Addressing the complexities of manual wheelchair (MWC) vibrations is crucial for the well-being of users and their integration into society. This study investigates the experimental choices influencing the assessment of vibration exposure, aiming to contribute for enhanced MWC developments and standardized design principles. By conducting a comprehensive full factorial experiment, the impact of various factors, including four MWC loads, two speeds, five floor types, and two MWC models was examined. Notably, findings highlight the predominant influence of floor type on vibration exposure, followed by speed and, to a lesser extent, MWC properties. Furthermore, the study suggests that enlisting an able-bodied participant is more representative than using a dummy when loading the MWC, providing valuable insights into the genuine MWC/user dyad response to vibrations. This research sets the stage for a more informed and standardized approach to address the vibration exposure faced by MWC users.
{"title":"Understanding vibration exposure in wheelchair users: Experimental insights","authors":"Delphine Chadefaux , Ophélie Lariviere , Christophe Sauret , Corentin Bosio , Patricia Thoreux","doi":"10.1016/j.medengphy.2024.104253","DOIUrl":"10.1016/j.medengphy.2024.104253","url":null,"abstract":"<div><div>Addressing the complexities of manual wheelchair (MWC) vibrations is crucial for the well-being of users and their integration into society. This study investigates the experimental choices influencing the assessment of vibration exposure, aiming to contribute for enhanced MWC developments and standardized design principles. By conducting a comprehensive full factorial experiment, the impact of various factors, including four MWC loads, two speeds, five floor types, and two MWC models was examined. Notably, findings highlight the predominant influence of floor type on vibration exposure, followed by speed and, to a lesser extent, MWC properties. Furthermore, the study suggests that enlisting an able-bodied participant is more representative than using a dummy when loading the MWC, providing valuable insights into the genuine MWC/user dyad response to vibrations. This research sets the stage for a more informed and standardized approach to address the vibration exposure faced by MWC users.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"133 ","pages":"Article 104253"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-18DOI: 10.1016/j.medengphy.2024.104245
Jiapeng He , Zhen Pan , Guowei Zhou , Jiangming Yu , Dayong Li
Cancellous bone plays a critical role as a shock absorber in the human skeletal system. Accurate assessment of its microstructure and mechanical properties is crucial for osteoporosis diagnosis and treatment. However, various methods with different indicators are adopted currently in the clinical and laboratory assessments which lead to confusion and inconvenience for cancellous bone analysis. In the current work, correlations among clinical indicators including CT-derived Hounsfield Unit (HU) & bone mineral density (BMD), laboratory indicators (mass density & volume fraction), and mechanical properties (modulus & strength) are explored. The results show that different indicators can be linearly linked through the HU value which can be adopted as a good microstructure indicator of cancellous bone. Additionally, the impacts of cancellous bone specimen preparation on clinical CT imaging and mechanical properties are also investigated. The results indicate common marrow-removal treatment can lead to decrease in mean HU value, deviation in HU value distribution, while it will increase the modulus and strength. The current work provides a valuable insight into the cancellous properties based on comprehensive analysis on the clinical and laboratory assessments which is critical for accurate diagnosis and personalized treatment.
松质骨在人体骨骼系统中扮演着减震器的重要角色。准确评估松质骨的微观结构和机械性能对骨质疏松症的诊断和治疗至关重要。然而，目前在临床和实验室评估中采用了各种不同指标的方法，导致松质骨分析的混乱和不便。本次研究探讨了临床指标（包括 CT 导出的 Hounsfield 单位（HU）及骨矿物质密度（BMD））、实验室指标（质量密度及体积分数）和机械性能（模量及强度）之间的相关性。结果表明，不同指标可通过 HU 值线性联系起来，HU 值可作为松质骨的良好微观结构指标。此外，还研究了松质骨标本制备对临床 CT 成像和机械性能的影响。结果表明，普通的去髓处理会导致平均 HU 值下降、HU 值分布偏差增大，而模量和强度则会增加。目前的研究基于对临床和实验室评估的综合分析，对松质骨特性提供了宝贵的见解，这对准确诊断和个性化治疗至关重要。
{"title":"Integrated analysis of clinical indicators and mechanical properties in cancellous bone","authors":"Jiapeng He , Zhen Pan , Guowei Zhou , Jiangming Yu , Dayong Li","doi":"10.1016/j.medengphy.2024.104245","DOIUrl":"10.1016/j.medengphy.2024.104245","url":null,"abstract":"<div><div>Cancellous bone plays a critical role as a shock absorber in the human skeletal system. Accurate assessment of its microstructure and mechanical properties is crucial for osteoporosis diagnosis and treatment. However, various methods with different indicators are adopted currently in the clinical and laboratory assessments which lead to confusion and inconvenience for cancellous bone analysis. In the current work, correlations among clinical indicators including CT-derived Hounsfield Unit (HU) & bone mineral density (BMD), laboratory indicators (mass density & volume fraction), and mechanical properties (modulus & strength) are explored. The results show that different indicators can be linearly linked through the HU value which can be adopted as a good microstructure indicator of cancellous bone. Additionally, the impacts of cancellous bone specimen preparation on clinical CT imaging and mechanical properties are also investigated. The results indicate common marrow-removal treatment can lead to decrease in mean HU value, deviation in HU value distribution, while it will increase the modulus and strength. The current work provides a valuable insight into the cancellous properties based on comprehensive analysis on the clinical and laboratory assessments which is critical for accurate diagnosis and personalized treatment.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"133 ","pages":"Article 104245"},"PeriodicalIF":1.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-18DOI: 10.1016/j.medengphy.2024.104244
Kaifeng Zheng , Jie Pan , Ziyan Jia , Shuyan Xiao , Weige Tao , Dachuan Zhang , Qing Li , Lingjiao Pan
Nucleus segmentation and counting play a crucial role in many cell analysis applications. However, the dense distribution and blurry boundaries of nucleus make nucleus segmentation tasks challenging. This paper proposes a novel segmentation and counting method. Firstly, TC-UNet++ is proposed to achieve a global segmentation. Then, the distance watershed method is used to finish local segmentation, which separate the adhesion and overlap part of the image. Finally, counting method is performed to obtain information on the counting number, area and center of mass of nucleus. TC-UNet++ achieved a Dice coefficient of 89.95% for cell instance segmentation on the Data Science Bowl dataset, surpassing the original U-Net++ by 0.23%. It also showed a 5.09% improvement in counting results compared to other methods. On the ALL-IDB dataset, TC-UNet++ reached a Dice coefficient of 83.97%, a 7.93% increase over the original U-Net++. Additionally, its counting results improved by 16.82% compared to other approaches. These results indicate that our method has a more complete and reasonable nucleus segmentation and counting scheme compared to other methods.
{"title":"A method of nucleus image segmentation and counting based on TC-UNet++ and distance watershed","authors":"Kaifeng Zheng , Jie Pan , Ziyan Jia , Shuyan Xiao , Weige Tao , Dachuan Zhang , Qing Li , Lingjiao Pan","doi":"10.1016/j.medengphy.2024.104244","DOIUrl":"10.1016/j.medengphy.2024.104244","url":null,"abstract":"<div><div>Nucleus segmentation and counting play a crucial role in many cell analysis applications. However, the dense distribution and blurry boundaries of nucleus make nucleus segmentation tasks challenging. This paper proposes a novel segmentation and counting method. Firstly, TC-UNet++ is proposed to achieve a global segmentation. Then, the distance watershed method is used to finish local segmentation, which separate the adhesion and overlap part of the image. Finally, counting method is performed to obtain information on the counting number, area and center of mass of nucleus. TC-UNet++ achieved a Dice coefficient of 89.95% for cell instance segmentation on the Data Science Bowl dataset, surpassing the original U-Net++ by 0.23%. It also showed a 5.09% improvement in counting results compared to other methods. On the ALL-IDB dataset, TC-UNet++ reached a Dice coefficient of 83.97%, a 7.93% increase over the original U-Net++. Additionally, its counting results improved by 16.82% compared to other approaches. These results indicate that our method has a more complete and reasonable nucleus segmentation and counting scheme compared to other methods.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"133 ","pages":"Article 104244"},"PeriodicalIF":1.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Porous interbody cages are often used in spinal fusion surgery since they allow bone ingrowth which facilitates long-term stability. However, the extent of bone ingrowth in and around porous interbody cages has scarcely been investigated. Moreover, tissue differentiation might not be similar around the superior and inferior cage-bone interfaces. Using mechanobiology-based numerical framework and physiologic loading conditions, the study investigates the spatial distribution of evolutionary bone ingrowth within randomly distributed porous interbody cages, having varied porosities. Finite Element (FE) microscale models, corresponding to cage porosities of 60 %, 72 %, and 83 %, were developed for the superior and inferior interfacial regions of the cage, along with the macroscale model of the implanted lumbar spine. The implant-bone relative displacements of different porosity models were mapped from macroscale to microscale model. Bone formation of 10–40 % was predicted across the porous cage models, resulting in an average Young's modulus ranging between 765 MPa and 915 MPa. Maximum bone ingrowth of ∼34 % was observed for the 83 % porous cage, which was subject to low implant-bone relative displacements (maximum 50μm). New bone formation was found to be greater at the superior interface (∼34 %) as compared to the inferior interface (∼30 %) for P83 model. Relatively greater volume of fibrous tissue was formed at the implant-bone interface for the cage with 60 % and 72 % porosities, which might lead to cage migration and eventual failure of the implant. Hence, the interbody cage with 83 % porosity appears to be most favorable for bone ingrowth, provided sufficient mechanical strength is offered.
{"title":"Bone ingrowth in randomly distributed porous interbody cage during lumbar spinal fusion","authors":"Rahul Gautam Talukdar , Santanu Dhara , Sanjay Gupta","doi":"10.1016/j.medengphy.2024.104248","DOIUrl":"10.1016/j.medengphy.2024.104248","url":null,"abstract":"<div><div>Porous interbody cages are often used in spinal fusion surgery since they allow bone ingrowth which facilitates long-term stability. However, the extent of bone ingrowth in and around porous interbody cages has scarcely been investigated. Moreover, tissue differentiation might not be similar around the superior and inferior cage-bone interfaces. Using mechanobiology-based numerical framework and physiologic loading conditions, the study investigates the spatial distribution of evolutionary bone ingrowth within randomly distributed porous interbody cages, having varied porosities. Finite Element (FE) microscale models, corresponding to cage porosities of 60 %, 72 %, and 83 %, were developed for the superior and inferior interfacial regions of the cage, along with the macroscale model of the implanted lumbar spine. The implant-bone relative displacements of different porosity models were mapped from macroscale to microscale model. Bone formation of 10–40 % was predicted across the porous cage models, resulting in an average Young's modulus ranging between 765 MPa and 915 MPa. Maximum bone ingrowth of ∼34 % was observed for the 83 % porous cage, which was subject to low implant-bone relative displacements (maximum 50μm). New bone formation was found to be greater at the superior interface (∼34 %) as compared to the inferior interface (∼30 %) for P83 model. Relatively greater volume of fibrous tissue was formed at the implant-bone interface for the cage with 60 % and 72 % porosities, which might lead to cage migration and eventual failure of the implant. Hence, the interbody cage with 83 % porosity appears to be most favorable for bone ingrowth, provided sufficient mechanical strength is offered.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"133 ","pages":"Article 104248"},"PeriodicalIF":1.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-16DOI: 10.1016/j.medengphy.2024.104250
Li Liu , XiaoYi Yang , PengFei Wang , Yu Huang , Xing Huang
To reveal the penetration mechanism and present the penetration characteristics of high-speed micro-jet with injection volume larger than 0.3 mL into soft tissue, the present study conducted experimental research on high-speed water-jet penetration into ballistic gelatin. The free jet dynamics of an air-powered needle-free injector that can emit up to 1.27 mL of liquid at once and the penetration dynamics were visualized to reveal the details of the penetration process. In the early unstable stage, the jet is emitted in the form of pulses, and the first jet pulse can rapidly generate an initial slender channel in gelatin in a very short time. In the subsequent stable stage, energy input produces dispersion and further increases the penetration depth slowly. Changing the driving pressure by the power source mainly changes the penetration depth increment by dispersion; while changing the nozzle diameter mainly affects the penetration depth in the initial stage. The central position of the dispersion area in the injection direction was firstly defined in the present work and it was found that an approximate linear relationship between this position and the maximum penetration depth exits for different nozzle diameters and driving pressures when injecting the same liquid dose. These research results can provide a basis for a thorough understanding of the penetration characteristics of high-speed micro-jet with injection volume larger than 0.3 mL into soft tissue, as well as the design and operation of the air-powered needle-free injector.
为了揭示注射量大于 0.3 mL 的高速微射流对软组织的渗透机理并呈现其渗透特性，本研究对高速水射流渗透弹道明胶进行了实验研究。通过对一次性可喷射 1.27 mL 液体的空气动力无针注射器的自由射流动力学和渗透动力学进行可视化研究，揭示了渗透过程的细节。在早期的不稳定阶段，射流以脉冲形式喷出，第一个射流脉冲能在极短的时间内迅速在明胶中生成一个初始细长通道。在随后的稳定阶段，能量输入产生分散，并进一步缓慢增加穿透深度。改变动力源的驱动压力主要是通过分散改变穿透深度的增加；而改变喷嘴直径主要影响初始阶段的穿透深度。本研究首次确定了分散区域在喷射方向上的中心位置，并发现在喷射相同剂量的液体时，不同喷嘴直径和驱动压力下该位置与最大穿透深度之间存在近似线性关系。这些研究成果为深入了解注射量大于 0.3 mL 的高速微射流在软组织中的穿透特性以及气动无针注射器的设计和操作提供了基础。
{"title":"Experimental studies on penetration process of high-speed water-jet into ballistic gelatin","authors":"Li Liu , XiaoYi Yang , PengFei Wang , Yu Huang , Xing Huang","doi":"10.1016/j.medengphy.2024.104250","DOIUrl":"10.1016/j.medengphy.2024.104250","url":null,"abstract":"<div><div>To reveal the penetration mechanism and present the penetration characteristics of high-speed micro-jet with injection volume larger than 0.3 mL into soft tissue, the present study conducted experimental research on high-speed water-jet penetration into ballistic gelatin. The free jet dynamics of an air-powered needle-free injector that can emit up to 1.27 mL of liquid at once and the penetration dynamics were visualized to reveal the details of the penetration process. In the early unstable stage, the jet is emitted in the form of pulses, and the first jet pulse can rapidly generate an initial slender channel in gelatin in a very short time. In the subsequent stable stage, energy input produces dispersion and further increases the penetration depth slowly. Changing the driving pressure by the power source mainly changes the penetration depth increment by dispersion; while changing the nozzle diameter mainly affects the penetration depth in the initial stage. The central position of the dispersion area in the injection direction was firstly defined in the present work and it was found that an approximate linear relationship between this position and the maximum penetration depth exits for different nozzle diameters and driving pressures when injecting the same liquid dose. These research results can provide a basis for a thorough understanding of the penetration characteristics of high-speed micro-jet with injection volume larger than 0.3 mL into soft tissue, as well as the design and operation of the air-powered needle-free injector.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"133 ","pages":"Article 104250"},"PeriodicalIF":1.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142538332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-16DOI: 10.1016/j.medengphy.2024.104246
Michael Skipper Andersen, Ilias Theodorakos
The mechanical properties of ligaments are important for multiple applications and are often estimated from laxity tests. However, the typical laxity tests are not optimized for this application and, a potential exists to develop better laxity tests in this respect. Therefore, the purpose of this study was to develop a methodology to identify optimal, dynamic laxity tests that isolate the stretch of the individual ligaments from each other. To this end, we applied an existing rigid body-based knee model and a dataset of ∼100.000 random samples of applied forces (0–150 N), moments (0–10 Nm) and knee flexion angles (0–90°) through Monte Carlo Simulations. For each modelled ligament bundle, we identified ten load cases; one producing the highest force and nine equally spaced between the maximal and zero force, where the maximal force in all other ligament bundles were minimized. We compared these novel laxity tests to standard internal/external and varus/valgus laxity tests using an isolation metric.
We found that no laxity test could stretch the anterior part of the posterior cruciate and medial cruciate ligaments (PCL and MCL), whereas for all other ligaments, except the posterior PCL, the new laxity tests isolated the ligament stretch 28 % to 450 % better than standard tests.
From our study, we conclude that it is possible to define better laxity tests than currently exist and these may be highly relevant for determination of mechanical properties of ligaments in vivo. Future studies should generalize our results and translate them to modern laxity measurements technologies.
{"title":"Methodology to identify subject-specific dynamic laxity tests to stretch individual parts of knee ligaments","authors":"Michael Skipper Andersen, Ilias Theodorakos","doi":"10.1016/j.medengphy.2024.104246","DOIUrl":"10.1016/j.medengphy.2024.104246","url":null,"abstract":"<div><div>The mechanical properties of ligaments are important for multiple applications and are often estimated from laxity tests. However, the typical laxity tests are not optimized for this application and, a potential exists to develop better laxity tests in this respect. Therefore, the purpose of this study was to develop a methodology to identify optimal, dynamic laxity tests that isolate the stretch of the individual ligaments from each other. To this end, we applied an existing rigid body-based knee model and a dataset of ∼100.000 random samples of applied forces (0–150 N), moments (0–10 Nm) and knee flexion angles (0–90°) through Monte Carlo Simulations. For each modelled ligament bundle, we identified ten load cases; one producing the highest force and nine equally spaced between the maximal and zero force, where the maximal force in all other ligament bundles were minimized. We compared these novel laxity tests to standard internal/external and varus/valgus laxity tests using an isolation metric.</div><div>We found that no laxity test could stretch the anterior part of the posterior cruciate and medial cruciate ligaments (PCL and MCL), whereas for all other ligaments, except the posterior PCL, the new laxity tests isolated the ligament stretch 28 % to 450 % better than standard tests.</div><div>From our study, we conclude that it is possible to define better laxity tests than currently exist and these may be highly relevant for determination of mechanical properties of ligaments <em>in vivo</em>. Future studies should generalize our results and translate them to modern laxity measurements technologies.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"133 ","pages":"Article 104246"},"PeriodicalIF":1.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-10DOI: 10.1016/j.medengphy.2024.104242
Hyunhee Bang , Hyun-Joo Lee , Suk-Joong Lee , Sanghyun Joung , Joon-Woo Kim , Chang-wug Oh , Il-Hyung Park
Challenges in minimally invasive surgeries, such as intramedullary nailing for long bone fractures, include radiation overexposure for patients and surgeons, potential malreduction, and physical burden on surgeons in maintaining the reduction status. A robotic bone fracture reduction system was developed in this study to address these problems. The system consists of a hexapod with six degrees of freedom, with a fracture reduction device and a master device. This study aimed to evaluate the novel system in a preclinical setting. The length of the six axes in the system can be adjusted to precisely control the length, angle, and rotation so that no additional traction is required. Fluoroscopic images can be remotely examined to reduce the risk of radiation exposure for surgeons. In this study, alignment accuracy and radiation exposure were measured using 32 bovine bone fracture models, and these surgical outcomes were compared to those of conventional manual surgery to verify the clinical usability and effectiveness of the system. The alignment accuracy was assessed by analyzing length, angulation, and rotation. The four surgeons participating in this study were divided into two groups (expert and novice) according to their clinical experience. All parameters in robotic surgery significantly decreased by approximately 4 mm and 8° on average (p ≤ 0.05) compared to conventional surgery. The mean radiation exposure in robot-assisted surgery was 0.11 mSv, showing a significant decrease compared to conventional surgery (p < 0.05). Reduction accuracy was higher in robotic surgery performed by the novice group than in conventional surgery performed by the expert group; however, standard deviation values were inversed. In conclusion, the bone fracture reduction robot system increased the alignment accuracy through precise control while reducing radiation exposure in surgeons, as the surgery was performed remotely. The use of this system is predicted to improve the accuracy and reproducibility of the surgery and the safety of medical staff.1
{"title":"Clinical usability and efficacy of a robotic bone fracture reduction system: A pilot animal study","authors":"Hyunhee Bang , Hyun-Joo Lee , Suk-Joong Lee , Sanghyun Joung , Joon-Woo Kim , Chang-wug Oh , Il-Hyung Park","doi":"10.1016/j.medengphy.2024.104242","DOIUrl":"10.1016/j.medengphy.2024.104242","url":null,"abstract":"<div><div>Challenges in minimally invasive surgeries, such as intramedullary nailing for long bone fractures, include radiation overexposure for patients and surgeons, potential malreduction, and physical burden on surgeons in maintaining the reduction status. A robotic bone fracture reduction system was developed in this study to address these problems. The system consists of a hexapod with six degrees of freedom, with a fracture reduction device and a master device. This study aimed to evaluate the novel system in a preclinical setting. The length of the six axes in the system can be adjusted to precisely control the length, angle, and rotation so that no additional traction is required. Fluoroscopic images can be remotely examined to reduce the risk of radiation exposure for surgeons. In this study, alignment accuracy and radiation exposure were measured using 32 bovine bone fracture models, and these surgical outcomes were compared to those of conventional manual surgery to verify the clinical usability and effectiveness of the system. The alignment accuracy was assessed by analyzing length, angulation, and rotation. The four surgeons participating in this study were divided into two groups (expert and novice) according to their clinical experience. All parameters in robotic surgery significantly decreased by approximately 4 mm and 8° on average (<em>p</em> ≤ 0.05) compared to conventional surgery. The mean radiation exposure in robot-assisted surgery was 0.11 mSv, showing a significant decrease compared to conventional surgery (<em>p</em> < 0.05). Reduction accuracy was higher in robotic surgery performed by the novice group than in conventional surgery performed by the expert group; however, standard deviation values were inversed. In conclusion, the bone fracture reduction robot system increased the alignment accuracy through precise control while reducing radiation exposure in surgeons, as the surgery was performed remotely. The use of this system is predicted to improve the accuracy and reproducibility of the surgery and the safety of medical staff.<span><span><sup>1</sup></span></span></div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"133 ","pages":"Article 104242"},"PeriodicalIF":1.7,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-09DOI: 10.1016/j.medengphy.2024.104243
George Athanassoulis Makris , Leonard Pastrav , Michiel Mulier , Georges Frederic Vles , Wim Desmet , Kathleen Denis
The clinical implementation of currently used devices for intraoperative fixation monitoring of femoral implants via vibration-based methods in cementless total hip arthroplasty is challenging, due to practical and regulatory issues. Motivated by the effectiveness of electromagnetic excitation in similar dental applications, this study investigates the use of electromagnetic excitation for femoral implant stability monitoring during cementless total hip arthroplasty. The results obtained from electromagnetic excitation were largely consistent with reference results obtained through impact excitation, with a Pearson Correlation Coefficient of 0.79 in the 0.1–8 kHz frequency band. Moreover, the peak frequencies obtained via the two methods yielded a relative difference of 0.20 ± 0.22 %. Next, the excitation device was successfully utilized in conjunction with a laser vibrometer to monitor the stability of the femoral implant during an in vitro insertion, proving the feasibility of contactless implant stability monitoring. These results indicate the promising potential of this contactless method for clinical implementation.
{"title":"Contactless femoral implant stability monitoring in cementless total hip arthroplasty, A step towards clinical implementation","authors":"George Athanassoulis Makris , Leonard Pastrav , Michiel Mulier , Georges Frederic Vles , Wim Desmet , Kathleen Denis","doi":"10.1016/j.medengphy.2024.104243","DOIUrl":"10.1016/j.medengphy.2024.104243","url":null,"abstract":"<div><div>The clinical implementation of currently used devices for intraoperative fixation monitoring of femoral implants via vibration-based methods in cementless total hip arthroplasty is challenging, due to practical and regulatory issues. Motivated by the effectiveness of electromagnetic excitation in similar dental applications, this study investigates the use of electromagnetic excitation for femoral implant stability monitoring during cementless total hip arthroplasty. The results obtained from electromagnetic excitation were largely consistent with reference results obtained through impact excitation, with a Pearson Correlation Coefficient of 0.79 in the 0.1–8 kHz frequency band. Moreover, the peak frequencies obtained via the two methods yielded a relative difference of 0.20 ± 0.22 %. Next, the excitation device was successfully utilized in conjunction with a laser vibrometer to monitor the stability of the femoral implant during an in vitro insertion, proving the feasibility of contactless implant stability monitoring. These results indicate the promising potential of this contactless method for clinical implementation.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"133 ","pages":"Article 104243"},"PeriodicalIF":1.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.medengphy.2024.104241
Deepjyoti Kalita , Hrishita Sharma , Jayanta Kumar Panda , Khalid B. Mirza
Emerging research has demonstrated the advantage of continuous glucose monitoring for use in artificial pancreas and diabetes management in general. Recent studies demonstrate that glucose level forecasting using deep learning can help avoid postprandial hyperglycemia (≥ 180 mg/dL) or hypoglycemia (≤70 mg/dL) from delayed or increased insulin dosing in artificial pancreas. In this paper, a novel hybrid deep learning framework with integration of content-based attention learning is presented, to effectively predict the glucose measurements with prediction horizons (PH) = 15, 30 and, 60 minutes for T1D and T2D patients based on past data. We also present a complete cloud-based system and mobile app used for collecting CGM sensor, physical activity data, CHO values and insulin measurements to perform glucose forecasts using the proposed model running on Cloud. This model was validated using clinical data of individual with Type 1 diabetes (OhioT1DM) and individual with Type 2 diabetes. The mean absolute relative difference (MARD) was 12.33±3.15, 7.14±1.76% for PH=60 and, 30 min respectively on OhioT1DM clinical Dataset. The root mean squared error (RMSE) was 29.41±5.92 mg/dL and 17.19±3.22 mg/dL and the mean absolute error (MAE) was 21.96±4.67 mg/dL and 12.58±2.34 mg/dL for PH=60 and, 30 min respectively on the same clinical dataset. It was observed that inclusion of physical activity leads to improved glucose forecasting accuracy. Furthermore, all these results were obtained by training the model on only 8 days of clinical data of a single patient, followed by testing on clinical data on the following days. The results indicate that training on a single patient data may lead to better personalisation and better glucose forecasting results compared to existing works.
{"title":"Platform for precise, personalised glucose forecasting through continuous glucose and physical activity monitoring and deep learning","authors":"Deepjyoti Kalita , Hrishita Sharma , Jayanta Kumar Panda , Khalid B. Mirza","doi":"10.1016/j.medengphy.2024.104241","DOIUrl":"10.1016/j.medengphy.2024.104241","url":null,"abstract":"<div><div>Emerging research has demonstrated the advantage of continuous glucose monitoring for use in artificial pancreas and diabetes management in general. Recent studies demonstrate that glucose level forecasting using deep learning can help avoid postprandial hyperglycemia (≥ 180 mg/dL) or hypoglycemia (≤70 mg/dL) from delayed or increased insulin dosing in artificial pancreas. In this paper, a novel hybrid deep learning framework with integration of content-based attention learning is presented, to effectively predict the glucose measurements with prediction horizons (PH) = 15, 30 and, 60 minutes for T1D and T2D patients based on past data. We also present a complete cloud-based system and mobile app used for collecting CGM sensor, physical activity data, CHO values and insulin measurements to perform glucose forecasts using the proposed model running on Cloud. This model was validated using clinical data of individual with Type 1 diabetes (OhioT1DM) and individual with Type 2 diabetes. The mean absolute relative difference (MARD) was 12.33±3.15, 7.14±1.76% for PH=60 and, 30 min respectively on OhioT1DM clinical Dataset. The root mean squared error (RMSE) was 29.41±5.92 mg/dL and 17.19±3.22 mg/dL and the mean absolute error (MAE) was 21.96±4.67 mg/dL and 12.58±2.34 mg/dL for PH=60 and, 30 min respectively on the same clinical dataset. It was observed that inclusion of physical activity leads to improved glucose forecasting accuracy. Furthermore, all these results were obtained by training the model on only 8 days of clinical data of a single patient, followed by testing on clinical data on the following days. The results indicate that training on a single patient data may lead to better <em>personalisation</em> and better glucose forecasting results compared to existing works.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"132 ","pages":"Article 104241"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.medengphy.2024.104237
Abdelghani Takha , Mohamed Lamine Talbi , Philippe Ravier
This study introduces a new method for modeling electrocardiogram (ECG)1 waveforms using Fractional Differential Equations (FDEs). By incorporating fractional calculus into the well-established McSharry model, the proposed approach achieves improved representation and high precision for a wide range of ECG waveforms. The research focuses on the impact of integrating fractional derivatives into Integer Differential Equation (IDE) models, enhancing the fidelity of ECG signal modeling.
To optimize the model's unknown parameters, a combination of the Predictor-Corrector method for solving FDEs and genetic algorithms for optimization is utilized. The effectiveness of the fractional-order model is assessed through distortion metrics, providing a comprehensive evaluation of the modeling quality.
Comparisons show that the fractional-order model outperforms the traditional McSharry IDE model in modeling quality and compression efficiency. It improves modeling quality by 48.40 % in MSE and compression efficiency by 23.18 % when applied on five beat types of MIT/BIH arrhythmia database. The fractional-order model demonstrates enhanced flexibility while preserving essential McSharry model characteristics, with fractional orders (α) ranging from 0.96 to 0.99 across five beat types.
{"title":"Fractional calculus integration for improved ECG modeling: A McSharry model expansion","authors":"Abdelghani Takha , Mohamed Lamine Talbi , Philippe Ravier","doi":"10.1016/j.medengphy.2024.104237","DOIUrl":"10.1016/j.medengphy.2024.104237","url":null,"abstract":"<div><div>This study introduces a new method for modeling electrocardiogram (ECG)<span><span><sup>1</sup></span></span> waveforms using Fractional Differential Equations (FDEs). By incorporating fractional calculus into the well-established McSharry model, the proposed approach achieves improved representation and high precision for a wide range of ECG waveforms. The research focuses on the impact of integrating fractional derivatives into Integer Differential Equation (IDE) models, enhancing the fidelity of ECG signal modeling.</div><div>To optimize the model's unknown parameters, a combination of the Predictor-Corrector method for solving FDEs and genetic algorithms for optimization is utilized. The effectiveness of the fractional-order model is assessed through distortion metrics, providing a comprehensive evaluation of the modeling quality.</div><div>Comparisons show that the fractional-order model outperforms the traditional McSharry IDE model in modeling quality and compression efficiency. It improves modeling quality by 48.40 % in MSE and compression efficiency by 23.18 % when applied on five beat types of MIT/BIH arrhythmia database. The fractional-order model demonstrates enhanced flexibility while preserving essential McSharry model characteristics, with fractional orders (α) ranging from 0.96 to 0.99 across five beat types.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"132 ","pages":"Article 104237"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142359020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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