Category: 4. Technology

  • Clinical insights on transforaminal lumbar interbody fusion (TLIF) imp

    Clinical insights on transforaminal lumbar interbody fusion (TLIF) imp

    Introduction

    Spinal degenerative diseases, such as degenerative disc disease and spondylolisthesis, are significant causes of chronic back pain and functional disability.1–4 Transforaminal lumbar interbody fusion (TLIF) has emerged as a widely adopted surgical procedure to treat these conditions, aiming to restore spinal stability through vertebral fusion.5 TLIF involves the placement of an interbody cage into the disc space after the removal of the damaged disc, which promotes fusion between adjacent vertebrae.6,7 Compared to other lumbar fusion techniques, TLIF allows for a minimally invasive approach that reduces tissue disruption and postoperative recovery time.8

    One of the key factors influencing the success of TLIF is bone health, particularly bone mineral density (BMD). Patients with osteopenia or osteoporosis are at an increased risk for complications such as cage subsidence, pedicle screw loosening, and pseudarthrosis—conditions that hinder successful fusion and may require revision surgery.9–12 Therefore, understanding and optimizing bone health is crucial for improving surgical outcomes in TLIF.13 Recent advancements in bone health assessment technologies, including high-resolution imaging techniques and novel biomarkers, have improved our ability to evaluate BMD more accurately and predict outcomes in spinal fusion surgeries.

    This systematic review seeks to provide clinical insights into TLIF procedures by examining key factors that enhance and monitor bone health following spinal fusion surgery. Specifically, we will explore the predictive value of BMD assessments, the role of bone graft materials in promoting fusion, and methods for monitoring postoperative bone health to prevent complications.

    Materials and Methods

    This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines,14 as shown in Figure 1. The primary objective is to evaluate the impact of bone health on TLIF outcomes, focusing on BMD, cage subsidence, pseudarthrosis rates, and fusion success. A comprehensive literature search was conducted across PubMed, Scopus and Cochrane databases to identify relevant studies published between 2010 and 2024. The search terms included combinations of “transforaminal lumbar interbody fusion”, “TLIF”, “bone mineral density”, “cage subsidence”, “osteoporosis”, “pseudarthrosis”, “bone graft”, and “fusion monitoring”. Studies were included if they provided clinical or radiographic outcomes related to TLIF and bone health.

    Figure 1 Selection criteria flow chart.

    Notes: PRISMA figure adapted from Liberati A, Altman D, Tetzlaff J et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Journal of clinical epidemiology. 2009;62(10). Creative Commons.14.

    In this review, the studies considered for inclusion were carefully selected based on several well-defined criteria an they are shown in Table 1.9,15–23 Primarily, we focused on studies that investigated patients who had undergone transforaminal lumbar interbody fusion (TLIF) surgery to address degenerative lumbar conditions. Our aim was to gather comprehensive insights into the role of bone mineral density (BMD), the materials used for bone grafting, the occurrence of cage subsidence, and the issue of pseudarthrosis—key factors that directly influence the success of TLIF procedures. The types of studies included varied, encompassing clinical trials, cohort studies, retrospective reviews, and systematic reviews, provided they were conducted on human subjects. To ensure relevance and consistency, only studies published in English between 2010 and 2024 were included in our analysis.

    Table 1 Studies Included in This Systematic Review

    Conversely, we excluded certain types of studies that did not meet our review’s objectives. Case reports and conference abstracts were omitted, as they often lack the depth of data required for a systematic analysis of TLIF outcomes. Similarly, studies focusing on other spinal fusion techniques that did not provide specific insights into TLIF were excluded to maintain a clear focus. Animal studies and preclinical trials were also not considered, as our review concentrated on clinical outcomes in human populations.

    For each included study, a structured approach was used to extract the necessary data. Key information collected included the study design and sample size, offering insight into the robustness and scope of each study. We also examined patient demographics, such as age, sex, and the presence of comorbidities, which are known to influence the outcomes of spinal fusion surgeries. Preoperative BMD assessments, including tools like DEXA scans and MRI-based vertebral bone quality (VBQ) scores, were recorded to assess the correlation between bone health and postoperative complications.

    Furthermore, details about the surgical techniques used, such as standard TLIF or minimally invasive TLIF (MIS-TLIF), were documented to explore any potential differences in outcomes between these approaches. Postoperative outcomes, such as the incidence of cage subsidence, pseudarthrosis, fusion rates, and screw loosening, were also critical elements of our data extraction process. Additionally, we paid close attention to the types of bone graft materials employed—whether autografts, allografts, or bone morphogenetic proteins (BMP)—as these materials significantly affect the fusion process. Lastly, the methods used to monitor bone health postoperatively, including radiography and CT scans, were collected to provide insights into the effectiveness of these techniques in detecting complications early.

    Quality Assessment

    The methodological quality of the studies was evaluated using the Newcastle-Ottawa Scale (NOS) for observational studies and the Cochrane Risk of Bias tool for randomized controlled trials.24 Studies with a score of 6 or above on the NOS or low risk of bias were considered of high quality as shown in Table 2.

    Table 2 Risk of Bias Assessment

    Results

    For this study, a total of 207 articles were initially identified. After removing all duplicates, a set of 94 articles remained for screening. Following the screening process and the application of inclusion and exclusion criteria, ten articles were selected (Table 1).

    Bone Mineral Density and TLIF Outcomes

    Several studies emphasized the importance of preoperative BMD assessment in predicting TLIF outcomes. Low BMD, particularly in osteopenic and osteoporotic patients, was consistently associated with higher rates of complications, such as cage subsidence and screw loosening.25–28 For instance, Ai et al (2024)15 demonstrated that MRI-based vertebral bone quality (VBQ) and endplate bone quality (EBQ) scores were strong predictors of cage subsidence. Higher VBQ and EBQ scores correlated with an increased risk of subsidence, with a cut-off VBQ score of 3.4 predicting subsidence with high sensitivity and specificity.

    Similarly, Bekas et al (2024) highlighted that lower BMD significantly affects the success of lumbar interbody fusion, including TLIF, and increases the likelihood of implant failure. The review of these studies suggests that patients with osteoporosis or osteopenia should undergo thorough BMD evaluations prior to surgery, as these assessments can inform surgical planning and the choice of implants and bone grafts.16

    Cage Subsidence and Predictive Factors

    Cage subsidence is a critical complication following TLIF that can result in loss of intervertebral height and revision surgery.29 Studies have explored various methods for predicting subsidence risk preoperatively. Khoylyan et al (2024) demonstrated the clinical utility of MRI-based VBQ scores in predicting subsidence in patients undergoing TLIF and posterior lumbar interbody fusion (PLIF). A VBQ score of 2.70 was found to have 100% sensitivity in predicting subsidence based on segmental lordosis changes.17

    The study by Chang et al (2024) found that patients with osteopenia had a significantly higher rate of screw loosening and cage subsidence following minimally invasive TLIF (MIS-TLIF). The research highlighted that the risk of complications is significantly greater in osteopenic patients compared to those with normal BMD, underscoring the need for more cautious surgical planning in these populations.9

    Graft Materials and Fusion Success

    A critical factor in the success of TLIF is the choice of bone graft material, which influences the rate of spinal fusion. Kim et al (2023) provided a comprehensive comparison of different graft materials, including autografts, allografts, and bone morphogenetic proteins (BMP). Autologous bone grafts, particularly iliac crest bone grafts (ICBG), remain the gold standard for TLIF due to their osteogenic, osteoconductive, and osteoinductive properties. However, the use of BMP has gained popularity due to its ability to promote bone growth without the morbidity associated with iliac crest harvesting.18

    Despite the promising results with BMP, Zhong et al (2024) found no significant reduction in the rate of pseudarthrosis when BMP was used in TLIF procedures compared to other graft materials. The study concluded that while BMP may enhance fusion rates, it does not significantly decrease the likelihood of revision surgery due to pseudarthrosis, particularly in patients with underlying comorbidities such as diabetes.19

    Pseudarthrosis and Radiographic Monitoring

    Pseudarthrosis, or nonunion of the vertebrae after fusion surgery, is a significant complication that affects patient outcomes and often necessitates revision surgery. Issa et al (2024) conducted a study on the use of computed tomography (CT) scans for assessing pseudarthrosis after lumbar fusion surgeries. Their findings demonstrated that CT scans remain the gold standard for detecting pseudarthrosis, especially when evaluating interbody fusion and facet joint fusion.20

    The study by Chen et al (2024) further examined the role of modic changes in influencing fusion rates. The meta-analysis revealed that patients with modic changes had a lower fusion rate at 3- and 6-month follow-ups compared to those without such changes. This finding highlights the importance of considering modic changes when assessing fusion progress postoperatively.21

    Surgical Techniques and Complications

    The comparison between different surgical techniques for TLIF, particularly MIS-TLIF versus traditional open TLIF, revealed notable differences in complication rates. Formby et al (2016) found that patients with osteoporosis who underwent TLIF had significantly higher rates of cage subsidence and iatrogenic fractures compared to non-osteoporotic patients. However, the radiographic complications did not translate into worse clinical outcomes, suggesting that careful patient selection and monitoring can mitigate the risks associated with osteoporosis in spinal fusion surgeries.22

    In terms of minimally invasive approaches, Chang et al (2024) reported a higher rate of screw loosening in osteopenic patients undergoing MIS-TLIF compared to those receiving dynamic stabilization. This suggests that while MIS-TLIF offers benefits such as smaller incision size and faster recovery, it may not be the optimal choice for patients with compromised bone quality.21

    Discussion

    The findings of this systematic review highlight the critical role of bone health in the success of transforaminal lumbar interbody fusion (TLIF) surgeries, particularly in patients with low bone mineral density (BMD). TLIF remains a preferred surgical approach for treating degenerative lumbar conditions, yet its success largely depends on patient-specific factors such as bone quality, preoperative preparation, and the choice of graft material.

    Several studies emphasized that low BMD, including osteopenia and osteoporosis, significantly increases the risk of complications such as cage subsidence, screw loosening, and pseudarthrosis.9,15,22 In particular, Ai et al (2024) demonstrated that both vertebral bone quality (VBQ) and endplate bone quality (EBQ) scores, derived from MRI assessments, were predictive of postoperative cage subsidence in TLIF patients.15 These findings suggest that preoperative BMD assessment, through techniques like dual-energy X-ray absorptiometry (DEXA) or MRI-based VBQ, should be integral to surgical planning for patients undergoing TLIF. Patients with lower BMD scores could benefit from alternative or enhanced surgical strategies, such as the use of stronger interbody cages or biological enhancements to mitigate the risks of implant failure.

    Cage subsidence is a well-documented complication that can compromise the stability of the interbody fusion and lead to further surgical intervention.30,31 The studies reviewed showed a clear association between BMD and the likelihood of subsidence,32 with Khoylyan et al (2024) suggesting that MRI-based VBQ scores may offer a clinically sensitive threshold for predicting subsidence risk.17 This finding is particularly important for surgeons aiming to prevent postoperative complications by adjusting surgical techniques or choosing more robust cage materials based on preoperative imaging.

    The utility of MRI-based assessments provides a radiation-free alternative to conventional BMD assessment methods, offering a convenient and reliable tool for preoperative risk stratification. By integrating these scoring systems into routine pre-surgical evaluations, surgeons can make informed decisions that improve patient outcomes, particularly for those at higher risk for cage subsidence.

    One of the key variables affecting fusion success in TLIF is the type of bone graft used. Kim et al (2023)9 provided a detailed comparison of autografts, allografts, and bone morphogenetic proteins (BMP), highlighting that autologous bone grafts, particularly iliac crest bone grafts (ICBG), remain the gold standard for promoting fusion due to their osteogenic properties. However, the morbidity associated with harvesting autografts has led to increased interest in alternative materials, such as BMP.

    Despite BMP’s promise in enhancing fusion rates, Zhong et al (2024)19 found no significant reduction in pseudarthrosis or reoperation rates when BMP was used compared to other graft materials. This suggests that while BMP may aid in achieving fusion, it may not offer significant advantages in preventing pseudarthrosis in the context of single-level TLIF procedures. The use of BMP may still be warranted in cases where autografts are not feasible, but careful consideration should be given to the patient’s overall health and potential risk factors such as diabetes, which can increase the likelihood of pseudarthrosis.

    Monitoring bone health and fusion success postoperatively is crucial to preventing complications such as pseudarthrosis. Several studies in this review support the use of computed tomography (CT) as the gold standard for assessing bone fusion, particularly in detecting pseudarthrosis.19,20 Issa et al (2024) emphasized that CT scans provide a reliable method for evaluating fusion in the posterolateral gutters, facet joints, and interbody spaces, which are critical areas for determining the success of TLIF.20

    In contrast, Chen et al (2024)9 suggested that the presence of modic changes can negatively impact the fusion rate, particularly in the early postoperative period. This highlights the need for regular and comprehensive radiographic monitoring, particularly in patients with modic changes or low BMD. Early detection of potential issues through CT or MRI can guide timely interventions, such as pharmacological support with agents that promote bone healing or revision surgery.

    Given the critical influence of bone health on TLIF outcomes, optimizing bone quality preoperatively is crucial, especially for patients with osteopenia or osteoporosis. Notably, strategies to improve bone health include pharmacological interventions such as bisphosphonates, selective estrogen receptor modulators (SERMs)33 and the use of bone-anabolic agents.34 While the studies reviewed provide valuable insights into enhancing and monitoring bone health in TLIF, several limitations remain. Many studies lacked long-term follow-up, which is critical for understanding the durability of fusion and the impact of BMD on outcomes over time. Additionally, there is limited consensus on the exact BMD threshold that significantly increases the risk of complications such as subsidence or pseudarthrosis, suggesting a need for future research to define these parameters more clearly.

    Moreover, while BMP and other graft materials have been extensively studied, there remains a lack of uniformity in the metrics used to evaluate their effectiveness. Standardized measures of fusion success, particularly in patients with low BMD, would allow for more robust comparisons across studies and help refine clinical guidelines.

    Future research should focus on longitudinal studies that track the long-term outcomes of TLIF in osteopenic and osteoporotic patients, as well as the development of novel biomaterials or pharmacological agents that specifically target bone health in the spinal fusion context. Additionally, the integration of advanced imaging techniques, such as MRI-based scoring systems, into routine clinical practice could be further explored to improve preoperative risk assessments and postoperative monitoring.

    Conclusion

    In conclusion, this systematic review underscores the importance of enhancing and monitoring bone health in patients undergoing TLIF. Preoperative BMD assessments, such as MRI-based VBQ scores, provide valuable insights into the risk of complications like cage subsidence and pseudarthrosis, enabling more tailored surgical strategies. While autografts remain the gold standard for bone grafting in TLIF, BMP and other alternative materials offer viable options for patients in whom autograft harvesting is not feasible. Postoperative monitoring with CT scans remains crucial for detecting complications early, particularly in high-risk patients with low BMD or modic changes.

    Further research is needed to establish clear BMD thresholds for surgical planning and to evaluate the long-term effectiveness of different graft materials in improving fusion success. By addressing these gaps, future studies can contribute to more personalized and effective treatment strategies for patients undergoing TLIF.

    Data Sharing Statement

    The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

    Author Contributions

    All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

    Disclosure

    The authors declare that they have no conflict of interest to disclose.

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    9. HK C, CC C, Cheng YW, et al. The effect of osteopenia and osteoporosis on screw loosening in MIS-TLIF and dynamic stabilization. Global Spine J. 2024;15(4):21925682241290747.

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    11. Chang HK, Ku J, Ku J, et al. Correlation of bone density to screw loosening in dynamic stabilization: an analysis of 176 patients. Sci Rep. 2021;11(1):17519. doi:10.1038/s41598-021-95232-y

    12. Tormenti MJ, Maserati MB, Bonfield CM, et al. Perioperative surgical complications of transforaminal lumbar interbody fusion: a single-center experience. J Neurosurg Spine. 2012;16(1):44–50. doi:10.3171/2011.9.SPINE11373

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    14. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.

    15. Ai Y, Zhu C, Chen Q, et al. Comparison of predictive value for cage subsidence between MRI-based endplate bone quality and vertebral bone quality scores following transforaminal lumbar interbody fusion: a retrospective propensity-matched study. Spine J. 2024;24(6):1046–1055. doi:10.1016/j.spinee.2024.01.014

    16. Bekas KN, Zafeiris C. The role of bone mineral density in a successful lumbar interbody fusion: a narrative review. Cureus. 2024;16(2):e54727. doi:10.7759/cureus.54727

    17. Khoylyan A, Girgis MY, Tang A, Vazquez F, Chen T. The utility of magnetic resonance imaging-based vertebral bone quality scores as a predictor of cage subsidence following transforaminal and posterior lumbar interbody fusion. Clin Spine Surg. 2024;38(3):E145–51.

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    24. Wells GA, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses. Ottawa Hospital Research Institute; 2013.

    25. Salzmann SN, Okano I, Jones C, et al. Preoperative MRI-based vertebral bone quality (VBQ) score assessment in patients undergoing lumbar spinal fusion. Spine J. 2022;22(8):1301–1308. doi:10.1016/j.spinee.2022.03.006

    26. Jones C, Okano I, Salzmann SN, et al. Endplate volumetric bone mineral density is a predictor for cage subsidence following lateral lumbar interbody fusion: a risk factor analysis. Spine J. 2021;21(10):1729–1737. doi:10.1016/j.spinee.2021.02.021

    27. Bocahut N, Audureau E, Poignard A, et al. Incidence and impact of implant subsidence after stand-alone lateral lumbar interbody fusion. Orthop Traumatol Surg Res. 2018;104(3):405–410. doi:10.1016/j.otsr.2017.11.018

    28. Okano I, Jones C, Salzmann SN, et al. Endplate volumetric bone mineral density measured by quantitative computed tomography as a novel predictive measure of severe cage subsidence after standalone lateral lumbar fusion. Eur Spine J. 2020;29(5):1131–1140. doi:10.1007/s00586-020-06348-0

    29. Hu F, Xue L, Zhao D, Chen C, Jing F, Yang Q. Magnetic resonance imaging-based vertebral bone quality score for prediction of cage subsidence and screw loosening in patients undergoing degenerative lumbar surgery: a meta-analysis. Neurospine. 2024;21(3):913–924. doi:10.14245/ns.2448496.248

    30. Ushirozako H, Hasegawa T, Ebata S, et al. Impact of sufficient contact between the autograft and endplate soon after surgery to prevent nonunion at 12 months following posterior lumbar interbody fusion. J Neurosurg Spine. 2020:1–10. doi:10.3171/2020.5

    31. Xi Z, Mummaneni PV, Wang M, et al. The association between lower Hounsfield units on computed tomography and cage subsidence after lateral lumbar interbody fusion. Neurosurg Focus. 2020;49(2):E8. doi:10.3171/2020.5.FOCUS20169

    32. Kim MC, Chung HT, Cho JL, Kim DJ, Chung NS. Subsidence of polyetheretherketone cage after minimally invasive transforaminal lumbar interbody fusion. J Spinal Disord Tech. 2013;26(2):87–92. doi:10.1097/BSD.0b013e318237b9b1

    33. Al-Najjar YA, Quraishi DA, Kumar N, Hussain I. Bone health optimization in adult spinal deformity patients: a narrative review. J Clin Med. 2024;13(16):4891. doi:10.3390/jcm13164891

    34. Hong N, Shin S, Lee S, Rhee Y. Romosozumab is associated with greater trabecular bone score improvement compared to denosumab in postmenopausal osteoporosis. Osteoporos Int. 2023;34(12):2059–2067. doi:10.1007/s00198-023-06889-2

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  • Following hiccup, macOS 26 beta 3 now available for Apple Silicon

    Following hiccup, macOS 26 beta 3 now available for Apple Silicon

    Earlier today, Apple released its new set of developer betas, but a distribution issue affected the Apple Silicon version of macOS Tahoe 26 developer beta 3. Now, the issue seems to have been resolved, and the update is now available for all compatible Macs.

    What happened?

    Users on X claimed that the hiccup involved Rosetta 26 beta 3, a required component for running Intel apps on Apple Silicon. Apple didn’t confirm the issue, but whatever the problem might have been, it seems to have been solved.

    This means that macOS Tahoe 26 beta 3 is now available for all compatible Macs, including those powered by M1, M2, and M3 chips.

    Here’s how to install the macOS Tahoe 26 developer beta 3:

    1. Backup your Mac
    2. Open System Settings
    3. Go to General ⇾ Software Update
    4. Click the ‘i’ icon next to Beta Updates
    5. From the dropdown menu in the top-right, select the macOS Developer Tahoe Beta
    6. Hit ‘Done’

    Any sign of the public beta?

    As Apple said during the WWDC25 keynote, public betas are expected to drop this month. Public betas typically arrive alongside developer beta 3 or 4, so the wait is almost over.

    As for developer beta 3, Apple hasn’t detailed what, if any, new features or changes made their way into the system beyond the usual under-the-hood improvements and bug fixes. But we’re already digging in to see what’s changed and will keep you posted, so be sure to check back soon.

    As always, if you spot any changes in today’s macOS Tahoe 26 beta 3, let us know in the comments.

    AirPods deals on Amazon

    FTC: We use income earning auto affiliate links. More.

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  • AI-enabled piezoelectric wearable device offers accurate and low-cost joint health tracking

    AI-enabled piezoelectric wearable device offers accurate and low-cost joint health tracking

    In the pursuit of more effective and accessible solutions for joint health monitoring, researchers are constantly seeking innovative ways to enhance the capabilities of wearable devices. A recent article published in Nano-Micro Letters, authored by Professor Jin-Chong Tan and Professor Hubin Zhao from the University of Oxford and University College London, presents a groundbreaking AI-enabled piezoelectric wearable device for accurate joint torque sensing, leveraging the unique properties of boron nitride nanotubes (BNNTs).

    Why this research matters

    • Enhanced joint health monitoring: Traditional methods for assessing joint torque are often confined to laboratory settings or require complex setups, limiting their feasibility for real-world applications. This new wearable device offers a portable, non-invasive solution for continuous joint torque monitoring, crucial for evaluating joint health, guiding interventions, and monitoring rehabilitation progress.
    • High sensitivity and accuracy: The device’s high-sensitivity BNNTs/polydimethylsiloxane composite enables precise and dynamic knee motion signal detection, while the lightweight neural network processes complex signals for accurate torque, angle, and load estimation, providing reliable data for joint health assessment.
    • Low-cost and accessible solution: The compatibility of the materials and design with low-power, resource-limited settings makes this wearable device a cost-effective and accessible solution for diverse populations across regions with varying levels of development, potentially revolutionizing joint health monitoring on a global scale.

    Innovative design and mechanisms

    • Boron nitride nanotubes and polydimethylsiloxane: BNNTs are highlighted as ideal materials for constructing high-performance piezoelectric sensors due to their exceptional mechanical strength, thermal stability, and intrinsic piezoelectric properties. The uniform dispersion of BNNTs in a PDMS matrix results in a highly sensitive piezoelectric film capable of capturing complex knee motion signals.
    • Inverse design structure: The wearable device employs an inverse-designed structure with a negative Poisson’s ratio, precisely matched to the biomechanics of the knee joint. This unique design ensures optimal biomechanical compatibility, enhancing motion tracking fidelity and enabling detailed sensing of complex loading conditions during knee movements.
    • Artificial intelligence integration: The integration of a lightweight on-device artificial neural network allows for real-time processing and analysis of the complex piezoelectric signals generated during movement. The AI algorithm accurately extracts targeted signals and maps them to corresponding physical characteristics, such as torque, angle, and loading, providing valuable insights into joint health.

    Applications and future outlook

    • Joint health monitoring: This wearable device can continuously monitor joint torque, offering valuable data for the evaluation of joint health and early detection of potential issues. It can be particularly beneficial for individuals with musculoskeletal conditions, the elderly, and athletes, enabling timely interventions and personalized rehabilitation plans.
    • Rehabilitation and injury prevention: By providing real-time torque assessment and risk assessment of joint injury, the device can play a crucial role in rehabilitation programs, ensuring safe and effective recovery. It can also help in preventing injuries by alerting users to potentially harmful joint movements or excessive torque.
    • Future research directions: Future research should focus on further optimizing the sensing materials, device design, and AI algorithms to enhance the performance, accuracy, and adaptability of the wearable device. Exploring additional complementary modalities and integrating the device with wearable robotics or exoskeletons could further expand its applications and utility in various fields.

    This innovative AI-enabled piezoelectric wearable device represents a significant step forward in joint health monitoring, offering a low-cost, high-sensitivity solution with broad potential applications. Stay tuned for more groundbreaking research from Professor Jin-Chong Tan and Professor Hubin Zhao’s team as they continue to push the boundaries of wearable technology and contribute to improved joint health and rehabilitation outcomes.

    Source:

    Shanghai Jiao Tong University

    Journal reference:

    Chang, J., et al. (2025). AI-Enabled Piezoelectric Wearable for Joint Torque Monitoring. Nano-Micro Letters. doi.org/10.1007/s40820-025-01753-w.

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  • Kingston IronKey Vault Privacy 80 review: Specs, features, price

    Kingston IronKey Vault Privacy 80 review: Specs, features, price

    The Kingston IronKey Vault Privacy 80 Encrypted External SSD won’t win awards for speed, but it will certainly keep your portable data safe.

    Transferring data between devices can be done in a few ways, but it’s hard to do it securely via offline means. Shifting important documents to a flash drive is convenient, especially for travel, but less so if someone else gains access to it.

    Unless there’s encryption or something else in the way, a stolen drive will leak its secrets with relative ease.

    The Kingston IronKey Vault Privacy 80 tries to solve the portable security issue, by being a personal encrypted Fort Knox for your data.

    Kingston IronKey Vault Privacy 80 Encrypted External SSD review: Design

    Your typical external storage usually consists of an enclosure with a port on one end for you to connect to nearby devices, often over USB. Kingston goes a lot further than that.

    Kingston IronKey Vault Privacy 80 Encrypted External SSD review: The large screen is used to unlock the drive

    The drive itself is rounded, and has a fairly typical size of at 4.8 inches long, 3.3 inches wide, and 0.7 inches thick. You don’t have any protruding connectors, but you do have a supplied pair of cables to connect to the USB-C port, via both USB-A and USB-C on the host.

    The front also has a mounted touchscreen, which would give casual observers the impression it was an MP3 player. At least, if it didn’t have the IronKey branding right below it.

    Kingston IronKey Vault Privacy 80 Encrypted External SSD review: Protection

    The main selling point of the IronKey Vault Privacy 80 is that it is an encrypted SSD. It’s a drive that has onboard hardware encryption, which works entirely independently of the operating system of the connected device.

    Blue electronic device with a digital keypad on a dark surface. The screen displays numbers, with 'IronKey' branding below. A cable connects to the top.
    Kingston IronKey Vault Privacy 80 Encrypted External SSD review: Unlocking the drive by entering a code on the screen

    That is to say, it doesn’t matter what device you connect the drive to, so long as it can support a USB mass storage device. The IronKey handles the security for itself.

    This security includes XTS-AES 256-bit encryption using a Common Criteria EAL5+ certified secure microprocessor. All that is also certified to FIPS 197, too.

    In use, the display is the main interaction point for the drive, in terms of security. You connect it to a host computer, then you enter a passcode onto the display.

    To prevent anyone from brute force attacking the drive, a process will automatically crypto-erase the drive if the Admin and User passwords are wrongly entered 15 times in a row. This is just the default, as you can adjust this from 10 tries to 30 tries.

    Blue IronKey data device with a screen displaying a lock symbol and status updates. Connected by a cable on a dark surface.
    Kingston IronKey Vault Privacy 80 Encrypted External SSD review: The drive is readable, but a tap will re-lock it

    The password used with the drive can be between six characters and up to 64 characters in length. The user can also set up password rules affecting the letters and numbers used.

    For business environments, there’s also the option to set up multiple passwords, so that an admin can have access to all of the features and settings.

    Users can also set up an automatic timeout, locking the drive after a selected period of time. This is handy for situations such as if someone leaves the drive hooked up to a computer, to prevent any impromptu snooping of the data.

    Going further into being protective, there are options for randomize touch-screen layouts to prevent others from watching someone tapping codes in from afar. A dual read-only mode uses two levels of protection to prevent the writing of data.

    There’s also a digitally-signed firmware to protect against BadUSB attacks.

    The drive comes formatted in exFAT.

    Kingston IronKey Vault Privacy 80 Encrypted External SSD review: Connectivity and storage

    Connecting using USB 3.2 Gen 1, which has a maximum throughput of 5Gbps, the IronKey Vault Privacy 80 is offered in multiple sizes. AppleInsider was provided with a 7,680GB capacity, though others are available with 960GB, 1,920GB, and 3,840GB.

    The actual connection speed of the drive itself is a bit lower than that theoretical maximum of 10 gigabit per second USB-C. With 250MB/s reads and 250MB/s writes on average, it’s not what you’d call a fast SSD.

    It still has the advantages of no hard drive platter seek time, but don’t expect Thunderbolt speed.

    And, that’s fine for what the drive is for.

    Disk speed test interface showing write speed at 296.9 MB/s, read speed at 212.9 MB/s, alongside a compatibility checklist for video formats and performance metrics.
    Kingston IronKey Vault Privacy 80 Encrypted External SSD review: Speed testing using Black Magic’s Disk Speed Test

    While slow compared to other SSDs, you do need to bear in mind that our tested speeds are with a fully-encrypted drive. It’s safe to say that it’s not going to be a drive used by anyone who needs fast access to stored materials.

    Content creators aren’t going to be editing from this drive, but they are also not the target market.

    Kingston IronKey Vault Privacy 80 Encrypted External SSD review: Tough, for those who really need it

    Secure external password-protected storage drives are certainly a limited market, but one that also has a lot of customers. With data protection being a thing enterprise customers seek due to various online and in-person threats, companies still want drives that are portable yet highly secure.

    Black rectangular case with a blue zipper, featuring the white 'Ironkey' logo on the front, set against a plain background.
    Kingston IronKey Vault Privacy 80 Encrypted External SSD review: The bag supplied with the drive

    The IronKey Vault Privacy 80 is small enough to be portable, offers enough capacity to be useful for large data troves, and with a considerable amount of security to boot.

    This is not a drive that the average consumer will really need, but it’s great to toss in a safety deposit box with crucial backups. For business users, it’s a drive that can easily become part of a security framework for highly sensitive projects.

    Kingston IronKey Vault Privacy 80 Encrypted External SSD review – Pros

    • Highly secure
    • Compact
    • Color touch screen with high accuracy

    Kingston IronKey Vault Privacy 80 Encrypted External SSD review – Cons

    • Relatively slow transfer speeds
    • Price is high, but warranted

    Rating: 4 out of 5

    The IronKey Vault Privacy 80 does what it says it will do. It will security vault data that isn’t speed-critical, and will do it without depending on one OS or another. Not everybody needs something like this, but if you’ve got a key set of data that you just can’t let fall into the wrong hands, this will keep it safe for you.

    Where to buy the Kingston IronKey Vault Privacy 80 Encrypted External SSD

    The Kingston IronKey Vault Privacy 80 is available from Amazon, starting from $279.99 for the 960GB model, with the 1.92TB at $369.99, the 3.8TB at $762.99, and the 7.6TB at $1,037.99. Current discounts as of July 7, 2025 price the 960GB model at $239.99, and the 1.92TB at $289.99.

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  • BMW celebrates 50 years of 3 Series with special six-cylinder sedan

    BMW celebrates 50 years of 3 Series with special six-cylinder sedan

    The 3 Series has been a linchpin of the BMW lineup for 50 years, and the German auto brand is celebrating this milestone with a special edition.

    The BMW 3 Series 50 Jahre Edition is based on the flagship M340i xDrive – powered by a turbocharged inline six-cylinder petrol engine – and priced at $127,600 before on-road costs.

    Just 50 examples of the 50-year edition are coming to Australia, appropriately enough, with first local customer deliveries expected in the fourth quarter of 2025.

    For context, the standard M340i xDrive is currently priced at $127,752 drive-away for buyers in New South Wales.

    Hundreds of new car deals are available through CarExpert right now. Get the experts on your side and score a great deal. Browse now.

    BMW says the special edition has specifications unique to the Australian and New Zealand markets, including BMW Individual Anthracite Metallic exterior paint and a limited-edition build plate on the centre console.

    Other specification highlights include:

    • 19-inch jet black M light alloy wheels
    • Carbon-fibre interior trim
    • M Sport Package Pro
      • M Sport brakes in red high-gloss
      • M Lights Shadow Line
      • M seat belts
      • Black Sapphire M rear spoiler

    As it’s based on the M340i xDrive, that means a 3.0-litre inline turbo-six can be found under the bonnet, producing 285kW of power and 500Nm of torque.

    It’s mated with an eight-speed automatic transmission and an all-wheel drive system as standard, and the M340i xDrive’s claimed 0-100km/h acceleration time is 4.4 seconds.