BACKGROUND: Cutaneous neurofibromas (cNFs) are a major cause of disfigurement in patients with Neurofibromatosis Type 1 (NF1). However, clinical trials investigating cNF treatments lack standardised outcome measures to objectively evaluate changes in cNF size and appearance. 3D imaging has been proposed as an objective standardised outcome measure however various systems exist with different features that affect useability in clinical settings. The aim of this study was to compare the accuracy, precision, feasibility, reliability and accessibility of three imaging systems.
METHODS: We compared the Vectra-H1, LifeViz-Micro and Cherry-Imaging systems. A total of 58 cNFs from 13 participants with NF1 were selected for imaging and analysis. The primary endpoint was accuracy as measured by comparison of measurements between imaging systems. Secondary endpoints included reliability between two operators, precision as measured with the average coefficient of variation, feasibility as determined by time to capture and analyse an image and accessibility as determined by cost.
RESULTS: There was no significant difference in accuracy between the three devices for length or surface area measurements (p > 0.05), and reliability and precision were similar. Volume measurements demonstrated the most variability compared to other measurements; LifeViz-Micro demonstrated the least measurement variability for surface area and image capture and analysis were fastest with LifeViz-Micro. LifeViz-Micro was better for imaging smaller number of cNFs (1-3), Vectra-H1 better for larger areas and Cherry for uneven surfaces.
CONCLUSIONS: All systems demonstrated excellent reliability but possess distinct advantages and limitations. Surface area is the most consistent and reliable parameter for measuring cNF size in clinical trials.

Predicting lifespan much more accurately is important for the palliative care team and the families they accompany. However, the way physicians estimate survival time has a gap between the real conditions. This is the first study to use a senseless wearable sensor to collect electrocardiograms from hospice care patients and explore the final moments of patients\' lives by analyzing heart rate variability.

UNASSIGNED: The purpose of this study is to compare the wear properties of UHMWPE acetabular liners after undergoing 3 million (3 Mc) and 5 million (5 Mc) cycles of in-vitro wear testing. The results will serve as a reference for the design of in-vitro testing for hip prostheses and as a control for clinical revision removals.
UNASSIGNED: Wear tests were conducted on three different sizes of acetabular liners (28 mm, 32 mm, and 36 mm internal diameters) using a hip simulator to determine the amount of wear after 3 and 5 million cycles. The analysis included the number, size, and shape of abrasive particles.
UNASSIGNED: After 3 and 5 million cycles of wear, the amount of wear on the acetabular liner increased as the inner diameter increased. The abrasive particles had an average equivalent circular area diameter (ECD) of 0.27 μm and 0.29 μm, and 94.4% and 90.1% of the aspect ratio (AR) less than 4.
UNASSIGNED: The amount of wear on the acetabular liner after 3 Mc wear can indicate the wear performance of the product. The number of particles increased and the percentage of fibrous particles was higher after 5 Mc wear compared to 3 Mc wear.
UNASSIGNED: 分析超高分子量聚乙烯髋臼内衬经历300万次（3 Mc）和500万次（5 Mc）体外磨损测试后磨损性能的差异，为髋关节假体体外测试试验设计作参考，并为临床翻修取出物作对照。.
UNASSIGNED: 使用髋关节模拟机，对内径为28 mm、32 mm、36 mm三种规格的髋臼内衬进行磨损测试，计算3 Mc和5 Mc磨损后的磨损量；分析磨屑颗粒的数量、大小和形状。.
UNASSIGNED: 经历3 Mc、5 Mc磨损后，髋臼内衬磨损量随内径的增大而增多；磨屑颗粒的等效圆面积直径（equivalent circular diameter, ECD）平均值为0.27 μm、0.29 μm，体态比（AR）小于4的占比为94.4%、90.1%。.
UNASSIGNED: 髋臼内衬经历3 Mc磨损后的磨损量可以反映出产品的磨损性能趋势；相比于3 Mc磨损，经历5 Mc磨损后颗粒数量增多、纤维状颗粒占比升高。.

In modern ophthalmic surgery, an intraocular lens (IOL) is commonly implanted into the patient\'s eye with an IOL injector. Many injectors are available, showing various technological differences, from the early manually loaded injector systems to the modern preloaded injectors. This review aims to give a concise overview of the defining characteristics of injector models and draws attention to complications that may occur during IOL implantation. One can differentiate injectors according to their preoperative preparation (manually loaded or preloaded), their implantation mechanism (push-type or screw-type or combined or automated), the size of the nozzle tip, the presence of an insertion depth control feature, and the injector\'s reusability. Potential complications are IOL misconfigurations such as a haptic-optic adhesion, adherence of the IOL to the injector plunger, an overriding plunger, uncontrolled IOL rotation, a trapped trailing haptic, or damage to the IOL. Additionally, during IOL implantation, the nozzle can become damaged with scratches, extensions, cracks, or bursts to the tip. While these complications rarely produce long-term consequences, manufacturers should try to prevent them by further improving their devices. Similarly, surgeons should evaluate new injectors carefully to ensure the highest possible surgical safety.
In der modernen Augenchirurgie wird eine Intraokularlinse (IOL) i. d. R. mithilfe eines IOL-Injektors in das Auge implantiert. Es gibt eine Vielzahl von Injektoren, die sich technologisch unterscheiden, von den frühen manuell zu ladenden Injektorsystemen bis hin zu den moderneren vorgeladenen IOL-Injektoren. Dieser Übersichtsartikel soll einen prägnanten Überblick über die charakteristischen Merkmale der unterschiedlichen Injektormodelle geben und auf Komplikationen aufmerksam machen, die während der IOL-Implantation auftreten können. Die Injektoren lassen sich nach ihrer präoperativen Vorbereitung (manuell geladen oder vorgeladen), ihrem Implantationsmechanismus (Druck- oder Schraubmechanismus, eine Kombination von beidem oder ein Automatismus), der Größe der Injektorspitze, dem Vorhandensein einer Funktion zur Kontrolle der Einführtiefe und der Wiederverwendbarkeit des Injektors unterscheiden. Zu den potenziellen Komplikationen gehören Fehlkonfigurationen der IOL, wie z. B. eine Haptik-Optik-Adhäsion, ein Anhaften der IOL am Kolben des Injektors, ein vorbeischiebender Injektorkolben, eine unkontrollierte IOL-Rotation, eine eingeklemmte Haptik oder eine Beschädigung der IOL. Darüber hinaus kann die Injektorspitze während der IOL-Implantation durch Kratzer, Ausdehnungen, Risse oder Aufplatzen der Spitze beschädigt werden. Obwohl diese Komplikationen selten langfristige Folgen haben, sollten die Hersteller versuchen, das Auftreten von Komplikationen durch weitere Verbesserungen der Injektoren zu verhindern. In der Zwischenzeit sollten Chirurgen vor der IOL-Implantation die IOL-Injektor-Systeme genaustens begutachten, um eine größtmögliche chirurgische Sicherheit zu gewährleisten.

Micro-sensors, such as pressure and flow sensors, are usually adopted to attain actual fluid information around swimming biomimetic robotic fish for hydrodynamic analysis and control. However, most of the reported micro-sensors are mounted discretely on body surfaces of robotic fish and it is impossible to analyzed the hydrodynamics between the caudal fin and the fluid. In this work, a biomimetic caudal fin integrated with a resistive pressure sensor is designed and fabricated by laser machined conductive carbon fibre composites. To analyze the pressure exerted on the caudal fin during underwater oscillation, the pressure on the caudal fin is measured under different oscillating frequencies and angles. Then a model developed from Bernoulli equation indicates that the maximum pressure difference is linear to the quadratic power of the oscillating frequency and the maximum oscillating angle. The fluid disturbance generated by caudal fin oscillating increases with an increase of oscillating frequency, resulting in the decrease of the efficiency of converting the kinetic energy of the caudal fin oscillation into the pressure difference on both sides of the caudal fin. However, perhaps due to the longer stability time of the disturbed fluid, this conversion efficiency increases with the increase of the maximum oscillating angle. Additionally, the pressure variation of the caudal fin oscillating with continuous different oscillating angles is also demonstrated to be detected effectively. It is suggested that the caudal fin integrated with the pressure sensor could be used for sensing thein situflow field in real time and analyzing the hydrodynamics of biomimetic robotic fish.

OBJECTIVE: Subcutaneous implantable cardioverter-defibrillators (S-ICDs) have become established in preventing sudden cardiac death, with some advantages over transvenous defibrillator systems, including a lower incidence of lead failures. Despite technological advancements, S-ICD carriers may suffer from significant complications, such as premature battery depletion (PBD), that led to an advisory for nearly 40 000 patients. This multicentre study evaluated the incidence of PBD in a large set of S-ICD patients.
RESULTS: Data from patients implanted with S-ICD models A209 and A219 between October 2012 and July 2023 across nine centres in Europe and the USA were reviewed. Incidence and implications of PBD, defined as clinically observed sudden drop in battery longevity, were analysed and compared to PBD with the definition of battery depletion within 60 months. Prospectively collected clinical data were obtained retrospectively from medical records, device telemetry, and manufacturer reports. This registry is listed on ClinicalTrials.gov (NCT05713708). Of the 1112 S-ICD devices analysed, 547 (49.2%) were equipped with a potentially affected capacitor linked to PBD occurrence, currently under Food and Drug Administration advisory. The median follow-up time for all patients was 46 [inter-quartile range (IQR) 24-63] months. Clinically suspected PBD was observed in 159 (29.1%) of cases, with a median time to generator removal or replacement of 65 (IQR 55-72) months, indicative of significant deviations from expected battery lifespan. Manufacturer confirmation of PBD was made in 91.7% of devices returned for analysis. No cases of PBD were observed in devices that were not under advisory.
CONCLUSIONS: This manufacturer-independent analysis highlights a notable incidence of PBD in patients equipped with S-ICD models under advisory, and the rate of PBD in this study corresponds to the rate currently estimated by the manufacturer. To the best of our knowledge, this provides the largest contemporary peer-reviewed study cohort investigating the actual incidence of PBD in S-ICD patients. These findings emphasize the importance of post-market registries in collaboration between clinicians and the manufacturer to optimize safety and efficacy in S-ICD treatment.

OBJECTIVE: Conduct a scoping review of research studies that describe rule-based clinical decision support (CDS) malfunctions.
METHODS: In April 2022, we searched three bibliographic databases (MEDLINE, CINAHL, and Embase) for literature referencing CDS malfunctions. We coded the identified malfunctions according to an existing CDS malfunction taxonomy and added new categories for factors not already captured. We also extracted and summarized information related to the CDS system, such as architecture, data source, and data format.
RESULTS: Twenty-eight articles met inclusion criteria, capturing 130 malfunctions. Architectures used included stand-alone systems (eg, web-based calculator), integrated systems (eg, best practices alerts), and service-oriented architectures (eg, distributed systems like SMART or CDS Hooks). No standards-based CDS malfunctions were identified. The \"Cause\" category of the original taxonomy includes three new types (organizational policy, hardware error, and data source) and two existing causes were expanded to include additional layers. Only 29 malfunctions (22%) described the potential impact of the malfunction on patient care.
CONCLUSIONS: While a substantial amount of research on CDS exists, our review indicates there is a limited focus on CDS malfunctions, with even less attention on malfunctions associated with modern delivery architectures such as SMART and CDS Hooks.
CONCLUSIONS: CDS malfunctions can and do occur across several different care delivery architectures. To account for advances in health information technology, existing taxonomies of CDS malfunctions must be continually updated. This will be especially important for service-oriented architectures, which connect several disparate systems, and are increasing in use.

In the early twenty-first century, extensive research has been conducted on geckos\' ability to climb vertical walls with the advancement of microscopy technology. Unprecedented studies and developments have focused on the adhesion mechanism, structural design, preparation methods, and applications of bioinspired dry adhesives. Notably, strong adhesion that adheres to both the principles of contact splitting and stress uniform distribution has been discovered and proposed. The increasing popularity of flexible electronic skins, soft crawling robots, and smart assembly systems has made switchable adhesion properties essential for smart adhesives. These adhesives are designed to be programmable and switchable in response to external stimuli such as magnetic fields, thermal changes, electrical signals, light exposure as well as mechanical processes. This paper provides a comprehensive review of the development history of bioinspired dry adhesives from achieving strong adhesion to realizing switchable adhesion.

This work examines the acoustically actuated motions of artificial flagellated micro-swimmers (AFMSs) and compares the motility of these micro-swimmers with the predictions based on the corrected resistive force theory (RFT) and the bar-joint model proposed in our previous work. The key ingredient in the theory is the introduction of a correction factorKin drag coefficients to correct the conventional RFT so that the dynamics of an acoustically actuated AFMS with rectangular cross-sections can be accurately modeled. Experimentally, such AFMSs can be easily manufactured based on digital light processing of ultra-violet (UV)-curable resins. We first determined the viscoelastic properties of a UV-cured resin through dynamic mechanical analysis. In particular, the high-frequency storage moduli and loss factors were obtained based on the assumption of time-temperature superposition (TTS), which were then applied in theoretical calculations. Though the extrapolation based on the TTS implied the uncertainty of high-frequency material response and there is limited accuracy in determining head oscillation amplitude, the differences between the measured terminal velocities of the AFMSs and the predicted ones are less than 50%, which, to us, is well acceptable. These results indicate that the motions of acoustic AFMS can be predicted, and thus, designed, which pave the way for their long-awaited applications in targeted therapy.

Objective.Micro-electrocorticographic (μECoG) arrays are able to record neural activities from the cortical surface, without the need to penetrate the brain parenchyma. Owing in part to small electrode sizes, previous studies have demonstrated that single-unit spikes could be detected from the cortical surface, and likely from Layer I neurons of the neocortex. Here we tested the ability to useμECoG arrays to decode, in rats, body position during open field navigation, through isolated single-unit activities.Approach. μECoG arrays were chronically implanted onto primary motor cortex (M1) of Wistar rats, and neural recording was performed in awake, behaving rats in an open-field enclosure. The signals were band-pass filtered between 300-3000 Hz. Threshold-crossing spikes were identified and sorted into distinct units based on defined criteria including waveform morphology and refractory period. Body positions were derived from video recordings. We used gradient-boosting machine to predict body position based on previous 100 ms of spike data, and correlation analyses to elucidate the relationship between position and spike patterns.Main results.Single-unit spikes could be extracted during chronic recording fromμECoG, and spatial position could be decoded from these spikes with a mean absolute error of prediction of 0.135 and 0.090 in the x- and y- dimensions (of a normalized range from 0 to 1), and Pearson\'s r of 0.607 and 0.571, respectively.Significance. μECoG can detect single-unit activities that likely arise from superficial neurons in the cortex and is a promising alternative to intracortical arrays, with the added benefit of scalability to cover large cortical surface with minimal incremental risks. More studies should be performed in human related to its use as brain-machine interface.