Three-dimensional medical printing and associated legal issues in plastic surgery: a scoping review

Three-dimensional printing (3DP) represents an emerging field of surgery. 3DP can facilitate the plastic surgeon’s workflow, including preoperative planning, intraoperative assistance, and postoperative follow-up. The broad clinical application spectrum stands in contrast to the paucity of research on the legal framework of 3DP. This imbalance poses a potential risk for medical malpractice lawsuits. To address this knowledge gap, we aimed to summarize the current body of legal literature on medical 3DP in the US legal system. By combining the promising clinical use of 3DP with its current legal regulations, plastic surgeons can enhance patient safety and outcomes

Face the Future-Artificial Intelligence in Oral and Maxillofacial Surgery.

Artificial intelligence (AI) has emerged as a versatile health-technology tool revolutionizing medical services through the implementation of predictive, preventative, individualized, and participatory approaches. AI encompasses different computational concepts such as machine learning, deep learning techniques, and neural networks. AI also presents a broad platform for improving preoperative planning, intraoperative workflow, and postoperative patient outcomes in the field of oral and maxillofacial surgery (OMFS). The purpose of this review is to present a comprehensive summary of the existing scientific knowledge. The authors thoroughly reviewed English-language PubMed/MEDLINE and Embase papers from their establishment to 1 December 2022. The search terms were (1) "OMFS" OR "oral and maxillofacial" OR "oral and maxillofacial surgery" OR "oral surgery" AND (2) "AI" OR "artificial intelligence". The search format was tailored to each database's syntax. To find pertinent material, each retrieved article and systematic review's reference list was thoroughly examined. According to the literature, AI is already being used in certain areas of OMFS, such as radiographic image quality improvement, diagnosis of cysts and tumors, and localization of cephalometric landmarks. Through additional research, it may be possible to provide practitioners in numerous disciplines with additional assistance to enhance preoperative planning, intraoperative screening, and postoperative monitoring. Overall, AI carries promising potential to advance the field of OMFS and generate novel solution possibilities for persisting clinical challenges. Herein, this review provides a comprehensive summary of AI in OMFS and sheds light on future research efforts. Further, the advanced analysis of complex medical imaging data can support surgeons in preoperative assessments, virtual surgical simulations, and individualized treatment strategies. AI also assists surgeons during intraoperative decision-making by offering immediate feedback and guidance to enhance surgical accuracy and reduce complication rates, for instance by predicting the risk of bleeding

Pseudomorphic InGaAs base ballistic hot‐electron device

We report the first successful incorporation of a pseudomorphic InGaAs base in a ballistic hot‐electron device. The device, with a 28‐nm‐thick In0.15Ga0.85As base, had a collector‐base breakdown voltage of 0.55 V and a maximum current transfer ratio of 0.89 at 4.2 K, considerably higher than the 0.75 in a comparable GaAs‐base device. Electron energy spectroscopy measurements revealed that at least 30% of the injected electrons traversed the InGaAs base ballistically, causing a strong modulation in the injected currents into the quantized base. The Γ‐L valley separation in the strained In0.15Ga0.85As was estimated to be about 410 meV.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/71077/2/APPLAB-53-20-1946-1.pd

Association of age with perioperative morbidity among patients undergoing surgical management of minor burns

INTRODUCTION: Burn injuries are associated with significant morbidity, often necessitating surgical management. Older patients are more prone to burns and more vulnerable to complications following major burns. While the relationship between senescence and major burns has already been thoroughly investigated, the role of age in minor burns remains unclear. To better understand differences between elderly and younger patients with predominantly minor burns, we analyzed a multi-institutional database. METHODS: We reviewed the 2008-2020 ACS-NSQIP database to identify patients who had suffered burns according to ICD coding and underwent initial burn surgery. RESULTS: We found 460 patients, of which 283 (62%) were male and 177 (38%) were female. The mean age of the study cohort was 46 ± 17 years, with nearly one-fourth (n = 108; 23%) of all patients being aged ≥60 years. While the majority (n = 293; 64%) suffered from third-degree burns, 22% (n = 99) and 15% (n = 68) were diagnosed with second-degree burns and unspecified burns, respectively. An average operation time of 46 min, a low mortality rate of 0.2% (n = 1), a short mean length of hospital stay (1 day), and an equal distribution of in- and outpatient care (51%, n = 234 and 49%, n = 226, respectively) indicated that the vast majority of patients suffered from minor burns. Patients aged ≥60 years showed a significantly prolonged length of hospital stay (p0.0001), creatinine (p>0.0001), white blood cell count (p=0.02), partial thromboplastin time (p = 0.004), and lower levels of albumin (p = 0.0009) and hematocrit (p>0.0001) were identified as risk factors for the occurrence of any complication. Further, complications were more frequent among patients with lower body burns. DISCUSSION: In conclusion, patients ≥60 years undergoing surgery for predominantly minor burns experienced significantly more complications. Minor lower body burns correlated with worse outcomes and a higher incidence of adverse events. Decreased levels of serum albumin and hematocrit and elevated values of blood urea nitrogen, creatinine, white blood count, and partial thromboplastin time were identified as predictive risk factors for complications

Three-dimensional Medical Printing and Associated Legal Issues in Plastic Surgery: A Scoping Review

Three-dimensional printing (3DP) represents an emerging field of surgery. 3DP can facilitate the plastic surgeon’s workflow, including preoperative planning, intraoperative assistance, and postoperative follow-up. The broad clinical application spectrum stands in contrast to the paucity of research on the legal framework of 3DP. This imbalance poses a potential risk for medical malpractice lawsuits. To address this knowledge gap, we aimed to summarize the current body of legal literature on medical 3DP in the US legal system. By combining the promising clinical use of 3DP with its current legal regulations, plastic surgeons can enhance patient safety and outcomes

Histomorphometry of the Sural Nerve for Use as a CFNG in Facial Reanimation Procedures

Facial palsy (FP) is a debilitating nerve pathology. Cross Face Nerve Grafting (CFNG) describes a surgical technique that uses nerve grafts to reanimate the paralyzed face. The sural nerve has been shown to be a reliable nerve graft with little donor side morbidity. Therefore, we aimed to investigate the microanatomy of the sural nerve. Biopsies were obtained from 15 FP patients who underwent CFNG using sural nerve grafts. Histological cross-sections were fixated, stained with PPD, and digitized. Histomorphometry and a validated software-based axon quantification were conducted. The median age of the operated patients was 37 years (5–62 years). There was a significant difference in axonal capacity decrease towards the periphery when comparing proximal vs. distal biopsies (p = 0.047), while the side of nerve harvest showed no significant differences in nerve caliber (proximal p = 0.253, distal p = 0.506) and axonal capacity for proximal and distal biopsies (proximal p = 0.414, distal p = 0.922). Age did not correlate with axonal capacity (proximal: R = −0.201, p = 0.603; distal: R = 0.317, p = 0.292). These novel insights into the microanatomy of the sural nerve may help refine CFNG techniques and individualize FP patient treatment plans, ultimately improving overall patient outcomes

Vortex Motion Noise in Micrometre-Sized Thin Films of the Amorphous Nb0.7Ge0.3 Weak-Pinning Superconductor

We report high-resolution measurements of voltage (V) noise in the mixed state of micrometre-sized thin films of amorphous Nb0.7Ge0.3, which is a good representative of weak-pinning superconductors. There is a remarkable difference between the noise below and above the irreversibility field Birr. Below Birr, in the presence of measurable pinning, the noise at small applied currents resembles shot noise, and in the regime of flux flow at larger currents decreases with increasing voltage due to a progressive ordering of the vortex motion. At magnetic fields B between Birr and the upper critical field Bc2 flux flow is present already at vanishingly small currents. In this regime the noise scales with (1-B/Bc2)^2 V^2 and has a frequency (f) spectrum of 1/f type. We interpret this noise in terms of the properties of strongly driven depinned vortex systems at high vortex density.Comment: 8 pages, 5 figures, version accepted for publication in PR

Evidence of Vortices on the Insulating Side of the Superconductor-Insulator Transition

The magnetoresistance of ultrathin insulating films of Bi has been studied with magnetic fields applied parallel and perpendicular to the plane of the sample. Deep in the strongly localized regime, the magnetoresistance is negative and independent of field orientation. As film thicknesses increase, the magnetoresistance becomes positive, and a difference between values measured in perpendicular and parallel fields appears, which is a linear function of the magnetic field and is positive. This is not consistent with the quantum interference picture. We suggest that it is due to vortices present on the insulating side of the superconductor-insulator transition.Comment: 4 pages, 3 figure