bluuebunny/crossref_metadata_2025_split huggingface dataset:
Designing Accessible VR Games to Assist Stroke Rehabilitation
Authors: Patil Shashidhar , Dubey Venketesh N. , Holi Pavitra , Geffard Franck 
Published: August 2024

Abstract
VR games have become an important part of rehabilitation therapy for stroke survivors particularly to recover limb movements. The success of recovery is dependent on the repetitive movement of limbs over a considerable amount of time. It has been shown that VR game-based rehabilitation can offer promising results for repetitive movements as compared to conventional therapies. To improve the effectiveness of VR games it has been argued that – specifically designed games offer better stroke rehabilitation to keep patients engaged and motivated. This paper presents the development of non-immersive accessible VR games designed for upper limb movements without overloading patients. These games are designed based on the suggestions received from clinicians and physiotherapists. The games provide a non-immersive yet quite engaging environment with real-time scoring of performance. A preliminary test of the games with the exoskeleton robot and discussions are presented.
Innovative Pediatric Box Trainer for Laparoscopy: Insights from Force Measurement
Authors: Wu Hang-Ling , Elsaadany Israa , Miller Scarlett , Moore Jason 
Published: August 2024

Abstract
This study explores the design and development of a laparoscopic surgery Pediatric Box trainer used with augmented reality (AR) training. A cohort of 11 medical residents from Hershey Medical Center, with varied experience in laparoscopic surgery, participated in a peg transfer task to assess hand-eye coordination, dexterity, and ambidexterity while interacting with the Pediatric Box trainer. Results showed the average force exerting on the needle holder averaged 0.43 N and 0.33 N for the dominant and non-dominate hands, respectively. Individual laparoscopic grasping profiles were shown to uniquely vary among users. Future work will further develop the system to provide more effective AR training feedback based on the grasping force sensed.
Design of a Sensorized Original Syringe (SOS) for a Training System for Central Venous Catheterization
Authors: Kaul Aayod , Brown Dailen , Moore Jason Z. , Miller Scarlett R. 
Published: August 2024

Abstract
A Sensorized Original Syringe (SOS) was designed for use to improve medical training for Central Venous Catheterization (CVC). The syringe provides a lower cost alternative to the robotic-assisted syringes previously utilized in such training. At the same time, it supports additional CVC training steps, such as the ability to place the guidewire through the needle and proper aspiration (pulling back on the syringe) follow-through. The SOS has been integrated into the Advanced Dynamic Haptic Robotic Trainer (DHRT+) system to train medical residents to safely perform central venous catheterization. An experiment was conducted to identify and compare the forces required by both types of syringes (SOS and robotic assisted) to insert the needle, as well as aspirate. The results illustrated that while the SOS was ergonomically closer to the medical syringe (comparing dimensions and range of motion), the robotic assisted syringe aspiration force and needle insertion force profile were closer to those of the medical syringe and allowed for diversity of force profiles to be trained. This design will be improved by utilizing methods to implement diverse, haptic feedback and improve the realism of aspiration force profiles.
Research and Development of a “Blind” Esophageal Food Bolus Disimpaction Device
Authors: Thurston Theresa , Farhangui Alexandra , Narwankar Medha , Fan Christopher 
Published: August 2024

Abstract
Esophageal food bolus impaction (EFBI) occurs when peristalsis fails and food becomes stuck within the esophagus. Without resolution, the patient is at risk of bolus aspiration, inability to clear oral secretions, dehydration, esophageal perforation, and possibly death. This is a common occurrence that requires emergent diagnosis and management, with approximately 10-20% of cases requiring endoscopic intervention [1]. The endoscope toolkit consists of the scope camera, a channel that allows for passage of therapeutic tools such as graspers that can slowly tease off bits of the bolus, roth nets for bolus capture, and CRE balloons that can dilate the lumen but do not allow the scope or other tools to pass. A better equipped device would be capable of a retrograde path for bolus removal without the need for camera guidance or gastroenterologist operational expertise. With EFBI being one of the most common non-biliary GI emergencies, there is a strong interest from clinicians to have more effective tools.
The Micro-CT Scanning of Human Hearts with Previously Implanted Clinical Devices: Subsequent Generation of High-Resolution Computational Models
Authors: Wethington Audrey , Boman Sophia , DeVos Amanda , Brigham John , Iaizzo Paul A. 
Published: August 2024

Abstract
The generation of high-resolution models of human hearts post-implantation is a very important tool for ultimately improving device designs and one's understanding of clinical outcomes. Cardiac device designs are always evolving and such is critical for ongoing treatment of specific cardiac diseases and abnormalities. A micro-computed tomography (μCT) scanner was used to generate high-resolution, 3-dimensional scans of perfusion-fixed human hearts that contained previously implanted devices. Following scanning, the generation of high-resolution computational models, &gt;90 microns, allowed for visualization of the device-tissue interfaces as well as the creation of various 3-D prints. The post-implantation device-tissue interactions down to 10 microns could be analyzed. For this project, we aimed to collect optimal scanning parameters for each heart, which in turn could be used in future studies to guide more efficient and targeted imaging. The scanning parameters included voltage, current, and frames per second. They were specific to and varied between hearts containing stents, pacemakers, implantable cardioverter defibrillators (ICD), and aortic valve replacements. This unique database should aid in the understanding of these device-tissue interactions by clinicians, students, and medical device designers.
Design, Verification and Validation of a Dynamic Model for an Intramuscular Autoinjector
Authors: Magubane Ntokozo , Ngoepe Malebogo , Sivarasu Sudesh 
Published: August 2024

Abstract
The development of new injectable molecules for different diseases and reformation of first-generation pharmaceuticals has led to growing interest in making autoinjectors usable for different medications. The major challenge in this quest is the complexity of injecting highly viscous drugs in large volumes. This research aims to develop a dynamic model to describe the influence of drug viscosity and volume on the injection process and evaluate the sensitivity of medication fluid behaviour to variations in component dimensions of the autoinjector fluid delivery system.
Using mathematical modelling, the plunger motion is characterised by the spring, fluid resistance and frictional forces between the vial and plunger. It displaces linearly and accelerates until maximum velocity is reached. Slow plunger motion is associated with increasing glide and break-loose force. Wall shear stress captured via Computational Fluid Dynamics (CFD) modelling is directly proportional to the medication viscosity and it increases linearly for Newtonian and shear-thinning medications.
Separation flow is observed in the syringe for viscosities between 15 - 80 cP. This represents decreasing flow as pressure increases, increasing the chances of needle deformation and injection pain due to tissue damage. Injecting highly-viscous drugs is possible via considerations of kinematic and rheological properties.
Design Consideration and Development of an MRI-Compatilbe Robot for Prostate Interventions
Authors: Lafreniere Samuel , Konh Bardia 
Published: August 2024

Abstract
Systematic (12-core) ultrasound-guided prostate biopsy is a poor technique traditionally used for detection of prostate cancer, originated in a time predating MRI technology. While ultrasound can reveal the position of the prostate and the needle, it is incapable of locating cancers within the gland— a capability that MRI possesses. Blind systematic biopsies are associated with significant rates of underdiagnosis and overdiagnosis. MRI has introduced the ability to locate the tumor, presenting a unique opportunity to perform targeted prostate biopsies. However, in-bore MRI prostate biopsy is not widely practiced, primarily because the procedure is time-consuming and expensive. Robotic teleoperated instruments that could expedite the operation could be the solution. This work presents design considerations and development of an MRI-compatible robot capable of performing in-bore teleoperative MRI-guided prostate biopsy.
Tactical Field Care Simulation: Evaluating Gender-Dependent Error Rates and Training Gaps
Authors: Drahos Bradley A. , Mabry Marshall L. , Craig Curtis M. , Schwieters Katelyn R. , Floersch Eugene , Morris Nichole L. 
Published: August 2024

Abstract
Simulation-based training is a primary method for ensuring skill acquisition and retention, particularly within medicine. The use of simulated training in combat medicine is one of the only methods for soldiers to practice lifesaving skills prior to the battlefield, thus it is imperative that soldiers have ample opportunity to experience high quality training scenarios. The current study assesses the relationship between errors made in a tactical field care simulation and the participants previous simulated training experience. Twenty-eight soldiers and ROTC cadets with CLS or equivalent training completed two tactical field care simulations providing treatment to a male and female simulator, in random order, both experiencing a GSW to the chest and trauma amputation to the leg. Errors in treating patient injuries were coded for analysis. The results indicate that participants committed more errors when treating the female simulator. Errors during tourniquet application, GSW treatment, and undressing were most common when the female was presented first. Previous simulation training experience was correlated with error rates, particularly in regard to undressing, indicating that a lack of undressing training correlated to increased undressing errors. Findings suggest a pronounced gap in simulation-based training using female simulators within the CLS training curriculum.
Accuracy of Mediapipe Visual Hand Tracking for use in Medical Training Procedures
Authors: Budzinski Cynthia , Wu Hang-Ling , Sarraf Elie , Miller Scarlett , Moore Jason 
Published: August 2024

Abstract
This paper explores the need for individualized feedback in medical simulation training for procedures such as endotracheal intubations and colonoscopies. Current pass-fail assessments lack the specificity required for skill refinement, leading to potential complications in critical procedures. This experiment investigates the application of visual hand tracking technology, specifically Google's MediaPipe, to offer quantitative feedback. Using a wooden hand model on a linear motor with a depth camera, this experiment explores tracking hand movements in real time. Google's MediaPipe software tracks 3D hand motions, generating data points for analysis. Results demonstrated consistent patterns in hand movements corresponding to linear motor actions. Total distance traveled by each point of interest and error analysis, averaging 3.1 mm, provided insights into the accuracy of visually measured hand movements. Visual hand tracking, such as MediaPipe, may prove to be a promising tool for refining operator techniques in critical medical procedures. The experiment explores the technology's accuracy and underscores its potential application in medical training, addressing a gap in current practices and emphasizing the importance of tailored feedback for improved patient outcomes.
Influence of Tissue Prestress and Calcification Levels on Iliac Balloon Angioplasty Biomechanics
Authors: Subramaniam Dhananjay Radhakrishnan , Kossuth Mary Beth 
Published: August 2024

Abstract
Balloon angioplasty is a well-established technique to treat lesions in the common and external iliac arteries. A potential unfavorable post-operative outcome of this procedure is rupture of the diseased artery wall. The objective of our study was to virtually evaluate the biomechanical responses of the diseased iliac artery wall resulting from deployment of a balloon, using finite-element analysis. To achieve this, we created a three-dimensional, anatomically accurate finite-element model of the diseased iliac artery. We prestressed the artery wall and computed the balloon-expansion induced stresses in the artery and plaque for different calcification levels. Our analyses showed that the vessel wall prestress was one order of magnitude smaller than those resulting from balloon expansion. Interestingly, our analyses also showed that moderate calcification levels result in higher arterial stresses when compared to those arising from low and heavy calcification levels. The results of our computational study could potentially assist in enhancing the design characteristics of angioplasty balloons to minimize the risk of post-operative iliac artery rupture.
A Modular Articulated Instrument for Manual Laparoscopic Manipulation
Authors: Scholnik Lily , Nelson Carl A. 
Published: August 2024

Abstract
Articulation can play a role in laparoscopic surgical instruments to increase access to surgical sites and avoid unwanted interference between instruments or between instruments and other tissues. The effect of articulation on instrument shape can also be influential in the feasibility of specialized surgical approaches such as single-incision laparoscopic surgery. In this paper, we present a modular instrument with an articulated shaft. The unique design allows preoperative configuration of the instrument’s shape to best suit the minimally invasive access path to the surgical site. The details of the design, prototyping efforts, and validation in simulation are presented.
Retainair: A New Line of Defense Against the Asthma Epidemic
Authors: Bednarz Patrick , Kang Mingyo , Lei Jacob , Somawardana Suran , Srinivasa Mira , Wu Moyuan 
Published: August 2024

Abstract
Asthma is a severe respiratory disease impacting almost 25 million Americans. Characterized by airway inflammation, asthma manifests in symptoms such as wheezing, chest tightness, and coughs. External triggers such as allergens initiate asthma attacks, which can be life-threatening. Thus, early detection of attacks is crucial and necessitates constant tracking of airway inflammation biomarkers. Fractional exhaled nitric oxide (FeNO) is a reliable inflammatory biomarker, positively correlated with poor asthma control, increased asthma risk, and reduced lung function. Currently, no devices provide comprehensive asthma risk assessments, and all current FeNO measurement methods lack portability and continuous monitoring. To address this gap, we propose RetainAIR: a personalized smart retainer that offers portable, comfortable, non-invasive, and continuous monitoring; enables point-of-care risk assessments; and permits timely intervention. RetainAIR detects FeNO fluctuations through electrochemical changes in an ionogel sensor, which are then sent to a machine learning algorithm that calculates FeNO fluctuations from baseline. The model demonstrates promising sensitivity and specificity values of 0.75 and 0.99, respectively. All values are then sent to a user-friendly app where patients can access their data. By continuously tracking and analyzing respiratory NO levels, RetainAIR provides asthma patients with a personalized device, timely warnings of imminent asthma attacks, and an overall analysis of asthma status to increase quality of life, lower economic burdens, and save lives.
A Novel Approach to Thromboembolic Event Detection: An Initial Evaluation
Authors: Alias Basil P. , Lo Emily , Toprani Divek , Lim Wesley 
Published: August 2024

Abstract
Electrical impedance tomography utilizes the electrical conductivity of a material to generate non-ionizing continuous cross-sectional imaging between a group of electrodes placed equidistant from each other in a conductive solution. Here we explore the use of electrical impedance tomography for detection of thromboembolic events through integration with inferior vena cava filters. We constructed a proof of concept prototype with electrodes spaced around the periphery of a simulated vessel and created software to control AC injection patterns through the electrodes in order to generate cross-sectional maps of relative resistance across the vessel. This initial study focused on quantifying the sensitivity of the initial device by utilizing a low-conductivity material in a conductive fluid to represent a thromboembolus in blood. The prototype successfully created cross-sectional, two-dimensional electrical resistance maps that detected both the presence and the general location of low-conductivity test materials within a conductive fluid. These results demonstrate the potential to utilize intravascular electrical impedance tomography to detect thromboemboli caught within an intravascular filter.
Evaluating the Effectiveness of a Novel, Rapidly Appliable Multifunctional Pulse Oximeter in Neonatal Care
Authors: Salafian Iman , Reid Davika , Laird Morgan E , Klunk Christopher , Rylander Christopher G. 
Published: August 2024

Abstract
Monitoring vital signs in neonates, particularly in resuscitation and intensive care, is crucial for effective neonatal management. Accurate blood oxygen saturation and heart rate measurements are essential for guiding therapeutic interventions and optimizing outcomes. Traditional pulse oximetry devices often face challenges in application speed, ease of use, and the risk of skin injury, especially in preterm infants. This study introduces a newly designed pulse oximeter to enhance the efficiency and safety of neonatal monitoring in clinical settings. It is engineered for fast and convenient attachment without adhesive or abrasive fasteners, reducing skin injury risks. It is compatible with standard bedside monitors and can measure hemoglobin oxygen saturation, heart rate, electrocardiography, and temperature. This pilot observational study in the postpartum unit assesses the new pulse oximeter’s performance against conventional devices. Results show a significant reduction in the time to attach the device and obtain stable and reliable readings for blood oxygen saturation and heart rate from the pulse oximeter’s sensors. Additionally, the nursing team’s satisfaction is enhanced with the redesigned device compared to the conventional one. These findings offer substantial insights into the new pulse oximeter’s effectiveness, potentially leading to a shift in neonatal vital signs monitoring towards a more rapid, safe, and comprehensive approach.
Material Comparison for Surgical Simulation Models
Authors: Dickey Walter J. , Hedge Robert , Bravo Cesar J. , Arena Christopher B. 
Published: August 2024

Abstract
In orthopedic surgical training of the hand, it is common to practice on lower fidelity models to refine sills. However, no comprehensive psychomotor simulator exists for fundamental skill sets considered critical to competency in hand surgery. It is becoming more common to use a three-dimensional (3D) printer to create models that have similar appearances to that of the bones and other anatomical structures. With the increase of the use of additive manufacturing (AM) technology, a more affordable and accessible way to produce in-house training models has been developed. There are many aspects that go into creation of these models with the first one being the selection of the material itself. Without examining the force of multiple different common AM polymers, it can be difficult to select one without countless trial and error. This study used a Stryker drill with wire collet and an Instron universal testing system to collect comparative force data using five different modeling materials compared to chicken bone. The data showed that the material with least average force difference from the bone models was polylactic acid (PLA).
Development and Evaluation of a Novel Flow Loop System for Interventional Training
Authors: Toprani Divek U. , Alias Basil P. , Lo Emily , Garami Zsolt , Corr Stuart J. , Lumsden Alan B. 
Published: August 2024

Abstract
Flow-loop systems are valuable tools due to their ability to mimic the intravascular environment. Here we propose a novel flow-loop system designed to train resident physicians in endovascular procedures with quantitative feedback in the form of size characterization of microemboli within the loop. The flow-loop incorporates a peristaltic pump to mimic physiological pulsatile flow with varying tube diameters to customize vascular resistance and custom housing for a pulsed-wave Doppler ultrasound probe. We conducted proof-of-concept studies using velocity-based, pulsed-wave Doppler ultrasound to correlate signal with particle size and found an inverse relationship between particle size and both displacement and average time per signal spike. These results suggest the ability to distinguish particles down to size 40 μm with sizes differing more than 300 μm. Future research will be focused on reducing data noise from Doppler Ultrasound probes, increasing data granularity, and testing carotid filters with the system. Envisioned for use in academic settings, this system will be a highly customizable tool for training resident physicians, allowing objective metrics for specific interventional procedures.
Migration of Leukocytes in Shear Flows: Insights from Simulations
Authors: Nguyen Tam T. , Akerkouch Lahcen , Le Trung B. 
Published: August 2024

Abstract
The objective of this study is to investigate the rolling dynamics of leukocytes in microchannel flows using a hybrid continuum-particle approach. Leukocytes play an essential role in the immune system, and their margination behavior has been extensively studied both experimentally and numerically. In this study, we have developed a series of numerical experiments using a hybrid DPD-CFD solver with the membrane stiffness of the modeled leukocytes as the primary investigation subject. Our results show that increasing the stiffness of the cell's membrane influences its deformability and trajectory in microchannel flows. The results obtained from this study could be valuable in designing next-generation micro-carriers for targeted drug delivery systems, which mimic the margination behavior of leukocytes.