{"title":"A lightweight method for regression-based normalization of the cross-sectional area for cervical spinal cord atrophy assessment.","authors":"Tayssir Boushila, Mouna Sahnoun, Fathi Kallel, Salma Sakka, Mariem Damak","doi":"10.1007/s11517-026-03644-7","DOIUrl":"10.1007/s11517-026-03644-7","url":null,"abstract":"<p><p>The cross-sectional area (CSA) of the cervical spinal cord (CSC) is a key biomarker for monitoring neurodegenerative diseases such as multiple sclerosis (MS). However, its clinical utility is limited by inter-subject variability (I-SV) due to anthropometric factors (height, sex) and MRI scanner differences, which can obscure true anatomical changes. This motivates the development of a normalization strategy to enhance the sensitivity of this established biomarker to pathological changes. Existing normalization methods rely on complex imaging features unavailable in many clinical datasets, thereby motivating the need for simpler approaches. We propose a lightweight regression-based normalization model for CSC-CSA using routinely available predictors. We evaluated the effect of these predictors across cervical spinal levels (CSL), demonstrating that the model captures a quantifiable proportion of I-SV reflected by a 15-23% reduction in the coefficient of variation (COV). Prior to normalization, CSC-CSA is measured using a novel fully automated landmark-based method. It is independent of vertebral labeling and spinal curvature, and uses spinal nerve midpoints as anatomical references. Model development was conducted using 267 healthy controls (HC) from the Spine Generic dataset. For validation, two external datasets were used: the public OpenNeuro dataset, comprising 10 HC, and a private dataset consisting of 23 scans acquired from 5 patients with MS. Bidirectional stepwise regression per CSL yielded adjusted [Formula: see text] of 0.09-0.17. This approach offers a practical, generalizable framework for normalizing CSC-CSA, enabling accurate cross-sectional and longitudinal analyses in MS cohorts, as well as quantifying atrophy linked to progressive MS.</p>","PeriodicalId":49840,"journal":{"name":"Medical & Biological Engineering & Computing","volume":" ","pages":"3353-3369"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632446","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":"Prediction and critical feature analysis for coronary artery calcification progression.","authors":"Ran Liu, Gaojian Yang, Wenyu Huang, Junyan Zhang, Yuting Lei, Rui Zhang, Zhongxiu Chen, Yong He, Hongmei Yan, Kaiyue Diao","doi":"10.1007/s11517-026-03647-4","DOIUrl":"10.1007/s11517-026-03647-4","url":null,"abstract":"<p><p>Coronary calcification is a prevalent pathology and strong cardiovascular indicator. However, its progression drivers remain poorly defined. With limited clinical samples, it is unclear if simple traditional machine learning can effectively predict progression, challenging risk assessment and individualized treatment. We assembled a serial CCTA dataset of 2,579 patients from West China Hospital. Using Random Forest, Gradient Boosting Decision Trees, XGBoost, and Logistic Regression with SHAP analysis, we identified key features of coronary artery calcification progression and built predictive models, then compared them with traditional clinical models. The Random Forest (RF) model achieved an AUC of 0.81 (95% CI: 0.78-0.84) vs. 0.64 (0.59-0.68) for the traditional model. Baseline CACS, plaque burden, and other CCTA features were key predictors, with critical thresholds determined. A coronary artery calcification progression prediction score (CACPPS) was derived to quantify personalized progression risk. The RF model also showed acceptable calibration (Brier score = 0.169; Hosmer-Lemeshow p = 0.415), favorable decision-curve net benefit, and an optimal CACPPS threshold of 0.566. In patients with suspected or confirmed CAD, a traditional yet interpretable machine learning model can predict CACS progression and generate CACPPS to support treatment decisions and dynamic individualized management, mitigating black-box concerns through indirect interpretability.</p>","PeriodicalId":49840,"journal":{"name":"Medical & Biological Engineering & Computing","volume":" ","pages":"3399-3411"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664585","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}
Zhe Sun, Xiaoyun Bi, Lubin Hong, Jinchuan Zheng, Zhihong Man
{"title":"A reconstruction method of missing torque data using a simplified neuromusculoskeletal (NMS) model.","authors":"Zhe Sun, Xiaoyun Bi, Lubin Hong, Jinchuan Zheng, Zhihong Man","doi":"10.1007/s11517-026-03651-8","DOIUrl":"10.1007/s11517-026-03651-8","url":null,"abstract":"<p><p>During exoskeleton rehabilitation training, providing the appropriate torque for recovery can enhance both the effectiveness and comfort of the training. However, due to torque sensor failures and wireless transmission issues, data acquisition may suffer from a loss of 200-800 time steps, which limits the model's predictive accuracy. Therefore, we designed a torque data reconstruction method based on a simplified neuromusculoskeletal model. This approach uses an interpretable model to generate estimated torques for reconstructing missing segments, thereby simulating the temporal characteristics of torque data. Experimental results demonstrate that training neural network models with reconstructed data yields an average 12.70% improvement in the [Formula: see text] of predicted torque compared to training with non-reconstructed data. This performance surpasses that of reconstruction methods based on periodic shift interpolation, chained equations multiple imputation, and neural network-based imputation for missing time series data.</p>","PeriodicalId":49840,"journal":{"name":"Medical & Biological Engineering & Computing","volume":" ","pages":"3427-3439"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680778","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":"Robot aided optical tweezers and microneedle assisted minimally invasive single cell mitochondria biopsy system.","authors":"Adnan Shakoor","doi":"10.1007/s11517-026-03652-7","DOIUrl":"10.1007/s11517-026-03652-7","url":null,"abstract":"<p><p>Single cell surgery, which involves removing or manipulating subcellular organelles from single cells, is increasingly being utilized in precision medicine to investigate illnesses and their causes. This article describes an optical tweezers (OTs)-assisted mitochondria biopsy method for performing minimally invasive automated organelle biopsy of single cells. A microfluidic chip device is utilized to hold a single cell, and OTs is used to trap and move the mitochondria to the edge of the cell membrane automatically, followed by automatic mitochondria biopsy with a bevelled microneedle. An image processing technique is also being developed to identify the location of the mitochondria and cell. To achieve precise and robust manipulation of organelles within the viscous cytoplasmic environment, a hybrid PID-adaptive sliding mode controller is implemented, ensuring accurate positioning of mitochondria for biopsy. The efficacy of the proposed robotic surgical system is proven experimentally using automated mitochondria biopsy from Hela cancer cells. Following mitochondrial extraction, JC-1 staining and cell viability assays were performed to evaluate immediate mitochondrial integrity as well as biopsied cell viability. The experimental findings indicate that the proposed OT aided mitochondria biopsy system outperforms the current mitochondria biopsy techniques in terms of cell viability and biopsy efficiency.</p>","PeriodicalId":49840,"journal":{"name":"Medical & Biological Engineering & Computing","volume":" ","pages":"3557-3568"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764853","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}
Mohammad Mansuri Poor, Mostafa Sohankar, Aghil Yousefi Koma, Mohsen Hamedi
{"title":"Real-time soft tissue balance assessment in total knee arthroplasty using a wireless flexible sensor array.","authors":"Mohammad Mansuri Poor, Mostafa Sohankar, Aghil Yousefi Koma, Mohsen Hamedi","doi":"10.1007/s11517-026-03625-w","DOIUrl":"10.1007/s11517-026-03625-w","url":null,"abstract":"<p><p>Soft tissue balance is crucial for the success of total knee arthroplasty (TKA), influencing joint stability, patient satisfaction, and implant longevity. However, intraoperative assessment of ligament tension is subjective and prone to error. In this study, we present a novel, low-cost, and highly sensitive force measurement system based on flexible sensors for real-time evaluation of soft tissue balance during TKA. The system integrates 24 sensor units (12 each in the medial and lateral compartments) embedded within a custom-designed spacer, enabling continuous real-time force measurements throughout the full knee motion range, including clinically relevant positions: full extension (0°), mid-flexion (45°), and deep flexion (90°). The sensors, fabricated from RTV silicone rubber filled with carbon nanotubes (CNTs) and carbon black, show high sensitivity (0.117 N⁻<sup>1</sup>) at low forces and stable performance across a wide detection range (0-100 N). A complete testing platform, including data acquisition circuitry and a graphical user interface (GUI), was developed to visualize pressure distribution during simulated surgery. The proposed system demonstrates rapid response (~ 0.4 s), low hysteresis (~ 1.18%), and high repeatability (CV < 3%) across 2000 loading cycles. These characteristics underscore its potential as a practical intraoperative tool to assist surgeons or robotic systems in optimizing soft tissue balance, thus enhancing TKA outcomes.</p>","PeriodicalId":49840,"journal":{"name":"Medical & Biological Engineering & Computing","volume":" ","pages":"3453-3469"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680754","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":"Dual-stage anatomical perception and reasoning framework for automated cobb angle estimation.","authors":"Fei Wang, Junhua Zhang, Hongjian Li, Qiyang Wang","doi":"10.1007/s11517-026-03659-0","DOIUrl":"10.1007/s11517-026-03659-0","url":null,"abstract":"<p><p>Accurate and automated Cobb angle measurement is essential for the diagnosis and management of Adolescent Idiopathic Scoliosis (AIS). However, existing deep learning approaches often ignore the intrinsic anatomical dependencies of the spine, which results in physiologically implausible estimations. We propose a two-stage anatomical perception and reasoning framework based on keypoint detection for Cobb angle measurement. The anatomical perception stage is built upon a Local-to-Global Aggregation Backbone (LGAB), which combines convolutional neural networks and Transformers to jointly capture local anatomical details and global spinal context. The resulting feature representations are further refined by a Semantic Guidance Module (SGM) to facilitate cross-scale feature fusion and improve vertebral keypoint localization. In the second stage anatomical reasoning, an Anatomical Reasoning Network (ARN) models all detected vertebral center keypoints as a structured graph. By embedding anatomical priors and applying dynamic relational reasoning, the ARN refines the spatial configuration of keypoints, which ensures anatomical coherence and corrects subtle localization errors. The optimized keypoints are then used to calculate the Cobb angle. The proposed framework achieves a Symmetric Mean Absolute Percentage Error (SMAPE) of 6.61%, a Cobb Mean Absolute Error (CMAE) of 2.67°, and an Error of Center ([Formula: see text]) of 24.58 pixels on the public AASCE 2019 Challenge dataset. Furthermore, the framework achieves a comparable CMAE of 2.11° on an independent clinical dataset. These results demonstrate that the proposed method provides a reliable foundation for precise and automated Cobb angle measurement.</p>","PeriodicalId":49840,"journal":{"name":"Medical & Biological Engineering & Computing","volume":" ","pages":"3657-3674"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800789","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":"A study on eye movement trajectory classification for strabismus screening via integration of global dependencies and temporal dynamics.","authors":"Zhuo Liang, Zihe Zhao, Enci Xie, Yuxuan Liu, Boxin Yao, Chenyu Tang, Shuo Gao","doi":"10.1007/s11517-026-03650-9","DOIUrl":"10.1007/s11517-026-03650-9","url":null,"abstract":"<p><p>Strabismus is a binocular visual disorder characterized by deviation of the visual axes, which may lead to irreversible impairments such as amblyopia if not recognized and intervened in time. To address the limitations of existing methods-including reliance on costly hardware, limited adaptability to dynamic conditions, and insufficient capability in strabismus subtype classification-this study proposes a wearable eye-tracker-based deep learning framework for categorizing eye movement sequences into controls, exotropes, and esotropes. The model integrates spatial, temporal, and global features using a hierarchical structure: spatial features are extracted by a modified ResNet-18, sequence dynamics are modeled using a bidirectional LSTM, and long-range temporal dependencies are captured in combination with a lightweight Transformer encoder. A conditional trigger-based model filtering strategy is introduced to enhance the model's sensitivity to minority-class samples. Experimental results demonstrate that the proposed method achieves an overall sample-level classification accuracy of 93.3%, with particularly strong performance in identifying adolescent esotropes, validating its potential for clinical and primary screening applications.</p>","PeriodicalId":49840,"journal":{"name":"Medical & Biological Engineering & Computing","volume":" ","pages":"3639-3655"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800804","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":"Neural networks improve repeatability of intravoxel incoherent motion (IVIM) parameter estimation in pancreatic diffusion-weighted MRI.","authors":"Nitzan Avidan-Pearl, Daphna Link-Sourani, Ram Weiss, Moti Freiman","doi":"10.1007/s11517-026-03637-6","DOIUrl":"10.1007/s11517-026-03637-6","url":null,"abstract":"<p><p>Intravoxel incoherent motion (IVIM) analysis in diffusion-weighted MRI (DWI-MRI) shows potential for characterizing pancreatic tissue, but its clinical application remains limited by sensitivity to fitting algorithms. This study assessed the repeatability of neural network (NN)-based IVIM fitting versus classical nonlinear least-squares in pancreatic DWI. The repeatability cohort included ten healthy volunteers and two type 1 diabetes (T1D) individuals, each scanned twice; the glucose-response cohort included three T1D participants and three healthy controls scanned pre- and post-oral glucose. Diffusion data were acquired at 13 b-values (0-1200 s/mm[Formula: see text]). Four NN-based methods (IVIM-NET, SUPER-IVIM-DC, U-Net, IVIM-MORPH) were compared with two classical approaches (SLS, SLS-TRF) using full (13-point) and reduced (7-point) protocols. Repeatability was quantified using within-subject coefficient of variation (wCV) and Bland-Altman analysis. All NN-based methods significantly improved test-retest repeatability of the perfusion fraction ƒ compared with classical approaches ([Formula: see text]), with SUPER-IVIM-DC showing the lowest wCV and IVIM-MORPH offering balanced performance across parameters. A reduced protocol shortened scan time through fewer acquisitions while maintaining or improving repeatability compared to the full protocol. Preliminary glucose-response results show both NN and classical IVIM analyses detect physiologically relevant changes. Parameter estimates varied across NN architectures, requiring further validation to establish accuracy.</p>","PeriodicalId":49840,"journal":{"name":"Medical & Biological Engineering & Computing","volume":" ","pages":"3305-3324"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622012","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}
Marcus Varanis, Mateus Ferraz, Daniel Longo, José Manoel Balthazar
{"title":"A nonlinear windkessel model for cardiovascular dynamics: Variable compliance and pathological simulations.","authors":"Marcus Varanis, Mateus Ferraz, Daniel Longo, José Manoel Balthazar","doi":"10.1007/s11517-026-03638-5","DOIUrl":"10.1007/s11517-026-03638-5","url":null,"abstract":"<p><p>Lumped-parameter cardiovascular models are computationally efficient and physiologically interpretable, but many still represent arterial compliance as linear and pressure-independent. Here, we introduce a nonlinear extension of a classical closed-loop Windkessel model by defining aortic compliance as an exponential function of aortic pressure. The heart, systemic circulation, and pulmonary circulation are represented as an RLC network with time-varying ventricular elastances, yielding a twelve-state formulation derived from Kirchhoff's laws. Under nominal conditions, the nonlinear model recovers the linear baseline, with near-superimposable pressure and flow waveforms and physiologically plausible steady-state indices. Away from the nominal operating point, the pressure-dependent law selectively modulates proximal pulsatility, while mean arterial pressure, stroke volume, and cardiac output remain comparatively preserved. Targeted parameter changes produce qualitative waveform and index-level signatures consistent with aortic regurgitation and arterial stiffening. The proposed formulation provides a compact, physiologically grounded platform for sensitivity analysis, pathological emulation, and early-stage evaluation of cardiovascular modeling scenarios.</p>","PeriodicalId":49840,"journal":{"name":"Medical & Biological Engineering & Computing","volume":" ","pages":"3283-3304"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594357","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}
Yu Wang, Qi Pan, Bin Wen, Qiong Wu, Qiumin Qu, Jilun Ye, Xu Zhang, Jin Xu
{"title":"A novel neurovascular coupling analysis method based on simultaneous EEG-fNIRS for investigating the effects of working memory load.","authors":"Yu Wang, Qi Pan, Bin Wen, Qiong Wu, Qiumin Qu, Jilun Ye, Xu Zhang, Jin Xu","doi":"10.1007/s11517-026-03635-8","DOIUrl":"10.1007/s11517-026-03635-8","url":null,"abstract":"<p><p>The relationship between neural activities and hemodynamic responses was referred to as neurovascular coupling (NVC). Although several methodologies were proposed for the NVC study, these approaches may be constrained in extracting event-related neural activities (ERNA) and lacking the characterization of NVC. To optimize the extraction of ERNA, the modified connectivity-related neural activity (CRNA) was extracted by combining the absolute value of neural oscillation with non-negative matrix factorization (NNMF). Then, cross-correlation between modified CRNA and hemoglobin oxygenation (HbO) was computed to represent NVC, and temporal and intensity parameters of NVC were extracted, respectively. A digit-Sternberg task was designed with three different levels for investigating effects of working memory load (WML) on NVC. Electroencephalography (EEG) and functional near infrared spectroscopy (fNIRS)were recorded simultaneously in 30 healthy elderly adults. We observed that as WML increased, NVC intensity at prefrontal and parietal regions exhibited a notable enhancement, while NVC lag exhibited a significant decrease. Furthermore, a significant negative correlation was found between NVC intensity and reaction time (RT). The proposed NVC analysis method could effectively characterize the influence of WML changes on NVC.</p>","PeriodicalId":49840,"journal":{"name":"Medical & Biological Engineering & Computing","volume":" ","pages":"3337-3352"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621929","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}