Evaluation of novel 3D-printed and conventional thermoplastic stereotactic high-precision patient fixation masks for radiotherapy.

PURPOSE: For stereotactic radiation therapy of intracranial malignancies, a patient's head needs to be immobilized with high accuracy. Fixation devices such as invasive stereotactic head frames or non-invasive thermoplastic mask systems are often used. However, especially stereotactic high-precision masks often cause discomfort for patients due to a long manufacturing time during which the patient is required to lie still and because the face is covered, including the mouth, nose, eyes, and ears. To avoid these issues, the target was to develop a non-invasive 3D-printable mask system with at least the accuracy of the high-precision masks, for producing masks which can be manufactured in the absence of patients and which allow the eyes, mouth, and nose to be uncovered during therapy. METHODS: For four volunteers, a personalized 3D-printed mask based on magnetic resonance imaging (MRI) data was designed and manufactured using fused filament fabrication (FFF). Additionally, for each of the volunteers, a conventional thermoplastic stereotactic high-precision mask from Brainlab AG (Munich, Germany) was fabricated. The intra-fractional fixation accuracy for each mask and volunteer was evaluated using the motion-correction algorithm of functional MRI measurements with and without guided motion. RESULTS: The average values for the translations and rotations of the volunteers' heads lie in the range between ±1 mm and ±1° for both masks. Interestingly, the standard deviations and the relative and absolute 3D displacements are lower for the 3D-printed masks compared to the Brainlab masks. CONCLUSION: It could be shown that the intra-fractional fixation accuracy of the 3D-printed masks was higher than for the conventional stereotactic high-precision masks.

Ionic liquid([C12mim][PF6])-assisted synthesis of TiO2 /Ti2O (PO4)2 nanosheets and the chemoresistive gas sensing of trimethylamine.

The architecture of PO43- modified 2D TiO2 nanosheets was constructed by ionic liquids (ILs)-assisted hydrothermal method. The nanosheet structure can be regulated by the addition of different amount of ionic liquid. Using the composite nanosheets  a chemoresistive gas sensor was prepared for trimethylamine (TMA) detection. Most reported TMA sensors need to be operated at a relatively high operating temperature, but in this paper, the as-synthesized PO43--modified 2D TiO2/Ti2O(PO4)2 nanosheet sensor has high response (S = 87.46), short response time (14.6 s), and good reproducibility to 100 ppm TMA gas, when the temperature is 170 °C. In contrast to the single-phase TiO2 sensor, the gas-sensing property of the composite one is obviously enhanced. Moreover, its response shows excellent linear relationship with TMA concentration from 0.2 to 500 ppm, and a detection limit of 0.2 ppm. The TMA detection mechanism was investigated by analyzing the changes of the surface adsorption oxygen content by XPS and gaseous products using gas chromatography after the sensor was in contact with TMA.

One step synthesis of PANI/Fe2O3 nanocomposites and flexible film for enhanced NH3 sensing performance at room temperature.

Novel sea cucumber-shaped polyaniline/ferric oxide (PANI/Fe2O3) nanocomposites were synthesized using a simple and efficient one step hydrothermal process, and the nanocomposites were further assembled onto a polyethylene terephthalate (PET) flexible substrate. Through the monitoring of the resistance of the PANI/Fe2O3 nanocomposites thick films and PANI/Fe2O3-PET flexible sensors, the responses of the sensors to various 100 ppm gases including methanol, triethylamine, aniline and another five gases were obtained. It was found that two kinds of sensors exhibit a high selectivity towards NH3. The PANI/Fe2O3 nanocomposites-based sensor has a good response and a low detection limit (0.3 ppm) at room temperature (20 ± 5 °C). It also shows a good linearity relationship in a certain concentration of NH3. After assembling into the PANI/Fe2O3-PET flexible film sensor, the response of the sensor is significantly increased to 6.12 for 100 ppm NH3, the detection limit is as low as 0.5 ppm, and the sensor shows good stability and linearity, which is more conducive to the application of such a material in wearable gas sensors.

Brain-derived neurotrophic factor levels under chronic natalizumab treatment in multiple sclerosis. A preliminary report.

AIM OF THE STUDY: Our main purpose was to investigate if the chronic treatment with the disease-modifying drug natalizumab shows quantifiable effect on BDNF levels in multiple sclerosis patients. MATERIALS AND METHODS: BDNF plasma concentration was evaluated using enzyme-linked immunosorbent assay in healthy individuals, not treated multiple sclerosis patients and patients treated with natalizumab. RESULTS: Multiple sclerosis patients have a significantly lower amount of peripheral BDNF than healthy individuals. Patients treated with natalizumab have significantly higher BDNF levels than not treated patients. CONCLUSIONS: Chronic natalizumab treatment is associated with significantly increased plasma BDNF concentration in multiple sclerosis.

[Multiple sclerosis with stroke-like symptoms: a diagnostic challenge. Case report]. / Sclerosis multiplex stroke jellegu tünetekkel: kihívó diagnózis egy eset kapcsán.

Stroke-like presentation of multiple sclerosis is a challenging diagnosis requiring quick and efficient decision in order to provide the best possible therapeutical option. This case presentation focuses on the difficulties of the differential diagnostic process. Even if signs were misleading, the stepwise and structured approach with the use of adequate diagnostic tools revealed the most likely diagnosis and, thus, assured the best clinical care.

Disease activity and disability evolution under glatiramer acetate: a clinical approach.

INTRODUCTION: By analyzing literature data regarding glatiramer acetate in the treatment of relapsing-remitting multiple sclerosis one might find controversial data but the majority of authors state that the clinical evolution under the treatment showed a positive course. MATERIALS AND METHODS: Our goal was to analyze groups of patients, both non-treated and treated with the drug, for relapse rate, Kurtzke's Expanded Disability Status Scale (EDSS) score, Multiple Sclerosis Functional Composite (MSFC) score - upper limb disability, lower limb disability and cognition, and for cognitive dysfunction, using the Montreal Cognitive Assessment (MoCA) test, in order to objectively quantify the clinical impact of the drug. RESULTS/CONCLUSIONS: Our results are in accordance with the literature for most of the investigated measures - relapse rate, EDSS, MSFC -, and furthermore suggest the possibility to use more extensively the MoCA test for evaluation of MS patients from the point of view of cognitive functions, after a much wider comparative assessment.

Multi-Step Relaxation Characterization and Viscoelastic Modeling to Predict the Long-Term Behavior of Bitumen-Free Road Pavements Based on Polymeric Resin and Thixotropic Filler.

Asphalt pavements are fundamental to modern transportation infrastructure, requiring elasticity, firmness, and longevity. However, traditional asphalt, based on bitumen, faces several limitations. To improve pavement performance, polymer resins are being used to substitute bitumen and improve requirements. Therefore, a deep understanding of the material behavior is required. This study presents the analysis of the relaxation behavior of a poly(methyl methacrylate)-based pavement and the influence of mineral fillers. An approach using a linear elastic-viscoelastic material model was selected based on evidence and validated across the linear and nonlinear deformation range. The results reveal no influence of the mineral fillers on the relaxation behavior. The presented modification of the linear elastic and viscoelastic modeling reveals accurate results to predict long-term pavement performance. This approach offers a practical method for forecasting asphalt behavior. Further research is needed to incorporate deformation behavior into the model.

Analysis of the Rotation Bending Test Method and Characterization of Unidirectional Carbon Fiber-Reinforced Polycarbonate Tapes at Processing Temperatures.

Bending is one of the dominant material deformation mechanisms that occurs during the forming process of unidirectional (UD) thermoplastic tapes. Experimental characterization of the bending behavior at processing temperatures is crucial to obtaining close-to-reality data sets for process analysis or material modeling for process simulation. The main purpose of this study is to characterize to a high degree of accuracy the temperature-dependent bending behavior of single and multi-ply specimens of carbon fiber-reinforced polycarbonate (PC/CF) UD tapes at processing temperatures, which implies a molten state of the thermoplastic matrix. The application of the rotation bending test using a customized fixture may come with systematic deviations in the measured moment that result from a pivot offset or an effective clearance that is unknown under realistic test conditions. The present research analyzes these effects with analytical methods, experimental investigations, and simulations using a finite element model. In this context, a compensation method for the toe-in effect is evaluated. With this approach, we were able to obtain reliable data and characterize the bending resistance within the desired processing window. The data reveal a major drop in bending resistance between 200 °C and 250 °C and a less significant decrease between 250 °C and 300 °C. Analysis of the thickness-normalized bending resistances indicates a non-linear relationship between specimen thickness and measured moment but an increasing shear-dominated characteristic at higher temperatures.

Additive and Lithographic Manufacturing of Biomedical Scaffold Structures Using a Versatile Thiol-Ene Photocurable Resin.

Additive and lithographic manufacturing technologies using photopolymerisation provide a powerful tool for fabricating multiscale structures, which is especially interesting for biomimetic scaffolds and biointerfaces. However, most resins are tailored to one particular fabrication technology, showing drawbacks for versatile use. Hence, we used a resin based on thiol-ene chemistry, leveraging its numerous advantages such as low oxygen inhibition, minimal shrinkage and high monomer conversion. The resin is tailored to applications in additive and lithographic technologies for future biofabrication where fast curing kinetics in the presence of oxygen are required, namely 3D inkjet printing, digital light processing and nanoimprint lithography. These technologies enable us to fabricate scaffolds over a span of six orders of magnitude with a maximum of 10 mm and a minimum of 150 nm in height, including bioinspired porous structures with controlled architecture, hole-patterned plates and micro/submicro patterned surfaces. Such versatile properties, combined with noncytotoxicity, degradability and the commercial availability of all the components render the resin as a prototyping material for tissue engineers.

Laboratory and Numerical Investigation of Pre-Tensioned Reinforced Concrete Railway Sleepers Combined with Plastic Fiber Reinforcement.

This research investigates the application of plastic fiber reinforcement in pre-tensioned reinforced concrete railway sleepers, conducting an in-depth examination in both experimental and computational aspects. Utilizing 3-point bending tests and the GOM ARAMIS system for Digital Image Correlation, this study meticulously evaluates the structural responses and crack development in conventional and plastic fiber-reinforced sleepers under varying bending moments. Complementing these tests, the investigation employs ABAQUS' advanced finite element modeling to enhance the analysis, ensuring precise calibration and validation of the numerical models. This dual approach comprehensively explains the mechanical behavior differences and stresses within the examined structures. The incorporation of plastic fibers not only demonstrates a significant improvement in mechanical strength and crack resistance but paves the way for advancements in railway sleeper technology. By shedding light on the enhanced durability and performance of reinforced concrete structures, this study makes a significant contribution to civil engineering materials science, highlighting the potential for innovative material applications in the construction industry.

Characterization of CD4+ and CD8+ Tregs in a Hodgkin's lymphoma patient presenting with myasthenia-like symptoms.

The co-occurrence of Hodgkin's lymphoma (HL) and myasthenia gravis (MG) is a rare phenomenon that is sometimes considered a paraneoplastic manifestation. There are a few documented cases in which myasthenia symptoms manifested only after the surgical removal of the tumor. However, the biological basis of this association is unknown. One hypothesis is that it derives from the infiltration of the residual thymic tissue by the developing tumor. In our case, the myasthenic symptoms led to the HL diagnosis. Our objective was to investigate the T cell phenotype in a HL patient presenting myasthenia-like symptoms. In patients with autoimmune disease, Tregs are usually decreased, but in some diseases, they appear to be increased. It has been speculated that this phenomenon may occur due to a homeostatic attempt by the immune system to control the expansion of auto-reactive effector cells. In the described patient the proportion of lymphoma infiltrating Tregs was high (more than 10% of CD4+ and 1.34% of CD8+ cells), suggesting that Tregs are increased in patients suffering from HL and eventually of myasthenia gravis. Treg involvement in HL is controversial and is currently under investigation. In this context, our data may contribute to a better understanding of the underlying mechanism of the link between HL and autoimmune phenomena.

Interface Characterization of Consolidated PPGF Tapes on PPGF Mat Material.

Laminated composites with thermoset matrices are already well established in major engineering fields like automotive and aviation. The primary drawbacks of such thermoset-based composites are the high cycle times required during manufacturing and their limited potential for recycling. Providing an alternative to thermoset-based composites, thermoplastic matrix materials gained more and more momentum by addressing these previously mentioned drawbacks. The preferred manufacturing technique for these materials employs fiber-reinforced thermoplastic tapes consolidated and formed together with a compatible substrate. The most critical aspect for all these applications is the stress or load transfer between the thermoplastic tapes and the substrate. If the interface is too weak and fails prior to the substrate or tape, a high amount of theoretical mechanical performance is lost. The presented research investigates the influence of variations in manufacturing parameters, within the industrially relevant process window, on the interface strength of the final composite. The investigated composite material consists of PPGF UD tapes consolidated on a PPGF mat substrate. In particular, the influence of the consolidation parameters of pressure, temperature, and time are of special interest. The results of this work reveal a 400% increase in the measured mean strain energy release rate upon increasing the consolidation time from 60 s to 120 s at a consolidation temperature of 230 °C and a pressure of one bar. In contrast to this, an increase in the consolidation pressure, at constant temperature and time, leads to a minor improvement in the GC value of 20%. For testing and characterizing the corresponding interface properties, a mandrel peel testing setup was employed.

Design and Additive Manufacturing of a Continuous Servo Pneumatic Actuator.

Despite an emerging interest in soft and rigid pneumatic lightweight robots, the pneumatic rotary actuators available to date either are unsuitable for servo pneumatic applications or provide a limited angular range. This study describes the functional principle, design, and manufacturing of a servo pneumatic rotary actuator that is suitable for continuous rotary motion and positioning. It contains nine radially arranged linear bellows actuators with rollers that push forward a cam profile. Proportional valves and a rotary encoder are used to control the bellows pressures in relation to the rotation angle. Introducing freely programmable servo pneumatic commutation increases versatility and allows the number of mechanical components to be reduced in comparison to state-of-the-art designs. The actuator presented is designed to be manufacturable using a combination of standard components, selective laser sintering, elastomer molding with novel multi-part cores and basic tools. Having a diameter of 110 mm and a width of 41 mm, our prototype weighs less than 500 g, produces a torque of 0.53 Nm at 1 bar pressure and a static positioning accuracy of 0.31° with no limit of angular motion. By providing a description of design, basic kinematic equations, manufacturing techniques, and a proof of concept, we enable the reader to envision and explore future applications.

Characterization and Modeling of Ply/Tool and Ply/Ply Slippage Phenomena of Unidirectional Polycarbonate CF Tapes.

Thermoplastic tapes are commonly processed by the rapid and efficient stamp forming process. During this forming process, the individual unidirectional tapes of the composite stack move relative to each other and relative to the surface of the tool while being in contact with the corresponding counterpart. As a result, the material exhibits a certain resistance against this movement, which is generally dependent on velocity, normal pressure, and temperature. Therefore, this work investigates the ply/tool and ply/ply slippage of unidirectional, carbon fiber reinforced polycarbonate tapes and provides an alternative implementation of the experimentally observed slippage using cohesive zone modeling. The backbone of the modeling approach is an experimental data set obtained from pull-through experiments. In comparison to common slippage or friction theories, the force plateau of thermoplastic UD tapes at elevated temperatures is observed after an initial force peak has been overcome. For both configurations, ply/tool and ply/ply, a reduction of the initial force peak was observed for increasing temperature. Furthermore, the resulting plateau force value is at least 36% higher in the ply/ply configuration compared to the ply/tool configuration at 200 °C. The derived cohesive zone model allows for accurate modeling of the initial force peak and the plateau.

Anastomosis between the facial nerve - ansa cervicalis and the facial nerve - hypoglossal nerve in rabbits: technical note for a practical use in peripheral facial palsy.

Background and aims: To emphasize the importance of laboratory dissections in perfecting surgical techniques. In this paper, we describe the technical details on rabbit dissection for practical applications. Methods: Four New Zealand rabbits were distributed into two groups and underwent anastomosis between the Facial Nerve and Ansa Cervicalis (group 1) and between the Facial Nerve and Hypoglossal Nerve (group 2). They were clinically and neurophysiologically evaluated after ten weeks. Electroneurography with skin electrodes were used to identify the motor activity of the involved muscles and nerves. Facial and ipsilateral tongue reinnervation was analyzed 40 weeks after anastomosis. Evoked electromyographic muscle tension was used to evaluate facial and tongue reinnervation. Results: Facial and ipsilateral tongue reinnervation was analyzed 40 weeks after anastomosis. Recorded evoked potentials showed improvement in facial reinnervation in all four rabbits. Rabbits undergoing FN-HN anastomosis still showed ipsilateral lingual paresis, based on EMG tests. The survival rate was 100%. Conclusions: The laboratory dissection plays a crucial role in training surgical specialists to achieve favorable patient outcomes. Both types of anastomosis can be used to achieve facial reinnervation; however, it is imperative to prevent ipsilateral lingual paralysis that may arise from using the hypoglossal nerve.

Selective detection of trace carbon monoxide at room temperature based on CuO nanosheets exposed to (111) crystal facets.

In recent years, carbon monoxide (CO) intoxication incidents occur frequently, and the sensitive detection of CO is particularly significant. At present, most reported carbon monoxide (CO) sensors meet the disadvantage of high working temperature. It is always a challenge to realize the sensitive detection of carbon monoxide at room temperature. In this study, CuO nanosheets exposed more (111) active crystal facets and oxygen vacancy defects were synthesized by a simple and environmentally friendly one-step hydrothermal method. The sensor has good comprehensive gas sensing performance, compared with other sensors that can detect CO at room temperature. The response value to 100 ppm CO at room temperature is as high as 39.6. In addition, it also has excellent selectivity, low detection limit (100 ppb), good reproducibility, moisture resistance and long-term stability (60 days). This excellent gas sensing performance is attributed to the special structural characteristics of 2D materials and the synergistic effect of more active crystal facets exposed on the crystal surface and oxygen vacancy defects. Therefore, it is expected to become a promising sensitive material for rapid and accurate detection of trace CO gas under low energy consumption, reduce the risk of poisoning, and then effectively protect human life safety.

Amino Acid-Based Polyphosphorodiamidates with Hydrolytically Labile Bonds for Degradation-Tuned Photopolymers.

Photochemical additive manufacturing technologies can produce complex geometries in short production times and thus have considerable potential as a tool to fabricate medical devices such as individualized patient-specific implants, prosthetics and tissue engineering scaffolds. However, most photopolymer resins degrade only slowly under the mild conditions required for many biomedical applications. Herein we report a novel platform consisting of amino acid-based polyphosphorodiamidate (APdA) monomers with hydrolytically cleavable bonds. The substituent on the α-amino acid can be used as a handle for facile control of hydrolysis rates of the monomers into their endogenous components, namely phosphate and the corresponding amino acid. Furthermore, monomer hydrolysis is considerably accelerated at lower pH values. The monomers underwent thiol-yne photopolymerization and could be 3D structured via multiphoton lithography. Copolymerization with commonly used hydrophobic thiols demonstrates not only their ability to regulate the ambient degradation rate of thiol-yne polyester photopolymer resins, but also desirable surface erosion behavior. Such degradation profiles, in the appropriate time frames, in suitably mild conditions, combined with their low cytotoxicity and 3D printability, render these novel photomonomers of significant interest for a wide range of biomaterial applications.

Kinematic Alignment in Total Knee Arthroplasty Reduces Polyethylene Contact Pressure by Increasing the Contact Area, When Compared to Mechanical Alignment-A Finite Element Analysis.

Unrestricted Kinematic alignment (KA) in total knee arthroplasty (TKA) replicates the joint line of each patient by adjusting the cuts based on the anatomy of the patient. Mechanical alignment (MA) aims to restore a neutral mechanical axis of the leg, irrespective of the joint line orientation. The purpose of the present study was to compare contact pressure and contact areas of the polyethylene (PE) bearing surface as well as von Mises stress of the PE-tibial tray interface for MA and KA in the same patient, using CT data and finite element analysis. Finite element models were created from lower leg CT scans of 10 patients with knee osteoarthritis with different phenotypes. Mechanical PE properties were experimentally determined by tensile tests on dumbbell specimens. For numerical simulation purposes an adjusted non-linear material model with the maximum load to failure of 30.5 MPa, was calibrated and utilized. Contact pressure points were the deepest parts of the polyethylene inlay. Contact pressures were either very similar or were increased for MA knees throughout the gait cycle. KA either increased or had a comparable contact area, compared to MA. KA and MA produced comparable von Mises stresses, although both alignments breached the failure point of 30.5 MPa in all 3 valgus knees. This might indicate a higher probability of failure at the inlay-tibial baseplate interface. By maintaining the joint line orientation, KA reduces or has comparable contact pressures on the PE bearing surface by increasing or maintaining the contact area throughout one gait cycle in a validated finite element analysis model in 10 different knee phenotypes. The von Mises stress on the PE-tibial component interface was comparable, except for the valgus knees, where the load to failure was achieved in both alignment strategies and slightly higher stresses were observed for KA. Further studies for different knee phenotypes are needed to better understand the pressure changes depending on the alignment strategy applied.

Controllable construction of ZnFe2O4-based micro-nano heterostructure for the rapid detection and degradation of VOCs.

Micro-nano heterogeneous oxides have received extensive attention due to their distinctive physicochemical properties. However, it is a challenge to prepare the hierarchical multicomponent metal oxide nanomaterials with abundant heterogeneous interfaces in a controllable way. In this work, the effective construction of the heterogeneous structure of the material is achieved by regulating the ratio of metal salts under thermal solvent condition. Three-dimensional spheres (ZnFe2O4) constructed by zero-dimensional ultra-small nanoparticles, in particular three-dimensional hollow sea urchin spheres (ZnO/ZnFe2O4) constructed by one-dimensional nanorods and three-dimensional hydrangeas (α-Fe2O3/ZnFe2O4) assembled by two-dimensional nanosheets were obtained. The two composite materials contain a large number of heterojunctions, which enhances the sensitivity of material to volatile organic compounds gas. Among them, the α-Fe2O3/ZnFe2O4 composite shows the best sensing performance for VOCs. For example, its response to 100 ppm acetone reaches 142 at 170 °C with the response time shortened to 3 s and the detection limit falling to 10 ppb. Meanwhile, the composite material presents a degradation rate of more than 90% for VOCs at a flow rate of 20 mL/min at 170 °C. In addition, the sensing and sensitivity mechanism of the composite material are studied in detail by combining GC-MS, XPS with UV diffuse reflectance tests.

Assessing the Efficacy of Anastomosis between Ansa Cervicalis and Facial Nerve for Patients with Concomitant Facial Palsy and Peripheral Neuropathy.

Background: For decades, patients with facial asymmetry have experienced social interaction difficulties, leading them to seek treatment in the hope of restoring facial symmetry and quality of life. Researchers evaluated numerous surgical techniques, but achieving results remains a significant hurdle. Specifically, anastomosis between the ansa cervicalis (AC) and facial nerve (FN) can hinder the patient's physical appearance. Objective: Our study goal was to examine the efficiency of anastomosis between AC and FN for facial motor function recovery even in the presence of peripheral neuropathy. Materials and Methods: Four patients diagnosed with facial palsy grade VI on the House & Brackmann Scale (HB) after vestibular schwannoma (VS) resection (Koos grade IV) via the retrosigmoid approach underwent AC and FN anastomosis. Outcomes were related to tumor grade, previous therapy, and the time between postoperative facial palsy and anastomosis. Images and neurophysiological data were evaluated. Results: After vs. resection, all four patients demonstrated HB grade VI facial palsy for an average of 17 months. During the follow-up program, lasting between 6 and 36 months, two patients were evaluated as having HB grade III facial palsy; the other two patients were diagnosed with grade IV HB facial palsy. None of the patients developed tongue atrophy, speech disorder, or masticatordys function. Conclusions: Anastomosis between the AC and FN is a safe and effective treatment for facial paralysis after cerebellopontine tumor resection. Nerve reanimation may be feasible even for patients with peripheral polyneuropathy. This study also offers a new option for patients with a progression-free status.