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Additive manufacturing (AM) is a technique that progressively deposits material in layer-by-layer manner (or in additive fashion) for producing a three-dimensional (3D) object, starting from the computer-aided design (CAD) model. This approach allows for the printing of complicated shaped objects and is quickly gaining traction in the aerospace, medical implant, jewelry, footwear, automotive, and fashion industries. AM, which was formerly used for single part customization, is currently being considered for mass customization of parts because of its positive impacts. However, part quality and build time are two main impediments to the deployment of AM for mass production. The optimal part orientation is fundamental for maximizing the part’s quality as well as being critical for reducing the fabrication time. This research provides a new method for multi-part AM production that improves quality while reducing overall build time. The automatic setup planning or orientation approach described in this paper employs two objective functions: the quality of the build component and the build time. To tackle the given problem, it introduces a three-step genetic algorithm (GA)-based solution. A feature-based technique is utilized to generate a collection of finite alternative orientations for each component within a specific part group to ensure each part’s individual build quality. Then, a GA was utilized to find the best combination of part build orientations at a global optimal level to reduce material consumption and build time. A case study of orienting nine components concurrently inside a given building chamber was provided for illustration. The findings suggest that the developed technique can increase quality, reduce support waste, and shorten overall production time. When components are positioned optimally rather than in random orientations, build time and support volume are reduced by approximately 7% and 16%, respectively.

Electrochemical micromachining (EMM) is a plausible method for manufacturing high accuracy and precision microscale components in a broad range of materials. EMM is commonly utilized to manufacture turbine blades for automobiles and aircrafts. In this present study, the EMM process was performed with a heat-treated copper tool electrode on aluminum 8011 alloy. The process parameters such as voltage, concentration of electrolyte, frequency, and duty factor were varied to analyze the effect of a heat-treated electrode on material removal rate (MRR), overcut, conicity, and circularity. It was observed that high MRR was obtained with lower overcut with an annealed electrode. The better conicity and circularity were obtained with a quenched electrode compared to other heat-treated and untreated tool electrodes. The artificial bee’s colony (ABC) algorithm was used to identify the optimum parameters and, finally, the confirmation test was carried out to evaluate the error difference on the machining process. The optimum combination of input process parameters found using TOPSIS and ABC algorithm for the EMM process are voltage (14 V), electrolyte concentration (30 g/L), frequency (60 Hz), and duty cycle (33%) for the annealed tool electrode and voltage (14 V), electrolyte concentration (20 g/L), frequency (70 Hz), and duty cycle (33%) for the quenched tool electrode. It was confirmed that 95% of accurate response values were proven under the optimum parameter combination.

The performance of a self-propelled rotary carbide tool when cutting hardened steel is evaluated in this study. Although various models for evaluating tool wear in traditional (fixed) tools have been introduced and deployed, there have been no efforts in the existing literature to predict the progression of tool wear while employing self-propelled rotary tools. The work-tool geometric relationship and the empirical function are used to build a flank wear model for self-propelled rotary cutting tools. Cutting experiments are conducted on AISI 4340 steel, which has a hardness of 54–56 HRC, at various cutting speeds and feeds. The rate of tool wear is measured at various intervals of time. The constant in the proposed model is obtained using genetic programming. When experimental and predicted flank wear are examined, the established model is found to be competent in estimating the rate of rotary tool flank wear progression.

Implants are the most popular option for restoring the facial anatomy in the event of a mishap. The commercially available craniofacial implants are of standard shapes, which need to be tailored and shaped to accurately fit the patient’s anatomy. The manual shaping of the implant to match the bone contours is conducted during surgical operation, and is a cumbersome and inaccurate process. Recent breakthroughs in computer-aided design, analysis, and additive manufacturing (AM) have allowed the precise and rapid manufacture of bespoke scaffolds for difficult anatomical restoration. The goal of this research is to investigate the use of scaffolds for craniofacial reconstruction and their fabrication using electron-beam additive manufacturing (EBAM). Personalized cheekbone scaffolds are additively fabricated using Ti6Al4V and subjected to compression testing. Finally, the scaffold design with the highest compressive strength is subjected to biomechanical analysis. The biomechanical analysis results indicate that the maximum Von Mises stress (40 MPa) and equivalent strain (0.4 µm) are significantly low in magnitude, thus providing a desirable implant that is both flexible and stable. The custom-designed cheekbone scaffold manufactured with AM technology not only aids in bone-implant ingrowth but also helps in reducing implant weight and ensuring implant stability and long-term effectiveness.

The rehabilitation of the skull’s bones is a difficult process that poses a challenge to the surgical team. Due to the range of design methods and the availability of materials, the main concerns are the implant design and material selection. Mirror-image reconstruction is one of the widely used implant reconstruction techniques, but it is not a feasible option in asymmetrical regions. The ideal design approach and material should result in an implant outcome that is compact, easy to fit, resilient, and provides the perfect aesthetic and functional outcomes irrespective of the location. The design technique for the making of the personalized implant must be easy to use and independent of the defect’s position on the skull. As a result, this article proposes a hybrid system that incorporates computer tomography acquisition, an adaptive design (or modeling) scheme, computational analysis, and accuracy assessment. The newly developed hybrid approach aims to obtain ideal cranial implants that are unique to each patient and defect. Polyetheretherketone (PEEK) is chosen to fabricate the implant because it is a viable alternative to titanium implants for personalized implants, and because it is simpler to use, lighter, and sturdy enough to shield the brain. The aesthetic result or the fitting accuracy is adequate, with a maximum deviation of 0.59 mm in the outside direction. The results of the biomechanical analysis demonstrate that the maximum Von Mises stress (8.15 MPa), Von Mises strain (0.002), and deformation (0.18 mm) are all extremely low, and the factor of safety is reasonably high, highlighting the implant’s load resistance potential and safety under high loading. Moreover, the time it takes to develop an implant model for any cranial defect using the proposed modeling scheme is very fast, at around one hour. This study illustrates that the utilized 3D reconstruction method and PEEK material would minimize time-consuming alterations while also improving the implant’s fit, stability, and strength.

Titanium alloy is widely used for orthodontic technology and easily machined using the EDM process. In the EDM process, the workpiece and tool electrode must be separated by a continuous air gap during the machining operation to generate discharge energy in this method. In the present study, an endeavor was made to analyze the effects of a servo feed air gap control and tool electrode in the EDM process. The developed mechanical setup consists of a linear action movement with zero backlash along the X-axis, which can be controlled up to 0.03 mm. It was observed that the suggested air gap control scheme can enhance the servo feed mechanism on a machining titanium alloy. A tungsten carbide electrode can enhance the surface measures owing to its ability to produce tiny craters with uniform distribution. Since it produces a little crater and has a higher melting point, a tungsten carbide electrode can create lesser surface roughness than a copper tool and brass tool electrode.

Abstract DNA damage-specific histone chaperone Aprataxin PNK-like factor (APLF) regulates mesenchymal-to-epithelial transition (MET) during cellular reprogramming. We investigated the role of APLF in epithelial-to-mesenchymal transition (EMT) linked to breast cancer invasiveness and metastasis. Here, we show that a significant manifestation of APLF is present in tumor sections of patients with invasive ductal carcinoma when compared to their normal adjacent tissues. APLF was significantly induced in triple negative breast cancer (TNBC) cells, MDAMB-231, in comparison to invasive MCF7 or normal MCF10A breast cells and supported by studies on invasive breast carcinoma in The Cancer Genome Atlas (TCGA). Functionally, APLF downregulation inhibited proliferative capacity, altered cell cycle behavior, induced apoptosis and impaired DNA repair ability of MDAMB-231 cells. Reduction in APLF level impeded invasive, migratory, tumorigenic and metastatic potential of TNBC cells with loss in expression of genes associated with EMT while upregulation of MET-specific gene E-cadherin (CDH1). So, here we provided novel evidence for enrichment of APLF in breast tumors, which could regulate metastasis-associated EMT in invasive breast cancer. We anticipate that APLF could be exploited as a biomarker for breast tumors and additionally could be targeted in sensitizing cancer cells towards DNA damaging agents.

Background: Health-care professionals across the globe are obligated to report adverse drug reactions (ADRs). The knowledge of ADRs and attitude of health-care professionals toward ADRs reporting is vital for patient safety. This study intends to investigate the knowledge of ADRs and attitude of health-care professionals toward ADRs reporting. Materials and Methods: A cross-sectional study using an anonymous questionnaire was conducted over a period of 3 months (September 2016 to November 2016) at King Saud Medical City, Riyadh, Saudi Arabia. This study included 399 questionnaires submitted by health-care professionals. Results: A total of 399 questionnaires were submitted by health-care professionals, of which only 14.8% knew the term “ADR” and 55.1% of the respondents reported ADRs during their practice. A total of 93.8% of the respondents agreed that ADR reporting should be made mandatory for health-care professionals, and 94.5% agreed that it improves the patient safety. Conclusion: The findings generally indicate that health-care professionals in a tertiary care setting have low awareness regarding the term “ADR.” Lack of pharmacovigilance training, amount of workload, and legal liabilities are the main causes of underreporting. More than half of the respondents agreed that ADR reporting eventually improves patient safety.

Applications of non-ferrous light metal alloys are especially popular in the field of aerospace. Hence it is important to investigate their properties in joining processes such as welding. Solid state joining process such as friction stir welding (FSW) is quite efficient for joining non-ferrous alloys, but with thick plates, challenges increase. In this study, Mg alloy plates of thickness 11.5 mm were successfully welded via single-pass FSW. Due to the dynamic recrystallization, grain size in the stir zone was reduced to 16 µm which is ≈15 times smaller than the parent material. The optimized rotational speed and traverse speed for optimum weld integrity were found to be 710 rpm and 100 mm/min, respectively. A sound weld with 98.96% joint efficiency, having an Ultimate Tensile Strength (UTS) of 161.8 MPa and elongation of 27.83%, was accomplished. Microhardness of the nugget was increased by 14.3%.

The CO-selective methanation process is considered as a promising CO removal process for compact fuel processors producing hydrogen, since the process selectively converts the trace of CO in the hydrogen-rich gas into methane without additional reactants. Two different types of efficient nickel-based catalysts, showing high activity and selectivity to the CO methanation reaction, were developed in our previous works; therefore, the kinetic models of the reactions over these nickel-based catalysts have been investigated adopting the mechanistic kinetic models based on the Langmuir chemisorption theory. In the methanation process, the product species can react with the reactant and also affect the adsorption/desorption of the molecules at the active sites. Thus, the kinetic parameter study should be carried out by global optimization handling all the rate equations for the plausible reactions at once. To estimate the kinetic parameters, an effective optimization algorithm combining both heuristic and deterministic methods is used due to the large solution space and the nonlinearity of the objective function. As a result, 14 kinetic parameters for each catalyst have been determined and the parameter sets for the catalysts have been compared to understand the catalytic characteristics.

Friction stir alloying (FSA) of commercially pure Cu with Ni, Zn, and Mg is implemented in the current study. Mechanical and microstructural aspects of the successfully fabricated alloy structure have been examined. Energy dispersive X-ray spectroscopy revealed a uniform distribution of alloying elements and coalescence at the atomic level. The compositional and grain size heterogeneity is managed in the stir zone, allowing for microstructural control with FSA. Thus, the present study is essential for the development of novel materials whose fabrication requires temperature well below the melting point of base metals. The alloying process is found to be accompanied by ultra-refined grains, with the smallest grain size being ~0.44 μm. The fabricated alloy managed to retain the FCC phase, and no brittle intermetallic compounds formed, according to X-ray diffraction. The fabricated alloy exhibits maximum and average microhardness enhancements of 18.4% and 6%, respectively. Tensile properties have also been investigated and correlated with microstructural morphology. A shift toward grain bimodality has also been documented, which is a highly sought-after property nowadays, especially to overcome the strength-ductility trade-off.

Background: Reconstruction of customized cranial implants with a mesh structure using computer-assisted design and additive manufacturing improves the implant design, surgical planning, defect evaluation, implant-tissue interaction and surgeon's accuracy. The objective of this study is to design, develop and fabricate cranial implant with mechanical properties closer to that of bone and drastically decreases the implant failure and to improve the esthetic outcome in cranial surgery with precision fitting for a better quality of life. A customized cranial mesh implant is designed digitally, based on the Digital Imaging and Communication in Medicine files and fabricated using state of the Art-Electron Beam Melting an Additive Manufacturing technology. The EBM produced titanium implant was evaluated based on their mechanical strength and structural characterization. Results: The result shows, the produced mesh implants have a high permeability of bone ingrowth with its reduced weight and modulus of elasticity closer to that the natural bone thus reducing the stress shielding effect. Scanning electron microscope and micro-computed tomography (CT) scanning confirms, that the produced cranial implant has a highly regular pattern of the porous structure with interconnected channels without any internal defect and voids. Conclusions: The study reveals that the use of mesh implants in cranial reconstruction satisfies the need of lighter implants with an adequate mechanical strength, thus restoring better functionality and esthetic outcomes for the patients.

Glycosylation is a fundamental modification of proteins and membrane lipids. Toxins that utilize glycans as their receptors have served as powerful tools to identify key players in glycosylation processes. Here, we carried out Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-Cas9-mediated genome-wide loss-of-function screens using two related bacterial toxins, Shiga-like toxins (Stxs) 1 and 2, which use a specific glycolipid, globotriaosylceramide (Gb3), as receptors, and the plant toxin ricin, which recognizes a broad range of glycans. The Stxs screens identified major glycosyltransferases (GTs) and transporters involved in Gb3 biosynthesis, while the ricin screen identified GTs and transporters involved in N-linked protein glycosylation and fucosylation. The screens also identified lysosomal-associated protein transmembrane 4 alpha (LAPTM4A), a poorly characterized four-pass membrane protein, as a factor specifically required for Stxs. Mass spectrometry analysis of glycolipids and their precursors demonstrates that LAPTM4A knockout (KO) cells lack Gb3 biosynthesis. This requirement of LAPTM4A for Gb3 synthesis is not shared by its homolog lysosomal-associated protein transmembrane 4 beta (LAPTM4B), and switching the domains between them determined that the second luminal domain of LAPTM4A is required, potentially acting as a specific "activator" for the GT that synthesizes Gb3. These screens also revealed two Golgi proteins, Transmembrane protein 165 (TMEM165) and Transmembrane 9 superfamily member 2 (TM9SF2), as shared factors required for both Stxs and ricin. TMEM165 KO and TM9SF2 KO cells both showed a reduction in not only Gb3 but also other glycosphingolipids, suggesting that they are required for maintaining proper levels of glycosylation in general in the Golgi. In addition, TM9SF2 KO cells also showed defective endosomal trafficking. These studies reveal key Golgi proteins critical for regulating glycosylation and glycolipid synthesis and provide novel therapeutic targets for blocking Stxs and ricin toxicity.

Additive manufacturing (AM), particularly electron beam melting (EBM), is becoming increasingly common in the medical industry because of its remarkable benefits. The application of personalized titanium alloy implants produced using EBM has received considerable attention in recent times due to their simplicity and efficacy. However, these tailored implants are not cost-effective, placing a tremendous strain on the patient. The use of additional materials as support during the manufacturing process is one of the key causes of its high cost. A lot of research has been done to lessen the use of supports through various types of support designs. There is indeed a noticeable paucity of studies in the literature that have examined customized implants produced without or minimal supports. This research, therefore, reports on the investigation of cranial implants fabricated with and without supports. The two personalized implants are evaluated in terms of their cost, fabrication time, and accuracy. The study showed impressive results for cranial implants manufactured without supports that cost 39% less than the implants with supports. Similarly, the implant’s (without supports) build time was 18% less than its equivalent with supports. The two implants also demonstrated similar fitting accuracy with 0.2613 mm error in the instance of implant built without supports and 0.2544 mm for the implant with supports. The results indicate that cranial implants can be produced without EBM supports, which can minimize both production time and cost substantially. However, the manufacture of other complex implants without supports needs further study. The future study also requires a detailed review of the mechanical and structural characteristics of cranial implants built without supports.

Titanium alloy is widely used in modern automobile industries due to its higher strength with corrosion resistance. Such higher strength materials can be effectively machined using unconventional machining processes, especially the electro-chemical micro machining (ECMM) process. It is important to enhance the machining process by investigating the effects of electrolytes and process parameters in ECMM. The presented work describes the influence of three different combinations of Sodium Chloride-based electrolytes on machining Titanium (Ti-6Al-4V) alloy. Based on the ECMM process parameters such as applied voltage, electrolytic concentration, frequency and duty cycle on response, characteristics are determined by the Taguchi design of experiments. The highest material removal rate (MRR) was achieved by the Sodium Chloride and Sodium Nitrate electrolyte. The combination of Sodium Chloride and Citric Acid achieve highest Overcut and Circularity. The optimal overcut was observed from the Sodium Chloride and Glycerol electrolyte due to the presence of glycerol. The better conicity was obtained from Sodium Chloride and Citric Acid in comparison with other electrolytes. A Sodium Chloride and Glycerol combination could generate better machined surface owing to the chelating effect of Glycerol.

The machining of ceramic materials is challenging and often impossible to realize with conventional machining tools. In various manufacturing applications, rotary ultrasonic milling (RUM) shows strengths, in particular for the development of high-quality micro-features in ceramic materials. The main variables that influence the performance and price of the product are surface roughness, edge chipping (EC), and material removal rate (MRR) during the processing of ceramics. RUM has been considered in this research for the milling of micro-pockets in bioceramic alumina (Al2O3). Response surface methodology in the context of a central composite design (CCD) is being used to plan the experiments. The impacts of important RUM input parameters concerning cutting speed, feed rate, depth of cut, frequency, and amplitude have been explored on the surface roughness in terms of arithmetic mean value (Ra), the EC, and the MRR of the machined pockets. The main effect and the interaction effect of the implemented RUM parameters show that by providing a lower feed rate and cutting depth levels and elevated frequency and cutting speed, the Ra and the EC can be minimized. At greater levels of feed rate and cutting depth, higher MRR can be obtained. The influence of RUM input parameters on the surface morphology was also recorded and analyzed using scanning electron microscopic (SEM) images. The study of the energy dispersive spectroscopy (EDS) shows that there is no modification in the alumina bioceramic material. Additionally, a multi-response optimization method has been applied by employing a desirability approach with the core objectives of minimizing the EC and Ra and maximizing the MRR of the milled pockets. The obtained experimental values for Ra, EC, and MRR at an optimized parametric setting were 0.301 µm, 12.45 µm, and 0.873 mm3/min respectively with a combined desirability index value of 0.73.

Technological advancements in healthcare influence medical practitioners as much as they impact the routine lives of the patients. The mandible reconstruction, which constitutes an important branch in facioplasty, has been a challenging task for medical professionals. As part of scientific innovation, tailor-made implants are valuable for sustaining and regenerating facial anatomy, as well as preserving the natural appearance. The challenge of choosing an acceptable implant design is a tedious process due to the growing number of designs with conspicuous effectiveness. The design should be agreeable, easy-to-design, sustainable, cost-effective, and undemanding for manufacturing. The optimal implant design can efficiently and effectively recover the structure and morphology of the flawed region. Evidently, among the many variants, the choice of appropriate design is one of the prevalent implant design problems and is still under consideration in most studies. This work is focused on the multiattribute decision-making (MCDM) approach to choosing the most effective implant design. The prevalence of subjectivity in decision-making and the presence of inconsistency from multiple sources emphasize the strategies that must take ambiguity and vagueness into account. An integrated MCDM methodology, assimilating two modern and popular techniques is adopted in this work. The preferred approach implements the Fuzzy Analytical Hierarchy Process based on the trapezoidal fuzzy number to extract the criteria weights in decision mapping and the Technique for Order of Preference by Similarity to Ideal Solution and VIKOR to assess design choices. A two-stage mechanism is the cornerstone of the established methodology. The first stage analyses the criteria from the point of view of the designer, the context of fabrication, and consumer experience. The second stage identifies the most viable and feasible design. The procedure applied in this analysis can be considered to choose the optimal implant design and to decide on areas of improvement that ensure greater patient experience.

This paper presents a model for assessing the performance of self-propelled rotary tool during the processing of hardened steel. A finite element (FE) model has been proposed in this analysis to study the hard turning of AISI 51200 hardened steel using a self-propelled rotary cutting tool. The model is developed by utilizing the explicit coupled temperature displacement analysis in the presence of realistic boundary conditions. This model does not take into account any assumptions regarding the heat partitioning and the tool-workpiece contact area. The model can predict the cutting forces, chip flow, induced stresses, and the generated temperature on the cutting tool and the workpiece. The nodal temperatures and heat flux data from the chip formation analysis are used to achieve steady-state temperatures on the cutting tool in the heat transfer analysis. The model outcomes are compared with reported experimental data and a good agreement has been found.

Titanium-aluminium-vanadium (Ti 6Al 4V) alloys, nickel alloys (Inconel 718), and duraluminum alloys (AA 2000 series) are widely used materials in numerous engineering applications wherein machined features are required to having good surface finish. In this research, micro-impressions of 12 µm depth are milled on these materials though laser milling. Response surface methodology based design of experiment is followed resulting in 54 experiments per work material. Five laser parameters are considered naming lamp current intensity (I), pulse frequency (f), scanning speed (V), layer thickness (LT), and track displacement (TD). Process performance is evaluated and compared in terms of surface roughness through several statistical and microscopic analysis. The significance, strength, and direction of each of the five laser parametric effects are deeply investigated for the said alloys. Optimized laser parameters are proposed to achieve minimum surface roughness. For the optimized combination of laser parameters to achieve minimum surface roughness (Ra) in the titanium alloy, the said alloy consists of I = 85%, f = 20 kHz, V = 250 mm/s, TD = 11 µm, and LT = 3 µm. Similarly, optimized parameters for nickel alloy are as follows: I = 85%, f = 20 kHz, V = 256 mm/s, TD = 8 µm, and LT = 1 µm. Minimum roughness (Ra) on the surface of aluminum alloys can be achieved under the following optimized parameters: I = 75%, f = 20 kHz, V = 200 mm/s, TD = 12 µm, and LT = 3 µm. Micro-impressions produced under optimized parameters have surface roughness of 0.56 µm, 2.46 µm, and 0.54 µm on titanium alloy, nickel alloy, and duralumin, respectively. Some engineering applications need to have high surface roughness (e.g., in case of biomedical implants) or some desired level of roughness. Therefore, validated statistical models are presented to estimate the desired level of roughness against any laser parametric settings.

During the survey (2011–2014) and documentation of foliicolous fungi of Pasra forest localities of Eturnagaram Wildlife Sanctuary, a black mildew fungus infected leaves of Hardwickia binata Roxb.(Fabaceae) were collected. A critical microscopic examination revealed that it as an undescribed species of the genus Sarcinella.

Mandibular reconstruction is a complicated task because of the complex nature of the regional anatomy. Computer-assisted tools are a promising means of improving the precision and safety of such complex surgeries. The digital techniques utilized in the reconstruction of mandibular defects based on medical data, computer-aided-design approaches, and three-dimensional (3D) printing are widely used to improve the patient’s aesthetic appearance and function, as well as the accuracy and quality of diagnosis, and surgical outcomes. Nevertheless, to ensure an acceptable aesthetical appearance and functional outcomes, the design must be based on proper anatomical reconstruction, mostly done in a virtual environment by skilled design engineers. Mirroring is one of the widely used techniques in the surgical navigation and reconstruction of mandibular defects. However, there are some discrepancies and mismatches in the mirrored anatomical models. Hence, in order to overcome these limitations in the mirroring technique, a novel approach called the cavity-filled technique was introduced. The objective of this study was to compare the accuracy of the newly recommended cavity-filled technique with the widely used mirror reconstruction technique in restoring mandibular defects. A prominent 3D comparison technique was employed in this work, where the resected and the reconstructed mandibles were superimposed to quantify the accuracy of the two techniques. From the analysis, it can be inferred that the cavity-filled technique with a root-mean-square value of 1.1019 mm produced better accuracy in contrast to the mirroring approach, which resulted in an error of 1.2683 mm. Consequently, by using the proposed cavity-filled design, the discrepancy between the reconstruction plate and the bone contour was mitigated. This method, owing to its high precision, can decrease the number of adjustments and the time of surgery, as well as ensure a quick recovery time with better implant tissue in-growth.

Micromachining has gained considerable interest across a wide range of applications. It ensures the production of microfeatures such as microchannels, micropockets, etc. Typically, the manufacturing of microchannels in bioceramics is a demanding task. The ubiquitous technologies, laser beam machining (LBM) and rotary ultrasonic machining (RUM), have tremendous potential. However, again, these machining methods do have inherent problems. LBM has issues concerning thermal damage, high surface roughness, and vulnerable dimensional accuracy. Likewise, RUM is associated with high machining costs and low material-removal rates. To overcome their limits, a synthesis of LBM and RUM processes known as laser rotary ultrasonic machining (LRUM) has been conceived. The bioceramic known as biolox forte was utilized in this investigation. The approach encompasses the exploratory study of the effects of fundamental input process parameters of LBM and RUM on the surface quality, machining time, and dimensional accuracy of the manufactured microchannels. The performance of LRUM was analyzed and the mechanism of LRUM tool wear was also investigated. The results revealed that the surface roughness, depth error, and width error is decreased by 88%, 70%, and 80% respectively in the LRUM process. Moreover, the machining time of LRUM is reduced by 85%.

A real-time roundabout detection and navigation system for smart vehicles and cities using laser simulator–fuzzy logic algorithms and sensor fusion in a road environment is presented in this paper. A wheeled mobile robot (WMR) is supposed to navigate autonomously on the road in real-time and reach a predefined goal while discovering and detecting the road roundabout. A complete modeling and path planning of the road’s roundabout intersection was derived to enable the WMR to navigate autonomously in indoor and outdoor terrains. A new algorithm, called Laser Simulator, has been introduced to detect various entities in a road roundabout setting, which is later integrated with fuzzy logic algorithm for making the right decision about the existence of the roundabout. The sensor fusion process involving the use of a Wi-Fi camera, laser range finder, and odometry was implemented to generate the robot’s path planning and localization within the road environment. The local maps were built using the extracted data from the camera and laser range finder to estimate the road parameters such as road width, side curbs, and roundabout center, all in two-dimensional space. The path generation algorithm was fully derived within the local maps and tested with a WMR platform in real-time.

The surface measures of machined titanium alloys as dental materials can be enhanced by adopting a decision-making algorithm in the machining process. The surface quality is normally characterized by more than one quality parameter. Hence, it is very important to establish multi-criteria decision making to compute the optimal process factors. In the present study, Taguchi−Grey analysis-based criteria decision making has been applied to the input process factors in the wire EDM (electric discharge machining) process. The recast layer thickness, wire wear ratio and micro hardness have been chosen to evaluate the quality measures. It was found that the wire electrode selection was the most influential factor on the quality measures in the WEDM process, due to its significance in creating spark energy. The optimal arrangement of the input process parameters has been found using the proposed approach as gap voltage (70 V), discharge current (15 A) and duty factor (0.6). It was proved that the proposed method can enhance the efficacy of the process. Utilizing the computed combination of optimal process parameters in surface quality analysis has significantly contributed to improving the quality of machining surface.

Report of a case, initially diagnosed as Anorexia Nervosa (AN) but later on revealing a fourth Ventricular Tumor is presented. Relevant literature is surveyed while drawing attention to the unusual location of the tumor, instead of hypothalamic area as customarily reported. Several years of duration between initial appearance of clinical signs and symptoms and discovery of the tumor require emphasizing the need to keep the diagnosis tentative and not to hesitate in following up any clues pointing to a probable organic base. [ABSTRACT FROM AUTHOR]

Reconstruction of zygomatic complex defects is a surgical challenge, owing to the accurate restoration of structural symmetry as well as facial projection. Generally, there are many available techniques for zygomatic reconstruction, but they hardly achieve aesthetic and functional properties. To our knowledge, there is no such study on zygomatic titanium bone reconstruction, which involves the complete steps from patient computed tomography scan to the fabrication of titanium zygomatic implant and evaluation of implant accuracy. The objective of this study is to propose an integrated system methodology for the reconstruction of complex zygomatic bony defects using titanium comprising several steps, right from the patient scan to implant fabrication while maintaining proper aesthetic and facial symmetry. The integrated system methodology involves computer-assisted implant design based on the patient computed tomography data, the implant fitting accuracy using three-dimensional comparison techniques, finite element analysis to investigate the biomechanical behavior under loading conditions, and finally titanium fabrication of the zygomatic implant using state-of-the-art electron beam melting technology. The resulting titanium implant has a superior aesthetic appearance and preferable biocompatibility. The customized mirrored implant accurately fit on the defective area and restored the tumor region with inconsequential inconsistency. Moreover, the outcome from the two-dimensional analysis provided a good accuracy within 2 mm as established through physical prototyping. Thus, the designed implant produced faultless fitting, favorable symmetry, and satisfying aesthetics. The simulation results also demonstrated the load resistant ability of the implant with max stress within 1.76 MPa. Certainly, the mirrored and electron beam melted titanium implant can be considered as the practical alternative for a bone substitute of complex zygomatic reconstruction.

Cerebral venous thrombosis (CVT) is a rare complication of lumbar puncture. Occasionally, the clinical picture of CVT may mimic post-dural puncture headache (PDPH) resulting in delayed diagnosis. A case of PDPH progressing to CVT is presented and the pathophysiology, diagnostic challenges and management options discussed in this article.

The use of additive manufacturing in medical applications has become more prevalent over the last decade. Studies have proved that reconstruction plates with a mesh structure enhance the biocompatibility and bone-ingrowth formation. However, limited studies have been reported in the customization and in vivo clinical assessment of mesh implants. The purpose of this study was to investigate the surgical treatment and implant fitting accuracy using three different reconstruction plates. Fifteen goats were divided into one control and three experimental groups (Groups 1, 2, and 3) with five in each group. An experimental segmental defect was created on these animals and was adopted with customized electron beam melting reconstruction titanium plates with mesh in Group 1 and without mesh in Group 2 and commercial reconstruction plate in Group 3. All the animals were subjected to radiographic analysis before and after surgery. The subjected animals were sacrificed after 3 months and the electron beam melting reconstruction plates were compared with the commercial plate based on clinical and histology analysis and implant fitting accuracy. Both the electron beam melting reconstruction plates (with mesh and without mesh) and commercial plates survived the three months post-operation, revealing good wound-healing with new bone formation and without any foreign-body reaction. The electron beam melting reconstructed plate with mesh (Group 1) was found to have a better implant fitting when compared to the other two groups. The average discrepancy between Groups 2 and 3 was not significant. Certainly, the commercial plate (Group 3) was found to have the least accuracy as compared to other electron beam melting reconstruction plates (Group 1 and Group 2). Custom design electron beam melting fabricated reconstruction plates possessed better functionality, aesthetic outcome, and long-term biocompatibility when compared to commercial plates. Animal results indicated that the electron beam melting plates with mesh (Group 1) were superior in comparison to the other two groups due to its ability to provide better bone-in-growth and osseointegration on its porous microstructure.

Electron beam melting (EBM) technology is a novel additive manufacturing (AM) technique, which uses computer controlled electron beams to create fully dense three-dimensional objects from metal powder. It gives the ability to produce any complex parts directly from a computer aided design (CAD) model without tools and dies, and with variety of materials. However, it is reported that EBM has limitations in building overhang structures, due to the poor thermal conductivity for the sintered powder particles under overhang surfaces. In the current study, 2D thermo-mechanical finite element models (FEM) are developed to predict the stresses and deformation associated with fabrication of overhang structures by EBM for Ti-6Al-4V alloy. Different support structure geometries are modeled and evaluated. Finally, the numerical results are validated by experimental work.

A custom made implant is critical in cranioplasty to cushion and restore intracranial anatomy, as well as to recover the appearance and attain cognitive stability in the patient. The utilization of customized titanium alloy implants using three-dimensional (3D) reconstruction technique and fabricated using Electron Beam Melting (EBM) has gained significant recognition in recent years, owing to their convenience and effectiveness. Besides, the conventional technique or the extant practice of transforming the standard plates is unreliable, arduous and tedious. As a result, this work aims to produce a customized cranial implant using 3D reconstruction that is reliable in terms of fitting accuracy, appearance, mechanical strength, and consistent material composition. A well-defined methodology initiating from EBM fabrication to final validation has been outlined in this work. The custom design of the implant was carried out by mirror reconstruction of the skull’s defective region, acquired through computer tomography. The design of the customized implant was then analyzed for mechanical stresses by applying finite element analysis. Consequently, the 3D model of the implant was fabricated from Ti6Al4V ELI powder with a thickness of ≃1.76−2 mm. Different tests were employed to evaluate the bio-mechanical stability and strength of the fabricated customized implant design. A 3D comparison study was performed to ensure there was anatomical accuracy, as well as to maintain gratifying aesthetics. The bio-mechanical analysis results revealed that the maximum Von Mises stress (2.5 MPa), strain distribution (1.49 × 10−4) and deformation (3.26 × 10−6 mm) were significantly low in magnitude, thus proving the implant load resistance ability. The average yield and tensile strengths for the fabricated Ti6Al4V ELI EBM specimen were found to be 825 MPa and 880 MPa, respectively, which were well over the prescribed strength for Ti6Al4V ELI implant material. The hardness study also resulted in an acceptable outcome within the acceptable range of 30−35 HRC. Certainly, the chemical composition of the fabricated EBM specimen was intact as established in EDX analysis. The weight of the cranial implant (128 grams) was also in agreement with substituted defected bone portion, ruling out any stress shielding effect. With the proposed approach, the anatomy of the cranium deformities can be retrieved effectively and efficiently. The implementation of 3D reconstruction techniques can conveniently reduce tedious alterations in the implant design and subsequent errors. It can be a valuable and reliable approach to enhance implant fitting, stability, and strength.

Segmental mandibular reconstruction has been a challenge for medical practitioners, despite significant advances in medical technology. There is a recent trend in relation to customized implants, made up of porous structures. These lightweight prosthesis scaffolds present a new direction in the evolution of mandibular restoration. Indeed, the design and properties of porous implants for mandibular reconstruction should be able to recover the anatomy and contour of the missing region as well as restore the functions, including mastication, swallowing, etc. In this work, two different designs for customized prosthesis scaffold have been assessed for mandibular continuity. These designs have been evaluated for functional and aesthetic aspects along with effective osseointegration. The two designs classified as top and bottom porous plate and inner porous plate were designed and realized through the integration of imaging technology (computer tomography), processing software and additive manufacturing (Electron Beam Melting). In addition, the proposed designs for prosthesis scaffolds were analyzed for their biomechanical properties, structural integrity, fitting accuracy and heaviness. The simulation of biomechanical activity revealed that the scaffold with top and bottom porous plate design inherited lower Von Mises stress (214.77 MPa) as compared to scaffold design with inner porous plate design (360.22 MPa). Moreover, the top and bottom porous plate design resulted in a better fit with an average deviation of 0.8274 mm and its structure was more efficiently interconnected through the network of channels without any cracks or powder material. Verily, this study has demonstrated the feasibility and effectiveness of the customized porous titanium implants in mandibular reconstruction. Notice that the design and formation of the porous implant play a crucial role in restoring the desired mandibular performance.

Catheter-directed thrombolysis (CDT) has been utilized as an adjunct to anticoagulant therapy in selected patients with deep vein thrombosis (DVT) for approximately 30 years. CDT used to be limited to patients with DVT causing acute limb threat and those exhibiting failure of initial anticoagulation, but has expanded over time. Randomized trials evaluating the first-line use of CDT for proximal DVT have demonstrated that CDT does not produce a major reduction in the occurrence of post-thrombotic syndrome (PTS) and that it is poorly suited for elderly patients and those with limited thrombus extent or major risk factors for bleeding. However, CDT does offer selected patients with acute iliofemoral DVT improvement in reducing early DVT symptoms, in achieving reduction in PTS severity, and in producing an improvement in health-related quality of life (QOL). Clinical practice guidelines from medical and surgical societies are now largely aligned with the randomized trial results. This review offers the reader an update on the results of recently completed clinical trials, and additional guidance on appropriate selection of patients with DVT for catheter-directed thrombolytic therapy. [ABSTRACT FROM AUTHOR]

Mandible defects and its deformities are serious complications and its precise reconstruction is one of the most challenging tasks in oral maxillofacial surgery. The commercially available standard mandible implants are manually bended before surgery to custom fit the patient’s jaw. A slight mismatch in the plate and bone alignment may result in the implant failure. However, with the integration of computer-aided design, rapid prototyping, and advanced imaging systems (computed tomography or magnetic resonance imaging), it is possible to produce a customized mandible implant that can precisely fit the patient’s jaw. The aim of this article is to compare a new design of customized mandible implant (sinewave plate) and compare it with the commonly used straight implant design. The finite element–simulated results reveal that the commonly used straight reconstruction plates are more prone to loosening of the screws due to its higher strain concentration on the screw hole when compared to newly designed sinewave reconstruction plate. Moreover, the straight plate is more sensitive to the chewing load variations and develops almost 20% increase in the stresses when compared to sinewave plate. The study reveals that the sinewave reconstruction plate can significantly enhance the stability and safety of the mandible implant.