Pub Date : 2025-09-04DOI: 10.1016/j.medengphy.2025.104427
Yue Zhang , Li’ang Zhao , Jiawei Wang , Xiaoxiao Zhao , Huazhe Yang , Wenjing Yu , Na Zhang
Bone infection and vascularization remain severe challenges in bone scaffold implantation surgery. Copper-based biomaterials have demonstrated dual functional capabilities for addressing these issues. However, achieving spatially controlled copper (Cu) content and distribution to maximize therapeutic efficacy without inducing cytotoxicity is still challenging. 3D printing technology, with its unique advantages in spatial controllability and personalized structure fabrication, provides a robust platform for developing functional copper-loaded scaffolds. This review systematically summarizes the development of 3D-printed copper-loaded biomaterial scaffolds across multiple material systems. We describe how 3D printing enables precise modulation of Cu ion release kinetics and scaffold architecture through controlled material composition and printing parameters, optimizing mechanical and biological performance. Furthermore, significant bottlenecks hindering clinical translation, particularly copper ion initialburst release and mechanical anisotropy, are highlighted. Strategies for overcoming these challenges are discussed to advance clinical translation of personalized copper-functionalized scaffolds for tissue regeneration.
{"title":"Research advances, challenges and outlooks of copper-containing scaffolds derived from 3D printing for tissue repair","authors":"Yue Zhang , Li’ang Zhao , Jiawei Wang , Xiaoxiao Zhao , Huazhe Yang , Wenjing Yu , Na Zhang","doi":"10.1016/j.medengphy.2025.104427","DOIUrl":"10.1016/j.medengphy.2025.104427","url":null,"abstract":"<div><div>Bone infection and vascularization remain severe challenges in bone scaffold implantation surgery. Copper-based biomaterials have demonstrated dual functional capabilities for addressing these issues. However, achieving spatially controlled copper (Cu) content and distribution to maximize therapeutic efficacy without inducing cytotoxicity is still challenging. 3D printing technology, with its unique advantages in spatial controllability and personalized structure fabrication, provides a robust platform for developing functional copper-loaded scaffolds. This review systematically summarizes the development of 3D-printed copper-loaded biomaterial scaffolds across multiple material systems. We describe how 3D printing enables precise modulation of Cu ion release kinetics and scaffold architecture through controlled material composition and printing parameters, optimizing mechanical and biological performance. Furthermore, significant bottlenecks hindering clinical translation, particularly copper ion initialburst release and mechanical anisotropy, are highlighted. Strategies for overcoming these challenges are discussed to advance clinical translation of personalized copper-functionalized scaffolds for tissue regeneration.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"146 ","pages":"Article 104427"},"PeriodicalIF":2.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027448","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}
Recent efforts in cancer targeting have focused on nanoparticle (NP) drug delivery, yet the complexity of NP uptake makes experimental studies challenging. To streamline this, numerical models help identify key parameters. This study's model, focusing on elliptical NPs, aims to optimize NP aspect ratios for selective uptake by breast cancer cells. Mechanical properties of cells were taken from literature, and the model suggests that non-deformable NPs with aspect ratios between 1/3 and 1/2 are optimal for selective cancer cell internalization. These promising results require experimental validation.
{"title":"Optimizing nanoparticle design for selective targeting of breast cancer cells","authors":"Sarah Iaquinta , Shahram Khazaie , Sylvain Fréour , Frédéric Jacquemin","doi":"10.1016/j.medengphy.2025.104420","DOIUrl":"10.1016/j.medengphy.2025.104420","url":null,"abstract":"<div><div>Recent efforts in cancer targeting have focused on nanoparticle (NP) drug delivery, yet the complexity of NP uptake makes experimental studies challenging. To streamline this, numerical models help identify key parameters. This study's model, focusing on elliptical NPs, aims to optimize NP aspect ratios for selective uptake by breast cancer cells. Mechanical properties of cells were taken from literature, and the model suggests that non-deformable NPs with aspect ratios between 1/3 and 1/2 are optimal for selective cancer cell internalization. These promising results require experimental validation.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"145 ","pages":"Article 104420"},"PeriodicalIF":2.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988764","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}
Studies have shown that riding an electrically assisted bicycle is a suitable form of physical activity for rehabilitation. The rise of connected devices has enabled the development of new wearable technologies for health assessment during cycling sessions, such as plethysmography t-shirts for cardiorespiratory monitoring and inertial measurement units for movement analysis.
This study aims to demonstrate the practical and technical feasibility of embedding measurements during outdoor cycling sessions. It also evaluates the validity of these measurements by comparing them to gold-standard methods in laboratory evaluations.
Two protocols were conducted: one with six participants to assess feasibility across various outdoor session profiles, and another with 20 participants to compare measurements to gold-standard methods using indoor laboratory equipment.
The results indicate that a smart electrically assisted bicycle is suitable for outdoor assessment of cardiorespiratory and movement analysis. Furthermore, the embedded equipment provides valid measurements in the laboratory when compared to gold-standard methods across a wide range of activity intensities.
{"title":"Integrating movement analysis and cardiorespiratory assessment in smart electrically assisted bicycle sessions- Proof of concept -","authors":"Vianney Poiron, Sébastien Letout, Pierre-Yves Gumery, Vincent Nougier, Carole Rolland, Claire Eychenne, Jean-Luc Bosson","doi":"10.1016/j.medengphy.2025.104426","DOIUrl":"10.1016/j.medengphy.2025.104426","url":null,"abstract":"<div><div>Studies have shown that riding an electrically assisted bicycle is a suitable form of physical activity for rehabilitation. The rise of connected devices has enabled the development of new wearable technologies for health assessment during cycling sessions, such as plethysmography t-shirts for cardiorespiratory monitoring and inertial measurement units for movement analysis.</div><div>This study aims to demonstrate the practical and technical feasibility of embedding measurements during outdoor cycling sessions. It also evaluates the validity of these measurements by comparing them to gold-standard methods in laboratory evaluations.</div><div>Two protocols were conducted: one with six participants to assess feasibility across various outdoor session profiles, and another with 20 participants to compare measurements to gold-standard methods using indoor laboratory equipment.</div><div>The results indicate that a smart electrically assisted bicycle is suitable for outdoor assessment of cardiorespiratory and movement analysis. Furthermore, the embedded equipment provides valid measurements in the laboratory when compared to gold-standard methods across a wide range of activity intensities.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"145 ","pages":"Article 104426"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010467","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 : 2025-08-27DOI: 10.1016/j.medengphy.2025.104419
Sergio González-Cabeza , Mario Sanz-Guerrero , Luis Piñuel , Mauro Luis Buelga Suárez , Gonzalo Luis Alonso Salinas , Marian Diaz-Vicente , Joaquín Recas
Inspired by recent advances in clinical research and the growing adoption of wearable ECG devices, this study explores the feasibility of using reduced-lead ECGs for automated detection of heart anomalies using deep learning, providing a more accessible and cost-effective alternative to traditional 12-lead ECGs. This research adapts and evaluates a state-of-the-art 12-lead deep learning model (from Ribeiro et al. [1]) for 3-lead configurations. The 12-lead ECG model architecture was trained from scratch on the public database PTB-XL. It was then modified to use 3 leads by only changing the input layer. Despite a 75% reduction in input data, the 3-lead model showed only a subtle 3% performance drop. To address this gap, the 3-lead model was further optimized using a novel strategy that combines transfer learning and a One-vs-All classification approach. Using PTB-XL's five-class setup (normal vs. four pathologies: myocardial infarction, ST/T change, conduction disturbance, and hypertrophy), we report the micro-averaged F1-score across all test samples. The new optimized 3-lead model achieves a global (micro-averaged) F1-score of 77% (vs. 78% for the 12-lead model). These findings highlight the potential of simplified and cost-effective reduced-lead classification models to deliver near-equivalent diagnostic accuracy. This advancement could democratize access to early cardiac diagnostics, particularly in resource-limited settings.
{"title":"Reducing leads, enhancing wearable practicality: A comparative study of 3-lead vs. 12-lead ECG classification","authors":"Sergio González-Cabeza , Mario Sanz-Guerrero , Luis Piñuel , Mauro Luis Buelga Suárez , Gonzalo Luis Alonso Salinas , Marian Diaz-Vicente , Joaquín Recas","doi":"10.1016/j.medengphy.2025.104419","DOIUrl":"10.1016/j.medengphy.2025.104419","url":null,"abstract":"<div><div>Inspired by recent advances in clinical research and the growing adoption of wearable ECG devices, this study explores the feasibility of using reduced-lead ECGs for automated detection of heart anomalies using deep learning, providing a more accessible and cost-effective alternative to traditional 12-lead ECGs. This research adapts and evaluates a state-of-the-art 12-lead deep learning model (from Ribeiro et al. <span><span>[1]</span></span>) for 3-lead configurations. The 12-lead ECG model architecture was trained from scratch on the public database PTB-XL. It was then modified to use 3 leads by only changing the input layer. Despite a 75% reduction in input data, the 3-lead model showed only a subtle 3% performance drop. To address this gap, the 3-lead model was further optimized using a novel strategy that combines transfer learning and a One-vs-All classification approach. Using PTB-XL's five-class setup (normal vs. four pathologies: myocardial infarction, ST/T change, conduction disturbance, and hypertrophy), we report the micro-averaged F1-score across all test samples. The new optimized 3-lead model achieves a global (micro-averaged) F1-score of 77% (vs. 78% for the 12-lead model). These findings highlight the potential of simplified and cost-effective reduced-lead classification models to deliver near-equivalent diagnostic accuracy. This advancement could democratize access to early cardiac diagnostics, particularly in resource-limited settings.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"145 ","pages":"Article 104419"},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913386","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 : 2025-08-26DOI: 10.1016/j.medengphy.2025.104424
Jiaqi Yang , Rohit Dey , Nirmala Rajaram , Yang Liu , William F. Weitzel , Yihao Zheng
Vascular access is required to draw the patient’s blood into the dialysis machine and return the filtered blood to the patient during hemodialysis to treat end-stage renal disease. The most reliable vascular access is the arteriovenous fistula (AVF), which unfortunately may develop significant stenosis or obstruction as a major complication. To evaluate the AVF geometry for potential pathological features, this study aims to develop and validate a free-hand 3D ultrasound imaging system using conventional 2D ultrasound scanning with scanner motion data from an electromagnetic (EMT) sensor to spatially register the 2D image planes into a 3D image reconstruction. To temporally synchronize the 2D ultrasound images with the EMT motion data, we developed a scanning protocol that would be practical for clinical settings to simultaneously generate data features in both ultrasound scan data and EMT tracking data. The accuracy and reliability of free-hand 3D ultrasound imaging were assessed using a wire phantom and an AVF ultrasound phantom. The results show that the average normalized root mean square errors of the 3D reconstructed models compared to the wire phantom and the AVF phantom are 0.497 ± 0.144 % and 0.571 ± 0.127 %, respectively, which indicates a high degree of accuracy and consistency. This study demonstrated the efficacy and potential clinical feasibility of using a 2D ultrasound scanner and EMT sensing for free-hand 3D ultrasound imaging of AVF for vascular access monitoring.
{"title":"Free-hand 3D ultrasound imaging for vascular access","authors":"Jiaqi Yang , Rohit Dey , Nirmala Rajaram , Yang Liu , William F. Weitzel , Yihao Zheng","doi":"10.1016/j.medengphy.2025.104424","DOIUrl":"10.1016/j.medengphy.2025.104424","url":null,"abstract":"<div><div>Vascular access is required to draw the patient’s blood into the dialysis machine and return the filtered blood to the patient during hemodialysis to treat end-stage renal disease. The most reliable vascular access is the arteriovenous fistula (AVF), which unfortunately may develop significant stenosis or obstruction as a major complication. To evaluate the AVF geometry for potential pathological features, this study aims to develop and validate a free-hand 3D ultrasound imaging system using conventional 2D ultrasound scanning with scanner motion data from an electromagnetic (EMT) sensor to spatially register the 2D image planes into a 3D image reconstruction. To temporally synchronize the 2D ultrasound images with the EMT motion data, we developed a scanning protocol that would be practical for clinical settings to simultaneously generate data features in both ultrasound scan data and EMT tracking data. The accuracy and reliability of free-hand 3D ultrasound imaging were assessed using a wire phantom and an AVF ultrasound phantom. The results show that the average normalized root mean square errors of the 3D reconstructed models compared to the wire phantom and the AVF phantom are 0.497 ± 0.144 % and 0.571 ± 0.127 %, respectively, which indicates a high degree of accuracy and consistency. This study demonstrated the efficacy and potential clinical feasibility of using a 2D ultrasound scanner and EMT sensing for free-hand 3D ultrasound imaging of AVF for vascular access monitoring.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"146 ","pages":"Article 104424"},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005358","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 : 2025-08-26DOI: 10.1016/j.medengphy.2025.104425
Sergey Filist , Riad Taha Al-Kasasbeh , Tigran Gevorkyan , Osama M.Al- Habahbeh , Olga Vladimirovna Shatalova , Nikolay A. Korenevskiy , Maksim Ilyash , Evgeny Starkov , Ashraf Shaqadan , Ahmad Telfah
This research develops bioimpedance spectroscopy methods aimed at improving the differential diagnosis of pancreatic diseases. A novel approach for forming descriptors from bioimpedance data is introduced, which involves analyzing four amplitude-phase-frequency characteristics obtained from quasi-orthogonal leads. This method establishes informative feature spaces utilized by a hybrid classifier specifically designed to differentiate between pancreatitis and pancreatic cancer. The hybrid classifier comprises five macro layers, integrating probabilistic neural networks and fuzzy logical inference. Comprehensive experimental software studies and clinical tests validate the system's performance, demonstrating diagnostic sensitivity and specificity levels comparable to established techniques. The findings suggest that utilizing multifrequency bioimpedance measurements in neural network classifiers enhances the accuracy of clinical decision-making, potentially leading to better diagnostic outcomes for pancreatic diseases.
{"title":"Hybrid artificial intelligence approaches and bioimpedance spectroscopy for classifying pancreatic disease","authors":"Sergey Filist , Riad Taha Al-Kasasbeh , Tigran Gevorkyan , Osama M.Al- Habahbeh , Olga Vladimirovna Shatalova , Nikolay A. Korenevskiy , Maksim Ilyash , Evgeny Starkov , Ashraf Shaqadan , Ahmad Telfah","doi":"10.1016/j.medengphy.2025.104425","DOIUrl":"10.1016/j.medengphy.2025.104425","url":null,"abstract":"<div><div>This research develops bioimpedance spectroscopy methods aimed at improving the differential diagnosis of pancreatic diseases. A novel approach for forming descriptors from bioimpedance data is introduced, which involves analyzing four amplitude-phase-frequency characteristics obtained from quasi-orthogonal leads. This method establishes informative feature spaces utilized by a hybrid classifier specifically designed to differentiate between pancreatitis and pancreatic cancer. The hybrid classifier comprises five macro layers, integrating probabilistic neural networks and fuzzy logical inference. Comprehensive experimental software studies and clinical tests validate the system's performance, demonstrating diagnostic sensitivity and specificity levels comparable to established techniques. The findings suggest that utilizing multifrequency bioimpedance measurements in neural network classifiers enhances the accuracy of clinical decision-making, potentially leading to better diagnostic outcomes for pancreatic diseases.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"145 ","pages":"Article 104425"},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916483","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 : 2025-08-25DOI: 10.1016/j.medengphy.2025.104423
Selim Bozkurt
Continuous Flow Left Ventricular Assist Devices (CF-LVADs) are used to support the failing left ventricle in patients with end-stage heart failure. CF-LVADs unload the left ventricle continuously and generate non-physiological blood flow in the cardiovascular system, which may cause major complications, including neurological events such as haemorrhagic strokes. Therefore, quantifying the blood velocities and analysing altered blood flow in the cerebral circulation during CF-LVAD support will help to understand the effects of mechanical circulatory support on cerebral blood flow. The aim of this study is to evaluate blood flow in the vertebrobasilar arteries in a healthy condition and heart failure with reduced ejection fraction and during HeartMate 3 CF-LVAD support. Blood velocities and wall shear stresses in the vertebrobasilar arteries were evaluated using Computational Fluid Dynamics analyses for a healthy condition, heart failure with reduced ejection fraction and during HeartMate 3 support. Simulation results showed that time-averaged wall shear stress and relative residence time decrease in the vertebrobasilar arteries in heart failure. HeartMate 3 support provides comparable cerebral arterial average blood flow rates, pressures, time-averaged wall shear stresses and relative residence times to healthy conditions, although wall shear stresses and blood velocities are altered.
{"title":"Evaluation of vertebrobasilar arterial blood flow during HeartMate3 support via computational fluid dynamics analyses","authors":"Selim Bozkurt","doi":"10.1016/j.medengphy.2025.104423","DOIUrl":"10.1016/j.medengphy.2025.104423","url":null,"abstract":"<div><div>Continuous Flow Left Ventricular Assist Devices (CF-LVADs) are used to support the failing left ventricle in patients with end-stage heart failure. CF-LVADs unload the left ventricle continuously and generate non-physiological blood flow in the cardiovascular system, which may cause major complications, including neurological events such as haemorrhagic strokes. Therefore, quantifying the blood velocities and analysing altered blood flow in the cerebral circulation during CF-LVAD support will help to understand the effects of mechanical circulatory support on cerebral blood flow. The aim of this study is to evaluate blood flow in the vertebrobasilar arteries in a healthy condition and heart failure with reduced ejection fraction and during HeartMate 3 CF-LVAD support. Blood velocities and wall shear stresses in the vertebrobasilar arteries were evaluated using Computational Fluid Dynamics analyses for a healthy condition, heart failure with reduced ejection fraction and during HeartMate 3 support. Simulation results showed that time-averaged wall shear stress and relative residence time decrease in the vertebrobasilar arteries in heart failure. HeartMate 3 support provides comparable cerebral arterial average blood flow rates, pressures, time-averaged wall shear stresses and relative residence times to healthy conditions, although wall shear stresses and blood velocities are altered.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"145 ","pages":"Article 104423"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916474","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 : 2025-08-25DOI: 10.1016/j.medengphy.2025.104421
Alinne A. Oliveira, Mansueto Gomes-Neto, Alanne Oliveira, Filipe Malta, Gabriel Novaes, Vitor Oliveira Carvalho, Rafael Pereira
Purpose
This study aimed to determine the test-retest reliability of the non-invasive P2/P1 ratio, a metric derived from cranial pulsatility waveforms, in healthy young adults under both resting and physiological stress conditions.
Methods
Intracranial pulsatility waveforms were acquired from 58 healthy young adults (mean age 23.4 ± 4.0 years). The protocol involved a 5-minute baseline, 1 min of maximal isometric handgrip effort, and a 5-minute recovery period. This procedure was repeated on three separate days. Relative reliability was evaluated using the Intraclass Correlation Coefficient (ICC), and absolute reliability was assessed with the Standard Error of Measurement (SEM) and the Minimum Detectable Change (MDC).
Results
The P2/P1 ratio demonstrated good test-retest reliability across all conditions: baseline (ICC = 0.72), during maximal isometric effort (ICC = 0.74), and recovery (ICC = 0.72). Absolute reliability was high, with a small Standard Error of Measurement (SEM ≤ 0.1) and a Minimum Detectable Change (MDC95) of approximately 0.24 established during the effort.
Conclusion
The non-invasively measured P2/P1 ratio is a reliable metric in healthy young adults, maintaining its consistency even during significant cardiovascular stress. This study also establishes the MDC, providing a quantitative threshold to distinguish true physiological changes from measurement error. These findings support the use of the P2/P1 ratio for monitoring cerebrovascular dynamics and provide foundational data for future studies in clinical populations, such as critically ill patients.
{"title":"Test-retest reliability of non-invasive P2/P1 ratio and time to peak at rest and during isometric handgrip stress","authors":"Alinne A. Oliveira, Mansueto Gomes-Neto, Alanne Oliveira, Filipe Malta, Gabriel Novaes, Vitor Oliveira Carvalho, Rafael Pereira","doi":"10.1016/j.medengphy.2025.104421","DOIUrl":"10.1016/j.medengphy.2025.104421","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to determine the test-retest reliability of the non-invasive P2/P1 ratio, a metric derived from cranial pulsatility waveforms, in healthy young adults under both resting and physiological stress conditions.</div></div><div><h3>Methods</h3><div>Intracranial pulsatility waveforms were acquired from 58 healthy young adults (mean age 23.4 ± 4.0 years). The protocol involved a 5-minute baseline, 1 min of maximal isometric handgrip effort, and a 5-minute recovery period. This procedure was repeated on three separate days. Relative reliability was evaluated using the Intraclass Correlation Coefficient (ICC), and absolute reliability was assessed with the Standard Error of Measurement (SEM) and the Minimum Detectable Change (MDC).</div></div><div><h3>Results</h3><div>The P2/P1 ratio demonstrated good test-retest reliability across all conditions: baseline (ICC = 0.72), during maximal isometric effort (ICC = 0.74), and recovery (ICC = 0.72). Absolute reliability was high, with a small Standard Error of Measurement (SEM ≤ 0.1) and a Minimum Detectable Change (MDC95) of approximately 0.24 established during the effort.</div></div><div><h3>Conclusion</h3><div>The non-invasively measured P2/P1 ratio is a reliable metric in healthy young adults, maintaining its consistency even during significant cardiovascular stress. This study also establishes the MDC, providing a quantitative threshold to distinguish true physiological changes from measurement error. These findings support the use of the P2/P1 ratio for monitoring cerebrovascular dynamics and provide foundational data for future studies in clinical populations, such as critically ill patients.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"145 ","pages":"Article 104421"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916482","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 : 2025-08-25DOI: 10.1016/j.medengphy.2025.104422
Silvia Bozzi , Silvia Colombo , Federica Bisconti , Paolo Fontanili , Marco Corbelli , Filippo Consolo , Giuseppe Passoni , Alberto C.L. Redaelli
Background
Cardiopulmonary bypass (CPB) plays a crucial role in cardiac surgery, with the pump being a key component affecting both hemolysis and thrombosis. Centrifugal levitating pumps (CP) have demonstrated superiority over roller pumps due to reduced hemolysis, but thrombotic risk remains a concern. Nonetheless, there exists a technological gap for newborn patients, with only two approved centrifugal pumps specifically tailored for their needs. Consequently, pumps originally designed for adults are often employed as substitutes for paediatric patients. However, the mismatch between pump characteristics and paediatric physiology can lead to issues like blood dilution, increased shear stress, and suboptimal performance.
Methods
This study investigates the hemodynamics of an adult CP compared to a downscaled newborn CP featuring a 40% reduction in priming volume. Computational fluid dynamics is used to assess differences in flow characteristics, shear stresses, and stagnation zones, with implications for blood damage and thrombogenicity.
Results and conclusion
The newborn pump features notably shorter exposure times (45% lower than the adult design), reduced peak stress values, and a 20% reduction in the volume of fluid exposed to stress levels exceeding 50 Pa, suggesting a potential decrease in the risk of blood damage. Additionally, its reduced extent of stagnation zones (0.13 ml compared to 0.21 ml) indicates improved washout performance, thus lowering the risk of platelet aggregation and thrombus formation. These findings suggest that using a paediatric pump instead of an adult pump at typical flow rates for newborn patients may reduce the risk of blood damage.
{"title":"Comparing fluid dynamics of newborn and adult centrifugal pumps in cardiopulmonary bypass procedures","authors":"Silvia Bozzi , Silvia Colombo , Federica Bisconti , Paolo Fontanili , Marco Corbelli , Filippo Consolo , Giuseppe Passoni , Alberto C.L. Redaelli","doi":"10.1016/j.medengphy.2025.104422","DOIUrl":"10.1016/j.medengphy.2025.104422","url":null,"abstract":"<div><h3>Background</h3><div>Cardiopulmonary bypass (CPB) plays a crucial role in cardiac surgery, with the pump being a key component affecting both hemolysis and thrombosis. Centrifugal levitating pumps (CP) have demonstrated superiority over roller pumps due to reduced hemolysis, but thrombotic risk remains a concern. Nonetheless, there exists a technological gap for newborn patients, with only two approved centrifugal pumps specifically tailored for their needs. Consequently, pumps originally designed for adults are often employed as substitutes for paediatric patients. However, the mismatch between pump characteristics and paediatric physiology can lead to issues like blood dilution, increased shear stress, and suboptimal performance.</div></div><div><h3>Methods</h3><div>This study investigates the hemodynamics of an adult CP compared to a downscaled newborn CP featuring a 40% reduction in priming volume. Computational fluid dynamics is used to assess differences in flow characteristics, shear stresses, and stagnation zones, with implications for blood damage and thrombogenicity.</div></div><div><h3>Results and conclusion</h3><div>The newborn pump features notably shorter exposure times (45% lower than the adult design), reduced peak stress values, and a 20% reduction in the volume of fluid exposed to stress levels exceeding 50 Pa, suggesting a potential decrease in the risk of blood damage. Additionally, its reduced extent of stagnation zones (0.13 ml compared to 0.21 ml) indicates improved washout performance, thus lowering the risk of platelet aggregation and thrombus formation. These findings suggest that using a paediatric pump instead of an adult pump at typical flow rates for newborn patients may reduce the risk of blood damage.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"145 ","pages":"Article 104422"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908035","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 : 2025-08-22DOI: 10.1016/j.medengphy.2025.104418
Piyush Mahajan, Amit Kaul
Early and accurate detection of cardiac arrhythmias is crucial for preventing severe cardiovascular events. This study proposes a CNN–GNN–BiLSTM integrated framework for automated ECG arrhythmia classification, combining spatial, relational, and temporal learning to achieve enhanced predictive accuracy. Convolutional Neural Networks (CNNs) serve as feature extractors from ECG spectrograms, while Graph Attention Networks (GATs) capture inter-beat relationships through graph-based modeling. In parallel, Bidirectional Long Short-Term Memory (BiLSTM) networks refine temporal dependencies, ensuring robust sequential representation. Outputs from GAT and BiLSTM modules are concatenated to form a unified feature representation, which is passed through a fully connected classifier for final prediction. The model is evaluated on three benchmark ECG datasets—MIT-BIH, PTB, and Chapman-Shaoxing—as well as a combined 11-class dataset, demonstrating superior generalization. Results indicate significant performance improvement over conventional deep learning approaches, achieving 96.0% overall accuracy and up to 99.89% accuracy on MIT-BIH. The proposed framework effectively mitigates misclassification errors and offers a scalable, real-time solution for AI-driven cardiac monitoring systems.
{"title":"Graph-enhanced deep learning for ECG arrhythmia detection: An integration of CNN-GNN-BiLSTM approach","authors":"Piyush Mahajan, Amit Kaul","doi":"10.1016/j.medengphy.2025.104418","DOIUrl":"10.1016/j.medengphy.2025.104418","url":null,"abstract":"<div><div>Early and accurate detection of cardiac arrhythmias is crucial for preventing severe cardiovascular events. This study proposes a CNN–GNN–BiLSTM integrated framework for automated ECG arrhythmia classification, combining spatial, relational, and temporal learning to achieve enhanced predictive accuracy. Convolutional Neural Networks (CNNs) serve as feature extractors from ECG spectrograms, while Graph Attention Networks (GATs) capture inter-beat relationships through graph-based modeling. In parallel, Bidirectional Long Short-Term Memory (BiLSTM) networks refine temporal dependencies, ensuring robust sequential representation. Outputs from GAT and BiLSTM modules are concatenated to form a unified feature representation, which is passed through a fully connected classifier for final prediction. The model is evaluated on three benchmark ECG datasets—MIT-BIH, PTB, and Chapman-Shaoxing—as well as a combined 11-class dataset, demonstrating superior generalization. Results indicate significant performance improvement over conventional deep learning approaches, achieving 96.0% overall accuracy and up to 99.89% accuracy on MIT-BIH. The proposed framework effectively mitigates misclassification errors and offers a scalable, real-time solution for AI-driven cardiac monitoring systems.</div></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":"145 ","pages":"Article 104418"},"PeriodicalIF":2.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896120","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号