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

When treating orthopaedic damage or illness and accidental fracture, bone grafting remains the gold standard of treatment. In cases where this approach does not seem achievable, bone tissue engineering can offer scaffolding as a substitute. Defective and fractured bone tissue is extracted and substituted with porous scaffold structures to aid in the process of tissue regeneration. 3D bioprinting has demonstrated enormous promise in recent years for producing scaffold structures with the necessary capabilities. In order to create composite biomaterial inks for 3D bioprinting, three different materials were combined such as silk fibroin, bone particles, and synthetic biopolymer poly (ε-caprolactone) (PCL). These biomaterials were used to fabricate the two composites scaffolds such as: silk fibroin + bovine bone (SFB) and silk fibroin + bovine bone + Polycaprolactone (SFBP). The biomechanical, structural, and biological elements of the manufactured composite scaffolds were characterized in order to determine their suitability as a possible biomaterial for the production of bone tissue. The in vitro bioactivity of the two composite scaffolds was assessed in the simulated body fluids, and the swelling and degradation characteristics of the two developed scaffolds were analyzed separately over time. The results showed that the mechanical durability of the composite scaffolds was enhanced by the bovine bone particles, up to a specific concentration in the silk fibroin matrix. Furthermore, the incorporation of bone particles improved the bioactive composite scaffolds' capacity to generate hydroxyapatite in vitro. The combined findings show that the two 3D printed bio-composites scaffolds have the required mechanical strength and may be applied to regeneration of bone tissue and restoration, since they resemble the characteristics of native bone.

Toe-in gait is a pathology in which the child walks and turns the foot inward instead of pointing straight ahead. The alignment of the lower limb structure changes in this disease, increasing the incidence of knee and hip osteoarthritis. This study aimed to determine the kinematic and joint loading in subjects walking with a toe-in gait pattern. This study selected two groups of subjects: normal subjects and those with toe-in gait due to an increased femoral head anteversion angle (each group consisted of 15 subjects). A Qualisys motion analysis system and a Kistler force plate were used to record the motions and forces applied to the leg while walking. OpenSim software (version 3.3) was used to analyze the range of motion, moments, muscle forces, and joint contact forces in both groups of subjects. The mean values of stride length for normal subjects (1.1 ± 0.141 m) and those with toe-in gait (0.94 ± 0.183 m) differed significantly. The mediolateral component of the ground reaction force decreased significantly in the toe-in gait group compared to normal subjects (p-value = 0.05). The peak force of most of the hip joint muscles increased significantly in those with toe-in gait compared to normal subjects (p-value < 0.05). The results of this study showed that those with toe-in gait, due to an increase in femoral head anteversion angle, only had a change in rotation of the pelvic and hip joint. There was no significant difference between walking speed and most ground reaction force components between normal subjects and those with toe-in gait. As the peaks of most of the hip joint muscles increased significantly in the toe-in gait group, this increased joint contact forces (especially the anteroposterior component of the hip joint and the mediolateral component of the knee joint), which may ultimately increase the incidence of hip and knee joint osteoarthritis.

The objective of the study is to investigate the vibration behavior of the entire spine inside the human body and the influence of muscle soft tissue and lower limbs on spinal response under vertical whole-body vibration. This study conducted modal and random response analyses to simulate the modal displacements and stress of all intervertebral discs in the vertical principal mode in the skeleton, upper, and whole body. Additionally, the acceleration response of intervertebral discs under vertical random excitation was investigated. The results revealed that removing muscle soft tissue and lower limbs significantly changed the resonant frequency, modal displacement, and stress. Particularly, there was a rapid increase in vertical displacement of the lumbar spine in the skeleton model. The reason for that was due to the lack of soft tissue to provide stability, leading to significant lumbar spine bending. Under random excitation, the fore-aft acceleration of intervertebral discs in the skeleton model was considerably larger than that in the whole body, especially in the lumbar spine where it can reach up to four times higher. Conversely, the vertical response of the intervertebral discs inside the human body model was 1.4-2.4 times larger than that of the skeleton model. Muscle soft tissue contributes to the strength of the spine, reducing fore-aft response. The muscle soft tissue in the gluteal region, connected below the spine, can lower the vertical natural frequency and attenuate spinal impact. Although the lower limbs enhance spinal stability, stimulation from the feet can superimpose vibrational responses in the spine.

The pancreas is adjacent to critical organs; excessive microwave ablation (MWA) can result in serious complications. The purpose of this paper is to provide the reference data of pancreas MWA for clinicians, analyze the ablation outcomes under different ablation parameters, and determine the critical temperature of pancreatic surface fat liquefaction outflow. Combinations of two power levels (30 W and 55 W), three antenna diameters (1.3 mm, 1.6 mm, and 1.9 mm), and three ablation times (1 min, 1.5 min, and 2 min) were applied to an ex vivo pig pancreas. Temperature measurements were taken at four thermocouple points. The center point is located 5 mm horizontally from the antenna slot, with a temperature measurement point located 5 mm above, below, and to the right of the center point. Main effect analysis and variance analysis were used to quantify the influences of each factor on the ablation outcomes. At 30 W, the antenna diameter contributing the most at 48.5%. At 30 W-1.3 mm-1 min, the spherical index (1.41) is closest to 1. At 55 W, the coagulation zone size was almost only affected by the ablation time, with a contribution rate of 28.7%, the temperature at point C exceeds point B. On the surface of the ex vivo porcine pancreas, the fat outflow temperature was 54ã. Ablation combinations with low power, short duration, and small antenna diameter results in a more nearly spherical coagulation zone. When performing MWA on the pancreas, it is advisable to avoid areas with higher fat content, while keeping the pancreatic surface temperature below 54°C.

A real-time hypothermia and hyperthermia monitoring system with a simple body sensor based on a Convolutional Neural Network (CNN) is presented. The sensor is produced with 3D-printed thermochromic material. Due to the color change feature of thermochromic materials with temperature, 3D-printed thermochromic Polylactic Acid (PLA) material was used to monitor temperature changes visually. In this paper, we have used the transfer learning technique and fine-tuned the AlexNet CNN. Thirty images for each temperature class between 28-44°C and 510 image data were used in the algorithm. We used 80% and 20% of the data for training and validation. We achieved 96.1% accuracy of validation with a fine-tuned AlexNet CNN. The material's characteristics suggest that it could be employed in delicate temperature sensing and monitoring applications, particularly for hypothermia and hyperthermia.

Technological advancements in the medical field are often slow and expensive, sometimes due to complexities associated with pre-clinical testing of medical devices and implants. There is therefore a growing need for new test beds that can mimic more closely the in vivo environment of physiological systems. In the present study, a novel bladder model was designed and fabricated with the aim of providing a pre-clinical testing platform for urological stents and catheters. The model is collapsible, has a Young's modulus that is comparable to a biological bladder, and can be actuated on-demand to enable voiding. Moreover, the developed fabrication technique provides versatility to adjust the model's shape, size, and thickness, through a rapid and relatively inexpensive process. When compared to a biological bladder, there is a significant difference in compliance; however, the model exhibits cystometry profiles during priming and voiding that are qualitatively comparable to a biological bladder. The developed bladder model has therefore potential for future usage in urological device testing; however, improvements are required to more closely replicate the architecture and relevant flow metrics of a physiological bladder.

Superabsorbent polymers (SAPs) are a key constituent in baby diapers and adult incontinence products. To develop new SAPs, lab tests are used to measure properties that are considered important for these products. However, these manual tests are often time-consuming and tedious. This paper introduces an automatic method to measure absorption under pressure (aAUP) using industry robots. The new robotic method addresses limitations in an industry standard absorption under pressure (AUP) method. The new aAUP method can run continuously, generating more and better data to aid in product development. It enables to put the Buchholz theory on SAPs for predicting their properties to practice by reduction of manual effort and by producing excellent data quality. This has been shown on commercial polymers from different production processes, with varied particle size distributions and shapes. The aAUP data has also been shown to accurately predict other properties of SAPs relevant for their application in hygiene articles, making it a useful tool for understanding the underlying science and facilitating product development.

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.

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 Barrier cream A (3M™ Cavilon™ Barrier cream) reduced friction and had much lower dynamic and static coefficients of friction than the other barrier treatments (Barrier cream B (Sorbaderm Barrier cream) and the Barrier spray C (Sorbaderm Barrier spray)). Barrier cream A 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.

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.