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

{"title":"Coronary hemodynamic simulation study.","authors":"Leilei Cheng, Zhenlei Chen, Fengyuan Yang, Rongyue Zheng, Wenming He, Fan Shi, Chang Liu, Fachang Wang, Li Wang, Yanqing Xie, Haoxuan Lu","doi":"10.1177/09544119241231028","DOIUrl":"10.1177/09544119241231028","url":null,"abstract":"<p><p>In this paper, a two-way fluid-structure coupling model is developed to simulate and analyze the hemodynamic process based on dynamic coronary angiography, and examine the influence of different hemodynamic parameters on coronary arteries in typical coronary stenosis lesions. Using the measured FFR pressure data of a patient, the pressure-time function curve is fitted to ensure the accuracy of the boundary conditions. The average error of the simulation pressure results compared to the test data is 6.74%. In addition, the results related to blood flow, pressure contour and wall shear stress contour in a typical cardiac cycle are obtained by simulation analysis. These results are found to be in good agreement with the laws of the real cardiac cycle, which verifies the rationality of the simulation. In conclusion, based on the modeling and hemodynamic simulation analysis process of dynamic coronary angiography, this paper proposes a method to assist the analysis and evaluation of coronary hemodynamic and functional parameters, which has certain practical significance.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"444-454"},"PeriodicalIF":1.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176097","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}

{"title":"In-vitro external fixation pin-site model proof of concept: A novel approach to studying wound healing in transcutaneous implants","authors":"Blake McCall, Karan Rana, Kate Sugden, Sarah Junaid","doi":"10.1177/09544119241234154","DOIUrl":"https://doi.org/10.1177/09544119241234154","url":null,"abstract":"External fixation is an essential surgical technique for treating trauma, limb lengthening and deformity correction, however infection is common, with infection rates ranging from 4.5 to 100% of cases. Throughout the literature researchers and clinicians have highlighted a relationship between excessive movement of the pin and skin and an increase in the patient’s risk of infection, however, currently no studies have addressed this role of pin-movement on pin-site wounds. This preliminary study describes a novel in vitro pin-site model, developed using a full-thickness human skin equivalent (HSE) model in conjunction with a bespoke mechanical system which simulates pin-movement. The effect of pin-movement on the wound healing response of the skin equivalents was assessed by measuring the expression of pro-inflammatory cytokines. Six human skin equivalent models were divided into three test groups: no pin as the control, static pin-site wound and dynamic pin-site wound ( n = 3). On day 3 concentrations of IL-1α and IL-8 showed a significant increase compared to the control when a static fixation pin was implanted into the skin equivalent ( p &lt; 0.05) and ( p &lt; 0.005) respectively. Levels of IL-1α and IL-8 increased further in the dynamic sample compared to the static sample ( p &lt; 0.05) and ( p &lt; 0.0005). This study demonstrates for the first time the application of HSE model to study external-fixation pin-movement in vitro. The results of this study demonstrated pin-movement has a negative effect on soft-tissue wound-healing, supporting the anecdotal evidence reported in the literature, however further analysis of wound heading would be required to verify this hypothesis.","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":"57 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140036668","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}

{"title":"Analysis of microvascular pattern in diabetes mellitus condition using the nailfold capillaroscopy images.","authors":"Sowmiya Elumalai, Nirmala Krishnamoorthi, Naveen Periyasamy, Mohamed Farazullah, Kiran Raj, Shriraam Mahadevan","doi":"10.1177/09544119231224510","DOIUrl":"10.1177/09544119231224510","url":null,"abstract":"<p><p>Diabetes is often considered a vascular disease due to its impact on blood vessels, it is a complex condition with various metabolic and autoimmune factors involved. One of the long term comorbidities of diabetes includes microvascular complications. The microvascular complications can be analyzed using the Nailfold capillaroscopy, a non-invasive technique that allows for the visualization and analysis of capillaries in the proximal nailfold area. Using advanced video capillaroscopy with high magnification, capillary images can be captured from and processed to analyze their morphology. The capillary images of normal group and diabetic group are acquired from 118 participants using nailfold capillaroscopy and the obtained images are preprocessed using image processing filters. The identification and segmentation of the capillaries are the challenges to be addressed in the processing of the images. Hence segmentation of capillaries is done using morphological operations, thresholding and convolutional neural networks. The performance of the filters and segmentation methods are evaluated using Mean Square Error (MSE), Peak signal to Noise Ratio (PSNR), Structural Similarity Index Measure (SSIM), Jaccard Index and Sorensen coefficient. By analyzing the morphological features namely the capillary diameter, density, distribution, presence of hemorrhage and the shape of the capillaries from both the groups, the capillary changes associated with diabetic condition were studied. It was found that the non diabetic participants considered in this study has capillary diameter in the range of 8-14 µm and the capillary density in the range of 10-30 capillaries per mm² whereas the diabetic participants has capillary diameter greater than 30 µm and the capillary density is less than 10 capillaries per mm². In addition to capillary density and diameter, the presence of hemorrhage, the orientation and distribution of the capillaries are also considered to differentiate the diabetic group from the non diabetic group. The classification of the participants are validated with the clinical history of the participants.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"340-347"},"PeriodicalIF":1.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139567324","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}

{"title":"Risk factors for periprosthetic femoral fracture risk around a cemented polished taper-slip stem using an osteoporotic composite bone model.","authors":"Sameer Jain, Jonathan N Lamb, Ruth Drake, Ian Entwistle, James P Baren, Zachary Thompson, Andrew R Beadling, Michael G Bryant, Farag Shuweihdi, Hemant Pandit","doi":"10.1177/09544119231225172","DOIUrl":"10.1177/09544119231225172","url":null,"abstract":"<p><p>This biomechanical study aimed to determine if variations in stem material, stem geometry, stem offset and cement viscosity affect mechanical resistance to postoperative periprosthetic fracture (PFF) after hip arthroplasty with a commonly used cemented polished taper-slip (PTS) stem (CPT, Zimmer Biomet) in a novel osteoporotic composite femoral bone model. Thirty-six osteoporotic composite femoral models were tested using a standardised in-vitro loading technique to simulate a typical PFF. Outcome measures were torque to failure (N), fracture energy (N/m²) and rotation to failure (°). Comparisons were made by stem material (cobalt chrome vs stainless steel), stem geometry (CPT stem vs Exeter stem), stem offset (standard offset vs extra extended offset) and cement viscosity (high viscosity vs low viscosity). Statistical comparisons were carried out with significance set at <i>p</i> < 0.05. All tested samples produced clinically representative fracture patterns with varying degrees of bone and cement comminution. There was no statistically significant difference in torque to failure, fracture energy or rotation to failure between any of the compared variables (all <i>p</i> > 0.05). This is the first biomechanical study on mechanical resistance to PFF using osteoporotic composite bone models. For the CPT stem, it confirms that stem material, stem offset, stem geometry and cement viscosity do not affect mechanical resistance to PFF in an osteoporotic bone model.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"324-331"},"PeriodicalIF":1.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486166","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}

{"title":"On the soft tissue ultrasound elastography using FEM based inversion approach.","authors":"Seyed Shahab Eshaghinia, Afshin Taghvaeipour, Mohammad Mohammadi Aghdam, Hassan Rivaz","doi":"10.1177/09544119231224674","DOIUrl":"10.1177/09544119231224674","url":null,"abstract":"<p><p>Elastography is a medical imaging modality that enables visualization of tissue stiffness. It involves quasi-static or harmonic mechanical stimulation of the tissue to generate a displacement field which is used as input in an inversion algorithm to reconstruct tissue elastic modulus. This paper considers quasi-static stimulation and presents a novel inversion technique for elastic modulus reconstruction. The technique follows an inverse finite element framework. Reconstructed elastic modulus maps produced in this technique do not depend on the initial guess, while it is computationally less involved than iterative reconstruction approaches. The method was first evaluated using simulated data (in-silico) where modulus reconstruction's sensitivity to displacement noise and elastic modulus was assessed. To demonstrate the method's performance, displacement fields of two tissue mimicking phantoms determined using three different motion tracking techniques were used as input to the developed elastography method to reconstruct the distribution of relative elastic modulus of the inclusion to background tissue. In the next stage, the relative elastic modulus of three clinical cases pertaining to liver cancer patient were determined. The obtained results demonstrate reasonably high elastic modulus reconstruction accuracy in comparison with similar direct methods. Also it is associated with reduced computational cost in comparison with iterative techniques, which suffer from convergence and uniqueness issues, following the same formulation concept. Moreover, in comparison with other methods which need initial guess, the presented method does not require initial guess while it is easy to understand and implement.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"271-287"},"PeriodicalIF":1.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139491907","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}

{"title":"Biomechanical analysis of combi-hole locking compression plate during fracture healing: A numerical study of screw configuration.","authors":"Zeyang Li, Stuart Pollard, Gemma Smith, Subodh Deshmukh, Ziyun Ding","doi":"10.1177/09544119241229157","DOIUrl":"10.1177/09544119241229157","url":null,"abstract":"<p><p>Locking compression plates (LCPs) have become a widely used option for treating femur bone fractures. However, the optimal screw configuration with combi-holes remains a subject of debate. The study aims to create a time-dependent finite element (FE) model to assess the impacts of different screw configurations on LCP fixation stiffness and healing efficiency across four healing stages during a complete fracture healing process. To simulate the healing process, we integrated a time-dependent callus formation mechanism into a FE model of the LCP with combi-holes. Three screw configuration parameters, namely working length, screw number, and screw position, were investigated. Increasing the working length negatively affected axial stiffness and healing efficiency (<i>p</i> < 0.001), while screw number or position had no significant impact (<i>p</i> > 0.01). The time-dependent model displayed a moderate correlation with the conventional time-independent model for axial stiffness and healing efficiency (ρ ≥ 0.733, <i>p</i> ≤ 0.025). The highest healing efficiency (95.2%) was observed in screw configuration C125 during the 4-8-week period. The results provide insights into managing fractures using LCPs with combi-holes over an extended duration. Under axial compressive loading conditions, the use of the C125 screw configuration can enhance callus formation during the 4-12-week period for transverse fractures. When employing the C12345 configuration, it becomes crucial to avoid overconstraint during the 4-8-week period.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"313-323"},"PeriodicalIF":1.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10941711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significantly better precision with new machine learning versus manual image registration software in processing images from single-plane fluoroscopy to determine tibiofemoral kinematics following total knee replacement.","authors":"Joseph Pourtabib, Maury L Hull","doi":"10.1177/09544119241232271","DOIUrl":"10.1177/09544119241232271","url":null,"abstract":"<p><p>One common method to determine tibiofemoral kinematics following total knee replacement (TKR) is to capture single-plane fluoroscopic images of a patient activity and determine anterior-posterior (AP) positions of the femoral condyles and internal-external (IE) tibial rotation. Although JointTrack is widely used to analyze such images, precision (i.e. repeatability) in determining AP positions and IE tibial rotations using the two publicly available programs has never been quantified. The objectives were to determine the precision and reproducibility of results using both programs. Fluoroscopic images of 16 patients who performed a weight-bearing deep knee bend following TKR were analyzed. JointTrack Manual (JTM) and JointTrack Machine Learning (JTML) were used to perform 3D model-to-2D image registration after which AP positions of the femoral condyles and IE tibial rotations were determined. Precision in AP positions and IE rotations was quantified. Intraclass correlation coefficients (ICCs) for both repeatability (i.e. intraobserver) and reproducibility (i.e. interobserver) also were determined. Precision using JTM was worse than JTML for AP positions of the medial and lateral femoral condyles (1.0 mm and 0.9 mm vs 0.3 mm and 0.4 mm, respectively; <i>p</i> < 0.001 for both). For IE tibial rotation, precision also was worse using JTM versus JTML (1.1º vs 0.9°, <i>p</i> = 0.010). ICC values for JTML indicated good to excellent agreement (range: 0.82-0.98) whereas ICC values for JTM indicated only moderate to good agreement (range: 0.58-0.88). JTML has better precision and reproducibility than JTM and also is more efficient to use. Therefore, use of JTML over JTM is strongly recommended.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"332-339"},"PeriodicalIF":1.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906299","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}

{"title":"Evaluation of the lumbar and abdominal muscles behavior in different sagittal plane angles during maximum voluntary isometric extension.","authors":"Sharareh Kian-Bostanabad, Mahmoodreza Azghani, Mohammad Parnianpour","doi":"10.1177/09544119231221896","DOIUrl":"10.1177/09544119231221896","url":null,"abstract":"<p><p>Physical positions and lumbar movements are directly related to lumbar disorders. It is known that the sagittal plane angle affects the person's ability to apply extension torque. However, there is no consensus on whether or not muscle activity and co-contractions change at these angles. This paper aimed to investigate the abdominal and lumbar muscles' behavior at different sagittal plane angles during maximum voluntary isometric extension (MVIE). We have evaluated our findings with the aid of a computational biomechanical model. Fourteen healthy males participated. A total of 16 muscles EMG were recorded during the lumbar MVIE on the Sharif Lumbar Isometric Strength Tester device in 5°, 15°, 30°, and 45° flexion. The torque and muscle activity changes and all co-contraction indexes (CCI) between 120 possible muscle pairs were calculated. Finally, the experimental test conditions were modeled in the AnyBody software, and the MVIE torque, muscle activity, and all CCIs were calculated. Also, muscle torque lever arms were calculated at different angles. Results show that MVIE at four angles is 137.94 ± 36.08, 148.63 ± 47.96, 168.09 ± 50.48, and 171.44 ± 53.95 N · m, respectively. Muscle activity and CCI are similar at all angles. The AnyBody model gives similar findings. Muscles torque lever arms change with angle. In conclusion, to determine the safety mode of lifting in the sagittal plane, it seems that the torque differences are due to changes in the geometrical muscle parameters (including the torque lever arm). Despite the almost constant muscular effort, subjects in the 30°-45° bending positions can apply more MVIE.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"301-312"},"PeriodicalIF":1.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139478802","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}

{"title":"Assessment of 3D printed mechanical metamaterials for prosthetic liners.","authors":"Kirstie M Devin, Jinghua Tang, Andrew R Hamilton, David Moser, Liudi Jiang","doi":"10.1177/09544119231225529","DOIUrl":"10.1177/09544119231225529","url":null,"abstract":"<p><p>This study focuses on novel design and evaluation of Elastic 50A (EL50) mechanical metamaterials with open-cell patterns for its potential application to lower limb residuum/socket interfaces, specifically that of a transtibial (TT) amputee. Mechanical characteristics, that is, effective Young's modulus (<i>E</i>), was tuned by altering metamaterial porosity, which was experimentally verified. Specifically, pore radius of the unit cell was varied to achieve a range of <i>E</i>-values (0.05-1.71 MPa) for these 3D printed metamaterials. Finite Element Analysis (FEA) was conducted to evaluate pressure distribution across key load-bearing anatomical sites of a TT residuum. Using designed metamaterials for homogeneous liners, pressure profiles were studied and compared with a silicone liner case. Additionally, a custom metamaterial liner was designed by assigning appropriate metamaterials to four load-sensitive and tolerant anatomical sites of the TT residuum. The results suggest that lowest pressure variation (PV), as a measure of pressure distribution levels and potential comfort for amputees, was achieved by the custom metamaterial liner compared to any of the homogeneous liners included in this study. It is envisaged that this work may aid future design and development of custom liners using now commonly available 3D printing technologies and available elastomer materials to maximise comfort, tissue safety and overall rehabilitation outcomes for lower limb amputees.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"348-357"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10941651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139567327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simple recognition of hand gestures using single-channel EMG signals.","authors":"Mina Pourmokhtari, Borhan Beigzadeh","doi":"10.1177/09544119231225528","DOIUrl":"10.1177/09544119231225528","url":null,"abstract":"<p><p>Electromyography (EMG) signals are used for many different purposes, such as recording and measuring the electrical activity generated by varying the body's skeletal muscles. Biosignals are different types of biomedical signals, like EMG signals, which can be used for the neural linkage with computers and are obtained from a particular part of the body such as tissue, muscle, organ, or cell system like the nervous system. Surface electromyography (SEMG) is a non-invasive method that can be used as an effective system for controlling upper arm prostheses. This study focused on classifying the five types of distinct finger movements investigated in four unique channels.We have used a classification technique, the k-nearest neighbors (KNN), to categorize the collected samples. Two time-domain features, (a) maximum (Max) and (b) minimum (Min), were used with one of these three features separately: mean absolute value (MAV), root mean square (RMS), and simple square integral (SSI) to classify gestures. We chose classification accuracy as a criterion for evaluating the effectiveness of every classification. We figured out that the first grouping, that is, (MAV, Max, Min), was the best choice for classification. The accuracy percentage in the four channels for the first group was 91.0%, 89.9%, 89.8%, and 96.0%, respectively.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"372-380"},"PeriodicalIF":1.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486170","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}