bluuebunny/crossref_metadata_2025_split huggingface dataset:
An MRI-Compatible Robot for Intracerebral Hemorrhage Removal
Authors: Chen Yue , Godage Isuru S. , Sengupta Saikat , Liu Cindy Lin , Weaver Kyle D. , Barth Eric J. , Webster Robert J. 
Published: October 2017

Intracerebral Hemorrhage (ICH) is the deadliest form of stroke and occurs when blood, leaked from a ruptured vessel pools in the brain forming a pool of semi-coagulated blood called a hematoma. 1 in 50 people will have an ICH in their lifetime [1] and the 30-day mortality rate is 43% with half of the deaths occurring in the acute phase, which motivates the need for safe and rapid treatment. However, literature reviews show no significant benefit of surgical removal vs. “watchful waiting”, despite the potential value of decompressing the brain. It has been hypothesized that this is due to the significant disruption of healthy brain tissue required to reach the hemorrhagic site in open brain surgery.
Recent studies conducted on phantom models have shown that a robotic needle made from curved, concentric, elastic tubes can reach a hemorrhagic site through a needle-sized path to successfully aspirate the hematoma. This approach has the potential to decompress the brain with far less disruption to surrounding brain tissue [4]. Those initial experiments were conducted under guidance from periodic (low rate) CT [2]. The need for intraoperative imaging was motivated by the fact that the brain shifts during aspiration, collapsing to fill the cavity left by voided blood. This approach has the potential advantage of “one stop shopping”, since ICH is typically diagnosed in the CT scanner. It is appealing to treat ICH immediately after diagnosis, while the patient is still in the scanner. However, CT also has the drawback of requiring ionizing radiation, as well as providing only intermittent images rather than real-time information.
In this paper, we consider a Magnetic Resonance Imaging (MRI) guided approach, which provides the converse in terms of both benefits and drawbacks. MRI is not typically used to diagnose ICH, but it can provide detailed soft-tissue and hematoma contrast [3], and fast image updates, enabling real-time monitoring of brain deformation during the aspiration process. Toward performing ICH aspiration with a concentric tube robot in an MRI environment, this paper presents accuracy and MR-compatibility tests for a new MR-compatible robot designed for ICH removal.
Mixed Ionic Electronic Conductors for Improved Charge Transport in Electrotherapeutic Devices
Authors: Shqau Krenar , Heintz Amy 
Published: October 2017

Electrotherapeutic devices require an electrode for coupling with the body. The most common electrodes are made of conducting corrosion resistance materials (e.g., TiN, Ir-IrO2, Pt) plus a coupling layer (e.g., electrolyte). The electrode is the location where redox reaction take place between the device and the tissue. As such, it must conduct both electrons and ions. The reactions can be capacitive, involving the charging and discharging of the electrode-electrolyte double layer, or faradaic. Capacitive charge-injection is more desirable than faradic charge-injection because no chemical species are created or consumed during a stimulation pulse. Most noble metal based electrodes are faradic or pseudo-capacitive, which can lead to performance changes over time. In addition, under the high rate of charge injection and high current density conditions of a neuromuscular stimulation pulse, access to all the accessible charges is limited by the interfacial resistance and low surface area at the electrode [1]. A particularly critical point is the passage of current between the surface of the skin and the electrical contact connected by wire to the device, which requires a low stable resistance that does not vary with time, humidity [2].
We have developed new hybrid mixed-ionic-electronic conductors (MIECs) that have the potential to overcome these deficiencies. The MIECs are an interconnected network of electrical and ionic conductors in an elastomeric matrix that provide: (1) high surface area for efficient capacitive charge-discharge; (2) high ionic conductivity for low interfacial resistance; (3) low ohmic resistance; and (4) excellent flexibility and toughness. Carbon nanotubes (CNTs) are the electrical conductors in the MIEC and hyaluronic acid (HA), along with moisture and ions, is the ionic conductor. Unlike the current state-of-the-art, conducting noble metals, this system exhibits good mechanical properties, high conductivity (up to 3000 mS/cm), high moisture retention (up to 100wt%) and high ion mobility, leading to facile electrode kinetics. This simple yet efficient system is promising for the fabrication of a variety of high performance flexible electrodes.
Improving Automatic Control of an Ankle-Foot Prosthesis Using Machine Learning Algorithms
Authors: Fairhurst Stuart R. , Koehler-McNicholas Sara R. , Slater Billie C. S. , Nickel Eric A. , Koester Karl A. , Voss Gregory O. , Hansen Andrew H. , Ferguson John E. 
Published: October 2017

Most commercially available lower-limb prostheses are designed for walking, not for standing. The Minneapolis VA Health Care System has developed a bimodal prosthetic ankle-foot system with distinct modes for walking and standing [1]. With this device, a prosthesis user can select standing or walking mode in order to maximize standing stability or walking functionality, depending on the activity and context. Additionally, the prosthesis was designed to allow for an “automatic mode” to switch between standing and walking modes based on readings from an onboard Inertial Measurement Unit (IMU) without requiring user interaction to manually switch modes. A smartphone app was also developed to facilitate changing between walking, standing and automatic modes.
The prosthesis described in [1] was used in a pilot study with 18 Veterans with lower-limb amputations to test static, dynamic, and functional postural stability. As part of the study, 17 Veterans were asked for qualitative feedback on the bimodal ankle-foot system (Table 1).
The majority of participants (82%) expressed an interest in having an automatic mode. The participants also indicated that the automatic mode would need to reach walking mode on their first step and to lock the ankle quickly once the standing position was achieved. When asked about how they wanted to control the modes of the prosthesis, 82% wanted to use a physical switch and only 12% wanted to use a smartphone app. The results indicated that the following major design changes would be needed:
1) A fast and accurate automatic mode
2) A physical switch for mode changes
This paper describes the use of machine learning algorithms to create an improved automatic mode and the use of stakeholder feedback to design a physical switch for the bimodal ankle-foot system.
Accurate Non-Invasive Temperature Monitoring Device
Authors: Augustine Garrett , Augustine Scott 
Published: October 2017

Core temperature is one of the most tightly auto-regulated physiological processes. Anesthetic drugs compromise the body’s ability to thermoregulate. When core temperature is outside of the normothermia range, patients are at increased risk of myriad complications. Hypothermic patients are at higher risk of, among other things, increased wound infections2, increased blood loss3, increased ICU times and hospital stays2, higher mortality rates4, increased transfusion requirements3. “Even mildly hypothermic patients could suffer an increase in adverse outcomes that can add costs of as much as $2,500–$7,000 per patient.”5 These risks are great such that clinicians actively warm hypothermic patients to achieve normothermia.
Given the importance of the core temperature on outcomes, there is a clear necessity for accurate core temperature measurement. Core temperature measurement is often misunderstood. Perhaps due to the pervasive home use of oral mercury thermometers to “take your temperature,” many wrongly assume that non-invasive core temperature is measured easily and accurately. Oral, axilla, nasal are all unreliable. Temporal/forehead and ear are particularly inaccurate. “Global authorities in anesthesiology and medicine have cited inadequacies with virtually all thermometry”6 False assurance or false alarm are both dangerous. There is currently no non-invasive way to reliably and accurately measure core temperature. Why is this?
The peripheral compartment is not in equilibrium with core. Fat and other layers further complicate the matter. Fat has the thermal conductivity of oak, and thus non-invasive methods to measure core are as Abreu puts it “taking measurements on the outside surface of an oak cask to determine the temperature of its contents.”6 Laws of Thermodynamics notwithstanding, many still try.
Invasive esophageal or rectal and to a lesser extent bladder, are the only way to accurately measure core. The fact is, in order to measure their patients’ core temperature vital sign accurately, clinicians have only available to them the medical equivalent of a meat thermometer.
Intubated patients under general anesthesia are perfectly suited for invasive core temperature monitoring. They are not going to gag the esophageal stethoscope, nor would they find rectal or bladder probing uncomfortable in their unconsciousness. Clinicians may find probing mildly unpleasant and a minor time consumption, but once again, given the lack of alternatives, the only real option is to grin and bear it.
General anesthesia is not without risks, especially with increasingly increasing patients, and as sedation or blocks become more popular, invasive core temperature monitoring is unpractical. This highlights the stark question: Is it possible to accurately and reliably ascertain core temperature non-invasively?
Assessing the Relationship Between Right Atrial Stiffness and Chamber Pressure to Quantitatively Define Myocardial Tensile Properties
Authors: Mattson Alexander R. , Eggen Michael D. , Grubac Vladimir , Iaizzo Paul A. 
Published: October 2017

Developing a successful cardiac device requires detailed knowledge of cardiac mechanical properties. For example, tissue failure characteristics and compliance feed into design criteria for many pacemaker leads (Zhao et al., 2011).
In the right atrium, tensile forces are exerted on the right atrial appendage in multiple clinical procedures. In a traditional lead implant, mechanical manipulations with a stylet aid a clinician in assessing lead fixation, with a seldom used “tug” test providing additional input. Atrial lead dislodgement remains one of the top complications for bradycardia pacing leads (Chahuan et al., 1994), in part because there is no standard mechanical assessment at implant to verify fixation. Thus, a deeper understanding of forces exerted on the atrium during implant, is fundamental to understanding the problem. Further characterization of the biomechanics relevant to atrial device implants will provide valuable design input for fixation tests and help drive research toward new atrial fixation mechanisms.
This study aims to better define the relationships between right atrial stiffness and the chamber pressures within the right atrium, so to characterize the link between tensile displacement within the right atrium, and the force exerted on an implanted device in a functional heart. These experiments quantitatively define the fixation force of a fixed cardiac device with a given pulled displacement; i.e. displacing the device a given distance will effectively ensure the experimentally derived fixation force.
Design and Biomechanical Evaluation Methodology of Pneumatic Ergonomic Crutch
Authors: Xiao Chenzhang , Jahanian Omid , Schnorenberg Alyssa , Slavens Brooke , Hsiao-Wecksler Elizabeth 
Published: October 2017

Lofstrand, or forearm, crutch users experience a concerning amount of force in their wrists that can approach 30% of body weight during swing-through gait, along with hyperextension of the wrist [1]. Such repetitive large loads and poor wrist posture could cause joint pain, injury and carpal tunnel syndrome in long-term crutch users [2].
To address these issues in Lofstrand crutch users, we previously reported two different designs. The first involved attaching a passive orthosis to the grip handle and shaft that directly supported the wrist [3]. The second proposed a soft pneumatic sleeve attached to the forearm cuff of the crutch along with a concept to harvest pneumatic energy during walking via a piston pump at the crutch tip, i.e., the Pneumatic Ergonomic Crutch (PEC) [4].
This paper first describes the full system design of the PEC, which contains an improved pneumatic sleeve orthosis, an energy-harvesting shock-absorbing crutch tip, and a control system with three modes of operation and safety protection. We also present pilot data from one healthy control subject performing a proposed biomechanical evaluation of the pneumatic sleeve orthosis. More tests will be conducted with a group of able-bodied subjects to evaluate the overall effectiveness of the PEC.
Design of a Passive Ankle Prosthesis With Energy Return That Increases With Increasing Walking Velocity
Authors: Folz Alexander J. , Schimmels Joseph M. 
Published: October 2017

An estimated 623,000 individuals are living with a major lower leg amputation in the United States [1]. Of these amputations, 78% were due to peripheral vascular disease (PVD) and 45% were due to PVD in individuals with type I or II diabetes [2]. With diabetes and PVD incidence levels on the rise [1] and those in a depressed socio-economic situation more susceptible to develop type II diabetes [3], the demand for affordable, high quality ankle prostheses has never been higher. Prostheses currently available on the market include both passive and active devices, neither of which fully satisfies user requirements.
Passive prostheses, the more commonly prescribed style, are economically priced but lack the powered push-off observed in a natural ankle [4] due to the absence of an actuator. As a result, passive prostheses cause a multitude of quality of life detriments to the end user including asymmetrical gait (for unilateral amputees), slower self-selected walking speeds, higher metabolic cost per distance traveled and increased pain in the residual limb [5–6].
Conversely, active devices can nearly match the functionality and powered push-off of a natural ankle [7] but are cost prohibitive. Among active devices, one of the most successful models is the BiOM. Initially developed at MIT, the BiOM uses an actuator in series with a spring to achieve near natural ankle behavior. In 2013, two years after the product’s official launch, the device cost approximately $50,000 and had only sold about 1,000 units [7].
The limitations of currently available ankle prostheses motivates work on a new solution, the EaSY-Walk (Early Stance Y-deflection), a passive ankle device that mimics several key aspects of a natural ankle joint, especially nonlinear rotational stiffness and rotational work output (powered push-off) that increases with walking velocity while remaining relatively inexpensive.
Soft-Robotic Endoscope Tip Design
Authors: Nuriyev Mikhail , Montayre Rudy , Taylor Austin , Tse Zion Tsz Ho 
Published: October 2017

Endoscopic procedures are minimally invasive and are commonly used in surgeries and various diagnoses. Endoscopes allow vision in very delicate and constricted areas of the human body. Although the endoscope is a very beneficial tool, it still has its disadvantages. Today’s metallic endoscopes are rigid and tend to be hard to manipulate on the fine scales necessary to work within the human body while minimizing harm. Endoscopes made of metal can easily puncture an internal organ if not directed properly [1].
Soft robotics is a new and unique system for designing and creating a new generation of medical devices [2]. With soft robotics, silicone-based molds can be controlled and driven using nothing more than tubing and air pressure (Fig. 1) [3]. Employing the principles of soft robotics, we are attempting to create a new kind of endoscope made from a silicon-based material. Ideally, a silicone-based endoscope would be cheap to produce and require almost no training to operate, while still maintaining the same benefits of metallic endoscopes. Endoscopes made from soft robotic actuators will have better dexterity due to the wall thickness allowing a full range of motion and flexion. In this study, it was hypothesized that additional controllability in the soft robotic endoscope design could be achieved by controlling the combination of wall thicknesses of the silicone molds during the fabrication process.
Analysis of Postural Stability After Concussion Using Empirical Mode Decomposition: A Pilot Study
Authors: Schneider Charles M. , Verma Ajay K. , Munia Tamanna T. K. , Romanick Mark , Tavakolian Kouhyar , Fazel-Rezai Reza 
Published: October 2017

Maintaining upright stance is a complex process, it requires appropriate functioning of a postural control system which consists of inputs from somatosensory, vestibular, musculoskeletal, and proprioceptive systems as well as from several brain regions [1–4]. A concussion is defined as a brain injury caused due to unexpected acceleration/deceleration of the head causing temporary alteration of brain function and it is a prevalent source of injury to football athletes [1]. With the altered function of the brain, the ability to maintain postural equilibrium becomes challenging due to the inability of individuals to respond promptly to stressors, thus, making maintenance of postural equilibrium rather difficult for individuals with a concussion. Effects of concussion on postural ability are shown to last up to three days post injury [5]. Postural stability test, therefore, can be performed to make a valid return to play (RTP) decision, pre-mature RTP is shown to have been catastrophic due to its potential to permanently impair previously affected region/functioning [1,5]. Postural sway data (center of pressure, COP) is traditionally analyzed to study the postural control. Therefore, COP can provide critical information regarding individual’s ability to maintain upright stance post injury.
A more sensitive concussion assessment tool based on electroencephalogram (EEG) is used to accurately track effects of concussion [6]. However, sophisticated electrode placement requirement inhibits its immediate applicability. In current preliminary research, we attempt to differentiate athletes with a history of concussion (experimental) from healthy (control) using postural data. In order to do so, a concept of empirical mode decomposition (EMD) was adopted. EMD has shown evidence in the literature to infer vital information pertaining to the complex underlying physiological phenomenon [4, 7–8]. In the current research, the resultant COP (COPr) was decomposed into its finite set of band-limited signals termed as intrinsic mode functions (IMFs) [8], a set of linear and nonlinear features were extracted from COPr and its IMfs. Lastly, a test of significance was conducted to infer the potential of postural data for differentiating concussed from healthy athletes.
Calculating the individual probability of successful ocriplasmin treatment in eyes with VMT syndrome: a multivariable prediction model from the EXPORT study
Authors: Paul Christoph , Heun Christine , Müller Hans-Helge , Hoerauf Hans , Feltgen Nicolas , Wachtlin Joachim , Kaymak Hakan , Mennel Stefan , Koss Michael Janusz , Fauser Sascha , Maier Mathias M , Schumann Ricarda G , Mueller Simone , Chang Petrus , Schmitz-Valckenberg Steffen , Kazerounian Sara , Szurman Peter , Lommatzsch Albrecht , Bertelmann Thomas 
Published: October 2017

Background/AimsTo evaluate predictive factors for the treatment success of ocriplasmin and to use these factors to generate a multivariate model to calculate the individual probability of successful treatment.MethodsData were collected in a retrospective, multicentre cohort study. Patients with vitreomacular traction (VMT) syndrome without a full-thickness macular hole were included if they received an intravitreal injection (IVI) of ocriplasmin. Five factors (age, gender, lens status, presence of epiretinal membrane (ERM) formation and horizontal diameter of VMT) were assessed on their association with VMT resolution. A multivariable logistic regression model was employed to further analyse these factors and calculate the individual probability of successful treatment.Results167 eyes of 167 patients were included. Univariate analysis revealed a significant correlation to VMT resolution for all analysed factors: age (years) (OR 0.9208; 95% CI 0.8845 to 0.9586; p<0.0001), gender (male) (OR 0.480; 95% CI 0.241 to 0.957; p=0.0371), lens status (phakic) (OR 2.042; 95% CI 1.054 to 3.958; p=0.0344), ERM formation (present) (OR 0.384; 95% CI 0.179 to 0.821; p=0.0136) and horizontal VMT diameter (µm) (OR 0.99812; 95% CI 0.99684 to 0.99941, p=0.0042). A significant multivariable logistic regression model was established with age and VMT diameter.ConclusionKnown predictive factors for VMT resolution after ocriplasmin IVI were confirmed in our study. We were able to combine them into a formula, ultimately allowing the calculation of an individual probability of treatment success with ocriplasmin in patients with VMT syndrome without FTHM.
Macular capillary plexuses after epiretinal membrane surgery: an optical coherence tomography angiography study
Authors: Kim Yoon Jeon , Kim Seungmo , Lee Joo Yong , Kim June-Gone , Yoon Young Hee 
Published: October 2017

AimsTo investigate macular vascular integrity using optical coherence tomography angiography (OCTA) in patients undergoing vitrectomy for idiopathic epiretinal membrane (ERM) removal and to determine its association with structural and visual outcomes.MethodsForty-three patients with unilateral ERM who were followed for ≥6 months after surgery were included. Ophthalmological evaluations included best-corrected visual acuity (BCVA) and spectral-domain OCT (SD-OCT) before surgery and 6 months after surgery. We obtained en face OCTA images of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) for both eyes 6 months after ERM removal. We compared eyes with ERM to unaffected fellow eyes as controls and used interocular differences in the analyses.ResultsCompared with the fellow eyes, eyes with ERM after surgery had a lower parafoveal vascular density (VD) and a smaller foveal avascular zone (FAZ) area in both SCP and DCP (all p<0.001). Interocular differences in the FAZ area and parafoveal VD were correlated with preoperative and postoperative central foveal thicknesses (all p<0.05). In addition, interocular differences in macular vascular integrity had a tendency to be correlated with SD-OCT parameters of the inner retinal layers. Finally, greater interocular differences in the FAZ area and parafoveal VD of both plexuses were significantly associated with worse postoperative BCVAs (all p<0.05).ConclusionsAssessing macular capillary plexuses via OCTA may be useful to quantify structural changes of the inner retinal layer and predict visual function in patients undergoing ERM removal surgery.