Alex Gaudio, Noemi Giordano, Mounya Elhilali, Samuel Schmidt, Francesco Renna
{"title":"Pulmonary Hypertension Detection from Heart Sound Analysis.","authors":"Alex Gaudio, Noemi Giordano, Mounya Elhilali, Samuel Schmidt, Francesco Renna","doi":"10.1109/TBME.2025.3555549","DOIUrl":"https://doi.org/10.1109/TBME.2025.3555549","url":null,"abstract":"<p><p>The detection of Pulmonary Hypertension (PH) from the computer analysis of digitized heart sounds is a low-cost and non-invasive solution for early PH detection and screening. We present an extensive cross-domain evaluation methodology with varying animals (humans and porcine animals) and varying auscultation technologies (phonocardiography and seisomocardiography) evaluated across four methods. We introduce PH-ELM, a resource-efficient PH detection model based on the extreme learning machine that is smaller ( fewer parameters), energy efficient ( fewer watts of power), faster ( faster to train, faster at inference), and more accurate on out-of-distribution testing (improves median accuracy by 0.09 area under the ROC curve (auROC)) in comparison to a previously best performing deep network. We make four observations from our analysis: (a) digital auscultation is a promising technology for the detection of pulmonary hypertension; (b) seismocardiography (SCG) signals and phonocardiography (PCG) signals are interchangeable to train PH detectors; (c) porcine heart sounds in the training data can be used to evaluate PH from human heart sounds (the PH-ELM model preserves 88 to of the best in-distribution baseline performance); (d) predictive performance of PH detection can be mostly preserved with as few as 10 heartbeats and capturing up to approximately 200 heartbeats per subject can improve performance.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An Exploration of the Electrocorticogram Signatures Evoked by Ultrasound Thalamus Stimulation Under Isoflurane Anesthesia in Rats.","authors":"Zhijie Wang, Zhiwei Li, Yingwei Li, Gengsheng Mao, Xiaoli Li, Zhenhu Liang","doi":"10.1109/TBME.2025.3555648","DOIUrl":"https://doi.org/10.1109/TBME.2025.3555648","url":null,"abstract":"<p><strong>Objective: </strong>The transcranial ultrasound stimulation (TUS) on the thalamus can indirectly induce cortical response. Studies have shown that general anesthetic induced unconsciousness is related to interruption of thalamocortical connectivity. However, the neural mechanism of how anesthesia levels influence cortical responses during ultrasound thalamus stimulation has never been explored yet. And it remains unknown what cortical responses signatures are evoked by ultrasound thalamus stimulation under different anesthesia levels.</p><p><strong>Methods: </strong>We recorded multichannel electrocorticogram (ECoG) evoked by ultrasound thalamus stimulation of rats at various isoflurane concentrations (i.e., 0.5%, 1.0%, 1.5%, and 2.0% (v/v)). We analyzed ECoG signatures in temporal, spatial, and frequency domains by using the ultrasound-evoked potentials (UEPs), omega complexity (OC), and phase amplitude coupling (PAC), respectively.</p><p><strong>Results: </strong>The pattern of UEPs was influenced by the anesthesia level, and the response amplitude of UEPs increased with the increase in anesthesia level (0.5% vs. 1.0% and 1.5% (v/v), p<0.05). . Also, the OC of stimulated ECoG decreased with the increase in anesthesia level (at the 1.0%, 1.5% and 2.0% (v/v), p<0.05). and the modulation index of PAC was anesthesia level-dependent.</p><p><strong>Conclusion: </strong>The cortical response induced by ultrasound thalamus stimulation is related to the anesthesia level. TUS on the thalamus combined with ECoG (TUS-ECoG) may be a potential non-invasive neuromodulation approach for understanding consciousness.</p><p><strong>Significance: </strong>This work supplied further implications on the neuromodulatory mechanisms and evaluative applications of TUS under general anesthesia.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A McDonald-Bowyer, L Caciolli, S El-Sheikh, J Opie, R Barod, D Stoyanov, A Stilli
{"title":"Comparison Between the PAF Rail and Surgical Instruments for Organ Manipulation in Laparoscopic and Robotic Surgery: A Randomised Cross-Over Usability Study.","authors":"A McDonald-Bowyer, L Caciolli, S El-Sheikh, J Opie, R Barod, D Stoyanov, A Stilli","doi":"10.1109/TBME.2025.3552900","DOIUrl":"https://doi.org/10.1109/TBME.2025.3552900","url":null,"abstract":"<p><p>This study evaluates the usability and workload associated with the pneumatically attachable flexible (PAF) rail, a soft robotic device designed for safer organ manipulation and retraction during robotic-assisted partial nephrectomy (RAPN) and other laparoscopic procedures. Fourteen expert robotic and laparoscopic surgeons performed a simulated surgical retraction task using the PAF rail and standard surgical instruments. Usability was assessed using the System Usability Scale (SUS), and workload was measured with the NASA-TLX. Qualitative feedback was also collected to explore surgeon perceptions, and analysed thematically. Histopathological analysis was conducted to assess tissue integrity following instrument interaction. The PAF rail achieved SUS scores exceeding the good usability threshold, particularly among urology surgeons. However, its use was associated with increased cognitive load and longer task completion times, especially for less experienced surgeons. Histopathological analysis showed no additional tissue damage from the PAF rail compared to existing instruments. This study demonstrates that the PAF rail has potential as a safe and effective method for organ manipulation and retraction, achieving good usability and showing no additional tissue damage compared to existing instruments.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Etienne Jessen, Marc C Steinbach, Dominik Schillinger
{"title":"Optimizing Non-Intersecting Synthetic Vascular Trees in Nonconvex Organs.","authors":"Etienne Jessen, Marc C Steinbach, Dominik Schillinger","doi":"10.1109/TBME.2025.3554339","DOIUrl":"https://doi.org/10.1109/TBME.2025.3554339","url":null,"abstract":"<p><strong>Objective: </strong>The understanding of the mechanisms driving vascular development is still limited. Techniques to generate vascular trees synthetically have been developed to tackle this problem. However, most algorithms are limited to single trees inside convex perfusion volumes. We introduce a new framework for generating multiple trees inside general nonconvex perfusion volumes.</p><p><strong>Methods: </strong>Our framework combines topology optimization and global geometry optimization into a single algorithmic approach. Our first contribution is defining a baseline problem based on Murray's original formulation, which accommodates efficient solution algorithms. The problem of finding the global minimum is cast into a nonlinear optimization problem (NLP) with merely super-linear solution effort. Our second contribution extends the NLP to constrain multiple vascular trees inside any nonconvex boundary while avoiding intersections. We test our framework against a benchmark of an anatomic region of brain tissue and a vasculature of the human liver.</p><p><strong>Results: </strong>In all cases, the total tree energy is improved significantly compared to local approaches.</p><p><strong>Conclusion: </strong>By avoiding intersections globally, we can reproduce key physiological features such as parallel running inflow vessels and tortuous vessels.</p><p><strong>Significance: </strong>The ability to generate non-intersecting vascular trees inside nonconvex organs can improve the functional assessment of organs.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hybrid Magnetic Locomotion Method for Capsule Robots.","authors":"Xinkai Yu, Jiaole Wang, Shuang Song","doi":"10.1109/TBME.2025.3553150","DOIUrl":"https://doi.org/10.1109/TBME.2025.3553150","url":null,"abstract":"<p><strong>Objective: </strong>Gastrointestinal (GI) capsule endoscopes typically rely on a single mode of locomotion, which limits their efficiency within the complex GI tract. To address this issue, this paper presents a hybrid magnetic locomotion method for capsule robots.</p><p><strong>Methods: </strong>The proposed method features two distinct locomotion modes: inchworm-like and spiral. These two locomotion modes can be independently controlled to adapt to different sections of the GI tract. By integrating a magnetic torsion spring (MTS), the capsule robot achieves hybrid locomotion under the control of an external magnetic field. The MTS exhibits a Dual-Mode Magnetic Response under varying magnetic field strengths. Different control methods have been developed based on the Dual-Mode Magnetic Response of the MTS.</p><p><strong>Results: </strong>A prototype has been fabricated and integrated with a commercial capsule endoscope, which has a diameter of 18 mm and a length of 31.3 mm. In vitro and phantom experiments validated the effectiveness of the proposed design and driving methods.</p><p><strong>Conclusion: </strong>By employing two independently controlled locomotion modes, the hybrid magnetic locomotion method efficiently drove the capsule endoscope through various GI environments.</p><p><strong>Significance: </strong>The hybrid magnetic locomotion method significantly improves the adaptability and efficiency of capsule robots within the GI tract, thereby reducing examination times and enhancing the overall effectiveness of GI endoscopic procedures.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jiawei Shuang, Athia Haron, Damian Crosby, Maedeh Mansoubi, Garry J Massey, Chaofan Lin, Frank L Bowling, Neil D Reeves, Helen Dawes, Glen Cooper, Andrew Weightman
{"title":"An active insole to reduce plantar pressure loading: using predictive finite element driven soft hydraulic actuators to minimise plantar pressure and the pressure time integral for diabetic foot ulceration risk management.","authors":"Jiawei Shuang, Athia Haron, Damian Crosby, Maedeh Mansoubi, Garry J Massey, Chaofan Lin, Frank L Bowling, Neil D Reeves, Helen Dawes, Glen Cooper, Andrew Weightman","doi":"10.1109/TBME.2025.3554888","DOIUrl":"https://doi.org/10.1109/TBME.2025.3554888","url":null,"abstract":"<p><strong>Objective: </strong>This paper aims to design, manufacture and evaluate an active insole to reduce plantar tissue loading to minimise the risk of diabetic foot ulceration for people living with diabetes.</p><p><strong>Methods: </strong>A prototype hydraulic soft robotic actuating insole was produced. It was controlled by an approximate finite element model of the participants' foot with a cost function to minimise plantar pressure loading and the pressure time integral. The system was evaluated during treadmill walking activity for 3 people (two people with diabetes and one healthy participant), measuring normal plantar stress in shoe both before and after shape changes.</p><p><strong>Results: </strong>The results from the participants demonstrate a reduction in average peak plantar pressure and pressure time integral by 35% [range from 9% - 52%] and 31% [range from 6% - 44%], respectively, at the high-risk region, whilst minimising edge effect and maintaining gait symmetry, regularity and cadence. The finite element driven controller was implemented when participants rested between walking periods, and it took less than six minutes to run.</p><p><strong>Conclusion: </strong>This study demonstrates, for the first time on diabetic participants, the feasibility of an active insole system using predictive finite element driven soft hydraulic actuators to reduce plantar loading in people with diabetes.</p><p><strong>Significance: </strong>Diabetic foot ulceration risk could be reduced using active insole technology and approximate predictive algorithms could play an important role to outwork this in real world activity.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Weizhao Wang, Carlo Saija, Zhouyang Xu, Aya Zeidan, Joshua Wilcox, Tiffany Patterson, Simon Redwood, Shuangyi Wang, Kawal Rhode, Richard Housden
{"title":"Development and Evaluation of a Robotic System for Safe Cardiac Sheath Delivery.","authors":"Weizhao Wang, Carlo Saija, Zhouyang Xu, Aya Zeidan, Joshua Wilcox, Tiffany Patterson, Simon Redwood, Shuangyi Wang, Kawal Rhode, Richard Housden","doi":"10.1109/TBME.2025.3553014","DOIUrl":"10.1109/TBME.2025.3553014","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop and evaluate a 3-degree-of-freedom (DoF) robotic system for the safe delivery of cardiac sheaths through challenging anatomical structures, including the fossa ovalis and pathways with tight curves.</p><p><strong>Methods: </strong>The robot and its kinematic model were built on a previously proposed single-DoF actuation module and bending model. A sheath delivery strategy (SDS) was developed, combining two control methods: tip position control to approach an optimal entry point and point-constrained control to maintain consistent navigation through this point, minimizing tissue contact. Technical performance was evaluated through trajectory-following and point-crossing tests, followed by feasibility experiments in a simulated scenario. Trials were conducted by three cardiologists using a validated phantom model under fluoroscopic guidance, comparing SDS with joint control (JC) and manual control (MC).</p><p><strong>Results: </strong>Average root mean square errors were 2.10 mm for tip position control and 1.86 mm for point-constrained control. SDS outperformed MC with significantly shorter trajectory lengths and lower root mean square jerk. Compared to JC, SDS reduced sheath-induced movements (an indirect measure of force) and increased retraction success rates at the fossa ovalis.</p><p><strong>Conclusion: </strong>The proposed robotic system reduced tissue wall contact compared to JC and provided smoother, more controlled operations than MC, ensuring safer and more effective delivery through confined pathways.</p><p><strong>Significance: </strong>This work contributes to advancing robotic-assisted cardiac sheath delivery, providing a reliable and safer method for navigating challenging anatomical structures.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah Linnemeier, Rosario Giuffrida, Krishnaraj Narayanaswamy, Bente Thamsen, Bernhard Semlitsch, Abhijeet Lale, Martin Stoiber, Michael Rohrich, Daniel Zimpfer, Marcus Granegger
{"title":"A Two-Stage Ventricular Assist Device for Pediatric Patients.","authors":"Sarah Linnemeier, Rosario Giuffrida, Krishnaraj Narayanaswamy, Bente Thamsen, Bernhard Semlitsch, Abhijeet Lale, Martin Stoiber, Michael Rohrich, Daniel Zimpfer, Marcus Granegger","doi":"10.1109/TBME.2025.3553731","DOIUrl":"10.1109/TBME.2025.3553731","url":null,"abstract":"<p><strong>Objective: </strong>Implantable ventricular assist devices to support pediatric patients with left ventricular failure remain an unmet medical need. The aim of this work was to assess the feasibility of a miniaturized two-stage pump concept as a left ventricular assist device (LVAD) intended for small pediatric patients.</p><p><strong>Methods: </strong>The pump leverages a two-stage design with a back-to-back impeller configuration. Computational fluid dynamics (CFD) alongside finite element method (FEM) analysis were utilized to design the pump and its actuation. The magnetic and hydrodynamic properties of the axial and radial bearing were designed and analyzed considering the motor characteristics. The hydraulic performance was validated in a flow loop, and hemocompatibility parameters were numerically assessed and compared to the HeartMate 3.</p><p><strong>Results: </strong>At design condition of 1.5 L/min and 6400 rpm, the Two-Stage Pump builds up a pressure of 58 mmHg. The dynamic analysis of the radial hydrodynamic journal bearing demonstrated that an impeller equilibrium position can be achieved by introducing an additional radial load to balance the forces. The axial reluctance force of the motor is shown to be sufficient to balance the axial forces. The motor losses of 0.18 W result in a local temperature increase of 0.4 K. Compared to the Heartmate 3, the Two-Stage Pump demonstrates similar or even superior hemocompatibility results for pediatric use at a reduced circumferential velocity of 3.7 m/s.</p><p><strong>Conclusion and significance: </strong>The concept of the Two-Stage Pump demonstratesfeasibility and presents compelling results to address the medical challenge of an implantable LVAD for pediatric patients.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"IEEE Transactions on Biomedical Engineering Information for Authors","authors":"","doi":"10.1109/TBME.2025.3542031","DOIUrl":"https://doi.org/10.1109/TBME.2025.3542031","url":null,"abstract":"","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"72 4","pages":"C3-C3"},"PeriodicalIF":4.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ieeexplore.ieee.org/stamp/stamp.jsp?tp=&arnumber=10935776","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sabine F Bensamoun, Kiaran P McGee, Mashhour Chakouch, Philippe Pouletaut, Fabrice Charleux
{"title":"Quantification of Lung Stiffness Using Magnetic Resonance Elastography (MRE): Clinical Validation for Smokers.","authors":"Sabine F Bensamoun, Kiaran P McGee, Mashhour Chakouch, Philippe Pouletaut, Fabrice Charleux","doi":"10.1109/TBME.2025.3553375","DOIUrl":"10.1109/TBME.2025.3553375","url":null,"abstract":"<p><p>: Tobacco-related pathologies are the most preventable diseases. The purpose is to provide personalized cartography of smoker lung stiffness using non-irradiating imaging modalities, MRI and MRE (magnetic resonance imaging/elastography).</p><p><strong>Methods: </strong>Thirty-four smokers were divided into five groups distributed with a range of pack-years (PY) of 10. All patients underwent three imaging tests (CT: computed tomography, MRI, MRE) to make possible measurements of lung density, with two modalities (CT, MR), and stiffness. CT lung density was measured using the Hounsfield number. MR density was obtained from a fast gradient echo sequence and validated with an in vitro 3D abdominal phantom. The MRE test was performed with a motion-encoding gradient (Z direction), a spin-echo echo-planar sequence and four offsets. A pneumatic driver (frequency: 50 Hz) was placed on the right lung and four axial phase images were recorded. Post-processing was then performed to record a personalized stiffness cartography.</p><p><strong>Results: </strong>CT density significantly increased in relation to PY, showing denser tissue for the heavy smokers. As MR density acquisition is less accurate than CT, a slight increase in lung density was obtained. MRE tests revealed a significant increase in stiffness with pack-year. Patient-specific lung stiffness showed inhomogeneous distribution of values.</p><p><strong>Conclusion: </strong>MRE could provide a personalized cartography of stiffness for regular uptake of the lung's mechanical behavior in smokers. The stiffness could become a biomarker for preventing future lung disease.</p><p><strong>Significance: </strong>MRE test could be an alternative to CT test for the follow-up of smokers.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}