pp 1-48 | Cite as
Materials Used as Tissue Phantoms in Medical Simulation
Abstract
Medical simulation is a technique used to train students and professional healthcare providers to perform a variety of clinical procedures without placing patients at risk. While medical simulation has been shown to reduce medical errors and associated costs, there exists a need for more realistic tissue analogue materials that account for tissue biomechanical responses in various situations. This chapter provides an overview of materials used in medical simulation by discussing concepts used in the mechanical characterization of materials, the complex structure and mechanical properties of biological tissues, the chemical structure and mechanical properties of materials commonly used in medical simulators, the designs of medical simulation devices on the market today and those reported in literature, and the recent developments and future directions in this field.
Notes
Acknowledgments
The authors would like to acknowledge John Kromer of the Miami University Libraries for his assistance with conducting the initial literature review.
References
- 1.America C on Q of HC in, Medicine I: To Err Is Human: Building a Safer Health System. National Academies Press, Washington (2000)Google Scholar
- 2.Pham, J.C., Aswani, M.S., Rosen, M., et al.: Reducing medical errors and adverse events. Annu. Rev. Med. 63, 447–463 (2012). Doi: 10.1146/annurev-med-061410-121352 CrossRefPubMedGoogle Scholar
- 3.FastStats: http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm. Accessed 14 June 2016
- 4.Van Den Bos, J., Rustagi, K., Gray, T., et al.: The $17.1 billion problem: the annual cost of measurable medical errors. Health Aff. (Millwood) 30, 596–603 (2011). Doi: 10.1377/hlthaff.2011.0084 CrossRefGoogle Scholar
- 5.Kunkler, K.: The role of medical simulation: an overview. Int. J. Med. Robot. 2, 203–210 (2006). Doi: 10.1002/rcs.101 CrossRefPubMedGoogle Scholar
- 6.Doherty-Restrepo, J.L., Tivener, K.: Current literature summary: review of high-fidelity simulation in professional education. Athl. Train. Educ. J. 9, 190–192 (2014). Doi: 10.4085/0904190 CrossRefGoogle Scholar
- 7.Cox, M., Irby, D.M., Reznick, R.K., MacRae, H.: Teaching surgical skills—changes in the wind. N. Engl. J. Med. 355, 2664–2669 (2006). Doi: 10.1056/NEJMra054785 CrossRefGoogle Scholar
- 8.Stunt, J., Wulms, P.-B., Kerkhoffs, G., et al.: How valid are commercially available medical simulators? Adv. Med. Educ. Pract., 385 (2014). Doi: 10.2147/AMEP.S63435
- 9.Cohen, J., Thompson, C.C.: The next generation of endoscopic simulation. Am. J. Gastroenterol. 108, 1036–1039 (2013). Doi: 10.1038/ajg.2012.390 ADSCrossRefPubMedGoogle Scholar
- 10.Nesbitt, J.C., St Julien, J., Absi, T.S., et al.: Tissue-based coronary surgery simulation: medical student deliberate practice can achieve equivalency to senior surgery residents. J. Thorac. Cardiovasc. Surg. 145, 1453–1459 (2013). Doi: 10.1016/j.jtcvs.2013.02.048 CrossRefPubMedGoogle Scholar
- 11.Cohen, J., Bosworth, B.P., Chak, A., et al.: Preservation and incorporation of valuable endoscopic innovations (PIVI) on the use of endoscopy simulators for training and assessing skill. Gastrointest. Endosc. 76, 471–475 (2012). Doi: 10.1016/j.gie.2012.03.248 ADSCrossRefPubMedGoogle Scholar
- 12.Lim, Y.-J., Deo, D., Singh, T.P., et al.: In situ measurement and modeling of biomechanical response of human cadaveric soft tissues for physics-based surgical simulation. Surg. Endosc. 23, 1298–1307 (2009). Doi: 10.1007/s00464-008-0154-z CrossRefPubMedGoogle Scholar
- 13.Barsness, K.A., Rooney, D.M., Davis, L.M.: The development and evaluation of a novel thoracoscopic diaphragmatic hernia repair simulator. J. Laparoendosc. Adv. Surg. Tech. 23, 714–718 (2013). Doi: 10.1089/lap.2013.0196 CrossRefGoogle Scholar
- 14.Wurm, G., Lehner, M., Tomancok, B., et al.: Cerebrovascular biomodeling for aneurysm surgery: simulation-based training by means of rapid prototyping technologies. Surg. Innov. 18, 294–306 (2011). Doi: 10.1177/1553350610395031 CrossRefPubMedGoogle Scholar
- 15.Sakezles, C.: Synthetic human tissue models can reduce the cost of device development. Med. Device Technol. 20 (2009)Google Scholar
- 16.Poniatowski, L.H., Wolf, J.S., Nakada, S.Y., et al.: Validity and acceptability of a high-fidelity physical simulation model for training of laparoscopic pyeloplasty. J. Endourol. 28, 393–398 (2014). Doi: 10.1089/end.2013.0678 CrossRefPubMedGoogle Scholar
- 17.Hibbeler, R.C.: Mechanics of materials. Prentice Hall, Upper Saddle River (2000)Google Scholar
- 18.Athanasiou, K.A., Natoli, R.M.: Introduction to continuum biomechanics. Synth. Lect. Biomed. Eng. 3, 1–206 (2008). Doi: 10.2200/S00121ED1V01Y200805BME019 CrossRefGoogle Scholar
- 19.Özkaya, N., Nordin, M., Goldsheyder, D., Leger, D.: Mechanical Properties of Biological Tissues. In: Fundam. Biomech., pp. 221–236. Springer, New York (2012)Google Scholar
- 20.Charlebois, M., Jirásek, M., Zysset, P.K.: A nonlocal constitutive model for trabecular bone softening in compression. Biomech. Model. Mechanobiol. 9, 597–611 (2010). Doi: 10.1007/s10237-010-0200-3 CrossRefPubMedGoogle Scholar
- 21.Boyce, M.C., Arruda, E.M.: Constitutive models of rubber elasticity: a review. Rubber Chem. Technol. 73, 504–523 (2000). Doi: 10.5254/1.3547602 CrossRefGoogle Scholar
- 22.Bower, A.F.: Applied Mechanics of Solids. CRC Press (2009). https://www.crcpress.com/Applied-Mechanics-of-Solids/Bower/p/book/9781439802472. Accessed 14 June 2016
- 23.Johansson, T., Meier, P., Blickhan, R.: A finite-element model for the mechanical analysis of skeletal muscles. J. Theor. Biol. 206, 131–149 (2000). Doi: 10.1006/jtbi.2000.2109 CrossRefPubMedGoogle Scholar
- 24.Zobitz, M.E., Luo, Z.-P., An, K.-N.: Determination of the compressive material properties of the supraspinatus tendon. J. Biomech. Eng. 123, 47–51 (2000). Doi: 10.1115/1.1339816 CrossRefGoogle Scholar
- 25.Shearer, T.: A new strain energy function for the hyperelastic modelling of ligaments and tendons based on fascicle microstructure. J. Biomech. 48, 290–297 (2015). Doi: 10.1016/j.jbiomech.2014.11.031 CrossRefPubMedGoogle Scholar
- 26.Groves, R.B., Coulman, S.A., Birchall, J.C., Evans, S.L.: An anisotropic, hyperelastic model for skin: Experimental measurements, finite element modelling and identification of parameters for human and murine skin. J. Mech. Behav. Biomed. Mater. 18, 167–180 (2013). Doi: 10.1016/j.jmbbm.2012.10.021 CrossRefPubMedGoogle Scholar
- 27.Kaster, T., Sack, I., Samani, A.: Measurement of the hyperelastic properties of ex vivo brain tissue slices. J. Biomech. 44, 1158–1163 (2011). Doi: 10.1016/j.jbiomech.2011.01.019 CrossRefPubMedGoogle Scholar
- 28.Roeder, R.K.: Mechanical characterization of biomaterials. Charact. Biomater. Newnes, 49–104 (2013)Google Scholar
- 29.Flügge, W.: Viscoelasticity. Springer Science & Business Media, Berlin (2013)Google Scholar
- 30.Oyen, M.L.: Mechanical characterisation of hydrogel materials. Int. Mater. Rev. 59, 44–59 (2013). Doi: 10.1179/1743280413Y.0000000022 CrossRefGoogle Scholar
- 31.Mow, V.C., Kuei, S.C., Lai, W.M., Armstrong, C.G.: Biphasic creep and stress relaxation of articular cartilage in compression: theory and experiments. J. Biomech. Eng. 102, 73–84 (1980). Doi: 10.1115/1.3138202 CrossRefPubMedGoogle Scholar
- 32.Simon, B.R.: Multiphase poroelastic finite element models for soft tissue structures. Appl. Mech. Rev. 45, 191–218 (1992)ADSMathSciNetCrossRefGoogle Scholar
- 33.Cheng, S., Bilston, L.E.: Unconfined compression of white matter. J. Biomech. 40, 117–124 (2007). Doi: 10.1016/j.jbiomech.2005.11.004 CrossRefPubMedGoogle Scholar
- 34.Raghunathan, S., Sparks, J.L.: Biphasic Poroviscoelastic Modeling of the Unconfined Compression of Porcine Liver Tissue, pp. 787–788 (2009). Doi: 10.1115/SBC2009-205045
- 35.Moran, E.C., LeRoith, T., Smith, T.L., et al.: Porohyperviscoelastic model simultaneously predicts parenchymal fluid pressure and reaction force in perfused liver. J. Biomech. Eng. 134, 91002 (2012)CrossRefGoogle Scholar
- 36.Evans, D.W., Moran, E.C., Baptista, P.M., et al.: Scale-dependent mechanical properties of native and decellularized liver tissue. Biomech. Model. Mechanobiol. 12, 569–580 (2013)CrossRefPubMedGoogle Scholar
- 37.Nishii, K., Reese, G., Moran, E.C., Sparks, J.L.: Multiscale computational model of fluid flow and matrix deformation in decellularized liver. J. Mech. Behav. Biomed. Mater. 57, 201–214 (2016). Doi: 10.1016/j.jmbbm.2015.11.033 CrossRefPubMedGoogle Scholar
- 38.Ní Annaidh, A., Bruyère, K., Destrade, M., et al.: Characterization of the anisotropic mechanical properties of excised human skin. J. Mech. Behav. Biomed. Mater. 5, 139–148 (2012). Doi: 10.1016/j.jmbbm.2011.08.016 CrossRefPubMedGoogle Scholar
- 39.Gennisson, J.-L., Deffieux, T., Macé, E., et al.: Viscoelastic and anisotropic mechanical properties of in vivo muscle tissue assessed by supersonic shear imaging. Ultrasound Med. Biol. 36, 789–801 (2010). Doi: 10.1016/j.ultrasmedbio.2010.02.013 CrossRefPubMedGoogle Scholar
- 40.Sasaki, N., Matsushima, N., Ikawa, T., et al.: Orientation of bone mineral and its role in the anisotropic mechanical properties of bone—transverse anisotropy. J. Biomech. 22, 157–164 (1989). Doi: 10.1016/0021-9290(89)90038-9 CrossRefPubMedGoogle Scholar
- 41.Ohashi, T., Abe, H., Matsumoto, T., Sato, M.: Pipette aspiration technique for the measurement of nonlinear and anisotropic mechanical properties of blood vessel walls under biaxial stretch. J. Biomech. 38, 2248–2256 (2005). Doi: 10.1016/j.jbiomech.2004.09.019 CrossRefPubMedGoogle Scholar
- 42.Chagnon, G., Rebouah, M., Favier, D.: Hyperelastic energy densities for soft biological tissues: a review. J. Elast. 120, 129–160 (2015). Doi: 10.1007/s10659-014-9508-z MathSciNetCrossRefMATHGoogle Scholar
- 43.Macosko, C.W.: Rheology: Principles, Measurements, and Applications. VCH (1994)Google Scholar
- 44.Junqueira, L.C., Carneiro, J.: Basic Histology: Text and Atlas. McGraw-Hill, New York (2005)Google Scholar
- 45.Moore, K.L., Dalley, A.F., Agur, A.M.R.: Clinically Oriented Anatomy. Lippincott Williams & Wilkins, Philadelphia (2013)Google Scholar
- 46.Clarke, B.: Normal bone anatomy and physiology. Clin. J. Am. Soc. Nephrol. CJASN 3, S131–S139 (2008). Doi: 10.2215/CJN.04151206 CrossRefPubMedGoogle Scholar
- 47.Jor, J.W.Y., Parker, M.D., Taberner, A.J., et al.: Computational and experimental characterization of skin mechanics: identifying current challenges and future directions. Wiley Interdiscip. Rev. Syst. Biol. Med. 5, 539–556 (2013). Doi: 10.1002/wsbm.1228 CrossRefPubMedGoogle Scholar
- 48.Simms, C.K.: Passive skeletal muscle mechanical behaviour: considerations for constitutive modelling. Comput. Meth. Biomech. Biomed. Eng. 15, 271 (2012). Doi: 10.1080/10255842.2012.713591 CrossRefGoogle Scholar
- 49.Ren, L., Yang, P., Wang, Z., et al.: Biomechanical and biophysical environment of bone from the macroscopic to the pericellular and molecular level. J. Mech. Behav. Biomed. Mater. 50, 104–122 (2015). Doi: 10.1016/j.jmbbm.2015.04.021 CrossRefPubMedGoogle Scholar
- 50.Vito, R.P., Dixon, S.A.: Blood vessel constitutive models—1995–2002. Annu. Rev. Biomed. Eng. 5, 413–439 (2003). Doi: 10.1146/annurev.bioeng.5.011303.120719 CrossRefPubMedGoogle Scholar
- 51.Agache, P.G., Monneur, C., Leveque, J.L., De Rigal, J.: Mechanical properties and Young’s modulus of human skin in vivo. Arch. Dermatol. Res. 269, 221–232 (1980). Doi: 10.1007/BF00406415 CrossRefPubMedGoogle Scholar
- 52.Ottenio, M., Tran, D., Ní Annaidh, A., et al.: Strain rate and anisotropy effects on the tensile failure characteristics of human skin. J. Mech. Behav. Biomed. Mater. 41, 241–250 (2015). Doi: 10.1016/j.jmbbm.2014.10.006 CrossRefPubMedGoogle Scholar
- 53.John, W., Chow, W.G.D.: Determining the force-length-velocity relations of the quadriceps muscles: II. Maximum muscle stress. Hum. Kinet. J. 15, 191–199 (1999)Google Scholar
- 54.Chakouch, M.K., Charleux, F., Bensamoun, S.F.: Quantifying the elastic property of nine thigh muscles using magnetic resonance elastography. PLoS ONE 10, e0138873 (2015). Doi: 10.1371/journal.pone.0138873 CrossRefPubMedPubMedCentralGoogle Scholar
- 55.Imbert, L., Aurégan, J.-C., Pernelle, K., Hoc, T.: Mechanical and mineral properties of osteogenesis imperfecta human bones at the tissue level. Bone 65, 18–24 (2014). Doi: 10.1016/j.bone.2014.04.030 CrossRefPubMedGoogle Scholar
- 56.Kobielarz, M., Chwiłkowska, A., Turek, A., et al.: Mechanical properties of selective digestion of elastin and collagen from human aortas (2015). Doi: 10.5277/ABB-00184-2014-02
- 57.Karimi, A., Navidbakhsh, M., Shojaei, A., Faghihi, S.: Measurement of the uniaxial mechanical properties of healthy and atherosclerotic human coronary arteries. Mater. Sci. Eng. C 33, 2550–2554 (2013). Doi: 10.1016/j.msec.2013.02.016 CrossRefGoogle Scholar
- 58.Alhosseini Hamedani, B., Navidbakhsh, M., Ahmadi Tafti, H.: Comparison between mechanical properties of human saphenous vein and umbilical vein. Biomed. Eng. OnLine 11, 59 (2012). Doi: 10.1186/1475-925X-11-59 CrossRefGoogle Scholar
- 59.Egorov, V.I., Schastlivtsev, I.V., Prut, E.V., et al.: Mechanical properties of the human gastrointestinal tract. J. Biomech. 35, 1417–1425 (2002). Doi: 10.1016/S0021-9290(02)00084-2 CrossRefPubMedGoogle Scholar
- 60.Nava, A., Mazza, E., Furrer, M., et al.: In vivo mechanical characterization of human liver. Med. Image Anal. 12, 203–216 (2008). Doi: 10.1016/j.media.2007.10.001 CrossRefPubMedGoogle Scholar
- 61.Fernández Farrés, I., Norton, I.T.: Formation kinetics and rheology of alginate fluid gels produced by in-situ calcium release. Food Hydrocoll. 40, 76–84 (2014). Doi: 10.1016/j.foodhyd.2014.02.005 CrossRefGoogle Scholar
- 62.Draget, K.I., Østgaard, K., Smidsrød, O.: Alginate-based solid media for plant tissue culture. Appl. Microbiol. Biotechnol. 31, 79–83 (1989). Doi: 10.1007/BF00252532 CrossRefGoogle Scholar
- 63.Drury, J.L., Dennis, R.G., Mooney, D.J.: The tensile properties of alginate hydrogels. Biomaterials 25, 3187–3199 (2004). Doi: 10.1016/j.biomaterials.2003.10.002 CrossRefPubMedGoogle Scholar
- 64.Yang, C.H., Wang, M.X., Haider, H., et al.: Strengthening alginate/polyacrylamide hydrogels using various multivalent cations. ACS Appl. Mater. Interfaces 5, 10418–10422 (2013). Doi: 10.1021/am403966x CrossRefPubMedGoogle Scholar
- 65.Peppas, N.A., Hilt, J.Z., Khademhosseini, A., Langer, R.: Hydrogels in biology and medicine: from molecular principles to bionanotechnology. Adv. Mater. 18, 1345–1360 (2006). Doi: 10.1002/adma.200501612 CrossRefGoogle Scholar
- 66.Hoffman, A.S.: Hydrogels for biomedical applications. Adv. Drug Deliv. Rev. 64, 18–23 (2012). Doi: 10.1016/j.addr.2012.09.010 CrossRefGoogle Scholar
- 67.Fitzgerald, M.M., Bootsma, K., Berberich, J.A., Sparks, J.L.: Tunable stress relaxation behavior of an alginate-polyacrylamide hydrogel: comparison with muscle tissue. Biomacromolecules 16, 1497–1505 (2015). Doi: 10.1021/bm501845j CrossRefPubMedGoogle Scholar
- 68.Kuo, C.K., Ma, P.X.: Ionically crosslinked alginate hydrogels as scaffolds for tissue engineering: part 1. Structure, gelation rate and mechanical properties. Biomaterials 22, 511–521 (2001). Doi: 10.1016/S0142-9612(00)00201-5 CrossRefPubMedGoogle Scholar
- 69.Draget, K.I., Østgaard, K., Smidsrød, O.: Homogeneous alginate gels: a technical approach. Carbohydr. Polym. 14, 159–178 (1990). Doi: 10.1016/0144-8617(90)90028-Q CrossRefGoogle Scholar
- 70.Sun, J.-Y., Zhao, X., Illeperuma, W.R.K., et al.: Highly stretchable and tough hydrogels. Nature 489, 133–136 (2012). Doi: 10.1038/nature11409 ADSCrossRefPubMedPubMedCentralGoogle Scholar
- 71.Mancini, M., Moresi, M., Rancini, R.: Mechanical properties of alginate gels: empirical characterisation. J. Food Eng. 39, 369–378 (1999). Doi: 10.1016/S0260-8774(99)00022-9 CrossRefGoogle Scholar
- 72.Ratner, B.D., Hoffman, A.S., Schoen, F.J., Lemons, J.E.: Biomaterials Science: An Introduction to Materials in Medicine. Academic Press, Cambridge (2004)Google Scholar
- 73.Stellwagen, J., Stellwagen, N.C.: Internal structure of the agarose gel matrix. J. Phys. Chem. 99, 4247–4251 (1995). Doi: 10.1021/j100012a054 CrossRefGoogle Scholar
- 74.Lee, K.Y., Mooney, D.J.: Hydrogels for tissue engineering. Chem. Rev. 101, 1869–1880 (2001). Doi: 10.1021/cr000108x CrossRefPubMedGoogle Scholar
- 75.Normand, V., Lootens, D.L., Amici, E., et al.: New insight into agarose gel mechanical properties. Biomacromolecules 1, 730–738 (2000). Doi: 10.1021/bm005583j CrossRefPubMedGoogle Scholar
- 76.Gong, J.P., Katsuyama, Y., Kurokawa, T., Osada, Y.: Double-network hydrogels with extremely high mechanical strength. Adv. Mater. 15, 1155–1158 (2003). Doi: 10.1002/adma.200304907 CrossRefGoogle Scholar
- 77.Darnell, M.C., Sun, J.-Y., Mehta, M., et al.: Performance and biocompatibility of extremely tough alginate/polyacrylamide hydrogels. Biomaterials 34, 8042–8048 (2013). Doi: 10.1016/j.biomaterials.2013.06.061 CrossRefPubMedPubMedCentralGoogle Scholar
- 78.Zhang, J., Daubert, C.R., Foegeding, E.A.: Characterization of polyacrylamide gels as an elastic model for food gels. Rheol. Acta 44, 622–630 (2005). Doi: 10.1007/s00397-005-0444-5 CrossRefGoogle Scholar
- 79.Herrick, W.G., Nguyen, T.V., Sleiman, M., et al.: PEG-phosphorylcholine hydrogels as tunable and versatile platforms for mechanobiology. Biomacromolecules 14, 2294–2304 (2013). Doi: 10.1021/bm400418g CrossRefPubMedGoogle Scholar
- 80.Tanaka, Y., Kuwabara, R., Na, Y.-H., et al.: Determination of fracture energy of high strength double network hydrogels. J. Phys. Chem. B 109, 11559–11562 (2005). Doi: 10.1021/jp0500790 CrossRefPubMedGoogle Scholar
- 81.Suthar, B., Xiao, H.X., Klempner, D., Frisch, K.C.: A review of kinetic studies on the formation of interpenetrating polymer networks. Polym. Adv. Technol. 7, 221–233 (1996). Doi: 10.1002/(SICI)1099-1581(199604)7:4<221:AID-PAT529>3.0.CO;2-A CrossRefGoogle Scholar
- 82.Teramoto, N., Saitoh, M., Kuroiwa, J., et al.: Morphology and mechanical properties of pullulan/poly(vinyl alcohol) blends crosslinked with glyoxal. J. Appl. Polym. Sci. 82, 2273–2280 (2001). Doi: 10.1002/app.2075 CrossRefGoogle Scholar
- 83.Stammen, J.A., Williams, S., Ku, D.N., Guldberg, R.E.: Mechanical properties of a novel PVA hydrogel in shear and unconfined compression. Biomaterials 22, 799–806 (2001). Doi: 10.1016/S0142-9612(00)00242-8 CrossRefPubMedGoogle Scholar
- 84.Wan, W.K., Campbell, G., Zhang, Z.F., et al.: Optimizing the tensile properties of polyvinyl alcohol hydrogel for the construction of a bioprosthetic heart valve stent. J. Biomed. Mater. Res. 63, 854–861 (2002). Doi: 10.1002/jbm.10333 CrossRefPubMedGoogle Scholar
- 85.Zhu, J.: Bioactive modification of poly(ethylene glycol) hydrogels for tissue engineering. Biomaterials 31, 4639–4656 (2010). Doi: 10.1016/j.biomaterials.2010.02.044 CrossRefPubMedPubMedCentralGoogle Scholar
- 86.Rahimi, A., Mashak, A.: Review on rubbers in medicine: natural, silicone and polyurethane rubbers. Plast. Rubber Compos. 42, 223–230 (2013). Doi: 10.1179/1743289811Y.0000000063 CrossRefGoogle Scholar
- 87.Frogley, M., Ravich, D., Wagner, H.D.: Mechanical properties of carbon nanoparticle-reinforced elastomers. Compos. Sci. Technol. 63, 1647–1654 (2003). Doi: 10.1016/S0266-3538(03)00066-6 CrossRefGoogle Scholar
- 88.Lötters, J.C., Olthuis, W., Veltink, P.H., Bergveld, P.: The mechanical properties of the rubber elastic polymer polydimethylsiloxane for sensor applications. J. Micromech. Microeng. 7, 145–147 (1997). Doi: 10.1088/0960-1317/7/3/017 CrossRefGoogle Scholar
- 89.Özbaş, Z., Gürdağ, G.: Swelling kinetics, mechanical properties, and release characteristics of chitosan-based semi-IPN hydrogels. J. Appl. Polym. Sci. 132, n/a–n/a (2015). Doi: 10.1002/app.41886
- 90.Chen, Q., Zhu, L., Huang, L., et al.: Fracture of the physically cross-linked first network in hybrid double network hydrogels. Macromolecules 47, 2140–2148 (2014). Doi: 10.1021/ma402542r ADSCrossRefGoogle Scholar
- 91.Hu, J., Kurokawa, T., Nakajima, T., et al.: High fracture efficiency and stress concentration phenomenon for microgel-reinforced hydrogels based on double-network principle. Macromolecules 45, 9445–9451 (2012). Doi: 10.1021/ma301933x ADSCrossRefGoogle Scholar
- 92.Tsukeshiba, H., Huang, M., Na, Y.-H., et al.: Effect of polymer entanglement on the toughening of double network hydrogels. J. Phys. Chem. B 109, 16304–16309 (2005). Doi: 10.1021/jp052419n CrossRefPubMedGoogle Scholar
- 93.Li, Y., Wang, C., Zhang, W., et al.: Preparation and characterization of PAM/SA tough hydrogels reinforced by IPN technique based on covalent/ionic crosslinking. J. Appl. Polym. Sci. 132, n/a–n/a (2015). Doi: 10.1002/app.41342
- 94.Draget, K.I., Strand, B., Hartmann, M., et al.: Ionic and acid gel formation of epimerised alginates; the effect of AlgE4. Int. J. Biol. Macromol. 27, 117–122 (2000)CrossRefPubMedGoogle Scholar
- 95.LeRoux, M.A., Guilak, F., Setton, L.A.: Compressive and shear properties of alginate gel: effects of sodium ions and alginate concentration. J. Biomed. Mater. Res. 47, 46–53 (1999). Doi: 10.1002/(SICI)1097-4636(199910)47:1<46:AID-JBM6>3.0.CO;2-N CrossRefPubMedGoogle Scholar
- 96.Madihally, S.V., Matthew, H.W.T.: Porous chitosan scaffolds for tissue engineering. Biomaterials 20, 1133–1142 (1999). Doi: 10.1016/S0142-9612(99)00011-3 CrossRefPubMedGoogle Scholar
- 97.Lee, J.W., Kim, S.Y., Kim, S.S., et al.: Synthesis and characteristics of interpenetrating polymer network hydrogel composed of chitosan and poly(acrylic acid). J. Appl. Polym. Sci. 73, 113–120 (1999). Doi: 10.1002/(SICI)1097-4628(19990705)73:1<113:AID-APP13>3.0.CO;2-D CrossRefGoogle Scholar
- 98.Li, C., Allen, J., Alliston, T., Pruitt, L.A.: The use of polyacrylamide gels for mechanical calibration of cartilage—a combined nanoindentation and unconfined compression study. J. Mech. Behav. Biomed. Mater. 4, 1540–1547 (2011). Doi: 10.1016/j.jmbbm.2011.02.004 CrossRefPubMedPubMedCentralGoogle Scholar
- 99.Peyton, S.R., Kim, P.D., Ghajar, C.M., et al.: The effects of matrix stiffness and RhoA on the phenotypic plasticity of smooth muscle cells in a 3-D biosynthetic hydrogel system. Biomaterials 29, 2597–2607 (2008). Doi: 10.1016/j.biomaterials.2008.02.005 CrossRefPubMedPubMedCentralGoogle Scholar
- 100.Peyton, S.R., Raub, C.B., Keschrumrus, V.P., Putnam, A.J.: The use of poly(ethylene glycol) hydrogels to investigate the impact of ECM chemistry and mechanics on smooth muscle cells. Biomaterials 27, 4881–4893 (2006). Doi: 10.1016/j.biomaterials.2006.05.012 CrossRefPubMedGoogle Scholar
- 101.Jirapinyo, P., Kumar, N., Thompson, C.C.: Validation of an endoscopic part-task training box as a skill assessment tool. Gastrointest. Endosc. 81, 967–973 (2015). Doi: 10.1016/j.gie.2014.08.007 CrossRefPubMedGoogle Scholar
- 102.Botden, S.M.B.I., Goossens, R., Jakimowicz, J.J.: Developing a realistic model for the training of the laparoscopic Nissen fundoplication. Simul. Healthc. J. Soc. Simul. Healthc. 5, 173–178 (2010). Doi: 10.1097/SIH.0b013e3181cd09bb CrossRefGoogle Scholar
- 103.Mattei, T.A., Frank, C., Bailey, J., et al.: Design of a synthetic simulator for pediatric lumbar spine pathologies: laboratory investigation. J. Neurosurg. Pediatr. 12, 192–201 (2013). Doi: 10.3171/2013.4.PEDS12540 CrossRefPubMedGoogle Scholar
- 104.Suzuki, M., Ogawa, Y., Kawano, A., et al.: Rapid prototyping of temporal bone for surgical training and medical education. Acta Otolaryngol. (Stockh) 124, 400–402 (2004). Doi: 10.1080/00016480410016478 CrossRefGoogle Scholar
- 105.Oliveira, M., Sooraj Hussain, N., Dias, A.G., et al.: 3-D biomodelling technology for maxillofacial reconstruction. Mater. Sci. Eng. C 28, 1347–1351 (2008). Doi: 10.1016/j.msec.2008.02.007 CrossRefGoogle Scholar
- 106.Varga, S., Smith, J., Minneti, M., et al.: Central venous catheterization using a perfused human cadaveric model: application to surgical education. J. Surg. Educ. 72, 28–32 (2015). Doi: 10.1016/j.jsurg.2014.07.005 CrossRefPubMedGoogle Scholar
- 107.Ohta, M., Handa, A., Iwata, H., et al.: Poly-vinyl alcohol hydrogel vascular models for in vitro aneurysm simulations: the key to low friction surfaces. Technol. Health Care 12, 225–233 (2004)PubMedGoogle Scholar
- 108.Kosukegawa, H., Mamada, K., Kuroki, K., et al.: Measurements of dynamic viscoelasticity of poly (vinyl alcohol) hydrogel for the development of blood vessel biomodeling. J. Fluid Sci. Technol. 3, 533–543 (2008). Doi: 10.1299/jfst.3.533 CrossRefGoogle Scholar
- 109.Takashima, K., Tsuzuki, S., Ooike, A., et al.: Numerical analysis and experimental observation of guidewire motion in a blood vessel model. Med. Eng. Phys. 36, 1672–1683 (2014). Doi: 10.1016/j.medengphy.2014.09.012 CrossRefPubMedGoogle Scholar
- 110.Brewin, M., Greenwald, S., Shaw, S., et al.: Characterisation of agarose gel as a tissue mimic material (TMM) for use in an anthropomorphic test object investigating the acoustic localization of coronary stenosis. J. Biomech. 45, S139 (2012). Doi: 10.1016/S0021-9290(12)70140-9 CrossRefGoogle Scholar
- 111.Shiraishi, I., Yamagishi, M., Hamaoka, K., et al.: Simulative operation on congenital heart disease using rubber-like urethane stereolithographic biomodels based on 3D datasets of multislice computed tomography. Eur. J. Cardiothorac. Surg. (2009). Doi: 10.1016/j.ejcts.2009.07.046 Google Scholar
- 112.Schmitt, K.-U., Walti, M., Schälli, O., et al.: Development of a model to mimic pleural space mechanics. Technol. Health Care 21, 369–378 (2013). Doi: 10.3233/THC-130737 PubMedGoogle Scholar
- 113.Thompson, C., Jirapinyo, P., Kumar, N., et al.: Development and initial validation of an endoscopic part-task training box. Endoscopy 46, 735–744 (2014). Doi: 10.1055/s-0034-1365463 CrossRefPubMedPubMedCentralGoogle Scholar
- 114.Bakarich, S.E., in het Panhuis, M., Beirne, S., et al.: Extrusion printing of ionic–covalent entanglement hydrogels with high toughness. J. Mater. Chem. B 1, 4939 (2013). Doi: 10.1039/c3tb21159b CrossRefGoogle Scholar
- 115.Hong, S., Sycks, D., Chan, H.F., et al.: 3D printing of highly stretchable and tough hydrogels into complex, cellularized structures. Adv. Mater. 27, 4035–4040 (2015). Doi: 10.1002/adma.201501099 CrossRefPubMedPubMedCentralGoogle Scholar