlled trial. Indices of EIMD were assessed at baseline, 0, 24, 48 and 72 h post-exercise, before exercise and testing were repeated after 14 days. Results were analysed using a three-way (time × condition × bout) linear mixed-effects model. Exercise impaired isometric and isokinetic strength, with soreness and thigh circumference elevated for 72 h (P < 0.001). Compression did not enhance recovery (P > 0.05), despite small to moderate effect sizes (ES, reported alongside 90% confidence intervals) for isokinetic strength (ES from 0.2 [-0.41, 0.82] to 0.65 [0.03, 1.28]). All variables recovered faster after the repeated bout (P < 0.005). However, RBE for peak isokinetic force was impaired in CG at 60° s-1 (group × bout interaction: χ2  = 4.24, P = 0.0395; ES = -0.56 [-1.18, 0.07]) and completely absent at 120° s-1 (χ2  = 16.2, P < 0.001, ES = -0.96 [-1.61, -0.32]) and 180° s-1 (χ2  = 10.4, P = 0.001, ES = -0.72 [-1.35, -0.09]). Compression blunted RBE at higher isokinetic velocities without improving recovery in non-resistance-trained males, potentially contraindicating their use following unaccustomed exercise in this population.

Preliminary study of cine-MRI compression in MR-guided radiotherapy

Background

Cine-magnetic resonance imaging (MRI) is currently used in real-time tumor tracking during magnetic resonance (MR)-guided radiotherapy. As a type of MRI specified for motion tracking, a few minutes' acquisition results in thousands of 2-dimensional (2D) images. For MR-guided radiotherapy consisting of multiple treatment fractions, the large number of cine-MRI images would be disproportionate to the tight clinical data storage available. To alleviate this issue, the feasibility of compression of cine-MRI via video encoders was investigated in this study.

Methods

The cine-MRI images were first sorted into 3 sequences according to their plane orientations. Then, each sequence was reordered according to their acquisition times [time-based (TB)] or content similarities [similarity-based (SB)]. As a result, 3 sequences were obtained for 3 plan orientations. Next, the obtained sequences were processed by a video encoder and the corresponding 3 video files were achieved. We employed 3 popular video encoders: Motion JPEG (M-JPEG), Advanced Video Coding (AVC), and High Efficiency Video Coding (HEVC). The performances of the sequence reordering methods and video encoders were evaluated based on a total of 150 image sets.

Results

The mean correlation quantities for SB sequences were higher than those for TB sequences by 3% (sagittal), 2% (coronal), and 1% (transverse), respectively. The average compression ratio (CR) yielded by the SB sequences was higher than that achieved by the TB sequences. Comparing with M-JPEG, the CRs obtained by AVC and HEVC were increased by 58% and 62% (sagittal), 16% and 23% (coronal), and 48% and 56% (transverse), respectively. Among the 3 video encoders, the highest CRs and restoration accuracy were achieved by HEVC.

Conclusions

HEVC with inter-frame coding is more effective in reducing the redundant information in consecutive images. It is feasible to implement the video encoder for high-performance cine-MRI compression.

Calibration of discrete element parameters for simulating wheat crushing

The mechanical properties of wheat grains were measured and analyzed using discrete element software, which provided crucial data for their processing in a mill. The foundational Hertz-Mindlin model was used as a theoretical framework to evaluate the accumulation angle of wheat grains. The Plackett-Burman, steepest ascent, and Box-Behnken methods were utilized in a series of experiments, with the accumulation angle serving as the dependent variable. Targeting the actual angle of repose in the response surface, the optimal parameters were derived using the regression equations. These included a static-friction coefficient of 0.3 between individual wheat grains, rolling-friction coefficient of 0.04 for wheat-wheat interactions, static-friction coefficient of 0.554 for wheat-tooth roller interactions, collision recovery coefficient of 0.5 for wheat-wheat collisions, collision recovery coefficient of 0.45 for wheat-tooth roller collisions, and rolling-friction coefficient of 0.05 for wheat-roller interactions. Relying on the bonding contact model of Hertz-Mindlin, virtual uniaxial compression tests were conducted to calibrate the wheat grain bonding parameters. A regression equation for the critical load was subsequently generated using the critical load of the wheat grain bonding model as the response variable. The optimal parameters were calculated and incorporated into the EDEM model for computation, which resulted in a relative error of 1.6% between the calculated and observed values, confirming the accuracy and feasibility of the calibration method, suggesting that the calibrated parameters were accurate.

Peri-firing compression in prevention of pancreatic fistula after distal pancreatectomy: A systematic review and a cohort study

BACKGROUND/AIMS

Clinically relevant postoperative pancreatic fistula (CR-POPF) after distal pancreatectomy (DP) occurs in 20%-40% of patients and remains a leading cause of morbidity and increased healthcare cost in this patient group. Recently, several studies suggested decreased risk of CR-POPF with the use of peri-firing compression (PFC) technique. The aim of this report was to conduct a systematic review to get an overview of the current knowledge on the use of PFC in DP. In addition, our experience with PFC was presented.

METHODS

The systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Also, 19 patients undergoing DP with the use of PFC at Oslo University Hospital were studied. The primary endpoint was incidence of CR-POPF.

RESULTS

Seven articles reporting a total of 771 patients were ultimately included in the systematic review. Only two of these were case-control studies examining outcomes in patients with and without PFC, while the rest were case series. These were heterogeneous in terms of staplers used, cartridge selection policy, and PFC technique. Both case-control studies reported significantly reduced CR- POPF incidence with PFC. Eight (21%) of our patients developed CR-POPF after DP with PFC. Only one patient developed CR-POPF among those with pancreatic transection site thickness ⩽1.5 cm.

CONCLUSION

Evidence on potential benefits of PFC in DP is limited in quantity and quality. Our findings suggest that the use of PFC does not lead to reduction in the incidence of CR-POPF. Yet, there might be a benefit from PFC when dealing with a thin pancreas.

Epithelial apoptotic pattern emerges from global and local regulation by cell apical area

Geometry is a fundamental attribute of biological systems, and it underlies cell and tissue dynamics. Cell geometry controls cell-cycle progression and mitosis and thus modulates tissue development and homeostasis. In sharp contrast and despite the extensive characterization of the genetic mechanisms of caspase activation, we know little about whether and how cell geometry controls apoptosis commitment in developing tissues. Here, we combined multiscale time-lapse microscopy of developing Drosophila epithelium, quantitative characterization of cell behaviors, and genetic and mechanical perturbations to determine how apoptosis is controlled during epithelial tissue development. We found that early in cell lives and well before extrusion, apoptosis commitment is linked to two distinct geometric features: a small apical area compared with other cells within the tissue and a small relative apical area with respect to the immediate neighboring cells. We showed that these global and local geometric characteristics are sufficient to recapitulate the tissue-scale apoptotic pattern. Furthermore, we established that the coupling between these two geometric features and apoptotic cells is dependent on the Hippo/YAP and Notch pathways. Overall, by exploring the links between cell geometry and apoptosis commitment, our work provides important insights into the spatial regulation of cell death in tissues and improves our understanding of the mechanisms that control cell number and tissue size.

Fundamentals or Icing on Top of the Cake? A Narrative Review of Recovery Strategies and Devices for Athletes

The sport and athletic performance industry has seen a plethora of new recovery devices and technologies over recent years, and it has become somewhat difficult for athletes, coaches, and practitioners to navigate the efficacy of such devices or whether they are even required at all. With the increase in recovery devices and tools, it has also become commonplace for athletes to overlook more traditional, well-established recovery strategies. In this narrative review, we discuss recovery strategies in relation to the hierarchy of scientific evidence, classifying them based on the strength of the evidence, ranging from meta-analyses through to case studies and reports. We report that foam rolling, compression garments, cryotherapy, photobiomodulation, hydrotherapy, and active recovery have a high level of positive evidence for improved recovery outcomes, while sauna, recovery boots/sleeves, occlusion cuffs, and massage guns currently have a lower level of evidence and mixed results for their efficacy. Finally, we provide guidance for practitioners when deciding on recovery strategies to use with athletes during different phases of the season.

TERSE/PROLIX (TRPX) - a new algorithm for fast and lossless compression and decompression of diffraction and cryo-EM data

High-throughput data collection in crystallography poses significant challenges in handling massive amounts of data. Here, TERSE/PROLIX (or TRPX for short) is presented, a novel lossless compression algorithm specifically designed for diffraction data. The algorithm is compared with established lossless compression algorithms implemented in gzip, bzip2, CBF (crystallographic binary file), Zstandard(zstd), LZ4 and HDF5 with gzip, LZF and bitshuffle+LZ4 filters, in terms of compression efficiency and speed, using continuous-rotation electron diffraction data of an inorganic compound and raw cryo-EM data. The results show that TRPX significantly outperforms all these algorithms in terms of speed and compression rate. It was 60 times faster than bzip2 (which achieved a similar compression rate), and more than 3 times faster than LZ4, which was the runner-up in terms of speed, but had a much worse compression rate. TRPX files are byte-order independent and upon compilation the algorithm occupies very little memory. It can therefore be readily implemented in hardware. By providing a tailored solution for diffraction and raw cryo-EM data, TRPX facilitates more efficient data analysis and interpretation while mitigating storage and transmission concerns. The C++20 compression/decompression code, custom TIFF library and an ImageJ/Fiji Java plugin for reading TRPX files are open-sourced on GitHub under the permissive MIT license.

Brain-imaging evidence for compression of binary sound sequences in human memory

According to the language-of-thought hypothesis, regular sequences are compressed in human memory using recursive loops akin to a mental program that predicts future items. We tested this theory by probing memory for 16-item sequences made of two sounds. We recorded brain activity with functional MRI and magneto-encephalography (MEG) while participants listened to a hierarchy of sequences of variable complexity, whose minimal description required transition probabilities, chunking, or nested structures. Occasional deviant sounds probed the participants' knowledge of the sequence. We predicted that task difficulty and brain activity would be proportional to the complexity derived from the minimal description length in our formal language. Furthermore, activity should increase with complexity for learned sequences, and decrease with complexity for deviants. These predictions were upheld in both fMRI and MEG, indicating that sequence predictions are highly dependent on sequence structure and become weaker and delayed as complexity increases. The proposed language recruited bilateral superior temporal, precentral, anterior intraparietal, and cerebellar cortices. These regions overlapped extensively with a localizer for mathematical calculation, and much less with spoken or written language processing. We propose that these areas collectively encode regular sequences as repetitions with variations and their recursive composition into nested structures.

Narrative review-diagnosing and managing malignant epidural spinal cord compression: an evidence-based approach

Background and Objective

Malignant spinal cord compression (MSCC) is a medical emergency. Clinical deterioration can occur quickly and irreversibly. MSCC is caused predominantly by metastatic cancer spread to the epidural space by epithelial or haematological malignancies. The primary diagnostic test is full-spine magnetic resonance imaging (MRI) since it has excellent soft tissue spatial resolution, and MSCC is multi-level in around one-third of cases. The modalities of therapy for MSCC are steroids, radiotherapy, and surgery. Radiotherapy is a mainstay of treatment since indications for surgery are limited. Recently randomised clinical trials exploring long course vs. short course radiotherapy have been undertaken as well as novel incorporation of stereotactic ablative radiotherapy (SABR). This review summarises these recent trials and identifies and discusses published data for novel treatment paradigms of MSCC.

Methods

Multiple medical databases were searched through January 7th, 2023 and identified relevant studies that examined the use of radiotherapy with or without surgery in the management of MSCC.

Key Content and Findings

In addition to a detailed overview of the pathophysiology and diagnosis of cord compression, we also examine all recent phase III clinical trials to date on the use of conventional radiotherapy in managing MSCC. Our review also provides a comprehensive summary and discussion of the novel approaches to the management of cord compression, including the role of SABR and a non-traditional surgical approach as well.

Conclusions

Shorter courses of radiotherapy can be considered for poor prognosis patients. For favourable prognosis patients, longer courses of treatment provide more durable local control. An emerging treatment paradigm is a hybrid approach of surgery and SABR, however this has not been studied prospectively.

Examining the Quasi-Static Uniaxial Compressive Behaviour of Commercial High-Performance Epoxy Matrices

Four commercial high-performance aerospace aromatic epoxy matrices, CYCOM®890, CYCOM®977-2, PR520, and PRISM EP2400, were cured to a standardised 2 h, 180 °C cure cycle and evaluated in quasi-static uniaxial compression, as well as by dynamic scanning calorimetry (DSC) and thermogravimetric analysis (TGA). The thermoplastic toughened CYCOM®977-2 formulation displayed an overall increase in true axial stress values across the entire stress-strain curve relative to the baseline CYCOM®890 sample. The particle-toughened PR520 sample exhibited an overall decrease in true axial stress values past the yield point of the material. The PRISM EP2400 resin, with combined toughening agents, led to true axial stress values across the entire plastic region of the stress-strain curve, which were in line with the stress values observed with the CYCOM®890 material. Interestingly, for all formulations, the dilation angles (associated with the volume change during plastic deformation), recorded at 0.3 plastic strain, were close to 0°, with the variations reflecting the polymer structure. Compression data collected for this series of commercial epoxy resins are in broad agreement with a selection of model epoxy resins based on di- and tetra-functional monomers, cured with polyamines or dicarboxylic anhydrides. However, the fully formulated resins demonstrate a significantly higher compressive modulus than the model resins, albeit at the expense of yield stress.

Effect of mechanical forces on the behavior of osteoblasts: a systematic review of in vitro studies

Mechanical loading can play a critical role in bone modeling/remodeling through osteoblasts, with several factors being involved in this process.The present study aims to systematically review the effect of mechanical stimulation on human osteoblast cell lineage combined with other variables.The PubMed and Scopus databases were electronically searched for studies analyzing the effect of compression and tension on human osteoblasts at different differentiation stages. Studies that used carcinogenic osteoblasts were excluded. In addition, studies that did not analyze the osteogenic differentiation or proliferation of cells were excluded. The risk of bias of the studies was evaluated using the modified CONSORT (Consolidated Standards of Reporting Trials) checklist. a total of 20 studies were included. The cells were subjected to tension and compression in 5 and 15 studies, respectively. The application of uniaxial and cyclic strain increased the proliferation of osteoblasts. The same increased pattern could be observed for the osteogenesis of the cells. The impact of the tensile force on the expression of the osteoclastic markers differed based on the loading characteristics. On the other side, the impact of compression on the proliferation of osteoblasts varied according to the magnitude and duration of the force. Besides, different patterns of alternations were observed among the osteogenic markers in response to compression. Meanwhile, compression increased the expression of the osteoclastic markers. It has been shown that the response of the markers related to bone formation or resorption can be altered based on the differentiation stage of the cells, the cell culture system, and the magnitude and duration of the force.

Persistent Radiculopathy Subsequent to Selective Nerve Root Block

Transforaminal selective nerve root blocks are commonly performed for low back pain but are not without risk. This case report describes a 55-year-old man who underwent transforaminal selective nerve root block at the left lumbar (L) 4, L5, and sacral (S) 1 levels for radiating low back pain in the setting of moderate narrowing of the left L4-L5 foramen with impingement on the exiting left L4 nerve roots seen on magnetic resonance imaging (MRI). He developed left foot drop immediately after the procedure and presented to the acupuncture clinic two weeks later with persistent pain, left foot drop, and paresthesia of the left lateral shin. A repeat MRI of the lumbar spine showed mild enhancement of the left cauda equina, including the L5 and possibly L4 nerve roots. The large volume of injection into an area with neuroforaminal narrowing as well as the cytotoxicity of the contrast and anesthetic agents may have contributed to axon damage and left foot drop.

Overview of Median Arcuate Ligament Syndrome: A Narrative Review

Median arcuate ligament syndrome (MALS) is a rare disorder caused primarily by compression of the celiac trunk by the median arcuate ligament (MAL). This disorder typically results in patients presenting with bloating, weight loss, nausea, vomiting, and abdominal pain. The MALS diagnosis is one of exclusion, as the disorder has no specific diagnostic criteria. Imaging modalities are often utilized to assist in making the diagnosis, such as ultrasound, computed tomography angiography (CTA), and magnetic resonance angiography (MRA). These imaging modalities typically reveal a stenosed celiac artery with post-stenotic dilation in patients. This disorder is usually treated by dividing the MAL, thus relieving the compression of the celiac artery. The surgery may be done through either an open approach or a minimally invasive approach, which can be either laparoscopic or robot-assisted. Most patients respond well to this treatment, though certain factors that predict a poorer response to treatment include elderly age, a history of alcohol abuse, and psychiatric illness.

The role of compression in large scale data transfer and storage of typical biomedical signals at hospitals

In modern hospitals, monitoring patients' vital signs and other biomedical signals is standard practice. With the advent of data-driven healthcare, Internet of medical things, wearable technologies, and machine learning, we expect this to accelerate and to be used in new and promising ways, including early warning systems and precision diagnostics. Hence, we see an ever-increasing need for retrieving, storing, and managing the large amount of biomedical signal data generated. The popularity of standards, such as HL7 FHIR for interoperability and data transfer, have also resulted in their use as a data storage model, which is inefficient. This article raises concern about the inefficiency of using FHIR for storage of biomedical signals and instead highlights the possibility of a sustainable storage based on data compression. Most reported efforts have focused on ECG signals; however, many other typical biomedical signals are understudied. In this article, we are considering arterial blood pressure, photoplethysmography, and respiration. We focus on simple lossless compression with low implementation complexity, low compression delay, and good compression ratios suitable for wide adoption. Our results show that it is easy to obtain a compression ratio of 2.7:1 for arterial blood pressure, 2.9:1 for photoplethysmography, and 4.1:1 for respiration.

Compression drives diverse transcriptomic and phenotypic adaptations in melanoma

Physical forces are prominent during tumor progression. However, it is still unclear how they impact and drive the diverse phenotypes found in cancer. Here, we apply an integrative approach to investigate the impact of compression on melanoma cells. We apply bioinformatics to screen for the most significant compression-induced transcriptomic changes and investigate phenotypic responses. We show that compression-induced transcriptomic changes are associated with both improvement and worsening of patient prognoses. Phenotypically, volumetric compression inhibits cell proliferation and cell migration. It also induces organelle stress and intracellular oxidative stress and increases pigmentation in malignant melanoma cells and normal human melanocytes. Finally, cells that have undergone compression become more resistant to cisplatin treatment. Our findings indicate that volumetric compression is a double-edged sword for melanoma progression and drives tumor evolution.

Impact of Compression on the Textural and Structural Properties of CPO-27(Ni)

The employment of metal-organic frameworks in powder form is undesirable from an industrial perspective due to process and safety issues. This work is devoted to evaluating the impact of compression on the textural and structural properties of CPO-27(Ni). For this purpose, CPO-27(Ni) was synthesized under hydrosolvothermal conditions and characterized. Then, the resulting powder was compressed into binderless pellets using variable compression forces ranging from 5-90 kN (37-678 MPa) and characterized by means of nitrogen adsorption/desorption, thermogravimetric analysis and powder X-ray diffraction to evaluate textural, thermal and structural changes. Both textural and structural properties decreased with increasing compression force. Thermal stability was impacted in pellets compressed at forces over 70 kN. CPO-27(Ni) pelletized at 5, 8 and 10 kN, and retained more than 94% of its initial textural properties, while a loss of about one-third of the textural property was observed for the two most compressed samples (70 and 90 kN) compared to the starting powder.

Efficient sequencing data compression and FPGA acceleration based on a two-step framework

With the increasing throughput of modern sequencing instruments, the cost of storing and transmitting sequencing data has also increased dramatically. Although many tools have been developed to compress sequencing data, there is still a need to develop a compressor with a higher compression ratio. We present a two-step framework for compressing sequencing data in this paper. The first step is to repack original data into a binary stream, while the second step is to compress the stream with a LZMA encoder. We develop a new strategy to encode the original file into a LZMA highly compressed stream. In addition an FPGA-accelerated of LZMA was implemented to speedup the second step. As a demonstration, we present repaq as a lossless non-reference compressor of FASTQ format files. We introduced a multifile redundancy elimination method, which is very useful for compressing paired-end sequencing data. According to our test results, the compression ratio of repaq is much higher than other FASTQ compressors. For some deep sequencing data, the compression ratio of repaq can be higher than 25, almost four times of Gzip. The framework presented in this paper can also be applied to develop new tools for compressing other sequencing data. The open-source code of repaq is available at: https://github.com/OpenGene/repaq.

Participant Reported Improvement in Cellulite by Vari-Pad Apparel and Objective Measurements - A "First Use" Pilot Study

Background

Cellulite affects 80-90% of post-pubertal females and, although cosmetic, has proven adverse psychological effects. A new compression garment with patented "vari-pad" technology has been developed, aiming to stimulate lymphatic return from the buttocks and thighs. The primary aim of this small pilot study was to assess participant satisfaction after using this garment in the short term and secondarily, to look for any objective improvements.

Methods

Eighteen female participants (mean 47.5y, range 26-60) completed the study. There were 2 weeks of "stabilisation", 4 weeks of wearing the garment, and 2 weeks of further assessment. With the initial assessment, there were 9 visits for each participant. At each visit, weight, participant satisfaction (0-10), 3D images (Canfield, USA) and transcutaneous water content (LymphScanner, Delfin Technologies, Finland) and comfort (0-10) were recorded.

Results

There was no significant weight change in any of the participants during the trial period. After 4 weeks of wearing the garment, there was a significant improvement in participant satisfaction of their cellulite (n = 15, p = 0.0036) with a mean improvement of 18.5%. 3D image analysis of dimple volume showed no significant change in buttock cellulite, a significant decrease in left thigh cellulite (n = 17, p = 0.0123), but not on the right (n = 14, p = 0.6890). There was a significant decrease of localised water (n = 36, p = 0.0041). Comfort was 86% (range 40-100%) and there were no adverse reactions to the garment.

Conclusion

The vari-padded compression garment produced a significant improvement in participant satisfaction after just 4 weeks of treatment. Objective measurements failed to show a significant difference in cellulite on the buttocks but showed a significant improvement in the thighs by analysis of both dimple volumes and reduced transcutaneous water measurements. Further study is suggested to demonstrate if longer timeframes for use of the apparel will lead to further significant improvement in the appearance of cellulite.

NCT Number

NCT05748678.

Colloidal tubular microrobots for cargo transport and compression

Microrobot swarms have seen increased interest in recent years due to their potentials for in vivo delivery and imaging with cooperative propulsion modes and enhanced imaging signals. Yet most swarms developed so far are limited to dense particle aggregates, far simpler than complicated three-dimensional assemblies of anisotropic particles. Here, we show via assembly path design that complex hollow tubular structures can be assembled from simple isotropic colloidal spheres and those complicated, metastable, microtubes can be formed from simple, energetically favorable colloidal membranes. The assembled microtubes can remain intact and roll under a precessing magnetic field, with propulsion directions and velocities precisely controlled by field components. The hollow spaces inside enable these tubular microrobots to grab, transport, and release cargos on command. We also demonstrate unique compressing and uncompressing capabilities with our tubular microrobots, making them effective microtweezers. Our work shows that complicated microrobots can be transformed from simple assemblies, providing an insight on building micromachines.

Acute Recovery after a Fatigue Protocol Using a Recovery Sports Legging: An Experimental Study

Enhancing recovery is a fundamental component of high-performance sports training since it enables practitioners to potentiate physical performance and minimise the risk of injuries. Using a new sports legging embedded with an intelligent system for electrostimulation, localised heating and compression (completely embodied into the textile structures), we aimed to analyse acute recovery following a fatigue protocol. Surface electromyography- and torque-related variables were recorded on eight recreational athletes. A fatigue protocol conducted in an isokinetic dynamometer allowed us to examine isometric torque and consequent post-exercise acute recovery after using the sports legging. Regarding peak torque, no differences were found between post-fatigue and post-recovery assessments in any variable; however, pre-fatigue registered a 16% greater peak torque when compared with post-fatigue for localised heating and compression recovery methods. Our data are supported by recent meta-analyses indicating that individual recovery methods, such as localised heating, electrostimulation and compression, are not effective to recover from a fatiguing exercise. In fact, none of the recovery methods available through the sports legging tested was effective in acutely recovering the torque values produced isometrically.