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

{"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}

{"title":"Optimization of activity-driven event detection for long-term ambulatory urodynamics.","authors":"Farhath Zareen, Mohammed Elazab, Brett Hanzlicek, Adam Doelman, Dennis Bourbeau, Steve Ja Majerus, Margot S Damaser, Robert Karam","doi":"10.1177/09544119241264304","DOIUrl":"10.1177/09544119241264304","url":null,"abstract":"<p><p>Lower urinary tract dysfunction (LUTD) is a debilitating condition that affects millions of individuals worldwide, greatly diminishing their quality of life. The use of wireless, catheter-free implantable devices for long-term ambulatory bladder monitoring, combined with a single-sensor system capable of detecting various bladder events, has the potential to significantly enhance the diagnosis and treatment of LUTD. However, these systems produce large amounts of bladder data that may contain physiological noise in the pressure signals caused by motion artifacts and sudden movements, such as coughing or laughing, potentially leading to false positives during bladder event classification and inaccurate diagnosis/treatment. Integration of activity recognition (AR) can improve classification accuracy, provide context regarding patient activity, and detect motion artifacts by identifying contractions that may result from patient movement. This work investigates the utility of including data from inertial measurement units (IMUs) in the classification pipeline, and considers various digital signal processing (DSP) and machine learning (ML) techniques for optimization and activity classification. In a case study, we analyze simultaneous bladder pressure and IMU data collected from an ambulating female Yucatan minipig. We identified 10 important, yet relatively inexpensive to compute signal features, with which we achieve an average 91.5% activity classification accuracy. Moreover, when classified activities are included in the bladder event analysis pipeline, we observe an improvement in classification accuracy, from 81% to 89.0%. These results suggest that certain IMU features can improve bladder event classification accuracy with low computational overhead.<b><i>Clinical Relevance</i></b>: This work establishes that activity recognition may be used in conjunction with single-channel bladder event detection systems to distinguish between contractions and motion artifacts for reducing the incorrect classification of bladder events. This is relevant for emerging sensors that measure intravesical pressure alone or for data analysis of bladder pressure in ambulatory subjects that contain significant abdominal pressure artifacts.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"608-618"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894130","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":"Automated closed-loop stimulation to inhibit neurogenic bladder overactivity.","authors":"Steve Majerus, Carvell Nguyen, Steven Brose, Gregory Nemunaitis, Margot Damaser, Dennis J Bourbeau","doi":"10.1177/09544119231172272","DOIUrl":"10.1177/09544119231172272","url":null,"abstract":"<p><p>Individuals with spinal cord injury (SCI) usually develop neurogenic detrusor overactivity (NDO), resulting in bladder urgency and incontinence, and reduced quality of life. Electrical stimulation of the genital nerves (GNS) can inhibit uncontrolled bladder contractions in individuals with SCI. An automated closed-loop bladder neuromodulation system currently does not exist but could improve this approach. We have developed a custom algorithm to identify bladder contractions and trigger stimulation from bladder pressure data without need for abdominal pressure measurement. The goal of this pilot study was to test the feasibility of automated closed-loop GNS using our custom algorithm to identify and inhibit reflex bladder contractions in real time. Experiments were conducted in a single session in a urodynamics laboratory in four individuals with SCI and NDO. Each participant completed standard cystometrograms without and with GNS. Our custom algorithm monitored bladder vesical pressure and controlled when GNS was turned on and off. The custom algorithm detected bladder contractions in real time, successfully inhibiting a total of 56 contractions across all four subjects. There were eight false positives, six of those occurring in one subject. It took approximately 4.0 ± 2.6 s for the algorithm to detect the onset of a bladder contraction and trigger stimulation. The algorithm maintained stimulation for approximately 3.5 ± 1.7 s, which was enough to inhibit activity and relieve feelings of urgency. Automated closed-loop stimulation was well-tolerated and subjects reported that algorithm decisions generally matched with their perceptions of bladder activity. The custom algorithm automatically, successfully identified bladder contractions to trigger stimulation to inhibit bladder contractions acutely. Closed-loop neuromodulation using our custom algorithm is feasible, but further testing is needed refine this approach for use in a home environment.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"619-627"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9456756","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":"Retracted: \"Optimized lung tumor diagnosis system using enhanced version of crow search algorithm, Zernike moments, and support vector machine\".","authors":"","doi":"10.1177/09544119241255854","DOIUrl":"https://doi.org/10.1177/09544119241255854","url":null,"abstract":"","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"9544119241255854"},"PeriodicalIF":1.8,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959159","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 effect of different mechanism combinations on sliding between brace and lower limb during walking and leg-raising.","authors":"Yuzhou Yan, Ruitao Gong, Mengzhao Cao, Bing Han, Hui Li, Geng Liu","doi":"10.1177/09544119241241440","DOIUrl":"10.1177/09544119241241440","url":null,"abstract":"<p><p>Knee braces are commonly used to support the knee joint and improve function. However, brace sliding caused by the misalignment between brace and knee during motion is a common problem, which reduces the therapeutic effect and leads to brace abandonment. To investigate the effect of mechanism combinations on sliding, an experimental brace was designed to isolate the mechanism as the sole variable. Ten healthy participants were recruited, each of whom worn four combinations of lateral/medial mechanisms: lateral and medial single-axis (SA), lateral super gear (SG) and medial non-circular gear (NCG), lateral four-bar linkage (FL) and medial SG, and lateral FL and medial NCG. The knee flexion angle was collected using inertial measurement units, and brace sliding was measured by 3D motion capture system. All combinations had significant changes in peak sliding of thigh and shank compared to the SA combination (<i>p</i> < 0.05), but lateral FL and medial NCG combination had the lowest peak and final sliding during walking and leg-raising, with significant reductions of 40.7 and 85.3% in peak sliding of thigh, and significant reductions of 56.3 and 72.0% in peak sliding of shank, respectively (<i>p</i> < 0.05). Moreover, the mechanism combination did not significantly impact the knee range of motion (<i>p</i> > 0.05). The mechanism combination that fit the instantaneous center of rotation of lateral/medial condyle of knee joint demonstrates a significant reduction in brace sliding. Additionally, the peak sliding during motion is significantly higher than the final sliding.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"500-507"},"PeriodicalIF":1.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294290","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}