Wearable Applicability of Respiratory Airflow Transducers: Current Approaches and Future Directions.

Advanced technologies employed in modern respiratory airflow transducers have exhibited powerful capabilities in accurately measuring respiratory flow under controlled and sedentary conditions, particularly in clinical settings. However, the wearable applicability of these transducers as face-mounted electronics for use in occupational and sporting activities remains unexplored. The present review addresses the critical wearability issue associated with current respiratory airflow transducers, including pneumotachographs, orifice flowmeters, turbine flowmeters, hot wire anemometers, ultrasound flowmeters, and piezoelectric airflow transducers. Furthermore, a comprehensive analysis and comparison of all factors that impact the wearable applicability of respiratory airflow transducers are conducted, considering dynamic accuracy, long-term usability, power consumption, calibration frequency, and cleaning requirements. The findings indicate that the piezoelectric airflow transducer stands out as a more viable option for wearables compared to other devices. We expect that this review will serve as a valuable engineering reference, guiding future research efforts in designing and developing wearable respiratory airflow transducers for ambulatory respiratory flow monitoring.

Recommended recumbency to avoid insertional complications during small-bore wire-guided thoracostomy tube placement in cats-a cadaver study.

BACKGROUND: Small-bore wire-guided thoracostomy tubes (SBWGTT) are commonly used in cats to manage pleural disease and generally have a low complication rate. Our study aimed to explore the correlation between recumbency of cats, placement method, and the occurrence of insertional complications to identify risk factors during SBWGTT placement. In this experimental cadaveric study, SBWGTT placement using a modified Seldinger technique was conducted in 24 feline cadavers. Cats, euthanized for reasons unrelated to the study, were randomly assigned to pleural effusion (EFF; n = 12) and pneumothorax (PNEU; n = 12) groups. Each cadaver was intubated and ventilated with a peak inspiratory pressure (PIP) of 10 mmHg, and sterile saline or air was instilled into the thorax over a 5 mm thoracoscopic trocar in the fourth intercostal space (ICS). Instillation was stopped when the lateral thoracic wall to lung distance (TWLD) reached 10 to 12 mm, measured with ultrasound in the favorable position. Sternal recumbency was the favorable position for the EFF group, and lateral recumbency for the PNEU group. Following the placement of the first SBWGTT in each group, the cadavers were positioned unfavorably (lateral recumbency for EFF group, sternal recumbency for PNEU group), and a second drain was introduced contralaterally. A bilateral 8th ICS thoracotomy was then performed to visually assess intrathoracic structures and drain integrity. A binary logistic regression mixed model was conducted to determine interaction between the induced condition and body position. RESULTS: A total of 48 SBWGTTs were placed, with complications observed in 33.3% (8/24) of cases. Five of these were major complications consisting of lung lacerations. Complications were more common in the unfavorable position, accounting for 75% of cases, although this result was not statistically significant. The odds of complication rates were > 70% in the unfavorable position and decreased with an increase in TWLD (< 30%). CONCLUSION: Complications associated with SBWGTT placement are influenced by recumbency, although the data did not reach statistical significance. Placing cats in lateral recumbency for pneumothorax treatment and sternal recumbency for pleural effusion treatment may reduce insertional complications.

Tensile, Fatigue Properties and Their Anisotropies of Al-Mg Alloy Fabricated by Wire-Arc Additive Manufacturing.

The microstructure, mechanical properties (tensile, fatigue, etc.) and the anisotropies of the Al-Mg alloy fabricated by wire arc additive manufacturing are studied in this work. The results show that the microstructure of the deposited alloy is composed of coarse columnar grains in the inner-layer region and fine equiaxed grains in the interlayer region. The tensile and fatigue properties exhibit strong anisotropies. The ultimate tensile strength (258 MPa), yield strength (140 MPa), elongation (21.3%), and fatigue life (2.56 × 105) of the sample along travel direction (0° direction) are the best, whereas those of the sample along the deposited direction (90° direction) are the lowest and those of the sample along 45° direction are the medium. It is found that the lowest strength and elongation of the sample in the deposited direction can be attributed to the large weak bonding areas between the deposition layers, whereas the lowest fatigue property is associated with the fatigue crack propagation along the grain boundaries of the columnar grains.

Effects of Pulse Interval on Forming Process in Wire Arc Metal Additive Manufacturing Using Pulsed Arc Plasma.

To overcome the material processing challenges induced by high levels of heat input in wire arc additive manufacturing (WAAM), an innovative WAAM method using pulsed arc plasma (PAP-WAAM), was developed by the authors in the previous study. In this method, the PAP generated by the pulsed voltage was used as the heat source. The pulse interval can be defined as the time interval between adjacent pulse voltages, which determines the ignition time and frequency of the arc plasma, thus influencing the forming process. However, the effect of pulse interval on the forming process has not yet been revealed. Here, the effects of pulse interval on forming process during the PAP-WAAM of Ti6Al4V, including thermal behavior, arc plasma characteristics, and metal transfer process, were investigated by experiments and simulation. The results exhibited that the interpass temperature and maximum peak temperature decrease with increasing pulse interval at the same arc plasma power, indicating an alleviation of heat accumulation along the building direction. As the pulse interval increased, the ignition mode of the arc plasma changed from ignition between the tungsten electrode and the previously deposited layer to ignition between the tungsten electrode and filler wire, which increased the proportion of discharge energy allocated to the filler wire, thus reducing the overall heat input required for material deposition. When the pulse interval was 300 and 400 ms, only the uninterrupted bridging transfer mode was observed during the deposition process. The uninterrupted bridging transfer is considered to contribute to forming a smooth and consistent layer appearance. In addition, longer pulse intervals resulted in less surface oxidation, narrower wall thickness, and better macrostructure, attributed to reduced heat input and improved effective heat dissipation. This research reveals the effect of pulse interval on forming process during PAP-WAAM, which benefits the fabrication of desirable metal parts.

Transprosthetic Fenestration With Electrified Wires. Experimental Evaluation of Three Multifilament Endografts.

PURPOSE: In situ fenestration of aortic endografts is an alternative endovascular technique for treatment of complex aortic aneurysms. While this technique has been carried out also to pass stent-grafts in individual cases, its feasibility and safety using different stent-grafts needs to be evaluated. METHODS: In a saline bath at water temperature of 37°C, a 0.018" Astato 30 guidewire was advanced through 3 different stent-grafts (RelayPro, Zenith and Endurant II) by applying external current of 180 W via an electrosurgery pencil. Puncture efficacy and quality of the fenestration after ballooning with a 6 mm percutaneous transluminal angioplasty (PTA) catheter were assessed. Then, balloon-expandable covered stents were deployed in the fenestrations and evaluated for stenosis, using microscopy and radiography. RESULTS: Crossing of the electrified guidewire was instantaneous in the Zenith (n:10) and RelayPro (n:10) groups but not in 3 of 10 punctures in the Endurant group (p<.05). The fenestration area created after PTA was significantly larger in the RelayPro (5.3 mm2 ± 1.8, interquartile range [IQR] 1.6) and Zenith group (6.7 mm2 ± 0.7, IQR 0.5) compared to Endurant (2.3 mm2 ± 0.4, IQR 0.5, p<.001). Fraying was observed in all groups while graft shredding was found in 8 cases after PTA of the Zenith and Endurant endografts and in 5 of the RelayPro group, but the difference was not significant. Vertical tearing was detected after RelayPro (2 out of 10) and Zenith (6 out of 10) fenestrations, no damage was found in the Endurant group (p<.01). Residual stenosis at the level of the fenestration after implantation of a 6 × 79 mm VBX stent had to be corrected in all Endurant cases with a high-pressure PTA catheter. No stenosis was found in the RelayPro and Zenith groups before and after flaring. CONCLUSIONS: The "electrified wire" technique is a feasible tool that can be used to perform in situ fenestration by perforation of the endograft fabric. Based on this experimental evaluation the "ideal graft" for this technique could not be identified. Long-term fatigue tests and comparison with other fenestration techniques are required. CLINICAL IMPACT: In situ endograft fenestration can be a useful technique in emergent aortic repair. Recently, the electrified wire technique has been proposed as alternative option to laser, radiofrequency and needle-based techniques. In comparison to these methods, the use of electrified wires can be performed without modifications of routine equipment. Additionally, the material costs can be substantially reduced. However, the effectiveness of this approach for fenestration of different prosthetic grafts is unknown. Based on our experimental studies, the electrified wire technique is feasible but the Endurant endograft requires more attempts, and the placement of a bridging stent should be completed with high-pressure balloons.

Comparing the efficacy of heat-activated NiTi (HANT) versus conventional NiTi archwires: A systematic review and meta-analysis.

OBJECTIVE: To assess the effectiveness of heat-activated NiTi (HANT) wires compared to NiTi wires during orthodontic alignment, through a systematic review and meta-analysis. SEARCH METHODS: We comprehensively searched databases up to January 2024, including MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane's CENTRAL, without language or date restrictions. SELECTION CRITERIA: Clinical studies aligning with the PICO question were included, and their bias risk was evaluated using the Cochrane Risk of Bias 2.0 tool. DATA COLLECTION AND ANALYSIS: Data were collected using custom forms, and a meta-analysis was performed using random-effects inverse variance. Primary outcome was Little's Irregularity Index (LII) changes. Secondary outcomes were pain intensity and root resorption. RESULTS: Thirteen clinical studies were reviewed, with nine included in the meta-analysis. No significant differences were observed in LII changes during the first four months, with similar findings in the first, second and third months. In the fourth month, NiTi wires exhibited higher reductions. Pain intensity did not differ between groups on the first or the seventh day. No significant difference in root resorption was found between the two groups. CONCLUSIONS: HANT and conventional NiTi wires showed comparable effectiveness in reducing LII, pain levels, and root resorption during the orthodontic alignment phase. While HANT wires may entail higher costs, their ease of insertion and ligation offer practical advantages. Ultimately, choosing between wire types should consider individual patient needs and clinician preferences.

Evlauation of Fixation Techniques in Naso-orbito-ethmoidal Fractures: A Comparative Study.

Objective: Comparing fixation procedures for managing naso-orbito-ethmoidal (NOE) fractures. Methods: Group A (plate and screw fixation), Group B (Kirschner wire (K-wire) fixation), Group C (absorbable plate and screw fixation), and Group D (No fixation) were formed from 120 NOE fracture patients. The facial injury severity scale, visual analogue scale, CT scans, and clinical examination examined functional and cosmetic outcomes, complications, and postoperative stability. Results: The study found that plate and screw fixation (Group A) had the highest stability and aesthetic results, followed by absorbable plate and screw fixation (Group C). Conservative management (Group D) had the worst outcomes, while K-wire fixation (Group B) had good results but more complications. Results showed substantial differences in functional, aesthetic, complications, and postoperative stability between groups (P < 0.05). Conclusion: Plate and screw fixation is the most successful and dependable approach for treating NOE fractures, with superior functional and aesthetic outcomes, reduced complications, and higher postoperative stability than K-wire fixation, absorbable plate and screw fixation, and conservative care. Absorbable plate and screw fixation may function instead of metal. Conservative care should be rare. Larger multicenter randomized controlled trials should corroborate these findings.

Scientific rationale for Clinical Practice Guidelines (part 2): what is the effectiveness of retention devices? / Argumentaire scientifique en vue de l'élaboration de recommandations professionnelles (partie 2) : efficacité des dispositifs de contention en termes de stabilité.

Introduction: Retention is the set of means, processes or devices that contribute to maintaining the teeth in the position and the arches in the shape given by the orthodontic treatment. The main objective is to propose Clinical Practice Guidelines (CPG) on orthodontic retention by answering four main questions. This article provides the first part of the answer to the second question: How effective are the retention devices? Materials and Methods: A literature review was carried out after a bibliographic search using keywords in bibliographic databases and in international organizations websites. Results: 652 articles were selected after the bibliographic search, and only 53 met the inclusion criteria. These were used to develop the CPG full-text and guidelines. Discussion: Ten CPGs were issued from this review, divided into 12 items, 10 of which are grade C and 2 are expert agreements. Conclusion: Forty CPGs about orthodontic retention were proposed from this literature review, 10 of which are presented in this second part. In the mandible, fixed retention provides better stability than removable retention and 6-tooth retention is more effective in maintaining incisal alignment. Fixed and removable retention are equivalent in maintaining extraction spaces and arch length. Removable retention allows for minimal tooth movement and establishment of occlusal contacts.

Introduction: La contention est l'ensemble de moyens, procédés ou dispositifs, contribuant à maintenir les dents dans la position et les arcades dans la forme, données par le traitement d'orthodontie. L'objectif principal était de proposer des recommandations de bonne pratique (RBP) sur la contention en orthodontie, en répondant à quatre questions principales. Cet article fournit la deuxième partie de l'argumentaire correspondant à la deuxième question : quelle est l'efficacité des dispositifs de contention ? Matériel et méthodes: Une revue de la littérature a été réalisée après recherche bibliographique par mots-clés dans les banques de données bibliographiques et sur les sites internet d'organismes internationaux. Résultats: 652 articles ont été sélectionnés à l'issue de la recherche bibliographique, mais seulement 53 répondaient aux critères d'inclusion. Ils ont permis de rédiger l'argumentaire scientifique et d'en tirer des RBP. Discussion: Dix recommandations ont pu être émises à partir de cet argumentaire, divisées en 12 items, dont 10 de grade C et 2 accords d'experts. Conclusion: Quarante RBP concernant la contention en orthodontie ont été proposées à partir de cette revue de la littérature dont dix qui sont exposées dans cette deuxième partie. À la mandibule, la contention fixe permet une meilleure stabilité que la contention amovible et la contention 6 dents est plus efficace pour le maintien de l'alignement incisif. Les contentions fixes et amovibles sont équivalentes pour maintenir les espaces d'avulsion et la longueur d'arcade. Les contentions amovibles permettent d'effectuer des mouvements dentaires minimes et l'établissement de contacts occlusaux.

Comparison between Volar Locking Plate and Kirschner Wire Fixation for Unstable Distal Radius Fracture: A Meta-Analysis of Randomized Controlled Trials.

Objective This study aims to compare the outcomes of volar locking plating (VLP) versus percutaneous Kirschner wires (K-wire) fixation for surgical management of unstable distal radius fractures. Methods We systematically searched multiple databases, including MEDLINE, EMBASE, Cochrane Central till January 2022 for randomized controlled trials (RCTs) that met eligibility criteria. Following outcomes were evaluated at 6-week, 3-, 6-, and 12-month follow-up period: Disabilities of the Arm, Shoulder, and Hand (DASH) score, Patient Rated Wrist Evaluation (PRWE) score, grip strength, range of motion, and complication incidence. Meta-analysis was performed using random effects models and results presented as risk ratios (RRs) or mean differences (MDs) with 95% confidence interval. Results Fourteen RCTs with 1,450 participants met the inclusion criteria. DASH scores were significantly better for VLP fixation at 6th week (MD = 19.02; p < 0.001), 3rd (MD = 10.79; p < 0.001), 6th (MD= 7.78; p < 0.001), and 12th month (MD = 2.94; p < 0.001) postoperation. At 3-month follow-up period, VLP treatment exhibited better grip strength (MD = - 10.32; p < 0.001) and PRWE scores (MD = 8.78; p < 0.001). There was a statistically significant early advantage in flexion, extension, pronation, supination, radial deviation, and ulnar deviation in the VLP group at 6-week follow-up, but at 1-year follow-up only significantly better extension was observed. At 1 year, radiographic outcomes were similar except for volar tilt favoring VLP fixation ( p < 0.001). Superficial infections were more common in patients treated with K-wire (RR = 2.89; p = 0.001), but there was no difference in total complications or reoperation rates ( p > 0.05). Conclusion This meta-analysis suggests that VLP fixation and K-wire fixation are both effective procedures, but existing literature does not provide sufficient evidence to demonstrate the superiority of either method. Although VLP fixation improves DASH score, extension and volar tilt at 12-month follow-up, the difference is small and unlikely to be noticeable to the patients.

Jailed Balloon Technique Versus Jailed Wire Technique for Side Branch Ostium Protection in Bifurcation Lesions: Evidence from Three-dimensional Optical Coherence Tomography Analysis.

Background: There is controversy regarding the effectiveness the of jailed wire technique (JWT) and jailed balloon technique (JBT) in preserving the side branch (SB) during treatment. This study compares the protective effect of JBT versus JWT on the SB ostium area in coronary bifurcation lesions using three-dimensional optical coherence tomography (3D-OCT). Methods: We obtained data from coronary heart disease patients who received OCT-guided percutaneous coronary intervention (PCI) for bifurcation lesions. The SB protection strategies were divided into JWT and JBT, with the latter further subdivided into active JBT (A-JBT) and conventional JBT (C-JBT). The primary endpoint was the SB ostium area difference measured by 3D-OCT before and after PCI. Partial correlation analysis and propensity score matching (PSM) was used to mitigate confounding biases. Results: A total of 207 bifurcation lesions from 191 patients were analyzed, including 136 lesions treated with JWT and 71 lesions treated with JBT. The SB ostium area was significantly greater in the JBT group compared to the JWT group (0.41 ± 1.22 mm2 vs. -0.25 ± 1.40 mm2, p = 0.001). Following 1:1 PSM to adjust for 60 pairs, the difference between groups was not statistically significant (0.28 ± 1.06 mm2 vs. -0.02 ± 1.29 mm2, p = 0.165). Subgroup analysis revealed that A-JBT provided superior protection in both true (0.47 ± 1.22 mm2 vs. -0.10 ± 1.10 mm2, p = 0.011) and non-true bifurcation lesions (0.56 ± 1.43 mm2 vs. -0.38 ± 1.62 mm2, p = 0.030) over JWT, while C-JBT provided protection similar to JWT. A positive partial correlation was observed between the diameter of the jailed balloon and the increase in SB ostium area (r = 0.296, p = 0.013). Conclusions: Overall, A-JBT, but not C-JBT, provided better protection in bifurcation lesions compared to JWT. The larger diameter of the jailed balloon, rather than the application of higher pressure, enhanced the SB protection.