Design of a Customized Neck Orthosis for FDM Manufacturing with a New Sustainable Bio-composite

The interest in developing customized external orthopaedic devices, thanks to the advent of Additive Manufacturing (AM), has grown in recent years. Greater attention was focused on upper limb casts, while applications to other body’s parts, such as the neck, were less investigated. In this paper the computer aided design (CAD) modelling, assessment and 3D printing with fused deposition modelling (FDM) of a customized neck orthosis are reported. The modelling, based on anatomic data of a volunteer subject, was aimed to obtain a lightweight, ventilated, hygienic and comfortable orthosis compared to the produced medical devices generally used for neck injuries. CAD models with different geometrical patterns, introduced for lightening and improving breathability, were considered, specifically, a honeycomb pattern and an elliptical holes pattern. These models were structurally assessed by means of finite elements analysis (FEA). Furthermore, an innovative composite material was considered for 3D printing. The material, Hemp Bio-Plastic® (HBP), composed by polylactic acid (PLA) and hemp shives, offers different advantages including lightweight, improved superficial finish and antibacterial properties. The results obtained in terms of design methodology and manufacturing by 3D printing of a prototype have shown the feasibility to develop customized cervical orthoses, with potentially improved performance with respect to cervical collars available on the market also thanks to the use of the innovative composite material

The risk of child and adolescent overweight is related to types of food consumed

<p>Abstract</p> <p>Background/Aims</p> <p>To investigate the association between the risk of overweight and the consumption of food groups in children and adolescents.</p> <p>Methods</p> <p>We studied 1764 healthy children and adolescents (age 6-19y) attending 16 Seventh-Day Adventist schools and 13 public schools using a 106-item non-quantitative food frequency questionnaire from the late 1980 Child-Adolescent Blood Pressure Study. Logistic regression models were used to compute the risk of overweight according to consumption of grains, nuts, vegetables, fruits, meats/fish/eggs, dairy, and, low nutrient-dense foods (LNDF).</p> <p>Results</p> <p>The frequency of consumption of grains, nuts, vegetables and LNDF were inversely related to the risk of being overweight and dairy increased the risk. Specifically, the odds ratio (95% CI) for children in the highest quartile or tertile of consumption compared with the lowest quartile or tertile were as follows: grains 0.59(0.41-0.83); nuts 0.60(0.43-0.85); vegetables 0.67(0.48-0.94); LNDF 0.43(0.29-0.63); and, dairy 1.36(0.97, 1.92).</p> <p>Conclusion</p> <p>The regular intake of specific plant foods may prevent overweight among children and adolescents.</p

Altered Cerebellar-Cerebral Functional Connectivity in Geriatric Depression

Although volumetric and activation changes in the cerebellum have frequently been reported in studies on major depression, its role in the neural mechanism of depression remains unclear. To understand how the cerebellum may relate to affective and cognitive dysfunction in depression, we investigated the resting-state functional connectivity between cerebellar regions and the cerebral cortex in samples of patients with geriatric depression (n = 11) and healthy controls (n = 18). Seed-based connectivity analyses were conducted using seeds from cerebellum regions previously identified as being involved in the executive, default-mode, affective-limbic, and motor networks. The results revealed that, compared with controls, individuals with depression show reduced functional connectivity between several cerebellum seed regions, specifically those in the executive and affective-limbic networks with the ventromedial prefrontal cortex (vmPFC) and increased functional connectivity between the motor-related cerebellum seed regions with the putamen and motor cortex. We further investigated whether the altered functional connectivity in depressed patients was associated with cognitive function and severity of depression. A positive correlation was found between the Crus II–vmPFC connectivity and performance on the Hopkins Verbal Learning Test-Revised delayed memory recall. Additionally, the vermis–posterior cinglate cortex (PCC) connectivity was positively correlated with depression severity. Our results suggest that cerebellum–vmPFC coupling may be related to cognitive function whereas cerebellum–PCC coupling may be related to emotion processing in geriatric depression

Pavlovian Reward Prediction and Receipt in Schizophrenia: Relationship to Anhedonia

Reward processing abnormalities have been implicated in the pathophysiology of negative symptoms such as anhedonia and avolition in schizophrenia. However, studies examining neural responses to reward anticipation and receipt have largely relied on instrumental tasks, which may confound reward processing abnormalities with deficits in response selection and execution. 25 chronic, medicated outpatients with schizophrenia and 20 healthy controls underwent functional magnetic resonance imaging using a Pavlovian reward prediction paradigm with no response requirements. Subjects passively viewed cues that predicted subsequent receipt of monetary reward or non-reward, and blood-oxygen-level-dependent signal was measured at the time of cue presentation and receipt. At the group level, neural responses to both reward anticipation and receipt were largely similar between groups. At the time of cue presentation, striatal anticipatory responses did not differ between patients and controls. Right anterior insula demonstrated greater activation for nonreward than reward cues in controls, and for reward than nonreward cues in patients. At the time of receipt, robust responses to receipt of reward vs. nonreward were seen in striatum, midbrain, and frontal cortex in both groups. Furthermore, both groups demonstrated responses to unexpected versus expected outcomes in cortical areas including bilateral dorsolateral prefrontal cortex. Individual difference analyses in patients revealed an association between physical anhedonia and activity in ventral striatum and ventromedial prefrontal cortex during anticipation of reward, in which greater anhedonia severity was associated with reduced activation to money versus no-money cues. In ventromedial prefrontal cortex, this relationship held among both controls and patients, suggesting a relationship between anticipatory activity and anhedonia irrespective of diagnosis. These findings suggest that in the absence of response requirements, brain responses to reward receipt are largely intact in medicated individuals with chronic schizophrenia, while reward anticipation responses in left ventral striatum are reduced in those patients with greater anhedonia severity

Surprised at All the Entropy: Hippocampal, Caudate and Midbrain Contributions to Learning from Prediction Errors

Influential concepts in neuroscientific research cast the brain a predictive machine that revises its predictions when they are violated by sensory input. This relates to the predictive coding account of perception, but also to learning. Learning from prediction errors has been suggested for take place in the hippocampal memory system as well as in the basal ganglia. The present fMRI study used an action-observation paradigm to investigate the contributions of the hippocampus, caudate nucleus and midbrain dopaminergic system to different types of learning: learning in the absence of prediction errors, learning from prediction errors, and responding to the accumulation of prediction errors in unpredictable stimulus configurations. We conducted analyses of the regions of interests' BOLD response towards these different types of learning, implementing a bootstrapping procedure to correct for false positives. We found both, caudate nucleus and the hippocampus to be activated by perceptual prediction errors. The hippocampal responses seemed to relate to the associative mismatch between a stored representation and current sensory input. Moreover, its response was significantly influenced by the average information, or Shannon entropy of the stimulus material. In accordance with earlier results, the habenula was activated by perceptual prediction errors. Lastly, we found that the substantia nigra was activated by the novelty of sensory input. In sum, we established that the midbrain dopaminergic system, the hippocampus, and the caudate nucleus were to different degrees significantly involved in the three different types of learning: acquisition of new information, learning from prediction errors and responding to unpredictable stimulus developments. We relate learning from perceptual prediction errors to the concept of predictive coding and related information theoretic accounts

Mindful Aging: The Effects of Regular Brief Mindfulness Practice on Electrophysiological Markers of Cognitive and Affective Processing in Older Adults

There is growing interest in the potential benefits of mindfulness meditation practices in terms of counteracting some of the cognitive effects associated with aging. Pursuing this question, the aim of the present study was to investigate the influence of mindfulness training on executive control and emotion regulation in older adults, by means of studying behavioral and electrophysiological changes. Participants, 55 to 75 years of age, were randomly allocated to an 8-week mindful breath awareness training group or an active control group engaging in brain training exercises. Before and after the training period, participants completed an emotional-counting Stroop task, designed to measure attentional control and emotion regulation processes. Concurrently, their brain activity was measured by means of 64-channel electroencephalography. The results show that engaging in just over 10 min of mindfulness practice five times per week resulted in significant improvements in behavioral (response latency) and electrophysiological (N2 event-related potential) measures related to general task performance. Analyses of the underlying cortical sources (Variable Resolution Electromagnetic Tomography, VARETA) indicate that this N2-related effect is primarily associated with changes in the right angular gyrus and other areas of the dorsal attention network. However, the study did not find the expected specific improvements in executive control and emotion regulation, which may be due to the training instructions or the relative brevity of the intervention. Overall, the results indicate that engaging in mindfulness meditation training improves the maintenance of goal-directed visuospatial attention and may be a useful strategy for counteracting cognitive decline associated with aging

Investigating the effects of cervical collar design and fit on the biomechanical and biomarker reaction at the skin

Peter R Worsley,&nbsp;Nathan D Stanger,&nbsp;Aran K Horrell, Dan L Bader Clinical Academic Facility, Faculty of Health Sciences, University of Southampton, Southampton, UK Background: Research has shown that up to 33% of pressure ulcers (PUs) acquired in hospitals result from the application of a medical device. Cervical collars (C-collars) have been impli-cated in causing PUs, due to the mechanical force they apply to the skin. In order to improve our understanding of collar-related PUs, the present study aimed to assess the biomechanical, biochemical, and microclimate effects of C-collar design and fitting tension. Methods: A cohort of 15 healthy volunteers was fit with two different C-collars according to the manufacturer guidelines. Two further collar tensions were also defined as loose and tight for each device. Each collar condition was applied for 15 minutes, with a 10 minute refractory period. Measurements at the device&ndash;skin interface included interface pressures, inflammatory biomarkers, microclimate, range of cervical motion, and comfort scores. Results: The interface pressures at each tissue site increased monotonically with greater collar tension (p&lt;0.01), irrespective of collar design. Biomarker analysis revealed that inflammatory cytokines (IL-1a) were elevated during collar application, with the highest increase during the tight fit condition, representing over a fourfold increase from unloaded conditions. Regardless of collar tension or type, there was an increase in temperature 1.5&deg;C &plusmn;0.8&deg;C compared to baseline values. Range of motion significantly decreased with greater strap tension (p&lt;0.05), with an associated increase in discomfort. Conclusion: The present findings revealed that increasing C-collar tensions caused elevated contact pressures at the device&ndash;skin interface, with a corresponding inflammatory response at the skin. These peak contact pressures were highest at the occiput, corresponding with reported PU locations. Devices should be designed to uniformly distribute pressures, and appropriate guidance is needed for their application. Keywords: cervical collar, pressure ulcer, device design, biomechanics, biomarker

Investigating the effects of strap tension during non-invasive ventilation mask application: a combined biomechanical and biomarker approach

Peter R Worsley,&nbsp;George Prudden,&nbsp;George Gower,&nbsp;Dan L Bader Southampton General Hospital, Clinical Academic Facility, Faculty of Health Sciences, University of Southampton, Southampton, UK Abstract: Non-invasive ventilation is commonly used for respiratory support. However, in some cases, mask application can cause pressure ulcers to specific features of the face, resulting in pain and reduced quality of life for the individual. This study investigated the effects of mask strap tension on the biomechanical and biomarker responses at the skin interface. Healthy participants (n=13) were recruited and assigned two different masks in a random order, which were fitted with three strap conditions representing increments of 5&nbsp;mm to increase tension. Masks were worn for 10&nbsp;minutes at each tension followed by a 10-minute refractory period. Assessment at the device&ndash;skin interface included measurements of pressures at the nose and cheeks, temperature and humidity, a selection of inflammatory cytokine concentrations collected from sebum and scores of comfort. The results indicated significantly higher interface pressures at the bridge of the nose compared to the cheeks for both masks (p&lt;0.05), with nasal interface pressures significantly increasing with elevated strap tension (p&lt;0.05). One inflammatory cytokine, IL-1&alpha;, increased following mask application at the highest tension, with median increases from baselines ranging from 21 to 33%. The other cytokines revealed a less consistent trend with strap tension. The participants reported statistically greater discomfort during elevated strap tension. Temperature and humidity values under the mask were elevated from ambient conditions, although no differences were observed between mask type or strap tension. The bony prominence on the bridge of the nose represented a vulnerable area of skin during respiratory mask application. This study has shown that mask strap tension has a significant effect on the pressure exerted on the nose. This can result in discomfort and an inflammatory response at the skin surface. Further studies are required to investigate respiratory mask application for appropriate individuals with comorbidities. Keywords: medical device, pressure ulcers, respiratory masks, non-invasive ventilation, biomarker