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SignificanceExtremity injury represents the leading cause of trauma hospitalizations among adults under the age of 65 years, and long-term impairments are often substantial. Restoring function depends, in large part, on bone and soft tissue healing. Thus, decisions around treatment strategy are based on assessment of the healing potential of injured bone and/or soft tissue. However, at the present, this assessment is based on subjective clinical clues and/or cadaveric studies without any objective measure. Optical imaging is an ideal method to solve several of these issues.AimThe aim is to highlight the current challenges in assessing bone and tissue perfusion/viability and the potentially high impact applications for optical imaging in orthopaedic surgery.ApproachThe prospective will review the current challenges faced by the orthopaedic surgeon and briefly discuss optical imaging tools that have been published. With this in mind, it will suggest key research areas that could be evolved to help make surgical assessments more objective and quantitative.ResultsOrthopaedic surgical procedures should benefit from incorporation of methods to measure functional blood perfusion or tissue metabolism. The types of measurements though can vary in the depth of tissue sampled, with some being quite superficial and others sensing several millimeters into the tissue. Most of these intrasurgical imaging tools represent an ideal way to improve surgical treatment of orthopaedic injuries due to their inherent point-of-care use and their compatibility with real-time management.ConclusionWhile there are several optical measurements to directly measure bone function, the choice of tools can determine also the signal strength and depth of sampling. For orthopaedic surgery, real-time data regarding bone and tissue perfusion should lead to more effective patient-specific management of common orthopaedic conditions, requiring deeper penetrance commonly seen with indocyanine green imaging. This will lower morbidity and result in decreased variability associated with how these conditions are managed.

Steel slag (SS) as solid waste, has low resource utilization efficiency and seriously endangers environmental safety and human health. To explore the potential utilization value of SS and address the flammability challenge of rigid polyurethane foam (RPUF), with a novel flame‐retardant system composed by SS and dimethyl methyl phosphonate (DMMP) was explored. The DMMP/SS system effectively improved the high temperature stability of the RPUF composites. When the mass ratio of SS and DMMP was 1:1, the limiting oxygen index of RPUF/DMMP/SS reached 23.1 vol% and UL‐94 vertical combustion tests passed V‐2 level. Upon incorporation of 15 wt% DMMP, the initial decomposition temperature (T−5 wt%) reduced to 165.3°C, a decrease of 32.2%, while the Tmax2 and residue yield at 700°C exhibited negligible alteration. The peak heat release rate of RPUF/DMMP/SS composite (118.20 W g−1) was 11.02% lower than that of pure RPUF, indicating the significant enhancement of fire safety of the composites. Results confirmed that a synergistic flame‐retardant mechanism was existed between DMMP and SS in enhancing the fire safety of RPUF composite. Introducing a 20 wt% SS content reduces the ID/IG ratio to 1.85, thereby markedly enhancing its heat resistance. This work provides a new application field of SS and paves a novel approach to enhance fire safety of polymers. [ABSTRACT FROM AUTHOR]

Ideally, neoadjuvant chemotherapy (NAC) assessment should predict pathologic complete response (pCR), a surrogate clinical endpoint for 5-year survival, as early as possible during typical 3- to 6-month breast cancer treatments. We introduce and demonstrate an approach for predicting pCR within 10 days of initiating NAC. The method uses a bedside diffuse optical spectroscopic imaging (DOSI) technology and logistic regression modeling. Tumor and normal tissue physiological properties were measured longitudinally throughout the course of NAC in 33 patients enrolled in the American College of Radiology Imaging Network multicenter breast cancer DOSI trial (ACRIN-6691). An image analysis scheme, employing z-score normalization to healthy tissue, produced models with robust predictions. Notably, logistic regression based on z-score normalization using only tissue oxygen saturation (StO2) measured within 10 days of the initial therapy dose was found to be a significant predictor of pCR (AUC  =  0.92; 95% CI: 0.82 to 1). This observation suggests that patients who show rapid convergence of tumor tissue StO2 to surrounding tissue StO2 are more likely to achieve pCR. This early predictor of pCR occurs prior to reductions in tumor size and could enable dynamic feedback for optimization of chemotherapy strategies in breast cancer.

We present a framework for characterizing the performance of an experimental imaging technology, diffuse optical spectroscopic imaging (DOSI), in a 2-year multicenter American College of Radiology Imaging Network (ACRIN) breast cancer study (ACRIN-6691). DOSI instruments combine broadband frequency-domain photon migration with time-independent near-infrared (650 to 1000 nm) spectroscopy to measure tissue absorption and reduced scattering spectra and tissue hemoglobin, water, and lipid composition. The goal of ACRIN-6691 was to test the effectiveness of optically derived imaging endpoints in predicting the final pathologic response of neoadjuvant chemotherapy (NAC). Sixty patients were enrolled over a 2-year period at participating sites and received multiple DOSI scans prior to and during 3- to 6-month NAC. The impact of three sources of error on accuracy and precision, including different operators, instruments, and calibration standards, was evaluated using a broadband reflectance standard and two different solid tissue-simulating optical phantoms. Instruments showed

The prospective multicenter ACRIN 6691 trial was designed to evaluate whether changes from baseline to mid-therapy in a diffuse optical spectroscopic imaging (DOSI)-derived imaging endpoint, the tissue optical index (TOI), predict pathologic complete response (pCR) in women undergoing breast cancer neoadjuvant chemotherapy (NAC). DOSI instruments were constructed at the University of California, Irvine (Irvine, CA), and delivered to six institutions where 60 subjects with newly diagnosed breast tumors (at least 2 cm in the longest dimension) were enrolled over a 2-year period. Bedside DOSI images of the tissue concentrations of deoxy-hemoglobin (ctHHb), oxy-hemoglobin (ctHbO2), water (ctH2O), lipid, and TOI (ctHHb × ctH2O/lipid) were acquired on both breasts up to four times during NAC treatment: baseline, 1-week, mid-point, and completion. Of the 34 subjects (mean age 48.4 ± 10.7 years) with complete, evaluable data from both normal and tumor-containing breast, 10 (29%) achieved pCR as determined by central pathology review. The percent change in tumor-to-normal TOI ratio (%TOITN) from baseline to mid-therapy ranged from -82% to 321%, with a median of -36%. Using pCR as the reference standard and ROC curve methodology, %TOITN AUC was 0.60 (95% CI, 0.39-0.81). In the cohort of 17 patients with baseline tumor oxygen saturation (%StO2) greater than the 77% population median, %TOITN AUC improved to 0.83 (95% CI, 0.63-1.00). We conclude that the combination of baseline functional properties and dynamic optical response shows promise for clinical outcome prediction. Cancer Res; 76(20); 5933-44. ©2016 AACR.

Iron tailings (ITS), as solid decay absolved afterward beneficiation, are adverse to the environment. ITS to prepare zinc‐containing mesoporous silicate (MAO‐Zn) by a calcination‐crystallization method are used. An admixture of ammonium polyphosphate (APP) and MAO‐Zn can solve the problem of poor flame retardancy in rigid polyurethane foam (RPUF), giving them higher thermal stability and lower heat release. The total heat release rate and smoke factor values exhibited by RPUF‐3 are 24.52 MJ m−2 and 234.29 MW m−2 respectively, a decrease of 38.45% and 29.60% respectively compared to pure RPUF. Lower combustible and toxic gas release intensities are in RPUF‐3. Meanwhile, RPUF‐3 possesses enhanced compactness char residue with higher graphitization degree, endowing RPUF‐3 with excellent fire observed performance. This work demonstrates the potential of ITS in the fire retardancy field. [ABSTRACT FROM AUTHOR]