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Introduction: There are 350 to 400 pediatric heart transplants annually according to the Pediatric Heart Transplant Database (Dipchand et al. 2014). Finding appropriate donors can be challenging especially for the pediatric population. The current standard of care is a donor-to-recipient weight ratio. This ratio is not necessarily a parameter directly indicative of the size of a heart, potentially leading to ill-fitting allografts (Tang et al. 2010). In this paper, a regression model is presented - developed by correlating total cardiac volume to non-invasive imaging parameters and patient characteristics – for use in determining ideal allograft fit with respect to total cardiac volume.
Methods: A virtual, 3D library of clinically-defined normal hearts was compiled from reconstructed CT and MR scans. Non-invasive imaging parameters and patient characteristics were collected and subjected to backward elimination linear regression to define a model relating patient parameters to the total cardiac volume. This regression model was then used to retrospectively accept or reject an ‘ideal’ donor graft from the library for 3 patients that had undergone heart transplantation. Oversized and undersized grafts were also transplanted to qualitatively analyze virtual transplantation specificity.
Results: The backward elimination approach of the data for the 20 patients rejected the factors of BMI, BSA, sex and both end-systolic and end-diastolic left ventricular measurements from echocardiography. Height and weight were included in the linear regression model yielding an adjusted R-squared of 82.5%. Height and weight showed statistical significance with p-values of 0.005 and 0.02 respectively. The final equation for the linear regression model was TCV = -169.320+ 2.874h + 3.578w ± 73 (h=height, w=weight, TCV= total cardiac volume).
Discussion: With the current regression model, height and weight significantly correlate to total cardiac volume. This regression model and virtual normal heart library provide for the possibility of virtual transplant and size-matching for transplantation. The study and regression model is, however, limited due to a small sample size. Additionally, the lack of volumetric resolution from the MR datasets is a potentially limiting factor. Despite these limitations the virtual library has the potential to be a critical tool for clinical care that will continue to grow as normal hearts are added to the virtual library.
Methods: A virtual, 3D library of clinically-defined normal hearts was compiled from reconstructed CT and MR scans. Non-invasive imaging parameters and patient characteristics were collected and subjected to backward elimination linear regression to define a model relating patient parameters to the total cardiac volume. This regression model was then used to retrospectively accept or reject an ‘ideal’ donor graft from the library for 3 patients that had undergone heart transplantation. Oversized and undersized grafts were also transplanted to qualitatively analyze virtual transplantation specificity.
Results: The backward elimination approach of the data for the 20 patients rejected the factors of BMI, BSA, sex and both end-systolic and end-diastolic left ventricular measurements from echocardiography. Height and weight were included in the linear regression model yielding an adjusted R-squared of 82.5%. Height and weight showed statistical significance with p-values of 0.005 and 0.02 respectively. The final equation for the linear regression model was TCV = -169.320+ 2.874h + 3.578w ± 73 (h=height, w=weight, TCV= total cardiac volume).
Discussion: With the current regression model, height and weight significantly correlate to total cardiac volume. This regression model and virtual normal heart library provide for the possibility of virtual transplant and size-matching for transplantation. The study and regression model is, however, limited due to a small sample size. Additionally, the lack of volumetric resolution from the MR datasets is a potentially limiting factor. Despite these limitations the virtual library has the potential to be a critical tool for clinical care that will continue to grow as normal hearts are added to the virtual library.
ContributorsSajadi, Susan (Co-author) / Lindquist, Jacob (Co-author) / Frakes, David (Thesis director) / Ryan, Justin (Committee member) / Harrington Bioengineering Program (Contributor) / School of International Letters and Cultures (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
The Honors Thesis involved the use of vertically-aligned, piezoelectric nanowire sensor arrays configured by Dr. Henry A. Sodano and Dr. Aneesh Koka from the University of Florida, in order to acquire acceleration data. Originally, the project was focused on interfacing and calibrating the barium titanate (BaTio3) sensors to measure wall shear stress, a fluid dynamic characteristic. In order to gain an understanding of these novel piezoelectric sensors, the experiments performed by Sodano and Koka were to be investigated, replicated, and results reproduced. After initial trial phases, signals failed to be consistently measured from the sensors and the project's emphasis was re-defined. The outlined goals were 1) to re-design the initial system used for signal acquisition, 2) test the improved signal acquisition system, 3) successfully measure output signals from the BaTiO3 nanowire sensors, and 4) determine the cause for inconsistent signal measurements from the piezoelectric nanawire sensors. Following a detailed review of the previous experimental procedures and the initial signal acquisition system, an improved acquisition system was designed and its expected behavior was tested and verified. Despite the introduction of the improved acquisition system, voltage outputs were unable to be measured as a function of shaker table acceleration. It was impossible to verify the effect of the improved signal acquisition system on the measured BaTiO3 nanowire sensor output. Based on an analysis of data collected using a commercial 3-axis acceleromoeter, it is hypothesized that the BaTiO3 nanowire sensors were broken after the first experimental trial due to an excessively applied force from an external source (i.e. shaker table, improper handling during experimentation, and/or improper handling during transportation).
ContributorsThomas, Jonah (Author) / Frakes, David (Thesis director) / LaBelle, Jeffrey (Contributor) / Barrett, The Honors College (Contributor)
Created2014-05
Description
In this study, the specific goal was to evaluate the effectiveness of utilizing a novel virtual reality software package with a haptic device to practice spine surgery. This spine surgery simulator was commissioned by Barrow Neurological Institute (BNI) and is as yet untested. To test the simulator, an experiment was run in which resident neurosurgeons at Barrow Neurological Institute were asked to perform two “virtual surgeries” with the spine surgical simulator, provide observations on the simulator, and then complete a questionnaire evaluating different aspects of the simulator. The mean questionnaire score across all the neurosurgical residents was found to be 65.5 % ± 9.4 % of the maximum score which suggests that certain aspects of the virtual spine surgical simulator were deemed to be effective by the resident neurosurgeons but that improvements need to be made for the simulator to be fully ready as a teaching and planning tool. As of right now, the simulator is more suited as a training tool instead of a planning tool. Improvements that should be implemented include changing the hardware placement of the haptic device and the computer, minimizing aberrant tactile feedback, and adding anatomical and planning detail to the software to provide a more accurate reflection of spine surgery. It was also suggested that future experiments that evaluate an improved simulator should ensure that participants are trained adequately and have enough time to complete surgical operations to get a fair assessment of the tool.
ContributorsIyer, Sudarshan Rajan (Author) / Frakes, David (Thesis director) / Crawford, Neil (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)
Created2015-05
Description
A specific type of Congenital Heart Defect (CHD) known as Coarctation (narrowing) of the Aorta (CoA) prevails in 10% of all CHD patients resulting in life-threatening conditions. Treatments involve limited medical therapy (i.e PGE1 therapy), but in majority of CoA cases, planned surgical treatments are very common. The surgical approach is dictated by the severity of the coarctation, by which the method of treatments is divided between minimally invasive and extensive invasive procedures. Modern diagnostic procedures allude to many disadvantages making it difficult for clinical practices to properly deliver an optimal form of care. Computational Fluid Dynamics (CFD) technique addresses these issues by providing new forms of diagnostic measures that is non-invasive, inexpensive, and more accurate compared to other evaluative devices. To explore further using the CFD based alternative diagnostic measure, this project aims to validate CFD techniques through in vitro studies that capture the fluid flow in anatomically accurate aortic structures. These studies combine particle image velocimetry and catheterization experimental techniques in order to provide a significant knowledge towards validation of fluid flow simulations.
ContributorsPathangey, Girish (Co-author) / Matheny, Chris (Co-author) / Frakes, David (Thesis director) / Pophal, Stephen (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)
Created2015-05
Description
The ability of cochlear implants (CI) to restore auditory function has advanced significantly in the past decade. Approximately 96,000 people in the United States benefit from these devices, which by the generation and transmission of electrical impulses, enable the brain to perceive sound. But due to the predominantly Western cochlear implant market, current CI characterization primarily focuses on improving the quality of American English. Only recently has research begun to evaluate CI performance using other languages such as Mandarin Chinese, which rely on distinct spectral characteristics not present in English. Mandarin, a tonal language utilizes four, distinct pitch patterns, which when voiced a syllable, conveys different meanings for the same word. This presents a challenge to hearing research as spectral, or frequency based information like pitch is readily acknowledged to be significantly reduced by CI processing algorithms. Thus the present study sought to identify the intelligibility differences for English and Mandarin when processed using current CI strategies. The objective of the study was to pinpoint any notable discrepancies in speech recognition, using voice-coded (vocoded) audio that simulates a CI generated stimuli. This approach allowed 12 normal hearing English speakers, and 9 normal hearing Mandarin listeners to participate in the experiment. The number of frequency channels available and the carrier type of excitation were varied in order to compare their effects on two cases of Mandarin intelligibility: Case 1) word recognition and Case 2) combined word and tone recognition. The results indicated a statistically significant difference between English and Mandarin intelligibility for Condition 1 (8Ch-Sinewave Carrier, p=0.022) given Case 1 and Condition 1 (8Ch-Sinewave Carrier, p=0.001) and Condition 3 (16Ch-Sinewave Carrier, p=0.001) given Case 2. The data suggests that the nature of the carrier type does have an effect on tonal language intelligibility and warrants further research as a design consideration for future cochlear implants.
ContributorsSchiltz, Jessica Hammitt (Author) / Berisha, Visar (Thesis director) / Frakes, David (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)
Created2015-05
Description
Electroencephalogram (EEG) used simultaneously with video monitoring can record detailed patient physiology during a seizure to aid diagnosis. However, current patient monitoring systems typically require a patient to stay in view of a fixed camera limiting their freedom of movement. The goal of this project is to design an automatic patient monitoring system with software to track patient movement in order to increase a patient's mobility. This report discusses the impact of an automatic patient monitoring system and the design steps used to create and test a functional prototype.
ContributorsBui, Robert Truong (Author) / Frakes, David (Thesis director) / Helms Tillery, Stephen (Committee member) / Barrett, The Honors College (Contributor) / Electrical Engineering Program (Contributor)
Created2014-05
Description
Cerebral aneurysms, also known as intracranial aneurysms, are sac-like lesions in the arteries of the brain that can rupture to cause subarachnoid hemorrhaging, damaging and killing brain cells. Metal coil embolization has been traditionally used to occlude and treat cerebral aneurysms to limited success, but polymer embolization has been suggested, because it can provide a greater fraction of occlusion. One such polymer with low cytotoxicity is poly(propylene glycol)diacrylate (PPODA) crosslinked via Michael-type addition with pentaerythritol tetrakis(3-mercaptopropionate) (QT). This study was performed to examine the behavior of PPODA-QT gel in vitro under pulsatile flow emulating physiological conditions. An idealized cerebral aneurysm flow model was designed based on geometries associated with an increase in rupture risk. Pressure was monitored at the apex of the aneurysm dome for varied flow rates and polymer filling fractions of 32.4, 78.2, and 100%. The results indicate that the amount of PPODA-QT deployed into the aneurysm decreases the peak-to-peak oscillation in pressure at the aneurysm wall by an inverse proportion. The 32.4 and 78.2% treatments did not significantly decrease the mean pressure applied to the aneurysm dome, but the 100% treatment greatly reduced it by diverting flow. This study indicates that the maximum filling fraction after swelling of PPODA-QT polymer should be deployed into the aneurysmal sac for treatment.
ContributorsWorkman, Christopher David (Author) / Vernon, Brent (Thesis director) / Frakes, David (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor) / Harrington Bioengineering Program (Contributor)
Created2014-05
Description
This paper summarizes the [1] ideas behind, [2] needs, [3] development, and [4] testing of 3D-printed sensor-stents known as Stentzors. This sensor was successfully developed entirely from scratch, tested, and was found to have an output of 3.2*10-6 volts per RMS pressure in pascals. This paper also recommends further work to render the Stentzor deployable in live subjects, including [1] further design optimization, [2] electrical isolation, [3] wireless data transmission, and [4] testing for aneurysm prevention.
ContributorsMeidinger, Aaron Michael (Author) / LaBelle, Jeffrey (Thesis director) / Frakes, David (Committee member) / Barrett, The Honors College (Contributor) / Mechanical and Aerospace Engineering Program (Contributor)
Created2014-05
Description
Intracranial aneurysms are blood \u2014filled sacs along the blood vessels in the brain. These aneurysms can be particularly dangerous due to difficulty in detection and potential lifethreatening outcome. When these aneurysms are detected, there are few treatment options to prevent rupture, one of which is endovascular stents. By placing a stent across the parent vessel, blood flow can be diverted from the aneurysm. Reduced flow reduces the chance of rupture and promotes clotting within the aneurysm. In this study, hemodynamics in idealized basilar tip aneurysm models were investigated at three flow rates using particle imaging velocimetry (PIV). Two models were created with increasing dome size (4mm vs 6mm), and constant dome-to-neck ratio (3:2) and parent vessel contact angle to represent growing aneurysm. With the pulsatile flow, data is acquired at three separate points in the cardiac cycle. Both of the models were studied untreated, treated with Enterprise stent and treated with Pipeline stent. Enterprise stent was developed mainly for structural support while the Pipeline stent was developed as a flow diverter. Due to target functions of the stents, Enterprise stent is more porous than the Pipeline stent. Hemodynamics were studied using a stereo particle image velocimetry technique. The flow in models was characterized by neck and aneurysmal RMS velocity, neck and aneurysm kinetic energy, cross neck flow. It was found that both of the stents are capable diverting flow. Enterprise reduced aneurysmal RMS velocity in model 1 by 38.7% and in model 2 by 76.2%. Pipeline stent reduced aneurysmal RMS velocity in model 1 by 71.4% and in model 2 by 88.1%. Both reductions are data for 3ml/s at peak systole pulsatile flow. Data shows that the Pipeline stent is better than Enterprise stent at reducing flow to the aneurysm.
ContributorsChung, Hanseung (Author) / Frakes, David (Thesis director) / Caplan, Michael (Committee member) / Babiker, Haithem (Committee member) / Barrett, The Honors College (Contributor) / Economics Program in CLAS (Contributor) / Harrington Bioengineering Program (Contributor)
Created2014-05
Description
Glioblastoma Multiforme (GBM) is an aggressive and deadly form of brain cancer with a median survival time of about a year with treatment. Due to the aggressive nature of these tumors and the tendency of gliomas to follow white matter tracks in the brain, each tumor mass has a unique growth pattern. Consequently it is difficult for neurosurgeons to anticipate where the tumor will spread in the brain, making treatment planning difficult. Archival patient data including MRI scans depicting the progress of tumors have been helpful in developing a model to predict Glioblastoma proliferation, but limited scans per patient make the tumor growth rate difficult to determine. Furthermore, patient treatment between scan points can significantly compound the challenge of accurately predicting the tumor growth. A partnership with Barrow Neurological Institute has allowed murine studies to be conducted in order to closely observe tumor growth and potentially improve the current model to more closely resemble intermittent stages of GBM growth without treatment effects.
ContributorsSnyder, Lena Haley (Author) / Kostelich, Eric (Thesis director) / Frakes, David (Committee member) / Barrett, The Honors College (Contributor) / School of Mathematical and Statistical Sciences (Contributor) / Harrington Bioengineering Program (Contributor)
Created2014-05