Bioengineering最新文献

Background: there is a high risk of falls in older adults. One of the factors contributing to fall episodes is advancing age due to deterioration of the proprioceptive system. Certain clinical procedures improve balance and posture, such as the use of insoles.

Objective: the objective of this study was to evaluate the impact of hard and soft insoles on static foot balance in healthy older adults compared to barefoot people.

Methods: a clinical trial was conducted with a sample size of 150 healthy adults (69 male and 81 women) with a mean age of 69.03 ± 3.82 years. Postural control was evaluated in different conditions of barefoot balance with hard and soft insoles.

Results: All tests were statistically significant (p < 0.001). The test with soft insoles presented higher stabilometric values and presented worse postural control compared to the barefoot and hard insoles in all eyes-open and eyes-closed conditions.

Conclusions: Hard and soft insoles show no improvement in postural control compared to barefoot standing. The findings suggest that soft insoles may result in impaired balance during standing. The density of the materials in the insoles emerges as a significant factor influencing postural control.

Adipose tissue in vivo is physiologically exposed to compound mechanical loading due to bodyweight bearing, posture, and motion. The capability of adipocytes to sense and respond to mechanical loading milieus to influence metabolic functions may provide a new insight into obesity and metabolic diseases such as type 2 diabetes (T2D). Here, we evidenced physiological mechanical loading control of adipocyte insulin signaling cascades. We exposed differentiated 3T3-L1 adipocytes to mechanical stretching and assessed key markers of insulin signaling, AKT activation, and GLUT4 translocation, required for glucose uptake. We showed that cyclic stretch loading at 5% strain and 1 Hz frequency increases AKT phosphorylation and GLUT4 translocation to the plasma membrane by approximately two-fold increases compared to unstretched controls for both markers as assessed by immunoblotting (p < 0.05). These results indicate that cyclic stretching activates insulin signaling and GLUT4 trafficking in adipocytes. In the mechanosensing mechanism study, focal adhesion kinase (FAK) inhibitor (FAK14) and RhoA kinase (ROCK) inhibitor (Y-27632) impaired actin cytoskeleton structural formation and significantly suppressed the stretch induction of AKT phosphorylation in adipocytes (p < 0.001). This suggests the regulatory role of focal adhesion and cytoskeletal mechanosensing in adipocyte insulin signaling under stretch loading. Our finding on the impact of mechanical stretch loading on key insulin signaling effectors in differentiated adipocytes and the mediatory role of focal adhesion and cytoskeleton mechanosensors is the first of its kind to our knowledge. This may suggest a therapeutic potential of mechanical loading cue in improving conditions of obesity and T2D. For instance, cyclic mechanical stretch loading of adipose tissue could be explored as a tool to improve insulin sensitivity in patients with obesity and T2D, and the mediatory mechanosensors such as FAK and ROCK may be targeted to further invigorate stretch-induced insulin signaling activation.

Mobile-based digital interventions for children with attention-deficit hyperactivity disorder (ADHD) have been developed to alleviate their symptoms. When developing mobile game-based digital interventions for ADHD treatment, it is important to research how the emotional responses of the target audience members-based on flashy visuals or difficulty adjustments to motivate the user-affect their content manipulation ability. This study performed a correlation analysis to examine the impact of perceived difficulty and enjoyment (interest) on the performance of children diagnosed with ADHD while engaging in game-based digital content. Statistically significant differences were observed in the following variables based on the enjoyment level: correct rate (p = 0.0040), decision time (p = 0.0302), difficulty (p < 0.0001), and touch time (p = 0.0249). Considering difficulty level, statistically significant differences were observed for correct rate (p = 0.0011), decision time (p = 0.0158), and difficulty (p < 0.0001). Correlation analysis between the variables correct rate, decision time, difficulty, touch, time limit, and touch time based on enjoyment and difficulty did not reveal significant correlations. Therefore, for children with ADHD, digital interventions should focus on the therapeutic goals rather than on flashy visuals or difficulty adjustments aimed at enhancing interest. Based on these results, further research exploring how psychological states affect performance regarding digital content is necessary.

Background: The COVID-19 pandemic severely impacted healthcare systems, affecting patient outcomes and resource allocation. This study applied automated machine learning (AutoML) to analyze key health outputs, such as discharge conditions, mortality, and COVID-19 cases, with the goal of improving responses to future crises.

Methods: AutoML was used to train and validate models on an ICD-10 dataset covering the first wave of COVID-19 in Romania (January-September 2020).

Results: For discharge outcomes, Light Gradient Boosted models achieved an F1 score of 0.9644, while for mortality 0.7545 was reached. A Generalized Linear Model blender achieved an F1 score of 0.9884 for "acute or emergency" cases, and an average blender reached 0.923 for COVID-19 cases. Older age, specific hospitals, and oncology wards were less associated with improved recovery rates, while mortality was linked to abnormal lab results and cardiovascular/respiratory diseases. Patients admitted without referral, or patients in hospitals in the central region and the capital region of Romania were more likely to be acute cases. Finally, counties such as Argeş (South-Muntenia) and Brașov (Center) showed higher COVID-19 infection rates regardless of age.

Conclusions: AutoML provided valuable insights into patient outcomes, highlighting variations in care and the need for targeted health strategies for both COVID-19 and other health challenges.

Over the last decade, organoid research has emerged as a transformative field in biomedical science, offering unparalleled opportunities in disease modeling, pharmacological testing, and tissue engineering [...].

Intracerebral hemorrhage (ICH) and perihematomal edema (PHE) are key imaging markers of primary and secondary brain injury in hemorrhagic stroke. Accurate segmentation and quantification of ICH and PHE can help with prognostication and guide treatment planning. In this study, we combined Swin-Unet Transformers with nnU-NETv2 convolutional network for segmentation of ICH and PHE on non-contrast head CTs. We also applied test-time data augmentations to assess individual-level prediction uncertainty, ensuring high confidence in prediction. The model was trained on 1782 CT scans from a multicentric trial and tested in two independent datasets from Yale (n = 396) and University of Berlin Charité Hospital and University Medical Center Hamburg-Eppendorf (n = 943). Model performance was evaluated with the Dice coefficient and Volume Similarity (VS). Our dual Swin-nnUNET model achieved a median (95% confidence interval) Dice = 0.93 (0.90-0.95) and VS = 0.97 (0.95-0.98) for ICH, and Dice = 0.70 (0.64-0.75) and VS = 0.87 (0.80-0.93) for PHE segmentation in the Yale cohort. Dice = 0.86 (0.80-0.90) and VS = 0.91 (0.85-0.95) for ICH and Dice = 0.65 (0.56-0.70) and VS = 0.86 (0.77-0.93) for PHE segmentation in the Berlin/Hamburg-Eppendorf cohort. Prediction uncertainty was associated with lower segmentation accuracy, smaller ICH/PHE volumes, and infratentorial location. Our results highlight the benefits of a dual transformer-convolutional neural network architecture for ICH/PHE segmentation and test-time augmentation for uncertainty quantification.

Hemorrhage remains a leading cause of death in both military and civilian trauma settings. Oftentimes, the control and treatment of hemorrhage requires central vascular access and well-trained medical personnel. Automated technology is being developed that can lower the skill threshold for life-saving interventions. Here, we conduct independent evaluation testing of one such device, the Vu-Path™ Ultrasound Guidance system, or Vu-Path™. The device was designed to simplify needle insertion using a needle holder that ensures the needle is within the ultrasound field of view during its insertion into tissue, along with guidance lines shown on the user interface. We evaluated the performance of this device in a range of laboratory, animal, and human testing platforms. Overall, the device had a high success rate, achieving an 83% insertion accuracy in live animal testing across both normal and hypotensive blood pressures. Vu-Path™ was faster than manual, ultrasound-guided needle insertion and was nearly 1.5 times quicker for arterial and 2.3 times quicker for venous access. Human usability feedback highlighted that 80% of the participants would use this device for central line placement. Study users noted that the guidance lines and small form factor were useful design features. However, issues were raised regarding the needle insertion angle being too steep, with potential positioning challenges as the needle remains fixed to the ultrasound probe. Regardless, 75% of the participants believed that personnel with any level of clinical background could use the device for central vascular access. Overall, Vu-Path™ performed well across a range of testing situations, and potential design improvements were noted. With adjustments to the device, central vascular access can be made more accessible on battlefields in the future.

Objectives: Early detection of cardiovascular diseases and their pre-existing conditions, arteriosclerosis and atherosclerosis, is crucial to increasing a patient's chance of survival. While imaging technologies and invasive procedures provide a reliable diagnosis, they carry high costs and risks for patients. This study aims to explore impedance plethysmography (IPG) as a non-invasive and affordable alternative for diagnosis.

Methods: To address the current lack of large-scale, high-quality impedance data, we introduce arterioscope.sim, a simulation platform that models arterial blood flow and computes the electrical conductivity of blood. The platform simulates bioimpedance measurements on specific body segments using patient-specific parameters. The study investigates how introducing arterial diseases into the simulation affects the bioimpedance signals.

Results: The simulation results demonstrate that introducing atherosclerosis and arteriosclerosis leads to significant changes in the computed signals compared to simulations of healthy arteries. Furthermore, simulation of a patient-specific healthy artery strongly correlates with measured signals from a healthy volunteer.

Conclusions and significance: arterioscope.sim effectively simulates bioimpedance signals in healthy and diseased arteries and highlights the potential of using these signals for early diagnosis of arterial diseases, offering a non-invasive and cost-effective alternative to traditional diagnostic methods.

A primary challenge following severe musculoskeletal trauma is incomplete muscle regeneration. Current therapies often fail to heal damaged muscle due to dysregulated healing programs and insufficient revascularization early in the repair process. There is a limited understanding of the temporal changes that occur during the early stages of muscle remodeling in response to engineered therapies. Previous work demonstrated that nanotopographically patterned scaffolds provide cytoskeletal guidance and direct endothelial angiogenic and anti-inflammatory phenotypes. The aim of this study was to evaluate how endothelial cell (EC) patterning guides temporal and histomorphological muscle remodeling after muscle injury. In the current study, mice were treated with EC-laden engineered constructs that exhibited either aligned or random patterning of collagen nanofibrils, following a volumetric muscle loss injury (VML). Remodeling was evaluated at 2, 7, and 21 days post injury. Over the 21-day study, all groups (Acellular Aligned, EC Aligned, EC Random) demonstrated similar significant increases in vascular density and myogenesis. Animals treated with acellular controls demonstrated a two-fold decrease in muscle cross-sectional area between days 2 and 21 post injury, consistent with VML-induced muscle atrophy; however, animals treated with patterned EC-laden constructs exhibited preservation of muscle mass. The implantation of an EC-laden construct led to a 50% increase in the number of animals exhibiting areas of fibrous remodeling adjacent to the construct, along with greater collagen deposition (p < 0.01) compared to acellular controls 21 days post injury. These findings suggest that nanotopographically patterned EC-laden constructs may guide early muscle-protective programs that support muscle mass retention through myo-vascular independent pathways.

For pediatric patients with full-thickness burns, achieving adequate dermal regeneration is essential to prevent inelastic scars that may hinder growth. Traditional autologous split-thickness skin grafts alone often fail to restore the dermal layer adequately. This study evaluates the long-term effect of using a NovoSorb^® Biodegradable Temporizing Matrix (BTM) as a dermal scaffold in four pediatric patients, promoting dermal formation before autografting. Pediatric burn patients treated at the University Children's Hospital Zurich between 2020 and 2022 underwent a two-step treatment involving NovoSorb^® BTM application, followed by autografting. Histological analysis, conducted through 22 punch biopsies taken up to 2.6 years post-application, demonstrated robust dermal reorganization, with mature epidermal regeneration and stable dermo-epidermal connections. Immunofluorescence staining showed rapid capillary ingrowth, while extracellular matrix components, including collagen and elastic fibers, gradually aligned over time, mimicking normal skin structure. By 2.6 years, the dermal layer displayed characteristics close to uninjured skin, with remnants of NovoSorb^® BTM degrading within five months post-application. This study suggests that NovoSorb^® BTM facilitates elastic scar formation, offering significant benefits for pediatric patients by reducing functional limitations associated with inelastic scarring.