Fatigue Performance of Type I and Type II Fibre Bragg Gratings Fabricated by Femtosecond Laser Inscription through the Coating.

Strain sensing technology using fibre Bragg grating (FBG) sensors is an attractive capability for aerospace structural health monitoring (SHM) and assessment because they offer resistance to harsh environments, low maintenance, and potential for high density and high strain sensing. The development of FBG inscription techniques through the fibre polymer coating using infrared (IR) lasers has overcome the mechanical weaknesses introduced by removal of the fibre coating, which is typically required for conventional UV laser inscription of FBGs. Type I and Type II femtosecond gratings are fabricated using through-coating inscription techniques, but the higher laser energy used for Type II gratings damages the glass fibre core, impacting mechanical performance. This paper investigates the fatigue performance of Type I and Type II through-coating FBG sensors with different fibre geometries and photosensitisation approaches to evaluate their overall reliability and durability, with a view to assess their performance for potential use in civil and defence SHM applications. The fatigue performance of FBG sensors was assessed under high-strain and high-frequency mechanical loading conditions by using a custom-designed electro-dynamically actuated loading assembly. In addition, pre- and post-fatigue microscopic analyses and high-resolution reflection spectrum characterisation were conducted to investigate the failure regions of the fibres and the effect of fatigue loading on reflection spectrum features. As expected, Type I gratings had a significantly higher fatigue life compared to Type II gratings. However, Type II gratings performed significantly better than conventional UV laser-inscribed FBGs and electrical foil strain gauges. Type II gratings withstand higher temperatures, and are therefore more suitable for application in harsh environments.

Conformal Load-Bearing Antenna Structures-Mechanical Loading Considerations.

One of the important functions of antennas is to facilitate wireless communication. The IEEE 802.11 is part of the IEEE802 set of local area network technical standards, and specifies the media access control and physical layer protocols for implementing wireless local area network computer communication. The network physical layer protocol with a centre frequency of 2.4 GHz has a bandwidth of 22 MHz. A conformal load-bearing antenna structure (CLAS) facilitating this communication band that is tuned to 2.4 GHz must remain within this bandwidth. The aim of this paper is to investigate the effects of mechanical loading imposed on a load-bearing patch antenna with respect to its ability to remain within the specified bandwidth. The mechanical loading configurations considered include tensile, biaxial, and twisting. This paper will also report on the response of the antenna patch to the presence of a disbond between the metallised antenna and its substrate, which can arise due to fabrication anomalies and operational usage. This numerical work will assist in the design of experimental testing of the mechanical and electromagnetic properties of an embedded CLAS, which will ultimately be used to inform selection of appropriate regions to place patch antennas on load-bearing deformable surfaces.

Fatigue Performance of Type I Fibre Bragg Grating Strain Sensors.

Although fibre Bragg gratings (FBGs) offer obvious potential for use in high-density, high-strain sensing applications, the adoption of this technology in the historically conservative aerospace industry has been slow. There are several contributing factors, one of which is variability in the reported performance of these sensors in harsh and fatigue prone environments. This paper reports on a comparative evaluation of the fatigue performance of FBG sensors written according to the same specifications using three different grating manufacturing processes: sensors written in stripped and re-coated fibres, sensors written during the fibre draw process and sensors written through fibre coating. Fatigue cycling of the fibres is provided by a customized electro-dynamically actuated loading assembly designed to provide high frequency and amplitude loading. Pre- and post-fatigue microscopic analysis and high-resolution transmission and reflection spectra scanning are conducted to investigate the fatigue performance of FBGs, the failure regions of fibres as well as any fatigue-related effects on the spectral profiles. It was found that because of the unique fabrication method, the sensors written through the fibre coating, also known as trans-jacket FBGs, show better fatigue performance than stripped and re-coated FBGs with greater control possible to tailor the optical reflection properties compared to gratings written in the draw tower. This emerging method for inscription of Type I gratings opens up the potential for mass production of higher reflectivity, apodised sensors with dense or complex array architectures which can be adopted as sensors for harsh environments such as in defence and aerospace industries.

Stressing the recurrent laryngeal nerve during thyroidectomy.

BACKGROUND: In thyroidectomy, little has been reported on the differential recurrent laryngeal nerve (RLN) palsy rates between the left and right sides. Even less is known about the potential differences causing these differential rates. This study reports the left versus right RLN palsy rates of total thyroidectomy cases in a single institution, relating them to the comparative stiffness of the left and right porcine RLNs. Computed stress modelling was also used to estimate the differential levels of tension within each RLN. METHODS: For the comparison of the left and right RLN palsy rates, 1926 cases of total thyroidectomy (between 2007 and 2013) from the Monash University Endocrine Surgery Unit were included. Stiffness of porcine RLNs was experimentally determined by measuring nerve extension against incremental increase in load. Additionally, the tension of intraoperatively stretched RLNs was estimated by computer modelling. RESULTS: The left RLN had a palsy rate of 0.9% (18/1926), which was significantly lower (P = 0.025) than the right RLN palsy rate of 1.8% (34/1926). The left porcine RLN was 22% stiffer than the right RLN (P = 0.004). The stress modelling estimated that at the apex of the artificial RLN genu during anteromedial rotation of the thyroid lobe, the right RLN experiences twice the tension experienced by the left RLN. CONCLUSION: The stiffer left RLN and the higher tension generated in the right RLN during thyroidectomy may jointly contribute to the higher right RLN palsy rate.

Applicability of randomized trials in radiation oncology to standard clinical practice.

BACKGROUND: Randomized controlled trials (RCTs) are commonly used to inform clinical practice; however, it is unclear how generalizable RCT data are to patients in routine clinical practice. The authors of this report assessed the availability and applicability of randomized evidence guiding medical decisions in a cohort of patients who were evaluated for consideration of definitive management in a radiation oncology clinic. METHODS: The medical records of consecutive, new patient consultations between January and March 2007 were reviewed. Patient medical decisions were classified as those with (Group 1) or without (Group 2) available, relevant level I evidence (phase 3 RCT) supporting recommended treatments. Group 1 medical decisions were further divided into 3 groups based on the extent of fulfilling eligibility criteria for each RCT: Group 1A included decisions that fulfilled all eligibility criteria; Group 1B, decisions that did not fulfill at least 1 minor eligibility criteria; or Group 1C, decisions that did not fulfill at least 1 major eligibility criteria. Patient and clinical characteristics were tested for correlations with the availability of evidence. RESULTS: Of the 393 evaluable patients, malignancies of the breast (30%), head and neck (18%), and genitourinary system (14%) were the most common presenting primary disease sites. Forty-seven percent of all medical decisions (n = 451) were made without available (36%) or applicable (11%) randomized evidence to inform clinical decision making. Primary tumor diagnosis was significantly associated with the availability of evidence (P < .0001). CONCLUSIONS: A significant proportion of medical decisions in an academic radiation oncology clinic were made without available or applicable level I evidence, underscoring the limitations of relying solely on RCTs for the development of evidence-based health care.

Genotype-guided tamoxifen dosing increases active metabolite exposure in women with reduced CYP2D6 metabolism: a multicenter study.

PURPOSE: We examined the feasibility of using CYP2D6 genotyping to determine optimal tamoxifen dose and investigated whether the key active tamoxifen metabolite, endoxifen, could be increased by genotype-guided tamoxifen dosing in patients with intermediate CYP2D6 metabolism. PATIENTS AND METHODS: One hundred nineteen patients on tamoxifen 20 mg daily ≥ 4 months and not on any strong CYP2D6 inhibiting medications were assayed for CYP2D6 genotype and plasma tamoxifen metabolite concentrations. Patients found to be CYP2D6 extensive metabolizers (EM) remained on 20 mg and those found to be intermediate (IM) or poor (PM) metabolizers were increased to 40 mg daily. Eighty-nine evaluable patients had tamoxifen metabolite measurements repeated 4 months later. RESULTS: As expected, the median baseline endoxifen concentration was higher in EM (34.3 ng/mL) compared with either IM (18.5 ng/mL; P = .0045) or PM (4.2 ng/mL; P < .001). When the dose was increased from 20 mg to 40 mg in IM and PM patients, the endoxifen concentration rose significantly; in IM there was a median intrapatient change from baseline of +7.6 ng/mL (-0.6 to 23.9; P < .001), and in PM there was a change of +6.1 ng/mL (2.6 to 12.5; P = .020). After the dose increase, there was no longer a significant difference in endoxifen concentrations between EM and IM patients (P = .84); however, the PM endoxifen concentration was still significantly lower. CONCLUSION: This study demonstrates the feasibility of genotype-driven tamoxifen dosing and demonstrates that doubling the tamoxifen dose can increase endoxifen concentrations in IM and PM patients.