Safety and efficacy of antenatal milk expressing for women with diabetes in pregnancy: protocol for a randomised controlled trial

Many maternity providers recommend that women with diabetes in pregnancy express and store breast milk in late pregnancy so breast milk is available after birth, given (1) infants of these women are at increased risk of hypoglycaemia in the first 24 h of life; and (2) the delay in lactogenesis II compared with women without diabetes that increases their infant's risk of receiving infant formula. The Diabetes and Antenatal Milk Expressing (DAME) trial will establish whether advising women with diabetes in pregnancy (pre-existing or gestational) to express breast milk from 36 weeks gestation increases the proportion of infants who require admission to special or neonatal intensive care units (SCN/NICU) compared with infants of women receiving standard care. Secondary outcomes include birth gestation, breastfeeding outcomes and economic impact.

Equivalent dynamic thermoviscoelastic modeling of ionic polymers

Ionic polymers have attracted considerable attention due to their interesting sensing and actuating behavior which make them a proper choice for use in a wide range of applications including biomimetic robots and biomedical devices. The complicated electro-chemo-mechanical dynamics of ionic polymer actuators is a drawback for their applications in functional devices. Therefore, establishing a mathematical model which could effectively predict the actuators' dynamic behavior is of great interest. In this paper, a mathematical model, named equivalent dynamic thermoviscoelastic (EDT) model, based on thermal analogy and beam theory is proposed for dynamic analysis of bending-type ionic polymer actuators. Then, the developed model is extended for analyzing the performance of the actuator in finite element software. The finite element analysis of the actuator enables consideration of material and geometric nonlinearities and facilitates modeling of functional devices based on the ionic polymer actuators. The proposed modeling approach is validated using experimental data.

Quality-based SQL: specifying information quality in relational database queries

A Structured Query Language extension uses an estimator module to evaluate quality profiles that rate the accuracy and completeness of query results. Users receive information that matches their defined quality constraints and better serves their data needs.

Development of a novel soft parallel robot equipped with polymeric artificial muscles

This paper presents the design, analysis and fabrication of a novel low-cost soft parallel robot for biomedical applications, including bio-micromanipulation devices. The robot consists of two active flexible polymer actuator-based links, which are connected to two rigid links by means of flexible joints. A mathematical model is established between the input voltage to the polymer actuators and the robot's end effector position. The robot has two degrees-of-freedom, making it suitable for handling planar micromanipulation tasks. Moreover, a number of robots can be configured to operate in a cooperative manner for increasing micromanipulation dexterity. Finally, the experimental results demonstrate two main motion modes of the robot.

Nonlinear large deformation dynamic analysis of electroactive polymer actuators

Electroactive polymers have attracted considerable attention in recent years due to their sensing and actuating properties which make them a material of choice for a wide range of applications including sensors, biomimetic robots, and biomedical micro devices. This paper presents an effective modeling strategy for nonlinear large deformation (small strains and moderate rotations) dynamic analysis of polymer actuators. Considering that the complicated electro-chemo-mechanical dynamics of these actuators is a drawback for their application in functional devices, establishing a mathematical model which can effectively predict the actuator's dynamic behavior can be of paramount importance. To effectively predict the actuator's dynamic behavior, a comprehensive mathematical model is proposed correlating the input voltage and the output bending displacement of polymer actuators. The proposed model, which is based on the rigid finite element (RFE) method, consists of two parts, namely electrical and mechanical models. The former is comprised of a ladder network of discrete resistive-capacitive components similar to the network used to model transmission lines, while the latter describes the actuator as a system of rigid links connected by spring-damping elements (sdes). Both electrical and mechanical components are validated through experimental results.

Enhancement of the antifouling properties and filtration performance of poly(ethersulfone) ultrafiltration membranes by incorporation of nanoporous titania nanoparticles

Nanoporous titania nanoparticles (NTNs) were synthesized and used as an additive at a low concentration of 0.1-1 wt % in the fabrication of poly(ethersulfone) (PES) ultrafiltration membranes via non-solvent-induced phase separation. The structure and properties of nanoparticles were characterized using nitrogen sorption, X-ray diffraction, scanning electron microscopy, and transmission electron microscopy. The NTNs have a size distribution with a particle size of mainly <100 nm and have a Brunauer, Emmett, and Teller surface area of ∼100 m2 g-1. The modified membranes were fabricated and investigated in terms of their pure water flux, solute rejection, and fouling resistance. The water permeability and molecular weight cutoffs (MWCOs) of membranes were determined under constant-pressure filtration in dead-end mode at 100 kPa. The membrane fouling resistance was characterized under constant flux operation using bovine serum albumin as a model foulant. The membranes were characterized in terms of morphology, porosity, pore size distribution, energy-dispersive X-ray spectroscopy, contact angle goniometry, surface free energy, and viscosity of the dope solution. Overall, the modified membrane showed increased wettability and reduced surface free energy and pore size. The modified UF membrane with 0.5 wt % NTN loading exhibited improved fouling resistance (fouling rate of 0.58 kPa/min compared to a rate of 0.70 kPa/min for the control membrane) with ∼80% water flux recovery. The same membrane showed an ∼20% increase in water flux, an improvement in MWCO, and a narrower pore size distribution.

Detection of Candida spp. in the vagina of a cohort of nulliparous pregnant women by culture and molecular methods: is there an association between maternal vaginal and infant oral colonisation?

BACKGROUND: Most studies describing vaginal Candida spp. in pregnancy focus on symptomatic vaginitis, rather than asymptomatic colonisation, and solely utilise microbiological culture. The extent to which asymptomatic vaginal carriage may represent a reservoir for infant oral colonisation has been highly debated. MATERIALS AND METHODS: This study formed part of the Candida and Staphylococcus Transmission Longitudinal Evaluation (CASTLE) study, in Melbourne, Australia, from 2009 to 2011 and used culture and molecular methods to examine vaginal swabs collected late in the third trimester of pregnancy for Candida spp. Oral swabs from infants were also examined using culture methods. RESULTS: Overall, 80 of 356 (22%) women were positive for Candida spp; the majority being Candida albicans (83%). Candida glabrata and other Candida spp. were also identified, but in much lower numbers. Molecular analysis identified numerous positive samples not detected by culture, including 13 cases of C. albicans. In addition, some positive samples only recorded to genus level by culture were accurately identified as either C. albicans or C. glabrata following molecular analyses. Eighteen infants recorded positive Candida spp. cultures, predominantly C. albicans. However, there were only four (25%) mother/infant dyads where C. albicans was detected. CONCLUSIONS: This study provides valuable data on asymptomatic colonisation rates of Candida spp. within an asymptomatic population of women late in pregnancy. The utilisation of molecular methods improved the rate of detection and provided a more accurate means for identification of non-albicans Candida spp. The low mother/infant colonisation rate suggests that non-maternal sources are likely involved in determining infant oral colonisation status.

Determinants of mastitis in women in the CASTLE study: a cohort study

BACKGROUND: Mastitis is an acute, debilitating condition that occurs in approximately 20 % of breastfeeding women who experience a red, painful breast with fever. This paper describes the factors correlated with mastitis and investigates the presence of Staphylococcus aureus in women who participated in the CASTLE (Candida and Staphylococcus Transmission: Longitudinal Evaluation) study. The CASTLE study was a prospective cohort study which recruited nulliparous women in late pregnancy in two maternity hospitals in Melbourne, Australia in 2009-2011.

METHODS: Women completed questionnaires at recruitment and six time-points in the first eight weeks postpartum. Postpartum questionnaires asked about incidences of mastitis, nipple damage, milk supply, expressing practices and breastfeeding problems. Nasal and nipple swabs were collected from mothers and babies, as well as breast milk samples. All samples were cultured for S. aureus. "Time at risk" of mastitis was defined as days between birth and first occurrence of mastitis (for women who developed mastitis) and days between birth and the last study time-point (for women who did not develop mastitis). Risk factors for incidence of mastitis occurring during the time at risk (Incident Rate Ratios [IRR]) were investigated using a discrete version of the multivariable proportional hazards regression model.

RESULTS: Twenty percent (70/346) of participants developed mastitis. Women had an increased risk of developing mastitis if they reported nipple damage (IRR 2.17, 95 % CI 1.21, 3.91), over-supply of breast milk (IRR 2.60, 95 % CI 1.58, 4.29), nipple shield use (IRR 2.93, 95 % CI 1.72, 5.01) or expressing several times a day (IRR 1.64, 95 % CI 1.01, 2.68). The presence of S. aureus on the nipple (IRR 1.72, 95 % CI 1.04, 2.85) or in milk (IRR 1.78, 95 % CI 1.08, 2.92) also increased the risk of developing mastitis.

CONCLUSIONS: Nipple damage, over-supply of breast milk, use of nipple shields and the presence of S. aureus on the nipple or in breast milk increased the mastitis risk in our prospective cohort study sample. Reducing nipple damage may help reduce maternal breast infections.

Sensitivity of the final properties of tailored hot stamping components to the process and material parameters

The final mechanical properties of hot stamped components are affected by many process and material parameters due to the multidisciplinary nature of this thermal-mechanical-metallurgical process. The phase transformation, which depends on the temperature field and history, determines the final microstructure and consequently the final mechanical properties. Tailored hot stamping parts - where the cooling rates are locally chosen to achieve structures with graded properties - has been increasingly adopted in the automotive industry. In this case, the robustness of final part properties is more critical than in the conventional hot stamping parts, where the part is fully quenched. In this study, a wide range of input parameters in a generalized hot stamping model have been investigated, examining the effect on the temperature history and resulting final material properties. A generic thermo-mechanical finite element model of hot stamping was created and a modified phase transformation model, based on Scheil's additive principle, has been applied. The comparison between modeling and experiments shows that the modified phase transformation model coupled with the incubation time provides higher accuracy on the simulation of transformation kinetics history. The robustness of four conditions relevant to tailored hot stamping was investigated: heated tooling (with low and high tool conductance), air cooling, and conventional hot stamping. The results show the high robustness of the conventional hot stamping compared to tailored hot stamping, with respect to the stamped component's final material properties (i.e. phase fraction and hardness). Furthermore, tailored hot stamping showed higher robustness when low conductivity tools are used relative to high conductivity tools.

Titanium in biomedical applications—properties and fabrication: a review

Ti and Ti-based alloys have unique properties such as high strength, low density and excellent corrosion resistance. These properties are essential for the manufacture of lightweight and high strength components for biomedical applications. In this paper, Ti properties such as metallurgy, mechanical properties, surface modification, corrosion resistance, biocompatibility and osseointegration in biomedical applications have been discussed. This paper also analyses the advantages and disadvantages of various Ti manufacturing processes for biomedical applications such as casting, powder metallurgy, cold and hot working, machining, laser engineering net shaping (LEN), superplastic forming, forging and ring rolling. The contributions of this research are twofold, firstly scrutinizing the behaviour of Ti and Ti-based alloys in-vivo and in-vitro experiments in biomedical applications to determine the factors leading to failure, and secondly strategies to achieve desired properties essential to improving the quality of patient outcomes after receiving surgical implants. Future research will be directed toward manufacturing of Ti for medical applications by improving the production process, for example using optimal design approaches in additive manufacturing and investigating alloys containing other materials in order to obtain better medical and mechanical characteristics.

Understanding temperature and contact pressure in hot stamped channels

This paper investigates the temperature and contact pressure conditions in hot stamped channels of boron steel. Hot stamping has been used for many years to produce high strength structural auto-motive components. The high tensile strengths achievable by hot stamping is beneficial where the intrusion during a vehicle crash is not desirable – e.g. for the vehicle occupant compartment. How-ever, the high blank temperatures and high temperature cycling causes a large amount of wear in the tooling. These conditions have led to high tool failures and die maintenance costs. Thus, un-derstanding the main causes of wear behaviour in the hot stamping process is of high interest to hot stampers.
To this aim, a generic 2D thermo-mechanical finite element model of a hat-shaped crash formed hot stamped component was developed (based on the authors previous hot stamp model), and a modified phase transformation model based on Scheil’s additive principle has been applied. The model was created in the finite element software ABAQUS Standard V6.13, including convection and radiation when the component was transferred from furnace to the tool as well as the air-cooling process. A USDFLD subroutine was used to model the phase transformation and a HET-VAL subroutine was used to model the latent heat. Contact heat conductance was a function of the pressure.
The authors have used techniques from their previous work on tool wear estimation for cold stamping to estimate the contact pressure on the tooling, and the amount of sliding that occurs over the tooling, and the corresponding tooling temperature. This data provides a unique data set to understand the wear on the tooling, and will eventually lead to a model for estimating tooling life.

The crash behaviour of hot stamped components – the effect of tailoring conditions

It is known that tailoring a hot stamping part, to achieve locally graded properties, can improve the crash behavior. Depending on the role of the structural part (carrying either bending or axial crash load), the best position for the local regions with lower strength and higher ductility can be different. The distribution of these local regions and their mechanical properties affects the crash behavior of the part in each loading case and therefore can be effectively designed to improve the crash performance. To investigate these effects and examine the improvement possibilities, a numerical thermalmechanical-metallurgical model of a hot stamping process and a representative side impact crash model were created and analysed. The hot stamping model was used to predict the consequent phase fractions and mechanical properties of tailored hot stamping parts produced with different tailoring scenarios. In the metallurgical model, a modified phase transformation model based on Scheil’s additive principle was incorporated. The geometry and mesh of the stamped part was exported to a crash numerical model with a 3-point bending configuration. A constitutive model was used to define the plastic behavior of the stamped part corresponding to different hardness values. Various possibilities in locally positioning the high strength or high ductility zones of material were examined. The results show that the positioning of the soft zones has a more significant effect on the crash performance than the variation in their mechanical properties of these soft zones.