Sizing and Layout Design of an Aeroelastic Wingbox Through Nested Optimization

The goals of this work are to 1) develop an optimization algorithm that can simultaneously handle a large number of sizing variables and topological layout variables for an aeroelastic wingbox optimization problem and 2) utilize this algorithm to ascertain the benefits of curvilinear wingbox components. The algorithm used here is a nested optimization, where the outer level optimizes the rib and skin stiffener layouts with a surrogate-based optimizer, and the inner level sizes all of the components via gradient-based optimization. Two optimizations are performed: one restricted to straight rib and stiffener components only, the other allowing curved members. A moderate 1.18% structural mass reduction is obtained through the use of curvilinear members

Comment on: "Diagnosis of Periprosthetic Joint Infection: The Role of Nuclear Medicine May Be Overestimated" by Claudio Diaz-Ledezma, Courtney Lamberton, Paul Lichtstein and Javad Parvizi

We read with interest the article by Diaz-Ledezma et al entitled“Diagnosis of Periprosthetic Joint Infection: The Role of NuclearMedicine May Be Overestimated”recently published in The Journal ofArthroplast

Computer 3D modeling of radiofrequency ablation of atypical cartilaginous tumours in long bones using finite element methods and real patient anatomy

BACKGROUND: Radiofrequency ablation (RFA) is a minimally invasive technique used for the treatment of neoplasms, with a growing interest in the treatment of bone tumours. However, the lack of data concerning the size of the resulting ablation zones in RFA of bone tumours makes prospective planning challenging, needed for safe and effective treatment. METHODS: Using retrospective computed tomography and magnetic resonance imaging data from patients treated with RFA of atypical cartilaginous tumours (ACTs), the bone, tumours, and final position of the RFA electrode were segmented from the medical images and used in finite element models to simulate RFA. Tissue parameters were optimised, and boundary conditions were defined to mimic the clinical scenario. The resulting ablation diameters from postoperative images were then measured and compared to the ones from the simulations, and the error between them was calculated. RESULTS: Seven cases had all the information required to create the finite element models. The resulting median error (in all three directions) was -1 mm, with interquartile ranges from -3 to 3 mm. The three-dimensional models showed that the thermal damage concentrates close to the cortical wall in the first minutes and then becomes more evenly distributed. CONCLUSIONS: Computer simulations can predict the ablation diameters with acceptable accuracy and may thus be utilised for patient planning. This could allow interventional radiologists to accurately define the time, electrode length, and position required to treat ACTs with RFA and make adjustments as needed to guarantee total tumour destruction while sparing as much healthy tissue as possible

Time to Reconsider Routine Percutaneous Biopsy in Spondylodiscitis?

Percutaneous image-guided biopsy currently has a central role in the diagnostic work-up of patients with suspected spondylodiscitis. However, on the basis of recent evidence, the value of routine image-guided biopsy in this disease can be challenged. In this article, we discuss this recent evidence and also share a new diagnostic algorithm for spondylodiscitis that was recently introduced at our institution. Thus, we may move from a rather dogmatic approach in which routine image-guided biopsy is performed in any case to a more individualized use of this procedure. Percutaneous image-guided biopsy, while valuable, is an invasive procedure, and evidence has shown rather disappointing positive microbiologic culture yields of around 33%. Recent evidence also has shown that percutaneous image-guided biopsy rarely adds any new information when blood cultures have positive findings and that an effective empiric treatment can be started in most of cases even when the microbiologic culprit remains unknown. Finally, there is currently no evidence that percutaneous image-guided biopsy improves patient outcome

A Framework for Optimal Control Allocation with Structural Load Constraints

Conventional aircraft generally employ mixing algorithms or lookup tables to determine control surface deflections needed to achieve moments commanded by the flight control system. Control allocation is the problem of converting desired moments into control effector commands. Next generation aircraft may have many multipurpose, redundant control surfaces, adding considerable complexity to the control allocation problem. These issues can be addressed with optimal control allocation. Most optimal control allocation algorithms have control surface position and rate constraints. However, these constraints are insufficient to ensure that the aircraft's structural load limits will not be exceeded by commanded surface deflections. In this paper, a framework is proposed to enable a flight control system with optimal control allocation to incorporate real-time structural load feedback and structural load constraints. A proof of concept simulation that demonstrates the framework in a simulation of a generic transport aircraft is presented

Should all hip and knee prosthetic joints be aspirated prior to revision surgery?

Aims It is essential to exclude a periprosthetic joint infection (PJI) prior to revision surgery. It is recommended to routinely aspirate the joint before surgery. However, this may not be necessary in a subgroup of patients. The aim of our study was to investigate if specific clinical and implant characteristics could be identified to rule out a PJI prior to revision surgery. Methods We retrospectively evaluated clinical and implant characteristics of patients who underwent a hip or knee revision surgery between October 2015 and October 2018. Patients were diagnosed with a PJI according to the MSIS diagnostic criteria. Results A total of 156 patients were analyzed, including 107 implants that were revised because of prosthetic loosening and 49 because of mechanical failure (i.e. instability, malalignment or malpositioning). No PJI was diagnosed in the group with mechanical failure. In the prosthetic loosening group, 20 of 107 were diagnosed with a PJI (19%). Although there was a significantly lower chance of having a PJI with an implant age of > 5 years combined with a CRP < 5 mg/L, an infection was still present in 3 out of 39 cases (8%). Conclusion Implants with solely mechanical failure without signs of loosening and low inflammatory parameters probably do not require a synovial fluid aspiration. These results need to be confirmed in a larger cohort of patients. In case of prosthetic loosening, all joints need to be aspirated before surgery as no specific characteristic could be identified to rule out an infection

Deformed Shape Calculation of a Full-Scale Wing Using Fiber Optic Strain Data from a Ground Loads Test

A ground loads test of a full-scale wing (175-ft span) was conducted using a fiber optic strain-sensing system to obtain distributed surface strain data. These data were input into previously developed deformed shape equations to calculate the wing s bending and twist deformation. A photogrammetry system measured actual shape deformation. The wing deflections reached 100 percent of the positive design limit load (equivalent to 3 g) and 97 percent of the negative design limit load (equivalent to -1 g). The calculated wing bending results were in excellent agreement with the actual bending; tip deflections were within +/- 2.7 in. (out of 155-in. max deflection) for 91 percent of the load steps. Experimental testing revealed valuable opportunities for improving the deformed shape equations robustness to real world (not perfect) strain data, which previous analytical testing did not detect. These improvements, which include filtering methods developed in this work, minimize errors due to numerical anomalies discovered in the remaining 9 percent of the load steps. As a result, all load steps attained +/- 2.7 in. accuracy. Wing twist results were very sensitive to errors in bending and require further development. A sensitivity analysis and recommendations for fiber implementation practices, along with, effective filtering methods are include

Effects of control temperature, ablation time, and background tissue in radiofrequency ablation of osteoid osteoma:A computer modeling study

To study the effects of the control temperature, ablation time, and the background tissue surrounding the tumor on the size of the ablation zone on radiofrequency ablation (RFA) of osteoid osteoma (OO). Finite element models of non‐cooled temperature‐controlled RFA of typical OOs were developed to determine the resulting ablation radius at control temperatures of 70, 80, and 90°C. Three different geometries were used, mimicking common cases of OO. The ablation radius was obtained by using the Arrhenius equation to determine cell viability. Ablation radii were larger for higher temperatures and also increased with time. All geometries and control temperatures tested had ablation radii larger than the tumor. The ablation radius developed rapidly in the first few minutes for all geometries and control temperatures tested, developing slowly towards the end of the ablation. Resistive heating and the temperature distribution showed differences depending on background tissue properties, resulting in differences in the ablation radius on each geometry. The ablation radius has a clear dependency not only on the properties of the tumor but also on the background tissue. Lower background tissue's electrical conductivity and blood perfusion rates seem to result in larger ablation zones. The differences observed between the different geometries suggest the need for patient‐specific planning, as the anatomical variations could cause significantly different outcomes where models like the one here presented could help to guarantee safe and successful tumor ablations

Culture yield of repeat percutaneous image-guided biopsy after a negative initial biopsy in suspected spondylodiscitis:a systematic review

Objective: To systematically review the published data on the culture yield of a repeat (second) percutaneous image-guided biopsy after negative initial biopsy in suspected spondylodiscitis. Materials and methods: A systematic search was performed of the PubMed/Medline and Embase databases. The methodological quality of the studies included was assessed. The proportions of positive cultures among all initial biopsies and second biopsies (after a negative initial biopsy) were calculated for each study and assessed for heterogeneity (defined as I2 > 50%). Results: Eight studies, comprising a total of 107 patients who underwent a second percutaneous image-guided biopsy after a culture-negative initial biopsy in suspected spondylodiscitis, were included. All eight studies were at risk of bias and were concerning with regard to applicability, particularly patient selection, flow of patients through the study, and timing of the biopsy. The proportions of positive cultures among all initial biopsies ranged from 10.3 to 52.5%, and were subject to heterogeneity (I2 = 73.7%). The proportions of positive cultures among all second biopsies after negative initial biopsy ranged from 0 to 60.0%, and were not subject to heterogeneity (I2 = 38.7%). Conclusion: Although a second percutaneous image-guided biopsy may have some value in patients with suspected spondylodiscitis, its exact value remains unclear, given the available poor-quality evidence. Future well-designed studies are needed to determine the role of a second percutaneous image-guided biopsy in this setting. Such studies should clearly describe the spectrum of patients that was selected for a second percutaneous image-guided biopsy, the method of biopsy, and differences compared with the first biopsy, if any