CMBES Proceedings

Modeling Blood Flow in Microcirculation: An In Vitro Study Using Capillary Microchannels

Maya Salame, Marianne Fenech — Fri, 23 May 2025 00:00:00 +0000

Microcirculatory blood flow is influenced by complex non-Newtonian properties, including shear-thinning behavior and the presence of a cell-free layer (CFL), a plasma-rich zone near vessel walls caused by hydrodynamic forces. Existing rheological models, such as Newtonian, Power Law, and Carreau, capture certain aspects of blood properties but fail to fully describe its dynamic flow characteristics. This study introduces the Core-Plasma Model, which combines Newtonian and non-Newtonian elements to represent the RBC core and CFL as a two-phase system. Evaluation across microchannel sizes and hematocrits highlights the Core-Plasma Model’s superiority in
capturing velocity profiles and shear dynamics, particularly in channels with larger CFLs. The Core-Plasma Model stands out as a promising tool for advancing microscale hemodynamic predictions and understanding microvascular flow.

Development and Validation of a Textile-Based Pressure Sensing System for Lower- Limb Prosthetic Sockets

Thierry Dugas, Calvin C Ngan, Jan Andrysek — Fri, 23 May 2025 00:00:00 +0000

Ill-fitting prosthetic sockets can lead to health complications and gait abnormalities for lower-limb prosthesis users [1]. To avoid these issues during limb growth, children require socket replacements every 1 to 2 years [2]. The exact frequency depends on the patient’s growth rate, making timely replacements challenging during rapid limb growth, particularly for individuals living far from a prosthetics clinic. Additionally, socket shape modifications during and after the fabrication process depend on subjective patient feedback, which can be challenging to obtain from children. Pressure sensors have been used in research to study limb-socket interfaces but remain largely impractical for clinical socket fit assessments and in-community socket fit monitoring [1], [3]. Through a collaboration with Myant Inc. (Toronto, Canada), this project developed textile-based pressure sensors integrated into a prosthetic sock format to address these challenges.

The first step in the development of this system is the selection of the optimal pressure-sensing textile material for the fabrication of the prosthetic sock and the sensors. Myant fabricated six textile pad samples made from different materials, each containing one textile-based pressure sensor. The sensor performance was evaluated using a universal testing machine (ZwickRoell, Ulm, Germany) against a validated commercially available point sensor (SingleTact, Glasgow, UK) [1]. Sensitivity was first confirmed by applying incremental loads of 2 N within a 40 N range and ensuring that the sensor readings increased relative to the applied force. The sensor repeatability was then evaluated by applying five repetitions of eight forces within a 40 N range in a randomized order. The percentage coefficient of variation is used to express the results from this test. Therefore, lower values indicate higher repeatability. Finally, loads of 10 N, 25 N, and 40 N were applied on the sensors for 10 minutes each to assess drift (i.e. measurement consistency over time). The repeatability and drift test sequences were repeated five times on each sensor.

The pad with sensitivity, repeatability, and drift equivalent to or greater than the SingleTact was selected as the optimal material for the sock fabrication. The optimal pad and the SingleTact showed average repeatability of 0.68 ± 0.05% and 0.98 ± 0.25%, respectively. The average drift for the optimal pad and the SingleTact was 2.56 ± 0.72% and 2.43 ± 1.78%, respectively. These results are comparable to those of other commercially available point sensors [4], [5]. Following this evaluation, Myant integrated 144 textile-based pressure sensors into a prosthetic sock format. The next step is to recruit three prosthesis users to validate the performance and comfort of the system during weight-shifting and walking.

The textile composition of the system will enable comfortable and seamless sensor integration at the limb-socket interface. The sock form factor will allow a high level of usability, enabling pressure monitoring in clinical settings or during daily activities [3]. Continuous socket fit data from free-living environments can help prosthetists intervene earlier to replace sockets, enable remote prosthetic care, and supplement subjective feedback for socket adjustments. The proposed system, therefore, has the potential to address the unique needs of pediatric prosthesis users.

Leveraging Existing Vital Signs Monitors for Early Warning Score Implementation

Liane Ladouceur, Danny Yang — Fri, 23 May 2025 00:00:00 +0000

In 2024, University Health Network (UHN) made the decision to implement National Early Warning Score 2 (NEWS2) in all inpatient units, emergency departments, and some outpatient areas. NEWS2 leverages vital signs measurements to identify risk of patient deterioration (Royal College of Physicians, 2017). This Quality Improvement initiative was aimed at achieving zero serious safety events related to failure to recognize patient deterioration, and to standardize escalation of care. As a high-impact project, implementing NEWS2 predictably presented considerable logistical challenges, especially for an extensive hospital network such as UHN. However, it also presented a number of novel challenges for Medical En-gineering, in maintaining interoperability of medical devices and providing support post-implementation.

For NEWS2 rollout, Medical Engineering’s role was initially limited to determining the feasibility of score calculation using the existing patient monitoring fleet. However, as logistical and workflow challenges arose, the team’s role grew to support evolving project requirements. Crucially, the Medical Engineering team investigated compatibility of changes with the existing workflows and advocated for greater change management in clinical areas most impacted by the project. Beyond this, the team leveraged existing vendor relationships to negotiate changes to software at no cost, demonstrating the critical value of Medical Engineering in large-scale projects.

Post-implementation support of the vital signs monitors (VSMs) fleet that enables NEWS2 has present-ed more novel challenges. Notably, for UHN’s VSM fleet, deploying a configuration change requires Med-ical Engineering staff to manually locate and upload a file to each VSM. With over 900 VSMs, any small update becomes a huge work effort requiring risk-benefit analyses and subsequent rollout planning. This was the case with some clinical requests for features post-go-live, and unexpected updates to the hospi-tal’s IT systems in late 2024, all of which required configuration changes. Additionally, there is a constant need for more EMR-connected VSMs as programs expand and awareness of NEWS2 value grows. This has raised the need for Medical Engineering to standardize the process for units to request and pay for new VSMs.

The rollout of NEWS2 at UHN has demonstrated the importance of engaging Medical Engineering teams early, and has reinforced an important ongoing role that Medical Engineering departments have for interoperability in healthcare technology. A key takeaway from this project has been the importance of Medical Engineering acting as a leader for clinically-initiated projects that include device-related implementations, and pushing to have stronger voices at the project leadership level when planning hospital wide projects. Further, this case study hopes to emphasize the changing need for post-implementation support from Medical Engineering.

Leveraging 3D Printing for a Low-Cost Loupe-Mounted Camera in Surgical Education

Tony Jiang — Fri, 23 May 2025 00:00:00 +0000

Background: Cleft palate surgery presents unique challenges, as it requires intricate work within confined spaces. These spaces are often obscured from the view of students and observers, limiting effective intraopera-tive education. The use of a camera to capture the surgeon’s perspective can significantly enhance both in-traoperative and post-operative teaching by providing a clear and direct view of the surgical field. However, existing solutions pose several challenges. Non-specialized action cameras are cumbersome to mount and oper-ate. While commercially available surgical loupe cameras are expensive, thus limiting accessibility.

Methods: The proposed solution employs an off the shelf, 4K 30fps, M12 mount camera, secured to the head-light mount of surgical loupes using a custom-designed, 3D-printed adjustable bracket. This ensures precise alignment with the surgeon's line of sight and compatibility with various loupe manufacturers and configura-tions. An additional Bluetooth foot pedal enables sterile hands-free operation, while a wireless video transceiver streams real-time video to external displays.

Results: The camera was tested by two plastic surgeons and delivered satisfactory results. The camera costs $84 CAD in parts and materials, weighs 28 grams, and provides 8.4 hours of battery life if streaming wirelessly in 4K at 30 fps.

Conclusion: This case highlights the potential of 3D printing to create highly customizable, low-cost solutions for addressing challenges in clinical medicine. With further promotion and awareness of 3D printing as a trans-formative technology, clinicians can be empowered to identify key areas for innovation and foster collaboration with engineers, driving the development of novel and effective tools for medical practice.

Adoption of an In-House Calibration Program for Biomedical Test Equipment

Scott Olsen, Alanna Hinchey, Mubshra Arshad , Nilay Lad — Fri, 23 May 2025 00:00:00 +0000

This report describes the results of a capstone project undertaken by students in the Bachelor of Technology program at the Northern Alberta Institute of Technology (NAIT). The sponsor of this project was the Northwest Territories Health and Social Services Authority (NTHSSA) Biomedical Engineering Department. The purpose of this project was to develop a business case to inform the sponsor of the viability of adopting an in-house calibration program for biomedical test equipment. Phase one involved a pan-Canadian survey of the Biomedical and Clinical Engineering Departments, a cost and benefit analysis, and a review of the current calibration and operation practices.
Three recommendations from the business case were presented to the project sponsor for review. The recommendations focus on addressing the availability of test equipment, reducing shipping delays, potential cost savings, and improved training and development of in-house expertise for biomedical engineering technologists. The final selection of the business case recommendation and implementation of that recommendation will be completed in phase two of this project. Conclusions and discussion from phase two of the capstone project included in this article will provide a protocol for the development of an in-house calibration program for biomedical test equipment. Further adoption of this protocol may be considered by in-house biomedical and clinical engineering departments across Canada.
The findings will be showcased in April 2025 at the NAIT Bachelor of Technology Capstone Project Showcase and are anticipated to contribute to ongoing discussions on calibration practices within biomedical engineering.

Automatic Hand Hygiene Monitoring Systems for Infection Prevention in Healthcare Settings: A Short Review of Literature

Ali Barzegar Khanghah, Shaghayegh Chavoshian, Atena Roshan Fekr — Fri, 23 May 2025 00:00:00 +0000

Healthcare-associated infections (HAIs) remain a

global challenge, with significant morbidity, mortality, and eco-

nomic implications. Improving Hand Hygiene (HH) compliance

is one of the most effective strategies for reducing HAIs. How-

ever, compliance rates remain suboptimal. Electronic Hand Hy-

giene Monitoring Systems (EHHMS) have emerged as a prom-

ising solution to address this challenge by providing real-time

feedback and promoting behavior change among healthcare

workers. This narrative review examines the methodologies

used in EHHMS, classifying them into four key categories: rule-

based systems, signal processing, machine learning, and data fu-

sion approaches. Rule-based systems, though widely used, are

limited by their static nature and inability to adapt to dynamic

healthcare environments. Signal processing methods focus on

localizing hand hygiene events, while machine learning (ML)

approaches mostly focused on HH quality. Data fusion tech-

niques improve monitoring by integrating inputs from multiple

sensors. Despite their potential, EHHMS face challenges in ac-

curacy, intrusiveness, and integration into clinical workflows.

This review highlights the potential role of ML in overcoming

these limitations. By addressing current barriers, EHHMS can

play a crucial role in enhancing HH practices and reducing HAI

rates, ultimately improving patient safety and healthcare qual-

ity.

Slip Resistance Comparison of Footwear on Two Flooring Types Using Mechanical Testing Approach

Shaghayegh Chavoshian, Chantal Gauvin , Atena Roshan Fekr — Fri, 23 May 2025 00:00:00 +0000

Slips and falls are major safety concerns across various populations, including healthcare workers, kitchen staff, warehouse employees, etc. Footwear type plays a crucial role in preventing slip-related falls. A high Coefficient of Friction (COF) between footwear soles and flooring surfaces is essential to maintain balance and stability. This study evaluated the COF of 12 commonly available footwear in the market on two types of floorings — quarry tile and Majorca Fog polished rectified porcelain (MFP) — under dry and wet conditions. According to the ASTM F3445-24 threshold of 0.4, all footwear was safe on dry surfaces for both types of tiles, and on wet quarry tiles, except footwear 2, but unsafe on wet MFP tiles. Statistical analysis showed that COF values for quarry tiles were significantly lower under dry conditions compared to MFP tiles. However, under wet conditions, the COF values for the quarry tile increased significantly, exceeding that of the MFP tile. These findings were proof of concept for ongoing efforts to design safer footwear considering footwear characteristics such as outsole material, and tread patterns that may influence slipping risk.

The Role of Autonomy in Electronic Hand Hygiene Monitoring Systems

Ali Barzegar Khanghah, Shay Chavoshian , Geoff Fernie , Atena Roshan Fekr — Fri, 23 May 2025 00:00:00 +0000

Proper hand hygiene (HH) is one of the most effective measures to prevent HAIs by minimizing the transmis-sion of pathogens. Reminder prompts have been demonstrated to play a significant role in improving HH compliance among healthcare workers (HCWs). Pre-vious studies have explored the efficacy of electronic hand hygiene monitoring systems (EHHMS) by enforc-ing uniform prompting protocols across all users. However, little is known about the effects of allowing HCWs to choose whether to activate or deactivate the prompting feature. This study investigates the impact of voluntary prompt deactivation on HH compliance rates in a Toronto hospital’s respiratory unit. A cohort of 23 HCWs was equipped with EHHMS badges and given the option to activate or deactivate the prompt. The badges delivered real-time prompting via discrete vibrations when HH is required upon entering or exiting patient areas. Over a 6-month period, their HH compliance rates were monitored. Compliance data were categorized into periods when the prompt was activated (Prompt-On) and deactivated (Prompt-Off), allowing for analysis of individual variability in prompt usage, as participants switched between activating and deactivat-ing the prompt at different times. The system automati-cally collected compliance data, which were then ana-lyzed using Wilcoxon signed-rank tests due to the non-normal distribution of the two groups. A total of 58,060 HH opportunities were recorded. The study revealed a significant difference in HH com-pliance rates between the Prompt-On and Prompt-Off groups (P<0.0001). Participants in the Prompt-On group demonstrated a mean compliance rate of 85% ± 16%, significantly higher than the Prompt-Off group, which had a mean compliance rate of 58% ± 25%, sug-gesting the critical role of real-time feedback in main-taining HH adherence. The findings of this study align with prior research emphasizing the importance of reminder prompts in enhancing HH compliance. Unlike previous studies, which applied uniform prompting protocols, this investi-gation highlights the detrimental effects of allowing HCWs to opt out of prompting [3]. The autonomy to deactivate prompts appears to undermine the overall effectiveness of EHHMS, leading to lower compliance rates and potentially increasing the risk of HAIs.

Three-Dimensional Ultrasound Synovial Blood Flow Volume Assessment in Thumb Osteoarthritis Patients

Fri, 23 May 2025 00:00:00 +0000

The basal thumb joint is commonly affected by osteoarthri-tis, which impacts hand function. Inflammation and changes in blood flow are known to be involved in the disease process and progression. The role of inflammation and blood flow in thumb osteoarthritis is not fully understood. Ultrasound imaging is used to assess the soft tissue features of the dis-ease but remains limited to two-dimensional visualization. The development of three-dimensional ultrasound for thumb osteoarthritis assessment provides comprehensive visuali-zation and volumetric measures. This study investigated three-dimensional ultrasound measures and their associa-tions with existing imaging and functional measures of thumb osteoarthritis. Our results showed lower pain and higher functional scores in thumb OA patients with synovial blood flow volumes using Superb microvascular imaging. This work demonstrated differences in pain and functional measures, while radiographic grading of patients with and without synovial blood flow was similar. These quantitative measures of synovial blood flow enable assessment and monitoring of vascular changes within the joint. Further investigation into the three-dimensional blood flow volume measures over time can improve the understanding of blood flow changes and their role in disease progression.

Regulatory Ambiguities in the Classification of Rehabilitation Equipment as Medical Devices in Canada

Susanne Tiraei — Fri, 23 May 2025 00:00:00 +0000

Rehabilitation devices often used for therapeutic purposes, present a regulatory challenge as they blur the lines between medical and non-medical devices. Many of the devices used in rehabilitation settings, including hospital rehab centers, meet the broad definition of medical devices under Health Canada's Medical Device Regulations. However, these devices often do not conform to the CSA 60601-1 standard, which outlines specific safety and performance requirements for electrical medical equipment. Additionally, the manufacturers typically so not intend for them to be used in this manner, creating ambiguity regarding their classification The absence of uniform adherence to this standard leads to a regulatory ambiguity, particular-ly as provincial jurisdictions hold discretion over whether to apply the CSA 60601-1 standard within their healthcare facilities.

While Health Canada’s MDR encompass a wide range of rehabilitation equipment, including devices used for physical therapy or rehabilitation exercises, the application of CSA 60601-1 is not universally mandated. This creates inconsistencies in the safety and regulatory oversight of such devices across differ-ent healthcare settings. Provincial authorities’ varying decisions on the application of this standard result in a lack of standardization in terms of compliance, leaving rehabilitation equipment subject to differing levels of safety scrutiny depending on regional policies.

The need for a more consistent regulatory approach becomes evident when considering the potential risks associated with the use of non-compliant equipment in clinical environments. A standardized framework for classifying rehabilitation devices, which includes clear guidelines for the application of CSA 60601-1, could provide clarity to manufacturers, healthcare providers, and regulatory bodies. Establishing such a framework would ensure that all devices falling within the definition of medical devices under the MDR meet a consistent standard for safety and performance, regardless of provincial jurisdiction.

Preliminary Characterization of Transradial Prosthesis Alignment

Katrina Meng, Calvin C Ngan, Jan Andrysek — Fri, 23 May 2025 00:00:00 +0000

A transradial (TR), or below elbow, prosthetic device is an artificial limb designed to replace the function of a missing upper extremity. However, there are several barriers to accessing quality prosthetic care, including a scarcity of highly trained prosthetists, long turnaround times, and material-intensive manufacturing processes[1]. Recent advancements have shown that digital technologies, such as CAD software and 3D printing have the potential to provide better-fitting devices while reducing clinician resources[2,3]. Despite these advancements, no methods for digitally designing TR prostheses have been fully integrated into clinical practice. The lack of literature on conventional TR prosthesis design makes it especially difficult to translate into digital workflows. The alignment, described as the precise position of the prosthetic components relative to the socket and arm, is critical for proper fit and function[4]. However, conventional alignment practices remain largely subjective, relying on the expertise of each prosthetist. This research aims to leverage digital technologies, such as 3D scanning, to quantify conventional alignment practices and translate these insights into data-driven digital workflows.

This study addresses these challenges through two objectives. First, semi-structured interviews with prosthetists reveals that alignment strategies often involve a combination of visual approximations and quantitative tools. Guiding lines are drawn on sockets to approximate wrist placement, supplemented by measurements such as the distance from the olecranon to the thumb tip and tracings of the contralateral limb. Common adjustments include medial wrist positioning and incorporating approximately five degrees of flexion and adduction to improve control. Prosthetists emphasized the relationship between function, cosmesis, and body symmetry, noting that deviations are highly case-specific and informed by collaborative discussions with patients. Second, imaging protocols were developed to quantify alignment using 3D scanning. This involves exploring two potential methods of measuring alignment for their relevance and repeatability: a global reference, which positions the prosthetic wrist in relation to a constant such as landmarks on the body or the contralateral limb; and a system reference, which aligns components using a joint and link biomechanical model. Preliminary testing demonstrated the feasibility of these methods for examining measurable trends. In one case study, the prosthetic limb was 19 mm longer than the contralateral limb, contrary to prosthetist expectations of maintaining body symmetry. Angular measurements indicated prosthetic adduction and pronation between 1-12 degrees, aligning with prosthetist reported practices.

This work establishes a foundation for ongoing analysis with a larger sample size, which will refine statistical models correlating measured alignment patterns with qualitative prosthetist input. By bridging conventional and digital approaches, this research provides quantitative insights which may be used for education and the development of data-driven digital workflows, ultimately improving the efficiency and effectiveness of TR prosthesis design.

Validation of Centre of Pressure Trajectory from a Portable Gait System

Kasra Moradi, Chris McGibbon — Fri, 23 May 2025 00:00:00 +0000

In New Brunswick, an average of eight seniors are admit-ted to hospital each day for a fall-related injury, costing the New Brunswick health care system almost $250M per year and representing the largest single contributor to injury-related health care costs in the province. Although interna-tional fall-risk assessment guidelines exist for identifying seniors at risk of falls, they are subjective and rarely employ technology. StepScan™ (Charlottetown PE) pressure sensi-tive tiles offer a potential solution for integrating portable technology into routine falls-risk assessment that can be performed in community clinics or the home; however, have not yet been subjected to head-to-head comparison with an accepted “gold standard” measurement system, for suitable tests of mobility and balance. The aims of this study were to fill this gap in knowledge. Fifteen healthy participants per-formed quiet standing, 5-times sit-to-stand task, and a sur-rogate test for walking – the step-up/step/down task, on the StepScan™ pressure tiles mounted on top of in-floor, rail mounted AMTI (Amherst MA) force plates in a motion analysis laboratory. Simultaneous registered trajectories of the centre of pressure (CoP) during standing and stepping tasks were compared for accuracy in global position (ran-dom error + bias) and relative position (random error only). Slow tasks such as standing had high bias (>20mm) but very good accuracy (1-2mm). Moderate speed tasks such as the 5-times sit-to-stand also had high bias (>20mm) but did not have acceptable accuracy (>15mm). Rapid stepping tasks had very low bias (<2mm) and acceptable accuracy (4-7mm). We conclude that StepScan™ CoP measurements have excel-lent precision for static balance assessment, and acceptable precision and trueness during a rapid stepping task, but limitations may exist for motor tasks such as the sit-to-stand. The variable bias observed for the different standing and stepping tasks is highly curious and requires more study.

Use of graph theory for biomimetic microchannel network blood flow analysis

Jesus Ramon Avila Trigueros, Marianne Fenech — Fri, 23 May 2025 00:00:00 +0000

This paper presents a novel application of graph theory to represent and analyze microcirculatory networks, specifical-ly a biomimetic microfluidic chip designed to mimic the human retina. Utilizing experimental data obtained via high-speed video microscopy and Particle Image Veloci-metry (PIV), the study develops a comprehensive graph-based framework. Key contributions include mapping exper-imental images onto a labeled retinal network, encoding fluid mechanical properties in graph nodes and edges, and storing experimental data in an organized structure. Results demonstrate the feasibility of the approach with a fully la-beled network of 193 channels, offering insights into fluid dynamics and mass conservation in microcirculatory sys-tems. The methodology facilitates future microfluidics re-search by providing a robust and scalable data storage and analysis tool, though further automation is needed to opti-mize workflow.

Mixed Reality-Enhanced Translation of CTA Data for DIEP Flap Reconstruction

Tony Jiang — Fri, 23 May 2025 00:00:00 +0000

Background: A CT angiogram (CTA) is commonly used to identify perforators in preparation for breast re-construction with a deep inferior epigastric perforator (DIEP) flap. The utility of this imaging data is limited by a surgeon’s ability to precisely translate the vascular anatomy from the CTA onto the patient to inform their flap design and harvest based on perforator location and intramuscular course. This study sought to evaluate the application of Augmented Reality (AR) for optimizing preoperative imaging to improve the efficacy of recon-struction with a DIEP flap.
Methods: A novel software was developed to translate patient-specific CTA data from the institutional imag-ing system was developed on two separate platforms, the Meta Quest 3 and the Apple Vision Pro. The accuracy of digital imaging segmentation, registration, and projection was evaluated on a mannequin. With institutional ethics approval, patients planned for breast reconstruction with a DIEP flap consented to the use of AR. In this single-surgeon feasibility trial, the visualization, registration, and interaction with the segmented vascular anat-omy were evaluated for its safety and utility in pre-operative flap design and intra-operative flap harvest. The AR headset was used to visualize and interact with the segmented imaging data to identify perforators and their intramuscular course.
Results: The reprojection error between the segmented virtual anatomy and the real-world patient anatomy was measured at 1.3mm. Three patients underwent immediate breast reconstruction with AR-assisted DIEP flap planning and harvest. Preoperatively, AR was used to translate the perforator locations and their intramuscular course from the CTA onto the patient, facilitating flap design and perforator selection. Intraoperatively, the application of AR effectively delineated the vascular anatomy of the DIE perforators and pedicle relative to the rectus muscle, fascia, and overlying subcutaneous tissue. With the AR headset, the surgeon registered, visual-ized and interacted with the digital imaging. Using AR, digital information was safely and effectively applied to inform flap design and harvest, with guidance on perforator selection, fascial incision placement and length, and intramuscular pedicle dissection.
Conclusions: AR can accurately, safely, and effectively translate preoperative imaging for clinical use in DIEP flap design and harvest. By leveraging this immersive technology, AR may serve as an adjunct in recon-structive procedures to optimize safety, efficacy, and operative workflow.

A Regional Review of Flexible Endoscope Service Delivery Models and Preventive Maintenance Practices

Nancy Suarez — Fri, 23 May 2025 00:00:00 +0000

While the literature surrounding flexible endoscopes predominantly focuses on disinfection and sterilization processes, there is a notable lack of guidance on managing these devices beyond reprocessing. This paper examines the broader role of the Biomedical Engineering (BME) Department in managing flexible endoscopes throughout their lifecycle. A regional review of service delivery models and preventive maintenance (PM) practices was conducted across 24 healthcare sites in the Lower Mainland of British Columbia. Using work order data extracted from the Computerized Maintenance Management System (CMMS), along with insights from site visits and interviews with BME technologists, Medical Device Reprocessing Department (MDRD) staff, and clinical teams, the study revealed crucial yet inconsistent BME involvement, variations in PM practices, gaps in data tracking, and communication barriers between departments. These findings highlight the need for clearer processes and guidance from a clinical engineering perspective. Practical recommendations are provided to address these gaps, focusing on standardizing workflows and defining the roles where BME provides the most value in flexible endoscope management.

Usability Evaluation of Computerized Maintenance Management System Replacement in British Columbia Biomedical Engineering

Cherryl Li , Alanna Bateman, Elizabeth Pratt, Emily Rose — Fri, 23 May 2025 00:00:00 +0000

Introduction: British Columbia Biomedical Engineering (BCBME) is comprised of four distinct Biomedical Engineering organizations that provide healthcare technology management services for seven regional health authorities across British Columbia. BCBME shares a provincial Computerized Maintenance Management System (CMMS) that has been implemented for approximately 10 years. In 2023, BCBME initiated the search for a replacement CMMS, aiming to leverage modern features such as mobile CMMS application access and increased integration with external applications and systems.
This report presents the findings and recommendations of the Usability Working Group within the BCBME CMMS Replacement Project. The working group evaluated three CMMS options over a two-month period to assess their usability using a human factors (HF) approach. The usability evaluation aimed to inform CMMS selection from a usability perspective, increase staff engagement throughout the procurement process, and proactively identify and address usability concerns prior to implementation.

Methodology: Heuristics evaluation [1] and user walkthroughs were employed to identify usability issues and gather end user feedback. These methods allowed the working group to proactively identify causes of inef-ficiency, frustration, and data quality issues (e.g., missing, inaccurate and/or incomplete data) while ensuring input and buy-in from end users. Heuristics evaluation was completed by three HF experts with clinical engi-neering backgrounds while 18 users from all seven regional health authorities participated in user walkthroughs. Participants varied between front-line technologists, supervisors, and managers or clinical engineers.

Results: Key findings include the identification of usability issues across all three CMMS options categorized by severity and violation theme. Strengths and weaknesses of each system were identified based on user feed-back and heuristic analysis. For instance, Vendor B emerged as the most preferred option among participants and had the fewest number of usability issues; however, some users found it difficult to navigate due to the display of large amounts of unorganized data. Vendor A was noted for its familiarity but had issues with limited searching capabilities and unclear error messages. Vendor C faced criticism for being unintuitive and difficult to navigate.

Discussion: Analysis is still in progress; however, the intention of this work is to guide the BCBME CMMS Replacement Project in selecting a new CMMS. The selection process will consider not only traditional criteria such as finance and utility but also consider usability as a critical factor in decision making. Once a CMMS option is selected, findings from this usability evaluation will inform implementation by proactively identifying and mitigating issues discovered prior to system go live. Overall, this structured HF approach provides valuable insights into how the recommended and selected CMMS can support BCBME’s goals of enhancing operational efficiency, user satisfaction, and data quality throughout the healthcare technology management lifecycle.

Capital Planning in Imaging: A Dashboard Approach for Strategic Decision-Making

Griffin Copp, Sonja Pejcic, Ian Connell — Fri, 23 May 2025 00:00:00 +0000

Capital planning for medical imaging devices presents unique challenges due to their complex lifecycles, varying funding sources, and critical operational dependencies. Despite the abundance of data collected on these assets, the lack of clear, real-time, and automated insights has limited its utility for stakeholders in understanding current and future needs. To address these challenges, we propose an integrated dashboard solution powered by Microsoft Power BI. This approach combines real-time data visualization, advanced scenario modeling, and actionable insights aligned with institutional priorities. By leveraging this solution, healthcare organizations can make data-driven decisions that enhance fiscal sustainability and operational efficiency.

Role of Medical Engineering in Patient Handling Equipment Support

Liane Ladouceur, Keili Shepherd — Fri, 23 May 2025 00:00:00 +0000

Recent years have seen a fundamental shift in the nature of Patient Handling Equipment (PHE), with ad-vancing technology moving this equipment from basic mechanical functionality towards complex devices that can support clinical decision making. In some cases, this has even resulted in formal qualification of PHE as medical devices. This shift has come with some loss of clarity about where the responsibility for maintenance and management of these devices lies, made even more complex by the ongoing push by many manufacturers toward service contracts. Unfortunately, this results in confusion at a clinical level about where to look for re-pairs and, as a consequence, extended downtimes for crucial equipment.

For University Health Network (UHN), PHE includes, but is not limited to, patient beds, stretchers, exam chairs, wheelchairs, patient lifts and IV poles. Currently, the role of UHN Medical Engineering department in supporting this type of equipment varies across hospitals. At West Park Healthcare Centre, which merged with UHN in 2024, Medical Engineering supports patient beds and other PHE equipment. This is different from other UHN sites where Medical Engineering manages planning and procurement of PHE equipment, while the Facili-ties department supports its maintenance. This division of responsibilities combined with the historical lack of investment in a sustainable replacement strategy has led to significant challenges, including lower priority maintenance and a poor understanding of the equipment’s age and condition. Unlike the other equipment supported by Medical Engineering or Facilities, PHE does not have an inventory management system. As a result, it is difficult to strategically plan equipment replacement and effectively distribute resources across the hospital. Additionally, there is an excess of broken equipment, such as patient beds and IV poles, and long equipment downtimes.

In this work, we discuss the implications of in-house and outsourced support models for PHE, as well as iden-tifying the appropriate team to support this equipment. Further, we present a business case for bringing the sup-port of PHE into Medical Engineering and open a conversation with Clinical Engineers and Biomedical Engineering Technologists from all hospitals about their experience with PHE support.

Experimental and Numerical Investigation of Polydopamine Nanoparticles for Enhanced Photothermal Cancer Therapy

Abby Chapman, Diego Combita , William Whelan, Marya Ahmed, Sundeep Singh — Fri, 23 May 2025 00:00:00 +0000

Photothermal therapies are considered to be a safe and promising choice for small, localized superficial tumors.

During photothermal therapies, near-infrared light generates heat and selectively destroys the tumorous tissue.

However, achieving precise control over the tissue heating confined only to the localized zone remains a chal-

lenge. Any deviation from the intended heating can lead to over-ablation, resulting in significant damage to the

surrounding healthy tissue and critical structures, or under-ablation, which increases the chances of tumor recur-

rences. To overcome these challenges, administering nanoparticles within a target tumor has been proven to gen-

erate more precise heating and minimize damage to the surrounding healthy tissues, thereby increasing the overall

efficacy of the procedure. The use of metallic nanoparticles (e.g., silver, gold) to enhance photothermal effects

has received significant attention over the past decade. However, this approach introduces concerns regarding

material toxicity and patient risk. Polymer-based nanomaterials, with their biocompatible and biodegradable prop-

erties, offer a promising alternative to address these complications, warranting further exploration. This study

aims to investigate the potential of polymer-based nanoparticles composed of polydopamine (PDA) to enhance

the effectiveness of photothermal therapies for cancer treatment. PDA nanoparticles are melanin-like structures

synthesized through the oxidation of 3,4-dihydroxy-L-phenylalanine (DOPA) in an alkaline aqueous environment

with oxygen, and their size can be easily controlled by adjusting the solution’s pH. In this study, the influence of

various concentrations of spherical PDA nanoparticles (1000, 400, 200, 100, 50, and 25 μg/mL) was explored

through in vitro photothermal experiments. The temperature profile of the samples during 808 nm laser irradiation

with an intensity of 1.4 W/cm2 was captured with a thermal camera. A concentration-dependent relationship was

identified, and the highest PDA concentration of 1000 μg/mL led to the largest temperature change of 19.4 °C.

Furthermore, a finite element-based computational model was developed to quantify spatio-temporal thermal dy-

namics across different PDA nanoparticle concentrations. The absorption cross-sections of individual PDA nano-

particles were derived using Maxwell’s equations and extrapolated to different concentrations. The computational

absorption spectrum was compared to experimental data obtained using a spectrophotometer, highlighting rea-

sonable agreement. Beer-Lambert’s law was then applied to model the heat transfer within the nanoparticle sus-

pension utilizing a Gaussian laser profile across different concentrations. The model was validated against exper-

imental in vitro photothermal data of maximum attained temperature, and a parametric sensitivity analysis was

conducted to assess the impact of laser power and nanoparticle size on the efficacy of nanoparticle-assisted pho-

tothermal therapy. Both experimental and computational results highlight the significance of nanoparticle con-

centration, size, and laser power in improving the photothermal response of polymer-based nanoparticles. The

optimal nanoparticle parameters generating enhanced photothermal effects have also been identified based on

parametric sensitivity analysis. This study offers valuable insights into the future advancements and clinical trans-

lation of precision photothermal therapy, benefiting millions affected by cancer.

Effect of Mesenchymal Stem Cell Conditioned Media on Fibroblasts: Implications for Skin Regeneration and Wound Healing

, Aidan Schafer, Devon Stone , Robert Burrell, Hilal Gul — Fri, 23 May 2025 00:00:00 +0000

Introduction

Stem cell-based therapies show great promise in regenerative medicine, with bone marrow-derived mesenchymal

stem cells (BM-MSC) being particularly noteworthy for their high multilineage differentiation and paracrine

signaling. MSC, derived from sources like cord blood, adipose tissue and bone marrow, are multipotent cells

capable of differentiating into various tissues as well as known for their regenerative and immunomodulatory

properties. Conditioned media from MSC (MSC-CM), rich in bioactive factors, offers a practical therapeutic

alternative, reducing immune reactions and ensuring consistent effects. MSC-CM has shown promise in wound

healing, skin rejuvenation, and other skin applications. In this study, we investigated the effects of BM-MSC-CM

on human dermal fibroblasts (HDFs), focusing on their proliferation, migration, and the promotion of collagen

and elastin synthesis. The research underscores the potential of BM-MSC-CM in developing safer, more effective

regenerative therapies for skin applications including skin regeneration, wound healing and anti-aging.

Methods

Flow cytometry evaluated BM-MSC markers using antibodies for CD73, CD105, CD90 and CD34, CD45. BM-

MSC-conditioned media (CM) was prepared by centrifuging and filtering media collected after 48 hours.

Superficial and deep tissue dermal fibroblasts were treated with 5%, 10%, and 20% BM-MSC-CM. Proliferation

was assessed with Alamar Blue. Migration was measured using a scratch wound healing assay in confluent

fibroblasts in 6-well plates, with healing observed and analyzed using ImageJ from day 0 to 3. Collagen content

was measured using Condrex Sirius Total Collagen Kit, and elastin content was measured using Fastin Kit.

Results

Flow cytometry results showed BM-MSC demonstrate the expected phenotype for human MSC (highly positive

expression of CD105, CD73, CD90, and negative expression of CD34 and CD45). The Alamar Blue assay

demonstrated that BM-MSC-CM significantly improved proliferation of fibroblasts compared to the control

conditioned media. The scratch wound healing assay revealed that BM-MSC-CM at 5%, 10%, and 20% enhanced

migration of fibroblasts (resulted in closure of the gap) with respect to control.

Conclusions

This study demonstrated the remarkable potential of BM-MSC-CM for enhancing the functional properties of

HDFs, which are crucial for skin regeneration and wound healing. However, further studies are needed to

evaluate/identify the key bioactive factors in BM-MSC-CM as well as their effects on skin tissue repair and wound

healing in vivo.

Automatic segmentation of the left ventricle from pediatric echocardiography images using SegFormer architecture

Melisa Mateu, Jimena Olveres-Montiel, Boris Escalante-Ramírez, Luc Duong — Fri, 23 May 2025 00:00:00 +0000

Echocardiography is the most widely used imag-

ing technique for congenital heart disease (CHD) detection, as-

sessing risk, and guiding treatment strategies in pediatric cardi-

ology. However, interpreting and analyzing these types of

images can be challenging due to their complexity, which is

some cases leads to inter-observer variability. This research

work aims to develop an automated left ventricle (LV) segmen-

tation method for pediatric echocardiography images using a

semantic transformer model known as SegFormer, for aiding in

the measurement of clinical image technique. Semantic trans-

formers have demonstrated exceptional performance in seg-

mentation tasks in recent years, making them a suitable choice

for this application. To achieve accurate LV segmentation, the

SegFormer model is trained using the EchoNet-Peds dataset,

which consists of annotated pediatric echocardiography videos.

The experimental results include segmented left ventricle im-

ages, evaluated in accuracy, mean absolute error (MAE), recall

and dice score metrics for performance comparison with other

pediatric segmentation method.

Development of a Music-Based Wearable Biofeedback System to Improve Lower Limb Amputee Gait Symmetry

Sebastian Silva, Calvin C Ngan, Jan Andrysek — Fri, 23 May 2025 00:00:00 +0000

Lower-limb amputees (LLAs) can exhibit asym- metric gait, commonly observed as stance-time asym- metry, which may contribute to the development of secondary conditions [1]. Access to conventional gait training is often impeded by factors such as healthcare funding, long travel times, or occupational obligations [2]. This has created a growing interest in technology- based alternatives for in-community gait rehabilita- tion. One such promising technique is the use of wear- able biofeedback systems (WBSs) for gait training, with multiple studies utilizing various feedback mo- dalities (visual, auditory, and vibrotactile) to attain positive outcomes for LLA participants, including a more normal gait pattern and improved gait symmetry [2]. Within the realm of auditory stimuli, rhythmic au- ditory stimulus (RAS), and more specifically music, may provide distinct advantages when applied to LLA gait. The entrainment of walking cadence and music tempo is a well-documented phenomenon, with studies having shown that music stimulus can improve the gait symmetry of hemiparetic stroke patients [3]. However, to date, there are no gait training systems that have ap- plied music-based feedback to correct gait asymmetry of LLAs. To address this gap, the goal of this project is to design and validate a wearable biofeedback sys- tem that employs a music-based strategy to improve the temporal gait symmetry of LLAs.

The physical WBS consists of two inertial sensors to measure cadence and gait symmetry, an Android phone to run the feedback algorithm, and headphones. Twenty able-bodied participants and ten LLA partici- pants will be recruited to evaluate the effectiveness of the proposed system. Participants will first complete a baseline assessment without RAS, to determine their average gait symmetry and cadence. They will then perform RAS walking trials with three different closed-loop feedback strategies, as well as with open- loop RAS. The music used in walking trials will be of

a constant tempo matching the participant’s average cadence, and rhythmically enhanced via metronome tones using beat detection algorithms [4]. Spotify’s API was used to generate a library of music with move- ment inducing features [5], across a range of tempos and covering a variety of genres. The developed closed loop feedback strategies include: 1) the metronome fades as the participant improves symmetry, 2) the vol- ume of the music increases in response to better sym- metry, and 3) a combined strategy where both effects occur simultaneously. Participants will complete ques- tionnaires to assess system usability [6], as well as the enjoyment [7], and task load [8] of each strategy.

Investigating the Efficacy of an EMF Blocking Blanket on Sleep Quality

Madhuri Sinha , Zahra Moussavi, Abnoor Kaur — Fri, 23 May 2025 00:00:00 +0000

Sleep Quality may be affected negatively by con-

tinuous electromagnetic fields (EMF) exposure from telecom-

munication devices, which may further lead to mental health

disorders such as anxiety and depression. There are multiple

products that claim to block EMF exposure and improve sleep

quality. The objective of this study was to have an unbiased

quantitative investigation of the efficacy of one such product

called “SleepGift” blanket, on sleep quality. A single-blind

cross-over study was conducted and the sleep study data of 16

healthy participants, who finished the study, was analyzed.

Each participant used real and sham SleepGift blankets for two

10-day study blocks, separated by 30 days of washout period.

Sleep data were recorded at pre- and post-intervention of each

real and sham block. Sleep quality was assessed using the Odds

Ratio Product (ORP) and sleep architecture, along with Elec-

troencephalography (EEG) metrics such as delta power, delta

durations and spindles. The results show no significant changes

in any of the measured parameters due to using SleepGift real

blanket. Given the small samples of this study, a larger data set

is recommended to achieve robust conclusion about the efficacy

of SleepGift blanket.

A Provincial Strategy for Clinical Engineering SOP and Policy Standardization: Challenges, Findings, and Solutions

Maryam Samiee, Chris Bzovey , Mohammed Tawhidul Islam — Fri, 23 May 2025 00:00:00 +0000

BACKGROUND

The establishment of consistent and robust Standard Operating Procedures (SOPs) and policies in Clinical Engineering (CE) is essential for optimizing service ef- ficiency, ensuring regulatory compliance, and aligning practices with industry standards. The CE program within Shared Health Manitoba, recently established, encompasses diverse service teams across the regions. The program faces a lack of uniformity in existing SOPs and policies following the recent merge. This lack of standardization is exacerbated by several fac- tors such as redundant or outdated legacy documents, and limitations in stakeholder engagement. Addressing these discrepancies necessitates a comprehensive and strategic approach to evaluate current documents, cat- egorize them, and prioritize areas for improvement. To tackle these challenges, a detailed environmental scan was conducted to gather and analyze existing SOPs and policies. The Clinical Engineering Standard of Practice (CESOP) served as the primary reference for identifying strengths, weaknesses, and gaps. Through this analysis, some gaps were uncovered in some areas, while other areas, were found to have substantial doc- umentation. Additionally, the analysis highlighted some gaps within CESOP itself.

PROPOSED PRESENTATION

This presentation will outline the results of the en- vironmental scan and propose a pathway toward the standardization and enhancement of CE SOPs and pol- icies across Manitoba. The key sections include:

2. Methodology:

Detailing stakeholder engagement strategies

and the processes for collecting relevant doc-

uments.
Explaining the framework used for classifying

and analyzing document based on their ma- turity status and alignment with CESOP guidelines.
Mapping findings into categories such as Ser- vice Management and Service Provision to ensure clarity and organization.

3. Findings and Challenges:

Presenting the key findings of the environ-

mental scan, emphasizing strengths in areas like resource management and identifying gaps in areas such as technology assessment.
Discussing challenges encountered during the process, including the management of redun- dant legacy documents, limitations in stake- holder engagement due to time constraints, and gaps within CESOP standards.

4. Strategic Recommendations:

Proposing a structured framework for SOP

and policy development to address identified

gaps and inefficiencies.
Recommending the formation of a Provincial

CE Policy/SOP Committee to oversee and

guide standardization efforts.
Outlining strategies for prioritizing develop-

ment based on the findings of the environ-

mental scan.

5. Outcomes and Future Directions:

• Recommending pathways for fostering col- laboration among CE teams and stakeholders to ensure sustainable improvements.

By presenting a systematic approach to SOP and policy standardization, this session aims to provide a replicable framework for other jurisdictions while fos- tering discussion on best practices in CE management.

•

Project Overview and Objectives:

Defining the scope of the project, focusing on

the review of internal CE documents. Articulating the objectives of the initiative, in- cluding benchmarking against CESOP stand-

ards and identifying critical gaps

A Mechatronic Needle Guidance System for Prostate-Specific Positron Emission Tomography and 3D Transrectal Ultrasound-Guided Trans-perineal Prostate Biopsy

Fri, 23 May 2025 00:00:00 +0000

Prostate cancer (PCa) is the most frequent cancer in men in Canada which the underlines importance of the devel- opment of new methods for diagnosis. The current study pre- sents a mechatronic needle guidance system which is to be used in conjunction with a prostate specific PET (P-PET) system and 3D transrectal ultrasound (TRUS) for trans-perineal prostate biopsy. The system consists of a motorized 3D TRUS system for the generation of volumetric images, a tracking arm for target- ing and a needle guidance device for needle placement and re- positioning. The mechatronic needle guidance system includes a needle template which is capable of two-dimensional manual translation, and it helps in the alignment of the needle with the P-PET defined lesions in real time with the help of TRUS. To coordinate the biopsy, a functional and anatomic imaging from P-PET and 3D TRUS were co-registered with the help of a land- mark-based registration method. The system was assessed us- ing a phantom which was designed to simulate the prostate gland with artificial lesions and the outcomes indicated that the needle path planning and placement was accurate with a mean guidance error of 0.85 ± 0.22 mm. This innovation incorporates the 3D TRUS imaging technology and the P-PET functional in- formation and the mechatronic needle guidance system for ac- curate and efficient needle placement. This paper aims at over- coming the challenges that are associated with 2D TRUS-guided techniques; hence it reduces false negative rates, the rates of re- peat procedures, and improves the identification of the early stage and high-grade PCa. Further research will concentrate in- teroperability, on the enhancement of the needle system’s guid- ance system to achieve better accuracy and the assessment of the system in clinical trials as a diagnostic and therapeutic tool in prostate cancer.

Automated 3D Doppler Ultrasound Imaging for Comprehensive Breast Lesion Assessment

Fri, 23 May 2025 00:00:00 +0000

Breast cancer is the most common cancer in

women worldwide. There are two million diagnoses

and 685,000 deaths annually. Early diagnosis is critical

to reducing mortality. Although screening with

mammography has been shown to have reduced breast

cancer-related mortality through early detection,

dense breast tissues reduce mammographic sensitivity,

potentially delaying diagnoses and contributing to

poorer outcomes. Therefore, there is a need for more

accessible and cost-effective supplemental screening

technologies, especially for high-risk populations and

women with dense breasts. To address these

challenges, a promising approach involves combining

widely available, cost-effective, and accessible

ultrasound-based technologies with economical

hardware, software modules, and automated

techniques. Among these technologies, Doppler

imaging plays a crucial role in the clinical evaluation

of breast abnormalities, as intratumoural blood flow

has been shown to correlate with the aggressiveness

and histological grade of the tumour. The development

of a novel automated, portable, and patient-dedicated

3D automated breast ultrasound (ABUS) system for

point-of-care breast cancer supplemental screening

holds significant promise. The proposed system has

previously demonstrated the capability to generate

accurate whole-breast B-mode images, which can aid

in the early detection of breast cancer in women with

dense breasts. Additionally, it offers the advantage of

incorporating Doppler imaging to assess blood flow

within suspicious lesions, a capability not commonly

available with commercial ABUS systems. By

leveraging Doppler imaging in conjunction with 3D B-

mode ABUS, this innovative approach could improve

breast cancer-related health outcomes and equity in

access to healthcare, especially for underserved and

vulnerable populations.

Segmentation of Muscularis Propria in Colon Histopathology Images Using Vision Transformers for Hirschsprung’s Disease

Fri, 23 May 2025 00:00:00 +0000

Hirschsprung’s disease is a congenital birth defect

diagnosed by identifying the lack of ganglion cells within the

colon’s muscularis propria, specifically within the myenteric

plexus regions. There may be advantages for quantitative

assessments of histopathology images of the colon, such as

counting the ganglion and assessing their spatial distribution;

however, this would be time-intensive for pathologists, costly,

and subject to inter- and intra-rater variability. Previous

research has demonstrated the potential for deep learning

approaches to automate histopathology image analysis,

including segmentation of the muscularis propria using

Convolutional Neural Networks (CNNs). Recently, Vision

Transformers (ViTs) have emerged as a powerful deep learning

approach due to their self-attention. This study explores the

application of ViTs for muscularis propria segmentation in

calretinin-stained histopathology images and compares their

performance to CNNs and shallow learning methods. The ViT

model achieved a Dice-Sørensen coefficient of 89.9% and Plexus

Inclusion Rate (PIR) of 100%, surpassing the CNN (Dice-

Sørensen coefficient of 89.2%, PIR of 96.0%) and k-means

clustering method (Dice-Sørensen coefficient of 80.7%; PIR

77.4%). Results assert that ViTs are a promising tool for

advancing Hirschsprung’s disease-related image analysis.

Enhanced Image Processing of Implanted Hydrogel Scaffold Images Using Propagation-Based Imaging Computed Tomography

Xiao Fan Ding , Zahra Khoz , Daniel Chen , Ning Zhu — Fri, 23 May 2025 00:00:00 +0000

This study showed how effective masking of

dense components (i.e., bone) in propagation-based imaging

computed tomography (PBI-CT) scans of biological samples can

enhance the outcomes of deep learning denoising techniques.

This was performed on ex vivo scans of hydrogel scaffolds im-

planted into animal hind limb and suppressing the overwhelm-

ing signal from the bone allowed for clearer and more distinct

visualization of hydrogel scaffolds. This proved essential for ob-

serving the interactions of hydrogel within the physiological en-

vironment. The detailed image processing steps offer to improve

the practical application of PBI-CT in tissue engineering and

regenerative medicine research.

End-To-End Automated Mean Linear Intercept Measurement System

Atallah Madi, Adrian Chan — Fri, 23 May 2025 00:00:00 +0000

The Mean Linear Intercept (MLI) measurement is a quantitative metric for assessing air space size in histopatho- logical images of lung tissue. Currently, MLI measurement in- volves human raters conducting manual image assessment that is time-consuming, labour-intensive, and subject to inter- and intra-rater variability. Our system utilizes a deep learning ap- proach for semantic segmentation to achieve a fully automated MLI measurement system with a graphical user interface. The system was trained on mouse lung images and tested on a rat lung image to investigate the generalizability to other animal models. The system computed an MLI score of 62.20 within 90 minutes using 8255 field-of-view (FOV) images extracted from the whole slide image. The human rater found the MLI score to be 62.49 within 41 minutes using 500 randomly selected FOVs. This result suggests that the system maintains its accuracy with rat lung images. Although the system took twice as long as the human rater, it processed >16× more FOVs, which leads to lower standard error in the MLI score.

Transforming Health Systems through Digital Infrastructure: Insights from CSA Z8005

Taurai Kurebwa, Andrew Henneberry — Fri, 23 May 2025 00:00:00 +0000

Summary: In this presentation, attendees will be provided with a detailed overview of the framework for plan- ning, designing, and implementing digital infrastructure that can support current and future health care digital infrastructure and technologies.

Key Learning Points:

Framework for Digital Infrastructure: Attendees will learn about the comprehensive framework pro-

vided by CSA Z8005, which includes guidance for planning and implementing digital infrastructure and digital health technologies. They will learn how the framework provides health care facilities direction on scalability, security, and future-proofing, to meet both current and future health care demands.
Integration and Interoperability Best Practices: Attendees will be introduced to principles and re- quirements for achieving integration and interoperability of digital health systems within healthcare fa- cilities. This includes the responsibilities of different interested parties, the importance of a master sys- tems integrator, and the use of an integration platform. The session will highlight how the standard, in light of the Connected Care for Canadians Act (Bill C-72), can be an important tool for hospital admin- istrators and policymakers, helping them drive the transformation needed to meet the demands of modern health care delivery.
Health System Transformation Tools: The presentation will cover tools for transforming health care systems through digital infrastructure. These include costing templates that help facilities budget for capital, implementation, and maintenance expenses. Operational readiness checklists are also provided to ensure that telecommunication spaces are suitable for the installation of active equipment. Further- more, the standard includes templates for selecting wireless staff communication devices, which guide HCFs in choosing devices that meet specific requirements such as ruggedness, waterproofing, and bar- code reading capabilities. CSA Z8005 also offers guidance on developing business cases for digital health care technologies, maintaining equipment lists, and creating security roadmaps. These tools are designed to help HCFs plan, implement, and maintain their digital infrastructure effectively, ensuring that all tech- nological investments are aligned with the facility’s overall digital health vision and strategy.

By the end of the presentation, attendees will have a clearer understanding of how to leverage the CSA Z8005 standard to transform their health care systems through effective digital infrastructure and technology integration. They will also be equipped with strategies on using the standard to implement scalable and interoperable digital solutions in their health care facilities.

Lessons Learned from Effective Password Management for Medical Devices in Hospitals

Veronica Lu — Fri, 23 May 2025 00:00:00 +0000

Introduction

The growing interconnectivity of medical devices in healthcare environments has significantly heightened cy-

bersecurity risks, leaving many devices vulnerable to unauthorized access and exploitation due to weak security

features. Effective password management is crucial not only for safeguarding sensitive patient data but also for

ensuring the continuous and safe operation of clinical systems (Cybersecurity Best Practices | Cybersecurity and

Infrastructure Security Agency CISA) This is also gaining the attention of governing bodies, with the Office of

the Auditor General in British Columbia setting out requirements for healthcare organizations, of which pass-

word management is one key recommendation.

Managing passwords in hospitals presents unique challenges due to the vast number of devices uncertainty

around the current status of passwords, and variation in the appropriate selection password management tools.

These challenges are compounded by limited resources, both in terms of personnel and time, making the imple-

mentation of robust protocols particularly difficult in busy healthcare environments.

This presentation outlines a practical, secure, and scalable approach to medical device password management

that balances real-world usability with strong cybersecurity demands.

Methods (Approach)

Our solution, prompted by a password exposure incident, was designed to protect against cyber threats while

being feasible for biomedical teams to adopt consistently.

To address the unique structure of our organization, which supports four distinct health authorities, we adopted a

flexible approach. Health Authority directory logins were integrated with medical device where possible to

streamline access, while centralized password management tools and two-factor authentication (2FA) were used

for devices without directory support. This ensured secure password storage across all systems.

Changing password is integrated into the computerized maintenance management system work-order process,

ensuring that password management tasks were clearly documented, tracked, and updated on a daily basis.

Through this integration, technologists were able to promptly address issues as they arose, while also maintain-

ing visibility and accountability across all teams involved.

Additionally, biomedical technologist were sent on dedicated cybersecurity education classes, as education was

recognized as a key component to raising cybersecurity awareness and ensuring the long-term success of these

protocols.

Results

Lower Mainland Biomedical Engineering manages a total inventory of 115,001 devices, and has successfully

secured 93.8% of them, leaving only 7,171 devices still requiring password management work.

This reflects the efficiency and effectiveness of our ongoing efforts to secure medical devices across the entire

organization.

Conclusions

This presentation emphasizes the importance of establishing effective communication with technologists to

manage unknown password statuses across large inventories, all within the constraints of available resources.

Real-world examples demonstrate how these solutions have improved device security, ensured compliance with

Office of the Auditor General of B.C. recommendations, and minimized operational disruptions. By achieving a

balance between protection and practicality, this approach offers hospitals a viable pathway to enhanced cyber-

security.

PACT: A predictive algorithm for automated upper-limb prosthetic socket design

Vishal Pendse, Calvin C Ngan, Jan Andrysek — Fri, 23 May 2025 00:00:00 +0000

Prosthetic socket design significantly affects prosthesis comfort and abandonment [1]. However, current processes

are subjective and time-intensive, relying on extensive clinician–patient interactions that can result in long lead

times and reduced access to care. Advances in digital scanning, additive manufacturing, and machine learning

present an opportunity to streamline the initial stages of this design process, freeing up clinicians’ time to focus

on where their expertise is most impactful [2]. Despite these advances, there remains limited understanding of

digital design applications for upper-limb prostheses [3]. To address this gap, we developed and validated the

Predictive Algorithm for Customized Transradial socket design (PACT), which accurately approximates prosthe-

tist-fabricated sockets (PFSs) for individualized prosthetic care.

Nineteen (n=19) participants with transradial limb absence were recruited during regular fitting appointments.

Their limbs and corresponding PFSs were scanned using the Spectra scanner (Vorum, Canada) to create a limb–

socket library. Our algorithm takes a new client’s limb as the input, scaling and comparing it to all limbs in the

library using the average Euclidean distance to determine the best match, whose corresponding socket is used as

a basis for design. Critical areas affecting socket functionality—such as the distal end and supracondylar suspen-

sion—are then adjusted for optimal fit.

Using leave-one-out validation, sockets were predicted for all 19 limbs and compared to their respective PFSs.

Strong Spearman’s rank correlation (ρ = 0.81, P < 0.05) between scaled limb shapes and socket fits validated the

accuracy of our scaling method. The algorithm consistently predicted reasonable approximations of PFSs, with a

mean deviation of only 2.1 ± 0.6 mm across the dataset—within the acceptable range of typical inter-prosthetist

variability observed during rectification for lower-limb [4] and transradial sockets [5]. Data clustering using ma-

chine learning (DBSCAN) identified localized regions on the socket needing improvement, specifically in ante-

rior–posterior compression and the trimlines. Preliminary client fitting sessions on a subsample of participants

showed that the 3D-printed predicted sockets provided satisfactory fit and suspension.

The results demonstrate that PACT predicts reasonable approximations of PFSs, marking the first integration of

clinician-created designs into predictive modeling for prosthetic sockets. Unlike prior research using genetic al-

gorithms [6] and the eigenvector algorithm [7], PACT offers a more tailored fit by incorporating clinician-in-

formed adjustments. The widespread deployment of this algorithm could significantly reduce the burden of pros-

thesis provision on clinicians and patients. Limitations include a relatively small sample size; future iterations of

this algorithm will incorporate machine-learning techniques for limb classification and additional fitting parame-

ters to advance toward end-to-end modeling.