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Investigation of knee joint stability in surgically repaired canine cruciate ligament ruptures by cyclic passive joint motions 循环被动关节运动对犬十字韧带断裂手术修复后膝关节稳定性的影响
Q4 Engineering Pub Date : 2023-09-01 DOI: 10.1515/cdbme-2023-1061
Thomas Reuter, Andreas Grundmann, Jens Siebert, Friederike Preuß, Dirk Barnewitz
Abstract The cranial cruciate ligament (CCL) rupture is a prevalent injury in dogs. A consequence of a cruciate ligament rupture is instability in the affected knee joint. A veterinary, mostly surgical treatment of the cruciate ligament rupture is usually unavoidable. The suitability of an arthroscopic surgical method with ligament replacement material was investigated. The stability of the knee joint was determined several times during 1,200 passive robotic motion cycles with movement radius between 90° flexion and 140° extension. The stability condition was measured by triggering the drawer test. After 300 motion cycles, the drawer test could be triggered (positive drawer test). In the following movement cycles up to 1,200 cycles, the drawer test could also be triggered. However, no significant differences occurred between these triggered drawer tests. The ligament replacement material showed no damage and no loosening after the tests. The first results showed that the developed arthroscopic surgical method could be a promising approach for the surgical treatment of cruciate ligament ruptures in canines.
颅十字韧带(CCL)断裂是犬的常见损伤。交叉韧带断裂的后果是受影响的膝关节不稳定。兽医,主要是手术治疗十字韧带断裂通常是不可避免的。研究了关节镜下韧带替代材料手术方法的适用性。在运动半径在90°屈曲和140°伸展之间的1200个被动机器人运动周期中,多次确定膝关节的稳定性。通过触发抽屉式试验对其稳定性进行了测试。300个运动循环后,可触发抽屉测试(阳性抽屉测试)。在接下来的1200个运动周期中,抽屉测试也可以被触发。然而,这些触发抽屉测试之间没有显著差异。经检查,韧带替代材料无损伤,无松动。初步结果表明,关节镜手术方法是治疗犬十字韧带断裂的一种很有前途的手术方法。
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引用次数: 0
A comparison of two CNN-based instrument detection approaches for automated surgical assistance systems 两种基于cnn的自动手术辅助系统仪器检测方法的比较
Q4 Engineering Pub Date : 2023-09-01 DOI: 10.1515/cdbme-2023-1150
Flakë Bajraktari, Kathrin Fleissner, Peter P. Pott
Abstract The shortage of operating room technicians has led to a growing demand for automated systems in the OR to maintain the quality of care. Robotic scrub nurse (RSN) systems are increasingly being developed, which perform tasks such as handling instruments and documenting the surgery. While research has focused on detecting instruments in the hands of surgical staff or recognizing surgical phases, there is a lack of research on detecting instruments on the instrument tray. Therefore, this study proposes and evaluates two distinct methodologies for instrument detection on the OR table using the deep learning approaches YOLOv5 and Mask R-CNN. The performance of the two approaches has been evaluated on 18 YOLOv5 models and twelve Mask R-CNN models, mainly differing in model size. Two sets of instruments were used to assess generalizability of the models. The results show a mean average precision (mAP) score of 0.978 for YOLOv5 and 0.846 for Mask R-CNN on the test dataset comprising three classes. An mAP of 0.874 and 0.707 have been computed respectively for the test dataset including six classes. The study provides a comparison of the performance of two suitable approaches for instrument detection on the instrument tray in the OR to enhance the development of RSN systems.
摘要手术室技术人员的短缺导致对手术室自动化系统的需求不断增长,以保持护理质量。机器人磨砂护士(RSN)系统正在不断发展,它们执行诸如处理仪器和记录手术等任务。目前的研究主要集中在检测手术人员手中的器械或识别手术阶段,而对检测器械托盘上的器械的研究较少。因此,本研究提出并评估了使用深度学习方法YOLOv5和Mask R-CNN在OR表上进行仪器检测的两种不同方法。在18个YOLOv5模型和12个Mask R-CNN模型上对两种方法的性能进行了评估,主要是模型大小不同。使用了两套工具来评估模型的通用性。结果表明,在包含三个类别的测试数据集上,YOLOv5的平均平均精度(mAP)得分为0.978,Mask R-CNN的平均平均精度(mAP)得分为0.846。对于包含6个类的测试数据集,分别计算出了0.874和0.707的mAP。本研究比较了两种适用于手术室仪器托盘的仪器检测方法的性能,以促进RSN系统的发展。
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引用次数: 0
High-Speed Laser Drilling for Dental Implantation: Ablation Process and Applicator Technology 高速激光钻牙种植:消融过程和应用技术
Q4 Engineering Pub Date : 2023-09-01 DOI: 10.1515/cdbme-2023-1162
Christina Giesen, Lazar Bochvarov, Marcel Bogdoll, Simon Vervoort, Achim Lenenbach, Yong-Min Yo
Abstract Conventional mechanical drilling for implant placement is limited to specific geometry and orientation, resulting in incorrect positioning and inadequate anchoring in thin or porous bone. This study presents the development of a laser-based ablation process and an applicator technology for precise and fast laser drilling in the oral cavity. For the process development, a CO2 laser with a wavelength of 10.6 μm was used. Pulse durations between 10 μs and 400 μs were investigated for fast laser drilling with low thermal impact. For efficient ablation and cooling of the bone tissue, we applied a fine water spray. The laser applicator is designed with an integrated scanning module, focusing optics and a compact water spray system with three spray nozzles in the applicator tip. The geometry of the cavities was analyzed using digital microscopy and scanning electron microscopy, allowing to measure the ablated volume and depth as well as investigating the bone microstructure. This study demonstrates a laser ablation process capable to generate cavities with an ablation rate of 1.75mm3/s which is about 80% higher than previously reported. At this ablation rate the melted zones were smaller than 30 μm. This paper demonstrates a concept for a dental laser drilling system with a fast ablation process and a highlyintegrated applicator for treatment in the oral cavity.
传统的机械钻孔种植体植入受限于特定的几何形状和方向,导致定位不正确,在薄骨或多孔骨中锚定不足。本研究提出了一种基于激光消融的工艺和应用技术,用于在口腔中进行精确和快速的激光钻孔。在工艺开发中,使用波长为10.6 μm的CO2激光器。研究了在10 μs ~ 400 μs范围内进行低热冲击快速激光钻孔的脉冲持续时间。为了有效地消融和冷却骨组织,我们使用了精细的水喷雾。激光喷射器设计有一个集成的扫描模块,聚焦光学和一个紧凑的水喷射系统,在喷射器尖端有三个喷嘴。使用数字显微镜和扫描电子显微镜分析腔体的几何形状,可以测量消融的体积和深度,并研究骨的微观结构。本研究展示了一种激光烧蚀工艺,能够产生1.75mm3/s的烧蚀速率,比先前报道的高约80%。在此烧蚀速率下,熔化区域小于30 μm。本文介绍了一种具有快速消融过程和高度集成应用器的口腔激光钻孔系统的概念。
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引用次数: 0
Lymph node metastases detection in Whole Slide Images using prototypical patterns and transformer-guided multiple instance learning 使用原型模式和变压器引导的多实例学习在整个幻灯片图像中检测淋巴结转移
Q4 Engineering Pub Date : 2023-09-01 DOI: 10.1515/cdbme-2023-1042
Thomas Wittenberg, Lukas Heinlein, Michaela Benz, Petr Kuritcyn, Volker Bruns, Arndt Hartmann, Carol Geppert, Felix Keil, Katja Evert
Abstract Background: The examination of lymph nodes (LNs) regarding metastases is vital for the staging of cancer patients, which is necessary for diagnosis and adequate treatment selection. Advancements in digital pathology, utilizing Whole-Slide Images (WSIs) and convolutional neural networks (CNNs), pose new opportunities to automate this procedure, thus reducing pathologists’ workload while simultaneously increasing the accuracy in metastases detection. Objective: To address the task of LN-metastases detection, the use of weakly supervised transformers are applied for the analysis of WSIs. Methods & Materials: As WSIs are too large to be processed as a whole, they are divided into non-overlapping patches, which are converted to feature vectors using a CNN network, pre-trained on HE-stained colon cancer resections. A subset of these patches serves as input for a transformer to predict if a LN contains a metastasis. Hence, selecting a representative subset is an important part of the pipeline. Hereby, a prototype based clustering is employed and different sampling strategies are tested. Finally, the chosen feature vectors are fed into a transformer-based multiple instance learning (MIL) architecture, classifying the LNs into healthy/negative (that is, containing no metastases), or metastatic/positive (that is, containing metastases). The proposed model is trained only on the Camelyon16 training data (LNs from breast cancer patients), and evaluated on the Camelyon16 test set. Results: The trained model achieves accuracies of up to 92.3% on the test data (from breast LNs). While the model struggles with smaller metastases, high specificities of up to 96.9% can be accomplished. Additionally, the model is evaluated on LNs from a different primary tumor (colon), where accuracies between 62.3% and 95.9% could be obtained. Conclusion: The investigated transformer-model performs very good on LN data from the public LN breast data, but the domain transfer to LNs from the colon needs more research.
背景:肿瘤转移淋巴结的检查对肿瘤患者的分期至关重要,是诊断和适当治疗选择的必要条件。数字病理学的进步,利用全幻灯片图像(WSIs)和卷积神经网络(cnn),为这一过程的自动化提供了新的机会,从而减少了病理学家的工作量,同时提高了转移检测的准确性。目的:为解决淋巴结转移检测的任务,应用弱监督变压器对淋巴结转移进行分析。方法,材料:由于wsi太大,无法作为一个整体进行处理,因此将其划分为不重叠的patch,使用CNN网络将其转换为特征向量,并对he染色的结肠癌切除术进行预训练。这些斑块的子集作为变压器的输入,用于预测LN是否包含转移。因此,选择具有代表性的子集是管道的重要组成部分。为此,采用了基于原型的聚类方法,并对不同的采样策略进行了测试。最后,将选择的特征向量馈送到基于转换器的多实例学习(MIL)架构中,将LNs分类为健康/阴性(即不包含转移)或转移/阳性(即包含转移)。该模型仅在Camelyon16训练数据(来自乳腺癌患者的LNs)上进行训练,并在Camelyon16测试集上进行评估。结果:训练后的模型在测试数据(来自乳腺ln)上达到了高达92.3%的准确率。虽然该模型与较小的转移瘤作斗争,但可以实现高达96.9%的高特异性。此外,该模型对来自不同原发肿瘤(结肠)的LNs进行了评估,准确率在62.3%至95.9%之间。结论:所研究的变压器模型对来自公共LN乳腺数据的LN数据表现良好,但从结肠到LN的域转移需要更多的研究。
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引用次数: 0
Limitations of Pacemaker Spike Detection in Capacitive ECGs via Deep Learning 基于深度学习的电容性心电图起搏器尖峰检测的局限性
Q4 Engineering Pub Date : 2023-09-01 DOI: 10.1515/cdbme-2023-1046
Maurice Rohr, Zhaolan Huang, Christoph Hoog Antink, Durmus Umutcan Uguz, Marian Walter, Steffen Leonhardt, Rosalia Dettori, Andreas Napp
Abstract Pacemaker spike detection is an important step in monitoring paced patients. Capacitive ECG facilitates unobtrusive monitoring of subjects during daily routines such as driving. Robust algorithms are required to deal with low signal quality and artifacts, e.g. by employing fusion of multiple signal channels. Due to the low signal-to-noise ratio of the measurement, there are limitations to detection accuracy compared to conventional ECG monitors. Especially low voltage stimulations such as bipolar pacemaker spikes are hard to detect. We present a convolutional network approach to improve on recent signal processing algorithms.We show a realistic evaluation of its performance using leave-one-subject-out cross validation (LOOCV), its dependence on the size of the receptive field, and an estimation of an upper performance bound.
心脏起搏器突波检测是监测心律失常患者的重要步骤。电容式ECG便于在日常生活中(如开车)对受试者进行不显眼的监测。需要稳健的算法来处理低信号质量和伪信号,例如采用多信号通道融合。由于测量的低信噪比,与传统的心电监护仪相比,检测精度存在局限性。特别是像双极起搏器尖峰这样的低电压刺激很难检测到。我们提出了一种卷积网络方法来改进最近的信号处理算法。我们使用留下一个主体的交叉验证(LOOCV)对其性能进行了现实的评估,它依赖于接受野的大小,以及对性能上限的估计。
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引用次数: 0
Development and Evaluation of a Cost-effective IMU System for Gait Analysis: Comparison with Vicon and VideoPose3D Algorithms 一种具有成本效益的步态分析IMU系统的开发和评估:与Vicon和VideoPose3D算法的比较
Q4 Engineering Pub Date : 2023-09-01 DOI: 10.1515/cdbme-2023-1064
Nikolas Wilhelm, Sami Haddadin, Carina M. Micheler, Jan J. Lang, Florian Hinterwimmer, Victor Schaack, Ricardo Smits, Rainer Burgkart
Abstract This study aimed to develop and evaluate a costeffective Inertial Measurement Unit (IMU) system for gait analysis, comparing its performance with the Vicon system and the VideoPose3D algorithm. The system comprises five calibrated sensors and a mobile app to measure lower body orientation during gait and stair climbing. Eight healthy participants were involved in the experiment, each performing ten repetitions to analyze hip and knee flexion angles. The IMU system demonstrated significantly lower mean square error than deep learning-based approaches and comparable results to the Vicon system, indicating its potential for clinical and research applications.
摘要:本研究旨在开发和评估一种具有成本效益的用于步态分析的惯性测量单元(IMU)系统,并将其与Vicon系统和VideoPose3D算法的性能进行比较。该系统包括五个校准传感器和一个移动应用程序,用于测量步态和爬楼梯时的下半身方向。八名健康的参与者参与了这项实验,每人重复十次来分析髋关节和膝关节的屈曲角度。与基于深度学习的方法相比,IMU系统的均方误差显著降低,结果与Vicon系统相当,表明其具有临床和研究应用的潜力。
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引用次数: 0
Evaluation of flushing parameters for clear view vascular endoscopy 清晰视野血管内窥镜冲洗参数的评价
Q4 Engineering Pub Date : 2023-09-01 DOI: 10.1515/cdbme-2023-1128
Axel Boese, Julian Böckmann, Stefan Klebingat, Roland Schwab, Daniel Behme
Abstract Vascular diseases like aneurysms or atherosclerosis belong to the leading causes of death. For diagnosis and treatment, medical imaging is essential. Standard imaging methods are Ultrasound, X-ray-based Angiography, Computed tomography or Magnet Resonant Imaging. Additionally, Intravascular Ultrasound or Optical Coherence Tomography are available for intravascular imaging. One imaging technique for direct investigation of the inner vessel is vascular endoscopy, also called angioscopy. It is based on the insertion of an optical endoscope into the blood vessel for direct imaging. Dependent on the vessel diameter, these endoscopes have to be very small. Angioscopy can provide valuable information about the condition of the vessel wall and serve for procedure observation or implant assessment. But angioscopy requires the absence of blood for a clear field of view. In prior research, we have already developed methods for the placement of a tiny optical fiber inside a catheter combination. As an essential step toward a clinical study, we now want to evaluate the flushing parameters needed to achieve a clear field of view for the endoscope. The parameters are affected by the blood flow and vessel diameter. We designed a test setup that allows angioscopic examination and the simulation of realistic conditions, such as blood flow and different vessel diameters and that includes a test pattern for image quality assessment.
动脉瘤、动脉粥样硬化等血管疾病是导致死亡的主要原因。对于诊断和治疗,医学成像是必不可少的。标准的成像方法是超声、基于x射线的血管造影、计算机断层扫描或磁共振成像。此外,血管内超声或光学相干断层扫描可用于血管内成像。一种直接检查内部血管的成像技术是血管内窥镜,也称为血管镜检查。它是基于将光学内窥镜插入血管进行直接成像。根据血管直径的不同,这些内窥镜必须非常小。血管镜检查可以提供有关血管壁状况的宝贵信息,并可用于手术观察或植入物评估。但是血管镜检查需要在没有血液的情况下获得清晰的视野。在之前的研究中,我们已经开发了在导管组合内放置微小光纤的方法。作为临床研究的重要一步,我们现在想要评估为内窥镜获得清晰视野所需的冲洗参数。这些参数受血流和血管直径的影响。我们设计了一个测试装置,允许血管镜检查和模拟现实条件,如血流和不同的血管直径,其中包括图像质量评估的测试模式。
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引用次数: 0
Basic studies on the influence of hemorrhage on the antimicrobial effect of visible light in a trachea model 气管模型出血对可见光抗菌效果影响的基础研究
Q4 Engineering Pub Date : 2023-09-01 DOI: 10.1515/cdbme-2023-1077
Katharina Nuding, Ramin Lotfi, Peter Radermacher, Barbara Spellerberg, Jule Buehler, Ben Sicks, Katharina Hoenes, Martin Hessling
Abstract Ventilator-associated pneumoniae (VAP) are a major problem in intensive care units. Previous in vitro experiments revealed that blue or violet luminescent endotracheal tubes are capable of inhibiting bacterial growth and may thus prevent pathogens from entering the lung. However, while these in vitro studies were conducted in a relatively transparent bacterial suspension, subglottic secretions around endotracheal tubes can also contain highly absorbent components, such as blood. To investigate if light has an antimicrobial effect under such conditions, staphylococcal solutions containing various absorbent components were irradiated by blue or violet luminescent endotracheal tubes for up to 24 h in a tracheal model. Light was generated externally by LEDs or lasers and entered the tube via light guides. An antimicrobial effect was observed for blue and violet light, which was, however, inhibited to some extent in the presence of light adsorbing molecules. Under these conditions, violet light had a stronger effect than blue at low absorptions, while at strong absorptions the effects converged, with blue light even exhibiting a slightly stronger impact. Significant differences between lasers and LEDs could not be detected. In our model, inhibition of bacterial growth could be observed even in the presence of light absorbing molecules. Illuminating endotracheal tubes with blue or violet light may thus represent a promising strategy to migration of bacteria from the oropharynx into the trachea and, thereby, possibly decrease the incidence of VAP.
呼吸机相关性肺炎(VAP)是重症监护病房的一个主要问题。先前的体外实验表明,蓝色或紫色发光气管内管能够抑制细菌生长,从而可能阻止病原体进入肺部。然而,尽管这些体外研究是在相对透明的细菌悬浮液中进行的,但气管内管周围的声门下分泌物也可能含有高吸收性成分,如血液。为了研究光在这种条件下是否具有抗菌作用,在气管模型中,用蓝色或紫色发光气管内管照射含有各种吸收成分的葡萄球菌溶液长达24小时。光在外部由led或激光器产生,并通过光导管进入管中。对蓝光和紫外光均有抑菌作用,但有光吸附分子存在时抑菌作用受到一定程度的抑制。在这些条件下,紫光在低吸收率下比蓝光有更强的效果,而在强吸收率下,效果收敛,蓝光甚至表现出稍强的影响。无法检测到激光和led之间的显著差异。在我们的模型中,即使有吸收光的分子存在,也可以观察到细菌生长的抑制作用。因此,用蓝光或紫光照射气管内管可能是一种很有希望的策略,可以将细菌从口咽部迁移到气管内,从而可能降低VAP的发生率。
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引用次数: 0
Inkjet printability of Celecoxib drug solutions 塞来昔布药物溶液的喷墨印刷性能
Q4 Engineering Pub Date : 2023-09-01 DOI: 10.1515/cdbme-2023-1083
Ahmed Sannan, Robert Mau, Hermann Seitz, Thomas Eickner, Michael Teske, Niels Grabow
Abstract Inkjet printing is a versatile tool for the precise positioning of droplets that is used in many application areas such as 3D printing, biotechnology or pharmacy. This work focused on comparing the inkjet printability of different drug solutions of celecoxib (CLX), a non-steroidal anti-inflammatory drug, to produce drug depots in medical implants. CLX was dissolved in dimethyl sulfoxide (DMSO), poly(ethylene glycol) diacrylate (PEGDA) and a mixture of DMSO and PEGDA in a ratio of 1:1. The pure solvents and the drug solutions were inkjet printed using a Nanoplotter 2.1 with the NanoTip J printhead (GeSiM mbH, Radeberg, Germany). The voltage was varied from 60 V to 150 V using a step size of 5 V. Droplet volume and the trajectory of the droplets were investigated. For DMSO, DMSO-CLX, DMSO-PEGDA and DMSOPEGDA- CLX, reproducible droplet formation occurred with a droplet volume of approximately 300 pl - 500 pl and not more than one satellite droplet in a voltage range between 60 V to 80 V. Inkjet printing of PEGDA and PEGDA-CLX was not reproducible in the range of 60 V to 150 V. DMSO, DMSOPEGDA, DMSO-CLX and DMSO-PEGDA-CLX showed a high inkjet printability. In contrast, inkjet printability of PEGDA and PEGDA-CLX was very limited.
摘要喷墨打印是一种多功能的工具,用于液滴的精确定位,用于许多应用领域,如3D打印,生物技术或制药。本研究的重点是比较塞来昔布(一种非甾体抗炎药)不同药物溶液在医用植入物中生产药库的喷墨可打印性。CLX溶解在二甲亚砜(DMSO)、聚乙二醇二丙烯酸酯(PEGDA)和DMSO和PEGDA的混合物中,比例为1:1。使用NanoTip J打印头(GeSiM mbH, Radeberg,德国)的nano绘图仪2.1对纯溶剂和药物溶液进行喷墨打印。使用5 V的步长将电压从60 V变化到150 V。研究了液滴的体积和运动轨迹。对于DMSO, DMSO-CLX, DMSO- pegda和DMSOPEGDA- CLX,在60 V至80 V的电压范围内,可重复形成的液滴体积约为300 pl - 500 pl,不超过一个卫星液滴。PEGDA和PEGDA- clx的喷墨打印在60 ~ 150 V范围内是不可复制的。DMSO、DMSOPEGDA、DMSO- clx和DMSO- pegda - clx表现出较高的喷墨打印适性。相比之下,PEGDA和PEGDA- clx的喷墨打印能力非常有限。
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引用次数: 0
Diagnostic medical device for stabilized image perception of retinal blood vessels using entoptic phenomena 利用内视现象稳定视网膜血管图像感知的诊断医疗装置
Q4 Engineering Pub Date : 2023-09-01 DOI: 10.1515/cdbme-2023-1102
Carsten Tautorat, Kerstin Lebahn, Wolfram Schmidt, Niels Grabow, Rudolf Guthoff, Thomas Stahnke, Thomas Lips
Abstract A diagnostic medical tool is described that allows patients to non-invasively observe, describe and document their own retinal blood vessels using the Purkinje vascular entoptic test. We envision key applications of the Purkinje retinal image stabilization (PRIS) device in monitoring of diabetic retinopathy and cost-effective assessment of retinal visual acuity. To optimize our PRIS principle, we have developed a benchtop device with interchangeable light modules. The modular design is intended to provide maximum flexibility for determining appropriate PRIS stimulation parameters. In self-tests, we found that a pleasant entoptic perception occurs when a green luminous light spot (approx. 525 nm) moves on a circular path. The challenging part is to derive an objective diagnosis from a subjective phenomenon.
本文描述了一种诊断医疗工具,该工具允许患者使用浦肯野血管全视检查非侵入性地观察、描述和记录他们自己的视网膜血管。我们设想浦肯野视网膜图像稳定(PRIS)装置在糖尿病视网膜病变监测和视网膜视力的成本效益评估中的关键应用。为了优化我们的PRIS原理,我们开发了一种具有可互换光模块的台式设备。模块化设计旨在为确定合适的PRIS增产参数提供最大的灵活性。在自我测试中,我们发现当一个绿色的发光光点(大约。525nm)沿圆周运动。难点在于如何从主观现象中得出客观的诊断。
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引用次数: 0
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Current Directions in Biomedical Engineering
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