Annals of Biomedical Engineering最新文献_第7页

HeartMate 3 for Heart Failure with Preserved Ejection Fraction: In Vitro Hemodynamic Evaluation and Anatomical Fitting. 用于射血分数保留型心力衰竭的 HeartMate 3：体外血流动力学评估和解剖匹配。

IF 3 2区医学 Q3 ENGINEERING, BIOMEDICAL

Annals of Biomedical Engineering

Pub Date : 2024-07-16 DOI: 10.1007/s10439-024-03585-y

Nina Langer, Andrew F Stephens, Michael Šeman, David McGiffin, David M Kaye, Shaun D Gregory

Heart failure with preserved ejection fraction (HFpEF) constitutes approximately 50% of heart failure (HF) cases, and encompasses different phenotypes. Among these, most patients with HFpEF exhibit structural heart changes, often with smaller left ventricular cavities, which pose challenges for utilizing ventricular assist devices (VADs). A left atrial to aortic (LA-Ao) VAD configuration could address these challenges, potentially enhancing patient quality of life by lowering elevated mean left atrial pressure (MLAP). This study assessed the anatomical compatibility and left atrial unloading capacity using a simulated VAD-supported HFpEF patient. A HeartMate3-supported HFpEF patient in an LA-Ao configuration was simulated using a cardiovascular simulator. Hemodynamic parameters were recorded during rest and exercise at seven pump flow rates. Computed tomography scans of 14 HFpEF (NYHA II-III) and six heart failure with reduced ejection fraction patients were analysed for anatomical comparisons. HFpEF models were independently assessed for virtual anatomical fit with the HM3 in the LA-Ao configuration. Baseline MLAP was reduced from 15 to 11 mmHg with the addition of 1 L/min HM3 support in the rest condition. In an exercise simulation, 6 L/min of HM3 support was required to reduce the MLAP from 29 to 16 mmHg. The HM3 successfully accommodated six HFpEF patients without causing interference with other cardiac structures, whereas it caused impingement ranging from 4 to 14 mm in the remaining patients. This study demonstrated that the HM3 in an LA-Ao configuration may be suitable for unloading the left atrium and relieving pulmonary congestion in some HFpEF patients where size-related limitations can be addressed through pre-surgical anatomical fit analysis.

射血分数保留型心力衰竭（HFpEF）约占心力衰竭（HF）病例的 50%，并包括不同的表型。其中，大多数射血分数保留型心力衰竭患者的心脏结构发生了变化，左心室腔通常较小，这给使用心室辅助装置（VAD）带来了挑战。从左心房到主动脉（LA-Ao）的 VAD 配置可以应对这些挑战，通过降低升高的平均左心房压（MLAP），有可能提高患者的生活质量。本研究使用模拟 VAD 支持的高频血友病患者评估了解剖兼容性和左心房卸载能力。使用心血管模拟器模拟了一名 LA-Ao 配置的 HeartMate3 支持型 HFpEF 患者。在七种泵流量下记录静息和运动时的血流动力学参数。对 14 名 HFpEF（NYHA II-III）和 6 名射血分数降低的心力衰竭患者的计算机断层扫描进行分析，以进行解剖学比较。独立评估了 HFpEF 模型与 LA-Ao 配置中的 HM3 的虚拟解剖匹配度。在静息状态下，增加 1 L/min HM3 支持后，基线 MLAP 从 15 mmHg 降至 11 mmHg。在运动模拟中，需要 6 L/min 的 HM3 支持才能将 MLAP 从 29 mmHg 降低到 16 mmHg。HM3 成功地为六名高频低氧血症患者提供了支持，没有对其他心脏结构造成干扰，而对其余患者造成了 4 至 14 毫米的撞击。这项研究表明，LA-Ao 配置的 HM3 可能适用于一些 HFpEF 患者，为左心房减压并缓解肺充血，这些患者的尺寸限制可以通过术前解剖匹配分析来解决。

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引用次数: 0

An Extended Neck Position is Likely to Produce Cervical Spine Injuries Through Buckling in Accidental Head-First Impacts During Rugby Tackling 在橄榄球攻防战中，伸颈姿势很可能会在头部先着地的意外撞击中通过弯曲造成颈椎损伤。

IF 3 2区医学 Q3 ENGINEERING, BIOMEDICAL

Annals of Biomedical Engineering

Pub Date : 2024-07-14 DOI: 10.1007/s10439-024-03576-z

Pavlos Silvestros, Ryan D. Quarrington, Ezio Preatoni, Harinderjit S. Gill, Claire F. Jones, Dario Cazzola

Catastrophic cervical spine injuries in rugby often occur during tackling. The underlying mechanisms leading to these injuries remain unclear, with neck hyperflexion and buckling both proposed as the causative factor in the injury prevention literature. The aim of this study was to evaluate the effect of pre-impact head–neck posture on intervertebral neck loads and motions during a head-first rugby tackle. Using a validated, subject-specific musculoskeletal model of a rugby player, and computer simulations driven by in vivo and in vitro data, we examined the dynamic response of the cervical spine under such impact conditions. The simulations demonstrated that the initial head–neck sagittal-plane posture affected intervertebral loads and kinematics, with an extended neck resulting in buckling and supraphysiologic intervertebral shear and flexion loads and motions, typical of bilateral facet dislocation injuries. In contrast, an initially flexed neck increased axial compression forces and flexion angles without exceeding intervertebral physiological limits. These findings provide objective evidence that can inform injury prevention strategies or rugby law changes to improve the safety of the game of rugby.

橄榄球运动中的致命颈椎损伤往往发生在对抗过程中。导致这些损伤的根本机制仍不清楚，在损伤预防文献中，颈部过度屈曲和屈曲都被认为是致伤因素。本研究的目的是评估头部先着地的橄榄球擒抱动作中，撞击前的头颈姿势对颈部椎间负荷和运动的影响。通过使用经过验证的、针对特定对象的橄榄球运动员肌肉骨骼模型，以及由体内和体外数据驱动的计算机模拟，我们研究了颈椎在这种撞击条件下的动态响应。模拟结果表明，最初的头颈矢状面姿势会影响椎间负荷和运动学，颈部伸直会导致屈曲和超生理的椎间剪切和屈曲负荷和运动，这是典型的双侧椎面脱位损伤。相比之下，最初屈曲的颈部会增加轴向压缩力和屈曲角，但不会超过椎体间的生理极限。这些发现提供了客观证据，可为伤害预防策略或橄榄球法的修改提供参考，从而提高橄榄球比赛的安全性。

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引用次数: 0

Two-Stage Classification of Future Knee Osteoarthritis Severity After 8 Years Using MRI: Data from the Osteoarthritis Initiative. 使用磁共振成像对 8 年后未来膝关节骨性关节炎严重程度进行两阶段分类：骨关节炎倡议 "的数据。

IF 3 2区医学 Q3 ENGINEERING, BIOMEDICAL

Annals of Biomedical Engineering

Pub Date : 2024-07-09 DOI: 10.1007/s10439-024-03578-x

Teemu A T Nurmirinta, Mikael J Turunen, Rami K Korhonen, Jussi Tohka, Mimmi K Liukkonen, Mika E Mononen

Currently, there are no methods or tools available in clinical practice for classifying future knee osteoarthritis (KOA). In this study, we aimed to fill this gap by classifying future KOA into three severity grades: KL01 (healthy), KL2 (moderate), and KL34 (severe) based on the Kellgren-Lawrance scale. Due to the complex nature of multiclass classification, we used a two-stage method, which separates the classification task into two binary classifications (KL01 vs. KL234 in the first stage and KL2 vs. KL34 in the second stage). Our machine learning (ML) model used two Balanced Random Forest algorithms and was trained with gender, age, height, weight, and quantitative knee morphology obtained from magnetic resonance imaging. Our training dataset comprised longitudinal 8-year follow-up data of 1213 knees from the Osteoarthritis Initiative. Through extensive experimentation with various feature combinations, we identified KL baseline and weight as the most essential features, while gender surprisingly proved to be one of the least influential feature. Our best classification model generated a weighted F1 score of 79.0% and a balanced accuracy of 65.9%. The area under the receiver operating characteristic curve was 83.0% for healthy (KL01) versus moderate (KL2) or severe (KL34) KOA patients and 86.6% for moderate (KL2) versus severe (KL34) KOA patients. We found a statistically significant difference in performance between our two-stage classification model and the traditional single-stage classification model. These findings demonstrate the encouraging results of our two-stage classification model for multiclass KOA severity classification, suggesting its potential application in clinical settings in future.

目前，临床实践中还没有可用来对未来膝关节骨性关节炎（KOA）进行分级的方法或工具。在这项研究中，我们将未来 KOA 的严重程度分为三个等级，旨在填补这一空白：KL01（健康）、KL2（中度）和 KL34（重度）。由于多类分类的复杂性，我们采用了两阶段方法，将分类任务分为两个二元分类（第一阶段为 KL01 与 KL234，第二阶段为 KL2 与 KL34）。我们的机器学习（ML）模型使用了两种平衡随机森林算法，并通过性别、年龄、身高、体重和磁共振成像获得的膝关节形态定量数据进行训练。我们的训练数据集包括骨关节炎倡议（Osteoarthritis Initiative）1213 个膝关节的 8 年纵向随访数据。通过对各种特征组合的广泛试验，我们发现 KL 基线和体重是最基本的特征，而性别则出人意料地被证明是影响最小的特征之一。我们的最佳分类模型的加权 F1 得分为 79.0%，平衡准确率为 65.9%。健康（KL01）与中度（KL2）或重度（KL34）KOA 患者的接收者操作特征曲线下面积为 83.0%，中度（KL2）与重度（KL34）KOA 患者的接收者操作特征曲线下面积为 86.6%。我们发现，我们的两阶段分类模型与传统的单阶段分类模型在性能上有显著的统计学差异。这些研究结果表明，我们的两阶段分类模型在多级 KOA 严重程度分类中取得了令人鼓舞的结果，这表明它将来有可能应用于临床。

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引用次数: 0

Correction: Primary Creep Characterization in Porcine Lumbar Spine Subject to Repeated Loading. 更正：反复加载猪腰椎的初级蠕变特征。

IF 3 2区医学 Q3 ENGINEERING, BIOMEDICAL

Annals of Biomedical Engineering

Pub Date : 2024-07-09 DOI: 10.1007/s10439-024-03579-w

Concetta Morino, Shea Middleton, Joost Op't Eynde, Elizabeth Dimbath, Jason Kait, Jason Luck, Cameron Bass

引用次数: 0

Association of Sport Helmet Status on Concussion Presentation and Recovery in Male Collegiate Student-Athletes 运动头盔状态与男性大学生运动员脑震荡表现和恢复的关系。

IF 3 2区医学 Q3 ENGINEERING, BIOMEDICAL

Annals of Biomedical Engineering

Pub Date : 2024-07-08 DOI: 10.1007/s10439-024-03575-0

Adrian J. Boltz, Landon B. Lempke, Reid A. Syrydiuk, Stefan Duma, Paul Pasquina, Thomas W. McAllister, Michael McCrea, Avinash Chandran, Steven P. Broglio, CARE Consortium Investigators

Sporting helmets contain force attenuating materials which reduce traumatic head injury risk and may influence sport-related concussion (SRC) sequelae. The purpose of this study was to examine the association of sport helmet status with SRC-clinical presentation and recovery trajectories in men’s collegiate athletes. Sport helmet status was based on the nature of sports being either helmeted/non-helmeted. 1070 SRCs in helmeted (HELM) sports (Men’s-Football, Ice Hockey, and Lacrosse), and 399 SRCs in non-helmeted (NOHELM) sports (Men’s-Basketball, Cheerleading, Cross Country/Track & Field, Diving, Gymnastics, Soccer, Swimming, Tennis, and Volleyball) were analyzed. Multivariable negative binomial regression models analyzed associations between sport helmet status and post-injury cognition, balance, and symptom severity, adjusting for covariate effects (SRC history, loss of consciousness, anterograde/retrograde amnesia, event type). Kaplan-Meier curves evaluated median days to: initiation of return to play (iRTP) protocol, and unrestricted RTP (URTP) by sport helmet status. Log-rank tests were used to evaluate differential iRTP/URTP between groups. Two independent multivariable Weibull accelerated failure time models were used to examine differential iRTP and URTP between groups, after adjusting for aforementioned covariates and symptom severity score. Overall, the median days to iRTP and URTP was 6.3 and 12.0, respectively, and was comparable across NOHELM- and HELM-SRCs. Post-injury symptom severity was lower (Score Ratio 0.90, 95%CI 0.82, 0.98), and cognitive test performance was higher (Score Ratio 1.03, 95%CI 1.02, 1.05) in NOHELM-compared to HELM-SRCs. Estimated time spent recovering to iRTP/URTP was comparable between sport helmet status groups. Findings suggest that the grouping of sports into helmeted and non-helmeted show slight differences in clinical presentation but not recovery.

运动头盔含有减力材料，可降低头部外伤风险，并可能影响运动相关脑震荡（SRC）后遗症。本研究旨在探讨运动头盔状态与男子大学生运动员脑震荡临床表现和恢复轨迹之间的关系。运动头盔状态基于戴头盔/不戴头盔的运动性质。对戴头盔（HELM）运动项目（男子足球、冰上曲棍球和长曲棍球）的 1070 例 SRC 和不戴头盔（NOHELM）运动项目（男子篮球、啦啦队、越野/田径、跳水、体操、足球、游泳、网球和排球）的 399 例 SRC 进行了分析。多变量负二项回归模型分析了运动头盔状态与伤后认知能力、平衡能力和症状严重程度之间的关系，并调整了协变量效应（SRC史、意识丧失、前向/逆行性遗忘、事件类型）。卡普兰-梅耶曲线评估了按运动头盔状态划分的恢复比赛（iRTP）方案启动和无限制恢复比赛（URTP）的中位天数。对数秩检验用于评估组间 iRTP/URTP 的差异。在对上述协变量和症状严重程度评分进行调整后，使用两个独立的多变量 Weibull 加速失败时间模型来检测组间 iRTP 和 URTP 的差异。总体而言，iRTP 和 URTP 的中位天数分别为 6.3 天和 12.0 天，在 NOHELM-SRC 和 HELM-SRC 中具有可比性。与 HELM-SRC 相比，NOHELM 的伤后症状严重程度较低（得分比为 0.90，95%CI 为 0.82，0.98），认知测试成绩较高（得分比为 1.03，95%CI 为 1.02，1.05）。运动头盔状态组之间恢复到 iRTP/URTP 所花费的估计时间相当。研究结果表明，将运动分为戴头盔和不戴头盔两组在临床表现上略有不同，但在恢复上并无差异。

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引用次数: 0

A Comprehensive Literature Review on Advancements and Challenges in 3D Bioprinting of Human Organs: Ear, Skin, and Bone. 关于人体器官三维生物打印的进展与挑战的全面文献综述：耳、皮肤和骨骼。

IF 3 2区医学 Q3 ENGINEERING, BIOMEDICAL

Annals of Biomedical Engineering

Pub Date : 2024-07-08 DOI: 10.1007/s10439-024-03580-3

Aishwarya Varpe, Marwana Sayed, Nikhil S Mane

The field of 3D bioprinting is rapidly emerging within the realm of regenerative medicine, offering significant potential in dealing with the issue of organ shortages. Despite being in its early stages, it has the potential to replicate tissue structures accurately, providing new potential solutions for reconstructive surgery. This review explores the diverse applications of 3D bioprinting in regenerative medicine, pharmaceuticals, and the food industry, specifically focusing on ear, skin, and bone tissues due to their unique challenges and implications in the field. Significant progress has been made in cartilage and bone scaffold fabrication in ear reconstruction, yet challenges in functional maturation persist. Recent advancements highlight the potential for patient-specific ear substitutes, emphasizing the need for extensive clinical trials. In skin regeneration, 3D bioprinting addresses limitations in existing models, offering opportunities for improved wound healing and realistic skin models. While challenges exist, progress in biomaterials and in-situ bioprinting holds promise. In bone regeneration, 3D bioprinting presents personalized solutions for defects, but scaffold design refinement and addressing regulatory and ethical considerations are crucial. The transformative potential of 3D bioprinting in the field of medicine holds the promise of redefining therapeutic approaches and delivering personalized treatments and functional tissues. Interdisciplinary collaboration is essential for fully realizing the capabilities of 3D bioprinting. This review provides a detailed analysis of current methodologies, challenges, and prospects in 3D bioprinting for ear, skin, and bone tissue regeneration.

三维生物打印技术正在再生医学领域迅速崛起，为解决器官短缺问题提供了巨大潜力。尽管还处于早期阶段，但它具有准确复制组织结构的潜力，为重建手术提供了新的潜在解决方案。本综述探讨了三维生物打印在再生医学、制药和食品工业中的各种应用，特别侧重于耳、皮肤和骨组织，因为它们在该领域具有独特的挑战和影响。耳部重建中的软骨和骨支架制造已取得重大进展，但功能成熟方面的挑战依然存在。最近的进展突显了患者特异性耳替代物的潜力，强调了广泛临床试验的必要性。在皮肤再生方面，三维生物打印技术解决了现有模型的局限性，为改善伤口愈合和建立逼真的皮肤模型提供了机会。虽然挑战依然存在，但生物材料和原位生物打印技术的进步带来了希望。在骨再生方面，三维生物打印为缺损提供了个性化的解决方案，但支架设计的完善以及解决监管和伦理方面的问题至关重要。三维生物打印在医学领域的变革潜力有望重新定义治疗方法，提供个性化治疗和功能性组织。跨学科合作对于充分发挥三维生物打印的能力至关重要。本综述详细分析了耳部、皮肤和骨组织再生三维生物打印的当前方法、挑战和前景。

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引用次数: 0

Evaluation of the Transfemoral Bone–Implant Interface Properties Using Vibration Analysis 利用振动分析评估经股骨-植入物界面特性

IF 3 2区医学 Q3 ENGINEERING, BIOMEDICAL

Annals of Biomedical Engineering

Pub Date : 2024-07-08 DOI: 10.1007/s10439-024-03561-6

Mostafa Mohamed, Eric Beaudry, Ahmed W. Shehata, Donald Raboud, Jacqueline S. Hebert, Lindsey Westover

Evaluating the bone–implant interface (BII) properties of osseointegrated transfemoral (TFA) implants is important for early failure detection and prescribing loads during rehabilitation. The objective of this work is to derive and validate a 1D finite element (FE) model of the Osseointegrated Prosthetic Limb (OPL) TFA system that can: (1) model its dynamic behaviour and (2) extract the BII properties. The model was validated by: (1) comparing the 1D FE formulation to the analytical and 3D FE solutions for a simplified cylinder, (2) comparing the vibration modes of the actual TFA geometry using 1D and 3D FE models, and (3) evaluating the BII properties for three extreme conditions (LOW, INTERMEDIATE, and HIGH) generated using 3D FE and experimental (where the implant was embedded, using different adhesives, in synthetic femurs) signals for additional validation. The modes predicted by the 1D FE model converged to the analytical and the 3D FE solutions for the cylinder. The 1D model also matched the 3D FE solution with a maximum frequency difference of 2.02% for the TFA geometry. Finally, the 1D model extracted the BII stiffness and the system’s damping properties for the three conditions generated using the 3D FE simulations and the experimental INTERMEDIATE and HIGH signals. The agreement between the 1D FE and the 3D FE solutions for the TFA geometry indicates that the 1D model captures the system’s dynamic behaviour. Distinguishing between the different BII conditions demonstrates the 1D model’s potential use for the non-invasive clinical evaluation of the TFA BII properties.

评估骨结合经股骨（TFA）植入物的骨植入界面（BII）特性对于早期失效检测和康复过程中的负荷规定非常重要。这项工作的目的是推导并验证骨结合假肢（OPL）TFA 系统的一维有限元（FE）模型，该模型可以(1) 建立动态行为模型，(2) 提取 BII 特性。该模型通过以下方式进行验证(1) 将简化圆柱体的一维 FE 计算结果与分析和三维 FE 解决方案进行比较；(2) 使用一维和三维 FE 模型比较实际 TFA 几何形状的振动模式；(3) 使用三维 FE 和实验信号（使用不同粘合剂将植入物嵌入合成股骨）评估三种极端条件（低、中、高）下的 BII 特性，以进行额外验证。一维 FE 模型预测的模式与圆柱体的分析和三维 FE 解决方案趋同。对于 TFA 几何结构，一维模型也与三维 FE 解决方案相吻合，最大频率差为 2.02%。最后，一维模型提取了使用三维 FE 模拟和实验 INTERMEDIATE 和 HIGH 信号生成的三种条件下的 BII 刚度和系统阻尼特性。对于 TFA 几何结构，一维有限元和三维有限元解决方案之间的一致性表明，一维模型捕捉到了系统的动态行为。区分不同的 BII 条件表明，一维模型可用于对 TFA BII 特性进行无创临床评估。

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引用次数: 0

AI Shaming: The Silent Stigma among Academic Writers and Researchers AI 耻辱：学术作家和研究人员中无声的耻辱。

IF 3 2区医学 Q3 ENGINEERING, BIOMEDICAL

Annals of Biomedical Engineering

Pub Date : 2024-07-08 DOI: 10.1007/s10439-024-03582-1

Louie Giray

AI shaming refers to the practice of criticizing or looking down on individuals or organizations for using AI to generate content or perform tasks. AI shaming has emerged as a recent phenomenon in academia. This paper examines the characteristics, causes, and effects of AI shaming on academic writers and researchers. AI shaming often involves dismissing the validity or authenticity of AI-assisted work, suggesting that using AI is deceitful, lazy, or less valuable than human-only efforts. The paper identifies various profiles of individuals who engage in AI shaming, including traditionalists, technophobes, and elitists, and explores their motivations. The effects of AI shaming are multifaceted, ranging from inhibited technology adoption and stifled innovation to increased stress among researchers and missed opportunities for efficiency. These consequences may hinder academic progress and limit the potential benefits of AI in research and scholarship. Despite these challenges, the paper argues that academic writers and researchers should not be ashamed of using AI when done responsibly and ethically. By embracing AI as a tool to augment human capabilities and by being transparent about its use, academic writers and researchers can lead the way in demonstrating responsible AI integration.

人工智能羞辱指的是批评或看不起使用人工智能生成内容或执行任务的个人或组织的做法。人工智能羞辱是最近学术界出现的一种现象。本文探讨了人工智能羞辱的特点、原因以及对学术作家和研究人员的影响。人工智能羞辱通常涉及否定人工智能辅助工作的有效性或真实性，暗示使用人工智能是欺骗、懒惰或不如纯人工工作有价值。本文指出了参与人工智能羞辱的各种人的特征，包括传统主义者、技术恐惧者和精英主义者，并探讨了他们的动机。人工智能羞辱的影响是多方面的，从抑制技术应用和扼杀创新，到增加研究人员的压力和错失提高效率的机会，不一而足。这些后果可能会阻碍学术进步，限制人工智能在研究和学术方面的潜在效益。尽管存在这些挑战，本文认为，学术写作者和研究人员不应该为使用人工智能而感到羞耻，只要以负责任和合乎道德的方式使用人工智能。通过将人工智能作为增强人类能力的工具，并对其使用保持透明，学术作家和研究人员可以带头展示负责任的人工智能整合。

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引用次数: 0

Development of a Novel Soft Tissue Measurement Device for Individualized Finite Element Modeling in Custom-Fit CPAP Mask Evaluation. 开发一种新型软组织测量设备，用于在 CPAP 面罩定制评估中进行个性化有限元建模。

IF 3 2区医学 Q3 ENGINEERING, BIOMEDICAL

Annals of Biomedical Engineering

Pub Date : 2024-07-08 DOI: 10.1007/s10439-024-03581-2

Erica Martelly, Summer Lee, Kristina Martinez, Sandeep Rana, Kenji Shimada

Purpose: Individual facial soft tissue properties are necessary for creating individualized finite element (FE) models to evaluate medical devices such as continuous positive airway pressure (CPAP) masks. There are no standard tools available to measure facial soft tissue elastic moduli, and techniques in literature require advanced equipment or custom parts to replicate.

Methods: We propose a simple and inexpensive soft tissue measurement (STM) indenter device to estimate facial soft tissue elasticity at five sites: chin, cheek near lip, below cheekbone, cheekbone, and cheek. The STM device consists of a probe with a linear actuator and force sensor, an adjustment system for probe orientation, a head support frame, and a controller. The device was validated on six ballistics gel samples and then tested on 28 subjects. Soft tissue thickness was also collected for each subject using ultrasound.

Results: Thickness and elastic modulus measurements were successfully collected for all subjects. The mean elastic modulus for each site is E_c = 53.04 ± 20.97 kPa for the chin, E_l = 16.33 ± 8.37 kPa for the cheek near lip, E_bc = 27.09 ± 11.38 kPa for below cheekbone, E_cb = 64.79 ± 17.12 kPa for the cheekbone, and E_ch = 16.20 ± 5.09 kPa for the cheek. The thickness and elastic modulus values are in the range of previously reported values. One subject's measured soft tissue elastic moduli and thickness were used to evaluate custom-fit CPAP mask fit in comparison to a model of that subject with arbitrary elastic moduli and thickness. The model with measured values more closely resembles in vivo leakage results.

Conclusion: Overall, the STM provides a first estimate of facial soft tissue elasticity and is affordable and easy to build with mostly off-the-shelf parts. These values can be used to create personalized FE models to evaluate custom-fit CPAP masks.

目的：要创建个性化的有限元（FE）模型来评估持续气道正压（CPAP）面罩等医疗设备，就必须要有个性化的面部软组织特性。目前还没有测量面部软组织弹性模量的标准工具，文献中的技术需要先进的设备或定制部件才能复制：方法：我们提出了一种简单而廉价的软组织测量（STM）压头装置，用于估算面部软组织在五个部位的弹性：下巴、靠近嘴唇的脸颊、颧骨下方、颧骨和脸颊。STM 设备由一个带线性致动器和力传感器的探头、一个用于调整探头方向的调整系统、一个头部支撑架和一个控制器组成。该装置在六个弹道凝胶样本上进行了验证，然后在 28 名受试者身上进行了测试。还使用超声波采集了每个受试者的软组织厚度：结果：成功采集了所有受试者的厚度和弹性模量。每个部位的平均弹性模量分别为：下巴 Ec = 53.04 ± 20.97 kPa；颊部近唇 El = 16.33 ± 8.37 kPa；颧骨以下 Ebc = 27.09 ± 11.38 kPa；颧骨 Ecb = 64.79 ± 17.12 kPa；颊部 Ech = 16.20 ± 5.09 kPa。厚度和弹性模量值均在之前报告的范围内。一名受试者的软组织弹性模量和厚度测量值被用于评估定制 CPAP 面罩的匹配度，并与该受试者具有任意弹性模量和厚度的模型进行比较。采用测量值的模型更接近于体内泄漏结果：总之，STM 提供了对面部软组织弹性的初步估计，而且价格低廉，易于使用现成的部件制作。这些数值可用于创建个性化的 FE 模型，以评估定制的 CPAP 面罩。

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引用次数: 0

An In Silico Modelling Approach to Predict Hemodynamic Outcomes in Diabetic and Hypertensive Kidney Disease 预测糖尿病和高血压肾病血液动力学结果的硅模拟方法

IF 3 2区医学 Q3 ENGINEERING, BIOMEDICAL

Annals of Biomedical Engineering

Pub Date : 2024-07-05 DOI: 10.1007/s10439-024-03573-2

Ning Wang, Ivan Benemerito, Steven P Sourbron, Alberto Marzo

Early diagnosis of kidney disease remains an unmet clinical challenge, preventing timely and effective intervention. Diabetes and hypertension are two main causes of kidney disease, can often appear together, and can only be distinguished by invasive biopsy. In this study, we developed a modelling approach to simulate blood velocity, volumetric flow rate, and pressure wave propagation in arterial networks of ageing, diabetic, and hypertensive virtual populations. The model was validated by comparing our predictions for pressure, volumetric flow rate and waveform-derived indexes with in vivo data on ageing populations from the literature. The model simulated the effects of kidney disease, and was calibrated to align quantitatively with in vivo data on diabetic and hypertensive nephropathy from the literature. Our study identified some potential biomarkers extracted from renal blood flow rate and flow pulsatility. For typical patient age groups, resistive index values were 0.69 (SD 0.05) and 0.74 (SD 0.02) in the early and severe stages of diabetic nephropathy, respectively. Similar trends were observed in the same stages of hypertensive nephropathy, with a range from 0.65 (SD 0.07) to 0.73 (SD 0.05), respectively. Mean renal blood flow rate through a single diseased kidney ranged from 329 (SD 40, early) to 317 (SD 38, severe) ml/min in diabetic nephropathy and 443 (SD 54, early) to 388 (SD 47, severe) ml/min in hypertensive nephropathy, showing potential as a biomarker for early diagnosis of kidney disease. This modelling approach demonstrated its potential application in informing biomarker identification and facilitating the setup of clinical trials.

肾脏疾病的早期诊断仍是一项尚未解决的临床难题，妨碍了及时有效的干预。糖尿病和高血压是导致肾脏疾病的两个主要原因，经常会同时出现，只有通过侵入性活检才能加以区分。在这项研究中，我们开发了一种建模方法来模拟老龄化、糖尿病和高血压虚拟人群动脉网络中的血流速度、容积流速和压力波传播。通过将我们对压力、容积流速和波形衍生指标的预测与文献中有关老龄化人群的体内数据进行比较，对模型进行了验证。该模型模拟了肾脏疾病的影响，并与文献中有关糖尿病和高血压肾病的活体数据进行了定量校准。我们的研究从肾脏血流速度和血流脉动性中发现了一些潜在的生物标记物。对于典型的患者年龄组，糖尿病肾病早期和严重阶段的阻力指数值分别为 0.69（标清 0.05）和 0.74（标清 0.02）。在高血压肾病的相同阶段也观察到类似的趋势，范围分别为 0.65（标清 0.07）至 0.73（标清 0.05）。通过单个病变肾脏的平均肾血流量在糖尿病肾病中为 329（标清 40，早期）至 317（标清 38，重度）毫升/分钟，在高血压肾病中为 443（标清 54，早期）至 388（标清 47，重度）毫升/分钟，显示出作为肾病早期诊断生物标志物的潜力。这种建模方法证明了其在为生物标记物鉴定提供信息和促进临床试验设置方面的潜在应用。

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