Integrating musculoskeletal simulation and machine learning: a hybrid approach for personalized ankle-foot exoskeleton assistance strategies.

Lower limb exoskeletons have shown considerable potential in assisting human walking, particularly by reducing metabolic cost (MC), leading to a surge of interest in this field in recent years. However, owing to significant individual differences and the uncertainty of movements, challenges still exist in the personalized design and control of exoskeletons in human-robot interactions. In this study, we propose a hybrid data-driven approach that integrates musculoskeletal simulation with machine learning technology to customize personalized assistance strategies efficiently and adaptively for ankle-foot exoskeletons.

Predicting the severity of white matter lesions among patients with cerebrovascular risk factors based on retinal images and clinical laboratory data: a deep learning study.

Background And Purpose: As one common feature of cerebral small vascular disease (cSVD), white matter lesions (WMLs) could lead to reduction in brain function. Using a convenient, cheap, and non-intrusive method to detect WMLs could substantially benefit to patient management in the community screening, especially in the settings of availability or contraindication of magnetic resonance imaging (MRI). Therefore, this study aimed to develop a useful model to incorporate clinical laboratory data and retinal images using deep learning models to predict the severity of WMLs.

Evaluation of extent vs velocity of cortical venous filing in stroke outcome after endovascular thrombectomy.

Purpose: Abnormal venous drainage may affect the prognosis of patients undergoing endovascular reperfusion therapy (ERT). Herein, time-resolved dynamic computed tomography arteriography (dCTA) was applied to evaluate the relationship between the velocity and extent of cortical venous filling (CVF), collateral status and outcomes.

Methods: Thirty-five consecutive patients with acute anterior circulation occlusion who underwent ERT within 24 h of onset and successfully recanalized were enrolled.

Poor Internal Jugular Venous Outflow Is Associated with Poor Cortical Venous Outflow and Outcomes after Successful Endovascular Reperfusion Therapy.

Many patients show poor outcomes following endovascular reperfusion therapy (ERT), and poor cortical venous outflow is a risk factor for these poor outcomes. We investigated the association between the outflow of the internal jugular vein (IJV) and baseline cortical venous outflow and the outcomes after ERT. We retrospectively enrolled 78 patients diagnosed with an acute anterior circulation stroke and successful ERT.

Inhibitors of Glucosylceramide Synthase.

Glucosylceramide synthase can be targeted by high affinity small molecular weight inhibitors for the study of glycosphingolipid metabolism and function or for the treatment of glycosphingolipid storage disorders, including Gaucher and Fabry disease. This work is exemplified by the discovery and development of eliglustat tartrate, the first stand-alone small chemical entity approved for the treatment of Gaucher disease type 1. The development of inhibitors of glucosylceramide synthase that have utility for either research or clinical purposes begins with a testing funnel for screening candidate inhibitors for activity against this enzyme and for activity in lowering the content of glucosylceramide in intact cells.

Importance of posterior tibial slope in joint kinematics with an anterior cruciate ligament-deficient knee.

Aims: To fully quantify the effect of posterior tibial slope (PTS) angles on joint kinematics and contact mechanics of intact and anterior cruciate ligament-deficient (ACLD) knees during the gait cycle.

Methods: In this controlled laboratory study, we developed an original multiscale subject-specific finite element musculoskeletal framework model and integrated it with the tibiofemoral and patellofemoral joints with high-fidelity joint motion representations, to investigate the effects of 2.5° increases in PTS angles on joint dynamics and contact mechanics during the gait cycle.

The Digital Twin in Medicine: A Key to the Future of Healthcare?

There is a growing need for precise diagnosis and personalized treatment of disease in recent years. Providing treatment tailored to each patient and maximizing efficacy and efficiency are broad goals of the healthcare system. As an engineering concept that connects the physical entity and digital space, the digital twin (DT) entered our lives at the beginning of Industry 4.

Clinical applications and prospects of 3D printing guide templates in orthopaedics.

Background: With increasing requirements for medical effects, and huge differences among individuals, traditional surgical instruments are difficult to meet the patients' growing medical demands. 3D printing is increasingly mature, which connects to medical services critically as well. The patient specific surgical guide plate provides the condition for precision medicine in orthopaedics.

Multiscale modelling for investigating the long-term time-dependent biphasic behaviour of the articular cartilage in the natural hip joint.

A better understanding of the time-dependent biomechanical behaviour of the biphasic hip articular cartilage (AC) under physiological loadings is important to understand the onset of joint pathology and guide the clinical treatment. Current computational studies for the biphasic hip AC were usually limited to short-term duration or using elaborate loading. The present study aimed to develop a multiscale computational modelling to investigate the long-term biphasic behaviour of the hip AC under physiological loadings over multiple gait cycles.

Incremental Element Deletion-Based Finite Element Analysis of the Effects of Impact Speeds, Fall Postures, and Cortical Thicknesses on Femur Fracture.

The proximal femur's numerical simulation could give an effective method for predicting the risk of femoral fracture. However, the majority of existing numerical simulations is static, which does not correctly capture the dynamic properties of bone fractures. On the basis of femoral fracture analysis, a dynamic simulation using incremental element deletion (IED)-based finite element analysis (FEA) was developed and compared to XFEM in this study.

Multiscale finite element musculoskeletal model for intact knee dynamics.

Background And Objective: The dynamic characteristics of the intact knee joint are valuable for treating knee osteoarthritis and designing knee prostheses. However, it remains a challenge to elucidate the detailed dynamics of the knee due to its complexity of anatomical structure and complex interaction with body dynamics.

Methods: In this study, a unique subject-specific musculoskeletal model with a concurrent high-accuracy intact finite element knee model was created and used to simultaneously evaluate the kinematics and mechanics of an intact knee joint during the gait cycle.

Design of a self-centring drill bit for orthopaedic surgery: A systematic comparison of the drilling performance.

Bone drilling is an indispensable and demanding operation among many orthopaedic operations. A dedicated drill bit that can achieve low-trauma and self-centring drilling is in urgent need. In this study, a three-step orthopaedic low-traumatic drill bit design was proposed.

In vivo kinematical validated knee model for preclinical testing of total knee replacement.

Background And Objective: A computational knee model facilitates efficient component design evaluations and preclinical testing under various dynamic loadings. However, the development of a highly mimicked dynamic whole knee model with specified ligament constraints that provides high predictive accuracy with in-vivo experiments remains a challenge.

Methods: In the present study, a musculoskeletal integrated force-driven explicit finite-element knee model with tibiofemoral and patellofemoral joints constrained with detailed soft tissue was developed.

Application of spectral CT in the diagnosis of contrast encephalopathy following carotid artery stenting: a case report.

Background: Contrast encephalopathy is a rare complication of carotid artery stenting (CAS). Contrast encephalopathy is a diagnosis of exclusion that often needs to be distinguished from high perfusion syndrome, cerebral haemorrhage, subarachnoid haemorrhage (SAH), cerebral infarction and so on.

Case Presentation: In this study, we report on a 70-year-old man who was admitted to the hospital with transient ischaemic attacks presenting paroxysmal weakness of limbs in the previous 2 years.

Optimization of Eliglustat-Based Glucosylceramide Synthase Inhibitors as Substrate Reduction Therapy for Gaucher Disease Type 3.

There remain no approved therapies for rare but devastating neuronopathic glyocosphingolipid storage diseases, such as Sandhoff, Tay-Sachs, and Gaucher disease type 3. We previously reported initial optimization of the scaffold of eliglustat, an approved therapy for the peripheral symptoms of Gaucher disease type 1, to afford , which effected modest reductions in brain glucosylceramide (GlcCer) in normal mice at 60 mg/kg. The relatively poor pharmacokinetic properties and high Pgp-mediated efflux of prompted further optimization of the scaffold.

Enhanced In-Silico Polyethylene Wear Simulation of Total Knee Replacements During Daily Activities.

A computational wear simulator is an efficient tool for evaluating the wear of artificial knee joints. The classical Archard's wear law-based simulator has questionable accuracy and is focused on walking. In this study, an in silico polyethylene wear simulation of total knee replacements was developed considering the various highly demanding daily activities.

Pituitary Apoplexy Leading to Cerebral Infarction: A Systematic Review.

Background: Cerebral infarction caused by pituitary apoplexy (PA) is rare. To characterize the clinical features of cerebral infarction caused by PA, we performed a systematic review.

Summary: The clinical symptoms are mainly sudden headache, hemiplegia, visual impairment, disturbance of consciousness, and ophthalmalgia in patients with cerebral infarction caused by PA.

Thermographic assessment of heat-induced cellular damage during orthopedic surgery.

The heat generated during orthopedic surgery can cause thermal damage to bone cells, leading to cell necrosis, death, and bone resorption. In this study, the drill-exit surface in cortical bone drilling was firstly investigated by infrared thermography to understand the thermal characteristics of bone cutting. In order to mimic the short-term thermal condition of high temperature during surgical cutting, the osteoblasts were exposed to heat shock for short periods of time to investigate the effect of cutting heat on the bone.

Improvements of material removal in cortical bone via impact cutting method.

Bone cutting with high efficiency as well as low levels of forces and damage has a great significance for orthopaedic surgeries. Due to the brittleness and anisotropy of cortical bone, a conventional cutting process can cause irregular crack propagation and fractured bone chip, affecting the tissue removal process and postoperative recovery. In this paper, a high-frequency impact cutting method is investigated, and its effect on fracture propagation, chip formation and cutting forces is studied for orthogonal cutting.

Prediction for the Total MRI Burden of Cerebral Small Vessel Disease With Retinal Microvascular Abnormalities in Ischemic Stroke/TIA Patients.

The association of retinal microvascular abnormalities with the total cerebral small vessel disease (cSVD) burden found on brain MRI has not been determined. In the present study, we examined whether the retinopathy score could predict the total cSVD burden in ischemic stroke/transient ischemic attack (TIA) patients. A simple practical diagnostic tool may help identify candidates for MRI screening.

Analysis of fracture, force, and temperature in orthogonal elliptical vibration-assisted bone cutting.

Bone is a natural composite and its cutting is a common procedure in orthopedic surgery. The processing damage, cutting force, and cutting heat strongly influence postoperative recovery. In this study, a orthogonal elliptical vibration-assisted (EVA) bone cutting system is developed based on semi-brittle behaviors of bone to experimentally investigate fracture, cutting force, roughness and temperature rise.

Experimental and Finite Element Analysis of Force and Temperature in Ultrasonic Vibration Assisted Bone Cutting.

Bone cutting is an essential procedure of orthopedic surgery, while irreversible bone damage would be inevitably caused using the conventional cutting (CC) method. In this study, an ultrasonic vibration-assisted cutting (UVAC) method was applied in bone cutting to investigate the cutting performance, considering the cutting force and temperature rise, in comparison with CC. In addition, a finite element (FE) model was developed to investigate the cutting mechanism and the influence of a wide range of processing parameters on the performance of cutting bone.

Mechanism of material removal in orthogonal cutting of cortical bone.

of a mechanism of bone cutting has an important theoretical and practical significance for orthopaedic surgeries. In this study, the mechanism of material removal in orthogonal cutting of cortical bone is investigated. Chip morphology and crack propagation in cortical bone for various cutting directions and depth-of-cut (DOC) levels are analysed, with consideration of microstructural and sub-microstructural features and material anisotropy.

The Effect of Winter Temperature on Patients with Ischemic Stroke.

BACKGROUND The incidence of ischemic stroke increases in winter. This study aimed to explore the effect of winter temperatures on the risk factors, etiology, coagulation, and degree of neurological impairment in patients with ischemic stroke using temperature and rainfall data from the Guangzhou Meteorological Bureau during the winter months of December, January, and February. MATERIAL AND METHODS We divided 112 patients with ischemic stroke into low-temperature and non-low-temperature groups.