A novel low-cost uterine balloon tamponade kit to tackle maternal mortality in low-resource settings.

The 3.1 target of the Sustainable Development Goals of the United Nations aims to reduce the global maternal mortality ratio to less than 70 maternal deaths per 100,000 live births by 2030. The last updates on this target show a significant stagnation in the data, thus reducing the chance of meeting it. What makes this negative result even more serious is that these maternal deaths could be avoided through prevention and the wider use of pharmacological strategies and devices to stop postpartum haemorrhage (PPH). PPH is the leading obstetric cause of maternal mortality in low- and middle-income countries (LMICs). Despite low-cost devices based on the uterine balloon tamponade (UBT) technique are already available, they are not safe enough to guarantee the complete stop of the bleeding. When effective, they are too expensive, especially for LMICs. To address this issue, this study presents the design, mechanical characterisation and technology assessment performed to validate a novel low-cost UBT kit, particularly a novel component, i.e., the connector, which guarantees the kit's effectiveness and represents the main novelty. Results proved the device's effectiveness in stopping PPH in a simulated scenario. Moreover, economic and manufacturing evaluations demonstrated its potential to be adopted in LMICs.

Improving maternal safety: Usability and performance assessment of a new medical device for the treatment of postpartum haemorrhage.

Postpartum haemorrhage (PPH) is an obstetric emergency causing nearly one-quarter of maternal deaths worldwide, 99% of these in low-resource settings (LRSs). Uterine balloon tamponade (UBT) devices are a non-surgical treatment to stop PPH. In LRSs, low-cost versions of UBT devices are based on the condom balloon tamponade (CBT) technique, but their effectiveness is limited. This paper discusses the experimental study to assess the usability and performance of a medical device, BAMBI, designed as an alternative to current CBT devices. The testing phase involved medical and non-medical personnel and was focused on testing BAMBI's usability and effectiveness compared to a standard CBT solution. We collected measures of the execution time and the procedure outcome. Different training procedures were also compared. Results show a significant preference for the BAMBI device. Besides, medical and non-medical subjects reached comparable outcomes. This aspect is highly relevant in LRSs where the availability of medical personnel could be limited.

Biomimetic scaffolds using triply periodic minimal surface-based porous structures for biomedical applications.

The design of biomimetic porous scaffolds has been gaining attention in the biomedical sector lately. Shells, marine sponges, shark teeth, cancellous bone, sea urchin spine, and the armadillo armor structure are examples of biological systems that have already been studied to drive the design of innovative, porous, and multifunctional structures. Among these, triply periodic minimal surfaces (TPMSs) have attracted the attention of scientists for the fabrication of biomimetic porous scaffolds. The interest stems from their outstanding properties, which include mathematical controllable geometry features, highly interconnected porous architectures, high surface area to volume ratio, less stress concentration, tunable mechanical properties, and increased permeability. All these distinguishing features enable better cell adhesion, optimal integration to the surrounding tissue avoiding stress shieldings, a good permeability of fluid media and oxygen, and the possibility of vascularization. However, the sophisticated geometry of these TPMS-based structures has proven challenging to fabricate by conventional methods. The emergence of additive manufacturing (AM) and the enhanced manufacturing freedoms and flexibility it guarantees could solve some of the bottlenecks, thus leading to a surge of interest in designing and fabricating such structures in this field. Also, the feasibility of using AM technologies allows for obtaining size programmable TPMS printable in various materials, from polymers to metal alloys. Here, a comprehensive overview of 3D-printed TPMS porous structures is provided from a design for additive manufacturing (DfAM) and application perspective. First, design strategies, geometry design algorithms, and related topological optimization are introduced according to diverse requirements. Based on that, the performance control of TPMS and the pros and cons of the different AM processes for fabricating TPMS scaffolds are summarized. Lastly, practical applications of 3D-printed biomimetic TPMS porous structures for the biomedical field are presented to clarify the advantages and potential of such structures.

Birefringence properties of human immotile spermatozoa and ICSI outcome.

RESEARCH QUESTION: In sperm samples with complete asthenozoospermia, pregnancies are achieved by intracytoplasmic sperm injection (ICSI), but this condition has a negative impact on fertilization and embryo development owing to the difficulty of identifying viable cells for oocyte injection. Is the selection of sperm cells with head birefringence properties under polarizing light a successful strategy to identify viable spermatozoa? DESIGN: This study included 192 ICSI cycles with complete asthenozoospermia (83 ejaculated and 109 testicular samples) performed under polarized light. Two types of sperm head birefringence were distinguished: partial (presumably reacted spermatozoa) and total (presumably intact acrosome). In some sperm cells, no birefringence was present. The main outcome of the study was the cumulative live birth rate (cLBR) per ICSI cycle. RESULTS: Seventy-three deliveries resulted with 38.0% cLBR per ICSI cycle. The injection of birefringent spermatozoa led to significantly higher rates of fertilization, embryo development and implantation compared with the absence of birefringence (P < 0.001). Similarly, the resulting cLBR were 53.6% and 9.0%, respectively (P < 0.001). Spermatozoa with partial head birefringence yielded significantly higher fertilization and embryo utilization rates compared with total birefringence. The cLBR showed the same trend (62.7% and 46.7%, respectively, P = 0.048). Multiple logistic regression analysis showed the pattern of partial birefringence to be strongly associated with live birth rate. CONCLUSIONS: Immotile sperm cells with birefringence properties under polarized light have higher chances of inducing fertilization and embryo development compared with non-birefringent cells. In addition, a pattern of partial birefringence, associated with a reacted acrosome, is the strongest predictive factor for live birth delivery, both in ejaculated and testicular samples.

3D-Printed Architected Materials Inspired by Cubic Bravais Lattices.

Learning from Nature and leveraging 3D printing, mechanical testing, and numerical modeling, this study aims to provide a deeper understanding of the structure-property relationship of crystal-lattice-inspired materials, starting from the study of single unit cells inspired by the cubic Bravais crystal lattices. In particular, here we study the simple cubic (SC), body-centered cubic (BCC), and face-centered cubic (FCC) lattices. Mechanical testing of 3D-printed structures is used to investigate the influence of different printing parameters. Numerical models, validated based on experimental testing carried out on single unit cells and embedding manufacturing-induced defects, are used to derive the scaling laws for each studied topology, thus providing guidelines for materials selection and design, and the basis for future homogenization and optimization studies. We observe no clear effect of the layer thickness on the mechanical properties of both bulk material and lattice structures. Instead, the printing direction effect, negligible in solid samples, becomes relevant in lattice structures, yielding different stiffnesses of struts and nodes. This phenomenon is accounted for in the proposed simulation framework. The numerical models of large arrays, used to define the scaling laws, suggest that the chosen topologies have a mainly stretching-dominated behavior─a hallmark of structurally efficient structures─where the modulus scales linearly with the relative density. By looking ahead, mimicking the characteristic microscale structure of crystalline materials will allow replicating the typical behavior of crystals at a larger scale, combining the hardening traits of metallurgy with the characteristic behavior of polymers and the advantage of lightweight architected structures, leading to novel materials with multiple functions.

Auxetic structures used in kinesiology tapes can improve form-fitting and personalization.

Each year 65% of young athletes and 25% of physically active adults suffer from at least one musculoskeletal injury that prevents them from continuing with physical activity, negatively influencing their physical and mental well-being. The treatment of musculoskeletal injuries with the adhesive elastic kinesiology tape (KT) decreases the recovery time. Patients can thus recommence physical exercise earlier. Here, a novel KT based on auxetic structures is proposed to simplify the application procedure and allow personalization. This novel KT exploits the form-fitting property of auxetics as well as their ability to simultaneously expand in two perpendicular directions when stretched. The auxetic contribution is tuned by optimizing the structure design using analytical equations and experimental measurements. A reentrant honeycomb topology is selected to demonstrate the validity of the proposed approach. Prototypes of auxetic KT to treat general elbow pains and muscle tenseness in the forearm are developed.

Effects of Interpersonal Sensorimotor Synchronization on Dyadic Creativity: Gender Matters.

Although it is noted that interpersonal sensorimotor coordination can influence several high-level socio-cognitive processes, its impact on creative collaboration is nearly unexplored. Here, we investigated the effects of a form of sensorimotor coordination, that is, sensorimotor synchronization, on a subsequent creative collaboration task. 60 pairs (n total = 120 participants) formed by previously unacquainted individuals performed a tower-building task either jointly or alone, followed by a dyadic creativity task. Tower building time in the joint condition was recorded through a sensorized platform and creativity performance was evaluated by two independent raters based on the quantity and quality of generated ideas. We controlled for gender composition and for the disposition to cooperate and to adopt a creative, analytical style. Results showed that male-male couples were more creative after the joint-action condition, whereas female-female and mixed-gender couples were more creative after the solo condition. Regression analyses of tower building time on creativity performance revealed that building time was a significant predictor of creativity dimensions in male-male and in mixed-gender couples but did not predict creative performance in female-female couples. Overall, these findings suggest that the manipulation of sensorimotor coordination can influence performance in a subsequent creative collaboration task, with the nature, and magnitude of this effect depending on the gender composition of the dyads. These results have potential implications for the design of sensorimotor-based strategies to enhance dyadic creative performance in several contexts, especially for the organizational settings.