Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine

Polyether-ether-ketone (PEEK) has been widely applied in various fields due to its excellent mechanical properties and biocompatibility. The efficient and high-quality customized manufacturing of PEEK components are investigated in this study by the hybrid 3D printing and milling process. At first, the alternating hybrid process is selected and verified by comparing two typical hybrid process categories and conducting experiments, respectively. Second, a set of procedures are designed to automate the engineering application of the hybrid process trying to avoid the disadvantages of manual programing...

Bulk metallic glasses (BMGs) have garnered significant attention in recent decades due to the outstanding physical, chemical, and biomedical characteristics. The biomedical application of metallic glass also received extensive attention. This report investigates the interplay among antibacterial performance, crystallization and processing parameters of Zr-based bulk metallic glass (Zr-BMG) following nanosecond laser irradiation. We examined surface morphology, crystallization behavior, surface quality, binding energy, and ion release properties post-laser irradiation...

As the natural conclusion of talent identification in sports, talent development is the process that involves improving biomechanical capacities and bio-motor abilities. The development progress can be objectively assessed and monitored through measurements of trainability. This study introduces a practical methodology to assess motor control as a trainable factor using kinematic data. The study focused on establishing the relationship between kinematic data and changes in muscle strength and dynamic balance...

An asymmetric windswept posture is often seen in children with severe cerebral palsy (CP). However, it is still unclear how long children with CP remain in the windswept posture in daily life. Thus, we developed a triple-accelerometer system for detecting windswept posture. The aim of this study was to assess the validity of a system for classifying various body postures and movements. We assessed the accuracy of our system in nine healthy young adults (age range, 21-23 years). The participants wore acceleration monitors on the sternum and both thighs, then spent 3 min each in eight different positions and three physical activities...

The rapid advancement of artificial intelligence (AI) in healthcare has the potential to revolutionize the global healthcare sector and medicine in general. However, integrating AI technologies in healthcare requires access to large amounts of personal health-related data (HRD), which raises concerns regarding confidential personal information considering unregulated and not transparent data ownership. Setting up the patient's welfare as an unquestionable principle, this commentary explores the various ethical aspects of using HRD in AI applications, focusing on informed consent, data ownership, data sharing, financial considerations, accountability, and ethical standards...

Explant analysis can provide important understanding of how artificial joints perform in the human body. The articulating surfaces of the metacarpal head and the radius cup from a chromium nitride coated metal-on-metal Motec wrist implant were analysed. Due to bone resorption and aseptic loosening, the implant was removed after 6 years in the patient, and metallosis was observed during removal. Visually, some areas of the articulating surfaces appeared polished, others were dulled. A chemical composition analysis of the metacarpal head showed that the polished surfaces were chromium rich, implying this surface was the original chromium nitride coating, whereas the dulled surfaces were cobalt rich, indicating the underlying cobalt chromium substrate...

The present study assessed the effect of active application of self-etch adhesives with diode laser irradiation on the shear dentin bond strength. Sixty bovine incisors, each embedded individually in hard plaster blocks, were divided into two groups based on the adhesive system used: Group 1 Adper Easy One and Group 2 Clearfil SE Protect. Based on the application technique of self-etch adhesives, each main group was further divided into three subgroups: passive application, active application with a micro-brush, and active application with a 976-nm diode laser tip (phototherapy active application)...

The selection of internal fixation as the primary fixation modality for the patient is one of the challenges for the surgeon treating the patient in question. A model of the lateral tibial plateau fracture was established. Three different configurations of internal fixators namely L bone plate, T bone plate, and screw-washer were analyzed. Three stages after surgery were simulated to assess the displacement of bone plates, screws, washers, and the stress shielding ratio in the fracture area.At three stages after surgery, the T bone plate showed better stability for patients during rehabilitation compared with the remaining two schemes, and the screw-washer scheme was the least stable due to the larger internal fixation displacement and stress shielding ratio in the fracture area...

The annuus fibrosus (AF) and nucleus pulposus (NP) of the intervertebral disc (IVD) work in conjunction to dissipate spinal loads. In this study we have isolated the contribution of the NP to the overall response of the disc and investigated the effect of extreme structural changes to the disc on the mechanical behaviour. Linear stiffness, overall load range, hysteresis area and total energy were used to evaluate the impact of these changes on the spine and surrounding structures. Six porcine lumbar isolated disc specimens were tested in 6 DOFs with a 400 N compressive axial preload at low strain rates in three conditions: intact (IN), after total nucleotomy (NN) and after the injection of bone cement into the nuclear void (SN)...

Bone microstructure governs microcrack propagation complexity. Current research, relying on linear elastic fracture mechanics, inadequately considers authentic multi-level structures, like cement lines and osteons, impacting stress intensity at cracks. This study, by constructing models encompassing single or multiple osteons, delves into the influence of factors like crack length, osteon radius, and modulus ratio on the stress intensity factor at the crack tip. Employing a fracture mechanics phase-field approach to simulate crack propagation paths, it particularly explores the role of cement lines as weak interfaces in crack extension...

Aseptic loosening is the primary cause of failure following posterior-stabilized total knee arthroplasty. It is unclear whether tibial post loading of posterior-stabilized prosthesis increases the risk of aseptic loosening of the tibial prosthesis. The purpose of this study is to investigate the biomechanical effects of tibial post loading on the tibial prosthesis fixation interface during level walking, squatting, stair descent, and standing up-sitting down activities. In this paper, finite element models with and without post were established to compare the effects of tibial post loading on the von Mises stress of the proximal tibia, shear stress of the cement, and the bone-prosthesis interface micromotion during four physiological activities...

The conical stem tibial design of total ankle replacement (TAR) has high implant-bone micromotion. This may lead to aseptic loosening which can be avoided by improving the tibial design. The objective was to propose the best stem design parameters to reduce implant-bone micromotion along with minimizing stress shielding using an integrated Finite Element-Multi Criteria Decision Making (FE-MCDM) approach. FE models of implanted tibia bones were prepared by changing the height of the stem, the diameter of the stem, and the slant of the stem...

A biologically-inspired actuation system, including muscles, spinal reflexes, and vestibular feedback, may be capable of achieving more natural gait mechanics in powered prostheses or exoskeletons. In this study, we developed a Virtual Muscle Reflex (VMR) system to control ankle torque and tuned it using data from human responses to anteroposterior mechanical perturbations at three walking speeds. The system consists of three Hill-Type muscles, simulated in real time, and uses feedback from ground reaction force and from stretch sensors on the virtual muscle fibers...

The photoplethysmographic (PPG) signal of the finger is being used to create embedded devices that estimate physiological variables. This project outlines an innovative method for developing a synthetic PPG generator that produces both actual reference digital signals and their equivalent analog signals using open-source technology. A series of PPG profiles is synthesized using three variant Gaussian functions. A low-frequency trend induced by respiratory frequency and background noise are then added. To generate a diverse range of continuously variable PPG profiles within specified boundaries and customizable levels of interference, all parameters undergo random fluctuations on a cycle-by-cycle basis, as per user-defined constraints...

The objectives of this study were to compare the chondrogenic potential of cells derived from different layers of Mandibular condyle cartilage and to gain further understanding of the impact of chondrogenic cues when embedded into a novel hydrogel scaffold (PGH, a polymer blend of poly (ethylene glycol), gelatin, and heparin) compared to a gelatin hydrogel scaffold (GEL). Cartilage layer cells (CLCs) and fibroblastic superficial layer cells (SLCs) were harvested from the mandibular condyle of boer goats obtained from a local abattoir...

A real-time hypothermia and hyperthermia monitoring system with a simple body sensor based on a Convolutional Neural Network (CNN) is presented. The sensor is produced with 3D-printed thermochromic material. Due to the color change feature of thermochromic materials with temperature, 3D-printed thermochromic Polylactic Acid (PLA) material was used to monitor temperature changes visually. In this paper, we have used the transfer learning technique and fine-tuned the AlexNet CNN. Thirty images for each temperature class between 28-44°C and 510 image data were used in the algorithm...

Lower urinary tract dysfunction (LUTD) is a debilitating condition that affects millions of individuals worldwide, greatly diminishing their quality of life. The use of wireless, catheter-free implantable devices for long-term ambulatory bladder monitoring, combined with a single-sensor system capable of detecting various bladder events, has the potential to significantly enhance the diagnosis and treatment of LUTD. However, these systems produce large amounts of bladder data that may contain physiological noise in the pressure signals caused by motion artifacts and sudden movements, such as coughing or laughing, potentially leading to false positives during bladder event classification and inaccurate diagnosis/treatment...

Technological advancements in the medical field are often slow and expensive, sometimes due to complexities associated with pre-clinical testing of medical devices and implants. There is therefore a growing need for new test beds that can mimic more closely the in vivo environment of physiological systems. In the present study, a novel bladder model was designed and fabricated with the aim of providing a pre-clinical testing platform for urological stents and catheters. The model is collapsible, has a Young's modulus that is comparable to a biological bladder, and can be actuated on-demand to enable voiding...

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Steady-state visually evoked potential is one of the active explorations in the brain-computer interface research. Electroencephalogram based brain computer interface studies have been widely applied to perceive solutions for real-world problems in the healthcare domain. The classification of externally bestowed visual stimuli of different frequencies on a human was experimented to identify the need of paralytic people. Although many classifiers are at the fingertip of machine learning technology, recent research has proven that ensemble learning is more efficacious than individual classifiers...