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  • 1.
    Buendia, Ruben
    et al.
    University of Borås, Sweden.
    bogonez-franco, Paco
    Technical University of Catalonia.
    Nescolarde, Lexa
    Technical University of Catalonia.
    Seoane, Fernando
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS).
    Influence of electrode mismatch on Cole parameter estimation from Total Right Side Electrical Bioimpedance Spectroscopy measurements2012In: Medical Engineering and Physics, ISSN 1350-4533, E-ISSN 1873-4030, Vol. 34, no 7, p. 1024-1028Article in journal (Refereed)
    Abstract [en]

    Applications based on measurements of Electrical Bioimpedance (EBI) spectroscopy analysis, like assessment of body composition, have proliferated in the past years. Currently Body Composition Assessment (BCA) based in Bioimpedance Spectroscopy (BIS) analysis relays on an accurate estimation of the Cole parameters R-0 and R-infinity. A recent study by Bogonez-Franco et al. has proposed electrode mismatch as source of remarkable artefacts in BIS measurements. Using Total Right Side BIS measurements from the aforementioned study, this work has focused on the influence of electrode mismatch on the estimation of R-0 and R-infinity using the Non-Linear Least Square curve fitting technique on the modulus of the impedance. The results show that electrode mismatch on the voltage sensing electrodes produces an overestimation of the impedance spectrum leading to a wrong estimation of the parameters R-0 and R-infinity, and consequently obtaining values around 4% larger that the values obtained from BIS without electrode mismatch. The specific key factors behind electrode mismatch or its influence on the analysis of single and spectroscopy measurements have not been investigated yet, no compensation or correction technique is available to overcome the deviation produced on the EBI measurement. Since textile-enabled EBI applications using dry textrodes, i.e. textile electrodes with dry skin-electrode interfaces and potentially large values of electrode polarization impedance are more prone to produce electrode mismatch, the lack of a correction or compensation technique might hinder the proliferation of textile-enabled EBI applications for personalized healthcare monitoring.

  • 2. Evegren, Philip
    et al.
    Fuchs, Laszlo
    KTH, School of Engineering Sciences (SCI), Mechanics, Fluid Mechanics of Industrial Processes.
    Revstedt, Johan
    Wall shear stress variations in a 90-degree bifurcation in 3D pulsating flows2010In: Medical Engineering and Physics, ISSN 1350-4533, E-ISSN 1873-4030, Vol. 32, no 2, p. 189-202Article in journal (Refereed)
    Abstract [en]

    The exact role of fluid mechanics in the patho-physiological process of atherosclerosis has been a research topic over many years, yet without clear conclusive result. One has observed that morphological manifestations of the disease are found at some well-defined locations: certain vessel bifurcations and in curvatures. The flow in these regions is characterized by unsteadiness and often separation. Currently there are no complete theories that can explain the process since the different components in the process are not fully understood. Here we carry out detailed computations of the unsteady flow in an arterial segment typical to location of early appearance of arterial lesions. We study the wall shear stress (WSS) field variations near a junction with the purpose of identifying fluid-mechanical parameters that can be related to sites of atheroslcerosis. The results show that regions associated with atherosclerosis experience highly elevated temporal- and spatial-derivatives of the WSS, also at less commonly known locations. Thus, large derivatives in time and space do not seem unique for the most common areas of atherosclerosis. Differences in WSS character between these locations are identified as differences in the time period of back flow as well as differences in the magnitude of the WSS derivatives. The data is presented in a way that facilitates understanding of the variations in WSS.

  • 3. Gharehbaghi, Arash
    et al.
    Borga, Magnus
    Janerot Sjöberg, Birgitta
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.
    Ask, Per
    A novel method for discrimination between innocent and pathological heart murmurs2015In: Medical Engineering and Physics, ISSN 1350-4533, E-ISSN 1873-4030, Vol. 37, no 7, p. 674-682Article in journal (Refereed)
    Abstract [en]

    This paper presents a novel method for discrimination between innocent and pathological murmurs using the growing time support vector machine (GTSVM). The proposed method is tailored for characterizing innocent murmurs (IM) by putting more emphasis on the early parts of the signal as IMs are often heard in early systolic phase. Individuals with mild to severe aortic stenosis (AS) and IM are the two groups subjected to analysis, taking the normal individuals with no murmur (NM) as the control group. The AS is selected due to the similarity of its murmur to IM, particularly in mild cases. To investigate the effect of the growing time windows, the performance of the GTSVM is compared to that of a conventional support vector machine (SVM), using repeated random sub-sampling method. The mean value of the classification rate/sensitivity is found to be 88%/86% for the GTSVM and 84%/83% for the SVM. The statistical evaluations show that the GTSVM significantly improves performance of the classification as compared to the SVM.

  • 4.
    Karimi, Mohammad Taghi
    et al.
    Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
    Gutierrez-Farewik, Elena
    KTH, School of Engineering Sciences (SCI), Mechanics, Biomechanics.
    McGarry, Anthony
    Department of Biomedical Engineering, University of Strathclyde, Glasgow, United Kingdom.
    Evaluation of the hip joint contact force in subjects with Perthes based on OpenSIM2019In: Medical Engineering and Physics, ISSN 1350-4533, E-ISSN 1873-4030, Vol. 67, p. 44-48Article in journal (Refereed)
    Abstract [en]

    The head of femoral bone is deformed in the subjects with Leg Calve Perthes disease (LCPD). This may be due to the excessive loads applied on it. There are no studies that report the hip joint contact force in subjects with LCPD. Therefore, the aim of this study was to evaluate the hip joint contact force in subjects with Perthes disease. Ten typically-developing (TD) children and 10 children with LCPD were recruited in this study. The kinematics and kinetics of the subjects were evaluated in 3D motion analysis. The hip joint contact force was approximated using OpenSIM software. Differences were determined with an independent t-test. There was a significant difference between walking speed of TD and Perthes subjects (63.8 (±8.1) and 57.4 (±7.0) m/min, respectively). The first peak of hip joint contact force was 4.8 (±1.7) N/BW in Perthes subjects, compared to 7.6 (±2.5) N/BW in TD subjects (p = 0.004). The peak hip joint contact force in mediolateral and anteroposterior directions was significantly lower in Perthes subjects (p < 0.05). The hip joint excursion was 40.0 (±5.6) and 46.4 (±8.5) degrees in Perthes and normal subjects, respectively (p = 0.03). The hip joint contact forces were lower in the subjects with Perthes disease. Therefore, it can be concluded that the strategies used by LCPD subjects were successful to decrease hip joint contact force.

  • 5.
    Maksuti, Elira
    et al.
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.
    Bjällmark, Anna
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging. Karolinska Institute, Sweden .
    Broomé, Michael
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging. Karolinska Institute, Sweden .
    Modelling the heart with the atrioventricular plane as a piston unit2015In: Medical Engineering and Physics, ISSN 1350-4533, E-ISSN 1873-4030, Vol. 37, no 1, p. 87-92Article in journal (Refereed)
    Abstract [en]

    Medical imaging and clinical studies have proven that the heart pumps by means of minor outer volume changes and back-and-forth longitudinal movements in the atrioventricular (AV) region. The magnitude of AV-plane displacement has also shown to be a reliable index for diagnosis of heart failure. Despite this, AV-plane displacement is usually omitted from cardiovascular modelling. We present a lumped-parameter cardiac model in which the heart is described as a displacement pump with the AV plane functioning as a piston unit (AV piston). This unit is constructed of different upper and lower areas analogous with the difference in the atrial and ventricular cross-sections. The model output reproduces normal physiology, with a left ventricular pressure in the range of 8-130 mmHg, an atrial pressure of approximatly 9 mmHg, and an arterial pressure change between 75 mmHg and 130 mmHg. In addition, the model reproduces the direction of the main systolic and diastolic movements of the AV piston with realistic velocity magnitude (similar to 10 cm/s). Moreover, changes in the simulated systolic ventricular-contraction force influence diastolic filling, emphasizing the coupling between cardiac systolic and diastolic functions. The agreement between the simulation and normal physiology highlights the importance of myocardial longitudinal movements and of atrioventricular interactions in cardiac pumping.

  • 6.
    Man, V.
    et al.
    Brno Univ Technol, Inst Solid Mech Mechatron & Biomech, Brno, Czech Republic..
    Polzer, S.
    Brno Univ Technol, Inst Solid Mech Mechatron & Biomech, Brno, Czech Republic..
    Gasser, Thomas Christian
    KTH, School of Engineering Sciences (SCI), Solid Mechanics (Dept.).
    Novotny, T.
    Masaryk Univ, Dept Surg 2, St Annes Univ Hosp, Brno, Czech Republic.;Masaryk Univ, Fac Med, Brno, Czech Republic..
    Bursa, J.
    Brno Univ Technol, Inst Solid Mech Mechatron & Biomech, Brno, Czech Republic..
    Impact of isotropic constitutive descriptions on the predicted peak wall stress in abdominal aortic aneurysms2018In: Medical Engineering and Physics, ISSN 1350-4533, E-ISSN 1873-4030, Vol. 53, p. 49-57Article in journal (Refereed)
    Abstract [en]

    Biomechanics-based assessment of Abdominal Aortic Aneurysm (AAA) rupture risk has gained considerable scientific and clinical momentum. However, computation of peak wall stress (PWS) using state-ofthe-art finite element models is time demanding. This study investigates which features of the constitutive description of AAA wall are decisive for achieving acceptable stress predictions in it. Influence of five different isotropic constitutive descriptions of AAA wall is tested; models reflect realistic non-linear, artificially stiff non-linear, or artificially stiff pseudo-linear constitutive descriptions of AAA wall. Influence of the AAA wall model is tested on idealized (n = 4) and patient-specific (n = 16) AAA geometries. Wall stress computations consider a (hypothetical) load-free configuration and include residual stresses homogenizing the stresses across the wall. Wall stress differences amongst the different descriptions were statistically analyzed. When the qualitatively similar non-linear response of the AAA wall with low initial stiffness and subsequent strain stiffening was taken into consideration, wall stress (and PWS) predictions did not change significantly. Keeping this non-linear feature when using an artificially stiff wall can save up to 30% of the computational time, without significant change in PWS. In contrast, a stiff pseudo-linear elastic model may underestimate the PWS and is not reliable for AAA wall stress computations.

  • 7. Polzer, S.
    et al.
    Gasser, T. Christian
    KTH, School of Engineering Sciences (SCI), Mechanics, Biomechanics.
    Bursa, J.
    Staffa, R.
    Vlachovsky, R.
    Man, V.
    Skacel, P.
    Importance of material model in wall stress prediction in abdominal aortic aneurysms2013In: Medical Engineering and Physics, ISSN 1350-4533, E-ISSN 1873-4030, Vol. 35, no 9, p. 1282-1289Article in journal (Refereed)
    Abstract [en]

    Background: Results of biomechanical simulation of the abdominal aortic aneurysm (AAA) depend on the constitutive description of the wall. Based on in vitro and in vivo experimental data several constitutive models for the AAA wall have been proposed in the literature. Those models differ strongly from each other and their impact on the computed stress in biomechanical simulation is not clearly understood. Methods: Finite element (FE) models of AAAs from 7 patients who underwent elective surgical repair were used to compute wall stresses. AAA geometry was reconstructed from CT angiography (CT-A) data and patient-specific (PS) constitutive descriptions of the wall were derived from planar biaxial testing of anterior wall tissue samples. In total 28 FE models were used, where the wall was described by either patient-specific or previously reported study-average properties. This data was derived from either uniaxial or biaxial in vitro testing. Computed wall stress fields were compared on node-by-node basis. Results: Different constitutive models for the AAA wall cause significantly different predictions of wall stress. While study-average data from biaxial testing gives globally the same stress field as the patient-specific wall properties, the material model based on uniaxial test data overestimates the wall stress on average by 30. kPa or about 67% of the mean stress. A quasi-linear description based on the in vivo measured distensibility of the AAA wall leads to a completely altered stress field and overestimates the wall stress by about 75. kPa or about 167% of the mean stress. Conclusion: The present study demonstrated that the constitutive description of the wall is crucial for AAA wall stress prediction. Consequently, results obtained using different models should not be mutually compared unless different stress gradients across the wall are not taken into account. Highly nonlinear material models should be preferred when the response of AAA to increased blood pressure is investigated, while the quasi-linear model with high initial stiffness produces negligible stress gradients across the wall and thus, it is more appropriate when response to mean blood pressure is calculated.

  • 8. Smoljkić, M.
    et al.
    Verbrugghe, P.
    Larsson, Matilda
    KTH, School of Technology and Health (STH), Medical Engineering. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Widman, Erik
    KTH, School of Technology and Health (STH), Medical Engineering.
    Fehervary, H.
    D'hooge, J.
    Vander Sloten, J.
    Famaey, N.
    Comparison of in vivo vs. ex situ obtained material properties of sheep common carotid artery2018In: Medical Engineering and Physics, ISSN 1350-4533, E-ISSN 1873-4030, Vol. 55, p. 16-24Article in journal (Refereed)
    Abstract [en]

    Patient-specific biomechanical modelling can improve preoperative surgical planning. This requires patient-specific geometry as well as patient-specific material properties as input. The latter are, however, still quite challenging to estimate in vivo. This study focuses on the estimation of the mechanical properties of the arterial wall. Firstly, in vivo pressure, diameter and thickness of the arterial wall were acquired for sheep common carotid arteries. Next, the animals were sacrificed and the tissue was stored for mechanical testing. Planar biaxial tests were performed to obtain experimental stress-stretch curves. Finally, parameters for the hyperelastic Mooney–Rivlin and Gasser–Ogden–Holzapfel (GOH) material model were estimated based on the in vivo obtained pressure-diameter data as well as on the ex situ experimental stress-stretch curves. Both material models were able to capture the in vivo behaviour of the tissue. However, in the ex situ case only the GOH model provided satisfactory results. When comparing different fitting approaches, in vivo vs. ex situ, each of them showed its own advantages and disadvantages. The in vivo approach estimates the properties of the tissue in its physiological state while the ex situ approach allows to apply different loadings to properly capture the anisotropy of the tissue. Both of them could be further enhanced by improving the estimation of the stress-free state, i.e. by adding residual circumferential stresses in vivo and by accounting for the flattening effect of the tested samples ex vivo.

  • 9.
    Wang, Ruoli
    et al.
    KTH, School of Engineering Sciences (SCI), Mechanics, Biomechanics. KTH, School of Engineering Sciences (SCI), Centres, BioMEx. Karolinska Institutet, Sweden.
    Herman, Pawel
    KTH, School of Computer Science and Communication (CSC), Computational Science and Technology (CST).
    Ekeberg, Örjan
    KTH, School of Computer Science and Communication (CSC), Computational Science and Technology (CST).
    Gäverth, Johan
    Dept Women's and Children's Health, Karolinska Institutet.
    Fagergren, Anders
    AggeroMedTech AB, Stockholm.
    Forssberg, Hans
    Dept Women's and Children's Health, Karolinska Institutet.
    Neural and non-neural related properties in the spastic wrist flexors: An optimization study2017In: Medical Engineering and Physics, ISSN 1350-4533, E-ISSN 1873-4030, Vol. 47, p. 198-209Article in journal (Refereed)
    Abstract [en]

    Quantifying neural and non-neural contributions to increased joint resistance in spasticity is essential for a better understanding of its pathophysiological mechanisms and evaluating different intervention strategies. However, direct measurement of spasticity-related manifestations, e.g., motoneuron and biophysical properties in humans, is extremely challenging. In this vein, we developed a forward neuromusculoskeletal model that accounts for dynamics of muscle spindles, motoneuron pools, muscle activation and musculotendon of wrist flexors and relies on the joint angle and resistant torque as the only input measurement variables. By modeling the stretch reflex pathway, neural and non-neural related properties of the spastic wrist flexors were estimated during the wrist extension test. Joint angle and resistant torque were collected from 17 persons with chronic stroke and healthy controls using NeuroFlexor, a motorized force measurement device during the passive wrist extension test. The model was optimized by tuning the passive and stretch reflex-related parameters to fit the measured torque in each participant. We found that persons with moderate and severe spasticity had significantly higher stiffness than controls. Among subgroups of stroke survivors, the increased neural component was mainly due to a lower muscle spindle rate at 50% of the motoneuron recruitment. The motoneuron pool threshold was highly correlated to the motoneuron pool gain in all subgroups. The model can describe the overall resistant behavior of the wrist joint during the test. Compared to controls, increased resistance was predominantly due to higher elasticity and neural components. We concluded that in combination with the NeuroFlexor measurement, the proposed neuromusculoskeletal model and optimization scheme served as suitable tools for investigating potential parameter changes along the stretch-reflex pathway in persons with spasticity.

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