Characterization of Defects and Designed Flaws in Metal Additive Manufacturing (AM) Parts with X-ray Computed Tomography (XCT)

Metal Additive Manufacturing (AM) has great potential to revolutionize manufacturing industries, but a reliable method to detect defects in AM-produced parts with complex internal structures must be developed prior to its widespread adoption. In this research, defects occurring in additively manufactured metal parts are characterized with X-ray Computed Tomography (XCT). In addition, the concept of metrological XCT is introduced, with the goal of providing more accurate dimensional measurements of the internal features. Preliminary experiments have been conducted toward the larger goal of evaluating XCT as a viable option for nondestructive evaluation of AM-produced components. Critical to this evaluation is the principle of the Probability of Detection (PoD), which has not been previously determined for typical AM defects using XCT. The first step in determining the PoD for XCT is to develop a suitable artifact with embedded features that are representative of the defects occurring in AM-produced parts. Two sets of samples were built by AM and their embedded defects measured by XCT. In the first set of samples, the chosen AM processing parameters were suboptimal, ensuring that defects would be present in the parts. These parameters were also varied to understand their effect on the resulting microstructure and defect formation. Measurements of porosity and the pore size distribution were determined from the XCT images. In the second set of samples, synthetic internal features were added, some approximating typical AM defects. Dimensional XCT was used to evaluate the quality of these features. Based on the results, a future experiment with the goal of estimating the PoD of critical AM defects with an XCT system is suggested

Echocardiographic findings and subsequent risk of native valve endocarditis

Background: The association of echocardiographic findings and subsequent risk of left-sided native valve endocarditis (LS-NVE) is undefined. The aim of this study was to determine if transthoracic echocardiographic (TTE) measurements are associated with the subsequent development of LS-NVE in patients without cardiac predisposing conditions. Methods: Institutional databases were evaluated for adults diagnosed with LS-NVE from 2008 to 2020. Patients with prosthetic valves, cardiovascular implantable electronic devices, intracardiac devices, injection drug use, and predisposing cardiac conditions were excluded. Only patients who had a TTE performed 6 months to 3 years before the development of LS-NVE were included as cases. Controls were patients within the same Mayo location with a TTE report and were matched in a 1:3 ratio according to age, gender, Charlson Comorbidity Index, and echocardiography date. Results: There were 148 cases and 431 matched controls. As compared to controls, IE cases had a higher prevalence of diabetes mellitus (46.6% vs. 30.4%) and chronic kidney disease (46.6% vs. 28.1%) (p<0.001). Left ventricular outflow tract velocity (p=0.017), left ventricular ejection fraction (p=0.018), and E: e’ ratio (p=0.050) were associated with LS-NVE. Conclusions: Echocardiographic measurements were associated with subsequent LS-NVE development in this pilot study. A larger cohort of LS-NVE patients, however, is needed to validate these findings

Normal Global Longitudinal Strain: An Individual Patient Meta-Analysis

peer reviewed[No abstract available

X-ray computed tomography for additive manufacturing: a review

In this review, the use of x-ray computed tomography (XCT) is examined, identifying the requirement for volumetric dimensional measurements in industrial verification of additively manufactured (AM) parts. The XCT technology and AM processes are summarised, and their historical use is documented. The use of XCT and AM as tools for medical reverse engineering is discussed, and the transition of XCT from a tool used solely for imaging to a vital metrological instrument is documented. The current states of the combined technologies are then examined in detail, separated into porosity measurements and general dimensional measurements. In the conclusions of this review, the limitation of resolution on improvement of porosity measurements and the lack of research regarding the measurement of surface texture are identified as the primary barriers to ongoing adoption of XCT in AM. The limitations of both AM and XCT regarding slow speeds and high costs, when compared to other manufacturing and measurement techniques, are also noted as general barriers to continued adoption of XCT and AM

The impact of rheumatoid foot on disability in Colombian patients with rheumatoid arthritis

<p>Abstract</p> <p>Background</p> <p>Alterations in the feet of patients with rheumatoid arthritis (RA) are a cause of disability in this population. The purpose of this research was to evaluate the impact that foot impairment has on the patients' global quality of life (QOL) based on validated scales and its relationship to disease activity.</p> <p>Methods</p> <p>This was a cross-sectional study in which 95 patients with RA were enrolled. A complete physical examination, including a full foot assessment, was done. The Spanish versions of the Health Assessment Questionnaire (HAQ) Disability Index and of the Disease Activity Score (DAS 28) were administered. A logistic regression model was used to analyze data and obtain adjusted odds ratios (AORs).</p> <p>Results</p> <p>Foot deformities were observed in 78 (82%) of the patients; hallux valgus (65%), medial longitudinal arch flattening (42%), claw toe (lesser toes) (39%), dorsiflexion restriction (tibiotalar) (34%), cock-up toe (lesser toes) (25%), and transverse arch flattening (25%) were the most frequent. In the logistic regression analysis (adjusted for age, gender and duration of disease), forefoot movement pain, subtalar movement pain, tibiotalar movement pain and plantarflexion restriction (tibiotalar) were strongly associated with disease activity and disability. The positive squeeze test was significantly associated with disability risk (AOR = 6,3; 95% CI, 1.28–30.96; P = 0,02); hallux valgus, and dorsiflexion restriction (tibiotalar) were associated with disease activity.</p> <p>Conclusion</p> <p>Foot abnormalities are associated with active joint disease and disability in RA. Foot examinations provide complementary information related to the disability as an indirect measurement of quality of life and activity of disease in daily practice.</p

Looking through the 'window of opportunity': is there a new paradigm of podiatry care on the horizon in early rheumatoid arthritis?

Over the past decade there have been significant advances in the clinical understanding and care of rheumatoid arthritis (RA). Major paradigm changes include earlier disease detection and introduction of therapy, and 'tight control' of follow-up driven by regular measurement of disease activity parameters. The advent of tumour necrosis factor (TNF) inhibitors and other biologic therapies have further revolutionised care. Low disease state and remission with prevention of joint damage and irreversible disability are achievable therapeutic goals. Consequently new opportunities exist for all health professionals to contribute towards these advances. For podiatrists relevant issues range from greater awareness of current concepts including early referral guidelines through to the application of specialist skills to manage localised, residual disease activity and associated functional impairments. Here we describe a new paradigm of podiatry care in early RA. This is driven by current evidence that indicates that even in low disease activity states destruction of foot joints may be progressive and associated with accumulating disability. The paradigm parallels the medical model comprising early detection, targeted therapy, a new concept of tight control of foot arthritis, and disease monitoring

Genetic sharing and heritability of paediatric age of onset autoimmune diseases

Autoimmune diseases (AIDs) are polygenic diseases affecting 7–10 % of the population in the Western Hemisphere with few effective therapies. Here, we quantify the heritability of paediatric AIDs (pAIDs)