Surface profile analysis of laminated transfemoral prosthetic socket fabricated with different ratios of epoxy resin and acrylic resin.

Acrylic and epoxy are common types of resin used in fabricating sockets. Different types of resin will affect the internal surface of a laminated socket. This paper is to determine the best combination of ratio for epoxy and acrylic resin for a laminated prosthesis socket and to evaluate the surface profile analysis of different combinations of laminated prosthetic sockets for surface roughness. Transfemoral sockets were created using various resin-to-hardener ratios of 2:1, 3:1, 3:2, 2:3, and 1:3 for epoxy resin and 100:1, 100:2, 100:3, 100:4, and 100:5 for acrylic resin. Eight layers of stockinette consisting of four elastic stockinette and four Perlon stockinette were used. A sample with a size of 4 cm × 6 cm was cut out from the socket on the lateral side below the Greater Trochanter area. The Mitutoyo Sj-210 Surface Tester stylus was run through the sample and gave the Average Surface Roughness value (Ra), Root Mean Square Roughness value (Rq), and Ten-Point Mean Roughness value (Rz). Epoxy resin shows a smoother surface compared to acrylic resin with Ra values of is 0.766 µm, 0.9716 µm, 0.9847 µm and 1.5461 µm with 3:2, 3:1, 2:1 and 2:3 ratio respectively. However, for epoxy resin with ratio 1:3, the resin does not cure with the hardener. As for acrylic resin the Ra values are 1.0086 µm, 2.362 µm, 3.372 µm, 4.762 µm and 6.074 µm with 100: 1, 100:2, 100:5, 100:4 and 100:3 ratios, respectively. Epoxy resin is a better choice in fabricating a laminated socket considering the surface produced is smoother.

The sequential mediation model of students' willingness to continue online learning during the COVID-19 pandemic.

This study explored the factors influencing students' willingness to continue with the online learning system during the coronavirus disease 2019 (COVID-19) pandemic by adopting the stimulus-organism-response (SOR) theory. This study also incorporated e-learning readiness, performance, and satisfaction as mediators. The present study employed the purposive sampling method, whereby 2215 data of undergraduate students from a public university were gathered using an online survey and analysed using structural equation modelling (SEM) with Smart Partial Least Squares (SmartPLS). The results revealed that students' e-learning readiness, performance, and satisfaction positively influenced their willingness to continue online learning. Besides, students' e-learning readiness, performance, and satisfaction sequentially mediated the relationship between the online learning system quality and willingness to continue online learning. Significantly, this study provided new insights into the literature on students' willingness to continue online learning by providing empirical evidence on the factors that support their willingness to continue online learning during the COVID-19 pandemic.

3D-printed biphasic calcium phosphate scaffolds coated with an oxygen generating system for enhancing engineered tissue survival.

Tissue engineering scaffolds with oxygen generating elements have shown to be able to increase the level of oxygen and cell survivability in specific conditions. In this study, biphasic calcium phosphate (BCP) scaffolds with the composition of 60% hydroxyapatite (HA) and 40% beta-tricalcium phosphate (ß-TCP), which have shown a great potential for bone tissue engineering applications, were fabricated by a direct-write assembly (robocasting) technique. Then, the three-dimensional (3D)-printed scaffolds were coated with different ratios of an oxygen releasing agent, calcium peroxide (CPO), which encapsulated within a polycaprolactone (PCL) matrix through dip-coating, and used for in situ production of oxygen in the implanted sites. The structure, composition and morphology of the prepared scaffolds were characterized by different techniques. The oxygen release kinetics and biological investigations of the scaffolds were also studied in vitro. The results showed that oxygen release behaviour was sustained and dependant on the concentration of CPO encapsulated in the PCL coating matrix. It was also demonstrated that the coated scaffolds, having 3% CPO in the coating system, could provide a great potential for promoting bone ingrowth with improving osteoblast cells viability and proliferation under hypoxic conditions. The findings indicated that the prepared scaffolds could play a significant role in engineering of large bone tissue implants with limitations in oxygen diffusion.

Analysis of voluntary opening Ottobock Hook and Hosmer Hook for upper limb prosthetics: a preliminary study.

There are a number of prosthetic terminal devices which offer functional restoration to individuals with upper limb deficiencies. Hosmer and Ottobock are major commercial hook providers for prosthetic terminal devices. The concern of this paper is to analyse the voluntary opening (VO) Ottobock model 10A18 and Hosmer model 99P hooks (one band) during opening operation and to find out favourable features in the design. Two tests were conducted to analyse the performance of both hooks. The first test used a simple bench tool to investigate cable excursion and hook opening angle and the second test used force sensor to find out the force supplied at a different hook opening angle. The study found that the average cable excursion for both hooks is approximately 30% less than the hook's opening span with the force at the hook's tip section being inversely proportional to the force at the lateral section. Ottobock 10A18 has a better control for grasping larger objects, while Hosmer 99P has the highest average force at the tip section but yet less efficient in generating adequate force for activities of daily living. Favourable features identified are low cable excursion per hook opening span and balance lateral to hook tip pinch force.

Evaluation of Trigonella foenum-graecum extract in combination with swimming exercise compared to glibenclamide consumption on type 2 Diabetic rodents.

BACKGROUND/OBJECTIVE: The purpose of the present study was to evaluate the effect of fenugreek seed extract in combination with swimming exercise compared to glibenclamide consumption on type 2 diabetic rats. DESIGN: The acute toxicity test was carried out to choose the safe doses and identify the toxicity effects of the fenugreek seed extract. To investigate the hypoglycemic effect of the extract and its effect in combination with swimming training, 80 Wistar Kyoto male streptozotocin-induced diabetic rats were divided randomly into eight groups: diabetic control (C); fenugreek seed extract 0.8 g/kg (F1); fenugreek extract 1.6 g/kg (F2); swimming training (S); swimming training plus fenugreek extract 0.8 g/kg (SF1); swimming training plus fenugreek extract 1.6 g/kg (SF2); glibenclamide (G) and swimming training plus glibenclamide (SG). The rats were orally administrated with the treatments once a day with the respective treatment, and the training groups were subjected to swimming training every day for 60 min. Fasting blood samples were collected to measure fasting blood glucose, lipid profile, adiponectin, leptin, and insulin concentrations. RESULTS: The results obtained from acute toxicity study showed no toxicity effect of fenugreek seed extract on the tested dose. Biochemical analysis showed significant improvements in all of the groups compared to the control group (p<0.05). Plasma insulin concentration and insulin resistance (HOMA-IR) was significantly reduced in treated groups compared with the diabetic control group. Plasma leptin were significantly decreased in treated groups compared with the control group; while adiponectin had markedly increased (p<0.05). CONCLUSION: The findings suggest that fenugreek seed consuming, alongside swimming exercise, has a strong therapeutic effect on the improvement of diabetic parameters.

In Vitro Study of Surface Modified Poly(ethylene glycol)-Impregnated Sintered Bovine Bone Scaffolds on Human Fibroblast Cells.

Scaffold design from xenogeneic bone has the potential for tissue engineering (TE). However, major difficulties impede this potential, such as the wide range of properties in natural bone. In this study, sintered cortical bones from different parts of a bovine-femur impregnated with biodegradable poly(ethylene glycol) (PEG) binder by liquid phase adsorption were investigated. Flexural mechanical properties of the PEG-treated scaffolds showed that the scaffold is stiffer and stronger at a sintering condition of 1000°C compared with 900°C. In vitro cytotoxicity of the scaffolds evaluated by Alamar Blue assay and microscopic tests on human fibroblast cells is better at 1000°C compared with that at 900°C. Furthermore, in vitro biocompatibility and flexural property of scaffolds derived from different parts of a femur depend on morphology and heat-treatment condition. Therefore, the fabricated scaffolds from the distal and proximal parts at 1000°C are potential candidates for hard and soft TE applications, respectively.

A review on powder-based additive manufacturing for tissue engineering: selective laser sintering and inkjet 3D printing.

Since most starting materials for tissue engineering are in powder form, using powder-based additive manufacturing methods is attractive and practical. The principal point of employing additive manufacturing (AM) systems is to fabricate parts with arbitrary geometrical complexity with relatively minimal tooling cost and time. Selective laser sintering (SLS) and inkjet 3D printing (3DP) are two powerful and versatile AM techniques which are applicable to powder-based material systems. Hence, the latest state of knowledge available on the use of AM powder-based techniques in tissue engineering and their effect on mechanical and biological properties of fabricated tissues and scaffolds must be updated. Determining the effective setup of parameters, developing improved biocompatible/bioactive materials, and improving the mechanical/biological properties of laser sintered and 3D printed tissues are the three main concerns which have been investigated in this article.

Role of morphological structure, doping, and coating of different materials in the sensing characteristics of humidity sensors.

The humidity sensing characteristics of different sensing materials are important properties in order to monitor different products or events in a wide range of industrial sectors, research and development laboratories as well as daily life. The primary aim of this study is to compare the sensing characteristics, including impedance or resistance, capacitance, hysteresis, recovery and response times, and stability with respect to relative humidity, frequency, and temperature, of different materials. Various materials, including ceramics, semiconductors, and polymers, used for sensing relative humidity have been reviewed. Correlations of the different electrical characteristics of different doped sensor materials as the most unique feature of a material have been noted. The electrical properties of different sensor materials are found to change significantly with the morphological changes, doping concentration of different materials and film thickness of the substrate. Various applications and scopes are pointed out in the review article. We extensively reviewed almost all main kinds of relative humidity sensors and how their electrical characteristics vary with different doping concentrations, film thickness and basic sensing materials. Based on statistical tests, the zinc oxide-based sensing material is best for humidity sensor design since it shows extremely low hysteresis loss, minimum response and recovery times and excellent stability.

Mechanical and in vitro biological performance of graphene nanoplatelets reinforced calcium silicate composite.

Calcium silicate (CaSiO3, CS) ceramic composites reinforced with graphene nanoplatelets (GNP) were prepared using hot isostatic pressing (HIP) at 1150°C. Quantitative microstructural analysis suggests that GNP play a role in grain size and is responsible for the improved densification. Raman spectroscopy and scanning electron microscopy showed that GNP survived the harsh processing conditions of the selected HIP processing parameters. The uniform distribution of 1 wt.% GNP in the CS matrix, high densification and fine CS grain size help to improve the fracture toughness by ∼130%, hardness by ∼30% and brittleness index by ∼40% as compared to the CS matrix without GNP. The toughening mechanisms, such as crack bridging, pull-out, branching and deflection induced by GNP are observed and discussed. The GNP/CS composites exhibit good apatite-forming ability in the simulated body fluid (SBF). Our results indicate that the addition of GNP decreased pH value in SBF. Effect of addition of GNP on early adhesion and proliferation of human osteoblast cells (hFOB) was measured in vitro. The GNP/CS composites showed good biocompatibility and promoted cell viability and cell proliferation. The results indicated that the cell viability and proliferation are affected by time and concentration of GNP in the CS matrix.

Prosthetics socket that incorporates an air splint system focusing on dynamic interface pressure.

BACKGROUND: The interface pressure between the residual limb and prosthetic socket has a significant effect on an amputee's satisfaction and comfort. This paper presents the design and performance of a new prosthetic socket that uses an air splint system. METHODS: The air splint prosthetic socket system was implemented by combining the air splint with a pressure sensor that the transhumeral user controls through the use of a microcontroller. The modular construction of the system developed allows the FSR pressure sensors that are placed inside the air splint socket to determine the required size and fitting for the socket used. Fifteen transhumeral amputees participated in the study. RESULTS: The subject's dynamic pressure on the socket that's applied while wearing the air splint systems was recorded using F-socket transducers and microcontroller analysis. The values collected by the F-socket sensor for the air splint prosthetic socket system were determined accordingly by comparing the dynamic pressure applied using statically socket. The pressure volume of the air splint fluctuated and was recorded at an average of 38 kPa (2.5) to 41 kPa (1.3) over three hours. CONCLUSION: The air splint socket might reduce the pressure within the interface of residual limb. This is particularly important during the daily life activities and may reduce the pain and discomfort at the residual limb in comparison to the static socket. The potential development of an auto-adjusted socket that uses an air splint system as the prosthetic socket will be of interest to researchers involved in rehabilitation engineering, prosthetics and orthotics.

Clinical implication of interface pressure for a new prosthetic suspension system.

BACKGROUND: Prosthesis suspension systems can alter the distribution of pressure within the prosthetic socket. This study evaluates a new suspension system for lower limb prostheses, and aims to compare the interface pressure and amputees' satisfaction with the new system compared with a common prosthetic suspension system (pin/lock). METHODS: Ten transtibial amputees walked at a self-selected speed on a level ground with two different suspension systems, namely the pin/lock and HOLO system. The interface pressure was measured using the F-socket transducers at the proximal, middle and distal sites of residual limb. Furthermore, subjective feedback was logged to compare two systems. RESULTS: The pressure was significantly higher at the proximal and distal areas with the pin/lock suspension system during the swing phase of gait (P<0.05). Subjective feedback also showed traction at the stump with the pin/lock system. There were no significant differences in the pressure applied to the mid-anterior and mid posterior stump for both suspension systems. However, the lateral and medial sides exhibited higher pressure with the new system during stance phase. CONCLUSIONS: The intention of this study was to deepen understanding on the effect of suspension system on the load distribution over the residual limb. The new coupling system was proved compatible with the pin/lock system in terms of suspending the leg and amputee's satisfaction. On the other hand, the HOLO system could distribute the pressure more uniformly over the residual limb.

Synthesis, mechanical properties, and in vitro biocompatibility with osteoblasts of calcium silicate-reduced graphene oxide composites.

Calcium silicate (CaSiO3, CS) ceramics are promising bioactive materials for bone tissue engineering, particularly for bone repair. However, the low toughness of CS limits its application in load-bearing conditions. Recent findings indicating the promising biocompatibility of graphene imply that graphene can be used as an additive to improve the mechanical properties of composites. Here, we report a simple method for the synthesis of calcium silicate/reduced graphene oxide (CS/rGO) composites using a hydrothermal approach followed by hot isostatic pressing (HIP). Adding rGO to pure CS increased the hardness of the material by ∼40%, the elastic modulus by ∼52%, and the fracture toughness by ∼123%. Different toughening mechanisms were observed including crack bridging, crack branching, crack deflection, and rGO pull-out, thus increasing the resistance to crack propagation and leading to a considerable improvement in the fracture toughness of the composites. The formation of bone-like apatite on a range of CS/rGO composites with rGO weight percentages ranging from 0 to 1.5 has been investigated in simulated body fluid (SBF). The presence of a bone-like apatite layer on the composite surface after soaking in SBF was demonstrated by X-ray diffraction (XRD) and field emission scanning electron microscopy (FESEM). The biocompatibility of the CS/rGO composites was characterized using methyl thiazole tetrazolium (MTT) assays in vitro. The cell adhesion results showed that human osteoblast cells (hFOB) can adhere to and develop on the CS/rGO composites. In addition, the proliferation rate and alkaline phosphatase (ALP) activity of cells on the CS/rGO composites were improved compared with the pure CS ceramics. These results suggest that calcium silicate/reduced graphene oxide composites are promising materials for biomedical applications.

Facile synthesis of calcium silicate hydrate using sodium dodecyl sulfate as a surfactant assisted by ultrasonic irradiation.

Calcium silicate hydrate (CSH) consisting of nanosheets has been successfully synthesized assisted by a tip ultrasonic irradiation (UI) method using calcium nitrate (Ca(NO3)·4H2O), sodium silicate (Na2SiO3·9H2O) and sodium dodecyl sulfate (SDS) in water. Systematic studies found that reaction time of ultrasonic irradiation and concentrations of surfactant (SDS) in the system were important factors to control the crystallite size and morphologies. The products were characterized by X-ray power diffraction (XRD), field emission scanning electron microscopy (FESEM) and Fourier transform infrared spectrometry (FTIR). The size-strain plot (SSP) method was used to study the individual contributions of crystallite sizes and lattice strain on the peak broadening of the CSH. These characterization techniques revealed the successful formation of a crystalline phase with an average crystallite size of about 13 nm and nanosheet morphology at a reaction time of 10 min UI with 0.2 g SDS in solvent which were found to be optimum time and concentrations of SDS for the synthesis of CSH powders.

Wear Debris Characterization and Corresponding Biological Response: Artificial Hip and Knee Joints.

Wear debris, of deferent sizes, shapes and quantities, generated in artificial hip and knees is largely confined to the bone and joint interface. This debris interacts with periprosthetic tissue and may cause aseptic loosening. The purpose of this review is to summarize and collate findings of the recent demonstrations on debris characterization and their biological response that influences the occurrence in implant migration. A systematic review of peer-reviewed literature is performed, based on inclusion and exclusion criteria addressing mainly debris isolation, characterization, and biologic responses. Results show that debris characterization largely depends on their appropriate and accurate isolation protocol. The particles are found to be non-uniform in size and non-homogeneously distributed into the periprosthetic tissues. In addition, the sizes, shapes, and volumes of the particles are influenced by the types of joints, bearing geometry, material combination, and lubricant. Phagocytosis of wear debris is size dependent; high doses of submicron-sized particles induce significant level of secretion of bone resorbing factors. However, articles on wear debris from engineered surfaces (patterned and coated) are lacking. The findings suggest considering debris morphology as an important parameter to evaluate joint simulator and newly developed implant materials.

100 top-cited scientific papers in limb prosthetics.

Research has tremendously contributed to the developments in both practical and fundamental aspects of limb prosthetics. These advancements are reflected in scientific articles, particularly in the most cited papers. This article aimed to identify the 100 top-cited articles in the field of limb prosthetics and to investigate their main characteristics. Articles related to the field of limb prosthetics and published in the Web of Knowledge database of the Institute for Scientific Information (ISI) from the period of 1980 to 2012. The 100 most cited articles in limb prosthetics were selected based on the citation index report. All types of articles except for proceedings and letters were included in the study. The study design and level of evidence were determined using Sackett's initial rules of evidence. The level of evidence was categorized either as a systematic review or meta-analysis, randomized controlled trial, cohort study, case-control study, case series, expert opinion, or design and development. The top cited articles in prosthetics were published from 1980 to 2012 with a citation range of 11 to 90 times since publication. The mean citation rate was 24.43 (SD 16.7) times. Eighty-four percent of the articles were original publications and were most commonly prospective (76%) and case series studies (67%) that used human subjects (96%) providing level 4 evidence. Among the various fields, rehabilitation (47%), orthopedics (29%), and sport sciences (28%) were the most common fields of study. The study established that studies conducted in North America and were written in English had the highest citations. Top cited articles primarily dealt with lower limb prosthetics, specifically, on transtibial and transradial prosthetic limbs. Majority of the articles were experimental studies.

The capability of fiber Bragg grating sensors to measure amputees' trans-tibial stump/socket interface pressures.

This study presents the first investigation into the capability of fiber Bragg grating (FBG) sensors to measure interface pressure between the stump and the prosthetic sockets of a trans-tibial amputee. FBG element(s) were recoated with and embedded in a thin layer of epoxy material to form a sensing pad, which was in turn embedded in a silicone polymer material to form a pressure sensor. The sensor was tested in real time by inserting a heavy-duty balloon into the socket and inflating it by using an air compressor. This test was conducted to examine the sensitivity and repeatability of the sensor when subjected to pressure from the stump of the trans-tibial amputee and to mimic the actual environment of the amputee's Patellar Tendon (PT) bar. The sensor exhibited a sensitivity of 127 pm/N and a maximum FSO hysteresis of around ~0.09 in real-time operation. Very good reliability was achieved when the sensor was utilized for in situ measurements. This study may lead to smart FBG-based amputee stump/socket structures for pressure monitoring in amputee socket systems, which will result in better-designed prosthetic sockets that ensure improved patient satisfaction.

Development and evaluation of new coupling system for lower limb prostheses with acoustic alarm system.

Individuals with lower limb amputation need a secure suspension system for their prosthetic devices. A new coupling system was developed that is capable of suspending the prosthesis. The system's safety is ensured through an acoustic alarm system. This article explains how the system works and provides an in vivo evaluation of the device with regard to pistoning during walking. The system was designed to be used with silicone liners and is based on the requirements of prosthetic suspension systems. Mechanical testing was performed using a universal testing machine. The pistoning during walking was measured using a motion analysis system. The new coupling device produced significantly less pistoning compared to a common suspension system (pin/lock). The safety alarm system would buzz if the suspension was going to fail. The new coupling system could securely suspend the prostheses in transtibial amputees and produced less vertical movement than the pin/lock system.

Dental implants from functionally graded materials.

Functionally graded material (FGM) is a heterogeneous composite material including a number of constituents that exhibit a compositional gradient from one surface of the material to the other subsequently, resulting in a material with continuously varying properties in the thickness direction. FGMs are gaining attention for biomedical applications, especially for implants, owing to their reported superior composition. Dental implants can be functionally graded to create an optimized mechanical behavior and achieve the intended biocompatibility and osseointegration improvement. This review presents a comprehensive summary of biomaterials and manufacturing techniques researchers employ throughout the world. Generally, FGM and FGM porous biomaterials are more difficult to fabricate than uniform or homogenous biomaterials. Therefore, our discussion is intended to give the readers about successful and obstacles fabrication of FGM and porous FGM in dental implants that will bring state-of-the-art technology to the bedside and develop quality of life and present standards of care.

Development of a micro-gripper using piezoelectric bimorphs.

Piezoelectric bimorphs have been used as a micro-gripper in many applications, but the system might be complex and the response performance might not have been fully characterized. In this study the dynamic characteristics of bending piezoelectric bimorphs actuators were theoretically and experimentally investigated for micro-gripping applications in terms of deflection along the length, transient response, and frequency response with varying driving voltages and driving signals. In addition, the implementation of a parallel micro-gripper using bending piezoelectric bimorphs was presented. Both fingers were actuated separately to perform mini object handling. The bending piezoelectric bimorphs were fixed as cantilevers and individually driven using a high voltage amplifier and the bimorph deflection was measured using a non contact proximity sensor attached at the tip of one finger. The micro-gripper could perform precise micro-manipulation tasks and could handle objects down to 50 µm in size. This eliminates the need for external actuator extension of the microgripper as the grasping action was achieved directly with the piezoelectric bimorph, thus minimizing the weight and the complexity of the micro-gripper.