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This article focused on the study of the influence of morphological parameters on the mechanical performance (Young’s modulus) of Cellulose Acetate-Graphene Oxide nanocomposites produced by Supercritical CO2 assisted phase inversion, by means of an algorithm managing two parametric variational 3D finite element (FE) models simulating micro- and nano-level of the nanocomposite. Micro-level showed interconnected spherical pores, while nano-level showed a dispersion of not fully exfoliated graphene sheets. 3D FE model exploited the periodic representative volume element (PRVE) concept and accounted for the nanocomposite morphology as determined from Field Emission Scanning Electron Microscopy (FESEM) experiments. Model predictions were compared with experimental results obtained by compression tests at different weight percentages of graphene oxide with respect to the polymer. Once validated, such a FE simulation procedure allows to know in advance which and how to vary the geometrical parameters during the nanocomposite production to improve its final mechanical performance.

In this work an hypothesis of modeling nanofibers network of Poly-L-lactide (PLLA) scaffolds loaded with hydroxyapatite (HA) nanoparticles, suitable for tissue engineering applications, is presented to investigate the mechanical properties by FEM analysis. Scaffolds were produced by Supercritical CO2 drying of polymeric gels. FEM modeling of nanoporous biomaterials involves computational problems such as: the reproduction of the nano-morphology by means of different techniques, such as molecular dynamics simulations that hardly lead to results adherent to the experimental evidence; the reverse engineering to extrapolate geometric information; the identification of a periodic representative volume element (RVE) to reach more coherent results and to reduce the simulation computational effort. Basic modeling assumptions are: a) polymer particles are small enough to exhibit Brownian motion; b) scaffold SEM images show that the porous structure consists of curved fibers that depart from punctiform nuclei realizing a space frame; c) scaffold experimental compressive tests show that the porous material behaves as a soft isotropic material. On the basis of these assumptions, a parametric algorithm that creates a cubic RVE, showing a nanofibers network and having the same porosity of the real material, has been written; RVE size has been optimized on the bases of its material isotropic degree measured by an ad hoc created iterative algorithm for generating a rod spaceframe; RVE mechanical behavior has been optimized by curving appropriately each fiber according to the experimental data and on the basis of SEM imaging diagnostic. Linear FEM simulations on mechanical behavior have given qualitatively and quantitative satisfactory results when compared to the experimental ones.

Background and Objective: Many diseases of the spine require surgical treatments that are currently performed based on the experience of the surgeon. The basis of this study is to deliver an automatic and patient-specific algorithm able to come to the aid of the surgeons in pedicle arthrodesis operations, by finding the optimal direction of the screw insertion, the maximum screw diameter and the maximum screw length., Results: The paper introduce an algorithm based on the reconstructed geometry of a vertebra by 3D-scan that is able to identify the best introduction direction for screw and to select, from commercial and/or personalised databases, the best screws in order to maximize the occupation of the bone while not intersecting each other and not going through the walls of the pedicle and the bounds of the vertebral body. In fact, for pedicle arthrodesis surgery, the incorrect positioning of the screws may cause operating failures, an increase in the overall duration of surgery and, therefore, more harmful, real-time X-ray checks. In case of not availability on market, the algorithm also suggests parameters for designing and manufacturing an 'ad hoc' solution. The algorithm has been tested on 6 vertebras extracted by a medical database. Furthermore, the algorithm is based on a procedure through which the surgeon can freely choose the entering point of the screw (based on his/her own experience and will). A real patient vertebra has been processed with almost 400 different entering point, always giving a feedback on the possibility to use the entering point (in case of unavailability of a good trajectory) and on the individuation of the right trajectory and the choose of the better screws., Conclusions: In very recent bibliography, several papers deal with procedure to screw' trajectory planning in arthrodesis surgery by using Computer Aided surgery systems, and some of them used also modern methodologies (KBE, AI, Deep learning, etc.) methods for planning the surgery as better as possible. Nevertheless, no methodologies or algorithm have been still realized to plan the trajectory and choose the perfect fitting screws on the basis of the patient-specific vertebra. This paper represents a wind of novelty in this field and allow surgeons to use the proposed algorithm for planning their surgeries. Finally, it allows also the easy creation of a customized surgical template, characterized by two cylindrical guides that follow a correct trajectory previously calculated by means of that automatic algorithm generated on the basis of a vertebra CAD model for a specific patient. The surgeon will be able to set the template (drilling guides) on the patient's vertebra and safely apply the screws., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

By combining load adaptive algorithms with mechanobiological algorithms, a computational framework was developed to design and optimize the microarchitecture of irregular load adapted scaffolds for bone tissue engineering. Skeletonized cancellous bone-inspired lattice structures were built including linear fibers oriented along the internal flux of forces induced by the hypothesized boundary conditions. These structures were then converted into solid finite element models, which were optimized with mechanobiology-based optimization algorithms. The design variable was the diameter of the beams included in the scaffold, while the design objective was the maximization of the fraction of the scaffold volume predicted to be occupied by neo-formed bony tissue. The performance of the designed irregular scaffolds, intended as the capability to favor the formation of bone, was compared with that of the regular ones based on different unit cell geometries. Three different boundary and loading conditions were hypothesized, and for all of them, it was found that the irregular load adapted scaffolds perform better than the regular ones. Interestingly, the numerical predictions of the proposed framework are consistent with the results of experimental studies reported in the literature. The proposed framework appears to be a powerful tool that can be utilized to design high-performance irregular load adapted scaffolds capable of bearing complex load distributions.

Background: The integration of computer-aided design/computer-aided manufacturing (CAD/CAM) tools and medicine is rapidly developing for designing medical devices. A novel design for a 3D-printed patient-specific surgical template for thoracic pedicle screw insertion, using a procedure based on reverse engineering, is presented., Methods: The surgeon chooses the entry point on the vertebra. The optimal insertion direction and the size of the screws are defined via an algorithm on the basis of a patient-specific vertebra CAD model. The template features an innovative shape for a comfortable and univocal placement and a novel disengaging device., Results: Three spinal fusions were performed to test the template. Excellent results were achieved in terms of the accuracy of the screw positioning, reduction in surgery duration, and number of X-rays., Conclusions: A novel design for a customized, 3D-printed surgical template for thoracic spinal arthrodesis was presented, and improvements in terms of precision, duration, and safety were achieved without changing the standard procedure., (© 2019 John Wiley & Sons, Ltd.)

Many diseases of the spine require surgical treatments that are currently performed based on the experience of the surgeon. For pedicle arthrodesis surgery, two critical factors must be addressed: Screws must be applied correctly and exposure to harmful radiation must be avoided. The incorrect positioning of the screws may cause operating failures that lead to subsequent reoperations, an increase in the overall duration of surgery and, therefore, more harmful, real-time X-ray checks. In this paper, the authors solve these problems by developing a method to realize a customized surgical template that acts as a drilling template. The template has two cylindrical guides that follow a correct trajectory previously calculated by means of an automatic algorithm generated on the basis of a vertebra CAD model for a specific patient. The surgeon sets the template (drilling guides) on the patient's vertebra and safely applies the screws. Three surgical interventions for spinal stabilization have been performed using the template. These have had excellent results with regard to the accuracy of the screw positioning, reduction of the overall duration of the intervention, and reduction of the number of times the patient was exposed to X-rays.

The aim of this work is to show a quick and simple procedure able to identify the geometrical parameters of the intervertebral disc that strongly affect the behavior of the FEM model. First, we allocated a selection criterion for the minimum number of geometrical parameters that describe, with a good degree of approximation, a healthy human vertebra. Next, we carried out a sensitivity analysis using the 'Taguchi orthogonal array' to arrive at a quick identification of the parameters that strongly affect the behavior of the Fem model.

Scaffolds have been produced by supercritical CO2 drying of Poly-L-Lactid Acid (PLLA) gels loaded with micrometric fructose particles used as porogens. These structures show a microporous architecture generated by the voids left in the solid material by porogen leaching, while they maintain the nanostructure of the gel, consisting of a network of nanofilaments. These scaffolds have also been loaded with Hydroxyapatite (HA) nanoparticles, from 10 to 50% w/w with respect to the polymer, to improve the mechanical properties of the PLLA structure. Based on miscroscopic and mechanical considerations, we propose a parametric Finite Element Method (FEM) model of PLLA-HA composites that describes the microporous structure as a close-packing of equal spheres and the nanoscale structure as a space frame of isotropic curved fibers. The effect of HA on the mechanical properties of the scaffolds has been modeled on the basis of SEM images and by taking into consideration the formation of concentric cylinders of HA nanoparticles around PLLA nanofibers. Modeling analysis confirms that mechanical properties of these scaffolds depend on nanofibrous network connections and that bending is the major factor causing deformation of the network. The FEM model also takes into account the formation of HA multi-layer coating on some areas in the nanofiber network and its increase in thickness with HA percentage. The Young modulus tends to a plateau for HA percentages larger than 30% w/w and when the coverage of the nanofibers produced by HA nanoparticles reaches a loaded surface index of 0.14 in the FEM model., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: As the vitamin K content of human milk is low and the newborn infant's stores of vitamin K are small, vitamin K deficiency with hemorrhage in the newborn is a worldwide problem. Proteins Induced by Vitamin K Absence (PIVKA-II) are the inactive under-γ-carboxylated forms of vitamin K-dependent clotting factors and they could be useful in predicting subclinical vitamin K deficiency (VKD)., Objectives: To demonstrate that PIVKA-II are earlier markers of subclinical VKD than Prothrombin time (PT) in exclusively breast-fed newborns., Methods: A prospective, controlled, randomized study, including 53 term newborns receiving vitamin K prophylaxis (0.5 mg i.m.) at birth, was performed. At 30 days newborns were divided into three groups (G) receiving respectively: 25 μg/die of vitamin K (G I), 12 μg/die (G II) or placebo (G III). PIVKA-II and PT were measured on 30th and 90th days of life., Results: G III and GII showed a significant increase in PIVKA-II from 30 to 90 days of life respectively from 2.6 to 4.7 (p = 0.001) and from 2.3 to 3.5 (p < 0.001). No significant changes were found in GI. PT showed no significant changes among groups., Conclusions: PT is a less sensitive marker than PIVKA II. Oral supplementation with 25 μg/die avoids an increase of PIVKA-II. Despite increased PIVKA-II do not mean an impending occurrence of bleeding, they highlight a subclinical VKD and its relative risk.

Quantifying muscle force and fatigue is important in designing ergonomic work stations, in planning appropriate work-rest patterns, and in preventing/assessing the progress of disorders. In 14 subjects (seven males, seven females), muscle force and fatigue were estimated by subjective perception (based on Borg scale CR10) and objective indexes extracted from surface electromyogram (EMG). The experimental protocol consisted of an isometric task selective for the upper trapezius muscle at different force levels (10-80% of maximal voluntary contraction--MVC, in steps of 10%MVC) and one fatiguing contraction (constant force level at 50%MVC until exhaustion). Surface EMG signals were detected by a two-dimensional (2D) array of electrodes placed half way between C7 and the acromion. The following variables were calculated from EMG signals: muscle fibre conduction velocity (CV), root mean square value (RMS), mean frequency of the power spectrum (MNF), fractal dimension (FD), and entropy. All detected signals were also used to build topographical maps of RMS. Both subjective and objective indications of force and fatigue can provide information on exerted force and endurance time (ET). In particular, Borg ratings, RMS, and entropy were significantly related to force, and the rate of change of CV, MNF, FD, and Borg ratings were predictive of the endurance time. Moreover, significant differences were found in Borg ratings between males and females. The correlation coefficient of pairs of topographical maps of RMS was high (of the order of 0.8). This reflects a characteristic spatial-temporal recruitment of upper trapezius motor units that is not affected by force levels or fatigue.

A new class of spatial filters for surface electromyographic (EMG) signal detection is proposed. These filters are based on the 2-D spatial wavelet decomposition of the surface EMG recorded with a grid of electrodes and inverse transformation after zeroing a subset of the transformation coefficients. The filter transfer function depends on the selected mother wavelet in the two spatial directions. Wavelet parameterization is proposed with the aim of signal-based optimization of the transfer function of the spatial filter. The optimization criterion was the minimization of the entropy of the time samples of the output signal. The optimized spatial filter is linear and space invariant. In simulated and experimental recordings, the optimized wavelet filter showed increased selectivity with respect to previously proposed filters. For example, in simulation, the ratio between the peak-to-peak amplitude of action potentials generated by motor units 20 degrees apart in the transversal direction was 8.58% (with monopolar recording), 2.47% (double differential), 2.59% (normal double differential), and 0.47% (optimized wavelet filter). In experimental recordings, the duration of the detected action potentials decreased from (mean +/- SD) 6.9 +/- 0.3 ms (monopolar recording), to 4.5 +/- 0.2 ms (normal double differential), 3.7 +/- 0.2 (double differential), and 3.0 +/- 0.1 ms (optimized wavelet filter). In conclusion, the new class of spatial filters with the proposed signal-based optimization of the transfer function allows better discrimination of individual motor unit activities in surface EMG recordings than it was previously possible.

An aqueous decoction of mango (Mangifera indica L.) stem bark has been developed in Cuba on an industrial scale to be used as a nutritional supplement, cosmetic, and phytomedicine. Previously we reported its antioxidant activity, and we concluded that the product could be useful to prevent the production of reactive oxygen species and oxidative tissue damage in vivo. A phytochemical investigation of mango stem bark extract has led to the isolation of seven phenolic constituents: gallic acid, 3,4-dihydroxy benzoic acid, gallic acid methyl ester, gallic acid propyl ester, mangiferin, (+)-catechin, (-)-epicatechin, and benzoic acid and benzoic acid propyl ester. All structures were elucidated by ES-MS and NMR spectroscopic methods. Quantitative analysis of the compounds has been performed by HPLC, and mangiferin was found to be the predominant component. Total polyphenols were assayed also by the Folin-Ciocalteu method. The free sugars and polyols content was also determined by GC-MS.