articles+ search results

Humans, Magnetic Resonance Imaging methods, Magnetic Resonance Spectroscopy, Phantoms, Imaging, Acceleration, Reproducibility of Results, Heart diagnostic imaging, Image Interpretation, Computer-Assisted methods, and Myocardium

Purpose: Enabling fast and accessible myocardial T 1 mapping is crucial for extending its clinical application. We introduce Open-MOLLI-SMS combining simultaneous multi-slice (SMS) with auto-calibration and variable-rate selective excitation (VERSE)-multiband pulses to obtain all slices in a fast single-shot T 1 mapping sequence.
Methods: Open-MOLLI-SMS was developed by integrating SMS with the open-source method Open-MOLLI previously implemented in Pulseq. Three methods were integrated for Open-MOLLI-SMS: (1) auto-calibration blip patterns to ensure consistency between the data and coil information; (2) a blipped-balanced SSFP (bSSFP) readout to induce controlled aliasing in parallel imaging shifts without disturbing the bSSFP frequency response; and (3) a VERSE-multiband pulse for minimizing the achievable TR and the specific absortion rate (SAR) impact of SMS. Two (SMS2) or three (SMS3) slices were excited simultaneously and encoded with an in-plane acceleration factor of 2. Experiments were performed in the International Society for Magnetic Resonance in Medicine/National Institute of Standards and Technology phantom and five healthy volunteers.
Results: Phantom results show accurate T 1 estimates for reference values between 400 to 2200 ms. Artifacts were visible for Open-MOLLI-SMS3 but not replicated in vivo. In vivo Open-MOLLI-SMS (T 1 SMS2  = 993 ± 10 ms; T 1 SMS3  = 1031 ± 17 ms) provided similar values to mean T 1 single-band Open-MOLLI estimates (T 1 Open-MOLLI  = 1005 ± 47 ms). Open-MOLLI-SMS2 provided the closest estimates to the reference.
Conclusion: This proof-of-principle implementation study demonstrates the feasibility of speeding up T 1 -mapping acquisitions and increasing coverage by combining auto-calibration strategies with a blipped-bSFFP readout and VERSE multiband RF excitation pulses. The proposed methodology was built on the Open-MOLLI mapping sequence, which provides a fast means for prototyping and enables open-source sharing of the method.
(© 2023 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Animals, Bayes Theorem, Uncertainty, and Anthozoa

Emerging diseases can have devastating consequences for wildlife and require a rapid response. A critical first step towards developing appropriate management is identifying the etiology of the disease, which can be difficult to determine, particularly early in emergence. Gathering and synthesizing existing information about potential disease causes, by leveraging expert knowledge or relevant existing studies, provides a principled approach to quickly inform decision-making and management efforts. Additionally, updating the current state of knowledge as more information becomes available over time can reduce scientific uncertainty and lead to substantial improvement in the decision-making process and the application of management actions that incorporate and adapt to newly acquired scientific understanding. Here we present a rapid prototyping method for quantifying belief weights for competing hypotheses about the etiology of disease using a combination of formal expert elicitation and Bayesian hierarchical modeling. We illustrate the application of this approach for investigating the etiology of stony coral tissue loss disease (SCTLD) and discuss the opportunities and challenges of this approach for addressing emergent diseases. Lastly, we detail how our work may apply to other pressing management or conservation problems that require quick responses. We found the rapid prototyping methods to be an efficient and rapid means to narrow down the number of potential hypotheses, synthesize current understanding, and help prioritize future studies and experiments. This approach is rapid by providing a snapshot assessment of the current state of knowledge. It can also be updated periodically (e.g., annually) to assess changes in belief weights over time as scientific understanding increases. Synthesis and applications: The rapid prototyping approaches demonstrated here can be used to combine knowledge from multiple experts and/or studies to help with fast decision-making needed for urgent conservation issues including emerging diseases and other management problems that require rapid responses. These approaches can also be used to adjust belief weights over time as studies and expert knowledge accumulate and can be a helpful tool for adapting management decisions.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)

Humans, Models, Psychological, and Text Messaging

In an experiment so-termed sociotechnical prototypes based on either a graphical or a textual representation of an envisioned work system were evaluated with regard to their ability to communicate a design vision to people involved in a participatory design process. Results of the study reveal, in line with hypotheses, that the graphical prototype, in contrast to the textual one, was significantly better accepted as well as faster explored and evaluated. Moreover, results support the hypothesis that the graphical sociotechnical prototype helps to build up a more accurate mental representation of the system with regard to its elements (e.g. job roles, tasks). However, no positive effect on the mental representation of the system in terms of the relations between its elements (e.g. which role performs which task?) was found. Finally, practical implications and perspectives for further development of the sociotechnical prototyping approach to envision future work systems are discussed.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)

With the use of CAD/CAM technology and rapid prototyping, the opportunities for digitisation and technology are unlimited. 3D printing is going to revolutionise traditional teaching and laboratory methods with rapid progress of new materials, printing technology and machines. Given the large number of options available, one must keep up with the current and emerging technology in order to make benefit of the same. The aim of the study is to assess dental laboratory technicians' knowledge, understanding and practices related the use of 3D printing in dentistry in India.
Methods: From November 2021 to January 2022, a cross-sectional questionnaire-based study was done among dental laboratory technicians in India. Dental technicians were given access to a self-explanatory questionnaire via Google forms link consisting of 12 questions that evaluated their knowledge, awareness and practices regarding 3D printing. The CHERRIES protocol for presenting the findings of the survey was followed. Chi-square test and independent t-test was used for statistical analysis by SPSS version 20.0.
Results: A total of 191 responses were obtained after the questionnaire was circulated to 220 technicians. 171 dental technicians (89.53%) were acquainted of the usage of 3D printing in dentistry.169 (88.48%) Dental technicians preferred 3D printing to traditional procedures. Majority of dental technicians indicated they want to include the 3D printing into their regular work practices and believe digital technology will enhance our profession.
Conclusion: The level of awareness of digital dentistry and 3D printing among the participants is acceptable. Dental technicians at private laboratory showed better understanding about 3D printing as compared to technicians working at dental colleges nevertheless, dental education programmes, webinars and hands-on training should be undertaken that will enhance their expertise of 3D printing.
Competing Interests: No potential conflict of interest relevant to this article was reported.
(© 2023 The Authors.)

Humans, Lignin, Alginates pharmacology, Alginates chemistry, Calcium Phosphates pharmacology, Calcium Phosphates chemistry, Bone Regeneration, Osteogenesis, Printing, Three-Dimensional, Tissue Scaffolds chemistry, and Tissue Engineering methods

The bone is a connective, vascularized, and mineralized tissue that confers protection to organs, and participates in the support and locomotion of the human body, maintenance of homeostasis, as well as in hematopoiesis. However, throughout the lifetime, bone defects may arise due to traumas (mechanical fractures), diseases, and/or aging, which when too extensive compromise the ability of the bone to self-regenerate. To surpass such clinical situation, different therapeutic approaches have been pursued. Rapid prototyping techniques using composite materials (consisting of ceramics and polymers) have been used to produce customized 3D structures with osteoinductive and osteoconductive properties. In order to reinforce the mechanical and osteogenic properties of these 3D structures, herein, a new 3D scaffold was produced through the layer-by-layer deposition of a tricalcium phosphate (TCP), sodium alginate (SA), and lignin (LG) mixture using the Fab@Home 3D-Plotter. Three different TCP/LG/SA formulations, LG/SA ratio 1:3, 1:2, or 1:1, were produced and subsequently evaluated to determine their suitability for bone regeneration. The physicochemical assays demonstrated that the LG inclusion improved the mechanical resistance of the scaffolds, particularly in the 1:2 ratio, since a 15 % increase in the mechanical strength was observed. Moreover, all TCP/LG/SA formulations showed an enhanced wettability and maintained their capacity to promote the osteoblasts' adhesion and proliferation as well as their bioactivity (formation of hydroxyapatite crystals). Such results support the LG inclusion and application in the development of 3D scaffolds aimed for bone regeneration.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Stress, Mechanical, Bioreactors, Polyesters, Tissue Engineering methods, and Mechanotransduction, Cellular physiology

Objective: Tissue engineering (TE) is the study and development of biological substitutes to restore, maintain or improve tissue function. Tissue engineered constructs (TECs) still present differences in mechanical and biological properties compared to native tissue. Mechanotransduction is the process through which mechanical stimulation triggers proliferation, apoptosis, and extracellular matrix synthesis, among other cell activities. Regarding that aspect, the effect of in vitro stimulations such as compression, stretching, bending or fluid shear stress loading modalities have been extensively studied. A fluid flow used to produce contactless mechanical stimulation induced by an air pulse could be easily achieved in vivo without altering the tissue integrity.
Methods: A new air-pulse device for contactless and controlled mechanical simulation of a TECs was developed and validated in this study conducted in the following three phases: 1) conception of the controlled air-pulse device combined with a 3D printed bioreactor; 2) experimental and numerical mechanical characterization of the air-pulse impact by digital image correlation; and 3) achieving sterility and noncytotoxicity of the air-pulse and of the 3D printed bioreactor using a novel dedicated sterilization process.
Results: We demonstrated that the treated PLA (polylactic acid) was noncytotoxic and did not influence cell proliferation. An ethanol/autoclaved sterilization protocol for 3D printed objects in PLA has been developed in this study, enabling the use of 3D printing in cell culture. A numerical twin of the device was developed and experimentally characterized by digital image correlation. It showed a coefficient of determination R 2  = 0.98 between the numerical and averaged experimental surface displacement profiles of the TEC substitute.
Conclusion: The results of the study assessed the noncytotoxicity of PLA for prototyping by 3D printing the homemade bioreactor. A novel sterilization process for PLA was developed in this study based on a thermochemical process. A numerical twin using fluid-structure interaction method has been developed to investigate the micromechanical effects of air pulses inside the TEC, which cannot all be measured experimentally, for instance, wave propagation generated during the air-pulse impact. The device could be used to study the cell response to contactless cyclic mechanical stimulation, particularly in TEC with fibroblasts, stromal cells and mesenchymal stem cells, which have been shown to be sensitive to the frequency and strain level at the air-liquid interface.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier B.V. All rights reserved.)

Biotechnology, Microtechnology, Printing, Three-Dimensional, Microfluidics methods, and Cell Culture Techniques

Rapid prototyping of microfluidic chips is a key enabler for controlled biotechnology applications in microspaces, as it allows for the efficient design and production of microfluidic systems. With rapid prototyping, researchers and engineers can quickly create and test new microfluidic chip designs, which can then be optimized for specific applications in biotechnology. One of the key advantages of microfluidic chips for biotechnology is the ability to manipulate and control biological samples in a microspace, which enables precise and controlled experiments under well-defined conditions. This is particularly useful for applications such as cell culture, drug discovery, and diagnostic assays, where precise control over the biological environment is crucial for obtaining accurate results. Established methods, for example, soft lithography, 3D printing, injection molding, as well as other recently highlighted innovative approaches, will be compared and challenges as well as limitations will be discussed. It will be shown that rapid prototyping of microfluidic chips enables the use of advanced materials and technologies, such as smart materials and digital sensors, which can further enhance the capabilities of microfluidic systems for biotechnology applications. Overall, rapid prototyping of microfluidic chips is an important enabling technology for controlled biotechnology applications in microspaces, as well as for upscaling it into macroscopic bioreactors, and its continued development and improvement will play a critical role in advancing the field. The review will highlight recent trends in terms of materials and competing approaches and shed light on current challenges on the way toward integrated microtechnologies. Also, the possibility to easy and direct implementation of novel functions (membranes, functionalization of interfaces, etc.) is discussed.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)

Humans, Software, Pharmacists, Vancomycin, and Drug Monitoring

Background: Different software applications have been developed to support health care professionals in individualized drug dosing. However, their translation into clinical practice is limited, partly because of poor usability and integration into workflow, which can be attributed to the limited involvement of health care professionals in the development and implementation of drug dosing software. This study applied codesign principles to inform the design of a drug dosing software to address barriers in therapeutic drug monitoring using vancomycin as an example.
Methods: Three workshops (face-to-face and online) were conducted by design researchers with pharmacists and prescribers. User journey storyboards, user personas, and prototyping tools were used to explore existing barriers to practice and opportunities for innovation through drug dosing software design. A prototype of the software interface was developed for further evaluation.
Results: Health care professionals (11 hospital pharmacists and 6 prescribers) with ≥2 years of clinical experience were recruited. Confidence and software usability emerged as the main themes. Participants identified a lack of confidence in vancomycin dosing and pharmacokinetic understanding and difficulty in accessing practice guidelines as key barriers that could be addressed through software implementation. Accessibility to information (eg, guidelines and pharmacokinetic resources) and information presentation (eg, graphical) within the dosing software were dependent on the needs and experience of the user. A software prototype with a speedometer-dial visual to convey optimal doses was well received by participants.
Conclusions: The perspectives of health care professionals highlight the need for drug dosing software to be user centered and adaptable to the needs and workflow of end users. Continuous engagement with stakeholders on tool usability, training, and education is needed to promote the implementation in practice.
Competing Interests: The authors declare no conflict of interest.
(Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Microactuators can autonomously convert external energy into specific mechanical motions. With the feature sizes varying from the micrometer to millimeter scale, microactuators offer many operation and control possibilities for miniaturized devices. In recent years, advanced microfluidic techniques have revolutionized the fabrication, actuation, and functionalization of microactuators. Microfluidics can not only facilitate fabrication with continuously changing materials but also deliver various signals to stimulate the microactuators as desired, and consequently improve microfluidic chips with multiple functions. Herein, this cross-field that systematically correlates microactuator properties and microfluidic functions is comprehensively reviewed. The fabrication strategies are classified into two types according to the flow state of the microfluids: stop-flow and continuous-flow prototyping. The working mechanism of microactuators in microfluidic chips is discussed in detail. Finally, the applications of microactuator-enriched functional chips, which include tunable imaging devices, micromanipulation tools, micromotors, and microsensors, are summarized. The existing challenges and future perspectives are also discussed. It is believed that with the rapid progress of this cutting-edge field, intelligent microsystems may realize high-throughput manipulation, characterization, and analysis of tiny objects and find broad applications in various fields, such as tissue engineering, micro/nanorobotics, and analytical devices.
(© 2023 Wiley-VCH GmbH.)

Administration, Cutaneous, Drug Delivery Systems, Lasers, Needles, Dimethylpolysiloxanes chemistry, Polymers chemistry, and Carbon Dioxide

Microneedle-based transdermal drug delivery into the skin has gained attraction for the past few years. An affordable and effective fabrication methodology is required for the development of micron size needle. Manufacturing cost-effective microneedle patches in batch production is a challenging process. In this work, we proposed a cleanroom-free technique for fabrication of conical and pyramidal geometry of microneedle array for transdermal drug delivery. Using the COMSOL Multiphysics tool, the mechanical strength of the designed microneedle array under axial, bending, and buckling loads for the geometries during skin insertion was investigated. A CO 2 laser and polymer molding technique are used to fabricate 10 × 10 designed microneedle array structure. On an acrylic sheet, a designed pattern is engraved to produce a 20 mm × 20 mm sharp conical and pyramidal shape master mold. We successfully created a biocompatible polydimethylsiloxane (PDMS) microneedle patch with an average height of 1200 µm, base diameter of 650 µm, and a tip diameter of 50 µm using acrylic master mold. According to structural simulation analysis, the microneedle array will experience resultant stress that is within a safe range. The mechanical stability of the fabricated microneedle patch was investigated using hardness test and universal testing machine. The depth of penetration studies were performed in an in vitro Parafilm ® M model by manual compression tests and its detailed insertion depth was reported. The developed master mold is efficient to replicate several polydimethylsiloxane microneedle patches. The proposed combined method of laser processing and molding mechanism is simple and low-cost for rapid prototyping of microneedle array.
(© 2023. Controlled Release Society.)

Microplasma UV lamps have recently emerged as viable excimer-based sources of UV radiation, garnering significant attention during the recent COVID-19 pandemic for their use in disinfection applications because of their ability to emit human-safe far-UVC (200-240 nm) spectrums. An accurate model to simulate the radiation profile of microplasma UV lamps is of paramount importance to develop efficient microplasma lamp-implemented systems. We developed a 3D numerical model of microplasma UV lamps using the ray optics method. The simulation results for lamp irradiance and fluence rate were experimentally validated with standard optical radiometry and actinometry measurements, respectively. To improve the optical efficiency of microplasma lamps, an in-depth analysis of radiation behavior inside the standard commercially available lamp was performed using the geometrical optics method, and several potential scenarios were explored. A 2D modeling of an individual microcavity indicated that the current common lamp design can be significantly improved by preventing radiation loss, and small modifications in optical design can greatly increase the energy performance of the system. Based on the findings of this study, several virtual design concepts were proposed, and their performances were numerically compared with that of the original design of commercial microplasma lamps. The developed model can potentially be integrated with hydrodynamic and kinetic models for the virtual prototyping of complex photoreactors operating with UV microplasma lamps.
Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(© 2023 Elsevier Ltd. All rights reserved.)

Ex vivo hemocompatibility testing is a vital element of preclinical assessment for blood-contacting medical devices. Current approaches are resource intensive; thus, we investigated the feasibility of accelerating hemocompatibility testing by standardizing the number of pump exposures in loops of various sizes. Three identical blood loops were constructed, each with a custom-molded reservoir able to facilitate large-volume expansion. Using the HVAD rotary blood pump operating at 5 L·min-1 and 100 mmHg, three test volumes (80, 160, and 320 ml) were circulated for 4000 pump exposures. Blood sampling was performed at individualized intervals every one-sixth of total duration for the assessment of hemolysis and von Willebrand Factor (vWF) degradation. While steady increases in hemolysis (~24 mg·dl-1) were identified in all tests at completion, loop volume was not a primary discriminator. The normalized index of hemolysis did not vary significantly between loops (4.2-4.9 mg·100 L-1). vWF degradation progressively occurred with duration of testing to a similar extent under all conditions. These data support an accelerated approach to preclinical assessment of ex vivo blood damage. Adopting this approach enables: enhanced efficiency for rapid prototyping; reduced ex vivo blood aging, and; greater utility of blood, which is presently limited if 450 ml loops are desired.
Competing Interests: Disclosure: The authors have no conflicts of interest to report.
(Copyright © ASAIO 2023.)

Handwashing with soap is a widely advocated public health measure, but seldom practiced, partly because it is often difficult (especially outside of rich Western country contexts) to make both soap and water readily available in relevant situations. This study used both Behaviour Centred Design and Human Centred Design to guide development of a novel hand cleansing technology appropriate for the context of post-toilet hand cleansing in resource-poor societies. Extensive prototyping and field testing resulted in the pilot production of 'tab' soap, a small but durable single-use, decomposable substrate embedded with soap. It can be produced in dispenser roll or tear-off formats. With this affordable solution, one may use soap without worrying about contamination pretty much anytime and anywhere. A small-scale field test showed that all poor households in rural and peri-urban areas in Tanzania included in the proof-of-concept study (N = 12 households) would use the product reliably over the medium term. Tab soap awaits full-scale production and marketing but could make hand cleansing a more popular practice around the world.
Competing Interests: The authors have an interest in the innovation becoming available at scale and are working to develop partnerships, apply for grants and otherwise support such progress though no financial gain is expected. While a product is in development, there are currently no patents associated with this research to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
(Copyright: © 2023 Brial et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Fast imaging methods are needed to promote widespread clinical adoption of Ultrasound Tomography (UST), and more widely available UST hardware could support the experimental validation of new measurement configurations. In this work, an open-source 256-element transducer ring array was developed (morganjroberts.github.io/open-UST) and manufactured using rapid prototyping, for only £2k. Novel manufacturing techniques were used, resulting in a 1.17° mean beam axis skew angle, a 104 μm mean element position error, and a ±13.6 μm deviation in matching layer thickness. The nominal acoustic performance was measured using hydrophone scans and watershot data, and the 61.2 dB SNR, 55.4° opening angle, 10.2 mm beamwidth and 54% transmit-receive bandwidth (-12 dB), were found to be similar to existing systems, and compatible with state of the art full-waveform-inversion image reconstruction methods. The inter-element variation in acoustic performance was typically <10% without using normalisation, meaning that the elements can be modelled identically during image reconstruction, removing the need for individual source definitions based on hydrophone measurements. Finally, data from a phantom experiment was successfully reconstructed. These results demonstrate that the open-UST system is accessible for users, and suitable for UST imaging research.

Humans, Child, User-Centered Design, Indonesia, Mobile Applications, Telemedicine methods, and Leukemia

Background: A mobile health (mHealth) application can encourage parents and pediatric patients to be involved in caring for their child's health condition by providing the ability to identify and actively manage chemotherapy-related symptoms in their child. Several monitoring systems available today are diverse in features and system basis. This study aimed to develop and trial the Chemo Assist for Children (CAC) mHealth application for symptom management in children with acute lymphoblastic leukemia (ALL).
Methods: In this study, the development of the CAC application went through multiple phases and methods. Study phases included: (1) development of the application's feature based on the need assessment, (2) creation of content of application based on literature review, (3) develop prototyping of CAC, (4) expert review and feedback on the application content, (5) usability testing by targeted end-user.
Results: Based on need assessment, it was determined that parents with leukemia children were interested in symptom management of chemotherapy and preferred mobile applications. Therefore, a mHealth application was designed to include features to identify symptoms and provide recommendation strategies to manage the symptom. Usability evaluation by end-user revealed that mHealth is a valid, accessible, and appropriate application for users.
Conclusions: The CAC mHealth application developed can meet the needs of technology users to identify symptoms and manage chemotherapy-related symptoms in children with ALL. The CAC mHealth application can accommodate data not recorded at out-of-hospital care, increase the independence of symptom management, and improve communication between parents of children with ALL and health workers.
(© 2023. The Author(s).)

Background: Fatigue is an important symptom for many patients, including patients with kidney disease. Cognitive biases, such as attentional bias and self-identity bias, are thought to influence fatigue. Cognitive bias modification (CBM) training is a promising technique to counter fatigue.
Objective: We aimed to evaluate a CBM training among patients with kidney disease and health care professionals (HCPs) and assess acceptability and applicability in the clinical setting using an iterative design process to evaluate expectations and experiences with the training.
Methods: This was a longitudinal, qualitative, and multiple stakeholder-perspective usability study in which we interviewed end users and HCPs during the prototyping phase and after the end of training. We conducted semistructured interviews with 29 patients and 16 HCPs. The interviews were transcribed and analyzed thematically. Next to a general evaluation of the training, the acceptability of the training was evaluated using the Theoretical Framework of Acceptability, and applicability was assessed by evaluating obstacles and solutions for implementation in the kidney care setting.
Results: Generally, participants were positive about the training and its applicability. The biggest negatives were doubts about effectiveness and annoyance about the repetitive character of CBM. Acceptability was judged with a mixed evaluation, with a negative evaluation of perceived effectiveness; mixed results for burden, intervention coherence, and self-efficacy; and positive results for affective attitude, ethicality, and opportunity costs. Barriers for applicability were patients' varying computer skills, subjectivity of fatigue, and integration with regular treatment (eg, the role of HCPs). Possible solutions included assigning representatives among nurses, offering training on an app, and providing assistance via a help desk. The iterative design process, including repeated waves of testing user expectations and experiences, yielded complementary data.
Conclusions: To the best of our knowledge, this study is the first to introduce a CBM training targeting fatigue. Furthermore, this study provides one of the first user evaluations of a CBM training, both among patients with kidney disease and their care providers. Overall, the training was evaluated positively, although acceptability showed mixed results. Applicability was positive although barriers were identified. The proposed solutions require further testing, preferably following the same frameworks, as the iteration in this study contributed positively to the quality of the training. Therefore, future research should follow the same frameworks and consider stakeholders and end users in eHealth intervention design.
(©Jody Geerts, Marcel Pieterse, Goos Laverman, Femke Waanders, Nicole Oosterom, Jacqueline Slegten, Elske Salemink, Christina Bode. Originally published in JMIR Formative Research (https://formative.jmir.org), 29.05.2023.)

Humans, Materials Testing, Zirconium, Printing, Three-Dimensional, Crowns, and Dental Restoration Failure

Aim: The aim of the present study was the evaluation of the in vitro performance and fracture force of 3D-printed anterior implant-supported temporary partial dentures (TPDs) with different filler content.
Materials and Methods: Identical anterior resin-based TPDs (tooth sites 11 to 13; n = eight per material) were 3D printed from methacrylate resins with different filler content. A cartridge polymethyl methacrylate (PMMA) material was used as a reference. After temporary cementation, combined thermal cycling and mechanical loading (TCML) was performed on all the restorations to mimic clinical application. Behavior during TCML and fracture force was determined, and failures were analyzed. Data were statistically investigated (Kolmogorov-Smirnov test, one-way ANOVA; post hoc Bonferroni, Kaplan-Meier survival; α = 0.05).
Results: Failure during TCML varied between three failures and total failure during loading time. Mean survival time varied between 93 ± 206 x 103 cycles and 329 ± 84 x 103 cycles. Significantly different survival cycles between the individual materials could be determined (Mantel Cox log-rank test: chi-square: 21,861; degrees of freedom (df) = 4, P < 0.001). A correlation between filler level and survival cycles could be found (Pearson: 0.186, P = 0.065). Fracture values of the surviving TPDs varied between 499 and 835 N. Failures were characterized by fracture of the connector (n = 24) followed by fractures at the abutment (n = 10).
Conclusions: TDPs showed different filler-dependent survival. Individual 3D-printed materials provided comparable or even better performance than a standard cartridge system and might be sufficient for temporary application of at least half a year.

Despite being researched for decades, shape-shifting molecular crystals have yet to claim their spot as an actuating materials class among the primary functional materials. While the process for developing and commercializing materials can be lengthy, it inevitably starts with building an extensive knowledge base, which for molecular crystal actuators remains scattered and disjointed. Using machine learning for the first time, we identify inherent features and structure-function relationships that fundamentally impact the mechanical response of molecular crystal actuators. Our model can factor in different crystal properties in tandem and decipher their intersectional and combined effects on each actuation performance. This analysis is an open invitation to utilize interdisciplinary expertise in translating the current basic research on molecular crystal actuators into technology-based development that promotes large-scale experimentation and prototyping.

Female, Humans, Spectroscopy, Fourier Transform Infrared, Fluorouracil, Polyesters, and Uterine Cervical Neoplasms drug therapy

Solid lipid nanoparticles (SLNs) are used extensively to achieve site-specific drug delivery with improved bioavailability and reduced toxicity. This work focused on a new approach to provide site-specific stimuli-responsive delivery of SLNs loaded within thermo-sonic nano-organogel (TNO) variants to deliver the model chemotherapeutic agent 5-FU in treating cervical cancer. Pharmaceutically stable nanospherical SLNs comprising poly-L-lactic acid (PLA), palmitic acid (PA), and polyvinyl alcohol (PVA) were prepared and incorporated into TNO variants augmented by external thermal and ultrasound stimuli for release of 5-FU in the cervix. Results revealed that rate-modulated 5-FU release was achieved from SLNs (particle size =450.9 nm; PDI =0.541; zeta potential =-23.2 mV; %DL =33%) within an organogel upon exposure to either a single (thermo-) and/or both (thermo-sonic) stimuli. 5FU was released from all TNO variants with an initial burst on day 1 followed by sustained release over 14 days. TNO 1 provided desirable release over 15 days (44.29% vs. 67.13% under single (T) or combined (TU) stimuli, respectively). Release rates were primarily influenced by the SLN:TO ratio in tandem with biodegradation and hydrodynamic influx. Biodegradation by day 7 revealed that variant TNO 1 (1:5) released 5FU (46.8%) analogous to its initial mass than the other TNO variants (i.e., ratios of 2:5 and 3:5). FT-IR spectra revealed assimilation of the system components and corroborative with the DSC and XRD analysis (i.e., in ratios of PA:PLA 1:1 and 2:1). In conclusion, the TNO variants produced may be used as a potential stimuli-responsive platform for the site-specific delivery of chemotherapeutic agents such as 5-FU to treat cervical cancer.
(© 2023. The Author(s).)

The aim of this study was to introduce a new computer guided technique for debulking and contouring the craniofacial fibrous dysplasia involving the fronto-orbital and fronto-cranial regions. Computer-guided contouring was performed using a modified patient-specific surgical depth guide for six patients with craniofacial fibrous dysplasia involving the fronto-orbital and fronto-cranial regions. Virtual planning was performed to determine the desired amount of bone removal and construct the patient-specific surgical depth guide. Then, the guide was printed using rapid prototyping. In the surgical theatre, the guide was seated in position. Implant drills were inserted through the created depth holes according to the planned fixed depth to create depth holes. Finally, the bone in between the created holes was removed using cutting discs, bone chisels and surgical burs. Satisfaction with facial aesthetics was evaluated by the patients using a Likert scale, and by the surgeons using the Whitaker rating scale. The surgical procedures were uneventful for all the patients. All the patients were satisfied with the post-operative facial esthetics and categorized as category I Whitaker rating scale. Patient-specific surgical guide technique for recontouring of fronto-orbital and fronto-cranial fibrous dysplasia can be considered an accurate substitution technique that overcomes the drawbacks of the unpredictable conventional one. Further investigations are required.
Competing Interests: Declaration of competing interest None.
(Copyright © 2023 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)