Embracing additive manufacture: implications for foot and ankle orthosis design

<p>Abstract</p> <p>Background</p> <p>The design of foot and ankle orthoses is currently limited by the methods used to fabricate the devices, particularly in terms of geometric freedom and potential to include innovative new features. Additive manufacturing (AM) technologies, where objects are constructed via a series of sub-millimetre layers of a substrate material, may present the opportunity to overcome these limitations and allow novel devices to be produced that are highly personalised for the individual, both in terms of fit and functionality.</p> <p>Two novel devices, a foot orthosis (FO) designed to include adjustable elements to relieve pressure at the metatarsal heads, and an ankle foot orthosis (AFO) designed to have adjustable stiffness levels in the sagittal plane, were developed and fabricated using AM. The devices were then tested on a healthy participant to determine if the intended biomechanical modes of action were achieved.</p> <p>Results</p> <p>The adjustable, pressure relieving FO was found to be able to significantly reduce pressure under the targeted metatarsal heads. The AFO was shown to have distinct effects on ankle kinematics which could be varied by adjusting the stiffness level of the device.</p> <p>Conclusions</p> <p>The results presented here demonstrate the potential design freedom made available by AM, and suggest that it may allow novel personalised orthotic devices to be produced which are beyond the current state of the art.</p

How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

Integrating the selection of PHA storing biomass and nitrogen removal via nitrite for the treatment of the sludge reject water

Integrating the selection of PHA storing biomass and nitrogen removal via-nitrite for the treatment of the sludge reject wate

TWO WEEKLY SESSIONS OF COMBINED AEROBIC AND RESISTANCE EXERCISE ARE SUFFICIENT TO PROVIDE BENEFICIAL EFFECTS IN SUBJECTS WITH TYPE 2 DIABETES MELLITUS AND METABOLIC SYNDROME

none10noThis study was performed to establish whether only 2 sessions per week of combined aerobic and resistance exercise are enough to reduce glycated hemoglobin (HbA(1c) and to induce changes in skeletal muscle gene expression in Type 2 diabetes mellitus (DM2) subjects with metabolic syndrome. Eight DM2 subjects underwent a 1-yr exercise program consisting of 2 weekly sessions of 140 min that combined aerobic [at 55-70% of maximal oxygen uptake (VO(2max))] and resistance circuit training [at 60-80% of 1 repetition maximum (RM)]. The training significantly improved VO(2max) (from 33.5 +/- 3.8 ml/kg/min to 38.2 +/- 3.5 ml/kg/min, p=0.0085) and muscle strength (p<0.05). Changes over baseline were significant for HbA(1c), reduced by 0.45% (p=0.0084), fasting blood glucose (from 8.8 +/- 1.5 to 6.9 +/- 2.2 mmol/l, p=0.0132), waist circumference (from 98.9 +/- 4.8 to 95.9 +/- 4.6 cm, p=0.0054), body weight (from 87.5 +/- 10.7 to 85.7 +/- 10.1 kg, p=0.0375), systolic blood pressure (from 137 +/- 15 to 126 +/- 8 mmHg, p=0.0455), total cholesterol (from 220 +/- 24 to 184 +/- 13 mg/dl, p=0.0057), and LDL-cholesterol (from 150 +/- 16 to 105 +/- 15 mg/dl, p=0.0004). Mitochondrial DNA/nuclear DNA ratio at 6 and 12 months did not change. There was a significant increase of mRNA of peroxisome proliferator-activated receptor (PPAR)-gamma after 6 months of training (p=0.024); PPAR alpha mRNA levels were significantly increased at 6 (p=0.035) and 12 months (p=0.044). The mRNA quantification of other genes measured [mitochondrially encoded cytochrome c oxidase subunit II (MTCO2), cytochrome c oxidase subunit Vb (COX5b), PPAR gamma coactivator l alpha (PGC1 alpha), glucose transporter 4 (GLUT 4), forkhead transcription factor BOX O1 (FOXO-1), carnitine palmitoyltransferase 1 (CPT-1), lipoprotein lipase (LPL), and insulin receptor substrate 1 (IRS-1)] did not show significant changes at 6 and 12 months. This study suggests that a twice-per-week frequency of exercise is sufficient to improve glucose control and the expression of skeletal muscle PPAR gamma and PPAR alpha in DM2 subjects with metabolic syndrome.openC. FATONE; M. GUESCINI; S. BALDUCCI; S. BATTISTONI; A. SETTEQUATTRINI; R. PIPPI; L. STOCCHI; M. MANTUANO; V. STOCCHI; P. DE FEOC., Fatone; Guescini, Michele; S., Balducci; S., Battistoni; A., Settequattrini; R., Pippi; L., Stocchi; Mantuano, Michela; Stocchi, Vilberto; P., DE FE

Water–energy–food–climate nexus in an integrated peri‐urban wastewater treatment and reuse system: From theory to practice

none8This paper develops a framework for the identification, assessment and analysis of the water reuse–carbon–energy–food–climatic (WEFC) nexus in an integrated peri‐urban wastewater treatment and reuse system. This methodology was applied to the municipal wastewater treatment plant (WWTP) of Peschiera Borromeo (Milan, Italy) and its peri‐urban district to define the most possible affirmations and conflicts following the EU regulations 741/2020. Results of this work showed that transferring the WEFC nexus from theory to practice can realize sustainable resource management in the operating environment by providing a reduction in greenhouse gas (GHG) emissions, overall energy savings, reduction in water stress and optimization of agricultural prac-tices. Particularly, it was found that if the plant configuration is upgraded to reach water quality class C for water reuse, instead of wastewater discharge, energy savings are estimated to reach up to 7.1% and carbon emissions are supposed to be reduced up to 2.7%. In addition, enhancing water quality from class C to class A resulted in increments in energy and carbon footprint of 5.7% and 1.7%, respectively. Nevertheless, higher quality crops can be cultivated with reclaimed water in class A, with bigger economic revenues and high recovery of nutrients (e.g., recovery of 154450 kg N/y for tomato cultivation).openMarinelli E.; Radini S.; Akyol C.; Sgroi M.; Eusebi A.L.; Bischetti G.B.; Mancini A.; Fatone F.Marinelli, E.; Radini, S.; Akyol, C.; Sgroi, M.; Eusebi, A. L.; Bischetti, G. B.; Mancini, A.; Fatone, F

Which route of antibiotic administration should be used for third molar surgery? A split-mouth study to compare intramuscular and oral intake

Objectives. To compare the effectiveness of two different routes of antibiotic administration in preventing septic complications in patients undergoing third molar extraction. Materials and Methods. Twenty-four healthy patients requiring bilateral surgical removal of impacted mandibular third molars were successfully enrolled for this study. Depth of impaction, angulation, and relationship of the lower third molars with the mandibular branch had to be overlapping on both sides. A split-mouth design was chosen, so each patient underwent both the first and second surgeries, having for each extraction a different antibiotic route of administration. The second extraction was carried out 1 month later. To compare the effects of the two routes of antibiotic administration, inflammatory parameters, such as edema, trismus, pain, fever, dysphagia and lymphadenopathy were evaluated 2 and 7 days after surgery. Side effects of each therapy were evaluated 48h after surgery. Results. oral and intramuscular antibiotic therapies overlap in preventing post-operative complications in dental surgery (p>0.05), even if the oral intake, seems to promote the onset of significant gastrointestinal disorders (p=0.003). Conclusions. This study could help dentists in their ordinary practice to choose the right route of antibiotic administration in the third molar surgery. At the same effectiveness, the higher cost and the minor compliance of the patient seem not to justify a routine antibiotic intramuscular therapy, reserving it for patients with gastrointestinal disorders

Development of a Novel Process Integrating the Treatment of Sludge Reject Water and the Production of Polyhydroxyalkanoates (PHAs)

The Supporting Information is available free of charge on the ACS Publications website at DOI: https://doi.org/10.1021/acs.est.5b01776This study was carried out within the framework of the European projects LIVE WASTE (LIFE 12 ENV/CY/000544)

Technical and environmental evaluation of an integrated scheme for the co-treatment of wastewater and domestic organic waste in small communities

This research was supported by the EU projects: LIFE+ LIVE-WASTE (LIFE 12 ENV/CY/000544) and PIONEER (PCIN-2015-227) and by the BBVA programme “2015 edition of the BBVA Foundation Grants for Researchers and Cultural Creators” (2015-PO027). L. Lijó would like to thank the COST Action ES1202 for a Short Term Scientific Mission grant. Dr. S. González-Garcia would like to express her gratitude to the Spanish Ministry of Economy and Competitivity for financial support (Grants references JCI-2012-11898 and RYC-2014-14984). The authors (L. Lijó, S. González-García and M.T. Moreira) belong to CRETUS (AGRUP2015/02) and the Galician Competitive Research Group GRC 2013-032.This research was supported by the EU projects: LIFE+ LIVE-WASTE (LIFE 12 ENV/CY/000544) and PIONEER (PCIN-2015-227) and by the BBVA programme “2015 edition of the BBVA Foundation Grants for Researchers and Cultural Creators” (2015-PO027). L. Lijó would like to thank the COST Action ES1202 for a Short Term Scientific Mission grant. Dr. S. González-Garcia would like to express her gratitude to the Spanish Ministry of Economy and Competitivity for financial support (Grants references JCI-2012-11898 and RYC-2014-14984). The authors (L. Lijó, S. González-García and M.T. Moreira) belong to CRETUS (AGRUP2015/02) and the Galician Competitive Research Group GRC 2013-032