Resources, relationships, and resilience: The psychosocial experiences of women with lower limb absence during pregnancy and postpartum.

BACKGROUND: There is limited research on the unique needs of women with lower limb absence (LLA) during pregnancy and postpartum. The lack of information can negatively impact women's physical and emotional experiences. OBJECTIVE: The purpose of this study is to explore the psychosocial experiences of individuals with LLA through the pregnancy and postpartum periods, and to provide information to women and health care providers (HCPs) on what they can expect. METHODS: Semi-structured interviews were conducted with 19 women with LLA who had been pregnant in the previous 10 years. Interviews were analyzed using thematic analysis. RESULTS: Participants experienced uncertainty due to a lack of information and limited resources related to pregnancy and LLA. While most women had strong support networks including family, other mothers with LLA and HCPs, some women faced stigma or judgement from HCPs and people in their social networks. Some women had periods where they struggled mentally due to a temporary loss of independence. Despite these challenges, they demonstrated tremendous resilience and noted that their ability to adapt helped them to navigate the difficulties they experienced in the perinatal period (PNP). CONCLUSION: There is an immediate need to fill the 'information gap' about pregnancy and LLA. We recommend the development of support networks, informational guidelines, and further education for HCPs to better support women with LLA through the PNP. Further research is warranted to gain a better understanding of the mental health experiences of women with LLA in the PNP.

User perspectives of digital manufacturing for lower-limb prosthetic sockets.

BACKGROUND: There is growing interest to use digital technology (DT) for manufacturing lower-limb prosthetic sockets to improve efficiency and clinical outcomes. However, little is known about how lower-limb prosthesis users perceive DTs, such as 3D scanning and 3D printing. OBJECTIVES: This study aimed to provide an understanding of perceptions and experiences with DT for prosthetic socket manufacturing from the perspective of prosthesis users. STUDY DESIGN: A qualitative descriptive research study. METHODS: Nine lower-limb prosthesis users (mean age 56; 5 female; 4 male) participated in one-on-one semistructured telephone interviews. Inductive thematic analysis was performed to identify a codebook and emerging themes from the interview transcripts. RESULTS: Two major themes were identified: (1) expectations and prioritization of 3D printed socket usability and (2) facilitators and barriers to uptake of DT among patients. CONCLUSION: DT methods were found to be acceptable and feasible from a patient perspective, although technological advancements are still required, and real-time communication about the process may be vital for ensuring patient engagement. Consideration of these findings may improve patient satisfaction to emerging prosthesis treatment plans and ultimately support widespread adoption of DT as an additional tool for fabricating prosthetic sockets.

Ectopic Expression of Neurod1 Is Sufficient for Functional Recovery following a Sensory-Motor Cortical Stroke.

Stroke is the leading cause of adult disability worldwide. The majority of stroke survivors are left with devastating functional impairments for which few treatment options exist. Recently, a number of studies have used ectopic expression of transcription factors that direct neuronal cell fate with the intention of converting astrocytes to neurons in various models of brain injury and disease. While there have been reports that question whether astrocyte-to-neuron conversion occurs in vivo, here, we have asked if ectopic expression of the transcription factor Neurod1 is sufficient to promote improved functional outcomes when delivered in the subacute phase following endothelin-1-induced sensory-motor cortex stroke. We used an adeno-associated virus to deliver Neurod1 from the short GFAP promoter and demonstrated improved functional outcomes as early as 28 days post-stroke and persisting to at least 63 days post-stroke. Using Cre-based cell fate tracking, we showed that functional recovery correlated with the expression of neuronal markers in transduced cells by 28 days post-stroke. By 63 days post-stroke, the reporter-expressing cells comprised ~20% of all the neurons in the perilesional cortex and expressed markers of cortical neuron subtypes. Overall, our findings indicate that ectopic expression of Neurod1 in the stroke-injured brain is sufficient to enhance neural repair.

Business practices efficiency: Impact of integrating digital technology on clinical P&O practices.

Additive manufacturing (AM) is on the path to transforming the approach to Prosthetics and Orthotics (P&O) manufacturing. Although digitalization of limbs and other body parts is not new to the field, it has not been widely accepted by the industry for various reasons. However, the reliability and precision that AM can attain, and the availability of various materials is improving rapidly. This professional opinion article discusses the ways that AM has changed P&O services, with a specific focus on prosthetic socket manufacturing. Digitalizing P&O services will eventually change the business model used in clinics, which is further explored here.

A qualitative study exploring healthcare professionals' perceptions of lower limb 3D printed sockets.

PURPOSE: The purpose of this study was to explore healthcare professionals' (HCPs) perceptions and experiences related to 3D scanning and 3D printing for fabricating lower limb prosthetic sockets. MATERIALS AND METHODS: This study used a qualitative descriptive approach. Participants were recruited through HCPs' professional associations, social media posts, and snowball sampling. Purposive sampling was used to attain variation in provider type. One-on-one telephone interviews were conducted using a semi-structured interview guide. Inductive thematic analysis was performed to identify the main themes. RESULTS: Three themes were identified: (1) 3D scanning of the residual limb for designing prosthetic sockets is perceived as clean, quick, and convenient; (2) concerns about the strength and safety of 3D printed sockets for long-term use; (3) Adoption of 3D scanning and 3D printing technology for fabricating prosthetic sockets. CONCLUSION: We identified perceived benefits and challenges with digital technologies for fabricating prosthetic sockets. To increase adoption, more research demonstrating its efficacy compared to conventional methods, increasing 3D printing material quality, and improving software training programs are needed.Implications for Rehabilitation3D printing and 3D scanning are emerging digital technologies that can be used as alternative methods for prosthetic socket manufacturing in the field of rehabilitation.Our research identified perceived benefits of using digital technologies for fabricating prosthetics sockets (3D scanning is perceived as clean, quick, and convenient) and perceived challenges (concerns about the strength and safety of 3D printed sockets for long-term use and a prolonged learning curve).To increase adoption of these digital technologies, more training should be provided to prosthetists and support provided to integrate new processes into staff workloads.