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The bottom-up approach of 3D bioprinting uses biopolymeric bioink along with the defined cells and allows to engineer 3D tissues/organs. The process is multistep, comprising upstream designing of matrix blueprints, bioinks, crosslinking strategies, and downstream maturation of construct using a bioreactor. The present review aims to provide a holistic picture of the various phases in 3D bioprinting, the methods used, and their clinical applications, such as in regenerative medicine, disease study, drug testing, and in situ bioprinting. Also, highlighted upgraded versions of 4D and 5D printing for better biomimetic properties and uses of 3D nanoprinting technology for effective tissue reconstruction. [ABSTRACT FROM AUTHOR]

Automatic type identification of sub-axial spine fractures is of prime importance for orthopaedicians to reduce image interpretation time and increase patient care time. But identifying fracture types is challenging due to imbalanced datasets. In this work, CT scan images of fractured spine has been collected from a Tertiary Care hospital and extended Deep Convolutional Generative Adversarial Network (DCGAN) architecture is developed for generating spine fracture images that overcomes the imbalanced dataset problem. These enhanced dataset are clinically evaluated with Two Visual Turing Tests (VTTs): the first test to "identify real and generated images" and second test to determine "type of fractures in the generated images." The first VTT demonstrates that generated images of fractures are realistic and that even spine surgeons have difficulty in distinguishing them from real. The second VTT demonstrates that fracture lines are clearly visible in the generated images. The VTT results are analyzed using Fleiss Kappa statistical techniques to determine the inter-observer reliability of spine surgeons' clinical evaluation. The results showed high interobserver agreement for "type identification" in the generated images. The clinically evaluated generated images are provided to the proposed ensemble based type identification model, which outperformed other models in type identification. [ABSTRACT FROM AUTHOR]

Background: Vertebral Column Fractures (VCF) are a major public health concern with a high mortality rate, negative social and economic effects, and substantial morbidity. Through efficient management and preventative measures based on fundamental epidemiological data, the burden of disease can be reduced. Aim and Objectives: The objectives of this research work were to represent the epidemiology of VCF and to assess the interobserver agreement of VCF identification between spine surgeons using AO classification of Computed Tomography (CT) images. Material and Methods: A total of 456 cases of C3 to L5 spinal fractures with CT were noted. Comprehensive epidemiological profile of all the patients with VCF was recorded separately and was analyzed by SPSS software. Two spine surgeons classified 375 CT scans with a single level vertebral fracture using AO classification of the spine. Kappa coefficient (k), was used to find interobserver agreement in assessing of VCF. Results: Totally 456 cases of VCF with CT scan were collected. Mean ±SD age of men was 39.93 ± 12.07 years and women was 41.85 ± 12.22 years. The number of fractures in the 41-50 years age group was dominant (27.85%, n=127). About 82.20% of the patients had sustained a single fracture. The most common level was the thoracolumbar region (T12-L1), accounting for 41.60%. Type A fractures (68.00%) were the leading type of VCF. In deciding the subtype according to AO among single fracture, current study presented a very good interobserver agreement with (k = 0.884 with p-value = 0.018). Conclusion: In summary, current study presented a very good interobserver agreement in identifying the subtypes of VCF according to AO classification and also demonstrated epidemiology of VCF in west coast of south India. [ABSTRACT FROM AUTHOR]

Background: In tuberculosis (TB) endemic areas, other pyogenic causes of spine involvement may be missed. The study aimed to describe TB and non-TB causes of spine involvement and identify features that can help in differentiating them. Methods: A retrospective cohort study was conducted to screen the clinical records of all admitted patients (Kasturba Hospital, Manipal) in 2018--20 for a diagnosis of spondylitis and/or sacroiliitis. The clinical features, radiological findings, laboratory parameters, treatment details, and outcomes were compared among those diagnosed with confirmed TB, confirmed brucellosis, or confirmed pyogenic infection. A scoring system was also developed to differentiate spondylodiscitis due to tuberculous and pyogenic causes. The qualitative variables were compared using the Chi-square test, while quantitative variables were compared using the one-way analysis of variance test. Results: Of 120 patients with spine infections, a total of 85 patients were confirmed with the microbiological diagnosis of interest. Involvement of the thoracic spine, longer duration of illness, and caseous granulomatous reaction on histopathology was more common in TB patients. Male gender, involvement of lumbar vertebra, and neutrophilic infiltrate on histopathology were more common in brucellosis patients. Male gender, diabetes mellitus, involvement of lumbar vertebra, neutrophilic infiltrate on histopathology, leukocytosis, and increased C-reactive protein were more commonly seen in patients with pyogenic infection. The scoring system had a sensitivity and specificity of 75% and 91%, respectively, when used to differentiate TB from pyogenic infection. Conclusions: In resource-limited settings, suggestive findings can be used to decide empiric therapy. [ABSTRACT FROM AUTHOR]

Background: The hip joint is the largest joint after the knee, which gives stability to the whole human structure. The hip joint consists of a femoral head which articulates with the acetabulum. Due to age and wear between the joints, these joints need to be replaced with implants which can function just as a natural joint. Since the early 19th century, the hip joint arthroplasty has evolved, and many advances have been taken in the field which improved the whole procedure. Currently, there is a wide variety of implants available varying in the length of stem, shapes, and sizes. Material and Methods: In this analytical study of femur, circular, oval, ellipse and trapezoidal-shaped stem designs are considered in the present study. The human femur is modeled using Mimics. CATIA V-6 is used to model the implant models. Static structural analysis is carried out using ANSYS R-19 to evaluate the best implant design. Results: All the four hip implants exhibited the von Mises stresses, lesser than its yielded strength. However, circular and trapezoidal-shaped stems have less von Mises stress compared to ellipse and oval. Conclusion: This study shows the behavior of different implant designs when their cross-sections are varied. Further, these implants can be considered for dynamic analysis considering different gait cycles. By optimizing the implant design, life expectancy of the implant can be improved, which will avoid the revision of the hip implant in active adult patients. [ABSTRACT FROM AUTHOR]