Passive guided wave tomography for structural health monitoring.

In this paper the authors present a baseline-free quantitative method for imaging corrosion flaws in thin plates. It only requires an embedded guided wave sensor network used in a fully passive way, i.e., without active emission of waves. This method is called passive guided wave tomography. The aim of this development is the use of this method for the structural health monitoring of critical structures with heavy limitations on both sensor's intrusiveness and diagnostic's reliability because it allows the use of sensors that cannot emit elastic waves such as fiber Bragg gratings, which are less intrusive than piezoelectric transducers. The idea consists in using passive methods in order to retrieve the impulse response from elastic diffuse fields-naturally present in structures-measured simultaneously between the sensors. In this paper, two passive methods are studied: the ambient noise cross-correlation and the passive inverse filter. Once all the impulse responses between the sensors are retrieved, they are used as input data to perform guided wave tomography.

Prognosis of remaining bearing life with vibration signals using a sequential Monte Carlo framework.

This letter proposes a nonlinear hybrid model method to assess a bearing component's health for long-term prediction of the remaining useful life (RUL) before a breakdown occurs. This model uses neural training of a recursive extreme learning machine (RELM) core integrated with a Monte Carlo-based framework. Estimation of the model's parameters, along with the system states, is used to construct an updated model that is utilized for prediction. Practical experiments using the public benchmark dataset indicate that the RELM method demonstrates superior effectiveness for RUL estimation, as measured by the (α-λ) metric and the cumulative relative accuracy.

Assessment of Repaired Diagnostic Ultrasound Probes.

A growing number of repaired and refurbished diagnostic ultrasound probes are supplied by a small number of original equipment manufacturers (OEMs) and many third-party vendors. OEMs ensure that their devices meet regulatory requirements; any repairs using non-OEM materials carry the risk of non-compliance. The aim of this study was to test examples of probe repairs using methods selected to illustrate their possible impact on function. Of 3212 used probes assessed, 21 were found to have undergone repair involving functional parts: 9 incorrectly wired, 11 non-OEM arrays and 1 relensed probe. For repairs not involving functional parts, before and after electronic probe testing may be sufficient to determine that no damage has occurred. For repairs involving functional parts, a more comprehensive suite of tests is necessary to determine that the materials, parts and final product match the performance of the OEM probe and meet regulatory requirements.

A Decision Tree-Based Survival Analysis of Patients with a History of Inappropriate Implantable Cardioverter-Defibrillator Therapy.

Implantable cardioverter-defibrillators (ICDs) improve survival in patients who are at risk of sudden death. However, inappropriate therapy is commonly given to ICD recipients, and this situation may be associated with an increased risk of death. This study aimed to construct a risk stratification scheme by using decision tree analysis in patients who received inappropriate ICD therapy.Mortality was calculated from a retrospective data analysis of a multicenter cohort involving 417 ICD recipients. Inappropriate therapy was defined as therapy for nonventricular arrhythmias, including sinus tachycardia, supraventricular tachycardia, atrial fibrillation/flutter, oversensing, and lead failure. Inappropriate therapy included antitachycardia pacing, cardioversion, and defibrillation. The prognostic factors were identified by a Cox proportional hazards regression analysis, and we constructed a decision tree.During an average follow-up of 5.2 years, 48 patients (12%) had all-cause death. A multivariate Cox hazard model revealed that the age (hazard ratio [HR] 1.06, P < 0.001), ln B-type natriuretic peptide (BNP) (HR 1.47, P = 0.02), nonsinus rhythm at implantation (HR 2.70, P < 0.05), and inappropriate therapy occurring during sedentary/awake conditions (HR 3.51, P = 0.001) correlated with an increased risk of mortality. An inappropriate therapy due to abnormal sensing (HR 0.16, P = 0.04) decreased the risk of mortality. Furthermore, a decision tree analysis stratified the patients well by using 4 covariates: BNP, activity at the time of inappropriate therapy, mechanism of inappropriate therapy, and baseline rhythm at ICD implantation (log-rank test, P < 0.0001).We identified the predictors of mortality in inappropriate ICD therapy recipients and constructed a risk stratification scheme by using decision tree analysis.

Piezoelectric Transducer-Based Structural Health Monitoring for Aircraft Applications.

Structural health monitoring (SHM) is being widely evaluated by the aerospace industry as a method to improve the safety and reliability of aircraft structures and also reduce operational cost. Built-in sensor networks on an aircraft structure can provide crucial information regarding the condition, damage state and/or service environment of the structure. Among the various types of transducers used for SHM, piezoelectric materials are widely used because they can be employed as either actuators or sensors due to their piezoelectric effect and vice versa. This paper provides a brief overview of piezoelectric transducer-based SHM system technology developed for aircraft applications in the past two decades. The requirements for practical implementation and use of structural health monitoring systems in aircraft application are then introduced. State-of-the-art techniques for solving some practical issues, such as sensor network integration, scalability to large structures, reliability and effect of environmental conditions, robust damage detection and quantification are discussed. Development trend of SHM technology is also discussed.

Assessment of Cardiac Lead Perforation: Comparison Among Chest Radiography, Transthoracic Echocardiography and Electrocardiography-gated Contrast-enhanced Cardiac CT.

OBJECTIVES: Cardiac lead perforation is a rare but potentially life-threatening event. The purpose of this study was to investigate the diagnostic performances of chest radiography, transthoracic echocardiography (TTE) and electrocardiography (ECG)-gated contrast-enhanced cardiac CT in the assessment of cardiac lead perforation. METHODS: This retrospective study was approved by the ethics review board of Sun Yat-Sen Memorial Hospital at Sun Yat-Sen University (Guangzhou, China), and the need to obtain informed consent was waived. Between May 2010 and Oct 2017, 52 patients were clinically suspected to have a cardiac lead perforation and received chest radiography, TTE and ECG-gated contrast-enhanced cardiac CT. Among them, 13 patients were identified as having cardiac lead perforation. The diagnostic performances of these three modalities were evaluated by receiver-operating characteristic (ROC) curves using a composite reference standard of surgical and electrophysiological results and clinical follow-up. The areas under ROCs (AUROCs) were compared with the McNemar test. RESULTS: The accuracies of chest radiography, TTE and ECG-gated contrast-enhanced cardiac CT imaging for the diagnosis of cardiac lead perforation were 73.1%, 82.7% and 98.1%, respectively. ECG-gated contrast-enhanced cardiac CT had a higher AUROC than chest radiography (p < 0.001) and TTE (p < 0.001). CONCLUSIONS: ECG-gated contrast-enhanced cardiac CT is superior to both chest radiography and TTE imaging for the assessment of cardiac lead perforation. KEY POINTS: • ECG-gated contrast-enhanced cardiac CT has an accuracy of 98.1% in the diagnosis of cardiac lead perforation. • The AUROC of ECG-gated contrast-enhanced cardiac CT is higher than those of chest radiography and TTE imaging. • ECG-gated contrast-enhanced cardiac CT imaging has better diagnostic performance than both chest radiography and TTE imaging for the assessment of cardiac lead perforation.

Advances in the Structural Health Monitoring of Bridges Using Piezoelectric Transducers.

With the rapid development of the world's transportation infrastructure, many long-span bridges were constructed in recent years, especially in China. However, these bridges are easily subjected to various damages due to dynamic loads (such as wind-, earthquake-, and vehicle-induced vibration) or environmental factors (such as corrosion). Therefore, structural health monitoring (SHM) is vital to guarantee the safety of bridges in their service lives. With its wide frequency response range, fast response, simple preparation process, ease of processing, low cost, and other advantages, the piezoelectric transducer is commonly employed for the SHM of bridges. This paper summarizes the application of piezoelectric materials for the SHM of bridges, including the monitoring of the concrete strength, bolt looseness, steel corrosion, and grouting density. For each problem, the application of piezoelectric materials in different research methods is described. The related data processing methods for four types of bridge detection are briefly summarized, and the principles of each method in practical application are listed. Finally, issues to be studied when using piezoelectric materials for monitoring are discussed, and future application prospects and development directions are presented.

Ex vivo assessment and in vivo validation of non-invasive stent monitoring techniques based on microwave spectrometry.

Some conditions are well known to be directly associated with stent failure, including in-stent re-occlusion and stent fracture. Currently, identification of these high-risk conditions requires invasive and complex procedures. This study aims to assess microwave spectrometry (MWS) for monitoring stents non-invasively. Preliminary ex vivo data are presented to move to in vivo validation. Fifteen mice were assigned to receive subcutaneous stent implantations (n = 10) or sham operations (n = 5). MWS measurements were carried out at 0, 2, 4, 7, 14, 22, and 29 days of follow-up. Additionally, 5 stented animals were summited to micro-CT analyses at the same time points. At 29 days, 3 animals were included into a stent fracture subgroup and underwent a last MWS and micro-CT analysis. MWS was able to identify stent position and in-stent stenosis over time, also discerning significant differences from baseline measures (P < 0.001). Moreover, MWS identified fractured vs. non-fractured stents in vivo. Taken together, MWS emerges as a non-invasive, non-ionizing alternative for stent monitoring. MWS analysis clearly distinguished between in-stent stenosis and stent fracture phenomena.

3D assessment of damaged bicycle helmets and corresponding craniomaxillo-mandibular skull injuries: A feasibility study.

OBJECTIVES: In the Netherlands, cyclists continue to outnumber other road users in injuries and deaths. The wearing of bicycle helmets is not mandatory in the Netherlands even though research has shown that wearing bicycle helmets can reduce head and brain injuries by up to 88%. Therefore, the aim of this study was to assess the feasibility of using 3D technology to evaluate bicycle-related head injuries and helmet protection. METHODS: Three patients who had been involved in a bicycle accident while wearing a helmet were subjected to multi-detector row computed tomography (MDCT) imaging after trauma. The helmets were separately scanned using the same MDCT scanner with tube voltages ranging from 80kVp to 140kVp and tube currents ranging from 10mAs to 300mAs in order to determine the best image acquisition parameters for helmets. The acquired helmet images were converted into virtual 3D surface hence Standard Tessellation Language (STL) models and merged with MDCT-derived STL models of the patients' skulls. Finally, all skull fractures and corresponding helmet damage were visualized and related. RESULTS: Imaging bicycle helmets on an MDCT scanner proved to be feasible using a tube voltage of 120kVp and a tube current of 120mAs. Merging the resulting STL models of the patients' skull and helmet allowed the overall damage sustained by both skull and helmet to be related. CONCLUSION: Our proposed 3D method of assessing bicycle helmet damage and corresponding head injuries could offer valuable information for the development and design of safer bicycle helmets.

Technologies for Prolonging Cardiac Implantable Electronic Device Longevity.

Prolonged longevity of cardiac implantable electronic devices (CIEDs) is needed not only as a passive response to match the prolonging life expectancy of patient recipients, but will also actively prolong their life expectancy by avoiding/deferring the risks (and costs) associated with device replacement. CIEDs are still exclusively powered by nonrechargeable primary batteries, and energy exhaustion is the dominant and an inevitable cause of device replacement. The longevity of a CIED is thus determined by the attrition rate of its finite energy reserve. The energy available from a battery depends on its capacity (total amount of electric charge), chemistry (anode, cathode, and electrolyte), and internal architecture (stacked plate, folded plate, and spiral wound). The energy uses of a CIED vary and include a background current for running electronic circuitry, periodic radiofrequency telemetry, high-voltage capacitor reformation, constant ventricular pacing, and sporadic shocks for the cardiac resynchronization therapy defibrillators. The energy use by a CIED is primarily determined by the patient recipient's clinical needs, but the energy stored in the device battery is entirely under the manufacturer's control. A larger battery capacity generally results in a longer-lasting device, but improved battery chemistry and architecture may allow more space-efficient designs. Armed with the necessary technical knowledge, healthcare professionals and purchasers will be empowered to make judicious selection on device models and maximize the utilization of all their energy-saving features, to prolong device longevity for the benefits of their patients and healthcare systems.

Strategies for Derisking Translational Processes for Biomedical Technologies.

Inefficient translational processes for technology-oriented biomedical research have led to some prominent and frequent failures in the development of many leading drug candidates, several designated investigational drugs, and some medical devices, as well as documented patient harm and postmarket product withdrawals. Derisking this process, particularly in the early stages, should increase translational efficiency and streamline resource utilization, especially in an academic setting. In this opinion article, we identify a 12-step guideline for reducing risks typically associated with translating medical technologies as they move toward prototypes, preclinical proof of concept, and possible clinical testing. Integrating the described 12-step process should prove valuable for improving how early-stage academic biomedical concepts are cultivated, culled, and manicured toward intended clinical applications.

Is micro-computed tomography useful for wear assessment of ceramic femoral heads? A preliminary evaluation of volume measurements.

BACKGROUND: Wear associated with hip components represents the main clinical problem in these patients, and it is important to develop new techniques for more accurate measurements of that wear. Currently, the gravimetric method is the gold standard for assessing mass measurements in preclinical evaluations. However, this method does not give other information such as volumetric loss or surface deviation. This work aimed to develop and validate a new technique to quantify ceramic volume loss from in vitro experiments using micro-computed tomography (micro-CT). METHODS: An alumina (BIOLOX® forte) femoral head (Ø = 28 mm) was used. Mass and volume loss were approached by gravimetric method (using a four decimal place digital microbalance) and by using Skyscan 1176 microtomographic system, respectively. RESULTS: Standard error and coefficient of variance of both gravimetric and experimental groups demonstrated the reliability of the micro-CT analysis technique. CONCLUSIONS: In conclusion, the findings of the present study suggest that this new protocol could be considered an important tool for wear assessment and that we have found a reliable metrological protocol for volumetric analysis of ceramic femoral head prostheses, demonstrating that the micro-CT technique can be an important tool for wear assessment.

Variability and bias assessment in breast ADC measurement across multiple systems.

PURPOSE: To assess the ability of a recent, anatomically designed breast phantom incorporating T1 and diffusion elements to serve as a quality control device for quantitative comparison of apparent diffusion coefficient (ADC) measurements calculated from diffusion-weighted MRI (DWI) within and across MRI systems. MATERIALS AND METHODS: A bilateral breast phantom incorporating multiple T1 and diffusion tissue mimics and a geometric distortion array was imaged with DWI on 1.5 Tesla (T) and 3.0T scanners from two different manufacturers, using three different breast coils (three configurations total). Multiple measurements were acquired to assess the bias and variability of different diffusion weighted single-shot echo-planar imaging sequences on the scanner-coil systems. RESULTS: The repeatability of ADC measurements was mixed: the standard deviation relative to baseline across scanner-coil-sequences ranged from low variability (0.47, 95% confidence interval [CI]: 0.22-1.00) to high variability (1.69, 95% CI: 0.17-17.26), depending on material, with the lowest and highest variability from the same scanner-coil-sequence. Assessment of image distortion showed that right/left measurements of the geometric distortion array were 1 to 16% larger on the left coil side compared with the right coil side independent of scanner-coil systems, diffusion weighting, and phase-encoding direction. CONCLUSION: This breast phantom can be used to measure scanner-coil-sequence bias and variability for DWI. When establishing a multisystem study, this breast phantom may be used to minimize protocol differences (e.g., due to available sequences or shimming technique), to correct for bias that cannot be minimized, and to weigh results from each system depending on respective variability. J. Magn. Reson. Imaging 2016. J. MAGN. RESON. IMAGING 2016;44:846-855.

Simple radiographic assessment of bone quality is associated with loss of surgical fixation in patients with proximal humeral fractures.

AIM: This study aimed to determine if the ratio of cortical thickness to shaft diameter of the humerus, as measured on a simple anterior-posterior shoulder radiograph, is associated with surgical fixation failure. PATIENTS AND METHODS: 64 consecutive fractures in 63 patients (mean age 66.1 years, range 35-90) operated with surgical fixation between March 2011 and July 2014 using PERI-LOC locking plate and screws (Smith and Nephew, UK) were identified. Predictors of bone quality were measured from preoperative radiographs, including ratio of the medial cortex to shaft diameter (medial cortical ratio, MCR). Loss of fixation (displacement, screw cut out, or change in neck-shaft angle >4 degrees) was determined on follow-up radiographs. RESULTS: Loss of fixation occurred in 14 patients (21.9%) during the follow up. Patients were older in the failure group 72.8 vs. 64.2 years (p=0.007). The MCR was significantly lower in patients with failed fixation 0.170 vs 0.202, p=0.019. Loss of fixation is three times more likely in patients with a MCR <0.16 (41% vs. 14%, p=0.015). Increased fracture parts led to increased failure rate (p=0.0005). CONCLUSION: Medial cortex ratio is significantly associated with loss of surgical fixation and may prove to be a useful adjunct for clinical decision making in patients with proximal humeral fractures.

Safer radiation therapy treatment resulting from an equipment transition: A mixed-methods study.

PURPOSE: To realize individualized safe radiation therapy, reliable treatment equipment is essential in combination with a system-level improvement approach. We hypothesized that implementation of a system that integrated all required treatment equipment would result in improved safety and stability of the irradiation treatment process. METHODS AND MATERIALS: Seven accelerators, portal imaging, and the treatment planning software were replaced by an integrated system that included 6 accelerators. The number of reported safety incidents and root causes were recorded between 2010 and 2014. Time series analysis was performed, and quantitative results were explored by structured interviews. Additionally, downtime was recorded. RESULTS: From January 2010 to July 2014, 5085 incidents were reported. Reports related to the accelerators decreased from 33% (2010) to 20% (2013-2014) of total reports, whereas the number of delivered fractions per accelerator increased by 20% (2010: 643 per month; 2013: 795 per month). Reports related to portal imaging decreased from 16.5 reports per month (2010) to 3.1 (2013-2014). Of these portal imaging reports, 316 had at least 1 technical cause in 2010, which decreased to 13 in 2013-2014. Interviewees attributed the decreased reporting to the equipment transition, not to decreased safety awareness. Downtime decreased by 46%, from 5.4% in 2010 to 2.9% in 2013. CONCLUSIONS: The number of reported accelerator- and portal imaging-related incidents decreased significantly, whereas safety awareness remained stable. In addition, accelerator downtime decreased, possibly resulting in less rescheduling of patients and fewer disruptions of work processes. Therefore, we conclude that the risk for serious safety incidents and patient harm decreased after implementation of the new integrated system.

EEG-based usability assessment of 3D shutter glasses.

OBJECTIVE: Neurotechnology can contribute to the usability assessment of products by providing objective measures of neural workload and can uncover usability impediments that are not consciously perceived by test persons. In this study, the neural processing effort imposed on the viewer of 3D television by shutter glasses was quantified as a function of shutter frequency. In particular, we sought to determine the critical shutter frequency at which the 'neural flicker' vanishes, such that visual fatigue due to this additional neural effort can be prevented by increasing the frequency of the system. APPROACH: Twenty-three participants viewed an image through 3D shutter glasses, while multichannel electroencephalogram (EEG) was recorded. In total ten shutter frequencies were employed, selected individually for each participant to cover the range below, at and above the threshold of flicker perception. The source of the neural flicker correlate was extracted using independent component analysis and the flicker impact on the visual cortex was quantified by decoding the state of the shutter from the EEG. MAIN RESULT: Effects of the shutter glasses were traced in the EEG up to around 67 Hz-about 20 Hz over the flicker perception threshold-and vanished at the subsequent frequency level of 77 Hz. SIGNIFICANCE: The impact of the shutter glasses on the visual cortex can be detected by neurotechnology even when a flicker is not reported by the participants. Potential impact. Increasing the shutter frequency from the usual 50 Hz or 60 Hz to 77 Hz reduces the risk of visual fatigue and thus improves shutter-glass-based 3D usability.