Mechanical thrombectomy treatment for cerebral infarction in circulation after 40 h.

The treatment time window for acute cerebral infarction in global guidelines is within 24 h. We report a patient who was admitted to the hospital and underwent endovascular treatment reaching 40 h. During vascular examination, the thrombus moved to distant segment, and then the surgeon quickly performed endovascular treatment. The patient ultimately achieved a good outcome. This case indicates that thrombus is moveable at any time, we expected to provide advice to clinical doctors that vascular examination should also be arranged as soon as possible to clarify the etiology in stroke patients especially with low NIHSS scores.

Hydrogel Wound Dressings Accelerating Healing Process of Wounds in Movable Parts.

Skin is the largest organ in the human body and requires proper dressing to facilitate healing after an injury. Wounds on movable parts, such as the elbow, knee, wrist, and neck, usually undergo delayed and inefficient healing due to frequent movements. To better accommodate movable wounds, a variety of functional hydrogels have been successfully developed and used as flexible wound dressings. On the one hand, the mechanical properties, such as adhesion, stretchability, and self-healing, make these hydrogels suitable for mobile wounds and promote the healing process; on the other hand, the bioactivities, such as antibacterial and antioxidant performance, could further accelerate the wound healing process. In this review, we focus on the recent advances in hydrogel-based movable wound dressings and propose the challenges and perspectives of such dressings.

The Behavior of Long Thin Rectangular Plates under Normal Pressure-A Thorough Investigation.

Thin rectangular plates are considered basic structures in various sectors like aerospace, civil, and mechanical engineering. Moreover, isotropic and laminated composite plates subjected to transverse normal loading and undergoing small and large deflections have been extensively studied and published in the literature. Yet, it seems that the particular case of long thin plates having a high aspect ratio appears to be almost ignored by various scholars despite its engineering importance. The present study tries to fill this gap, yielding novel findings regarding the structural behavior of long thin plates in the small- and large-deflection regimes. In contrast to what is normally assumed in the literature, namely that a long plate with a high aspect ratio can be considered an infinitely long plate, the present results clearly show that the structural effects of the ends continue to exist near the remote ends of the long plate. An innovative finding is that long plates would (only on movable boundary conditions for the large-deflection regime) exhibit a larger mid-width displacement in comparison with deflections of infinitely long plates. This innovative higher deflection appears for both small and large-deflection regimes for both all-around simply supported and all-around clamped boundary conditions. This new finding was shown to be valid for both isotropic and orthotropic materials and presents a novel engineering approach for the old assumption well quoted in the literature that a relatively long plate on any boundary condition can be considered an infinite plate. Based on the present research, it is recommended that this assumption should be used carefully as the largest plate mid-deflection might occur at finite aspect ratios.

Recyclable Tough Adhesive Sheets with Movable Cross-Links for Sustainable Use.

Acrylic adhesive sheets have been used for many applications, from popular seal materials to high-end electrical devices. One of the basic and critical design features of adhesives is effective covalent cross-linking for superior adhesive properties. On the other hand, covalent cross-linking prevents reuse or recycling of the adhesive. This makes the adhesive sheets insoluble and poorly workable. For development of sustainable adhesives, we investigated the adhesive sheets based on acrylic elastomers with "Movable Cross-links" (M-PEA-CD (0.5)) copolymerized with 0.5 mol % cyclodextrin monomers. The peel strength and creep resistance of M-PEA-CD (0.5) were greater than those of adhesives (N-PEA) without any cross-links. M-PEA-CD (0.5) was recyclable via dissolution in ethyl acetate. Furthermore, the recycled M-PEA-CD (0.5) from solution exhibited the same adhesion properties as virgin M-PEA-CD (0.5). Spectroscopic and mechanical measurements indicated that topological cross-linking with Cyclodextrin (CD) moieties generated novel recyclable adhesive sheets without restricting the polymer main chains, unlike covalent cross-linking (CC-PEA). The movable cross-links were maintained in both the solid state and in solution, which allowed recycling of the elastomer via simple methods.

Effect of patient-specific factors on regeneration in lumbar spine at healthy disc and total disc replacement. Computer simulation.

BACKGROUND AND OBJECTIVE: Degenerative diseases of the spine have a negative impact on the quality of life of patients. This study presents the results of numerical modelling of the mechanical behaviour of the lumbar spine with patient-specific conditions at physiological loads. This paper aims to numerically study the influence of degenerative changes in the spine and the presence of an endoprosthesis on the creation of conditions for tissue regeneration. METHODS: A numerical model of the mechanical behaviour of lumbar spine at healthy and after total disc replacement under low-energy impacts equivalent to physiological loads is presented. The model is based on the movable cellular automaton method (discrete elements), where the mechanical behaviour of bone tissue is described using the Biot poroelasticity accounting for the presence and transfer of interstitial biological fluid. The nutritional pathways of the intervertebral disc in cases of healthy and osteoporotic bone tissues were predicted based on the analysis of the simulation results according to the mechanobiological principles. RESULTS: Simulation of total disc replacement showed that osseointegration of the artificial disc plates occurs only in healthy bone tissue. With total disc replacement in a patient with osteoporosis, there is an area of increased risk of bone resorption in the near-contact area, approximately 1 mm wide, around the fixators. Dynamic loads may improve the osseointegration of the implant in pathological conditions of the bone tissue. CONCLUSIONS: The results obtained in the case of healthy spine and osteoporotic bone tissues correspond to the experimental data on biomechanics and possible methods of IVD regeneration from the position of mechanobiological principles. The results obtained with an artificial disc (with keel-type fixation) showed that the use of this type of endoprosthesis in healthy bone tissues allows to reproduce the function of the natural intervertebral disc and does not contribute to the development of neoplastic processes. In the case of an artificial disc with osteoporosis of bone tissues, there is a zone with increased risk of tissue resorption and development of neoplastic processes in the area near the contact of the implant attachment. This circumstance can be compensated by increasing the loading level.

Improvement in Cohesive Properties of Adhesion Systems Using Movable Cross-Linked Materials with Stress Relaxation Properties.

A strong, tough, and stable adhesion system used in various environments must be developed. A long-lasting adhesion system should effectively perform in the following five aspects: adhesion strength, toughness, energy dissipation property, self-restoration property, and creep resistance property. However, these properties are difficult to balance using conventional adhesives. Here, a new topological adhesion system using single-movable cross-network (SC) materials [SC(DMAAm) Adh] was designed. 3-(Trimethoxysilyl) propyl acrylate was used as the anchor, N,N-dimethyl acrylamide (DMAAm) was used as the main chain monomer, and γ-cyclodextrin (γ-CD) units acted as movable cross-links. The movable cross-links provided SC(DMAAm) Adh with energy dissipation properties, thereby improving its toughness. The γ-CD units also acted as bulky stoppers that provided a high adhesion strength and self-restoration properties. Moreover, the combination of the movable cross-links and bulky stoppers provided creep resistance to SC(DMAAm) Adh. The performance of the adhesion systems under different mobilities of the polymer chains was examined by adjusting the water content. In proper water-containing states, all mechanical properties of SC(DMAAm) Adh were better than those of the adhesion systems using homopolymers [P(DMAAm) Adh] and polymers with covalent cross-linking points [CP(DMAAm) Adh].

Developing a novel quasi-3D movable water phantom for radiation therapy workable in the magnetic resonance environment.

Background: The use of magnetic resonance linear accelerators (MR-LINACs) for clinical treatment has opened up new possibilities and challenges in the field of radiation oncology. However, annual quality assurance (QA) is relatively understudied due to practical considerations. Thus, to overcome the difficulty of measuring the dose with a small water phantom for TRS-398 or TG-51 in all external beam radiation treatment unit environments, such as MR compatibility, we designed a remote phantom with a three-axis changeable capacity for QA. Methods: The designed water phantom was tested under an MR environment. The water phantom system comprised of three parts: a phantom box, a dose measurement tool, and a PMD401 drive system. The UNIDOSE universal dosimeter was used to collect beam data. The manufacturer's developer tools were utilized to position the measurement. To ensure magnetic field homogeneity, a distortion phantom was prepared using sixty fish oil capsules aligned radially to distinguish the oil and free air. The phantom was scanned in both the MR simulator and computed tomography (CT), and the acquired images were analyzed to determine the position shift. Results: The dimensions of the device are 30 cm in the X-axis, 20 cm in the Y-axis, and 17 cm in the Z-axis. Total cost of materials was no more than $10,000 US dollars. Our results indicate that the device can function normally in a regular 1.5 T MR environment without interference from the magnetic field. The water phantom's traveling speed was found to be approximately 5 mm/s with a position difference confined within 6 cm intervals during normal use. The distortion test results showed that the prepared MR environment has uniform magnetic field homogeneity. Conclusions: In this study, we constructed a prototype water phantom device that can function in an MR simulator without interference between the magnetic field and electronic components. Compared to other commercially available MR-LINAC water phantoms, our device offers a more cost-effective solution for routine monthly QA. It can shorten the duration of QA tests and relieve the burden on medical physicists.

Innovative Insights on the Thin Square Plate Large Deflection Problem.

Thin plates subjected to transverse load and undergoing large deflections have been widely studied and published in the literature. However, there is still a lack of information and understanding about the membrane stresses created under large deflections and their associated Airy stress function, as displayed in the well-known von Kármán equations set. The present study aims at providing explicit expressions for the membrane stresses, the deflections, and the Airy stress function for a general square plate area vertically uniformly loaded to reach large deflection state. This was obtained by using the results of a high-fidelity finite element analysis applied on a lateral loaded simply supported thin square plate, which are then casted to yield approximate Fourier series expressions for the membrane stresses, deflections, and the Airy stress function. The stress map figures provide a good understanding of the critical points on the plate, while the explicit mathematical expressions enabled the calculation of deflections and stresses for the entire plate area. Among other interesting findings, the presence of relatively high tensile and compressive membrane stresses existing near the plate edges was revealed, which might lead to potential failure hazards. The derivatives of the deflections and the Airy stress function enabled the validation of the large deflections von Kármán equations set for the investigated case, and it turned out that the generated expressions for the stresses and the lateral deflection based on a high-fidelity finite element model satisfy the second equation with a good accuracy, while the first one remains to further be investigated. Moreover, using the generated explicit equations, the load influence on the deflections and stresses was also analyzed to yield general novel expressions for the medium and very large deflections states. To generalize the investigated case, the stresses and the deflections were non-dimensionalized so they can be used for any material and plate dimensions.

Impact of Respiratory Motion on the Skin Dose for Breast Cancer in Tomotherapy: A Study in the In-house Moving Phantom.

Purpose: The dose expansion methods as the skin flash and virtual bolus were used to solve intrafraction movement for breast planning due to breathing motion. We investigated the skin dose in each planning method by using optically stimulated luminescence on an in-house moving phantom for breast cancer treatment in tomotherapy. The impact of respiratory motion on skin dose between static and dynamic phantom's conditions was evaluated. Methods: A phantom was developed with movement controlled by the respirator for generating the respiratory waveforms to simulate respiratory motion. Five optically stimulated luminescence dosimeters were placed on the phantom surface to investigate the skin dose for the TomoDirect and TomoHelical under static and dynamic conditions. Eight treatment plans were generated with and without skin flash or virtual bolus by varying the thickness. The difference in skin dose between the two phantom conditions for each plan was explored. Results: All plans demonstrated a skin dose of more than 87% of the prescription dose under static conditions. However, the skin dose was reduced to 84.1% (TomoDirect) and 78.9% (TomoHelical) for dynamic conditions. The treatment plans without skin flash or virtual bolus showed significant skin dose differences under static and dynamic conditions by 4.83% (TomoDirect) and 9.43% (TomoHelical), whereas the skin flash with two leaves (TomoDirect 2L) or virtual bolus of at least 1.0 cm thickness (VB1.0) application compensated the skin dose in case of intrafraction movements by presenting a skin dose difference of less than 2% between the static and dynamic conditions. Conclusion: The skin dose was reduced under dynamic conditions due to breathing motion. The skin flash method with TomoDirect 2L or virtual bolus application with 1.0 cm thickness was useful for maintaining skin dose following the prescription by compensating for intrafraction movement due to respiratory motion for breast cancer in tomotherapy.

Center of Pressure Behavior in Response to Unexpected Base of Support Shifting: A New Objective Tool for Dynamic Balance Assessment.

The translation of the base of support represents a promising approach for the objective assessment of dynamic balance control. Therefore, this study aimed to present a servo-controlled, electrically driven movable plate and a new set of parameters based on the center-of-pressure (CoP) trajectory. Twenty subjects were assessed on a force platform screwed over a movable plate that could combine the following settings: direction (forward (FW) and backward (BW)), displacement (25 mm, 50 mm, and 100 mm), and ramp rate (100 mm/s and 200 mm/s). The subjects underwent two sets of 12 trials randomly combining the plate settings. From the CoP trajectory of the 2.5 s time window after the perturbation, the 95% confidence-interval ellipse (Area95) and the CoP mean velocity (Unit Path) were calculated. Within the same time window, the first peak (FP), the maximal oscillations (ΔCoPMax), and the standard deviation (PPV) of the CoP anterior-posterior trajectory were calculated. The plate direction (p < 0.01), ramp rate (p < 0.001), and displacement (p < 0.01) affected the Area95, FP, and ΔCoPMax, while the Unit Path and PPV were influenced only by the ramp rate (p < 0.001) and displacement (p < 0.001). The servo-controlled, electrically driven movable plate and the CoP-related parameters presented in this study represent a new promising objective tool for dynamic balance assessment.