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Griffith JF, Leung CTP, Lee JCH, Leung JCS, Yeung DKW, Yung PSH. Positional MR imaging of normal and injured knees. Eur Radiol 2023; 33:1553-1564. [PMID: 36348091 DOI: 10.1007/s00330-022-09198-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 08/10/2022] [Accepted: 09/22/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES This study uses a practical positional MRI protocol to evaluate tibiofemoral translation and rotation in normal and injured knees. METHODS Following ethics approval, positional knee MRI of both knees was performed at 35° flexion, extension, and hyperextension in 34 normal subjects (mean age 31.1 ± 10 years) and 51 knee injury patients (mean age 36.4 ± 11.5 years, ACL tear n = 23, non-ACL injury n = 28). At each position, tibiofemoral translation and rotation were measured. RESULTS Normal knees showed 8.1 ± 3.3° external tibial rotation (i.e., compatible with physiological screw home mechanism) in hyperextension. The unaffected knee of ACL tear patients showed increased tibial anterior translation laterally (p = 0.005) and decreased external rotation (p = 0.002) in hyperextension compared to normal knees. ACL-tear knees had increased tibial anterior translation laterally (p < 0.001) and decreased external rotation (p < 0.001) compared to normal knees. Applying normal thresholds, fifteen (65%) of 23 ACL knees had excessive tibial anterior translation laterally while 17 (74%) had limited external rotation. None (0%) of 28 non-ACL-injured knees had excessive tibial anterior translation laterally while 13 (46%) had limited external rotation. Multidirectional malalignment was much more common in ACL-tear knees. CONCLUSIONS Positional MRI shows (a) physiological tibiofemoral movement in normal knees, (b) aberrant tibiofemoral alignment in the unaffected knee of ACL tear patients, and (c) a high frequency of abnormal tibiofemoral malalignment in injured knees which was more frequent, more pronounced, more multidirectional, and of a different pattern in ACL-tear knees than non-ACL-injured knees. KEY POINTS • Positional MRI shows physiological tibiofemoral translation and rotation in normal knees. • Positional MRI shows a different pattern of tibiofemoral alignment in the unaffected knee of ACL tear patients compared to normal control knees. • Positional MRI shows a high prevalence of abnormal tibiofemoral alignment in injured knees, which is more frequent and pronounced in ACL-tear knees than in ACL-intact injured knees.
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Affiliation(s)
- James F Griffith
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China.
| | - Cynthia T P Leung
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | - Jeremiah C H Lee
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | - Jason C S Leung
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
| | - David K W Yeung
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | - Patrick S H Yung
- Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
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202
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Opfermann JD, Contento JM, Mass PN, Krieger A, Berul CI, Kumthekar RN. A novel videoscope and tool kit for percutaneous pericardial access under direct visualization. Biomed Eng Online 2023; 22:19. [PMID: 36855095 PMCID: PMC9976548 DOI: 10.1186/s12938-023-01085-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/21/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Pericardial access is necessary for the application of epicardial cardiac therapies including ablation catheters, pacing and defibrillation leads, and left atrial appendage closure systems. Pericardial access under fluoroscopic guidance is difficult in patients without pericardial effusions and may result in coronary artery damage, ventricular injury, or perforation with potentially life-threatening pericardial bleeding in up to 10% of cases. There is a clinical need for a pericardial access technique to safely deliver epicardial cardiac therapies. METHODS In this paper, we describe the design and evaluation of a novel videoscope and tool kit to percutaneously access the pericardial space under direct visualization. Imaging is performed by a micro-CMOS camera with an automatic gain adjustment software to prevent image saturation. Imaging quality is quantified using known optical targets, while tool performance is evaluated in pediatric insufflation and pericardial access simulators. Device safety and efficacy is demonstrated by infant porcine preclinical studies (N = 6). RESULTS The videoscope has a resolution of 400 × 400 pixels, imaging rate of 30 frames per second, and fits within the lumen of a 14G needle. The tool can resolve features smaller than 39.4 µm, achieves a magnification of 24x, and has a maximum of 3.5% distortion within the field of view. Successful pericardial access was achieved in pediatric simulators and acute in vivo animal studies. During in vivo testing, it took the electrophysiologist an average of 66.83 ± 32.86 s to insert the pericardial access tool into the thoracic space and visualize the heart. After visualizing the heart, it took an average of 136.67 ± 80.63 s to access the pericardial space under direct visualization. The total time to pericardial access measured from needle insertion was 6.7 × quicker than pericardial access using alternative direct visualization techniques. There was no incidence of ventricular perforation. CONCLUSIONS Percutaneous pericardial access under direct visualization is a promising technique to access the pericardial space without complications in simulated and in vivo animal models.
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Affiliation(s)
- Justin D. Opfermann
- grid.21107.350000 0001 2171 9311Department of Mechanical Engineering, Johns Hopkins University, 3400 N. Charles Street, Baltimore, MD 21218 USA
| | - Jacqueline M. Contento
- grid.239560.b0000 0004 0482 1586Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Hospital, Washington, USA
| | - Paige N. Mass
- grid.239560.b0000 0004 0482 1586Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Hospital, Washington, USA
| | - Axel Krieger
- grid.21107.350000 0001 2171 9311Department of Mechanical Engineering, Johns Hopkins University, 3400 N. Charles Street, Baltimore, MD 21218 USA
| | - Charles I. Berul
- grid.239560.b0000 0004 0482 1586Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Hospital, Washington, USA ,grid.239560.b0000 0004 0482 1586Division of Cardiology, Children’s National Hospital, Washington, USA ,grid.4367.60000 0001 2355 7002George Washington School of Medicine, Washington, USA
| | - Rohan N. Kumthekar
- grid.240344.50000 0004 0392 3476Division of Cardiology, Nationwide Children’s Hospital, Columbus, USA ,grid.261331.40000 0001 2285 7943Department of Pediatrics, The Ohio State University College of Medicine, Columbus, USA
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203
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Kozioł A, López Pérez D, Laudańska Z, Malinowska-Korczak A, Babis K, Mykhailova O, D’Souza H, Tomalski P. Motor Overflow during Reaching in Infancy: Quantification of Limb Movement Using Inertial Motion Units. SENSORS (BASEL, SWITZERLAND) 2023; 23:2653. [PMID: 36904857 PMCID: PMC10007533 DOI: 10.3390/s23052653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/24/2023] [Accepted: 02/26/2023] [Indexed: 06/18/2023]
Abstract
Early in life, infants exhibit motor overflow, which can be defined as the generation of involuntary movements accompanying purposeful actions. We present the results of a quantitative study exploring motor overflow in 4-month-old infants. This is the first study quantifying motor overflow with high accuracy and precision provided by Inertial Motion Units. The study aimed to investigate the motor activity across the non-acting limbs during goal-directed action. To this end, we used wearable motion trackers to measure infant motor activity during a baby-gym task designed to capture overflow during reaching movements. The analysis was conducted on the subsample of participants (n = 20), who performed at least four reaches during the task. A series of Granger causality tests revealed that the activity differed depending on the non-acting limb and the type of the reaching movement. Importantly, on average, the non-acting arm preceded the activation of the acting arm. In contrast, the activity of the acting arm was followed by the activation of the legs. This may be caused by their distinct purposes in supporting postural stability and efficiency of movement execution. Finally, our findings demonstrate the utility of wearable motion trackers for precise measurement of infant movement dynamics.
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Affiliation(s)
- Agata Kozioł
- Neurocognitive Development Lab, Institute of Psychology, Polish Academy of Sciences, 00-378 Warsaw, Poland
- Graduate School for Social Research, Polish Academy of Sciences, 00-330 Warsaw, Poland
| | - David López Pérez
- Neurocognitive Development Lab, Institute of Psychology, Polish Academy of Sciences, 00-378 Warsaw, Poland
| | - Zuzanna Laudańska
- Neurocognitive Development Lab, Institute of Psychology, Polish Academy of Sciences, 00-378 Warsaw, Poland
- Graduate School for Social Research, Polish Academy of Sciences, 00-330 Warsaw, Poland
| | - Anna Malinowska-Korczak
- Neurocognitive Development Lab, Institute of Psychology, Polish Academy of Sciences, 00-378 Warsaw, Poland
| | - Karolina Babis
- Neurocognitive Development Lab, Institute of Psychology, Polish Academy of Sciences, 00-378 Warsaw, Poland
| | - Oleksandra Mykhailova
- Neurocognitive Development Lab, Institute of Psychology, Polish Academy of Sciences, 00-378 Warsaw, Poland
| | - Hana D’Souza
- Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff CF10 3AT, UK
| | - Przemysław Tomalski
- Neurocognitive Development Lab, Institute of Psychology, Polish Academy of Sciences, 00-378 Warsaw, Poland
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204
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Applying machine learning methods to enable automatic customisation of knee replacement implants from CT data. Sci Rep 2023; 13:3317. [PMID: 36849812 PMCID: PMC9971034 DOI: 10.1038/s41598-023-30483-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/23/2023] [Indexed: 03/01/2023] Open
Abstract
The aim of this study was to develop an automated pipeline capable of designing custom total knee replacement implants from CT scans. The developed pipeline firstly utilised a series of machine learning methods including classification, object detection, and image segmentation models, to extract geometrical information from inputted DICOM files. Statistical shape models then used the information to create femur and tibia 3D surface model predictions which were ultimately used by computer aided design scripts to generate customised implant designs. The developed pipeline was trained and tested using CT scan images, along with segmented 3D models, obtained for 98 Korean Asian subjects. The performance of the pipeline was tested computationally by virtually fitting outputted implant designs with 'ground truth' 3D models for each test subject's bones. This demonstrated the pipeline was capable of repeatably producing highly accurate designs, and its performance was not impacted by subject sex, height, age, or knee side. In conclusion, a robust, accurate and automatic, CT-based total knee replacement customisation pipeline was shown to be feasible and could afford significant time and cost advantages over conventional methods. The pipeline framework could also be adapted to enable customisation of other medical implants.
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205
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He L, Wen Z, Wang B, Li X, Wu D. Structural Design and Experimental Studies of Resonant Fiber Optic Scanner Driven by Co-Fired Multilayer Piezoelectric Ceramics. MICROMACHINES 2023; 14:517. [PMID: 36984924 PMCID: PMC10055889 DOI: 10.3390/mi14030517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Piezo-driven resonant fiber optic scanners are gaining more and more attention due to their simple structure, weak electromagnetic radiation, and non-friction loss. Conventional piezo-driven resonant fiber optic scanners typically use quadrature piezoelectric tubes (piezo tubes) operating in 31-mode with high drive voltage and low excitation efficiency. In order to solve the abovementioned problem, a resonant fiber scanner driven by co-fired multilayer piezoelectric ceramics (CMPCs) is proposed in which four CMPCs drive a cantilevered fiber optic in the first-order bending mode to achieve efficient and fast space-filling scanning. In this paper, the cantilever beam vibration model with base displacement excitation was derived to provide a theoretical basis for the design of the fiber optic scanner. The finite element method was used to guide the dynamic design of the scanner. Finally, the dynamics characteristics and scanning trajectory of the prepared scanner prototype were tested and compared with the theoretical and simulation calculation results. Experimental results showed that the scanner can achieve three types of space-filling scanning: spiral, Lissajous, and propeller. Compared with the structure using piezo tubes, the designed scanner achieved the same scanning range with smaller axial dimensions, lower drive voltage, and higher efficiency. The scanner can achieve a free end displacement of 10 mm in both horizontal and vertical directions under a sinusoidal excitation signal of 50 Vp-p and 200 Hz. The theoretical, simulation and experimental results validate the feasibility of the proposed scanner structure and provide new ideas for the design of resonant fiber optic scanners.
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206
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Shamritsky DZ, Berube EE, Sapountzis N, Diaz A, Krell EC, Wright TM, Parides M, Westrich GH, Mayman DJ, Sculco PK, Chalmers BP, Imhauser CW. Novel Arthrometer for Quantifying In Vivo Knee Laxity in Three Planes Following Total Knee Arthroplasty. J Arthroplasty 2023; 38:S190-S195. [PMID: 36813213 DOI: 10.1016/j.arth.2023.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/08/2023] [Accepted: 02/11/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Knee instability is a leading cause of dissatisfaction following total knee arthroplasty (TKA). Instability can involve abnormal laxity in multiple directions including varus-valgus (VV) angulation, anterior-posterior (AP) translation, and internal-external rotation (IER). No existing arthrometer objectively quantifies knee laxity in all three of these directions. The study objectives were to verify the safety and assess reliability of a novel multiplanar arthrometer. METHODS The arthrometer utilized a five degree-of-freedom instrumented linkage. Two examiners each conducted two tests on the leg that had received a TKA of 20 patients (mean age 65 years (range, 53-75); 9 men, 11 women), with nine and eleven distinct patients tested at 3-month and 1-year postoperative time points, respectively. AP forces from -10 to 30 Newtons, VV moments of ±3 Newton-meters, and IER moments of ±2.5 Newton-meters were applied to each subject's replaced knee. Severity and location of knee pain during testing were assessed using a visual analog scale. Intraexaminer and interexaminer reliabilities were characterized using intraclass correlation coefficients. RESULTS All subjects successfully completed testing. Pain during testing averaged 0.7 (out of possible 10; range, 0-2.5). Intraexaminer reliability was >0.77 for all loading directions and examiners. Interexaminer reliability and 95% confidence intervals were 0.85 (0.66-0.94), 0.67 (0.35-0.85), and 0.54 (0.16-0.79) in the VV, IER, and AP directions, respectively. CONCLUSION The novel arthrometer was safe for evaluating AP, VV, and IER laxities in subjects who had received TKA. This device could be used to examine relationships between laxity and patient perceptions of knee instability.
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Affiliation(s)
- David Z Shamritsky
- Department of Biomechanics, Hospital for Special Surgery, New York, New York
| | - Erin E Berube
- Department of Biomechanics, Hospital for Special Surgery, New York, New York
| | - Nicolas Sapountzis
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, New York
| | - Allison Diaz
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, New York
| | - Ethan C Krell
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, New York
| | - Timothy M Wright
- Department of Biomechanics, Hospital for Special Surgery, New York, New York
| | - Michael Parides
- Department of Biostatistics and Bioinformatics, Hospital for Special Surgery, New York, New York
| | - Geoffrey H Westrich
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, New York
| | - David J Mayman
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, New York
| | - Peter K Sculco
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, New York
| | - Brian P Chalmers
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, New York
| | - Carl W Imhauser
- Department of Biomechanics, Hospital for Special Surgery, New York, New York
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207
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Lussenburg K, Scali M, Stolk M, Robijns D, Sakes A, Breedveld P. Exploring High-Precision Non-Assembly Mechanisms: Design of a Vitrectome Mechanism for Eye Surgery. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1772. [PMID: 36902888 PMCID: PMC10004359 DOI: 10.3390/ma16051772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
A vitrectome is a commonly used instrument in eye surgery, which is used to cut and aspirate the vitreous body out of the eye. The mechanism of the vitrectome consists of miniature components that need to be assembled by hand due to their size. Non-assembly 3D printing, in which fully functional mechanisms can be produced in a single production step, can help create a more streamlined production process. We propose a vitrectome design based on a dual-diaphragm mechanism, which can be produced with minimal assembly steps using PolyJet printing. Two different diaphragm designs were tested to fulfill the requirements of the mechanism: a homogenous design based on 'digital' materials and a design using an ortho-planar spring. Both designs were able to fulfill the required displacement for the mechanism of 0.8 mm, as well as cutting forces of at least 8 N. The requirements for the cutting speed of the mechanism of 8000 RPM were not fulfilled by both designs, since the viscoelastic nature of the PolyJet materials resulted in a slow response time. The proposed mechanism does show promise to be used in vitrectomy; however, we suggest that more research into different design directions is required.
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Affiliation(s)
- Kirsten Lussenburg
- Bio-Inspired Technology Group (BITE), Department BioMechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Marta Scali
- Dutch Ophthalmic Research Center International (DORC), 3214 VC Zuidland, The Netherlands
| | - Maarten Stolk
- Bio-Inspired Technology Group (BITE), Department BioMechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Daisy Robijns
- Bio-Inspired Technology Group (BITE), Department BioMechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Aimée Sakes
- Bio-Inspired Technology Group (BITE), Department BioMechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Paul Breedveld
- Bio-Inspired Technology Group (BITE), Department BioMechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
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208
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Shi H, Liang Z, Zhang B, Wang H. Design and Performance Verification of a Novel RCM Mechanism for a Minimally Invasive Surgical Robot. SENSORS (BASEL, SWITZERLAND) 2023; 23:2361. [PMID: 36850959 PMCID: PMC9963641 DOI: 10.3390/s23042361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Minimally invasive surgical robots have the advantages of high positioning accuracy, good stability, and flexible operation, which can effectively improve the quality of surgery and reduce the difficulty for doctors to operate. However, in order to realize the translation of the existing RCM mechanism, it is often necessary to add a mobile unit, which is often bulky and occupies most space above the patient's body, thus causing interference to the operation. In this paper, a new type of planar RCM mechanism is proposed. Based on this mechanism, a 3-DOF robotic arm is designed, which can complete the required motion for surgery without adding a mobile unit. In this paper, the geometric model of the mechanism is first introduced, and the RCM point of the mechanism is proven during the motion process. Then, based on the establishment of the geometric model of the mechanism, a kinematics analysis of the mechanism is carried out. The singularity, the Jacobian matrix, and the kinematic performance of the mechanism are analyzed, and the working space of the mechanism is verified according to the kinematic equations. Finally, a prototype of the RCM mechanism was built, and its functionality was tested using a master-slave control strategy.
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209
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Ljungblad S. Applying ”designerly framing” to understand assisted feeding as social aesthetic bodily experiences. ACM TRANSACTIONS ON HUMAN-ROBOT INTERACTION 2023. [DOI: 10.1145/3583742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
What could it mean to take a designerly perspective of a robotic eating aid to get a more holistic understanding of meals as social and embodied experiences? In this paper we provide a new perspective of bodily experiences of assisted feeding. We apply ”designerly framing” in the context of meals and Human Robot Interaction (HRI) and contribute with insights for researchers with backgrounds other than design into how ”designerly framing” can foreground social and aesthetic use. The study focuses on experiences of assisted feeding of five people with impairments in their arms or hands. All of the subjects have long-term experience of meal assistance, and four also have experience of using a robotic eating aid. The data collection comprises seven interview sessions held in peoples homes, a functional analysis of the meal experience, and a workshop held at a design agency. The ”designerly framing” is also supported by a theoretical framework describing different types of use to open the meal as a design space. This complements and extends existing knowledge on acceptance and abandonment of assistive technology and assistive robotics for the meal.
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Affiliation(s)
- Sara Ljungblad
- University of Gothenburg, Chalmers University of Technology, Sweden
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210
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A new era: Comparing wired to wireless endoscopy. Curr Urol 2023. [DOI: 10.1097/cu9.0000000000000176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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211
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Ballentine M, Kennedy A, Melby N, Bednar A, Moser R, Moores LC, Alberts EM, Laber CH, Crouch RA. Acute and Chronic Toxicity of Uncured Resin Feedstocks for Vat Photopolymerization 3D Printing to a Cladoceran (Ceriodaphnia Dubia). BULLETIN OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2023; 110:56. [PMID: 36792856 DOI: 10.1007/s00128-023-03698-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
The accessibility and popularity of additive manufacturing (AM) has increased over the past decade. Environmental hazard assessment and safety data sheets for 3D printer feedstocks has lagged technology development. Vat photopolymerization may have unique risks relative to other AM technologies due to mishandling of uncured monomers/oligomer feedstocks and its decreasing cost enabling uninformed residential use. The acute and chronic toxicity of six uncured resins to Ceriodaphnia dubia was explored. Two-day acute toxicity (LC50) ranged from 2.6 to 33 mg/L and inhibition concentrations (IC25) values for reproduction ranged from 0.33 to 16 mg/L. Cleaning and waste management procedures recommended in user guides could be the most hazardous handling scenario as use of isopropyl alcohol increases miscibility and thus the fate, transport and bioavailability of the uncured resins. Residential users may often be poorly informed about potential toxicity and the need for a plan for use, handling, and waste management of uncured resins.
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Affiliation(s)
- Mark Ballentine
- US Army Engineer Research and Development Center, Environmental Laboratory, 39180, Vicksburg, MS, USA.
| | - Alan Kennedy
- US Army Engineer Research and Development Center, Environmental Laboratory, 39180, Vicksburg, MS, USA
- Virginia Polytechnic Institute and State University, Macromolecules Innovation Institute, 24061, Blacksburg, VA, USA
| | - Nicolas Melby
- US Army Engineer Research and Development Center, Environmental Laboratory, 39180, Vicksburg, MS, USA
| | - Anthony Bednar
- US Army Engineer Research and Development Center, Environmental Laboratory, 39180, Vicksburg, MS, USA
| | - Robert Moser
- US Army Engineer Research and Development Center, Environmental Laboratory, 39180, Vicksburg, MS, USA
| | - Lee C Moores
- US Army Engineer Research and Development Center, Environmental Laboratory, 39180, Vicksburg, MS, USA
| | - Erik M Alberts
- US Army Engineer Research and Development Center, Environmental Laboratory, 39180, Vicksburg, MS, USA
| | - Charles H Laber
- US Army Engineer Research and Development Center, Environmental Laboratory, 39180, Vicksburg, MS, USA
| | - Rebecca A Crouch
- US Army Engineer Research and Development Center, Environmental Laboratory, 39180, Vicksburg, MS, USA
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212
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Seibold M, Spirig JM, Esfandiari H, Farshad M, Fürnstahl P. Translation of Medical AR Research into Clinical Practice. J Imaging 2023; 9:jimaging9020044. [PMID: 36826963 PMCID: PMC9961816 DOI: 10.3390/jimaging9020044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 02/17/2023] Open
Abstract
Translational research is aimed at turning discoveries from basic science into results that advance patient treatment. The translation of technical solutions into clinical use is a complex, iterative process that involves different stages of design, development, and validation, such as the identification of unmet clinical needs, technical conception, development, verification and validation, regulatory matters, and ethics. For this reason, many promising technical developments at the interface of technology, informatics, and medicine remain research prototypes without finding their way into clinical practice. Augmented reality is a technology that is now making its breakthrough into patient care, even though it has been available for decades. In this work, we explain the translational process for Medical AR devices and present associated challenges and opportunities. To the best knowledge of the authors, this concept paper is the first to present a guideline for the translation of medical AR research into clinical practice.
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Affiliation(s)
- Matthias Seibold
- Research in Orthopedic Computer Science, Balgrist University Hospital, University of Zurich, CH-8008 Zurich, Switzerland
- Computer Aided Medical Procedures and Augmented Reality, Technical University Munich, DE-85748 Garching, Germany
- Correspondence:
| | - José Miguel Spirig
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, CH-8008 Zurich, Switzerland
| | - Hooman Esfandiari
- Research in Orthopedic Computer Science, Balgrist University Hospital, University of Zurich, CH-8008 Zurich, Switzerland
| | - Mazda Farshad
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, CH-8008 Zurich, Switzerland
| | - Philipp Fürnstahl
- Research in Orthopedic Computer Science, Balgrist University Hospital, University of Zurich, CH-8008 Zurich, Switzerland
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213
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Domínguez-Ruiz A, López-Caudana EO, Lugo-González E, Espinosa-García FJ, Ambrocio-Delgado R, García UD, López-Gutiérrez R, Alfaro-Ponce M, Ponce P. Low limb prostheses and complex human prosthetic interaction: A systematic literature review. Front Robot AI 2023; 10:1032748. [PMID: 36860557 PMCID: PMC9968924 DOI: 10.3389/frobt.2023.1032748] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/11/2023] [Indexed: 02/15/2023] Open
Abstract
A few years ago, powered prostheses triggered new technological advances in diverse areas such as mobility, comfort, and design, which have been essential to improving the quality of life of individuals with lower limb disability. The human body is a complex system involving mental and physical health, meaning a dependant relationship between its organs and lifestyle. The elements used in the design of these prostheses are critical and related to lower limb amputation level, user morphology and human-prosthetic interaction. Hence, several technologies have been employed to accomplish the end user's needs, for example, advanced materials, control systems, electronics, energy management, signal processing, and artificial intelligence. This paper presents a systematic literature review on such technologies, to identify the latest advances, challenges, and opportunities in developing lower limb prostheses with the analysis on the most significant papers. Powered prostheses for walking in different terrains were illustrated and examined, with the kind of movement the device should perform by considering the electronics, automatic control, and energy efficiency. Results show a lack of a specific and generalised structure to be followed by new developments, gaps in energy management and improved smoother patient interaction. Additionally, Human Prosthetic Interaction (HPI) is a term introduced in this paper since no other research has integrated this interaction in communication between the artificial limb and the end-user. The main goal of this paper is to provide, with the found evidence, a set of steps and components to be followed by new researchers and experts looking to improve knowledge in this field.
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Affiliation(s)
- Adan Domínguez-Ruiz
- Institute for the Future of Education, Tecnologico de Monterrey, Mexico City, México
| | | | - Esther Lugo-González
- Instituto de Electrónica y Mecatrónica, Universidad Tecnológica de la Mixteca, Huajuapan de León, Oaxaca, México
| | | | - Rocío Ambrocio-Delgado
- División de Estudios de Posgrado, Universidad Tecnológica de la Mixteca, Huajuapan de León, Oaxaca, México
| | - Ulises D. García
- CONACYT-CINVESTAV, Av. Instituto Politécnico Nacional 2508, col. San Pedro Zacatenco, Ciudad deMéxico, México
| | - Ricardo López-Gutiérrez
- CONACYT-CINVESTAV, Av. Instituto Politécnico Nacional 2508, col. San Pedro Zacatenco, Ciudad deMéxico, México
| | - Mariel Alfaro-Ponce
- Institute of Advanced Materials for Sustainable Manufacturing, Tecnologico de Monterrey, Mexico City, México
| | - Pedro Ponce
- Institute of Advanced Materials for Sustainable Manufacturing, Tecnologico de Monterrey, Mexico City, México,*Correspondence: Pedro Ponce,
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214
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Mackertich-Sengerdy G, Campbell SD, Werner DH. Tailored compliant mechanisms for reconfigurable electromagnetic devices. Nat Commun 2023; 14:683. [PMID: 36781857 PMCID: PMC9925788 DOI: 10.1038/s41467-023-36143-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 01/18/2023] [Indexed: 02/15/2023] Open
Abstract
Reconfigurable electromagnetic devices, specifically reconfigurable antennas, have shown to be integral to the future of communication systems. However, mechanically robust designs that can survive real-world, harsh environment applications and high-power conditions remain rare to this day. In this paper, the general framework for a field of both discrete and continuously mechanically reconfigurable devices is established by combining compliant mechanisms with electromagnetics. To exemplify this new concept, a reconfigurable compliant mechanism antenna is demonstrated which exhibits continuously tunable performance across a broad band of frequencies. Moreover, three additional examples are also introduced that further showcase the versatility and advanced capabilities of compliant mechanism enabled electromagnetic devices. Unlike previous approaches, this is achieved with minimal part counts, additive manufacturing techniques, and high reliability, which mechanical compliant mechanism devices are known for. The results presented exemplify how compliant mechanisms have the capacity to transform the broader field of reconfigurable electromagnetic devices.
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Affiliation(s)
- Galestan Mackertich-Sengerdy
- Department of Electrical Engineering, Computational Electromagnetics and Antennas Research Laboratory (CEARL), The Pennsylvania State University, University Park, PA, 16802, USA.
| | - Sawyer D. Campbell
- grid.29857.310000 0001 2097 4281Department of Electrical Engineering, Computational Electromagnetics and Antennas Research Laboratory (CEARL), The Pennsylvania State University, University Park, PA 16802 USA
| | - Douglas H. Werner
- grid.29857.310000 0001 2097 4281Department of Electrical Engineering, Computational Electromagnetics and Antennas Research Laboratory (CEARL), The Pennsylvania State University, University Park, PA 16802 USA
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215
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Xiao J, Chen J, Li M, Zhang L. Design and Experiment of an Ultrasound-Assisted Corneal Trephination System. MICROMACHINES 2023; 14:438. [PMID: 36838138 PMCID: PMC9966510 DOI: 10.3390/mi14020438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/04/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
According to the advantages of ultrasonic vibration cutting, an ultrasound-assisted corneal trepanation robotic system is developed to improve the accuracy of corneal trephination depth and corneal incision quality in corneal trephination operations. Firstly, we analyzed the reasons for the difficulty in controlling the depth of trephination in corneal transplantations from the perspective of the biomechanical properties of the cornea. Based on the advantages of ultrasonic vibration cutting, we introduced an ultrasonic-vibration-assisted cutting method for corneal trephination and analyzed the cutting mechanism. Secondly, we described the surgical demands of corneal trephination and listed the design requirements of a robotic system. Thirdly, we introduced the design details of said system, including the system's overall structure, the ultrasound-assisted end effector, the key mechanisms of the robotic system, and the human-machine interaction interface. We designed the end effector based on ultrasonic vibration cutting and its eccentric adjustment system in an innovative way. Additionally, we then presented a procedure for robot-assisted corneal trephination. Finally, we performed several cutting experiments on grapes and porcine eyeballs in vitro. The results show that, compared with manual trephine, ultrasound-assisted corneal trephination has a better operation effect on the accuracy of corneal trephination depth and corneal incision quality.
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Affiliation(s)
- Jingjing Xiao
- College of Computer and Information Engineering, Xiamen University of Technology, Xiamen 361024, China
| | - Jialong Chen
- College of Computer and Information Engineering, Xiamen University of Technology, Xiamen 361024, China
| | - Mengqiong Li
- Affiliated Xiamen Eye Center, Xiamen University, Xiamen 361001, China
| | - Leiyu Zhang
- Beijing Key Laboratory of Advanced Manufacturing Technology, Beijing University of Technology, Beijing 100124, China
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216
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Kong X, Ravikumar V, Mulpuru SK, Roukoz H, Tolkacheva EG. A Data-Driven Preprocessing Framework for Atrial Fibrillation Intracardiac Electrocardiogram Analysis. ENTROPY (BASEL, SWITZERLAND) 2023; 25:332. [PMID: 36832698 PMCID: PMC9955244 DOI: 10.3390/e25020332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Atrial Fibrillation (AF) is the most common cardiac arrhythmia. Signal-processing approaches are widely used for the analysis of intracardiac electrograms (iEGMs), which are collected during catheter ablation from patients with AF. In order to identify possible targets for ablation therapy, dominant frequency (DF) is widely used and incorporated in electroanatomical mapping systems. Recently, a more robust measure, multiscale frequency (MSF), for iEGM data analysis was adopted and validated. However, before completing any iEGM analysis, a suitable bandpass (BP) filter must be applied to remove noise. Currently, no clear guidelines for BP filter characteristics exist. The lower bound of the BP filter is usually set to 3-5 Hz, while the upper bound (BP¯th) of the BP filter varies from 15 Hz to 50 Hz according to many researchers. This large range of BP¯th subsequently affects the efficiency of further analysis. In this paper, we aimed to develop a data-driven preprocessing framework for iEGM analysis, and validate it based on DF and MSF techniques. To achieve this goal, we optimized the BP¯th using a data-driven approach (DBSCAN clustering) and demonstrated the effects of different BP¯th on subsequent DF and MSF analysis of clinically recorded iEGMs from patients with AF. Our results demonstrated that our preprocessing framework with BP¯th = 15 Hz has the best performance in terms of the highest Dunn index. We further demonstrated that the removal of noisy and contact-loss leads is necessary for performing correct data iEGMs data analysis.
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Affiliation(s)
- Xiangzhen Kong
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN 55455, USA
| | - Vasanth Ravikumar
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN 55455, USA
| | - Siva K. Mulpuru
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA
| | - Henri Roukoz
- Division of Cardiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Elena G. Tolkacheva
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455, USA
- Lillehei Heart Institute, University of Minnesota, Minneapolis, MN 55455, USA
- Institute for Engineering in Medicine, University of Minnesota, Minneapolis, MN 55455, USA
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217
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Kight A, Pirozzi I, Liang X, McElhinney DB, Han AK, Dual SA, Cutkosky M. Decoupling Transmission and Transduction for Improved Durability of Highly Stretchable, Soft Strain Sensing: Applications in Human Health Monitoring. SENSORS (BASEL, SWITZERLAND) 2023; 23:1955. [PMID: 36850551 PMCID: PMC9967534 DOI: 10.3390/s23041955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/24/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
This work presents a modular approach to the development of strain sensors for large deformations. The proposed method separates the extension and signal transduction mechanisms using a soft, elastomeric transmission and a high-sensitivity microelectromechanical system (MEMS) transducer. By separating the transmission and transduction, they can be optimized independently for application-specific mechanical and electrical performance. This work investigates the potential of this approach for human health monitoring as an implantable cardiac strain sensor for measuring global longitudinal strain (GLS). The durability of the sensor was evaluated by conducting cyclic loading tests over one million cycles, and the results showed negligible drift. To account for hysteresis and frequency-dependent effects, a lumped-parameter model was developed to represent the viscoelastic behavior of the sensor. Multiple model orders were considered and compared using validation and test data sets that mimic physiologically relevant dynamics. Results support the choice of a second-order model, which reduces error by 73% compared to a linear calibration. In addition, we evaluated the suitability of this sensor for the proposed application by demonstrating its ability to operate on compliant, curved surfaces. The effects of friction and boundary conditions are also empirically assessed and discussed.
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Affiliation(s)
- Ali Kight
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA
| | - Ileana Pirozzi
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA
| | - Xinyi Liang
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA
| | - Doff B. McElhinney
- Department of Cardiology, Lucile Packard Children’s Hospital, Stanford University, Stanford, CA 94305, USA
| | - Amy Kyungwon Han
- Department of Mechanical Engineering, Seoul National University, Seoul 08826, Republic of Korea
| | - Seraina A. Dual
- Department of Biomedical Engineering, KTH Royal Institute of Technology, 11428 Stockholm, Sweden
| | - Mark Cutkosky
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA
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218
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3D printing for respiratory physiotherapy: a tale of three disciplines. ANNALS OF 3D PRINTED MEDICINE 2023. [DOI: 10.1016/j.stlm.2022.100096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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219
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Rocchi M, Ingram M, Claus P, D'hooge J, Meyns B, Fresiello L. Use of 3D anatomical models in mock circulatory loops for cardiac medical device testing. Artif Organs 2023; 47:260-272. [PMID: 36370033 DOI: 10.1111/aor.14433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 08/16/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Mock circulatory loops (MCLs) are mechanical representations of the cardiovascular system largely used to test the hemodynamic performance of cardiovascular medical devices (MD). Thanks to 3 dimensional (3D) printing technologies, MCLs can nowadays also incorporate anatomical models so to offer enhanced testing capabilities. The aim of this review is to provide an overview on MCLs and to discuss the recent developments of 3D anatomical models for cardiovascular MD testing. METHODS The review first analyses the different techniques to develop 3D anatomical models, in both rigid and compliant materials. In the second section, the state of the art of MCLs with 3D models is discussed, along with the testing of different MDs: implantable blood pumps, heart valves, and imaging techniques. For each class of MD, the MCL is analyzed in terms of: the cardiovascular model embedded, the 3D model implemented (the anatomy represented, the material used, and the activation method), and the testing applications. DISCUSSIONS AND CONCLUSIONS MCLs serve the purpose of testing cardiovascular MDs in different (patho-)physiological scenarios. The addition of 3D anatomical models enables more realistic connections of the MD with the implantation site and enhances the testing capabilities of the MCL. Current attempts focus on the development of personalized MCLs to test MDs in patient-specific hemodynamic and anatomical scenarios. The main limitation of MCLs is the impossibility to assess the impact of a MD in the long-term and at a biological level, for which animal experiments are still needed.
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Affiliation(s)
- Maria Rocchi
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Marcus Ingram
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Piet Claus
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Jan D'hooge
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Bart Meyns
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Libera Fresiello
- Cardiovasuclar and Respiratory Physiology, University of Twente, Enschede, The Netherlands
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220
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Advances in applications of head mounted devices (HMDs): Physical techniques for drug delivery and neuromodulation. J Control Release 2023; 354:810-820. [PMID: 36709924 DOI: 10.1016/j.jconrel.2023.01.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/23/2023] [Accepted: 01/23/2023] [Indexed: 01/31/2023]
Abstract
Head-mounted medical devices (HMDs) are disruptive inventions representing laboratories and clinical institutions worldwide are climbing the apexes of brain science. These complex devices are inextricably linked with a wide range knowledge containing the Physics, Imaging, Biomedical engineering, Biology and Pharmacology, particularly could be specifically designed for individuals, and finally exerting integrated bio-effect. The salient characteristics of them are non-invasive intervening in human brain's physiological structures, and alterating the biological process, such as thermal ablating the tumor, opening the BBB to deliver drugs and neuromodulating to enhance cognitive performance or manipulate prosthetic. The increasing demand and universally accepted of them have set off a dramatic upsurge in HMDs' studies, seminal applications of them span from clinical use to psychiatric disorders and neurological modulation. With subsequent pre-clinical studies and human trials emerging, the mechanisms of transcranial stimulation methods of them were widely studied, and could be basically came down to three notable approach: magnetic, electrical and ultrasonic stimulation. This review provides a comprehensive overviews of their stimulating mechanisms, and recent advances in clinic and military. We described the potential impact of HMDs on brain science, and current challenges to extensively adopt them as promising alternative treating tools.
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221
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Marconi G, Gopalai AA, Chauhan S. A triple compound pendulum model to analyse the effect of an ankle-foot orthosis on swing phase kinematics. Med Eng Phys 2023; 112:103951. [PMID: 36842774 DOI: 10.1016/j.medengphy.2023.103951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 11/15/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Abstract
Powered ankle-foot orthoses can be utilised to overcome gait abnormalities such as foot drop; however, normal gait is rarely restored with compensatory gait patterns arising and prevalence of gait asymmetry. Therefore, this study aims to determine the effect of orthosis mass and mass distribution on the swing phase of gait, to understand residual gait asymmetry with orthosis use. Using a triple compound pendulum model, which accounts for mass distribution of the limb and orthosis, the swing phase of gait is simulated in terms of natural dynamics and the effect of an orthosis on kinematic parameters is quantitatively determined. It was found that additional mass causes faster and shorter steps on the affected side due to rapid knee extension and reduced hip flexion, with particular actuator positions and natural cadence causing varying severity of these effects. Our study suggests that this model could be used as a preliminary design tool to identify subject specific optimum orthosis mass distribution of a powered ankle-foot orthosis, without the need for motion data or experimental trials. This optimisation intends to more accurately mimic natural swing phase kinematics, consequently allowing for the reduction in severity of gait asymmetry and the potential to improve rehabilitative outcomes.
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Affiliation(s)
- Grace Marconi
- Department of Mechanical and Aerospace Engineering, Monash University, Australia.
| | | | - Sunita Chauhan
- Department of Mechanical and Aerospace Engineering, Monash University, Australia
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222
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Zhou Y. Recent advances in wearable actuated ankle-foot orthoses: Medical effects, design, and control. Proc Inst Mech Eng H 2023; 237:163-178. [PMID: 36515408 DOI: 10.1177/09544119221142335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This paper presents a survey on recent advances of wearable actuated ankle-foot orthoses (AAFOs). First of all, their medical functions are investigated. From the short-term aspect, they lead to rectification of pathological gaits, reduction of metabolic cost, and improvement of gait performance. After AAFO-based walking training with sufficient time, free walking performance can be enhanced. Then, key design factors are studied. First, primary design parameters are investigated. Second, common actuators are analysed. Third, human-robot interaction (HRI), ergonomics, safety, and application places, are considered. In the following section, control technologies are reviewed from the aspects of rehabilitation stages, gait feature quantities, and controller characteristics. Finally, existing problems are discussed; development trends are prospected.
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Affiliation(s)
- Yuan Zhou
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
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223
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Janardhanan S, Chandran V, Rajan R. On the design of a compact emergency mechanical ventilator with negative expiratory exit pressure for COVID-19 patients. J Med Eng Technol 2023; 47:94-103. [PMID: 35895010 DOI: 10.1080/03091902.2022.2099024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The present work deals with the design of a cylinder-piston arrangement to deliver the required tidal volume (TV) of air to the patient through the respiratory tract especially in the setting of severe acute respiratory syndrome corona virus 2 (SARS CoV-2) or corona virus disease (COVID-19). The design ensures that only the desired volume of air is delivered in each breath and a negative pressure is retained at the delivery point in a separate cylinder. The frequency of piston motion is the same as that of the average human respiratory rate (RR). The effect of negative pressure on time of evacuation under the present condition has been verified. The present design provides a compact ventilator unit with a surface area of 0.8 × 0.4 m2 with a minimal power requirement of 116.48 W. An RR of 16 is obtained with a volume flow rate in lit/s by using a twin cylinder arrangement with bore diameter 0.1 m and length 0.4 m. The ratio of inspiration time to expiration time is designed to be 1:2 by controlling the stroke frequency as 16 and piston speed 0.32 m/s. The present design provides promising quantitative information on the design of an automated continuous mechanical ventilator (CMV), which is different from bag mask valve (BMV) operated ventilators, and on preventing and minimising barotrauma.
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Affiliation(s)
- Sheeja Janardhanan
- School of Naval Architecture and Ocean Engineering, Indian Maritime University, Visakhapatnam, India
| | - Vidya Chandran
- Department of Mechanical Engineering, SCMS School of Engineering and Technology, Karukutty, Ernakulam, India
| | - Rajesh Rajan
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Kuwait City, Kuwait
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224
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Hatakenaka K, Hijikata W, Fujiwara T, Ohuchi K, Inoue Y. Prevention of thrombus formation in blood pump by mechanical circular orbital excitation of impeller in magnetically levitated centrifugal pump. Artif Organs 2023; 47:425-431. [PMID: 36305737 PMCID: PMC10098525 DOI: 10.1111/aor.14443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/22/2022] [Accepted: 10/15/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Mechanical circulatory support devices, such as left ventricular assist devices, have recently been used in patients with heart failure as destination therapy but the formation of thrombus in blood pumps remains a critical problem. In this study, we propose a mechanical antithrombogenic method by impeller excitation using a magnetically levitated (Maglev) centrifugal pump. Previous studies have shown that one-directional excitation prevents thrombus; however, it is effective in only one direction. In this study, we aimed to obtain a better effect by vibrating it in a circular orbit to induce uniform changes in the shear-rate field entirely around the impeller. METHODS The blood coagulation time was compared using porcine blood. (1) The flow rate was set to 1 L/min, and applied excitation was at a frequency of 280 Hz and amplitude of 3 μm. (2) Moreover, the effect was compared by varying the frequency, amplitude, and direction of the excitation. In this experiment, the flow rate was set to 0.3 L/min. RESULTS (1) The thrombus formation time was 77 min without excitation and 133 min with excitation, which was 1.7 times longer. (2) The results showed no difference between (280 Hz, 3 μm) and (50 Hz, 16 μm) circular orbital excitations, and no directional difference, with thrombus formation of 2.5 times longer under all conditions than that without excitation. CONCLUSION In the case of simple reciprocating excitation, the time was approximately 1.2 times longer. This indicated that the circular orbital excitation is more effective.
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Affiliation(s)
- Kohei Hatakenaka
- School of Engineering, Tokyo Institute of Technology, Tokyo, Japan
| | - Wataru Hijikata
- School of Engineering, Tokyo Institute of Technology, Tokyo, Japan
| | - Tatsuki Fujiwara
- Department of Cardiovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsuhiro Ohuchi
- Center for Experimental Animals, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Inoue
- Advanced Medical Engineering Research Center, Asahikawa Medical University, Asahikawa, Japan
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225
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Niu D, Xu Q, Xu H, Yin S, Hao Z, Shi H, Zhou J, Tai S, Zou Z, Yang C, Liang C. Fabrication and application of a wireless high-definition endoscopic system in urological surgeries. BJU Int 2023; 131:183-189. [PMID: 35199469 PMCID: PMC10078773 DOI: 10.1111/bju.15718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 02/04/2022] [Accepted: 02/16/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To introduce a wireless high-definition endoscopic system (WHES) and compare it with a Storz high-definition (HD) system for image resolution, colour resolution, weight, and costs. MATERIALS AND METHODS The WHES incorporated a portable light-emitting diode light source and a wireless camera module, which can be compatible with different types of endoscopes. Images were wirelessly transmitted to a monitor or mobile platform such as smartphone through a receiver. The International Standards Organization 12233 resolution chart image was used for the comparison of image resolution and Munsell Colour Checker Chart for colour resolution. In all, 38 endourologists used a Likert questionnaire to blindly evaluate cystoscopic images from a patient with haematuria. The surgical team was asked about the overall performance of the WHES in 20 laparoscopic adrenalectomies using a unvalidated subjective survey. RESULTS There was no difference in image resolution between the two systems (5.82 vs 5.89 line pairs/mm). Without lens and respective light sources, there were better purple (ΔE = 21.48 vs 28.73), blue (ΔE = 34.88 vs 38.6) and red colour resolution (ΔE = 29.01 vs 35.45) for the WHES camera (P < 0.05), but orange (ΔE = 43.45 vs 36.52) and yellow (ΔE = 52.7 vs 35.93) resolutions were better for the Storz HD camera (P < 0.05). Comparing the WHES to a Storz laparoscopic system, the Storz system still had better resolution of orange and yellow, while the resolution of purple, blue, and red was similar for the two systems. The expert comments on resolution, brightness, and colour for cystoscopy were not statistically different, but the ergonomics score for the WHES was higher (3.7 vs 3.33, P = 0.038). The overall cost of the WHES was $23 000-25 000 compared with $45 000-50 000 for a Storz system. There were 100% general satisfaction for the WHES in the survey. CONCLUSION We developed a new WHES that provides the same resolution images as a Storz laparoscopic system and acceptable colour resolution with the advantages of wireless connection, small volume, low cost, portability, and high-speed wireless transmission.
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Affiliation(s)
- Di Niu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Qihang Xu
- Hefei Deming Electronics Co Ltd, Hefei, China
| | - Hanjiang Xu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Shuiping Yin
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Zongyao Hao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Haoqiang Shi
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Jun Zhou
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Sheng Tai
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Zhihui Zou
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Cheng Yang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
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226
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Du Y, Zhang S, Cheng D, Liu Y, Sun M, Zhao Q, Cui M, Zhao X. The full model of micropipette aspiration of cells: A mesoscopic simulation. Acta Biomater 2023; 157:297-309. [PMID: 36543279 DOI: 10.1016/j.actbio.2022.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/01/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
Studies on the interaction between cells and micromanipulation tools are necessary to optimize the procedures and improve the developmental potential of cells. The molecular dynamics simulation is not possible for such a large-scale simulation, and the spring-damped viscoelastic models and the constitutive equations of the continuum are usually adopted to model the cells as a whole without consideration of the different properties presented by the heterogeneous subcellular components. In this study, we utilized coarse-grained modeling to develop a subcellular model of suspension cell dynamics and a model of a holding micropipette for the fixation of a suspension cell, and designed a large-scale, accurate mesoscopic simulation environment for specific cell micromanipulation. We established a triangular mesh cell membrane and a uniformly distributed, non-intersecting cytoskeleton network and added polymerization/depolymerization processes to connect the cytoskeleton chains with the membrane and cross-linking proteins. In the cell aspiration model, we adopted the profile of the reversed Poiseuille flow to calibrate the viscosity of the fluid and set the bounce-back condition and the appropriate solid-fluid force coefficient to realize non-slip flow at the boundary. The rheological properties of the cells during micropipette aspiration were further analyzed in the simulation by varying parameters such as the inner diameter of the micropipette, negative pressure, and maximum bond length. The model well reproduced the experimentally observed cell deformation phenomenon at low and high pressures. The dynamic response of the cell elongation observed from the simulation was consistent with that obtained from the analysis of the experimental data collected from a custom-designed micromanipulation system. STATEMENT OF SIGNIFICANCE: In this study, we extended the coarse-grained modeling of cells by developing a relatively large-scale micromanipulation environment consisting of a subcellular cell dynamics model and a fluid flow model for cell aspiration. We simulated cytoskeleton filaments that were uniformly distributed in space via applying Harmonic energy to model cytoskeleton with a high level of fidelity. The shortcoming of the soft repulsion in the solid-fluid interaction in the current simulation technique was solved by implementing the bounce-back boundary and the condition that the total force imposed by the wall particles on the fluid particles was equal to the pressure of the fluid. This work paved the way for understanding the mechanical properties of cells and improving the biological efficacy of micromanipulation.
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Affiliation(s)
- Yue Du
- Institute of Robotics and Automatic Information System, College of Artificial Intelligence, Nankai University, China; Tianjin Key Laboratory of Intelligent Robotics, Nankai University, China; Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, China
| | - Shuai Zhang
- Institute of Robotics and Automatic Information System, College of Artificial Intelligence, Nankai University, China; Tianjin Key Laboratory of Intelligent Robotics, Nankai University, China; Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, China
| | - Dai Cheng
- Institute of Robotics and Automatic Information System, College of Artificial Intelligence, Nankai University, China; Tianjin Key Laboratory of Intelligent Robotics, Nankai University, China
| | - Yaowei Liu
- Institute of Robotics and Automatic Information System, College of Artificial Intelligence, Nankai University, China; Tianjin Key Laboratory of Intelligent Robotics, Nankai University, China; Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, China
| | - Mingzhu Sun
- Institute of Robotics and Automatic Information System, College of Artificial Intelligence, Nankai University, China; Tianjin Key Laboratory of Intelligent Robotics, Nankai University, China; Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, China
| | - Qili Zhao
- Institute of Robotics and Automatic Information System, College of Artificial Intelligence, Nankai University, China; Tianjin Key Laboratory of Intelligent Robotics, Nankai University, China; Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, China
| | - Maosheng Cui
- Institute of Animal Science and Veterinary of Tianjin, Tianjin, China
| | - Xin Zhao
- Institute of Robotics and Automatic Information System, College of Artificial Intelligence, Nankai University, China; Tianjin Key Laboratory of Intelligent Robotics, Nankai University, China; Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, China.
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227
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Nesbitt DQ, Nelson ML, Shannon KS, Lujan TJ. Dots-on-Plots: A Web Application to Analyze Stress-Strain Curves From Tensile Tests of Soft Tissue. J Biomech Eng 2023; 145:024504. [PMID: 36098481 PMCID: PMC9791671 DOI: 10.1115/1.4055593] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 09/02/2022] [Indexed: 12/30/2022]
Abstract
The calculation of tensile mechanical properties from stress-strain curves is a fundamental step in characterizing material behavior, yet no standardized method exists to perform these calculations for soft tissue. To address this deficiency, we developed a free web application called Dots-on-Plots2 that fully automates the calculation of tensile mechanical properties from stress-strain curves. The analyzed mechanical properties include the strength, strain, and energy at four points of interest (transition, yield, ultimate, and rupture), and the linear modulus. Users of Dots-on-Plots can upload multiple files, view and download results, and adjust threshold settings. This study determined a threshold setting that minimized error when calculating the transition point, where the stress-strain curve "transitions" from a nonlinear "toe" region to a linear region. Using the optimal threshold (2% stress deviation from a linear region fit), Dots-on-Plots calculated the transition strains from twenty tensile experiments of human meniscus to be 0.049 ± 0.007, which nearly matched the known transition strain values of 0.050 ± 0.006 (determined using finite element parameter optimization). The sensitivity of the calculated transition strain to the shape of various stress-strain curves was analyzed using sets of model-generated synthetic data. This free web application offers a convenient and reliable tool to systematically enhance the speed, transparency, and consistency of mechanical analysis across biomedical research groups.
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Affiliation(s)
- Derek Q. Nesbitt
- Biomedical Engineering Doctoral Program, Boise State University, Boise, ID 83725
| | - Miranda L. Nelson
- Biomedical Engineering Doctoral Program, Boise State University, Boise, ID 83725
| | - Kyle S. Shannon
- Research Computing Support, Boise State University, Boise, ID 83725
| | - Trevor J. Lujan
- Department of Mechanical & Biomedical Engineering, Boise State University, Boise, ID 83725
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228
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Pose F, Ciarrocchi N, Videla C, Redelico FO. Permutation Entropy Analysis to Intracranial Hypertension from a Porcine Model. ENTROPY (BASEL, SWITZERLAND) 2023; 25:267. [PMID: 36832634 PMCID: PMC9955102 DOI: 10.3390/e25020267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/20/2022] [Accepted: 12/28/2022] [Indexed: 06/18/2023]
Abstract
Intracranial pressure (ICP) monitoring is commonly used in the follow-up of patients in intensive care units, but only a small part of the information available in the ICP time series is exploited. One of the most important features to guide patient follow-up and treatment is intracranial compliance. We propose using permutation entropy (PE) as a method to extract non-obvious information from the ICP curve. We analyzed the results of a pig experiment with sliding windows of 3600 samples and 1000 displacement samples, and estimated their respective PEs, their associated probability distributions, and the number of missing patterns (NMP). We observed that the behavior of PE is inverse to that of ICP, in addition to the fact that NMP appears as a surrogate for intracranial compliance. In lesion-free periods, PE is usually greater than 0.3, and normalized NMP is less than 90% and p(s1)>p(s720). Any deviation from these values could be a possible warning of altered neurophysiology. In the terminal phases of the lesion, the normalized NMP is higher than 95%, and PE is not sensitive to changes in ICP and p(s720)>p(s1). The results show that it could be used for real-time patient monitoring or as input for a machine learning tool.
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Affiliation(s)
- Fernando Pose
- Instituto de Medicina Traslacional e Ingeniería Biomédica, CONICET, Hospital Italiano de Buenos Aires, Instituto Universitario del Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires C1199ABB, Argentina
| | - Nicolas Ciarrocchi
- Servicio de Terapia Intensiva de Adultos, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires C1199ABB, Argentina
| | - Carlos Videla
- Servicio de Terapia Intensiva de Adultos, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires C1199ABB, Argentina
| | - Francisco O. Redelico
- Instituto de Medicina Traslacional e Ingeniería Biomédica, CONICET, Hospital Italiano de Buenos Aires, Instituto Universitario del Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires C1199ABB, Argentina
- Departamento de Ciencia y Tecnología, Universidad Nacional de Quilmes, Bernal B1876BXD, Argentina
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229
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Sousa LB, Almeida I, Bernardes RA, Leite TR, Negrão R, Apóstolo J, Salgueiro-Oliveira A, Parreira P. A three step protocol for the development of an innovative footwear (shoe and sensor based insole) to prevent diabetic foot ulceration. Front Public Health 2023; 11:1061383. [PMID: 36794077 PMCID: PMC9922787 DOI: 10.3389/fpubh.2023.1061383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/06/2023] [Indexed: 01/31/2023] Open
Abstract
Background The incidence of diabetic foot ulceration (DFU) is increasing worldwide. Therapeutic footwear is usually recommended in clinical practice for preventing foot ulcers in persons with diabetes. The project Science DiabetICC Footwear aims to develop innovative footwear to prevent DFU, specifically a shoe and sensor-based insole, which will allow for monitoring pressure, temperature, and humidity parameters. Method This study presents a three-step protocol for the development and evaluation of this therapeutic footwear, specifically: (i) a first observational study will specify the user requirements and contexts of use; (ii) after the design solutions were developed for shoe and insole, the semi-functional prototypes will be evaluated against the initial requirements; (iii) and a pre-clinical study protocol will enable the evaluation of the final functional prototype. The eligible diabetic participants will be involved in each stage of product development. The data will be collected using interviews, clinical evaluation of the foot, 3D foot parameters and plantar pressure evaluation. This three-step protocol was defined according to the national and international legal requirements, ISO norms for medical devices development, and was also reviewed and approved by the Ethics Committee of the Health Sciences Research Unit: Nursing (UICISA: E) of the Nursing School of Coimbra (ESEnfC). Results The involvement of end-users (diabetic patients) will enable the definition of user requirements and contexts of use to develop design solutions for the footwear. Those design solutions will be prototyped and evaluated by end-users to achieve the final design for therapeutic footwear. The final functional prototype will be evaluated in pre-clinical studies to ensure that the footwear meets all the requirements to move forward to clinical studies. Discussion The three-step study outlined in this protocol will provide the necessary insights during the product development, ensuring this new therapeutic footwear's main functional and ergonomic features for DFU prevention.
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Affiliation(s)
- Liliana B. Sousa
- Health Sciences Research Unit, Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal,*Correspondence: Liliana B. Sousa ✉
| | - Inês Almeida
- Health Sciences Research Unit, Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Rafael A. Bernardes
- Health Sciences Research Unit, Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Teófilo R. Leite
- Indústrias e Comércio de Calçado S. A. (ICC), Sol-Pinheiro, Guimarães, Portugal
| | - Rui Negrão
- Health Sciences Research Unit, Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - João Apóstolo
- Health Sciences Research Unit, Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Anabela Salgueiro-Oliveira
- Health Sciences Research Unit, Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Pedro Parreira
- Health Sciences Research Unit, Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
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230
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Limpabandhu C, Hu Y, Ren H, Song W, Ho Tse ZT. Magnetically steerable catheters: State of the art review. Proc Inst Mech Eng H 2023; 237:297-308. [PMID: 36704957 PMCID: PMC10052423 DOI: 10.1177/09544119221148799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Magnetically steerable catheters (MSCs) have caught the interest of researchers due to their various potential uses in clinical applications, for example, minimally invasive surgery. Many significant advances in the design, implementation and analysis of MSCs have been accomplished in the last decade. This review concentrates on the configurations of current MSCs with an in depth look at control of the device and the specific workspace. This review also evaluates MSCs and references possible future system designs and difficulties. The concept of magnetic manipulation is briefly presented. Then, by category, the MSC is introduced. Following that, a discussion of future works and challenges of the review systems is provided. The conclusions are finally addressed.
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Affiliation(s)
- Chayabhan Limpabandhu
- School of Engineering and Materials Science, Queen Mary University of London, London, UK
| | - Yihua Hu
- Department of Electronic Engineering, University of York, York, UK
| | - Hongliang Ren
- Department of Electronic Engineering, University of York, York, UK
| | - Wenzhan Song
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong
| | - Zion Tsz Ho Tse
- School of Engineering and Materials Science, Queen Mary University of London, London, UK
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231
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Bunge A, Chiriac A, Sofronie M, Crăciunescu I, Porav AS, Turcu R. Anticoagulant Properties of Coated Fe-Pd Ferromagnetic Shape Memory Ribbons. Int J Mol Sci 2023; 24:ijms24032452. [PMID: 36768774 PMCID: PMC9917221 DOI: 10.3390/ijms24032452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 01/28/2023] Open
Abstract
Shape memory alloys, especially ferromagnetic shape memory alloys, are interesting new materials for the manufacturing of stents. Iron-palladium alloys in particular can be used to manufacture self-expanding temporary stents due to their optimum rate of degradation, which is between that of magnesium and pure iron, two metals commonly used in temporary stent research. In order to avoid blood clotting upon the introduction of the stent, they are often coated with anticoagulants. In this study, sulfated pectin, a heparin mimetic, was synthesized in different ways and used as coating on multiple iron-palladium alloys. The static and dynamic prothrombin time (PT) and activated partial thromboplastin time (APTT) of the prepared materials were compared to samples uncoated or coated with polyethylene glycol. While no large differences were observed in the prothrombin time measurements, the activated partial thromboplastin time increased significantly with all alloys coated with sulfated pectin. Aside from that, sulfated pectin synthesized by different methods also caused slight changes in the activated partial thromboplastin time. These findings show that iron-palladium alloys can be coated with anticoagulants to improve their utility as material for temporary stents. Sulfated pectin was characterized by nuclear magnetic resonance (NMR) and Fourier-transform infrared (FTIR) spectroscopy, and the coated alloys by scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDX).
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Affiliation(s)
- Alexander Bunge
- National Institute R&D for Isotopic and Molecular Technology, 67-103 Donat Street, 400293 Cluj-Napoca, Romania
| | - Alexandru Chiriac
- Department of Neurosurgery, “Grigore T. Popa” University of Medicine and Pharmacy, Str. Universității nr. 16, 700115 Iasi, Romania
| | - Mihaela Sofronie
- National Institute of Materials Physics, Atomistilor Street 405A, 077125 Magurele, Romania
| | - Izabell Crăciunescu
- National Institute R&D for Isotopic and Molecular Technology, 67-103 Donat Street, 400293 Cluj-Napoca, Romania
| | - Alin Sebastian Porav
- National Institute R&D for Isotopic and Molecular Technology, 67-103 Donat Street, 400293 Cluj-Napoca, Romania
| | - Rodica Turcu
- National Institute R&D for Isotopic and Molecular Technology, 67-103 Donat Street, 400293 Cluj-Napoca, Romania
- Correspondence:
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232
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Kooiman VGM, van Staveren ES, Leijendekkers RA, Buurke JH, Verdonschot N, Prinsen EC, Weerdesteyn V. Testing and evaluation of lower limb prosthesis prototypes in people with a transfemoral amputation: a scoping review on research protocols. J Neuroeng Rehabil 2023; 20:1. [PMID: 36635703 PMCID: PMC9835280 DOI: 10.1186/s12984-023-01125-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 01/07/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND When developing new lower limb prostheses, prototypes are tested to obtain insights into the performance. However, large variations between research protocols may complicate establishing the potential added value of newly developed prototypes over other prostheses. OBJECTIVE This review aims at identifying participant characteristics, research protocols, reference values, aims, and corresponding outcome measures used during prosthesis prototype testing on people with a transfemoral amputation. METHODS A systematic search was done on PubMed and Scopus from 2000 to December 2020. Articles were included if testing was done on adults with transfemoral or knee disarticulation amputation; testing involved walking with a non-commercially available prototype leg prosthesis consisting of at least a knee component; and included evaluations of the participants' functioning with the prosthesis prototype. RESULTS From the initial search of 2027 articles, 48 articles were included in this review. 20 studies were single-subject studies and 4 studies included a cohort of 10 or more persons with a transfemoral amputation. Only 5 articles reported all the pre-defined participant characteristics that were deemed relevant. The familiarization time with the prosthesis prototype prior to testing ranged from 5 to 10 min to 3 months; in 25% of the articles did not mention the extent of the familiarization period. Mobility was most often mentioned as the development or testing aim. A total of 270 outcome measures were identified, kinetic/kinematic gait parameters were most often reported. The majority of outcome measures corresponded to the mobility aim. For 48% of the stated development aims and 4% of the testing aims, no corresponding outcome measure could be assigned. Results indicated large inconsistencies in research protocols and outcome measures used to validate pre-determined aims. CONCLUSIONS The large variation in prosthesis prototype testing and reporting calls for the development of a core set of reported participant characteristics, testing protocols, and specific and well-founded outcome measures, tailored to the various aims and development phases. The use of such a core set can give greater insights into progress of developments and determine which developments have additional benefits over the state-of-the-art. This review may contribute as initial input towards the development of such a core set.
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Affiliation(s)
- Vera G M Kooiman
- Orthopedic Research Laboratory, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
- Department of Rehabilitation, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Eline S van Staveren
- Roessingh Research and Development, PO Box 310, 7500 AH, Enschede, The Netherlands
| | - Ruud A Leijendekkers
- Orthopedic Research Laboratory, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- Department of Rehabilitation, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Jaap H Buurke
- Roessingh Research and Development, PO Box 310, 7500 AH, Enschede, The Netherlands
- Roessingh Center for Rehabilitation, Postbus 310, 7500 AH, Enschede, The Netherlands
- Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands
| | - Nico Verdonschot
- Orthopedic Research Laboratory, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands
| | - Erik C Prinsen
- Roessingh Research and Development, PO Box 310, 7500 AH, Enschede, The Netherlands
- Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands
| | - Vivian Weerdesteyn
- Department of Rehabilitation, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- Sint Maartenskliniek, Research & Rehabilitation, P.O. Box 9011, 6500 GM, Nijmegen, The Netherlands
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233
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Using early health economic modeling to inform medical innovation development: a soft robotic sock in poststroke patients in Singapore. Int J Technol Assess Health Care 2023; 39:e4. [PMID: 36628458 DOI: 10.1017/s026646232200335x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Based on a real-world collaboration with innovators in applying early health economic modeling, we aimed to offer practical steps that health technology assessment (HTA) researchers and innovators can follow and promote the usage of early HTA among research and development (R&D) communities. METHODS The HTA researcher was approached by the innovator to carry out an early HTA ahead of the first clinical trial of the technology, a soft robotic sock for poststroke patients. Early health economic modeling was selected to understand the potential value of the technology and to help uncover the information gap. Threshold analysis was used to identify the target product profiles. Value-of-information analysis was conducted to understand the uncertainties and the need for further research. RESULTS Based on the expected price and clinical effectiveness by the innovator, the new technology was found to be cost-saving compared to the current practice. Risk reduction in deep vein thrombosis and ankle contracture, the incidence rate of ankle contracture, the compliance rate of the new technology, and utility scores were found to have high impacts on the value-for-money of the new technology. The value of information was low if the new technology can achieve the expected clinical effectiveness. A list of parameters was recommended for data collection in the impending clinical trial. CONCLUSIONS This work, based on a real-world collaboration, has illustrated that early health economic modeling can inform medical innovation development. We provided practical steps in order to achieve more efficient R&D investment in medical innovation moving forward.
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234
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Yang T, Jin Y, Neogi A. Acoustic Attenuation and Dispersion in Fatty Tissues and Tissue Phantoms Influencing Ultrasound Biomedical Imaging. ACS OMEGA 2023; 8:1319-1330. [PMID: 36643513 PMCID: PMC9835773 DOI: 10.1021/acsomega.2c06750] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
The development of ultrasonic imaging techniques is optimized using artificial tissue phantoms before the practical applications. However, due to the strong attenuation and dispersion, accumulated fatty tissues can significantly impact the resolution and even feasibility of certain ultrasonic imaging modalities. An appropriate characterization of the acoustic properties on fatty phantoms can help the community to overcome the limitations. Some of the existing methods heavily overestimate attenuation coefficients by including the reflection loss and dispersion effects. Hence, in this study, we use numerical simulation-based comparison between two major attenuation measurement configurations. We further pointed out the pulse dispersion in viscoelastic tissue phantoms by simulations, which barely attracted attention in the existing studies. Using the selected attenuation and dispersion testing methods that were selected from the numerical simulation, we experimentally characterized the acoustic properties of common fatty tissue phantoms and compared the acoustic properties with the natural porcine fatty tissue samples. Furthermore, we selected one of the tissue phantoms to construct ultrasound imaging samples with some biomasses. With the known attenuation and dispersion of the tissue phantom, we showed the clarity enhancement of ultrasound imaging by signal post-processing to weaken the attenuation and dispersion effects.
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Affiliation(s)
- Teng Yang
- Department
of Physics, University of North Texas, Denton, Texas76203, United States
- Department
of Materials Science and Engineering,University
of North Texas, Denton, Texas76207, United States
| | - Yuqi Jin
- Department
of Physics, University of North Texas, Denton, Texas76203, United States
| | - Arup Neogi
- Department
of Physics, University of North Texas, Denton, Texas76203, United States
- Institute
of Fundamental and Frontier Sciences, University
of Electronic Science and Technology of China, Chengdu611731, P. R. China
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Fu J, Wang H, Na R, Jisaihan A, Wang Z, Ohno Y. Recent advancements in digital health management using multi-modal signal monitoring. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:5194-5222. [PMID: 36896542 DOI: 10.3934/mbe.2023241] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Healthcare is the method of keeping or enhancing physical and mental well-being with its aid of illness and injury prevention, diagnosis, and treatment. The majority of conventional healthcare practices involve manual management and upkeep of client demographic information, case histories, diagnoses, medications, invoicing, and drug stock upkeep, which can result in human errors that have an impact on clients. By linking all the essential parameter monitoring equipment through a network with a decision-support system, digital health management based on Internet of Things (IoT) eliminates human errors and aids the doctor in making more accurate and timely diagnoses. The term "Internet of Medical Things" (IoMT) refers to medical devices that have the ability to communicate data over a network without requiring human-to-human or human-to-computer interaction. Meanwhile, more effective monitoring gadgets have been made due to the technology advancements, and these devices can typically record a few physiological signals simultaneously, including the electrocardiogram (ECG) signal, the electroglottography (EGG) signal, the electroencephalogram (EEG) signal, and the electrooculogram (EOG) signal. Yet, there has not been much research on the connection between digital health management and multi-modal signal monitoring. To bridge the gap, this article reviews the latest advancements in digital health management using multi-modal signal monitoring. Specifically, three digital health processes, namely, lower-limb data collection, statistical analysis of lower-limb data, and lower-limb rehabilitation via digital health management, are covered in this article, with the aim to fully review the current application of digital health technology in lower-limb symptom recovery.
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Affiliation(s)
- Jiayu Fu
- Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan
| | - Haiyan Wang
- Ma'anshan University, maanshan 243000, China
| | - Risu Na
- Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan
- Shanghai Jian Qiao University, Shanghai 201315, China
| | - A Jisaihan
- Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan
| | - Zhixiong Wang
- Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan
- Ma'anshan University, maanshan 243000, China
| | - Yuko Ohno
- Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan
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236
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Hamrol A, Hoffmann M, Lisek M, Bozek J. The Quality of Surgical Instrument Surfaces Machined with Robotic Belt Grinding. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16020630. [PMID: 36676377 PMCID: PMC9860604 DOI: 10.3390/ma16020630] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 06/01/2023]
Abstract
Belt grinding is commonly used in the finishing of non-functional shaped surfaces of surgical instruments. Most often it is carried out manually. The subject of this article is the possibility of replacing manual belt grinding with robotic grinding. A research stand was built, the machining process was programmed, and a comparative study of manual and robotic grinding was carried out. The subject of the research were the arms of orthodontic forceps. The condition of the treated surface, defined by its structure and roughness and the geometric accuracy and the error of the shape of the arm in the selected cross-section were adopted as the comparative criteria. Research has shown that robotic belt grinding is more efficient in terms of quality and produces more consistent results than manual grinding.
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Affiliation(s)
- Adam Hamrol
- Faculty of Mechanical Engineering, Poznan University of Technology, Piotrowo 3, 60-138 Poznan, Poland
| | | | - Marcin Lisek
- Aesculap Chifa, Tysiaclecia 14, 64-300 Nowy Tomysl, Poland
| | - Jedrzej Bozek
- Aesculap Chifa, Tysiaclecia 14, 64-300 Nowy Tomysl, Poland
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237
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Ji X, Littman A, Hettiarachchige RO, Piovesan D. The Effect of Key Anthropometric and Biomechanics Variables Affecting the Lower Back Forces of Healthcare Workers. SENSORS (BASEL, SWITZERLAND) 2023; 23:658. [PMID: 36679454 PMCID: PMC9864406 DOI: 10.3390/s23020658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 12/28/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Wearable devices are becoming ubiquitous and can be used to better estimate postures and movements to reduce the risk of injuries. Thirty-three participants were recruited in this study to perform two daily repetitive patient transfer tasks while the full body movements were acquired using a set of magneto-inertial wearable devices. The use of wearable devices allowed for the estimation of the forces provoked on the lower back during the entire task performance. In postures where the forces exceeded the warning threshold found in the literature, healthcare workers were considered to have a greater risk of injury. Additionally, the maximum force exerted by each hand to avoid injury to the spinal column was also estimated. Knowing the key anthropometric variables associated with musculoskeletal disorders (MSDs) will enable engineers and researchers to design better assistive devices and injury prevention programs in diverse workplaces.
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238
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Patel SK, Surve J, Parmar J, Ahmed K, Bui FM, Al-Zahrani FA. Recent Advances in Biosensors for Detection of COVID-19 and Other Viruses. IEEE Rev Biomed Eng 2023; 16:22-37. [PMID: 36197867 PMCID: PMC10009816 DOI: 10.1109/rbme.2022.3212038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/28/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022]
Abstract
This century has introduced very deadly, dangerous, and infectious diseases to humankind such as the influenza virus, Ebola virus, Zika virus, and the most infectious SARS-CoV-2 commonly known as COVID-19 and have caused epidemics and pandemics across the globe. For some of these diseases, proper medications, and vaccinations are missing and the early detection of these viruses will be critical to saving the patients. And even the vaccines are available for COVID-19, the new variants of COVID-19 such as Delta, and Omicron are spreading at large. The available virus detection techniques take a long time, are costly, and complex and some of them generates false negative or false positive that might cost patients their lives. The biosensor technique is one of the best qualified to address this difficult challenge. In this systematic review, we have summarized recent advancements in biosensor-based detection of these pandemic viruses including COVID-19. Biosensors are emerging as efficient and economical analytical diagnostic instruments for early-stage illness detection. They are highly suitable for applications related to healthcare, wearable electronics, safety, environment, military, and agriculture. We strongly believe that these insights will aid in the study and development of a new generation of adaptable virus biosensors for fellow researchers.
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Affiliation(s)
- Shobhit K. Patel
- Department of Computer EngineeringMarwadi UniversityRajkot360003India
| | - Jaymit Surve
- Department of Electrical EngineeringMarwadi UniversityRajkot360003India
| | - Juveriya Parmar
- Department of Mechanical and Materials EngineeringUniversity of Nebraska - LincolnNebraska68588USA
- Department of Electronics and Communication EngineeringMarwadi UniversityRajkot360003India
| | - Kawsar Ahmed
- Department of Electrical and Computer EngineeringUniversity of SaskatchewanSaskatoonSKS79 5A9Canada
- Group of Bio-PhotomatiX, Department of Information and Communication TechnologyMawlana Bhashani Science and Technology UniversitySantoshTangail1902Bangladesh
| | - Francis M. Bui
- Department of Electrical and Computer EngineeringUniversity of SaskatchewanSaskatoonSKS79 5A9Canada
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239
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Effect of Infill Parameters on the Compressive Strength of 3D-Printed Nylon-Based Material. Polymers (Basel) 2023; 15:polym15020255. [PMID: 36679135 PMCID: PMC9862055 DOI: 10.3390/polym15020255] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/21/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
3D printing is the most suitable method to manufacture the frame parts of powered ankle-foot prostheses but the compressive strength of the 3D-printed part needs to be ensured. According to the compression test standard ASTM D695, the effect of infill pattern and density, which is transferred to the mass of the standard specimen, on the compressive strength is investigated with a carbon fiber-reinforced nylon material. With the same infill pattern, specimens with more mass have a higher compressive strength. With the same mass, specimens with triangular fill have a higher compressive strength than those with rectangular and gyroid fills. Compared with specimens with a solid fill, specimens with a triangular fill can also provide more compressive strength in a unit mass. According to the results of standard specimens, following the requirement of strength and lightweight, 41% triangular fill is selected to manufacture the supporting part of a powered ankle-foot prosthesis. Under a compressive load of 1225 N, the strain of the assembly of the standard adaptor and the 3D-printed part is 1.32 ± 0.04%, which can meet the requirement of the design. This study can provide evidence for other 3D-printed applications with the requirement of compressive strength.
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240
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de Almeida e Bueno L, Kwong MT, Bergmann JHM. Performance of Oral Cavity Sensors: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:588. [PMID: 36679385 PMCID: PMC9862524 DOI: 10.3390/s23020588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/21/2022] [Accepted: 12/28/2022] [Indexed: 05/31/2023]
Abstract
Technological advancements are enabling new applications within biomedical engineering. As a connection point between the outer environment and the human system, the oral cavity offers unique opportunities for sensing technologies. This paper systematically reviews the performance of measurement systems tested in the human oral cavity. Performance was defined by metrics related to accuracy and agreement estimation. A comprehensive search identifying human studies that reported on the accuracy or agreement of intraoral sensors found 85 research papers. Most of the literature (62%) was in dentistry, followed by neurology (21%), and physical medicine and rehabilitation (12%). The remaining papers were on internal medicine, obstetrics, and aerospace medicine. Most of the studies applied force or pressure sensors (32%), while optical and image sensors were applied most widely across fields. The main challenges for future adoption include the lack of large human trials, the maturity of emerging technologies (e.g., biochemical sensors), and the absence of standardization of evaluation in specific fields. New research should aim to employ robust performance metrics to evaluate their systems and incorporate real-world evidence as part of the evaluation process. Oral cavity sensors offer the potential for applications in healthcare and wellbeing, but for many technologies, more research is needed.
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Affiliation(s)
| | - Man Ting Kwong
- Guy’s and St. Thomas’ NHS Foundation Trust, St. Thomas’ Hospital, Westminster Bridge Rd., London SE1 7EH, UK
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241
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Le NT, Thwe Chit MM, Truong TL, Siritantikorn A, Kongruttanachok N, Asdornwised W, Chaitusaney S, Benjapolakul W. Deployment of Smart Specimen Transport System Using RFID and NB-IoT Technologies for Hospital Laboratory. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23010546. [PMID: 36617144 PMCID: PMC9823357 DOI: 10.3390/s23010546] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/25/2022] [Accepted: 12/28/2022] [Indexed: 06/12/2023]
Abstract
In this study, we propose a specimen tube prototype and smart specimen transport box using radio frequency identification (RFID) and narrow band-Internet of Things (NB-IoT) technology to use in the Department of Laboratory Medicine, King Chulalongkorn Memorial Hospital. Our proposed method replaces the existing system, based on barcode technology, with shortage usage and low reliability. In addition, tube-tagged barcode has not eliminated the lost or incorrect delivery issues in many laboratories. In this solution, the passive RFID tag is attached to the surface of the specimen tube and stores information such as patient records, required tests, and receiver laboratory location. This information can be written and read multiple times using an RFID device. While delivering the specimen tubes via our proposed smart specimen transport box from one clinical laboratory to another, the NB-IoT attached to the box monitors the temperature and humidity values inside the box and tracks the box's GPS location to check whether the box arrives at the destination. The environmental condition inside the specimen transport box is sent to the cloud and can be monitored by doctors. The experimental results have proven the innovation of our solution and opened a new dimension for integrating RFID and IoT technologies into the specimen logistic system in the hospital.
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Affiliation(s)
- Ngoc Thien Le
- Center of Excellence in Artificial Intelligence, Machine Learning and Smart Grid Technology, Department of Electrical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok 10330, Thailand
| | - Mya Myet Thwe Chit
- Center of Excellence in Artificial Intelligence, Machine Learning and Smart Grid Technology, Department of Electrical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok 10330, Thailand
| | - Thanh Le Truong
- Center of Excellence in Artificial Intelligence, Machine Learning and Smart Grid Technology, Department of Electrical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok 10330, Thailand
| | - Atchasai Siritantikorn
- Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Narisorn Kongruttanachok
- Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Widhyakorn Asdornwised
- Center of Excellence in Artificial Intelligence, Machine Learning and Smart Grid Technology, Department of Electrical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok 10330, Thailand
| | - Surachai Chaitusaney
- Center of Excellence in Artificial Intelligence, Machine Learning and Smart Grid Technology, Department of Electrical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok 10330, Thailand
| | - Watit Benjapolakul
- Center of Excellence in Artificial Intelligence, Machine Learning and Smart Grid Technology, Department of Electrical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok 10330, Thailand
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242
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T M, D K, M G, AG F. Orphan Medical Devices and Pediatric Cardiology - What Interventionists in Europe Need to Know, and What Needs to be Done. Pediatr Cardiol 2023; 44:271-279. [PMID: 36258097 PMCID: PMC9579647 DOI: 10.1007/s00246-022-03029-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 10/10/2022] [Indexed: 02/07/2023]
Abstract
Medical devices include a great diversity of technologies, which are evaluated and approved in the European Union (EU) according to a revised law that came into effect on 26 May 2021, known as the Medical Device Regulation or MDR (EU 745/2017). It has a transition period that allows products that were approved under the previous rules (the EU Medical Device Directives) to continue to be marketed until 26 May 2024 at the latest. As a result of a series of unforeseen factors, there is a possibility that the MDR may result in products becoming unavailable, with the consequent risk of a loss of some interventions that are reliant upon those devices. Devices that are used for orphan or pediatric indications are particularly vulnerable to this. There is an urgent need for policy to be developed to protect essential medical devices for orphan indications and for use in children, to ensure that necessary interventions can continue, and to ensure a more sustainable system in Europe over the longer term. Pediatric cardiologists in Europe need to be aware that particular medical devices may become unavailable over the next two years, and they should contribute to plans to mitigate this risk, so that they can continue to deliver the best possible care for their patients. This commentary examines the factors which have contributed to this issue and suggests ways that policy can be developed to address it.Article title: Kindly check and confirm the edit made in the title.Title is okay.
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Affiliation(s)
- Melvin T
- School of Medicine, Trinity College Dublin, Dublin, Ireland.
| | - Kenny D
- Children’s Health Ireland at Crumlin and Mater Hospital, Dublin, Ireland
| | - Gewillig M
- University Hospital Leuven, Leuven, Belgium
| | - Fraser AG
- Department of Cardiology, University Hospital of Wales, Cardiff, CF14 4XW UK
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243
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Usevitch DE, Bronheim RS, Reyes MC, Babilonia C, Margalit A, Jain A, Armand M. Review of Enhanced Handheld Surgical Drills. Crit Rev Biomed Eng 2023; 51:29-50. [PMID: 37824333 PMCID: PMC10874117 DOI: 10.1615/critrevbiomedeng.2023049106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
The handheld drill has been used as a conventional surgical tool for centuries. Alongside the recent successes of surgical robots, the development of new and enhanced medical drills has improved surgeon ability without requiring the high cost and consuming setup times that plague medical robot systems. This work provides an overview of enhanced handheld surgical drill research focusing on systems that include some form of image guidance and do not require additional hardware that physically supports or guides drilling. Drilling is reviewed by main contribution divided into audio-, visual-, or hardware-enhanced drills. A vision for future work to enhance handheld drilling systems is also discussed.
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Affiliation(s)
- David E. Usevitch
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, United States
- Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, MD, United States
| | - Rachel S. Bronheim
- Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, MD, United States
| | - Miguel C. Reyes
- Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, MD, United States
| | - Carlos Babilonia
- Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, MD, United States
| | - Adam Margalit
- Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, MD, United States
| | - Amit Jain
- Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, MD, United States
| | - Mehran Armand
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD, United States
- Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, MD, United States
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244
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An Improved Design of Knee Orthosis Using Self-Adaptive Bonobo Optimizer (SaBO). J INTELL ROBOT SYST 2023. [DOI: 10.1007/s10846-022-01802-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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245
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Roberts SH, Goodwin ML, Bobba CM, Al-Qudsi O, Satyapriya SV, Tripathi RS, Papadimos TJ, Whitson BA. Continuous renal replacement therapy and extracorporeal membrane oxygenation: implications in the COVID-19 era. Perfusion 2023; 38:18-27. [PMID: 34494489 DOI: 10.1177/02676591211042561] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The novel severe acute respiratory syndrome coronavirus 2, SARS-CoV-2 (coronavirus Disease 19 (COVID-19)) was identified as the causative agent of viral pneumonias in Wuhan, China in December 2019, and has emerged as a pandemic causing acute respiratory distress syndrome (ARDS) and multiple organ dysfunction. Interim guidance by the World Health Organization states that extracorporeal membrane oxygenation (ECMO) should be considered as a rescue therapy in COVID-19-related ARDS. International registries tracking ECMO in COVID-19 patients reveal a 21%-70% incidence of acute renal injury requiring renal replacement therapy (RRT) during ECMO support. The indications for initiating RRT in patients on ECMO are similar to those for patients not requiring ECMO. RRT can be administered during ECMO via a temporary dialysis catheter, placement of a circuit in-line hemofilter, or direct connection of continuous RRT in-line with the ECMO circuit. Here we review methods for RRT during ECMO, RRT initiation and timing during ECMO, anticoagulation strategies, and novel cytokine filtration approaches to minimize COVID-19's pathophysiological impact.
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Affiliation(s)
- Sophia H Roberts
- Division of Cardiac Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.,The Ohio State University College of Medicine, Columbus, OH, USA
| | - Matthew L Goodwin
- Division of Cardiac Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Christopher M Bobba
- Division of Cardiac Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.,The Ohio State University College of Medicine, Columbus, OH, USA
| | - Omar Al-Qudsi
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - S Veena Satyapriya
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Ravi S Tripathi
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Thomas J Papadimos
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Bryan A Whitson
- Division of Cardiac Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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246
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Norton NM, Fischer KJ. Effects of micropipette handle diameter and inclusion of finger rest on basilar thumb joint contact mechanics. Med Eng Phys 2023; 111:103940. [PMID: 36792232 DOI: 10.1016/j.medengphy.2022.103940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 10/27/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022]
Abstract
Micropipette users commonly experience problems in the hand and upper limbs. Mechanical factors are thought to contribute to osteoarthritis (OA) initiation and progression in the basilar thumb joint. Finite element analysis can be used to examine the effects of micropipette design on contact mechanics measures within the basilar thumb joint. This pilot study examined the effect of micropipette handle diameter (12 mm, 25 mm, and 40 mm) and the presence of a finger rest on contact area, contact force, and peak contact pressure in the basilar thumb joint. All contact mechanics measures decreased with increasing handle diameter with significant differences between the 12 mm diameter and the 40 mm diameter handles (contact area down about 30 mm2, contact force down about 15 N, and peak pressure down about 1 MPa). Decreasing contact mechanics measures with increasing diameter matched our expectations that contact measures would decrease with a more open grip. Contact mechanics measures were higher (p < 0.05) with a finger rest for contact area and force. We expected peak contact pressure and contact area to decrease with the presence of a finger rest. The unexpected outcome may have been due to non-randomized testing order and fatigue during testing.
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Affiliation(s)
- Nolan M Norton
- Bioengineering Program, University of Kansas, 1132 Learned Hall 1530 W 15th St., Lawrence, KS 66045, United States
| | - Kenneth J Fischer
- Bioengineering Program, University of Kansas, 1132 Learned Hall 1530 W 15th St., Lawrence, KS 66045, United States; Mechanical Engineering, University of Kansas, 3138 Learned Hall 1530 W 15th St., Lawrence, KS 66045, United States; Orthopedics and Sports Medicine, University of Kansas Medical Center, Mail Stop 3107, 3901 Rainbow Boulevard, Kansas City, KS 66160, United States.
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247
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Armstrong SA, Jafary R, Forsythe JS, Gregory SD. Tissue-Mimicking Materials for Ultrasound-Guided Needle Intervention Phantoms: A Comprehensive Review. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:18-30. [PMID: 36210247 DOI: 10.1016/j.ultrasmedbio.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 07/07/2022] [Accepted: 07/30/2022] [Indexed: 06/16/2023]
Abstract
Ultrasound-guided needle interventions are common procedures in medicine, and tissue-mimicking phantoms are widely used for simulation training to bridge the gap between theory and clinical practice in a controlled environment. This review assesses tissue-mimicking materials from 24 studies as candidates for a high-fidelity ultrasound phantom, including methods for evaluating relevant acoustic and mechanical properties and to what extent the reported materials mimic the superficial layers of biological tissue. Speed of sound, acoustic attenuation, Young's modulus, hardness, needle interaction forces, training efficiency and material limitations were systematically evaluated. Although gelatin and agar have the closest acoustic values to tissue, mechanical properties are limited, and strict storage protocols must be employed to counteract dehydration and microbial growth. Polyvinyl chloride (PVC) has superior mechanical properties and is a suitable alternative if durability is desired and some ultrasound realism to human tissue may be sacrificed. Polyvinyl alcohol (PVA), while also requiring hydration, performs well across all categories. Furthermore, we propose a framework for the evaluation of future ultrasound-guided needle intervention tissue phantoms to increase the fidelity of training programs and thereby improve clinical performance.
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Affiliation(s)
- Sophie A Armstrong
- Department of Mechanical and Aerospace Engineering, Monash University, Clayton, Victoria, Australia; Cardio-respiratory Engineering and Technology Laboratory (CREATElab), Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
| | - Rezan Jafary
- Department of Mechanical and Aerospace Engineering, Monash University, Clayton, Victoria, Australia; Cardio-respiratory Engineering and Technology Laboratory (CREATElab), Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - John S Forsythe
- Department of Materials Science and Engineering, Monash University, Clayton, Victoria, Australia
| | - Shaun D Gregory
- Department of Mechanical and Aerospace Engineering, Monash University, Clayton, Victoria, Australia; Cardio-respiratory Engineering and Technology Laboratory (CREATElab), Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
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248
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Patient-Specific Immersed Finite Element-Difference Model of Transcatheter Aortic Valve Replacement. Ann Biomed Eng 2023; 51:103-116. [PMID: 36264408 PMCID: PMC9832092 DOI: 10.1007/s10439-022-03047-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/03/2022] [Indexed: 01/28/2023]
Abstract
Transcatheter aortic valve replacement (TAVR) first received FDA approval for high-risk surgical patients in 2011 and has been approved for low-risk surgical patients since 2019. It is now the most common type of aortic valve replacement, and its use continues to accelerate. Computer modeling and simulation (CM&S) is a tool to aid in TAVR device design, regulatory approval, and indication in patient-specific care. This study introduces a computational fluid-structure interaction (FSI) model of TAVR with Medtronic's CoreValve Evolut R device using the immersed finite element-difference (IFED) method. We perform dynamic simulations of crimping and deployment of the Evolut R, as well as device behavior across the cardiac cycle in a patient-specific aortic root anatomy reconstructed from computed tomography (CT) image data. These IFED simulations, which incorporate biomechanics models fit to experimental tensile test data, automatically capture the contact within the device and between the self-expanding stent and native anatomy. Further, we apply realistic driving and loading conditions based on clinical measurements of human ventricular and aortic pressures and flow rates to demonstrate that our Evolut R model supports a physiological diastolic pressure load and provides informative clinical performance predictions.
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249
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Ponnaluri SV, Hariharan P, Herbertson LH, Manning KB, Malinauskas RA, Craven BA. Results of the Interlaboratory Computational Fluid Dynamics Study of the FDA Benchmark Blood Pump. Ann Biomed Eng 2023; 51:253-269. [PMID: 36401112 DOI: 10.1007/s10439-022-03105-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/21/2022] [Indexed: 11/19/2022]
Abstract
Computational fluid dynamics (CFD) is widely used to simulate blood-contacting medical devices. To be relied upon to inform high-risk decision making, however, model credibility should be demonstrated through validation. To provide robust data sets for validation, researchers at the FDA and collaborators developed two benchmark medical device flow models: a nozzle and a centrifugal blood pump. Experimental measurements of the flow fields and hemolysis were acquired using each model. Concurrently, separate open interlaboratory CFD studies were performed in which participants from around the world, who were blinded to the measurements, submitted CFD predictions of each benchmark model. In this study, we report the results of the interlaboratory CFD study of the FDA benchmark blood pump. We analyze the results of 24 CFD submissions using a wide range of different flow solvers, methods, and modeling parameters. To assess the accuracy of the CFD predictions, we compare the results with experimental measurements of three quantities of interest (pressure head, velocity field, and hemolysis) at different pump operating conditions. We also investigate the influence of different CFD methods and modeling choices used by the participants. Our analyses reveal that, while a number of CFD submissions accurately predicted the pump performance for individual cases, no single participant was able to accurately predict all quantities of interest across all conditions. Several participants accurately predicted the pressure head at all conditions and the velocity field in all but one or two cases. Only one of the eight participants who submitted hemolysis results accurately predicted absolute plasma free hemoglobin levels at a majority of the conditions, though most participants were successful at predicting relative hemolysis levels between conditions. Overall, this study highlights the need to validate CFD modeling of rotary blood pumps across the entire range of operating conditions and for all quantities of interest, as some operating conditions and regions (e.g., the pump diffuser) are more challenging to accurately predict than others. All quantities of interest should be validated because, as shown here, it is possible to accurately predict hemolysis despite having relatively inaccurate predictions of the flow field.
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Affiliation(s)
- Sailahari V Ponnaluri
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD, USA.,Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, USA
| | - Prasanna Hariharan
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Luke H Herbertson
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Keefe B Manning
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, USA.,Department of Surgery, Penn State Hershey Medical Center, Hershey, PA, USA
| | - Richard A Malinauskas
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Brent A Craven
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD, USA.
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250
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Bhatt S, Joshi D, Rakesh PK, Godiyal AK. Advances in additive manufacturing processes and their use for the fabrication of lower limb prosthetic devices. Expert Rev Med Devices 2023; 20:17-27. [PMID: 36637907 DOI: 10.1080/17434440.2023.2169130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Traditional methods of prosthesis fabrication are not efficient and user centric and are made for common purposes without focusing on individual demands of user which leads to rejection of prosthesis for long-term use. Utilizing advanced additive manufacturing techniques for fabrication of prosthesis makes the development process user centric and covers all the user demands thus providing better fit, comfort, and more stable gait rehabilitation for the user. AREAS COVERED The articles reporting fabrication of lower limb prosthesis and its socket are included in the study. Standard fabrication and additive manufacturing method are both systematically assessed by the reviewers. The review also covers the advanced methods of additive manufacturing that are presently being used for fabrication of rehabilitation devices. EXPERT OPINION Additive manufacturing method of fabrication of prosthesis provides more flexibility for manufacturing prosthesis parts as per demand of the user. The fabrication method takes into account the residual limb and thus makes the prosthesis user-specific providing better comfort and fit.
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Affiliation(s)
- Shaurya Bhatt
- Department of Mechanical Engineering, National Institute of Technology Uttarakhand, Srinagar Garhwal, India
| | - Deepak Joshi
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, India
| | - Pawan Kumar Rakesh
- Department of Mechanical Engineering, National Institute of Technology Uttarakhand, Srinagar Garhwal, India
| | - Anoop Kant Godiyal
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Science, Delhi, India
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