The accuracy of breast MRI radiomic methodologies in predicting pathological complete response to neoadjuvant chemotherapy: A systematic review and network meta-analysis.

BACKGROUND: Achieving pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) improves survival outcomes for breast cancer patients. Currently, conventional histopathological biomarkers predicting such responses are inconsistent. Studies investigating radiomic texture analysis from breast magnetic resonance imaging (MRI) to predict pCR have varied radiomic protocols introducing heterogeneity between results. Thus, the efficacy of radiomic profiles compared to conventional strategies to predict pCR are inconclusive. PURPOSE: Comparing the predictive accuracy of different breast MRI radiomic protocols to identify the optimal strategy in predicting pCR to NAC. MATERIAL AND METHODS: A systematic review and network meta-analysis was performed according to PRISMA guidelines. Four databases were searched up to October 4th, 2021. Nine predictive strategies were compared, including conventional biomarker parameters, MRI radiomic analysis conducted before, during, or after NAC, combination strategies and nomographic methodology. RESULTS: 14 studies included radiomic data from 2,722 breast cancers, of which 994 were used in validation cohorts. All MRI derived radiomic features improved predictive accuracy when compared to biomarkers, except for pre-NAC MRI radiomics (odds ratio [OR]: 0.00; 95 % CI: -0.07-0.08). During-NAC and post-NAC MRI improved predictive accuracy compared to Pre-NAC MRI (OR: 0.14, 95 % CI: 0.02-0.26) and (OR: 0.26, 95 % CI: 0.07-0.45) respectively. Combining multiple MRIs did not improve predictive performance compared to Mid- or Post-NAC MRIs individually. CONCLUSION: Radiomic analysis of breast MRIs improve identification of patients likely to achieve a pCR to NAC. Post-NAC MRI are the most accurate imaging method to extrapolate radiomic data to predict pCR.

Understanding the deformation gradient in Abaqus and key guidelines for anisotropic hyperelastic user material subroutines (UMATs).

This tutorial paper provides a step-by-step guide to developing a comprehensive understanding of the different forms of the deformation gradient used in Abaqus, and outlines a number of key issues that must be considered when developing an Abaqus user defined material subroutine (UMAT) in which the Cauchy stress is computed from the deformation gradient. Firstly, we examine the "classical" forms of global and local deformation gradients. We then show that Abaqus/Standard does not use the classical form of the local deformation gradient when continuum elements are used, and we highlight the important implications for UMAT development. We outline the key steps that must be implemented in developing an anisotropic fibre-reinforced hyperelastic UMAT for use with continuum elements and local orientation systems. We also demonstrate that a classical local deformation gradient is provided by Abaqus/Standard if structural (shell and membrane) elements are used, and by Abaqus/Explicit for all element types. We emphasise, however, that the majority of biomechanical simulations rely on the use of continuum elements with a local coordinate system in Abaqus/Standard, and therefore the development of a hyperelastic UMAT requires an in-depth and precise understanding of the form of the non-classical deformation gradient provided as input by Abaqus. Several worked examples and case studies are provided for each section, so that the details and implications of the form of the deformation gradient can be fully understood. For each worked example in this tutorial paper the source files and code (Abaqus input files, UMATs, and Matlab script files) are provided, allowing the reader to efficiently explore the implications of the form of the deformation gradient in the development of a UMAT.

Influence of shape-memory stent grafts on local aortic compliance.

The effect of repair techniques on the biomechanics of the aorta is poorly understood, resulting in significant levels of postoperative complications for patients worldwide. This study presents a computational analysis of the influence of Nitinol-based devices on the biomechanical performance of a healthy patient-specific human aorta. Simulations reveal that Nitinol stent-grafts stretch the artery wall so that collagen is stretched to a straightened high-stiffness configuration. The high-compliance regime (HCR) associated with low diastolic lumen pressure is eliminated, and the artery operates in a low-compliance regime (LCR) throughout the entire cardiac cycle. The slope of the lumen pressure-area curve for the LCR post-implantation is almost identical to that of the native vessel during systole. This negligible change from the native LCR slope occurs because the stent-graft increases its diameter from the crimped configuration during deployment so that it reaches a low-stiffness unloading plateau. The effective radial stiffness of the implant along this unloading plateau is negligible compared to the stiffness of the artery wall. Provided the Nitinol device unloads sufficiently during deployment to the unloading plateau, the degree of oversizing has a negligible effect on the pressure-area response of the vessel, as each device exerts approximately the same radial force, the slope of which is negligible compared to the LCR slope of the native artery. We show that 10% oversizing based on the observed diastolic diameter in the mid descending thoracic aorta results in a complete loss of contact between the device and the wall during systole, which could lead to an endoleak and stent migration. 20% oversizing reaches the Dacron enforced area limit (DEAL) during the pulse pressure and results in an effective zero-compliance in the later portion of systole.

ICESat-2/ATLAS Onboard Flight Science Receiver Algorithms: Purpose, Process, and Performance.

The Advanced Topographic Laser Altimetry System (ATLAS) is the sole instrument on the Ice, Cloud, and land Elevation Satellite 2 (ICESat-2). Without some method of reducing the transmitted data, the volume of ATLAS telemetry would far exceed the normal X-band downlink capability or require many more ground station contacts. The ATLAS Onboard Flight Science Receiver Algorithms (hereinafter Receiver Algorithms or Algorithms) control the amount of science data that is telemetered from the instrument, limiting the data volume by distinguishing surface echoes from background noise, and allowing the instrument to telemeter data from only a small vertical region about the signal. This is accomplished through the transfer of the spacecraft's location and attitude to the instrument every second, use of an onboard Digital Elevation Model, implementation of signal processing techniques, and use of onboard relief and surface type reference maps. Extensive ground testing verified the performance of the Algorithms. On-orbit analysis shows that the Algorithms are working as expected from the ground testing; they are performing well and meeting the mission requirements.

Mechanical Characterization of Thrombi Retrieved With Endovascular Thrombectomy in Patients With Acute Ischemic Stroke.

Background and Purpose: Mechanical properties of thromboemboli play an important role in the efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke. However, very limited data on mechanical properties of human stroke thrombi are available. We aimed to mechanically characterize thrombi retrieved with EVT, and to assess the relationship between thrombus composition and thrombus stiffness. Methods: Forty-one thrombi from 19 patients with acute stroke who underwent EVT between July and October 2019 were mechanically analyzed, directly after EVT. We performed unconfined compression experiments and determined tangent modulus at 75% strain (Et75) as a measure for thrombus stiffness. Thrombi were histologically analyzed for fibrin/platelets, erythrocytes, leukocytes, and platelets, and we assessed the relationship between histological components and Et75 with univariable and multivariable linear mixed regression. Results: Median Et75 was 560 (interquartile range, 393­1161) kPa. In the multivariable analysis, fibrin/platelets were associated with increased Et75 (aß, 9 [95% CI, 5 to 13]) kPa, erythrocytes were associated with decreased Et75% (aß, −9 [95% CI, −5 to −13]) kPa. We found no association between leukocytes and Et75. High platelet values were strongly associated with increased Et75 (aß, 56 [95% CI, 38­73]). Conclusions: Fibrin/platelet content of thrombi retrieved with EVT for acute ischemic stroke is strongly associated with increased thrombus stiffness. For thrombi with high platelet values, there was a very strong relationship with thrombus stiffness. Our data provide a basis for future research on the development of next-generation EVT devices tailored to thrombus composition.

Development of an FEA framework for analysis of subject-specific aortic compliance based on 4D flow MRI.

This paper presents a subject-specific in-silico framework in which we uncover the relationship between the spatially varying constituents of the aorta and the non-linear compliance of the vessel during the cardiac cycle uncovered through our MRI investigations. A microstructurally motivated constitutive model is developed, and simulations reveal that internal vessel contractility, due to pre-stretched elastin and actively generated smooth muscle cell stress, must be incorporated, along with collagen strain stiffening, in order to accurately predict the non-linear pressure-area relationship observed in-vivo. Modelling of elastin and smooth muscle cell contractility allows for the identification of the reference vessel configuration at zero-lumen pressure, in addition to accurately predicting high- and low-compliance regimes under a physiological range of pressures. This modelling approach is also shown to capture the key features of elastin digestion and SMC activation experiments. The volume fractions of the constituent components of the aortic material model were computed so that the in-silico pressure-area curves accurately predict the corresponding MRI data at each location. Simulations reveal that collagen and smooth muscle volume fractions increase distally, while elastin volume fraction decreases distally, consistent with reported histological data. Furthermore, the strain at which collagen transitions from low to high stiffness is lower in the abdominal aorta, again supporting the histological finding that collagen waviness is lower distally. The analyses presented in this paper provide new insights into the heterogeneous structure-function relationship that underlies aortic biomechanics. Furthermore, this subject-specific MRI/FEA methodology provides a foundation for personalised in-silico clinical analysis and tailored aortic device development. STATEMENT OF SIGNIFICANCE: This study provides a significant advance in in-silico medicine by capturing the structure/function relationship of the subject-specific human aorta presented in our previous MRI analyses. A physiologically based aortic constitutive model is developed, and simulations reveal that internal vessel contractility must be incorporated, along with collagen strain stiffening, to accurately predict the in-vivo non-linear pressure-area relationship. Furthermore, this is the first subject-specific model to predict spatial variation in the volume fractions of aortic wall constituents. Previous studies perform phenomenological hyperelastic curve fits to medical imaging data and ignore the prestress contribution of elastin, collagen, and SMCs and the associated zero-pressure reference state of the vessel. This novel MRI/FEA framework can be used as an in-silico diagnostic tool for the early stage detection of aortic pathologies.

Investigating the Mechanical Behavior of Clot Analogues Through Experimental and Computational Analysis.

With mechanical thrombectomy emerging as the new standard of care for stroke treatment, clot analogues provide an extremely useful tool in the testing and design of these treatment devices. The aim of this study is to characterise the mechanical behavior of thrombus analogues as a function of composition. Platelet-contracted clot analogues were prepared from blood mixtures of various hematocrits. Mechanical testing was performed whereby clots were subjected to unconfined compression between two rigid plates. Two loading protocols were imposed: cyclic compression for 10 cycles at a constant strain-rate magnitude; stress-relaxation at a constant applied compressive strain. A hyper-viscoelastic constitutive law was identified and calibrated based on the experimental mechanical test data. Scanning electron microscopy (SEM) investigated the clot microstructure at various time-points. Clot analogue composition was found to strongly affect the observed mechanical behavior. The SEM found that the microstructure of the clot analogues was affected by the storage solution and age of the clot. The proposed hyper-viscoelastic constitutive model was found to successfully capture the material test data. The results presented in this study are of key importance to the evaluation and future development mechanical thrombectomy devices and procedures.

A Dual-VENC Four-Dimensional Flow MRI Framework for Analysis of Subject-Specific Heterogeneous Nonlinear Vessel Deformation.

Advancement of subject-specific in silico medicine requires new imaging protocols tailored to specific anatomical features, paired with new constitutive model development based on structure/function relationships. In this study, we develop a new dual-velocity encoding coefficient (VENC) 4D flow MRI protocol that provides unprecedented spatial and temporal resolution of in vivo aortic deformation. All previous dual-VENC 4D flow MRI studies in the literature focus on an isolated segment of the aorta, which fail to capture the full spectrum of aortic heterogeneity that exists along the vessel length. The imaging protocol developed provides high sensitivity to all blood flow velocities throughout the entire cardiac cycle, overcoming the challenge of accurately measuring the highly unsteady nonuniform flow field in the aorta. Cross-sectional area change, volumetric flow rate, and compliance are observed to decrease with distance from the heart, while pulse wave velocity (PWV) is observed to increase. A nonlinear aortic lumen pressure-area relationship is observed throughout the aorta such that a high vessel compliance occurs during diastole, and a low vessel compliance occurs during systole. This suggests that a single value of compliance may not accurately represent vessel behavior during a cardiac cycle in vivo. This high-resolution MRI data provide key information on the spatial variation in nonlinear aortic compliance, which can significantly advance the state-of-the-art of in-silico diagnostic techniques for the human aorta.

Influence of multi-axial dynamic constraint on cell alignment and contractility in engineered tissues.

In this study an experimental rig is developed to investigate the influence of tissue constraint and cyclic loading on cell alignment and active cell force generation in uniaxial and biaxial engineered tissues constructs. Addition of contractile cells to collagen hydrogels dramatically increases the measured forces in uniaxial and biaxial constructs under dynamic loading. This increase in measured force is due to active cell contractility, as is evident from the decreased force after treatment with cytochalasin D. Prior to dynamic loading, cells are highly aligned in uniaxially constrained tissues but are uniformly distributed in biaxially constrained tissues, demonstrating the importance of tissue constraints on cell alignment. Dynamic uniaxial stretching resulted in a slight increase in cell alignment in the centre of the tissue, whereas dynamic biaxial stretching had no significant effect on cell alignment. Our active modelling framework accurately predicts our experimental trends and suggests that a slightly higher (3%) total SF formation occurs at the centre of a biaxial tissue compared to the uniaxial tissue. However, high alignment of SFs and lateral compaction in the case of the uniaxially constrained tissue results in a significantly higher (75%) actively generated cell contractile stress, compared to the biaxially constrained tissue. These findings have significant implications for engineering of contractile tissue constructs.

A new anisotropic soft tissue model for elimination of unphysical auxetic behaviour.

Auxetic behaviour, the unphysical transverse expansion during uniaxial tension, is a common and undesirable feature of classical anisotropic hyperelastic constitutive models for soft tissue. In this study we uncover the underlying mechanism of such behaviour; high levels of in-plane compaction occurs due to increasing tension in strain-stiffening fibres, leading to unphysical out-of-plane expansion. We demonstrate that auxetic behaviour is primarily influenced by the ratio of fibre to matrix stiffness, and is accentuated by strain-stiffening fibres in a constant stiffness matrix (e.g., the widely used neo-Hookean matrix with exponentially stiffening fibres). We propose a new bilinear strain stiffening fibre and matrix (BLFM) model which allows close control of the fibre-matrix stiffness ratio, thereby robustly eliminating auxetic behaviour. We demonstrate that our model provides accurate prediction of experimentally observed out-of-plane compaction, in addition to stress-stretch anisotropy, for arterial tissue subjected to uniaxial tension testing.

An experimental and computational investigation of the material behaviour of discrete homogenous iliofemoral and carotid atherosclerotic plaque constituents.

An enhanced understanding of the structure and mechanical behavior of atherosclerotic plaque can potentially provide key guidance for clinical intervention and vascular device design. This study presents an investigation of morphological and mechanical properties of iliofemoral (n = 8) and carotid (n = 22) atherosclerotic plaque constituents. µCT analysis is used characterize the content and morphology of calcifications in excised plaques. Calcified particles contribute a significant proportion of the average plaque volume (7.6% carotid; 19.1% iliofemoral), and on average over 50% of this volume (53.7 ± 18.6% carotid; 61.7 ± 15% iliofemoral) is accounted for by the largest individual particle found in the plaque. Fibrous tissue and calcifications were isolated for mechanical testing. Unconfined compression testing of isolated calcifications uncovered viscoelastic behavior. Tensile stress relaxation uncovered viscoelastic behavior in fibrous atherosclerotic samples. Iliofemoral fibrous samples were found to be statistically significantly stiffer (*p < 0.05) than carotid fibrous samples. Results show isolated calcifications are approximately two orders of magnitude stiffer than non-calcified fibrous tissue. The results from this study advance the current understanding of plaque mechanics and suggest that computational simulation of angioplasty procedures should incorporate a discrete representation of atherosclerotic plaque constituents.

Quantification of the regional bioarchitecture in the human aorta.

Regional variance in human aortic bioarchitecture responsible for the elasticity of the vessel is poorly understood. The current study quantifies the elements responsible for aortic compliance, namely, elastin, collagen and smooth muscle cells, using histological and stereological techniques on human tissue with a focus on regional heterogeneity. Using donated cadaveric tissue, a series of samples were excised between the proximal ascending aorta and the distal abdominal aorta, for five cadavers, each of which underwent various staining procedures to enhance specific constituents of the wall. Using polarised light microscopy techniques, the orientation of collagen fibres was studied for each location and each tunical layer of the aorta. Significant transmural and longitudinal heterogeneity in collagen fibre orientations were uncovered throughout the vessel. It is shown that a von Mises mixture model is required accurately to fit the complex collagen fibre distributions that exist along the aorta. Additionally, collagen and smooth muscle cell density was observed to increase with increasing distance from the heart, whereas elastin density decreased. Evidence clearly demonstrates that the aorta is a highly heterogeneous vessel which cannot be simplistically represented by a single compliance value. The quantification and fitting of the regional aortic bioarchitectural data, although not without its limitations, including mean cohort age of 77.6 years, facilitates the development of next-generation finite element models that can potentially simulate the influence of regional aortic composition and microstructure on vessel biomechanics.

Mechanical behavior of in vitro blood clots and the implications for acute ischemic stroke treatment.

BACKGROUND: Clot mechanical properties are influenced by composition and the arrangement of components within the clot. This work investigates the effects of platelet-driven contraction on blood clot microstructure and mechanical behavior, and provides insight into some implications for mechanical thrombectomy. METHODS: Platelet-contracted clot analogues (PCCs) and non-contracted clot analogues (NCCs) were prepared from blood mixtures of various hematocrits (%H), that is, the volume percentage of red blood cells (RBCs) in the mixture. Mechanical testing was performed to compare the behavior of the analogues with previously tested human thromboemboli. Scanning electron microscopy and histology investigated the clot microstructure and composition. The association between clot properties and their behavior during mechanical behavior was also investigated. RESULTS: Overall, PCCs were found to be stiffer than NCCs, across all hematocrits. PCCs with a low %H resisted complete ingestion via contact aspiration alone or complete retrieval with stent-retrievers. PCCs with a higher %H and all NCCs were fully retrievable, although the likelihood of fragmentation was increased in clots with a greater %H. Histologically, there was little difference in the RBC and fibrin content between PCCs and NCCs with the same %H. However, the microstructure of the two groups differed significantly. CONCLUSION: A selection of repeatable clot analogues with a range of mechanical properties have been developed for in vitro modeling of acute ischemic stroke. Platelet contraction significantly affects clot volume and microstructure, and in turn clot stiffness. The significant difference in mechanical properties and microstructure, but without an appreciable difference in histology, implies that histological studies of explanted human clots alone may not prove to be predictive of the mechanical behavior of the clots in thrombectomy.

Time and laser ranging: a window of opportunity for geodesy, navigation and metrology.

Recent progress in the domain of time and frequency (T/F) standards requires important improvements of existing time distribution links. Among these, the accuracy of time transfer is actually an important part of the concerns in order to establish and maintain time & space references from ground and/or space facilities. Several time transfers by laser link projects have been carried out over the past 10 years with numerous scientific and metrological objectives. Satellite Laser ranging (SLR) has proven to be a fundamental tool, offering a straightforward, conceptually simple, highly accurate and unambiguous observable. Depending on the mission, LR is used to transmit time over two-way or one-way distances from 500 to several millions of km. The following missions and their objectives employed this technique: European Laser Timing (ELT) at 450 km, Time Transfer by Laser Link (T2L2) at 1,336 km, Laser Time Transfer (LTT) at 36,000 km, Lunar Reconnaissance Orbiter (LRO) at 350,000 km, and MErcury Surface, Space ENvironment, GEochemistry, and Ranging (MESSENGER) at tens of million km. This article describes the synergy between SLR and T/F technologies developed on the ground and in space and as well as the state of the art of their exploitation. The performance and sources of limitation of such space missions are analyzed. It shows that current and future challenges lie in the improvement of the time accuracy and stability of the time for ground geodetic observatories. The role of the next generation of SLR systems is emphasized both in space and at ground level, from the point of view of GGOS and valuable exploitation of the synergy between time synchronization, ranging and data transfer.

Modernizing and Expanding the NASA Space Geodesy Network to Meet Future Geodetic Requirements.

NASA maintains and operates a global network of Very Long Baseline Interferometry (VLBI), Satellite Laser Ranging (SLR), and Global Navigation Satellite System (GNSS) ground stations as part of the NASA Space Geodesy Program. The NASA Space Geodesy Network (NSGN) provides the geodetic products that support Earth observations and the related science requirements as outlined by the US National Research Council (NRC 2010, 2018). The Global Geodetic Observing System (GGOS) and the NRC have set an ambitious goal of improving the Terrestrial Reference Frame (TRF) to have an accuracy of 1 millimeter and stability of 0.1 millimeters per year, an order of magnitude beyond current capabilities. NASA and its partners within GGOS are addressing this challenge by planning and implementing modern geodetic stations co-located at existing and new sites around the world. In 2013, NASA demonstrated the performance of its next-generation systems at the prototype next-generation core site at NASA's Goddard Geophysical and Astronomical Observatory in Greenbelt, Maryland. Implementation of a new broadband VLBI station in Hawaii was completed in 2016. NASA is currently implementing new VLBI and SLR stations in Texas and is planning the replacement of its other aging domestic and international legacy stations. In this article, we describe critical gaps in the current global network and discuss how the new NSGN will expand the global geodetic coverage and ultimately improve the geodetic products. We also describe the characteristics of a modern NSGN site and the capabilities of the next-generation NASA SLR and VLBI systems. Finally, we outline the plans for efficiently operating the NSGN by centralizing and automating the operations of the new geodetic stations.

Thermodynamic Modeling of the Statistics of Cell Spreading on Ligand-Coated Elastic Substrates.

Biological spread cells exist in a perpetually fluctuating state and therefore cannot be described in terms of a unique deterministic system. For modeling approaches to provide novel insight and uncover new mechanisms that drive cell behavior, a framework is required that progresses from traditional deterministic methods (whereby simulation of an experiment predicts a single outcome). In this study, we implement a new, to our knowledge, modeling approach for the analysis of cell spreading on ligand-coated substrates, extending the framework for nonequilibrium thermodynamics of cells developed by Shishvan et al. to include active focal adhesion assembly. We demonstrate that the model correctly predicts the coupled influence of surface collagen density and substrate stiffness on cell spreading, as reported experimentally by Engler et al. Low surface collagen densities are shown to result in a high probability that cells will be restricted to low spread areas. Furthermore, elastic free energy induced by substrate deformation lowers the probability of observing a highly spread cell, and, consequentially, lower cell tractions affect the assembly of focal adhesions. Experimentally measurable observables such as cell spread area and aspect ratio can be directly postprocessed from the computed homeostatic ensemble of (several million) spread states. This allows for the prediction of mean and SDs of such experimental observables. This class of cell mechanics modeling presents a significant advance on conventional deterministic approaches.

In-flight characterization of the lunar orbiter laser altimeter instrument pointing and far-field pattern.

The Lunar Orbiter Laser Altimeter (LOLA) aboard the Lunar Reconnaissance Orbiter (LRO) has collected nearly seven billion measurements of surface height on the Moon with an absolute accuracy of ∼1 m and a precision of ∼10 cm. Converting time-of-flight laser altimeter measurements to topographic elevations requires accurate knowledge of the laser pointing with respect to the spacecraft body-fixed coordinate system. To that end, we have utilized altimetric crossovers from LOLA, as well as bidirectional observations of the LOLA laser and receiver boresight via an Earth-based laser tracking ground station. Based on a sample of ∼780,000 globally distributed crossovers from the circular-orbit phase of LRO's mission (∼27 months), we derive corrections to the LOLA laser boresight. These corrections improve the cross-track and along-track agreement of the crossovers by 24% and 33%, respectively, yielding RMS residuals of ∼10 m. Since early in the LRO mission, the bidirectional laser tracking experiments have confirmed a pointing anomaly when the LOLA instrument is facing toward deep space or the night side of the Moon and have allowed the reconstruction of the laser far-field pattern and receiver telescope pointing. By conducting such experiments shortly after launch and nearly eight years later, we have directly measured changes in the laser characteristics and obtained critical data to understand the laser behavior and refine the instrument pointing model. The methods and results presented here are also relevant to the design, fabrication, and operation of future planetary laser altimeters and their long-term behavior in the space environment.

NASA's Satellite Laser Ranging Systems for the 21st Century.

For over 40 years, NASA's global network of satellite laser ranging (SLR) stations has provided a significant percentage of the global orbital data used to define the International Terrestrial Reference Frame (ITRF). The current NASA legacy network is reaching its end-of-life and a new generation of systems must be ready to take its place. Scientific demands of sub-millimeter precision ranging and the ever-increasing number of tracking targets give aggressive performance requirements to this new generation of systems. Using lessons learned from the legacy systems and the successful development of a prototype station, a new network of SLR stations, called the Space Geodesy Satellite Laser Ranging (SGSLR) systems, is being developed. These will be the state-of-the-art SLR component of NASA's Space Geodesy Project (SGP). Each of SGSLR's nine subsystems has been designed to produce a robust, kilohertz laser ranging system with 24/7 operational capability and with minimal human intervention. SGSLR's data must support the aggressive goals of the Global Geodetic Observing System (GGOS), which are 1 millimeter (mm) position accuracy and 0.1 mm per year stability of the ITRF. This paper will describe the major requirements and accompanying design of the new SGSLR systems, how the systems will be tested, and the expected system performance.

Review of Mechanical Testing and Modelling of Thrombus Material for Vascular Implant and Device Design.

A thrombus or blood clot is a solid mass, made up of a network of fibrin, platelets and other blood components. Blood clots can form through various pathways, for example as a result of exposed tissue factor from vascular injury, as a result of low flow/stasis, or in very high shear flow conditions. Embolization of cardiac or vascular originating blood clots, causing an occlusion of the neurovasculature, is the major cause of stroke and accounts for 85% of all stroke. With mechanical thrombectomy emerging as the new standard of care in the treatment of acute ischemic stroke (AIS), the need to generate a better understanding of the biomechanical properties and material behaviour of thrombus material has never been greater, as it could have many potential benefits for the analysis and performance of these treatment devices. Defining the material properties of a thrombus has obvious implications for the development of these treatment devices. However, to-date this definition has not been adequately established. While some experimentation has been performed, model development has been extremely limited. This paper reviews the previous literature on mechanical testing of thrombus material. It also explores the use of various constitutive and computational models to model thrombus formation and material behaviour.

Unlocking stories: Older women's experiences of intimate partner violence told through creative expression.

WHAT IS KNOWN ON THE SUBJECT: Intimate partner violence (IPV) impacts significantly on the lives and health of those who experience abuse The impact of IPV exerts a detrimental impact on mental health as well as physical health, but this is often not recognized by professionals WHAT THE STUDY ADDS TO EXISTING KNOWLEDGE: This study highlights the impact of IPV on the lives and health of older women from the perspective of older women themselves The approach taken to the study illuminates the ways in which older women describe their experiences within the broader narratives of their experiences This study has explored the particular situation for older women as told through creative expression and their own stories of survivorship. IMPLICATIONS FOR PRACTICE: Nurses and other healthcare professionals need to be aware of the enduring impact of IPV for older women, particularly within the context of mental health Those working with older women also need to be alert to the potential barriers to disclosure and disjuncture between professional dialogue and personal narrative ABSTRACT: Introduction Intimate partner violence (IPV) exerts a detrimental impact on the lives and health of all who experience abuse. This includes both physical and mental health and well-being. The experiences of older women however may be different, and these differences may not be recognized or accounted for within existing care provision. Aim To explore the impact of IPV on the lives and health of older women told from the particular perspective of older women themselves as these accounts are largely absence from existing IPV discourse. Method An arts-based research approach with five older women survivors of IPV through the codevelopment and organization of an arts-based workshop. The workshop essentially encompassed four main arts strands and included the creation of clay models and poetry. Findings The findings of the study highlight the significant impact of IPV on the lives, mental health and well-being of older women. This included feelings of social isolation, inability to trust others and a loss of self-identity. Discussion Intimate partner violence is a global issue and as such of relevance for those working in healthcare contexts beyond the UK. While there is a growing body of evidence surrounding IPV and older women, this has largely been presented through researcher-led accounts and as such the narratives of women themselves may not have been adequately acknowledged. Unlike much of the existing evidence, this study has explored the particular situation for older women as told through creative expression and their own stories of survivorship. In this study, the fluidity of the potential materials available in the workshops meant that both the representations through which the women spoke and the primacy of their voices, over those of more traditional researcher accounts, were in evidence throughout. Implications for Practice Mental health nurses and practitioners are often on the front line for care and support for older client populations. IPV across the life span is a global issue for healthcare practitioners. It is anticipated that the findings of this study will provide the mechanism through which mental health nurses and other practitioners may reflect on older women's accounts of IPV as told by older women in this study in their own words. Reframing from dominant professional discourse to personal narrative is central to person-centred approaches and is central to contemporary practice. Ultimately, this has the potential to improve the effectiveness of care provision and support. Relevance to Mental Health Nursing The findings presented in this study have the potential to provide a powerful tool for those working within mental health contexts and healthcare professionals working with older populations more generally to consider both the hidden nature of IPV and the ways in which IPV can significantly impact on mental health and well-being in later life.