Design, fabrication, and characterization of thermoplastic microlenses for fiber-optic probe imaging.

Microlens-ended fibers could find great usefulness in future biomedical applications, particularly in endoscopic imaging applications. In this context, this paper focuses on microlens-attached specialty optical fibers such as imaging fiber that can be used for probe imaging applications. Stand-alone self-aligned polymer microlenses have been fabricated by microcompression molding. The fabrication parameters have been optimized for different materials, such as poly(methyl methacrylate) (PMMA), polycarbonate (PC Lexan 123R), Zeonor 1060R (ZNR), and Topas COC. A comparison study of the focusing and spatial resolution of the fabricated lenses is performed prior to employing them for fiber-optic fluorescence imaging applications.

Submental intubation in oral and maxillofacial surgery: a systematic review 1986-2018.

Submental intubation is a low-risk alternative to tracheostomy when nasotracheal or orotracheal intubation is not appropriate. To improve the selection of patients and clinical outcomes we have explored published papers on submental intubation in oral and maxillofacial surgery, and included a proposal for a decision pathway. Systematic searches of PubMed, Scopus, and Cochrane databases for papers published between 1986 and 2018 yielded 116 eligible articles (one randomised controlled trial, 61 case series, 40 case reports, six surgical techniques, and eight letters) that included 2 229 patients. Measured outcomes were the indications, techniques, devices used, time taken to complete the procedure, and complications. Indications were trauma (81%), orthognathic surgery (15%), disease (2%), and cosmetic surgery (1%). Technical preferences were for a one-tube (84%) over a two-tube technique (6%), and a paramedian (52%) over a median incision (33%). The preferred device was a reinforced endotracheal tube (85%). The mean (range) intubation time was 10 (2-37) minutes. The complication rate was 7% (n=152), the most common being superficial skin infection (n=54), hypertrophic scarring (n=18), and damage to the tube apparatus (n=15). Submental intubation has minimal complications, takes a short time to do, and it is a useful alternative to tracheostomy in some oral and maxillofacial operations. More robust evidence regarding the selection of patients, modifications to the technique, and a comparison of risk with that of tracheostomy, are needed for further evaluation of its feasibility.

Potential rapid solutions to maintain ventilation in the event of anaesthesia machine failure with no access to the patient's airway.

Anaesthesia machine failure requires rapid solutions to maintain ventilation and anaesthesia. During procedures with poor access to the patient's airway, it may not be possible to use a self-inflating mechanical ventilation device (SIMVD) for emergency ventilation, and alternative solutions are needed. We evaluated five methods for rescue ventilation using a patient simulator. In Method 1, we used the inspiratory and expiratory tubes and the alternative common gas outlet (ACGO) on the anaesthesia machine to produce a Mapleson E system. In Method 2, we used the tubes, ACGO and an open-ended reservoir bag to produce a Mapleson F system, controlling the bag to achieve ventilation. In Method 3, we attached a SIMVD to the inspiratory tube, and controlled occlusion of the expiratory tube. In Method 4, we used the tubes and ACGO in a Mapleson F configuration, replacing the open-ended bag with a SIMVD to facilitate manual ventilation. In Method 5, we attached a SIMVD to the expiratory tube and left the inspiratory tube attached to its mounting. We were able to achieve ventilation, maintain inhalational anaesthesia, and prevent expired gas rebreathing in Methods 1 and 2. In Method 3 ventilation was achieved with minimal rebreathing of expiratory gas, but with no inhalational agent. Methods 4 and 5 led to rebreathing. Our findings indicate that Methods 1 or 2 are the preferred rapid solutions to maintain ventilation and inhalational anaesthesia in the event of anaesthesia machine failure where there is poor airway access.

Spark plasma sintering of hydroxyapatite powders.

Dense hydroxyapatite (HA) compacts have been successfully fabricated by a spark plasma sintering (SPS). The sintering behavior of HA powders at different temperatures ranging from 850 degrees C to 1100 degrees C was studied. Results showed that spark plasma sintering resulted in rapid densification to near theoretical density. The HA compact was homogeneously sintered at 950 degrees C in a short sintering duration of 5 min, while maintaining high quality and high relative density (>99.5%). The density, microhardness and Young's modulus of HA sintered compact initially increased with the sintering temperature, reached a maximum value at around 950-1000 degrees C, then decreased with further increase in the temperature due to the decomposition of HA into beta-tricalcium phosphates. Fracture toughness results showed no significant difference with increasing temperature due to the combined influences of density and grain size. Microstructure analysis showed no noticeable grain growth under different sintering temperatures due to the short time exposure at high temperatures.

Microstructures and mechanical properties of powder injection molded Ti-6Al-4V/HA powder.

Taguchi method with an L9 orthogonal array was employed to investigate the sintered properties of Ti-6Al-4V/HA tensile bars produced by powder injection molding. The effects of sintering factors at the 90% significance level: sintering temperature (1050 degrees C, 1100 degrees C and 1150 degrees C), heating rate (5 degrees C/min, 7.5 degrees C/min and 10 degrees C/min), holding time (30, 45 and 60 min) and cooling rate (5 degrees C/min, 20 degrees C/min and 40 degrees C/min) were investigated. Results showed that sintering temperature, heating rate and cooling rate have significant effects on sintered properties, whereas the influence of holding time was insignificant. It was found that a sintering temperature of 1100 degrees C, a heating rate of 7.5 degrees C/min and a cooling rate of 5 degrees C/min increased the relative density, Vicker's microhardness, flexural strength and flexural modulus. However, a further increment of sintering temperature to 1150 degrees C did not show any discernable improvement in the relative density and Vicker's microhardness, but there was a slight increase of 0.6% and 0.9% in the flexural strength and flexural modulus, respectively. Mechanically strong Ti-6Al-4V/HA parts with an open porosity of around 50% were developed.

Processing of HA-coated Ti-6Al-4V by a ceramic slurry approach: an in vitro study.

Hydroxyapatite-coated titanium alloy composite powders (Ti-6Al-4V/HA) was produced by a ceramic slurry approach. The aim was to evaluate the stability of the coating when subjected to a physiological medium simulated body fluid (SBF). Three consolidation conditions (700 degrees C for 5 h, 700 degrees C for 8 h and 700 degrees C for 11 h) were used in the production of the Ti-6Al-4V/HA composite powders. Results showed that biodissolution followed by apatite precipitation had taken place after soaking in SBF. In addition, it was found that consolidation at 700 degrees C for 5 h resulted in a weak mechanical locking of calcium phosphate on the Ti-6Al-4V surfaces; and the formation of small crystallites, which would increase the dissolution rate.

In vitro behavior of sintered powder injection molded Ti-6Al-4V/HA.

This article reports the morphology and mechanical properties of sintered powder injection molded Ti-6Al-4V/HA parts in a simulated physiological environment. Sintered Ti-6Al-4V/HA parts were immersed in a simulated body fluid (SBF) with ion concentrations that were comparable to those of human blood plasma for a total period of 12 weeks. At intervals of 2 weeks, the immersed Ti-6Al-4V/HA parts were analyzed with the use of scanning electron microscopy (SEM), X-ray diffractometry (XRD), and inductively coupled plasma-atomic emission spectroscopy (ICP-AES). Mechanical properties such as flexural strength, flexural modulus, compressive strength, and compressive modulus were also evaluated. Results showed that complete dissolution of the more soluble phases such as tricalcium phosphate (TCP), tetracalcium phosphate (TTCP), and calcium oxide (CaO) were found after 2 weeks of immersion in SBF. ICP analysis showed that high calcium concentration release of around 200 ppm was observed in the SBF solution after 2-4 weeks of immersion, indicating that dissolution has taken place. Next, a gradual decrease in calcium concentration release in the SBF solution was observed after immersion for 4-6 weeks, with increasing amounts of calcium phosphate precipitates being observed on the Ti-6Al-4V/HA surface. Mechanical properties such as strength and modulus were found to deteriorate during 2-4 weeks of immersion, followed by gradual increment as the immersion period increased. This study also showed that parts sintered at 1150 C exhibited faster dissolution and precipitation rates than parts sintered at 1050 C in a physiological environment.