Deviation compensation in LPBF series production via statistical predeformation and structural pattern analysis

This article proposes two approaches for a tailored geometrical deviation compensation for Laser-Powder-Bed-Fusion production. The deviation compensation is performed by a non-rigid deformation of the manufacturing geometry in each iteration to reduce the geometrical deviations from the target geometry. It is important for geometric compensation approaches to separate deterministic deviations from random scatter, since compensating scatter can result in unstable behaviour. In order to compensate only deterministic deviations two novel approaches for a local estimation of the scatter are successfully introduced and tested using a hybrid model of a series production cycle

Enhancing Parkinson's disease diagnosis accuracy through speech signal algorithm modeling

Parkinson's disease (PD), one of whose symptoms is dysphonia, is a prevalent neurodegenerative disease. The use of outdated diagnosis techniques, which yield inaccurate and unreliable results, continues to represent an obstacle in early-stage detection and diagnosis for clinical professionals in the medical field. To solve this issue, the study proposes using machine learning and deep learning models to analyze processed speech signals of patients' voice recordings. Datasets of these processed speech signals were obtained and experimented on by random forest and logistic regression classifiers. Results were highly successful, with 90% accuracy produced by the random forest classifier and 81.5% by the logistic regression classifier. Furthermore, a deep neural network was implemented to investigate if such variation in method could add to the findings. It proved to be effective, as the neural network yielded an accuracy of nearly 92%. Such results suggest that it is possible to accurately diagnose early-stage PD through merely testing patients' voices. This research calls for a revolutionary diagnostic approach in decision support systems, and is the first step in a market-wide implementation of healthcare software dedicated to the aid of clinicians in early diagnosis of PD

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

A Comprehensive Review on Brain–Computer Interface (BCI)-Based Machine and Deep Learning Algorithms for Stroke Rehabilitation

This literature review explores the pivotal role of brain–computer interface (BCI) technology, coupled with electroencephalogram (EEG) technology, in advancing rehabilitation for individuals with damaged muscles and motor systems. This study provides a comprehensive overview of recent developments in BCI and motor control for rehabilitation, emphasizing the integration of user-friendly technological support and robotic prosthetics powered by brain activity. This review critically examines the latest strides in BCI technology and its application in motor skill recovery. Special attention is given to prevalent EEG devices adaptable for BCI-driven rehabilitation. The study surveys significant contributions in the realm of machine learning-based and deep learning-based rehabilitation evaluation. The integration of BCI with EEG technology demonstrates promising outcomes for enhancing motor skills in rehabilitation. The study identifies key EEG devices suitable for BCI applications, discusses advancements in machine learning approaches for rehabilitation assessment, and highlights the emergence of novel robotic prosthetics powered by brain activity. Furthermore, it showcases successful case studies illustrating the practical implementation of BCI-driven rehabilitation techniques and their positive impact on diverse patient populations. This review serves as a cornerstone for informed decision-making in the field of BCI technology for rehabilitation. The results highlight BCI’s diverse advantages, enhancing motor control and robotic integration. The findings highlight the potential of BCI in reshaping rehabilitation practices and offer insights and recommendations for future research directions. This study contributes significantly to the ongoing transformation of BCI technology, particularly through the utilization of EEG equipment, providing a roadmap for researchers in this dynamic domain

Mn3_3O4_4/ZnO-Al2_2O3_3-CeO2_2 mixed oxide catalyst derived from Mn-doped Zn-(Al/Ce)-LDHs: efficient visible light photodegradation of clofibric acid in water

International audienceMn$_3$O$_4$/ZnO-Al$_2$O$_3$-CeO$_2$ catalyst was synthesized through a solid-state process from a 3% Mn-doped Zn-(Al/Ce) layered double hydroxide structure. Detailed structural and optical characterization using XRD, FTIR, UV-visible DRS, and TEM was conducted. By investigating clofibric acid (CA) degradation in aqueous solution, Mn$_3$O$_4$/ZnO-Al$_2$O$_3$-CeO$_2$ photocatalytic activity was evaluated. The results show that the heterostructure mixed oxide catalyst has excellent CA photodegradation performance. Further, the characterization reveals that such photocatalytic efficiency can be attributed to two facts that are summarized in the optical properties and the synergic effect between Mn and Ce elements. The sample demonstrated a narrow band gap of 2.34 eV based on DRS. According to the experimental results of the photodegradation, after 120 min of irradiation, the photocatalyst exhibited the highest photocatalytic activity, with a degradation efficiency of 93.6%. Optimization outcomes indicated that maximum degradation efficiency was attained under the following optimum conditions: catalyst dose of 0.3 g/L, initial dye concentration of 20 mg/L, pH 3.86, and 120 min of reaction time. The quenching test demonstrates that photogenerated electrons and superoxide radicals are the most powerful reactive species. The catalyst could be useful in decreasing the photogenerated charges recombination, which offers more redox cycles simultaneously during the catalytic process. The strong Ce-Mn interaction and the formation of their different oxidation states offer a high degradation efficiency by facilitating electron-hole transfer. The introduction of Mn$_3$O$_4$ in the catalyst can effectively improve the visible absorption properties, which are beneficial in the photocatalytic process by reaching a high catalytic efficiency at a low cost