Bioengineering doi: 10.3390/bioengineering11030288
Authors: Lorenzo Fiori Stefano Filippo Castiglia Giorgia Chini Francesco Draicchio Floriana Sacco Mariano Serrao Antonella Tatarelli Tiwana Varrecchia Alberto Ranavolo
The central nervous system (CNS) controls movements and regulates joint stiffness with muscle co-activation, but until now, few studies have examined muscle pairs during running. This study aims to investigate differences in lower limb muscle coactivation during gait at different speeds, from walking to running. Nineteen healthy runners walked and ran at speeds ranging from 0.8 km/h to 9.3 km/h. Twelve lower limb muscles’ co-activation was calculated using the time-varying multi-muscle co-activation function (TMCf) with global, flexor–extension, and rostro–caudal approaches. Spatiotemporal and kinematic parameters were also measured. We found that TMCf, spatiotemporal, and kinematic parameters were significantly affected by gait speed for all approaches. Significant differences were observed in the main parameters of each co-activation approach and in the spatiotemporal and kinematic parameters at the transition between walking and running. In particular, significant differences were observed in the global co-activation (CIglob, main effect F(1,17) = 641.04, p < 0.001; at the transition p < 0.001), the stride length (main effect F(1,17) = 253.03, p < 0.001; at the transition p < 0.001), the stride frequency (main effect F(1,17) = 714.22, p < 0.001; at the transition p < 0.001) and the Center of Mass displacement in the vertical (CoMy, main effect F(1,17) = 426.2, p < 0.001; at the transition p < 0.001) and medial–lateral (CoMz, main effect F(1,17) = 120.29 p < 0.001; at the transition p < 0.001) directions. Regarding the correlation analysis, the CoMy was positively correlated with a higher CIglob (r = 0.88, p < 0.001) and negatively correlated with Full Width at Half Maximum (FWHMglob, r = −0.83, p < 0.001), whereas the CoMz was positively correlated with the global Center of Activity (CoAglob, r = 0.97, p < 0.001). Positive and negative strong correlations were found between global co-activation parameters and center of mass displacements, as well as some spatiotemporal parameters, regardless of gait speed. Our findings suggest that walking and running have different co-activation patterns and kinematic characteristics, with the whole-limb stiffness exerted more synchronously and stably during running. The co-activation indexes and kinematic parameters could be the result of global co-activation, which is a sensory-control integration process used by the CNS to deal with more demanding and potentially unstable tasks like running.
]]>Bioengineering doi: 10.3390/bioengineering11030287
Authors: Andreas Kammerer Frederik Alexander Hartmann Christoph Nau Maximilian Leiblein Alexander Schaible Jonas Neijhoft Dirk Henrich René Verboket Maren Janko
Critical-size bone defects up to 25 cm can be treated successfully using the induced membrane technique established by Masquelet. To shorten this procedure, human acellular dermis (HAD) has had success in replacing this membrane in rat models. The aim of this study was to compare bone healing for smaller and larger defects using an induced membrane and HAD in a rat model. Using our established femoral defect model in rats, the animals were placed into four groups and defects of 5 mm or 10 mm size were set, either filling them with autologous spongiosa and surrounding the defect with HAD or waiting for the induced membrane to form around a cement spacer and filling this cavity in a second operation with a cancellous bone graft. Healing was assessed eight weeks after the operation using µ-CT, histological staining, and an assessment of the progress of bone formation using an established bone healing score. The α-smooth muscle actin used as a signal of blood vessel formation was stained and counted. The 5 mm defects showed significantly better bone union and a higher bone healing score than the 10 mm defects. HAD being used for the smaller defects resulted in a significantly higher bone healing score even than for the induced membrane and significantly higher blood vessel formation, corroborating the good results achieved by using HAD in previous studies. In comparison, same-sized groups showed significant differences in bone healing as well as blood vessel formation, suggesting that 5 mm defects are large enough to show different results in healing depending on treatment; therefore, 5 mm is a viable size for further studies on bone healing.
]]>Bioengineering doi: 10.3390/bioengineering11030286
Authors: Legeng Lin Wanyi Qing Yanhuan Huang Fuqiang Ye Wei Rong Waiming Li Jiao Jiao Xiaoling Hu
Focal vibratory stimulation (FVS) and neuromuscular electrical stimulation (NMES) are promising technologies for sensory rehabilitation after stroke. However, the differences between these techniques in immediate neuromodulatory effects on the poststroke cortex are not yet fully understood. In this research, cortical responses in persons with chronic stroke (n = 15) and unimpaired controls (n = 15) were measured by whole-brain electroencephalography (EEG) when FVS and NMES at different intensities were applied transcutaneously to the forearm muscles. Both FVS and sensory-level NMES induced alpha and beta oscillations in the sensorimotor cortex after stroke, significantly exceeding baseline levels (p < 0.05). These oscillations exhibited bilateral sensory deficiency, early adaptation, and contralesional compensation compared to the control group. FVS resulted in a significantly faster P300 response (p < 0.05) and higher theta oscillation (p < 0.05) compared to NMES. The beta desynchronization over the contralesional frontal–parietal area remained during NMES (p > 0.05), but it was significantly weakened during FVS (p < 0.05) after stroke. The results indicated that both FVS and NMES effectively activated the sensorimotor cortex after stroke. However, FVS was particularly effective in eliciting transient involuntary attention, while NMES primarily fostered the cortical responses of the targeted muscles in the contralesional motor cortex.
]]>Bioengineering doi: 10.3390/bioengineering11030285
Authors: Tea Sokač Cvetnić Korina Krog Davor Valinger Jasenka Gajdoš Kljusurić Maja Benković Tamara Jurina Tamara Jakovljević Ivana Radojčić Redovniković Ana Jurinjak Tušek
The reusability of by-products in the food industry is consistent with sustainable and greener production; therefore, the aim of this paper was to evaluate the applicability of multiple linear regression (MLR), piecewise linear regression (PLR) and artificial neural network models (ANN) to the prediction of grape-skin compost’s physicochemical properties (moisture, dry matter, organic matter, ash content, carbon content, nitrogen content, C/N ratio, total colour change of compost samples, pH, conductivity, total dissolved solids and total colour change of compost extract samples) during in-vessel composting based on the initial composting conditions (air-flow rate, moisture content and day of sampling). Based on the coefficient of determination for prediction, the adjusted coefficient of determination for calibration, the root-mean-square error of prediction (RMSEP), the standard error of prediction (SEP), the ratio of prediction to deviation (RPD) and the ratio of the error range (RER), it can be concluded that all developed MLR and PLR models are acceptable for process screening. Furthermore, the ANN model developed for predicting moisture and dry-matter content can be used for quality control (RER >11). The obtained results show the great potential of multivariate modelling for analysis of the physicochemical properties of compost during composting, confirming the high applicability of modelling in greener production processes.
]]>Bioengineering doi: 10.3390/bioengineering11030284
Authors: Lina Schütte Katharina Hausmann Christoph Schwarz Franziska Ersoy Ralf G. Berger
Following the idea of a circular bioeconomy, the use of side streams as substitutes for cultivation media (components) in bioprocesses would mean an enormous economic and ecological advantage. Costly compounds in conventional media for the production of the triterpene squalene in thraustochytrids are the main carbon source and complex nitrogen sources. Among other side streams examined, extracts from the spent mycelium of the basidiomycete Pleurotus ostreatus were best-suited to acting as alternative nitrogen sources in cultivation media for thraustochytrids. The total nitrogen (3.76 ± 0.01 and 4.24 ± 0.04%, respectively) and protein (16.47 ± 0.06 and 18.57 ± 0.18%, respectively) contents of the fruiting body and mycelium were determined. The fungal cells were hydrolyzed and extracted to generate accessible nitrogen sources. Under preferred conditions, the extracts from the fruiting body and mycelium contained 73.63 ± 1.19 and 89.93 ± 7.54 mM of free amino groups, respectively. Cultivations of Schizochytrium sp. S31 on a medium using a mycelium extract as a complex nitrogen source showed decelerated growth but a similar squalene yield (123.79 ± 14.11 mg/L after 216 h) compared to a conventional medium (111.29 ± 19.96 mg/L, although improvable by additional complex nitrogen source).
]]>Bioengineering doi: 10.3390/bioengineering11030283
Authors: Alicia Falcon-Caro Evtim Peytchev Saeid Sanei
Here, we present an effective application of adaptive cooperative networks, namely assisting disables in navigating in a crowd in a pandemic or emergency situation. To achieve this, we model crowd movement and introduce a cooperative learning approach to enable cooperation and self-organization of the crowd members with impaired health or on wheelchairs to ensure their safe movement in the crowd. Here, it is assumed that the movement path and the varying locations of the other crowd members can be estimated by each agent. Therefore, the network nodes (agents) should continuously reorganize themselves by varying their speeds and distances from each other, from the surrounding walls, and from obstacles within a predefined limit. It is also demonstrated how the available wireless trackers such as AirTags can be used for this purpose. The model effectiveness is examined with respect to the real-time changes in environmental parameters and its efficacy is verified.
]]>Bioengineering doi: 10.3390/bioengineering11030282
Authors: Nesrin Dursun Hakki Gülşen
Hydrogen creates water during combustion. Therefore, it is expected to be the most promising environmentally friendly energy alternative in the coming years. This study used extract liquid obtained from the waste nigella sativa generated by the black cumin oil industry. The performance of biological hydrogen manufacturing via dark fermentation was investigated in the fluidized bed reactor (FBR) and completely stirred tank reactor (CSTR) under the operation conditions of pH 5.0, 4.0, and 6.0 and a hydraulic retention time (HRT) of 36 and 24 h. The performance of hydrogen manufacturing was determined to be good under an organic loading ratio (OLR) of 6.66 g.nigella sativa extract/L and pH 4.0. According to these conditions, the maximum amount of hydrogen in CSTR and FBR was found to be 20.8 and 7.6 mL H2/day, respectively. The operating process of the reactors displayed that a reduction in HRT augmented biohydrogen manufacturing. The work that used mixed culture found that the dominant microbial population at pH 4.0 involved Hydrogenimonas thermophila, Sulfurospirillum carboxydovorans, Sulfurospirillum cavolei, Sulfurospirillum alkalitolerans, and Thiofractor thiocaminus. No research on waste black cumin extract was found in biohydrogen studies, and it was determined that this substrate source is applicable for biological hydrogen manufacturing.
]]>Bioengineering doi: 10.3390/bioengineering11030281
Authors: J. Shanthi Sravan Leonidas Matsakas Omprakash Sarkar
Advancements in biological wastewater treatment with sustainable and circularity approaches have a wide scope of application. Biological wastewater treatment is widely used to remove/recover organic pollutants and nutrients from a diverse wastewater spectrum. However, conventional biological processes face challenges, such as low efficiency, high energy consumption, and the generation of excess sludge. To overcome these limitations, integrated strategies that combine biological treatment with other physical, chemical, or biological methods have been developed and applied in recent years. This review emphasizes the recent advances in integrated strategies for biological wastewater treatment, focusing on their mechanisms, benefits, challenges, and prospects. The review also discusses the potential applications of integrated strategies for diverse wastewater treatment towards green energy and resource recovery, along with low-carbon fuel production. Biological treatment methods, viz., bioremediation, electro-coagulation, electro-flocculation, electro-Fenton, advanced oxidation, electro-oxidation, bioelectrochemical systems, and photo-remediation, are summarized with respect to non-genetically modified metabolic reactions. Different conducting materials (CMs) play a significant role in mass/charge transfer metabolic processes and aid in enhancing fermentation rates. Carbon, metal, and nano-based CMs hybridization in different processes provide favorable conditions to the fermentative biocatalyst and trigger their activity towards overcoming the limitations of the conventional process. The emerging field of nanotechnology provides novel additional opportunities to surmount the constraints of conventional process for enhanced waste remediation and resource valorization. Holistically, integrated strategies are promising alternatives for improving the efficiency and effectiveness of biological wastewater treatment while also contributing to the circular economy and environmental protection.
]]>Bioengineering doi: 10.3390/bioengineering11030280
Authors: Federica Camuncoli Giorgia Malerba Emilia Biffi Eleonora Diella Eugenio Di Stanislao Guerrino Rosellini Daniele Panzeri Luigi Piccinini Manuela Galli
Cerebral palsy poses challenges in walking, necessitating ankle foot orthoses (AFOs) for stability. Gait analysis, particularly on slopes, is crucial for effective AFO assessment. The study aimed to compare the performance of commercially available AFOs with a new sports-specific AFO in children with hemiplegic cerebral palsy and to assess the effects of varying slopes on gait. Eighteen participants, aged 6–11, with hemiplegia, underwent gait analysis using GRAIL technology. Two AFO types were tested on slopes (uphill +10 deg, downhill −5 deg, level-ground). Kinematic, kinetic, and spatiotemporal parameters were analyzed. The new AFO contributed to significant changes in ankle dorsi-plantar-flexion, foot progression, and trunk and hip rotation during downhill walking. Additionally, the new AFO had varied effects on spatiotemporal gait parameters, with an increased stride length during downhill walking. Slope variations significantly influenced the kinematics and kinetics. This study provides valuable insights into AFO effectiveness and the impact of slopes on gait in hemiplegic cerebral palsy. The findings underscore the need for personalized interventions, considering environmental factors, and enhancing clinical and research approaches for improving mobility in cerebral palsy.
]]>Bioengineering doi: 10.3390/bioengineering11030279
Authors: Florian Wichlas Marco Necchi Teresa Gruber Valeska Hofmann Susanne Deininger Sebastian Hubertus Markus Deininger Amelie Deluca Eva Steidle-Kloc Jan Pruszak Jörn Wittig Christian Deininger
Background: The lack of resources limits the treatment of craniomaxillofacial fractures (CMF) in low-income countries (LIC). Therefore, Barton bandages and/or interdental wiring are considered in these regions. Fracture reduction is maintained by permanent occlusion for 6 weeks, which often leads to limited compliance and dissatisfying results. The aim of this cadaver-based study is to evaluate the feasibility of the use of an external face fixator (EFF) for the treatment of CMF, its biomechanical values and to define the optimal pin insertion points and angles. Materials and Methods: An AO hand fixator was used. CMF of types Le Fort 1–3 with split fractures of the hard palate were treated with EFF on 13 anatomical specimens. Fractures were created using a chisel, and pins were placed in specific anatomical regions. The maximal pull-out force [N] of pins was analysed by a tensile force gauge, and Fmax of the mandibular pins was evaluated. Computer tomography scans were performed on the healthy, fractured and EFF-treated skulls. Results: The pull-out forces for the single pins were mandibular pins (n = 15, median 488.0 N), supraorbital pins (n = 15, median 455.0 N), zygomatic pins (n = 14, median 269.1 N), medial hard palate pins (n = 12, median 208.4 N) and lateral hard palate pins (n = 8, median 49.6 N). Conclusions: The results indicate that the operation technique is feasible, and the stability of the EFF is sufficient for maintaining the reduction. The required pins can safely be inserted into the described areas with good reduction results. Using EFF offers a feasible alternative to the non-surgical treatment of CMF in LIC.
]]>Bioengineering doi: 10.3390/bioengineering11030278
Authors: Christos Chadoulos Dimitrios Tsaopoulos Andreas Symeonidis Serafeim Moustakidis John Theocharis
In this paper, we propose a dense multi-scale adaptive graph convolutional network (DMA-GCN) method for automatic segmentation of the knee joint cartilage from MR images. Under the multi-atlas setting, the suggested approach exhibits several novelties, as described in the following. First, our models integrate both local-level and global-level learning simultaneously. The local learning task aggregates spatial contextual information from aligned spatial neighborhoods of nodes, at multiple scales, while global learning explores pairwise affinities between nodes, located globally at different positions in the image. We propose two different structures of building models, whereby the local and global convolutional units are combined by following an alternating or a sequential manner. Secondly, based on the previous models, we develop the DMA-GCN network, by utilizing a densely connected architecture with residual skip connections. This is a deeper GCN structure, expanded over different block layers, thus being capable of providing more expressive node feature representations. Third, all units pertaining to the overall network are equipped with their individual adaptive graph learning mechanism, which allows the graph structures to be automatically learned during training. The proposed cartilage segmentation method is evaluated on the entire publicly available Osteoarthritis Initiative (OAI) cohort. To this end, we have devised a thorough experimental setup, with the goal of investigating the effect of several factors of our approach on the classification rates. Furthermore, we present exhaustive comparative results, considering traditional existing methods, six deep learning segmentation methods, and seven graph-based convolution methods, including the currently most representative models from this field. The obtained results demonstrate that the DMA-GCN outperforms all competing methods across all evaluation measures, providing DSC=95.71% and DSC=94.02% for the segmentation of femoral and tibial cartilage, respectively.
]]>Bioengineering doi: 10.3390/bioengineering11030277
Authors: Jessica Podda Ludovico Pedullà Giampaolo Brichetto Andrea Tacchino
Background: People with multiple sclerosis (PwMS) frequently present both cognitive and motor impairments, so it is reasonable to assume they may have difficulties in executing dual-tasks (DT). The aim of the present study is to identify novel technology-based parameters to assess cognitive-motor interference (CMI) in PwMS. In particular, we focused on the definition of dual-task cost (DTC) measures using wearable and portable tools such as insoles and mobile apps. Methods: All participants underwent a verbal fluency task (cognitive single-task, ST), a motor ST of walking, and a combination of these tasks (DT). Number of words uttered in the cognitive ST and steps recorded by insoles were used to calculate the motor and cognitive DTC. Results: The number of steps strongly correlated with the walked meters for both single- (r = 0.88, p < 0.05) and dual- (r = 0.91, p < 0.05) tasks. Motor but not cognitive performances significantly worsened during DT. Over the cognitive ST and DT, the number of pronounced words progressively decreased, probably due to the activation of different cognitive processes. Cognitive efforts could be the cause of cognitive task prioritization. Conclusions: Our findings promote the use of low-cost devices to assess CMI easily in the clinical context and to detect ecologically valid DT impairments.
]]>Bioengineering doi: 10.3390/bioengineering11030276
Authors: Zaihao Wang Yuhao Ding Wei Yuan Hongyu Chen Wei Chen Chen Chen
EEG, which can provide brain alteration information via recording the electrical activity of neurons in the cerebral cortex, has been widely used in neurophysiology. However, conventional wet electrodes in EEG monitoring typically suffer from inherent limitations, including the requirement of skin pretreatment, the risk of superficial skin infections, and signal performance deterioration that may occur over time due to the air drying of the conductive gel. Although the emergence of dry electrodes has overcome these shortcomings, their electrode–skin contact impedance is significantly high and unstable, especially in hair-covered areas. To address the above problems, an active claw-shaped dry electrode is designed, moving from electrode morphological design, slurry preparation, and coating to active electrode circuit design. The active claw-shaped dry electrode, which consists of a claw-shaped electrode and active electrode circuit, is dedicated to offering a flexible solution for elevating electrode fittings on the scalp in hair-covered areas, reducing electrode–skin contact impedance and thus improving the quality of the acquired EEG signal. The performance of the proposed electrodes was verified by impedance, active electrode circuit, eyes open-closed, steady-state visually evoked potential (SSVEP), and anti-interference tests, based on EEG signal acquisition. Experimental results show that the proposed claw-shaped electrodes (without active circuit) can offer a better fit between the scalp and electrodes, with a low electrode–skin contact impedance (18.62 KΩ@1 Hz in the hairless region and 122.15 KΩ@1 Hz in the hair-covered region). In addition, with the active circuit, the signal-to-noise ratio (SNR) of the acquiring EEG signal was improved and power frequency interference was restrained, therefore, the proposed electrodes can yield an EEG signal quality comparable to wet electrodes.
]]>Bioengineering doi: 10.3390/bioengineering11030275
Authors: Qian Xiang Jiaxin Wang Yong Liu Shijie Guo Lei Liu
The gait recognition of exoskeletons includes motion recognition and gait phase recognition under various road conditions. The recognition of gait phase is a prerequisite for predicting exoskeleton assistance time. The estimation of real-time assistance time is crucial for the safety and accurate control of lower-limb exoskeletons. To solve the problem of predicting exoskeleton assistance time, this paper proposes a gait recognition model based on inertial measurement units that combines the real-time motion state recognition of support vector machines and phase recognition of long short-term memory networks. A recognition validation experiment was conducted on 30 subjects to determine the reliability of the gait recognition model. The results showed that the accuracy of motion state and gait phase were 99.98% and 98.26%, respectively. Based on the proposed SVM-LSTM gait model, exoskeleton assistance time was predicted. A test was conducted on 10 subjects, and the results showed that using assistive therapy based on exercise status and gait stage can significantly improve gait movement and reduce metabolic costs by an average of more than 10%.
]]>Bioengineering doi: 10.3390/bioengineering11030274
Authors: Giorgio Novelli Andrea Filippi Andrea Cartocci Sergio Mirabella Marco Talarico Elena De Ponti Maria Costanza Meazzini Davide Sozzi Gabriele Canzi Marco Anghileri
Mandibular fractures are very common in maxillofacial trauma surgery. While previous studies have focused on possible risk factors related to post-operative complications, none have tried to identify pre-existing conditions that may increase the risk of mandibular fractures. We hypothesized, through clinical observation, that anatomical conditions involving poor dental contacts, such as malocclusions, may increase the risk of mandibular fractures. This work was subdivided into two parts. In the first part, Digital Imaging and Communications in Medicine (DICOM) data of four healthy patients characterized by different dentoskeletal occlusions (class I, class II, class III, and anterior open bite) have been used to develop four finite element models (FEMs) that accurately reproduce human bone structure. A vertical and lateral impact have been simulated at increasing speed on each model, analyzing the force distribution within the mandibular bone. Both vertical and lateral impact showed higher level of stress at the impact point and in the condylar area in models characterized by malocclusion. Specifically, the class III and the open bite models, at the same speed of impact, had higher values for a longer period, reaching critical stress levels that are correlated with mandibular fracture, while normal occlusion seems to be a protective condition. In the second part of this study, the engineering results were validated through the comparison with a sample of patients previously treated for mandibular fracture. Data from 223 mandibular fractures, due to low-energy injuries, were retrospectively collected to evaluate a possible correlation between pre-existing malocclusion and fracture patterns, considering grade of displacement, numbers of foci, and associated CFI score. Patients were classified, according to their occlusion, into Class I, Class II, Class III, and anterior open bite or poor occlusal contact (POC). Class I patients showed lower frequencies of fracture than class II, III, and open bite or POC patients. Class I was associated with displaced fractures in 16.1% of cases, class II in 47.1%, class III in 48.8% and open bite/POC in 65.2% of cases (p-value < 0.0001). In class I patients we observed a single non-displaced fracture in 51.6% of cases, compared to 12.9% of Class II, 19.5% of Class III and 22.7% of the open bite/POC group. Our analysis shows that class I appears to better dissipate forces applied on the mandible in low-energy injuries. A higher number of dental contacts showed a lower rate of multifocal and displaced fractures, mitigating the effect of direct forces onto the bone. The correlation between clinical data and virtual simulation on FEM models seems to point out that virtual simulation successfully predicts fracture patterns and risk of association with different type of occlusion. Better knowledge of biomechanics and force dissipation on the human body may lead to the development of more effective safety devices, and help select patients to plan medical, orthodontic/dental, and/or surgical intervention to prevent injuries.
]]>Bioengineering doi: 10.3390/bioengineering11030273
Authors: Kenji Yoshitsugu Eisuke Shimizu Hiroki Nishimura Rohan Khemlani Shintaro Nakayama Tadamasa Takemura
Ophthalmological services face global inadequacies, especially in low- and middle-income countries, which are marked by a shortage of practitioners and equipment. This study employed a portable slit lamp microscope with video capabilities and cloud storage for more equitable global diagnostic resource distribution. To enhance accessibility and quality of care, this study targets corneal opacity, which is a global cause of blindness. This study has two purposes. The first is to detect corneal opacity from videos in which the anterior segment of the eye is captured. The other is to develop an AI pipeline to detect corneal opacities. First, we extracted image frames from videos and processed them using a convolutional neural network (CNN) model. Second, we manually annotated the images to extract only the corneal margins, adjusted the contrast with CLAHE, and processed them using the CNN model. Finally, we performed semantic segmentation of the cornea using annotated data. The results showed an accuracy of 0.8 for image frames and 0.96 for corneal margins. Dice and IoU achieved a score of 0.94 for semantic segmentation of the corneal margins. Although corneal opacity detection from video frames seemed challenging in the early stages of this study, manual annotation, corneal extraction, and CLAHE contrast adjustment significantly improved accuracy. The incorporation of manual annotation into the AI pipeline, through semantic segmentation, facilitated high accuracy in detecting corneal opacity.
]]>Bioengineering doi: 10.3390/bioengineering11030272
Authors: Ji-Ho Ahn Young-Jun Lim Jungwon Lee Yeon-Wha Baek Myung-Joo Kim Ho-Beom Kwon
Narrow-diameter implants (NDI) serve as a solution for treating limited bone volume in the anterior mandible. This study aimed to evaluate the one-year clinical outcomes of various NDIs in the mandibular incisor area after immediate loading in partially edentulous patients. This single-center, prospective, single-blinded, randomized controlled trial study included 21 patients, with 7 patients in each of the following groups: control (BLT NC SLActive®; Straumann), experimental group 1 (CMI IS-III Active® S-Narrow; Neobiotech), and experimental group 2 (CMI IS-III Active® Narrow; Neobiotech). Using full digital flow, two fixtures were placed in each patient and immediately provisionalized on the day of surgery. Evaluations encompassed periapical radiographs, implant stability quotient (ISQ), implant stability test (IST) readings, per-implant soft tissue health, patient satisfaction surveys, and esthetic score assessments. Definitive prostheses were delivered twelve weeks post-surgery (CRiS, number: KCT0007300). Following exclusions due to low stability values (n = 2), fixture failure (n = 5), and voluntary withdrawal (n = 1), the implant success rate for patients completing all clinical protocols stood at 100%. The resulting patient failure rates in the control, experimental group 1, and experimental group 2 were 50.0%, 42.9%, and 14.3%, respectively. There were no significant differences between the groups in terms of marginal bone loss, soft tissue health, patient satisfaction, and esthetic scores. Narrow implants showed superior clinical outcomes, followed by S-Narrow and Straumann implants. Calculated one-year survival rates at the implant level were 66.7% for the control group, 85.7% for experimental group 1, and 100% for experimental group 2. All three types of NDIs showed acceptable clinical and radiographic results during the year-long observation period.
]]>Bioengineering doi: 10.3390/bioengineering11030271
Authors: Sang Beom Han Yu-Chi Liu Chang Liu Jodhbir S. Mehta
Fuchs endothelial corneal dystrophy (FECD) is a complex genetic disorder characterized by the slow and progressive degeneration of corneal endothelial cells. Thus, it may result in corneal endothelial decompensation and irreversible corneal edema. Moreover, FECD is associated with alterations in all corneal layers, such as thickening of the Descemet membrane, stromal scarring, subepithelial fibrosis, and the formation of epithelial bullae. Hence, anterior segment imaging devices that enable precise measurement of functional and anatomical changes in the cornea are essential for the management of FECD. In this review, the authors will introduce studies on the application of various imaging modalities, such as anterior segment optical coherence tomography, Scheimpflug corneal tomography, specular microscopy, in vitro confocal microscopy, and retroillumination photography, in the diagnosis and monitoring of FECD and discuss the results of these studies. The application of novel technologies, including image processing technology and artificial intelligence, that are expected to further enhance the accuracy, precision, and speed of the imaging technologies will also be discussed.
]]>Bioengineering doi: 10.3390/bioengineering11030269
Authors: Aurèle Goetz Pablo Jeken-Rico Yves Chau Jacques Sédat Aurélien Larcher Elie Hachem
Computational fluid dynamics is intensively used to deepen our understanding of aneurysm growth and rupture in an attempt to support physicians during therapy planning. Numerous studies assumed fully rigid vessel walls in their simulations, whose sole haemodynamics may fail to provide a satisfactory criterion for rupture risk assessment. Moreover, direct in vivo observations of intracranial aneurysm pulsation were recently reported, encouraging the development of fluid–structure interaction for their modelling and for new assessments. In this work, we describe a new fluid–structure interaction functional setting for the careful evaluation of different aneurysm shapes. The configurations consist of three real aneurysm domes positioned on a toroidal channel. All geometric features, employed meshes, flow quantities, comparisons with the rigid wall model and corresponding plots are provided for the sake of reproducibility. The results emphasise the alteration of flow patterns and haemodynamic descriptors when wall deformations were taken into account compared with a standard rigid wall approach, thereby underlining the impact of fluid–structure interaction modelling.
]]>Bioengineering doi: 10.3390/bioengineering11030270
Authors: Luoyi Kong Mohan Huang Lingfeng Zhang Lawrence Wing Chi Chan
Medical imaging serves as a crucial tool in current cancer diagnosis. However, the quality of medical images is often compromised to minimize the potential risks associated with patient image acquisition. Computer-aided diagnosis systems have made significant advancements in recent years. These systems utilize computer algorithms to identify abnormal features in medical images, assisting radiologists in improving diagnostic accuracy and achieving consistency in image and disease interpretation. Importantly, the quality of medical images, as the target data, determines the achievable level of performance by artificial intelligence algorithms. However, the pixel value range of medical images differs from that of the digital images typically processed via artificial intelligence algorithms, and blindly incorporating such data for training can result in suboptimal algorithm performance. In this study, we propose a medical image-enhancement scheme that integrates generic digital image processing and medical image processing modules. This scheme aims to enhance medical image data by endowing them with high-contrast and smooth characteristics. We conducted experimental testing to demonstrate the effectiveness of this scheme in improving the performance of a medical image segmentation algorithm.
]]>Bioengineering doi: 10.3390/bioengineering11030268
Authors: Atefeh Ebrahimian Mona Schalk Mark Dürkop Michael Maurer Rudolf Bliem Harald Kühnel
Microcarrier-based cell culture is a commonly used method to facilitate the growth of anchorage-dependent cells like MA 104 for antigen manufacturing. However, conventionally, static cell culture is employed for cell propagation before seeding the production bioreactor with microcarriers (MCs). This study demonstrates the effective replacement of the conventional method by serial subculturing on MCs with in situ cell detachment under optimal conditions in closed culture units. This study proves that MA 104 can be subcultured at least five times on Cytodex 1 MC without the need for separating cells and MC after cell harvest. Process parameters impacting cell growth were studied post in situ cell detachment in a scaled-down model. Optimization, using augmented Design of Experiments (DoE) combined with hybrid modeling, facilitated rapid screening of the design space for critical process parameters (CPPs). Optimized conditions included an inoculation density of >16 cells/bead, 3.5–4.5 g/L of Cytodex 1, and a controlled agitation speed, starting at Njs (minimum agitation speed) for the first day with a maximum increase of 25% thereafter. With these design spaces for CPPs, a cell density of 2.6 ± 0.5 × 106 cells/mL was achieved after five days. This refined bioprocess methodology offers a reliable and efficient approach for seed training in stirred tank reactors, which is particularly beneficial for viral vaccine production.
]]>Bioengineering doi: 10.3390/bioengineering11030267
Authors: Ana Isabel Sousa Carlos Marques-Neves Pedro Manuel Vieira
Chromatic Pupillometry, used to assess Pupil Light Reflex (PLR) to a coloured light stimulus, has regained interest since the discovery of melanopsin in the intrinsically photosensitive Retinal Ganglion Cells (ipRGCs). This technique has shown the potential to be used as a screening tool for neuro-ophthalmological diseases; however, most of the pupillometers available are expensive and not portable, making it harder for them to be used as a widespread screening tool. In this study, we developed a smartphone-based system for chromatic pupillometry that allows targeted stimulation of the ipRGCs. Using a smartphone, this system is portable and accessible and takes advantage of the location of the ipRGCs in the perifovea. The system incorporates a 3D-printed support for the smartphone and an illumination system. Preliminary tests were carried out on a single individual and then validated on eleven healthy individuals with two different LED intensities. The average Post-Illumination Pupil Light Response 6 s after the stimuli offsets (PIPR-6s) showed a difference between the blue and the red stimuli of 9.5% for both intensities, which aligns with the studies using full-field stimulators. The results validated this system for a targeted stimulation of the ipRGCs for chromatic pupillometry, with the potential to be a portable and accessible screening tool for neuro-ophthalmological diseases.
]]>Bioengineering doi: 10.3390/bioengineering11030266
Authors: Usharani Bhimavarapu Nalini Chintalapudi Gopi Battineni
There is no doubt that brain tumors are one of the leading causes of death in the world. A biopsy is considered the most important procedure in cancer diagnosis, but it comes with drawbacks, including low sensitivity, risks during biopsy treatment, and a lengthy wait for results. Early identification provides patients with a better prognosis and reduces treatment costs. The conventional methods of identifying brain tumors are based on medical professional skills, so there is a possibility of human error. The labor-intensive nature of traditional approaches makes healthcare resources expensive. A variety of imaging methods are available to detect brain tumors, including magnetic resonance imaging (MRI) and computed tomography (CT). Medical imaging research is being advanced by computer-aided diagnostic processes that enable visualization. Using clustering, automatic tumor segmentation leads to accurate tumor detection that reduces risk and helps with effective treatment. This study proposed a better Fuzzy C-Means segmentation algorithm for MRI images. To reduce complexity, the most relevant shape, texture, and color features are selected. The improved Extreme Learning machine classifies the tumors with 98.56% accuracy, 99.14% precision, and 99.25% recall. The proposed classifier consistently demonstrates higher accuracy across all tumor classes compared to existing models. Specifically, the proposed model exhibits accuracy improvements ranging from 1.21% to 6.23% when compared to other models. This consistent enhancement in accuracy emphasizes the robust performance of the proposed classifier, suggesting its potential for more accurate and reliable brain tumor classification. The improved algorithm achieved accuracy, precision, and recall rates of 98.47%, 98.59%, and 98.74% on the Fig share dataset and 99.42%, 99.75%, and 99.28% on the Kaggle dataset, respectively, which surpasses competing algorithms, particularly in detecting glioma grades. The proposed algorithm shows an improvement in accuracy, of approximately 5.39%, in the Fig share dataset and of 6.22% in the Kaggle dataset when compared to existing models. Despite challenges, including artifacts and computational complexity, the study’s commitment to refining the technique and addressing limitations positions the improved FCM model as a noteworthy advancement in the realm of precise and efficient brain tumor identification.
]]>Bioengineering doi: 10.3390/bioengineering11030265
Authors: Heejoo Lim Yoonji Joo Eunji Ha Yumi Song Sujung Yoon Taehoon Shin
Convolutional neural networks (CNNs) have been used widely to predict biological brain age based on brain magnetic resonance (MR) images. However, CNNs focus mainly on spatially local features and their aggregates and barely on the connective information between distant regions. To overcome this issue, we propose a novel multi-hop graph attention (MGA) module that exploits both the local and global connections of image features when combined with CNNs. After insertion between convolutional layers, MGA first converts the convolution-derived feature map into graph-structured data by using patch embedding and embedding-distance-based scoring. Multi-hop connections between the graph nodes are modeled by using the Markov chain process. After performing multi-hop graph attention, MGA re-converts the graph into an updated feature map and transfers it to the next convolutional layer. We combined the MGA module with sSE (spatial squeeze and excitation)-ResNet18 for our final prediction model (MGA-sSE-ResNet18) and performed various hyperparameter evaluations to identify the optimal parameter combinations. With 2788 three-dimensional T1-weighted MR images of healthy subjects, we verified the effectiveness of MGA-sSE-ResNet18 with comparisons to four established, general-purpose CNNs and two representative brain age prediction models. The proposed model yielded an optimal performance with a mean absolute error of 2.822 years and Pearson’s correlation coefficient (PCC) of 0.968, demonstrating the potential of the MGA module to improve the accuracy of brain age prediction.
]]>Bioengineering doi: 10.3390/bioengineering11030264
Authors: Deqiang Deng Tianli Hao Lisen Lu Muyang Yang Zhen Zeng Jonathan F. Lovell Yushuai Liu Honglin Jin
Currently, immunotherapy is one of the most effective treatment strategies for cancer. However, the efficacy of any specific anti-tumor immunotherapy can vary based on the dynamic characteristics of immune cells, such as their rate of migration and cell-to-cell interactions. Therefore, understanding the dynamics among cells involved in the immune response can inform the optimization and improvement of existing immunotherapy strategies. In vivo imaging technologies use optical microscopy techniques to visualize the movement and behavior of cells in vivo, including cells involved in the immune response, thereby showing great potential for application in the field of cancer immunotherapy. In this review, we briefly introduce the technical aspects required for in vivo imaging, such as fluorescent protein labeling, the construction of transgenic mice, and various window chamber models. Then, we discuss the elucidation of new phenomena and mechanisms relating to tumor immunotherapy that has been made possible by the application of in vivo imaging technology. Specifically, in vivo imaging has supported the characterization of the movement of T cells during immune checkpoint inhibitor therapy and the kinetic analysis of dendritic cell migration in tumor vaccine therapy. Finally, we provide a perspective on the challenges and future research directions for the use of in vivo imaging technology in cancer immunotherapy.
]]>Bioengineering doi: 10.3390/bioengineering11030263
Authors: Erfaneh Gharavi Nathan J. LeRoy Guangtao Zheng Aidong Zhang Donald E. Brown Nathan C. Sheffield
As available genomic interval data increase in scale, we require fast systems to search them. A common approach is simple string matching to compare a search term to metadata, but this is limited by incomplete or inaccurate annotations. An alternative is to compare data directly through genomic region overlap analysis, but this approach leads to challenges like sparsity, high dimensionality, and computational expense. We require novel methods to quickly and flexibly query large, messy genomic interval databases. Here, we develop a genomic interval search system using representation learning. We train numerical embeddings for a collection of region sets simultaneously with their metadata labels, capturing similarity between region sets and their metadata in a low-dimensional space. Using these learned co-embeddings, we develop a system that solves three related information retrieval tasks using embedding distance computations: retrieving region sets related to a user query string, suggesting new labels for database region sets, and retrieving database region sets similar to a query region set. We evaluate these use cases and show that jointly learned representations of region sets and metadata are a promising approach for fast, flexible, and accurate genomic region information retrieval.
]]>Bioengineering doi: 10.3390/bioengineering11030262
Authors: Roxana Iacob Emil Radu Iacob Emil Robert Stoicescu Delius Mario Ghenciu Daiana Marina Cocolea Amalia Constantinescu Laura Andreea Ghenciu Diana Luminita Manolescu
Breast cancer, affecting both genders, but mostly females, exhibits shifting demographic patterns, with an increasing incidence in younger age groups. Early identification through mammography, clinical examinations, and breast self-exams enhances treatment efficacy, but challenges persist in low- and medium-income countries due to limited imaging resources. This review assesses the feasibility of employing breast ultrasound as the primary breast cancer screening method, particularly in resource-constrained regions. Following the PRISMA guidelines, this study examines 52 publications from the last five years. Breast ultrasound, distinct from mammography, offers advantages like radiation-free imaging, suitability for repeated screenings, and preference for younger populations. Real-time imaging and dense breast tissue evaluation enhance sensitivity, accessibility, and cost-effectiveness. However, limitations include reduced specificity, operator dependence, and challenges in detecting microcalcifications. Automatic breast ultrasound (ABUS) addresses some issues but faces constraints like potential inaccuracies and limited microcalcification detection. The analysis underscores the need for a comprehensive approach to breast cancer screening, emphasizing international collaboration and addressing limitations, especially in resource-constrained settings. Despite advancements, notably with ABUS, the primary goal is to contribute insights for optimizing breast cancer screening globally, improving outcomes, and mitigating the impact of this debilitating disease.
]]>Bioengineering doi: 10.3390/bioengineering11030261
Authors: Aline Grein-Iankovski Karina Andrighetti de Oliveira Braga Daniel Formariz Legendre Paulo Francisco Guerreiro Cardoso Watson Loh
Cilia are biological structures essential to drive the mobility of secretions and maintain the proper function of the respiratory airways. However, this motile self-cleaning process is significantly compromised in the presence of silicone tracheal prosthesis, leading to biofilm growth and impeding effective treatment. To address this challenge and enhance the performance of these devices, we propose the fabrication of magnetic silicone cilia, with the prospect of their integration onto silicone prostheses. The present study presents a fabrication method based on magnetic self-assembly and assesses the interaction behavior of the cilia array with biological mucus. This protocol allows for the customization of cilia dimensions across a wide range of aspect ratios (from 6 to 85) and array densities (from 10 to 80 cilia/mm2) by adjusting the fabrication parameters, offering flexibility for adjustments according to their required characteristics. Furthermore, we evaluated the suitability of different cilia arrays for biomedical applications by analyzing their interaction with bullfrog mucus, simulating the airways environment. Our findings demonstrate that the fabricated cilia are mechanically resistant to the viscous fluid and still exhibit controlled movement under the influence of an external moving magnet. A correlation between cilia dimensions and mucus wettability profile suggests a potential role in facilitating mucus depuration, paving the way for further advancements aimed at enhancing the performance of silicone prostheses in clinical settings.
]]>Bioengineering doi: 10.3390/bioengineering11030260
Authors: Xi Yang Chengpeng Chai Hongzhi Zuo Yun-Hsuan Chen Junhui Shi Cheng Ma Mohamad Sawan
Optical-based imaging has improved from early single-location research to further sophisticated imaging in 2D topography and 3D tomography. These techniques have the benefit of high specificity and non-radiative safety for brain detection and therapy. However, their performance is limited by complex tissue structures. To overcome the difficulty in successful brain imaging applications, we conducted a simulation using 16 optical source types within a brain model that is based on the Monte Carlo method. In addition, we propose an evaluation method of the optical propagating depth and resolution, specifically one based on the optical distribution for brain applications. Based on the results, the best optical source types were determined in each layer. The maximum propagating depth and corresponding source were extracted. The optical source propagating field width was acquired in different depths. The maximum and minimum widths, as well as the corresponding source, were determined. This paper provides a reference for evaluating the optical propagating depth and resolution from an optical simulation aspect, and it has the potential to optimize the performance of optical-based techniques.
]]>Bioengineering doi: 10.3390/bioengineering11030259
Authors: Manjusha Annaji Nur Mita Ishwor Poudel Sai H. S. Boddu Oladiran Fasina R. Jayachandra Babu
Despite rapid progress in tissue engineering, the repair and regeneration of bone defects remains challenging, especially for non-homogenous and complicated defects. We have developed and characterized biodegradable drug-eluting scaffolds for bone regeneration utilizing direct powder extrusion-based three-dimensional (3D) printing techniques. The PLGA scaffolds were fabricated using poly (lactic-co-glycolic acid) (PLGA) with inherent viscosities of 0.2 dl/g and 0.4 dl/g and ketoprofen. The effect of parameters such as the infill, geometry, and wall thickness of the drug carrier on the release kinetics of ketoprofen was studied. The release studies revealed that infill density significantly impacts the release performance, where 10% infill showed faster and almost complete release of the drug, whereas 50% infill demonstrated a sustained release. The Korsmeyer–Peppas model showed the best fit for release data irrespective of the PLGA molecular weight and infill density. It was demonstrated that printing parameters such as infill density, scaffold wall thickness, and geometry played an important role in controlling the release and, therefore, in designing customized drug-eluting scaffolds for bone regeneration.
]]>Bioengineering doi: 10.3390/bioengineering11030258
Authors: Pei L. Robins Sergey N. Makaroff Michael Dib Sarah H. Lisanby Zhi-De Deng
Neurostimulation devices that use rotating permanent magnets are being explored for their potential therapeutic benefits in patients with psychiatric and neurological disorders. This study aims to characterize the electric field (E-field) for ten configurations of rotating magnets using finite element analysis and phantom measurements. Various configurations were modeled, including single or multiple magnets, and bipolar or multipolar magnets, rotated at 10, 13.3, and 350 revolutions per second (rps). E-field strengths were also measured using a hollow sphere (r=9.2 cm) filled with a 0.9% sodium chloride solution and with a dipole probe. The E-field spatial distribution is determined by the magnets’ dimensions, number of poles, direction of the magnetization, and axis of rotation, while the E-field strength is determined by the magnets’ rotational frequency and magnetic field strength. The induced E-field strength on the surface of the head ranged between 0.0092 and 0.52 V/m. In the range of rotational frequencies applied, the induced E-field strengths were approximately an order or two of magnitude lower than those delivered by conventional transcranial magnetic stimulation. The impact of rotational frequency on E-field strength represents a confound in clinical trials that seek to tailor rotational frequency to individual neural oscillations. This factor could explain some of the variability observed in clinical trial outcomes.
]]>Bioengineering doi: 10.3390/bioengineering11030257
Authors: Pei-An Lee Clark DuMontier Wanting Yu Levi Ask Junhong Zhou Marcia A. Testa Dae Kim Gregory Abel Tom Travison Brad Manor On-Yee Lo
The four-meter gait speed (4MGS) is a recommended physical performance test in older adults but is challenging to implement clinically. We developed a smartphone application (App) with a four-meter ribbon for remote 4MGS testing at home. This study aimed to assess the validity and reliability of this smartphone App-based assessment of the home 4MGS. We assessed the validity of the smartphone App by comparing it against a gold standard video assessment of the 4MGS conducted by study staff visiting community-dwelling older adults and against the stopwatch-based measurement. Moreover, we assessed the test–retest reliability in two supervised sessions and three additional sessions performed by the participants independently, without staff supervision. The 4MGS measured by the smartphone App was highly correlated with video-based 4MGS (r = 0.94), with minimal differences (mean = 0.07 m/s, ± 1.96 SD = 0.12) across a range of gait speeds. The test–retest reliability for the smartphone App 4MGS was high (ICC values: 0.75 to 0.93). The home 4MGS in older adults can be measured accurately and reliably using a smartphone in the pants pocket and a four-meter strip of ribbon. Leveraging existing technology carried by a significant portion of the older adult population could overcome barriers in busy clinical settings for this well-established objective mobility test.
]]>Bioengineering doi: 10.3390/bioengineering11030256
Authors: Itay Barnea Lior Luria Arik Girsault Ofira Dabah Matan Dudaie Simcha K. Mirsky Drorit Merkel Natan T. Shaked
Myelodysplastic syndromes (MDSs) are a group of potentially deadly diseases that affect the morphology and function of neutrophils. Rapid diagnosis of MDS is crucial for the initiation of treatment that can vastly improve disease outcome. In this work, we present a new approach for detecting morphological differences between neutrophils isolated from blood samples of high-risk MDS patients and blood bank donors (BBDs). Using fluorescent flow cytometry, neutrophils were stained with 2′,7′-dichlorofluorescin diacetate (DCF), which reacts with reactive oxygen species (ROS), and Hoechst, which binds to DNA. We observed that BBDs possessed two cell clusters (designated H and L), whereas MDS patients possessed a single cluster (L). Later, we used FACS to sort the H and the L cells and used interferometric phase microscopy (IPM) to image the cells without utilizing cell staining. IPM images showed that H cells are characterized by low optical path delay (OPD) in the nucleus relative to the cytoplasm, especially in cell vesicles containing ROS, whereas L cells are characterized by low OPD in the cytoplasm relative to the nucleus and no ROS-containing vesicles. Moreover, L cells present a higher average OPD and dry mass compared to H cells. When examining neutrophils from MDS patients and BBDs by IPM during flow, we identified ~20% of cells as H cells in BBDs in contrast to ~4% in MDS patients. These results indicate that IPM can be utilized for the diagnosis of complex hematological pathologies such as MDS.
]]>Bioengineering doi: 10.3390/bioengineering11030255
Authors: Olfa Ben Moussa Louise Parveau Inès Aouimeur Grégory Egaud Corantin Maurin Sofiane Fraine Sébastien Urbaniak Chantal Perrache Zhiguo He Sedao Xxx Oliver Dorado Cortez Sylvain Poinard Cyril Mauclair Philippe Gain Gilles Thuret
The bioengineering of corneal endothelial grafts consists of seeding in vitro cultured corneal endothelial cells onto a thin, transparent, biocompatible, and sufficiently robust carrier which can withstand surgical manipulations. This is one of the most realistic alternatives to donor corneas, which are in chronic global shortage. The anterior capsule of the crystalline lens has already been identified as one of the best possible carriers, but its challenging manual preparation has limited its use. In this study, we describe a femtosecond laser cutting process of the anterior capsule of whole lenses in order to obtain capsule discs of 8 mm diameter, similar to conventional endothelial grafts. Circular marks made on the periphery of the disc indicate its orientation. Immersion in water for 3 days is sufficient to completely remove the lens epithelial cells and to enable the seeding of corneal endothelial cells, which remain viable after 27 days of culture. Therefore, this method provides a transparent, decellularized disc ready to form viable tissue engineered endothelial grafts.
]]>Bioengineering doi: 10.3390/bioengineering11030254
Authors: Ritipong Wongkhuenkaew Sansanee Auephanwiriyakul Marasri Chaiworawitkul Nipon Theera-Umpon Uklid Yeesarapat
Three-dimensional registration with the affine transform is one of the most important steps in 3D reconstruction. In this paper, the modified grey wolf optimizer with behavior considerations and dimensional learning (BCDL-GWO) algorithm as a registration method is introduced. To refine the 3D registration result, we incorporate the iterative closet point (ICP). The BCDL-GWO with ICP method is implemented on the scanned commercial orthodontic tooth and regular tooth models. Since this is a registration from multi-views of optical images, the hierarchical structure is implemented. According to the results for both models, the proposed algorithm produces high-quality 3D visualization images with the smallest mean squared error of about 7.2186 and 7.3999 μm2, respectively. Our results are compared with the statistical randomization-based particle swarm optimization (SR-PSO). The results show that the BCDL-GWO with ICP is better than those from the SR-PSO. However, the computational complexities of both methods are similar.
]]>Bioengineering doi: 10.3390/bioengineering11030253
Authors: Sarah Al-Maawi Eva Dohle Robert Sader Shahram Ghanaati
Platelet-rich fibrin (PRF) has assumed an important role in supporting tissue regeneration in different fields. To date, the standard protocol for liquid PRF requires at least 10 mL of peripheral blood. The present study aimed to analyze the composition, growth factor release, and effects on the cell proliferation of PRF samples produced using 3 mL vs. 10 mL of peripheral blood in vitro. Peripheral venous blood from six healthy donors was used to prepare liquid PRF using either 3 mL or 10 mL tubes. Three different centrifugation protocols were used according to the low-speed centrifugation concept. The cellular distribution was evaluated using immunohistology and automated cell count. ELISA was used to determine the release of different growth factors (EGF, TGF-β1, and PDGF) and interleukin 8 at different time points. Primary human osteoblasts (pOBs) were cultivated for 7 days using PRF-conditioned media acquired from either 3 mL or 10 mL of peripheral blood. The results showed that 3 mL of peripheral blood is sufficient to produce a liquid PRF concentrate similar to that acquired when using 10 mL blood. The concentrations of platelets and leukocytes were comparable regardless of the initial blood volume (3 mL vs. 10 mL). Similarly, the release of growth factors (EGF, TGF-β1, and PDGF) and interleukin 8 was often comparable in both groups over 7 days. The cultivation of pOBs using PRF-conditioned media showed a similar proliferation rate regardless of the initial blood volume. This proliferation rate was also similar to that of pOBs treated with 20% FBS-conditioned media. These findings validated the use of 3 mL of peripheral blood to generate liquid PRF matrices according to the low-speed centrifugation concept, which may open new application fields for research purposes such as in vivo experiments and clinical applications such as pediatric surgery.
]]>Bioengineering doi: 10.3390/bioengineering11030252
Authors: Taimoor Shakeel Sheikh Migyung Cho
The histopathological segmentation of nuclear types is a challenging task because nuclei exhibit distinct morphologies, textures, and staining characteristics. Accurate segmentation is critical because it affects the diagnostic workflow for patient assessment. In this study, a framework was proposed for segmenting various types of nuclei from different organs of the body. The proposed framework improved the segmentation performance for each nuclear type using radiomics. First, we used distinct radiomic features to extract and analyze quantitative information about each type of nucleus and subsequently trained various classifiers based on the best input sub-features of each radiomic feature selected by a LASSO operator. Second, we inputted the outputs of the best classifier to various segmentation models to learn the variants of nuclei. Using the MoNuSAC2020 dataset, we achieved state-of-the-art segmentation performance for each category of nuclei type despite the complexity, overlapping, and obscure regions. The generalized adaptability of the proposed framework was verified by the consistent performance obtained in whole slide images of different organs of the body and radiomic features.
]]>Bioengineering doi: 10.3390/bioengineering11030251
Authors: Chun-Hong Cheng Zhikun Yuen Shutao Chen Kwan-Long Wong Jing-Wei Chin Tsz-Tai Chan Richard H. Y. So
Blood oxygen saturation (SpO2) is an essential physiological parameter for evaluating a person’s health. While conventional SpO2 measurement devices like pulse oximeters require skin contact, advanced computer vision technology can enable remote SpO2 monitoring through a regular camera without skin contact. In this paper, we propose novel deep learning models to measure SpO2 remotely from facial videos and evaluate them using a public benchmark database, VIPL-HR. We utilize a spatial–temporal representation to encode SpO2 information recorded by conventional RGB cameras and directly pass it into selected convolutional neural networks to predict SpO2. The best deep learning model achieves 1.274% in mean absolute error and 1.71% in root mean squared error, which exceed the international standard of 4% for an approved pulse oximeter. Our results significantly outperform the conventional analytical Ratio of Ratios model for contactless SpO2 measurement. Results of sensitivity analyses of the influence of spatial–temporal representation color spaces, subject scenarios, acquisition devices, and SpO2 ranges on the model performance are reported with explainability analyses to provide more insights for this emerging research field.
]]>Bioengineering doi: 10.3390/bioengineering11030250
Authors: Leo Yan Li-Han Moshe Eizenman Runjie Bill Shi Yvonne M. Buys Graham E. Trope Willy Wong
Perimetry and optical coherence tomography (OCT) are both used to monitor glaucoma progression. However, combining these modalities can be a challenge due to differences in data types. To overcome this, we have developed an autoencoder data fusion (AEDF) model to learn compact encoding (AE-fused data) from both perimetry and OCT. The AEDF model, optimized specifically for visual field (VF) progression detection, incorporates an encoding loss to ensure the interpretation of the AE-fused data is similar to VF data while capturing key features from OCT measurements. For model training and evaluation, our study included 2504 longitudinal VF and OCT tests from 140 glaucoma patients. VF progression was determined from linear regression slopes of longitudinal mean deviations. Progression detection with AE-fused data was compared to VF-only data (standard clinical method) as well as data from a Bayesian linear regression (BLR) model. In the initial 2-year follow-up period, AE-fused data achieved a detection F1 score of 0.60 (95% CI: 0.57 to 0.62), significantly outperforming (p < 0.001) the clinical method (0.45, 95% CI: 0.43 to 0.47) and the BLR model (0.48, 95% CI: 0.45 to 0.51). The capacity of the AEDF model to generate clinically interpretable fused data that improves VF progression detection makes it a promising data integration tool in glaucoma management.
]]>Bioengineering doi: 10.3390/bioengineering11030249
Authors: Tianyuan Guan Rigwed Tatu Koffi Wima Marc Oria Jose L. Peiro Chia-Ying Lin Marepalli. B. Rao
A biodegradable hybrid polymer patch was invented at the University of Cincinnati to cover gaps on the skin over the spinal column of a growing fetus, characterized by the medical condition spina bifida. The inserted patch faces amniotic fluid (AF) on one side and cerebrospinal fluid on the other side. The goal is to provide a profile of the roughness of a patch over time at 0, 4, 8, 12, and 16 weeks with a 95% confidence band. The patch is soaked in a test tube filled with either amniotic fluid (AF) or phosphate-buffered saline (PBS) in the lab. If roughness is measured at any time point for a patch, the patch is destroyed. Thus, it is impossible to measure roughness at all weeks of interest for any patch. It is important to assess the roughness of a patch because the rougher the patch is, the faster the skin grows under the patch. We use a model-based approach with Monte Carlo simulations to estimate the profile over time with a 95% confidence band. The roughness profiles are similar with both liquids. The profile can be used as a template for future experiments on the composition of patches.
]]>Bioengineering doi: 10.3390/bioengineering11030248
Authors: Wei-Hsuan Lin Tsung-Yu Huang Shu-Wei Chen Joseph Hamill Jung-Tang Kung Wen-Tzu Tang
This study investigates the influence of the quality of the “deep squat” movement, adapted from the Functional Movement Screen (FMS) system, on the lower extremity movement pattern during baseball throwing, and its potential impact on throwing performance and propulsion efficiency. Twenty-two baseball players were recruited and categorized into two groups: 13 in the high-score squat group (HSS) and 9 in the low-score squat group (LSS), based on their deep squat screening results. This research explored disparities in ball velocity, propulsion efficiency, propulsion ground reaction force (GRF) characteristics, and throwing kinematics between these two groups. The findings revealed no significant difference in ball velocity between the groups. However, the LSS group demonstrated a lower propulsion GRF efficiency (p < 0.030, ES = 0.46), along with a higher vertical peak GRF (p < 0.002, ES = 0.66). In the pivot leg, the HSS group exhibited significantly lower impulse forces in the Impulse Fresultant (p < 0.035, ES = 0.45), throwing direction (p < 0.049, ES = 0.42), and vertical direction (p < 0.048, ES = 0.42). Additionally, the contribution to the ball velocity of the pivot leg was significantly greater in the HSS group, along with significantly better efficiency in Impulse Fresultant (p < 0.035, ES = 0.45), throwing direction (p < 0.053, ES = 0.41), and vertical direction (p < 0.032, ES = 0.46). In the leading leg, the HSS group demonstrated significantly lower impulse forces in the Impulse Fresultant (p < 0.001, ES = 0.69), throwing direction (p < 0.007, ES = 0.58), and vertical direction (p < 0.001, ES = 0.70). Moreover, the contribution to the ball velocity of the leading leg was significantly greater in the HSS group, accompanied by significantly better efficiency in Impulse Fresultant (p < 0.003, ES = 0.63), throwing direction (p < 0.005, ES = 0.60), and vertical direction (p < 0.021, ES = 0.49). In conclusion, this study suggests that squat screening is a valuable tool for assessing propulsion efficiency. Coaches and trainers should be mindful of players with low squat quality but high throwing performance, as they may face increased impact and injury risks in the future.
]]>Bioengineering doi: 10.3390/bioengineering11030247
Authors: Alexander Nemeth Bruno Vasconcelos Gurgel Adam Lowenstein Luiz Juliasse Rafael S. Siroma Zoe Zhu Jamil Awad Shibli Carlos Fernando Mourão
Temporomandibular joint disorders (TMDs) are prevalent musculoskeletal conditions involving pain and dysfunction of jaw mobility and function, which have proven difficult to treat satisfactorily. The present study aimed to assess the effectiveness of a liquid platelet-rich fibrin (i-PRF) infusion during arthrocentesis versus other options using coadjuvant materials to reduce TMD symptoms. A literature search was conducted using PubMed, EMBASE, Web of Science, Scopus, and ClinicalTrials.gov for RCTs published before January 2024, comparing i-PRF to any other TMD treatment. This systematic review was registered on PROSPERO (CRD42023495364). The searches generated several recent RCTs that compared i-PRF injection combined with arthrocentesis (AC) to AC-only or AC with platelet-rich plasma (PRP). The outcomes analyzed included measures of pain (visual analog scale, VAS), maximum mouth opening, joint sounds, and MRI-verified changes in joint structure. Across the RCTs, the addition of i-PRF injection to AC resulted in significant improvements in pain relief, joint function, mouth opening, and structural changes compared to AC-only or with PRP over follow-up periods ranging from 6 to 12 months. Current clinical evidence favors using i-PRF as an adjunct to AC rather than AC-only or AC with PRP for the treatment of TMDs. The improvements in subjective and objective outcome measures are clinically meaningful. Still, additional high-quality RCTs with larger sample sizes and longer follow-ups are required to strengthen the evidence base and better define the role of i-PRF in TMD management guidelines.
]]>Bioengineering doi: 10.3390/bioengineering11030246
Authors: Daniel J. Cognetti Mikalyn T. Defoor Tony T. Yuan Andrew J. Sheean
The unique physical demands of tactical athletes put immense stress on the knee joint, making these individuals susceptible to injury. In order to ensure operational readiness, management options must restore and preserve the native architecture and minimize downtime, while optimizing functionality. Osteochondral lesions (OCL) of the knee have long been acknowledged as significant sources of knee pain and functional deficits. The management of OCL is predicated on certain injury characteristics, including lesion location and the extent of subchondral disease. Techniques such as marrow stimulation, allograft and autologous chondrocyte implantation are examined in detail, with a focus on their application and suitability in tactical athlete populations. Moreover, the restoration of the osteochondral unit (OCU) is highlighted as a central aspect of knee joint preservation. The discussion encompasses the biomechanical considerations and outcomes associated with various cartilage restoration techniques. Factors influencing procedure selection, including lesion size, location, and patient-specific variables, are thoroughly examined. Additionally, the review underscores the critical role of post-operative rehabilitation and conditioning programs in optimizing outcomes. Strengthening the surrounding musculature, enhancing joint stability, and refining movement patterns are paramount in facilitating the successful integration of preservation procedures. This narrative review aims to provide a comprehensive resource for surgeons, engineers, and sports medicine practitioners engaged in the care of tactical athletes and the field of cartilage restoration. The integration of advanced preservation techniques and tailored rehabilitation protocols offers a promising avenue for sustaining knee joint health and function in this demanding population.
]]>Bioengineering doi: 10.3390/bioengineering11030245
Authors: Yongxiao Li Wanting Xu Xinpei Wang Ruizhi Lai Xiaohui Qiu Zekai Zeng Zhe Wang Junqing Wang
In this study, we advance our exploration of Apolipoprotein A-I (apoA-I) peptide analogs (APAs) for their application in nanodisc (ND) assembly, focusing on the dynamic conformational characteristics and the potential for drug delivery. We explore APA-ND interactions with an emphasis on curcumin encapsulation, utilizing molecular dynamic simulations and in vitro assessments to evaluate the efficacy of various APA-ND formulations as drug carriers. The methodological approach involved the generation of three unique apoA-I α-11/3 helical mimics, resulting in fifteen distinct APAs. Their structural integrity was rigorously assessed using ColabFold-AF2, with particular attention to pLDDT and pTM scores. Extensive molecular dynamics simulations, covering 1.7 μs across 17 ND systems, were conducted to investigate the influence of APA sequence variations on ND stability and interactions. This study reveals that the composition of APAs, notably the presence of Proline, Serine, and Tryptophan, significantly impacts ND stability and morphology. Oligomeric APAs, in particular, demonstrated superior stability and distinct interaction patterns compared to their monomeric counterparts. Additionally, hydrodynamic diameter measurements over eight weeks indicated sequence-dependent stability, highlighting the potential of specific APA configurations for sustained colloidal stability. In vitro study successfully encapsulated curcumin in [AA]3/DMPC ND formulations, revealing concentration-dependent stability and interaction dynamics. The findings underscore the remarkable capability of APA-NDs to maintain structural integrity and efficient drug encapsulation, positioning them as a promising platform for drug delivery. The study concludes by emphasizing the tunability and versatility of APA-NDs in drug formulation, potentially revolutionizing nanomedicine by enabling customized APA sequences and ND properties for targeted drug delivery.
]]>Bioengineering doi: 10.3390/bioengineering11030243
Authors: Shun Iwasaki Koichi Deguchi Ryosuke Iwai Yasuhide Nakayama Hiroomi Okuyama
The treatment of long-tracheal lesion is difficult because there are currently no viable grafts for tracheal replacement. To solve this problem, we have developed an autologous Tissue-Engineered Trachea (aTET), which is made up of collagenous tissues and cartilage-like structures derived from rat chondrocytes. This graft induced successful long-term survival in a small-animal experiment in our previous study. In this study, we investigated the regeneration process of an aTET to attain reproducible success. We prepared an aTET by using a specially designed mold and performed patch tracheoplasty with an aTET. We assigned twenty-seven rats to three groups according to the three types of patch grafts used: aTET patches (the aTET group), fresh tracheal autograft patches (the Ag group), or polylactic acid and polycaprolactone copolymer sheets (the PPc group). In each group, gross and histological evaluations were performed at 1 month (n = 3), 3 months (n = 3), and 6 months (n = 3) after implantation. We obtained high survival rates in all groups, but only the PPc group attained thick tracheal walls with granular tissues and no tracheal regeneration. On the other hand, the aTET and Ag groups reproducibly achieved complete tracheal regeneration in 6 months. So, an aTET could be a promising candidate for tracheal regeneration grafts.
]]>Bioengineering doi: 10.3390/bioengineering11030244
Authors: Gianpaolo Serino Fabio Distefano Elisabetta M. Zanetti Giulia Pascoletti Gabriella Epasto
Polyether-ether-2-ketone (PEKK) is a high-performance thermoplastic polymer used in various fields, from aerospace to medical applications, due to its exceptional mechanical and thermal properties. Nonetheless, the mechanical behavior of 3D-printed PEKK still deserves to be more thoroughly investigated, especially in view of its production by 3D printing, where mechanical properties measured at different scales are likely to be correlated to one another and to all play a major role in determining biomechanical properties, which include mechanical strength on one side and osteointegration ability on the other side. This work explores the mechanical behavior of 3D-printed PEKK through a multiscale approach, having performed both nanoindentation tests and standard tensile and compression tests, where a detailed view of strain distribution was achieved through Digital Image Correlation (DIC) techniques. Furthermore, for specimens tested up to failure, their fractured surfaces were analyzed through Scanning Electron Microscopy (SEM) to clearly outline fracture modes. Additionally, the internal structure of 3D-printed PEKK was explored through Computed Tomography (CT) imaging, providing a three-dimensional view of the internal structure and the presence of voids and other imperfections. Finally, surface morphology was analyzed through confocal microscopy. The multiscale approach adopted in the present work offers information about the global and local behavior of the PEKK, also assessing its material properties down to the nanoscale. Due to its novelty as a polymeric material, no previous studies have approached a multiscale analysis of 3D-printed PEKK. The findings of this study contribute to a comprehensive understanding of 3D-printed PEKK along with criteria for process optimization in order to customize its properties to meet specific application requirements. This research not only advances the knowledge of PEKK as a 3D-printing material but also provides insights into the multifaceted nature of multiscale material characterization.
]]>Bioengineering doi: 10.3390/bioengineering11030242
Authors: Cheng Zhang Fanlei Ran Lei Du Xiaohui Wang Lei Liu Jinming Liu Quan Chen Yang Cao Lijun Bi Haiying Hang
The cellular prion protein (PrPc) is a cell surface glycoprotein that is highly expressed in a variety of cancer tissues in addition to the nervous system, and its elevated expression is correlated to poor prognosis in many cancer patients. Our team previously found that patients with colorectal cancer (CRC) with high-level PrPc expression had significantly poorer survival than those with no or low-level PrPc expression. Mouse antibodies for PrPc inhibited tumor initiation and liver metastasis of PrPc-positive human CRC cells in mouse model experiments. PrPc is a candidate target for CRC therapy. In this study, we newly cloned a mouse anti-PrPc antibody (Clone 6) and humanized it, then affinity-matured this antibody using a CHO cell display with a peptide antigen and full-length PrPc, respectively. We obtained two humanized antibody clones with affinities toward a full-length PrPc of about 10- and 100-fold of that of the original antibody. The two humanized antibodies bound to the PrPc displayed significantly better on the cell surface than Clone 6. Used for Western blotting and immunohistochemistry, the humanized antibody with the highest affinity is superior to the two most frequently used commercial antibodies (8H4 and 3F4). The two new antibodies have the potential to be developed as useful reagents for PrPc detection and even therapeutic antibodies targeting PrPc-positive cancers.
]]>Bioengineering doi: 10.3390/bioengineering11030241
Authors: Daheui Kim Jun Hyeok Lee Min Suk Park Ma Rhip Ahn Daiwon Jun Jung Ho Lee
Lower extremity reconstruction is challenging because of its intricate anatomy and dynamic biomechanics. Although microsurgical free tissue transfer offers pivotal solutions to limited local tissue availability, vascular pedicle exposure after free tissue transfer is common. We evaluated a novel method of managing pedicle exposure after free tissue transfer using a reprocessed micronized dermal substitute. Ten patients who underwent lower-extremity reconstruction using free tissue transfer and micronized dermal substitute between January and December 2023 were retrospectively reviewed. When native tissue could not be closed over the pedicle, reprocessed micronized artificial dermal matrix (rmADM) was cut and stacked to protect and stabilize it. Epithelialization was achieved by secondary skin grafting or healing by secondary intention. Flap dimensions, recipient artery and vein, ADM size, time required for granulation tissue maturation and complete epithelialization, and flap outcomes were analyzed. The mean age was 55.80 ± 20.70 years, and six patients (60%) were diabetic. The mean rmADM coverage area was 8.70 ± 8.41 cm2, and the average time required for complete epithelialization was 50.89 ± 14.21 days. Except for one total necrosis due to bypass graft failure, nine limbs were successfully salvaged. Application of rmADM offers numerous advantages, including vascular collapse prevention, moisture maintenance, granulation tissue growth promotion, and pedicle stabilization.
]]>Bioengineering doi: 10.3390/bioengineering11030240
Authors: Prakash Kumar Karn Waleed H. Abdulla
This paper presents a novel U-Net model incorporating a hybrid attention mechanism for automating the segmentation of sub-retinal layers in Optical Coherence Tomography (OCT) images. OCT is an ophthalmology tool that provides detailed insights into retinal structures. Manual segmentation of these layers is time-consuming and subjective, calling for automated solutions. Our proposed model combines edge and spatial attention mechanisms with the U-Net architecture to improve segmentation accuracy. By leveraging attention mechanisms, the U-Net focuses selectively on image features. Extensive evaluations using datasets demonstrate that our model outperforms existing approaches, making it a valuable tool for medical professionals. The study also highlights the model’s robustness through performance metrics such as an average Dice score of 94.99%, Adjusted Rand Index (ARI) of 97.00%, and Strength of Agreement (SOA) classifications like “Almost Perfect”, “Excellent”, and “Very Strong”. This advanced predictive model shows promise in expediting processes and enhancing the precision of ocular imaging in real-world applications.
]]>Bioengineering doi: 10.3390/bioengineering11030239
Authors: Sverre Gullikstad Johnsen
Computational rhinology is a specialized branch of biomechanics leveraging engineering techniques for mathematical modelling and simulation to complement the medical field of rhinology. Computational rhinology has already contributed significantly to advancing our understanding of the nasal function, including airflow patterns, mucosal cooling, particle deposition, and drug delivery, and is foreseen as a crucial element in, e.g., the development of virtual surgery as a clinical, patient-specific decision support tool. The current paper delves into the field of computational rhinology from a nasal airflow perspective, highlighting the use of computational fluid dynamics to enhance diagnostics and treatment of breathing disorders. This paper consists of three distinct parts—an introduction to and review of the field of computational rhinology, a review of the published literature on in vitro and in silico studies of nasal airflow, and the presentation and analysis of previously unpublished high-fidelity CFD simulation data of in silico rhinomanometry. While the two first parts of this paper summarize the current status and challenges in the application of computational tools in rhinology, the last part addresses the gross disagreement commonly observed when comparing in silico and in vivo rhinomanometry results. It is concluded that this discrepancy cannot readily be explained by CFD model deficiencies caused by poor choice of turbulence model, insufficient spatial or temporal resolution, or neglecting transient effects. Hence, alternative explanations such as nasal cavity compliance or drag effects due to nasal hair should be investigated.
]]>Bioengineering doi: 10.3390/bioengineering11030238
Authors: Sapir Hazan Shenberger Idit Avrahami
Percutaneous mechanical circulatory support (MCS) devices are designed for short-term treatment in cases of acute decompensated heart failure as a bridge to transplant or recovery. Some of the known complications of MCS treatments are related to their hemodynamics in the aorta. The current study investigates the effect of MCS on the aortic flow. The study uses combined experimental and numerical methods to delineate complex flow structures. Particle image velocimetry (PIV) is used to capture the vortical and turbulent flow characteristics in a glass model of the human aorta. Computational fluid dynamics (CFD) analyses are used to complete the 3D flow in the aorta. Three specific MCS configurations are examined: a suction pump with a counterclockwise (CCW) rotating impeller, a suction pump with a clockwise (CW) rotating impeller, and a discharge pump with a straight jet. These models were examined under varying flow rates (1–2.5 L/min). The results show that the pump configuration strongly influences the flow in the thoracic aorta. The rotating impeller of the suction pump induces a dominant swirling flow in the aorta. The swirling flow distributes the incoming jet and reduces the turbulent intensity near the aortic valve and in the aorta. In addition, at high flow rates, the local vortices formed near the pump are washed downstream toward the aortic arch. Specifically, an MCS device with a CCW rotating impeller induces a non-physiological CCW helical flow in the descending aorta (which is opposite to the natural helical flow), while CW swirl combines better with the natural helical flow.
]]>Bioengineering doi: 10.3390/bioengineering11030236
Authors: Anmol Monga Dilbag Singh Hector L. de Moura Xiaoxia Zhang Marcelo V. W. Zibetti Ravinder R. Regatte
Magnetic resonance imaging (MRI) stands as a vital medical imaging technique, renowned for its ability to offer high-resolution images of the human body with remarkable soft-tissue contrast. This enables healthcare professionals to gain valuable insights into various aspects of the human body, including morphology, structural integrity, and physiological processes. Quantitative imaging provides compositional measurements of the human body, but, currently, either it takes a long scan time or is limited to low spatial resolutions. Undersampled k-space data acquisitions have significantly helped to reduce MRI scan time, while compressed sensing (CS) and deep learning (DL) reconstructions have mitigated the associated undersampling artifacts. Alternatively, magnetic resonance fingerprinting (MRF) provides an efficient and versatile framework to acquire and quantify multiple tissue properties simultaneously from a single fast MRI scan. The MRF framework involves four key aspects: (1) pulse sequence design; (2) rapid (undersampled) data acquisition; (3) encoding of tissue properties in MR signal evolutions or fingerprints; and (4) simultaneous recovery of multiple quantitative spatial maps. This paper provides an extensive literature review of the MRF framework, addressing the trends associated with these four key aspects. There are specific challenges in MRF for all ranges of magnetic field strengths and all body parts, which can present opportunities for further investigation. We aim to review the best practices in each key aspect of MRF, as well as for different applications, such as cardiac, brain, and musculoskeletal imaging, among others. A comprehensive review of these applications will enable us to assess future trends and their implications for the translation of MRF into these biomedical imaging applications.
]]>Bioengineering doi: 10.3390/bioengineering11030237
Authors: Martin Stolz
We aim to develop new portable desktop tissue analysers (DTAs) to provide fast, low-cost, and precise test results for fast nanomechanical profiling of tumours. This paper will explain the reasoning for choosing indentation-type atomic force microscopy (IT-AFM) to reveal the functional details of cancer. Determining the subtype, cancer stage, and prognosis will be possible, which aids in choosing the best treatment. DTAs are based on fast IT-AFM at the size of a small box that can be made for a low budget compared to other clinical imaging tools. The DTAs can work in remote areas and all parts of the world. There are a number of direct benefits: First, it is no longer needed to wait a week for the pathology report as the test will only take 10 min. Second, it avoids the complicated steps of making histopathology slides and saves costs of labour. Third, computers and robots are more consistent, more reliable, and more economical than human workers which may result in fewer diagnostic errors. Fourth, the IT-AFM analysis is capable of distinguishing between various cancer subtypes. Fifth, the IT-AFM analysis could reveal new insights about why immunotherapy fails. Sixth, IT-AFM may provide new insights into the neoadjuvant treatment response. Seventh, the healthcare system saves money by reducing diagnostic backlogs. Eighth, the results are stored on a central server and can be accessed to develop strategies to prevent cancer. To bring the IT-AFM technology from the bench to the operation theatre, a fast IT-AFM sensor needs to be developed and integrated into the DTAs.
]]>Bioengineering doi: 10.3390/bioengineering11030235
Authors: Samo K. Fokter Živa Ledinek Milka Kljaić Dujić Igor Novak
The majority of contemporary total hip arthroplasty (THA) implants are constructed from Ti alloys, which are generally believed to generate fewer adverse local tissue reactions (ALTRs) compared to CoCr alloys. This study presents a case of unusual primary THA failure where a substantial release of Ti alloy debris was observed. A 52-year-old active male underwent THA after post-traumatic aseptic necrosis of the femoral head in 2006. Seventeen years after the procedure, the patient presented with groin pain and a restricted range of motion. X-rays revealed the protrusion of the alumina ceramic head through the Ti6Al4V acetabular cup. Trace element analysis indicated significantly elevated levels of serum Ti, Al, and V. CT and MRI confirmed Ti alloy cup failure and a severe ALTR. During revision surgery, it was found that the worn-out ceramic head was in direct contact with the acetabular cup, having protruded through a central hole it had created over time. No acetabular liner was found. Histological analysis of his tissue samples showed wear-induced synovitis with areas of multinucleated foreign body giant cells and the accumulation of numerous metal particles but no acute inflammatory response. Six months after the revision THA, the patient has experienced favourable outcomes. This case provides an instructive illustration for studying the consequences of the substantial release of Ti alloy debris from orthopedic implants.
]]>Bioengineering doi: 10.3390/bioengineering11030234
Authors: Veniamin Y. Sidorov Tatiana N. Sidorova Philip C. Samson Ronald S. Reiserer Clayton M. Britt M. Diana Neely Kevin C. Ess John P. Wikswo
The implementation of three-dimensional tissue engineering concurrently with stem cell technology holds great promise for in vitro research in pharmacology and toxicology and modeling cardiac diseases, particularly for rare genetic and pediatric diseases for which animal models, immortal cell lines, and biopsy samples are unavailable. It also allows for a rapid assessment of phenotype–genotype relationships and tissue response to pharmacological manipulation. Mutations in the TSC1 and TSC2 genes lead to dysfunctional mTOR signaling and cause tuberous sclerosis complex (TSC), a genetic disorder that affects multiple organ systems, principally the brain, heart, skin, and kidneys. Here we differentiated healthy (CC3) and tuberous sclerosis (TSP8-15) human induced pluripotent stem cells (hiPSCs) into cardiomyocytes to create engineered cardiac tissue constructs (ECTCs). We investigated and compared their mechano-elastic properties and gene expression and assessed the effects of rapamycin, a potent inhibitor of the mechanistic target of rapamycin (mTOR). The TSP8-15 ECTCs had increased chronotropy compared to healthy ECTCs. Rapamycin induced positive inotropic and chronotropic effects (i.e., increased contractility and beating frequency, respectively) in the CC3 ECTCs but did not cause significant changes in the TSP8-15 ECTCs. A differential gene expression analysis revealed 926 up- and 439 down-regulated genes in the TSP8-15 ECTCs compared to their healthy counterparts. The application of rapamycin initiated the differential expression of 101 and 31 genes in the CC3 and TSP8-15 ECTCs, respectively. A gene ontology analysis showed that in the CC3 ECTCs, the positive inotropic and chronotropic effects of rapamycin correlated with positively regulated biological processes, which were primarily related to the metabolism of lipids and fatty and amino acids, and with negatively regulated processes, which were predominantly associated with cell proliferation and muscle and tissue development. In conclusion, this study describes for the first time an in vitro TSC cardiac tissue model, illustrates the response of normal and TSC ECTCs to rapamycin, and provides new insights into the mechanisms of TSC.
]]>Bioengineering doi: 10.3390/bioengineering11030232
Authors: Cate Wisdom Nicholas Chartrain Kelli Blaize-Wise George J. Klarmann Kristin H. Gilchrist Vincent B. Ho
Medical response to military conflicts, natural disasters, and humanitarian crises are challenged by operational logistics with unreliable supply chains, delayed medical evacuation, and compatibility of the disparate medical equipment and consumables. In these environments, stocks of supplies will become more quickly depleted and the need for equipment parts increases secondary to their higher likelihood for failure from overuse. Additive Manufacturing (AM), or 3D printing, at or closer to the point-of-need provides potential solutions to mitigate these logistics challenges. AM’s ability to tailor the resultant product through computer design enables real-time modification of a product to meet a specific situation. In this study, we deployed two different 3D printers to an arctic locale to demonstrate the utility of 3D printing and bioprinting in austere environments. Deployment of AM solutions in austere environments will likely impact medical care following natural disasters and conflicts with contested logistics. The work presented here furthers the readiness status of AM for use in austere environments to manufacture medical equipment parts and demonstrates its potential use for tissue engineering and advanced medical treatments in remote environments.
]]>Bioengineering doi: 10.3390/bioengineering11030233
Authors: Feifei Li Jiannan Liu Xiaoyun Liu Yaobin Wu Lei Qian Wenhua Huang Yanbing Li
Gastric cancer poses a societal and economic burden, prompting an exploration into the development of materials suitable for gastric reconstruction. However, there is a dearth of studies on the mechanical properties of porcine and human stomachs. Therefore, this study was conducted to elucidate their mechanical properties, focusing on interspecies correlations. Stress relaxation and tensile tests assessed the hyperelastic and viscoelastic characteristics of porcine and human stomachs. The thickness, stress–strain curve, elastic modulus, and stress relaxation were assessed. Porcine stomachs were significantly thicker than human stomachs. The stiffness contrast between porcine and human stomachs was evident. Porcine stomachs demonstrated varying elastic modulus values, with the highest in the longitudinal mucosa layer of the corpus and the lowest in the longitudinal intact layer of the fundus. In human stomachs, the elastic modulus of the longitudinal muscular layer of the antrum was the highest, whereas that of the circumferential muscularis layer of the corpus was the lowest. The degree of stress relaxation was higher in human stomachs than in porcine stomachs. This study comprehensively elucidated the differences between porcine and human stomachs attributable to variations across different regions and tissue layers, providing essential biomechanical support for subsequent studies in this field.
]]>Bioengineering doi: 10.3390/bioengineering11030231
Authors: Po-Jen Hsiao Ruei-Lin Wang Fu-Kang Hu Fu-Ru Tsai Chih-Chien Chiu Wen-Fang Chiang Kun-Lin Wu Yuan-Kuei Li Jenq-Shyong Chan Chi-Ming Chu Chi-Wen Chang
Objective: Chronic kidney disease (CKD) is one of the most common diseases worldwide. The increasing prevalence and incidence of CKD have contributed to the critical problem of high medical costs. Due to stressful environments, aircrew members may have a high risk of renal dysfunction. A better strategy to prevent CKD progression in Air Force personnel would be to diagnosis CKD at an early stage. Since few studies have been conducted in Taiwan to examine the long-term trends in early CKD in Air Force aircrew members, this study is highly important. We investigated the prevalence of CKD and established a predictive model of disease variation among aircrew members. Materials and Methods: In this retrospective study, we included all subjects who had received physical examinations at a military hospital from 2004 to 2010 and who could be tracked for four years. The Abbreviated Modification of Diet in Renal Disease Formula (aMDRD) was used to estimate the glomerular filtration rate (GFR) and was combined with the National Kidney Foundation/ Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI) to identify CKD patients. Results: A total of 212 aircrew members were assessed. The results showed that the prevalence of CKD was 3.8%, 9.4%, 9.0%, and 9.4% in each of the four years. According to the logistic regression analysis, abnormal urobilinogen levels, ketones, and white blood cell (WBC) counts in urine and a positive urine occult blood test increased the risk of CKD. A positive urine occult blood test can be used to predict the future risk of CKD. Moreover, the generalized estimating equation (GEE) model showed that a greater risk of CKD with increased examination time, age and seniority had a negative effect. In conclusion, abnormal urobilinogen levels, ketones, and urine WBC counts in urine as well as a positive urine occult blood test might serve as independent predictors for CKD. Conclusion: In the future, we can focus not only on annual physical examinations but also on simple and accurate examinations, such as urine occult blood testing, to determine the risk of CKD and prevent its progression in our aircrew members.
]]>Bioengineering doi: 10.3390/bioengineering11030230
Authors: Elissa Elia Christophe Caneparo Catherine McMartin Stéphane Chabaud Stéphane Bolduc
The penis is a complex organ with a development cycle from the fetal stage to puberty. In addition, it may suffer from either congenital or acquired anomalies. Penile surgical reconstruction has been the center of interest for many researchers but is still challenging due to the complexity of its anatomy and functionality. In this review, penile anatomy, pathologies, and current treatments are described, including surgical techniques and tissue engineering approaches. The self-assembly technique currently applied is emphasized since it is considered promising for an adequate tissue-engineered penile reconstructed substitute.
]]>Bioengineering doi: 10.3390/bioengineering11030229
Authors: Franco Marinelli Camila Venegas Joaquin Victorio Ruiz Nicole Farfán-Beltrán Erwin Staub Pablo Navarro Josefa Alarcón-Apablaza Ramón Fuentes
Edentulism can generate negative impacts on self-esteem, interpersonal relationships, and oral functions. Removable prostheses are commonly used for tooth replacement, but they may cause discomfort due to micromovements during mastication. Objective and quantifiable methods are needed to evaluate these micromovements. A pilot study was conducted to determine the micromovements in removable prostheses during mastication using a 3D electromagnetic articulography (EMA-3D) system. One elderly participant wearing lower removable prostheses and an upper total well-fitting removable prosthesis was studied. The EMA-3D system was used to record movements in three spatial planes. Peanuts were given as test food, and the participant was instructed to chew normally while recordings were carried out until feeling the need to swallow. Analyses of the upper total prosthesis show micromovements ranging from 0.63 ± 0.11 to 1.02 ± 0.13 mm. During simultaneous analyses of the upper prosthesis and lower partial prosthesis, interference was not observed. This pilot study demonstrated the feasibility of using the EMA-3D system to evaluate micromovements in removable prostheses during mastication. Further research is needed to evaluate a larger sample and assess the clinical implications of these micromovements.
]]>Bioengineering doi: 10.3390/bioengineering11030228
Authors: Dardo Menditti Mario Santagata David Guida Roberta Magliulo Giovanni Maria D’Antonio Samuel Staglianò Ciro Emiliano Boschetti
Oral Potentially Malignant Disorder (OPMD) is a significant concern for clinicians due to the risk of malignant transformation. Oral Squamous Cell Carcinoma (OSCC) is a common type of cancer with a low survival rate, causing over 200,000 new cases globally each year. Despite advancements in diagnosis and treatment, the five-year survival rate for OSCC patients remains under 50%. Early diagnosis can greatly improve the chances of survival. Therefore, understanding the development and transformation of OSCC and developing new diagnostic methods is crucial. The field of oral medicine has been advanced by technological and molecular innovations, leading to the integration of new medical technologies into dental practice. This study aims to outline the potential role of non-invasive imaging techniques and molecular signatures for the early detection of Oral Malignant and Potentially Malignant Disorders.
]]>Bioengineering doi: 10.3390/bioengineering11030226
Authors: Xinyi Yang Michael Silosky Jonathan Wehrend Daniel V. Litwiller Muthiah Nachiappan Scott D. Metzler Debashis Ghosh Fuyong Xing Bennett B. Chin
Deep learning (DL) algorithms used for DOTATATE PET lesion detection typically require large, well-annotated training datasets. These are difficult to obtain due to low incidence of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and the high cost of manual annotation. Furthermore, networks trained and tested with data acquired from site specific PET/CT instrumentation, acquisition and processing protocols have reduced performance when tested with offsite data. This lack of generalizability requires even larger, more diverse training datasets. The objective of this study is to investigate the feasibility of improving DL algorithm performance by better matching the background noise in training datasets to higher noise, out-of-domain testing datasets. 68Ga-DOTATATE PET/CT datasets were obtained from two scanners: Scanner1, a state-of-the-art digital PET/CT (GE DMI PET/CT; n = 83 subjects), and Scanner2, an older-generation analog PET/CT (GE STE; n = 123 subjects). Set1, the data set from Scanner1, was reconstructed with standard clinical parameters (5 min; Q.Clear) and list-mode reconstructions (VPFXS 2, 3, 4, and 5-min). Set2, data from Scanner2 representing out-of-domain clinical scans, used standard iterative reconstruction (5 min; OSEM). A deep neural network was trained with each dataset: Network1 for Scanner1 and Network2 for Scanner2. DL performance (Network1) was tested with out-of-domain test data (Set2). To evaluate the effect of training sample size, we tested DL model performance using a fraction (25%, 50% and 75%) of Set1 for training. Scanner1, list-mode 2-min reconstructed data demonstrated the most similar noise level compared that of Set2, resulting in the best performance (F1 = 0.713). This was not significantly different compared to the highest performance, upper-bound limit using in-domain training for Network2 (F1 = 0.755; p-value = 0.103). Regarding sample size, the F1 score significantly increased from 25% training data (F1 = 0.478) to 100% training data (F1 = 0.713; p < 0.001). List-mode data from modern PET scanners can be reconstructed to better match the noise properties of older scanners. Using existing data and their associated annotations dramatically reduces the cost and effort in generating these datasets and significantly improves the performance of existing DL algorithms. List-mode reconstructions can provide an efficient, low-cost method to improve DL algorithm generalizability.
]]>Bioengineering doi: 10.3390/bioengineering11030227
Authors: Seong-Hyeon Kang Youngjin Lee
This study aimed to remove motion artifacts from brain magnetic resonance (MR) images using a U-Net model. In addition, a simulation method was proposed to increase the size of the dataset required to train the U-Net model while avoiding the overfitting problem. The volume data were rotated and translated with random intensity and frequency, in three dimensions, and were iterated as the number of slices in the volume data. Then, for every slice, a portion of the motion-free k-space data was replaced with motion k-space data, respectively. In addition, based on the transposed k-space data, we acquired MR images with motion artifacts and residual maps and constructed datasets. For a quantitative evaluation, the root mean square error (RMSE), peak signal-to-noise ratio (PSNR), coefficient of correlation (CC), and universal image quality index (UQI) were measured. The U-Net models for motion artifact reduction with the residual map-based dataset showed the best performance across all evaluation factors. In particular, the RMSE, PSNR, CC, and UQI improved by approximately 5.35×, 1.51×, 1.12×, and 1.01×, respectively, and the U-Net model with the residual map-based dataset was compared with the direct images. In conclusion, our simulation-based dataset demonstrates that U-Net models can be effectively trained for motion artifact reduction.
]]>Bioengineering doi: 10.3390/bioengineering11030225
Authors: Guangya Yu Qi Ye Tong Ruan
The construction of medical knowledge graphs (MKGs) is steadily progressing from manual to automatic methods, which inevitably introduce noise, which could impair the performance of downstream healthcare applications. Existing error detection approaches depend on the topological structure and external labels of entities in MKGs to improve their quality. Nevertheless, due to the cost of manual annotation and imperfect automatic algorithms, precise entity labels in MKGs cannot be readily obtained. To address these issues, we propose an approach named Enhancing error detection on Medical knowledge graphs via intrinsic labEL (EMKGEL). Considering the absence of hyper-view KG, we establish a hyper-view KG and a triplet-level KG for implicit label information and neighborhood information, respectively. Inspired by the success of graph attention networks (GATs), we introduce the hyper-view GAT to incorporate label messages and neighborhood information into representation learning. We leverage a confidence score that combines local and global trustworthiness to estimate the triplets. To validate the effectiveness of our approach, we conducted experiments on three publicly available MKGs, namely PharmKG-8k, DiseaseKG, and DiaKG. Compared with the baseline models, the Precision@K value improved by 0.7%, 6.1%, and 3.6%, respectively, on these datasets. Furthermore, our method empirically showed that it significantly outperformed the baseline on a general knowledge graph, Nell-995.
]]>Bioengineering doi: 10.3390/bioengineering11030224
Authors: David W Carmichael Serge Vulliemoz Teresa Murta Umair Chaudhary Suejen Perani Roman Rodionov Maria Joao Rosa Karl J Friston Louis Lemieux
There are considerable gaps in our understanding of the relationship between human brain activity measured at different temporal and spatial scales. Here, electrocorticography (ECoG) measures were used to predict functional MRI changes in the sensorimotor cortex in two brain states: at rest and during motor performance. The specificity of this relationship to spatial co-localisation of the two signals was also investigated. We acquired simultaneous ECoG-fMRI in the sensorimotor cortex of three patients with epilepsy. During motor activity, high gamma power was the only frequency band where the electrophysiological response was co-localised with fMRI measures across all subjects. The best model of fMRI changes across states was its principal components, a parsimonious description of the entire ECoG spectrogram. This model performed much better than any others that were based either on the classical frequency bands or on summary measures of cross-spectral changes. The region-specific fMRI signal is reflected in spatially and spectrally distributed EEG activity.
]]>Bioengineering doi: 10.3390/bioengineering11030223
Authors: Takashi Uesugi Yoshiaki Shimoo Motohiro Munakata Yu Kataoka Daisuke Sato Kikue Yamaguchi Minoru Sanda Michiya Fujimaki Kazuhisa Nakayama Tae Watanabe Paulo Malo
Early implant failure occurring within 1 year after implantation has been attributed to various factors. Particularly, early failure can lead to challenges in maintaining a full-arch prosthetic device, necessitating prompt intervention, including reoperation. This study aimed to retrospectively examine implant- and patient-related factors and the effects of photofunctionalisation associated with early failure in patients who underwent treatment using the all-on-four concept in both the maxilla and mandible. We conducted this retrospective study comprising 561 patients with 2364 implants who underwent implant-supported immediate loading with fixed full-arch rehabilitation using the all-on-four concept. We aimed to assess the survival rate within 1 year after implantation and determine the risk factors influencing early failure. The 1-year survival rates after implantation were 97.1% (patient level) and 98.9% (implant level) for the maxilla and 98.5% (patient level) and 99.6% (implant level) for the mandible. There was a significant difference in the implant-level survival rates between the maxilla and mandible, with a lower rate in the maxilla (p = 0.043). The risk factors associated with early implant failure according to the all-on-four concept included the maxilla (implant level) and smoking (patient level). We could not find a significant effect of photofunctionalisation on early failure (p = 0.25) following this treatment protocol.
]]>Bioengineering doi: 10.3390/bioengineering11030222
Authors: Luca Neri Ilaria Gallelli Massimo Dall’Olio Jessica Lago Claudio Borghi Igor Diemberger Ivan Corazza
Background: Wearable devices represent a new approach for monitoring key clinical parameters, such as ECG signals, for research and health purposes. These devices could outcompete medical devices in terms of affordability and use in out-clinic settings, allowing remote monitoring. The major limitation, especially when compared to implantable devices, is the presence of artifacts. Several authors reported a relevant percentage of recording time with poor/unusable traces for ECG, potentially hampering the use of these devices for this purpose. For this reason, it is of the utmost importance to develop a simple and inexpensive system enabling the user of the wearable devices to have immediate feedback on the quality of the acquired signal, allowing for real-time correction. Methods: A simple algorithm that can work in real time to verify the quality of the ECG signal (acceptable and unacceptable) was validated. Based on simple statistical parameters, the algorithm was blindly tested by comparison with ECG tracings previously classified by two expert cardiologists. Results: The classifications of 7200 10s-signal samples acquired on 20 patients with a commercial wearable ECG monitor were compared. The algorithm has an overall efficiency of approximately 95%, with a sensitivity of 94.7% and a specificity of 95.3%. Conclusions: The results demonstrate that even a simple algorithm can be used to classify signal coarseness, and this could allow real-time intervention by the subject or the technician.
]]>Bioengineering doi: 10.3390/bioengineering11030221
Authors: Jiaxuan Cheng Lanting Yang Yishan Ye Lvfu He Shihao Chen Junjie Wang
Keratoconus (KC), a leading cause of vision impairment, has an unclear aetiology. This study used Mendelian randomization (MR) to explore the causal links between various factors (smoking, asthma, Down syndrome, inflammatory bowel disease, atopic dermatitis, and serum 25-hydroxyvitamin D levels) and KC. A two-sample MR design, grounded in genome-wide association study (GWAS) summary statistics, was adopted using data from FinnGen, UK Biobank, and other GWAS-related articles. The inverse-variance weighted (IVW) method was employed, complemented by the Wald ratio method for factors with only one single-nucleotide polymorphism (SNP). Sensitivity and stability were assessed through Cochrane’s Q test, the MR-Egger intercept test, MR-PRESSO outlier test, and the leave-one-out analysis. The IVW results for the ORA (Ocular Response Analyzer) biomechanical parameters indicated significant associations between tobacco smoking (CH: p < 0.001; CRF: p = 0.009) and inflammatory bowel disease (CH: p = 0.032; CRF: p = 0.001) and corneal biomechanics. The Wald ratio method showed tobacco smoking was associated with a lower risk of KC (p = 0.024). Conversely, asthma (p = 0.009), atopic dermatitis (p = 0.012), inflammatory bowel disease (p = 0.017), and serum 25-hydroxyvitamin D levels (p = 0.039) were associated with a higher risk of KC by IVW, and the same applied to Down syndrome (p = 0.004) using the Wald ratio. These results underscore the role of corneal biomechanics as potential mediators in KC risk, warranting further investigation using Corvis ST and Brillouin microscopy. The findings emphasise the importance of timely screening for specific populations in KC prevention and management.
]]>Bioengineering doi: 10.3390/bioengineering11030220
Authors: Abdorreza Alavi Gharahbagh Vahid Hajihashemi José J. M. Machado João Manuel R. S. Tavares
Kidney disease remains one of the most common ailments worldwide, with cancer being one of its most common forms. Early diagnosis can significantly increase the good prognosis for the patient. The development of an artificial intelligence-based system to assist in kidney cancer diagnosis is crucial because kidney illness is a global health concern, and there are limited nephrologists qualified to evaluate kidney cancer. Diagnosing and categorising different forms of renal failure presents the biggest treatment hurdle for kidney cancer. Thus, this article presents a novel method for detecting and classifying kidney cancer subgroups in Computed Tomography (CT) images based on an asymmetric local statistical pixel distribution. In the first step, the input image is non-overlapping windowed, and a statistical distribution of its pixels in each cancer type is built. Then, the method builds the asymmetric statistical distribution of the image’s gradient pixels. Finally, the cancer type is identified by applying the two built statistical distributions to a Deep Neural Network (DNN). The proposed method was evaluated using a dataset collected and authorised by the Dhaka Central International Medical Hospital in Bangladesh, which includes 12,446 CT images of the whole abdomen and urogram, acquired with and without contrast. Based on the results, it is possible to confirm that the proposed method outperformed state-of-the-art methods in terms of the usual correctness criteria. The accuracy of the proposed method for all kidney cancer subtypes presented in the dataset was 99.89%, which is promising.
]]>Bioengineering doi: 10.3390/bioengineering11030219
Authors: Xi Xu Jianqiang Li Zhichao Zhu Linna Zhao Huina Wang Changwei Song Yining Chen Qing Zhao Jijiang Yang Yan Pei
Disease diagnosis represents a critical and arduous endeavor within the medical field. Artificial intelligence (AI) techniques, spanning from machine learning and deep learning to large model paradigms, stand poised to significantly augment physicians in rendering more evidence-based decisions, thus presenting a pioneering solution for clinical practice. Traditionally, the amalgamation of diverse medical data modalities (e.g., image, text, speech, genetic data, physiological signals) is imperative to facilitate a comprehensive disease analysis, a topic of burgeoning interest among both researchers and clinicians in recent times. Hence, there exists a pressing need to synthesize the latest strides in multi-modal data and AI technologies in the realm of medical diagnosis. In this paper, we narrow our focus to five specific disorders (Alzheimer’s disease, breast cancer, depression, heart disease, epilepsy), elucidating advanced endeavors in their diagnosis and treatment through the lens of artificial intelligence. Our survey not only delineates detailed diagnostic methodologies across varying modalities but also underscores commonly utilized public datasets, the intricacies of feature engineering, prevalent classification models, and envisaged challenges for future endeavors. In essence, our research endeavors to contribute to the advancement of diagnostic methodologies, furnishing invaluable insights for clinical decision making.
]]>Bioengineering doi: 10.3390/bioengineering11030218
Authors: Mark Broadwin Frances Imarhia Amy Oh Christopher R. Stone Frank W. Sellke Sankha Bhowmick M. Ruhul Abid
Cardiovascular disease (CVD) remains the leading cause of mortality worldwide. In particular, patients who suffer from ischemic heart disease (IHD) that is not amenable to surgical or percutaneous revascularization techniques have limited treatment options. Furthermore, after revascularization is successfully implemented, there are a number of pathophysiological changes to the myocardium, including but not limited to ischemia-reperfusion injury, necrosis, altered inflammation, tissue remodeling, and dyskinetic wall motion. Electrospinning, a nanofiber scaffold fabrication technique, has recently emerged as an attractive option as a potential therapeutic platform for the treatment of cardiovascular disease. Electrospun scaffolds made of biocompatible materials have the ability to mimic the native extracellular matrix and are compatible with drug delivery. These inherent properties, combined with ease of customization and a low cost of production, have made electrospun scaffolds an active area of research for the treatment of cardiovascular disease. In this review, we aim to discuss the current state of electrospinning from the fundamentals of scaffold creation to the current role of electrospun materials as both bioengineered extracellular matrices and drug delivery vehicles in the treatment of CVD, with a special emphasis on the potential clinical applications in myocardial ischemia.
]]>Bioengineering doi: 10.3390/bioengineering11030216
Authors: Graziano Lepri Francesco Oddi Rosario Alfio Gulino Daniele Giansanti
(Background) Domiciliary radiology, which originated in pioneering studies in 1958, has transformed healthcare, particularly during the COVID-19 pandemic, through advancements such as miniaturization and digitization. This evolution, driven by the synergy of advanced technologies and robust data networks, reshapes the intersection of domiciliary radiology and mobile technology in healthcare delivery. (Objective) The objective of this study is to overview the reviews in this field with reference to the last five years to face the state of development and integration of this practice in the health domain. (Methods) A review was conducted on PubMed and Scopus, applying a standard checklist and a qualification process. The outcome detected 21 studies. (Key Content and Findings) The exploration of mobile and domiciliary radiology unveils a compelling and optimistic perspective. Notable strides in this dynamic field include the integration of Artificial Intelligence (AI), revolutionary applications in telemedicine, and the educational potential of mobile devices. Post-COVID-19, telemedicine advances and the influential role of AI in pediatric radiology signify significant progress. Mobile mammography units emerge as a solution for underserved women, highlighting the crucial importance of early breast cancer detection. The investigation into domiciliary radiology, especially with mobile X-ray equipment, points toward a promising frontier, prompting in-depth research for comprehensive insights into its potential benefits for diverse populations. The study also identifies limitations and suggests future exploration in various domains of mobile and domiciliary radiology. A key recommendation stresses the strategic prioritization of multi-domain technology assessment initiatives, with scientific societies’ endorsement, emphasizing regulatory considerations for responsible and ethical technology integration in healthcare practices. The broader landscape of technology assessment should aim to be innovative, ethical, and aligned with societal needs and regulatory standards. (Conclusions) The dynamic state of the field is evident, with active exploration of new frontiers. This overview also provides a roadmap, urging scholars, industry players, and regulators to collectively contribute to the further integration of this technology in the health domain.
]]>Bioengineering doi: 10.3390/bioengineering11030217
Authors: Hamid Abbasi Joanne O. Davidson Simerdeep K. Dhillon Kelly Q. Zhou Guido Wassink Alistair J. Gunn Laura Bennet
Brain maturity and many clinical treatments such as therapeutic hypothermia (TH) can significantly influence the morphology of neonatal EEG seizures after hypoxia–ischemia (HI), and so there is a need for generalized automatic seizure identification. This study validates efficacy of advanced deep-learning pattern classifiers based on a convolutional neural network (CNN) for seizure detection after HI in fetal sheep and determines the effects of maturation and brain cooling on their accuracy. The cohorts included HI–normothermia term (n = 7), HI–hypothermia term (n = 14), sham–normothermia term (n = 5), and HI–normothermia preterm (n = 14) groups, with a total of >17,300 h of recordings. Algorithms were trained and tested using leave-one-out cross-validation and k-fold cross-validation approaches. The accuracy of the term-trained seizure detectors was consistently excellent for HI–normothermia preterm data (accuracy = 99.5%, area under curve (AUC) = 99.2%). Conversely, when the HI–normothermia preterm data were used in training, the performance on HI–normothermia term and HI–hypothermia term data fell (accuracy = 98.6%, AUC = 96.5% and accuracy = 96.9%, AUC = 89.6%, respectively). Findings suggest that HI–normothermia preterm seizures do not contain all the spectral features seen at term. Nevertheless, an average 5-fold cross-validated accuracy of 99.7% (AUC = 99.4%) was achieved from all seizure detectors. This significant advancement highlights the reliability of the proposed deep-learning algorithms in identifying clinically translatable post-HI stereotypic seizures in 256Hz recordings, regardless of maturity and with minimal impact from hypothermia.
]]>Bioengineering doi: 10.3390/bioengineering11030215
Authors: Se-Wook Pyo Jeong-Won Paik Da-Na Lee Young-Wook Seo Jin-Young Park Sunjai Kim Seong-Ho Choi
This animal study was aimed to evaluate the efficacy of new bone formation and volume maintenance according to the particle type and the collagen membrane function for grafted octacalcium phosphate (OCP) in rabbit calvarial defects. The synthetic bone substitutes were prepared in powder form with 90% OCP and granular form with 76% OCP, respectively. The calvarial defects were divided into four groups according to the particle type and the membrane application. All specimens were acquired 2 weeks (n = 5) and 8 weeks (n = 5) after surgery. According to the micro-CT results, the new bone volume increased at 2 weeks in the 76% OCP groups compared to the 90% OCP groups, and the bone volume ratio was significantly lower in the 90% OCP group after 2 weeks. The histomorphometric analysis results indicated that the new bone area and its ratio in all experimental groups were increased at 8 weeks except for the group with 90% OCP without a membrane. Furthermore, the residual bone graft area and its ratio in the 90% OCP groups were decreased at 8 weeks. In conclusion, all types of OCP could be applied as biocompatible bone graft materials regardless of its density and membrane application. Neither the OCP concentration nor the membrane application had a significant effect on new bone formation in the defect area, but the higher the OCP concentration, the less graft volume maintenance was needed.
]]>Bioengineering doi: 10.3390/bioengineering11030214
Authors: Ioannis Kakkos Theodoros P. Vagenas Anna Zygogianni George K. Matsopoulos
The delineation of parotid glands in head and neck (HN) carcinoma is critical to assess radiotherapy (RT) planning. Segmentation processes ensure precise target position and treatment precision, facilitate monitoring of anatomical changes, enable plan adaptation, and enhance overall patient safety. In this context, artificial intelligence (AI) and deep learning (DL) have proven exceedingly effective in precisely outlining tumor tissues and, by extension, the organs at risk. This paper introduces a DL framework using the AttentionUNet neural network for automatic parotid gland segmentation in HN cancer. Extensive evaluation of the model is performed in two public and one private dataset, while segmentation accuracy is compared with other state-of-the-art DL segmentation schemas. To assess replanning necessity during treatment, an additional registration method is implemented on the segmentation output, aligning images of different modalities (Computed Tomography (CT) and Cone Beam CT (CBCT)). AttentionUNet outperforms similar DL methods (Dice Similarity Coefficient: 82.65% ± 1.03, Hausdorff Distance: 6.24 mm ± 2.47), confirming its effectiveness. Moreover, the subsequent registration procedure displays increased similarity, providing insights into the effects of RT procedures for treatment planning adaptations. The implementation of the proposed methods indicates the effectiveness of DL not only for automatic delineation of the anatomical structures, but also for the provision of information for adaptive RT support.
]]>Bioengineering doi: 10.3390/bioengineering11030213
Authors: Raya Al-Rayesse Ossama Al-Jabban Ammar Eid Alaa Kabtoleh Frédéric Addiego Davide Mancino Youssef Haikel Naji Kharouf
The present in vitro study focuses on the filling ability of three different bioceramic cements with or without the addition of a bioceramic sealer in an open apex model on the marginal apical adaptation, tubule infiltrations, and void distributions as well as the interface between the cement and the sealer materials. To this end, sixty mandibular premolars were used. MTA-Biorep (BR), Biodentine (BD), and Well-Root Putty (WR) were used to obturate the open apex model with or without the addition of a bioceramic sealer, namely TotalFill® BC sealer™ (TF). A digital optical microscope and scanning electron microscope (SEM) were used to investigate the cement–dentin interface, marginal apical adaptation, and the material infiltration into the dentinal tubules. Micro-computed X-ray tomography and digital optical microscopy were used to investigate the cement–sealer interface. The results were analyzed by using the Kruskal–Wallis test. No significant difference was found between the groups for the marginal apical adaptation quality (p > 0.05). Good adaptation of the dentin–cement interface was found for all tested groups and the sealer was placed between the cement material and dentinal walls. All the groups demonstrated some infiltrations into the dentinal tubules at the coronal part except for the BR group. A good internal interface was found between the cement and the sealer with the presence of voids at the external interface. A larger number of voids were found in the case of the BD-TF group compared to each of the other two groups (p < 0.05). Within the limitations of the present in vitro study, all the groups demonstrated good marginal apical adaptation. The use of a sealer in an open apex does not guarantee good filling and, in addition, creates voids at the external interfaces with the dental walls when the premixed sealer is used with powder–liquid cement systems. The use of a premixed bioceramic cement could offer fewer complications than when a powder–liquid cement system is used.
]]>Bioengineering doi: 10.3390/bioengineering11030212
Authors: Matthias Heusel Gunnar Grim Joel Rauhut Matthias Franzreb
Dynamic crossflow filtration (DCF) is the state-of-the-art technology for solid–liquid separation from viscous and sensitive feed streams in the food and biopharma industry. Up to now, the potential of industrial processes is often not fully exploited, because fixed recipes are usually applied to run the processes. In order to take the varying properties of biological feed materials into account, we aim to develop a digital twin of an industrial brownfield DCF plant, allowing to optimize setpoint decisions in almost real time. The core of the digital twin is a mechanistic–empirical process model combining fundamental filtration laws with process expert knowledge. The effect of variation in the selected process and model parameters on plant productivity has been assessed using a model-based design-of-experiments approach, and a regression metamodel has been trained with the data. A cyclic program that bidirectionally communicates with the DCF asset serves as frame of the digital twin. It monitors the process dynamics membrane torque and transmembrane pressure and feeds back the optimum permeate flow rate setpoint to the physical asset in almost real-time during process runs. We considered a total of 24 industrial production batches from the filtration of grape juice from the years 2022 and 2023 in the study. After implementation of the digital twin on site, the campaign mean productivity increased by 15% over the course of the year 2023. The presented digital twin framework is a simple example how an industrial established process can be controlled by a hybrid model-based algorithm. With a digital process dynamics model at hand, the presented metamodel optimization approach can be easily transferred to other (bio)chemical processes.
]]>Bioengineering doi: 10.3390/bioengineering11030210
Authors: Xinqi Li Yuheng Huang Archana Malagi Chia-Chi Yang Ghazal Yoosefian Li-Ting Huang Eric Tang Chang Gao Fei Han Xiaoming Bi Min-Chi Ku Hsin-Jung Yang Hui Han
B0 field inhomogeneity is a long-lasting issue for Cardiac MRI (CMR) in high-field (3T and above) scanners. The inhomogeneous B0 fields can lead to corrupted image quality, prolonged scan time, and false diagnosis. B0 shimming is the most straightforward way to improve the B0 homogeneity. However, today’s standard cardiac shimming protocol requires manual selection of a shim volume, which often falsely includes regions with large B0 deviation (e.g., liver, fat, and chest wall). The flawed shim field compromises the reliability of high-field CMR protocols, which significantly reduces the scan efficiency and hinders its wider clinical adoption. This study aims to develop a dual-channel deep learning model that can reliably contour the cardiac region for B0 shim without human interaction and under variable imaging protocols. By utilizing both the magnitude and phase information, the model achieved a high segmentation accuracy in the B0 field maps compared to the conventional single-channel methods (Dice score: 2D-mag = 0.866, 3D-mag = 0.907, and 3D-mag-phase = 0.938, all p < 0.05). Furthermore, it shows better generalizability against the common variations in MRI imaging parameters and enables significantly improved B0 shim compared to the standard method (SD(B0Shim): Proposed = 15 ± 11% vs. Standard = 6 ± 12%, p < 0.05). The proposed autonomous model can boost the reliability of cardiac shimming at 3T and serve as the foundation for more reliable and efficient high-field CMR imaging in clinical routines.
]]>Bioengineering doi: 10.3390/bioengineering11030211
Authors: Mikko J. Lammi Chengjuan Qu
Cartilage defects and osteoarthritis are health problems which are major burdens on health care systems globally, especially in aging populations. Cartilage is a vulnerable tissue, which generally faces a progressive degenerative process when injured. This makes it the 11th most common cause of global disability. Conservative methods are used to treat the initial phases of the illness, while orthopedic management is the method used for more progressed phases. These include, for instance, arthroscopic shaving, microfracturing and mosaicplasty, and joint replacement as the final treatment. Cell-based implantation methods have also been developed. Despite reports of successful treatments, they often suffer from the non-optimal nature of chondrocyte phenotype in the repair tissue. Thus, improved strategies to control the phenotype of the regenerating cells are needed. Avascular tissue cartilage relies on diffusion for nutrients acquisition and the removal of metabolic waste products. A low oxygen content is also present in cartilage, and the chondrocytes are, in fact, well adapted to it. Therefore, this raises an idea that the regulation of oxygen tension could be a strategy to control the chondrocyte phenotype expression, important in cartilage tissue for regenerative purposes. This narrative review discusses the aspects related to oxygen tension in the metabolism and regulation of articular and growth plate chondrocytes and progenitor cell phenotypes, and the role of some microenvironmental factors as regulators of chondrocytes.
]]>Bioengineering doi: 10.3390/bioengineering11030209
Authors: Alexandra Carvalho Ana Filipa Ferreira Maria Soares Susana Santos Patrícia Tomé Juliana Machado-Simões Ana Sofia Pais Ana Paula Sousa Artur Paiva Teresa Almeida-Santos
Platelet-rich plasma (PRP) has emerged as a promising therapy in regenerative medicine. However, the lack of standardization in PRP preparation protocols presents a challenge in achieving reproducible and accurate results. This study aimed to optimize the PRP preparation protocol by investigating the impact of two different anticoagulants, sodium citrate (SC) and ethylenediaminetetraacetic acid (EDTA), and resuspension media, plasma versus sodium chloride (NaCl). Platelet recovery rates were calculated and compared between groups, in addition to platelet activity and vascular endothelial growth factor (VEGF) released into plasma after PRP activation. The platelet recovery rate was higher with EDTA in comparison to SC (51.04% vs. 29.85%, p = 0.005). Platelet activity was also higher, with a higher expression of two platelet antibodies, platelet surface P-Selectin (CD62p) and PAC-1, in the EDTA group. The concentration of VEGF was higher with SC in comparison to EDTA (628.73 vs. 265.44 pg/mL, p = 0.013). Platelet recovery rates and VEGF levels were higher in PRP resuspended in plasma when compared to NaCl (61.60% vs. 48.61%, p = 0.011 and 363.32 vs. 159.83 pg/mL, p = 0.005, respectively). Our study reinforces the superiority of EDTA (as anticoagulant) and plasma (for resuspension) in obtaining a higher platelet recovery and preserving platelet functionality during PRP preparation.
]]>Bioengineering doi: 10.3390/bioengineering11030208
Authors: Na Eun Mun Thi Kim Chi Tran Dong Hui Park Jin Hee Im Jae Il Park Thanh Dat Le Young Jin Moon Seong-Young Kwon Su Woong Yoo
In this study, we developed an endoscopic hyperspectral imaging (eHSI) system and evaluated its performance in analyzing tissues within tissue phantoms and orthotopic mouse pancreatic tumor models. Our custom-built eHSI system incorporated a liquid crystal tunable filter. To assess its tissue discrimination capabilities, we acquired images of tissue phantoms, distinguishing between fat and muscle regions. The system underwent supervised training using labeled samples, and this classification model was then applied to other tissue phantom images for evaluation. In the tissue phantom experiment, the eHSI effectively differentiated muscle from fat and background tissues. The precision scores regarding fat tissue classification were 98.3% for the support vector machine, 97.7% for the neural network, and 96.0% with a light gradient-boosting machine algorithm, respectively. Furthermore, we applied the eHSI system to identify tumors within an orthotopic mouse pancreatic tumor model. The F-score of each pancreatic tumor-bearing model reached 73.1% for the KPC tumor model and 63.1% for the Pan02 tumor models. The refined imaging conditions and optimization of the fine-tuning of classification algorithms enhance the versatility and diagnostic efficacy of eHSI in biomedical applications.
]]>Bioengineering doi: 10.3390/bioengineering11030207
Authors: Andrea Steuwe Benedikt Kamp Saif Afat Alena Akinina Schekeb Aludin Elif Gülsah Bas Josephine Berger Evelyn Bohrer Alexander Brose Susanne Martina Büttner Constantin Ehrengut Mirjam Gerwing Sergio Grosu Alexander Gussew Felix Güttler Andreas Heinrich Petra Jiraskova Christopher Kloth Jonathan Kottlors Marc-David Kuennemann Christian Liska Nora Lubina Mathias Manzke Felix G. Meinel Hans-Jonas Meyer Andreas Mittermeier Thorsten Persigehl Lars-Patrick Schmill Manuel Steinhardt The RACOON Study Group The RACOON Study Group Gerald Antoch Birte Valentin
CT protocols that diagnose COVID-19 vary in regard to the associated radiation exposure and the desired image quality (IQ). This study aims to evaluate CT protocols of hospitals participating in the RACOON (Radiological Cooperative Network) project, consolidating CT protocols to provide recommendations and strategies for future pandemics. In this retrospective study, CT acquisitions of COVID-19 patients scanned between March 2020 and October 2020 (RACOON phase 1) were included, and all non-contrast protocols were evaluated. For this purpose, CT protocol parameters, IQ ratings, radiation exposure (CTDIvol), and central patient diameters were sampled. Eventually, the data from 14 sites and 534 CT acquisitions were analyzed. IQ was rated good for 81% of the evaluated examinations. Motion, beam-hardening artefacts, or image noise were reasons for a suboptimal IQ. The tube potential ranged between 80 and 140 kVp, with the majority between 100 and 120 kVp. CTDIvol was 3.7 ± 3.4 mGy. Most healthcare facilities included did not have a specific non-contrast CT protocol. Furthermore, CT protocols for chest imaging varied in their settings and radiation exposure. In future, it will be necessary to make recommendations regarding the required IQ and protocol parameters for the majority of CT scanners to enable comparable IQ as well as radiation exposure for different sites but identical diagnostic questions.
]]>Bioengineering doi: 10.3390/bioengineering11030206
Authors: Maha Alattar Alok Govind Shraddha Mainali
Sleep disorders, prevalent in the general population, present significant health challenges. The current diagnostic approach, based on a manual analysis of overnight polysomnograms (PSGs), is costly and time-consuming. Artificial intelligence has emerged as a promising tool in this context, offering a more accessible and personalized approach to diagnosis, particularly beneficial for under-served populations. This is a systematic review of AI-based models for sleep disorder diagnostics that were trained, validated, and tested on diverse clinical datasets. An extensive search of PubMed and IEEE databases yielded 2114 articles, but only 18 met our stringent selection criteria, underscoring the scarcity of thoroughly validated AI models in sleep medicine. The findings emphasize the necessity of a rigorous validation of AI models on multimodal clinical data, a step crucial for their integration into clinical practice. This would be in line with the American Academy of Sleep Medicine’s support of AI research.
]]>Bioengineering doi: 10.3390/bioengineering11030205
Authors: Aaqib Ayub Yuen Ki Cheong Jesus Calvo Castro Oliver Cumberlege Andreas Chrysanthou
Disinfection of nosocomial pathogens in hospitals is crucial to combat healthcare-acquired infections, which can be acquired by patients, visitors and healthcare workers. However, the presence of a wide range of pathogens and biofilms, combined with the indiscriminate use of antibiotics, presents infection control teams in healthcare facilities with ongoing challenges in the selection of biocides and application methods. This necessitates the development of biocides and innovative disinfection methods that overcome the shortcomings of conventional methods. This comprehensive review finds the use of hydrogen peroxide vapour to be a superior alternative to conventional methods. Motivated by observations in previous studies, herein, we provide a comprehensive overview on the utilisation of hydrogen peroxide vapour as a superior high-level disinfection alternative in hospital settings. This review finds hydrogen peroxide vapour to be very close to an ideal disinfectant due to its proven efficacy against a wide range of microorganisms, safety to use, lack of toxicity concerns and good material compatibility. The superiority of hydrogen peroxide vapour was recently demonstrated in the case of decontamination of N95/FFP2 masks for reuse to address the critical shortage caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the COVID-19 pandemic. Despite the significant number of studies demonstrating antimicrobial activity, there remains a need to critically understand the mechanism of action by performing studies that simultaneously measure damage to all bacterial cell components and assess the correlation of this damage with a reduction in viable cell count. This can lead to improvement in antimicrobial efficacy and foster the development of superior approaches.
]]>Bioengineering doi: 10.3390/bioengineering11030204
Authors: Fabiula Schwartz de Azevedo Gabriela de Castro Almeida Bruno Alvares de Azevedo Ivan Fernney Ibanez Aguilar Bruno Nieckele Azevedo Pedro Soares Teixeira Gabriel Cordeiro Camargo Marcelo Goulart Correia Angela Ourivio Nieckele Glaucia Maria Moraes Oliveira
Ascending aortic aneurysm (AAoA) is a silent disease with high mortality; however, the factors associated with a worse prognosis are not completely understood. The objective of this observational, longitudinal, single-center study was to identify the hemodynamic patterns and their influence on AAoA growth using computational fluid dynamics (CFD), focusing on the effects of geometrical variations on aortic hemodynamics. Personalized anatomic models were obtained from angiotomography scans of 30 patients in two different years (with intervals of one to three years between them), of which 16 (53%) showed aneurysm growth (defined as an increase in the ascending aorta volume by 5% or more). Numerically determined velocity and pressure fields were compared with the outcome of aneurysm growth. Through a statistical analysis, hemodynamic characteristics were found to be associated with aneurysm growth: average and maximum high pressure (superior to 100 Pa); average and maximum high wall shear stress (superior to 7 Pa) combined with high pressure (>100 Pa); and stress load over time (maximum pressure multiplied by the time interval between the exams). This study provides insights into a worse prognosis of this serious disease and may collaborate for the expansion of knowledge about mechanobiology in the progression of AAoA.
]]>Bioengineering doi: 10.3390/bioengineering11030203
Authors: Tadashi Umeno Kazuki Mori Ryosuke Iwai Takayuki Kawashima Takashi Shuto Yumiko Nakashima Tsutomu Tajikawa Yasuhide Nakayama Shinji Miyamoto
Biotubes are autologous tubular tissues developed within a patient’s body through in-body tissue architecture, and they demonstrate high potential for early clinical application as a vascular replacement. In this pilot study, we used large animals to perform implantation experiments in preparation for preclinical testing of Biotube. The biological response after Biotube implantation was histologically evaluated. The designed Biotubes (length: 50 cm, internal diameter: 4 mm, and wall thickness: 0.85 mm) were obtained by embedding molds on the backs of six goats for a predetermined period (1–5 months). The same goats underwent bypass surgery on the carotid arteries using Biotubes (average length: 12 cm). After implantation, echocardiography was used to periodically monitor patency and blood flow velocity. The maximum observation period was 6 months, and tissue analysis was conducted after graft removal, including the anastomosis. All molds generated Biotubes that exceeded the tensile strength of normal goat carotid arteries, and eight randomly selected Biotubes were implanted. Thrombotic occlusion occurred immediately postoperatively (1 tube) if anticoagulation was insufficient, and two tubes, with insufficient Biotube strength (<5 N), were ruptured within a week. Five tubes maintained patency for >2 months without aneurysm formation. The spots far from the anastomosis became stenosed within 3 months (3 tubes) when Biotubes had a wide intensity distribution, but the shape of the remaining two tubes remained unchanged for 6 months. The entire length of the bypass region was walled with an αSMA-positive cell layer, and an endothelial cell layer covered most of the lumen at 2 months. Complete endothelial laying of the luminal surface was obtained at 3 months after implantation, and a vascular wall structure similar to that of native blood vessels was formed, which was maintained even at 6 months. The stenosis was indicated to be caused by fibrin adhesion on the luminal surface, migration of repair macrophages, and granulation formation due to the overproliferation of αSMA-positive fibroblasts. We revealed the importance of Biotubes that are homogeneous, demonstrate a tensile strength > 5 N, and are implanted under appropriate antithrombotic conditions to achieve long-term patency of Biotube. Further, we clarified the Biotube regeneration process and the mechanism of stenosis. Finally, we obtained the necessary conditions for a confirmatory implant study planned shortly.
]]>Bioengineering doi: 10.3390/bioengineering11030202
Authors: Oliver Denton Yifei Wan Laura Beattie Téa Jack Preston McGoldrick Holly McAllister Cara Mullan Catriona M. Douglas Wenmiao Shu
Acute recurrent tonsillitis is a chronic, biofilm-related infection that is a significant burden to patients and healthcare systems. It is often treated with repeated courses of antibiotics, which contributes to antimicrobial resistance. Studying biofilms is key to understanding this disease. In vitro modelling using 3D bioprinted hydrogels is a promising approach to achieve this. A novel gelatin-PEGDA pseudomonas fluorescens-laden bioink was developed and bioprinted in a 3D hydrogel construct fabricated using computer-aided design to mimic the tonsillar biofilm environment. The bioprinted constructs were cultured at 37 °C in lysogeny broth for 12 days. Bacterial growth was assessed by spectrophotometry. Cellular viability analysis was conducted using optical fluorescence microscopy (FDA/PI staining). A biocompatible 3D-printed bacteria-laden hydrogel construct was successfully fabricated. Bacterial growth was observed using optical fluorescence microscopy. A live/dead cellular-staining protocol demonstrated bacterial viability. Results obtained after the 12-day culture period showed higher bacterial growth in the 1% gelatin concentration construct compared to the 0% control. This study demonstrates the first use of a bacteria-laden gelatin-PEGDA hydrogel for biofabrication of a 3D-printed construct designed to model acute recurrent tonsillitis. Initiating a study with clinically relevant ex vivo tonsil bacteria will be an important next step in improving treatment of this impactful but understudied disease.
]]>Bioengineering doi: 10.3390/bioengineering11030201
Authors: Priscilla González-Pereira Ryan Trinh Alex Vasuthasawat Angelo Bartsch-Jiménez Constanza Nuñez-Soto Claudia Altamirano
Augmentation of glycoprotein synthesis requirements induces endoplasmic reticulum (ER) stress, activating the unfolded protein response (UPR) and triggering unconventional XBP1 splicing. As a result, XBP1s orchestrates the expression of essential genes to reduce stress and restore homeostasis. When this mechanism fails, chronic stress may lead to apoptosis, which is thought to be associated with exceeding a threshold in XBP1s levels. Glycoprotein assembly is also affected by glutamine (Gln) availability, limiting nucleotide sugars (NS), and preventing compliance with the increased demands. In contrast, increased Gln intake synthesizes ammonia as a by-product, potentially reaching toxic levels. IgA2m(1)-producer mouse myeloma cells (SP2/0) were used as the cellular mammalian model. We explored how IgA2m(1)-specific productivity (qIgA2m(1)) is affected by (i) overexpression of human XBP1s (h-XBP1s) levels and (ii) Gln availability, evaluating the kinetic behavior in batch cultures. The study revealed a two and a five-fold increase in qIgA2m(1) when lower and higher levels of XBP1s were expressed, respectively. High h-XBP1s overexpression mitigated not only ammonia but also lactate accumulation. Moreover, XBP1s overexpressor showed resilience to hydrodynamic stress in serum-free environments. These findings suggest a potential application of h-XBP1s overexpression as a feasible and cost-effective strategy for bioprocess scalability.
]]>Bioengineering doi: 10.3390/bioengineering11030200
Authors: Brian M. Leonard Vladimir V. Shuvaev Trent A. Bullock Kalpani N. Udeni Galpayage Dona Vladimir R. Muzykantov Allison M. Andrews Servio H. Ramirez
The neuroinflammatory cascade triggered by traumatic brain injury (TBI) represents a clinically important point for therapeutic intervention. Neuroinflammation generates oxidative stress in the form of high-energy reactive oxygen and nitrogen species, which are key mediators of TBI pathology. The role of the blood–brain barrier (BBB) is essential for proper neuronal function and is vulnerable to oxidative stress. Results herein explore the notion that attenuating oxidative stress at the vasculature after TBI may result in improved BBB integrity and neuroprotection. Utilizing amino-chemistry, a biological construct (designated “dual conjugate” for short) was generated by covalently binding two antioxidant enzymes (superoxide dismutase 1 (SOD-1) and catalase (CAT)) to antibodies specific for ICAM-1. Bioengineering of the conjugate preserved its targeting and enzymatic functions, as evaluated by real-time bioenergetic measurements (via the Seahorse-XF platform), in brain endothelial cells exposed to increasing concentrations of hydrogen peroxide or a superoxide anion donor. Results showed that the dual conjugate effectively mitigated the mitochondrial stress due to oxidative damage. Furthermore, dual conjugate administration also improved BBB and endothelial protection under oxidative insult in an in vitro model of TBI utilizing a software-controlled stretching device that induces a 20% in mechanical strain on the endothelial cells. Additionally, the dual conjugate was also effective in reducing indices of neuroinflammation in a controlled cortical impact (CCI)-TBI animal model. Thus, these studies provide proof of concept that targeted dual antioxidant biologicals may offer a means to regulate oxidative stress-associated cellular damage during neurotrauma.
]]>Bioengineering doi: 10.3390/bioengineering11030199
Authors: Alexander Lacki Antonio Martinez-Millana
Critical care physicians are commonly faced with patients exhibiting atrial fibrillation (AF), a cardiac arrhythmia with multifaceted origins. Recent investigations shed light on the heterogeneity among AF patients by uncovering unique AF phenotypes, characterized by differing treatment strategies and clinical outcomes. In this retrospective study encompassing 9401 AF patients in an intensive care cohort, we sought to identify differences in average treatment effects (ATEs) across different patient groups. We extract data from the MIMIC-III database, use hierarchical agglomerative clustering to identify patients’ phenotypes, and assign them to treatment groups based on their initial drug administration during AF episodes. The treatment options examined included beta blockers (BBs), potassium channel blockers (PCBs), calcium channel blockers (CCBs), and magnesium sulfate (MgS). Utilizing multiple imputation and inverse probability of treatment weighting, we estimate ATEs related to rhythm control, rate control, and mortality, approximated as hourly and daily rates (%/h, %/d). Our analysis unveiled four distinctive AF phenotypes: (1) postoperative hypertensive, (2) non-cardiovascular mutlimorbid, (3) cardiovascular multimorbid, and (4) valvulopathy atrial dilation. PCBs showed the highest cardioversion rates across phenotypes, ranging from 11.6%/h (9.35–13.3) to 7.69%/h (5.80–9.22). While CCBs demonstrated the highest effectiveness in controlling ventricular rates within the overall patient cohort, PCBs and MgS outperformed them in specific phenotypes. PCBs exhibited the most favorable mortality outcomes overall, except for the non-cardiovascular multimorbid cluster, where BBs displayed a lower mortality rate of 1.33%/d [1.04–1.93] compared to PCBs’ 1.68%/d [1.10–2.24]. The results of this study underscore the significant diversity in ATEs among individuals with AF and suggest that phenotype-based classification could be a valuable tool for physicians, providing personalized insights to inform clinical decision making.
]]>Bioengineering doi: 10.3390/bioengineering11020198
Authors: Marco Mammana Alessandro Bonis Vincenzo Verzeletti Andrea Dell’Amore Federico Rea
Patients affected by long-segment tracheal defects or stenoses represent an unsolved surgical issue, since they cannot be treated with the conventional surgery of tracheal resection and consequent anastomosis. Hence, different strategies for tracheal replacement have been proposed (synthetic materials, aortic allografts, transplantation, autologous tissue composites, and tissue engineering), each with advantages and drawbacks. Tracheal tissue engineering, on the other hand, aims at recreating a fully functional tracheal substitute, without the need for the patient to receive lifelong immunosuppression or endotracheal stents. Tissue engineering approaches involve the use of a scaffold, stem cells, and humoral signals. This paper reviews the main aspects of tracheal TE, starting from the choice of the scaffold to the type of stem cells that can be used to seed the scaffold, the methods for their culture and expansion, the issue of graft revascularization at the moment of in vivo implantation, and experimental models of tracheal research. Moreover, a critical insight on the state of the art of tracheal tissue engineering is also presented.
]]>Bioengineering doi: 10.3390/bioengineering11020197
Authors: Ruben Foresti Anna Fornasari Claudio Bianchini Massoni Arianna Mersanne Chiara Martini Elisa Cabrini Antonio Freyrie Paolo Perini
There is currently a shift in surgical training from traditional methods to simulation-based approaches, recognizing the necessity of more effective and controlled learning environments. This study introduces a completely new 3D-printed modular system for endovascular surgery training (M-SET), developed to allow various difficulty levels. Its design was based on computed tomography angiographies from real patient data with femoro-popliteal lesions. The study aimed to explore the integration of simulation training via a 3D model into the surgical training curriculum and its effect on their performance. Our preliminary study included 12 volunteer trainees randomized 1:1 into the standard simulation (SS) group (3 stepwise difficulty training sessions) and the random simulation (RS) group (random difficulty of the M-SET). A senior surgeon evaluated and timed the final training session. Feedback reports were assessed through the Student Satisfaction and Self-Confidence in Learning Scale. The SS group completed the training sessions in about half time (23.13 ± 9.2 min vs. 44.6 ± 12.8 min). Trainees expressed high satisfaction with the training program supported by the M-SET. Our 3D-printed modular training model meets the current need for new endovascular training approaches, offering a customizable, accessible, and effective simulation-based educational program with the aim of reducing the time required to reach a high level of practical skills.
]]>Bioengineering doi: 10.3390/bioengineering11020196
Authors: Lai-Ying Lu Yi-Ting Chen I-Ling Chen Yu-Chang Shih Rosalie Tzu-Li Liu Yi-Jing Lai Chau Yee Ng
Vitiligo, a psychologically distressing pigmentary disorder characterized by white depigmented patches due to melanocyte loss, necessitates non-invasive tools for early detection and treatment response monitoring. High-cellular-resolution full-field optical coherence tomography (CRFF-OCT) is emerging in pigmentary disorder assessment, but its applicability in vitiligo repigmentation after tissue grafting remains unexplored. To investigate the feasibility of CRFF-OCT for evaluating vitiligo lesions following tissue grafting, our investigation involved ten vitiligo patients who underwent suction blister epidermal grafting and laser ablation at a tertiary center between 2021 and 2022. Over a six-month period, clinical features, dermoscopy, and photography data were recorded. Utilizing CRFF-OCT along with artificial intelligence (AI) applications, repigmentation features were captured and analyzed. The CRFF-OCT analysis revealed a distinct dark band in vitiligo lesion skin, indicating melanin loss. Grafted areas exhibited melanocytes with dendrites around the epidermal-dermal junction and hair follicles. CRFF-OCT demonstrated its efficacy in the early detection of melanocyte recovery and accurate melanin quantification. This study introduces CRFF-OCT as a real-time, non-invasive, and in vivo evaluation tool for assessing vitiligo repigmentation, offering valuable insights into pigmentary disorders and treatment responses.
]]>Bioengineering doi: 10.3390/bioengineering11020195
Authors: Kikue Yamaguchi Motohiro Munakata Kota Ishii Takashi Uesugi
A screw-fixed superstructure is predominantly selected for implant prostheses because of the concern regarding developing peri-implantitis, although its infection route remains unclear. Focusing on microleakage from access holes, the present study clinically investigated the bacterial flora in access holes with different sealing materials. We examined 38 sites in 19 patients with two adjacent screw-fixed superstructures. Composite resin was used in the control group, and zinc-containing glass ionomer cement was used in the test group. Bacteria were collected from the access holes 28 days after superstructure placement and were subjected to DNA hybridization analysis. The same patient comparisons of the bacterial counts showed a significant decrease in 14 bacterial species for the red, yellow, and purple complexes in the test group (p < 0.05). In addition, the same patient comparisons of the bacterial ratios showed a significant decrease in six bacterial species for the orange, green, yellow, and purple complexes in the test group (p < 0.05). Furthermore, the same patient comparisons of the implant positivity rates showed a significant decrease in the six bacterial species for the orange, yellow, and purple complexes in the test group. The results of this study indicate that zinc-containing glass ionomer cement is effective as a sealing material for access holes.
]]>Bioengineering doi: 10.3390/bioengineering11020194
Authors: Ata Jodeiri Hadi Seyedarabi Sebelan Danishvar Seyyed Hossein Shafiei Jafar Ganjpour Sales Moein Khoori Shakiba Rahimi Seyed Mohammad Javad Mortazavi
Accurate and reliable estimation of the pelvic tilt is one of the essential pre-planning factors for total hip arthroplasty to prevent common post-operative complications such as implant impingement and dislocation. Inspired by the latest advances in deep learning-based systems, our focus in this paper has been to present an innovative and accurate method for estimating the functional pelvic tilt (PT) from a standing anterior–posterior (AP) radiography image. We introduce an encoder–decoder-style network based on a concurrent learning approach called VGG-UNET (VGG embedded in U-NET), where a deep fully convolutional network known as VGG is embedded at the encoder part of an image segmentation network, i.e., U-NET. In the bottleneck of the VGG-UNET, in addition to the decoder path, we use another path utilizing light-weight convolutional and fully connected layers to combine all extracted feature maps from the final convolution layer of VGG and thus regress PT. In the test phase, we exclude the decoder path and consider only a single target task i.e., PT estimation. The absolute errors obtained using VGG-UNET, VGG, and Mask R-CNN are 3.04 ± 2.49, 3.92 ± 2.92, and 4.97 ± 3.87, respectively. It is observed that the VGG-UNET leads to a more accurate prediction with a lower standard deviation (STD). Our experimental results demonstrate that the proposed multi-task network leads to a significantly improved performance compared to the best-reported results based on cascaded networks.
]]>Bioengineering doi: 10.3390/bioengineering11020193
Authors: Giovanna Strangis Massimiliano Labardi Giuseppe Gallone Mario Milazzo Simone Capaccioli Francesca Forli Patrizia Cinelli Stefano Berrettini Maurizia Seggiani Serena Danti Paolo Parchi
Bone defects are a significant health problem worldwide. Novel treatment approaches in the tissue engineering field rely on the use of biomaterial scaffolds to stimulate and guide the regeneration of damaged tissue that cannot repair or regrow spontaneously. This work aimed at developing and characterizing new piezoelectric scaffolds to provide electric bio-signals naturally present in bone and vascular tissues. Mixing and extrusion were used to obtain nanocomposites made of polyhydroxybutyrate (PHB) as a matrix and barium titanate (BaTiO3) nanoparticles as a filler, at BaTiO3/PHB compositions of 5/95, 10/90, 15/85 and 20/80 (w/w%). The morphological, thermal, mechanical and piezoelectric properties of the nanocomposites were studied. Scanning electron microscopy analysis showed good nanoparticle dispersion within the polymer matrix. Considerable increases in the Young’s modulus, compressive strength and the piezoelectric coefficient d31 were observed with increasing BaTiO3 content, with d31 = 37 pm/V in 20/80 (w/w%) BaTiO3/PHB. 3D printing was used to produce porous cubic-shaped scaffolds using a 90° lay-down pattern, with pore size ranging in 0.60–0.77 mm and good mechanical stability. Biodegradation tests conducted for 8 weeks in saline solution at 37 °C showed low mass loss (∼4%) for 3D printed scaffolds. The results obtained in terms of piezoelectric, mechanical and chemical properties of the nanocomposite provide a new promising strategy for vascularized bone tissue engineering.
]]>Bioengineering doi: 10.3390/bioengineering11020192
Authors: Motohiro Munakata Yu Kataoka Kikue Yamaguchi Minoru Sanda
Implant therapy is now an established treatment with high long-term success and survival rates. However, early implant failure, which occurs within one year of superstructure placement, occurs at a higher rate than late failure, which is represented by peri-implantitis caused by bacterial infection. Furthermore, various risk factors for early failure have been reported, including patient-related factors, such as systemic diseases, smoking, and bone quality and quantity, as well as surgery-related factors, such as surgeons’ skill, osteogenesis technique, and selection of graft material, and implant-related factors, such as initial implant fixation and implant length diameter. Due to the wide variety of relevant factors reported, it is difficult to identify the cause of the problem. The purpose of this review is to discuss the risk factors associated with various types of bone augmentation which have a close causal relationship with early implant failure, and to determine the optimal bone grafting material for bone augmentation procedures to avoid early implant failure.
]]>Bioengineering doi: 10.3390/bioengineering11020191
Authors: Elisa Choukroun Maximilien Parnot Jerome Surmenian Reinhard Gruber Nicolas Cohen Nicolas Davido Alain Simonpieri Charles Savoldelli Franck Afota Hicham El Mjabber Joseph Choukroun
Based on the evidence of a significant communication and connection pathway between the bone and immune systems, a new science has emerged: osteoimmunology. Indeed, the immune system has a considerable impact on bone health and diseases, as well as on bone formation during grafts and its stability over time. Chronic inflammation induces the excessive production of oxidants. An imbalance between the levels of oxidants and antioxidants is called oxidative stress. This physio-pathological state causes both molecular and cellular damage, which leads to DNA alterations, genetic mutations and cell apoptosis, and thus, impaired immunity followed by delayed or compromised wound healing. Oxidative stress levels experienced by the body affect bone regeneration and maintenance around teeth and dental implants. As the immune system and bone remodeling are interconnected, bone loss is a consequence of immune dysregulation. Therefore, oral tissue deficiencies such as periodontitis and peri-implantitis should be regarded as immune diseases. Bone management strategies should include both biological and surgical solutions. These protocols tend to improve immunity through antioxidant production to enhance bone formation and prevent bone loss. This narrative review aims to highlight the relationship between inflammation, oxidation, immunity and bone health in the oral cavity. It intends to help clinicians to detect high-risk situations in oral surgery and to propose biological and clinical solutions that will enhance patients’ immune responses and surgical treatment outcomes.
]]>Bioengineering doi: 10.3390/bioengineering11020190
Authors: Sung Ho Choi Yeo Kyoung Won Sung Jin Na DeokJo Nam Dong Hui Lim
This study aimed to evaluate the spherical aberration (SA) in different corneal areas before and after femtosecond laser-assisted in situ keratomileusis (fLASIK) and transepithelial photorefractive keratectomy (tPRK), with the goal of identifying the limitations of and potential improvements in using SA within a 6 mm area. The study included 62 patients who underwent fLASIK and tPRK. Complete eye examinations including keratometry, corneal epithelial thickness, central corneal thickness, and topography were performed preoperatively and postoperatively. Anterior, posterior, and total corneal aberrations were measured preoperatively and three months postoperatively, with pupil diameters ranging from 2 to 8 mm. In the fLASIK group, compared to the preoperative SA, the anterior and total SA increased postoperatively in the 6 and 7 mm areas. In the tPRK group, meanwhile, the anterior and total SA of the 5 mm or larger areas increased postoperatively. An area of 6 mm or larger showed an increase in correlation with the changes in Q value and refractive correction. As the corneal SA and asphericity in the 6 mm zone cannot specifically demonstrate the status of areas smaller than 6 mm or changes in the optical zone after laser refractive surgery, comparison with normal values in various areas of the cornea is necessary.
]]>Bioengineering doi: 10.3390/bioengineering11020189
Authors: Zahra Parsa Ramdhane Dhib Mehrab Mehrvar
This review emphasizes the significance of formulating control strategies for biological and advanced oxidation process (AOP)-based wastewater treatment systems. The aim is to guarantee that the effluent quality continuously aligns with environmental regulations while operating costs are minimized. It highlights the significance of understanding the dynamic behaviour of the process in developing effective control schemes. The most common process control strategies in wastewater treatment plants (WWTPs) are explained and listed. It is emphasized that the proper control scheme should be selected based on the process dynamic behaviour and control goal. This study further discusses the challenges associated with the control of wastewater treatment processes, including inadequacies in developed models, the limitations of most control strategies to the simulation stage, the imperative requirement for real-time data, and the financial and technical intricacies associated with implementing advanced controller hardware. It is discussed that the necessity of the availability of real-time data to achieve reliable control can be achieved by implementing proper, accurate hardware sensors in suitable locations of the process or by developing and implementing soft sensors. This study recommends further investigation on available actuators and the criteria for choosing the most appropriate one to achieve robust and reliable control in WWTPs, especially for biological and AOP-based treatment approaches.
]]>