{"title":"Safety and Feasibility of Intradialytic Exercise Including Upper Limb Neuromuscular Electrical Stimulation in Adults With Chronic Kidney Disease: A Randomized Controlled Pilot Clinical Trial.","authors":"Mariana Rios Rosa, Vitoria Silva de Souza, Flavia Marini Paro, Daniella Cristina De Assis Pinto Gomes, Michelly Louise Sartório Altoé Toledo, Alexandre Bittencourt Pedreira, Halina Duarte, Veronica Lourenço Wittmer, Marcela Cangussu Barbalho Moulim","doi":"10.1111/aor.70006","DOIUrl":"https://doi.org/10.1111/aor.70006","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the safety and feasibility of an intradialytic exercise protocol, including unilateral upper limb neuromuscular electrical stimulation (NMES) superimposed on a voluntary contraction combined with leg cycle ergometer exercise, in adults with chronic kidney disease (CKD).</p><p><strong>Methods: </strong>This was a pilot randomized clinical trial in which patients with CKD underwent an intradialytic exercise protocol using a cycle ergometer and active upper limb NMES in the intervention group (IG) or cycle ergometer and SHAM in the control group (CG). Safety was assessed by monitoring blood pressure, heart rate (HR), peripheral oxygen saturation, and any abnormal signs or adverse events. Feasibility was evaluated based on the rate of adherence to the protocol, number of dropouts, and protocol acceptability by patients and healthcare teams.</p><p><strong>Results: </strong>HR increased in both groups during exercise, but there was no difference between the groups. The post-exercise HR remained higher than the initial HR only in the IG (p = 0.04), and the post-exercise systolic blood pressure (SBP) was lower than the initial SBP only in the CG (p = 0.05); however, these variables remained within the safety values. The adherence rate was 87.5% in the IG and 82.29% in the CG, with no reported adverse events, and the majority expressed interest in continuing exercise after the end of the study, with positive acceptance from the healthcare staff at the HD center.</p><p><strong>Conclusion: </strong>This intradialytic exercise protocol, including active upper limb NMES, seems to be safe and feasible, suggesting that NMES may be incorporated into intradialytic protocols.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05374863.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aakash M Shah, John A Treffalls, Jacopo D'Andria Ursoleo, Brian E Woolley, Brett F Curran, Ander Doran-Gallastegi
{"title":"Recent Progress in the Field of Artificial Organs.","authors":"Aakash M Shah, John A Treffalls, Jacopo D'Andria Ursoleo, Brian E Woolley, Brett F Curran, Ander Doran-Gallastegi","doi":"10.1111/aor.70002","DOIUrl":"https://doi.org/10.1111/aor.70002","url":null,"abstract":"","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mehdi Boubaddi, Florence Jeune, Chetana Lim, Claire Goumard, Eric Savier, Géraldine Rousseau, Fabiano Perdigao, Olivier Scatton
{"title":"Hypothermic Oxygenated Machine Perfusion (HOPE) During Total Vascular Exclusion With Veno-Venous Bypass for Giant Hepatic Hemangioma Resection.","authors":"Mehdi Boubaddi, Florence Jeune, Chetana Lim, Claire Goumard, Eric Savier, Géraldine Rousseau, Fabiano Perdigao, Olivier Scatton","doi":"10.1111/aor.15065","DOIUrl":"https://doi.org/10.1111/aor.15065","url":null,"abstract":"<p><p>Hypothermic oxygenated machine perfusion (HOPE) during total vascular exclusion with veno-venous bypass for major hepatic resection is a safe procedure and could help to reduce ischemia-reperfusion lesions and related complications.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Kidney Machine Perfusion Is Associated With Improved Long-Term Graft Survival Mediated by Reduced Delayed Graft Function: A Mate-Kidney Analysis.","authors":"Gabriel Cojuc-Konigsberg, Bhavna Chopra","doi":"10.1111/aor.15066","DOIUrl":"https://doi.org/10.1111/aor.15066","url":null,"abstract":"<p><strong>Background: </strong>Kidney machine perfusion (MP) prevents delayed graft function (DGF). Whether this benefit translates into improved long-term graft survival (LGS) remains uncertain. We evaluated the association between MP and LGS and its potential mediation by DGF.</p><p><strong>Methods: </strong>UNOS analysis of adult deceased donor kidney transplant recipients (KTRs) from January 2010 to June 2019. We selected KTRs with cold ischemia time (CIT) > 12 h and on tacrolimus maintenance. We included KTRs from dual-kidney donors and compared outcomes where one mate kidney received MP and the other did not. The primary endpoint was all-cause graft failure (GF) analyzed using a stratified multivariable Cox proportional hazards model. We assessed the association of MP and DGF with conditional logistic regression. We evaluated the mediation effect of DGF by combining the predictor and outcome models and bootstrapping with 1000 iterations to calculate 95% confidence intervals (CI).</p><p><strong>Results: </strong>We included 2355 mate-kidney pairs with 5.8 years (IQR 4-8) median follow-up. MP was associated with lower GF risk (aHR 0.86, 95% CI 0.75-0.98) and DGF odds (aOR 0.41, 95% CI 0.34-0.51) than no MP. DGF fully mediated the association between MP and GF, as the effect was no longer statistically significant after adjusting for DGF (aHR 0.89, 95% CI 0.78-1.03). DGF explained 76.8% of the association between MP and GF.</p><p><strong>Conclusions: </strong>In mate-kidney pairs with discordant MP use and CIT > 12 h, MP was associated with decreased GF risk, mediated by decreased DGF likelihood. MP both mate kidneys with CIT > 12 h should be considered to potentially improve LGS.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fernando Leonel Da Rosa Jurao, Emilia Fushimi, Fabricio Garelli
{"title":"Switched Controllers in Fully Closed Loop Insulin Delivery Systems: Reducing the Trade-Off Between Prandial Control and Safety.","authors":"Fernando Leonel Da Rosa Jurao, Emilia Fushimi, Fabricio Garelli","doi":"10.1111/aor.15064","DOIUrl":"https://doi.org/10.1111/aor.15064","url":null,"abstract":"<p><strong>Background: </strong>One of the main challenges in control algorithm design for full closed-loop automated insulin delivery systems is the trade-off between the effective compensation of meal-related disturbances and ensuring user safety during the postprandial and fasting periods.</p><p><strong>Methods: </strong>This paper proposes and evaluates the performance of a switched tuning strategy, a promising but relatively underexplored solution in this domain. This method employs two distinct tunings of a primary control algorithm: an aggressive tuning for meal compensation and a conservative tuning for fasting periods. The analysis considers implementing the switched strategy for three control algorithms: model predictive control and proportional-derivative control, both widely used for glucose regulation, and a linear quadratic Gaussian control, an optimal algorithm previously validated in clinical settings under a switched structure. Additionally, to obtain a more comprehensive understanding of the switched strategy implications, two nonswitched controllers are implemented for each control algorithm: an aggressive and a conservative tuning strategy.</p><p><strong>Results: </strong>The switched strategy significantly improves the trade-off between meal compensation and safety, increasing the time within the target range of 70-180 [mg/dL] for all three algorithms. For proportional-derivative control, the time in range increases from 69.1% with the conservative tuning and 83.1% with the aggressive to 86.6% with the switched structure. For model predictive control, the improvement is from 73.4% and 74.1% to 85.8%. Last, linear quadratic Gaussian control increases from 65.0% and 70.4% to 85.6%.</p><p><strong>Conclusion: </strong>The findings suggest that the switched strategy may be a feasible and straightforward approach for enhancing meal compensation without increasing the risk of postprandial hypoglycemia in people with diabetes.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Damiano Patrono, Nicola De Stefano, Renato Romagnoli
{"title":"The Challenges of Pushing the Limits of Organ Utilization by Ex-Situ Machine Perfusion.","authors":"Damiano Patrono, Nicola De Stefano, Renato Romagnoli","doi":"10.1111/aor.15067","DOIUrl":"https://doi.org/10.1111/aor.15067","url":null,"abstract":"","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin J Schürmann, Bennet F Holst, Pia Creutz, Thomas Schmitz-Rode, Ulrich Steinseifer, Johanna C Clauser
{"title":"Ghost Cells as a Two-Phase Blood Analog Fluid -Fluorescent Mechanical Hemolysis Detection.","authors":"Benjamin J Schürmann, Bennet F Holst, Pia Creutz, Thomas Schmitz-Rode, Ulrich Steinseifer, Johanna C Clauser","doi":"10.1111/aor.15061","DOIUrl":"https://doi.org/10.1111/aor.15061","url":null,"abstract":"<p><strong>Background: </strong>This study investigated fluorescent hemolysis detection as an optical method to detect local hemolysis in mechanical circulatory support systems, addressing the limitations of standard hemolysis tests and current simulation methods. Standard tests, per ASTM1841-19, quantify general hemolysis but do not localize it.</p><p><strong>Methods: </strong>We employ a two-phase blood analog fluid composed of calcium-loaded ghost cells and phosphate-buffered saline. Ghost cells are hemoglobin-depleted red blood cells, allowing for optical measurements. A calcium-sensitive fluorescent indicator (Cal590 potassium salt, AAT Bioquest, Pleasanton, USA), activated by calcium released upon ghost cell hemolysis, enables fluorescent hemolysis detection. Hemolysis tests were conducted using porcine whole blood and the blood analog fluid, confirming that both undergo mechanical hemolysis in the Food and Drug Administration pump model.</p><p><strong>Results: </strong>The results revealed increased fluorescence intensity in response to hemolysis, with a quantitative fluorescence increase of 8.85/min at 3500 rpm and 2.5 L/min, indicating hemolysis, particularly at the rotor tip. Through image processing of fluorescence images, local hemolysis was visualized.</p><p><strong>Conclusion: </strong>This study is the first to use fluorescent hemolysis detection for local detection of mechanical hemolysis. Further refinement may enhance the design of mechanical circulatory support systems and bridge simulation limitations with experimental, localized hemolysis detection.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thomas C Palazzolo, Giselle C Matlis, Ethan Pastor, Ashwini Selvakumar, Aidan Crozier, Vakhtang Tchantchaleishvili, Randy M Stevens, Amy L Throckmorton
{"title":"Activation Mechanism Design for a Dual-Blood Pumping System for Pediatric Heart Failure.","authors":"Thomas C Palazzolo, Giselle C Matlis, Ethan Pastor, Ashwini Selvakumar, Aidan Crozier, Vakhtang Tchantchaleishvili, Randy M Stevens, Amy L Throckmorton","doi":"10.1111/aor.15062","DOIUrl":"https://doi.org/10.1111/aor.15062","url":null,"abstract":"<p><strong>Objective: </strong>Pediatric patients face significant challenges in the treatment of end-stage congenital or acquired heart failure (HF). Mechanical circulatory support (MCS) devices can serve as a bridge to transplant, but the few available MCS solutions are associated with deleterious patient outcomes when compared to adults. We are working to address this gap by developing a novel double-blood pump VAD to provide effective single-device support across the pediatric age range. Our innovative design integrates both an axial pump and a centrifugal pump in one implantable device and utilizes a unique mechanism to activate the secondary centrifugal pump as cardiac demands increase.</p><p><strong>Methods: </strong>We developed a configuration for the novel activation mechanism through virtual studies against functional requirements and anatomical fit constraints, iteratively improved the activation mechanism design to meet qualitative and quantitative design targets, evaluated the design through in vitro functional and hydraulic experimentation, and determined the hemolytic profile of the proposed design through hemolytic flow loop testing and analysis.</p><p><strong>Results: </strong>Multiple iterations of design improvements resulted in a prototype that could effectively and repeatably actuate in situ while providing leak-free support at physiological pressures and flows. Hemolytic testing demonstrated that the blood damage potential is low.</p><p><strong>Conclusion: </strong>The results from this study validate the proposed activation mechanism design and support the continued translational development of the Drexel Double Dragon VAD.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohamed J Saadh, Waleed K Abdulsahib, Saida Saidkhodjaeva, Gaurav Sanghvi, Suhas Ballal, R S K Sharma, Piyus Kumar Pathak, Aman Shankhyan, Abhinav Kumar, Fadhil Feez Sead, M V N L Chaitanya, Reza Akhavan-Sigari
{"title":"The Significance of Prolonged Physical Activity in Neurogenesis and Neural Regeneration: Comparing Clinical Studies With Proposed AI-Based Framework.","authors":"Mohamed J Saadh, Waleed K Abdulsahib, Saida Saidkhodjaeva, Gaurav Sanghvi, Suhas Ballal, R S K Sharma, Piyus Kumar Pathak, Aman Shankhyan, Abhinav Kumar, Fadhil Feez Sead, M V N L Chaitanya, Reza Akhavan-Sigari","doi":"10.1111/aor.15059","DOIUrl":"https://doi.org/10.1111/aor.15059","url":null,"abstract":"<p><strong>Background: </strong>Adult neurogenesis is the biological process whereby neural stem cells (NSCs) differentiate into neurons and glial cells in specific areas of the adult brain. Impairments in neurogenesis may lead to many complications, including neurodegenerative illnesses and psychiatric problems. In the adult brain, new neurons are generated from neural stem or progenitor cells (NPCs) through a meticulously controlled process that governs both cell proliferation and the specification of neuronal identity.</p><p><strong>Methods: </strong>This review discusses how artificial intelligence (AI) can be applied to analyze the effects of exercise on neural stem cell proliferation, focusing on data collection, AI model training, and the prediction of outcomes such as neural regeneration and recovery. AI-based models, including machine learning algorithms and deep learning techniques, offer promising tools for understanding and predicting the mechanisms underlying neurogenesis, potentially guiding personalized interventions for individuals with neurological conditions.</p><p><strong>Results: </strong>Adult neurogenesis is fundamentally impacted by several physiological, pathological, and pharmacological variables. These factors encompass exercise, age, severe brain injury, epilepsy, and antidepressant therapies.</p><p><strong>Conclusion: </strong>Recent studies indicate that physical exercise is a vital external element that significantly promotes adult neurogenesis in the hippocampus.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}