Comparing the Performance of Rolled Steel and 3D-Printed 316L Stainless Steel.

Three-dimensional printing is a non-conventional additive manufacturing process. It is different from the conventional subtractive manufacturing process. It offers exceptional rapid prototyping capabilities and results that conventional subtractive manufacturing methods cannot attain, especially in applications involving curved or intricately shaped components. Despite its advantages, metal 3D printing will face porosity, warpage, and surface roughness issues. These issues will affect the future practical application of the parts indirectly, for example, by affecting the structural strength and the parts' assembly capability. Therefore, this study compares the qualities of the warpage, weight, and surface roughness after milling and grinding processes for the same material (316L stainless steel) between rolled steel and 3D-printed steel. The experimental results show that 3D-printed parts are approximately 13% to 14% lighter than rolled steel. The surface roughness performance of 3D-printed steel is better than that of rolled steel for the same material after milling or grinding processing. The hardness of the 3D-printed steel is better than that of the rolled steel. This research verifies that 3D additive manufacturing can use surface processing to optimize surface performance and achieve the functions of lightness and hardness.

Fluid-Structure Interaction Based Algorithms for IOP and Corneal Material Behavior.

Purpose: This paper presents and clinically validates two algorithms for estimating intraocular pressure (IOP) and corneal material behavior using numerical models that consider the fluid-structure interaction between the cornea and the air-puff used in non-contact tonometry. Methods: A novel multi-physics fluid-structure interaction model of the air-puff test was employed in a parametric numerical study simulating human eyes under air-puff pressure with a wide range of central corneal thickness (CCT = 445-645 µm), curvature (R = 7.4-8.4 mm), material stiffness and IOP (10-25 mmHg). Models were internally loaded with IOP using a fluid cavity, then externally with air-puff loading simulated using a turbulent computational fluid dynamics model. Corneal dynamic response parameters were extracted and used in development of two algorithms for IOP and corneal material behavior; fIOP and fSSI, respectively. The two algorithms were validated against clinical corneal dynamic response parameters for 476 healthy participants. The predictions of IOP and corneal material behavior were tested on how they varied with CCT, R, and age. Results: The present study produced a biomechanically corrected estimation of intraocular pressure (fIOP) and a corneal material stiffness parameter or Stress-Strain Index (fSSI), both of which showed no significant correlation with R (p > 0.05) and CCT (p > 0.05). Further, fIOP had no significant correlation with age (p > 0.05), while fSSI was significantly correlated with age (p = 0.001), which was found earlier to be strongly correlated with material stiffness. Conclusion: The present study introduced two novel algorithms for estimating IOP and biomechanical material behavior of healthy corneas in-vivo. Consideration of the fluid structure interaction between the cornea and the air puff of non-contact tonometry in developing these algorithms led to improvements in performance compared with bIOP and SSI.

Simulation of Air Puff Tonometry Test Using Arbitrary Lagrangian-Eulerian (ALE) Deforming Mesh for Corneal Material Characterisation.

: Purpose: To improve numerical simulation of the non-contact tonometry test by using arbitrary Lagrangian-Eulerian deforming mesh in the coupling between computational fluid dynamics model of an air jet and finite element model of the human eye. METHODS: Computational fluid dynamics model simulated impingement of the air puff and employed Spallart-Allmaras model to capture turbulence of the air jet. The time span of the jet was 30 ms and maximum Reynolds number was Re=2.3×104, with jet orifice diameter 2.4 mm and impinging distance 11 mm. The model of the human eye was analysed using finite element method with regional hyperelastic material variation and corneal patient-specific topography starting from stress-free configuration. The cornea was free to deform as a response to the air puff using an adaptive deforming mesh at every time step of the solution. Aqueous and vitreous humours were simulated as a fluid cavity filled with incompressible fluid with a density of 1000 kg/m3. RESULTS: Using the adaptive deforming mesh in numerical simulation of the air puff test improved the traditional understanding of how pressure distribution on cornea changes with time of the test. There was a mean decrease in maximum pressure (at corneal apex) of 6.29 ± 2.2% and a development of negative pressure on a peripheral corneal region 2-4 mm away from cornea centre. CONCLUSIONS: The study presented an improvement of numerical simulation of the air puff test, which will lead to more accurate intraocular pressure (IOP) and corneal material behaviour estimation. The parametric study showed that pressure of the air puff is different from one model to another, value-wise and distribution-wise, based on cornea biomechanical parameters.

Development and validation of a new intraocular pressure estimate for patients with soft corneas.

PURPOSE: To introduce and clinically validate a new method of estimating intraocular pressure (IOP) in patients with keratoconus and soft corneas with the aim of significantly reducing dependence on corneal biomechanics. SETTING: Vincieye Clinic, Milan, Italy, and Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Brazil. DESIGN: Retrospective case series. METHOD: This study comprised participants enrolled at two hospitals on two continents. Numerical analysis based on the finite element method was performed to simulate the effect of tonometric air pressure of the Corvis ST dynamic Scheimpflug analyzer on eye globes with wide variations in thickness, geometry, and tissue. The numerical predictions of ocular behavior were used to develop a new algorithm to produce predictions of the biomechanically corrected IOP (bIOP) in eyes with a soft cornea (bIOPs). Predictions of the bIOPs were assessed in the keratoconic clinical datasets (because on average these corneas are softer) and compared with the previously developed bIOP algorithm predictions obtained for normal healthy eyes. RESULTS: The study comprised 722 eyes (722 participants). The main outcome was the absence of a significant difference in IOP between healthy eyes and keratoconic eyes when the bIOP and bIOPs algorithms were used (P > .05). There was, however, a significant difference with the uncorrected Scheimpflug analyzer IOP in both groups (P < .001). Furthermore, the bIOPs predictions were significantly less affected by corneal thickness and patient age than the Scheimpflug analyzer IOP. CONCLUSION: The bIOPs algorithm was more reliable at estimating the IOP in eyes with a soft cornea and was validated for use in eyes with keratoconus.

Determination of Corneal Biomechanical Behavior in-vivo for Healthy Eyes Using CorVis ST Tonometry: Stress-Strain Index.

Purpose: This study aims to introduce and clinically validate a new algorithm that can determine the biomechanical properties of the human cornea in vivo. Methods: A parametric study was conducted involving representative finite element models of human ocular globes with wide ranges of geometries and material biomechanical behavior. The models were subjected to different levels of intraocular pressure (IOP) and the action of external air puff produced by a non-contact tonometer. Predictions of dynamic corneal response under air pressure were analyzed to develop an algorithm that can predict the cornea's material behavior. The algorithm was assessed using clinical data obtained from 480 healthy participants where its predictions of material behavior were tested against variations in central corneal thickness (CCT), IOP and age, and compared against those obtained in earlier studies on ex-vivo human ocular tissue. Results: The algorithm produced a material stiffness parameter (Stress-Strain Index or SSI) that showed no significant correlation with both CCT (p > 0.05) and IOP (p > 0.05), but was significantly correlated with age (p < 0.01). The stiffness estimates and their variation with age were also significantly correlated (p < 0.01) with stiffness estimates obtained earlier in studies on ex-vivo human tissue. Conclusions: The study introduced and validated a new method for estimating the in vivo biomechanical behavior of healthy corneal tissue. The method can aid optimization of procedures that interfere mechanically with the cornea such as refractive surgeries and introduction of corneal implants.

Integrating Refined Kano Model and QFD for Service Quality Improvement in Healthy Fast-Food Chain Restaurants.

People are paying greater attention to health. To maintain a good health status and obtain food fast, customers may go to healthy fast-food chain restaurants such as Subway more often than before in China and Taiwan. Healthy fast-food chain restaurants come with a healthy spin, seeking to differentiate themselves from other fast-food restaurants. This paper combined the refined Kano model and the quality function deployment (QFD) method. The refined Kano model was used to understand how customers perceive service attributes developed based on DINESERV measurements. QFD was employed to describe the relationships among the critical service attributes and corresponding improvements as well as to identify the priority for these improvements. The analysis results revealed that providing limited offers (due to periods, seasons, and regions) should be at the top of their improvement list, followed by staff suggestions for ingredients, and a temperature display to enhance the image of fresh ingredients. Other improvement actions include providing regular launches of new flavors/products, designing new and attractive slogans, and providing restaurant apps.

Ex-vivo experimental validation of biomechanically-corrected intraocular pressure measurements on human eyes using the CorVis ST.

The purpose of this study was to assess the validity of the Corvis ST (Oculus; Wetzlar, Germany) biomechanical correction algorithm (bIOP) in determining intraocular pressure (IOP) using experiments on ex-vivo human eyes. Five ex-vivo human ocular globes (age 69 ±â€¯3 years) were obtained and tested within 3-5 days post mortem. Using a custom-built inflation rig, the internal pressure of the eyes was controlled mechanically and measured using the CorVis ST (CVS-IOP). The CVS-IOP measurements were then corrected to produce bIOP, which was developed for being less affected by variations in corneal biomechanical parameters, including tissue thickness and material properties. True IOP (IOPt) was defined as the pressure inside of the globe as monitored using a fixed pressure transducer. Statistical analyses were performed to assess the accuracy of both CVS-IOP and bIOP, and their correlation with corneal thickness. While no significant differences were found between bIOP and IOPt (0.3 ±â€¯1.6 mmHg, P = 0.989) using ANOVA and Bonferroni Post-Hoc test, the differences between CVS-IOP and IOPt were significant (7.5 ±â€¯3.2 mmHg, P < 0.001). Similarly, bIOP exhibited no significant correlation with central corneal thickness (p = 0.756), whereas CVS-IOP was significantly correlated with the thickness (p < 0.001). The bIOP correction has been successful in providing close estimates of true IOP in ex-vivo tests conducted on human donor eye globes, and in reducing association with the cornea's thickness.

Clinical evaluation of a new correction algorithm for dynamic Scheimpflug analyzer tonometry before and after laser in situ keratomileusis and small-incision lenticule extraction.

PURPOSE: To compare a biomechanically corrected intraocular pressure (bIOP) algorithm provided by the dynamic Scheimpflug analyzer (Corvis ST) with Goldmann applanation tonometry IOP (Goldmann IOP) and standard dynamic Scheimpflug analyzer IOP measurements before and after laser in situ keratomileusis (LASIK) and refractive lenticule extraction small-incision lenticule extraction (SMILE) surgeries. SETTING: Smile Eye Clinic, Munich, Germany, and University of Liverpool, Liverpool, United Kingdom. DESIGN: Retrospective case series. METHODS: Patients scheduled for LASIK and patients scheduled for small-incision lenticule extraction for myopia or myopic astigmatism were included. The preoperative and postoperative evaluations included Goldmann, Scheimpflug tomography, and dynamic Scheimpflug analyzer IOP measurements. RESULTS: The study comprised 14 patients in the LASIK group and 22 patients in the small-incision lenticule extraction group. Preoperative Goldmann IOP and Scheimpflug analyzer IOP values showed significant positive correlation with central corneal thickness (CCT) (P = .05 for LASIK; P = .003 for small-incision lenticule extraction). No significant correlation was found between bIOP and CCT (P > .05). After both surgeries, there were significant decreases in Goldmann IOP (-3.2 mm Hg ± 3.4 [SD] and -3.2 ± 2.1 mm Hg, respectively; both P < .001) and Scheimpflug analyzer IOP (-3.7 ± 2.1 mm Hg and -3.3 ± 2.0 mm Hg, respectively, both P < .001) compared with preoperative readings, whereas bIOP did not differ significantly (0.1 ± 2.1 mm Hg and 0.8 ± 1.8 mm Hg, respectively; P = .80 and P = .273, respectively). CONCLUSIONS: The bIOP readings before and after LASIK and small-incision lenticule extraction were neither significantly different nor correlated with CCT. In contrast, both Goldmann IOP and Scheimpflug analyzer IOP had significant reductions postoperatively and showed significant correlation with CCT preoperatively.

The Relationship Between Mechanical Properties, Ultrastructural Changes, and Intrafibrillar Bond Formation in Corneal UVA/Riboflavin Cross-linking Treatment for Keratoconus.

PURPOSE: To determine the relationship between mechanical behavior in cross-linked corneas and changes in the corneal ultrastructure after corneal cross-linking (CXL). METHODS: Porcine corneas were treated following the "Dresden" protocol, the current gold standard for clinical treatment, consisting of dropwise application of 0.1% riboflavin in 20% dextran followed by 30 minutes of ultraviolet-A (UVA) irradiation. The effect of CXL was assessed using uniaxial tensile testing, transmission electron microscopy, and Fourier transform infrared spectroscopy, with results compared against corneas treated with each of the treatment solution components individually. RESULTS: UVA/riboflavin cross-linked corneas displayed 28% ± 17% increase in the material tangent modulus compared with dextran treatment alone, and altered collagen architecture within the first 300 µm of stromal depth consisting of 5% increase in the thickness of collagen fibrils, no significant changes to interfibrillar spacing, and an 8% to 12% decrease in number of fibrils per unit area. Fourier transform infrared spectroscopy confirmed formation of interfibrillar bonds (P = .012) induced by UVA-mediated CXL. CONCLUSIONS: The data support a model wherein collagen fibril diameter and structural density are fundamental parameters in defining tissue stiffening following UVA/riboflavin CXL and provide benchmarks against which modifications to the Dresden CXL protocol can be evaluated. [J Refract Surg. 2018;34(4):264-272.].