arXiv subjects

Yohan Payan

Publications and source records attributed to Yohan Payan.

At least 19 recordsLinked to original sources

arXiv2024

Biomechanical modeling of the human tongue

The tongue is a crucial organ for performing basic biological functions, such as chewing, swallowing and phonation. Understanding how it behaves, its motor control and involvement in the execution of these different tasks is therefore an important issue for the management and therapeutic treatment of pathologies relating to these essential functions so that quality of life can be preserved. This chapter focuses on the biomechanical modeling of this organ, as one of the key steps towards this understanding. Such a modeling will be an important tool to predict and control the functional impact of lingual surgery in the field of computer-assisted medical interventions.

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arXiv2023

Current poisson's ratio values of finite element models are too low to consider soft tissues nearly-incompressible: illustration on the human heel region

Finite element analysis of soft tissues is a well-developed method that allows estimation of mechanical quantities (e.g. stresses, strains). A constitutive law has to be used to characterise the individual tissues. This is complex as biological tissues are generally visco-hyperelastic, anisotropic, and heterogenous. A specific characteristic, their nearly incompressibility, was well reported in the literature, but very little effort has been made to compare volume variations computed by the simulations with in vivo measurements. In the present study, volume changes of the fat pad during controlled indentations of the human heel region were estimated from segmented medical images using digital volume correlation. Indentations were repeated with high and mild intensity normal and shear loads. The experiment was reproduced using finite element modelling with several values of Poisson's ratio for the fat pad, extracted from literature values (from 0.4500 to 0.4999). Estimated fat pad volume changes were compared to the measured ones to assess the best value of Poisson's ratio in each indentation case. The impact of the Poisson's ratio on the Jacobian of the deformation gradient and the volumetric strains was also computed. A single value of Poisson's ratio could not fit all the indentation cases. Estimated volume changes were between 0.9 % - 11.7 % with a Poisson's ratio from 0.4500 to 0.4999. The best fit was obtained with a 0.4900 Poisson's ratio except for the high normal load where a value of 0.4999 resulted in less error. In conclusion, special care should be taken when setting the Poisson's ratio as the resulting estimated deformations may become unrealistic when the value is far from incompressible materials.

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arXiv2023

FIM: A fatigued-injured muscle model based on the sliding filament theory

Skeletal muscle modeling has a vital role in movement studies and the development of therapeutic approaches. In the current study, a Huxley-based model for skeletal muscle is proposed, which demonstrates the impact of impairments in muscle characteristics. This model focuses on three identified ions: H + , inorganic phosphate Pi and Ca 2+. Modifications are made to actin-myosin attachment and detachment rates to study the effects of H + and Pi. Additionally, an activation coefficient is included to represent the role of calcium ions interacting with troponin, highlighting the importance of Ca 2+. It is found that maximum isometric muscle force decreases by 9.5% due to a reduction in pH from 7.4 to 6.5 and by 47.5% in case of the combination of a reduction in pH and an increase of Pi concentration up to 30 mM, respectively. Then the force decline caused by a fall in the active calcium ions is studied. When only 15% of the total calcium in the myofibrillar space is able to interact with troponin, up to 80% force drop is anticipated by the model. The proposed fatigued-injured muscle model is useful to study the effect of various shortening velocities and initial muscletendon lengths on muscle force; in addition, the benefits of the model go beyond predicting the force in different conditions as it can also predict muscle stiffness and power. The power and stiffness decrease by 40% and 6.5%, respectively, due to the pH reduction, and the simultaneous accumulation of H + and Pi leads to a 50% and 18% drop in power and stiffness.

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arXiv2023

Finite element analysis of biomechanical interactions of a subcutaneous suspension suture and human face soft-tissue: a cadaver study

In order to study the local interactions between facial soft-tissues and a Silhouette Soft suspension suture, a CE marked medical device designed for the repositioning of soft tissues in the face and the neck, Finite element simulations were run, in which a model of the suture was embedded in a three-layer Finite Element structure that accounts for the local mechanical organization of human facial soft tissues. A 2D axisymmetric model of the local interactions was designed in ANSYS, in which the geometry of the tissue, the boundary conditions and the applied loadings were considered to locally mimic those of human face soft tissue constrained by the suture in facial tissue repositioning. The Silhouette Soft suture is composed of a knotted thread and sliding cones that are anchored in the tissue. Hence, simulating these interactions requires special attention for an accurate modelling of contact mechanics. As tissue is modelled as a hyper-elastic material, the displacement of the facial soft tissue changes in a nonlinear way with the intensity of stress induced by the suture and the number of the cones. Our simulations show that for a 4-cone suture a displacement of 4.35mm for a 2.0N external loading and of 7.6mm for 4.0N. Increasing the number of cones led to the decrease in the equivalent local strain (around 20%) and stress (around 60%) applied to the tissue. The simulated displacements are in general agreement with experimental observations.

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arXiv2023

Definition and evaluation of a finite element model of the human heel for diabetic foot ulcer prevention under shearing loads

Diabetic foot ulcers are triggered by mechanical loadings applied to the surface of the plantar skin. Strain is considered to play a crucial role in relation to ulcer etiology and can be assessed by Finite Element (FE) modelling. A difficulty in the generation of these models is the choice of the soft tissue material properties. In the literature, many studies attempt to model the behavior of the heel soft tissues by implementing constitutive laws that can differ significantly in terms of mechanical response. Moreover, current FE models lack of proper evaluation techniques that could estimate their ability to simulate realistic strains. In this article, we propose and evaluate a FE model of the human heel for diabetic foot ulcer prevention. Soft tissue constitutive laws are defined through the fitting of experimental stretch-stress curves published in the literature. The model is then evaluated through Digital Volume Correlation (DVC) based on non-rigid 3D Magnetic Resonance Image Registration. The results from FE analysis and DVC show similar strain locations in the fat pad and strain intensities according to the type of applied loads. For additional comparisons, different sets of constitutive models published in the literature are applied into the proposed FE mesh and simulated with the same boundary conditions. In this case, the results in terms of strains show great diversity in locations and intensities, suggesting that more research should be developed to gain insight into the mechanical properties of these tissues.

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arXiv2023

Pressure Ulcers and Dressings: A Strain Sensitivity Analysis of the Boundary Conditions of a Finite Element Model

Recently, a new bi-layer dressing was proposed by Urgo RID to reduce the healing time of pressure ulcers (PU). This dressing was numerically evaluated in previously published work. In the current work, the influence on the maximal shear strains of modelling parameters such as the dressing local geometry, the pressure applied by the gauze inside the wound, the wound deepness, and the mattress stiffness, was assessed. A sensitivity analysis was performed on these four parameters. Among all experiments, the mean maximal Green--Lagrange shear strain was 0.29. The gauze pressure explained 60% of the model response in terms of the volume of tissues under strains of 0.3, while the wound deepness explained 28%. The mattress had a significant, but low impact, whereas the dressing local geometry had no significant impact. As expected, the wound deepness was one of the most influential parameters. The gauze turned out to be more significant than expected. This may be explained by the large range of values chosen for this study. The results should be extended to more subjects, but still suggest that the gauze is a parameter that might not be neglected. Care should also be taken in clinical practice when using gauze that could have either a positive or negative impact on the soft tissues' strains. This may also depend on the wound deepness.

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arXiv2022

In vivo quantification of 3D displacement in sacral soft tissues under compression: Relevance of 2D US-based measurements for pressure ulcer risk assessment

OBJECTIVE: 2D Ultrasound (US) imaging has been recently investigated as a more accessible alternative to 3D Magnetic Resonance Imaging (MRI) for the estimation of soft issue motion under external mechanical loading. In the context of pressure ulcer prevention, the aim of this pilot MRI study was to design an experiment to characterize the sacral soft tissue motion under a controlled mechanical loading. Such an experiment targeted the estimation of the discrepancy between tissue motion assessed using a 2D imaging modality (echography) versus tissue motion assessed using a (reference) 3D imaging modality (MRI).METHODS: One healthy male volunteer participated in the study. An MRI-compatible custom-made setup was designed and used to load the top region of the sacrum with a 3D-printed copy of the US transducer. Five MR images were collected, one in the unloaded and four in the different loaded configurations (400-1200 [g]). Then, a 3D displacement field for each loading configuration was extracted based on the results of digital volume correlation. Tissue motion was separated into the X, Y, Z directions of the MRI coordinate system and the ratios between the out-of-plane and in-plane components were assessed for each voxel of the selected region of interest.RESULTS: Ratios between the out-of-plane and in-plane displacement components were higher than 0.6 for more than half of the voxels in the region of interest for all load cases and higher than 1 for at least quarter of the voxels when loads of 400-800 [g] were used.CONCLUSION: The out-of-ultrasound-plane tissue displacement was not negligible, therefore 2D US imaging should be used with caution for the evaluation of the tissue motion in the sacrum region. The 3D US modality should be further investigated for this application.

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arXiv2022

MR-based quantitative measurement of human soft tissue internal strains for pressure ulcer prevention

Pressure ulcers are a severe disease affecting patients that are bedridden or in a wheelchair bound for long periods of time. These wounds can develop in the deep layers of the skin of specific parts of the body, mostly on heels or sacrum, making them hard to detect in their early stages. Strain levels have been identified as a direct danger indicator for triggering pressure ulcers. Prevention could be possible with the implementation of subject-specific Finite Element (FE) models. However, generation and validation of such FE models is a complex task, and the current implemented techniques offer only a partial solution of the entire problem considering only external displacements and pressures, or cadaveric samples. In this paper, we propose an in vivo solution based on the 3D non-rigid registration between two Magnetic Resonance (MR) images, one in an unloaded configuration and the other deformed by means of a plate or an indenter. From the results of the image registration, the displacement field and subsequent strain maps for the soft tissues were computed. An extensive study, considering different cases (on heel pad and sacrum regions) was performed to evaluate the reproducibility and accuracy of the results obtained with this methodology.The implemented technique can give insight for several applications. It adds a useful tool for better understanding the propagation of deformations in the heel soft tissues that could generate pressure ulcers. This methodology can be used to obtain data on the material properties of the soft tissues to define constitutive laws for FE simulations and finally it offers a promising technique for validating FE models.

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arXiv2022

Biomechanical Lower Limb Model to Predict Patellar Position Alteration after Medial Open Wedge High Tibial Osteotomy

Medial open-wedge high tibial osteotomy is a surgical treatment for patients with a varus deformity and early-stage medial knee osteoarthritis. Observations suggest that this surgery can negatively affect the patellofemoral joint and change the patellofemoral kinematics. However, what causes these effects and how the correction angle can change the surgery's impact on the patellofemoral joint has not been investigated before. The objective of this study was to develop a biomechanical model that can predict the surgery's impact on the patellar position and find the correlation between the opening angles and the patellar position after the surgery. A combined finite element and multibody model of the lower limb was developed. The model's capabilities for predicting the patellofemoral kinematics were evaluated by performing a passive deep flexion simulation of the native knee and comparing the outcomes with magnetic resonance images of the study subject at various flexion angles. The model at a fixed knee flexion angle was then used to simulate the high tibial osteotomy surgery virtually. The results showed a correlation between the wedge opening angles and the patellar position in various degrees of freedom. These results indicate that larger wedge openings result in increased values of patellar distalization, lateral patellar shift, patellar rotation, and patellar internal tilt. The developed model in this study can be used in future studies to monitor the stress distribution on the patellar cartilage and connecting tissues to investigate their relationship with observations of pain and cartilage injury due to post-operative altered patellar kinematics.

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arXiv2022

Measurement and Analysis of Lobar Lung Deformation After a Change of Patient Position During Video-Assisted Thoracoscopic Surgery

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical technique for the diagnosis and treatment of early-stage lung cancer. During VATS, large lung deformation occurs as a result of a change of patient position and a pneumothorax (lung deflation), which hinders the intraoperative localization of pulmonary nodules. Modeling lung deformation during VATS for surgical navigation is desirable, but the mechanisms causing such deformation are yet not well-understood. In this study, we estimate, quantify and analyze the lung deformation occurring after a change of patient position during VATS. We used deformable image registration to estimate the lung deformation between a preoperative CT (in supine position) and an intraoperative CBCT (in lateral decubitus position) of six VATS clinical cases. We accounted for sliding motion between lobes and against the thoracic wall and obtained consistently low average target registration errors (under 1 mm). We observed large lung displacement (up to 40 mm); considerable sliding motion between lobes and against the thoracic wall (up to 30 mm); and localized volume changes indicating deformation. These findings demonstrate the complexity of the change of patient position phenomenon, which should necessarily be taken into account to model lung deformation for intraoperative guidance during VATS.

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arXiv2021

MR-compatible loading device for assessment of heel pad internal tissue displacements under shearing load

In the last decade, the role of shearing loads has been increasingly suspected to play a determinant impact in the formation of deep pressure ulcers. In vivo observations of such deformations are complex to obtain. Previous studies only provide global measurements of such deformations without getting the quantitative values of the loads that generate these deformations. To study the role that shearing loads have in the aetiology of heel pressure ulcers, an MR-compatible device for the application of shearing and normal loads was designed. Magnetic resonance imaging is a key feature that allows to monitor deformations of soft tissues after loading in a non-invasive way. Measuring applied forces in an MR-environment is challenging due to the impossibility to use magnetic materials. In our device, forces are applied through the compression of springs made in polylactide. Shearing and normal loads were applied on the plantar skin of the human heel by means of an indenting plate while acquiring MR images. The device materials did not introduce any imaging artifact and allowed for high quality MR measurements permitting to identify the deformation of the internal components of the heel. The obtained subject-specific results are an original data set that can be used in validations for Finite Element analysis and therefore contribute to a better understanding of the factors involved in pressure ulcer development.

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arXiv2020

Biomechanical monitoring and machine learning for the detection of lying postures

Background: Pressure mapping technology has been adapted to monitor over prolonged periods to evaluate pressure ulcer risk in individuals during extended lying postures. However, temporal pressure distribution signals are not currently used to identify posture or mobility. The present study was designed to examine the potential of an automated approach for the detection of a range of static lying postures and corresponding transitions between postures.Methods: Healthy subjects (n = 19) adopted a range of sagittal and lateral lying postures. Parameters reflecting both the interactions at the support surface and body movements were continuously monitored. Subsequently, the derivative of each signal was examined to identify transitions between postures. Three machine learning algorithms, namely Na{\"i}ve-Bayes, k-Nearest Neighbors and Support Vector Machine classifiers, were assessed to predict a range of static postures, established with a training model (n = 9) and validated with new input from test data (n = 10).Findings: Results showed that the derivative signals provided a means to detect transitions between postures, with actimetry providing the most distinct signal perturbations. The accuracy in predicting the range of postures from new test data ranged between 82%--100%, 70%--98% and 69%--100% for Na{\"i}ve-Bayes, k-Nearest Neighbors and Support Vector Machine classifiers, respectively.Interpretation: The present study demonstrated that detection of both static postures and their corresponding transitions was achieved by combining machine learning algorithms with robust parameters from two monitoring systems. This approach has the potential to provide reliable indicators of posture and mobility, to support personalised pressure ulcer prevention strategies.

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arXiv2018

A biomechanical breast model evaluated with respect to MRI data collected in three different positions

Background: Mammography is a specific type of breast imaging that uses low-dose X-rays to detect cancer in early stage. During the exam, the women breast is compressed between two plates in order to even out the breast thickness and to spread out the soft tissues. This technique improves exam quality but can be uncomfortable for the patient. The perceived discomfort can be assessed by the means of a breast biomechanical model. Alternative breast compression techniques may be computationally investigated trough finite elements simulations.Methods: The aim of this work is to develop and evaluate a new biomechanical Finite Element (FE) breast model. The complex breast anatomy is considered including adipose and glandular tissues, muscle, skin, suspensory ligaments and pectoral fascias. Material hyper-elasticity is modeled using the Neo-Hookean material models. The stress-free breast geometry and subject-specific constitutive models are derived using tissues deformations measurements from MR images.Findings: The breast geometry in three breast configurations were computed using the breast stress-free geometry together with the estimated set of equivalent Young's modulus (Ebreast_r=0.3 kPa, Ebreast_l=0.2 kPa, Eskin=4 kPa, Efascia=120 kPa). The Hausdorff distance between estimated and measured breast geometries for prone, supine and supine tilted configurations is equal to 2.17 mm, 1.72mm and 5.90mm respectively.Interpretation: A subject-specific breast model allows a better characterization of breast mechanics. However, the model presents some limitations when estimating the supine tilted breast configuration. The results show clearly the difficulties to characterize soft tissues mechanics at large strain ranges with Neo-Hookean material models.

physics.med-ph↗

arXiv2018

Simulation of breast compression using a new biomechanical model

Mammography is currently the primary imaging modality for breast cancer screening and plays an important role in cancer diagnostics. A standard mammographic image acquisition always includes the compression of the breast prior x-ray exposure. The breast is compressed between two plates (the image receptor and the compression paddle) until a nearly uniform breast thickness is obtained. The breast flattening improves diagnostic image quality 1 and reduces the absorbed dose 2. However, this technique can also be a source of discomfort and might deter some women from attending breast screening by mammography 3,4. Therefore, the characterization of the pain perceived during breast compression is of potential interest to compare different compression approaches. The aim of this work is to develop simulation tools enabling the characterization of existing breast compression techniques in terms of patient comfort, dose delivered to the patient and resulting image quality. A 3D biomechanical model of the breast was developed providing physics-based predictions of tissue motion and internal stress and strain intensity. The internal stress and strain intensity are assumed to be directly correlated with the patient discomfort. The resulting compressed breast model is integrated in an image simulation framework to assess both image quality and average glandular dose. We present the results of compression simulations on two breast geometries, under different compression paddles (flex or rigid).

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arXiv2018

Breast biomecanical modeling for compression optimization in digital breast tomosynthesis

Mammography is a specific type of breast imaging that uses low-dose X-rays to detect cancer in early stage. During the exam, the women breast is compressed between two plates until a nearly uniform breast thickness is obtained. This technique improves image quality and reduces dose but can also be the source of discomfort and sometimes pain for the patient. Therefore, alternative techniques allowing reduced breast compression is of potential interest. The aim of this work is to develop a 3D biomechanical Finite Element (FE) breast model in order to analyze various breast compression strategies and their impact on image quality and radiation dose. Large breast deformations are simulated using this FE model with ANSYS software. A particular attention is granted to the computation of the residual stress in the model due to gravity and boundary conditions (thorax anatomy, position of the patient inside the MRI machine). Previously developed biomechanical breast models use a simplified breast anatomy by modeling adipose and fibroglandular tissues only (Rajagopal et al. in Wiley Interdiscip Rev: Syst Biol Med 2:293--304, 2010). However, breast reconstruction surgery has proven the importance of suspensory ligaments and breast fasciae on breast mechanics (Lockwood in Plast Reconstr Surg 103:1411--1420, 1999). We are therefore consider using a more realistic breast anatomy by including skin, muscles, and suspensory ligaments. The breast tissues are modeled as neo-Hookean materials. A physical correct modeling of the breast requires the knowledge of the stress-free breast configuration. Here, this undeformed shape (i.e., without any residual stress) is computed using the prediction--correction iterative scheme proposed by Eiben et al. (Ann of Biomed Eng 44:154--173, 2016). The unloading procedure uses the breast configuration in prone and supine position in order to find a unique displacement vector field induced by gravitational forces. The 3D breast geometry is reconstructed from MRI images that are segmented (Yushkevich et al. in Neuroimage 31:1116--1128, 2006) to differentiate the four main tissue types. The breast volume is discretized with a hexa-dominant FE meshing tool as a unique volume. Finally, the model is evaluated by comparing the estimated breast deformations under gravity load with the experimental ones measured in three body positions: prone, supine, and oblique supine.

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arXiv2018

Personalized modeling for real-time pressure ulcer prevention in sitting posture

, Ischial pressure ulcer is an important risk for every paraplegic person and a major public health issue. Pressure ulcers appear following excessive compression of buttock's soft tissues by bony structures, and particularly in ischial and sacral bones. Current prevention techniques are mainly based on daily skin inspection to spot red patches or injuries. Nevertheless, most pressure ulcers occur internally and are difficult to detect early. Estimating internal strains within soft tissues could help to evaluate the risk of pressure ulcer. A subject-specific biomechanical model could be used to assess internal strains from measured skin surface pressures. However, a realistic 3D non-linear Finite Element buttock model, with different layers of tissue materials for skin, fat and muscles, requires somewhere between minutes and hours to compute, therefore forbidding its use in a real-time daily prevention context. In this article, we propose to optimize these computations by using a reduced order modeling technique (ROM) based on proper orthogonal decompositions of the pressure and strain fields coupled with a machine learning method. ROM allows strains to be evaluated inside the model interactively (i.e. in less than a second) for any pressure field measured below the buttocks. In our case, with only 19 modes of variation of pressure patterns, an error divergence of one percent is observed compared to the full scale simulation for evaluating the strain field. This reduced model could therefore be the first step towards interactive pressure ulcer prevention in a daily setup. Highlights-Buttocks biomechanical modelling,-Reduced order model,-Daily pressure ulcer prevention.

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arXiv2018

Reduction of Prolonged Excessive Pressure in Seated Persons With Paraplegia Using Wireless Lingual Tactile Feedback: A Randomized Controlled Trial

Pressure ulcers (PU) are known to be a high-cost disease with a risk of severe morbidity. This work evaluates a new clinical strategy based on an innovative medical device (Tongue Display Unit-TDU) that implements perceptive supplementation in order to reduce prolonged excessive pressure, recognized as one of the main causes of PU. A randomized, controlled, parallel-group trial was carried out with 12 subjects with spinal cord injuries (SCI). Subjects were assigned to the control (without TDU, n=6) or intervention (with TDU, n=5) group. Each subject took part in two sessions, during which the subject, seated on a pressure map sensor, watched a movie for one hour. The TDU was activated during the second session of the intervention group. Intention-to-treat analysis showed that the improvement in adequate weight shifting between the two sessions was higher in the intervention group (0.84 [0.24; 0.89]) than in the control group (0.01 [-0.01; 0.09]; p=0.004) and that the ratio of prolonged excessive pressure between the two sessions was lower in the intervention group (0.74 [0.37; 1.92]) than in the control group (1.72 [1.32; 2.56]; p=0.06). The pressure map sensor was evaluated as being convenient for use in daily life, however this was not the case for the TDU. This work shows that persons with SCI could benefit from a system based on perceptive supplementation that alerts and guides the user on how to adapt their posture in order to reduce prolonged excessive pressure, one of the main causes of PU.

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arXiv2014

Smart Diabetic Socks: Embedded device for diabetic foot prevention

1) Objectives Most foot ulcers are the consequence of a trauma (repetitive high stress, ill-fitting footwear, or an object inside the shoe) associated to diabetes. They are often followed by amputation and shorten life expectancy. This paper describes the prototype of the Smart Diabetic Socks that has been developed in the context of the French ANR TecSan project. The objective is to prevent pressure foot ulcers for diabetic persons. 2) Material and methods A fully wireless, customizable and washable "smart sock" has been designed. It is made of a textile which fibers are knitted in a way they provide measurements of the pressure exerted under and all around the foot in real-life conditions. This device is coupled with a subject-specific Finite Element foot model that simulates the internal strains within the soft tissues of the foot. 3) Results A number of derived stress indicators can be computed based on that analysis, such as the accumulated stress dose, high internal strains or peak pressures near bony prominences during gait. In case of risks for pressure ulcer, an alert is sent to the person and/or to the clinician. A watch, a smart-phone or a distant laptop can be used for providing such alert.

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