Pub Date : 2026-01-20eCollection Date: 2025-01-01DOI: 10.3389/fmedt.2025.1728913
Amit S Padaki, Alexa L Zarzour, Kelly R Keene, Carlo A Canepa, Dana R Levin, Erik L Antonsen
Objectives: To evaluate the accuracy of heart rate and respiratory rate acquired by commercially-available device cameras and software.
Methods: One-hundred and eleven subjects were enrolled at an urban academic teaching hospital in Texas. Heart rate (HR) and respiratory rate (RR) measurements were obtained using three commercially-available cameras and processed using software from Presage Technologies. These values were compared to manual counts of a three-lead ECG and end-tidal CO2 from a patient monitor.
Results: The cameras were able to capture HR in 83% of the measurements and RR in 94% of the RR measurements. Camera-acquired HR showed an extremely high correlation with R∼0.99 and a root-mean-square error (RMSE) of 1.62. Respiratory rate showed a high correlation with R∼0.91 and an RMSE of 1.71.
Conclusions: Heart rate and respiratory rate can be accurately acquired using commercially-available camera devices and software for signal processing.
{"title":"Clinical validation of non-contact vital signs in an emergency department setting.","authors":"Amit S Padaki, Alexa L Zarzour, Kelly R Keene, Carlo A Canepa, Dana R Levin, Erik L Antonsen","doi":"10.3389/fmedt.2025.1728913","DOIUrl":"10.3389/fmedt.2025.1728913","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the accuracy of heart rate and respiratory rate acquired by commercially-available device cameras and software.</p><p><strong>Methods: </strong>One-hundred and eleven subjects were enrolled at an urban academic teaching hospital in Texas. Heart rate (HR) and respiratory rate (RR) measurements were obtained using three commercially-available cameras and processed using software from Presage Technologies. These values were compared to manual counts of a three-lead ECG and end-tidal CO2 from a patient monitor.</p><p><strong>Results: </strong>The cameras were able to capture HR in 83% of the measurements and RR in 94% of the RR measurements. Camera-acquired HR showed an extremely high correlation with R∼0.99 and a root-mean-square error (RMSE) of 1.62. Respiratory rate showed a high correlation with R∼0.91 and an RMSE of 1.71.</p><p><strong>Conclusions: </strong>Heart rate and respiratory rate can be accurately acquired using commercially-available camera devices and software for signal processing.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"7 ","pages":"1728913"},"PeriodicalIF":3.8,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12864396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-16eCollection Date: 2025-01-01DOI: 10.3389/fmedt.2025.1756558
Belen R Ballester, Matthew Reaney, Christina Mack, Salma Ajraoui
[This corrects the article DOI: 10.3389/fmedt.2025.1567537.].
[这更正了文章DOI: 10.3389/fmedt.2025.1567537.]。
{"title":"Correction: A hybrid, iterative approach, to support the development of fit-for-purpose sensor-derived measures.","authors":"Belen R Ballester, Matthew Reaney, Christina Mack, Salma Ajraoui","doi":"10.3389/fmedt.2025.1756558","DOIUrl":"https://doi.org/10.3389/fmedt.2025.1756558","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fmedt.2025.1567537.].</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"7 ","pages":"1756558"},"PeriodicalIF":3.8,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13eCollection Date: 2025-01-01DOI: 10.3389/fmedt.2025.1748577
Yijiao Wu, Yuzhuo Yang, Xudong Pan, Shunzhou Yu
Background: Ventricular assist devices (VADs) are an effective treatment for end-stage heart failure and can significantly improve patients' quality of life. However, when the rotational speed of the VAD does not match the intraventricular blood volume, ventricular suction may occur. Severe suction can lead to ventricular collapse, making accurate and real-time suction detection critically important.
Methods: Two statistical features and two frequency-domain features were extracted from the pump flow signal to build a classification and regression tree (CART) model. Additionally, a secondary decision-making process was applied using a time-domain threshold.
Results: The proposed method was validated using both in vivo and in vitro experimental data. Experimental results show that, compared to existing suction detection techniques, the proposed approach not only reduces computational complexity but also achieves higher detection accuracy and enhanced algorithmic stability.
Conclusions: The proposed method provides a more efficient and reliable solution for real-time ventricular suction detection, which is crucial for the safe operation of VADs in clinical settings.
{"title":"Ventricular suction detection algorithm designed for ventricular assist devices.","authors":"Yijiao Wu, Yuzhuo Yang, Xudong Pan, Shunzhou Yu","doi":"10.3389/fmedt.2025.1748577","DOIUrl":"https://doi.org/10.3389/fmedt.2025.1748577","url":null,"abstract":"<p><strong>Background: </strong>Ventricular assist devices (VADs) are an effective treatment for end-stage heart failure and can significantly improve patients' quality of life. However, when the rotational speed of the VAD does not match the intraventricular blood volume, ventricular suction may occur. Severe suction can lead to ventricular collapse, making accurate and real-time suction detection critically important.</p><p><strong>Methods: </strong>Two statistical features and two frequency-domain features were extracted from the pump flow signal to build a classification and regression tree (CART) model. Additionally, a secondary decision-making process was applied using a time-domain threshold.</p><p><strong>Results: </strong>The proposed method was validated using both <i>in vivo</i> and <i>in vitro</i> experimental data. Experimental results show that, compared to existing suction detection techniques, the proposed approach not only reduces computational complexity but also achieves higher detection accuracy and enhanced algorithmic stability.</p><p><strong>Conclusions: </strong>The proposed method provides a more efficient and reliable solution for real-time ventricular suction detection, which is crucial for the safe operation of VADs in clinical settings.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"7 ","pages":"1748577"},"PeriodicalIF":3.8,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146095383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-12eCollection Date: 2025-01-01DOI: 10.3389/fmedt.2025.1683835
Zaher Nahle
In 2025, three U.S. agencies within the Department of Health and Human Services (FDA, NIH, CDC) alongside EPA and the Departments of the Navy and Veterans Affairs, began substituting animal testing applications with reliable, human-relevant methods. The impact of this shift in public policy taking place at agencies historically bullish on animal testing is still reverberating in the United States and around the world. Here, we examine the circumstances that enabled such momentous reforms, including the role of the FDA Modernization Act 2.0 in advancing new alternative methods, collectively referred to as NAMs. We explain how animal testing, despite its poor value in predicting the safety and efficacy of drugs in humans, came to dominate drug discovery, basic sciences, and environmental toxicity assessments since the inception of the Federal Food, Drug, and Cosmetic Act (Federal FD&C Act) in 1938. Specifically, we identify critical junctures, including catastrophic government decisions, that made the overall research enterprise acutely dependent on animals, leading to the existing predicament-an indefensible 92% failure rate in translating drugs from preclinical studies to actual therapies. Notably, our analysis chronicles events through the lens of "path dependency," a social sciences phenomenon that occurs when faulty past decisions lock-in future action. Finally, we recognize that our narrative is a departure from the medical establishment account or the talking points of powerful interest groups, including some in the academic elite who continue to shore up animal-centric paradigms in drug development for reasons we also outline.
2025年,美国卫生与公众服务部的三个机构(FDA、NIH、CDC)以及EPA、海军和退伍军人事务部开始用可靠的、与人类相关的方法取代动物试验应用。这一公共政策转变的影响,发生在历来看好动物试验的机构,至今仍在美国和世界各地引起反响。在这里,我们研究了促成这些重大改革的环境,包括FDA现代化法案2.0在推进新的替代方法方面的作用,统称为NAMs。尽管动物实验在预测药物对人类的安全性和有效性方面价值不高,但我们解释了自1938年《联邦食品、药品和化妆品法案》(Federal Food, drug, and Cosmetic Act,简称FD&C Act)颁布以来,动物实验是如何主导药物发现、基础科学和环境毒性评估的。具体来说,我们确定了关键时刻,包括灾难性的政府决策,这使得整个研究企业严重依赖于动物,导致了现有的困境——在将药物从临床前研究转化为实际治疗方面,高达92%的失败率是不可辩护的。值得注意的是,我们的分析通过“路径依赖”的视角来记录事件,这是一种社会科学现象,发生在错误的过去决定锁定未来行动时。最后,我们认识到,我们的叙述偏离了医疗机构的叙述或强大利益集团的谈话要点,包括一些学术精英,他们继续支持以动物为中心的药物开发范式,原因我们也概述了。
{"title":"Path dependency and the rescuing of the biomedical research enterprise.","authors":"Zaher Nahle","doi":"10.3389/fmedt.2025.1683835","DOIUrl":"10.3389/fmedt.2025.1683835","url":null,"abstract":"<p><p>In 2025, three U.S. agencies within the Department of Health and Human Services (FDA, NIH, CDC) alongside EPA and the Departments of the Navy and Veterans Affairs, began substituting animal testing applications with reliable, human-relevant methods. The impact of this shift in public policy taking place at agencies historically bullish on animal testing is still reverberating in the United States and around the world. Here, we examine the circumstances that enabled such momentous reforms, including the role of the FDA Modernization Act 2.0 in advancing new alternative methods, collectively referred to as NAMs. We explain how animal testing, despite its poor value in predicting the safety and efficacy of drugs in humans, came to dominate drug discovery, basic sciences, and environmental toxicity assessments since the inception of the Federal Food, Drug, and Cosmetic Act (Federal FD&C Act) in 1938. Specifically, we identify critical junctures, including catastrophic government decisions, that made the overall research enterprise acutely dependent on animals, leading to the existing predicament-an indefensible 92% failure rate in translating drugs from preclinical studies to actual therapies. Notably, our analysis chronicles events through the lens of \"path dependency,\" a social sciences phenomenon that occurs when faulty past decisions lock-in future action. Finally, we recognize that our narrative is a departure from the medical establishment account or the talking points of powerful interest groups, including some in the academic elite who continue to shore up animal-centric paradigms in drug development for reasons we also outline.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"7 ","pages":"1683835"},"PeriodicalIF":3.8,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12832638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-09eCollection Date: 2025-01-01DOI: 10.3389/fmedt.2025.1702201
Philipp Nolte, Chris Johann Ackurat, Marcel Brettmacher, Marius Reichardt, Marieke Stammes, Christoph Rußmann, Christian Dullin
Introduction: Phantoms and reference structures are essential tools for calibration and correlative imaging in pre-clinical and research applications of X-ray-based imaging. They serve as reference standards, ensuring consistency and accuracy in imaging results. However, generating individual phantoms often involves a complex creation process, high production costs, and significant time investment.
Material and methods: Conic reference structures were 3D printed using a mixture of UV-curable resin and X-ray contrast agents. These structures were then embedded together with lung specimens of SARS-CoV-2-infected rhesus macaques in a methyl methacrylate-based solution. The polymerized blocks were scanned using propagation-based phase-contrast microCT, a method chosen for its superior ability to enhance contrast, especially in low-absorbing biological samples. Utilizing the conic reference structures, subsequently performed histological sections were co-registered into the 3D context of the microCT datasets.
Results: The produced 3D printed models were highly visible in terms of contrast and detail in both imaging methods, allowing for a precise co-registration of microCT and histological imaging.
Conclusions: The novel methodology of using contrast agents and resin in 3D printing enables the generation of customizable, contrast-specific phantoms and reference structures. These can be straightforwardly segmented from the embedding material, significantly simplifying and enhancing the workflow of multimodal imaging processes. In this study, 3D printed conic reference structures were effectively used to automate and streamline the precise multimodal fusion of microCT and histological imaging.
{"title":"X-ray contrast-adjustable 3D printing for multimodal fusion of microCT and histology.","authors":"Philipp Nolte, Chris Johann Ackurat, Marcel Brettmacher, Marius Reichardt, Marieke Stammes, Christoph Rußmann, Christian Dullin","doi":"10.3389/fmedt.2025.1702201","DOIUrl":"10.3389/fmedt.2025.1702201","url":null,"abstract":"<p><strong>Introduction: </strong>Phantoms and reference structures are essential tools for calibration and correlative imaging in pre-clinical and research applications of X-ray-based imaging. They serve as reference standards, ensuring consistency and accuracy in imaging results. However, generating individual phantoms often involves a complex creation process, high production costs, and significant time investment.</p><p><strong>Material and methods: </strong>Conic reference structures were 3D printed using a mixture of UV-curable resin and X-ray contrast agents. These structures were then embedded together with lung specimens of SARS-CoV-2-infected rhesus macaques in a methyl methacrylate-based solution. The polymerized blocks were scanned using propagation-based phase-contrast microCT, a method chosen for its superior ability to enhance contrast, especially in low-absorbing biological samples. Utilizing the conic reference structures, subsequently performed histological sections were co-registered into the 3D context of the microCT datasets.</p><p><strong>Results: </strong>The produced 3D printed models were highly visible in terms of contrast and detail in both imaging methods, allowing for a precise co-registration of microCT and histological imaging.</p><p><strong>Conclusions: </strong>The novel methodology of using contrast agents and resin in 3D printing enables the generation of customizable, contrast-specific phantoms and reference structures. These can be straightforwardly segmented from the embedding material, significantly simplifying and enhancing the workflow of multimodal imaging processes. In this study, 3D printed conic reference structures were effectively used to automate and streamline the precise multimodal fusion of microCT and histological imaging.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"7 ","pages":"1702201"},"PeriodicalIF":3.8,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12827677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-09eCollection Date: 2025-01-01DOI: 10.3389/fmedt.2025.1678192
Qingchao Zhu, Nengquan Sheng, Zhigang Wang, Yang Xia
Objective: This study aims to evaluate the clinical efficacy of laparoscopic hiatal hernia repair (LHHR) in treating gastroesophageal reflux disease (GERD) and to through the therapeutic effect of total (360°) and partial (270°) laparoscopic fundoplication.
Methods: This retrospective observational study enrolled 100 patients, both with and without documented extra-oesophageal symptoms of GERD. Data were extracted from medical records, covering basic information, symptoms, treatments, and follow-up. Symptom relief and quality of life were assessed via GERD-Q score, Reflux Symptom Index (RSI), and EORTC QLQ-C30 scale, offering a foundation for comprehensive GERD patient management and treatment evaluation in clinical practice.
Results: The DeMeester index significantly decreased postoperatively in both the laparoscopic Nissen fundoplication (LNF) group (from 55.23 ± 25.12 to 11.45 ± 10.20, p < 0.05) and the laparoscopic Toupet fundoplication (LTF) group (from 60.51 ± 28.40 to 11.70 ± 9.65, p < 0.05). The RSI scores improved at 12 months postoperatively in both groups: LNF group (from 23.1 ± 15.4 to 13.7 ± 9.6, p < 0.05) and LTF group (from 21.9 ± 15.8 to 12.8 ± 8.2, p < 0.05). The GERD scores also improved postoperatively: LNF group (from 13 ± 5.0 to 10 ± 4.4, p < 0.05) and LTF group (from 10 ± 4.7 to 7.5 ± 4.5, p < 0.05).
Conclusion: Our report demonstrates that LHHR significantly improved GERD regarding symptom frequency, acid reflux occurrences and DeMeester score. Both LNF and LTF provide good results.
目的:本研究旨在评价腹腔镜裂孔疝修补术(LHHR)治疗胃食管反流病(GERD)的临床疗效,并通过全(360°)和部分(270°)腹腔镜翻底术的治疗效果进行比较。方法:这项回顾性观察性研究纳入了100例患者,包括有或没有食管外症状的胃食管反流。数据从医疗记录中提取,包括基本信息、症状、治疗和随访。采用GERD- q评分、反流症状指数(RSI)和EORTC QLQ-C30量表评估患者的症状缓解和生活质量,为临床对GERD患者进行综合管理和治疗评价提供依据。结果:两组患者术后DeMeester指数均显著降低(从55.23±25.12降至11.45±10.20,p p p p p p p p)。结论:我们的报告显示,LHHR在症状频率、胃酸反流发生率和DeMeester评分方面均显著改善了GERD。LNF和LTF都提供了良好的结果。
{"title":"Comparison of Nissen vs. Toupet fundoplication in laparoscopic hiatal hernia repair for gastroesophageal reflux disease with extra-esophageal symptoms.","authors":"Qingchao Zhu, Nengquan Sheng, Zhigang Wang, Yang Xia","doi":"10.3389/fmedt.2025.1678192","DOIUrl":"10.3389/fmedt.2025.1678192","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the clinical efficacy of laparoscopic hiatal hernia repair (LHHR) in treating gastroesophageal reflux disease (GERD) and to through the therapeutic effect of total (360°) and partial (270°) laparoscopic fundoplication.</p><p><strong>Methods: </strong>This retrospective observational study enrolled 100 patients, both with and without documented extra-oesophageal symptoms of GERD. Data were extracted from medical records, covering basic information, symptoms, treatments, and follow-up. Symptom relief and quality of life were assessed via GERD-Q score, Reflux Symptom Index (RSI), and EORTC QLQ-C30 scale, offering a foundation for comprehensive GERD patient management and treatment evaluation in clinical practice.</p><p><strong>Results: </strong>The DeMeester index significantly decreased postoperatively in both the laparoscopic Nissen fundoplication (LNF) group (from 55.23 ± 25.12 to 11.45 ± 10.20, <i>p</i> < 0.05) and the laparoscopic Toupet fundoplication (LTF) group (from 60.51 ± 28.40 to 11.70 ± 9.65, <i>p</i> < 0.05). The RSI scores improved at 12 months postoperatively in both groups: LNF group (from 23.1 ± 15.4 to 13.7 ± 9.6, <i>p</i> < 0.05) and LTF group (from 21.9 ± 15.8 to 12.8 ± 8.2, <i>p</i> < 0.05). The GERD scores also improved postoperatively: LNF group (from 13 ± 5.0 to 10 ± 4.4, <i>p</i> < 0.05) and LTF group (from 10 ± 4.7 to 7.5 ± 4.5, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Our report demonstrates that LHHR significantly improved GERD regarding symptom frequency, acid reflux occurrences and DeMeester score. Both LNF and LTF provide good results.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"7 ","pages":"1678192"},"PeriodicalIF":3.8,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12827679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-06eCollection Date: 2025-01-01DOI: 10.3389/fmedt.2025.1693030
Stefan Schob, Jörg Ukkat, Gregor Scharf, Yvonne Maybaum, Lea Tauber, Clara Lüdeke, Endres John, Karl Julius Büchner, Robert Fiedler, Christian Frahm, Mathias Wieprecht, Silvio Brandt, Mohamed Alsabbagh, Ararat Minasyan, Andreas Simgen, Richard Brill, Jakob Albrecht, Walter Alexander Wohlgemuth, Maximilian de Bucourt, Marie-Sophie Schüngel
<p><strong>Purpose: </strong>Endovascular treatment of visceral and peripheral aneurysms has become the modality of choice over the past few decades. A variety of different techniques are being applied, including deconstructive approaches, such as parent vessel occlusion with coils or liquid embolic agents, and reconstructive approaches, such as stent grafting, stent-assisted coiling, or balloon-assisted coiling. Reconstruction is preferred over vessel or segmental sacrifice due to the risk of ischemia in the dependent territory. However, conventional reconstructive techniques fail, possibly due to the tortuosity of the parent artery or involvement of arterial bifurcations. Flow diversion, a comparatively novel method using densely braided stents, has become well established as a therapeutic option for the treatment of uncoilable or failed aneurysms in cerebral circulation because flow diverter stents can be implanted in highly tortuous vessels and can also be used to treat bifurcation aneurysms without causing occlusion of non-collateralized side branches under sufficient inhibition of platelet function. A few reports have been published on the use of flow diverter stents for the treatment of aneurysms in visceral or peripheral circulation, but systematic studies are lacking. The purpose of this multicenter study is to summarize the experience of different vascular centers that have utilized flow diversion techniques in peripheral vasculature.</p><p><strong>Materials and methods: </strong>This multicentric retrospective analysis includes data from 10 vascular centers on treatments performed between 2022 and 2025. Aside from the safety and feasibility of the approach, procedural aspects, antiplatelet medication, follow-up results, and complications were investigated in a retrospective manner.</p><p><strong>Results: </strong>A total of 36 patients (22 female, with a mean age of 59.2 years, ranging between 36 and 80 years), one with two aneurysms, were treated in the following arterial territories with decreasing frequency: splenic artery (<i>n</i> = 18), hepatic arteries (<i>n</i> = 8), renal artery (<i>n</i> = 7), superior mesenteric artery (<i>n</i> = 1), gastroduodenal artery (<i>n</i> = 1), external iliac artery (<i>n</i> = 1), and inferior genicular artery (<i>n</i> = 1). From a technical perspective, all treatments were performed successfully. A total of four aneurysms (11%) were occluded immediately at the end of the procedure, while in 33 aneurysms (89%), the perfusion was reduced to a varying extent. At the first follow-up study scheduled after 3 months, 17 aneurysms (46%) were occluded, 14 (38%) showed reduced perfusion, and the remaining six patients had not yet undergone follow-up. At 12 months following the procedure, 26 patients with lesions underwent follow-up. A total of 27 aneurysms (73%) were occluded after 12 months, with 17 of them already examined at the 3-month study, two of those without a follow-up at 3 months and one exhib
{"title":"The treatment of challenging visceral and peripheral arterial aneurysms with flow diversion-a German multicentric observational study.","authors":"Stefan Schob, Jörg Ukkat, Gregor Scharf, Yvonne Maybaum, Lea Tauber, Clara Lüdeke, Endres John, Karl Julius Büchner, Robert Fiedler, Christian Frahm, Mathias Wieprecht, Silvio Brandt, Mohamed Alsabbagh, Ararat Minasyan, Andreas Simgen, Richard Brill, Jakob Albrecht, Walter Alexander Wohlgemuth, Maximilian de Bucourt, Marie-Sophie Schüngel","doi":"10.3389/fmedt.2025.1693030","DOIUrl":"10.3389/fmedt.2025.1693030","url":null,"abstract":"<p><strong>Purpose: </strong>Endovascular treatment of visceral and peripheral aneurysms has become the modality of choice over the past few decades. A variety of different techniques are being applied, including deconstructive approaches, such as parent vessel occlusion with coils or liquid embolic agents, and reconstructive approaches, such as stent grafting, stent-assisted coiling, or balloon-assisted coiling. Reconstruction is preferred over vessel or segmental sacrifice due to the risk of ischemia in the dependent territory. However, conventional reconstructive techniques fail, possibly due to the tortuosity of the parent artery or involvement of arterial bifurcations. Flow diversion, a comparatively novel method using densely braided stents, has become well established as a therapeutic option for the treatment of uncoilable or failed aneurysms in cerebral circulation because flow diverter stents can be implanted in highly tortuous vessels and can also be used to treat bifurcation aneurysms without causing occlusion of non-collateralized side branches under sufficient inhibition of platelet function. A few reports have been published on the use of flow diverter stents for the treatment of aneurysms in visceral or peripheral circulation, but systematic studies are lacking. The purpose of this multicenter study is to summarize the experience of different vascular centers that have utilized flow diversion techniques in peripheral vasculature.</p><p><strong>Materials and methods: </strong>This multicentric retrospective analysis includes data from 10 vascular centers on treatments performed between 2022 and 2025. Aside from the safety and feasibility of the approach, procedural aspects, antiplatelet medication, follow-up results, and complications were investigated in a retrospective manner.</p><p><strong>Results: </strong>A total of 36 patients (22 female, with a mean age of 59.2 years, ranging between 36 and 80 years), one with two aneurysms, were treated in the following arterial territories with decreasing frequency: splenic artery (<i>n</i> = 18), hepatic arteries (<i>n</i> = 8), renal artery (<i>n</i> = 7), superior mesenteric artery (<i>n</i> = 1), gastroduodenal artery (<i>n</i> = 1), external iliac artery (<i>n</i> = 1), and inferior genicular artery (<i>n</i> = 1). From a technical perspective, all treatments were performed successfully. A total of four aneurysms (11%) were occluded immediately at the end of the procedure, while in 33 aneurysms (89%), the perfusion was reduced to a varying extent. At the first follow-up study scheduled after 3 months, 17 aneurysms (46%) were occluded, 14 (38%) showed reduced perfusion, and the remaining six patients had not yet undergone follow-up. At 12 months following the procedure, 26 patients with lesions underwent follow-up. A total of 27 aneurysms (73%) were occluded after 12 months, with 17 of them already examined at the 3-month study, two of those without a follow-up at 3 months and one exhib","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"7 ","pages":"1693030"},"PeriodicalIF":3.8,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18eCollection Date: 2025-01-01DOI: 10.3389/fmedt.2025.1715676
Runci Li, Sarah R Needham, Igor Kraev, Mariya Hristova, Sigrun Lange
Neonatal hypoxia ischaemia (HI) affects 1-3 per 1,000 live births, is a major cause of infant mortality and morbidity, and leads to adverse long-term neurological outcomes, while reliable biomarkers are scarce. Extracellular vesicles (EVs) are small membrane vesicles released from cells and play key roles in cellular communication through the transfer of diverse cargoes, including proteins, and can be isolated from various body fluids. Here, we developed a new non-invasive method of biofluid-EV profiling, isolating EVs from eye lavage. Our data demonstrate that in a neonatal HI mouse model of mild and severe insults, significant differences are found in EV eye lavage signatures. We identified increased EV numbers and modifications in EV size profiles and EV's proteomic cargo signatures in eye lavage from HI animals compared to controls. A protein-protein interaction network analysis of the EV proteome cargoes identified enrichment in Gene Ontology and Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathways in the HI groups associated with various homeostatic and disease-related pathways. The specific changes in the mild HI group included pathways for ribosome biogenesis, translation, RNA processing, gene expression, blood coagulation, innate immunity, antioxidant activity, phospholipid binding, post-synapse, cell cortex, and HIF-1 signalling. The enriched pathways only associated with the EV proteome of the severe HI group included cytoskeleton organisation, peptide cross-linking, monosaccharide biosynthesis, peroxidase activity, extrinsic component of plasma membrane, the GAIT complex, mast cell granulation, ruffle, and sealing of the nuclear envelope by the endosomal sorting complex required for transport III. Here, we report a new non-invasive method using eye lavage EV signatures to identify changes in response to HI. Our results highlight eye lavage EVs as potential clinical biomarkers for predicting changes that occur in the brain and eye due to different neonatal HI injury severities.
{"title":"Extracellular vesicle signatures from eye lavage as novel non-invasive biomarkers for hypoxic ischaemic insult-findings from a neonatal mouse model.","authors":"Runci Li, Sarah R Needham, Igor Kraev, Mariya Hristova, Sigrun Lange","doi":"10.3389/fmedt.2025.1715676","DOIUrl":"10.3389/fmedt.2025.1715676","url":null,"abstract":"<p><p>Neonatal hypoxia ischaemia (HI) affects 1-3 per 1,000 live births, is a major cause of infant mortality and morbidity, and leads to adverse long-term neurological outcomes, while reliable biomarkers are scarce. Extracellular vesicles (EVs) are small membrane vesicles released from cells and play key roles in cellular communication through the transfer of diverse cargoes, including proteins, and can be isolated from various body fluids. Here, we developed a new non-invasive method of biofluid-EV profiling, isolating EVs from eye lavage. Our data demonstrate that in a neonatal HI mouse model of mild and severe insults, significant differences are found in EV eye lavage signatures. We identified increased EV numbers and modifications in EV size profiles and EV's proteomic cargo signatures in eye lavage from HI animals compared to controls. A protein-protein interaction network analysis of the EV proteome cargoes identified enrichment in Gene Ontology and Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathways in the HI groups associated with various homeostatic and disease-related pathways. The specific changes in the mild HI group included pathways for ribosome biogenesis, translation, RNA processing, gene expression, blood coagulation, innate immunity, antioxidant activity, phospholipid binding, post-synapse, cell cortex, and HIF-1 signalling. The enriched pathways only associated with the EV proteome of the severe HI group included cytoskeleton organisation, peptide cross-linking, monosaccharide biosynthesis, peroxidase activity, extrinsic component of plasma membrane, the GAIT complex, mast cell granulation, ruffle, and sealing of the nuclear envelope by the endosomal sorting complex required for transport III. Here, we report a new non-invasive method using eye lavage EV signatures to identify changes in response to HI. Our results highlight eye lavage EVs as potential clinical biomarkers for predicting changes that occur in the brain and eye due to different neonatal HI injury severities.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"7 ","pages":"1715676"},"PeriodicalIF":3.8,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12756510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18eCollection Date: 2025-01-01DOI: 10.3389/fmedt.2025.1686131
Davide Astori, Francesco Sturla, Alessandro Caimi, Francesco Secchi, Luca Giugno, Alberto Redaelli, Mario Carminati, Emiliano Votta
Background and objective: Calcific obstruction of the pulmonary conduit is a late complication of surgical implantation of a homograft in congenital patients. Percutaneous pulmonary valve implantation (PPVI) is an effective alternative to surgical repair. However, this procedure is affected by several complications, with coronary artery (CA) compression being one of the most severe. High-fidelity finite element (FE) models can provide accurate predictions but are too computationally expensive for routine use, whereas simplified models sacrifice mechanical fidelity. This study proposes a novel FE-based framework to investigate conduit pre-stenting feasibility, while aiming to balance computational efficiency with predictive accuracy within clinically relevant timelines.
Methods: A semi-automated pipeline was developed, requiring manual input only for the segmentation of computed tomography (CT), virtual stent positioning, and simulation launch. Patient-specific geometries were meshed and processed through an automated in-house script, generating ready-to-run Abaqus input files. A multifactorial CA compression risk index was introduced, integrating baseline and post-expansion distances between the pulmonary artery and CA, and their changes during the procedure. The FE simulation of the pre-stenting procedure was tested on 10 PPVI candidates, simulating CP-stent implantation. Simulation accuracy was assessed against fluoroscopy-derived stent diameters.
Results: The full simulation process required less than 10 h per case, with minimal operator workload. FE-predicted stent configuration showed strong agreement with fluoroscopic measurements ( = 0.87), with a mean absolute error of 3.5 4.4%. Accuracy was highest in patients with calcific volumes <0.8 (error <0.5 mm). CA compression index identified 2 high-risk, 2 moderate-risk, and 6 negligible-risk patients. Peri-procedural fluoroscopy was not available for one negligible-risk patient; it excluded CA compression for the remaining negligible-risk patients (true negatives), for all moderate-risk patients, and for one high-risk patient (false positive); it highlighted CA compression for the remaining high-risk patient (true positive).
Conclusions: The proposed FE simulation framework enables patient-specific prediction of stent configuration and CA compression risk within clinically compatible timelines. The balanced trade-off between mechanical fidelity and computational efficiency supports its potential integration into pre-procedural planning of conduit pre-stenting and PPVI.
{"title":"FE-based risk assessment of coronary artery compression in pulmonary conduit pre-stenting: optimizing the balance between time-expense and reliability.","authors":"Davide Astori, Francesco Sturla, Alessandro Caimi, Francesco Secchi, Luca Giugno, Alberto Redaelli, Mario Carminati, Emiliano Votta","doi":"10.3389/fmedt.2025.1686131","DOIUrl":"10.3389/fmedt.2025.1686131","url":null,"abstract":"<p><strong>Background and objective: </strong>Calcific obstruction of the pulmonary conduit is a late complication of surgical implantation of a homograft in congenital patients. Percutaneous pulmonary valve implantation (PPVI) is an effective alternative to surgical repair. However, this procedure is affected by several complications, with coronary artery (CA) compression being one of the most severe. High-fidelity finite element (FE) models can provide accurate predictions but are too computationally expensive for routine use, whereas simplified models sacrifice mechanical fidelity. This study proposes a novel FE-based framework to investigate conduit pre-stenting feasibility, while aiming to balance computational efficiency with predictive accuracy within clinically relevant timelines.</p><p><strong>Methods: </strong>A semi-automated pipeline was developed, requiring manual input only for the segmentation of computed tomography (CT), virtual stent positioning, and simulation launch. Patient-specific geometries were meshed and processed through an automated <i>in-house</i> script, generating ready-to-run Abaqus input files. A multifactorial CA compression risk index was introduced, integrating baseline and post-expansion distances between the pulmonary artery and CA, and their changes during the procedure. The FE simulation of the pre-stenting procedure was tested on 10 PPVI candidates, simulating CP-stent implantation. Simulation accuracy was assessed against fluoroscopy-derived stent diameters.</p><p><strong>Results: </strong>The full simulation process required less than 10 h per case, with minimal operator workload. FE-predicted stent configuration showed strong agreement with fluoroscopic measurements ( <math><msup><mi>R</mi> <mn>2</mn></msup> </math> = 0.87), with a mean absolute error of 3.5 <math><mo>±</mo></math> 4.4%. Accuracy was highest in patients with calcific volumes <0.8 <math> <msup><mrow><mi>cm</mi></mrow> <mn>3</mn></msup> </math> (error <0.5 mm). CA compression index identified 2 high-risk, 2 moderate-risk, and 6 negligible-risk patients. Peri-procedural fluoroscopy was not available for one negligible-risk patient; it excluded CA compression for the remaining negligible-risk patients (true negatives), for all moderate-risk patients, and for one high-risk patient (false positive); it highlighted CA compression for the remaining high-risk patient (true positive).</p><p><strong>Conclusions: </strong>The proposed FE simulation framework enables patient-specific prediction of stent configuration and CA compression risk within clinically compatible timelines. The balanced trade-off between mechanical fidelity and computational efficiency supports its potential integration into pre-procedural planning of conduit pre-stenting and PPVI.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"7 ","pages":"1686131"},"PeriodicalIF":3.8,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12756087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-12eCollection Date: 2025-01-01DOI: 10.3389/fmedt.2025.1751147
Ali Asger Bhojiya, Abhinav Saurabh, Devendra Jain
{"title":"Editorial: Microbial therapeutics: harnessing the human microbiome for disease treatment and prevention.","authors":"Ali Asger Bhojiya, Abhinav Saurabh, Devendra Jain","doi":"10.3389/fmedt.2025.1751147","DOIUrl":"https://doi.org/10.3389/fmedt.2025.1751147","url":null,"abstract":"","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"7 ","pages":"1751147"},"PeriodicalIF":3.8,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12741119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145852017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}