Research has tremendously contributed to the developments in both practical and fundamental aspects of limb prosthetics. These advancements are reflected in scientific articles, particularly in the most cited papers. This article aimed to identify the 100 top-cited articles in the field of limb prosthetics and to investigate their main characteristics. Articles related to the field of limb prosthetics and published in the Web of Knowledge database of the Institute for Scientific Information (ISI) from the period of 1980 to 2012. The 100 most cited articles in limb prosthetics were selected based on the citation index report. All types of articles except for proceedings and letters were included in the study. The study design and level of evidence were determined using Sackett’s initial rules of evidence. The level of evidence was categorized either as a systematic review or meta-analysis, randomized controlled trial, cohort study, case–control study, case series, expert opinion, or design and development. The top cited articles in prosthetics were published from 1980 to 2012 with a citation range of 11 to 90 times since publication. The mean citation rate was 24.43 (SD 16.7) times. Eighty-four percent of the articles were original publications and were most commonly prospective (76%) and case series studies (67%) that used human subjects (96%) providing level 4 evidence. Among the various fields, rehabilitation (47%), orthopedics (29%), and sport sciences (28%) were the most common fields of study. The study established that studies conducted in North America and were written in English had the highest citations. Top cited articles primarily dealt with lower limb prosthetics, specifically, on transtibial and transradial prosthetic limbs. Majority of the articles were experimental studies.
Citation-classics; Orthotics; Prosthetics; Journals; Association; Archives; Science; Bias
This paper describes a method for automatic analysis of the choroid in OCT images of the eye fundus in ophthalmology. The problem of vascular lesions occurs e.g. in a large population of patients having diabetes or macular degeneration. Their correct diagnosis and quantitative assessment of the treatment progress are a critical part of the eye fundus diagnosis.
Material and method
The study analysed about 1’000 OCT images acquired using SOCT Copernicus (Optopol Tech. SA, Zawiercie, Poland). The proposed algorithm for image analysis enabled to analyse the texture of the choroid portion located beneath the RPE (Retinal Pigment Epithelium) layer. The analysis was performed using the profiled algorithm based on morphological analysis and texture analysis and a classifier in the form of decision trees.
The location of the centres of gravity of individual objects present in the image beneath the RPE layer proved to be important in the evaluation of different types of images. In addition, the value of the standard deviation and the number of objects in a scene were equally important. These features enabled classification of three different forms of the choroid that were related to retinal pathology: diabetic edema (the classification gave accuracy ACC1 = 0.73), ischemia of the inner retinal layers (ACC2 = 0.83) and scarring fibro vascular tissue (ACC3 = 0.69). For the cut decision tree the results were as follows: ACC1 = 0.76, ACC2 = 0.81, ACC3 = 0.68.
The created decision tree enabled to obtain satisfactory results of the classification of three types of choroidal imaging. In addition, it was shown that for the assumed characteristics and the developed classifier, the location of B-scan does not significantly affect the results. The image analysis method for texture analysis presented in the paper confirmed its usefulness in choroid imaging. Currently the application is further studied in the Clinical Department of Ophthalmology in the District Railway Hospital in Katowice, Medical University of Silesia, Poland.
Eye; Image processing; OCT; Texture analysis; Conditional erosion and dilation
Total hip replacement (THR) is considered to be the most effective treatment option for advanced osteoarthritis of the hip in large breed dogs. However, a proportion of post-THR patients suffer prosthesis dislocation for various reasons, which may be addressed by a constrained acetabular prosthesis design. The study proposed a new THR with constrained acetabular component that aimed to decrease the incidence of postoperative dislocation while maintaining the necessary range of motion (ROM); and, through computer-simulated implantations, evaluated the ROM of the THR with and without malpositioning of the acetabular component.
A new THR with a constrained acetabular component that had an inward eccentric lining and a 60° cut-out on the dorsal side was designed, and its computer-aided design models were implanted into the pelvic and femoral models reconstructed from the computed tomography data of six healthy Labrador Retriever dogs. The allowable and functional ROM of the implanted THR were determined via computer simulations. The contact patterns between the bone or the prosthetic components at extreme positions of the THR were analyzed. Influence of malpositioning of the acetabular component on the ROM was assessed.
The means (SD) of the functional ranges for flexion, extension, adduction, abduction, internal rotation and external rotation were 51.8° (6.6°), 163.3° (7.3°), 33.5° (5.7°), 74.0° (3.7°), 41.5° (8.3°) and 65.2° (9.9°), respectively. Malpositioning of the acetabular component by 20° in one direction was found to reduce ROM in other directions (reducing lateral opening: flexion: 12°, adduction: 20°, internal/external rotations: < 20°; increasing lateral opening: extension and abduction: < 16°; reducing retroversion: extension: < 20°, abduction: 15°, external rotation: < 20°; increasing retroversion: flexion: < 20°, abduction, adduction and internal rotation: 20°).
From the computer-aided surgical simulations, the new THR was found to have sufficient functional ranges for flexion, extension, abduction, adduction and external rotation for Labrador Retrievers. Analysis of the malpositioning of the acetabular component suggests that accurate placement of the acetabular component is critical for achieving desirable ROM for daily activities.
Total hip replacement; Constrained acetabular component; Range of motion; Computer simulation; Canine
This study compared the adequacy of dental cone beam computed tomography (CBCT) and micro computed tomography (micro-CT) in evaluating the structural parameters of trabecular bones.
The cellular synthetic bones in 4 density groups (Groups 1–4: 0.12, 0.16, 0.20, and 0.32 g/cm3) were used in this study. Each group comprised 8 experimental specimens that were approximately 1 cm3. Dental CBCT and micro-CT scans were conducted on each specimen to obtain independent measurements of the following 4 trabecular bone structural parameters: bone volume fraction (BV/TV), specific bone surface (BS/BV), trabecular thickness (Tb.Th.), and trabecular separation (Tb.Sp.). Wilcoxon signed ranks tests were used to compare the measurement variations between the dental CBCT and micro-CT scans. A Spearman analysis was conducted to calculate the correlation coefficients (r) of the dental CBCT and micro-CT measurements.
Results and Conclusion
Of the 4 groups, the BV/TV and Tb.Th. measured using dental CBCT were larger compared with those measured using micro-CT. By contrast, the BS/BV measured using dental CBCT was significantly less compared with those measured using micro-CT. Furthermore, in the low-density groups (Groups 1 and 2), the Tb.Sp. measured using dental CBCT was smaller compared with those measured using micro-CT. However, the Tb.Sp. measured using dental CBCT was slightly larger in the high-density groups (Groups 3 and 4) than it was in the low density groups. The correlation coefficients between the BV/TV, BS/BV, Tb.Th., and Tb.Sp. values measured using dental CBCT and micro-CT were 0.9296 (p < .001), 0.8061 (p < .001), 0.9390 (p < .001), and 0.9583 (p < .001), respectively. Although the dental CBCT and micro-CT approaches exhibited high correlations, the absolute values of BV/TV, BS/BV, Tb.Th., Tb.Sp. differed significantly between these measurements. Additional studies must be conducted to evaluate using dental CBCT in clinical practice.
Breast density is a significant breast cancer risk factor measured from mammograms. The most appropriate method for measuring breast density for risk applications is still under investigation. Calibration standardizes mammograms to account for acquisition technique differences prior to making breast density measurements. We evaluated whether a calibration methodology developed for an indirect x-ray conversion full field digital mammography (FFDM) technology applies to direct x-ray conversion FFDM systems.
Breast tissue equivalent (BTE) phantom images were used to establish calibration datasets for three similar direct x-ray conversion FFDM systems. The calibration dataset for each unit is a function of the target/filter combination, x-ray tube voltage, current × time (mAs), phantom height, and two detector fields of view (FOVs). Methods were investigated to reduce the amount of calibration data by restricting the height, mAs, and FOV sampling. Calibration accuracy was evaluated with mixture phantoms. We also compared both intra- and inter-system calibration characteristics and accuracy.
Calibration methods developed previously apply to direct x-ray conversion systems with modification. Calibration accuracy was largely within the acceptable range of ± 4 standardized units from the ideal value over the entire acquisition parameter space for the direct conversion units. Acceptable calibration accuracy was maintained with a cubic-spline height interpolation, representing a modification to previous work. Calibration data is unit specific, can be acquired with the large FOV, and requires a minimum of one reference mAs sample. The mAs sampling, calibration accuracy, and the necessity for machine specific calibration data are common characteristics and in agreement with our previous work.
The generality of our calibration approach was established under ideal conditions. Evaluation with patient data using breast cancer status as the endpoint is required to demonstrate that the approach produces a breast density measure associated with breast cancer.
Breast density; Calibration; Phantom imaging; Direct x-ray conversion; Full field digital mammography
Large amounts of electro-oculographic (EOG) data, recorded during electroencephalographic (EEG) measurements, go underutilized. We present an automatic, auto-calibrating algorithm that allows efficient analysis of such data sets.
The auto-calibration is based on automatic threshold value estimation. Amplitude threshold values for saccades and blinks are determined based on features in the recorded signal. The performance of the developed algorithm was tested by analyzing 4854 saccades and 213 blinks recorded in two different conditions: a task where the eye movements were controlled (saccade task) and a task with free viewing (multitask). The results were compared with results from a video-oculography (VOG) device and manually scored blinks.
The algorithm achieved 93% detection sensitivity for blinks with 4% false positive rate. The detection sensitivity for horizontal saccades was between 98% and 100%, and for oblique saccades between 95% and 100%. The classification sensitivity for horizontal and large oblique saccades (10 deg) was larger than 89%, and for vertical saccades larger than 82%. The duration and peak velocities of the detected horizontal saccades were similar to those in the literature. In the multitask measurement the detection sensitivity for saccades was 97% with a 6% false positive rate.
The developed algorithm enables reliable analysis of EOG data recorded both during EEG and as a separate metrics.
EOG; Saccade; Blink; Auto-calibrating; Data mining
Electroencephalography (EEG) is best suited for long-term monitoring of brain functions in patients with disorders of consciousness (DOC). Mathematical tools are needed to facilitate efficient interpretation of long-duration sleep-wake EEG recordings.
Starting with matching pursuit (MP) decomposition, we automatically detect and parametrize sleep spindles, slow wave activity, K-complexes and alpha, beta and theta waves present in EEG recordings, and automatically construct profiles of their time evolution, relevant to the assessment of residual brain function in patients with DOC.
Above proposed EEG profiles were computed for 32 patients diagnosed as minimally conscious state (MCS, 20 patients), vegetative state/unresponsive wakefulness syndrome (VS/UWS, 11 patients) and Locked-in Syndrome (LiS, 1 patient). Their interpretation revealed significant correlations between patients’ behavioral diagnosis and: (a) occurrence of sleep EEG patterns including sleep spindles, slow wave activity and light/deep sleep cycles, (b) appearance and variability across time of alpha, beta, and theta rhythms. Discrimination between MCS and VS/UWS based upon prominent features of these profiles classified correctly 87% of cases.
Proposed EEG profiles offer user-independent, repeatable, comprehensive and continuous representation of relevant EEG characteristics, intended as an aid in differentiation between VS/UWS and MCS states and diagnostic prognosis. To enable further development of this methodology into clinically usable tests, we share user-friendly software for MP decomposition of EEG (http://braintech.pl/svarog) and scripts used for creation of the presented profiles (attached to this article).
Electroencephalography; Matching Pursuit; Disorders of consciousness; Minimally conscious state; Vegetative state; Locked-in syndrome
Aqueous humor flows regularly from posterior chamber to anterior chamber, and this flow much involves intraocular pressure, the eye tissue nutrition and metabolism.
To visualize and measure the intraocular flow regular pattern of aqueous humor.
Intraocular flow in the vitro eyeball is driven to simulate the physiological aqueous humor flow, and the flow field is measured by Particle Image Velocimetry(PIV). Fluorescent particle solution of a certain concentration was infused into the root of Posterior Chamber(PC) of vitro rabbit eye to simulate the generation of aqueous and was drained out at a certain hydrostatic pressure from the angle of Anterior Chamber(AC) to represent the drainage of aqueous. PIV method was used to record and calculate the flow on the midsagittal plane of the eyeball.
Velocity vector distribution in AC has been obtained, and the distribution shows symmetry feature to some extent. Fluorescent particle solution first fills the PC as it is continuously infused, then surges into AC through the pupil, flows upwards toward the central cornea, reflecting and scattering, and eventually converges along the inner cornea surface towards the outflow points at the periphery of the eyeball. Velocity values around the pupillary margin are within the range of 0.008-0.012 m/s, which are close to theoretical values of 0.0133 m/s, under the driving rate of 100 μl/min.
Flow field of aqueous humor can be measured by PIV method, which makes it possible to study the aqueous humor dynamics by experimental method. Our study provides a basis for experimental research on aqueous humor flow; further, it possibly helps to diagnose and treat eye diseases as shear force damage of ocular tissues and destructions on corneal endothelial cells from the point of intraocular flow field.
Aqueous humor flow; PIV; Flow field; Velocity vector
Monitoring retinal oxygenation is of primary importance in detecting the presence of some common eye diseases. To improve the estimation of oxygen tension in retinal vessels, regularized least-squares (RLS) method was shown to be very effective compared with the conventional least-squares (LS) estimation. In this study, we propose an accelerated RLS estimation method for the problem of assessing the oxygenation of retinal vessels from phosphorescence lifetime images.
In the previous work, gradient descent algorithms were used to find the minimum of the RLS cost function. This approach is computationally expensive, especially when the oxygen tension map is large. In this study, using a closed-form solution of the RLS estimation and some inherent properties of the problem at hand, the RLS process is reduced to the weighted averaging of the LS estimates. This decreases the computational complexity of the RLS estimation considerably without sacrificing its performance.
Performance analyses are conducted using both real and simulated data sets. In terms of computational complexity, the proposed RLS estimation method is significantly better than RLS methods that use gradient descent algorithms to find the minimum of the cost function. Additionally, there is no significant difference between the estimates acquired by the proposed and conventional RLS estimation methods.
The proposed RLS estimation method for computing the retinal oxygen tension is computationally efficient, and produces estimates with negligible difference from those obtained by iterative RLS methods. Further, the results of this study can be applied to other lifetime imaging problems that have similar properties.
Accelerated estimation; Closed-form solution; Regularized estimation; Retinal oxygen tension; Phosphorescence lifetime imaging
Ultrasound imaging of the heart is a commonly used clinical tool to assess cardiac function. The basis for this analysis is the quantification of cardiac blood flow and myocardial velocities. These are typically measured using different imaging modes and on different cardiac cycles. However, due to beat-to-beat variations such as irregular heart rhythm and transient events, simultaneous acquisition is preferred. There exists specialized ultrasound systems for this purpose; however, it would be beneficial if this could be achieved using conventional ultrasound systems due to their wide availability. The conventional Duplex mode ultrasound allows simultaneous acquisition, however at a highly reduced spatial and temporal resolution.
The aim of this work was to present and evaluate the performance of a novel method to recover myocardial tissue velocity using conventional Duplex ultrasound imaging, and to demonstrate its feasibility for the assessment of simultaneous blood flow and myocardial velocity in-vivo. The essence of the method was the estimation of the axial phase shift of robust echogenic structures between subsequent image frames. The performance of the method was evaluated on synthetic tissue mimicking B-mode image sequences at different frame rates (20–60 Hz) and tissue velocities (peak velocities 5-15cm/s), using cardiac deformation and displacement characteristics. The performance was also compared to a standard 2-D speckle tracking technique.
The method had an overall high performance at frame rates above 25 Hz, with less than 15% error of the peak diastolic velocity, and less than 10 ms peak timing error. The method showed superior performance compared to the 2-D tracking technique at frame rates below 50 Hz. The in-vivo quantification of simultaneous blood flow and myocardial tissue velocities verified the echocardiographic patterns and features of healthy subjects and the specific patient group.
A novel myocardial velocity quantification method was presented and high performance at frame rates above 25 Hz was shown. In-vivo quantification of simultaneous myocardial and blood flow velocities was feasible using the proposed method and conventional Duplex mode imaging. We propose that the methodology is suitable for retrospective as well as prospective studies on the mechanics and hemodynamics of the heart.
Ultrasound; Heart; Simultaneous; Echocardiography; Blood flow; Myocardial; Velocity; Low frame rate; Duplex
To apply advanced methods of communication, sensing, and instrumentation technologies to make a system that can help patients suffering from hemispatial neglect caused by higher cortical function disorder.
By using several sensors and actuators, the objective was to construct a tailor-made system for each patient. The input part of the system consists of sensors, an interface and transmitters. The output part consists of a receiver, logical arithmetic, an output interface and actuators. The information from the input part is sent to the output part in a wireless manner allowing the mobility of the input and output parts.
The system and its functionality were realized. Voice alarming and neck muscle stimuli were applied to two patients. We could verify the applicability of the system to remind the patients to put on their wheelchair’s brake and raise its footrest before attempting to stand for transferring to their beds.
The designed and constructed multi-input/output system can be used effectively to alarm the patients.
Hemiplegic; Neglect; Wireless; Instrumentation; Alarming system
Fetal spinal magnetic resonance imaging (MRI) is a prenatal routine for proper assessment of fetus development, especially when suspected spinal malformations occur while ultrasound fails to provide details. Limited by hardware, fetal spine MR images suffer from its low resolution.
High-resolution MR images can directly enhance readability and improve diagnosis accuracy. Image interpolation for higher resolution is required in clinical situations, while many methods fail to preserve edge structures. Edge carries heavy structural messages of objects in visual scenes for doctors to detect suspicions, classify malformations and make correct diagnosis. Effective interpolation with well-preserved edge structures is still challenging.
In this paper, we propose an edge-directed interpolation (EDI) method and apply it on a group of fetal spine MR images to evaluate its feasibility and performance. This method takes edge messages from Canny edge detector to guide further pixel modification. First, low-resolution (LR) images of fetal spine are interpolated into high-resolution (HR) images with targeted factor by bi-linear method. Then edge information from LR and HR images is put into a twofold strategy to sharpen or soften edge structures. Finally a HR image with well-preserved edge structures is generated. The HR images obtained from proposed method are validated and compared with that from other four EDI methods. Performances are evaluated from six metrics, and subjective analysis of visual quality is based on regions of interest (ROI).
All these five EDI methods are able to generate HR images with enriched details. From quantitative analysis of six metrics, the proposed method outperforms the other four from signal-to-noise ratio (SNR), peak signal-to-noise ratio (PSNR), structure similarity index (SSIM), feature similarity index (FSIM) and mutual information (MI) with seconds-level time consumptions (TC). Visual analysis of ROI shows that the proposed method maintains better consistency in edge structures with the original images.
The proposed method classifies edge orientations into four categories and well preserves structures. It generates convincing HR images with fine details and is suitable in real-time situations. Iterative curvature-based interpolation (ICBI) method may result in crisper edges, while the other three methods are sensitive to noise and artifacts.
Magnetic resonance imaging; Fetal spine; Edge-directed interpolation
Motion characteristics of CoP (Centre of Pressure, the point of application of the resultant ground reaction force acting on the plate) are useful for foot type characteristics detection. To date, only few studies have investigated the nonlinear characteristics of CoP velocity and acceleration during the stance phase. The aim of this study is to investigate whether CoP regularity is different among four foot types (normal foot, pes valgus, hallux valgus and pes cavus); this might be useful for classification and diagnosis of foot injuries and diseases. To meet this goal, sample entropy, a measure of time-series regularity, was used to quantify the CoP regularity of four foot types.
One hundred and sixty five subjects that had the same foot type bilaterally (48 subjects with healthy feet, 22 with pes valgus, 47 with hallux valgus, and 48 with pes cavus) were recruited for this study. A Footscan® system was used to collect CoP data when each subject walked at normal and steady speed. The velocity and acceleration in medial-lateral (ML) and anterior-posterior (AP) directions, and resultant velocity and acceleration were derived from CoP. The sample entropy is the negative natural logarithm of the conditional probability that a subseries of length m that matches pointwise within a tolerance r also matches at the next point. This was used to quantify variables of CoP velocity and acceleration of four foot types. The parameters r (the tolerance) and m (the matching length) for sample entropy calculation have been determined by an optimal method.
It has been found that in order to analyze all CoP parameters of velocity and acceleration during the stance phase of walking gait, for each variable there is a different optimal r value. On the contrary, the value m=4 is optimal for all variables.
Sample entropies of both velocity and acceleration in AP direction were highly correlated with their corresponding resultant variables for r>0.91. The sample entropy of the velocity in AP direction was moderately correlated with the one of the acceleration in the same direction (r≥0.673), as well as with the resultant acceleration (r≥0.660). The sample entropy of resultant velocity was moderately correlated with the one of the acceleration in AP direction, as well as with the resultant acceleration (for the both r≥0.689). Moderate correlations were found between variables for the left foot and their corresponding variables for the right foot.
Sample entropies of AP velocity, resultant velocity, AP acceleration, and resultant acceleration of the right foot as well as AP velocity and resultant velocity of the left foot were, respectively, significantly different among the four foot types.
It can be concluded that the sample entropy of AP velocity (or the resultant velocity) of the left foot, ML velocity, resultant velocity, ML acceleration and resultant acceleration could serve for evaluation of foot types or selection of appropriate footwear.
Gait; Foot pressure; Velocity; Acceleration; Foot types; Biomechanics
Muscle fiber orientation (MFO) is an important parameter related to musculoskeletal functions. The traditional manual method for MFO estimation in sonograms was labor-intensive. The automatic methods proposed in recent years also involved voting procedures which were computationally expensive.
In this paper, we proposed a new framework to efficiently estimate MFO in sonograms. We firstly employed Multi-scale Vessel Enhancement Filtering (MVEF) to enhance fascicles in the sonograms and then the enhanced images were binarized. Finally, line-shaped patterns in the binary map were detected one by one, according to their shape properties. Specifically speaking, for the long-and-thinner regions, the orientation of the targeted muscle fibre was directly computed, without voting procedures, as the orientation of the ellipse that had the same normalized second central moments as the region. For other cases, the Hough voting procedure might be employed for orientation estimation. The performance of the algorithm was evaluated using four various group of sonograms, which are a dataset used in previous reports, 33 sonograms of gastrocnemius from 11 young healthy subjects, one sonogram sequence including 200 frames from a subject and 256 frames from an aged subject with cerebral infarction respectively.
It was demonstrated in the experiments that measurements of the proposed method agreed well with those of the manual method and achieved much more efficiency than the previous Re-voting Hough Transform (RVHT) algorithm.
Results of the experiments suggested that, without compromising the accuracy, in the proposed framework the previous orientation estimation algorithm was accelerated by reduction of its dependence on voting procedures.
Ultrasound; Muscle; Hough transform; Orientation; Line detection; Image segmentation
Knowing the orientation of the head is important in many fields, including medicine. Many methods and measuring systems exist, but usually they use different markers or sensors attached to the subject’s head for head orientation determination. In certain applications these attachments may represent a burden or a distraction to the subject under study which may have an unfavourable impact on the measurement. We propose a non-contact optical method for head-to-trunk orientation measurement that does not require any attachments to the subject under study.
An innovative handheld 3D apparatus has been developed for non-invasive and fast 3D shape measurements. It is based on the triangulation principle in combination with fringe projection. The shape of the subject’s upper trunk and head is reconstructed from a single image using the Fourier transform profilometry method. Two shape measurements are required to determine the head-to-trunk orientation angles: one in the reference (neutral) position and the other one in the position of interest. The algorithm for the head-to-trunk orientation angle extraction is based on the separate alignment of the shape of the subject’s upper trunk and head against the corresponding shape in the reference pose. Single factor analysis of variance (ANOVA) was used for statistical characterisation of the method precision.
The method and the 3D apparatus were verified in-vitro using a mannequin and a reference orientation tracker. The uncertainty of the calculated orientation was 2°. During the in-vivo test with a human subject diagnosed with cervical dystonia (aged 60), the repeatability of the measurements was 3°. In-vitro and in-vivo comparison was done on the basis of an experiment with the mannequin and a healthy male (aged 29). These results show that only the difference between flexion/extension measured angles was statistically significant. The differences between means were less than 1° for all ranges.
The new non-contact method enables the compensation of the movement of the measuring instrument or the subject’s body as a whole, is non-invasive, requires little additional equipment and causes little stress for the subject and operator. We find that it is appropriate for measurements of the head orientation with respect to the trunk for the characterization of the cervical dystonia.
3D measurements; Head-to-trunk orientation; 3D alignment; Handheld 3D measuring system
The replacement of hard tissues demands biocompatible and sometimes bioactive materials with properties similar to those of bone. Nano-composites made of biocompatible polymers and bioactive inorganic nano particles such as HDPE/HA have attracted attention as permanent bone substitutes due to their excellent mechanical properties and biocompatibility.
The HDPE/HA nano-composite is prepared using melt blending at different HA loading ratios. For evaluation of the degradation by radiation, gamma rays of 35 kGy, and 70 kGy were used to irradiate the samples at room temperature in vacuum. The effects of accelerated ageing after gamma irradiation on morphological, mechanical and thermal properties of HDPE/HA nano-composites were measured.
In Vitro test results showed that the HDPE and all HDPE/HA nano-composites do not exhibit any cytotoxicity to WISH cell line. The results also indicated that the tensile properties of HDPE/HA nano-composite increased with increasing the HA content except fracture strain decreased. The dynamic mechanical analysis (DMA) results showed that the storage and loss moduli increased with increasing the HA ratio and the testing frequency. Finally, it is remarked that all properties of HDPE/HA is dependent on the irradiation dose and accelerated aging.
Based on the experimental results, it is found that the addition of 10%, 20% and 30% HA increases the HDPE stiffness by 23%, 44 and 59% respectively. At the same time, the G’ increased from 2.25E11 MPa for neat HDPE to 4.7E11 MPa when 30% HA was added to the polymer matrix. Also, significant improvements in these properties have been observed due to irradiation. Finally, the overall properties of HDPE and its nano-composite properties significantly decreased due to aging and should be taken into consideration in the design of bone substitutes. It is attributed that the developed HDPE/HA nano-composites could be a good alternative material for bone tissue regeneration due to their acceptable properties.
HDPE; HA; Nano-composite; DSC; DMA; Mechanical; Accelerated aging; Gamma radiation
Pneumatic tourniquets are medical devices that occlude blood flow to distal part of extremities and are commonly used in upper limb surgeries to provide a dry, clean and bloodless field. To decrease pressure-related injuries and potential risk of complications subjected to the high inflation pressure of pneumatic tourniquet, minimal inflation pressures are recommended.
A new occlusion pressure mathematical model for the upper limb was established based on the correlation analysis between several possible influencing parameters and the minimal pneumatic tourniquet pressure at which the peripheral pulse disappeared was recorded using a digital plethysmograph. A prototype of an adaptive pneumatic tourniquet which automatically varies the pressure in the tourniquet cuff according to the above prediction model was developed for the upper limb which used the lowest possible inflation pressure to achieve occlusion. The prototype comprises a blood pressure monitoring module, an inflatable tourniquet cuff, and a pressure relief mechanism to maintain an optimal cuff inflation pressure. Simulation experiments were conducted to verify the function and stability of the designed adaptive pneumatic tourniquet and clinical experiments using volunteers were undertaken to evaluate the performance of the prototype design in achieving adequate haemostasis in the upper limb.
Results demonstrated that the mean arterial occlusion pressure was 152.3 ± 16.7 mmHg, obviously below the 250 to 300 mmHg previously recommended (J Bone Joint Surg Br 68:625-628, 1986 and Arthroscopy 11:307–311, 1995).
In conclusion, this adaptive method and apparatus which can provide minimal inflation pressure may be a clinically practical alternative for upper limb surgery performed with pneumatic tourniquets.
Pneumatic tourniquet; Upper limb; Arterial occlusion pressure; Microprocessor
The repair surgery of congenital heart disease (CHD) associated with the right ventricular (RV)-pulmonary artery (PA) pathophysiology often left patients with critical post-operative lesions, leading to regurgitation and obstruction in the PAs. These lesions need longitudinal (with time) assessment for monitoring the RV function, in order for patients to have appropriate treatment before irreversible RV dysfunction occurs. In this research, we computed energy loss in the branch PAs using blood flow and pressure drop data obtained from 4D phase contrast (PC) MRI, to non-invasively quantify the RV-PA pathophysiology.
4D PC MRI was acquired for a CHD patient with abnormal RV-PA physiology, including pulmonary regurgitation and PA stenosis, and a subject with normal RV-PA physiology. The blood velocity, flow rate, and pressure drop data, obtained from 4D PC MRI, were used to compute and compare the energy loss values between the patient and normal subjects.
The pressure drop in the branch PAs for the patient was −1.3 mmHg/s and −0.2 mmHg/s for the RPA and LPA, respectively, and was larger (one order of magnitude) than that for the control. Similarly, the total energy loss in the branch PAs for the patient, -96.9 mJ/s and −16.4 mJ/s, for the RPA and LPA, respectively, was larger than that for the control.
The amount of energy loss in the pulmonary blood flow for the patient was considerably larger than the normal subject due to PA regurgitation and PA stenosis. Thus, we believe that the status of RV-PA pathophysiology for CHD patients can be evaluated non-invasively using energy loss endpoint.
4D phase contrast MRI; Pulmonary insufficiency; Energy-based endpoint
Matching pursuit algorithm (MP), especially with recent multivariate extensions, offers unique advantages in analysis of EEG and MEG.
We propose a novel construction of an optimal Gabor dictionary, based upon the metrics introduced in this paper. We implement this construction in a freely available software for MP decomposition of multivariate time series, with a user friendly interface via the Svarog package (Signal Viewer, Analyzer and Recorder On GPL, http://braintech.pl/svarog), and provide a hands-on introduction to its application to EEG. Finally, we describe numerical and mathematical optimizations used in this implementation.
Optimal Gabor dictionaries, based on the metric introduced in this paper, for the first time allowed for a priori assessment of maximum one-step error of the MP algorithm. Variants of multivariate MP, implemented in the accompanying software, are organized according to the mathematical properties of the algorithms, relevant in the light of EEG/MEG analysis. Some of these variants have been successfully applied to both multichannel and multitrial EEG and MEG in previous studies, improving preprocessing for EEG/MEG inverse solutions and parameterization of evoked potentials in single trials; we mention also ongoing work and possible novel applications.
Mathematical results presented in this paper improve our understanding of the basics of the MP algorithm. Simple introduction of its properties and advantages, together with the accompanying stable and user-friendly Open Source software package, pave the way for a widespread and reproducible analysis of multivariate EEG and MEG time series and novel applications, while retaining a high degree of compatibility with the traditional, visual analysis of EEG.
Matching pursuit; EEG; MEG; Time-frequency; Gabor dictionary; Metrics
The myocardium exhibits heterogeneous nature due to scarring after Myocardial Infarction (MI). In Cardiac Magnetic Resonance (CMR) imaging, Late Gadolinium (LG) contrast agent enhances the intensity of scarred area in the myocardium.
In this paper, we propose a probability mapping technique using Texture and Intensity features to describe heterogeneous nature of the scarred myocardium in Cardiac Magnetic Resonance (CMR) images after Myocardial Infarction (MI). Scarred tissue and non-scarred tissue are represented with high and low probabilities, respectively. Intermediate values possibly indicate areas where the scarred and healthy tissues are interwoven. The probability map of scarred myocardium is calculated by using a probability function based on Bayes rule. Any set of features can be used in the probability function.
In the present study, we demonstrate the use of two different types of features. One is based on the mean intensity of pixel and the other on underlying texture information of the scarred and non-scarred myocardium. Examples of probability maps computed using the mean intensity of pixel and the underlying texture information are presented. We hypothesize that the probability mapping of myocardium offers alternate visualization, possibly showing the details with physiological significance difficult to detect visually in the original CMR image.
The probability mapping obtained from the two features provides a way to define different cardiac segments which offer a way to identify areas in the myocardium of diagnostic importance (like core and border areas in scarred myocardium).
This article is a review of the book “Joining and assembly of medical materials and devices” edited by Y. (Norman) Zhou and Mark D. Breyen. This book (hardcover) was published by Woodhead Publishing, Cambridge, UK in 2013. The contents of the book and its relevance to medical device design and education are discussed in this invited review.
Biomaterials; Medical device assembly; Medical device joining; Welding; Bonding; Tissue adhesives
This article is a review of the book “Biomedical Signal and Image Processing” by Kayvan Najarian and Robert Splinter, which is published by CRC Press, Taylor & Francis Group. It will evaluate the contents of the book and discuss its suitability as a textbook, while mentioning highlights of the book, and providing comparison with other textbooks.
Biomedical; Fourier; Image processing; Signal processing; Textbook
Poly (ethylene glycol) (PEG) has attracted broad interest for tissue engineering applications. The aim of this study was to synthesize 4-arm -PEG-20kDa with the terminal group of diacrylate (4-arm-PEG-DA) and evaluate its dual functionality for decellularized porcine aortic valve (DAV) based on its mechanical and biological properties.
4-arm-PEG-DA was synthesized by graft copolymerization of linear PEG 20,000 monomers, and characterized by IR1H NMR and 13C NMR; PEGylation of DAV was achieved by the Michael addition reaction between propylene acyl and thiol, its effect was tested by uniaxial planar tensile testing, hematoxylin and eosin (HE) and scanning electron microscopy (SEM). Gly-Arg-Gly-Asp-Ser-Pro-Cys (GRGDSPC) peptides and vascular endothelial growth factor-165 (VEGF165) were conjugated onto DAV by branched PEG-DA (GRGDSPC-PEG-DAV-PEG-VEGF165).
Mechanical testing confirmed that PEG-cross-linking significantly enhanced the tensile strength of DAV. Immunofluoresce confirmed the GRGDSPC peptides and VEGF165 were conjugated effectively onto DAV; the quantification of conjunction was completed roughly using spectrophotometry and ELISA. The human umbilical vein endothelial cells (HUVECs) grew and spread well on the GRGDSPC-PEG-DAV-PEG-VEGF165.
Therefore, PEGylation of DAV not only can improve the tensile strength of DAV, and can also mediate the conjugation of bioactive molecule (VEGF165 and GRGDSPC peptides) on DAV, which might be suitable for further development of tissue engineered heart valve.
Decellularized valves; Polyethylene glycol; GRGDSPC peptides; VEGF165; Michael addition reaction
EMG-to-force estimation based on muscle models, for voluntary contraction has many applications in human motion analysis. The so-called Hill model is recognized as a standard model for this practical use. However, it is a phenomenological model whereby muscle activation, force-length and force-velocity properties are considered independently. Perreault reported Hill modeling errors were large for different firing frequencies, level of activation and speed of contraction. It may be due to the lack of coupling between activation and force-velocity properties. In this paper, we discuss EMG-force estimation with a multi-scale physiology based model, which has a link to underlying crossbridge dynamics. Differently from the Hill model, the proposed method provides dual dynamics of recruitment and calcium activation.
The ankle torque was measured for the plantar flexion along with EMG measurements of the medial gastrocnemius (GAS) and soleus (SOL). In addition to Hill representation of the passive elements, three models of the contractile parts have been compared. Using common EMG signals during isometric contraction in four able-bodied subjects, torque was estimated by the linear Hill model, the nonlinear Hill model and the multi-scale physiological model that refers to Huxley theory. The comparison was made in normalized scale versus the case in maximum voluntary contraction.
The estimation results obtained with the multi-scale model showed the best performances both in fast-short and slow-long term contraction in randomized tests for all the four subjects. The RMS errors were improved with the nonlinear Hill model compared to linear Hill, however it showed limitations to account for the different speed of contractions. Average error was 16.9% with the linear Hill model, 9.3% with the modified Hill model. In contrast, the error in the multi-scale model was 6.1% while maintaining a uniform estimation performance in both fast and slow contractions schemes.
We introduced a novel approach that allows EMG-force estimation based on a multi-scale physiology model integrating Hill approach for the passive elements and microscopic cross-bridge representations for the contractile element. The experimental evaluation highlights estimation improvements especially a larger range of contraction conditions with integration of the neural activation frequency property and force-velocity relationship through cross-bridge dynamics consideration.
Muscle model; EMG; Muscle force estimation; Hill model; Multi-scale physiology
In a previous study (Vaghefi et al. 2012) we described a 3D computer model that used finite element modeling to capture the structure and function of the ocular lens. This model accurately predicted the steady state properties of the lens including the circulating ionic and fluid fluxes that are believed to underpin the lens internal microcirculation system. In the absence of a blood supply, this system brings nutrients to the core of the lens and removes waste products faster than would be achieved by passive diffusion alone. Here we test the predictive properties of our model by investigating whether it can accurately mimic the experimentally measured changes to lens steady-state properties induced by either depolarising the lens potential or reducing Na+ pump rate.
To mimic experimental manipulations reported in the literature, the boundary conditions of the model were progressively altered and the model resolved for each new set of conditions. Depolarisation of lens potential was implemented by increasing the extracellular [K+], while inhibition of the Na+ pump was stimulated by utilising the inherent temperature sensitivity of the pump and changing the temperature at which the model was solved.
Our model correctly predicted that increasing extracellular [K+] depolarizes the lens potential, reducing and then reversing the magnitude of net current densities around the lens. While lowering the temperature reduced Na+ pump activity and caused a reduction in circulating current, it had a minimal effect on the lens potential, a result consistent with published experimental data.
We have shown that our model is capable of accurately simulating the effects of two known experimental manipulations on lens steady-state properties. Our results suggest that the model will be a valuable predictive tool to support ongoing studies of lens structure and function.
Computational modelling; Ocular lens; Microcirculation; Finite element; Physiological perturbations