Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine最新文献

Artificial intelligence and health-related data: The patient’s best interest and data ownership dilemma 人工智能与健康相关数据：患者最佳利益与数据所有权的两难选择

IF 1.8 4区医学

Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine Pub Date : 2024-09-14 DOI: 10.1177/09544119241279630

Arkadiusz Dziedzic, Julien Issa, Akhilanand Chaurasia, Marta Tanasiewicz

{"title":"Artificial intelligence and health-related data: The patient’s best interest and data ownership dilemma","authors":"Arkadiusz Dziedzic, Julien Issa, Akhilanand Chaurasia, Marta Tanasiewicz","doi":"10.1177/09544119241279630","DOIUrl":"https://doi.org/10.1177/09544119241279630","url":null,"abstract":"The rapid advancement of artificial intelligence (AI) in healthcare has the potential to revolutionize the global healthcare sector and medicine in general. However, integrating AI technologies in healthcare requires access to large amounts of personal health-related data (HRD), which raises concerns regarding confidential personal information considering unregulated and not transparent data ownership. Setting up the patient’s welfare as an unquestionable principle, this commentary explores the various ethical aspects of using HRD in AI applications, focusing on informed consent, data ownership, data sharing, financial considerations, accountability, and ethical standards. Three models of potential collaboration between AI-specializing firms and healthcare providers are evaluated: the commercial model, the equitable profit-sharing model, and the public-funded non-profit model. Each model has its advantages and challenges, necessitating a careful balance between ethical considerations, financial implications, and technological advancements. Policymakers and healthcare regulators are urged to establish transparent legislation to safeguard patient privacy, ensure informed consent, and promote the responsible use of HRD in AI applications. This commentary emphasizes the importance of addressing ethical issues to protect basic patient rights, foster responsible collaborations, and ensure the ethical use of health-related data in AI-based healthcare applications. While the coexistence of regulated AI and healthcare professionals is inevitable for validating the cost-effectiveness of AI use in healthcare economics, the transparency of HRD sources is deemed of utmost importance in the best interest of the patient.","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Explant analysis of a chromium nitride coated metal-on-metal total wrist replacement: A case study 氮化铬涂层金属全腕关节置换术的切口分析：病例研究

IF 1.8 4区医学

Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine Pub Date : 2024-09-11 DOI: 10.1177/09544119241277697

Thomas J Joyce, Göksu Kandemir, Duncan McGuire, Michael Solomons, Daniel J Brown

{"title":"Explant analysis of a chromium nitride coated metal-on-metal total wrist replacement: A case study","authors":"Thomas J Joyce, Göksu Kandemir, Duncan McGuire, Michael Solomons, Daniel J Brown","doi":"10.1177/09544119241277697","DOIUrl":"https://doi.org/10.1177/09544119241277697","url":null,"abstract":"Explant analysis can provide important understanding of how artificial joints perform in the human body. The articulating surfaces of the metacarpal head and the radius cup from a chromium nitride coated metal-on-metal Motec wrist implant were analysed. Due to bone resorption and aseptic loosening, the implant was removed after 6 years in the patient, and metallosis was observed during removal. Visually, some areas of the articulating surfaces appeared polished, others were dulled. A chemical composition analysis of the metacarpal head showed that the polished surfaces were chromium rich, implying this surface was the original chromium nitride coating, whereas the dulled surfaces were cobalt rich, indicating the underlying cobalt chromium substrate. In addition, the underlying cobalt chromium substrate was an order of magnitude rougher than the polished surface, indicating the scale of damage to it. It is speculated that the loss of the coating, and the subsequent damage to the underlying substrate due to a third-body wear process, led to osteolysis and the metallosis seen at revision surgery.","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142222423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of self-etch adhesive agitation with diode laser on dentin bond strength 二极管激光搅拌自酸蚀粘合剂对牙本质粘接强度的影响

IF 1.8 4区医学

Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine Pub Date : 2024-09-11 DOI: 10.1177/09544119241276069

Muhammet Kerim Ayar, Kerim Safa Kul

{"title":"Effects of self-etch adhesive agitation with diode laser on dentin bond strength","authors":"Muhammet Kerim Ayar, Kerim Safa Kul","doi":"10.1177/09544119241276069","DOIUrl":"https://doi.org/10.1177/09544119241276069","url":null,"abstract":"The present study assessed the effect of active application of self-etch adhesives with diode laser irradiation on the shear dentin bond strength. Sixty bovine incisors, each embedded individually in hard plaster blocks, were divided into two groups based on the adhesive system used: Group 1 Adper Easy One and Group 2 Clearfil SE Protect. Based on the application technique of self-etch adhesives, each main group was further divided into three subgroups: passive application, active application with a micro-brush, and active application with a 976-nm diode laser tip (phototherapy active application). Shear bond strength tests were conducted using a universal testing machine and the data were analyzed by two-way ANOVA. Post hoc multiple comparisons were performed with the Tukey HSD test. Additionally, the statistical analysis of failure mode distribution was carried out using the chi-squared test ( p < 0.05). While the adhesive system exhibited significant differences in shear dentin bond strengths, there were no significant differences in application techniques. Regardless of the application technique, Clearfil SE Protect demonstrated significantly higher dentin bond strength than Adper Easy One. In the present study, the utilization of phototherapy through a 976-nm diode laser for the active application of the tested self-etch adhesives demonstrated similar initial dentin bond strengths to conventional application methods.","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142222424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effect of structural changes on the low strain rate behaviour of the intervertebral disc. 结构变化对椎间盘低应变率行为的影响。

IF 1.7 4区医学

Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine Pub Date : 2024-08-24 DOI: 10.1177/09544119241272915

Samantha Hayward, Patrick S Keogh, Anthony W Miles, Sabina Gheduzzi

{"title":"The effect of structural changes on the low strain rate behaviour of the intervertebral disc.","authors":"Samantha Hayward, Patrick S Keogh, Anthony W Miles, Sabina Gheduzzi","doi":"10.1177/09544119241272915","DOIUrl":"https://doi.org/10.1177/09544119241272915","url":null,"abstract":"The annuus fibrosus (AF) and nucleus pulposus (NP) of the intervertebral disc (IVD) work in conjunction to dissipate spinal loads. In this study we have isolated the contribution of the NP to the overall response of the disc and investigated the effect of extreme structural changes to the disc on the mechanical behaviour. Linear stiffness, overall load range, hysteresis area and total energy were used to evaluate the impact of these changes on the spine and surrounding structures. Six porcine lumbar isolated disc specimens were tested in 6 DOFs with a 400 N compressive axial preload at low strain rates in three conditions: intact (IN), after total nucleotomy (NN) and after the injection of bone cement into the nuclear void (SN). The latter two conditions, NN and SN, were chosen to emulate the effect of extreme changes to the NP on disc behaviour. When comparing with intact specimens, significant changes were noted primarily in axial compression-extension, mediolateral bending and flexion-extension. NN and SN cases demonstrated significant increases in linear stiffness, overall load range and total energy for mediolateral bending and flexion-extension compared to the intact (IN) state. SN also demonstrated a significant increase in total energy for axial compression-extension, and significant decreases in the elastic contribution to total energy in all axes except flexion-extension. These changes to total energy indicate that surrounding spinal structures would incur additional loading to produce the same motion in vivo after structural changes to the disc.","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Computational analysis of the biomechanical stability of internal fixation of the lateral tibial plateau fracture: A mechanical stability study. 胫骨外侧平台骨折内固定的生物力学稳定性计算分析：机械稳定性研究。

IF 1.7 4区医学

Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine Pub Date : 2024-08-24 DOI: 10.1177/09544119241272782

Yafeng Li, Fengyuan Lu, Peng Yi, Zichun Zou, Xi Zhang, Jing Zhang

{"title":"Computational analysis of the biomechanical stability of internal fixation of the lateral tibial plateau fracture: A mechanical stability study.","authors":"Yafeng Li, Fengyuan Lu, Peng Yi, Zichun Zou, Xi Zhang, Jing Zhang","doi":"10.1177/09544119241272782","DOIUrl":"https://doi.org/10.1177/09544119241272782","url":null,"abstract":"The selection of internal fixation as the primary fixation modality for the patient is one of the challenges for the surgeon treating the patient in question. A model of the lateral tibial plateau fracture was established. Three different configurations of internal fixators namely L bone plate, T bone plate, and screw-washer were analyzed. Three stages after surgery were simulated to assess the displacement of bone plates, screws, washers, and the stress shielding ratio in the fracture area.At three stages after surgery, the T bone plate showed better stability for patients during rehabilitation compared with the remaining two schemes, and the screw-washer scheme was the least stable due to the larger internal fixation displacement and stress shielding ratio in the fracture area. In contrast, the L bone plate scheme showed better stability in the early stages after surgery but was second only to the screw-washer scheme in the middle and late stages after surgery. The T bone plate showed better stability and became a new selection for surgeons to treat related patients. At three stages after surgery, the T bone plate has better biomechanical stability compared to the L bone plate and screw-washer schemes.","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Microcrack behavior in bone: Stress field analysis at osteon cement line tips. 骨骼中的微裂缝行为：骨水泥线尖端的应力场分析

IF 1.7 4区医学

Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine Pub Date : 2024-08-23 DOI: 10.1177/09544119241272854

Chunhui Ji, Xiuyan Yang, Liang Zhang, Xicheng Chen, Yadi Sun, Bin Lin

引用次数: 0

Tibial post loading increases the risk of aseptic loosening of posterior-stabilized tibial prosthesis. 胫骨后加载会增加后稳定胫骨假体无菌性松动的风险。

IF 1.7 4区医学

Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine Pub Date : 2024-08-23 DOI: 10.1177/09544119241272756

Zhenxian Chen, Jianian Han, Jing Zhang, Yinghu Peng, Lei Guo, Shibin Chen, Zhongmin Jin

{"title":"Tibial post loading increases the risk of aseptic loosening of posterior-stabilized tibial prosthesis.","authors":"Zhenxian Chen, Jianian Han, Jing Zhang, Yinghu Peng, Lei Guo, Shibin Chen, Zhongmin Jin","doi":"10.1177/09544119241272756","DOIUrl":"https://doi.org/10.1177/09544119241272756","url":null,"abstract":"Aseptic loosening is the primary cause of failure following posterior-stabilized total knee arthroplasty. It is unclear whether tibial post loading of posterior-stabilized prosthesis increases the risk of aseptic loosening of the tibial prosthesis. The purpose of this study is to investigate the biomechanical effects of tibial post loading on the tibial prosthesis fixation interface during level walking, squatting, stair descent, and standing up-sitting down activities. In this paper, finite element models with and without post were established to compare the effects of tibial post loading on the von Mises stress of the proximal tibia, shear stress of the cement, and the bone-prosthesis interface micromotion during four physiological activities. The tibial post loading had an insignificant influence on tibial biomechanics and bone-prosthesis interface micromotion during leveling walking activity. However, compared to the insert without post condition, tibial post loading significantly increased the maximum tibial von Mises stress, the maximum shear stress in the medial of cement, and the bone-prosthesis interface peak micromotion by 912.84%, 612.77%, and 921.09%, respectively, at the moment of the maximum flexion angle for the stair descent activity, and 637.92%, 351.43%, and 519.13%, respectively, at the moment of the maximum flexion angle for the standing up-sitting down activity. Tibial post loading increased the risk of postoperative aseptic loosening of tibial prosthesis in patients with posterior-stabilized total knee arthroplasty, and it was recommended that the post-cam contact mechanism of posterior-stabilized prosthesis should be optimized to reduce the biomechanical impact of tibial post loading on tibial prosthesis fixation.","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Design modification and selection of improved stem design of the conical stem tibial implant for TAR using FE analysis and different MCDM methods. 利用有限元分析和不同的 MCDM 方法，对用于 TAR 的锥形柄胫骨植入物进行设计修改并选择改进的柄设计。

IF 1.7 4区医学

Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine Pub Date : 2024-08-20 DOI: 10.1177/09544119241272839

Jyoti, Rajesh Ghosh

{"title":"Design modification and selection of improved stem design of the conical stem tibial implant for TAR using FE analysis and different MCDM methods.","authors":"Jyoti, Rajesh Ghosh","doi":"10.1177/09544119241272839","DOIUrl":"https://doi.org/10.1177/09544119241272839","url":null,"abstract":"The conical stem tibial design of total ankle replacement (TAR) has high implant-bone micromotion. This may lead to aseptic loosening which can be avoided by improving the tibial design. The objective was to propose the best stem design parameters to reduce implant-bone micromotion along with minimizing stress shielding using an integrated Finite Element-Multi Criteria Decision Making (FE-MCDM) approach. FE models of implanted tibia bones were prepared by changing the height of the stem, the diameter of the stem, and the slant of the stem. Weighted Aggregated Sum Product Assessment (WASPAS), Technique for Order of Preference by Similarities to Ideal Solution (TOPSIS), Evaluation based on Distance from Average Solution (EDAS), and VIseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) MCDM techniques with equal weights for micromotion and stress shielding were considered. The micromotion and stress shielding were greater when the height of the stem was increased. Whereas, the increase in diameter and slant affected them marginally. The best-performing design was the Model with stem height 6 mm (diameter 6.4 mm and slant 4°) and after that was the Model with stem height 8 mm (diameter 6.4 mm and slant 4°), and then the Model with stem height 10 mm (diameter 6.4 mm and slant 4°). The height of the stem is the most important stem design parameter. Shorter height, moderate thickness, and moderate slanting stem designs are recommended.","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Virtual muscles and reflex control generates human-like ankle torques during gait perturbations. 虚拟肌肉和反射控制可在步态扰动时产生类似人类的踝关节扭矩。

IF 1.7 4区医学

Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine Pub Date : 2024-08-13 DOI: 10.1177/09544119241272766

Sandra Hnat, Antonie J van den Bogert

{"title":"Virtual muscles and reflex control generates human-like ankle torques during gait perturbations.","authors":"Sandra Hnat, Antonie J van den Bogert","doi":"10.1177/09544119241272766","DOIUrl":"https://doi.org/10.1177/09544119241272766","url":null,"abstract":"A biologically-inspired actuation system, including muscles, spinal reflexes, and vestibular feedback, may be capable of achieving more natural gait mechanics in powered prostheses or exoskeletons. In this study, we developed a Virtual Muscle Reflex (VMR) system to control ankle torque and tuned it using data from human responses to anteroposterior mechanical perturbations at three walking speeds. The system consists of three Hill-Type muscles, simulated in real time, and uses feedback from ground reaction force and from stretch sensors on the virtual muscle fibers. Controller gains, muscle properties, and reflex/vestibular time delays were optimized using Covariance Matrix Adaptation (CMA) to minimize the difference between the VMR torque output and the torque measured from the experiment. We repeated the procedure using a conventional finite-state impedance controller. For both controllers, the coefficient of determination (<math><mrow><msup><mrow><mi>R</mi></mrow><mrow><mn>2</mn></mrow></msup></mrow></math>) and root-mean-square error (RMSE) was calculated as a function of time within the gait cycle. The VMR had lower RMSE than the impedance controller in 70%, and in 60% of the trials, the <math><mrow><msup><mrow><mi>R</mi></mrow><mrow><mn>2</mn></mrow></msup></mrow></math> of the VMR controller was higher than for the impedance controller. We concluded that the VMR system can better reproduce the human responses to perturbations than the impedance controller.","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Open-source synthetic photoplethysmographic signal generator with analog output. 带模拟输出的开源合成光敏血压信号发生器。

IF 1.7 4区医学

Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine Pub Date : 2024-08-10 DOI: 10.1177/09544119241272833

Alessandro Gentilin

{"title":"Open-source synthetic photoplethysmographic signal generator with analog output.","authors":"Alessandro Gentilin","doi":"10.1177/09544119241272833","DOIUrl":"https://doi.org/10.1177/09544119241272833","url":null,"abstract":"The photoplethysmographic (PPG) signal of the finger is being used to create embedded devices that estimate physiological variables. This project outlines an innovative method for developing a synthetic PPG generator that produces both actual reference digital signals and their equivalent analog signals using open-source technology. A series of PPG profiles is synthesized using three variant Gaussian functions. A low-frequency trend induced by respiratory frequency and background noise are then added. To generate a diverse range of continuously variable PPG profiles within specified boundaries and customizable levels of interference, all parameters undergo random fluctuations on a cycle-by-cycle basis, as per user-defined constraints. The generated signal is then converted into its equivalent analog form through the use of an RC filter that low-frequency filters a Pulse-Width Modulation square wave that is modulated directly by the generated signal. The software returns different PPG profiles and allows the signal comparison before vs after the addition of different-intensity modulated respiratory trends and background noise. The digital signal is faithfully converted into an equivalent analog voltage signal capable of reproducing not only the waveform profile but also the respiratory trend and various levels of noise.","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0