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NEJE interviews Robert Seliger, CEO of Sentillion

There are over 40 million amputees globally with more than 185,000 Americans losing their limbs every year. For most of the world, prosthetic devices remain too expensive and uncomfortable. This paper aims to outline advancements made by a multidisciplinary research group, interested in advancing the restoration of human motion through accessible lower limb prostheses.

Customization, comfort and functionality are the most important metrics reported by prosthetists and patients. The work of this paper presents the design and manufacturing of a custom made, cost-effective and functional three-dimensional (3D) printed transtibial prosthesis monocoque design. The design of the prosthesis integrates 3D imaging, modelling and optimization techniques coupled with additive manufacturing.

The successful fabrication of a functional monocoque prosthesis through 3D printing indicates the workflow may be a solution to the worldwide accessibility crisis. The digital workflow developed in this work offers great potential for providing prosthetic devices to rural communities, which lack access to skilled prosthetic physicians. The authors found that using the workflow together with 3D printing, this study can create custom monocoque prostheses (Figure 16). These prostheses are comfortable, functional and properly aligned. In comparison with traditional prosthetic devices, the authors slowered the average cost, weight and time of production by 95%, 55% and 95%, respectively.

This novel digital design and manufacturing workflow has the potential to democratize and globally proliferate access to prosthetic devices, which restore the patient’s mobility, quality of life and health. LIMBER’s toolbox can reach places where proper prosthetic and orthotic care is not available. The digital workflow reduces the cost of making custom devices by an order of magnitude, enabling broader reach, faster access and improved comfort. This is particularly important for children who grow quickly and need new devices every few months or years, timely access is both physically and psychologically important.

In this manuscript, the authors show the application of digital design techniques for fabricating prosthetic devices. The proposed workflow implements several advantageous changes and, most importantly, digitally blends the three components of a transtibial prosthesis into a single, 3D printable monocoque device. The development of a novel unibody transtibial device that is properly aligned and adjusted digitally, greatly reduces the number of visits an amputee must make to a clinic to have a certified prosthetist adjust and modify their prosthesis. The authors believe this novel workflow has the potential to ease the worldwide accessibility crisis for prostheses.

The purpose of the present study was the development of a methodology for translating predicted rates of decompression sickness (DCS), following tower escape from a sunken submarine, into predicted probability of survival, a more useful statistic for making operational decisions.

Predictions were made, using existing models, for the probabilities of a range of DCS symptoms following submarine tower escape. Subject matter expert estimates of the effect of these symptoms on a submariner’s ability to survive in benign weather conditions on the sea surface until rescued were combined with the likelihoods of the different symptoms occurring using standard probability theory. Plots were generated showing the dependence of predicted probability of survival following escape on the escape depth and the pressure within the stricken submarine.

Current advice on whether to attempt tower escape is based on avoiding rates of DCS above approximately 5%–10%. Consideration of predicted survival rates, based on subject matter expert opinion, suggests that the current advice might be considered as conservative in the distressed submarine scenario, as DCS rates of 10% are not anticipated to markedly affect survival rates.

According to the authors’ knowledge, this study represents the first attempt to quantify the effect of different DCS symptoms on the probability of survival in submarine tower escape.

This paper aims to present a detailed mechanical design of a seven-degrees-of-freedom mobile parallel robot for the tungsten inert gas (TIG) welding and machining processes in fusion reactor. Detailed mechanical design of the robot is presented and both the kinematic and dynamic behaviors are studied.

First, the model of the mobile parallel robot was created in computer-aided design (CAD) software, then the simulation and optimization of the robot were completed to meet the design requirements. Then the robot was manufactured and assembled. Finally, the machining and tungsten inert gas (TIG) welding tests were performed for validation.

Currently, the implementation of the robot system has been successfully carried out in the laboratory. The excellent performance has indicated that the robot’s mechanical and software designs are suitable for the given tasks. The quality and accuracy of welding and machining has reached the requirements.

This mobile parallel industrial robot is particularly used in fusion reactor. Furthermore, the structure of the mobile parallel robot can be optimized for different applications.

Breast-cancer-related lymphedema (BCRL) is a negative condition that affects biopsychosocial aspects of patients treated with breast cancer. Yoga has been reported as one of the complementary and alternative approaches used by patients diagnosed with BCRL. The aim of this systematic review was to explore the effectiveness of yoga on BCRL.

A systematic literature was performed by searching existing papers from the electronic scientific databases. Five papers were exclusively examined. Four studies were conducted in women with BCRL, and one study was conducted with women at risk for BCRL.

Four types of yoga were evaluated in relationship with BCRL, namely: the Satyananda Yoga tradition, the modified Hatha yoga, the aerobic yoga training and the Ashtanga-based yoga practices. Four of five included studies reported that decrease in arm volume was not reported for all yoga-type interventions. One study showed no significant evidence that yoga was associated with limb volume change in women at risk of BCRL. Similarly, three studies reported that the change-of-arm-volume measures were not significantly different between the yoga and the control groups or in the same group before and after the yoga program. One quasi-experimental study reported arm volume significantly decreased after attending the yoga program.

This review reported the importance of being aware that yoga is not shown to be an effective strategy for managing or preventing BCRL. However, quality of research methodology, small sample sizes and the limited number of related studies should be acknowledged. Until more rigorous studies are performed, yoga may continue to be used as a complement to traditional therapy under the supervision of certified trainers.