Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine最新文献

{"title":"Research priorities for diagnostic instrumentation in urinary incontinence.","authors":"Andrew Gammie, Stefan De Wachter","doi":"10.1177/09544119231193884","DOIUrl":"10.1177/09544119231193884","url":null,"abstract":"<p><p>The International Consultation on Incontinence (ICI) captures current evidence on incontinence. The conference 'Incontinence: The Engineering Challenge XIII' in November 2021 heard an update on the most recent ICI summary on urodynamic testing. This paper summarises the ICI recommendations for future research in urodynamics, with a view to informing engineers of issues and challenges that could benefit from engineering solutions. Engineers are encouraged to contribute to the following areas of research, which will have a direct and positive effect on patients' quality of life and overall health: (a) Urine flow measurement: home- and app-based devices, machine learning analysis of flow shape, (b) Pressure measurement: normal values for and validation of new technologies, including air-filled, non-invasive and urethral pressure reflectometry, (c) Ultrasound imaging: bladder wall biomechanics, bladder shape analysis, (d) Assess normal and abnormal value ranges, and diagnostic performance and (e) Specific trials in understudied patient groups including those with symptoms resistant to treatment, children and the frail elderly.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"682-687"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10508271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Friction between human skin and incontinence pads in the presence of barrier protection products.","authors":"Rachel Morecroft, Katherine Tomlinson, Roger Lewis, Matt Carré","doi":"10.1177/09544119231178477","DOIUrl":"10.1177/09544119231178477","url":null,"abstract":"<p><p>This novel experimental work aims to bring further knowledge of frictional performance of common barrier products used in the treatment of incontinence-associated dermatitis and determine how the skin-pad interface changes when a treatment is applied to the skin. Key data is reported and there is an in-depth analysis into friction profiles which reveals great differences between how different skin-pad tribosystems operate when exposed to commercially available barrier treatments. In a wet-pad state <i>Barrier cream A</i> (3M™ Cavilon™ Barrier cream) reduced friction and had much lower dynamic and static coefficients of friction than the other barrier treatments (<i>Barrier cream B</i> (Sorbaderm Barrier cream) and the <i>Barrier spray C</i> (Sorbaderm Barrier spray)). <i>Barrier cream A</i> provided stable friction coefficients in reciprocating sliding, whereas the other treatments, and untreated skin, did not display this unique characteristic. The barrier spray gave rise to high static friction coefficients and exhibited the most stick-slip. All three candidate barrier protection products were found to reduce directional differences in the static coefficient of friction: indicative of reduced shear loading. Knowledge of the desirable frictional properties would drive innovation in product development, and benefit companies, clinicians and users.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"644-654"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9599395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technology for managing incontinence: What are the research priorities?","authors":"Mandy Fader, Cathy L Murphy, Donna Z Bliss, Brian S Buckley, Rowan Cockerell, Alan M Cottenden, Jan Kottner, Joan Ostaszkiewicz","doi":"10.1177/09544119241233639","DOIUrl":"10.1177/09544119241233639","url":null,"abstract":"<p><p>Incontinence and toileting difficulties can often be successfully addressed by treating their underlying causes. However, (complete) cure is not always possible and continence products to prevent or contain unresolved leakage or to facilitate toileting are in widespread use. Many people use them successfully but identifying the product(s) most likely to meet individual needs can be challenging and the recently published Seventh International Consultation on Incontinence includes a chapter which draws on the literature to provide evidence-based recommendations to help clinicians and product users to select appropriate products. This paper is based on the same evidence, but reviewed from the different perspective of those keen to identify unmet needs and develop improved products. For each of the main continence product categories it (i) outlines the design approach and key features of what is currently available; (ii) provides a generic functional design specification; (iii) reviews how well existing products meet the requirements of their main user groups; and (iv) suggests priorities for the attention of product designers. It also flags some core scientific problems which - if successfully addressed - would likely yield benefits in multiple incontinence product contexts.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"688-703"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engineering in medicine, special issue on incontinence technology.","authors":"Peter Culmer, Alan Cottenden","doi":"10.1177/09544119241261884","DOIUrl":"10.1177/09544119241261884","url":null,"abstract":"","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"577-578"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detecting and monitoring incontinence associated dermatitis: Does impedance spectroscopy have a part to play?","authors":"Emily J Owen, Rachel A Heylen, Kyle Stewart, Paul G Winyard, A Toby A Jenkins","doi":"10.1177/09544119231159178","DOIUrl":"10.1177/09544119231159178","url":null,"abstract":"<p><p>In this review, current understanding of the prevention and treatment of Incontinence Associated Dermatitis (IAD) is discussed. The need for preventative measures which target specific faecal/urinary irritants is highlighted, including the role of urease inhibitors. There is no existing internationally and clinically accepted method to diagnose and categorise the severity of IAD. Diagnosis currently relies on visual inspection; non-invasive techniques to assess skin barrier function could remove subjectiveness, particularly in darker skin tones. Impedance spectroscopy is a non-invasive technique which can be used to monitor skin barrier function, supporting visual assessments. Six studies (2003-2021) which used impedance to assess dermatitis were reviewed; inflamed skin was distinguishable from healthy skin in each case. This suggests that impedance spectroscopy could be useful in diagnosis early-stage IAD, potentially enabling earlier intervention. Finally, the authors present their initial findings on the role of urease in skin breakdown in an <i>in vivo</i> IAD model, using impedance spectroscopy.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"655-666"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10861183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Holistically sustainable continence care: A working definition, the case of single-used absorbent hygiene products (AHPs) and the need for ecosystems thinking.","authors":"Tiina Vaittinen, Krista Koljonen, Susanna Tella, Eveliina Asikainen, Katri Laatikainen","doi":"10.1177/09544119231188860","DOIUrl":"10.1177/09544119231188860","url":null,"abstract":"<p><p>Incontinence is a common health issue that affects hundreds of millions of people across the world. The solution is often to manage the condition with different kinds of single-use continence technologies, such as incontinence pads and other absorbent hygiene products (AHPs). Throughout their life cycle, these fossil-based products form a remarkable yet inadequately addressed ecological burden in society, contributing to global warming and other environmental degradation. The products are a necessity for their users' wellbeing. When looking for sustainability transitions in this field, focus on individual consumer-choice is thus inadequate - and unfair to the users. The industry is already seeking to decrease its carbon footprint. Yet, to tackle the environmental impact of single-use continence products, also societies and health systems at large must start taking continence seriously. Arguing that continence-aware societies are more sustainable societies, we devise in this article a society-wide working definition for holistically sustainable continence care. Involving dimensions of social, ecological and economic sustainability, the concept draws attention to the wide range of technologies, infrastructures and care practices that emerge around populations' continence needs. Holistically sustainable continence care is thus not only about AHPs. However, in this article, we examine holistically sustainable continence care through the case of AHPs. We review what is known about the environmental impact AHPs, discuss the impact of care practices on aggregate material usage, the future of biobased and degradable incontinence pads, as well as questions of waste management and circular economy. The case of AHPs shows how holistically sustainable continence care is a wider question than technological product development. In the end of the article, we envision an ecosystem where technologies, infrastructures and practices of holistically sustainable continence care can flourish, beyond the focus on singular technologies.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"667-681"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10185800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An estimation of the biomechanical properties of the continent and incontinent woman bladder via inverse finite element analysis.","authors":"Maria Elisabete Teixeira da Silva, Fábio André Teixeira Pinheiro, Nuno Miguel Ferreira, Fernanda Sofia Quintela da Silva Brandão, Pedro Alexandre Lopes de Sousa Martins, Marco Paulo Lages Parente, Maria Teresa da Quinta E Costa Mascarenhas Saraiva, António Augusto Fernandes, Renato Manuel Natal Jorge","doi":"10.1177/09544119241237356","DOIUrl":"10.1177/09544119241237356","url":null,"abstract":"<p><p>Stress urinary incontinence often results from pelvic support structures' weakening or damage. This dysfunction is related to direct injury of the pelvic organ's muscular, ligamentous or connective tissue structures due to aging, vaginal delivery or increase of the intra-abdominal pressure, for example, defecation or due to obesity. Mechanical changes alter the soft tissues' microstructural composition and therefore may affect their biomechanical properties. This study focuses on adapting an inverse finite element analysis to estimate the in vivo bladder's biomechanical properties of two groups of women (continent group (G1) and incontinent group (G2)). These properties were estimated based on MRI, by comparing measurement of the bladder neck's displacements during dynamic MRI acquired in Valsalva maneuver with the results from inverse analysis. For G2, the intra-abdominal pressure was adjusted after applying a 95% impairment to the supporting structures. The material parameters were estimated for the two groups using the Ogden hyperelastic constitutive model. Finite element analysis results showed that the bladder tissue of women with stress urinary incontinence have the highest stiffness (α₁ = 0.202 MPa and µ₁ = 7.720 MPa) approximately 47% higher when compared to continent women. According to the bladder neck's supero-inferior displacement measured in the MRI, the intra-abdominal pressure values were adjusted for the G2, presenting a difference of 20% (4.0 kPa for G1 and 5.0 kPa for G2). The knowledge of the pelvic structures' biomechanical properties, through this non-invasive methodology, can be crucial in the choice of the synthetic mesh to treat dysfunction when considering personalized options.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"598-607"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the properties of intermittent catheters to inform future development.","authors":"Jessica V Moore, Jane Burns, Nicola McClelland, James Quinn, Colin P McCoy","doi":"10.1177/09544119231178468","DOIUrl":"10.1177/09544119231178468","url":null,"abstract":"<p><p>Despite the extensive use of intermittent catheters (ICs) in healthcare, various issues persist for long-term IC users, such as pain, discomfort, infection, and tissue damage, including strictures, scarring and micro-abrasions. A lubricous IC surface is considered necessary to reduce patient pain and trauma, and therefore is a primary focus of IC development to improve patient comfort. While an important consideration, other factors should be routinely investigated to inform future IC development. An array of in vitro tests should be employed to assess IC's lubricity, biocompatibility and the risk of urinary tract infection development associated with their use. Herein, we highlight the importance of current in vitro characterisation techniques, the demand for optimisation and an unmet need to develop a universal 'toolkit' to assess IC properties.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"713-727"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9593015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving urinary incontinence management and sleep quality with wetness sensing technology in absorbent products.","authors":"Jens Hellmold, Wim Vanderperren","doi":"10.1177/09544119241263667","DOIUrl":"10.1177/09544119241263667","url":null,"abstract":"<p><p>Using absorbent products to manage the urinary incontinence (UI) of dependent residents in care facilities (such as nursing homes, and hospitals) requires frequent routine checks throughout the day and night to see if products need changing. Timely changes of saturated products are necessary to avoid long-lasting skin exposure to wet absorbent products, unpleasant odor, leaking of such products and embarrassing moments for the users. Limited staffing, high workload, and peaks on the demand for caregiving are challenges that hamper swift support for the care dependent population. This paper describes novel sensing technology that has been developed for monitoring the wet state of absorbent products remotely. The Orizon system by Ontex enables caregivers to prioritize care routines, avoid sleep disturbance at night and achieve effective leakage prevention. Moreover, the monitoring data can be used to understand the individual product usage and incontinence pattern of individuals, helping incontinence specialists to choose the optimal product and implement appropriate toilet training for each user.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"633-643"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The unmet needs in vaginal pessaries.","authors":"Angie Rantell","doi":"10.1177/09544119241231991","DOIUrl":"10.1177/09544119241231991","url":null,"abstract":"<p><p>A pessary is a medical device that is inserted into the vagina to provide structural support to one or more of the descending vaginal compartments in women with pelvic organ prolapse. It is a common management option offered to women in the short and long term. This article will discuss the current use of vaginal pessaries for POP, the current challenges with their use and common complications seen in practise. It will also discuss the unmet needs in the current products available on the market and suggest ideas for product design, materials and considerations for future development.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"704-712"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}