An investigation into patient-specific 3D printed titanium stents and the use of etching to overcome Selective Laser Melting design constraints

Due to limitations in available paediatric stents for treatment of aortic coarctation, adult stents are often used off-label resulting in less than optimal outcomes. The increasingly widespread use of CT and/or MR imaging for pre-surgical assessment, and the emergence of additive manufacturing processes such as 3D printing, could enable bespoke devices to be produced efficiently and cost-effectively. However, 3D printed metallic stents need to be self-supporting leading to limitations in their design. In this study, we investigate the use of etching to overcome these design constraints and improve stent surface finish. Furthermore, using a combination of experimental bench testing and finite element (FE) methods we investigate how etching influences stent performance. Then using an inverse finite element approach the material properties of the printed and etched stents were calibrated and compared. We show that without etching the titanium stents, the inverse FE approach underestimates the stiffness of the as-built stent (E = 33.89 GPa) when compared to an average of 76.84 GPa for the etched stent designs. Finally, using patient-specific finite element models the different stents’ performance were tested to assess patient outcomes and lumen gain and vessel stresses were found to be strongly influenced by the stent design and postprocessing. Within this study, etching is confirmed as a means to create open-cell stent designs whilst still conforming to additive manufacturing ‘rules’ and concomitantly improving stent surface finish. Additionally, the feasibility of using an in-vivo imaging-to-product development pipeline is demonstrated that enables patient-specific stents to be produced for varying anatomies to achieve optimum device performance.</p

In-vitro Study of Effect of the Design of the Stent on the Arterial Waveforms

Peripheral arterial disease (PAD) occurs as a result of atherosclerosis, which involves plaque formation on the inner walls of the arteries. This reduces the size of the vessel’s lumen and restricts blood flow to the leg muscles, leading to pain, the death of tissue and even the amputation of the lower leg. One treatment method for PAD is the placement of a stent, which acts as a scaffold holding open the artery, increasing blood flow to the lower extremities. However, the stents for PAD are known to fail more regularly due to the complicated biomechanical conditions such as heavy calcified and long atherosclerotic lesions. Stenting in the peripheral arteries still fail in 25% of vessels after 2 years. One of the major influences on the rate of restenosis is the rate at which the platelets become activated. This activation is controlled by changes of wall shear stress, which is in turn influenced by the flow rate, and pressure. This study hypothesizes that stents in the arteries can cause the reflection of the waveform, which would alter the flow rate and pressure waveforms, causing increase in the rate of restenosis. This is potentially why various in-vivo studies have found that stents with thicker struts cause increased levels of restenosis.In this study, the effect of stent design on haemodynamic flow will be investigated, with the intention of optimising the designs currently in use in medicine. By setting up an in-vitro experiment, with an artificial artery, it is possible to record the flow rate, change in diameter and pressure caused to the blood flow by the stent. In this experiment, it is intended to use a series of 3D printed stents of two designs (Palmaz and Zigzag), with differing, strut thickness to determine which causes the most reflection, in an attempt to optimise the stent design

Laser powder bed fusion at sub-atmospheric pressures

The perceived advantages of laser powder bed fusion (PBF) at reduced pressure include a more stable melt pool and reduced porosity. In this study, high-speed imaging was used to investigate the interaction of the laser beam with the powder bed at sub-atmospheric pressures. At atmospheric pressure, the laser plume produces a flow in the ambient atmosphere that entrains particles toward the melt pool. As the pressure decreases, this hydrodynamic entrainment increases but eventually the expansion of the laser plume prevents the particles reaching the melt pool: profiles and cross-sections of the track reveal a drastic reduction in its cross-sectional area. As the pressure decreases further, into the molecular flow regime, particles are only repelled by the plume away from the melt pool. The regime between 1 bar and ∼50 mbar (the threshold pressure at which the penetration depth no longer increases) could provide a window for successful processing but might require a pre-sinter to maintain the integrity of the powder bed. Lower pressures would definitely require a pre-sinter, for which the additional processing time and increase in process complexity might be justified for porosity-critical applications

Age at menarche and the menstrual pattern of secondary school adolescents in northwest Ethiopia

<p>Abstract</p> <p>Background</p> <p>Population studies on normal and dysfunctional characteristics of menstrual cycles are scarce in Ethiopia. In addition variability in menarcheal age and menstrual characteristics are common. Knowledge on this variability is necessary for patient education and to guide clinical evaluation.</p> <p>Methods</p> <p>A cross sectional study was conducted in two small towns called Dabat and Kola Diba, northwest Ethiopia between April and May 2007. Systematic sampling method was used to select 622 school girls from two secondary schools. A pretested questionnaire prepared in Amharic was used to gather data. Selected girls cooperated in answering the questionnaire in their classrooms under the supervision of the research team. Only 612 of the adolescent females were included in the final analysis, of which 305 were from Koladiba High School and 307 from Dabat.</p> <p>Results</p> <p>The age of the study subjects ranges between 14 and 19 with a mean (standard deviation) of 16.9 ± 1 years. About 92.2% had attained menarche by the time the survey was conducted. The probit analysis of the <it>status quo </it>data yielded a median (CI) age at menarche of 14.8 (13.9-15.3) years. The average age at menarche by recall method was 15.8 ± 1 years. The mean age at menarche was 0.3 years younger for urban females compared with rural ones (p < 0.001). A cycle length between 21 and 35 days was observed in 70.3% of the girls. The mean duration of flow was 4 ± 1.3 days with a range of 2-7 days. The menstrual cycles were irregular in 42.8% of the subjects. The overall prevalence of dysmenorrhoea was 72% among these subjects. Premenstrual symptoms were present in 435 of the females (75.4%). The leading sources of menarcheal information to the adolescents were mothers (39.7%), followed by their friends (26.6%) and teachers (21.8%).</p> <p>Conclusion</p> <p>In this study age of menarche was found to be delayed which is even higher than the findings indicated similar studies conducted in Ethiopia and other African countries. A significant number of students complain of abnormal menstrual cycle, dysmenorrhoea and premenstrual symptoms which call for appropriate counselling and management.</p

Epoxyeicosatrienoic acids regulate adipocyte differentiation of mouse 3T3 cells, via PGC-1α activation, which is required for HO-1 expression and increased mitochondrial function

Epoxyeicosatrienoic acid (EET) contributes to browning of white adipose stem cells to ameliorate obesity/diabetes and insulin resistance. In the current study, we show that EET altered preadipocyte function, enhanced peroxisome proliferation-activated receptor γ coactivator α (PGC-1α) expression, and increased mitochondrial function in the 3T3-L1 preadipocyte subjected to adipogenesis. Cells treated with EET resulted in an increase, P \u3c 0.05, in PGC-1α and a decrease in mitochondria-derived ROS (MitoSox), P \u3c 0.05. The EET increase in heme oxygenase-1 (HO-1) levels is dependent on activation of PGC-1α as cells deficient in PGC-1α (PGC-1α knockout adipocyte cell) have an impaired ability to express HO-1, P \u3c 0.02. Additionally, adipocytes treated with EET exhibited an increase in mitochondrial superoxide dismutase (SOD) in a PGC-1α-dependent manner, P \u3c 0.05. The increase in PGC-1α was associated with an increase in β-catenin, P \u3c 0.05, adiponectin expression, P \u3c 0.05, and lipid accumulation, P \u3c 0.02. EET decreased heme levels and mitochondria-derived ROS (MitoSox), P \u3c 0.05, compared to adipocytes that were untreated. EET also decreased mesoderm-specific transcript (MEST) mRNA and protein levels (P \u3c 0.05). Adipocyte secretion of EET act in an autocrine/paracrine manner to increase PGC-1α is required for activation of HO-1 expression. This is the first study to dissect the mechanism by which the antiadipogenic and anti-inflammatory lipid, EET, induces the PGC-1α signaling cascade and reprograms the adipocyte phenotype by regulating mitochondrial function and HO-1 expression, leading to an increase in healthy, that is, small, adipocytes and a decrease in adipocyte enlargement and terminal differentiation. This is manifested by an increase in mitochondrial function and an increase in the canonical Wnt signaling cascade during adipocyte proliferation and terminal differentiation

Isospin Dependence in the Odd-Even Staggering of Nuclear Binding Energies

The FRS-ESR facility at GSI provides unique conditions for precision measurements of large areas on the nuclear mass surface in a single experiment. Values for masses of 604 neutron-deficient nuclides (30<=Z<=92) were obtained with a typical uncertainty of 30 microunits. The masses of 114 nuclides were determined for the first time. The odd-even staggering (OES) of nuclear masses was systematically investigated for isotopic chains between the proton shell closures at Z=50 and Z=82. The results were compared with predictions of modern nuclear models. The comparison revealed that the measured trend of OES is not reproduced by the theories fitted to masses only. The spectral pairing gaps extracted from models adjusted to both masses, and density related observables of nuclei agree better with the experimental data.Comment: Physics Review Letters 95 (2005) 042501 http://link.aps.org/abstract/PRL/v95/e04250

Present and Future Experiments with Stored Exotic Nuclei at Relativistic Energies

Recent progress is presented from experiments on masses and lifetimes of bare and few-electron exotic nuclei at GSI.Comment: Proceedings of International Conference on "Frontiers in Nuclear Structure, Astrophysics and Reactions", Kos, Greece, September 12-17, 200

In situ observation of calcium oxide treatment of inclusions in molten steel by confocal microscopy

Calcium treatment of aluminum killed steel was observed in situ using high-temperature confocal scanning laser microscope (HT-CSLM). This technique along with a novel experimental design enables continuous observation of clustering behavior of inclusions before and after the calcium treatment. Results show that the increase in average inclusion size in non-calcium-treated condition was much faster compared to calcium-treated condition. Results also show that the magnitude of attractive capillary force between inclusion particles in non-treated condition was about 10−15 N for larger particles (10 µm) and 10−16 N for smaller particles (5 µm) and acting length of force was about 30 µm. In the case of calcium-treated condition, the magnitude and acting length of force was reduced to 10−16 N and 10 µm, respectively, for particles of all sizes. This change in attractive capillary attractive force is due to change in inclusion morphology from solid alumina disks to liquid lens particles during calcium treatment